On this popup episode of She Thinks, we talk to Dr. Claudette Lajam an orthopedic surgeon at NYU Langone who herself recovered from COVID-19 and is now back at work, volunteering in the medical ward to treat patients. Dr. Lajam offers insight on what the “new normal” will be like at hospitals and talks about her experience with the virus. 

She Thinks Podcast · A Doctor Who Recovered From COVID-19 Shares What Having the Virus Is Like

Transcript

Beverley Hallberg:

Hey, everyone. It’s Beverley Hallberg. Welcome to a special pop-up episode of She Thinks, your favorite podcast from the Independent Women’s Forum, where we talk with women and sometimes men about the policy issues that impact you and the people you care about most. Enjoy!

Elizabeth:

I’m Elizabeth Tew, Communications Manager at Independent Women’s Forum. I’m joined today by a very special guest to discuss COVID-19. She’s an Orthopedic Surgeon at NYU Langone who herself recovered from the virus. She’s now back at work, volunteering in the medical ward to treat COVID-positive patients. Welcome, Dr. Claudette Lajam. So happy to have you with us.

Claudette:

Thanks, so much for having me, Elizabeth. It’s such an honor to be part of this group.

Elizabeth:

I want to kick things off with the question probably on everyone’s mind after that intro. You yourself had COVID-19. You’ve recovered, and we are all glad for that.

Claudette:

Yes.

Elizabeth:

What was having the virus like for you?

Claudette:

Well, I’m actually one of the luckier ones, where I did not need to be hospitalized, but I was pretty sick. It’s not a kind disease. It’s very, very difficult to breathe, very weak, dizzy, fatigued, and it’s still, in some ways, a little bit affecting me, and making me feel ill. But I did recover from it, thank goodness. A lot of people were much more severely affected than I was, but it did hit me pretty hard. Healthcare workers have been affected by it, so it’s good that we can recover from it. We’re very lucky when we can.

Elizabeth:

Absolutely, and now that you are recovered, you’re back volunteering. You are treating patients and I’m sure it probably means a lot to them to be able to have a doctor who herself overcame this virus.

Claudette:

Yes, it’s actually wonderful. So my real job, my day job, I’m an orthopedic surgeon, so I am a hip and knee replacement doctor. So, that’s what I would be normally doing in my normal practice, and since COVID-19 became a worldwide epidemic and since we’ve stopped doing elective practice, we have been trying to take care of our patients by doing telemedicine and then just trying to keep in contact with them. But most of our elective practice has been shut down. So, most of my colleagues and I have been doing other things, and one of the other things that’s been an option to us is to volunteer and work on the medical wards and go and take care of the patients who have this disease.

Now, I’m at NYU Langone Health System, and we had quite a few patients with COVID in our system, and we’re very lucky that that does seem to be looking positive in that direction. We seem to be not taking in as many new patients, home, which is great. So I have been volunteering on the patient wards, and first of all, it feels good to have a purpose when you go back to work. When you have had a disease that has been made and it is, pretty scary, but in the media and what you see on television, it’s made to appear to be so frightening, and patients in the hospital have this disease and they’re all alone and they can’t have visitors and everyone’s wearing masks and looks like they’re in outer space, and it’s a positive experience to have a doctor who can come in and say, I had this and I’m recovered and here I am back, and perhaps maybe it gives them a little bit of hope that they see you and say, wow, you know what? She got better. Maybe I can get better. And if that gives them a little bit of hope, then that’s worth it for me.

Elizabeth:

Absolutely, and obviously with this virus, everything is so much about hope and we’ve seen inspiring stories of doctors and nurses volunteering just like you are doing and answering the call where it’s needed most. And I know you are in a hot spot right now. You are in New York, we’ve all seen the headlines. It looks like things are maybe starting to slow down where you were. I certainly know there’s a lot of talk of states planning to reopen soon. So, I think the next natural question on everyone’s mind becomes, okay, well what does this mean for us now? Is it going to be safe to go to doctor’s offices?

Claudette:

Well, that is a very good question and it’s a very important question, and there’s two reasons for that. One of them is, we need to start thinking about people who have medical conditions other than COVID-19. While COVID-19 was an emergency, and it’s important to address that. It’s also important, very important to address medical conditions that aren’t COVID. Millions of people in our city and state who have serious medical conditions that have been put on hold because we’ve been addressing this crisis and we need to start addressing those other medical conditions. So it’s very important to do that.

And the second reason we need to start thinking about that is because we are indeed starting to see the numbers receding of the new COVID-19 cases, and that’s very encouraging, and of course, so to be somewhat, maybe a little bit optimistic about that. So it’s important to start thinking about that because we cannot just treat COVID-19 in a vacuum. We need to start thinking about other medical conditions and our other patients who need care. So with the proper precautions, it can be safe to start opening up doctor’s offices, and that’s something we were about today in our office. How do we communicate this to our patients? How do we explain to our patients that we are ready to start seeing them? These are the precautions we have in place. This is what you can expect when you go to the doctor’s office.

You can expect that perhaps someone will take your temperature. You can expect that you will be expected to wear a face covering or a mask when you’re there. You can expect that you probably will not be allowed to have someone with you in the office, a child, or unless you have a disability that requires you to have someone with you. At least in our practice, that’s the rule right now, and we will be maintaining space between the patients, so we may not have as full a schedule for the appointments as normally. So yes, we want to open the offices, but we also want to make sure everyone is safe, especially in a place like New York City. Maybe there are other places in the country, where they don’t need to do the same thing as we need to do in New York. But here we need to think about these things in this way.

Elizabeth:

Right, and you of course, being an orthopedic surgeon, I know obviously a lot of elective surgeries were put on hold so that the COVID patients could take priority, all hands on deck situation. So what then, becomes next for all those people who have had their surgeries put on hold, what should they be doing as we start to open back up?

Claudette:

Our surgeries are elective, but mobility is an extremely important function in human beings and not being able to walk is a very, very severe disability and being able to get our patients back walking around again is a big deal. So, the folks who have had their surgeries delayed because of this, thank you for putting your care on hold so that we can treat others who have emergency needs and I thank you for doing that. That takes a lot of courage and patience but we have to start thinking about addressing those patients and we had been discussing this in our hospital and how do we get those patients taken care of.

Now again, we want to make sure patients are safe, we want to make sure our staff are safe. So, we want to make sure [inaudible 00:08:14] gives us the green light to go ahead and once we have appropriate staff and spaces, and we do indeed have figured out that we do have appropriate staff and spaces at our institution right now, start booking those patients for surgery. Now again, they will probably need to be tested for COVID and they may need to have their temperature taken when they get to the hospital. Again, the visitor policy may be in effect. Our staff will be tested as well. We’re going to encourage folks to have a minimal stay in the hospital and try to use virtual solutions when we can, so we won’t be operating on patients who require longer hospital stays at this time. We’ll probably be delaying those a little further along, but we are going to come up with some solutions so that we can take care of these patients who need care and do it safely.

Elizabeth:

I know also we’ve seen a huge drop off in the numbers of patients who are going to the ER. I imagine that will probably start to pick up again soon, too. Is that a trend that you have also seen? Do you expect that to pick up again quickly or do you think people will try to hold off and not go in out of the fear?

Claudette:

What I see myself, is that folks have instead been going to a lot of the urgent care facilities that have popped up over the past few years instead of going to facility-based emergency rooms, and I think those facilities have really provided a very good service for patients who need care, who haven’t needed care for the COVID-related reasons. In fact, our facility has offered an orthopedic emergency care for many, many years and that has come in very, very handy during this crisis because we have used that facility and created an orthopedic only emergency room during the crisis, so that folks who have had orthopedic emergencies do not need to go to the regular emergency room and they can just go to that place and have their orthopedic care. So, those types of facilities are very valuable during this time, which is why it’s important during a crisis to see what happens and you can really learn a lot and maybe take those lessons and use them for after the crisis and see maybe, hey, you know what? Maybe we need to focus and see how we can maybe change our practice a little bit and learn some lessons.

Elizabeth:

There’s been a lot of talk of antibody tests, DNA tests going forward as maybe a way to prevent something like this from happening in the future. I was wondering, as a doctor, if you could give us any insight for us there? Will these be effective going forward, do you think?

Claudette:

Well, obviously it’s the question on everyone’s mind and there’s a lot of misunderstandings about what testing does. Obviously testing is not a cure. Testing is just, okay, let’s see if there’s evidence that the virus is in you or was in you. And there’s ways to tell whether the virus is in you, and that’s by checking just to see if the virus components are in you and the DNA, or it’s actually an RNA test, it’s a different kind of a structure. There’s an RNA test where they stick a swab into your nose and I can tell you it’s not very pleasant to have that test, but it’s a test that’s done. It can also stay positive after the virus is no longer reproducing itself. So little pieces of RNA can cause a positive test even if the person is not contagious anymore. You can get some false tests out of that test. So, those tests just aren’t perfect, but it’s useful to know if you have symptoms and you get a positive test that okay, you should stay away from other people. It is a helpful thing to have.

You can also get a negative test if the test isn’t done properly. Now, the antibody tests basically tells you if your body has made defenses against the virus and that tells you whether that virus has been in your body and if your body is now prepared to fight the virus, and most of the antibody tests that are around now are antibodies against one piece of that virus. Now, I don’t have a lot of time to explain how antibodies work, but what antibodies are is, antibodies are things that stick to the invader and stick to a part of the invader that’s shaped a certain way. And the antibody tests that are out there now, are to find an antibody that’s shaped to something called a spiked antigen protein, and that’s the one that’s most common. Now, this test is most useful about 14 days after the symptoms are done.

So, you can get a lot of false tests, a false positive test, from that antibody test. So it’s not perfect. So I guess the short answer to your question is, we have the tests, but they’re not perfect. So they aren’t the great solution to our problems. Hopefully that helps explain things rather than confuse you more.

Elizabeth:

No, I think it does not confuse me. It explains things very well. Obviously I know everyone probably wants a solution, but like you said, it’s just not that simple. So I guess you could probably rightly say, time will tell and as innovation continues, maybe one day we will be able to get there.

Claudette:

Well, also the other part is that antibodies being in your body don’t necessarily mean that they are protecting you from the virus. So there’s two steps to that. The test can show that you have them, but the next step is they have to show that they’re actually preventing you from getting it again. So, we have a little more work to do there.

Elizabeth:

Well, Dr. Lajam, I imagine we could probably take up a whole hour talking about this topic. I do want to thank you though for joining us with your excellent insight and stay safe out there as you continue to volunteer to treat these patients.

Claudette:

Thank you very much for having me on and good luck and I hope you and your loved ones stay safe and healthy during this time.

Elizabeth:

We hope you take away something new from today’s conversation, and if you enjoyed this episode of, She Thinks, or like the podcast in general, we’d love if you could take a moment to leave us a rating or a review over on iTunes. Share this episode and let your friends know they can find more She Thinks episodes on their favorite podcast app. From all of us here, thank you for tuning in. I think you think, you think, she thinks.