• Douglas M. Lakin
    Kaitlin A. Kraemer
    Paradise Valley Med. Clinic
    Ph: (480) 614-5800
  • 9977 North 90th Street,
    Suite 180
    Scottsdale, AZ 85258
    Fax: (480) 614-6322
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‘I HAVE COVID…WHAT DO I DO?’ GUIDELINES FOR THE VACCINATED & UNVACCINATED

July 4, 2022 by Doctordoug

COVID CHECKLIST FOR THE DOUBLE OR TRIPLE VACCINATED:

I HAVE GOTTEN 2 OR 3 VACCINES…AND HAVE BEEN DIAGNOSED WITH COVID (OMICRON LIKELY) …. NOW WHAT DO I DO?????

THIS IS CHECKLIST FOR THOSE OVER 50 (THIS LIST APPLIES TO THE YOUNGER SET BUT THE LEVEL OF CONCERN IS MUCH LESS):

  1. UNDERSTAND THE TIMECOURSE OF COVID
  2. QUARANTINE FOR 5 DAYS FROM FIRST SYMPTOMS (IF THIS IS CLEAR) OR FROM THE DATE OF YOUR POSITIVE TEST.  MASK STRICTLY FOR ADDITIONAL 5 DAYS
  3. MONITOR YOURSELF DAILY…TEMPERATURE AND OXYGEN LEVELS…IF YOU HAVE THE EQUIPMENT
  4. HYDRATE WELL, EAT IF YOU CAN
  5. TREAT SYMPTOMS AS REQUIRED
  6. KNOW THAT THE MOST IMPORTANT SYMPTOM IS TO WATCH FOR TRUE SHORTNESS OF BREATH.   IF THAT DEVELOPS, GO TO THE EMERGENCY ROOM
  7. CONCERNS….BE IN TOUCH DURING YOUR ILLNESS AND PROVIDE US UPDATES ON FEVER AND OXYGEN LEVELS
  8. NO TESTING IS REQUIRED AFTER YOUR ILLNESS

TIME COURSE/EXPECTATIONS:

COVID COURSE:

THREE PHASES OF COVID:

  • JAILBIRD
  • PAROLE BIRD
  • FREE BIRD

JAILBIRD:   STRICT QUARANTINE:   5 DAYS FROM DATE OF FIRST SIGNIFICANT SYMPTOMS IF OBVIOUS OR FROM DATE OF TESTING IF UNCERTAIN BASED ON SYMPTOMS (MUST ALSO BE FEVER FREE FOR 24 HOURS)

PAROLE BIRD:  DAY 6-10.    MASKING WHEN IN THE PRESENCE OF OTHERS INSIDE (NOT REQUIRED OUTSIDE IF SPACIOUS.)   DO NOT SHARE THE SAME BEDROOM AT NIGHT.

FREE BIRD:   DAY 11+ NO RESTRICTIONS.

No testing is needed to prove you are cleared!

QUARANTINING:

  • Do not share a BEDROOM with housemates. Use your own bathroom.
  • Wear a mask when in the presence of others. 

COVID HOME KIT:

  1. DIGITAL ORAL THERMOMETER:    TO MONITOR FEVER.

 MANY BRANDS ARE FINE…HERE IS ONE EXAMPLE:

2 PULSE OXIMETER:   TO CHECK OXYGEN LEVELS. 

MANY BRANDS ARE FINE…HERE IS ONE EXAMPLE:

OTHER ITEMS FROM THE HOME MEDICAL KIT (SEE BELOW FOR USE OF PRODUCTS):

  • TYLENOL/ADVIL/ OR ALEVE (ADVIL AND ALEVE ARE SAFE IN COVID)
  • Sudafed 30mg tablets
  • Chlorpheniramine 4mg tablets
  • Robitussin DM syrup
  • Imodium AD

Most Common Symptoms

They consist of the same set of symptoms as the common cold/rival respiratory syndrome, but they are worse.

Common/Hallmark symptoms:

·        High fever (over 100.4, but can range from 99’s to 104+)

·        Fatigue

·        Cough

Other symptoms can include milder issues:

·        Loss of Smell and/or Taste

·        Nausea without Vomiting

·        Sore Throat

·        Aching muscles throughout the body

·        Headache

·        Occasional diarrhea …

·        Nasal congestion (occasional)

Aches and Pains and Fever:

·        Tylenol 650 – 1000mg four times per day is preferred for treating these symptoms, but if not working well, you may use:

·         Advil (Ibuprofen 200mg), 2 – 3 tablets….2 – 3 x per day or Aleve (naproxen 220mg), 1 – 2 tablets…1 – 2 x per day,

·        Drink good amounts of clear liquids (anything you can see through)

Sore Throat:

·         Saltwater gargling

1.    Dissolve 1 teaspoon of salt in a glass of warm water.

2.    Gargle for 15 seconds and spit.

3.    Repeat during the day every 2 – 4 hours to relieve pain.

·         Pain relief medications: Advil (Ibuprofen 200mg), 2 – 3 tablets….2 – 3 x per day or Aleve (naproxen 220mg), 1 – 2 tablets…1 – 2 x per day, or Tylenol 650 – 1000mg four times per day.

DIET RECOMMENDATIONS TO PREVENT DEHYDRATION IN ILLNESS:

Preventing dehydration is of utmost importance in an acute illness.

Clear liquids (any liquid that light can easily shine through) are the best liquids to use. 

These include:

  • Plain Water
  • Gatorade (or other electrolyte solutions that are similar) ….do not use sugar-free versions of these drinks as the calories in these drinks are helpful is treating the illness and may be the only calories the person can absorb for the first hours or days
  • Tea
  • Cranberry Juice, Apple Juice (watered down…mixed ½ & ½ with water), White Grape Juice
  • Broth from Chicken Soup, Matzo Ball Soup, Bullion
  • Popsicles

Sipping liquids …sip, sip, sip….and pushing the fluids progressively with time is the most important treatment provided.  Focus on this above all else!

Foods:  Maintaining good dietary intake is important during the acute phase of illness, so long as appetite is present.  Do not push foods if uninterested…focus on liquids.  That said, if appetite remains acceptable, food can consist of anything that interests your appetite and is tolerable.  Healthier choices are best, but if you want a hamburger…go ahead!  Easy to digest foods include:

  • Toast (plain white bread)
  • Crackers (Saltines)
  • Plain Noodles
  • Breakfast cereals
  • Bananas, Citrus fruits
  • Apple Sauce
  • Cooked chicken and meats
  • Macaroni (with or without cheese)
  • Plain Rice

Cough:

·        Steam: Either in the form of a hot, steamy shower or using a hot pot of water and covering with a towel and put your head under the towel. Both methods will provide humid air to the irritated air passages and soothe the cough.

·        Cough Syrup: Robitussin DM or Delsym cough syrup can be used to suppress cough.

·        You may require a prescription cough syrup with Codeine.  Contact me if that is the case.

Sinus Congestion and Drainage (RARE SYMPTOM):

·        Use a decongestant such as Sudafed 30mg, 1 – 2 pills up to four times per day, or use a drying antihistamine such as Chlortrimeton 4mg, up to four times per day. Other cold medications (over the counter) can be used.

·         Claritin, Zyrtec, Allegra will not work for congestion symptoms from an infection. Do Not Use.

Nausea Treatment:

This is the most difficult issue to treat at home as there is very little one can do to settle the stomach. Coca-Cola with the carbonation eliminated (Flat Coke), Ginger Ale, or Ginger Root…. can be tried, but these are often inadequate, and the key to getting the stomach to settle is getting a good nausea medication.

If nausea is persistent, then calling for a prescription medication is often a good idea. Phenergan (Promethazine), Compazine (prochlorperazine), Zofran (Ondansetron) are very effective in treatment.  Sometimes we use them in combination either as a pill or a suppository.

The KEYS are:

1.   Settling the Stomach…so that liquids can be taken

2.   Focusing on Liquids…so that dehydration does not set in

3.   Eating light foods… if possible (to provide energy for healing). This is not a requirement for healing from an acute GI illness; so, do not feel that the sick person needs to eat food. The only requirement is liquid intake!

When to Seek Medical Assistance

•          There is no medication to treat this virus, so the resolution takes time.

Worsening symptoms/Signs of Complications:

•          If you are getting significantly short of breath please be in touch.  If progressive and worsening, you need to be seen and hospitalized.  Best to go the ER if shortness of breath is a significant symptom

COVID CHECKLIST FOR THE UNVACCINATED:

I HAVE BEEN DIAGNOSED WITH COVID…. NOW WHAT DO I DO?????

THIS IS CHECKLIST FOR THOSE OVER 50 (THIS LIST APPLIES TO THE YOUNGER SET BUT THE LEVEL OF CONCERN IS MUCH LESS):

  1. UNDERSTAND THE TIMECOURSE OF COVID
  2. QUARANTINE FOR 10 DAYS FROM FIRST SYMPTOMS (IF THIS IS CLEAR) OR FROM THE DATE OF YOUR POSITIVE TEST
  3. MONITOR YOURSELF TWICE DAILY…TEMPERATURE AND OXYGEN LEVELS
  4. HYDRATE WELL, EAT IF YOU CAN
  5. TREAT SYMPTOMS AS REQUIRED
  6. KNOW THAT THE MOST IMPORTANT SYMPTOM IS TO WATCH FOR TRUE SHORTNESS OF BREATH.   IF THAT DEVELOPS, GO TO THE EMERGENCY ROOM
  7. CONCERNS….BE IN TOUCH DURING YOUR ILLNESS AND PROVIDE US UPDATES ON FEVER AND OXYGEN LEVELS
  8. NO TESTING IS REQUIRED AFTER YOUR ILLNESS, ALTHOUGH YOU CAN HAVE A BLOOD TEST FOR ANTIBODIES AFTER 21 DAYS WHEN YOU ARE FREE

TIME COURSE/EXPECTATIONS:

COVID COURSE:

TWO PHASES OF COVID:

  • JAILBIRD
  • FREE BIRD

JAILBIRD:   STRICT QUARANTINE:   10 DAYS FROM DATE OF FIRST SIGNIFICANT SYMPTOMS IF OBVIOUS OR FROM DATE OF TESTING IF UNCERTAIN BASED ON SYMPTOMS (MUST ALSO BE FEVER FREE FOR 3 DAYS AS WELL)

FREE BIRD:  DAY 11 AND BEYOND.  NO RESTRICTIONS.

Although I do not recommend testing to prove the virus has cleared after infection, if you have testing and are clear, then the above protocol is not applied.

QUARANTINING:

  • Do not share a bathroom with housemates if possible. Use your own bathroom.
  • Do not share utensils with others and clean your own utensils and/or use paper/disposable eating materials if possible.
  • Avoid sharing living spaces with housemates, to the extent your living situations allows.
  • Wear a mask when in the presence of others. Wear when you are with others as much as possible.
  • Wash your hands frequently.  Use cleanser on surfaces frequently.

COVID HOME KIT:

  1. DIGITAL ORAL THERMOMETER:    TO MONITOR FEVER.

 MANY BRANDS ARE FINE…HERE IS ONE EXAMPLE:

2 PULSE OXIMETER:   TO CHECK OXYGEN LEVELS. 

MANY BRANDS ARE FINE…HERE IS ONE EXAMPLE:

OTHER ITEMS FROM THE HOME MEDICAL KIT (SEE BELOW FOR USE OF PRODUCTS):

  • TYLENOL/ADVIL/ OR ALEVE (ADVIL AND ALEVE ARE SAFE IN COVID)
  • Sudafed 30mg tablets
  • Chlorpheniramine 4mg tablets
  • Robitussin DM syrup
  • Immodium AD

HYDROXYCHLOROQUINE IS NOT RECOMMENDED TO PREVENT OR TREAT COVID AT THIS TIME.   THE DATA DOES NOT SUPPORT Its USE.

CARING FOR YOURSELF IF YOU THINK YOU MAY HAVE COVID OR IF YOU HAVE BEEN DIAGNOSED WITH COVID:

  1. Check your temperature twice daily and keep a log.  No temperature is dangerous…adults do not have to worry about this.  This is just about monitoring your condition.  If you have concerns, be in touch.
  1. Check oxygen level twice daily and keep a log.  A declining oxygen level can indicate early decompensation from COVID.   Normal oxygen saturation is 97-100%.    If lower than that it may be normal for you, but the trend is what matters.   If you are declining into the low 90’s, if you are feeling particularly short of breath…then it is time to check checked at the Emergency Room (which is safe to do!)    If you have concerns…be in touch.
  1. Manage symptoms just like any other viral infection (see below)

Most Common Symptoms

They consist of the same set of symptoms as the common cold/rival respiratory syndrome, but they are worse.

Common/Hallmark symptoms:

·        High fever (over 100.4, but can range from 99’s to 104+)

·        Fatigue

·        Cough

Other symptoms can include milder issues:

·        Loss of Smell and/or Taste

·        Nausea without Vomiting

·        Sore Throat

·        Aching muscles throughout the body

·        Headache

·        Occasional diarrhea …

·        Nasal congestion (occasional)

Symptomatic treatment for the most bothersome symptoms

  • Plan to:
    Monitor temperature twice daily and record.  
  • Monitor oxygen levels twice daily and record.  If dropping significantly you should be in touch.

Aches and Pains and Fever:

·        Tylenol 650 – 1000mg four times per day is preferred for treating these symptoms, but if not working well, you may use:

·         Advil (Ibuprofen 200mg), 2 – 3 tablets….2 – 3 x per day or Aleve (naproxen 220mg), 1 – 2 tablets…1 – 2 x per day,

·        Drink good amounts of clear liquids (anything you can see through)

Sore Throat:

·         Saltwater gargling

1.    Dissolve 1 teaspoon of salt in a glass of warm water.

2.    Gargle for 15 seconds and spit.

3.    Repeat during the day every 2 – 4 hours to relieve pain.

·         Pain relief medications: Advil (Ibuprofen 200mg), 2 – 3 tablets….2 – 3 x per day or Aleve (naproxen 220mg), 1 – 2 tablets…1 – 2 x per day, or Tylenol 650 – 1000mg four times per day.

DIET RECOMMENDATIONS TO PREVENT DEHYDRATION IN ILLNESS:

Preventing dehydration is of utmost importance in an acute illness.

Clear liquids (any liquid that light can easily shine through) are the best liquids to use. 

These include:

  • Plain Water
  • Gatorade (or other electrolyte solutions that are similar) ….do not use sugar-free versions of these drinks as the calories in these drinks are helpful is treating the illness and may be the only calories the person can absorb for the first hours or days
  • Tea
  • Cranberry Juice, Apple Juice (watered down…mixed ½ & ½ with water), White Grape Juice
  • Broth from Chicken Soup, Matzo Ball Soup, Bullion
  • Popsicles

Sipping liquids …sip, sip, sip….and pushing the fluids progressively with time is the most important treatment provided.  Focus on this above all else!

Foods:  Maintaining good dietary intake is important during the acute phase of illness, so long as appetite is present.  Do not push foods if uninterested…focus on liquids.  That said, if appetite remains acceptable, food can consist of anything that interests your appetite and is tolerable.  Healthier choices are best, but if you want a hamburger…go ahead!  Easy to digest foods include:

  • Toast (plain white bread)
  • Crackers (Saltines)
  • Plain Noodles
  • Breakfast cereals
  • Bananas, Citrus fruits
  • Apple Sauce
  • Cooked chicken and meats
  • Macaroni (with or without cheese)
  • Plain Rice

Cough:

·        Steam: Either in the form of a hot, steamy shower or using a hot pot of water and covering with a towel and put your head under the towel. Both methods will provide humid air to the irritated air passages and soothe the cough.

·        Cough Syrup: Robitussin DM or Delsym cough syrup can be used to suppress cough.

·        You may require a prescription cough syrup with Codeine.  Contact me if that is the case.

Sinus Congestion and Drainage (RARE SYMPTOM):

·        Use a decongestant such as Sudafed 30mg, 1 – 2 pills up to four times per day, or use a drying antihistamine such as Chlortrimeton 4mg, up to four times per day. Other cold medications (over the counter) can be used.

·         Claritin, Zyrtec, Allegra will not work for congestion symptoms from an infection. Do Not Use.

Nausea Treatment:

This is the most difficult issue to treat at home as there is very little one can do to settle the stomach. Coca-Cola with the carbonation eliminated (Flat Coke), Ginger Ale, or Ginger Root…. can be tried, but these are often inadequate, and the key to getting the stomach to settle is getting a good nausea medication.

If nausea is persistent, then calling for a prescription medication is often a good idea. Phenergan (Promethazine), Compazine (prochlorperazine), Zofran (Ondansetron) are very effective in treatment.  Sometimes we use them in combination either as a pill or a suppository.

The KEYS are:

1.   Settling the Stomach…so that liquids can be taken

2.   Focusing on Liquids…so that dehydration does not set in

3.   Eating light foods… if possible (to provide energy for healing). This is not a requirement for healing from an acute GI illness; so, do not feel that the sick person needs to eat food. The only requirement is liquid intake!

When to Seek Medical Assistance

•          There is no medication to treat this virus, so the resolution takes time.

Worsening symptoms/Signs of Complications:

•          If you are getting significantly short of breath please be in touch.  If progressive and worsening, you need to be seen and possibly hospitalized.  Best to go the ER if shortness of breath is a significant symptom

How Long to Recover

•          The COVID is a viral infection that will generally take from 3–7 days to develop, 3-7 days to improve and then from 3-7 days to completely resolve.

Filed Under: homepage-updates

Introducing ‘Phreesia’… Another Way To Connect With Our Office!

June 9, 2022 by Doctordoug

Phreesia knows that internal medicine requires a comprehensive approach to the prevention, diagnosis and treatment of disease and chronic conditions throughout the course of a patient’s adult life. Whether you’re managing the demand for wellness visits or acute care, working to create a better patient experience or just trying to run a more efficient practice, we can help.

Whether you need an annual exam or a follow-up visit, Phreesia offers the the convenience of self-scheduling or requesting appointments.

  • Say goodbye to clipboards and scanning
  • An easier way to make appointments
  • The right questions, the right answers
  • Activate patients throughout their registration journey
  • Insurance information collected for billing
  • Online payments made easier
FAQ

Q: What is Phreesia?

A: Phreesia gives healthcare organizations a suite of applications to manage the patient intake process, including mobile registration. Mobile check-in allows you to complete pre-visit registration from your own device (any smartphone, computer or tablet) ahead of time and in the privacy of your home.

Q: Why is Dr. Lakin’s office partnering with Phreesia?

A: Dr. Lakin’s office is partnering with Phreesia to save you time when arriving at our practice and to ensure that your health records will always be up-to-date. The information you enter is private and secure and will allow our team to better care for you.

Q: Is the Phreesia system secure?

A: Yes. Phreesia provides industry-leading privacy and security for our patients’ data. They are held to the same standards as Dr. Lakin’s office related to protecting your family’s information. For additional information about Phreesia’s security visit https://www.phreesia.com/patient-privacy.

Q: Do we need to use the new system for every appointment?

A: Yes. But once you have completed the initial registration, the next time will be much quicker because Phreesia saves your answers.

Q: Do I need to download an app to do mobile check-in?

A: No. There is no app – you simply click the link provided in the text message or email. This allows you to securely answer any registration and medical questions necessary for your appointment.

Q: Can I complete the forms in a language other than English?

A: Yes! Mobile registration is available in 20 different languages, and the PhreesiaPads in the office offer Spanish in addition to English.

Q: What happens if I can’t finish my registration before the appointment?

A: That’s okay! If you have not completed your registration before the visit, see one of our receptionists, and they will be happy to send you a new link. Don’t worry, Phreesia saves information you entered previously.

Q: What if I have questions or feedback?

A: You can talk with any of our receptionists in the clinic, reach out through the Contact Us page on https://www.doctordoug.com/ or send a secure message through the Patient Portal.

More Questions?
Please contact Marlene directly….. CLICK HERE

Filed Under: homepage-updates

Updated Mask Policy in Our Office

December 23, 2021 by Doctordoug

At our office, we are continuing to follow CDC guidelines and will strive for ways to keep our patients and staff safe.
 
 

We recommend that all unvaccinated and vaccinated patients and visitors entering our office cover their nose and mouth at all times.

To prevent further spread of the Delta & Omicron variants, the US Centers for Disease Control and Prevention updated its mask guidance on September 9, 2022, to recommend that fully vaccinated people wear masks  when in areas with “substantial” and “high” transmission of Covid-19.

 

 

 

Stay healthy & safe!

Dr. Lakin


Filed Under: homepage-updates

Introducing ‘MyIR Mobile’

August 30, 2021 by Doctordoug

MyIR Mobile in partnership with your State Health Department allows you to review your immunization history, get reminders for future immunizations, and even print your own official records… it’s all free, simple and secure.
CLICK HERE TO LOGIN OR REGISTER

Filed Under: homepage-updates

COVID-19 Testing Sites

February 8, 2021 by Doctordoug

ALTERNATIVE LOCATIONS FOR COVID TESTING OTHER THAN OUR OFFICE:

Arcpoint Labs

https://www.arcpointlabs.com/scottsdale-north

Walgreens

https://www.walgreens.com/findcare/covid19/testing

Aveon Health

http://aveonhealth.com/sick-visit/

Honor Healthcare

https://www.honorhealth.com/coronavirus-covid-19/testing

Mesa Community College System:

https://embrywomenshealth.com/testing-blitz/

Nextcare Testing:

https://nextcare.com/curbside//

Arizona Department of Health COVID Testing Locations

https://www.azdhs.gov/preparedness/epidemiology-disease-control/infectious-disease-epidemiology/index.php#novel-coronavirus-testing

 

Arizona COVID-19 hotline at 844-542-8201 for more information about testing options and availability in your area.

 

Filed Under: homepage-updates

ATTENTION ALL PATIENTS: REGISTER FOR DR. LAKIN’S SECURE PATIENT PORTAL ‘MyHealthRecord.com’ NOW!

February 2, 2020 by Doctordoug

Did you receive your invitation email?  If not, contact our office so we can send one to you!

 

Dr. Lakin and staff are very excited to announce we have upgraded our secure patient portal!
We changed vendors, and our new secure portal, MyHealthRecord.com, is easier to use and easier for us to respond to your medical requests.

At your convenience

  • View your health record from any Internet-enabled device
  • Exchange secure messages with Dr. Lakin and staff
  • Request and manage appointments

Anytime access

  • Lab orders
  • Test results
  • Upcoming appointments
  • Document & form postings from our practice

To be linked to our new patient portal, MyHealthRecord.com, you are required to complete a short questionnaire.  This is a very simple process…. quick and easy.  If you need assistance, we are always here to help.
Get your invitation email and register today!

 

Additional Tips for Logging in:

Clear your cache and cookies (browsing history) in whichever browser you’re using (such as Google Chrome, Firefox, Microsoft Edge, etc)

Once cleared, close and reopen the browser and click on the link.  You can also access the portal directly using our URL of www.myhealthrecord.com

Remember to always click the ‘Retrieve your latest health Record’ when logging in

Filed Under: homepage-updates

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