Residency During The Pandemic

This week's guest columnist is Dr. Hanh-My Tran, a Family Practice resident at the University Hospital and Clinics here in Lafayette. I recall one elderly patient I took care of in the ICU. He had COVID, which in turn caused multiple organs to fail. Inflammation was killing his kidneys, his liver, and his lung capacity. After two weeks on the ventilator he continued losing ground, and his family agreed to switch from life-saving measures to comfort care for the end. The worst part: I had to tell the family that visitors weren't allowed. Coronavirus is rampant enough, and no one wants other family to get sick, maybe die, and compound the tragedy. I gowned up in full PPE, took in an iPad, and Facetimed the family. Devastated, the children and grandchildren said their goodbyes, crying in the camera. This last year of residency was supposed to be seeing more patients, honing procedural skills, and broadening my experience with different diseases. Instead, my fellow residents and I have learned to tackle a pandemic. Early on we were designated for more adult floor and ICU shifts to shore up personnel for that first surge. As the attending doctors and hospitals have gotten more efficient at COVID care, we've resumed a mostly normal schedule.  In pediatrics, we've not had anything near our usual volume of patients, since with COVID precautions kids have been pretty healthy, not passing colds to each other. But kids have suffered other ways. As adults, we tend to understand what stressors make us feel overwhelmed, angry, sad, anxious, and depressed. Children learn how to respond to stressors as they grow and develop. COVID has forced them to grow up a little faster this year. Isolation, social distancing, and fear of family and friends getting sick are taking their toll. Anxiety and depression are rising in children and teens, and counseling services were scarce in the best of times. So besides your own stress, watch your kids for the subtle signs of depression- changes in mood and appetite, unusually defiant behavior, self-isolation. Respond to these sympathetically now, so your kids can learn to cope too. I have a condition that weakens my immune system, so I follow guidelines on COVID prevention religiously. I'm always masked, wear PPE with patients, and of course wash my hands until they're red and raw. But COVID-19 is highly contagious and sneaky, and I contracted it nonetheless. My first symptom was fatigue, but since residency is a 60-70 work week, that wasn't abnormal. I had no fever, cough, or trouble breathing. However, my partner got sick with cough, fever, and aches, and tested positive. He works from home, so he probably got it from me. "What's mine is yours, what's yours is mine" didn't  have that poetic ring when I tested positive too. The worst part for me was the loss of taste and smell for two months. I l dropped weight, but don't recommend COVID as a weight-loss plan. No taste or smell takes a lot of fun out of life, and is a major depressor in affected patients. However, both my adults and children in clinic have drastically gained weight since COVID started. Trapped in the house, they've increased snacking and eating. Physical activity is also down, with limited school, sports, and outdoor time. Obesity has been escalating globally, and is now an epidemic within the pandemic! Overweight kids have more trouble looming than just achy feet. Obese kids become obese adults, and have a head start on the attending heart disease and cancer risks. They also get sleep apnea, joint pain, and diabetes. High blood pressure in children, and thus risk of future strokes, is also rising. "Curing" obesity is harder than treating cancer. Medical attempts at weight loss lag behind cancer cure rates. As we discussed above, more children have depression and anxiety due to the pandemic, and obesity compounds depression. Feeling achy, being bullied, and social isolation are a trifecta of misery. The lessons are clear: keep your kids to routines: three healthy meals daily, limited and healthy snacks, regular bed-times. Get them moving! Less screen time!  Besides masking and distancing, you've got to fight Coronavirus at home as well as in public. For our kids' futures, it's a battle we must win.