Believe it or not, I like going in to see my doctor. For someone who cares enough about health to do a podcast episode every week on it, it’s a chance to get some professional insight and real-life point of view on medicine. Plus he’s just a nice guy.
I’ll have a separate episode on how my annual physical went and what you can learn from it. But today I’ll share with you how a primary care physician is handling the pandemic.
At time of my visit, and this was the beginning of September 2020 (actually 8/31), he had seen 12 confirmed cases of COVID-19. Fortunately, none of the staff has been infected. For about 6 weeks, they were down to about 50% of the normal number of patients who come through. But now they are back to business as usual. But a portion of patients now see him through video calls. The office has any patient who is sick call in that way. This has obvious limitations. For example, he had a call with a young girl about a possible appendicitis. Since she didn’t have some of the common symptoms such as nausea and vomiting, a hands-on exam with palpation of her abdomen would have allowed him to be more certain about the diagnosis.
So here is how he is treating COVID-19 patients. First he has a video call with them, since they are sick. If they meet the qualifications—he didn’t tell me but here are the CDC guidelines:
People who have symptoms of COVID-19
People who have had close contact (within 6 feet of an infected person for at least 15 minutes) with someone with confirmed COVID-19
People who have been asked or referred to get testing by their healthcare provider, localexternal icon or state health department
If they meet any of those, he has them come in for a test, which is taken in the parking lot outside the office. And since it can take several days to get the results, he makes an immediate determination as to whether they are likely to be infected. If so, he begins treatment even before the test comes back. Otherwise he would lose that time, he’s normally experiencing a 3-day turnaround on the tests.
We hear that a vaccine is coming soon, there has been a monumental effort worldwide to make it happen, but even when the vaccine for SARS-COV-2 is available, it won’t help those who are already sick.
So here is the course of treatment available to Dr. Bicak, which he may prescribe to a confirmed or probable case of COVID:
Magnesium Glutamate – this helps combat the cytokine storm that I talked about in episode 241, which was about the inflammation aspect of the diease. Unfortunately the magnesiuim you can usually get at your local store is more likely to be magnesium oxide or magnesium citrate, both of which can cause diarrhea.
He mentioned Z-packs, which I believe cannot be combined with hydrooxychhoroquine, which brings me to my next point.
Hydroxychloroquine, sometimes known as HCQ, according to Dr. Bicak, really works against COVID, but some retailers, Walmart in particular, have decided not to carry it. Patients can usually get it at a local independent pharmacy, and he knows some that he sends patients to. We can only speculate as to why Walmart would refuse to carry this drug. the doc thought it could be that they didn’t want COVID-positive people in their stores. Another possibility is that it’s political, since it has been recommended by the president. if that is true, it is a scary thing indeed.
Dr. Bicak says it is unheard of for a businessperson to make a decision like this. He’s frustrated that he is a physician, prescribes a drug, and then walmart will not fill the scrip.
Anyway, the good news is that so far, all of my doctor’s COVID-19 patients have recovered. I hope that trend continues, until we can get a vaccine and this long nightmare will be over.
References:
Interview with Ajdahan Bicak, MD, 8/31/2020
https://thehill.com/policy/healthcare/494012-nih-recommends-against-combining-hydroxychloroquine-with-z-pak-to-treat