Emergency Medicine: Most of us still frazzled by effects of COVID pandemic

Over recent months, there's been an increase in patients seeking emergency care and delays in people getting a bed when they've been admitted to the hospital. Everyone seems especially stressed out, from the EMS providers, to the emergency department and hospital staff, to the patients themselves who are understandably upset and frustrated.

Jenny came to the emergency department (ED) with complaints of crampy abdominal pain, nausea and occasional vomiting. I asked her my usual questions for a patient with symptoms like hers, including if she could be pregnant. She said there was no chance because she recently had a child and was using birth control. She seemed anxious and said she was tired that no one could tell her what was going on.

Jenny had been seen in the ED a few times before her visit with me with similar symptoms. Her prior workups had not found any abnormalities. Jenny had followed up with her family physician, who also had not been able to get to the bottom of her symptoms and referred her to see a gastroenterologist. She called to schedule that appointment and they could not get her scheduled for more than two months.

Jenny’s abdomen was very tender when I examined her and she winced in pain when I touched her right lower quadrant. Worried it might be her appendix, I ordered labs and a CT scan.

The nurse put an IV in Jenny, got her blood work sent to the lab, and gave her medications for pain and nausea. She completed her CT scan afterward. When I went in to discuss her results, she looked much calmer and said she was feeling better. Her CT scan, thankfully, didn't show any sign of appendicitis or other abnormality. Her workup was essentially normal again. When I told her that, she became tearful and was quite upset that we did not find something.

I've seen a significant increase in patients suffering from anxiety over the past year, so I asked Jenny if there was anything else going on that could be making her feel unwell. At first, she gave me a puzzled look and then nodded her head. She said she was under a lot of stress, but figured everyone was. She was a new mom and had recently started back to work as a teacher. She said that work used to be an enjoyable place, but in recent months she felt increasingly burdened by the increased workload and pressure she felt to get her students caught up from all the time they missed during the COVID pandemic school shutdown. She said she was starting to dislike going to work.

I asked Jenny how she was coping with the stress. She looked at me and admitted that she was not doing anything to care for herself. She was just too busy taking care of her family and her students and was lucky to get 6 hours of sleep each night, she said.

I asked Jenny what she thought about meditation. She said she knew of a few friends that had tried it and had thought about trying it, but didn’t think she had the time. I told Jenny that I had recently started meditating and have found it to be very helpful. I explained that I didn’t have a specific cause for her abdominal pain, but that excessive stress and fatigue can cause many physical symptoms. I suggested that these factors could be contributing to her symptoms since we had not been able to find another specific cause.

Jenny seemed very interested in learning more about meditation. I had her sit back in the bed in a relaxed position. I asked her to take a few slow, purposeful breaths and had her focus on her breathing. Her shoulders relaxed after just a few breaths.

After a few minutes, she said this was the calmest she had felt in months. Meditation has been shown to have long-lasting positive effects. It decreases stress, allows you to connect better with others and yourself, and improves focus. It can also provide some much-needed space in your life.

Researchers have found that there has been a significant increase in anxiety and depression in Americans since the onset of the COVID pandemic. As a result, they say, there's an increased need for mental health and other supportive services to help people deal with the social, economic, and psychological stressors. While I am not suggesting that meditation can fix these issues, it can improve a person’s ability to respond to increased stressors. It's important for each of us to do what we can to take care of ourselves so we can deal with the changes we're faced with in our lives.

I encouraged Jenny to learn more about meditation and dedicate some time to herself every day. As we are wisely advised when traveling with children on an airplane: You must put the oxygen mask on yourself before you assist others.

Dr. Erika Kube is an emergency physician who works for Mid-Ohio Emergency Services and OhioHealth.drerikakubemd@gmail.com