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Covid Blog 2021 Physicals Orange County

By editor
March 16, 2021

With apologies to Gilbert and Sullivan, this is for all you Pirates of Penzance fans who have had to deal with the pandemic over the last year.
 
Pirates of Pandemic Patter
(to be sung at a rapid tempo)
 
After all the quarantine it’s time to move around, even dance
Ask Gilbert and Sullivan; sing along to Pirates of Penzance
 
You are the very model of a novel coronavirus
You ruin health, economy, and holidays are quite the fuss
 
Sneaky how you incubate, 2 weeks ‘til you rear your ugly head
Some folks don’t even know they’re sick while others can’t get out of bed
 
You mimic every symptom out there, what a tangled web you weave
So many “experts,” self-appointed, hard to know whom to believe
 
CDC just cracks us up, thinks it knows exactly when you’ll leave
You come and go without reservation, offering no reprieve
 
 
Time to take a break from the patter
Let’s talk important next steps that really do matter.
 
Whether you’ve had COVID or not, you’ll need a checkup in 2021.
 
It will be different than any physical you’ve ever had before.
 
In fact, at Caduceus there are three categories of checkups for 2021. As we introduce HUEY, DEWEY and LOUIE, see to which one you relate.  Call us quacks if you like, however Caduceus may be the only medical group with COVID specific checkups for 2021!!!
 
 
HUEY-
 
HUEY has not had COVID.  He mostly stayed home, wasn’t able to exercise, packed on the COVID 19 pounds, may have consumed more than his usual amount of cheeseburgers and does recall daily happy hour.  Diabetes runs in his family however he’s sure he’s fine.  HUEY schedules his annual checkup which includes:

  • Lab work to check on diabetes, high cholesterol, fatty liver and more
  • If female, mammogram and Pap, depending on date of last test
  • COVID antibody testing.  Huey may have been an asymptomatic case and already have protection.  Or Huey many have gotten the vaccine(s) and have antibodies

If over 50, HUEY meets criteria for:

  • Colon cancer screening
  • PSA if male
  • Bone density testing
  • Shingles vaccine

If over 65, HUEY meets criteria for pneumonia vaccine.
 
HUEY is still nervous to go out in public, so the good news is HUEY DOESN’T HAVE TO COME INTO THE OFFICE.  We can start the 2021 checkup from the comfort of your home or office.
 

  • Curbside lab draws
  • Video Visits to review the tests
  • We’ll go from there – some things will require an office visit as we haven’t figured out how to biopsy a mole, pierce an ear, or do a Pap remotely.

 
 
Can’t resist the urge to rhyme
Let’s indulge the patter one more time
 
Virus analogy is a dragon, with a very long tail
Ignore bedrest and do too much, the symptoms come back without fail
 
Docs try and try, I don’t know why, as we all know there is no cure
Despite Hydroxychloroquine and Ivermectin, you endure
 
Z-Pak, zinc, lots of vitamins, then Decadron and Tylenol
Trying any and everything, like throwing pasta at the wall
 
Has convalescent plasma become the ultimate gift to give?
Will sharing antibodies be the thing that helps others to live?
 
Prone position, oxygen, Remdesivir flowing through the vein
As soon as something starts to work it transforms into a new strain
 
 
DEWEY-
 
DEWEY did have COVID last year, not a bad case.  DEWEY took a Z-Pak, some cough medicine, and had an inhaler, just in case.  He feels pretty lucky to have been out of commission only a short time.  He’s pretty sure he’s back to 100%.
 
In addition to EVERYTHING COVERED in HUEY’s physical, DEWEY’s checkup will include some additional post COVID labs.  Studies show that even people with asymptomatic or mild cases may have post-COVID Syndrome, affecting their organs.  Labs may include:
         

  • Tests double checking your heart, lung, kidney, and liver function
  • Additional labs looking for post-COVID inflammation
  • Antibody testing monthly

 
 
OK, it’s time
A little more rhyme…
 
IgM and IgG – antibodies are talk of the town
Everybody wants a bunch, to last and last and never go down
 
Pandemic rocked our world so hard and now the aftershocks we feel
Enter Moderna, Pfizer, J& J – is vaccine the real deal?
 
You are the very model of a novel coronavirus
You ruin health, economy, and holidays are quite the fuss
 
Learning more each day; using science and common sense best we can
Let’s hope virus this mutates out, and leaves as fast as it began!
 
 
LOUIE has survived the monster virus, had a severe case, may or may not have been to the hospital and may or may not be feeling back to 100%.  LOUIE may still be experiencing fatigue, occasionally still needs inhalers, sometimes can’t sleep, and his head feels a little foggy.  Oh, and LOUIE’s gut is still bothersome.  LOUIE is not alone.  We are shocked at the number of patients who still have lingering post Covid symptoms.  Post-Acute Sequelae of Sars-CoV-2 infection (PASC) is a thing.  Worldwide, reported incidence ranges from 10-30%.  LOUIE has won the war, however the battleground may have sustained some damage and needs time to repair.  LOUIE’s annual checkup will include everything that HUEY’s and DEWEY’s did, and can also start from the comfort of home or office. We may run a few additional tests or labs to specifically check on LOUIE’s heart, lungs, kidneys and brain depending on the severity of LOUIE’s post Covid symptoms.  Tests may include:
 

  • EKG
  • Echocardiogram
  • Pulmonary Function Studies
  • Pulmonary Rehab
  • Antibody testing monthly
     
    So, for 2021, are you HUEY, DEWEY or LOUIE?
     
    We recommend antibody testing regularly for everyone and will offer monthly antibody options for all categories.
     
    We’ve instructed staff not to giggle if they receive a call asking to schedule a HUEY/DEWEY/LOUIE physical!

    Gregg DeNicola MD CMO, Caduceus Medical Group, PDQ Urgent Care & More, & PDQ Telehealth
    Mary DeNicola DNP PDQ Operations Officer 

 

 

 

 

 


Orange County Exclusive Caduceus Interview with "Cov"

By editor
October 22, 2020

(The author directs readers to watch the films Blazing SaddlesYoung FrankensteinHigh Anxiety, and The Producers prior to reading this blog. Failure to do so may cause credit-or blame- to be given to the author when it should be directed to Mr. Brooks.)
 
"Life is a play- We're unrehearsed"--Mel Brooks
 
Our loyal patients probably know Caduceus was the first medical group in the area to offer curbside services and flu tests in February, curbside and telehealth Covid testing in March, and higher complexity Covid antibody testing in April.
 
Now we are proud to announce our newest achievement.
 
By taking mucus from a Covid positive patient, isolating the RNA, charging it with 1.21 gigawatts of nuclear power, and putting it through a 3D printer, we have been able to convert a Covid particle into human form! Tweaking the uploading process using Epson microchips, the virus was converted into an exact life-sized replica of Mel Brooks!
 
Best of all, Caduceus has secured exclusive rights to an actual face to face interview with the virus, who has asked to be referred to as "Cov.”  As CMO I am honored to be the interviewer.  FYI-I am no Carl Reiner.
 
CMO: Welcome Cov, full disclosure- I have been trying to destroy you over the past 7 months. So tell me- How are you feeling today?
Cov: (Singing) High anxiety ... it's always the same; high anxiety ... it's you that I blame.
 
CMO: Sorry. Oh I get it!! You're programmed with Mel’s brain. Reminiscent of one of my favorite movies of yours, Young Frankenstein.
Cov: Ummm...remember, I am NOT actually Mel Brooks- I simply took on his form.
CMO: Oh, of course- I should have known...
Cov: Besides it’s pronounced "Fronkensteen."
 
CMO: Let’s get right to what our readers want to know; Did you come through bats in China? Or were you a lab-made conspiracy to affect the US Elections?
Cov: Sorry to disappoint everyone, but we are just an old- fashioned mutation from the plain vanilla Coronavirus that causes the common cold.
 
Our first mutation was in bats, a favorite host of Coronavirus.  But we got tired of hanging upside down all day, plus have you ever had to live right over piles of guano? We wanted a new host, and humans were perfect. Nice big nostrils to invade, and better yet, they flush the toilet.. well most of them anyway.
 
CMO: So was it your plan on taking over the entire planet?
Cov: Hey, we were happy in China. I mean, what’s to not love about Peking Duck? But one day one of the viruses said "let’s get Italian,” so we infected Italian tourists, not realizing all he wanted was a plate of marinara!

It was an honest mistake. So a few Italians get infected, and POW! Next thing you know we are global. We are thinking since Italians won’t keep quiet, always laughing and singing, it kept spreading.
 
CMO: Is it true you live in the nasal and oral cavities?
Cov: Well DUH! We are Coronaviruses. That's our hood. Oh, we produce cytokines that do damage in all parts of the body, but inside the nose for us is like your Malibu beach house.
 
 
CMO: So masks should keep you from infecting other humans then?
Cov: Oh masks are a huge pain. Nothing worse than floating through the air looking for some place to land, and all we see are masks! It’s like you humans using a Club on your new car’s steering wheel. A good thief can get it off, but why not just go to the car next to it without a Club? We see someone without a mask and we say BINGO! If we try, we get through most masks 20% of the time. But then we have to get past the mask of the person nearby so it’s just not worth it.  Especially with so many people anti-maskers. They make our job really easy.
 
CMO: So how does Covid get around? Can you guys fly?
Cov: For a CMO you don't know your virology very well! No we don't have wings. We depend on a good cough or sigh to get us out of one oral cavity and into another.

If God wanted us to fly, he'd have bought us tickets!
 
CMO: And you can only float for about six feet? So the X's on the floor do work?
Cov: Well our best athletes can make it 10 feet with a good breeze. But with us being able to aerosolize, we can actually travel over 40 feet in a small area with good air pushing us. We just look for someone without a mask, naturally. But the closer together humans are the easier our job is.
 
CMO: So will you share what's your "Kryptonite?” Does Plaquenil scare you?
Cov: Ok you seem like a nice guy. I’ll level with you...yes, Plaquenil was a problem for us. See, we survive by replicating in the human host. Plaquenil does inhibit our replication. Thank God Trump praised us, that made everyone hate it.  By the time studies were started we had mutated against it.
Same with Remdesivir. It was killing us off, but now we know a mutation to counteract it.  Fact is, nothing kills us.
 
CMO: So there's nothing you guys fear? You are just going to infect the entire planet?
Cov: Wellll....ummm.
CMO: Come on Co....spill it; just between us.
Cov: (Mumbling) antibodies.
CMO: What was that mumble?  Antibodies? Like IgG?
 
Cov: You didn't hear it from me...But it’s DEVASTATING! We float into a nice warm nose, start replicating and then WHAM! The IgG eats us whole! Its barbaric!
CMO: It’s called Phagocytosis. A well known immunologic mechanism. So it DOES work against Covid! The CDC and WHO are wrong?
Cov: Yeah we cut a deal. They cast doubt that antibodies work and we stay out of their headquarters. They know we don't stand a chance against IgG. It’s like trying to break into a sailboat surrounded by 100 Navy Seals!  Thank Heaven only 10% of the people we try to infect have it.
 
 
CMO: Wait! Was it part of the deal that the CDC not advise repeat swabs on known infections?
Cov: No comment. (Whistling....)
 
CMO: So you must be worried about a vaccine coming soon? After all, a vaccine is simply a lot of antibody in a syringe.
Cov: Naw. We figure there are enough anti-vaxxers to infect to keep us in business for many years. We find them refusing vaccines as showing no respect, right? So those are our first targets.
 
CMO: So why did you infect President Trump?
Cov: The guy with the big hair and red hat? Yeah, we targeted him. He was always dissing us. Saying we are no threat. Not encouraging masks.  Having super spreader events. Viruses have feelings too!
 
CMO: How did you get in? Was the Secret Service a problem?
Cov: Are you kidding me? We just went in the nostrils of a couple of White House interns. A Rose Garden ceremony, and the rest was like taking acorns from a blind squirrel!
 
CMO: Looks like you got the whole White House staff?
Cov: Once we had Trump, we figured why not settle down in the White House? The West Wing is totally cool, and the Situation Room is a trip! We even got a few top secret passwords I can share with you later!
 
CMO: But did he really have a pretty mild case like he claimed?
Cov: Yeah, we didn’t send out the Big Boys. I mean he is the President after all. Just some of our lower level guys to scare him a bit.
 
CMO: Would you say you are political?
Cov: Don't be stupid; be a smarty! Come and join the Democratic party!
CMO: I think you mean NAZI Party?  In the...
Cov: Whoa! Be careful! We are in a blue state! You'll get boycotted!
CMO: No, No - I mean in The Producers that line went...oh never mind.
 
CMO: You realize Covid has caused over a million deaths globally? Don't you feel just a little guilty?
Cov: Does a bear feel guilty when he catches a salmon swimming upstream? Does a shark feel guilty swallowing a seal whole? It’s what we do. If it bothers you so much, invent an antiviral agent to combat us like you did with HIV.
CMO: Well perhaps Caduceus is in its lab every day doing just that?
Cov: Don't make me laugh---we are Covid and we will just mutate away from anything you invent.
 
CMO: Well, Co, Thanks for the interview. I learned a lot. Say, since we have kind of bonded here, before you turn back into 125 nanometers, want to hang out awhile? What do you like to do?
Cov: Sure. 2 things. I like chess.
 
 
CMO: A virus knows how to play chess?
Cov: Yeah - it was uploaded from one of our mutations--I think when we visited Magnus Carlsen.
 
CMO: Chess sounds kind of dull. What's the other thing you like to do?
Cov: Kill people.
CMO: Let’s play chess.
 
 
Gregg DeNicola MD
Caduceus Medical Group
Chief Medical Officer
 
-KNOW IF YOU'RE CONTAGIOUS.
-KNOW IF YOU'RE IMMUNE.
-SET UP A REGULAR TESTING PROGRAM FOR SWABS AND ANTIBODY TESTS. 
-STAY HUNKERED DOWN FOR NON-ESSENTIAL ACTIVITIES.