Meet the Local Artist: Marissa Quinn

Marissa Quinn is a full-time artist working out of Kailua Kona, Hawaii, and Cardiff, California.

 Born and raised in Encinitas, Marissa was raised in connection with the sea and marine cycles. In 2015, Quinn graduated with her master’s degree in Fine Art (MFA) from Azusa Pacific University, where she concentrated her studies on drawing, specifically in the illustration of extinct and/or endangered flora and fauna. Upon graduating, Quinn landed a solo exhibition at the Museum of Art and History in Lancaster, California, launching her into a full-time career as an artist. At that time, Quinn’s correspondence with environmental researchers across the nation shared a common urgency to educate the public about the interconnectedness of the ocean to the health of the planet, inspiring her to move back to the sea in her hometown of Encinitas. As a surfer, educator, and artist she currently creates large-scale drawings of marine growth and degradation in order to educate her community while collaborating with oceanic conservation groups including Pangea Seed, Lonely Whale, Surfrider Foundation, Keiko Conservation, and Changing Tides Foundation amongst many more.

Her work is currently in several museums and galleries between San Diego and Los Angeles including the Museum of Art and History in Lancaster, the Oceanside Museum of Art, Lux Art Gallery, and Sparks Gallery. Her murals span from California, Michigan, Ohio, and Maryland, to Bali, Indonesia.

Quinn is currently on faculty at Point Loma Nazarene University where she teaches Drawing 1 to undergraduate art students. 

Join Marissa Quinn and Cardiff 101 from October 22-24th in the Cardiff COVID Art Project and be a part of a collaborative art piece that will commemorate our experience in the pandemic by reconnecting our Cardiff-by-the-Sea community. Space is limited. Click here to donate and sign-up.

You can follow Quinn’s journey daily through her Instagram (@marissaquinn) and through her monthly email newsletter found on her website: www.marissaquinn-art.com

Build a Strong Relationship with Your Doctor

You’ve waited several weeks to see your doctor, but after you leave the office you still have questions, and you don’t quite understand your diagnosis. If this sounds familiar, it’s time to improve your relationship with your physician.

A good patient-physician relationship can go a long way in helping you stay healthy — and getting the care you need when you’re not feeling well.

“Patients who take an active role in their care may not only feel more satisfied with their doctors, but also more in control over their own health and well-being,” says Rebecca Shragge, DO, an internal medicine physician at Scripps Coastal Medical Center Hillcrest.

Communication, respect and trust are keys to any healthy relationship. And the relationship with your health care provider should be no different. Here are eight ways to help you build a good patient-physician relationship and get the most out of your appointments.

1.   Be prepared for your appointment

Take a few minutes to prepare for your appointment with your physician so you can make the most of your time together. You may be able to message your concerns ahead of your appointment through a patient portal.

Common questions to consider include:

• Do you have a new symptom you want to discuss?

• Do you want to go over how a treatment is affecting your daily life?

• What side effects are common with a particular medication you are prescribed?

• Do you need vaccines, including the flu, pneumonia or shingles?

“Before your visit, make a list of your symptoms and how long each has been present,” suggests Dr. Shragge. “Write down what medications you’re taking, including vitamins and supplements, and the dosages for each.”

 If you need lab work or other tests, get them before your appointment so you and your doctor can go over them together

2. Prioritize health issues to discuss

Start your discussion with your physician with the most important health issue or question on your mind.

“Don’t put off things you really need to discuss until the end of the visit. Bring them up right away,” says Dr. Shragge.

3. Follow COVID safety precautions

Be prepared to follow COVID safety protocols before entering the clinic and at the doctor’s office, including wearing a face covering and physical distancing.

At Scripps, all physicians, staff members, patients and visitors are required to wear face coverings. Scripps also offers curbside check-in as an additional safety measure so that you can remain in your vehicle until an exam room is ready for your visit.

4. Bring a companion to your appointment when necessary

Bring a friend or loved one with you, especially if you feel like you have trouble retaining information or you are discussing something serious like cancer or heart disease. Be aware of any visitor restrictions in place due to COVID-19.

“Bringing a friend or family member along can be extremely helpful when it comes to asking questions and clarifying information, especially for older patients or anyone who is nervous about seeing the doctor, or someone who needs a language interpreter,” says Dr. Shragge.

5. Be honest with your physician

Your lifestyle and daily habits impact your health, and the information you share with your physician is confidential so be candid. If you are not honest about things, such as smoking or having a couple of cocktails daily or occasionally skipping your medications, your physician won’t have accurate information, and that can impact your care.

“Let your doctor know what has happened in your life since your last visit,” says Dr. Shragge “For instance, mention any changes you have noticed in your appetite, weight, sleep or energy level.”

Don’t feel embarrassed. Your doctor isn’t perfect, and he or she doesn’t expect you to be either.

6. Be sure you understand your care plan

Before you leave the doctor’s office, make sure all your questions have been answered or if you need to schedule a follow-up visit. Have a clear understanding of everything your doctor has told you about your condition and what you need to do, such as getting lab tests, taking medications and caring for yourself at home.

“If you’re not quite sure about something, don’t hesitate to ask for clarification before you leave,” says Dr. Shragge. “If you have questions once you get home, contact your health care team by calling the office or using an online patient portal to leave a message.”

7. Communicate with your physician, use patient portal

Many health care organizations offer patients a secure health portal in order to communicate with their physicians and manage their health records.

Scripps Clinic and Scripps Coastal Medical Center patients can use MyScripps, the online patient portal where you can check test results, schedule appointments, review your medical history and leave messages for your physician.

8. Follow your care plan

Follow your individualized care plan to get results and monitor progress. Your care plan may include tasks such as monitoring your blood sugar, getting more exercise or taking your blood pressure.

If a physician’s recommendation doesn’t sound doable or your medication isn’t working, let them know so you can re-evaluate and make adjustments to your plan.

Three Simple Shifts to Improve Your Pets Nutrition

By Pupologie

Dogs and cats are very resilient creatures and we have seen that they can survive on very little nutrition. Many pet parents purchase the same bag of pet food each month, trusting that it is complete and balanced as it states on the bag, and not giving it much further thought. If this is you, you’re not alone. And if you are reading this article, you probably have a sense that there may be more you could be doing to potentially increase your pet’s longevity and well-being.

Fifteen years ago, I discovered that there is a gaping chasm between the quality of one brand to the next and that the guidelines for creating a pet food allow for health degrading ingredients to be commonly used in pet diets.

As a very protective pet momma, this fact really struck a chord with me and it is what led me to create Pupologie.

For further exploration on pet food guidelines and the truths about the ingredients, I highly recommend Susan Thixton’s blog www.thetruthaboutpetfood.com and I encourage you to watch the documentary Pet Fooled, which is available on Netflix.

1. THINK ROTATION AND VARIETY

One of the simplest ways to improve your pets’ nutrition is by offering variety! A variety of nutrients from a variety of sources is biologically what our pets are built for. Dogs became “man’s best friend” as descendants of wolves. Wolves hunt in packs eating a variety of prey and scavenging. As they integrated into man’s best friend, they would eat whatever man would eat. Leftover scraps from the camp and the dinner table. Cats are pure predators and still to this day hunt whatever prey they can get their paws on if permitted to do so.

The pet diet as we know it today is built upon modern convenience, rather than what your pet actually needs. We’ve been lulled into thinking that if it states “complete and balanced” on the bag, then it must be sufficient. Further perpetuating that idea are commercials with slogans like “Good for the life of your pet” and a gross misrepresentation of true nutritional education within the Veterinarian curriculum. And over the last 70 decades, as we have come to accept the modern way of feeding our pets, we are witnessing a shortening of their expected lifespan and an increase of ailments that were once unheard of in pets.

Adopt a habit of choosing a minimum of three base diets and cycle through them. A base diet can be any pre-made commercial diet or a homemade diet using a balanced recipe. It is a myth that changing your pet’s diet is “bad” for them. To avoid any stomach upsets, the key in introducing anything new in your pet’s diet is slow and steady. I recommend adding a 1 part portion of the new food with 3 parts of the familiar food for the first time. Do that for about two to four feedings and monitor your pet. Check their stools. If there are changes such as extreme stool softening, continue to feed this ratio until the stools become firmer. Once the stools are regular, move forward with a 1 part new to 2 part familiar for two to four feedings. Continue increasing the ratio of the new food, decreasing the ratio of the familiar food, and monitoring the stools until you are able to fully integrate over to the new food with no stool issues. Do this any time you are introducing new foods and eventually you will be able to cycle between the different foods, switching back and forth, as often as you’d like.

If you find that the new food doesn’t really produce a happy pet with a happy stool, do not be alarmed and do not give up hope. Every pet has unique needs and finding the proteins and other ingredients that jive well with your pet is a simple process of trial and error.

2. SUPPORT THE GUT

A happy gut is foundational in keeping all other systems functioning. Focus on ensuring there is a flourishing array of gut flora and healthy gut lining.

I recommend adding in pre and probiotics as a routine mix-in daily or at least 3 times a week.

To support the gut lining add in bone broth two or three times a week as well. Bone broth helps to heal any little tears or holes in the gut that may have occurred and it has a slew of other health benefits, including joint support.

3. ADDRESS TAURINE AND HEART HEALTH

There is currently evidence in recent studies that the standard requirements for dog foods to be labeled “complete and balanced,” is lacking an important amino acid called Taurine which is connected to heart and eye health. It has been a requirement in cat food for decades, however, it was deemed unnecessary for dog food. The evidence that is currently under investigation is showing that some dogs are having heart issues linked to a lack of taurine.

The guidelines will likely be changed to accommodate these findings once they have conclusive evidence, but until then, there are natural sources you can add to your pets’ diet to ensure your pet has plenty of this amino acid.

• Sardines and Salmon

• Organ meats such as giblets, liver, heart, kidneys

• Dark meat

• Clams and Mussels

• Eggs

Add in any combination of the items on the list a few times a week and you will be covering your pets’ need for taurine, not to mention they will thoroughly enjoy the deliciousness.

Continue reading at Pupologie.com

Cardiff-by-the-Sea Ocean View Rentals

By: Cardiff Vacations

Cardiff-by-the-Sea is a beautiful, beach community, an independent part of the city of Encinitas, where you can find good vibes, great surfing spots, and many other fun local attractions. Cardiff has the perfect blend of relaxation and entertainment, being located in a serene natural location but still close to the city of San Diego (only 20 minutes away), where you are sure to find enjoyment for all tastes. 

Located in Cardiff-by-the-Sea, you will find Cardiff Vacations’ modern yet classy ocean view properties, ready to offer you the best vacation experience in the San Diego area. Owned by Alison and Julio Sanchez, the properties have an inspiring story of becoming what they are today. Before they become vacation rentals, they were Alison’s childhood home. When Alison’s mother got sick the couple moved in with her to care for her. When she passed away Alison and Julio had to decide what to do with the properties and, as there were so many memories tying them to this place, they decided to not sell, but renovate and rent them so that other people can get a taste of Cardiff’s magic.

At Cardiff Vacations, you can choose from three beautifully renovated villas: the Parkhouse, the Penthouse, and the cozy Seacottage. No matter which one you choose you are bound to have an amazing experience. The properties are fully furnished and equipped with everything you could need, including cooking utensils and some spices, so you don’t have to worry about a thing and fully enjoy your stay and explore all the local attractions. And the best part, the homes are located within walking distance to the beach and other major local attractions. 

The great perks of the properties include outside decks that offer some of the most amazing ocean views, where you can relax by the firepit, enjoy a glass of your favorite drink, let go of any stress and fully relax.  

Other features that will make your vacation even better:

• quartzite stone island and countertop with seating for 6

• luxurious bathrooms

• casual chic décor

• Turkish cotton towels

• the deck is furnished with an outside table, a grill, and a couch

• modern lighting & furniture

• washer & dryer

• free wi-fi

If you are planning a vacation to the sunny coast of San Diego, Cardiff-by-the-Sea is definitely a destination to be considered. If you would like to know more about the area and how to plan your vacation days to get the best out of your time here, check out Cardiff Vacations’ daily vacation planner for the latest events in the area and the most interesting attractions you can find here.

Can Loneliness Lead to Chronic Health Issues?

By: Scripps Healthcare

5 tips to combat loneliness and social isolation and boost health

For almost a full year, fear of the COVID-19 virus kept many people around the world confined to their homes, only interacting with colleagues, friends and relatives by phone or video. While the lockdown may have been necessary to reduce the spread of the virus, it contributed to the rise of two other significant health conditions: social isolation and loneliness.

These conditions are not the same, though they may be related. Social isolation is a lack of social contact with others, while loneliness is feeling alone or disconnected with or without social contact. Social isolation can cause some people to feel lonely, but even people who socialize often can feel lonely if their relationships are not satisfying or fulfilling.

The Centers for Disease Control and Prevention (CDC) says that both are public health risks that affect a significant number of people in the United States, especially older adults. One report found that more than one-third of adults age 45 and older feel lonely, and nearly one-fourth of those age 65 and older are socially isolated. Older adults are more likely to live alone, and factors, such as retirement, hearing loss, decreased mobility and illness, can limit their interactions with others.

Emotional pain can cause physical illness

Loneliness and isolation can lead to significant emotional and mental health issues; along with feeling disconnected, people experiencing loneliness may find it hard to trust others or may feel threatened. Like physical pain, emotional pain can activate the body’s stress responses. Over time, this can result in chronic inflammation and reduced immunity, which can raise the risk of chronic diseases.

“Research has linked social isolation and loneliness to higher risks for serious health conditions including high blood pressure, heart disease, stroke, obesity, depression, and anxiety,” says Michael Pham, DO, an internal medicine physician at Scripps Coastal Medical Center Carlsbad.

According to the CDC:

• Social isolation significantly increased a person’s risk of premature death from all causes.

• Social isolation was associated with about a 50% increased risk of dementia.

• Poor social relationships characterized by social isolation or loneliness were associated with a 29% increased risk of heart disease and a 32% increased risk of stroke.

• Heart failure patients who experienced loneliness had nearly 4 times the average risk of death, 68% increased risk of hospitalization, and 57% increased risk of emergency department visits.

In addition, loneliness was associated with increasing depression, anxiety and suicide among both older and younger adults. In a June 2020 study, symptoms of anxiety, depression, substance use associated with COVID-19 and serious suicidal thoughts in the previous 30 days were most commonly reported by those ages 18–24.

5 tips to combat social isolation and loneliness

If you’re feeling isolated or lonely, or know someone who is, it’s important to take action to help prevent negative physical and emotional effects. Studies show that people who engage in meaningful, productive activities with others experience better moods, have a sense of purpose and tend to live longer. These tips can help alleviate isolation and loneliness:

1. Make self-care a priority. Exercise, eat healthy meals, get enough sleep and try to spend time outdoors every day.

2. Make an effort every day to connect with family or friends in person, over the phone, by text or online. Go for a walk with a friend or neighbor or play games together online.

3. Find an activity that you enjoy. Join an online book club, take a class or join a group that shares your interest. Check with your local community center or faith-based organization for options.

4. Consider adopting a pet if you can. Caring for a companion animal can be rewarding and comforting and can lower stress and blood pressure. If you can’t have a pet at home, look into volunteering at a local shelter or pet-sitting for a neighbor.

5. Volunteer at an organization that is meaningful to you. Becoming involved with a cause can ward off feelings of loneliness and help you meet people with similar interests.

“If feelings of isolation or loneliness are affecting your emotional or physical health, talk to your doctor,” says Dr. Pham. “Be very honest about how you’re feeling and how it is affecting your life. Your doctor can offer suggestions and resources to help you feel better and improve your quality of life.”

Top 3 Things to do in Encinitas for the Best Summer Vacation

by Cardiff Vacations

Encinitas is a lovely beach city in the northern area of San Diego County, best known as a world-class surfing destination. Also known as “The Flower Capital of the World” because of its great collection of gardens and nurseries, Encinitas offers a wide selection of local attractions and provides fun for all ages and tastes. If you are planning a getaway in the area this summer, here are the top things to do in Encinitas that will ensure you have the best vacation experience:

1. Enjoy a fun Day at a Local Beach

Parallel to the historic Highway 101 you will find some of the best hidden gems in San Diego’s North County Coastal region, Encinitas’ beaches. Here you can find:

•  legendary surf spots, 

• terrain that varies from pristine sandy beaches to rocky bluffs overlooking the ocean,

• authentic beach culture,

• great snorkeling areas,

• tide pools.

If you’re not sure which of the beautiful Encinitas’ beaches to choose during your stay, here is a brief overlook at some of the most popular ones:

• Cardiff State Beach

The Cardiff State Beach is a great family-friendly, dog-friendly beach with lots of parking spots and two access points, one in the north and the other in the south. The north access point is right next to the entrance to the beautiful San Elijo Lagoon. 

The south access point is known as Seaside Beach, it is a popular location for surfers and the two reefs make it a great location for diving as well. When the tide is out, the reefs get exposed and you get the chance to discover interesting sea creatures in the tide pools.  

• San Elijo Beach

San Elijo Beach, located further North from Cardiff State Beach, stretches from San Elijo Lagoon all the way up to Swami's State Beach in Encinitas, where you can find a lovely campground for overnight camping. 

This beach is many's favorite because of its location, and beautiful scenery. The views as you walk down to Cardiff-by-the-Sea from Encinitas are sure to blow you away.

• Swami's Beach

As an internationally-known surf spot, Swami’s Beach draws in surfers from all over the world, being possibly one of the best surfing spots in all of California. It is especially popular in the fall-winter season when waves can reach heights over 10 feet. 

Besides being such an incredible surfing destination, Swami’s Beach is also a very strong spiritual location. Home to the Self-Realization Fellowship Temple, Swami’s is one of the places where yoga history was first born in the US.  

2. Visit the San Elijo Lagoon Ecological Reserve

As mentioned above, the San Elijo Lagoon is located right next to the northern access point of Cardiff State Beach. This 1,000-acre lagoon is one of US' largest remaining coastal wetlands. Here you can walk through seven miles of trails and discover a diversity of plants and animals, including:

• 300 species of plants, 

• 26 mammal species, 

• at least 23 species of fish, 

• more than 300 bird species.

The San Elijo Lagoon Ecological Reserve is a great vacation destination if you are traveling with your kids as there are many educational activities happening here all the time, such as:

• guided weekend tours

• Children’s Story Time

• nature-themed family days and festivals

• cultural and natural exhibits

3. Admire Gorgeous Views While Hiking Some of the Best Trails in San Diego

With stunning coast to mountain landscape, ocean views and beautiful diverse wetlands, the Encinitas area is bound to amaze you with some of the best hiking trails San Diego County has to offer. The trails vary in difficulty and some of them are also kid friendly so you can enjoy them during your family vacation. Here are some of the best hiking trails around Encinitas that we recommend you check out:

• Crest Canyon Open Space Preserve Loop Trail

Located in Del Mar Heights Rd, San Diego, the Crest Canyon trail is a hidden gem, perfect for a family hike, nestled in the western corner of the San Dieguito River Park. This is a 2.1 miles long trail, accessible all year round, good for all skill levels that offers beautiful views and a chance to see the rare Torrey pine trees. Besides hiking, you can also enjoy some bird-watching here.  

• La Orilla Trail

La Orilla Trail is located near Cardiff-by-the-Sea, starting at the San Elijo Ecological Lagoon, and reaching the little more challenging Annie Canyon’s Trail.  It is 3 miles long, out and back, and is accessible all year round. At the beginning of the trail you can admire local Eucalyptus trees and native wild desert grapevines and along the way you can also enjoy the beautiful local wildflowers and birds.

• Annie Canyon's Trail

Annie Canyon’s Trail has beautiful rugged wilderness hiking paths located in an ecological reserve, near Solana Beach, Encinitas. This trail is just a bit more difficult due to its steep and at times really narrow pathways. It is still family friendly though and your kids will love safely climbing around the rocks.  Once you reach the viewpoint up top you can admire a stunning ocean view. 

• Manchester Preserve Hiking Trails

The Manchester Preserve is like an oasis in the middle of the city of Encinitas comprised of a network of trails that are a little bit more challenging to the untrained but that offer a chance of wildlife sightings. A short loop around the reserve will take you about an hour or less.

To truly comprehend all of what the Encinitas area has to offer, it would be best to experience it firsthand so I suggest next time you are thinking of going on your vacation, seriously consider Encinitas as your vacation destination, as you are bound to have a great time here.  

About the author: Julio Sanchez is the proud owner of Cardiff Vacations, a luxury vacation rentals business in the coastal area of Cardiff-by-the-Sea, Encinitas, CA.

My Doctor Is Not In, Can I See an NP or a PA?

by Scripps Healthcare

Nurse practitioners and physician assistants can both treat you

Your cough isn’t getting any better after a week. Your throat is aching now. But when you try to make an appointment, your primary care doctor is not available.

You’re asked if you’d like to see someone sooner. A nurse practitioner (NP) or physician assistant (PA) can see you in the morning.

Not sure what to do? Or the difference between physician assistants and nurse practitioners?

There are differences in their training and requirements. But both are licensed health care providers who can treat patients. And as their ranks grow, they are helping to increase access to health care for millions of Americans.

“Nurse practitioners and physician assistants are highly qualified medical professionals who can provide the same general care services as physicians,” says Carol Coloma, NP, a family nurse practitioner at Scripps HealthExpress in San Marcos.

In contrast to a nurse or medical assistant, who can take your weight and blood pressure and prepare you to see the doctor, a NP and PA can examine and treat you. Both hold advanced education degrees and extensive medical training.

Nurse practitioners and physician assistants in primary care

The number of NPs and PAs has steadily risen since the 1960s when programs for these medical professions began largely in response to a nationwide shortage of primary care physicians. Today, there are more than 325,000 licensed NPs, and about 140,000 certified PAs, practicing in the United States in a variety of health care settings.

At Scripps, NPs and PAs staff more than a dozen Scripps HealthExpress walk-in clinics. These convenient clinics — located at Scripps Clinic and Scripps Coastal Medical Center sites across San Diego County — provide same-day care for minor illnesses and injuries. Primary care teams made up of primary care physicians, NPs and PAs are also common at Scripps primary and specialty care offices.

Nurse practitioner’s role and scope of practice

Both PAs and NPs must have completed specific educational requirements and training programs in order to be able to treat patients. NPs and PAs provide the same general care services as physicians, including:

• Conducting physical exams

• Diagnosing and treating common, routine and acute illnesses

• Ordering and interpreting lab tests and X-rays

• Prescribing medication

What’s the difference between an NP and a PA?

Although their roles are similar, NPs and PAs have some differences in background and training.

NP programs are based on the nursing model and have a strong population focus. All applicants must be registered nurses (RNs) before they can complete the graduate-level education and clinical training needed to earn an NP degree.

NP licensing is done at the state level, generally by the board of nursing for the state in which the NP will practice. Certification is sometimes required to obtain a license. Certification is granted by national organizations in specialty areas of nursing practice.

Understanding the NP’s role

In addition to providing general care, NPs generally play a greater role in patient education and counseling than PAs. They focus on illness prevention and staying well. Most NPs specialize in primary care areas, such as family medicine, gerontology, women’s health, pediatrics or acute care.

A handful of states require NPs to practice in collaboration with a physician, including California, or under a physician’s direct supervision. Many states allow NPs to practice without any physician involvement.

Understanding the PA’s role

Physician assistant programs are master's level programs. Students must complete at least two years of college coursework in basic and behavioral sciences before applying to a PA program. Many PA programs also require prior health care experience with hands-on patient care.

Most students have a bachelor’s degree and about three years of health care experience before entering a PA program, according to the American Academy of Physician Assistants.

PA programs are based on the medical model and are more disease-centered. In addition to classroom and laboratory instruction, PAs complete clinical rotations in areas such as primary care, surgery, pediatrics and emergency medicine. PAs practice in medicine in all settings, including primary, emergency and surgical subspecialties.

The designation of PA-C, or physician assistant-certified, means the PA has been certified by the National Commission on Certification of Physician Assistants. Like NPs, many PAs pursue additional education to focus in a specific area.

Most states, including California, require PAs to have an agreement with a specific physician in order to practice.

PA vs. NP

So how do you know whether to see the doctor or a PA or NP?

“When you are faced with the choice of seeing an NP or PA right away or waiting for a physician, it’s generally better to get in and be seen,” Coloma says.

For coughs, earaches, rashes and other routine ailments, it’s fine to see an NP or PA. “Both work under the supervision of a physician and will discuss your care with him or her in case your problem turns out to be something more serious,” Coloma says.

Coloma adds, “The PA or NP will make sure your doctor is aware of your condition and proper actions are taken to provide the care you need.”

Pet First Aid Kits

by Veterinary Specialty Hospital

Every pet parent’s worst fear is having something bad happen to their beloved friend, which is why we are happy to share our Pet First Aid Kit tool with you! Having one of these handy can prevent an injury from becoming worse while you head to the vet, and will give you peace of mind that when an accident does happen, you're prepared! We hope that your pet never has an accident, but if they do, VSH Sorrento Valley and VSH North County are here for you!

 Continue reading: https://www.ethosvet.com/blog-post/pet-first-aid-kits/

The Learning List

By Pupologie

If you are tired of feeling insecure and unsure about what choices to make for your pet’s wellbeing, this list is for you.

When I was twenty-three years old, someone taught me how to read pet food labels.  At the start of the lesson, I was looking forward to learning something new that could help me on my journey of pet parenting.  By the end of the lesson, I was stunned and sick inside over the unthinkable things I learned.  The WRONG things that I learned. My naivety was instantly snatched up and I was forever changed. From there I set out to learn everything I could so that I would be able to make a difference.  Two years later I opened Pupologie and I have been helping pet families avoid the traps and navigate the toxic terrain ever since.

This is a compilation of the literature, videos, and links that have been most helpful to me in navigating the world of pet nutrition and the overlapping world of commercial pet food. Through these resources you will learn everything you need to know: the good, the bad, the despicable.

Continue reading at Pupolgie.com

How to Schedule a Mammogram During Coronavirus Pandemic: What to Know

How to Schedule a Mammogram During Coronavirus Pandemic: What to Know

by Scripps Healthcare

Screening mammograms and COVID-19 vaccines are important

Scheduling an annual screening mammogram remains the best way to detect any early signs of breast cancer. However, some people have had questions about scheduling a mammogram during the COVID-19 pandemic. How safe are health facilities? Can I postpone my mammogram? Can the COVID-19 vaccine affect my mammogram?

Let’s start with what hasn’t changed. Breast cancer is still the second most common cancer among women in the United States according to the Centers for Disease Control and Prevention (CDC). Research shows it is easier to treat breast cancer when it is caught early. A screening mammogram is used to look for signs of breast cancer in women who don’t have any breast symptoms or problems.

Health care facilities, like those at Scripps, are still safe places for mammograms, with enhanced precautions in place to protect patients, doctors, nurses and staff from potential exposure to the coronavirus.

“If you are overdue for one, we encourage you to schedule your annual screening mammogram and work with your doctor if you have any questions,” says Rebecca Hsu, MD, a diagnostic radiologist at Scripps MD Anderson Cancer Center and Scripps Clinic. “Regular mammograms are the best tests doctors have to find breast cancer early.”

COVID vaccine and mammograms

If you are unable to schedule your screening mammogram before receiving the COVID-19 vaccine, doctors recommend having your mammogram done a minimum of four weeks after receiving your second vaccine dose. This applies to two-dose vaccines by Moderna and Pfizer.

The reason for this recommendation is that some women who receive these vaccines develop swollen lymph nodes, usually under the arm on the same side of the body where the vaccine was injected. This is a normal immune reaction to the vaccine and generally subsides within four weeks. It’s not yet known if the recently approved Johnson & Johnson vaccine may have a similar effect.

Scripps experts are raising awareness about timing considerations for scheduling screening mammograms and the COVID-19 vaccine.

“Because enlarged lymph nodes can be seen on mammograms, patients due for their annual screening mammograms are encouraged to schedule their mammograms either before they have received the first dose of the vaccine or at least four weeks after they have received the second dose. This will reduce the chances of getting called back for additional imaging due to the enlarged lymph nodes,” Dr. Hsu says.

Under normal circumstances, swollen lymph nodes are a sign of breast cancer and would raise concern appearing on a mammogram and would require further testing.

If you get vaccinated first and do not want to miss a scheduled mammogram, make sure to tell your doctor about your vaccination to help get the most accurate mammogram reading.

Is it safe to delay a screening mammogram?

For patients of average risk, postponing an annual screening mammogram a month or two during the pandemic should not affect the risk of breast cancer.

“If you are significantly overdue for a mammogram, it is especially important to make and keep your mammogram appointment,” Dr. Hsu says.

A delay is only recommended for screening mammograms, where the patient has no breast cancer symptoms. There should be no delay if the patient has symptoms.

A diagnostic mammogram is used to look at a woman’s breast if she has breast symptoms or if a change is seen on a screening mammogram. A diagnostic mammogram may include extra views of the breast that aren’t part of screening mammograms.

You should contact your doctor right away if you notice changes in your breasts or are experiencing unusual symptoms.

Be on the lookout for the warning signs of breast cancer. Consult with your doctor if you develop any of these symptoms:

• Bloody or clear nipple discharge that occurs without squeezing the nipple

• Breast dimpling or puckering

• Swollen, red or warm breasts

• Changes in size or shape

• A hard knot or thickening in the underarm area or inside the breast

• A scaly, itchy rash or sore on the nipple

• Inversion (pulling inward) of the nipple or breast

• Pain in one spot that doesn’t go away in two to three weeks

How safe are breast care locations?

If you’re a Scripps patient, don’t hesitate to schedule a doctor’s visit to discuss a medical issue, change of health status or for a preventive visit, including a mammogram, due to concerns about COVID-19.

“We have extensive safety procedures and protocols in place to protect patients, doctors, nurses, staff members and anyone else who enters a Scripps facility,” says Ghazala Sharieff, MD, MBA, Scripps chief medical officer, clinical excellence and experience.

Those safety precautions include:

• Curbside check-in through the MyScripps mobile app

• Asking that patients visit their doctor without a companion, if possible

• Screening for everyone entering a facility

• Requiring all physicians, staff members, patients and visitors to wear face masks or coverings

• Rigorous cleaning and disinfecting protocols for all facilities and equipment

Steps you can take to protect yourself from COVID

In addition to wearing a face covering, you can take other steps to reduce your risk when you go to your doctor’s office, including:

• Practice social distancing in waiting rooms.

• Practice proper hygiene by washing your hands frequently with soap and warm water for at least 20 seconds.

• Use hand sanitizer before and after your visit.

• Avoid touching communal surfaces in the office, such as doorknobs and elevator buttons, as much as possible.

• Avoid touching your face, eyes, nose and mouth.

• Do not come in if you are feeling sick or have a fever or cough.

While a mammogram takes only a short while to complete, it does involve close contact between a patient and medical professional.

“We have safety measures in place for every step of your visit and we encourage you to ask questions about how we do breast imaging,” Dr. Hsu says.

End-of-Life-Care Planning Matters During Difficult Times

COVID-19 pandemic highlights importance of advance directives

by Scripps Healthcare

Planning ahead for end-of-life medical care can help bring some peace of mind during a crisis situation. The coronavirus pandemic has reminded us to be ready to have this conversation in case of a serious illness like COVID-19.

While most people who get COVID are able to recover at home, others might require intensive care and extended hospitalization. You don’t have to wait until you’re very sick to express your wishes for health care. In fact, it’s better to have these planning conversations before you have to go to a hospital, nursing home or other health care facility.

You can do this by using an advance directive, which allows you to specify medical treatment you want or don’t want if you become severely ill.

David Wang, MD

“Advance directives are important documents that protect a person’s health care wishes. They help individuals receive their desired medical care even when illness or injury prevents them from communicating,“ says David Wang, MD, a palliative medicine specialist at Scripps. “These documents guide your medical teams in knowing who speaks for you when you cannot speak for yourself.“

These legally recognized tools have been underutilized in the past. According to a 2017 study, only about a quarter of adults in the United States had recorded their end-of-life care wishes in advance directives or Physician Orders for Life-Sustaining Treatment (POLST) forms.

What is an advance directive?

An advance health care directive includes a patient’s wishes in case of a catastrophic medical event, such as from COVID. It has two parts: the individual health care instruction and power of attorney for health care.

What is individual health care instruction?

The individual health care instruction defines what should be done medically when a patient becomes too ill or injured to communicate. It explains the kind of interventions the patient would want or not want, such as being resuscitated or going on a ventilator, or instead allowing a natural death. People can cancel or change these documents at any time.

What is power of attorney for health care

The power of attorney for health care allows patients to designate an agent to make medical decisions for them when they are unable. An agent may be an adult relative or a friend.

Agents must try to determine what the patient would have wanted if not specified in the individual health care instruction. Medical teams must follow the agent’s decisions unless a requested treatment would be ineffective or harmful.

Physician Orders for Life-Sustaining Treatment (POLST)

The POLST form is used in California and complements an advance directive. It converts a patient’s wishes regarding life-sustaining treatment into legal physician orders, which can be followed by emergency medical first responders.

The provider discusses options and preferences with the patient before the form is signed. The POLST becomes a tool to make these discussions part of the patient’s medical record. At the heart of these documents are the patient’s rights regarding autonomy in health care decisions.

While an advance directive may be used to show a patient’s preferences, it does not have to be followed if deemed to be ambiguous or not in the patient’s best interests. On the other hand, the POLST is a physician’s medical order. It remains with patients wherever they receive care and must be honored.

Patients 18 and older may obtain these forms from their physicians or health care system. Once completed, patients should record them in their medical files, and give copies to their agents and family members. Patients may change or cancel them, provided they can competently communicate their wishes.

“Both advance directives and POLST forms memorialize important decisions that arise from weighty conversations. What is even more important is then courageously sharing these wishes with your loved ones,” Dr. Wang says.

Additional assistance and resources are available at the National Hospice and Palliative Care Organization.

COVID-19 Screening Questions: Honest Answers Are Important

COVID-19 Screening Questions: Honest Answers Are Important

Concealing COVID symptoms at medical offices puts many at risk

by Scripps Healthcare

There is a growing concern among health care providers regarding patients who fail to disclose they have symptoms of COVID-19 before entering a medical facility.

“Waiting until you are in an exam room to disclose to your doctor that you have COVID-19 or COVID symptoms is simply too late,” says Ghazala Sharieff, MD, MBA, Scripps chief medical officer, acute care, clinical excellence and experience. “Accurate information affects the way we approach personal protective equipment and the rooms we may put patients in. It protects health workers, patients and visitors.”

Everyone entering a Scripps Health treatment facility must be screened for COVID-19 by answering questions about possible symptoms and/or exposure for the coronavirus. The screening tool is only one of several added safety measures Scripps has taken to help prevent the spread of the virus — but it is a vital one that is dependent on honest answers from patients in order to be effective.

“It’s important to answer screening questions carefully and not rush the process just to make your appointment on time or because you’re afraid you won’t be seen if you say you have a symptom,” Dr. Sharieff says. “You will receive the care you need regardless of your symptoms.”

COVID concealment

A recent study in the Journal of Health Psychology found that people who had tested positive for COVID-19 or had symptoms weren’t always honest about their condition around others.

The study surveyed 451 adults in the United States and found women were more likely to disclose health symptoms than men, and older adults were more honest about COVID-19 status and behaviors than younger people.

“Often, lying feels easier and safer than being honest,” says Leah Welch, PhD, a psychologist at Scripps Health. “The study showed approximately one-third of participants who had tested positive denied having symptoms when asked by others and more than one-half reported some level of concealment of their symptoms.”

Why we lie

“Concealing key health information can protect ourselves and our image, but then, negatively impact others,” according to Welch. “It’s important that we do all we can to keep ourselves and others safe, and not jeopardize the health of others.”

Honest disclosures about COVID-19 diagnosis, symptoms and behaviors are imperative to help monitor the spread of the virus and protect the health of the community.

“Concealing your COVID status to the screeners upon entry not only impedes efforts to slow the spread of the virus, but it also can risk the health of the doctors and staff who are taking care of you if they are not alerted to take the proper precautions,” says Dr. Sharieff.

If you suspect you may have COVID, please call the COVID nurse line at 888-261-8431 or use a virtual care options.

Don’t be afraid to seek care due to fears of COVID-19

Health officials urge people not to delay any time-sensitive care for a medical condition due to fears of coronavirus. Medical facilities that follow recommended COVID-19 safety measures are still safe places to visit.

“People also should not hesitate to seek emergency care  because their condition may require rapid or advanced treatments that are only available in a hospital setting,” Dr. Sharieff says.

COVID safety at Scripps

At Scripps, safety measures have been implemented at all facilities, including:

• Screenings for everyone entering facilities

• Required face coverings for all physicians, staff and patients

• Curbside check-in option and social distancing in waiting rooms

• Rigorous cleaning and disinfection for all facilities and equipment

• Dedicated entrance and isolated zones for patients with coronavirus symptoms

• Limited visitors to all Scripps facilities

5 Questions to Ask When Looking for a New Doctor

By Scripps Healthcare

It’s open enrollment time - get answers before choosing a primary care physician

Trust, confidence and effective two-way communication are keys to a successful doctor-patient relationship.

When it comes time to select a new primary care doctor, the five questions below can provide important information about his or her knowledge, experience, communication style and more, and help you determine if the doctor is a good fit for you and your family.

1. What are the doctor’s medical qualifications and experience?

The minimum requirements for a physician are medical school, an internship and residency in an area of specialization, such as primary care. Some physicians go on to complete a fellowship, which is another period of specialized medical training or research.

“In addition to education, a physician’s certifications, professional experience and areas of interest can provide valuable insight into his or her expertise,” says Marie Lee, MD, a family medicine physician at Scripps Medical Center Jefferson in Oceanside. “If you have a specific interest, such as women’s health, consider finding a physician who shares that interest.”

You may find it helpful to ask about the following:

• Board certification

  • Board certification indicates that a physician has gone beyond basic licensing and met national standards for education, knowledge, experience and skills in a specific medical specialty. Studies have shown that board-certified physicians provide higher quality care and have better patient care outcomes.

• Teaching or lecturing at universities or medical schools

  • Many experienced physicians serve as adjunct faculty or guest speakers at schools and medical conferences.

• Special areas of expertise

  • A primary care physician may have an interest in complementary therapies, such as acupuncture. A gynecologist may specialize in treating infertility or menopause.

• Participation in research studies or clinical trials

  • This may indicate that the physician is involved in the development of new and advanced treatments.

2. Which accredited hospitals does the doctor use?

“It’s important to consider what will happen if you need surgery or care at a hospital in both inpatient and outpatient situations,” says Dr. Lee. “You want to have as much faith in the staff caring for you in the hospital as you do in your physician.”

Make sure your doctor admits patients to a hospital, clinic or surgery center that has undergone a rigorous on-site evaluation and meets established quality and safety standards, such as that provided by The Joint Commission. Also, verify that your insurance plan covers care at those facilities.

3. What is the physician-patient communication style?

The way your physician communicates with you can make the difference between a positive relationship or a frustrating one.

Some physicians tell patients exactly what to do, such as which medication to take, rather than discussing options with them. This is welcomed by patients who want the doctor to make all decisions about their care.

Others offer several options and make a recommendation. For example, “You can reduce the sodium in your diet or take medication to control your blood pressure. I would recommend the medication.”

Still others explain all treatment options, discuss the pros and cons of each, and leave the final decision up to the patient.

“The best fit depends on how involved the patient wants to be with his or her own care decisions, and how open the doctor is to the patient’s participation in those decisions,” says Dr. Lee. “Ideally, you want to find a good match.”

4. Can I communicate with my physician through an online patient portal?

Ask how accessible the physician is. Most physicians have access to an online patient portal to communicate with their patients. Online health portals make it easy to ask questions and clarify any issues that came up in an office visit.

5. What if care is needed on short notice or after office hours?

In the case of a sudden illness or injury, are last-minute appointments available? Some physicians will have another member of the care team — such as a physician assistant or nurse practitioner — accessible to handle such cases.

“Knowing what to expect from a new physician can help build a stronger relationship, which can lead to higher satisfaction on both sides,” says Dr. Lee.

Also, find out who covers for the doctor after office hours. If there is no on-call physician, research your other options, which may include urgent, walk-in or emergency care. In addition, virtual care may be available after hours, such as a symptom checker, e-visit or video visit.

Flu vs. Coronavirus: What’s the Difference?

Getting a flu shot is especially important this year due to COVID-19. Health experts believe the seasonal flu and the virus that causes COVID-19 will both be circulating this fall and winter and could put a strain on the health care system.

While a vaccine for COVID-19 isn’t ready yet for public use, the seasonal flu vaccine is widely available and is considered the most effective way to prevent the flu. Like COVID-19, the flu can cause severe illness and even death.

“Getting vaccinated for influenza is the best thing you can do to protect yourself from the flu while continuing to take preventive actions to avoid getting COVID-19 — including frequent hand washing, wearing a face covering, physical distancing and avoiding crowds,” says Ghazala Sharieff, MD, MBA, Scripps Health chief medical officer, clinical excellence and experience.

The following are frequently asked questions about the flu and COVID-19 and the importance of getting an annual flu shot.

1.   Is the coronavirus different from the flu?

Flu and COVID-19 are both contagious respiratory illnesses but are caused by different viruses. COVID-19 is caused by infection with a novel coronavirus known as SARS-CoV-2. Flu is caused by infection with influenza viruses. Both can spread from person to person.

“Because some of the symptoms of flu and COVID-19 are similar, it may be hard to tell the difference based on symptoms alone, and testing may be needed to help determine the cause of those symptoms,” Dr. Sharieff says.

2.   What are similarities and differences between flu and COVID-19 symptoms?

Similarities in symptoms between flu and COVID-19 include:

• Fever or chills

• Cough

• Shortness of breath

• Fatigue

• Sore throat

• Runny or stuffy nose

• Muscle pain or body aches

• Headache

• Vomiting and diarrhea in some cases

Symptoms of COVID-19 that are different from the flu include loss of taste or smell.

Also, people tend to develop flu symptoms one to four days after infection. COVID-19 symptoms may appear two to 14 days after infection.

3.   Can I have flu and COVID-19 at the same time?

It’s possible to have flu and COVID-19 at the same time. Experts are still studying how common this can be. It’s also unclear how the two viruses might interact or affect overall sickness when infecting the same person.

4.   Is COVID-19 more dangerous than flu?

Flu and COVID-19 can both result in serious illness that can lead to hospitalization and even death. COVID-19 appears to be more deadly than seasonal flu based on current data.

5.   Should I get a flu shot if I had COVID-19 earlier this year?

Yes. Getting a flu shot will not protect against COVID-19, but it will reduce the risk of flu illness.

“If you had the flu or COVID-19 earlier this year, it does not protect you from a future flu infection. The best way to prevent seasonal flu is to get vaccinated every year,” Dr. Sharieff says.

6.   Should I get a flu shot if I have COVID-19?

No. People who have or suspect they have COVID-19 should delay getting a flu shot even if they have no symptoms.

They should do this to avoid exposing health care workers and other patients to COVID-19. They should wait until they have met the criteria set by the Centers for Disease Control and Prevention (CDC) to discontinue home isolation.

7.   When should I get a flu vaccine?

September and October are good times to get vaccinated. But it can be done as late as January or as long as flu viruses are circulating.

8.   Where is the safest place to get a flu vaccine?

A flu vaccine can be safely received at multiple locations, including your doctor’s office, health departments and pharmacies. Use VaccineFinder to find flu shot locations near you.

In San Diego County, flu vaccines are available at most Scripps Clinic and Scripps Coastal Medical Center primary care sites, which are open by appointment to all Scripps patients. Drive-through vaccination is available at many of the sites.

When going to get a flu shot, practice preventive measures, including wearing face covering and physical distancing.

How Does COVID-19 Affect Older Adults?

Six ways to prevent illness, social isolation and lonelinessOlder adults – especially those with medical conditions – have been hit hard by COVID-19 and need extra support.

Those age 65 and older account for 80 percent of coronavirus-related deaths, according to the Centers for Disease Control and Prevention (CDC). People 85 and older have the highest risk of severe illness from COVID-19.

Many seniors are staying safe by staying home and social distancing, but are now at increased risk of social isolation and loneliness, which can result in depression, anxiety and other health problems.

Fortunately, many services are available to help seniors stay safe and socially engaged during the pandemic. These services include food delivery, online exercise programs and other free or low-cost offerings through public health services.

“We want our seniors, especially those most at risk for severe illness from COVID-19, to stay home as much as possible during the pandemic and to have a support system in place that can help ensure their safety and well-being at home,” says Alexander Meilan, DO, an internal medicine physician at Scripps Clinic Torrey Pines.

Dr. Meilan recommends the following:

1.   Don’t hesitate to seek emergency and non-emergency care

Don’t delay going to the emergency room or calling 911 for any medical emergency. Emergency departments have COVID-19 prevention plans to keep their patients and staff safe.

Staying in contact with your doctor is important especially for seniors with chronic conditions. In many cases, non-emergency visits can be done via telemedicine. In some cases, an in-person visit is necessary, such as getting an annual flu shot.

Caregivers can help their seniors download a telemedicine app to their smart phones or tablets and teach them how to use it. Make sure the app has privacy features to protect patient health information.

2.   Stay connected, prevent loneliness

Older adults should have a plan to safely stay in touch with family and friends during the pandemic to help prevent the ill-effects of social isolation and loneliness.

“Older adults should have someone they can reach out to if they need help getting food, medicine and other supplies. If they live alone, regular human contact can mean a lot to their health and well-being,” says Dr. Meilan.

Regularly scheduled phone calls, video conferences, texting and emails can help make up for a lack of in-person contact.

Caregivers can help their seniors set up and understand video conferencing options, such as FaceTime or Zoom.

3.   Stay physically active

Getting exercise may seem harder with gyms closed or concerns about going to one when they open. Many options are available to stay active without risk of exposure during the pandemic.

Find fun and creative ways to stay active at home. Join an online exercise class or find an exercise video for seniors on YouTube.

Go out for a walk. Make sure to wear a mask, especially if physical distancing is going to be difficult. Caregivers can join their seniors in a walk but should also take precautions.

Staying active may be harder for older adults with medical conditions that limit their ability to regularly exercise. The CDC recommends 150 minutes of moderate-intensity aerobic exercise per week but says those who cannot do this much should stay as physically active as their abilities and conditions will allow.

According to the CDC, regular exercise:

• Improves sleep

• Improves balance and reduces risk of falling

• Improves joint mobility

• Extends years of active life

• Helps prevent weak bones and muscle loss

• Delays onset of cognitive decline.

4.   Check delivery and pick up options

For those who have concerns about going out to buy groceries due to COVID-19 or who lack transportation or have limited physical mobility, look for grocery stores that offer pickup and delivery services to reduce their risk of exposure. Ask if they offer discounts or free delivery for seniors. Consider asking a neighbor or other family member to do the shopping for you.

For those who prefer to shop in person, look for stores that offer senior-only hours. Make sure they require customers to wear face covering. Get in and out of the store as quickly as possible.

Caregivers who shop for food for their seniors can set aside time for conversation after delivering groceries to help prevent loneliness.

5.   Prevent falls at home

More time at home may increase the chances of an accidental fall that results in injury. Learn how to reduce the risk of falling at home.

Make home safer, for example, by removing loose rugs, adding handrails to stairs and hallways if needed and keeping adequate lighting in dark areas.

Also:

• Schedule a risk assessment for falls with health care provider.

• Stay active, focus on balance, strength training and flexibility exercises.

• Schedule annual vision and hearing exams.

• Manage medications, understand their side effects.

6.   Make a list of resources

Create a list of organizations to contact for information, health care services

including mental health or counseling as well as food and other support.

• San Diego County’s Aging and Independence Services provides an array of services, including access to home-based support services, meals and counseling help.

• Elderhelp of San Diego provides community-based solutions through staff and volunteers committed to helping older adults live independently in their own homes.

• Stay at Home. Save Lives. Check in is a statewide campaign in California to help combat isolation and food insecurity among people 65 and older.

• AARP Foundation's Connect2Affect program provides information, and options for older people to stay socially connected.

• The federal Substance Abuse and Mental Health Services Administration has a hotline, 800-662-HELP (4357), to help people find counseling services in their area.

COVID-19 testing from Scripps Healthcare

FAQs on Coronavirus Diagnostic and Antibody Testing 

By Scripps Healthcare

What are the different types of COVID-19 tests and what do they all mean?

Because of the rapid developments in testing, there has been some confusion around the different types of COVID-19 tests being offered. Here is what you need to know about testing being offered at Scripps Health:

Coronavirus (COVID-19) Tests

What is it?

The CDC recommends a COVID-19 test called a nasopharyngeal swab which checks samples from your respiratory system (such as swabs of the inside of the nose) to tell you if you currently have an infection with SARS-CoV-2, the virus that causes COVID-19. 

How does it work?

A care provider in protective gear will ask about your symptoms and take your temperature. They will then put a special 6-inch cotton swab up both sides of your nose and move it around for about 15 seconds. It won’t hurt, but it might be uncomfortable. We then test the fluid on the swab to detect the presence of the virus.

Because of recent advances, test results are available very quickly.

How can I get tested for COVID-19?

Scripps Health is testing people with moderate symptoms of COVID-19, especially those who are at higher risk. This includes health care workers, older adults, and patients with compromised immune systems or chronic medical conditions such as diabetes, heart disease, chronic lung disease and chronic kidney or liver disease. 

Scripps is also testing all patients for COVID-19 who are being admitted to our hospitals, obstetric patients and those scheduled for surgery. 

If you suspect you have symptoms of COVID-19, please call our nurse line at 888-261-8431 before coming in or use one of our virtual care options.

When will I get my results?

If you are tested at an outpatient testing facility, you can expect test results in less than 24 hours. 

If you are tested as a patient admitted to a Scripps hospital or in one of our Emergency Departments, your care team will quickly receive your results typically within 2 hours.

Can the COVID-19 test ever produce false negatives?

False negatives are an issue with any test. This may be because the amount of the virus in your sample is so low, it can't even be detected or because not enough of your sample was taken for an accurate reading.

“At Scripps, we are well aware of the potential for false negatives, and our strategy has been to use universal precautions, in that all health care workers in our system wear a surgical mask while in a patient care area, wear fresh gloves with every patient, and perform meticulous hand hygiene,” says Ghazala Sharieff, MD, MBA, Scripps chief medical officer, clinical excellence and experience. “Also, if we have a strong suspicion for COVID, we don’t rely on a single negative test and we retest as needed.”

What Happens After I Get Tested?

A positive COVID-19 test means you currently have or recently had the virus. Monitor your symptoms and get medical help right away if you have trouble breathing, confusion, or bluish lips or face.

Learn more about taking steps to avoid spreading the virus here. 

If you test negative for COVID-19, you probably were not infected at the time your sample was collected. However, that does not mean you will not get sick. It is possible that you were very early in your infection when your sample was collected and that you could test positive later. Or you could be exposed later and then develop illness. In other words, a negative test result does not mean you won’t get sick later. This means you could still spread the virus.

Coronavirus Antibody Testing

What is it?

Commonly referred to as “antibody testing,” "antigen testing" or "serology" – this test is not used to diagnose COVID-19. Rather, it is a blood test to determine if you have been exposed to COVID-19 at any point in the past – in which case your body would have created antibodies in response to the infection. An antibody is a protein made by our bodies in response to an infection. Once created, antibodies typically help the body fight off an infection.  

How do I get the COVID antibody test?

Scripps Health currently is offering antibody testing in very limited circumstances. Antibody testing requires an order from a physician. Patients with questions about antibody testing should contact their doctor. For more information about antibody testing, visit the CDC. 

Is there any benefit to COVID-19 serology test?

There is still much uncertainty about the value and use of testing for antibodies related to the new coronavirus.

The CDC is still studying and determining the exact benefits to antibody testing. The antibody test provides an estimate of how many people have been infected in order to determine how many in the public remain at risk. This may help with trends and future predictions about the progression of the pandemic.

“Having antibodies to the virus does not guarantee a person will not contract it again. We just don’t know enough about this virus yet,” says Dr. Sharieff. 

COVID-19 Plasma Infusion Study

What is it?

The COVID-19 plasma study is a relatively new clinical study that offers treatment to critically ill COVID-19 patients. This is not a diagnostic test or an antibody test. Scripps is the first health care provider in San Diego County to use an experimental therapy as a possible treatment for COVID-19 patients.

How does it work?

Convalescent plasma therapy takes plasma donated by someone who has recovered from COVID-19 and transfuses it into a hospitalized patient currently battling a serious COVID-19 infection. 

“The idea behind the treatment is that people who have fully recovered from COVID-19 have antibodies in their plasma that can attack the virus when transfused into patients with serious, active disease,” says Dr. Sharieff. “The hope is that the plasma will be helpful to very sick COVID-19 patients and speed their recovery.”

While the therapy is still experimental, the FDA is allowing physicians to use plasma from recovered patients to treat those with “serious or immediately life-threatening COVID-19 infections” under an emergency approval system.

Is this treatment working so far?

“Plasma therapy treatment is relatively new, and we are studying its benefits every day,” says Dr. Sharieff. “So far, initial results for Scripps Health patients appear to be promising.”

How to Donate Convalescent Plasma

If someone you know has tested positive for COVID-19 and recovered, they are likely eligible to donate plasma. The American Red Cross recently started a national program to collect and distribute plasma, and current supply is low. Plasma can also be donated through the Scripps Bone Marrow Transplant/Apheresis program by contacting Michelle Meyer at meyer.michelle@scrippshealth.org.

Message from Scripps

What to Do If Someone at Home has Coronavirus Symptoms

CDC says isolate at home if sick and prevent spread

You may be doing everything health experts are recommending to prevent getting COVID-19, such as washing your hands often and practicing social distancing. But what happens when you or someone in your house starts showing COVID-19 symptoms or has tested positive for the new coronavirus?

While an unpleasant situation to think about, it is critically important to be prepared for any emergency at home involving COVID-19.

The Centers for Disease Control and Prevention (CDC) says most people who get COVID-19 will only have what is considered a mild illness and will be able to recover at home.

Nevertheless, people with COVID-19 need to monitor their symptoms. If they show any of the emergency warning signs — including trouble breathing, persistent pain in chest — they need to seek medical attention right away. Additional steps must be taken to help prevent the spread of the potentially deadly virus in the household.

What is home isolation?

“Home isolation is recommended for people who are ill with COVID-19 and are a risk to their family and visitors. They must be carefully watched in case their symptoms worsen,” says Ghazala Sharieff, MD, Scripps chief medical officer, clinical excellence and experience. 

The CDC recommends that people with COVID-19 or who believe they are infected should:

• Stay home and do not leave unless it’s for medical care. Get rest and stay hydrated.

• Monitor your symptoms and call medical facilities ahead of time before seeking care there.

• Keep a distance from others as much as possible. Stay in a separate room and use a separate bathroom.

• Wear a cloth face covering over your mouth and nose when around others.

• Cover your coughs and sneezes; throw away tissues in a lined trash can and immediately wash hands.

• Clean all high-touch surfaces in your isolation area – including phones, remote controls, counters, tabletops, doorknobs, bathroom fixtures, toilets, keyboards, tablets and bedside tables.

• Let someone else clean and disinfect surfaces in common areas, but not your bedroom and bathroom as long as you’re sick.

• Don’t use public transportation, ridesharing or taxis.

In addition to isolating yourself if you're sick, the whole household should quarantine at home for 14 days, as symptoms may appear two to 14 days after exposure.

Caring at home for people with COVID-19

If someone in your house has COVID-19 or symptoms and is told to stay home and monitor their condition, you may provide support for the sick person, but be careful.

“The person who is sick should stay in a separate room and use a separate bathroom if possible,” says Dr. Sharieff. “Check up on them several times a day and monitor for emergency signs.”

Make sure the sick person is drinking plenty of fluids to stay hydrated and getting plenty of rest. Provide over-the-counter medication to treat symptoms when appropriate.

“Ask through the door how they are doing. Give them a video call if they aren’t too ill,” Dr. Sharieff says. “If you must go inside, keep your distance and wear a mask, especially if the sick person can’t wear one and use gloves.”

Wash your hands with soap and water after interacting with the sick person to help prevent the spread of germs in the household.

In addition, the CDC recommends the following measures be taken for people who are sick:

• Have them take their temperature regularly.

• Make sure they wear a cloth face covering their mouth and nose when around others and stay six feet away.

• Call their health care provider if they are getting sicker (such as not being able to eat, drink or go to the bathroom).

• Limit contact with animals. There is no evidence of pet-to-human transmission, but caution is urged.

• Prohibit visitors who do not need to be in the home.

People who are not sick should not clean the room of someone who has COVID-19, or should do it only on an as-needed basis and take precautions. If you only have one bathroom, use air conditioning or an opened window – weather permitting – to improve airflow.

When to end home isolation

According to the CDC, the following conditions are recommended before ending home isolation if you haven’t been tested:

• No fever for at least 72 hours (without using fever-reducing medicine).

• Other symptoms are gone, such as coughing or shortness of breath.

• At least seven days have passed since the first symptoms appeared.

Ending home isolation should be done in consultation with your health care provider and state and local health departments.

Prepare in advance

It’s not too late to plan ahead in case you or someone in your house gets sick with COVID-19 and is told to isolate at home while they recover.

Basic supplies to have on hand should include:

•   A working thermometer to monitor fever

•   Fever-reducing medications

•   Rubber or latex disposable gloves

•   Regular soap and hand sanitizer

•   Tissues to cover sneezes and coughs

•   Disinfectant cleaning supplies

If you have a medical emergency and need to call 911, tell the operator that you have or might have COVID-19.

Edward Jones

Edward Jones: CARES Act Provides Investors, Business Owners with Opportunities

Contact: Trevor Heglund

For Edward Jones financial advisors, passage of the Coronavirus Aid, Relief and Economic Security (CARES) Act has been a jolt of good news in an otherwise deeply unsettling time.

"Obviously, our biggest concern is for the well-being of everyone in our community," Trevor Heglund says. "And we hope everyone is practicing social distancing and doing everything they can to keep themselves, their loved ones and their neighbors safe and healthy. But beyond the physical worries caused by the coronavirus, there have been deep economic concerns, and the CARES Act is an important move toward addressing some of these."

Heglund says that several provisions of the CARES Act may be of particular benefit to investors:

Direct payments - Individuals will receive a one-time payment of up to $1,200; this amount is reduced for incomes over $75,000 and eliminated altogether at $99,000. Joint filers  will receive up to $2,400, with this amount reduced for incomes over $150,000 and eliminated at $198,000 for joint filers with no children. Plus, taxpayers with children will receive an extra $500 for each dependent child under the age of 17.

"One possible idea for this money is to use it as part of an emergency fund," Heglund says. "By putting it in a low-risk, liquid account, you'll have it available when you need it for any large, unexpected expenses during the next several months."
 
Expanded unemployment benefits - The CARE Act provides $250 billion for extended unemployment insurance, expands eligibility and provides workers with an additional $600 per week for four months, in addition to what state programs pay. Unemployment benefits will also be extended through Dec. 31 for eligible workers. And the provisions also cover the self-employed, independent contractors and "gig economy" workers.

"These benefits can provide a lifeline to many workers," Heglund says. "And they may be able to help people avoid liquidating some long-term investments earmarked for retirement just to meet their daily cash flow needs. So, in that sense, the money can help individuals feel more secure today and in the future."

No penalty on early withdrawals - Typically, individuals must pay a 10% penalty on early withdrawals from IRAs, 401(k)s and similar retirement accounts. Under the CARES Act, this penalty will be waived for individuals who qualify for COVID-19 relief for distributions up to $100,000 in aggregate from IRAs and plans that allow COVID-19 distributions. Withdrawals will still be taxable, but the taxes can be spread out over three years.

"Waiving the 10% penalty is a positive move during times like this," Heglund says, "but we would still advise our clients that, if they really have a need for the money, to look at other sources first, because IRAs and 401(k)s are long-term vehicles designed to help support people during their retirement years."

Suspension of required withdrawals - Owners of traditional IRAs and 401(k)s are usually required to start taking withdrawals from these accounts once they reach 72. The CARES Act waives these required minimum distributions for 2020.

"Of course, if people need the money, they can still tap into these funds," Heglund says. "But, if not, this provision gives the money even more time to grow on a tax-deferred basis.

Increase in retirement plan loan limit - 401(k) investors who qualify for COVID-19 relief can now borrow up to $100,000 from their accounts, up from $50,000, provided their plan allows loans.

"We recommend that you exhaust some of the other provisions associated with the CARES Act first, such as mortgage and student loan relief, or using the direct payment to bridge the gap on current expenses before taking a distribution or loan from your retirement account," Heglund says. "If you decide to take a withdrawal or loan we recommend you work with your financial advisor to consider developing strategies to recontribute/pay back these funds over time to reduce any long-term impact to your retirement goals."

Another key part of the CARES Act provides $349 billion to help small businesses - those with fewer than 500 employees - retain workers and avoid closing up shop. A significant part of this small-business relief is the Paycheck Protection Program. This initiative provides federally guaranteed loans to small businesses that maintain their payroll during this emergency. Significantly, these loans may be forgiven if borrowers use the loans for payroll and other essential business expenses (such as mortgage interest, rent and utilities) and maintain their payroll during the crisis. 

"Small businesses are really the economic backbone in many of the communities in which we have our offices," Heglund says. "I would certainly encourage our clients who are business owners, and any business owner, to explore this opportunity."

Ultimately, Heglund says, the CARES Act may be seen as another steppingstone on the road back to recovery, from a financial standpoint.

"We've still got some major challenges, but it's encouraging to see our lawmakers coming together to offer some concrete steps to provide relief to investors and business owners," Heglund says. "We all need to work together to get through this challenging time, and I'm confident we'll do just that."

Edward Jones, a Fortune 500 company headquartered in St. Louis, provides financial services in the U.S. and, through its affiliate, in Canada. Every aspect of the firm's business, from the investments its financial advisors offer to the location of its branch offices, caters to individual investors. The firm's 18,000-plus financial advisors serve more than 7 million clients and care for $1.3 trillion in assets under management. Visit our website at edwardjones.com and recruiting website at careers.edwardjones.com. Member SIPC.

Contact Trevor Heglund

760-632-8054

The Fittest Dog

The Fittest Dog is a rapidly growing dog running business based in Cardiff, but serving a large part of San Diego County.  Owner Kimberli Weeks started this business as racepacepups in 2016, and after three years of logging thousands of miles running San Diego dogs, has brought on a team of talented athletes and outdoor enthusiasts who believe in this mission based business of getting our dogs fit, both physically AND mentally.  

Ernie in Cardiff-by-the-Sea. The Fittest Dog is a dog running service owned by Kimberli Weeks.

Hiring The Fittest Dog to run your dog in a one-on-one method as opposed to hiring a dog walking service, has benefits most owners don't realize beforehand.  With over 53% of US dogs overweight or obese, now is the time to make a difference in the longevity of your dogs life!  Kimberli says the first time an owner of a previously anxious recent rescue, cried to her that her dog has been transformed, she realized this was much more than "just a fun dog run".  This exact moment is what changed her business to a passionate cause.  Anxious pups need a positive redirection and the focus running brings is pure joy when calm energy takes over, and skittish barking subsides!  She also has had Veterinarians refer patients to her service to be put on weight loss fitness programs, and hunting dogs during off season to stay fit!  Her business has helped all levels of fitness and will continue to do so on a larger platform. 

In 2020, The Fittest Dog will continue local partnerships as well as new national canine wellness brands.  She is an advocate on dog fitness and welcomes any questions, whether it be over phone, email or even outside Seaside Market where she will most likely be petting your dog!   Read more about her newly rebranded business at www.thefittestdog.com, and be sure to check out the blog section, with tips and gear reviews all dog owners should read!

Follow @thefittestdog on Instagram and Facebook!

SDG&E

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SDG&E Holiday Tips and December Rebates

ACT SOON – INCREASED REBATES FOR BUSINESS PRODUCTS STARTING DECEMBER 7, 2019

SDG&E business rebates have been substantially increased but only from December 7 – 31!

From cooking to refrigeration to lighting equipment, business rebate amounts have been raised for a short time. These products must be installed by December 31, 2019. Take advantage of these amazing deals before they’re gone. Here is a sample of the increased rebates offered.

To view the product catalog visit sdge.com/NLrebates. Check out sdge.com/BES for even more temporarily increased business rebates. For business program information, tips and solutions, go to sdge.com/business.

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SAVE ENERGY AND KEEP YOUR BUSINESS SAFE THIS HOLIDAY SEASON 

With office parties to coordinate and gifts to send, things can get hectic for businesses during the holidays, as well as expensive. One expense a business can cut down on and save energy on is electricity. When it comes to saving energy, it’s often the simplest but most overlooked things that can have the most impact. Do your part this holiday season to save energy and keep your customers, business and employees safe. Here are a few tips to help you get started. 

1. Opt for LED lights. As the Department of Energy notes, LED lights consume 70 percent less energy than conventional incandescent lights. Install safer and more energy-efficient lighting like LED holiday lights. LEDs are also cooler than incandescent lights reducing the risk of combustion and are sturdier making them more resistant to breakage.

2. Use power strips to energize holiday decorations. Holiday lights and neon decorations bring festive cheer into a business space but when these items aren’t on – they still draw energy. Help reduce this expense by plugging holiday decorations into a power strip and turning it off when energy isn’t being used.

3. Get creative with your lighting display. Not everything is about strands of lights. Reflective ornaments and tinsel are just as bright at night, multiplying your resources for shine.

4. Use rechargeable batteries. Rather than plugging holiday decorations into the electrical mains, use battery-powered decorations instead. Rechargeable batteries are more cost-effective than conventional batteries and will save electricity.

5. Install a timer for holiday lights. Holiday lights flickering away on a tree with nobody there to enjoy them is a waste of energy and money. Installing a light timer in the office allows you to turn lights on and off at specific times, meaning lights won’t be left on unnecessarily.

6. Prevent a fire. Keep flammable substances a safe distance away from open flames or electric heaters to prevent objects and equipment from catching fire.

7. Update your contact information. SDG&E can send you email and text alerts in the event of an emergency or outage with the latest information. Update your contact information and enroll today at sdge.com/myaccount.

For more tips on how to keep your business safe and save energy this holiday season, visit sdge.com/business-winter.