I think that wearing a mask is almost an act
of love for those who can't or for those who
are immunocompromised.
When I am not working in the ER and I'm out
where I'm going to be in close proximity or
I'm going to talk, I wear a N95 because I
do not want any of my particles getting to
them.
But, just if you can and you're able to wear
masks, it's not about, we're not getting into
politics here, we’re literally showing an
act of love.
And people get very heated about this and
it’s not a big deal.
We don't know enough about this virus, but
we do know that it's weird because you're
healthy for so long and you're asymptomatic
but your viral loads are high.
Thank you for joining me for today's episode
of the Midpoint.
I have the pleasure to speak with Dr. Jennifer
Pfleghaar, who works as an ER doctor and also
runs her own integrative medicine practice.
She is here to share what she sees from diverse
sides of human health, from the emergency
cases in the ER to the importance of [the]
immune system and daily nutrition.
Hi, Dr. Pfleghaar, thank you for joining me
for this episode of the Midpoint.
Hi!
Thanks for having me, I'm really excited.
Awesome, we’re glad to have you.
So, we know that you're a very busy person.
You are an ER doctor and you also run an integrative
medicine practice on the side.
It's really interesting to see that combination
in terms of the crisis these days.
I’m really interested to know, what is happening
in terms of the ER and in the hospital?
What has the situation in the hospital over
the last couple of weeks been like?
Well, it’s definitely been a roller coaster.
Toledo in general has not been a hot spot
like New York, let's say.
So you hear the frontlines there because we
all talk, colleagues try to help each other,
especially in the ER, we always do that.
You're hearing from the frontlines in New
York City and first we heard from Seattle,
long time, you know like how to treat these
patients, what to do.
This is something that we've never seen from
a respiratory standpoint before.
It just doesn't behave like usual viruses,
so it's been kind of interesting.
We kind of all ramped up, everyone was studying
the papers, making sure we were prepared to
treat our patients the best, and then we just
waited.
And while we were waiting, the ERs were actually
not busy.
It was like the calm before the storm.
A lot of my friends and colleagues have experienced
this, and I think it's been hard on physicians
and providers because the volume has gone
down a lot.
Actually, you know shifts have been cut back
in the areas that aren't a hot spot.
So, it's been very interesting.
We're all prepared for a surge, but if it
comes.
But, at the same time this is awesome because
it means we were all mitigating so well in
flattening the curve.
I don't see it as a negative, I see it as
a positive.
But, it’s been kind of weird.
We’re slowly starting to pick up again in
the ER, but for the last couple of months
it’s been odd because sometimes you’d
be sitting there like, it’s so quiet here.
So, there has been some preparation behind
the scene?
I think in terms of Ohio especially, we’ve
kind of acted before some of the other states
have in terms of mandating staying at home.
In particular with the hospital, we've seen
some in other cities, like lack in PPE, protective
gear, for our front-line workers, and so was
that something that you guys had to kind of
go through processes and obtaining that gear?
Yes.
So, every hospital system has a different
way of handling it.
I've been really impressed where I work, we've
always had PPE and I've always felt safe.
But, we are more stringent about it, so we
have like a little bag that we put our PPE
in and use it for a couple shifts, especially
the N95s.
You’re not going to toss those.
It’s crazy, where before if you had a patient
that you were worried about tuberculosis,
let’s say where you would need an N95, you
would wear it in there, you’d just discard
it.
You wouldn’t even think about it.
But now, we’re sanitizing masks and really
saving it.
The other thing, I don’t know if people
know the N95 mask, you can actually fail a
fit test.
At my facility where I work, we wear, you
get fit tested for that N95 mask.
What that means is if there's an air leak
around it, then you have to wear the big PAPR,
the big hood.
I fail my fit test for a regular N95, so if
I'm going to do a high risk procedure, like
an intubation, I put on my PAPRs.
And that's what that’s called, the PAPRs,
with the big hood you'll see.
That’s for people who fail.
There's also like what painters wear, the
actual gas mask.
With the valves.
With the valves.
I have that.
I bring that with me to my ER shift because
ER doctors, we have this mentality—we’re
kind of like always prepared for everything
because you never know what's going to come in.
So I bring that kind of an emergency kit with
me to every ER shift just in case all the
PAPRs were being used or something so we would
all be protected.
The other thing I bring from home, which is
a good hack, is a poncho, a clear poncho.
And when you’re intubating someone, you
put that over them so it protects everyone
in the room and I did use that once and it
works really well.
So I think I'm just so proud of the medical
community.
You know, nurses, physicians, respiratory
therapists, everyone's been so creative and
amazing with all of this.
Yeah.
So has there been, so you've had experience
then with some people coming in with respiratory
respiratory symptoms.
What does the protocol say, someone comes
in with a symptom?
They’re coughing or sneezing, maybe it's
getting worse and not getting better.
What is the protocol right now in the hospitals
for that?
The thing about protocols throughout this whole
COVID-19 is that they can change every hour,
hour, every day.
They're always changing for the better.
Where I work right now, we have a hot zone,
which a possible COVID complaint goes to.
And then we have a separate area for say a
kid falls and gets a cut.
So it's just very impressive how we are working
through everything.
If someone does have complaints that we think
they might be COVID-positive, we all gown
up.
We don our N95’s with our equipment.
Everyone, also, if you're considering COVID-19
as a diagnosis, there is a sheet and you write
your name on it.
Everyone in and out of the room, so it was
an actual positive test, everyone would be
notified.
So it's really about serving the patients
and protecting our staff and the healthcare worker.
I mean I'm very impressed with how Toledo,
in general, is handling it.
I think that a lot of people still require
more information about what the front-line
workers are facing and how it's not just about
us as an individual, but actually our part
is really important in protecting others around
us, right?
And the big thing is, like I said, it's changing
all the time, how many tests we have available
and who we can test?
So someone comes in, but their vital signs
look good and they're looking good.
But, they have this cough and they might be
positive.
We might not be able to test them.
We might just say, “Right now, you're safe
to go home, but come back if anything changes.”
So, I know that can be frustrating and I know
we're trying to get more tests, things are
changing, so I think patients through all
of this because it’s such a weird time is
the best way to describe it.
Yeah, and there's been a lot of in the news,
talks about mutations and new symptoms showing
up.
So in some ways, you guys really have to be
on the prepared end and kind of facing all
of the emergency potentials, right?
In some ways that's the kind of spontaneous
part of the job that is so difficult to prepare
for.
Right, it’s a lot to keep up on.
Especially, when all this was new, I mean
I would spend hours at night just reading
over all of the cases, all of the new journals.
Just to make sure I knew what I was talking
about and it was evidence-based, especially,
not only all of my friends asked me questions,
family.
And I want to be prepared.
I also went to some urgent care telemedicine
when I wasn't working in the ER and I would
get… that was really hard to see because
these people are at home and they are scared
to go anywhere.
And I had to send some of them to the ER because
I'm like I'm worried about your breathing
and that was the hardest thing for me, talking
about it to you, is that what we don't realize
is people are really suffering at home because
they're scared to get help because they're
scared of getting the virus.
So that was emotionally kind of hard for me
to see.
And the anxiety and depression going on.
I spoke with a girl and she lived in an apartment
by herself.
And she was struggling with anxiety and depression,
and it broke my heart because she lived alone
alone in a city.
I think that this is so complex.
It's not just physical, the mental implications
of all of this I think it's honestly being
overlooked a little bit.
I think we need to focus on mental health
moving forward because of everything, our
economy and the fear with all of this.
Right and in some ways you've turned pretty
quickly to telemedicine and using information
information technology, using the internet to get some
connection out there.
And as you said, it's not just physical, it's
as much emotional and a sense of support from
a greater community.
So you've been able to do that.
Could you maybe talk a little bit about what
you were able to do from your end, besides
your important job as an ER doctor?
Yeah, so my passion.
I love ER, but I am so passionate about integrative
medicine, so it's an alternative medicine,
evidence-based, more preventative.
So, I've been really turning to social media
to help people, making informative videos
on COVID-19, what's going on, what are some
different things you can do at home. because
I like to think of it as we're kind of preparing
for battle against this virus.
So you want your best self, your best body
to be ready to fight for it because honestly,
I think we're all going to be exposed to this
eventually.
And like you said and mentioned it that it
does mutate.
It's similar to the flu that it's a virus
that mutates.
It's going to be different.
It's going to change; it already has mutated.
So we're going to see this; it's not just
going to disappear one day.
So I think preparing what the focus should
be on is knowing what you can do preventively
to keep your body healthy.
What are the right supplements?
Let's talk about that.
It’s been a real big passion of mine to
create social media, to create posts, to give
out information because I don't think everyone
just wants to hear the negative news.
I think the positive, like what I can do proactively.
I think that is reassuring, also.
Are there specific factors and conditions
that make some people more vulnerable and
some comorbidity factors that you're seeing?
By far, hypertension and diabetes are the
top two.
That we are really seeing when they look at
morbidity and mortality for this.
And then honestly, just today, a study came
out from China and the correlation with obesity
is huge.
And the chart, the pie chart, your risk of
adverse effect and outcomes was like this
[draws an increasing slope in the air] with
your BMI, your body mass index.
What comes with obesity?
Insulin-resistance, diabetes, blood pressure,
so it makes sense to me.
So when I study like that I'm like, “Okay.
Come on, you guys.
Let's cook at home, let’s not get fast food.
Let's get healthy as a nation and our death
toll is going up and up, but our weight as
a country has been going up and up.
And that goes with chemicals in our food and
pesticides and toxins and instant gratification
gratification with food.
And everything's fast and you know, I do an
80/20 rule.
We cook at home 80% of the time.
We still have treats.
You're not depriving yourself, but for risk
factors: obesity, diabetes, hypertension.
And these are all chronic diseases and diseases
of inflammation, so diseases that you just
don't get overnight. Some people are more genetically
susceptible, but these are things that you
can pay attention to.
To help yourself.
And you know that's the really sad thing is
so many people that come into the emergency
room they’re on diabetes medications, they’re
on high blood pressure [medication].
I mean it's rare to see someone just on an
aspirin a day.
I mean usually they’re the healthy ninety-year-old
grandmother that just had chest pain and lives
lives by herself.
But the more medications you have, the more at risk you're going to be at for even just the regular flu,
but you know SARS-[CoV]-]2 or COVID-19 is
really hitting hard.
Now, there are some cases of young people
getting this, being on a ventilator, with no
risk factors, or of having prolonged hospital stays, but I don't want people to be scared by this.
Until we look at each one of those cases,
who knows if they had an inflammatory process
going on in their body?
Who knows if their gut health was good
or if they were taking over the counter Pepcid
everyday for acid reflux.
So when people are “healthy” or [have]
“no comorbidities” I question that because
we're just not living optimally in this country.
When it comes to it, when I do an integrative
medicine intake, someone you know, they say
I'm healthy, but we discover lots of underlying
issues.
If we live in fear about this, then that’s
going to cause stress and inflammation and
hurt your immune system.
That's not helpful either.
I like to present facts, but not fear because
that’s going to do more harm.
You're having both sides, both on the emergent
medicine end and the long-term; what you can
do to bolster your body and what you should
do to live a truly healthy lifestyle.
Those two actually come together.
I think that's something that I'm hearing
from you is that there are..it isn't random.
Actually, there are some things that you can
do right now.
I wonder if you, like what you advise?
The patient's that you're seeing, besides
just medicine, but there are some things that
we do that do have a consequence in terms
of our vulnerability to the virus.
Other than the risk factors, drinking alcohol
decreases your immune function.
I feel like a lot of people are doing that
right now to get over the depression.
I know.
That is what hurts so bad as a physician because
people are self-medicating.
I hear the statistic alcohol sales have gone
up 110% and it breaks my heart.
I'll have like one drink a week, maybe, or
glass of wine or something, but even while
I'm drinking I'm like, oh my immune function’s
going down. But, sugar decreases your immune
system for a couple hours after intake.
So for me, I'm kind of odd, but when I go
into an ER shift, I usually work night shift,
but I do my vitamin C, my zinc, my quercetin,
I do my whole botanical regimen and then I
fast while I'm at work.
I don't need any sugar, I just drink clean
filtered water.
You’ve got to be smart and you can seek
out this information.
This is why I try to teach people on social
media, because I want that information to
be out there for free and for them to be healthy.
But yeah, things like alcohol and sugar, if
you get sick or if you're feeling sick, or
you're going into a high-risk situation like
an ER shift or a gathering once stuff starts
lifting up, just be smart.
Just say I'm going to boost my immune system, I'm
just going to drink water.
Just make smart choices.
Those are some things, keeping that immune
system strong, preparing it for battle.
Kind of like when someone prepares for a 5K
or marathon.
You're training.
You’re not just going to go out there and
run it.
You'll fail.
We didn't get to talk about this earlier,
but I was just wondering, maybe you can run
through like your day-to-day?
What do you do to get prepared when you have
to go to work at the hospital?
When I'm getting ready to go in, I kind of
have a weird routine.
We all go to work in our scrubs, everyone's
kind of doing this, we talked about it as
an ER group.
And then we change before we come home.
I have a bunch of garbage bags.
I look like I’m carrying a grocery bag and
I have my pumping because I'm breastfeeding.
I have my pumping supply in there with the
bag and then I have my little emergency kit
in case there's an intubation with my mask,
with the poncho.
I have this biocidin throat spray that if
we intubate someone I spray my throat and
then I offer it to the nurses just in case
we got some viral load it would kill it.
It's made from botanicals.
Then I have an extra pair of glasses in there.
So I have all that in my bag and then if it’s
a day shift I'm going to pack food in a separate
bag, and then I have a big thing of filtered
water to really stay hydrated.
What we all usually do is we're wearing masks
the whole time, but then you can just take
it off, chug your water, and then you put
it back on.Then after the shift, I'm going
to change out of my scrubs at the hospital,
put on other clothes and then go home.
Outside of my house I take off my shoes and
I leave them outside.
Then I go straight to the laundry and I take
off all my work clothes.
I always have a separate laundry basket for
my work clothes anyway because there's MRSA, there's bugs,
it's gross.
So, I put them in the hamper and then I go
to my shower and I wash my whole body and
I wash my hair, and then I go to bed if it's
a night shift and I nurse the baby.
I wash my hair unless I have a cap on.
Sometimes I'll wear one of those surgical
caps, and then I won’t have to wash my hair.
A lot of those people are working full-time,
because right now I’m just part-time in
the ER, the women have been...their hair is
a mess because they're washing it so much.
That's another thing you don't see.
And then if you're wearing the mask for 12
hours straight and you don't get a break to
take it off, you're getting the welts there.
There’s a lot of things that are just different.
In addition, I really make sure I'm taking
vitamin C right before going in.
I also take quercetin, which is a botanical,
it helps zinc get into the cells to fight
viruses, the biflavonoids I take.
I’m usually really on key with my supplements,
but I take a little bit extra zinc and vitamin
C for me before going into work.
And then you come home and make sure you get
sleep.
You make sure you try not to be stressed at
work, because that’s bad for your immune
system.
It's been a little humbling the whole experience,
because you go into work and patients are
like, thank you for your service, or thanks
for what you're doing.
I’ve done this as long as I can remember
in the ER.
I've always wanted to serve and help people
and help patients.
I personally think it's hard for me to take
that in sometimes.
I'm the person ... I always if I have a patient
that has a Vietnam hat on or something, I
always say thank you for your service and
we talk about the war a little bit.
It's a little hard for me sometimes to be
called a frontline hero, honestly, because
when I took my oath to be a doctor, I mean
that was when I just gave my life to the profession.
I think it's great that nurses are getting
more recognition, and physicians, but this
is what we love.
As a physician, I took an oath.
There's not many professions that do that.
I am very grateful that I can serve in general
during this.
I wouldn't change it for anything.
As it may be the last question for you, what
advice would you give our viewers watching
this, or even your viewers that you talk to
on your platform?
What is the advice that you would want them
to know, and what would you like to maybe
see and hear from the community?
I really just want everyone to live a healthy
life and feel good, that's my passion.
You need to start with a good base and that's
nutrition, and a lot of people struggle with
this.
There's the internet now, where you can look
up healthy ways to eat, different diets, whatever
works for you, but eat your vegetables.
Eating vegetables it’s shown to decrease
mortality study after study, time after time.
Try to notice if you're self-coping with sugar
or alcohol, because those two do have a negative
effect on your immune function.
So, if you are in a place where you need help,
go get it.
There's online therapists, we're here in the
ER, if any mental illness, there's no reason
why I should stay home.
No one will, we [are] always in the ER, I
open everyone with open arms.
People are like, I feel bad for coming, I'm
like, no.
You're here because you need to be, and I'm
here for you to talk to.
I don’t want anyone to struggle in silence.
So, going on with that, make sure you're taking
good supplements, whether you’re getting
vitamin C in oranges or you’re taking a
supplement, and zinc, quercetin, probiotics,
melatonin, I mean has been shown to possibly
help against SARS, so there's a bunch of different
things I go into detail more on my platform
with that.
And then, I know that people are kind of upset
about the whole wearing a mask thing and I
just wanted to touch base on that.
I wear a mask; I actually wear an N95 if I'm
really close to people because I could be
an asymptomatic carrier because I’m healthy.
And this could also affect me and I could
be in the hospital.
We just don't know enough yet.
But, wearing a mask is almost like an act of
love.
I think that wearing a mask is almost an act
of love for those who can't or for those who
are immunocompromised.
So when I am not working in the ER and I'm
out where I'm going to be in close proximity
or I'm going to talk, I wear an N95 because
I do not want any of my particles getting
to them.
Or if you're just walking at the Farmers Market,
just wear a cotton mask.
Have your kids wear one; kids are coughing
and sneezing and shooting those particles.
So just tell them.There are people, and I think
the one group that we forget about are the
people that get anxious when they wear a mask.
It's not dangerous to wear a mask.
If you’re over the age of 2, you can pull
it off.
But some people, they get really anxious and
I don't think we should shame people that
don't wear masks.
We don't know, but just if you can and you're
able to wear masks, it's not about ... we're
not getting into the politics here.
We’re literally showing an act of love.
And people get very heated about this and
it’s not a big deal.
It’s just we don’t know enough about this
virus, but we do know that it is weird because
you're healthy for so long and you’re asymptomatic,
but your viral loads are high.
So I guess that would also be a good thing.
One other thing would be [to] get outside,
walk, be in nature.
So exercise, just walking around in nature,
being in nature, putting your feet in the
grass, grounding, and meditation; I mean that's
the one thing that I wish I could get everyone
to do, okay? It's really, especially, in these
times right now of uncertainty so meditation.
Something that you know just try it out Yeah,
well thank you so much.
I think those are really great tips.
It's even more important that you added the
notes about the mask because that is a huge
point of contention as we speak.
And I think you're right.
I totally agree that it's not about politics
and it's just something that as we've been
talking about this entire episode, it's our
bodies.
We're all humans and we all have a biological
immune system that needs to take care of and
there are certain things that like wearing
masks that [are] basically proven that it
will reduce how much we can spread and how
much the virus will be contagious in our own
community.
So I think you're right it is in an act of
love that we hope to be sharing with the community.
And thank you so much for your time and again,
I know you might not want to hear it, but
thank you for your service as we really truly
are beneficiaries in this community for not
just the service and the skills, but also
the information that we hope to be spreading.
Thank you so much for having me.
It was so nice talking to you and I had a
good time.
Thank you doctor.
Thank you for tuning in and I hope you got
something new from today's episode. As we learned,
the toll of the pandemic is as much mental
as it is physical.
We also heard just how important it is to
show an act of love toward fellow citizens
through mask-wearing.
This time may be difficult, but it can very
well be an urgent call for us to get on a
healthier and more conscientious track for the
future of our country.
If you enjoyed this conversation, like, subscribe
and share our content. As always stay safe,
stay healthy, which made be eating more
vegetables, and stay human.
