Coronavirus: The new temporary normal

Posted by Nurse Linda in Daily Dose on March 25, 2020 # COVID-19, Health

The coronavirus is here in a huge way. Many of us are self-isolating and keeping social distance. We are washing our hands, the correct way. If we can, we are working from home. These activities are especially necessary for those of us who are elderly and immunosuppressed.

That includes me. Elderly, ouch. Immunosuppressed, like many. Spinal cord injury is an immunosuppressed condition. Many people are immunosuppressed for other reasons. For me, it is a condition that occurred as a result of serious illness but like many of those with spinal cord injury, for the most part, it did not disrupt life too much until now. Individuals with chronic conditions are at risk due to changes in the immune system.15 Ways to Slow the Spread

Being in the risky group, I decided to go to the grocery store at the senior and immunocompromised designated time. After all, I qualify. Like you, I am taking this extremely seriously. The hours are from 8-9am. I decided to arrive about 8:15 because I did not want to be in a crowd at the door waiting for the store to open. At 8:15, the store was very crowded. That makes it difficult to keep social distances. One man offered me a bag for my fruit that he had just pulled but then withdrew the offer because he had touched the bag. A new reality takes time for adjustment.

My grocery has a portable sink for hand washing before you enter and after you leave. Great idea. I tried it. The water was freezing cold, so it was difficult to maintain 20 seconds of washing. I don’t think many people could tolerate it plus warm water is needed. I still had soap and friction. Next on to the cart. I use the sanitizing cloth on my hands first and then use a disposable cloth on the cart. Sometimes, I take the cloth with me to use when pushing the cart and picking up items.

There were a few customers who were disappointed because they could not get the items they wanted. That creates high tension. Unpleasant exchanges happened. In some stores, physical fighting has occurred. People need to take a step back and a deep breath. Most foods were there but not the preferred brands. Certainly, no paper or cleaning supplies. Many people are hoarding which leaves little for the rest of us. Shifts in manufacturing are occurring to make up for demands. This will take some time, but products will be coming. Everyone remember to buy only what is needed so this shortage does not put others at risk.

I tried to thank everyone working for their support. Workers are putting themselves at risk by being in the public. Thank those that are not seen. There are many people that are in the supply chain that we do not see but their efforts are allowing us to get things we need. A good example are big rig drivers that are delivering supplies, individuals in manufacturing and warehouse workers. There are many others. Emergency personnel and healthcare professionals that are in the midst of trying to keep their patients safe as well as their own safety and their families. The pressure on these individuals is tremendous.

Many people are attempting to help the situation. One whiskey brewer in my area is sending their supply of high-octane alcohol to a neighboring hand sanitizer manufacturer. He is giving it to them with the agreement that a percentage of hand sanitizer will be given to first responders, healthcare providers and individuals at high risk. What a way to pull together. There are so many great stories like this. If you get moment, listen to the stories in your community. You can thank them on their webpage. Even though you might not be directly affected, what is helpful to one is helpful to all of us.

Like so many, I find myself sort of lost in the new, temporary normal. Yes, temporary because this will pass. The when is questionable. I am a homebody but not everyone likes being inside. I can also easily entertain myself. Some people struggle with both.

There are a few things that can help you adjust to this shift in life. First, get up at a regular time every day. Most people already do this, but it is very easy to snuggle down just a bit longer when you do not have to leave the house. Regular times of getting up and going to bed will help your body and mind. This can also improve your sleep pattern.

Second, get dressed. Change your clothes in the morning to signal to yourself that it is a new day. Occasionally, put on something nice, even if you cannot or choose not to go outside of your home. I miss my ‘work clothes’ so I put on a jacket, jewelry or something different than ‘home clothes’ just to boost my mood.

Third, pay attention to personal hygiene. You might not be going out or seeing people in person, but your general health and mental wellbeing will welcome personal cleanliness.

There are several ways to organize your day. Some people who go out daily for activities or work find being at home is like a long week end or vacation, until they realize there is no return to routine date set. It can become easy to do nothing which will lead to boredom and increase anxiety. Creating a new routine will help with consistency so even though no one can control the outside world, you can control your own personal activities.

Structure Your Day
Putting some self-imposed structure into your day might be the choice for you. After spinal cord injury, there is some structure that needs to happen such as bladder care, bowel programs and skin care. You already have these built into your day. Without a regular routine, these activities can slide to a point where your routine is no longer followed which can lead to unnecessary complications. Be sure to stick with your daily routine for care even if the usual signals that you use for initiating the activity is not there. But what about the entire rest of the day?

Look at the activities that you plan to do to fill your time. This does not mean wasting time but accomplishing some goals that perhaps you did not have time for previously. Create a schedule for yourself. Break tasks down into simple steps to be accomplished over days or weeks so you do not become bored or overwhelmed with any one activity. When locked into just one activity, you might forget to cath, do your pressure releases or even eat in a timely manner. On the other hand, people who are now in their homes and can choose what and when to do something tend to eat too often, or snack continuously. A schedule for your new environment can help.

Think of things that you would like to accomplish. This might be doing something new that you did not have time to do before. Create a daily routine that includes self-care, work or school. Include activities that are required of you. Then put in your chosen activities. For instance, without leaving your home, you might find you have extra time in the day that you previously used for commuting or you might not be shopping but ordering online or having a neighbor shop for you. Since we are sheltering in place, you might have more time to occupy yourself.

Randomize Your Day
Some individuals do not like structure. You can still organize your day to ensure your health without a strict schedule. You will need to do your routine self-care, work and school but in your free time, choose some activities that you would like to accomplish. Write them on a piece of paper and put them into a bowl. You can draw them out when needed and begin that task. It adds an element of novelty to the day. This approach will make it much more palatable to those who appreciate less rigidity.

Mix Structure and Randomization to Your Day
People generally prefer a little of both structure and randomization, so mix or switch between the two. You are not bound by a strict set of rules, but you do need to live life. The important aspect is to keep working toward tasks or goals, so you have a sense of accomplishment instead of just whiling away the hours. Some sort of plan or structure can help reduce stress in uncertain times.

Other Ideas
Are you glued to the TV or computer for news about coronavirus (COVID-19)? I have been listening to every bit of information and sifting through what is real and what is opinion. One night I was watching a special dedicated to it. About half way through, I realized the very reputably produced program was horrifying me. Take a break from the news if you are feeling overwhelmed. Listen just once or twice a day, which ever makes you more comfortable. Be sure to listen to the world, national and local reports so you are up to speed with what is happening. It is important to be well informed but control your intake to the amount you need. Yes, this is a huge problem that will be difficult for us all, but we will get through this. Yes, you can live through this.

Eat healthy. It is easy to swing by the kitchen when you are home and pick up a cookie or two or more because you are not out of your environment. Many people who work from home or have just retired comment about how hard it is to regulate your intake when your kitchen is right there and stuffed full of goodies. Some people are filling their time with cooking which is a good comfort tool but be sure you are not over-portioning yourself or filling your belly and not just your time.

Maintain your social distance. You can still be in contact with loved ones and friends via telephone, and social media. You can have people who are not ill or exposed around you especially as caregivers. We don’t always know about exposures but have conversations about activities with the people you need. Most people know their caregivers well so it can be easier to talk with them about their activities. Be sure they follow the hygiene rules. Today, you can sit outside if not near others. Check the current regulation status before you do.

Prioritize exercise. This is where that schedule can become important. If you do not exercise, now is the time to start with range of motion. Start slow but overtime, work up to three times a day. We will get through this. It will be nice to be even healthier at the end than today.

Pediatric Consideration
There has been much comment about children and COVID-19. It appears that coronavirus affects children and teens more than previously reported. Children with spinal cord injury are immunosuppressed so their risk is greater.

It is important to follow the recommendations available to us all. Keep a structure with your children at home. There will be school online. Be sure your child participates. This is a huge switch for them. Some children might not have the dedication to stick with online programming. It will be important for you to encourage and praise their learning as you would do with in school education. Children need to understand that school, now online, is important.

To work from home and manage a family is a challenge. As a caregiver, you will need to think about your own wellbeing. If you can take a moment to step outside or at least out of the room, count to ten or just close your eyes when appropriate. Being all together in your home is going to be a challenge for single and couple parents. But we will get through this and we will be stronger for it.

Post your questions or concerns about COVID-19 on Reeve Connect for our Information Specialists and experts to address.

Linda Schultz, Ph.D., CRRN, a leader and provider of rehabilitation nursing for over 30 years, and a friend of the Christopher & Dana Reeve Foundation for close to two decades. Within our online community, she writes about and answers your SCI-related healthcare questions in our Heath & Wellness discussion.