Tag Archives: coronavirus

SARS-CoV-2 Recovery and Athletes

SARS-CoV-2  Infection recovery for AthletesArticle by:
DR. EVAN MALONE
NON-LAWYER
BOARD-CERTIFIED INTERNAL MEDICINE PHYSICIAN

It is not difficult to speak with someone and not have them share their first-hand experience with SARS-CoV-2 infection.  If anything, someone close to them has been infected and impacted by the infection.

Rebound and Recovery From Acute Infection

What is not as readily discussed is the rebound and recovery from an acute infection.  Acute infection being distinct from a positive test in that there is a period of defining symptoms:  fever, myalgia, dyspnea, cough, lethargy, etc.

Just as the spectrum of symptoms is broad – ranging from nuisance, innocent symptoms (loss of smell, mild headache) to the more extreme hypoxia warranting hospitalization – the same is true for the duration of the symptomatic period across various individuals – some limited to less than two days, others spanning many weeks.

Can I Go Back To Working Out/Exercising?

Applying this nebulous symptom severity index and symptom duration timeframe to acute infection in an otherwise active, fitness-minded, perhaps obsessed age-group athlete and leaves one wondering “can I get back to working out?”  For the first many months of the global pandemic, this perhaps may have been taken as a bit of a selfish query – the desire to return to exercise when raised in the context of the gravity of the illness for many (death, hospitalization, loss of livelihood).

Along the way, in 2020 we collectively learned about the virus and its impact on the population and the human body.  Research into the mechanisms of infection, transmission, prevention, treatment, recovery, and short- and long-term impact – a different study or dataset or conclusion was being published nearly every hour of every day.

In the late summer of 2020, some guidance began to take shape for the exercise-minded individual recovering from acute infection.  Domestically, much of this was driven by research focusing on collegiate-level athletes, to understand when and in what manner it was safe for these young athletes to return to their respective sports.

Joe’s COVID Journey, Recovery, and Return to Exercise.

In Joe’s situation his symptom onset was around September 5, 2020 (Labor Day weekend), his positive PCR sample would result on September 7, 2020.  During the next many days his prime goal apart from strict isolation protocol was managing his symptoms and monitoring any systemic manifestations (shortness of breath, chest pain, confusion).  As that initial string of days wound by, interrupted by Hurricane Sally (landfall September 15-16, 2020, he would be confronted with fatigue and the sensation of breathlessness which was temporized and stabilized with supplemental oxygen use and a combination of systemic (oral) and inhaled steroid agents.  At this point, he understood that this was likely impacting his cardiopulmonary system beyond the simple nuisance symptoms which are mostly contained to the upper respiratory tract (nasal and sinus congestion).  This added another layer to what would end up being an additional step to take prior to returning to physical exertion (exercise) which is part of his daily routine as a multi-sport athlete.  This was somewhat uncharted territory for both Joe as well as the medical community as a whole – studies were being conducted to best understand the next step or steps to take.

Studies On The Heart and COVID-19 Infection

One of the first such studies was published on September 11, 2020, in JAMA Cardiology (Rajpal S, Tong MS, Borchers J, et al. Cardiovascular Magnetic Resonance Findings in Competitive Athletes Recovering From COVID-19 Infection. JAMA Cardiol. 2021;6(1):116–118. doi:10.1001/jamacardio.2020.4916) detailing cardiac evaluation including studies such as the electrocardiogram (EKG), echocardiogram (ultrasound of the heart), and cardiac MRI.  The test modality of choice is to be dictated by the severity of the symptoms and the findings along each step of the algorithm.  This would provide some guidance as to which athletes were at higher risk for myocarditis, cardiomyopathy, malignant dysrhythmia, or even sudden cardiac death and then to help apply some guidelines on activity limitations moving forward.

Lingering Effect of COVID-19 Infection

So, using that as a launching pad for the discussion with his physician, Joe and his medical provider team decided it was best to proceed with cardiac screening – EKG (electrocardiogram – electrical tracing of the heartbeat and myocardial contraction) and echocardiogram (ultrasound of the heart).  These studies would occur in late September, roughly 4 weeks after his initial symptom onset.  The tests were not fully “normal” as the echocardiogram (ultrasound image of the heart) revealed some enlargement of the right side of the heart – a potential sign that there was some increased stress or workload on the right side of the heart attempting to pump blood to the lungs for oxygenation (and carbon dioxide removal).  This prompted Joe and his medical provider to lean on some of these recent studies and pursue the cardiac MRI study to best visualize and understand if there was any myocardial involvement (i.e. myocarditis) otherwise known as inflammation of the muscle tissue which makes up the heart.  Inflamed muscles are something Joe is keenly aware of with his exercise routine, but an inflamed cardiac muscle is not on the same level as inflamed skeletal muscles weary from a long workout or race.

As the cardiac MRI was being coordinated, the instructions were simple:  “take it easy and don’t get the heart rate up.”  Translated, this meant no exercise.  The potential risk being cardiac arrhythmia or heart failure if the already-angry myocardial tissue was additionally stressed.

Fortunately for Joe, the cardiac MRI would reveal normal myocardial tissue and the right side of the heart appeared normal as well.  The suggestion of the abnormal right-sided chambers on the echocardiogram was not present (or had resolved with additional time for recovery) on the MRI study.

Joe was now free to get back into his daily exercise routine – only limitation being “do what you can, take it easy getting back into it, and listen to your body.”

WATCH JOE VIDEO ABOUT HIS COVID JOURNEY HERE >

WATCH VIDEO ABOUT DR. EVAN MALONE’S DELTA VARIANT EXPERIENCE >

Fast forward many months later, and very similar guidance has emerged for application to the recreational athlete desiring to return to exercise.  The algorithm is meant to accompany the examination by and assessment of a qualified medical professional.

Key Points on Returning To Play.

For any age-group athlete looking to get back to fitness, exercise, physical exertion the first step following the acute infection (i.e. isolation period) should be an evaluation by your primary care provider.  A “return to play” or “return to physical exertion” discussion should be had.  For some it may be as simple as routine, annual bloodwork, or non-invasive testing.  For others it may include a larger, more-involved battery of tests.

 

 

 

 

Joe Zarzaur is a Board Certified Civil Trial Attorney whose firm is dedicated to promoting community safety since 2007. ZARZAUR LAW’S AREAS OF PRACTICE: Serious Personal Injury, Product Defect, Auto Accidents, Cycling Accidents, Motor Vehicle Accidents, Products Liability, Wrongful Death, Community Safety, Boat and Jet Ski Accidents, Slip and Fall Injuries, and more. Licensed in Alabama and Florida.

If you’ve been the victim of an accident, it’s important that you don’t make any rash decisions. Put yourself in the best possible position to receive the justice you deserve. It is also important to consult with a Board Certified Trial lawyer who has the knowledge and experience to help you. We know accidents can be stressful and want to make the process as easy as possible for you. Call Zarzaur Law, P.A. today at (855) Hire-Joe, or by requesting a free case review through our website.

What Zarzaur Law, PA is Doing to Keep All Employees Safe While Returning to Work.

As Zarzaur Law, PA prepares to gradually bring staff back into the office, it is very important to protect everyone and safety is priority one!

Here is what the firm is doing to keep everyone safe during this transition time from teleworking to re-entering the office full time.

ZARZAUR LAW, P.A. + COVID-19

Before Reporting To Building:
Stay home if you are sick (fever, myalgia, cough, shortness of breath), except to get medical care.

Notify management if you become acutely ill (above) or have a sick close contact (co-habitants, significant other).

Commuting To Building:
Do not park in close proximity to others, park in open area while maintaining a safe walk to building entrance.

Do not touch handrails, elevator buttons, parking meters, door handles (besides office building).

Entry to building at Romana Street entrance (upstairs) – OR – Palafox Street entrance (downstairs).

Upon Entering Building (Before Doing Anything Else):
Wash your hands with soap and warm water, at least 20 seconds.
(Use hand sanitizer with at least 60% alcohol if soap and warm water not available – 30 seconds).

Exterior of all personal items brought into office must be disinfected with antiseptic wipe – coffee cup, water bottle, mobile phone, handbag, purse, wallet.

Wash hands again after disinfecting personal items.

Check temperature (see below).

Body Temperature Checks:
Three times daily: upon entering building at start of shift, mid-shift check (lunch break (full day staff), mid-morning or mid-afternoon (half-day staff), end of shift check upon leaving building. Wash hands (or use hand sanitizer) prior to handling thermometer.

Wipe handle and buttons of thermometer with alcohol swab after use of thermometer.

Document each temperature reading with a Slack message to Joe – temperature with date/time

Wash hands (or use hand sanitizer) after using thermometer.

Movement Within Office:
Maintain six foot separation from others in the office, including hallway and stairwell traffic.

One person at a time in common spaces – hallway, kitchen/coffee, copier/fax/scanner, water cooler, stairwell.

Only use your assigned workspace.

No use of conference rooms without permission.

Diligence on need to leave building at any time besides end of shift.

*** Three times daily = start of shift, mid-shift, end of shift.

Hygiene:
Cough and sneeze – cover mouth with tissue, immediately dispose of tissue.

Immediately wash hands and re-sanitize workspace and electronics.

All paper towels are single use and to be placed in provided receptacles immediately after use.

Workspace:
Surfaces disinfected three times daily. ***

Electronics:
Use only your assigned machine (computer) and office phone.

Sanitize machine (keyboard, mouse, mousepad) and phone (handpiece, earpiece, keypad) three times daily. ***

Personal Items:
Do not allow others to borrow or use pens, mobile phones, keys, coffee cups.

Make your own coffee.

Sanitizing The Office:
Handrails, coffee/water, copier/fax/scanner, sink handles/faucets, and door handles (inside and outside) must be sanitized three times daily ***
> management to decide on rotating assignment vs single owner of this task

Kitchen and coffee counter surfaces to be sanitized thee times daily ***

Conference room tables to be sanitized before and after every use – permission required for use.

Visitors:
Front door guests – utilize doorbell, reception wears mask/gloves when interacting, inform of closed office protocol.

All visitors, vendors, clients must be approved prior to permission into building.

Visitors must follow hand washing protocol upon entry to building.
Disinfect all surfaces and touch points when visitors exit building.

*** Three times daily = start of shift, mid-shift, end of shift.

The Zarzaur Law firm remains fully operational and the staff is working hard on client’s behalf (safely and remotely). Attorneys will still be seeing clients either safely in office or via video conferencing.

Joe Zarzaur, founder of Zarzaur Law, P.A., a Pensacola Personal Injury law firm, has created this blog in an effort to educate the many citizens and visitors of Pensacola, Florida about their legal rights. Joe Zarzaur knows the ins and outs of Florida law, and offers friendly-quality legal help whether you have experienced an auto accident/car wreck, have been a victim of medical malpractice or are in need of a personal injury lawyer. For more information, visit: https://www.zarzaurlaw.com

11 E Romana Street
Pensacola, FL 32502
Telephone: 850-444-9299
Email: info@zarzaurlaw.com

 

Zarzaur Law, PA Offers Virtual Meetings in Wake of Cornonavirus (COVID19) Outbreak.

Zarzaur Law's Joe ZarzaurIf you have a serious injury case, action shouldn’t be delayed.

If you are unable to meet in person due to the coronavirus (COVID19) outbreak or any other reason, please contact us.

We’re still here working. We conduct virtual meetings with our clients regularly, and will do it for you.

 

 


Zarzaur Law, P.A. is aware of the coronavirus (COVID19) concerns of everyone in our community.

For over two weeks, the firm has taken steps to insure that our office is sanitized for each client. We have also taken extra steps to make certain that all staff members are symptom free and that their body temperatures are normal prior to coming to work. Further, we have inquired and insured that no staff member has come into contact with any international travelers or national travelers that may be coming from domestic hot spots in their free time. If they have we have asked them to self quarantine for two weeks.

We will continue to see clients, one at a time, to make sure that all clients with personal injury legal issues are handled in a timely and professional manner. The firm also recognizes that given the cancellation of schools and other institutions, many potential new personal injury clients cannot attend meetings “in person”. To address this issue, our firm -which has always offered “virtual meetings” with potential clients- has stepped up our technological capabilities and is utilizing Zoom® video conferencing software/hardware to provide high quality video conferencing for any potential personal injury client to have a free face to face consultation with one of our personal injury lawyers. As always, the firm will continue to speak to each potential client first by phone and if the matter results in a meeting we will provide the potential client to attend such meeting via video conferencing and provide all documents to you electronically. This will permit the hiring of our firm for your personal injury case to be consummated without requiring you to leave your families and home.

Exact instructions for these consultations will be provided during the initial call with our firm. These procedures will go into effect immediately and will continue until our community is completely on the other side of this COVID19 issue.

We urge everyone to heed all recommendations provided by our state and federal scientific communities and to stay put in their homes and not to congregate in crowds, adhere to stringent personal hygiene protocols, and make certain to be aware of those in your families that make up the high risk group for coronavirus.

The following is a list of links to various reliable sources for the latest information on the virus both local and federal:

CENTER FOR INFECTIOUS DISEASE AND RESEARCH AND POLICY >

FL DEPARTMENT OF HEALTH >

CDC >

Zarzaur Law, P.A. will continue to provide excellent legal services to our clients and remain committed to offer those services even as we all deal with the challenges of this time.

Joe Zarzaur, founder of Zarzaur Law, P.A., a Pensacola Personal Injury law firm, has created this blog in an effort to educate the many citizens and visitors of Pensacola, Florida about their legal rights. Joe Zarzaur knows the ins and outs of Florida law, and offers friendly-quality legal help whether you have experienced an auto accident/car wreck, have been a victim of medical malpractice or are in need of a personal injury lawyer. For more information, visit: https://www.zarzaurlaw.com

11 E Romana Street
Pensacola, FL 32502
Telephone: 850-444-9299
Email: info@zarzaurlaw.com