Category: General

In health care, we are often there through some of the most devastating times of our patients’ lives. Never has this been truer than over the past 2 ½ years of the COVID-19 pandemic. We are tired and heartbroken from caring for so many critically ill patients and sometimes even being with them in their last moments. This is especially difficult for us here at Fisher-Titus, since many of our patients are our neighbors, family, and friends from our tight-knit community. However, despite the exhaustion we feel dealing with sometimes devastating outcomes, the individualized, compassionate care we provide can leave a defining impact on patients’ families for years to come.

Read Viki Collins’ story about how our Fisher-Titus family made a positive impact on her family even as they grieved the loss of her husband, Dave.

Viki and Dave met while they were both volunteering for a local fire department where they lived in New York.

“Dave had this big heart that always saw the best in everyone,” Viki says. “He just always gave back. As soon as he turned 18 he started volunteering for the fire department.”

At the time they met, Viki was a basic EMT going back to school for advanced EMT critical care. She was a busy, single mom of her two sons, Logan and Liam when Dave asked her out on their first date.

“I said, ‘listen, I’m a single mom, I’m working full time, and I’m going to school, I don’t have time for you,’” Viki remembers with a laugh. “Even though we met volunteering, I was still very stingy with what I would give and do being a single mom. But Dave relit that fire for me – he reminded me that there was always something you could do and give back.”

But Dave persisted. He brought her coffee to work every day until he eventually won her over. They began dating in November, were engaged by March, and married the following October.

“We had a small wedding first and then and our Catholic ceremony later,” Viki explains. “Dave always joked that he loved me enough to marry me twice.”

Dave took on Viki’s two oldest boys as his own and they had two more boys, MJ and Stanley, together. They moved to Ohio and Viki has worked at Fisher-Titus for three years, now serving as Patient Access Supervisor.

Right after Thanksgiving 2021, Dave and Viki were both diagnosed with COVID-19. Soon after diagnosis, Dave was unable to keep his head up and was struggling to breathe so Viki took him to the Fisher-Titus Emergency Department.

“The ER staff was phenomenal,” Viki says. “Even though I couldn’t be in there with him, he was texting me, calling me, and keeping me updated.”

Unfortunately, Dave continued to get worse and was admitted to the hospital. He later was moved to the ICU before passing away on December 18.

Although Dave’s hospital stay did not end the way anyone would have hoped, Viki insists that the experience overall was positive thanks to the staff at Fisher-Titus.

“Obviously, I’d much rather have my husband home with me,” Viki explains. “But it wasn’t a bad outcome because of the hospital. Fisher-Titus really did everything they could to make it a positive experience and have a positive impact on our family.”

Viki remembers several instances where employees went above and beyond to support Dave and their family during his stay.

“After he was moved to the ICU, I walked in one day and the Safety & Security Liaison at the Pavilion was wearing a small, silver cross,” she describes. “I had asked where she got it from because Dave had wanted one. She was willing to take it off and give it to me. I didn’t take it—but she was willing to do that for us.”

Coming from health care, Viki understands more than most about what her husband was going through and was very involved in Dave’s care. She kept up through his patient portal and wanted to know everything that was going on even though she couldn’t always be there due to visitation restrictions.

“When he got to the floor, the nurses were very, very good,” Viki remembers. “Whenever I was there, they made a point to come into the room and talk to me. There was a time when something had happened when I wasn’t there and the nurse, Dalibor, called me to let me know. He started with ‘I want you to know, there’s nothing wrong’ before explaining what had happened and that they caught it immediately and fixed it. He was honest and up front and starting that way was huge for me.”

Viki expresses her gratitude for all of Dave’s caregivers taking the time to get to know him and his family.

“Theresa Stygles was the nurse practitioner with Pulmonary Medicine that was on Dave’s care,” Viki explains. “One day, she was rounding while I was visiting Dave and she wanted to know more about our story—how we met, who he was—she got to know him, so he wasn’t just a body in a bed. When I left the day he passed, she stopped and gave me a hug, and you could tell she was upset.”

She also had conversations with Dave’s doctors about what types of treatments they may be able to try. Given her background, she was familiar with what treatments were available and what successes other hospitals were seeing with various treatments.

“Every time I asked about something, they would respond with ‘I’ll look into it,’ ‘I’ll try,’ or ‘I’ll see what I can do but I make no promises,’” says Viki. “But nothing was ever off the table. I understood they were limited on what they could do but if it was something we could try, they were going to try it.”

Once Dave had been admitted into the ICU and was more seriously sick, Viki remembers the support and validation she felt from everyone she encountered.

“As with any long hospital stay, it wasn’t all rainbows and sunshine,” Viki says. “There were a couple of concerns I had along the way and I raised them—that was my husband—but the thing that was so nice, was that even when I was probably being a little unreasonable, not a single person treated me that way.”

Viki continues, “The nursing supervisor, the physicians, they understood that I was in a time of crisis and in survival mode myself. Even though I’ve been in the medical field forever, my brain was not there. They treated me with so much respect, validated my concerns, and explained what was going on in terms I understood.”

Eventually, Viki had to have some tough conversations and make some difficult decisions with his care team about how much intervention they would do.

“Even before Dave got to the point where we needed to stop care, I had a very long discussion with Dr. Alahmad and I had told him I was willing to do normal procedures that Dave may not have normally agreed to as long as I knew at the end of the day we were not prolonging his death. Dave and I were both in health care and we’d had the conversation that quality of life was more important than quantity,” Viki explains.

“At one point when Dave was in ICU, Dr. Alahmad called me, explained everything they were doing and said ‘We are doing everything medically we can, I’m going to pray for him,’” she remembers. “That might seem small, but I know everyone did everything they could and they would’ve fought as long as I asked them to.”

When the time came for Viki to have the tough conversation about stopping care, she recognizes the support she felt from his care team even then.

“Dr. Alahmad called me on the 18^th and told me we were to that point we had talked about,” she remembers. “He said, ‘Anything else you want to try, I will arrange it and get him where he needs to be,’ but he said, ‘Viki we are prolonging his death at this point.’ That was all I needed to hear. He didn’t beat around the bush, and he didn’t give me false hope which is so important.”

Viki believes the care Dave received at Fisher-Titus was not something they would have found everywhere, adding that she doesn’t think it’s just because she’s an employee.

“I worked for another small hospital for over 10 years in New York. After leaving I said I’d never step foot to work in a hospital again—I didn’t believe they cared about their community,” Viki explained. “Even before everything with Dave, I had said ‘I don’t think I’ll ever leave Fisher-Titus.’ And this experience only strengthened that feeling. Everyone from housekeeping up through administration ‘walks the walk’ and cares for our patients with the understanding that we are caring for our community.”

Viki also recognizes that the understanding that our patients are our fellow community members leads to individualized care you may not find in other health care facilities.

“Obviously we’ve had to be restrictive with visitation due to COVID. However, the fact that we’ve allowed some visitation I think has made a huge impact.” Viki continues, “I also think we are so open to hearing feedback. The fact that Dave’s team was willing to go to administration and advocate for Dave and for me—everyone is so willing to consider individual circumstances and how policies may impact care. It goes back to them seeing the community and the individual, not just ‘this is what our policy is.’”

Viki says her experience has made the aftermath of losing her husband less challenging than one might expect.

“Because of the positive experience I had with Fisher-Titus, I feel like my grieving has been manageable,” Viki explains. “I had the communication with everyone at Fisher-Titus and I had that support so while it was a sudden loss, it wasn’t like it was a sudden loss and I was alone. Even when he was passing away, they came in and they checked him and then they told me to take all the time I need. They absolutely wanted to make sure I was in a good place.”

She recognizes that health care professionals are dealing with a lot due to the COVID-19 pandemic. But Viki says that despite that, staff continued to put their best foot forward for their patients and families.

“I know we are so burnt out in health care—it’s all of it over the past 2 ½ years—but even though I know those nurses are burnt out and tired, not once did they show it. Not once could you see it on their faces,” Viki remembers. “At the end of the day, I’m sure they went home and were exhausted. The ICU staff, the floor staff, and the ER staff—you never once saw that fatigue and that burn out.”

Viki wants Dave’s care team and every single Fisher-Titus employee to know the difference they make for their patients and their families.

“It was a crappy outcome, but a positive experience,” Viki states. “I really feel like from the people scrubbing the floors to the people scrubbing the claims and charges, everybody does a good job of making sure we support each other and put that best foot forward for the patient. The care Dave got was phenomenal and it has had a huge, positive impact on my family.”

Washing your hands helps to prevent you from getting sick. What if the hand dryers that you are using to dry your hands after you wash them are putting bacteria right back on them?

In an effort to eliminate touch points, and be more environmentally aware, many businesses and organizations have turned to using hand dryers in their restrooms as opposed to paper towels. However, a study published by Cambridge University suggests that this might not be a good idea.

We touch a lot of different things throughout the day and are exposed to a lot of bacteria and germs. The best practice for staying healthy and eliminating those germs is hand washing. It is important that you wash your hands thoroughly throughout the day and especially in certain situations such as after going to the bathroom and before eating. We have always been taught good hand washing etiquette and told that improper hand washing is what leads to the spread of bacteria, but maybe the bigger problem that we should be looking at is if hand dryers are the best method for drying our hands after washing them.

The results of the study showed that there were significantly more bacteria present on the individuals’ hands that were dried in a hand dryer than the ones that used paper towels. Additionally, all of the surfaces that were touched, in this study, after using the hand dryer displayed higher bacterial levels than the surfaces that were touched after paper towel use.

What does this mean for drying your hands from now on? What if there are only hand dryers available?

Tamara Binger, an infection preventionist here at Fisher-Titus, provided us with some advice about navigating hand dryers and some other important tips about hand washing.

“While it is something to consider when you are using public restrooms, you can still use a hand dryer and have relatively clean hands,” Binger said. “Germs spread more when your hands are wet, so it is more important that you dry your hands than how you choose to dry them. If a hand dryer does not completely dry your hands and you end up wiping them on your clothes to dry them completely, use some hand sanitizer to be sure that your hands are clean. Additionally, there are different types of hand dryers, and some require you to stick your hands in them. If you touch a hand dryer while you are drying your hands, you should use hand sanitizer after you finish drying them just to be sure your hands are still clean.”

Binger continues, “when you wash your hands, it is important that you wash the backs of your hands, in-between your fingers, under your nails, and up to at least your wrists. This should take you 15-20 seconds to do. Once you finish washing your hands, it is important that you avoid touching a dirty surface. If there are paper towels available, use one to turn off the faucet. If there are none, use a clean tissue, or clean piece of toilet paper to turn it off.”

Ultimately, there is no way to completely avoid the germs that are present in public restrooms, but it is important to be aware of ways that you can limit your exposure to them. No matter the bathroom situation, remember to carry hand sanitizer with you because you never know when you might need it.

March 21^st is World Down Syndrome Day. It’s celebrated across the globe to shed light on Down syndrome and recognize the dignity, rights, and well-being of people who have it. The day was selected to signify the uniqueness of the triplication (trisomy) of the 21^st chromosome that causes Down syndrome.

This year, Down Syndrome International (DSI) is asking us all to think about, “What does inclusion mean? Are you helping to promote inclusion in your community?” While access and inclusion have improved over the years, there is still more work to do. The reality is that people with Down syndrome and disabilities still face challenges and barriers to be included fully in our society.

Why do these barriers still exist? Misconceptions about individuals with Down syndrome and a poor understanding about inclusion gaps likely contribute.

What is Down Syndrome?

Down syndrome is a genetic disorder where a person has three copies of chromosome 21 instead of two. Here are some other facts about Down syndrome:

• The average lifespan is around 60 years today, a significant increase from what it used to be.
• Although people with Down syndrome have physical and intellectual delays from birth, there is a wide range of abilities within the population.
• A growing number of people with Down syndrome are living independently.
• People with Down syndrome are predisposed to certain medical conditions including congenital heart defects, sleep apnea, and Alzheimer’s disease.
• There may be an increased risk of celiac disease, autism, childhood leukemia, and seizures.
• Appropriate medical care for individuals with Down syndrome can make a huge difference in their physical and intellectual development.
• Early intervention for babies with Down syndrome is important. Therapies in their first five years can make a huge difference.

Individuals with Down syndrome should have the opportunity to enhance their quality of life and realize their life aspirations. They should be seen as valued members of their communities and have the right to be included and take part in society. DSI calls this, “inclusive participation” and describes it as:

• Having access to information in a way that can be understood;
• Having the opportunity to share their unique ideas, experiences, and knowledge just like everyone else;
• Have the time, support, and adjustments needed to take part.

Simply, inclusive participation is about removing the barriers that still exist for individuals with Down syndrome and other disabilities.

At Fisher-Titus Medical Center, we are committed to helping individuals with Down syndrome or other disabilities maximize their potential and improve access to the world around them. We offer a variety of treatments and services to help:

Physical Therapy: Activities and exercises that help build motor skills, increase muscle strength, and improve posture and balance. A physical therapist can also help a child with Down syndrome compensate for any physical challenges.

Speech therapy: Helps improve their communication skills and use language more efficiently. A speech therapist can help them develop skills necessary for communication and even help infants with breastfeeding as that can help build muscles used for speech. The therapist can work with the child to develop alternate forms of communication like sign language or pictures. Learning to communicate is an ongoing process so these therapies are often beneficial as children with Down syndrome enter school and even later in life.

Occupational Therapy: Helps adjust everyday tasks and conditions to match a person’s needs and abilities. This can help individuals with Down syndrome learn self-care skills like eating, getting dressed, writing, and using a computer. The occupational therapist can also suggest tools to help improve everyday functions. As the child grows and enters high school, the therapist may help teenagers find jobs, careers, or skills that match their interests and strengths.

Emotional and Behavioral Therapies: Children with Down syndrome may become frustrated, develop compulsive behaviors, and have Attention Deficit Hyperactivity Disorder and other mental health issues. The therapists can help understand why a child is acting out, create strategies for avoiding or preventing these situations, and teach positive ways of responding.

For more information on physical, occupational or speech therapy, call 419-660-2700 or talk to your child’s primary care provider about a referral. For more information on emotional or behavioral therapy, visit fishertitus.org/behavioral-health.

By: Judy Zellner, LPCC, Fisher-Titus Behavioral Health

Woman receiving compliment Monday, January 24 is National Compliment Day. This day is a good reminder of the power of kind and positive words. We sometimes get caught up in our own lives and forget that giving a genuine compliment is an amazing way to give someone a healthy boost. It can be a powerful gift to give. Think of the last time someone gave you a compliment. It can be an awesome feeling. Someone was seeing YOUR value at that moment.

Compliments are not only good for the people receiving them, but also for the people giving them. You can make someone’s day by sharing the positivity of a compliment. Giving a genuine compliment can bring good into the world by seeing the best in others and putting your appreciation in words. That can also help us see the good in ourselves and our lives around us.

So, how do you give a compliment? It’s important to give a compliment freely without expecting anything in return. Use empathy and honesty. Tell them what you genuinely think is special about them.

Next, how do you receive a compliment? Sometimes this can be awkward, especially if you are not used to getting compliments. Remember that a compliment is a person’s gift to you. So, accept it with grace and with a smile, and don’t downplay it. Just respond simply with a “thank you.”

Let’s celebrate National Compliment Day with the gift of a heart-felt compliment to someone. You never know what a difference it may make in someone’s life.

By Linda Stevenson, Chief Information Officer, Fisher-Titus

Keeping your internet-connected devices free from malware and infections makes the internet safer for you and more secure for everyone.

The Keep a Clean Machine campaign is an ongoing effort to help everyone understand the importance of protecting internet-connected devices from malware and infections – especially malware that connects your devices with botnets.

What Are Botnets?

Botnets are networks of personal computers infected by malware and remote controlled by criminals. Botnets are used to send junk email (spam), attack websites and distribute more malware, among other things.

The malware used by botnets can infect your computer, turning it into a “bot” or “zombie,” meaning your computer can become part of the botnet and help criminals do their dirty work.

To learn more about botnets, visit Microsoft Security’s Botnet page and read the “Botnets 101: Everything You Need To Know” blog from StopBadware and the National Cyber Security Alliance.

Prevention:

• Keep a Clean Machine
• Keep security software current: Having the latest security software, web browser and operating system are the best defenses against viruses, malware and other online threats.
• Automate software updates: Many software programs will automatically connect and update to defend against known risks. Turn on automatic updates if that’s an available option.
• Protect all devices that connect to the internet: Along with computers, smartphones, gaming systems and other web-enabled devices also need protection from viruses and malware.
• Plug & scan: “USBs” and other external devices can be infected by viruses and malware. Use your security software to scan them.
• Connect With Care
• When in doubt, throw it out: Links in email, tweets, posts and online advertising are often the way cybercriminals compromise your computer. If it looks suspicious, even if you know the source, it’s best to delete or, if appropriate, mark as junk email.
• Get savvy about WiFi hotspots: Limit the type of business you conduct and adjust the security settings on your device to limit who can access your machine.

If You Think You’re Infected

Act quickly: If you are notified, become aware or suspect your computer is infected, take immediate steps to remove malware.

Detection:

Here are some free resources to help you see if your computer is infected:

• Avast
• AVG Free Antivirus
• Bitdefender
• ESET Online Scanner
• Kaspersky Virus Scanner
• McAfee Security Scan
• Qualys Browser Check
• Sophos Free Security Tools
• Symantec Security Scan
• Trend Micro HouseCall Virus Scan

Remediation:

• Norton by Spmantec: Power Eraser
• VIPRE Rescue

Recovery:

Once your computer is malware-free, here are some suggestions to get you back on track:

Change your passwords. A strong password is a sentence that is at least 12 characters long. Focus on positive sentences or phrases that you like to think about and are easy to remember (for example, “I love country music.”). On many sites, you can even use spaces! And remember, unique account, unique password.

Make sure your antivirus software, operating system and web browsers are up to date.

Visit identitytheft.gov to report identity theft and get a recovery plan and visit the Identity Theft Resource Center for free victim resources.

By: Linda Stevenson, Chief Information Officer

We all spend time on the internet these days. It’s likely you have internet access at home that the whole family uses for work, school, entertainment, and more. Most of our electronic devices connect to the internet including computers, TVs, smartphones, gaming systems, and even wearable devices. In previous columns, we’ve discussed how to secure your devices and keep them clean and up to date. The next step is to ensure your home internet network is protected so you and your family can be online more safely and securely.

Secure your wireless router

In this day and age, most of us probably have wireless internet in our homes which means we have a wireless router. While this makes connecting to the internet with multiple devices convenient, it can also leave your network and your personal information vulnerable to others within range of your router.

Here are some tips for securing your wireless router from the National Cybersecurity Alliance:

• Change the name of your router. The default ID—called a service set identifier (SSID) or extended service set identifier (ESSID)—is assigned by the router’s manufacturer. Change your router to a name that is unique to you and won’t be easily guessed by others.
• Change the preset password on your router. Leaving the default password unchanged makes is much easier for hackers to access your network. You should change is as soon as possible after setting up your router. A strong password is a sentence that is at least 12 characters long.
• Review security options. When choosing your router’s level of security, opt for WPA2, if available, or WPA. These levels are more secure than the WEP option.
• Create a guest password. Some routers allow for guests to use networks via separate guest passwords. If you have many visitors to your home, it’s a good idea to set up a guest network.
• Use a firewall. Firewalls help keep hackers from using your device to send out your personal information without your permission. While antivirus software scans incoming email and files, a firewall is like a guard, watching for attempts to access your system and blocking communications with sources you don’t permit. Your operating system and/or security software likely comes with  a pre-installed firewall, but make sure you turn on these features.

Additional online security tips

Take these additional steps to protect yourself while using the internet:

• Keep security software current. Having the latest security software, web browser, and operating system is the best defense against viruses, malware, and other online threats.
• Protect all devices that connect to the internet. Computer, smartphones, gaming systems, and any other web-enabled devices need protection from viruses and malware.
• Plug & scan. USBs and other external devices can be infected by viruses and malware. Use your security software to scan them before using them.
• Protect your finances. When banking and shopping, check to be sure the sites are security enabled. Look for web addresses with https:// which means the site takes extra measures to help secure your information. http:// is not secure.
• Back it up. Protect your valuable work, music, photos, and other digital information by making electronic copies of your important files and storing them safely.

By: Cyndi Whetstone, BSN, RN, Stroke Coordinator

May is Stroke Awareness Month, and while it’s always a good time to refresh yourself on the signs and symptoms of a stroke, this year it may be especially important with the COVID-19 pandemic.

COVID-19 and Stroke Risk

According to recent studies, individuals who had COVID-19 may be at an increased risk for experiencing a stroke. In many cases, the patients in the study who experience stroke did not present typical symptoms of COVID-19 (shortness of breath, fever, etc.) and did not have any known pre-existing risk factors.

While studies are still being conducted and doctors are still examining possible connections between COVID-19 and stroke, they hypothesize that it’s because COVID-19 targets the brain and the blood vessels in the brain. Additionally, COVID-19 affects the heart and can cause irregular heart rhythm which can create a clot that can then migrate to the brain and produce a stroke.

Recognizing a Stroke

Since we know COVID-19 may put you at an increased risk for stroke, it’s important to understand what stroke looks like so you can recognize it in yourself and others should it ever occur. Knowing the common stroke warning signs and what to do someone is having a stroke can be the difference between recovery and disability. The acronym BE FAST can help you remember these signs:

• B – Balance. Is the person suddenly having trouble with balance or coordination?
• E – Eyes. Is the person experiencing suddenly blurred or double vision or a sudden loss of vision in one or both eyes?
• F – Face drooping. Does one side of the face droop or is it numb? Ask the person to smile.
• A – Arm Weakness. Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
• S – Speech Difficulty. Is speech slurred, are they unable to speak, or are they hard to understand? Ask the person to repeat a simple sentence like, “The sky is blue.” Is the sentence repeated correctly?
• T – Time to call 911. If the person shows any of these symptoms, even if the symptoms go away, call 911 and get them to the hospital immediately.

Stroke Care at Fisher-Titus

Fisher-Titus is a certified Primary Stroke Center through the Healthcare Facilities Accreditation Program. This means that we have the ability to stabilize and treat acute stroke patients, provide acute care, and administer tPA and other acute therapies safely and efficiently.

Additionally, Fisher-Titus received the 2020 American Heart Association/American Stroke Association’s (AHA/ASA) Get with the Guidelines Stroke Gold Plus achievement award. We were also recognized as a recipient of the Target: Stroke Elite Plus Honor Roll with Target: Type 2 Diabetes Award.

By: Ken C. Murray, Ph.D., LPCC-S

Managing stress is all about taking charge: Taking charge of your thoughts, your emotions, your schedule, your environment, and the way you deal with problems. The ultimate goal is a balanced life, with time for work, relationships, relaxation, and fun (plus the resilience to hold up under pressure and meet challenges head on).

Stress management starts with identifying the sources of stress in your life. This isn’t as easy as it sounds. Your true sources of stress aren’t always obvious, and it’s all too easy to overlook your own stress-inducing thoughts, feelings, and behaviors. Sure, you may know that you’re constantly worried about school or work deadlines. But maybe it’s your procrastination, rather than the actual assignment demands, that leads to deadline stress. To identify your true sources of stress, look closely at your habits, attitude, and excuses. Until you accept responsibility for the role you play in creating or maintaining it, your stress level will remain outside your control.

There are many healthy ways to manage and cope with stress, but they all require change. You can either change the situation or change your reaction. When deciding which option to choose, it’s helpful to think of the Four A’s: Avoid, Alter, Adapt, or Accept.

Not all stress can be avoided (and it’s not healthy to avoid a situation that needs immediate attention), but you may be surprised by the number of stressors in your life that you can eliminate. Know your limits and stick to them. Remember:

• Avoid people who stress you out.
• Take control of your environment.
• Avoid hot-button topics.
• Cut down your To-Do list: Distinguish between the “shoulds” and the “musts.”

If you can’t avoid a stressful situation, try to alter it. Figure out what you can do to change things so that the problem will be less in the future. Often, this involves changing the way you communicate and operate in your daily life:

• Express your feelings, instead of bottling them up.
• Be willing to compromise.
• Be more assertive: Set personal limits and boundaries
• Manage your time more efficiently.

If you can’t change the stressor, then you might have to change yourself. You can adapt to stressful situations and regain your sense of control by changing your expectations and attitude:

Reframe problems: Try a more positive perspective.

Look at the Big Picture: How important will this be in the long run?

Adjust your standards: No perfectionism…learn to be okay with “good enough.”

Focus on the positive: Reflect on all the things you appreciate in your life.

Adjust Your Attitude: Change your thinking: Eliminate words such as, “Always, Never, Should, and Must.”

Some sources of stress are just unavoidable. You can’t prevent or change stressors such as the death of a loved one, a serious illness, or a national recession. In such cases, the best way to cope with stress is to accept things as they are. Acceptance may be difficult, but in the long run, it’s easier than railing against a situation that you can’t change:

• Don’t try to control the uncontrollable: Particularly the behavior of other people.
• Look for the upside: “What doesn’t kill us…makes us stronger.”
• Share your feelings: Talk to a friend, family member, or therapist.
• Let go of anger and resentments: Free yourself from negative energy by moving on.

The work you put in to reduce, prevent, and cope with stress will more than pay off in the long run.

About Ken Murray

Ken Murray, Ph.D., LPCC-S provides counseling services to children, adults, and families addressing a wide range of mental health concerns. Ken specializes in providing counseling for children and families and has experience with providing counseling for parent and leading parenting classes. For more information about Fisher-Titus Behavioral Health, visit fishertitus.org/behavioral-health.

After being discharged from the hospital, Virgie Connors’ battle with COVID-19 was far from over. The North Central EMS Paramedicine Program gave Virgie and her family peace of mind as she returned home.

In August of 2020, Virgie started to come down with the sniffles. Given the state of the pandemic, she called her primary care provider right away to see about getting a COVID‐19 test. That call was on a Thursday and she made a testing appointment for the following Tuesday.

While she waited for her appointment, she mostly stayed in bed to rest. Besides her sniffles, she had significant night sweats. However, she had been regularly checking her temperature and never had a fever.
“You know, they were telling everyone to look for a temperature, but I never had a fever,” Virgie said.

By the time Tuesday rolled around, she could barely walk to the car. A family member drove her to get tested and she decided to go straight to the Fisher‐Titus Emergency Room after.

“When she first started having symptoms, we didn’t want to jump the gun and tell her to go into the Emergency Room,” said Amanda Swaynigm, Virgie’s daughter and North Central EMS employee. “But then when the time came, it actually got very scary because she could barely walk going into the ER.”

“It was hurting to breathe and that’s when I said, ‘I’m going to the ER,’” Virgie said.

Given Virgie’s symptoms, it was presumed that she was positive for COVID‐19 and due to visitation precautions in place to prevent the spread of COVID‐19, her family was not able to be with her at the Emergency Room. Her diagnosis would later be confirmed by the positive COVID‐19 test from earlier that day.

“It’s scary because you’re just leaving her,” Amanda explained. “We couldn’t go in with her to make sure she was OK.”

Virgie was admitted to Fisher‐Titus and stayed for four days. She had pneumonia, AFib (irregular heartbeat), and tachycardia (heart rate over 100 beats per minute) as a result of COVID‐19.

“I did feel better when she called me and said she was being admitted,” Amanda said. “Then you know she’s in the best care.”

Virgie was able to communicate with her family the whole time she was admitted.

As a North Central EMS employee, Amanda was aware of the Paramedicine Program and asked for it for her mom after discharge.

“They told me there would be somebody coming out from North Central EMS to do an EKG and vitals a couple times a week,” Virgie said. “Thank goodness, because I was kind of scared leaving the hospital.”

Over the next few weeks after being discharged, Bryan, a medic from North Central EMS, came out around eight times to check on Virgie. First, a couple times a week and then once a week.

“Bryan was very professional,” Virgie said. “He was very informative. He explained everything even after he did the EKG. It gave me a little more peace of mind.”

During the first visit, Bryan called Virgie’s primary care provider to talk about her vitals and her EKG. After each following visit, the EKGs and vitals would be sent directly to Virgie’s entire care team including her
cardiologist.

Virgie and her husband John have a close relationship with their family. They have two daughters: Amanda and her younger sister, Ashley Connors. They also have four grandchildren ranging in age from seven to 17.

“All the grandkids as well as my sister and I have always been very close with my parents, seeing them almost daily for family dinners,” Amanda explained. “It took a toll on all of us not being able to see them in person, but we did gain peace of mind after each visit Bryan had with her.”

Although Virgie is still feeling some of the lasting effects of COVID‐19 including lethargy and some heart‐related side effects, she says she’s feeling much better. And she and her family are grateful for the sense of security that came from having the paramedicine program to help them through that time.

“I was so happy we asked for paramedicine,” Amanda said. “Our entire family felt so much better knowing someone would be there in a couple days to re‐check her vitals. It is such a good resource, and I really hope that more families and doctors can use it.”

Community Paramedicine is a new concept in rural health care. It expands the role of the paramedic from the traditional emergency setting. North Central EMS will work with Fisher-Titus to identify patients who have difficulty accessing primary care services.
Paramedics will provide scheduled, in-home care to improve long-term health outcomes of the medically underserved and improve the quality of life of patients with chronic diseases.

Recently, a link has been found between atrial fibrillation (AFib) and obstructive sleep apnea. In a recent study published in JACC: Clinical Electrophysiology, approximately 82% of AFib patients had undiagnosed sleep apnea.

So what is AFib and what is sleep apnea?

Atrial fibrillation, or Afib, affects an estimated 6 million Americans. It is an arrhythmia characterized by a quivering or irregular heartbeat that can lead to stroke and other heart-related complications. Normally, your heart contracts and relaxes to a regular beat. In AFib, the upper chambers of the heart (the atria) beat irregularly (quiver) instead of beating effectively to move blood to the ventricles.

Some people may have no symptoms of AFib but those that do may experience:

• Pain in the chest
• Chest pain
• Dizziness
• Fatigue
• Inability to exercise
• Weakness
• Fast heart rate or palpitations
• Shortness of breath

Obstructive sleep apnea is the intermittent airflow blockage during sleep. Symptoms of sleep apnea can include:

• Excessive daytime sleepiness
• Snoring
• Gasping during sleep
• Insomnia
• Episodes of no breathing, breathing through the mouth, loud breathing, or shortness of breath
• Hyperactivity or irritability
• Bedwetting or excessive urination at night
• Fatigue
• Depression
• Dry mouth
• Headache
• Lack of concentration
• Memory loss
• Sore throat
• Teeth grinding

After diagnosing a patient with atrial fibrillation, a doctor might recommend testing for obstructive sleep apnea, or OSA.

Although atrial fibrillation can have a range of causes — age, heart disease, and hypertension among them — this recent research reveals a strong link between AFib and OSA.

If you think you may have sleep apnea, the Fisher Titus Sleep Center can help. The Sleep Center is located on Executive Dr. in Norwalk and does not require a referral from your primary care physician for a sleep study.

We are flexible and perform sleep studies weekdays or weekends to accommodate the patient’s schedule. A bariatric room is available as well as options to sleep elevated. We have a very experienced sleep staff that are all registered. The sleep center is accredited through ACHC.

To schedule a sleep study, call 419-668-5537 and choose option 1.

About Nichole

Nichole Hance, BS, RRT, RCP is the Manager of Respiratory Services at Fisher-Titus. For more information about the Sleep Center, visit fishertitus.org/sleep-center.

January 28 is Data Privacy Day. The goal of Data Privacy Day is to highlight easy ways to protect your personal information. Take control of your personal information by learning about the types of cyber attacks and how to avoid becoming a victim.

Types of Cyber Attacks

• A Social Engineering Attack uses human interaction to obtain or compromise information about an organization, or its computer systems. Example: Someone claiming to be with a company you are familiar with asking questions to piece together information to infiltrate the network.
• A Phishing Attack uses non-personal interaction, like email or websites, to solicit personal information by posing as a trustworthy or familiar entity. Example: An email requesting account information, often suggesting there is a problem.
• A Vishing Attack leverages voice communication and can be combined with other forms of social engineering enticing a victim to divulge sensitive information. Example: A phone call saying the IRS is looking for you and if you don’t call back, a warrant for your arrest will be issued.
• A Smishing Attack exploits text messages containing links that when clicked may automatically open a browser window, email message, or dial a number. Example: A text message that says, “You’ve been selected to win a Caribbean Cruise! Visit this link to claim your prize!”

Avoid Being a Victim

• Trust your gut when receiving an email, phone call, or text message you aren’t expecting. Be suspicious if they are asking about sensitive information.
• Do not provide personal or financial information unless you are certain of a person’s authority to have it. Never reveal in an email or respond to email solicitations for this information.
• Secured sites can be recognized by starting with “https://”. Check for a Privacy Policy on the site; if there isn’t one, that’s a red flag.
• Pay attention to the URL of a website. Malicious websites may look identical to a legitimate site, but the URL may use a variation in spelling or a different domain.
• If you are unsure whether an email request is legitimate, verify it by contacting the company directly. Do not use contact information provided on a website connected to the request.

What to Do if You Are a Victim

• Report it to the appropriate people.
• Immediately change passwords and do not use compromised passwords in the future.
• Contact your financial institution and close any accounts that may be compromised and watch for unexplainable charges.
• Watch for other signs of identity theft such as calls about accounts you didn’t open, unexpected denials on your credit card, or weird accounts on your credit statement. Missing bills you usually receive can also be a red flag.

Now that the vaccine is rolling out to the public, we know many people have questions as they begin to decide whether to receive the vaccine. Most importantly, the Pfizer and Moderna vaccines have been proven safe and effective in large scale testing trials with minimal side effects and will be an important asset in fighting the spread of COVID-19.

Here are some of the most frequently asked questions about the Pfizer and Moderna COVID-19 vaccines, the only ones currently approved by the Federal Drug Administration (FDA).

Why is a vaccine for COVID-19 important?

The COVID-19 vaccine is an important tool in stopping the mass spread of the coronavirus. Vaccines help boost immune systems by introducing your body to previews of what the real virus looks like, without causing disease. This preview gives your immune system time to design powerful antibodies to fight the real virus if you are ever exposed or infected. If you receive the complete 2 dose  COVID-19 vaccine, and then have an exposure to the coronavirus, your body is ready to fight the virus, stopping the disease. Full protection is achieved 2 weeks after the second dose so it is important to continue to take precautions during and after the vaccine process

How effective are the Pfizer and Moderna vaccines?

In large scale clinical trials using diverse populations, after administration of both doses of the vaccine, effectiveness of each vaccine is approximately 95% across all populations enrolled.

How do the Pfizer and Moderna vaccines work?

The coronavirus is an RNA type of virus. RNA, short for ribonucleic acid, like DNA, plays an essential role within your body for coding, decoding, regulation, and expression of genes. Using RNA technology, scientists were able to map the genetic code sequence of an important part of the coronavirus – the “spike” protein, which is often shown in pictures of the COVID-19 molecule.

This genetic code sequence acts as a set of instructions. These “instructions” are coded into messenger RNA (mRNA) for use within the vaccine. All of your cells have naturally occurring mRNA made from your DNA. The life cycle of mRNA in your cells is only a few days. When the vaccine is injected, the mRNA is taken into cells within your body. It does not enter our DNA. It instructs these cells to make copies of the artificial spike protein as if the cells have been infected by the real coronavirus. Your cells are then able to learn about the spike protein and give the immune system a preview of what the real virus looks like. This preview gives your immune system time to design its own natural antibodies that neutralize the real virus if you are ever infected.

It is important to note mRNA technology isn’t new; it has been used safely in the oncology field since 1989 for significant cancer treatment advances.

Will the vaccine protect against the new strains of COVID-19?

There are new strains of COVID-19, which is not unusual for any virus that causes illness. With COVID-19, what has not changed is the way it causes infection, utilizing the spike protein to infect human cells. The vaccines currently approved by the FDA cause the body to make antibodies that identify the spike protein as something to attack. Since that protein has not significantly changed, vaccines will continue to provide a high level of protection.

Is the mRNA vaccine safe?

Yes. The vaccine has been proven safe through large scale clinical trials. Specifically, the Pfizer trial had 44,000 enrolled in their trial and Moderna had 36,000 participants. Enrollees were diverse in age, race, ethnicity, and gender, and were monitored for over 2 months following the second vaccine dose. There have been some reported cases of allergic reaction in people with a significant history of  anaphylactic type reactions. The efficacy for these trials did not include children or pregnant women, however, and the duration of protection has not yet been established but is anticipated to be a year or more.

As with any vaccine that is developed, it must undergo rigorous testing before approval. That is the reason for standardized clinical trials involving many diverse populations that are closely monitored for adverse events, side effects, as well as effectiveness. These highly regulated trials are carried out by organizations independent of the vaccine companies and require highly detailed reporting to the FDA prior to formal approval. These currently approved vaccines have gone through the same testing as any other vaccine that is FDA approved.

Can I get COVID-19 from the vaccine?

There is no way the mRNA vaccine can cause a COVID-19 infection as it only uses a very small piece of protein from the virus and not the entire virus itself.

What are the side effects of the mRNA vaccine?

Side effects of the Pfizer and Moderna COVID-19 vaccine are very similar to other vaccines you may have received and range from mild to moderate. The most common side effects include injection site redness and tenderness, fatigue, headache, muscle pain, chills, joint pain, and fever. The chance of having a serious reaction was very low (less than 0.5%).

Should I be concerned about potential long-term side effects?

COVID-19 mRNA vaccine studies are ongoing for the next 24-36 months. Historically, however, vaccine studies have shown that 90% of adverse reactions/side effects—both short and long-term—occur within 45 days after the last dose of the vaccine. Both Pfizer and Moderna did not request FDA approval until their phase 3 trial reporting was beyond 2 months after the last doses were administered.

Are there fertility, pregnancy, or breastfeeding concerns with the COVID-19 vaccine?

There is no scientific evidence to suggest that the COVID-19 vaccine could affect fertility. The CDC currently recommends that women do not become pregnant until two months after the second dose of the vaccine and that a breastfeeding mother can decide whether to receive the vaccine. Studies are ongoing related to safety in pregnancy and breastfeeding as well as children.

What specific allergies have been related to a higher chance of allergic reaction to the COVID-19 mRNA vaccine?

The recommendation related to allergy concerns is to not get the vaccine if you have experienced severe allergic reactions in the past related to food, medication, or vaccines. This would apply to people who typically carry an Epi pen for treatment of severe anaphylactic reactions.

Is the COVID-19 vaccine safe for those who are immunocompromised or with autoimmune conditions?

Individuals with autoimmune conditions, on autoimmune medications, or with weakened immune systems should discuss the vaccine with their primary care provider or rheumatologist.

If I had COVID-19 within the last 90 days and I’m fully recovered/showing no symptoms, can I be vaccinated?

Per CDC guidance, anyone that falls into a prioritized group can receive a vaccination even if they already had COVID-19. Anyone currently infected with COVID-19 should wait to get vaccinated until after their illness has resolved and after they have met the criteria to discontinue isolation.

When can I get the vaccine?

We are currently rolling out vaccines as recommended by the Ohio Department of Health in a staged process. This stage 1b is for adults age 80and older. Each week moving forward will include other age groups and those with congenital or early onset medical conditions, and adults working in schools,,. If you fall into one of those populations and would like to receive a vaccine, please fill out a vaccine interest form at fishertitus.org/coronavirus. A Fisher-Titus employee will review your registration information to determine when you will be eligible to receive the vaccine and will call you back to schedule a vaccine appointment.

Once we have completed phase 1B and move to the next phase of vaccine distribution, we will share more information on our social media channels, website, and through local media.

If I get the vaccine, do I still have to wear a mask?

Yes. While experts continue to learn more about the protection that COVID-19 vaccines provide under real-life conditions, it’s important for everyone to continue using all the tools available to us to help stop this pandemic, like covering your mouth and nose with a mask, washing hands often, and staying at least six feet away from others. All these together provide the best protection from getting and spreading COVID-19.

It’s the start of a new year and many of us are probably trying to implement healthy lifestyle changes into our regular routine. However, the cold weather and the ongoing COVID-19 pandemic keeping us at home and inside makes exercise difficult for many people. Here are some exercises you can do at home with little to no equipment.

Upper Body Exercises

Incline or countertop pushups. This exercise targets the main muscles in your chest but doesn’t put the same stress on your elbows and reduces the body weight you are lifting in a traditional pushup. All you need is a stable surface like a wall, table, or countertop. Put your hands on the surface and do your pushups like you would if you were on the floor.

Bicep curls. These exercises will work the bicep muscles at the front of your upper arms as well as the muscles in your lower arms. These can be done with weights or your can use canned food from your cupboards. If you’re looking at getting some free weights, select ones that you can life ten times with good form. If you’re a beginner, five to ten pounds per weight is a good starting point. You’ll use these weights for the next three upper body exercises.

1. Stand tall with your feet hip-width apart and your abdominal muscles engaged.
2. Hold one weight in each hand and relax your arms at your sides with palms facing forward.
3. Bend your arm at the elbow and lift the weights towards your shoulders. Keep your elbows tucked close to your ribs and exhale as you lift.
4. Lower your weights to the starting position. Try doing three sets of 8-10 reps, resting between each set.

Lateral arm raises. This exercise will focus on your deltoid muscles.

1. Stand in the same position as you started your bicep curls in but with your palms toward your body.
2. Raise your arms out on each side a couple inches and hold for a few seconds.
3. Raise your arms more, keeping your arms completely straight, and stopping when your elbow reach shoulder-height and your body forms a “T.” Hold this for a few seconds.
4. Slowly lower your weights (about two times as slow as when you lifted them), breathing out as you lower them.

Bent over rows. This will target the muscles in your upper and middle back.

1. With a weight in each hand, bend forward at a 45-degree angle. Keep your back straight, brace your abdominal muscles, and breathe in.
2. Lift both weights straight up while breathing out. Your arms shouldn’t go higher than your shoulders. Try to keep your wrists from moving too much and don’t squat as you lift.
3. Lower the weights slowly while inhaling.
4. Don’t stand up in between reps.

Overhead press. This exercise works on strength throughout your shoulders.

1. Stand up straight, fee shoulder-width apart, and with a straight back.
2. Hold your weights at your shoulders with your thumbs towards your body and your knuckles facing up.
3. Raise your weights slowly above your head while breathing out and hold above your head.
4. Return your weights to your shoulders while breathing in.

Lower Body Exercises

Body weight squats. Squats strengthen every muscle in your lower body. Stand straight up and bend your knees like you’re sitting in a chair. Stand back up and repeat 8-10 times. Avoid knee pain from squats by keeping the weight on your heels and your knees behind your toes.

Backward lunges holding on to a chair. Lunges help stretch tight hip flexors and work your entire lower body. Place a chair backwards in front of you for this exercise to grab on to and help you maintain balance.

1. Stand up with your legs parallel.
2. Hold on to your chair if needed, bend your right knee, and step your left leg straight back onto the ball of your foot, as far as you are comfortable.
3. Straighten your back leg but don’t lock your knee. Hold the stretch for 30 seconds, breathing deeply.
4. Bring your back leg forward and return to the standing position. Repeat on the opposite side.

Calf raises. These will stretch and strengthen the muscles in you lower legs. Keep your feet shoulder-width apart, slowly raise your heels keeping your knees straight but not locked and pause for one second before lowering your heels back down. Repeat 10-30 times.

Planks. This will work your core muscles. Find a place on the floor that you can extend your full body. Use an exercise mat or a couple folded towels for padding under your hands/arms and feet/knees. Lay on your stomach with your forearms and toes on the floor. Your elbows should be directly under your shoulders. Engage your abdominal muscles and pull your belly button toward your spine. You can be up either on your toes or your knees. Avoid arching your back, letting your hips sag, or tilting your head up. Your torso should be straight and rigid, forming a straight line from your ears to your toes (or to your tailbone if you are doing a modified version on your knees). Hold this position for ten seconds to start and as time goes on, work up to 30, 45, and 60 seconds.

With any new exercise routine, it’s important to start slowly and cautiously to avoid injury. If you are exercising for the first time, you may even want to consult your doctor to discuss what they might recommend for you.

About Jeri

Jeri Inmon, PT is a rehabilitation manger at Fisher-Titus. Fisher-Titus Rehabilitation offers Clinical Personal Training at the Walcher Rehabilitation Center Gym. Sessions are $35 for one hour. Call 419-660-2700 to schedule.

In my experience as a mental health counselor, most people seem to hate the whole idea of “New Year’s Resolutions,” to the point where I do not use that term in therapy. I just focus on “goals” in the coming year. I think the reason that so many people hate making New Year’s Resolutions is that we (I include myself) have broken so many of them over the years that the whole concept triggers feelings of shame and guilt, instead of the hope and motivation that is intended.

I remember being a new therapist and working with a depressed young man. We created a whole written list of things that he could do to help himself feel better. When he came back to our next session, he hadn’t done a single thing on the list. He said that the piece of paper had felt like it weighed about 10 pounds as he left my office, because it was more stuff that he should do, but knew he wouldn’t. It had overwhelmed rather than motivated him.

I have since learned that the best goals are small ones that are more likely to be accomplished. We often start out with a BIG PLAN to “eat healthy” or “get in shape.” By the 3^rd day, we’re back in McDonald’s and didn’t make it to the gym. In fact, I like goals that are tiny, so small that they are not intimidating and are more likely to succeed. I sometimes ask my clients to commit to a goal that is so small that they would be embarrassed to come back to our next session and tell me, “I didn’t do it.”

For example, instead of making a commitment to “get in shape” someone could commit to doing 5 push-ups, or going up/down a few stairs every day, before taking a shower. If someone wants to read more, that might mean reading one paragraph before bedtime. In the case of meditating, it might be taking 3 calming breaths, first thing in the morning.

You make it so simple that you don’t have any reasonable excuse not to do it. Call it a “micro-goal.” So even when you’re busy, or you’re sick, or you’re tired…it’s so tiny that you can still do it. It’s hard to use the “I was too busy” excuse for not doing something that literally takes 1-2 minutes. No one is that busy.

I had to give up lifting weights years ago, due to back problems. About 5 years ago, I committed to doing push-ups every day, before I take a shower. I started with 5, and now I do 20. It may not sound like much, but even small stuff adds up (20 push-ups x 30 days = 600 push-ups per month). Aside from a few lapses, I’ve been able to keep that going for 5+ years.

As an added bonus, when you have micro-goals that you can easily accomplish every day, it gives you a regular sense of success (rather than failure). Even if nothing else got done today…at least I did my push-ups.

About Ken Murray

Ken Murray, Ph.D., LPCC-S provides counseling services to children, adults, and families addressing a wide range of mental health concerns. Ken specializes in providing counseling for children and families and has experience with providing counseling for parent and leading parenting classes. For more information about Fisher-Titus Behavioral Health, visit fishertitus.org/behavioral-health.

Huron County is seeing a significant increase in COVID-19 positive cases. Individually, our caregivers chose a career in healthcare due to a desire to provide care to people in need. Throughout this pandemic, we have prepared to be here for you when you need us. As our intensive care unit and hospital rooms fill with cases of COVID-19—many of which are a result of preventable community spread—we are at risk of not being able to provide the care you expect from us.

Right now at Fisher-Titus, our employees continue to come in every day and give their all to fight COVID-19 in our community. We have expanded our bed availability, including doubling our intensive care unit beds, and identifying overflow areas into other areas of the hospital so we can continue providing exceptional care for our patients. Our staff garb up with N95s, masks, shields, gowns, gloves, and sometimes more for 12 hour shifts in order to protect themselves and care for their patients.

While these caregivers are ready to care for the community and are dedicated to fighting COVID-19, the state of the pandemic right now is taking a toll on them. Hear from them what they are seeing and feeling right now at Fisher-Titus:

Mackenzie, Critical Care Nurse Manager

Right now I’m feeling tired. I’m exhausted. We put in lots of hours and time and support not only for our patients but for our employees. It’s exhausting. It’s been really rough.

In my staff I’m seeing a lot of burnout. I see a lot of frustration. I see that they’re tired, they’re exhausted. Garbing up and down for every patient all the time for 12-hour shifts, they leave with marks on their face, skin irritation, hand irritation…you can tell they’re getting tired.

Back in March and April we anticipated the worst, but we didn’t really see the volumes back then that we’re seeing now. Fast forward a couple months, now we have full units, full ICU, overflow onto med-surg, nurses taking more patients to accommodate caring for the volume of patients. And they’re more critical. We’re seeing more critical patients.

It’s a lot different. It’s now what we prepared for in March when we were ready with the community closed and now everything’s still open so it’s just harder to manage.

Me personally, I would say trying to leave it behind, trying to go home and live a normal life, that’s probably the hardest. Seeing patients that die alone or lonely, that’s difficult.

To the community I would say, think of the people here—employees and patients. Stay home as much as you can. Be mindful about how you felt when this all started. It’s real. It’s not going anywhere. It’s worse now than it was then.

Follow the guidelines that the CDC gives, that the governor gives, that you hear from your community health care providers. Just isolate and protect each other.

Nichole, Respiratory Services Manager

At this point in the pandemic, I’m feeling slightly overwhelmed and stressed. I feel right now that my staff is feeling the pressure from the increase and volume and how sick our patients are. They’re pulling together as a team, they’re working very hard; however, I also do see the fear they have. Everyone is a mother, a father, a sister, a brother, you know we all have family and they’re starting to feel that fear.

I know it’s hard with the holiday season approaching, everyone wants to get together with their friends and their family, but I feel that we’ve all put our guard down and it’s time to put that guard back up.

Right now, here at Fisher-Titus, we are seeing an increase in numbers. Therefore, we need to pull together as a community and really slow the spread to protect ourselves and our community and then to hopefully have a light at the end of the tunnel once this is all passed.

Brandi, Charge Nurse, Emergency Department

I feel a little bit more worried every day I come to work. A lot of the patients we’ve been seeing lately have been positive.

It’s hard to care for these patients and then go home to your kids and hope that you’re not taking anything home to them. It is a scary time.

This is getting bad again and you need to take this seriously. It’s your grandparents it’s your parents, it’s your aunts and uncles and you don’t want to put them at risk. A lot of people don’t take that seriously and I think it’s because they don’t see it on a firsthand basis like we do.

Wear your mask, wash your hands, limit your outings. Don’t get together for Thanksgiving. We have all these holidays coming up and we want to spend it with our families but if we spend this one with them, it may be that we don’t get to spend the next one with them.

Liana, Med-Surg Nurse, COVID Unit

I’m feeling nervous for what’s to come and exhausted from what has come.

There’s extreme burnout among the nurses taking care of the COVID patients. You’re talking about gowning up when you go in, gowning up when you come out. You’re talking about family members calling all day long for updates and we don’t blame them. There’s just an increase in burnout.

We know we didn’t sign up for this, but we would literally pour our heart and soul into our jobs to help people. That’s what drives us. That’s what makes our hearts beat is helping other people that’s who we are.

This is serious. Don’t think that you can’t get it. Don’t think that your family can’t get it. Don’t think that you can’t pick it up the places that you’re going because you can. This is real and it is going on.

Wear your mask. It’s respectful of you as a person to wear a mask in the community. I have had several patients who have had it who have not had symptoms that end up having COVID. If they don’t wear a mask, look at all the people that they’ve given it to. No, they didn’t know they had it, but they gave it to people that do know they have it now.

If the patient’s not critical then fine, and there’s a lot that aren’t critical. But, you’re talking about a very fine line that you ride with a COVID patient. They can go past that line at any point. And that’s always in your mind. Can we handle it? Yeah. But does it get to you after three weeks of on-edge taking care of patients that ride that thin line? Yes. You just want a break. You want to get out of that twilight zone for a little bit.

Wear your mask or, better yet, stay home.”

Help us fight COVID-19 right here in our own community.

We are asking you all to join our employees in the fight against COVID-19. We need your help.

• Wear your mask
• Distance yourself from those outside your household
• Practice proper hand hygiene

We need everyone to work together to slow the spread right her in our own community.

For more information, visit fishertitus.org/coronavirus.

We understand how difficult it can be to have a loved one in a long-term care facility during the COVID-19 pandemic. As we work hard to protect residents and staff from the spread of COVID-19 by following Ohio Department of Health, Centers for Disease Control and Prevention, and Centers for Medicare & Medicaid Services guidelines, families may not be able to visit and interact with their loved ones in the same ways they’re used to.

However, your loved one’s caregivers are still committed to helping residents stay connected with their families. Here are some ideas on how to keep in touch and how we’re supporting communication between our residents and their families at The Carriage House and The Norwalk Memorial Home.

Take advantage of the available technology.

We are teaching and assisting residents to use video chat applications and will help them read emails or texts on personal devices if needed. Reach out via video, chat, email, text, and phone calls. If you need help coordinating these things, we are happy to assist any way we can.

Send cards and letters.

Share messages of support and updates on family members to your loved ones. We will make sure residents have the necessary supplies like paper, pens, envelopes, and postage so they can reply. If needed, we can also write dictated replies.

Send recorded video messages via email or text message.

If your schedule or other challenges make it difficult to arrange a live video chat, you can record a message and send it to your loved one via email or text message. We will share the messages with them and help them record replies.

Window and outdoor visitation and “parades.”

We can work with families to schedule window visits, outdoor visitation, and car parades when weather permits. We will make every effort to ensure residents can safely participate as long as these activities are scheduled in advance.

Visuals to show you care.

We will help you find space outside for ribbons, flowers, posters, and banners that your loved one can see.

Assemble care packages.

Include pictures, cards, drawings, snacks, and entertainment items your loved one would enjoy (such as books, magazines, and puzzles). Care packages for Norwalk Memorial Home residents can be dropped off at the Fisher-Titus Patient Pavilion entrance and Carriage House residents’ packages can be dropped off at the front door.

Dedications on the in-house intercom system.

We can dedicate songs or share messages through the intercom before broadcasting a movie or playing music. If your loved one has a favorite song, poem, movie, or television show, please let us know.

Send flowers from the Fisher-Titus Gift Shop.

Petal Pushers by Mandy stocks the gift shop daily with beautiful fresh flower arrangements. To order an arrangement for delivery to a Norwalk Memorial Home or Carriage House resident, call the gift shop at 419-660-2800.

These are just a few ideas. We encourage families to get creative in finding ways to connect with their loved ones safely during the pandemic. If you think of any additional ideas or creative ways we can work together to support our residents, please let us know by contacting Stephanie Whitt at 419-668-4228 or John Tucker at 419-668-5162.

About Stephanie

Stephanie Whitt, CTRS, CDP is the Senior Care Services Manager at Fisher-Titus. She has been with Fisher-Titus since 2008. For more information about Senior Services at Fisher-Titus, visit fishertitus.org/senior-health-services for more information.

There is a lot that I value and enjoy about having grown up in, been shaped by and living in this community. One of my favorite things about our community and its people is the generosity and the kindness.

While on a weekend trip to Detroit in about 1987, our family bumped into the Hancock family at the Henry Ford Museum. The Hancocks had moved away from Norwalk several years earlier. Mr. Hancock said something like, “I have lived on the East Coast, the West Coast and a number of cities in between, and I have never seen anything like Norwalk, Ohio. You truly care about your neighbors. When someone gets sick or when someone is down on their luck, you come together, and you help them out. When something needs to get done, you pull together, give your time, work hard and make it happen.”

A contractor for Fisher-Titus shared a similar observation with me at the Fisher-Titus Foundation’s 2020 Golf Outing. “If I had to explain Fisher-Titus’ brand or culture, I would say it is kindness.” I knew exactly what she meant and was proud that this woman, who spends lots of time in lots of health systems in lots of communities across the Midwest, had this experience with my colleagues and neighbors.

I have been thinking about our generosity, resilience and unity a lot this year. Despite the pandemic, the economic challenges, the hardships, the isolation, and despite a divisive year for our country, when the chips were down we sacrificed, came together, worked hard and accomplished some really big things. We loved our neighbors.

Our contractors, our health system, our business community and two school systems came together, donated money, gave thousands of “man hours” and equipment hours, and built a new home for our football and track athletes, school communities and residents.

When the pandemic hit and PPE was in short supply, our businesses, schools and residents stepped up and PPE came pouring in for healthcare workers and first responders. There were teachers and students fabricating masks with 3D printers. Volunteers started sewing cloth masks. Contractors dropped off cases of N95s. People found a way to support their favorite local restaurants and support frontline healthcare workers with a meal.

Many of our neighbors went to work to take care of us — stocking our groceries, delivering our mail, fixing our cars, treating the sick, putting out fires, babysitting our children — at great risk to themselves. Other neighbors stayed home to keep us safe, at great financial cost and emotional burden.

And through all of this, our community continued to support its churches, food banks, schools, non-profits and hospital to meet the needs of our neighbors.

Philanthropy is the desire to promote the welfare of others, often expressed by generously donating money to good causes. Sunday, Nov. 15 is National Philanthropy Day, a day to acknowledge and thank the philanthropists who have given us our hospitals, libraries, parks, schools, churches, community centers, museums, health research and disease cures, and the arts. The lives we enjoy today and the opportunities we have had owe so much to the generosity and stewardship of the people who came before us.

We are all called to leave our little corner of the world better than we found it — in big and little ways, using our talents and our treasure. We have this beautiful community, full of amenities usually reserved for bigger and wealthier cities, because of the sacrifice and stewardship of John Ernsthausen, Warren C. Whitney, William and Lura (Titus) Fisher, and hundreds of philanthropists who often humbly and silently support needs in our community.

This year, I will observe the day with a quiet thank you for the comforts and opportunities gifted to me. I will be grateful for the outpouring of generosity, sacrifice and kindness that have carried me and my neighbors through some dark days this year. And I will write a couple checks to organizations that will leave our community better for my kids, my grandchild and those who will come after me.

To learn more about the work of the Fisher-Titus Foundation, visit www.fishertitus.org/foundation.

November is National Family Caregiver Month. Over 53 million Americans are caregivers to family, friends, and neighbors and that number is only expected to grow as the senior population in the country increases.

Under normal circumstances, being a loved one’s primary caregiver is stressful. The COVID-19 pandemic has added to this stress as you continue caring for your loved one while trying to keep yourself and them safe from the spread of COVID-19. Feelings of stress, worry, and isolation have impacted everyone during the pandemic but may be magnified for those who serve as a primary caregiver for a loved one.

As you care for others, it’s important to take care of yourself as well both physically and mentally. There’s a saying that goes “you can’t pour from an empty glass,” meaning that if you aren’t taking care of yourself, you won’t be able to give your best to another person. Here are some tips for taking care of yourself as you take care of someone else.

Make sure your physical needs are met.

It’s easy for us to get caught up in our never-ending to-do lists and forget to meet our basic physical needs. This is especially true for caregivers. Make sure you are getting enough sleep, eating nutritious meals three times a day, drinking enough water, and staying active. If you aren’t caring for these needs, you will be tired mentally and physically and caregiving will take an even greater toll on your health.

Acknowledge your feelings about caregiving.

When you’re caring for another person, a lot of the focus—both with them and when talking with others—can be on them. You may be asked what they need or how they feel and those may be the first thoughts on your mind as well. This might make you feel like part of your job as a caregiver is to sacrifice your own happiness to take care of them and you may feel as if you are being selfish if you think of your own feelings. However, you are still a person with feelings and it’s OK to feel a lot of emotions about being a caregiver. You might feel exhausted, stressed, resentful, isolated and alone, or even hopeless. Try not to ignore them as they won’t go away, they’ll just build up until they eventually come out. Find outlets for expressing these feelings like talking to trusted friends, journaling, support groups, or counseling.

Manage your expectations of yourself.

Remember that you are only one person and there is only so much you can do on your own. It’s easy to put pressure on yourself to meet all their needs since they’re unable to by themselves but even if you dedicated all your time and energy to caregiving, you still probably couldn’t do it all on your own. Be realistic of what you’re able to accomplish on your own.

Ask for help.

Find ways to share the caregiving load whenever possible. This could be having a family member take over for a couple hours so you can nap or do something you enjoy. There may be local organizations where you can ask for volunteers to help you out or more formal services like respite care. As you look into these options, involve the person you care for. Ask them what they need and want. There may be things that you’ve been taking care of that they could manage for themselves. Depending on your relationship, you can also have a conversation about how you are feeling so they understand why you are looking for other outlets to help you care for them.

Set boundaries.

You may have to have difficult conversations about what you are willing and able to do as a caregiver. It could be that other family is capable of helping but have chosen to leave the burden on you. Or, it could be that the person you’re caring for has unreasonable expectations of you. Before you approach these conversations, it can help to write out your thoughts or talk them through with a trusted friend. Decide what boundaries you need to set for your own wellbeing and stick to them. It’s OK to be firm. People often struggle with new boundaries but in time they will adjust. You’ll have a better experience as a caregiver if you communicate clearly with everyone involved.

John Tucker is the Director of Senior Services at Fisher-Titus. Fisher-Titus offers a continuum of care for seniors including Home Health, Assisted Living, and Skilled Nursing. For more information, visit fishertitus.org/senior-health-services

Day-in and day-out hospital caregivers, emergency management services, paramedics and your local physicians are on the front lines caring for patients and the community as COVID-19 devastates our lives presenting challenges that we’ve never experienced before.

Fisher-Titus – including the medical center, medical care group, and North Central EMS – have continually reviewed and revised the policies and procedures put into place to meet these challenges to help keep our staff, patients, and guests safe. While we understand things like stricter visitor guidelines can be frustrating, please know we are doing this for the health and wellness of our community.

This pandemic is far from over and the last seven months we have seen every aspect of our lives altered from shopping at the grocery store to our daily interactions with family and friends. Recent information released from the state shows Ohio’s current positivity rate is 4.1 percent as compared to 2.7 percent on September 23 and 24. A total of 51 counties are considered high incidence and/or Alert Level 3 on Ohio’s Public Health Advisory System. Even more devastating, more than 5,000 Ohioans have died from COVID-19 and over 16,000 have been hospitalized.

Additionally, Ohio COVID-19 hospitalizations are trending upward in recent weeks, particularly in rural areas and in our community. Hospital beds, ventilators, ICU beds are essential to providing care for COVID-19 patients. We need all Ohioans to take preventative action to stop this spread of COVID-19 and prevent surges to our health care system. Today there are communities across the country with hospitals overwhelmed with patients. Just a few months ago, three states (Florida, Texas and California) had many communities with hospitals overwhelmed (VOX Media).

Even in our own county we are seeing an increase in positive cases as we further approach into what is traditionally cold and flu season as reported on the Ohio Department of Health’s COVID-19 dashboard. According to the dashboard, the most number of cases for Huron County are from those in the 20-29 age range while hospitalizations and deaths are adversely effecting those aged 70-79.

The health care services in our community are strong but when faced with a pandemic such as COVID-19 and the rapid spread it brings, our health care services will be overwhelmed if preventative measures aren’t taken by you. We are approaching a time of year where colder weather will increase more indoor activity and interaction, not the best situation for preventing the spread of this virus. We are also coming upon a time of year where we will gather for holiday festivities, community celebrations, sporting events and family reunions. We are all seeing the impact of “COVID fatigue” and it’s imperative we don’t fray and we must stay the course.

The actions we need everyone to take are important, they matter, and they will ensure our businesses stay open, our economy keeps going and we don’t have our health care system disrupted. By taking preventative measures, wearing a mask, social distancing, and hand washing, you are minimizing your chances of getting infected or spreading the disease. First and foremost, masks protect others – especially the vulnerable. While the risk of spreading COVID-19 is lower when at least one individual is wearing a mask, the probability is lowest (70%+ less likely) when both (or all) parties are wearing masks while practicing physical distancing.

We appreciate all those doing their part to keep themselves and others safe as we navigate this evolving virus. Patients with questions may contact their doctor to discuss their concerns to learn how best to be preventive so we can quickly end this pandemic.

Like just about everything else this year, Halloween 2020 is bound to look a little different. But that doesn’t mean you can’t have fun! As you make your Halloween plans, keep in mind that COVID-19 is still very much around and use these tips based on Ohio Department of Health and Centers for Disease Control guidance to plan a safe and fun holiday.

1. Limit activities that put you in close contact with others outside your household.

Unfortunately, that means that you should avoid hayrides and haunted houses this year. Exercise caution when deciding to participate in trick-or-treat or other events. Try to choose events or attractions that are mainly outdoors and/or allow for physical distancing.

2. Avoid large in-person Halloween parties.

Should you choose to hold a smaller party, limit attendance to 10 people or less. You should also hold the party in an outdoor area that allows for physical distancing. Avoid activities like bobbing for apples that may promote the spread of COVID-19.

3. Always wear a mask.

No, not the spooky kind this year! Whenever you are around those outside your household you should wear a cloth mask or surgical mask to avoid spreading COVID-19. You can get creative and find face coverings that match your costume or are Halloween themed. Costume masks should not substitute a cloth mask and should not be worn over a cloth mask as it can make breathing more difficult. Children under two should not wear a mask.

4. Practice good hand hygiene.

Wash your hands with soap and water when you can. You should also carry hand sanitizer and use it often especially after coming into contact with high-touch surfaces and before and after eating.

5. Limit the number of houses you visit for trick-or-treat.

Pick a few houses to stop at rather than visiting dozens. Remind your children to maintain six “spooky feet” apart when getting their treats and when walking from house to house. If you have small children, it may be best if you hold them bag for them and retrieve their candy for them. Try to refrain from having children grab their own treats from a common bowl or container or be sure to sanitize after.

6. Put collected candy aside for 48-72 hours before letting them go through their treats.

It is believed that the virus cannot live longer than 72 hours on surfaces. Once the 72 hours have passed they can then enjoy the treats they collected and you have the comfort of knowing they are less likely to come in contact with COVID-19.

7. Have treats ready for them when you get home from trick-or-treat.

Pick up your own bag of candy or other treats so your children have something safe ready for them to enjoy when you get home. Trick-or-treating leads to a monstrous appetite!

8. Sanitize candy wrappers before eating.

You can choose to use sanitizing wipes to disinfect the outside of the candy wrappers when you arrive home if you do not let it sit out for 48-72 hours untouched. Remember to never wipe unpackaged food.

9. Avoid handmade items.

Only allow children to eat factory-wrapped treats and do not accept homemade treats made by strangers.

10. Consider planning alternate types of events that allow for physical distancing.

Think of ways you can adapt your Halloween traditions to better allow for physical distancing. Some ideas include:

• Drive through trick-or-treat. Children can wear costumes and face coverings and stay in the car while individuals spaced six feet or more apart pass out candy
• Drive by costume or car-decorating contests
• Leaving pre-packaged treats or friends and neighbors
• Decorate your house or host a neighborhood house decoration contest
• Hide treats for kids in your family and have a Halloween scavenger hunt
• Hold video conference costume parties or pumpkin decorating
• Carving or decorating pumpkins with members of your household or outside at a safe distance with neighbors and friends
• Organize a Halloween scavenger hunt where children are given lists of Halloween-themed things to look for while they walk outdoors from house to house admiring Halloween decorations at a distance

11. Consider your risk and the risk of your family members as well as local COVID-19 data.

If you or someone you are in frequent contact with is at greater risk of complications if infected with COVID-19, take extra precautions. These include individuals with certain health conditions, women who are pregnant, and older adults. If you are unsure of your risk and what precautions you should be taking, contact your doctor. You should also keep in mind what color level the county is at as that will give you a sense of how much COVID-19 is spreading in our community.

As always, we wish you and your family a fun, safe, and Spooktacular Halloween 2020!

About the Authors

Dr. Aml Kelada, Dr. Elizabeth Olds, and Kathryn Falter, CPNP are all providers at Fisher-Titus Pediatrics in Norwalk. Fisher-Titus Pediatrics has same-day and next-day appointment availability and virtual visits. Existing patients can schedule online by visiting fishertitus.org/schedule.

September is National Suicide Prevention Month, an annual month-long campaign to inform and increase awareness around suicide prevention and the warning signs of suicide.

According to the Ohio Suicide Prevention Foundation, 1,836 Ohioans die by suicide in an average year, and nearly 12% of those are young people. Those numbers are bad enough, but 2020 hasn’t exactly been an “average” year, and it’s not over yet.

On top of the usual life stressors that can overwhelm people, we are dealing with unprecedented events in this country: COVID-19, financial uncertainty, and social unrest. As a counselor, I have seen people becoming more and more stressed as this year has unfolded. This makes the subject of suicide prevention even more pertinent in these times.

What are Suicide Risk Factors?

Suicide risk factors are characteristics or conditions that increase the chance that a person may try to take their own life.

One risk factor is a person’s health. This can include mental health; severe, chronic medical conditions; and chronic pain issues.

Another risk factor is a person’s environment. This includes an individual’s stress levels related to personal loss, relationship problems, financial struggles, traumatic events, or other life changing events. Another environmental factor is a person’s access to the lethal means of suicide, including firearms and drugs.

Historical risk factors include previous suicide attempts, family history of suicide, and childhood abuse, neglect, or trauma.

Warning Signs of Suicide

Suicide warning signs often precede actual attempts. Most people who take their own lives exhibit one or more warning signs, either through what they say, or what they do.

If a person talks about feeling hopeless, having no reason to live, being a burden to others, or feeling trapped, they may be contemplating suicide.

Behaviors that may signal risk include increased use of alcohol or drugs, researching suicide methods, withdrawing from activities, isolating from family and friends, sleeping too much or too little, visiting or calling people to say “goodbye”, and giving away prized possessions.

Ironically, some people who have decided to end their lives actually seem to “improve”, primarily because they think they have found a solution to their problems.

If you or someone you know is exhibiting any of these signs, you can call the Crisis Hotline at 800-826-1306. There is also a Crisis Text Line you can reach out to by simply texting “4hope” to 741741.

A way to learn more about suicide prevention is through programs such as Question, Persuade, Refer (QPR). This training teaches people to:

Question….a person about suicide;

Persuade….the person to get help; and

Refer……….the person to the appropriate resource.

If you are interested in learning more about this program, the Huron County Board of Mental Health & Addiction Services is offering virtual QPR trainings throughout the month of September. More information on dates and times may be found on the MHAS Board website (http://huroncountymhas.org) or you can call them at: 419-681-6268.

About Ken Murray

Ken Murray, Ph.D., LPCC-S provides counseling services to children, adults, and families addressing a wide range of mental health concerns. Ken specializes in providing counseling for children and families and has experience with providing counseling for parent and leading parenting classes. For more information about Fisher-Titus Behavioral Health, visit fishertitus.org/behavioral-health.

Over the past few years, Fisher-Titus has hosted several sessions of Couch to 5K. Couch to 5K is a free nine-week program that helps participants work their way up to running, jogging, or walking their first 5K. Through this program, there have been many local success stories where participants were able to jumpstart a new fitness routine with Couch to 5K.

Erica Bowman of Sandusky completed her first Couch to 5K program in the fall of 2017 after learning about it on the radio.

“The program was fun and challenging,” Erica said of her experience that first time. “I have exercise induced asthma and training myself to breathe correctly while running took time. The training program helped with the timing of runs and walks so I could concentrate on my breathing and endurance.”

Prior to Couch to 5K, Erica was not a runner.

“I fell in love with running through the program,” she said. “I also made lifelong friends with whom I still get together three years later to walk/run the trails and complete races. I am even godmother to the son of one of my Couch to 5K friends.”

Since that first program, Erica estimates she has completed more than 50 5K races both virtual and local, six 10K races, and a 15K.

Erica says Couch to 5K drove her to aim higher and create more challenging goals for herself.

“I have run a 10K and I’m training to complete my first half marathon this summer.” Erica said. “My ultimate goal is to run a full marathon at Disney World for my 40th birthday in two years.”

Norwalk resident Cyndy Kenne completed Couch to 5K for the first time in spring 2017. According to Cyndy, at that time her health was not in the best place and she struggled to walk up a flight of stairs. But, she was able to complete the program and it helped her kickstart a new, healthier lifestyle.

Since completing her first program, Cyndy estimates she’s participated in Couch to 5K seven times.

“Couch to 5K has impacted my life in so many ways!” said Cyndy. “I have made new friends, lost weight, increased my confidence, met new people at races, and have gotten to travel to new places to race.”

In 2019, Cyndy completed 20 5K races and one 10K race. On April 1st of 2020, she also completed the Winter Warrior challenge where she walked 250 miles over the course of four months.

Cyndy wants to let people know that you don’t have to be an athlete to participate in Couch to 5K and start a new, healthy routine.

“I’m not a ‘jock’ who can lose a little weight and run a marathon,” she says. “I have a 75% obstruction in my throat that makes it difficult to breathe, I’m still not skinny but, I’m healthier than some people who are.”

She invites everyone to try the program.

“If I can do this, you can,” Cyndy said. “If you think you can’t, meet me on the trail and we can do it together!”

For more information on the upcoming fall session of Couch to 5K, click here.

In October of 2018, Fisher-Titus partnered with MetroHealth in Cleveland to provide a higher level of trauma care close to home for the community.

Since then, care has been provided for countless trauma patients at Fisher-Titus, a Level III Trauma Center since 2009. The partnership with MetroHealth enables us to increase our knowledge base, expand our expertise, and increase the level of care we provide to our patients who experience a traumatic injury.

One of these patients is Monroeville resident Chad Stang.

What started as a routine softball tournament on October 5, 2019 turned into a series of events Chad Stang will likely not soon forget.

While sliding to catch a ball, Chad collided with another player whose shoulder hit his stomach. Despite the incident, Chad finished that game and started the next game as a designated hitter.

While running to first on a hit, Chad noticed some lightheadedness. Knowing that one of his friends in the stands was an emergency nurse, he went to talk to her.

“I was telling her I almost passed out and ended up passing out in front of her,” Chad explained.

Still, he stayed for the remainder of the tournament. As time went on, Chad began having muscle spasms starting in his shoulder and moving down his right side. When he got home, he tried to control the spasms by laying down with a heating pad and an ice pack, but they persisted. At that point he knew he had to seek help at the Fisher‐Titus Emergency Department.

By the time he arrived, Chad had enough discomfort that he was not able to lay flat without feeling pain.

“It was pretty miserable to lay down. I felt like I didn’t have any abs,” said Chad.

Chad was given medication and had some tests and it wasn’t long before he realized this may not be the routine injury he initially thought.

“While we were sitting there, we heard that my room was upgraded to trauma level 2 and we knew that wasn’t a good thing,” he said.

The doctor came to talk to Chad about his scans. The tests showed that he had a hematoma on his abdomen as well as blood on his liver and spleen and trauma to his colon. Because of his injuries, he was admitted for observation.

Three days later on October 8, Chad was having a particularly difficult day.

“I felt bad all day,” Chad remembered. “The TV was never on, my phone stayed on the stand.”

That evening, the STNA caring for Chad began checking on his heart. His heart rate was high and the care team began taking steps to stabilize his heart. Once stabilized Chad was moved to the ICU. He wasn’t there long before Fisher‐Titus/MetroHealth Trauma Surgeon, Dr. Esther Tseng came to talk to him. She told him that his kidneys were failing, and he would need surgery as soon as possible.

About an hour later, Chad was wheeled into surgery.

Five hours later Chad woke up from surgery.

Chad remained at Fisher‐Titus for the next ten days beginning his road to recovery.

Not having food since the day of his injury, it was a total of 10 days before he was able to eat solid food again. Over the course of his time in the hospital, Chad lost approximately 23 pounds.

“I worked out and played softball. To go from that to not being able to walk very far without my oxygen dropping and the nurses telling me I had to stop because they were afraid I was going to pass out was pretty crazy,” he said.

After 13 days, Chad was able to go home but the recovery process was not much easier. He had trouble lying on a flat bed and getting comfortable while sleeping. Chad was off work from his job as District Manager for Huron County Soil and Water Conservation for six weeks and it took that long for his wound to fully heal. It was three months post‐surgery before Chad could sit up from laying without using his arms to lift himself.

“It was a long process,” Chad recalled. “Thirteen days in a hospital is pretty crazy, but I definitely had great care.”

During this time, Chad also received care at home from Fisher‐Titus Home Health and was having regular checkups with the MetroHealth Trauma team, mostly here in Norwalk.

“Dr. Tseng and the rest of the Fisher‐Titus/MetroHealth trauma team are all absolutely fantastic. It’s a huge, huge pick‐up by Fisher‐Titus to have them in‐house as trauma surgeons. They’re all awesome people,” said Chad.

Trauma Program Manager for the Fisher‐Titus/ MetroHealth partnership Andrea Wetherill also expressed her gratitude for the MetroHealth trauma team.

“As a long‐standing emergency nurse at Fisher‐Titus and a resident of the community, I personally appreciate the onboarding of MetroHealth to support our trauma services,” Andrea said. “Taking care of trauma locally is not new to our emergency department; however, since the partnership began, we have been able to keep trauma care close to home. We do not want to see you hurt, but should an accident occur, we are here 24/7 to care for you!”

Previously, many patients were transferred to higher level trauma centers due to the complexity of their injuries. The same trauma surgeons that care for patients at MetroHealth main campus in Cleveland, care for the patients locally at Fisher‐Titus so these more complex cases can be treated close to home.

MetroHealth is committed to maintaining outstanding local care to Norwalk and the surrounding communities.

“They bring years of knowledge, experience, and best care practices to our community not only for trauma, but also for acute care surgical needs,” Andrea added. “The partnership has led to so many successful recoveries, many of which fully recuperated by strictly undergoing all acute and rehabilitation trauma services at Fisher‐Titus,”

Finally, after four months, Chad was able to start working out again and he began preparing for his next planned surgery with Dr. Tseng.

That surgery took place at MetroHealth in Cleveland with Dr. Tseng on March 3, 2020.

“It’s crazy how different the two surgeries were. I was worried because of how long it took to bounce back last time,” he said.

This time, Chad was in the hospital for seven days and was able to resume a workout routine just five weeks later. He returned to work after only 13 days post‐surgery to his job that requires frequent walking and site visits.

“Since then it’s been great. I’ve had no more issues and everything seems to be getting back to normal,” he said.

He’s slowly regaining his strength. After his first surgery, he said it took five months to gain eight pounds. This time he’s gained six pounds in two months. While he’s not yet back to the level of activity he was pre‐injury, Chad looks forward to getting back to lifting weights and playing softball.

“We are excited that Chad is in his final steps of recovery,” Andrea shared. “His resiliency makes him a trauma warrior!”

For more information on the Fisher‐Titus/MetroHealth trauma program, visit fishertitus.org/trauma.

We are fortunate to be close to a great source of summer fun—Lake Erie. Since there are still a few warm weeks left of summer, you may be looking to head to the lake before temperatures cool down and the kids head back to school. Before you head out, make sure you are prepared to enjoy the beach safely.

Come Prepared

Before you leave, make sure you check these items off your list.

• Proper attire. Wear light colored clothing that covers as much skin as possible to prevent sun damage and make sure you have Coast Guard approved life jackets for all children in your family and anyone who may not be a strong swimmer.
• Bring the sunscreen. August sun can be strong especially during peak hours. Be sure to pack broad-spectrum, waterproof sunscreen with at least 30 SPF. Reapply every two hours and always after swimming, sweating, or towel drying.
• Pack enough food and water. If you are planning on spending a few hours at the beach, you want to make sure you have food and water to stay hydrated. If it’s hot and you’re doing a lot of physical activity, you will expend energy more quickly and that can lead to dehydration.
• Bring your phone. Make sure your phone is charged and handy. If something goes wrong, you want to have it at the ready so you can call for help, if needed.
• Know what to do in an emergency. You should be able to recognize the signs of someone who is in trouble in the water so that you know how to react in an emergency. It’s also a good idea for a few people in your family to know CPR so that it can be administered while waiting for EMS.

Know your abilities

One of the most important things in any type of swimming situation is knowing your own limitations and the limitations of those in your group. These can include your level of physical fitness, any medical conditions, and your swimming ability.

It’s important to know these five basic skills and how to use them in every type of water environment.

• Enter water that’s over your head and return to the surface
• Float or tread water for at least one minute
• Flip over and turn around in the water
• Swim at least 25 yards
• Exit the water

Watch for hazards

There are many hazards at Lake Erie beaches that can interfere with your swimming and increase your risk of injury.

• Pay attention to posted warnings. This can include water quality information to prevent you from getting sick, warnings about high waves and/or rip currents, and postings about whether or not there is a lifeguard on duty.
• Be aware of thunder and lightning. If a storm comes, leave the water immediately and find shelter indoors and stay there for at least 30 minutes after the last thunder clap. If you are outside, avoid open areas, tall, isolated trees, and metal objects.
• Know the shoreline. Every beach is different. Familiarize yourself with the place you are swimming and avoid things like drop-offs and rip currents.
• Be aware of fast-moving currents, waves, and rapids. In shallow water they can knock you down and make it difficult to get back up. Lake Erie is prone to high waves and strong currents and it’s important to never swim on rough days. Check for beach advisories before heading out.
• Watch for underwater hazards. Rocks and debris, vegetation and fish, or drop-offs that change the water depth unexpectedly can be swimming hazards.
• Be mindful of other people’s activities. At beaches, there are large groups of people sharing the water and it can be easy to run into someone else and get injured.
• Prepare for unexpected changes. Temperatures can drop quickly and waves can appear even on a calm day.

Slow the spread

While the risk of contracting COVID-19 while visiting a beach is low, there is still a chance if precautions are not taken.

• Observe physical distancing guidelines. You should maintain six feet of distance or more between yourself and others who live outside your household.
• Bring a mask. It’s good to have one on hand if there are concessions, rentals, or other crowded areas where you may be interacting with other people. Make sure you store it in a dry place as wet masks can make it difficult to breathe.
• Stay home if you are sick. If you or someone in your family isn’t feeling well, it’s best to reschedule your beach day for another time.

About Katie Howell

Katie Howell, APRN, CNP is a Nurse Practitioner with Fisher-Titus Convenient Care in Norwalk. Fisher-Titus Convenient Care treats a variety of acute non-emergency illnesses and minor injuries with walk-in appointments with evening and weekend hours. For more information, visit fishertitus.org/convenient-care.

There’s still a little over a month left in summer before kids return to schoolwork and the weather begins to cool down. While this summer has probably looked different than what you may be accustomed to, a family picnic is a great summer activity that can be enjoyed while keeping in mind physical distancing practices.

As cases of COVID-19 continue to rise in our county, we want to make sure the community knows that they can get testing close to home at Fisher-Titus.

Where should I start if I want to get tested for COVID-19?

A physician’s order is required for any COVID-19 testing. Please contact your primary care provider to determine the type of COVID-19 test you may need. Different tests are needed if you have been exhibiting flu like symptoms versus an antibody test to determine if you may have previously been infected with COVID-19. If you are asymptomatic but have had a known exposure, there is a value in a discussion with your primary care provider to understand if testing is right for you.

How can I get a doctor’s order for COVID-19 testing if I do not have a primary care physician?

If you do not have a primary care physician, Fisher-Titus primary care physicians are accepting new patients, and many have same-day and next-day availability. You can schedule an appointment by calling 419-660-2900.

Virtual Visits are also available through the Amwell app using the service key “FISHERTITUS.” You can request an appointment anytime, anywhere and discuss an order for COVID-19 testing. Visit fishertitus.org/virtualvisits for more information.

If you are unable to establish a visit with a primary care provider, you can also visit Fisher-Titus Convenient Care or the Emergency Department if your condition requires immediate care.

How much does a COVID-19 test cost?

The cost of a COVID-19 test varies depending on insurance coverage. You can check with your insurance company for the cost.

How long does it take to get the results?

Result times can vary from three hours to seven days. This can be affected by the guidelines put out by the state lab for who receives priority testing. We are working very closely with our partner labs to process tests as quickly as possible. Delays in testing can also be caused by limits in the amount of overall national testing supplies.

How will I get my results?

If your condition requires hospitalization, your results will be provided directly to you by your health care provider at Fisher-Titus Medical Center. If you are tested but remain an outpatient, you can obtain your results from your primary care physician who ordered the test, or if you are an established patient, through the myFisherTitus patient portal. Our laboratory is unable to give out results over the phone.

Many people have been grieving their “pre-COVID” lives where we were free to congregate, shop, eat, and leave the house whenever we pleased. We have to realize that we are going through a grieving process for those lives and everyone will be in their own stages of grief at different times: shock and denial, pain and guilt, anger, bargaining, depression, acceptance, and hope.

It was reported by all Huron County law enforcement agencies, that between January 1, 2020 and April 14,2020, there was 26% increase in rates for suicidal individuals/mental health reports compared to the same period in 2019. While we were “flattening the curve” of the pandemic, mental health symptoms and trauma responses were increasing.

Many symptoms of anxiety and depression have increased in frequency and severity due to isolation, restricted access to distractions outside of the home, uncertainty, feeling choices or freedoms have been taken, basic living needs not being met, and health related stressors.

Take the time to think about what you need the most and what you feel you are grieving the loss of during this process. Then, as the “stay at home” orders are lifted and people go back to work, children are able to go back to their childcare providers and school, look at what you can start to implement back into your routine. Create genuine personal connections, get outside and be physical, and reconnect with your community. Visit your local boutique shops, swap out your library books, schedule those hair appointments, eat at your favorite hometown restaurants, and take time to find new local services that you can support as they help you.

Be aware that some symptoms like panic and heightened sensitivity to social settings could still linger. New worries may come to mind and symptoms may even heighten as you start engaging in this “new normal”. Know that it’s to be expected in these situations and try relaxation techniques and deep breathing before you go out. If these symptoms persist or cause concern, then seek out support from your peers and from professionals. And remember, we are all going through the experience together, so you are not alone.

The Fisher-Titus Behavioral Health team provides psychiatric diagnostic evaluations for all ages and offers individual, couples, and family counseling and medication management for all psychiatric diagnoses including:

• Anxiety
• Depression
• Mood disorders
• Psychotic disorders
• Autism
• Bipolar disorders
• Adjustment disorders
• Emotional disturbances
• Disruptive behavior
• Parenting concerns
• Trauma and abuse
• Family issues
• Grief

The Fisher-Titus Behavioral Health team encourages patients to live healthy lifestyles and promotes the use of coping skills and self-care in the form of exercise, deep breathing techniques, journaling thoughts and feelings, and more.

We offer a complete range of outpatient mental health services, provided by our licensed staff. We also offer virtual visits. Learn more by calling 419-668-0311.

Our new Tax Day is less than a month away! Although we got some extra time this year due to the coronavirus pandemic, there are probably many people who have not yet filed.

Tax season is a busy time for online scams. With many users filing online, there are many ways cybercriminals attempt to intercept sensitive, personal information used to steal identities.

Here are some tips for scams to look out for and how to protect yourself as you file your taxes this year.

Scams to watch out for

• IRS-Impersonation Phone Scams. You may get a call from someone claiming to be with the IRS and insisting you owe money that should be paid through a gift card or wire service. The real IRS will not call you and demand immediate payment. Typically, they will mail you a bill if you owe money.
• Phishing, email, and malware schemes. These come in the form of unsolicited emails, texts, social media posts, or fake websites that may prompt you to click a link or share personal/financial information. Thieves can use this information to pilfer funds or commit identity theft and unfamiliar links can contain viruses which can infect your computer if opened.
• Fraudulent tax returns. The IRS only accepts one tax return per Social Security number. To avoid someone else filing a return as you, try to file early. To prevent criminals from getting the information needed to file fraudulent returns, protect personal information by only sharing your Social Security number when necessary, check your credit report regularly for suspicious information, and never throw papers with sensitive information in the trash.
• Tax preparer fraud. Most tax preparers are honest but some may target unsuspecting taxpayers in order to commit refund fraud and/or identity theft. Remember, preparers must sign the tax return with their IRS preparer identification number.

Read the full article on NorwalkOhioNews.com.

Many of us are probably looking forward to 4^th of July celebrations this weekend. While celebrations probably will look different this year with coronavirus precautions, there is still lots of fun that can be had at home.

We want to make sure our community stays safe this week. Read these tips for participating in fun, Independence Day activities as safely as possible.

Firework Safety Tips

While it is illegal in Ohio to set off fireworks, there are other items such as smoke devices and sparklers that are sold many places and provide lots of summer fun. However, they can still be very dangerous. In 2017, 12,900 people suffered fireworks-related injuries.

Whether you are using sparklers or plan to be around fireworks, these tips can help you avoid burns or other injury:

• Adults should always supervise fireworks activity and never allow children to play with or ignite fireworks.
• Take caution with sparklers. They are often viewed as “safe,” but they are the leading cause of fireworks-related ER visits. They burn at about 2,000 degrees and can catch on clothing causing serious burns.
• Keep a bucket of water handy in case of fire.
• If fireworks malfunction, do not relight them. Douse them with water and throw them away.
• Never light fireworks in a container, especially one that is glass or metal.

How to Grill Safely

Who doesn’t love a summer cookout? Nothing beats the smell of the grill cooking on a summer day. When not used properly, grills can be a fire hazard. According to the National Fire Protection Association, grills cause an average of 10 deaths per year, 160 injuries, and nearly $150 million in property damage.

If your holiday plans include a backyard barbeque, keep these precautions in mind:

• Keep the grill well away from your home, deck railings, branches or overhangs, and other items or structures.
• Open the grill before lighting.
• Regularly clean your grill removing grease of fat buildup in the trays below your gas or propane grills so it cannot be ignited.
• Keep pets and children away from the grill.
• Avoid wearing loose clothing that could catch fire while grilling.

Pool Safety Tips

Swimming is a great way to cool down and have fun. But water can also pose serious dangers. According to the CDC, between 2005 and 2014 there were an average of around 3,500 fatal unintentional drownings annually not related to boating and an additional 332 boating-related drownings.

• Pay close attention to children and less-experienced swimmers. Make sure they have coast-guard approved floatation devices if they are not able to swim on their own.
• Designate someone to watch the water and do regularly head counts to make sure they can see everyone. This person should be paying close attention to the water and not be on their phone or distracted in other ways.
• Never swim alone.
• Swim sober.
• Have a phone nearby so you can quickly call for help in case of emergency.
• Do not swim beyond your abilities.
• Leave the water immediately in case of thunder and lightning and stay out for at least 30 minute after the last thunder clap.

Tips to Stay Hydrated

Many people’s idea of the perfect Fourth of July includes sunshine and hot temperatures. If you’re not careful, these can lead to dehydration. Dehydration can cause serious complications such as heat injuries ranging from mild cramps to heat exhaustion or heatstroke.

Take these steps to stay hydrated as you enjoy your holiday weekend:

• Drink plenty of water. It is recommended that you drink between six and eight cups of fluids a day.
• Don’t skip meals as much of your fluids comes from your food. Additionally, you lose salt and electrolytes as you sweat and your food will help your body replace what you lose.
• Drink before you feel thirsty. If you feel thirsty, you’re already behind in fluid replacement.
• Make sure your children are getting enough fluids.
• Dress in light, cool clothing. Dark colors will make you feel hotter and sweat more.
• Avoid alcohol. Even though you may want to enjoy a beverage responsibly, alcohol is dehydrating so you should limit yourself and drink lots of water to make up for it.

About Andrea Wetherill

Andrea Wetherill, MSN, RN is the Trauma Program Manager for the Fisher-Titus/MetroHealth partnership. Fisher-Titus is a Level III Trauma Center and a Level II Adult Cardiac Cath Lab.

At Fisher-Titus, we know our employees want more than just a job – they want a career that makes them feel empowered with opportunities for career growth and increased earning potential.

We have a variety of ways to help you advance your career, including educational assistance. This means that the sky is the limit – you can start out at an entry level position, use the tools we have available, and land that dream job you have been thinking about.

In fact, we have several current employees throughout the organization who have taken advantage of these tools. We have employees who started out in non-clinical departments like dietary and environmental services who are now registered nurses, nursing managers, and more.

For more information, click here.

To read the full article, visit NorwalkOhioNews.com.

Since the start of the COVID-19 pandemic, we’ve heard about the limited number of tests that have been available. Because testing is limited, we have known that it’s likely more people have been infected than we know, and we have all been wondering how widespread COVID-19 actually is in our community.

Thanks to a partnership between Fisher-Titus, Family Health Services, and Huron County Public Health, Huron County residents ages 10 and up can receive a COVID-19 antibody test with no out-of-pocket cost. Testing will be offered in New London, Willard, and Norwalk between June 18 and June 29. Appointments are required, no walk-ins will be accepted, and you can schedule your testing by calling 419-663-7511. For those with insurance coverage, the insurance company will be billed so please have your insurance information ready when calling to register.

What is Viral Testing vs. Antibody Testing?

You likely are hearing about two types of testing for COVID-19. A direct test for the COVID 19 virus checks samples from your respiratory system (typically a nasal swab) to see if you are currently infected while a COVID 19 antibody test checks your blood for antibodies that formed when you have recovered indicating you had a past infection.

If you are currently experiencing symptoms of COVID-19, your primary care provider can determine whether you may need a direct viral test for COVID-19. Fisher-Titus can test for current COVID-19 infections in-house, but testing requires an order from a physician and an appointment. We also offer Virtual Visits for COVID-19 screening and you can learn more about it at fishertitus.org/virtualvisits.

With more evidence showing COVID-19 may have been in Ohio and spreading earlier than originally thought, many individuals are wondering, “did I already have it?” especially since it is possible to have the virus without ever showing symptoms. This is where COVID 19 antibody testing comes in.

Antibodies are disease-specific proteins called immunoglobulins that help fight off infections and usually provide protection against getting that disease again, also know as immunity. While COVID-19 is a new disease and we continue to learn new things about it every day, it is believed that a COVID-19 antibody test done through a blood draw can determine whether a person was previously infected and now has some immunity to the disease.

How to Understanding Antibody Test Results

Once you have your testing done, it will be a few days before you receive your results

If you test positive, it is likely you were previously infected with COVID-19 or at least were infected with a related virus of the same family.

It is not yet known for sure whether having COVID-19 antibodies protects individuals from getting the virus again or, if they do, how long the protection may last. That’s why it’s important to continue protecting yourself and others by taking precautions even if your antibody test comes back positive. You should talk to your primary care provider about your test result to further understand what it means.

If you had a positive test and currently do not have symptoms, you likely do not have an active infection. If you do have symptoms, it’s possible you may still have an active infection. Talk to your health care provider as they may recommend a viral test to determine if you are currently infected.

If your test was negative, you could still have a current infection. Antibodies take one to three weeks after infection to develop and in some people it may take longer or they may not develop antibodies at all. Depending on the type of test used there can be false negative tests however the type we use at Fisher-Titus is one of the most accurate available and is FDA approved.

Regardless of whether you test positive or negative, it’s important to continue taking steps to protect yourself and others until we know more about COVID-19. However, we understand there is a lot of curiosity from the community about whether they have had the disease. This testing can satisfy that curiosity and also help us better understand how much the disease has spread in our community.

About AUTHOR

Dr. Gary Moorman is the Chief Medical Officer for Fisher-Titus. Dr. Moorman returned to Fisher-Titus in 2019 after having previously served as Vice President for Medical Affairs from 2011 to 2013. Huron County residents ages 10 and up can now make appointments for antibody testing by calling 419-663-7511between the hours of 8 a.m. and 4:30 p.m.

As businesses and other public places begin to lift restrictions and welcome visitors back, we are still encouraged to take precautions. One of these precautions is wearing masks in public places especially where social distancing is difficult to maintain.

Here are some answers to frequently asked questions about cloth face coverings that can help you understand how they work to slow the spread of COVID-19 and why we will be seeing them a lot more in the coming weeks and even months.

How is COVID-19 spread?

COVID-19 spreads primarily from person to person through respiratory droplets from an infected person coughing, sneezing, or talking. When the respiratory droplets leave the infected person, they can land in the mouths or noses of people who are nearby.

Even though individuals who know they are infected with COVID-19 or are not feeling well should isolate at home, some people with COVID-19 may not show symptoms. This is why it’s so important for everyone to practice physical distancing and wear cloth face coverings in public.

Read the full article at NorwalkOhioNews.com.

This summer will likely look different from what we’re used to. Although many restrictions are being lifted and the curve has been flattened, COVID-19 is still spreading. As we settle into what has come to be known as the “new normal,” it’s important to continue being mindful of the precautions you can take to slow the spread of COVID-19.

Public pools regulated by local health departments were allowed to open on May 26. With warm weather in sight, online schooling wrapping up for the year for many students, and many of us feeling stir crazy, it’s understandable that people are eager to cool off at their favorite pools.

According to the CDC, there is no evidence that COVID-19 can spread through the water in pools, hot tubs, spas, or water play areas. Proper operation and maintenance of the facility including disinfection with chemicals like chlorine should inactivate the virus.

Public pools will be required to put many safety measures in place and other measures will be strongly recommended so you will likely notice some differences should you choose to visit these facilities.

Read full article on NorwalkOhioNews.com.

Memorial Day marks the unofficial start of summer. Warm weather usually rolls in for good around this time, school is winding down, and everyone is feeling stir crazy after a long winter and a rainy spring.

This year, there’s the added layer of our spring being full of COVID-19 precautions like staying home, distancing ourselves from loved ones, and not being able to visit some of our favorite restaurants and stores.

Now that restrictions are lifting and the weather looks like it will finally cooperate, everyone is eager to get outside. Here are some tips so you can enjoy your summer while staying safe and healthy.

Bike safety

Biking is a great way to spend time with your family. Before you pedal off this, make sure you keep bike safety in mind.

• Wear a properly fitted helmet.
• Wear proper clothing including good footwear. Avoid loose clothes and flip flops that could interfere with the bicycle.
• Make sure bikes are the appropriate size. There should be 1 to 3 inches between you and the top of your bike when you stand straddling it with both feet flat on the ground.
• Check your brakes and check and oil the chain.
• Check tire pressure.

Water safety

Water can be fun but it can also be dangerous. To stay safe while playing in or near water, follow these tips:

• Avoid swimming past your ability or in rough water.
• Never leave children unattended even if they are experience swimmers.
• Never swim alone.
• Make sure water is deep enough before diving.
• Teach children to avoid playing around open bodies of water.
• Discourage children from jumping in to help another swimmer. Teach them to throw the victim a flotation device or something long to grab and to call an adult for help.
• Make sure young children wear properly fitting, coast guard approved life jackets when swimming or playing near water.

Bugs

Unfortunately bug bites and stings are part of the territory when it comes to summer. Take these precautions to avoid bites and stings:

• Check under decks and eaves for bee and wasp nests.
• Use insect repellent on the outside of clothing as well as exposed skin.
• Use repellent containing no more than 30% DEET.
• Avoid bright colored or floral clothing and scented soaps, perfumes, and hair products.
• To avoid ticks, wear long-sleeved shirts and pants and tuck your shirt into your pants and your pants into your socks.
• Check one another for ticks at the end of the day.

Sun and heat safety

Those most at risk for heat-related illness are young children and the elderly. Remember the following to protect yourself and family members from heatstroke and sunburn:

• The sun’s rays are strongest between 10 a.m. and 4 p.m. Take extra precautions during those times.
• Apply sunscreen 30 minutes before going out and every two hours while outside. If you are swimming or sweating you will need to use waterproof sunscreen and reapply more often.
• Sunscreen should have SPF of 15 to 30 and should protect against UVA and UVB rays.
• The sun’s rays can be damaging even on cloudy days.
• Watch for signs of heat-related illness such as fainting, dizziness, headache, nausea, flushed appearance, increased heart rate, and body temperature of 103 or higher.
• Drink lots of fluids and avoid beverages with alcohol or caffeine.
• Wear light colored, loose fitting clothing, a hat, and sunglasses with 100% UV protection.
• Keep children under one out of the sun as much as possible.

Avoid groups

Although COVID-19 restrictions are being lifted, the virus is still spreading in our communities. COVID-19 can spread especially quickly in large groups. Try to avoid gatherings of more than 10 people and crowded places to help slow the spread of COVID-19.

Social distance

If you choose to go to a restaurant, store, or other public place, keep in mind proper social distancing. Many places will likely have 6 feet of distance marked for their customers so you can visualize the distance. Staying 6 feet away from others who are not in your household will help slow the spread of COVID-19.

Remember, should you get sick or injured, Fisher-Titus is here for you. Convenient Care is open Monday-Friday from 9 a.m.-8:30 p.m. and Saturday and Sunday 9 a.m.-3 p.m. We also offer scheduled and on-demand virtual visits and our Emergency Room is here for you 24/7. For more information, visit fishertitus.org/access.

About Lauren Bailey

Lauren Bailey, CNP is a Nurse Practitioner at Fisher-Titus Convenient Care in Norwalk. Fisher-Titus Convenient Care is staffed by physicians, nurse practitioners, and physician assistants to serve as a user-friendly option for patients who can’t get in to see their primary care provider when injury or illness strikes. For more information, visit fishertitus.org/convenient-care.

Why are masks important? Masks are a very important part of helping slow the spread of COVID-19. The Center for Disease Control & Prevention (CDC) recommends that people wear a cloth face covering over their nose and mouth to protect the people around them. This is because COVID-19 can spread even if a person is not showing symptoms.

Why are masks required in the hospital when they aren’t elsewhere? In mid-April, the CDC revised its guidelines relating to face masks for use at healthcare facilities. The CDC stated: “To address asymptomatic and pre-symptomatic transmission, implement source control for everyone entering a healthcare facility (e.g., healthcare personnel, patients, visitors), regardless of symptoms. This action is recommended to help prevent transmission from infected individuals who may or may not have symptoms of COVID-19”. To continue our alignment with CDC guidelines and recommendations around the use of PPE, we revised our own PPE guidelines based on the above change. In addition, at the end of April, Governor Mike DeWine issued a mandate that all employees have to wear a face covering while on the job.

How should I clean my mask? Your cloth mask should be laundered after each time you wear it. Wash your mask in a washing machine with hot water, then dry in a dryer on high heat.

Teens connect to the online world much differently than their parents do – thanks in part to our rapidly advancing technologies. Today more than ever, teens lead complex online lives and are faced with real-world problems online.

In the National Cyber Security Alliance’s (NCSA) second annual Keeping Up With Generation App: NCSA Parent/Teen Online Safety Survey, 34 percent of teen internet users (13-17 years old) report that someone has been mean or cruel to them online in the past year, with 52 percent of those incidents involving something they said or did, 35 percent involving something about their appearance and about one in four involving their sexual orientation, gender, or race. In addition, the issue of “fake news” is also a worrisome topic for both parents and teens. Nearly 50 percent of teens said they were “very” or “somewhat” concerned about mistakenly spreading fake news or misinformation. Parents are even more concerned, with more than 60 percent indicating that they were “very” or “somewhat” concerned that their teen would spread misinformation.

The results of this research have led NCSA to set some new recommendations for helping teens be safer and more secure online. In general, online teens reported that their parents are their primary source for learning about online safety and security. These conversations tended to focus on what should and should not be shared on cell phones (74%) and ways to behave toward others online or on the phone (64%). Even as more of these family tech talks are happening, 57% of the teens report having online accounts of which their parents are unaware, such as a social media site or app.

As technology continues to become fully integrated into young people’s lives, it will be nearly impossible for parents to know everything their children do online. Additionally, parents need to understand that teens may seek help from – or be asked for help by – their peers. Forty-one percent of the teens surveyed reported that a friend of theirs has sought help because of something that happened online. Focus points of family tech talks should include how to offer helpful advice and how to determine when a situation requires adult assistance.

NCSA recommends rethinking the family tech talk to help both parents and teens learn how to better recognize and resist online issues and be resilient when faced with problems.

Rethinking the Rules

Too often, parenting in the age of the internet focuses on setting rules and trying to understand and keep track of everything young people are doing. Online safety isn’t just about following designated procedures or being totally educated on everything about the internet. The survey revealed a significant digital disconnect with both parents and teens reporting dissimilar expectations around what kinds of rules actually exist and if they are being followed. In one example, nearly a third of teens (28%) state their household has no rules, while 8 percent of parents indicate there are no rules at home for their children’s use of technology.

While NCSA believes rules still play an important role in helping young people stay safe and more secure online, we recommend revising the approach to online safety rules and taking the following into consideration:

• Make rules that can be enforced. It’s easy to create a laundry list of rules. Making rules that are impractical to follow or enforce won’t make young people safer or more secure and can create a situation where rules lose meaning and parents become disengaged. For example, as a majority of teens have online accounts that their parents aren’t aware of, rules requiring advance permission before creating accounts are likely to be broken and unenforceable. Before setting a rule, think about whether it will significantly improve your children’s safety and how you can keep the lines of communication on the issue open.
• Have a core set of rules the whole family follows. The most impactful rules are those that apply equally to everyone. So create a set of rules that everyone in the family is expected to follow. For example, limiting use of devices during meal times or other times spent together as a family, practicing discretion when sharing personally identifiable information about family members, and seeking permission from one another before sharing information, such as posting photos on social networks.
• Make rules together and change them over time. Young people may surprise you with how much they already know about being safer and more secure online. Ask them about the rules they have made for themselves and the practices they currently follow. Then have them establish rules they can commit to following. Make sure that the rules evolve as your children grow. What is an appropriate rule for a 10-year-old may not be appropriate for a teen, so periodically revisit your expectations.

It’s not about the technology – it’s about how it is used.

There can often be hysteria around the latest app or how young people use devices. Connected devices are not unlike cars. Many cars can travel at speeds way above the speed limit, so teaching responsible use and good behaviors is key to safety. For example, smart devices have cameras that can be used to spark and promote creativity, and apps may have functions that allow video chat or live streaming. They can also be used to send inappropriate images or create security vulnerabilities. Teaching the family how to use the technology appropriately and manage privacy and security settings will help everyone learn how to better protect themselves online.

Establish a safe environment for technology conversations.

Although teens might not always come to you for online advice, it’s important to be prepared to help them when they do. Work to create an environment of trust in which your kids can comfortably talk to you about their experiences and issues without fear of punishment or blame, even if they have broken an established rule. Additionally, consider asking your teen to talk about their friends’ experiences and problems online; they may be more comfortable discussing someone else’s experience than their own.

Help teens help their friends.

Strong peer-to-peer relationships are fundamental parts of adolescent development, and many teens are likely to turn to their friends for help with problems online. You can expect your child may be consulted by a friend for help.

Talk to your teens about developing the tools and knowledge they need to protect themselves as well as advise their friends with online safety concerns. This can include how to block users on sites and how to report problems or abuse to the sites and apps they use.

Help your teen understand their capacity for responding to issues and challenges they face, and encourage them to seek help from someone they trust if a problem they or their friends have seems beyond their ability.

Establish some parameters about when they should seek adult help, such as if a friend may harm themselves or others or the law has been broken. While teens are unlikely to intervene directly in an online incident a friend is experiencing, role-play and strategize about how they would handle problems.

Being safe and secure online is about trying to prevent negative incidents, but also building resilience.

Talk to teens about your shared concerns.

Despite their differences, parents and teens actually share many concerns about technology. Similar to last year, the survey found that when it comes to online safety, parents and teens share common concerns on topics like someone accessing a teen’s account without permission, someone sharing a teen’s personal information and having a teen’s photo or video shared that they wanted to keep private.

Source: StopThinkConnect.org

We may take it for granted sometimes, but our hearing is an important part of our quality of life. Hearing loss not only affects how you experience the world around you but if left untreated, it can increase a person’s risk for dementia, depression, falls, and memory and balance issues. In the United States there are approximately 48 million individuals that have hearing loss and while many people assume it only affects older people, 62% of those with hearing loss are under age 65.

Just like you should have regular visits with your primary care provider, dentist, or eye doctor, checking your hearing should be part of your regular health routine. Hearing loss can be gradual, so getting it checked annually can help you track slight changes from year to year.

While you should get regular hearing checks regardless if you are having symptoms as they can be subtle, signs of hearing loss can include:

• Muffling of speech and other sounds
• Difficulty understanding words, especially against background noise or in a crowd
• Trouble hearing consonants
• Frequently asking others to speak more slowly, clearly, and loudly
• Needing to turn up the volume on the TV or radio
• Withdrawal from conversations
• Avoidance of some social settings

When you get a hearing evaluation, there are a few things the audiologist may ask you to do.

1. Provide personal and family histories. The provider may ask about your personal hearing health or any history of hearing loss in your family. It’s important to have a full picture of anything that could affect your hearing such as genetic factors or medical conditions such as ear infections, allergies, colds, or past head traumas.
2. Noise Exposure Evaluation. If your job, hobbies, or social activities frequently expose you to loud noises, it may put you at higher risk for hearing loss.
3. Otoscopic exam. Earwax and other obstructions can affect your hearing. An otoscope allows the audiologist to observe your ear canal and ear drum and check for any potential obstructions.
4. Pure tone test. For this test, you will wear headphones and will sit in a quiet room. You will listen for faint tones and either raise your hand or press a button when you hear the tone. Your responses to the tones will help the audiologist determine which frequencies you are able to hear and which frequencies you may be having trouble hearing.
5. Speech test. This test helps determine what spoken sounds you can hear and at what volumes.

The good news is, hearing loss is very treatable, especially when detected early through regular hearing screenings. Treatment depends on the cause and severity of your hearing loss but may include:

• Removing wax blockage
• Surgical procedures
• Hearing aids
• Cochlear implants

While some services at the Fisher-Titus Hearing Center have been put on hold due to COVID-19, we are providing contactless hearing aid services and supply pick ups as well offering discounted hearing aid cleaning services. For more information on our contactless services, call the Fisher-titus Rehabilitation Department at 419-660-2700. As soon as it is safe to do so and in line with local and state recommendations, we look forward to resuming our normal audiology services which include:

• Comprehensive adult and pediatric hearing screenings with an audiologist
• Assistive devices
• Ear molds
• Battery sales
• Hearing aid services including the latest in digital hearing aid fitting and repairs
• Custom noise protection
• Swim plugs

About Caitlin Robertson

Caitlin Robertson, Au.D., CCC-A, F-AAA is an audiologist with Fisher-Titus. A native of Norwalk, Caitlin works with patients of all ages from newborns who fail universal infant newborn hearing screenings to older patients. For more information about the Fisher-Titus Hearing Center, visit fishertitus.org/hearing-center.

Most of us are spending more time at home lately in order to prevent the spread of COVID-19. While many are spring cleaning your house to fill the time, it’s also important to spring clean your digital life as well. Take the time while at home to make sure you are in a healthy place with your digital life. Here are some tips from The National Cyber Security Alliance (NCSA) and the Better Business Bureau (BBB) for doing a digital declutter.

Keep a clean machine. Keeping software updated on internet-connected devices (computers, smartphones, tablets, etc.) reduce the risk of infection from malware.

Lock down your login. Utilize the strongest authentication tools available for all your accounts. Usernames and passwords alone are not enough to protect email, banking, and social media accounts. Biometrics, security keys, or unique one-time codes sent to your mobile device are all additional measures you should implement to strengthen the security of your accounts.

Declutter your mobile life. Most of us have apps we are not using or that need updating. Go through all the apps on your phone and delete ones you are not using and update others. It’s also important to keep the operating system up to date, as the updates often have key security change in them.

Do a digital file purge. Treat your digital files like paper files. Start with your email and save only those you need and unsubscribe to emails you no longer need or want to receive. Back up important data to a secure cloud site or another device where it can be safely stored. Password protect your backup files. Also remember to backup files before you get rid of old devices.

Own your online presence. Review privacy and security settings on the websites you use. It’s OK to limit how much you share and with whom.

Know what devices to digitally shred. Think beyond your computer, phone, and tablet—they are not the only devices that capture and store sensitive information. External hard drives, USB drives, wearables, networking equipment, printers, and more can all store personal information.  Smart TV’s even have your personal login information to access streaming accounts.    Make sure you remove your personal data before disposing of any electronic device.

Clear out stockpiles. If you have old hard drives or other devices, information can still exist on them and be stolen. Wipe and/or destroy unused/unneeded hard drives.

Empty your trash or recycle bin on all devices and be certain to wipe and overwrite. Deleting a file and emptying the trash bin on your computer is not enough to completely get rid of a file. Permanently delete old filed using a program that deletes the data, wipes it from your device, and overwrites it by putting random data in its place.

For more information on cyber security, visit stopthinkconnect.org. For more information on how Fisher-Titus is responding to COVID-19, visit fishertitus.org/coronavirus.

About Linda Stevenson

Linda Stevenson is the Chief Information Officer at Fisher-Titus. With over 30 years in health care, Linda has had the opportunity to support all areas of the hospital with much of her experience in managing major hospital initiatives including HIPAA, Data Security and Privacy, Meaningful Use, and electronic medical record implementations.

During the current pandemic, you may be wondering about the best way to see a doctor or other clinician and follow the stay at home order and social distancing guidelines. Fisher-Titus offers many options right here in our community so you can still see a health care professional and prevent the spread of COVID-19.

Telehealth

Almost all of the Fisher-Titus doctors and Advanced Practice Practitioners are able to care for patients virtually by video or with a phone call for minor ailments. These telehealth options may be the right option for you or a loved one. Call your provider and ask if a virtual is the right option for your health care needs. Not all appointments can be done virtually, but your provider team will help determine whether a telehealth visit is the right appointment for you and when the appointment can be rescheduled.

To schedule a virtual visit with a Fisher-Titus Medical Care provider, current patients can simply call the office of the provider and let the scheduler know they’d like to be seen through a video visit. These appointments will be billed out through insurance at their normal rate, just as if they were being seen in person in the office.

Some appointments still need to be completed face-to-face with your doctor or practitioner. Your provider team will help you determine the best solution to provide the care you need.

Convenient Care

If you are not experiencing any respiratory symptoms (coughing, shortness of breath, etc.), Fisher-Titus Convenient Care is available on the north side of Norwalk on US 250. You can check into the clinic from the comfort of your car and the team will call you in so that you can still social distance while waiting to be seen. When registering, the Convenient Care team will ask about your health and if they detect any respiratory symptoms you may be directed to another site of care.

COVID-19 Virtual Screenings

If you are experiencing coronavirus symptoms and do not have a primary care provider or would like an immediate COVID-19 evaluation, a screening can now be done through a video visit using the Fisher-Titus Amwell telemedicine service.

To get started, simply download the Amwell app from the Apple or Android app store or visit fishertitus.amwell.com and enter the service key FISHERTITUS to be connected with a board certified and experienced medical provider see patients over secure network any time of day, anywhere. No appointment is necessary and the visit is only $59 or less, depending on your insurance.

Emergency Room Mobile Assessment

For people experiencing respiratory symptoms, the Fisher-Titus Emergency Department provides a mobile assessment. Set up outside Fisher-Titus Medical Center off Shady Lane, the mobile assessment provides you an opportunity for a medical screening exam from an Emergency Department provider without leaving your vehicle. Please note – this is not drive up or drive through testing. Testing for COVID-19 is limited across the state and must be ordered by a provider.

If you need further monitoring or treatment after the assessment, you will be directed to a treatment area inside of the Emergency Department. Whether additional treatment is needed or not, an Emergency Department provider will make recommendations for what your next steps should be, including testing, if it is needed.

To enter the mobile Emergency Department assessment area, turn onto Shady Lane drive from Benedict Avenue, and then turn left onto Fisher-Titus Parkway. Follow the signs for the drive-through assessment located in front of the Snyder/White Heart & Vascular Center.

Avoiding unnecessary trips from home and taking precautions when you must go out are important components to slowing the spread of COVID-19. Everyone at Fisher-Titus Health wants to ensure you are getting the needed care for all of your health concerns. We are proud to provide many different health care options and resources in our community and helping prevent the spread of COVID-19.

For more information about assessment options and how Fisher-Titus is responding to the coronavirus pandemic, visit fishertitus.org/coronavirus or follow us on Facebook.

About Matt Mattner

Matt Mattner is the Chief Operation Officer at Fisher-Titus. For more information about Fisher-Titus Virtual Visits, visit fishertitus.org/virtualvisits. For more information about coronavirus, visit fishertitus.org/coronavirus.

Over the last few weeks, we’ve been asked by local, state, and national health authorities to stay home as much as possible in order to slow the spread of COVID-19. While we can still seek out essential services, it’s important to take precautions when we do. Here is more information on what you can do to slow the spread and what you should do if you develop COVID-19 symptoms to avoid further spreading the virus.

Slow the spread

We often hear the term “social distancing” used when talking about slowing the spread of COVID-19. Social distancing is maintaining at least a 6-foot distance, avoiding crowds or groups over 10 people, and not shaking hands or hugging. It’s important to keep social distancing in mind any time you leave the house whether it is to get groceries or go for a walk.

Here are some other tips for slowing the spread:

• If you are older or have a serious underlying health condition, you should stay home and away from other people. If you need groceries or other necessities, try to have someone bring them to you and leave them outside your door.
• Work from home as much as possible. Student should do schooling at home as much as possible.
• Avoid gatherings in groups of more than 10 even if everyone in the group is feeling healthy.
• Avoid unnecessary travel including shopping trips and social visits.
• Practice good hygiene by washing hands frequently, avoiding touching your face, sneezing and coughing into a tissue or the inside of your elbow, and disinfecting surfaces often.

What to do if you feel sick

The most common symptoms of COVID-19 are:

• Fever
• Dry cough
• Shortness of breath

According to the World Health Organization (WHO) some people may also experience aches and pains, nasal congestion, runny nose, sore throat, or diarrhea. Since symptoms can vary from person to person, the best thing you can do if you feel sick is to stay home and call your primary care provider. If one person in the house is sick, the everyone in the household should stay home and act as if they are also sick so they do not spread the virus.

Most people who have COVID-19 experience mild symptoms and recover from the disease at home. If you call your primary care provider with mild symptoms, they may advise that you isolate and monitor symptoms at home. You should not leave the house except to get medical care and even then, take precautions to avoid spreading the virus.

If you develop severe symptoms you should immediately go to the nearest Emergency Room or call 911. Be sure to tell them your symptoms so they can take additional precautions and you should wear a face mask if possible. Emergency warning signs include:

• Trouble breathing
• Persistent pain or pressure in the chest
• New confusion or inability to arouse
• Bluish lips or face

This list is not all inclusive so you should stay in touch with your primary care provider as your symptoms change.

Fisher-Titus Virtual Visits

In order to continue providing the same level of care for our patients during the COVID-19 pandemic, Fisher-Titus has launched virtual visits for patients.

If you are experiencing COVID-19 symptoms, you can complete an online screening at fishertitus.amwell.com. Enter the service key FISHERTITUS.

Additionally, many regular visits with Fisher-Titus Medical Care providers can now be completed over the phone or via video call. If you need to see your doctor for any reason, call the office and ask if your visit can be done virtually. For more information, visit fishertitus.org/virtualvisits.

About Tami Binger

Tami Binger, RN is an infection preventionist certified in infection control at Fisher-Titus. For more information on COVID-19 preparedness, visit fishertitus.org/coronavirus.

Panic. On-edge. Overwhelmed. Unsure. Surviving. Worried. Numb. Depressed. Frightened. Angry. Calm.

I have heard all of these words used to describe how some have felt during the Coronavirus or COVID-19 outbreak. There isn’t a “right way” or a “wrong way” to feel about what is going on.

This is a worldwide situation that is life-changing and will be discussed for years to come in history classes. The children that are being “homeschooled” today will one day tell their grandchildren what it was like living through the COVID-19 pandemic. Children—and most adults—look to each other to gauge reactions to stressful situations and moods can shift depending on those reactions. Which feeling words do you want them to use to describe these moments?

Everyone is stressed or anxious to different degrees during this unprecedented situation. Our routines are off, places are closed, finances are being effected, and a time frames for when things will be back to normal are unknown. Stress and anxiety are  to be expected.

Putting some familiarity back into chaos helps us gain a sense of control and shift our moods and reactions to ones that are more positive. Here are some things you can do to help feel like you have some normalcy and positivity in the midst of all this unknown:

1. Keep up with a routine. Start by setting regular wake up times, getting dressed each day, keeping up on hygiene, eating balanced meals, scheduling time to do work/homework, and going to bed around the same time each night.
2. Make lists. Creating a to-do list will give you a sense of accomplishment and purpose; you can even write down all of the things listed above and check them off as you go. The point is to get back into a routine and know what is to come next.
3. Come up with things you can do at home to stay busy. If you live with others, think about what you can do together and make a creative “bucket list” or “honey do” list now that you have more time at home. These lists could be different games, activities, movies, scrapbooking, or crafts you have wanted to do together or it could be home projects inside or outside of the house that everyone has been putting off.
4. Get outside when possible. Getting outside often can be very beneficial especially after a long cold winter like we just had. You can go outside for a walk or just to enjoy the sun while still practicing social distancing.
5. Stay social in other ways. If you live alone, you can schedule date nights over the phone or better yet on one of the many social platforms that has video conferencing capabilities. Don’t forget to check in on your friends, extended family members, and neighbors.

Also try to remember that some positives can come from this. We have to be mindful to make the effort to point them out to ourselves and others when we notice them.

Preparing

For a full checklist, view the Household Checklist provided by the Ohio Department of Health at coronavirus.ohio.gov.

• Clean and disinfect high-touch surfaces often. These include counters, tabletops, doorknobs, light switches, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables. Also clean any surfaces that may have blood, stool, or body fluids on them.
• Keep an adequate supply of water, food, and pet food in your home.
• If you take prescription drugs, contact your health care provider, pharmacist, or insurance provider about keeping an emergency supply at home.
• Keep a working thermometer and respiratory medications, like decongestants, expectorants, and analgesics (ibuprofen, acetaminophen), on hand.

Get a flu shot this season if you haven’t already. It won’t protect against COVID-19, but it can help protect against flu or lessen symptoms if you get it, lessening the strain on health care facilities.

Preventing/Slowing the Spread

To help stop the spread of any viral respiratory disease, including Coronavirus, you should:

• Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer if soap and water are not available.
• Avoid touching your mouth, nose, or eyes.
• Cover coughs/sneezes with your arm or a tissue.
• Avoid exposure to others who are at risk.

Additional precautions you can take include social distancing measures specific to Coronavirus and recommended by state, local, and federal health agencies, such as:

• Stay home if you are sick and contact your primary care provider for further guidance.
• If your children are sick, keep them at home and contact your primary care provider.
• If someone in your household tests positive for COVID-19 or is suspected of having COVID-19, keep the entire household at home.
• If you are an older person, stay home and away from other people as you are at greater risk for getting seriously ill from the coronavirus.
• If you have a serious underlying health condition that weakens your lung, heart, or immune system functions, stay home and away from other people.

Even if you are young, don’t feel sick, or are otherwise not a greater risk for being affected by COVID-19, you can take the following precautions in order to protect yourself, your community, and your loved ones:

• Work from home whenever possible.
• If you work in a critical infrastructure industry (such as health care, pharmaceutical, and food supply) and will be maintaining normal work schedules, you should follow CDC guidance to protect your health at work.
• Avoid social gatherings in groups of ten or more.
• Avoid unnecessary travel including shopping trips, vacations, and social visits.

The best thing to do is remain calm, take preventative and precautionary measures, and use credible sources such as the CDC, local health department, and the Ohio Department of Health for updates. For more information about how Fisher-Titus is responding to the COVID-19 situation including up-to-date visitor restrictions, visit fishertitus.org/coronavirus.

About Tami Binger

Tami Binger, RN is an infection preventionist certified in infection control at Fisher-Titus. For more information on COVID-19 preparedness, visit fishertitus.org/coronavirus.

Social Distancing

• Do not shake hands
• Avoid crowds
• Maintain 6 feet of distance
• Stay home if you are sick

Self-Monitoring & Self-Quarantining

• Aims to keep people who were exposed or who may have been exposed away from others
• Regularly check temperature
• Watch for signs of respiratory illness
• Limit interactions
• Lasts 14 days (symptoms may appear sooner)

Isolation

• Triggered by a COVID-19 diagnosis
• Can happen whether you are sick at home or in the hospital
• More rigid infectious disease precautions, such as wearing masks, should be taken

Quarantine

• Individuals or groups are on lock-down
• Mandated by state or federal law

For more information, visit NPR.org

For more information on how Fisher-Titus is responding to the COVID-19 situation, click here.

Now that Coronavirus has spread to the United States and there have been cases of community transmission, it’s important for our community to know how to be prepared and that Fisher-Titus has proactively taken action to be prepared and ready. Fisher-Titus is in regular contact with Huron County Public Health, Ohio Department of Health, CDC, and regional partners to assure a state of readiness.

In fact, on February 6 we implemented screening measures in accordance with public health and CDC recommendations at all our patient access points. This included plans for addressing symptoms, quarantine processes, and ways to keep our patients, guests, staff, and volunteers safe at the hospital, ambulatory offices, and for North Central EMS.

History of Coronavirus

Coronavirus has actually been around since the mid-1960s and are named for the crown-like spikes on their surface. There are seven different types of coronavirus that typically give humans cold-like symptoms and some of those you may have heard of before including MERS and SARS. Rarely, animal coronaviruses that infect animals emerge to infect people and can spread between people, just like with our current coronavirus – Novel Coronavirus 2019 (COVID-19). Early on, many of the patients at the epicenter of the outbreak in Wuhan, Hubei Province, China had some link to a large seafood and live animal market, suggesting animal-to-person spread. Later, a growing number of patients reportedly did not have exposure to animal markets, indicating person-to-person spread.

Symptoms of Coronavirus

Those who have contracted it have had mild to severe respiratory illness with symptoms of fever, cough, shortness of breath, typically 2-14 days after exposure. These have been people who have traveled to China, Japan, Italy, Iran, and South Korea, as well as been in contact with others who have also traveled to these locations. If you have an international travel planned, it is best to check the up-to-date travel information from the Centers for Disease and Prevention. If you have traveled to any of the above-listed destinations and experience any of the symptoms, please call your health care provider or local hospital to seek guidance if it is not a medical emergency. Explain your symptoms, travel history, and any additional exposure you may have had. Do not visit your health care provider without calling first to help reduce exposure to others.

Reducing the risk

As with any illness the best way to reduce your risk is to follow a few simple steps including:

• Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer if soap and water are not available.
• Avoid touching your mouth, nose, or eyes.
• Cover coughs/sneezes with your arm or a tissue.
• Avoid exposure to others who are at risk. Stay home if you are sick.

The Centers for Disease Control and Prevention also has a variety of tips on how to protect yourself and the community.

Be prepared

There are many ways you can prepare your household in the case of an outbreak in our area. The Ohio Department of Health has created a Household Checklist with a variety of great tips, including:

• Clean and disinfect high-touch surfaces often. These include counters, tabletops, doorknobs, light switches, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables. Also clean any surfaces that may have blood, stool, or body fluids on them.
• Keep an adequate supply of water, food, and pet food in your home. If you take prescription drugs, contact your health care provider, pharmacist, or insurance provider about keeping an emergency supply at home.
• Keep a working thermometer and respiratory medications, like decongestants, expectorants, and analgesics (ibuprofen, acetaminophen), on hand.
• Get a flu shot this season if you haven’t already. It won’t protect against COVID-19, but it can help protect against flu or lessen symptoms if you get it, lessening the strain on health care facilities.

The best thing to do is remain calm, take preventative and precautionary measures, and use credible sources such as the CDC, local health department, and the Ohio Department of Health for updates.

May is National Stroke Awareness Month. This makes it the perfect time to learn about stroke risk factors and prevention, along with how to recognize a stroke and what to do after you’ve experienced a stroke. According to the National Stroke Association, approximately 65,000 Americans will experience a stroke in May alone.  This guide to stroke awareness month will highlight the risk factors as well as ways you can prevent yourself from ultimately experiencing a stroke at some point in your life.

Stroke Risk Factors & Prevention

While some stroke risk factors are outside of your control, many can be managed. Doing these things can reduce your risk of stroke:

• Controlling high blood pressure
• Staying active
• Controlling lipids (blood fats)
• Healthy diet
• Maintaining a healthy weight
• Not smoking
• Maintaining heart health
• Reducing alcohol intake
• Managing stress
• Managing diabetes

It’s also important to understand that certain segments of our population are more susceptible to suffering from a stroke. Below is a list of the populations who are at greater risk.

People at Greater Risk of a Stroke 

• Those over 55
• Women
• African Americans, Hispanic, and Asian/Pacific Islanders
• Those who have a family history (parent, grandparent, or sibling) of stroke
• Those who have had a previous stroke
• Fibromuscular dysplasia (FMD)
• Patent Foramen Ovale (PFO)
• Atrial Fibrillation (aFib)
• Those who have experienced a Transient Ischemic Attack (TIA), a brief episode of stroke-like symptoms that usually cause no permanent damage or disability. The greatest risk for these individuals is within the first week after the TIA.

Recognizing a Stroke

The acronym F.A.S.T. is the easiest way to remember the most common stroke symptoms. This refers to your face, arms, speech and time as highlighted below.

• F – Face. One side of the face may droop
• A – Arms. One arm may be weaker than the other
• S – Speech. Speech may be slurred or strange
• T – Time. If you observe any of these signs, call 9-1-1 immediately.

Other possible stroke symptoms include sudden confusion, vision problems, dizziness, loss of balance or coordination, trouble walking, and severe headache. It’s important to note the time you first observed stroke symptoms as it can impact treatment.

Fisher-Titus is certified as Primary Stroke Center through the Healthcare Facilities Accreditation Program (HFAP) meaning that we are able to stabilize and treat acute stroke patients, provide acute care, and administer tPA and other acute therapies. In order to maintain this certification, we have to meet the following standards:

• The program director must have extensive experience in acute stroke
• Stroke code team arrival at bedside must be within 15 minutes
• Lab testing and advanced imaging capabilities must be available 24/7
• Must have access to neurologists 24/7
• Must have neurosurgical expertise available or able to transfer patients within two hours
• Must have a designated stroke unit
• Staff must meet education requirements

Life After a Stroke

Rehabilitation is a large part of stroke recovery for many people. Physical therapy can help with problems in moving and balance. Your physical therapist may also suggest exercises to strengthen muscles for walking, standing, and other activities. Occupational therapy helps stroke survivors learn strategies to manage daily activities such as eating, bathing, dressing, writing, or cooking. Speech therapy can help with re-learning language skills (talking, reading, and writing) and can help with swallowing problems. All of these therapies are offered at Fisher-Titus so you can recover close to home.

Once an individual has had a stroke, they are at an increased risk for repeat stroke. It is important for stroke survivors to talk to their doctor about what lifestyle changes they should make to help reduce any additional stroke risk.

Support groups can be very beneficial for stroke survivors. Fisher-Titus hosts a regular Coffee and Conversation Stroke Support Group for stroke survivors and their caregivers. For more information about the stroke support group, call (419) 663-1975 ext. 3093.

Dr. Steven Benedict is a Neurologist with Advanced Neurological Associates. Fisher-Titus has been a Primary Stroke Center since 2007.

By: Lindsey Esker, MA, CCC-SLP, Manager, Rehabilitation

April is Autism Awareness Month, and it’s a great time to work to better understand autism spectrum disorder (ASD) and appreciate and accept those who are “on the spectrum.” The more we know, the better we can support individuals with ASD and their families and celebrate their unique talents and gifts.

What is Autism?

Autism spectrum disorder (ASD) is a developmental disability that can cause social, communication, and behavioral challenges. Autism is caused by differences in the brain and while some individuals with ASD have a known difference, such as a genetic condition, other causes are not yet known. Scientists believe there are multiple causes of ASD that act together to change the most common ways people develop.

You often cannot tell if a person has ASD just by looking at them. There is often nothing about how they look that sets them apart from other people. However, they may behave, interact, and learn in ways that are different from most other people.

The abilities of people with ASD can vary significantly. For example, some individuals with ASD may have advanced conversation skills whereas others may be nonverbal. Some people with ASD need a lot of help in their daily lives while others can work and live with little to no support.

ASD begins before the age of 3 years and can last throughout a person’s life, but symptoms may improve over time. Some children show signs of ASD withing the first 12 months of life where others may not show signs until around 24 months. Sometimes, children with ASD might gain new skills and might meet developmental milestones until around 18-21 months when they stop gaining new skills or lose skills they once had.

When to Seek an Autism Assessment

Signs and symptoms of ASD include a wide range of issues with social communication and interaction, restricted or repetitive behaviors or interests, and more. It is important to note that some people without ASD might also have some of these symptoms but for those with ASD, these characteristics can make life challenging

Examples of social communication and social interaction characteristics related to ASD can include:

• Avoids or does not keep eye contact
• Does not respond to name
• Does not show facial expressions like happy, sad, angry
• Does not play simple interactive games like pat-a-cake by
• Uses few or no gestures (e.g., does not wave goodbye)
• Does not share interests with others (e.g., showing you an object that they like)
• Does not notice when others are hurt or sad
• Shows little interest in peers
• Has trouble understanding other people’s feelings or talking about own feelings

Examples of restricted or repetitive interests and behaviors related to ASD can include:

• Lines up toys or other objects and gets upset when order is changed
• Repeats words or phrases
• Plays with toys the same way every time
• Is focused on parts of objects (e.g., wheels on a toy car)
• Gets upset by minor changes
• Has obsessive interests
• Must follow certain routines
• Flaps hands, rocks body, or spins self in circles
• Has unusual reactions to the way things sound, smell, taste, look, or feel

Many people with ASD have other characteristics including:

• Delayed language skills
• Delayed movement skills
• Delayed cognitive or learning skills
• Hyperactive, impulsive, and/or inattentive behavior
• Unusual eating and sleeping habits
• Gastrointestinal issues
• Unusual mood or emotional reactions
• Anxiety, stress, or excessive worry
• Lack of fear or more fear than expected

The signs and symptoms of ASD can be identified by early surveillance and screening. Surveillance or developmental monitoring is an active on-going process of watching a child grow and encouraging conversations between parents and providers about a child’s skills and abilities. Your child’s provider will look at whether your child is meeting typical developmental milestones in playing, learning, speaking, behaving, and moving.

At your child’s regular well-child visits, you may be asked to fill out a checklist or questionnaire specifically designed to identify problems that need further evaluation. These are typically at the 9-, 18-, and 24-month visits. Autism specific screenings usually occur at the 18- and 24-month visits. Additionally, if you have any concerns about your child or if they exhibit any of the above signs of ASD you can always talk to your doctor and they can recommend screenings if necessary.

Diagnostic and Treatment Options at Fisher-Titus

If your child’s developmental monitoring or screenings identifies an area of concern, you may be referred for specialized assessments with a psychologist, neurologist, developmental pediatrician, etc. . At Fisher-Titus, we provide autism diagnostic assessments utilizing the Autism Diagnostic Observation Schedule 2^nd -edition (ADOS-2). This is the gold standard assessment for ASD. If you or your child’s physician would like an autism diagnostic assessment, you can contact our pediatric therapy department at 419-660-2700.