New Learning on COVID: It’s Attacking the Heart

Emerging data show that some of the coronavirus’s most potent damage is inflicted on the heart

It seems like a lifetime ago, but at one time we were naive enough to think that COVID was an infection specific to the lungs. We’ve learned a lot in the last six months. We now know that there is hardly any part of the body this virus doesn’t attack. Some of the virus’s most potent damage is inflicted on the heart, and it can result in organ failure.

Meet Eduardo Rodriguez, poised to start as #1 pitcher for the Boston Red Sox

In July the 27-year-old tested positive for COVID. “I’ve never been that sick in my life, and I don’t want to get that sick again.” His symptoms abated, but he felt so tired after throwing 20 pitches during practice that trainers told him to stop and rest. Tests showed he had a condition many are still struggling to understand: COVID-associated myocarditis. Mr. Rodriguez won’t be taking the mound in the 2020 season.

And a patient in his early 50s with COVID-related heart disease

Myocarditis means inflammation of the heart muscle. Some patients are never bothered by it, but for others it can have serious implications. One 50-year old patient had been in perfect health with no history of serious illness when he contracted COVID. When the fevers and body aches started, he isolated himself and waited to get better. But his condition deteriorated and he accumulated gallons of fluid in his legs. When he came to the hospital unable to catch a breath, it wasn’t his lungs that had pushed him to the brink–it was his heart. He is now being evaluated to see if he needs a heart transplant.

MRI scans of patients recovered from COVID

A German study examines the way SARS-CoV-2 affects the heart. Researchers studied 100 individuals, with a median age of just 49, who had recovered from COVID. Researchers performed MRI scans of their hearts and made some alarming discoveries: Nearly 80% had persistent abnormalities and 60% had evidence of myocarditis. The degree of myocarditis was not explained by the severity of the initial illness.

Though the study has some flaws, it makes clear that in young patients who had seemingly overcome SARS-CoV-2 it’s fairly common for the heart to be affected. We may be seeing only the beginning of the damage. Despite treatment, more severe forms of Covid-19-associated myocarditis can lead to permanent damage of the heart, which in turn can lead to heart failure.

Deferred care results in a bump in heart attacks and death

Since February 2020, nearly 25,000 more Americans have died of heart disease than in the same period in previous years. Some of these deaths could be put down to COVID, but the majority are likely to be because patients deferred care for their hearts. That could lead to a wave of untreated heart disease in the wake of the pandemic.

The AMA’s Message: Don’t Die of Doubt

The American Heart Association has a new campaign called “Don’t Die of Doubt” to address the alarming reduction in people calling 911 or seeking medical care after a heart attack or stroke.

• It’s been clear that high-risk people are those who are overweight, have diabetes or high blood pressure. Add those with heart conditions to that high-risk list. The CDC recommends that the more than 30M Americans living with heart disease take extra precautions.
• Doctors and researchers should no longer think of Covid-19 as a disease of the lungs but as one that can affect any part of the body, especially the heart.
• The only way to prevent more people dying of heart disease, both from damage caused by the virus as well as from deferred care of heart disease, is to control the pandemic.

COVID has created an urgency on many levels, including creating a Living Trust

As the COVID crisis drags on, more clients are scheduling appointments to create or update their Living Trusts. Our Trust package includes a Power of Attorney and an Advance Healthcare Directive. It also includes a Pour Over Will, and for those families with children under 18, it means that they can name a Guardian rather than having the court appoint one for you. Creating a Trust helps provide peace of mind during these uncertain times. Best of all, we guide you through it and we prepare the legal documents. At California Document Preparers, for most of our services, we charge one flat fee. We’re helpful, compassionate and affordable.

We service the entire East Bay and North Bay areas

Berkeley, El Cerrito, Richmond, Pinole, Alameda, San Leandro, Castro Valley Newark, San Lorenzo, Concord, Alamo, Danville, Lafayette, Orinda, Moraga, Pleasant Hill, Martinez, Pittsburg, Antioch, Brentwood, Oakley, Discovery Bay, Pleasanton, San Ramon, Livermore, Tracy and Fremont. Our clients also live in the Napa Valley, Benicia, Vallejo, Martinez, Fairfield.

The source of this article: Haider Warraich (@haiderwarraich), the author of “State of the Heart: Exploring the History, Science, and Future of Cardiac Disease,” is a cardiologist and researcher at the Veterans Affairs Boston Healthcare System, Brigham and Women’s Hospital and Harvard Medical School.

Our Memories Will Fail As We Age, Right? Wrong

 

Even 20-year-olds forget the simplest things

Are you over 60 and alarmed as you find yourself forgetting things? I drove down the street yesterday and for a flashing moment, I completely forgot why I was on that street. I was going to the bank, of course, and I remembered as soon as I saw the signage. But what if I hadn’t recognized that familiar brand? Isn’t that enough reason to send me rushing off to the nearest neurologist?

Like my friends, I forget names that I used to pull up effortlessly. I misplace objects, finding them in unlikely places. And yet my long-term memories are fully intact. I remember the names of my third-grade classmates and arcane details from long ago journey or the details of a favorite meal. A friend whose husband died of Alzheimer’s told me that he lost whole decades at a time. The 90s, then the 80s. By the end, he remembered nothing. For my mother, active and healthy until her death at 94, this was her worst fear–losing her mind.

A neuroscientist in a New York Times article tells us that the problem is not necessarily age-related

Short-term memory contains the contents of your thoughts right now, including what you intend to do in the next few seconds. It’s doing some mental gymnastics, thinking about what you’ll say next or that you’re now walking to the hall closet to get a pair of gloves.

Short-term memory is easily disturbed or disrupted

It depends on your actively paying attention to the items that are in your mental to-do list. But any distraction can disrupt short-term memory. Our ability to automatically restore the contents of our short-term memory declines slightly with every decade after 30.

It may not be age but the story we tell ourselves

According to neurologist Dr. Daniel J. Levitin, 20-year-olds make the same short-term memory errors that 70-year-olds do. The relevant difference is not age; rather, how we describe these events. Twenty-year-olds don’t think, “Oh dear, this must be early-onset Alzheimer’s.” They think, “I’ve got a lot on my plate right now”, or “I really need to get more than four hours of sleep.” The 70-year-old observes these same events and worries about his/her brain health.

Memory impairment is not inevitable

In the absence of brain disease, even the oldest older adults show little or no cognitive or memory decline beyond age 85 and 90, as shown in a 2018 study.

Some aspects of memory actually get better as we age

• Our ability to extract patterns, regularities and to make accurate predictions improves over time because we’ve had more experience.
• Older adults have to search through more memories than do younger adults to find what they’re looking for. I always think of my memory as a huge database. An older person simply has a lot more data to sort through to find the answer!

New experiences help keep your mind pliable and fresh

Dr. Levitin discusses something with which many of us can relate. He calls up a treasured childhood memory of a Butterfinger candy bar and the smell of fresh grass in the spring. “I don’t feel 50 years older. I can see the world through the eyes of that mischievous 10-year-old. I can remember when the taste of a Butterfinger was the most delectable thing in the world. I can remember the grassy smell of a spring meadow. These were sensory pleasures that were novel and exciting back then.

“I can still eat a Butterfinger and smell spring meadows, but the sensory experience has dulled through repetition, familiarity and aging. So I try to keep things novel and exciting. My favorite chocolatier introduces new artisanal chocolates a few times a year and I try to savor them. I go to new parks and forests where I’m more likely to encounter the smells of new grasses and trees.

“When I find them, these things I remember for months and years, because they are new. And experiencing new things is the best way to keep the mind young, pliable and growing — into our 80s, 90s and beyond.”

Many of our Living Trust clients are older

Many of these clients are still working, some are retired, others are thinking about it. Age-related topics such as memory loss frequently surface in our conversations about estate planning documents—especially in regard to end-of-life planning or incapacity planning.

COVID has also helped create an urgency about creating a Living Trust

As the COVID crisis drags on, more clients are scheduling appointments to create or update their Living Trusts. Our Trust package includes a Power of Attorney and an Advance Healthcare Directive. It also includes a Pour Over Will, and for those families with children under 18, it means that they can name a Guardian rather than having the court appoint one for you. Creating a Trust helps provide peace of mind during these uncertain times. Best of all, we guide you through it and we prepare the legal documents.

At California Document Preparers, for most of our services, we charge one flat fee. We’re helpful, compassionate and affordable

Itching to Get Away? Travel in the Time of COVID

We’re well into our sixth month of COVID restrictions. We’ve mismanaged our response to the pandemic, so we can’t travel to countries in the European Union. But it’s fall, the best time of year to travel, and many of us are itching to get away. Surprisingly, there are quite a few countries that would be delighted to take our tourist dollars, including the Maldives, Jamaica, Mexico, the Caribbean, Serbia, Croatia, Turkey, Ecuador and Brazil. Dependencies may include a temperature check, COVID test and the ability to show a place of residence during our stay.

Travel closer to home: What does a COVID vacation look like?

I traveled to Washington state’s Whidbey Island a month or so ago. I flew into Seattle’s SeaTac airport, rented a car and drove up to the island—about a two-hour trip.

Some observations: Forget about social distancing on the airplane

There were no COVID concessions on my flight–it was packed. It may be that we can expect that—the airline industry has been hit hard by COVID. With fewer flights to popular destinations, I suspect these flights will be full. Be comforted by the fact that air is circulated and filtered on airplanes, so most viruses don’t spread easily on flights. Reduce the risk by frequently washing your hands, using hand sanitizer, wiping down your tray table, wearing a mask, opening up the vent above you and freezing to death for the duration of the flight.

Be aware that your flight may be canceled and cost more. A colleague flew from Oakland to eastern Washington, and his expensive connecting flights were canceled in both directions. This translates to a lot of extra time hanging out in airports—and increasing your risk of exposure. He’s in the high-risk group with health issues, so this trip was terrifying for him.

To be aware of:

• If you need to rent a car. In some areas this could pose a problem because people are renting cars and taking road trips instead of flying.
• For a road trip: Pack a cooler with water and food. Fewer stops are safer.
• While we’re used to a high level of COVID awareness in the Bay Area, this is not the case in many parts of the country. Iowa and South Dakota have no mask requirement. In 17 states, there is some mask requirement, which means that the level of COVID safety will vary by city and county.

Everyone knows the drill by now

For my little adventure, everyone, everywhere, was masked and social distancing—at the car rental counter, cafes and shops. The TSA team wear masks, face shields and gloves. As I drove up to Whidbey, I noticed that the rest areas were closed. For those traveling with kids on longer road trips, this could pose a problem. Kids require frequent snack and bio breaks.

If you’re planning a road trip: Some tips from the experts

Do some research and be flexible. Even if you’re doing a business trip that will require renting a car at the airport, there’s a very good chance you’ll encounter closures and frustration.

• Research travel advisories.
• Don’t leave home without hand sanitizers and disinfecting wet wipes, disposable gloves, sealable disposable plastic bags and tissues. You’re allowed to carry a 12-oz bottle of hand sanitizer on the plane with you.
• Expect to be wearing a mask in all indoor public places, so bring a stash.
• Stop and buy water and snacks—it will limit the number of times you need to stop for refreshments.
• Drivers may want to wear disposable gloves while pumping gas. Pay with a credit card rather than cash, eliminating a face/face interaction.

Bathroom access these days can be challenging

Limit fluids. Many public restrooms are closed. Starbucks or other fast-food establishments may prevent noncustomers or even customers from using their bathrooms.

Dining

Restaurants in some states have resumed dine-in service, but there will be limitations on the number of people permitted in a given space. Eating in outside patios or decks is safer. Consider purchasing your own food and eating outdoors. This will all become more difficult as the weather gets cooler.

Sleeping

If staying in a hotel, call ahead to confirm your reservation.

• Consider renting a home rather than staying in a hotel—you’ll have a kitchen to cook your own meals.
• Guidelines from the American Hotel & Lodging Association include stringent cleaning procedures for everything from elevator buttons to exercise equipment.
• Recommended guidelines include wiping down high-touch areas–doorknobs, TV remote control, etc.
• For stays of more than one night, forgo housekeeping services so that you can control sanitization and limit the number of people who come in and out of your room.

Trying not to touch handles, doorknobs, elevator buttons, escalator railings, etc. is challenging. Keep hand sanitizer in your bag and use frequently.

Before leaving on your trip: Create or update your Living Trust

 

COVID has created an urgency on many levels, including creating a Living Trust

As the COVID crisis drags on, more clients are scheduling appointments to create or update their Living Trusts. Our Trust package includes a Power of Attorney and an Advance Healthcare Directive. It also includes a Pour Over Will, and for those families with children under 18, this means that they can name a Guardian rather than having the court appoint one for them.

Creating a Trust helps provide peace of mind during these uncertain times. Best of all, we guide you through it and we prepare the legal documents. At California Document Preparers, for most of our services, we charge one flat fee. We’re helpful, compassionate and affordable.

We service the entire East Bay and North Bay areas

Berkeley, El Cerrito, Richmond, Pinole, Alameda, San Leandro, Castro Valley Newark, San Lorenzo, Concord, Alamo, Danville, Lafayette, Orinda, Moraga, Pleasant Hill, Martinez, Pittsburg, Antioch, Brentwood, Oakley, Discovery Bay, Pleasanton, San Ramon, Livermore, Tracy and Fremont. Our clients also live in the Napa Valley, Benicia, Vallejo, Martinez, Fairfield.

I had a client who was reluctant to give out her business card because her website was still in development. She was afraid there would be this huge rush of new clients going to her website, only to be profoundly disappointed that it wasn’t live. 

Unfortunately, it’s just not that easy

People will go to your website to validate you. We all do this—we meet people and go to their websites to learn more. But in general, a website doesn’t just get found on its own. You need to drive traffic to your site. 

• Give users a reason to go there. 
• Update your site with fresh content and links from social media sites. 
• Understand the way that Google accesses and organizes information. This will help your website rank higher in a search query.

Search engines are in the business of organizing content

Think of search engines as answering machines. They discover, understand and organize the internet’s content.

Search engines have three primary functions. They:

• Crawl: Scour the Internet for content, looking over the code/content for each URL they find. 
• Index: Store and organize the content found during the crawling process. Once a page is in the index, it’s eligible to compete in relevant search queries.
• Rank: The content that will best answer a searcher’s query. The results are ordered by relevance.

Search engine ranking and crawling

When we perform one of the gazillion searches we initiate every day, Google scours its index for highly relevant content and orders up that content in the hopes of solving the searcher’s query. In general, the higher a website is ranked, the more relevant the query.

Crawling is the discovery process

Search engines send out a team of robots (known as bots, crawlers or spiders) to find new and updated content. Keep in mind that content isn’t just a page–it can be an image, a video, a PDF, an infographic, etc. Content is discovered by links. Every piece of content has a description. That’s why it’s important to label content with a meaningful description. An image, IMAG4324.jpg should be labeled “Morning sunrise, NameOfYourCompany.jpg”. Don’t forget to also fill out the alt field. 

Google discovers content by following links

Google’s index is similar to that of a library, with information about all the webpages it knows about. When Google visits your website, it detects new/changed content and updates its index. Google discovers content by following links from one page to another. That’s why it’s important to create an inner linking strategy on your website. Think about the relationships among page topics, then create links among them. Not only are you increasing your SEO value, but it’s a way to keep users on your site, drilling down through pages from topic to topic.  

Is it time for a long overdue website upgrade?

COVID downtime can make this the perfect time for that long overdue website upgrade. I don’t know anyone who isn’t updating his/her website right now, including me! Contact Top of Mind Marketing. We’re writers and content marketing specialists. 

New Urgency to Pass the Equal Rights Amendment

We all thought the Equal Rights Amendment (ERA) was a done deal—that’s how naive we were. Proposed nearly a century ago, the ERA is periodically propelled forward. Some of us remember the National Organization for Women (NOW) passionately advocating for the ERA’s passage in the 70s. But the clock ran out, and only 35 of the required 38 states had signed on.

Today’s political climate and the #MeToo movement are adding renewed urgency

Within the past three years Nevada, Illinois and Virginia became the 36th, 37th and 38th states to pass the ERA, but it must pass additional legal hurdles before it can be added to the U.S. Constitution. The biggest hurdle? “It’s hard to get equal rights when you don’t have equal rights,” says Julie C. Suk, a dean and professor of sociology at the City University of New York. “Many people do not realize women have no guaranteed equal rights under the U.S. Constitution.”— Iris Y. Martinez, Illinois state senator.

What does the ERA mean for women? It would:

• Require states to intervene in cases of gender violence, guard against discrimination on the basis of pregnancy and motherhood.
• Provide a federal guarantee of equal pay. Women still make 79 cents to a man’s dollar. Women of color take home even less. Women who are pushed out of work while they are pregnant have no legal protections. Only 17% of American workers have access to paid parental leave.

Updating the Constitution is the only failsafe way to root out legal gender-based discrimination.

40 years of deadlines and extensions; Ruth Bader Ginsburg (RBG) suggests starting all over

The 92nd Congress, which passed the ERA in 1972, gave state legislatures seven years to ratify the amendment, later extending the deadline to ten years. Several groups of legislators in the House and Senate have passed legislation to dispense with the ratification deadline. Some advocates, such as Supreme Court Justice Ruth Bader Ginsburg, suggest that supporters start all over. The Washington-based ERA Coalition/Fund for Women’s Equality seems to think there is enough momentum to overcome hurdles. It has more than 100 groups as members working in concert with dozens of lead organizations.

“There is a healthy combination of national coordination and local grassroots activism,” says Jessica Neuwirth, an international women’s rights lawyer at Hunter College’s Public Policy Institute in New York City and the coalition’s co-president.

Support is almost universal, she says, referencing a 2015 coalition survey. “ERA Coalition polling shows that 94% of Americans and 99% of millennials support a constitutional sex equality amendment,” she says.

Advocating for paid family medical leave and equal pay

Jennifer Carroll Foy, a lawyer in the Washington, D.C. area, who this year helped make her state the 38th to ratify the ERA, gave birth to twin sons during her successful campaign for Virginia’s House of Delegates. When she was a student, a Supreme Court decision enabled her to attend the Virginia Military Institute in Lexington, a public college that had refused to admit women.

“I know the struggles of simultaneously being a mother and working a full-time job”

That’s why I am fighting to institute paid family medical leave policies, fair scheduling laws and equal pay for equal work policies. I also believe that we must ensure all women have access to affordable birth control and cancer screenings.”

Low wages and violence toward women tend to go hand in hand. Working in low-paid service-industry jobs, women are particularly susceptible to sexual harassment and may not be able to afford to quit.

Not all women want the ERA; who remembers Phyllis Schlafly?

Pro-ERA activists of the ‘70s hoped the issues would all be sorted out by now. When Congress sent the ERA out to the states, dozens signed on right away, but opposition mobilized, stoking fear that it would upend societal norms. Phyllis Schlafly, a conservative leader and popular author of that era, suggested the ERA would set women back. She organized the Stop Taking Our Privileges (STOP) ERA campaign.

In the late 1970s, Schlafly became a constitutional lawyer, sometimes opening remarks with “I’d like to thank my husband for letting me be here tonight.” The organization claimed the proposed amendment would take away sexual assault laws, alimony and the tendency for courts to award custody to mothers in a divorce. They balked at a military that could draft women and warned that single-sex restrooms would be eliminated.

There’s been a natural evolution

Some of the privileges Schlafly fought to preserve have evolved naturally without the ERA in place:

• Women of means may be the ones paying support in a divorce, and shared parental custody is considered ideal.
• Single-stall restrooms increasingly are gender neutral.
• Women now account for more than 1 in 6 service members in the four military branches under the Department of Defense.

“Sex equality is guaranteed in most constitutions in the world, including every constitution written since World War II,” Neuwirth says.

Justice Ginsburg has said the ERA’s passage is important to her because she wants to be able to pull out her pocket Constitution to show her granddaughter that the foundational laws of this country ensure all women are equal to men. Sexual equality is something that Ginsburg demonstrates every single day in her role on the Supreme Court.

Equal rights is a topic that surfaced recently at one of our CDP offices

This was a conversation with one of our clients, a baby boomer in her 70s. She had been reading about the ERA resurfacing as a political issue. The irony, of course, is that we had all assumed the ERA had passed, even though we know that women don’t have equal rights. She remembered Phyllis Schlafly, Eleanor Smeal and NOW. Ruth Bader Ginsberg now advocates rebooting the ratification process. The #MeToo movement just may have provided enough momentum for this to pass.

We finished what our client came in to our office to accomplish

We assisted our client in creating her Living Trust. Our Trust package includes a Power of Attorney and an Advance Healthcare Directive. We guided her through the process and prepared the legal documents. For most of our services, we charge one flat fee. We’re helpful, compassionate and affordable. Schedule an appointment today at one of our three Bay Area offices in Dublin, Walnut Creek or Oakland. 

We service the entire East Bay area

Berkeley, El Cerrito, Richmond, Pinole, Alameda, San Leandro, Castro Valley Newark, San Lorenzo, Concord, Alamo, Danville, Lafayette, Orinda, Moraga, Pleasant Hill, Martinez, Pittsburg, Antioch, Brentwood, Oakley, Discovery Bay, Pleasanton, San Ramon, Livermore, Tracy and Fremont.