Our recent podcast on COVID 19 was so popular, we decided to do a deeper dive into the particular risks women face and how we can best protect ourselves and those we care about.

In this webinar/podcast, Gennev CEO Jill Angelo talks to Dr. Rebecca Dunsmoor-Su, Chief Medical Officer and director of the Gennev Telemedicine program, Health Coaches Lauren Leedy and Stasi Kasianchuk of the Gennev HealthFix program, and Dr. Swapna Vaidya, psychiatrist, on ways we can stay physically and emotionally healthy in this very unusual, very unpredictable time.

You can also view the webinar video on YouTube. A list of mentioned resources and the full transcript are below.

Resources mentioned in the video:

  1. Fitness:
    1. Barre3
    2. DownDog
    3. Peloton
    4. Class Pass
  2. Meal Delivery:
    1. Thistle
    2. Splendid Spoon
    3. Sun Basket
  3. Grocery Delivery:
    1. Amazon Fresh
    2. Whole Foods
  4. General information:
    1. Centers for Disease Control
    2. Harvard Health
    3. Coronavirus tracker
    4. Mental Health and Coping resource
    5. Coronavirus Masterlist of resources for psychological health

Transcript:

Gennev CEO Jill Angelo:

All right. Well we're three minutes past. I'm kind of prompt, we have a lot to cover today, so let's go ahead and get started. First of all welcome to everybody. This is a special, a special edition of a webinar that we've really never done before around coronavirus and the relationship of it as women with menopause stress and the risks that we are experiencing during this kind of unprecedented time in history. I want to welcome you. We have a number of presenters today. We're going to jump right into it here rather quickly. But just kind of to level set the, the basis and kind of the reason why we're hosting this webinar today is very much around we as women are having to go through a lot of adjustment right now.

Our kids are home from school for those of you, those of you who have kids at home. Our businesses might be struggling. We're working from home, we're trying to balance childcare with, with work. And in some cases our immune systems could be compromised if we're older or have other conditions that compromise that. And we just wanted to bring together our team of experts to really talk about how we might be compromised from a health perspective but also mental health and then finally what we can actually do to strengthen our immune systems and even some life hacks to try to manage through this part of history. So I'm Jill Angelo. I didn't introduce myself, but I'm Jill Angelo. I'm the co founder and CEO of Gennev and with me today you can see the faces and we're going to move live to everybody here in just a moment, but Swapna Vaidya is an MD and psychiatrist focused on behavioral health and women's health in particular.

Swapna has been an incredible partner with us in working with women in midlife and so we're really excited to have Swapna with us today. Dr. Rebecca Dunsmoor-Su is an MD. She's an OB GYN. She's certified by the North American Menopause Society. She's also the chief medical officer at Gennev. And is my partner in crime. She's runs the health practice of this company and it's just really awesome, always, to have her taking the helm on, on this topic.

Stasi Kasianchuk is a registered dietitian nutritionist. She's also a physiologist. She's one of our health coaches at Gennev. In November last year we started a new offering called HealthFix. It's a membership for women who want to manage more lifestyle approaches to menopause care and to even just strengthening their own immune system in the second half of life. And Stasi is one of our health coaches.

And then Lauren Leedy is our director of health coaching. She leads our health coaching team. She's also a registered dietitian nutritionist and has just a rich background. Both of them have worked both on the data side of health, but also with women in midlife. So brought them on board. We're going to talk nutrition, exercise, lifestyle, stress, sleep, all those things.

So without further ado, I will move us on. But before, if, if any of you are new to Gennev, just to give you a quick little overview of who we are, we're an online clinic for women in menopause. Specifically we offer telemedicine services via doctors specifically OB GYNs. We also have a chat and video access to our health coaches and registered dietitians through our HealthFix membership. And then we also offer over the counter health and wellness products such as dietary supplements, lubricants and hygiene products, all formulated for women's health and menopause. And finally, we are a platform for free education and community.

This is the place for women to come if you want to really manage your health in the second half of life. And so we're thrilled that you joined us today. So with that I'm going to stop sharing slides. We're going to get to actually the people. And so all of our presenters some of you are muted. I'll remind you if you start talking to unmute. But what we're going to do is we're going to start by just, I'm going to plant some questions and we're going to go over some content a little bit more from an overview perspective, and then I will open it up for live questions in the last 20 minutes or so of our hour together. And so if you do have questions along the way, you can always pop them into chat. Again, chat is on the bottom menu here in your zoom window. So with that, let's go ahead and kick it off. And I'm going to direct the first question to Rebecca. Just to talk a little bit about COVID 19 and coronavirus and our susceptibility as women in midlife and menopause. Do we have to worry? Do we have any extra worries? Can you just kind of give us a little bit of an overview and what you've seen so far?

Dr. Rebecca Dunsmoor-Su:

I'm happy to go and hopefully I remembered to unmute myself to do so. Hi everyone. I'm glad you could all join us either on the Zoom or on Facebook live or any of our other platforms. I think it's important to talk about this with a special focus on women's health because the more we learn about this virus, the more we find that it affects different populations, differently. Currently, I'm at last, last I looked to the who and the CDC for their data, it looks like the biggest risk factors with this virus are age and preexisting conditions. So what we're seeing is that as we get older, the risk of serious illness and even death does increase. The highest risk group obviously being in their eighties and nineties. Some of that is due to preexisting conditions, but some of that is simply just age and immune system as it, as it ages, it's less effective.

The preexisting conditions that seem to be the most concerning are things that reduce immunity. So obviously cancer treatment medications that you might be taking to reduce your immune system such as steroids or biologics. But the other, the conditions that are, seem to be very concerning are underlying heart disease and lung disease. So people who perhaps feel who perhaps have heart failure at baseline or who have baseline COPD or asthma might be at slightly higher risk if they catch this virus. That being said, it does not necessarily spare anyone. You know, we're seeing healthy 40 year olds go, go into the ICU. So I tell everybody, you can't assume because you're on the younger side and you're relatively healthy, that it won't impact you. We all need to be cautious. And in terms of women and women in menopause, women do not seem to be at, at baseline higher risk from this.

It, if anything is equal risk to men and women if not slightly higher risk in men from what we're seeing. That may also just be who it's affected so far and who's been tested. It's really hard to know. We haven't tested extensively enough to really know that. But really menopause itself is not necessarily a risk.

Where I see risk coming in is that menopause can have huge impacts on our immune system because of stress and sleep disturbances. And so really addressing those issues of menopause are key in making sure that we keep ourselves healthy and able to combat this virus.

Jill Angelo:

That's great. Thank you. Rebecca. One thing I just want to come back to you on for one second. You had talked about medications that people might be on that might make you more, is it susceptible or weakened, our systems. What are those, can you just call those out again?

Dr. Rebecca Dunsmoor-Su:

So the ones that we all think of are steroids. So a lot of people need to be on chronic steroids for a variety of reasons. The medications that we tend to call biologics, they typically end with AB or MAB MABs. And those are usually used for things like rheumatoid arthritis or psoriasis or psoriatic arthritis. Any chronic rheumatologic conditions, we tend to suppress the immune system somewhat because the immune system is the thing on the attack in those conditions. And then the other medications we worry about are things like chemotherapy medications that attack the immune system, attack cancer cells. But also the immune system. So those are sort of the big categories. I would think about.

Jill Angelo:

I saw Swapna was nodding her head, Dr. Vaidya. And I want to direct the next question to you. So you're working right now with, with patients with mental health challenges and, and maybe stress in dealing with, with coronavirus. Can you talk a little bit about what you're seeing so far?

Dr. Swapna Vaidya:

Yes. thank you, Jill. And thank you for the opportunity to, you know, talk to all of you and to sort of share some of the situations that we're seeing right now. And one of the things that I'm seeing is a lot of uncertainty and anxiety regarding the situation as it's evolving. I'm certain that we are all also feeling it because this is a very new novel situation for all of us. At this point in time, what we are trying to focus on is to stay calm the most that we can and to actually make sure that our patients are being informed that there are dynamic things that are happening and changing, but at the same time, it's so important to take care of yourselves. One of my very good psychiatrist friends actually sort of jotted down a few very simple things.

One of this is that we're all in this together. There are simple things we can do. Wash hands, you know, maintain social distancing, listen, be patient. This too shall pass. But at this point in time, the wealth of information that's coming and it's very overwhelming. I think it's very important to channelize what you're trying to learn from the media and elsewhere. I think it's so important to take care of each other. I think one of the things that we as women have to remember is that we are the pillar of a family, I mean as it is a woman is struggling all the time, she has to multitask. And this situation has even now driven it 10 to 20 times more intense. Now if you're talking about families being cooped up together, now you're talking about dynamics. How are we coping with our relationships?

How are the anxieties coming around? Are we taking care of each other? What about the older population that is living with us? So these are the questions that are coming up a lot and a lot of answers that I have to say to them is that, which is as I'm telling myself, is to take care of each other. Facetime is good, really social distancing. A lot of people are coming and asking me, but why can't I just go and play and have a play date? And I really feel it's very important at this point in time to understand the situation of flattening the curve. So as much as you know, engage in self care, you know, follow a good diet, exercise, follow daily routine. It's okay to go for walks. Meditate, take deep breaths and just simple things as I would say.

You know one of my patients was sort of saying, can you just come up with a simple routine? What should I do? How can I make sure this doesn't happen? It's, it just jot it down, right? Like, I mean, okay, what, what do you need? Right? So just kind of make a list. How are you coping? You have one coat, use that coat to go out. Use one bag, you know, simplified your life. And collectively, if we all look into this together, I think we can get through this. You know there have been pandemics and there have been natural disasters and you know, the one thing that I've learned, I was actually in New York when 911 did happen and what I really saw was the community come together and collectively address this and you know, things were evolving and even then we didn't know what was going to happen, but it did pass. And I think this shall pass too, this is my advice to myself and to everybody else, you know, meditate daily breaths. We're all going to be in this together. We're going to pass this.

Jill Angelo:

Thank you. I think that's so reassuring, Swapna. Like it's, it's a positive message and we need to hear positivity during this time. Just to kind of go in a little bit deeper around I saw one interesting tweet this weekend around, you know, think about others versus yourself. Even if you are out having dinner or something like that, it's about the others in your home, whether you're living with elderly parents or people who are more susceptible to this than you are. That kind of notion of being unselfish and, or caring for the others. I think oftentimes women go to the far right or left on that spectrum. I see women locking down their households right and left. We're in that kind of the hub of it all here in Seattle. Can you share a little bit more about how, you know, in terms of that thinking of others how we as women can encourage, you know, grown kids or others in our family, in our household that do just want to get out and be with their friends or go out to dinner, that they've got to think about others beyond just themselves, who they feel even if they feel very healthy.

Dr. Swapna Vaidya:

You know, I'm Jill, I'm glad that you brought this up and this is such an important time and this is what I was talking about, having a collective consciousness because this is not so much about each one of us individually, but it's about that vulnerable population. It's about your grandparents. It's about that you know, those sector of people who are older with comorbid medical conditions that you as a healthy adult, you may go out and you probably might have a milder version, but here you are at the risk of probably perpetuating it and giving it to somebody in your family who might have a very, very drastic reaction. So I think it's important to sort of like reinforce this behavior and how would you do it? By promoting this yourself, you know, by pulling up facts, by teaching your kids, but involving your kids.

And I think having age-appropriate discussions with the kids. You know, I have a five-year-old, so I think I kind of like having made some rhymes with him about hand washing with Humpty Dumpty or Happy Birthday, he selects one or the other. Involving them and actually educating them because even if he's five or 10 or 15 or what have you, education and having a clarity about it really helps.

And I know I keep going back to, we are all in this together, but that's really the mantra that I keep coming back to. We also as a society have to be collectively conscious. I do have patients asking people, why do I need to be quarantined? I’m healthy. I mean I need to go out. I'm anxious, I'm cooped up. And I know it's a difficult time, but it's so important for us as a society to understand that we really are in this together so that we can help flatten the curve and we can actually protect the vulnerable people around us.

And at the same time, self care is very important. So one thing I would like to add, Jill, is that as women, we tend to not care about ourselves. It's always about the other person first, whether it's your husband or your kids or your mother-in-law. But it's important to look at what your needs are and it's okay to be anxious and it's okay to not know and it's okay to say, Hey, you know, I don't have the answers. Can we, you know, sort of like I need help sometimes. So self-care, understanding, you know, when to kind of put your own oxygen mask, as I say, I know that analogy, it's so important. So as much as we can do to promote healthy active behaviors involving our kids in healthy active initiatives. And you know I'm sure everyone is involved in Facebook and WhatsApp and what have you. But to kind of promote it to create a healthy platform to share healthy coping mechanisms. I mean we have great people on our panel right now, you know, for the nutrition as well as the other health coaches. And I'm also excited to hear more about for myself as to what I can do during this time. But I think that those kinds of things and those kinds of tips would help so much as we all go through this together.

Dr. Rebecca Dunsmoor-Su:

I just, before you jump in, Jill, wanted to add Swapna brings up a really, really important point, which is that most of us will do just fine with this virus and we're going to be fine. We probably won't even require hospitalization, but some proportion of us will. And really the goal of the social distancing is so that as people get this and do require hospitalization, ICU care, and even ventilators, we do it one at a time rather than all at once. Because we will run out of space, we will run out of supplies, and we will run out of healthcare providers, if all of us get it all at once. So really what you're doing is protecting others, even though you might come through it OK. We need to make sure that this happens slowly and gently across sort of this whole nation. We're all going to get this. None of us is immune, but if we can do it slowly and carefully, we might just make it through this.

Jill Angelo:

I think that's a really important point. Thanks Rebecca. And thank you, Swapna you know, I can hear you're, you're you're, you're a mom and action right now doing your job as well as managing family at home. So you're, you're an example for sure. So thank you.

Let's let's then pop to nutrition. I'm Lauren, I'm going to go to you next. Lauren is our director of health coaching at Gennev: registered dietitian, nutritionist, and I know your husband as well is one of those on the front lines in the healthcare system right now. So to Rebecca's point around everyone's gotta be thinking about others and their health and able to care for others. You're, you're, you're doing that in your household. Can you talk a little bit about immune response? Because we all want to keep our immune systems really strong and a lot of that comes, it starts with what we put in our bodies. So talk a little bit about how you're, you're coaching your clients right now and thinking through that.

Coach Lauren Leedy:

Thanks, Jill. And yes, it's a really challenging time. And I too am a mom and this is, this is hard, you know, to, to balance everything. And at the same time to Swapna’s point to take care of yourself. Like it's so hard as women to put yourself first. So I'm hoping that women still at this time continue to nourish their bodies well. To support an immune response, the big thing is to load your body full of nutrients from whole foods. I'm not talking about going and taking certain supplements. There's going to be a lot of, lot out there, a lot of people capitalizing on the fact that people are trying to boost their immune system right now and promote supplements. The best thing you can do is load your body full of nutritious whole foods and make sure you're getting adequate fluids.

Coach Lauren Leedy:

So that's going to do the, the best to prepare your body for actually attacking or getting rid of this virus. And I know what complicates things right now is the fact that our supply is limited and a lot of us are trying to avoid places like the grocery store and getting food or maybe we have kids at home and we just can't take the time to go out and get that food. So I'm really recommending to my clients that they use this time at home to try out some new techniques they might have always wanted to try. For example, there's a lot of amazing meal delivery services out there that you can sign up and have cooking kits or fully prepared meals sent to your home. It's a really great way to involve your kids too if you do have kids at home to prepare some of these different cooking kits.

Another idea too with fluids, a lot of us struggle with getting enough fluids. One simple technique I wanted to share that, you know, women could try to do while they're at home is the rubber band method. So a lot of people love this technique. Figuring out how many bottles of water you need to drink in a day, and putting that number of rubber bands around the water bottle. Every time you finish it, you take off a rubber band. So the goal is to get them all off by the end of the day. And, and it's amazing what just nourishing your body and giving yourself enough fluid can do. The other thing I might add just because as women you're probably got your hands full right now, that this doesn't have to be elaborate. You don't have to feel like you’re cooking all the time. Some time saving tips, you know, use the package foods that are out there and dress them up.

This doesn't have to be perfect eating, you know, add veggies to a frozen pizza that you have. Throw some extra veggies in a soup or a smoothie, make simple modifications or batch cook once and freeze. So you have multiple meals to work off of. So that's, you know, it really doesn't have to be more complicated than what we generally promote.

Jill Angelo:

And how about how about in terms of foods that really boost the immune system? Just call those out. I know we kind of read about it all the time, but, but why don't you just call those out? What are some specific ones.

Coach Lauren Leedy:

So really fresh fruits and vegetables that are going to be rich in antioxidants. Those are going to the best thing. So the brighter in color they are the better, but you really can't go wrong with fresh fruits and vegetables. Just a whole foods based diet, not singling out one nutrient or one food in particular. Those are going to be your best bets.

Jill Angelo:

I know in Instagram posts, I think last week you posted a number of these food delivery options. So we should go ahead and include those in our followup on notes for this webinar. But also are, is there any overall guide that you're watching? Because I know every business is vulnerable during this time. Are any of these delivery services like curbing delivery because they also don't want to put their staff at risk? Or any, have you heard anything there yet? Are they all functioning?

Coach Lauren Leedy:

Yeah. So I did try to do a grocery delivery service this weekend myself and it was definitely delayed. So another tip I have too, if you need something right away, our local businesses right now, like you said, small businesses, they're really vulnerable and they're hurting and we we don't, you know, want them to, to crash and we want to support them, but at the same time, there's recommendations to not go to restaurants. Many of them are still open for delivery, takeout. So please use those businesses and maybe try out a new restaurant but get a delivery or get a go pick up your order as another quick strategy. The other thing I wanted to highlight that at Gennev I think is health coaches. You know, put us to the test, use your health coach. Let us know what's in your pantry right now. And we are more than happy to help you put together a healthy, nutritious meal. So this doesn't have to be starting from scratch. Like you tell one of us exactly what you have. And we love doing this. We'd love to help you come up with a creative easy throw together meal.

Jill Angelo:

That's awesome. That's great. It's kind of like having someone come over and take a look at your closet and put together like outfits for you.

Coach Lauren Leedy:

It’s our own chopped challenge.

Jill Angelo:

Yeah. Yeah. That's great. That's awesome. That's awesome. Well then on that note I'm going to move to Stasi. Stasi, your colleague on the coaching side of Gennev. And Stasi you focus a lot on just managing kind of exercise and activity and how even that can help manage the stress and/or sleep challenges that we might be feeling during this time. Can you talk a little bit about more about you know, immune response measures that women can take and that you've been talking to women about? As we're all cooped up, can't go to the gym, you know.

Coach Stasi Kasianchuk:

Yeah, absolutely. And exercise definitely is a passion of mine. Something I'm right now, especially I'm navigating how do I continue to move my body to be able to be my best self as well as we look to manage this. And exercise I love to similar to nutrition is that there's a lot of varieties. There's not a one size fits all approach. And so that gives you a lot of opportunity to try something that's going to find to find something that's gonna work best for you. And during this time I think it's important to come back to, again, all of the messages we've heard here. Swapna had some great points on, you know, routine. How can you keep a routine or maintain a routine?

A lot of the women that I work with around menopause, it's a different, it's a new time of their life, so they are trying to establish a new routine and I encourage now you might have an extra challenge in finding that routine, but incorporating your family. If you have kids at home, kids need to move too, it can help them get some energy out. So maintaining or establishing a movement routine throughout your day. Now if you're someone who has more been used to having your exercise time in the morning, maybe that's changed up a little bit, especially if you can't go to your gym. But still designate that time. So if you can keep the morning time, great. Maybe it has to move to the afternoon or you can still get benefits from spreading it out. So if you don't have that hour but you can spread out 15, 20 minute blocks throughout the day, bring the kids along. You know, maybe you're, if it's safe, if you are not a high risk population and it's safe for you to go outside and remain social distance that is definitely an option.

I think the fresh air and sunshine if it's available to you is really good for us right now. Just remembering to maintain those public health recommendations around where you are outside. So I think that's establishing that routine and incorporating the family is a great way to keep moving and really help to manage that stress when we are in that one place for too long and not moving our body. We know that sedentary behavior is not supportive of our health, so how we can fit that in right now is going to be important.

Jill Angelo:

That's great. I know I noticed this morning on my, my morning run, every time I'd meet someone on the sidewalk, like the other person would either go to the street, like we totally like avoided each other even on the sidewalk, which was interesting. So yeah, it's very real.

Coach Stasi Kasianchuk

I have that experience too. Yesterday and it was interesting feeling that it was all of a sudden it was a sign of respect to do that. So interesting times right now, but accepting that, OK, that’s your side of the sidewalk. I have no problem going to the other side. No offense. We're doing it for each other.

Jill Angelo:

Yeah. You know, one thing I hear you talk about, Stasi, a lot is journaling and and again, this notion of routine and maybe it changing or whatever. Is there comfort in journaling too? You know, I might feel like, Oh God, it's going to like push it in my face, all the things I'm doing wrong, you know, and be another stress. Or is it comforting and healthy? Like talk a little bit about just even documenting what we're doing on a daily basis.

Coach Stasi Kasianchuk:

Absolutely. Yeah. Journaling is really helpful for women during menopause because so many things are changing and rapidly it can be difficult to remember what happened yesterday, let alone last week or last month. And because we're trying to see what patterns are happening to then best put together a toolbox to support women during this time. So every, what I, when I'm working with clients, I want them to establish a toolbox so they have the tools to pull out when certain symptoms come up and they feel prepared for that. Doing the journaling can allow you to see what's happening over time. And so a lot of women will notice patterns. Oh wow, this happened, this did happen last month. I have it documented. Okay, this might start happening every four or five weeks. So what can I do ahead of that curve to best prepare myself for these situations?

And I think this is relative right now too because this is an added stress. How can you reflect on what's going on, what you really need right now.Aand Swapna you know talked about jotting things down of what do you need in this present moment. I think journaling can be helpful for that as well. I think as women we not to get into the genetics of it, cause I don't know, I'm not an expert in that area, but I honestly think women tend to hold things in their head more and we let things and Swapna, feel free to jump in, but it feels like it's a, a, a storm in our head. And so that first step of journaling I find, I talked to a client on Friday where she was actually working more on journaling related to perfectionistic thoughts. And how those perfectionistic thoughts were taking over.

And by journaling those, she was able to identify it. And in reviewing her journaling, she was able to identify areas where she wanted to focus on this week moving forward. So then it, it pulled out a focus point rather than having to focus on everything. So I think journaling can be really helpful as that step. Could also be a step of where do I need to have a conversation about this versus, okay, this is the journaling's helping me here. But sometimes it means reaching out to either a healthcare practitioner, whether it be a psychologist, psychiatrist, or therapist, or even as a health coach. We have areas, we where therapy is outside of our scope of practice. But there certainly can be techniques around behavior change and dealing with emotions that we can use to support people.

Jill Angelo:

You know. And one last thing I'm going to come back to you on is why is it those conversations we have in our heads, whether it's perfectionism, perfectionist, or I'm not getting this done or I'm worried about my business or my job, or what am I going to do with the kids tomorrow? Like I've got a stack of homework I'm supposed to be taking them through and you know, why do we think about those things in the middle of the night? Like that's my problem.

Last night I just, I was like I was a mess and you would've thought the world was crashing and I wake up and things are fine, but why, why does it happen then?

Coach Stasi Kasianchuk:

I think the you know, the, the importance of sleep is because it is that time when our body can relax and process without having a lot of other inputs. So we, all of a sudden it's this, we've given ourselves permission, that guard’s down a little bit and then the body starts to go to work. But if we're in a heightened state of awareness, we may not have that guard down enough so that we can fall asleep. Or if we're working with hormonal fluctuations during menopause that are disrupting our sleep all of these things can then add other layers. So then the body strides to recover and process, but you're not actually fully asleep. It's kinda like if the anesthesiologist didn't quite you know, put the anesthesia in all the way and you're awake and aware you're feeling fine. But again, you don't have, the body's not doing it without you, so to speak.

Jill Angelo:

Yeah. I see. I see Swapna nodding her head a lot. Any comments on that and why the voices get louder at night?

Dr. Swapna Vaidya:

Well, you know so I think that I would go back to this philosophy of women. We are holding everything together. The family members are looking at us as this woman, she's going to take care of everything. And we are, you know, so during the day we have certain things going on. We are jotting down things, we have our activities going on. But it is during that nighttime when you're unwinding. And that's when those racing thoughts happen. And especially in women, I think it's important even with the fact that the menopausal situation with the hormonal fluctuations that can affect sleep. So sleep hygiene is important universally, but especially during the trial time of stress and trauma, it's so important to kind of understand and be mindful about sleep hygiene. So I think it's important that one understands that you have to kind of like look at winding down your day.

What can you do? Maybe you can take a bath, maybe you can kind of read a book. Again, self-care, you know, sort of like avoiding news, avoiding media, avoiding Facebook because that's the time your mind is actually unwinding and then going with racing thoughts and then you cannot control that. So it's so important to be mindful and say, okay, no, I'm not going to look at the Facebook right now. I'm not going to look at Instagram. I need to de-stress. I need to read something which is optimistic, which is positive. I need to actually listen to meditation apps. I did that last night because my mind was racing and I made a conscious effort. I said, I'm gonna switch on my meditation app. And I listened to the river, the sounds of the river and I fell asleep. So I can see myself going through it and I'm trying to kind of like just navigate it as much as everyone else is, but focus on your sleep because sleep is also important for immunity.

And so everything is so interconnected. So as much as you can try to be mindful about it, but you know, also accept the fact that these are uncertain times. So be kind to yourselves. Yeah. You know, you're going to have some thoughts you're going to race, sometimes you're going to be anxious. Just be kind to yourself and say, okay, you know, what can I do about it? How can I be proactive about it? When can I seek help? I think, you know it's important to understand when I need professional help versus when I can just keep it within myself. So that's an important distinction also I would like to make: reach out.

Jill Angelo:

That's great. That's great. You know, speaking of that, reaching out. And this question is a little bit for, for Rebecca. You know, as we think about you know, telemedicine and the ability to, you know, connect with health providers like we're doing here versus going to the clinic or the ER in some cases, not that I want to, you know, push down any kind of emergencies that certainly exist, but how, how do we as women, like know, if, you know, if we should reach out to somebody for help and then how can telemedicine start to help kind of bridge that to give us a mechanism so that we don't have to put ourselves in danger or leave room for people who are critically ill?

Dr. Rebecca Dunsmoor-Su:

And that's a really good question, Jill. I think the things to recognize are that, you know, I think all of us are thinking about, well, do I need to go and get tested? Do I need to know if I've had this virus? The answer is if you are not critically ill, you don't need to get tested and you don't need to know at this point. We don't have the testing capacity in this country to test everybody just cause we want to know. So right now the most recent guidance we got from the Washington State Department of Health this morning was that those who need to be tested are people who are critically ill and healthcare workers and people who are parts of particular clusters that they're trying to identify. But if you've got a cough and a fever but you're overall breathing okay, you should stay home.

If you want reassurance about whether or not you're the right candidate to stay home, then absolutely reach out via telemedicine. You know, Gennev does a lot of great menopause care. We can do general gynecology care for people. We're probably not your top resource for COVID care. And we are all OB GYN. We do some basic primary care but infectious disease is not our specialty. But there are other great partners and telemedicine who do have tons of primary care doctors who can just answer those questions. And just say, Hey, you know what? You sound like you're okay. Why don't you stay home, stay away from others. Don't fill up that ER, that's already full of people with respiratory significant respiratory symptoms.

The other thing is don't go to general appointments right now. Your annual can wait. You know, if you think you might have a yeast infection, call us. We can do that over the phone, you know, or over video. We don't need to be filling up our doctors’ offices with things that can wait until this settles down a bit.

And definitely thinking about, you know, how urgent is this complaint right now? If you have a question on, a lot of doctor's offices will answer whether you need to come in. Yeah, I know. You know, I, I maintain a full practice as a gynecologist and our office is triaging everybody right now and saying, Hey, you know what? This can wait a couple of weeks or no, you need to still come in. So definitely, you know, the best first step is asking your physician. But of course all of us who do telemedicine us at Gennev and our partners in different areas and specialties, we're all there for you to be able to answer those questions online as well.

Jill Angelo:

I'm glad you addressed the, the notion of should I get tested because I don't, I can’t tell you how many times if I've had a little bit of a sore throat or a sniffle or a bad headache in the last few weeks, I've wondered, Oh my gosh, am I, am I contagious, you know, do I have something, should I get tested? What if I'm endangering anybody else? Like how, how do you manage through that? And any of you can comment on that. Cause I know I struggle with that and I feel it. And I sometimes wonder if it's in my head too.

Dr. Rebecca Dunsmoor-Su

It's not in your head. We all, we are all worried and we all want to know if we're contagious and if we're going to hurt other people. I think the point where we are in this country right now is that if you have a sniffle, if you have a sore throat, if you have a fever, please just stay home. Just don't risk anybody. And I know there are folks who can't stay home for whatever reason, whether they're a frontline worker, whether they have no one else to shop for them and they're out of food, in which case, you know, take the best precautions you can and try to avoid contact at all costs. But testing's not really the answer. You know, if it doesn't matter if we know that you have COVID, we shouldn't be giving anybody anything right now. You know, flu is, seasonal flu is still going around at a pretty rapid rate, which can look very similar. And we, you know, having the flu, you can also get COVID at the same time, which is a huge immune stressor. So just staying away from others, it doesn't matter whether it's COVID or flu or some other virus, we all just need to stay home and stay away from each other.

If you are sick, if you are short of breath, if your fever is very high and won't go down, then it's worth seeking further care and then we might need to test you and/or hospitalize you.

Jill Angelo:

Great. Great. And I know testing capabilities is different in every state, correct? So who do you check with?

Dr. Rebecca Dunsmoor-Su:

It's vastly different in every state and it's rapidly changing even in the State of Washington. And we're ground zero for all of this. We cannot possibly test everybody and different tests go to different places depending on how critical it is. Some of these tests are being sent to Washington, some of these tests are being done at the University of Washington. Some of these tests are being done at Lab Corp. It really depends on how urgent the answer is. And in a lot of states there's very little testing capacity. So step one is to call your physician, your primary care physician. They should be probably the most up to date on what testing is available. If they do not know, they may refer you to either your department of health or the emergency room nearest you.

But the emergency rooms right now are overwhelmed and understaffed because emergency doctors are starting to get sick. And so we really need to avoid the emergency room unless you absolutely need them.

Jill Angelo:

Yeah. Thank you. That's great. Well I do want to open it up for questions. Again, if you do have a question that you'd like to direct to any one of our panelists go ahead and, and put it in the chat. And while people are doing that you know, are there other topics, any one of the panelists that we haven't addressed that you'd like to call out? I'll just pause and let any of you jump in.

Coach Stasi Kasianchuk:

Can I jump in for a couple, Jill? Oh, you know, if they gave out, tried to put on a positive spin. I'd been looking at a lot of resources and really been supported by the group fitness community that is stepping up right now. For me, a part of exercise, I have a background in personal training and group exercise, so it's always had a special place in my heart and I've continued to participate in a lot of those programs.

Unfortunately right now as you can imagine, going to a group exercise studio that might be in close quarters, sharing equipment, not the, not the best place, but a lot of these businesses have stepped up to provide free online resources. So a variety of different options out there for you. So some of the ones that I saw over the weekend, Down Dog is yoga, barre, and they also have some cardio workouts. They're offering free, their free app through April 1st. So that's an option. Barre3 which is barre, barre yoga Pilates combo does include some cardio and light light weights. And you can do it with or without equipment. They're offering a 15 day free online trial. So that's another option. Peloton the app, so you don't have to have the Peloton equipment, although if that is in your budget to purchase a Peloton treadmill or bike, now might be a great time to do that. But the Peloton app is even one that you don't, they're offering a 30 day free trial. You don't need to have the equipment. It has running. It has yoga, it has weights, things that you can do at your house. Even body weight workouts. ClassPass is one that they have waived all cancellation fees. They're offering flexibility around that until we get through this. And then they also offer at home workouts as well that you can stream for through your phone or your computer.

So those are options and I've done some of those and they're pretty intense. I remember the last one I did, I was, I was sore for two days. So if that's something you know, if you're really looking for those higher intensity workouts to be able to do at home. And I think it is important to continue to keep that community and being able to find those ways to do that.

And some other things, even if you are social distancing, maybe you're someone that used to go for walks with friends, talk on the phone while you're walking. That can be a great way to move your body, away from other people, but still carrying on that conversation. So just some suggestions there.

The one final reminder I will put out there is that again, the body does best in balance. If you have not been exercising, this isn't the time to start a marathon training program. But light walking, movement, yoga, those are great, great workouts. If you have been exercising, just look to continue your routine. And again, just finding things that keep your body moving. It doesn't need to be extreme. We don't want to be 100% sedentary, but we don't need to be running 30 miles a day either.

Dr. Rebecca Dunsmoor-Su

Yeah. And I wanted, Jill, I wanted to jump in and say one thing I'm finding very important for myself in this time is while we need to maintain our distance from each other, we don't need to distance ourselves socially. So FaceTime, Zoom. You can use zoom for 40 minutes for free, you know, get a group of girlfriends together on the Zoom and everybody make their own glass of wine and/or sparkling water and just have some time together. I know a lot of groups are getting together, so like I'm part of a large alumni organization for the women's college I attended and we're actually having a national get together to sing some traditional songs just altogether to be together at what you know, at a time when we need that support. And make sure that those social activities do not involve rehashing and over hashing the Coronavirus. You know what: watch the news once a day, let the news wash over you and then go talk about, you know, your kids or clothes or you know, your favorite gardening, something else with your friends because we need to stop thinking about it from time to time.

Dr. Swapna Vaidya:

Yeah. I just wanted to quickly jump in and say I completely agree with everything and all these good tips that were shared. And it's so important to not socially isolate because this is the time to actually reach out and to say to each other, Hey, you know, do you have any tips? I mean, you know, what are you doing? Can be sort of like just FaceTime or get together and talk about this because I'm struggling too. And I feel like that is so important because it's another thing in all too that I wanted to focus on is to not actually to be kind to everybody because a lot of this uncertainty has also brought suspicion and fear, and I think this is not the time to point fingers. And this is not the time to say, you know what have you done or what have you not done? I think it's the time to be together and see what we can do to help each other. So I just want to say, be kind to each other. Kindness is so important during this time. That's just, you know, what I would like to see.

Jill Angelo:

Thanks. That's great. That's so true. I was listening to a podcast over the weekend about the kindness of Tom Hanks and, you know, and, and it's just, it, it's real. Kindness goes a long way. It's a, makes you feel good too.

We have a question that came in for Lauren. What's the best way to wash fruits and veggies during this time? And you know, even in the back of my mind is I think about food delivery services. Someone's touching my food, you know, just again, the little like paranoia that kind of pops up in our heads. Can you talk a little bit about that?

Coach Lauren Leedy:

That's a great question. And I think a lot of us are concerned with just the supply chain. And the number of people touching things and even, you know, I did have to pop to the grocery store the other day and I thought, you know, who's, who's touching all the products that I'm going to be eating? And so my recommendation around that is that coronavirus can't survive on surfaces for long periods of time. So it's not like if you buy an apple, you know, if you're giving it, if it's several hours before you go to eat it, the Coronavirus isn't likely to be on it. So I wouldn't say you need to take you need to add in like a fruit and veggie wash or anything extra. What I would say is just continue to wash your fruit, fruits and veggies well like you would at any point just to minimize the spread of, you know, flu or anything that's out there.

However, I will say if you are concerned or definitely if you are someone who is immunocompromised in any way, this would be a great time to actually cook your fruits and veggies and limit you know, eating things like salads and whatnot as it is just because also from a foodborne illness perspective, if your immune system is compromised in any way, cooking those fruits and vegetables is going to likely destroy any microbes or anything on there that could be infectious. Great question.

Dr. Rebecca Dunsmoor-Su:

Yeah, that is good. I think we'd talk about coronavirus not what it can and can't live on. It can live on surfaces primarily the non-porous surfaces where it survives the longest. And so those are the things that need to be wiped down. But certainly just if you're worried about any surface, you know, either wipe it or wash it. Soap is the best thing. So if you have an apple and you're worried that someone else touched it, take it over to the sink and wash it with a little bit of dish soap and then rinse it off. It's not going to change your apple. And that's, so we'll take away the envelope around the virus and make it non-functional.

Jill Angelo:

That's great. That's, that's good. You know, one other tip that I heard Lauren mention the other day for those of us who used to be commuting now what do we do with our commute time if we don't have kids that we're trying to manage at home? I thought your, you had a tip the other day around repurpose your commute time to do meal planning or to, you know, kinda think about the nutrition side of things. Just repurposing that time and almost like categorizing or compartmentalizing it. I thought that was a great, a great tip.

Coach Lauren Leedy:

Sure. Yeah, definitely. I mean, try and look at this time as, if you're working from home you have that extra time that you'd spend commuting, you know, take the time to throw some items in a crock pot or an instant pot or whatever you use. Look at it as a time to start doing some meal prep too, so that when you are finished your workday that you actually will have a meal ready to go and what a great time to involve kids and do a learning activity too, to actually have them help you out with the meal prep. Or even, building on what Stasi has said too, and some of the great tips she's given about workouts, you know, use that extra time to try to fit in a workout or even try some family exercise too.

Jill Angelo:

That's great. Great. I know we had a question about will we share some of the fitness resources, some of those ideas that you had shared, Stasi, in the followup on this webinar. And we will certainly do that. So we can do that. I know you also put those out on an Instagram story, so if you do follow Gennev on Instagram, Stasi did a bit of a story on that one day on that as well. Any other questions?

Any danger in riding in an Uber?

Dr. Rebecca Dunsmoor-Su:

It is, so this is Dr. Rebecca. You're not maintaining a very good social distance if you're in an Uber. Unlike cabs, these don't, these cars don't have barriers. You don't know how they're cleaned. That being said, you know, Uber drivers depend on people riding in their Ubers for their livelihood. So they're really struggling during this time.

So if you must go somewhere and you're going to take an Uber I know Uber has been very cautiously checking with their drivers every day to make sure that they’re symptom free. If they're not symptom-free, they shut them off for 14 days. So they should not be out on the streets if they have any symptoms. But you know, bring along some bleach wipes, wipe down the backseat of the car. You know, it try, you know, you, your Uber driver pulls up and is coughing say, no thank you. But I know some of us are going to have to get around. And you know, if you don't have your own car, it's probably safer to be in an Uber than on a crowded subway train in New York City. It's all a, it's all a balance of risk and benefit. So just do your best and please, please, please, if you have symptoms or if someone near you has symptoms, please don't go out and do that.

Jill Angelo

I read an article about Seattle public transit and that they were saying, you know, they were telling riders it's okay to get up and move if you know, if the person next to you is coughing. It's just the state that we're in. It's not being impolite. It's just, where we are now.

Dr. Rebecca Dunsmoor-Su:

Can I make a quick point? You know, I think we've all seen people out and about with masks over their faces. Those cloth masks, those ear loop masks do not protect you from this. It comes in the sides. You know, it, you almost touch your face more just because that mask is sitting there over it. And one thing we're starting to see in the healthcare arena is that we are running out of masks. People show up in the ER and steal them and people show up in the ER and steal the hand sanitizer. And you need us to stay healthy. We need those supplies. You know, please do not go out and buy and N95 masks. You can find them on the internet. People will sell them to you, but if they're not fitted correctly, they're useless. And there's a very specific way that healthcare providers are fitted for those masks. Please leave those for the healthcare providers so we can stay healthy and take care of you all.

Jill Angelo:

That's an interesting point. I've never, never thought of that. Thank you for adding that. Any other, any other questions from our panelists or from our attendees or comments from the panelists?

While we're thinking of that I'm going to ask Shannon to bring up a little poll. We want to continue to do these webinars but specifically around specific topics. And so we're going to ask you to vote. And so if we can go ahead and pull up that poll. And if you, even if you don't see it appearing on your screen, on the bottom menu, there's an option that says polls. If you can go ahead and click that button. It says, what additional webinars would you like to see from Gennev? Choose as many as you like. It's multiple choice. Because obviously this was a pretty broad swath today.

But we want to, you know, do more specific topics that are meaningful and helpful to you. Maybe even in more intimate settings where we involve your faces too. So we are kind of getting a little bit more of that social engagement as a community because now's the time to kind of pull together. So go ahead and vote while we're here and go ahead and submit that and we'll reveal those results before we close.

Before we do leave. I see another question around an elder parent, my 70, 72 year old husband who is two years post heart attack. Had a quadruple bypass. Hyper. He's hypertensive, he's diabetic, he's on Metformin. He wants to play pickleball three times a week outdoors, should he?

Dr. Rebecca Dunsmoor-Su:

The answer is genuinely no, he shouldn't. You know, you, you cannot in that scenario stay far enough away from people and anything you touch on your way to and from that pickleball is suspect. And that is a person who is most definitely at high risk from this virus. So staying indoors and staying away from others is just the safest thing to do. And I know that people are not listening to that advice. We see people out and about all the time. I know people just want to get on with their lives, but you know, it's safest not to do those things right now.

Jill Angelo:

Yeah. Yeah. And that's gotta be hard. Thank you. From the community member who mentioned, she said, “thank you. He is a little crabby.” And I could every, we're all crabby at times. But it's hard also to be the enforcer. So Rebecca, would you write a doctor's note maybe on that note?

Dr. Rebecca Dunsmoor-Su:

No, no, no. There's no for me, I don't take care of men, but I will say that you know, you can only be the enforcer to a point. You know, at some point he has to take responsibility for himself and you can only give him the best advice and he will either listen or not. And you can't blame yourself for that.

Coach Stasi Kasianchuk:

Maybe he could check out some of the apps. You can give him a list of apps and have them choose from those.

Dr. Rebecca Dunsmoor-Su:

Too bad we don't still have like that Wii Fit thing where you could play pickleball or Nintendo or whatever that was.

Jill Angelo:

We're so Gen X! Yeah.

Jill Angelo:

Yeah. Any other questions coming through? Right, Shannon went ahead and displayed the poll results, so hopefully you see those. If you don't, click the chat button and it'll come up. It looks like the two that run that came ahead or the top three are stress and coping with self isolation; menopause, emotional symptoms; and nutrition. So we've got more deep dives on all of those. We certainly can do, I know we scratched the surface on all of them today, so thank you for voting. We'll take that to heart in terms of future webinars that we go ahead and publish or even podcasts that we do. Our podcast library is pretty rich with information. If you're a podcast listener check it out, you can download, you know, subscribe to the Gennev podcast on any one of your podcasts favorites, whether it's iTunes or Stitcher or Spotify. It's out there. So with that, any closing comments from any of our panelists before we close up?

Dr. Rebecca Dunsmoor-Su:

I just want to reemphasize Dr. Vaidya’s advice: be kind to each other. You know, people are scared, people are anxious and you know, give them a little bit of space to be those things. Before we close out, Jill, I was just gonna answer the last question that popped up really quickly, which is, what about travel? Should we cancel domestic flights? We should not be traveling if we don't need to. It's, there is no way to isolate in that situation. Then some people have to travel and have to get home. I know a lot of college students are trying to get home right now, so those things have to happen, but any, it's not time for vacation right now. That’s all from me.

Jill Angelo:

Great point. All right, well thank you again. Everybody thanks for those who were able to join in those who listen in the future. I know we had a large set of registrants for this, so it's an important topic. So stay safe everybody and have a great Monday. Bye.

How are you protecting yourself from the coronavirus? Have you cancelled plans, postponed trips, are you talking with friends on the Internet rather than in person? Are you getting regular exercise and practicing good self-care? We'd love to hear how you're getting through this very unique time, so share with us in the Gennev Community forums!