Managing Your Fear of COVID-19

It’s important that we know how coronavirus spreads so we can avoid catching and spreading the virus. But for some, a healthy level of caution can become an unhealthy fear. Melanie Lobel, MD, psychiatrist at Lexington Medical Specialists, offers some ways to help us manage our anxiety about the virus.

“Even for someone who has never had a problem with anxiety, fear of the unknown about the virus’ potential impact on our health, finances, relationships and routines can be overwhelming. And for someone who already has an anxiety disorder, it can be a really difficult time,” said Dr. Lobel.

She encourages us all to proactively manage our mental health during this unprecedented time by using these tactics:

*Focus on what you can control (your own behavior and choices) instead of the things you can’t control. Wear a mask, wash your hands and practice safe physical distancing. Limit the amount of time a day you watch or read the news.
*Stay informed with information from credible sources, like the Centers for Disease Control and Prevention. Avoid getting caught up in unfounded theories.
*Stay connected to friends, family and co-workers. Even if you’re staying home, you can use technology to help you maintain your important relationships. Try playing a game online using Zoom or FaceTime. Laughter and fun can help us put things into perspective.
*Avoid or limit substances. While it may be tempting to use alcohol or drugs to escape our worries, they often lead to more problems, including poor sleep, depression and increased anxiety after the substance wears off.

Melanie Lobel, MD

If you or someone you love is experiencing anxiety or depression, there are many options you can consider to help you cope:

Mobile apps like Calm or Headspace provide meditation, mindfulness and relaxation techniques to reduce anxiety.

Virtual talk therapy with a licensed mental health provider through Talkspace. There are also many local providers offering virtual therapy.
In-person or online therapy with a local provider. Find a provider at Psychology Today, Lexington County Community Mental Health Center or Columbia Area Mental Health Center.

If anxiety or depression escalates to the point that you or your loved one feels suicidal, contact the National Suicide Prevention Lifeline at 1-800-273-8255, or call 9-1-1.

As we navigate this stressful time, Dr. Lobel shared a quote from Nobel Prize winning scientist Marie Curie as encouragement: “Nothing in life is to be feared. It is only to be understood. Now is the time to understand more, so that we may fear less.”

An Innovative Plasma Exchange Helps COVID-19 Patients at Lexington Medical Center

Debra Allen has worked as a librarian for 40 years. But she never thought she’d share a story like this one. With the help of an innovative therapy at Lexington Medical Center, Debra survived a very serious, life-threatening battle with COVID-19.

Debra Allen

As the first cases of COVID-19 were diagnosed in South Carolina in early March, Debra started feeling sick. “I felt like I was coming down with something. I became short of breath. Then, I could hardly breathe at all,” she said.

The 65 year old had pneumonia last year but noted this situation as much worse. Debra’s husband Ed rushed her from their home in St. Matthews to the Lexington Medical Center Emergency department on Saturday, March 14, where a busy triage tent had been set up outside to screen patients with respiratory symptoms.

“My oxygen levels were 70 percent. They put me on oxygen right away,” she said.

Doctors performed a COVID-19 test and admitted Debra to the hospital. With a strict no visitation policy in place, Ed drove the 45 minutes home and nervously waited for news.

The next day, Debra’s temperature spiked to 104 degrees. She was in septic shock with multiple organ dysfunction and acute respiratory distress syndrome, and she required medicine to maintain her blood pressure along with a machine to help her breathe. When her test results came back, Debra’s nurse called Ed and told him his beloved wife of 39 years had COVID-19 and was in critical condition.

“My jaw hit the floor,” Ed said. “It’s just me, her and the cats. I wanted them to let me sit at her bedside in a HAZMAT suit because the hardest part was not being able to talk to her hour to hour. But I couldn’t.”

Debra’s heart began racing. She has a history of atrial fibrillation, a condition where the heart beats in an abnormal rhythm. In addition, COVID-19 weakened her heart, leading to congestive heart failure. Cardiologists had to perform a procedure to shock Debra’s heart into beating normally.

Ed and Debra Allen at home in St. Matthews

At home in St. Matthews, Ed carried his phone with him around the clock. He and Debra were college sweethearts who’ve been together ever since they met on a blind date at the University of South Carolina in 1976. “I slept with the phone on her pillow at night because I was so afraid I was going to get a call,” he said.

Debra received many medicines to treat her COVID-19, from antibiotics to steroids and more, under the care of Matthew J. Day, DO, a critical care physician at Lexington Medical Center. Her situation was dire. “Mrs. Allen was Lexington Medical Center’s first serious COVID-19 case,” said Dr. Day. “Her condition kept declining despite aggressive care.”

That’s when Dr. Day told Debra he wanted to try therapeutic plasma exchange, known as TPE or PLEX. This innovative and aggressive treatment replaces a sick patient’s “inflamed” plasma with standard “clean” plasma supplied by the American Red Cross in a three-hour, bedside treatment. The idea is that plasma from a healthy person can help a patient fight COVID-19.

This treatment has been used for many years for other conditions, but medical intensive care physicians at Lexington Medical Center have used it since late 2019 for patients with septic shock and multiple organ failure. In March, they started using it for patients with COVID-19.

Therapeutic plasma exchange is different than the more widely used convalescent plasma, which transfuses plasma from a recovered COVID-19 patient. Lexington Medical Center is one of only a handful of hospitals in the nation using this type of plasma exchange for COVID-19 patients.

“COVID-19 alters chemical communicators in the body that help fight infection,” Dr. Day said. “We think the donor plasma may be able to tell the body how to fight the infection and mitigate the body’s response to it.”

Dr. Matthew Day takes care of a patient in Lexington Medical Center’s Critical Care Unit.

Starting with the lungs and moving around the body, COVID-19 causes chronic inflammation, blood vessel dysfunction and clotting issues. Doctors think the healthy plasma can remove inflammation, allowing organs to heal, too.

One day after Debra’s plasma exchange, the tide turned. “I woke up feeling better,” Debra said. “They started to reduce my oxygen. By the end of the week, I was out of bed and in the chair. I was able to eat again.”

And she wasn’t alone. In a group of eight COVID-19 patients at Lexington Medical Center, doctors saw a remarkable improvement in six of them shortly after the plasma exchange. Five recovered and were discharged. The sixth went off life support. Considering the seriousness of their illnesses, doctors say that percentage is exponentially higher than expected. “This type of plasma exchange appears to be one of many tools we can use to treat COVID-19,” said Dr. Day.

Dr. Day and his colleagues have written a paper about the successful use of plasma exchange for patients with sepsis and multiple organ failure. Since then, Lexington Medical Center has received calls from hospitals around the world with questions about this therapy for COVID-19 patients. Among others, Debra’s husband Ed is a believer.

“I think the plasma made the difference for her,” he said. “She looks and sounds better than she has in a long time.”

Debra spent a total of two weeks in the hospital and is now back home in St. Matthews. “I feel the best I’ve felt in more than a year,” Debra said.

Dr. Day hopes to continue using this type of plasma exchange. “Innovative change is often slow in most places,” he said. “But at Lexington Medical Center, everyone has stepped up and said, ‘If this is going to help patients, we’ve got to make it happen.’”

The Connection Between Lifestyle Choices and COVID-19

We know that lifestyle choices can impact your health. During the COVID-19 pandemic, it’s especially important to pay attention to how your behavior impacts wellness. In this WLTX interview, Dr. Payton Foust of Lexington Family Practice Gilbert offers important information to help keep you healthy and safe.

Dr. Foust said it’s becoming easier to see the impact of social isolation we’ve been experiencing for the last two months.

“People are dealing with anxiety and depression at home,” he said. “We’re seeing an increase in substance abuse, smoking cigarettes and marijuana, vaping, and drinking alcohol.”

Each of those has implications any time, but they’re more concerning during a pandemic like COVID-19.

Smoking impacts lung function. That’s especially problematic because COVID-19 is a virus that attacks the lungs. In addition, alcohol can weaken the immune system and impact sleep – factors that can make individuals more susceptible to COVID-19.

Dr. Foust emphasizes the importance of good nutrition including plenty of fruits and vegetables, and exercising regularly with proper social distancing.

Finally, it’s important to focus on mental health. Virtual meet ups with friends to talk or even share a lunch or dinner date are important and constructive ways to stay grounded and keep things in perspective during this difficult time. We’re all in this together.