CALL US FIRST! We do not want you going to urgent care of the Emergency Room. Currently there are no pediatricians in urgent cares in the metro area, so your child will not get good care. Secondly, ER visits are very costly and often not necessary. When your child is sick or injured, call us and we can discuss what the best next step is. Likely you can do something at home for your child and if needed come see us the next day. We have pediatric nurses and doctors available to you 24/7 (FREE OF CHARGE) to help you through the difficult times. Just call our office number, 303-369-6977, and ask to speak to a nurse or doctor.
Halloween! How do we do Halloween for the kids during the pandemic. See this article below to give you ideas to make it safe and fun!
https://www.healthychildren.org/English/health-issues/conditions/COVID-19/Pages/Halloween-COVID-Safety-Tips.aspx
HEALTHYCHILDREN.ORG
Halloween & COVID-19: Have Fun While Staying Safe
Another great resource with lots of information to answer your questions about COVID19 in our community:
covid19.colorado.gov
Do you feel you or your child might have COVID-19 and want to get tested? Here are some ways to do this:
1. LabCorp is offering in-home testing kids that can be ordered by patients through LabCorp’s Pixel website.
o https://www.Pixel.labcorp.com
o No provider order is needed. Patients will be presented with a questionnaire to see if they qualify for COVID-19 testing. If they do, they will proceed to enter their insurance information and their address. A kit will be sent by FedEx to their home. They will self-swab and mail the kit back. Current turnaround is 4-6 days. Insurance will cover the cost.
2. In addition, the following list includes the current local COVID-19 testing sites that do not also require an appointment for evaluation.
o The University of Colorado – no referral needed.
§ https://www.uchealth.org/services/infectious-diseases/coronavirus-covid-19/antibody-testing/
o The City of Denver at the Pepsi Center- free for Denver residents. No referral needed.
§ https://www.denvergov.org/content/denvergov/en/covid-19/recovery-guidance/testing.html
o National Jewish- physician referral required. May be completed online.
§ https://www.nationaljewish.org/patients-visitors/patient-info/important-updates/coronavirus-information-and-resources/patient-care/covid-19-testing-physician-referrals
3. Children's Hospital of Colorado -
Requires a physician order by Dr. Weiner. Drive up site that requires an appointment
A doctor’s experience in Arizona recently. Please take heed. Wear your masks. Colorado is not in this situation yet.
Karin Wells
July 5 at 1:15 AM ·
# **DR. BRANDON BIKOWSKI WRITES:** **This week I was one of the COVID doctors in the hospital. Before I went on service, I had planned to share my experiences when I got home after my last shift. That didn't happen because I was mentally and emotionally exhausted after being at the hospital for 15+ hours.**
# **I am going to try to break things down so that the general public can understand, because I want everyone, not just my fellow healthcare workers, to be as scared as I am.**
# This is going to be long, but hopefully will be worth the read for someone.
# For references purposes, I am a Hospitalist, which is sort of like your primary care doctor when you're in the hospital. We manage your chronic medical conditions and most of your acute issues in the hospital and consult specialists when we need additional help with complex decision making or a specialized procedure to be performed. We are also the primary point of contact for your nurse on most issues.
# I live in Arizona, the current COVID-19 hot spot. Arizona never really closed. Any level of closure that we obtained was the result of petitions with thousands of signatures from physicians. Despite pretty much being able to do anything you wanted to do except get your hair/nails done or eat out at a restaurant (carry out stayed open), people protested the state being closed.
# The state reopened immediately when criteria were put out to guide how and when states should reopen. To be clear, Arizona did not meet a single criteria for reopening. In addition, masks were not mandated. Governor Ducey avoided mandating masks and made it the responsibility of city Mayors to make any mandates. Mandatory masks were just implemented a few days ago.
# As you have almost certainly seen in the news, the rapid reopening without mandated masks has been catastrophic. In a couple of weeks we have gone from a few hundred cases per day to around 3,500 cases per day.
# A few weeks ago, I was working at the COVID-free hospital designated to be the primary elective surgery campus within the network. The past few days, our recently reopened COVID Unit has been near or completely full. I shared the patient's on the unit with one other hospitalist.
# Before I went on service this week, I read anything and everything I could to prepare myself to be the COVID doc. I was up to date on all of the latest recommendations. I was a little nervous, but felt like I was armed with the information that would allow me to help my patients.
# I quickly learned that there is no possible way to prepare for how to treat a COVID patient. There is no rhyme, reason, or pattern. There is no possible way to predict what will happen with your patient.
# In my sign out to the doc taking over for me today, I prefaced the individual patient sign outs with, "one slightly improving, one with less oxygen requirements but possible new liver failure developing, everyone else getting worse."
# I have never seen anything like this. None of us have. We have no idea what we are doing. We are sharing evidence from small studies that could help and utilizing treatments that we think and hope are helpful. Of course, we also thought hydroxychloroquine was helpful a couple of months ago. So, we're hopefully helping people, maybe hurting them, and trying our best.
# We are flipping people on their stomachs while wide awake on a machine pushing oxygen into their lungs to try and help; this is called the prone position, and it works, but you're stuck in that position for as long as we can keep you there. The longer the better.
# Anyone on supplemental oxygen is receiving dexamethasone based on the European study that came out last week. We were using Remdesivir, but a patient I admitted two days ago is the last one that will receive it from our current stockpile.
# Convalescent plasma from patients that had COVID, recovered, and donated plasma is being administered, but studies suggest that antibody concentration diminishes by up to 90% within 2-3 months, so who knows if that's even doing anything.
# I realized in the past two days that oxygen saturation numbers that you see on the machines are completely worthless in many COVID patients. So, the one thing we thought we knew, that COVID causes profound hypoxia, was true, but it's actually much worse than we thought.
# In order to figure out if you are hypoxic (low blood oxygen levels), a needle is stuck into an artery in your wrist as often as is needed. It hurts. A lot. I will have a needle stuck into your artery as often as I need to. I'm sorry, I know it hurts, but it's for your own good.
# In any other time, most of my patients would already be intubated on a ventilator. We are managing so many critically ill patients on regular hospital floors. If we sent everyone to the ICU that would normally be there based on their current status and put them all on ventilators, all resources would be depleted in a day.
# The patients I cared for the past few days were the most miserable, uncomfortable, terrified patients I have seen in the past four years. I sat with them while they cried because they are scared that they will get worse and get intubated and die without ever seeing their loved ones again. I can't comfort them by saying they'll get better soon, because I don't know that they will.
# All I can tell them is that we're doing everything we can and I really hope they improve. I held a patients hand while she cried and screamed, "oh my god, I'm going to die, aren't I? I'm dying" when I told her we couldn't give her more oxygen without intubating her and putting her on life support. I then tried to comfort her children over the phone after I informed them they were not allowed to come in to the hospital to be with her. They asked if someone could be there to comfort her if she is going to die.
# Many of my patients were young. Many have no underlying conditions that predispose them to a bad outcome, yet are one bad blood oxygen reading away from needing to be intubated.
# COVID does not care who you are.
# I am scared and you should be, too.
# All of that is to send the following message:
# Please, please, stay home if you can. If you need to go out, WEAR A MASK! Do not touch your face. Wash your hands and sanitize often. I can't promise you won't end up in the hospital with COVID even if you do all of these things, but I promise it's the best shot you've got.
# **UPDATE, JULY 2, 2020**
# **The Chief Medical Officers of the major health organizations in AZ met up to create a triage plan for how things should be allocated for when we run out of resources.**
# **Basically, you will be assigned a score. That score will determine if you receive treatment or if treatment will be withheld.**
# **To be clear, this is not yet implemented, but based on the lack of interventions to prevent the spread of COVID-19 in recent weeks, I anticipate it will be implemented throughout the state. Before you say this is fake, it’s not, but trust me, I wish it were.**
# **We never needed to get to this point. This was all completely avoidable.**
# **This makes me sick.**
# **STAY HOME.**
# **IF YOU GO OUT, WEAR A MASK AND SOCIAL DISTANCE.**
# **WASH YOUR HANDS**
**——————————————-—**
# P.S. THANK YOU to all the amazing RNs, RTs, PCTs, Pharmacists, Pharmacy techs, lab techs, physical, occupational & speech therapists, social workers, case managers, environmental service workers, and everyone else that makes it possible to care for these patients in the best way we know how. You don't get enough credit. You all are the real MVPs.
______________________________________
# ADDENDUM: To be clear, COVID-19 is caused by a virus. This is a PUBLIC HEALTH CRISIS. It is not, never has been, and never will be a political issue. Politics have played a huge role in getting us into this mess, and it's time to cut them out. COVID doesn't discriminate, and it definitely doesn't care who you're going to vote for. When you see/hear/read anything related to COVID-19, pay attention to who is posting the information. If it is not coming from a medical professional, question your source.
______________________________________
# ADDENDUM-2: I am so incredibly shocked at how widely this has been shared. Thank you all! Please continue to share! Since people are reading this, I would like to use this platform to ask you to PLEASE talk with your loved ones about your wishes.
# If you have an advance directive, please bring it with you if you are unfortunately in need of hospitalization. If you do not have an advance directive, it's time to get one. If we do not know what you would like to be done, we assume that the answer is everything.
# If your loved one or listed MPOA is unaware of your wishes, they will likely also err on the side of doing everything. Help them to make those very difficult decisions by making your wishes known. Do not wait until you are in the hospital, because it may be too late. Please look up what it means to be "full code" vs "DNR/DNI." Know what you would want done to you.
NOTE FROM KARIN: I copied a copy and made it larger and easier to read... Because it’s important.
https://youtu.be/1DSt6rSSDIQ
YOUTUBE.COM
The Doctor is In! #CallYourPediatrician
Covid vaccine #1 done!!
I am so grateful that massive funding and brilliant minds were able to create a vaccine to save the world. I feel very confident in the safety and efficacy of the vaccine, especially now that millions of doses have been given, just 2 weeks from approval. I look forward to continuing to practice pediatrics without the fear of exposure that has loomed over us this year while just doing our jobs . In addition, we were so grateful for the use of telehealth services and creative ways to meet our patients needs during this difficult year.
I also look forward to some day being able to vaccinate all of our pediatric patients once enough studies have been done to show that it is safe and effective for them.
Hopeful for a brighter 2021!!! Happy New Year!!!
My colleague Vandna Jerath MD compiled this information below. Please help your elderly family members and friends in Colorado get vaccinated. It’s no easy task for them but you can help save a life and help this pandemic come to an end.
Also, please check out this link for options: https://www.tchd.org/866/COVID-19-Vaccine
TCHD.ORG
COVID-19 Vaccine | Tri-County Health Department - Official Website
