HealthONE - April 14, 2020

Nutrition tips for transplant patients during COVID-19

Does the constant barrage of news updates about COVID-19, the stay at home orders and the lack of toilet paper have you feeling stressed? Do you often find yourself searching for comfort foods more often? You are not alone! However, during times of high stress, it’s important to find productive ways to cope to keep your body and mind healthy. The Presbyterian/St. Luke’s (PSL) transplant program is here to provide support to all of our patients and help them learn how to stay healthy during the coronavirus pandemic.

Healthy eating versus stress eating

Stressful events, whether major or minor, cause a physiological response in our brain known as "fight or flight". When our sympathetic nervous system is triggered, our body dumps adrenaline and cortisol into our system and extra glucose is released into our bloodstream to provide our muscles with fuel.

During short-term stressful events, the "fight or flight" response can help us stay focused and alert. However, the effects of chronic stress can contribute to unwanted weight gain, weakened immune system, high blood pressure, heart disease, cancer, digestive problems and depression.

Specifically for nutrition, chronic stress can lead to the following:

  • Changes in appetite or food intake (increase or decrease).
  • Changes in food cravings – typically increase in intake of foods high in simple sugars.
  • Increase in intake of caffeine, alcohol or other substances.
  • Changes in gut function that can potentially cause digestive issues. Additionally, chronic stress can worsen pre-existing digestive issues, such as heartburn or Irritable Bowel Syndrome.
  • Headaches, fatigue, muscle tension or sleeplessness.

During times of high stress, it can be helpful to be mindful of your body so that you can identify what type of hunger you are feeling. Ask yourself is it a physical hunger or emotional hunger? Use the table below to help determine whether you are eating to support your body or your mind.

Physical (below the neck, or based in the stomach):Emotional (above the neck):
This hunger is gradual This hunger can be sudden
Open to different foods Is for a specific food
Is patient Is urgent
Occurs out of physical need Can be paired with an upsetting emotion (e.g. stress, sadness, anger, frustration, or boredom)
Involves deliberate choices and awareness of eating Involves automatic or absent-minded eating
Stops when full Does not notice or stop eating, in response to fullness
Realizes eating is necessary Feels guilty about eating

If you have determined that you are eating to soothe emotions, you may be stress eating. But how do you combat the "emotional" hunger? Before you pick up that comfort food, stop & think. Ask yourself "Am I really hungry"? Or am I eating because of my emotions? If you chose the latter, try to determine what you need right now that would be soothing other than food. Learning to identify what you really need can help you learn how to stop stress eating.

If you need social connection during the coronavirus:

  • Connect with a friend through FaceTime, Skype, Zoom or by phone.
  • Engage in discussion with family members who are home.

If you need activity or movement during the coronavirus:

  • Engage in movement that you enjoy
  • Yoga
  • Walk or run over your lunch break
  • Walk your dog
  • Do an online exercise class
  • Dance while you make lunch or dinner
  • Go on a bike ride

If you need mental stimulation during the coronavirus :

  • Do a puzzle
  • Play a game
  • Read or write
  • Color, draw, or paint
  • Knit, crochet

If you need solitude during the coronavirus:

  • Take a bath
  • Go on a (personal) walk
  • Find a spot in your home to be alone
  • Take a nap

If you need spiritual connection during the coronavirus:

  • Pray
  • Write a poem
  • Meditate
  • Sing a song

The goal is to be able to identify when you are eating to soothe your emotions and find healthier coping mechanisms.

Sources

  • Modified from Behavioral Health and Nutrition Fact Sheet: Stress Management
  • Modified from Virtue, Doreen. Constant Cravings A-Z. (Carlsbad, CA: Hay House, 1999)

How to stay healthy during COVID-19

Our community is working hard to contain the spread of COVID-19. Your health and safety are our top priority and we ask that you follow the recommendations below. We continue to closely monitor this rapidly evolving situation and will provide updates as it becomes necessary.

What is coronavirus

COVID-19 is a new corona virus that has not been previously identified and is not the same as the corona viruses that commonly circulate among humans, causing mild illness, such as the common cold. This strain was first identified in Wuhan, China in Dec 2019 and has now spread globally.

What are the symptoms of coronavirus?

Current symptoms include mild to severe respiratory illness. People who have been diagnosed with COVID-19 display:

  • Congestion
  • Cough
  • Fever
  • Flu-like symptoms
  • Trouble breathing
  • Wheezing

Symptoms may appear in as few as 2 days or up to 14 days after exposure to the virus. People who are immunocompromised may have fewer symptoms (e.g. absence of fever) when they initially get sick.

For further information, please visit the Centers for Disease Control website.

How does the coronavirus spread?

At this time, COVID-19 is thought to spread mainly from person to person. This can happen between people who are in close contact with one another. Droplets that are produced when an infected person coughs or sneezes may land in the mouths or noses of people who are nearby, or possibly be inhaled into their lungs. COVID-19 can also spread from contact with surfaces or objects with novel corona virus on them, by touching infected surfaces or objects and then touching your own mouth, nose or eyes.

What is our transplant program doing to keep patients safe?

Your health and safety are of utmost importance to us. Because of this, we have put certain processes in place to protect you:

  • We are performing screening of all patients and caregivers coming into the hospital or clinic for respiratory symptoms, travel history, and risk of exposure to COVID-19. If you screen positive, you will be asked to wear a mask and either asked to go home or sent to the ER for further evaluation.
  • For hospitalized transplant patients, no visitors will be allowed at this time.
  • For the transplant clinic, we are limiting patient’s visits to one caregiver. The caregiver will be screened on entering clinic and has to pass screening to stay.
  • No children age 12 years old or younger are allowed into the transplant center.
  • If you have a scheduled clinic appointment and have any of the above symptoms, please call to reschedule and to obtain further guidance.
  • If you have a scheduled clinic appointment, you may be asked to reschedule depending on the urgency of your visit.
  • If you develop fever, congestion, cough, flu-like symptoms, wheezing or trouble breathing (and/or recent travel or exposure to a confirmed or suspected COVID-19 infected person), please call the transplant clinic for further guidance (if you have mild symptoms). IF you are planning to go to the ER (for more severe symptoms), please call the ER and notify them of your arrival. Mention that you are a transplant patient with above symptoms. Please do not come to clinic.
The Transplant Center can be reached at (720) 754-2155. After hours and weekends, please call the hospital operator at (720) 754-6000 and ask to be connected to the on call coordinator

What can I do to protect myself from COVID 19?

  • The risk of contracting this illness is equal to the number and duration of person-to-person interactions an individual has. Reducing these contacts will reduce your probability of becoming infected.
    • If you are a post-transplant patient, contact The Transplant Center to discuss assistance in requesting time off from work if needed.
    • Contact your HR department to inquire about leave of absence options.
    • If you are a post-transplant patient and need to continue working, please practice social distancing, conducting virtual meetings, and following the steps outlined below.
    • Avoid using public transportation to get to the workplace.
  • It is important for us to remember these everyday habits that can protect us and others from common respiratory illness:
    • Practice good hand hygiene by washing your hands often, either using soap and water or alcohol based hand gel for at least 20 seconds.
    • Clean and disinfect frequently touched objects and surfaces.
    • Avoid contact with people who are sick.
    • Avoid touching your eyes, nose, mouth.
    • Cover our cough or sneeze with a tissue, then throw tissue in trash.
    • Stay at least 6 feet away from other people to prevent droplet transmission.
  • Avoid public areas, public transportation, social gatherings and large events. Social distancing right now is the key to preventing spread of the virus.
  • Delay elective surgeries if possible.
  • The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) maintain websites that are being updated daily as the outbreak evolves, and travel recommendations will likely change over time.
    • The CDC has recommended suspending all non-essential travel to China, Iran, Italy, South Korea, Vietnam and Myanmar. It is also recommended to avoid cruises into or within Asia. Enhanced precautions are recommended with travel to Japan.
  • We recommend that transplant patients and family members restrict all travel at this time (only if absolutely necessary).
  • We recommend you work from home (if that is an option). If that is not an option, please follow all above precautions at your work place.

How to stay mentally healthy during the coronavirus

Our Transplant Center cares about your emotional wellbeing.  We understand that the outbreak of coronavirus (COVID-19) may be stressful for our transplant patients. Fear and anxiety about this virus can be overwhelming. However, effectively coping with stress will make you, the people you care about and your community stronger. Below are links to specific information on COVID-19 for transplant candidates and recipients. In addition, there is information on how to care for your behavioral health during these trying times.

The American Society for Transplantation now has an updated webpage of frequently asked questions from transplant candidates and recipients regarding COVID-19. 

American Transplant Foundation

The American Transplant Foundation recently started a blog called "Transplant Recipients and COVID-19.” 

Things you can do to support yourself:

  • Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the pandemic repeatedly can be upsetting.
  • Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.
  • Make time to unwind. Try to do some other activities you enjoy.
  • Connect with others. Talk with people you trust about your concerns and how you are feeling.
  • Taking care of yourself, your friends, and your family can help you cope with stress. Helping others cope with their stress can also make your community stronger.

From:  Centers for Disease Control and Prevention, Mental Health and Coping during COVID-19

Caring for your behavioral health and COVID-19

Ten-step prescription for resilience:

  1. Keep a positive attitude
  2. Reframe your stressful thoughts
  3. Use your faith or moral compass as a support
  4. Learn from a resilient role model
  5. Accept the situation for what it is. Face your Fears.
  6. Develop active coping skills
  7. Establish and nurture a supportive social network
  8. Prioritize your physical well-being. 
  9. Train your brain
  10. Play to your strengths

From the book:  Resilience: The Science of Mastering Life’s Greatest Challenges, by Dr. Dennis Charney and Dr. Steven Southwick

SAMHSA (Substance Abuse and Mental Health Services Administration) has an article on tips for social distancing, quarantine and isolation during an infectious disease outbreak.

If you, or someone you care about, are feeling overwhelmed with emotions like sadness, depression, or anxiety, call:  

SAMHSA’s Disaster Distress Helpline
Toll-Free: 1-800-985-5990 (English and español)
SMS: Text TalkWithUs to 66746
SMS (español): “Hablanos” al 66746
TTY: 1-800-846-8517
Website (English): SAMHSA in English
Website (español): SAMHSA en español

April 10, 2020
During the coronavirus pandemic, we are offering virtual doctor’s visits to provide patients convenient and safe access to their physicians.
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