Dr. Roxane Hionis, an internal medicine primary care specialist in Wayne, PA, spoke with HNA about the current Coronavirus pandemic. Dr. Hionis discusses her experiences during these turbulent times and projects a few recommendations everyone can do to stay healthy. Roxane Hionis was born and raised in Ohio. She received a bachelor’s degree in Biology and French Literature from Brown University in Providence, RI. She received her M.D. from Case Western Reserve University School of Medicine in Cleveland, OH. She completed a residency in Internal Medicine at Hahnemann University Hospital in Philadelphia. She has been voted “Top Doc” by Philadelphia Magazine for the past two years. She currently practices in a private practice in Wayne, PA, and lives with her husband and three daughters in Bryn Mawr, PA.
Aphrodite Kotrotsios (AK): What do you think is the difference between patients you are seeing in your office vs. patients in the ER?
Dr. Roxane Hionis (DRH): Things have unraveled pretty quickly. In the beginning, we were just limiting our office visits to people who had no cough or other upper respiratory symptoms. In the past two weeks, however, we are doing mostly telemedicine. Many of our patients are elderly and we do not want them to come to the office and potentially risk getting infected. Since the elderly and those with certain medical conditions are more likely to develop severe disease, I think this is a prudent move. We can handle many problems remotely. Even patients suspected of having COVID 19 are mostly handled remotely. Main Line Health has set up drive-through testing centers and we are able to refer patients for testing. Only if patients are having shortness of breath, confusion or altered mental status are they being sent to the emergency room. So, the ER is getting only the most severe cases.
(AK): Has it been a scary experience for you and your staff?
(DRH): It is scary to think that we may lose some of our patients to this virus. As a small office, we become very close to our patients and really mourn losing anybody. So far, I have been lucky. My patients who have gotten COVID 19 have done well. Yes, the staff is scared if someone has to come into the office. We do not allow anyone to sit in the waiting room. They must wear gloves and are taken directly to the exam room. We wear gloves and masks and goggles, etc. Mostly, we are trying to NOT have anyone come to the office as it is safer for everyone that way.
(AK): What measures have you implemented to keep you, your staff and patients safe?
(DRH): They are mostly working from home.
(AK): What is your biggest message to your patients coming in with symptoms and patients that are symptomatic that are looking for holistic approaches to medicine?
(DRH): The most important thing is to make sure your immune system is working properly since that is what we need to fight this virus. Eat healthy- lots of vegetables and fruits. Avoid processed foods and simple carbohydrates. Get plenty of sleep. Exercise. Take some vitamin D. Take a multivitamin. Your best bet is to avoid the virus by staying at home, washing your hands, etc. but if you do get it, take Tylenol instead of ibuprofen or naproxen or any other nonsteroidal anti-inflammatory drugs as some people believe that these make the symptoms worse (although this is still controversial).
(AK): Have you had any scary moments with patients that needed to be rushed to the ER?
(AK): What are some telltale signs that make you suggest that a person needs to go to the hospital?
(DRH): Very high fever that won’t come down with Tylenol, severe shortness of breath, confusion, inability to arouse, persistent chest pain, blue lips or fingernails. These are a few signs that you really need to go to the hospital. People should consult their doctors if they have other signs. They will be able to tell them if they need an ER evaluation or not.
(AK): Generally, speaking, being a front line healthcare provider, serving your community, how do you cope with the stressors of this pandemic?
(DRH): I talk to my colleagues and pray that a vaccine is developed soon!
(AK): Do you have what you need to test symptomatic patients or is there still an issue?
(DRH): I have been able to test my patients who are symptomatic. It was difficult in the very beginning but once Main Line Health opened their testing centers, it improved a lot. I think that it was probably not necessary to demand that every test be sent to the CDC as the government did in the first week or two. Now that Quest and Labcorp can run the tests, it has improved. However, it is still taking a week to get those results back. By that time, people are either getting better or have been sent to the hospital. Of course, it is important that people self-quarantine during the testing period, especially from any family members with high-risk conditions such as heart disease, immune deficiencies or lung problems. I am hoping that the new rapid test that was just approved will become widely available as that will help immensely in instructing and informing patients.