Wow!  I never would have believed that I, Stewart Segal MD, would endorse the use of Telemed.  Not in a million years could I have imagined telling patients to avoid seeing their docs in person.  Coronavirus has changed everything.

If you are ill, do not go to your doctor’s office, immediate care center or ER.  Call your family doc for instructions.  Expect to wait a long time for a response as most of your docs’ patients will be calling him/her. If you don’t have a family doc, call a hospital-based urgicare center.

The real question is do you have the Coronavirus or not.  Testing for the Coronavirus is not readily available.  If you get sick, assume you have Coronavirus and isolate yourself from the rest of the world as much as possible.  Initial treatment of the Coronavirus is the same as for any other virus.

Rest, lots of fluids, acetaminophen or ibuprofen, combined with prayer are my treatment of choice and is what the phone doc is most likely to prescribe. The real dilemma is discerning when it’s time to go to the ER/hospital.  Shortness of breath and difficulty breathing are your two big indicators that will trigger an urgent call to your doc or a trip to the hospital.

Once you’ve determined that you or a loved one has a worsening respiratory tract infection that is probably Covid-19 and you’ve discussed it with your doc, you are off to the hospital for definitive testing and oxygen.

Yesterday I wrote about the stubborn spouse.  What do you do when your sick spouse is having trouble breathing and refuses to follow the docs instruction and will not go to the ER.  The following conversation is one I’ve had too many times in my life.

ICU Waiting Room

“Mrs. “X,” I’m Dr Segal.  Your husband is on a respirator and stable.  His condition is critical.  If only he would have come in earlier.  What happened?”

Mrs. “X” – “He has been sick for a week.  He started having shortness of breath yesterday.  I knew you were busy, so I called the ER and they told me to bring him in.  He can be a real jerk!  He told me he wasn’t going to the hospital as it was just a bad cold. When I told him he was either going to the hospital or I’d call the paramedics, he told me that “IF YOU CALL THE PARAMEIDCS, I’LL NEVER TALK TO YOU AGAIN!  So, I didn’t call the paramedics until he became so weak, I thought he might die.”

Dr Segal – “Did it dawn on you that if he died, HE WOULD NEVER TALK TO YOU AGAIN? In the future it is better to have a pissed off spouse than a dead one.”

For all of you married to a stubborn spouse, God bless you.  I hold meetings of the Cursed Spouse Married to a Stubborn Person (CSMSP) on the first Thursday of every month.  Stubborn spouses are welcome but will never come.  

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