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INTRO: As part of our vision to transform the healthcare experience. Temecula Valley hospital brings you T V H health chat.

Caitlin Whyte: Welcome to TVH health chat with Temecula Valley hospital. I'm Caitlin Whyte And as we continue to battle the coronavirus pandemic, it's essential to keep up with the care of our other conditions as well.

Joining us today to talk about heart health during the pandemic is Dr. Andrew ho the medical chief of staff at Temecula Valley hospital. So Dr. Ho, we're talking all about heart disease today. Tell us why it's so important to stay on top of screenings and care. Even during the COVID-19 pandemic.

Dr. Andrew Ho: Thank you Caitlin for asking such a wonderful question.

Certainly I have seen a lot through this whole COVID pandemic. And even though the numbers are much better, we're suddenly very much in a pandemic as I speak. And I've seen so many tragic stories, uh, both sides, people who actually have COVID as well as people who don't have COVID, but suffer from chronic conditions because they are so afraid to come into the hospital.

To seek treatment for the cardiovascular problems that patients that just refuse to come in, they are so afraid. They think that the hospital is filled with COVID patient, which is not true. And even though they have angina, which is a type of symptom that results from patients who have blocked Audrey's they just sit at home and wait and to.

The angina symptoms, progressively worsen. And next thing you know, the patient has a heart attack and dies at home. And this is a scenario that I see over and over and over again. And I think the word needs to get out there that patients get, even though COVID is a scary condition. Yes, it's definitely not good to catch COVID, but at the same time, you have to go out there with protective device mask on and seek the care that you need for your current cardiovascular conditions.

Caitlin Whyte: Tell us about people with heart conditions. Do they have a higher risk of developing a severe case of COVID-19?

Dr. Andrew Ho: Absolutely Kevin patients who have preexisting cardiovascular conditions and even patients who have pre-existing risk factors for cardiovascular conditions, uh, at higher risk for developing severe symptoms from COVID 19 infections and higher rates of death among these patients who have cardiovascular conditions.

And I have to tell you a story about a patient. I had this patient is a very nice older gentleman in his. Seventies, early seventies. And I saved his life about 10 years ago when I was just coming out from training, he had cardiac arrest and we brought him back as best to his coronary arteries. And I've always thought that eventually he would succumb to his cardiovascular DV.

At the height of the pandemic, the patient decided to retire and move out of California to a different state, to live a, what he told me was a quote, a simpler life. And a few months later, I got word from his wife that once they moved over to the other date, the patient actually contracted COVID-19. And fashion and Ashley passed away in the hospital.

And so that's this story certainly emphasizes the fact that patients who already either have risk factors for cardiovascular disease or who have preexisting cardiovascular disease, do have a higher risk of having a much more severe infection and hospital course and high risk of even dying from the COVID-19 infection.

Caitlin Whyte: So, what would you tell your patients about reducing their risks of COVID-19? You know, you mentioned that they still should be coming to the hospital to stay on top of their screenings, but what else can they do to be safe right

Dr. Andrew Ho: now? So I certainly have a lot of advice for patients because I do get asked a lot of questions from my patients about what to do.

Given the COVID pandemic. And what I tell patients is that what I see, especially during this last search that we had of COVID-19 infection is that patients actually got it from family gatherings. That seem to be the most common place the patients got it. For example, not from going out and, and buying us to go food, not from.

Going through the drive-through that from even going to the grocery store, Ashley, but a lot of family gatherings resulted in transmission, the COVID-19 infection. And so, but I tell him, yeah, patients that, yes, they on top of your cardiovascular health. Make sure you see your, your physicians on schedule as needed, and also try to avoid unnecessary family.

gatherings I think it's okay to have a small bubble of people that you hang out with and see on a weekly basis. But I think the high risk ones are. The ones that come back from out of state college students that come back from college and then, you know, those big gatherings like Thanksgiving, Christmas, et cetera, those inevitably end up with much, much higher risk of transmission of COVID-19 infections.

Caitlin Whyte: Are you recommending to your patients with heart conditions to get vaccinated?

Dr. Andrew Ho: Absolutely. In fact, when the Pfizer vaccine came out and Ashley were released from the hospital, I think I was the first one in line to get the vaccine, my Tuli to the belief in the vaccine and its effectiveness for controlling this pandemic.

Yes. There side effects. Absolutely each and every one of those vaccines, whether it be Pfizer, McKenna. The AstraZeneca, they all have tight attacks. I think you get it from the first dose or the second dose and deciding that it can be very varied. For example, myself, both after the first Pfizer dose and the second Pfizer dose, I developed chills for a few hours.

I developed. Uh, back backache for a few hours, really significant fatigue for a few hours, but by the next morning I was back to normal and I felt really invigorated that at least I have some level of protection fire to get in the vest scene. Certainly all the frontline workers, including physicians, nurses, et cetera.

We also felt. Like we would kind of get COVID for sure. It just because the numbers were so high and after the vaccine, a lot of us saw lipid, less stressed about it. We felt a little bit more protected and we felt like we can do our jobs better without this huge lumen fear that eventually we to succumb to the COVID-19 infection.

So again, uh, yes. Other side effects, absolutely. Other side effects. Whenever you make, add with a Deepak ATVs Joe's et cetera, are they worth it to prevent you from getting a severe COVID-19 infection? I absolutely think so. I think a lot of us out there community certainly have not been able to see firsthand like myself, how patients look when they have a serious COVID-19 infection.

And I think once you see how patients look in the hospital, they're on ventilators. They have to be put on, what's called a prone position. There are multiple drips just to keep them alive. Then you realize that this is not an infection. You want to have a gap. And I think a lot of people out there like you, that.

Oh, you know, once they get the COVID-19 infection, they've gotta recover well and that'd be done with it. And they always throw around this term called herd immunity and herd immunity will come, but we are already overweight over 500,000 desks and we're going to see. 500,000 more. If people keep believing that herd immunity is what's going to save us in this community.

And the other point I make to people who questioned about the fascination, they want to wait, or they don't want to get it is that you have really two times when you want to get the fascination, you have to get the vaccination before you get the COVID-19 infection, or you can wait until after you get COVID-19 fashion.

And then you still have to get the best donation. And the reason was because the natural infection does not protect you. Long-term from getting another coordinating infection pretty much. That's an easy way to put it. Do you really have two choices either? You get the COVID fascination now, or you wait till after you get the COVID-19 infection and then you still have to get the vaccination.

Caitlin Whyte: Just how is Temecula keeping heart patients safe when they do come in for procedures or checkups? 

Dr. Andrew Ho: So certainly I spent 95% of my time at Temecula Valley hospital. And so I know that the hospital very well, I can't speak so much for the, all the hospitals around the area, just because I don't spend as much time there, but that's a medical event.

Any hospital, we have this unique advantages that the hospital is very new and therefore the ventilation systems are very good and. The hospital was designed such that we can literally section of a unit by unit in the hospital and we can also. Certainly session off floor by floor. And so, for example, during the search, this recent search that we had, we literally sectioned off a whole floor just to house COVID 19 patients.

And therefore you can see how the separation is so effective, that if you have patients who come in, let's say you have a heart attack, but you don't have COVID-19 infection. You wouldn't really, almost never. Come across a patient who has COVID-19 infection and that's because the. The way that hospitals design their new ventilation system, that they have allows us to separate patients very effectively.

And therefore the chance of cross-contamination is extremely low. I've had patients who clearly were about to have a heart attack. They have this. Aggressive anginal symptoms. And when I see it on my device that you have to come into the hospital. And the first question they asked her, what Dr. Ho is, is it safe to go, am I going to get COVID?

And I always tell them that you have a chance of dying. So this current heart condition right now, is several times higher than your chance of contacting COVID when you actually come into the hospital. And I think once I say that patients have this new perspective as to what they need to do and.

Inevitably, they do end up agreeing to come into the hospital to get treated for their cardiac condition. 

Caitlin Whyte: And wrappingup here. Dr. Ho what should people with heart disease think about when seeking care these days.

Dr. Andrew Ho:  Thank you, Caitlin. Again, that's another great question that you asked patients who have heart conditions as symptoms from heart conditions, or they have pre-existing conditions and they're looking.

For, for the care of their condition. I think there's a few things to keep in mind when they are seeking care in this area. Let's start with the clinic, certainly in the pandemic. And I think going forward the field of medicine, I think we will forever be changed as to how we deliver care to patients. And I really doubt that we will go back a hundred percent to what we'll be doing before.

And what will we, we were doing before with. We've looked past patients in our clinic, we would pack 20, 30 patients in a waiting area. And then we would have them sit next to each other, you know, on the beds in some clinics. They're so busy that the patients by just standing next to each other in the hallway, waiting to get in, that can not anymore in this pandemic and going forward.

And so when you're seeking care, let's say from a cardiologist in the outpatient setting, you want to see if the cardiologist has instituted changes to adapt to this new way of treating patients. And so you want to see if that office offers, for example, tell them yes. And meaning a video capability where that's sometimes where you just don't need to come in in prison.

You can nasty. Talk to the doctor and have a nice conversation and code or go over your test results on video. And so when, when physicians Fastly demonstrate that they have adapted, then you know that, um, they have also thought about other ways to reduce a risk of transmission of COVID-19 when patients actually see that invitation.

So I got a story to demonstrate that and, uh, basically it demonstrates, it demonstrates how. Telemedicine or video at medicine can sometimes be just as effective a patient coming in in person waiting amounts, 30, 40 people in a waiting room, rubbing off against other people waiting there and still you get pretty much the same result.

That's when you actually meet the physician in video. So my story goes a few weeks ago. I saw a patient on video. Basically Spotify, a video visit up with the patient and the patient is a long-time patient of mine. Her husband was next to her on the video. And during the visit, I, I told her husband and I told the patient as well.

I said, this is something, something not right here. The patient was a little bit confused. I didn't like the color in her face. She looked a little bit kale and I told the patient that and the husband that. I know the patients very well, and I feel like there's something that's not right. And I would like to come in for full blood tests and also to get an EKG and the osseous.

So next thing you know, I got the blood test and that night the blood test results came back and I called the husband. And I said, you gotta bring her into the hospital immediately because her sodium level is at a critically low level. And so he was very thankful. He brought her, his wife into the hospital.

They had to stay there for three days to get treatment for this though. Sodium level. And so the next time, uh, decided to bring her in. Once she recovered from the hospital and she went home, I decided to bring her in the hospital in for a follow-up visit inside the hospital now. And the husband told me this, this story, and it demonstrates again that, you know, sometimes video is really just as good as in-person because the husband.

Had told me that a week prior to me seeing the unheard video, when I noticed that something was wrong with her, they had asked, they seen the other doctor in person and the other doctor did not see anything wrong with the patient, even though clearly her sodium level had been abnormal for quite some time.

And so you can see that when you adapt the ways you do things, when you think outside the box, you certainly. Can be just as effective as the way you've always done in which, in which you see patients in person all the time, you can accurately diagnose patients on video. You can completely take care of them on video and not necessarily always have to bring the demand and physical in-person in the clinic to take care of them.

And then therefore, by doing that, you significantly reduce the overall risk of transmitting COVID-19 from patient to patient in your waiting room.

Caitlin Whyte: Great. Well, Dr. Ho, is there anything we didn't touch on today that you'd like to add?

Dr. Andrew Ho: Thank you Katelyn. One last thing I wanted to add, we request to cardiovascular health and this COVID-19 pandemic is that even though you are in the midst of pandemic, do you have to isolate yourself?

It doesn't mean that you stop taking care of yourself, especially your cardiovascular health. And I, I see still often the patients get the reason, the pandemic as the reason why they gain 20 pounds, 30 pounds. I don't think it needs to be necessarily. So even when we are in a search and you have to remain isolated, you can still do work in your backyard.

You can still put your mask on and walk outside along the sidewalk. You can still walk up here, walk down here. You can still walk upstairs, downstairs. And therefore, I think if you keep up your physical activity, you're likely not gain the 20 pounds that everybody. I mentioned gaining during the COVID pandemic and gaining 20 pounds for a lot of patients, it's a huge deal because that's just enough to put a patient into a range of higher blood pressures.

It will not a diabetes control and out the water, and it can even put you into congestive heart failure. And so there's a lot of unnecessary outcomes that you can certainly prevent by continue to be conscious of your cardiovascular health, continue to engage in regular physical activities. And it doesn't necessarily need to be so where you gain 20 pounds in the midst of a COVID tightening search.

Caitlin Whyte: Well, thank you so much for joining us today, Dr. Ho, you're listening to TVH health chat with Temecula Valley. For more information, please visit Temecula Valley hospital.com. I'm Caitlin Whyte. Thanks for listening.