Courtney Collen Sebesta (Host): Hey there, welcome to Her Kind of Healthy, a new health podcast series brought to you by Sanford Women’s. I’m your host, Courtney Collen with Sanford Health News. We are starting brand new conversations about age-old topics from fertility and postpartum depression to managing stress, healthy living and so much more. Her Kind of Healthy is designed to bring you honest conversations about self-care, happiness and your overall well-being with our Sanford Health experts.
We’re glad you’re here. Today, we’re talking with Dr. Cindy Davis on care during COVID. She is a Sanford Women’s Health specialist and provider in all areas of obstetrics and gynecology. Dr. Davis, thank you so much for being with us today.
Cindy Davis, M.D. (Guest): Happy to be here. Thank you.
Host: We’re so excited to get to know you and talk to you a little bit about all things women’s health, especially during this pandemic and continuing that care. But first, I’ll have you tell us about yourself and your role as an OB/GYN at Sanford Health.
Dr. Davis: Sure. I am a generalist, meaning I do OB and GYN and I love them both. I couldn’t give up either one. And I started at Chamberlain here in the last few months, although I’ve been in South Dakota for quite a while and I loved being there. I fell in love with the people right away. I liked the patients right off the bat. I love the community; the river is great. Everything about it. And people are very happy to have care there so, it’s good to be — feel wanted and needed.
Host: Talk about some of the specialty areas and the care you specifically provide to women in Chamberlain.
Dr. Davis: Absolutely. I do a lot of general OB but a lot of high risk as well. I love OB and even when things aren’t perfectly right, many times we have great outcomes and it’s great to be there with a family for that time in their lives. I have a lot of things I love to do in gynecology as well. One of the things that’s unusual is help people with chronic pelvic pain. That’s an unusual thing. Obviously, helping with infertility is a big thing for us and one of the things we can help women most with is bleeding problems and things like that. So, all of those things are very important to me.
Host: Of all of those things, what do you enjoy most about being a part of women’s health at Sanford?
Dr. Davis: It has to be the patients. Just the excitement when you diagnose a new pregnancy. Obviously, they are the ones who accomplished the fact but to be there when the future starts opening up in that way. So, and even to get people through difficult times and a tough diagnosis, it’s really a special role that I feel is a gift to help walk with people through those times.
Host: So, let’s shift now into COVID-19 and continuing care. Our latest market research indicates OB is one of those things people aren’t comfortable seeking care for just yet. What is your reaction to that?
Dr. Davis: Well I think we have to be very careful to not inflate the risk of COVID beyond the medical concerns regarding pregnancy. So, those are fancy words to say that you still need OB care. And the problems that can happen with obstetrics haven’t gone away. The chances of getting COVID in the clinic is less than at the grocery store. We’ve come such a long way in learning to be careful about that in the clinic setting. So, the need for care hasn’t gone away. And we’ve only gotten better at helping people get safe care.
Host: What are you hearing from women during this pandemic? Are they expressing their concerns?
Dr. Davis: There’s a lot of fear of course. And any exposure to COVID is scary. We often get a quick phone call and have to help people through the triage process of understanding when to test and when not to test. I do think that one of the things that really pops out to me is confusion. There’s so many mixed messages. We get on the internet or our next door neighbor hasn’t come out of her house for two months because COVID is killing everybody, but Grandpa just sent me an email that says that it’s all a hoax. There’s so much information out there. How to sort through it, how serious to be about it but the thing is you don’t have to figure it out. We’re there to help you figure it out.
Host: Yeah and talk about how you’re working with your patients specifically and how COVID-19 has impacted the way that you deliver care.
Dr. Davis: Well I actually think communication has improved. We are accessible and so if there’s a question and you’re not sure if it needs to be seen; call us. That’s what we’re there for. Our desire to provide care hasn’t changed at all even though it can’t always be in person. And we are doing a lot more telemedicine. Initially, that felt awkward to me and less personal but frankly, it’s become second nature in some ways and there’s a lot of impersonal things about COVID for example, seeing your doctor with a mask on and you can’t see their smile. Telemedicine gets by some of that. So, there’s pluses to the different aspects of care that have evolved.
Host: Would that be one of the biggest changes? I was going to ask you what has been the biggest change since this pandemic really started and what’s been the most difficult too?
Dr. Davis: Well, I think the biggest change is people are afraid to come in for care from misinformation. And they don’t realize that many more people die of heart disease and cancer every year than die of COVID. That’s not to minimize the risk of COVID at all. It’s just to say there’s a perspective in these things and your health care provider can help you figure that out.
Host: What is it like to be pregnant in a pandemic? So, specifically, those women that you care for, what are you hearing from them? And what do you tell them to ease any fear or concern they have?
Dr. Davis: There’s a lot of mixed feelings because there’s always excitement, almost always excitement about a new pregnancy. Many people have been trying for a while. But then of course, there’s the fallout: Am I at higher risk, is my family at higher risk, is the baby at risk? And news is coming out but mostly it’s very reassuring news. Although there is some data pointing to an increased risk of more severe COVID in pregnant women, more ICU admissions, the reassuring news is the mortality rate is not higher. So, yes, we may have to take extra care, but you are no more likely to die from COVID with the information we have at hand. The trick is to contact us if there’s a problem and not wait until things get severe.
Host: So, now when it comes to labor and delivery and the birth experience, what types of safety measures are in place for expecting moms and maybe their support person and what has changed over the course of the last seven or eight months?
Dr. Davis: Sometimes it feels like, what hasn’t changed? And things have evolved and will continue to evolve but obviously, we’re wearing masks, we’re being very careful about keeping our hands clean and things like that. We have special entrances if you’re possibly COVID symptom investigation, then that’s kept separate from the main area. We try not to leave people in the waiting rooms anymore. There’s many, many changes that have happened. I’ve been amazed at how quickly we’ve adapted, and patients have adapted to the changes. It’s sometimes a little bit hard for families who the birth experience is a large family experience. But everybody seems to understand we’re protecting moms and babies.
Host: It’s good to know that they are accepting the changes and they’re comfortable and that’s what it’s all about, right. Making them feel comfortable no matter where they are in their pregnancy, before pregnancy, after baby.
Dr. Davis: Exactly. This needs to be the joyous experience despite the fears that are going around, and we try and keep it that way.
Host: Yeah. So, let’s shift now to those annual appointments and wellness exams. Like I was saying earlier, that market research suggesting that women are afraid to come in and get their care and for OB/GYN care, that means what exams, what appointments, what shouldn’t wait during COVID-19?
Dr. Davis: Well, I always say that Superwoman has nothing on the average Midwestern woman. She would almost have to be dying to go in for care sometimes. She’s tough. But she’s a momma bear related to the rest of her family. Whether that’s extended family or whatever. So, I think that one thing that has evolved is the well woman exam is not oh, you just get to see your doctor once a year and vice versa. We are actually screening for important things and for example, we don’t have a good method of screening for ovarian cancer and even though the pelvic exam isn’t perfect, when you combine that with a review of symptoms, et cetera, that’s part of a well woman exam, we can make a significant difference. Even more so for uterine cancer symptoms. So, we’re screening for some very important female illnesses that really cannot be put off until COVID’s done.
Host: What other exams or appointments shouldn’t wait?
Dr. Davis: Immunizations and I cannot stress enough, that we all should be getting our flu shot this season. There are cases where you can’t get it and that is a discussion between you and your provider. However, this is the year to especially arm yourself as much as possible. We’re very concerned about an influenza epidemic with the COVID epidemic and you can be proactive about this. The flu shot is available and starting to become more available. So, immunizations are important and of course childhood immunizations too in that sense.
Host: What are some of the risks that we face if we put off these exams, these well women visits, these immunizations? What could happen? What should we be concerned about?
Dr. Davis: Well, I think we’re very concerned about missed diagnosis, the fancy medical term basically for saying something needs to dealt with now. And again, women are very strong, and they don’t know when to call the doctor and they’re favoring not coming in or calling because of COVID. Well in reality, let us help you figure that out. We can do that on the phone. Tell us what’s going on. I think the other thing we haven’t addressed is mental health. And I always think that women are designed to be the worriers for the family, but that translates into more anxiety and sometimes depression. And we know that about 40 to 50% of people say that the stress of COVID has had a significant impact on their mental health. And too often I hear people dismiss that, well everybody’s going through it, it won’t be forever. Well I can see that they have a significant issue going on with depression and there can be some bad repercussions from that. So, don’t ignore that and say it’s just a sign of the times. It’s very important that we talk about it. It may mean a telemedicine visit; it may mean a phone conversation. But you’re not alone.
Host: Yeah, absolutely. You know one of the screenings that we saw significantly drop was the mammogram. Sanford Health saw a huge drop in mammograms screenings earlier this spring which lead to significant decreases in breast cancer diagnoses numbers which is concerning for a lot of providers I’ve been talking to. What’s your reaction to that?
Dr. Davis: Well obviously, we’re missing some. It’s not that the cancers went away. We’re not detecting them and for example, we’re still not back up. The big medical health information company EPIC which Sanford uses had a 90% reduction in the first three months of the pandemic and we’re still at 20-30% below baseline. That means there’s some cancers we’re going to diagnose at a higher stage and less treatable. And that’s very, very scary. But the second part of that is there’s going to be a tremendous demand at some point when we have to play catch up with these things. And are we going to be able to meet that need? That’s a significant question.
Host: So, how important is it that we stick to these exams, this care? You had mentioned a number of different really hot topics, immunizations, mammograms, annual screenings for cancer. What do you want women to know that will get them off the couch to make an appointment today?
Dr. Davis: I think the take home point is we’re in this together. And you don’t have to figure it all out because we’re there to help you. Help us help you figure out what needs — what can be put off safely and what needs to be seen. And being stoic and tough is great, but not if it hurts your health down the road. We, as women need to be there for our families and for ourselves. It’s very important to actually pay attention to things that will affect our future health.
Host: Yeah. And speaking of maintaining that health, today, tomorrow and the future, you had mentioned this pandemic is really taking its toll on our mental health, our physical health. What can we be doing at home right now today, no matter our age, ability, lifestyle, to maintain that good health?
Dr. Davis: Don’t forget your self-care. Our stress reduction techniques. We may have to modify those. Exercise for us may look more like walking on the treadmill; it may not be going to a gym class. It may be watching a video. But that’s a huge way we keep ourselves healthy. Remember to eat well. We need, if we do get COVID, we need to go into that fully charged with a fully charged immune system. And the other thing is sleep. We are up more. We are anxious or depressed and we’re not sleeping well. That’s critical to staying healthy and our ability to take care of our loved ones and fighting off COVID if we get it.
Host: Absolutely. Is there anything else that you want our listeners at home to know on this topic of continuing care during COVID-19?
Dr. Davis: Well, don’t forget that the number one killer of women is heart disease. And women present with different symptoms often. And they can be hard to figure out. In the first six months of COVID, there was a marked decrease in ER visits for chest pain and shortness of breath. However, we know the risk of dying from stroke and MI increased during that time. In fact, above COVID deaths numbers and so, it’s very important to maintain care of chronic medical conditions such as hypertension, very much diabetes and asthma. These are not minor things that can become big things. And we have to be very careful about chronic medical conditions. The CDC estimates 60% of us have some sort of chronic medical condition and so, it’s all of us who are in this and at risk. It’s not really easy to just say it’s somebody else’s problem. So, it’s important to get care for those things.
Host: Yeah, we’re all in this together, right?
Dr. Davis: Absolutely.
Host: Well Dr. Davis, thank you so much for being with us today. We appreciate all of your insight and information and the — just stressing the importance of women continuing that care.
Dr. Davis: It was my pleasure.
Host: I’m Courtney Collen with Sanford Health News. Be on the lookout for our next episode of Her Kind of Healthy coming your way soon. Stay well. And have a great day.
Posted In COVID-19, Expert Q&A, Flu, Imaging, Pregnancy, Specialty Care, Virtual Care, Wellness, Women's