CBB Voices Blog2020-06-22T14:35:19-07:00

Jason Prystowsky MD, MPH: Some Omicron reflections from the last week

Jason Prystowsky MD, MPH: Some Omicron reflections from the last week
From your friendly, neighborhood, community ER doc (who worked 12 of the last 14 days). . .
1) Omicron is here. It is 3x more contagious than Delta variant and 6-8x more contagious than original variant. It is causing “breakthrough infections” in those vaccinated (more so in those with J&J or two doses mRNA vaccine rather than 3 doses and boosted). Thus far it appears to cause less severe illness especially in those who have already had COVID or have been vaccinated. If (or when) you get COVID, you may be asymptomatic or you may feel miserable. As of today, we are out of the monoclonal antibody infusions that have shown to be minimally to moderately effective at preventing severe disease. We also do not have the new Merck or Pfizer antivirals. If you come to the ER expecting unavailable or ineffective interventions, you will not get them so please do not make demands or threats. Ivermectin and hydroxychloroquine are NOT effective treatments. If you catch COVID please stay hydrated, rest, invest in a pulse oximeter (about $30) and check your oxygen level every few hours (should consistently above 96% in healthy lungs). Please notify everyone you had been in contact with for the 5 days before you got sick (indoors, >15 minutes, <6 feet apart, both not wearing masks). Contact your physician for a telehealth visit so that a health professional can monitor your symptoms. I have seen athletic, healthy, young people be completely bed ridden with COVID for 2 weeks, so set your expectations. If you do have COVID… do NOT go to work, go out to eat with friends, go to a house party, go to the grocery store, go to gym, go to hot yoga, get a massage, go to a wedding, watch Fox news, smoke/vape marijuana, tobacco, methamphetamines, knowingly expose other people to COVID, order unnecessary things on amazon (all are activities I have heard from COVID patients within the last week). Reasons to come to the ER or call your physician: pulse oximetry <90% consistently, dehydrated and unable to keep down fluids, severe chest pain, severe shortness of breath, confusion; or for children, persistent fever and symptoms that are worse than a mild cold (rash, diarrhea, inability to eat, short of breath, pulse oximetry <90%). Please see the CDC criteria for MIS-C.
2) Testing. There is a lot of misinformation out there about testing, so be sure you are getting your information from reliable sources. PCR (or nucleic acid amplification tests) are the most accurate, but they are also more expensive and take longer for results to come back. Rapid antigen tests are faster, can be purchased at pharmacies, and are currently being distributed by local public health agencies. These tests are usually accurate if you are symptomatic but are less accurate if you are asymptomatic, or pre-symptomatic (i.e. you have been exposed and are worried you may have it, but have not developed symptoms yet). Last I checked, CVS was sold out of rapid antigen tests and SB county public health ran out. I know that various local urgent cares are offering COVID testing including Cottage Urgent Care, MedCenter, and Sansum Urgent Care. There are some local businesses that can do same-day testing but can be expensive (such as South Coast Analytics). Teachers and students can get PCR screening at Earl Warren Showgrounds, but need to make an appointment. UCSB students have access to testing through student health. If you need to be tested for work or school, please check with your supervisor about where to go. If you come to the ER, we are always happy to evaluate you, but please do not come to the ER demanding to be tested unless you are sick or experiencing an emergency.
3) Vaccines. The Pfizer and Moderna vaccines are safe and effective. Please get the vaccine if you are eligible and have not already gotten it. Please get the booster. If you do not believe in vaccines, please shut the hell up. Spreading misinformation is dangerous and hurts people. We stopped agreeing to disagree when I started missing family time so I could spend more time treating COVID patients who don’t believe in vaccines. Those who catch COVID and have had the vaccine and booster are getting a mild form, and are rarely hospitalized. Nobody should die from a preventable illness. COVID19 deaths are preventable with a vaccine.
4) Masks while indoors. Please wear a mask while indoors. Please feel emboldened to remind other people to wear masks while indoors. Surgical paper masks are more effective than cloth masks. Multiple layer masks are more effective than single layer masks. N95s are the most effective. If you refuse to wear a mask indoors because you have a medical exemption, then stay the hell home. Your medical exemption should probably prevent you from interacting with other people during a pandemic. If you refuse to wear a mask while indoors in a public space, then you are a selfish narcissist or you are < 3 years old (and an age-appropriate selfish narcissist).
5) Quarantine. This is a moving target as the CDC recently changed guidelines from 10 days to 5 days. The change was made because Omicron has a shorter incubation period, but, more importantly, is the HR component; we are unable to staff hospitals, fire stations, grocery stores, police departments, and all essential functions if everyone quarantines for 10 days given how fast this variant spreads. Consider your workplace safety, the new CDC guidelines, and how essential it is to have people at work or school when making a calculated decision about how long to quarantine after exposure or infection.
6) Avoid misinformation. This is a dynamic situation with constant changing science. Please fact check information and get information from reliable sources. If you live locally in Santa Barbara please review the local SB public health department resources (https://sbcphd.maps.arcgis.com/apps/MapSeries/index.html…). You can also check the CDC (https://www.cdc.gov/coronavirus/2019-ncov/index.html) or California Department of Public Health (https://covid19.ca.gov). If you are a doctor, clinician, public health expert, then please continue to share public service announcements that are cited, and evidence supported. If you are not a clinician or public health expert, then please only share reputable sources that improve the quality of health in our community. If you are sharing conspiracy theories, your own fringe personal opinions, or dangerous misinformation… then stop. You are part of the problem.
7) Burnout. If you work in healthcare, EMS, public service, then you are burnt out or you are an enlightened bodhisattva and blissfully ignorant of your own fatigue. Thank you for your service. You are my people, and I love you. If you are not in healthcare or essential public service, then please be respectful of those who are. Show support or at least behave in a civilized respectful manner. I have seen more temper tantrums, entitlement, vitriol hostility, and frankly childish behavior in the last few weeks. We are exhausted and over it too. We cancelled our holiday plans and are desperately covering sick calls, and constantly looking for childcare so we can work overtime to keep our hospitals open and functioning above capacity. When you come to the ER and start making demands and threats, it impairs our ability to care for you and your family effectively. Be kind. Be patient. We will take excellent care of you in the ER, and if there are delays it is probably because there is someone more ill than you who has our attention. You reminding us that your brother is a malpractice lawyer or that you are calling the hospital CEO to complain just confirms for us that you are indeed an asshole. And be aware that our hospitals are either full or almost full. Now is the not the time to take up extreme sports, drive recklessly, or do anything that begins with “hold my beer, and watch this. . .” We may not have the staffing or resources to provide you with optimal care.
PS … if you are a troll who indulges in misinformation and has the time and lack of moral character to leave hostile adversarial comments, please make no comments. My diplomacy is struggling a bit these days, and losing your friendship maybe the small price to pay to advocate for the health of my community, my colleagues, and my own self-care.
Stay healthy Santa Barbara. We will get through this.
From your local, friendly, community, neighborhood emergency physician,
Jason Prystowsky MD, MPH
~~~~~
2022-01-10T10:52:16-08:00January 10th, 2022|

Mariela Socolovsky: Reflections on a Cold and Rainy Winter Night

Mariela Socolovsky: Reflections on a Cold and Rainy Winter Night

Note: This is an email I sent to our CBB staff on the night of Wednesday, December 22nd after returning from a night of service with CBB community members at Pershing Park. -Mariela Socolovsky, Director of Community Engagement

Wow! This was an amazing night. It rained a lot, and we weren’t sure if guests would show up. Some of them did and picked up things for a friend too. They were immensely grateful, to get a warm(ish) meal, water, bananas, and the amazing bags that [Director of BHY Preschool] Jen [Lewis] and her little helpers from the preschool prepared. These bags tonight will be life savers! With the blanket, warm hat, dry socks and emergency blankets, and all the rest of the goodies. Kira, Abby, Susie Mauceri and Diane Abel were rock stars! Kirstin Sedlin, like always, showed up with a bunch of sleeping bags and warm clothes, amazing!! And Kira is truly an amazing leader, managing everything while talking to the guests to learn where we should go next to meet more people in need. We ended up being there for a long hour and a half and the pop-up tent was so helpful! Thank you, Rabbi Daniel, for the suggestion, and Abad for the help.

Susie, Kira, Abby and I drove to the train station to meet more clients there. And then to the warming center at the Unitarian church to share all the leftovers.

Rabbi D, your jacket saved me (even though if anyone is wondering, is not waterproof 😂 but kept me warm)!

Why am I telling you all of this even before jumping into a much-needed hot shower? Because I want to make sure that you know: each little thing we do makes a difference, and this is the difference we make, we help someone that is sleeping in the streets under the rain on a cold winter night have another layer of warm clothing, a hearty meal, and with that the feeling that someone cares. And yes, don’t be mistaken please, YOU’RE most definitely a part of this, each little act, when each one of us does their work, is conducive to this (answering questions on the phone, promoting the Amazon wish list, giving helpful tips, providing support, assembling bags, inspiring people, fundraising money, loading a car with boxes). So thank you!! Thank you also on behalf of them.

And yes, I’m sentimental, it was very hard to see and be around this with the knowledge that I was going home to a hot shower.

May we be able to count our blessings!

~~~~~

Note: now that I’m sharing this with our broader community, it’s imperative for me to make sure that you also hear this: THANK YOU! Every single act you do to help sustain Pershing Park’s initiative makes a HUGE difference. Delivering the bananas, sending things from the Amazon wish list, cooking, serving, making donations, inquiring, caring. Thank you.
~~~~~

Mariela Socolovsky is the Director of Community Engagement at Congregation B’nai Brith. 

2021-12-27T14:34:22-08:00December 27th, 2021|

Becca Wrench: Mi Shebeirach List

Becca Wrench: Mi Shebeirach List

I had my name added to the Mi Shebeirach list – the prayer for healing – on January 7, 2021.  Two days before that I had been diagnosed with breast cancer.  Every time I go to services I hear this list read and see if I recognize any names. If I do, I think good thoughts for them, and if I know someone I’ll I say their name aloud at the appropriate time.

But suddenly here I was, at 44 years of age, unexpectedly diagnosed with breast cancer, asking for my name to be added.

Since that initial request I have had a whole bunch of imaging, more doctor appointments than anyone should go to, three surgeries, 16 sessions of chemo, and 33 sessions of radiation.  I just had my last session of radiation on December 2, 2021.  The next day I emailed Rabbi Steve, Rabbi Brenner, and Cantor Mark and let them know it was time to remove my name.

I met with Rabbi Steve as my treatment was beginning to wind down and he asked me what it was like to hear my name read when I was at temple.  He indicated that not many people are actually present to hear their own name being read aloud.

I have thought a lot about that. When I attended services in person and heard my name being said it made me feel uncomfortable, but at the same time I appreciated hearing my name being said.  It made me cry every time I heard it, but it also reminded me that others were thinking of me.  If my cancer is cured and it does not come back and/or my life is prolonged in the future, then I truly believe I have science to thank.  But having my name read each week couldn’t have hurt my chances.

My older daughter Adele’s bat mitzvah was in January 2021.  I have to say, being at Adele’s bat mitzvah and having my name read when I had only known about my cancer for a couple of weeks was very challenging.  In retrospect, in an odd way, it made her Bat Mitzvah even more special.  We had so many family and friends participating on Zoom (and a small group in person) that I was really thankful that I had so many people thinking of my wellbeing and wishing for my health all at the same time.  And more importantly, despite my health issues, we were all celebrating Adele on her very special day.

At this point the doctors say I am cancer free.  I will begin taking monthly ovarian suppression shots and medication on a daily basis that will stop my body from producing estrogen and progesterone – the hope is that this will stop the cancer from returning. And we hope that the aggressive treatment I received stopped the cancer from escaping to somewhere else in my body.  Within the next year or so I will have my right breast removed (so I will have one less place to worry about cancer wise) and reconstruction on both sides.  But right now I am cancer free.  It will take a while to adjust, but I am not sick anymore.

I think that when someone is sick with cancer or other major illnesses people don’t always know what to say.  Something that I appreciated was having people just let me know they were thinking of me.  Having my name on the Mi Shebeirach list reminded me that people were thinking of me and wishing me their best and hoping that I would be healthy soon.

I can’t tell you how much I hate cancer and how unfair it is.  But my name no longer needs to be on the Mi Shebeirach list.  And that is something to be thankful for.

~~~~~

Becca Wrench loves camping, skiing, swimming, and going to the beach with her husband Dean and daughters Adele and Leorah.

2021-12-17T10:39:21-08:00December 20th, 2021|

Elizabeth Mason: Thanksgivikuh

Elizabeth Mason: Thanksgivikuh

Our Hebrew calendar found us segueing from Thanksgiving to Hanukkah within a matter of days this year. As such, the gestalt of Thanksgiving evoked a background for gratitude, light and dedication of the soul.

Within the microcosm of the Mason family, there emerged a small-scale miracle around this period of time, its presence not dissimilar in substance to that of the Maccabees all those many years ago. On the Saturday before the 24th of November, the ignition device in my oven gave up the ghost. In the machinations of my musings, a plaintive query arose: “what am I going to do?!” I had committed to making several dozen muffins for CBB’s monthly contribution to nourishing our local homeless population. As such, I needed my oven and appliance repair services in the Santa Barbara area are scant. It has been my customary experience in the past, that all of these services tend to book their appointments well in advance of the desired date and the window of opportunity for me, was narrow.

Early on Monday the 26th, I contacted a store and left a voice message on their machine. Certain that personnel would be receptive to calls upon opening, I was dismayed at the impending delay. To my relief, I received a return call a half an hour later and just prior to noon, my oven was fixed! Another nerve-wracking concern however, thrust me into mild paralysis. I had never made muffins in bulk and was now faced with the dilemma of how to navigate the appropriate measurements. It was too late to consult with Doug Weinstein for a tutorial, so I simply crossed my fingers and forged ahead. The recipe called for eleven eggs, but I had to approximate the rest of the ingredients. Wednesday morning found me tenuously removing the first batch from the oven. I paused, took a bite and sighed with relief. The muffins were moist and flavorful, another small “miracle”.

With this task behind me, I found myself reminiscing upon 66 years, a lifetime of memories. Two “miracles” during these years, impacted my life enormously. The first involved my marriage to Joe and the second was comprised of  uncanny circumstances which had  culminated in the advent of our baby. All my previous dreams, aspirations and fulfilled goals, though significant, paled in comparison to these two manifestations of my soul’s deepest desires.

By my mid-thirties no prospects of a soul mate had crossed my path, and I imagined myself as one approaching her “expiration date.” Six years before, I had left Santa Barbara to pursue graduate studies in what I considered to be a questionable area of California. The locale was situated several hours North West of Santa Barbara, a city I would have never normally have considered for the next leg of my life’s journey. But peculiar circumstances in the past three years had directed me to this large and unattractive city and its university. A seer from my religious community had also egged me on in this endeavor.

Time elapsed and I had completed my academic goals. One Sunday in May of 1987, I found myself perusing some books in the foyer of the religious community to which I belonged. In a dissociative state of mind, I inadvertently filed in the recesses of my brain the presence of a young man. Retrospectively, this person reminded me that he had been standing about three feet to my right. Four months later while attempting a call to a close friend, she briefly relayed to me that she had been speaking with someone on the other line and that she would return my call shortly. Before returning to the initial caller, she paused briefly and hinted in a curious manner that I would be surprised about who she was speaking with, but would fill me in when she had the chance to explain.

The call turned out to be with a gentleman who had been inquiring about me. He lived several miles North of where I was currently residing and was affiliated with a religious group similar to mine. He had noticed me while visiting our group the previous May. Within a day, we were talking on the phone. Five months later, we were married. Our “miracle” commenced when we both left Southern California to take up residence far away from our cities of origin, but had nonetheless “found” each other during a three hour window of time. We were the same age, had never been married and had waited patiently for the “right one.” That was thirty-four years ago.

As I approached forty another situation haunted me; infertility and scant resources with which to pursue the options necessary to become parents. Many sources considered us an “older” couple, and as such, from the vantage point of social services, we were not perceived as ideal prospects for adoption. In the circumstances leading up to my “second miracle,” once again intuition set the stage.

A few years prior and in anticipation of our move back to Santa Barbara, I began to envision working with clients who were severely marginalized. Although I had previously counseled populations who were compromised financially and often with culturally-divergent worldviews, I had never imagined myself working with the homeless or severely drug-addicted populations. Quite frankly, the thought of doing this felt intimidating to me and clearly out of my comfort zone. Nonetheless, once back in Santa Barbara, that is precisely what I did!

I ended up as a case manager at a local shelter working with women who were either chemically addicted or what is referred to as “dually-diagnosed”. During the previous year, the men’s counterpart of the shelter had accepted a young African-American man who had recently completed the program and returned home. Not really so unusual in and of itself. Several local men of ethnic diversity had attended this program. What differed however, is that this young man had resided in Chicago and had been directed  to our program from a church there. From a ghetto environment, he somehow managed to travel the 3,000 miles to our facility in Santa Barbara.

Meanwhile, his cousin Inez was herself struggling with addiction and was pregnant as well. Impressed with the success of their young man, her extended family were eager to give Inez the same opportunity that he himself had been blessed with. They pooled their resources and sent her West to recover. Her intention, as well, was to find a home for her baby. She was already the single mother of two, and felt incapable of caring for a third. As case manager, I thought I had the ethical obligation to assist her in finding an African-American family who would be willing to adopt her baby. Inez had not been raised among caucasian people, so it was assumed that she would choose a black family to provide a home for her child. Instead, she expressed to me that she was open to giving  up her baby to any loving family who would be amenable to raising her. She had met me, and eventually Joe, and knew that we were unable to have biological children. It was in this way that Inez determined that Joe and I should have her baby.

On August 18, 1993, Janina Marybeth Mason was born. Upon her birth, she not only inherited caucasian parents, but cousins of mixed ethnicity as well. She fit right in. I was the first to hold my long-awaited, longed for little girl. Joe, Inez and myself agreed to an open adoption: three people hoping and praying for a meaningful life for this baby. Another miracle? A compassionate adoption attorney, charging us but a fraction of the cost that most people pay during the adoption process.

~~~~~
Elizabeth Araluce Mason is a licensed Marriage and Family Therapist, a social advocate for the marginalized populations who reside in Santa Barbara and an author of several published poems and articles pertaining to social issues, both local and nation-wide. She is the wife of Joe and mother of Janina, who reside in Goleta and Santa Barbara, respectively.

2021-12-15T10:51:16-08:00December 15th, 2021|
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