Winter Preparedness

Podcast transcript

INTRO
Welcome to Docs in a Pod, presented by WellMed. Over the next half-hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-hosts Dr. Tamika Perry and award winning veteran broadcaster Ron Aaron will share information to improve your health and well being. And now, here are Ron Aaron and Dr. Tamika Perry.

RON AARON
We are so pleased you are with us today on the award winning Docs in a Pod. Our podcast is available wherever you get your podcast. We're also on the radio in several markets in Texas and Florida as well. Markets, meaning cities in those two states. I'm Ron Aaron. Our co-host today is Desarea Murray. She is a nurse practitioner with WellMed at Live Oak in Dallas, Texas. Desarea has been with them for quite a while, and she is somebody who understands how to keep patients healthy, involved, and prepared for whatever it may be that is facing them. So, Desarea, what led you into healthcare?

DESAREA MURRAY, NP
I knew from when I was a child and my parents gave me a Fisher-Price doctor's kit that I wanted to be checking blood pressure and listening to people's hearts the rest of my life.

RON AARON
And you stuck with it?

DESAREA MURRAY, NP
I am, but I'm happy, Ron. This is where I want to be and what I want to be doing.

RON AARON
That's pretty cool. One of the things that, especially up in Dallas you're aware of is occasionally winter does come. For many of your patients, understanding what that means and how that may be a change in their lives is certainly worthy to talk about. We have Dr. Robert Streck joining us. Dr. Streck is passionate about helping patients live healthy lives. He enjoys supporting patients as they work to overcome or manage their health challenges. You can find him at the WellMed at West Plano Clinic. We're delighted to have you, Dr. Streck. Thanks for being with us.

DR. ROBERT STRECK
Oh, it's a pleasure to be here.

RON AARON
So, tell me, as you think about winter preparedness, I know that if you live where I live in San Antonio, freeze warning comes, you drip your pipes or you cover your outdoor pipes. That's winter preparedness. What do we do for our bodies?

DR. ROBERT STRECK
That's a good question. I think being prepared to have warm clothing around just in case the power goes out. I think we're familiar here in Texas that we don't tend to get snowstorms, we get ice storms. That tends to knock down power lines and really make it cold in our homes. So, I think preparing your bodies by having food around, things that don't perish, things you can eat, having medications, making sure you have a good supply of medications. If there's any forecast of winter storms, make sure that you've got at least a week's worth of medication that will last you from the time that storm begins.

RON AARON
Is that something your pharmacy can give you additional tablets if you're near the end of a prescription but it's not really due yet to refill but you're worried about running out?

DR. ROBERT STRECK
I think it's something the pharmacist can work with you on, and if you need to talk with your primary care physician about some early refills or short refills, they can certainly help you with that as well. Now, I can remember when we had the deep freeze in San Antonio a few years ago, we lost power for four days. At one point for two of those days, the temperature at our house fell to 48 degrees. That's cold.

DR. ROBERT STRECK
That's very cold. That's cold enough to get some exposure-related health issues for sure.

RON AARON
What were those exposure-related health issues be?

DR. ROBERT STRECK
Hypothermia is the one that's probably the biggest concern around here. Core body temperature getting too low, and it can really interfere with your body's functions. We really need to have that core body temperature stay warm for our organs and our body parts to function correctly. So, people can get confused and dizzy and confused because of the body temperature being too low, and that can become a very life-threatening issue very, very quickly.

RON AARON
How do I know if I'm confused more than I'm normally confused?

DR. ROBERT STRECK
You might need a bystander to tell you.

RON AARON
That's why God made spouses, right?

DR. ROBERT STRECK
Exactly.

RON AARON
As you think about your patients and the time of year now, we're heading into November, December, January, colder months. Even with global warming, there are still cold months. Do you talk with your patients about this?

DR. ROBERT STRECK
It's not something I've routinely been in the practice of doing, but I think considering the climate issues we've had lately in the more intense storms and the more unpredictable weather, it's something that we need to talk about more frequently. It gets overlooked a lot in the South.

DESAREA MURRAY, NP
I would agree.

RON AARON
Desarea, do you?

DESAREA MURRAY, NP
I don't either, but I think we definitely should implement that in conversation, especially with the last couple of years in this area of Texas specifically and how the weather has really impacted health and safety for patients.

RON AARON
Storms are stormier than they've ever been. More tornadoes, higher wind, higher temperatures, and some cases lower temperatures.

DESAREA MURRAY, NP
I would agree. I think our last ice storm was about a three to four-day shut down as well, just like what was experienced in San Antonio and people were really struggling. There was no power and there were restrictions if you did have power.

RON AAON
I grew up in Ohio and I was telling Dr. Streck off the air we knew what cold weather was and people who are listening to us now in Ohio are probably laughing at wow, they're worried about a day or two of ice.

DR. ROBERT STRECK
That's for sure. We're not ready for it down here.

RON AARON
Stick with us for a minute. I want to let folks know who may have just joined us, you're listening to the award-winning Docs in a pod. Our podcast is available wherever you get your podcast. I'm Ron Aaron along with our co-host today, Desarea Murray, nurse practitioner. We're talking with Dr. Robert Streck, talking about winter and cold weather. Dr. Streck, the flip side of that, and I know we're talking about winter and cold, but because of global warming, because of the incredibly high temperatures people have been experiencing, I'm sure you worry for your patients about how they deal with hot weather.

DR. ROBERT STRECK
Oh, absolutely. It's probably a bigger issue down here in Texas than we have with cold weather, for sure. Staying cool is harder and harder, and energy costs are going up and up and incomes are not shifting much with inflation, so it's getting to be a bit of a squeeze for everybody.

RON AARON
For patients who perhaps want to keep doing that yard work or maybe they have an outdoor job, what are some of the things they should worry about that would give them a tip that, hey, maybe you're suffering from overheating.

DR. ROBERT STRECK
That's a good question. I think much like hypothermia, feeling kind of confused and dizzy and just like something's off, and that can sometimes be an early or even a late sign. We're used to sweating. We sweat a lot. If anybody's like me, they just sweat the minute they walk out the door in the summer. When you stop sweating, that's when it's a real problem.

RON AARON
Oh, that's interesting.

DR. ROBERT STRECK
When you don't, your body isn't making any more sweat.

RON AARON
Why is that happening?

DR. ROBERT STRECK
Well, it could be from severe dehydration. If you don't have enough extra water in the body, if you're not getting enough fluids to replace the sweat you're making, you'll stop making it. That can cause your body to overheat even faster. We need that water coming through our bodies to help pull heat off our skin more efficiently. Getting dry just makes it harder to get cool.

DESAREA MURRAY, NP
I do find myself talking with patients about drinking water year around because when you're hot, you're thirsty naturally, but I think sometimes in that winter or cooler state, you don't drink as much because you're not as thirsty, but it's still important to stay hydrated when it's cold outside, too.

RON AARON
Dr. Streck, is that right?

DR. ROBERT STRECK
I would absolutely agree with that. I have a lot of patients that are on medications that may make them make more urine. They may have problems with their urinary incontinence and as a result may choose to drink less water, and that's going to put them at even higher risk of dehydration when they're faced with one of these kinds of extreme weather events where it's harder to stay hydrated.

RON AARON
How does that impact your body, your heart, for example, if you're dehydrated?

DR. ROBERT STRECK
Well, it can affect the heart and it can affect the kidneys. When the kidneys aren't functioning well, toxins build up. They stop clearing medications the right way. Doses can build up and become toxic. I mean, the body really depends on that fluid balance to stay pretty consistent.

RON AARON
How much water is enough water?

DR. ROBERT STRECK
That is a question I get asked often, and I don't always have a good answer for. I think anytime you're thirsty you should be drinking water. If you're feeling thirsty, You're probably already a little bit dehydrated. So, it's important to have water nearby. It's getting really popular for people to be carrying around their trendy water vessels. There we go, right here.

RON AARON
What you can't see because for those who are listening, we see each other on zoom and when Dr. Streck mentioned carrying around your trendy water bottles I immediately lifted my Stanley, and Desarea lifted hers. So, there you go.

DESAREA MURRAY, NP
Mine is bedazzled, just so you know.

RON AARON
That's pretty cool. Then I discovered a box of water, which I've been drinking from lately.

DR. ROBERT STRECK
That good old boxed water. Does it taste like cardboard?

RON AARON
Yeah. It's a combination of cardboard and plastic, all recyclable.

DR. ROBERT STRECK
Oh, good.

RON AARON
So, it makes me feel like I'm contributing to society.

DR. ROBERT STRECK
Protect that environment, keep that global warming to a minimum.

RON AARON
Exactly. As you think about winter, and we started off by talking about winter preparedness, we are indeed heading into a time of year when there is a risk for ice, sometimes snow, sometimes the bane of existence, freezing rain. There are a lot of folks who want to go outside anyhow, and then the risk of slips and falls is there as well. Dr. Streck, how do you prevent that other than just stay home?

DR. ROBERT STRECK
That's another good question, and I've seen a lot of broken bones from these slips and falls, some in my own family. I think if you have any issues with balance, if you have issues with joint pains that slow you down, it's going to be really important that you have your mobility aids around. Whether that be a cane, walker, rollator, those can get treacherous on ice as well. I think we don't often keep a whole lot of snow melted around the house like they do up north or over on the coast. But having some salt to salt the walkways, if you know that there's going to be ice coming in to prevent the ice from building up.

RON AARON
Kitty litter works just as well. It doesn't melt it, but it's safer.

DR. ROBERT STRECK
For sure.

RON AARON
What's a rollator? I heard that term on another show we just did it. I'm not sure if I know and folks know what that is.

DR. ROBERT STRECK
Yeah, a rollator is kind of like the Cadillac of walkers. It's usually got a couple handles. It has four wheels rather than kind of the two wheels that you think of with a gray aluminum walker that people think about. It oftentimes has a seat. People can stop and rest when they need to, but they offer a lot of stability, and they offer that kind of place to stop and rest if you need to when you're out and about.

RON AARON
Does it come with a radio, air, and defroster?

DR. ROBERT STRECK
Premium models.

RON AARON
For folks who are new to this part of the world, who've come from the north, who left all their winter clothes up north because you're not going to need them here, is appropriate clothing a challenge that many of your patients face understanding how to protect themselves?

DR. ROBERT STRECK
It's not one I've faced a whole lot of times. It's not a common complaint that I have, but it may be that I don't ask about it enough. I think layering in Texas is important because those temperatures fluctuate so much throughout the day. Maybe you don't have your $400 goose down jacket, but you've got a couple flannels and some t-shirts and a light jacket. You can layer those up and stay warm and be able to kind of peel those layers off as you need to as the temperatures warm up throughout the day.

RON AARON
In San Antonio today was mid 60s in the morning, going to over 90 in the afternoon. So, that's a big fluctuation.

DESAREA MURRAY, NP
I would agree with Dr. Streck. The layering here and the wide range of temperature change in this area is just outstanding. It can be 50, 40 degrees in the morning and by one o'clock you're in the 80's. So, that layering does help.

RON AARON
We're going to come right back to both of you in just a moment. You're listening to the award winning Docs in a Pod. I'm Ron Aaron. Desarea Murray, nurse practitioner, our co-host today and our special guest, Dr. Robert Streck. We're talking about winter preparedness and the flip side of that is summer heat preparedness. All that and more on Docs in a Pod.

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RON AARON
Thank you so much for sticking with us right here on the award winning Docs in a Pod. I'm Ron Aaron along with our co-host, nurse practitioner Desarea Murray, and we're talking with Physician Dr. Robert Streck talking about winter preparedness, health and wellness and a whole lot more. One of the things I noted in your biography, Dr. Streck, is that you like to help patients embrace a healthier future by helping them personalize their care plan. How does that work?

DR. ROBERT STRECK
I think it really starts with having a conversation and finding out what people's desires are, what their needs are, finding out what's important to them. It'd be a lot faster, a lot easier if I just walked into the room and said, this is what your numbers look like, this is the drug you're going to take, I'll see you in three months. But that is just not the right way to do it, and one size does not fit all. So, we'll typically have a conversation, I'll present options. Thinking about what could be, what may be, what do they want to do? Oftentimes we land somewhere in the middle, but there's no right answers with your health. We're here really more to give recommendations than orders. That's what I tell all of my patients.

RON AARON
What led you into medicine?

DR. ROBERT STRECK
I kind of fell into it. It's a bit of a winding path on the way.

DESAREA MURRAY, NP
No Fisher-Price kit?

DR. ROBERT STRECK
No Fisher-Price kit. I wanted to be a marine biologist when I was a kid. But I fell into science. I’ve always been kind of drawn to them. As I got into high school thinking practically, how do I apply science and find fulfillment? Medicine was that way, and I took a real sharp turn from orthopedic surgery towards internal medicine. But I think sometimes your specialty finds you.

RON AARON
Interesting. My dad used to tell the story, he's long gone now, but when he went to college at Western Reserve University in Cleveland, Ohio, he thought he'd become a physician, and when he showed up, the line for doctors was much longer than the line for pharmacists. So, he got in the line and became a pharmacist. Back then it wasn't as complicated to get into school, and that explained how he was a pharmacist.

DR. ROBERT STRECK
It will find you.

RON AARON
As you think, Dr. Streck, about working with your patients and developing that personalized plan, how receptive are they to working with you? Because a lot of patients are used to what you initially said, here, take this three times a day, call me in a month.

DR. ROBERT STRECK
I get a lot of feedback that it's refreshing. I get told a lot so that people feel heard. So, I've gotten a lot of positive reinforcement from my interactions. When I moved away from working for the government and finding a job kind of more in the private and civilian sector, having a practice where I was going to have time to spend with my patients and to have these conversations was really critical. That was something that WellMed at the time was offering for me. They still do. I think compared to some other physician offices. We really get protected time with our patients.

RON AARON
So, you're not on an assembly line? You have to see X numbers of patients and just keep them rolling through.

DR. ROBERT STRECK
Absolutely not. No, it’s really quality focused. A lot of emphasis on the patient physician relationship and making sure that the care team is really caring for their patients rather than reacting.

RON AARON
Now, you said government. You worked for the V.A. in Washington DC for a period of time.

DR. ROBERT STRECK
I did. I worked for the V. A. System for about four years.

RON AARON
In a V. A. hospital?

DR. ROBERT STRECK
Yeah, I worked for the primary care clinics in the hospital. I started in Houston V. A. and then I moved to Washington DC V. A when my wife's work brought us out that way.

RON AARON
How was that?

DR. ROBERT STRECK
It was an interesting time. It was peak COVID. I moved in May of 2020. Yeah, no, it was a fun way to spend my first year out of residency, too was getting slammed with a worldwide pandemic of unprecedented proportions.

DESAREA MUIRRAY, NP
Oh, no.

DR. ROBERT STRECK
So, it was an interesting time, but being in the Capitol for those three years was a really cool time. I witnessed a lot of history happen and helped a lot of people along the way.

RON AARON
That's cool. Yeah, I lived in Washington DC for a lot of years as well, working on Capitol Hill and in government and it is clearly an amazing place to be. I'm happy not to be there now, but it was a great place to be. As you listen to this, Desarea, and you think about working with your patients, what are some of the things that you talk to them about in terms of managing their own health?

DESAREA MURRAY, NP
I always have a conversation with the patient asking them what their personal goals are. So, I agree with Robert that it's important to have that time where you can get to know the patient, get to know what their needs are, get to know their dynamics outside of just their health because it all ties in together. So, I think it's very important to be able to have a relationship where the patient also feels comfortable talking to you about certain things. And it takes time to build that. I agree with you too, Robert, that WellMed does allow that time for the provider to be in the room and get to know the patient so that we can develop a plan or some type of things in place to help them reach their personal goals, as well as the goals I have for them.

RON AARON
Do you work with them in establishing those goals?

DESAREA MURRAY, NP
Oh, absolutely. And that's what it's all about. I also agree with something that Robert said earlier that it's more about just kind of helping that person get to where they want to be versus giving them orders of what to do where we recommend this is what may be best for you after listening. That's the key part after listening to what's going on and what's wrong in the first place.

RON AARON
As you think, Dr. Streck, about adjusting, especially folks who are new to San Antonio, new to Dallas, new to Texas, where the weather is so different. How do your patients deal with that adjustment? Those who are new to this area?

DR. ROBERT STRECK
Well, I think it depends on where they came from. But a lot of people find that Texas has a lot of allergens. That's been a big adjustment for a lot of people.

DESAREA MURRAY, NP
Oh, yes.

DR. ROBERT STRECK
Just length of the summers. I mean, it's like 11 and a half months out of the year. It's just so hot. It's hard to do anything outdoors. I mean, it's been an adjustment for a lot of people who maybe lived in more temperate climates. They had more chances to go out and exercise outdoors and walk and hike and go biking. But there's several months of the year where it's just too hot to go out and do that safely for a lot of people.

RON AARON
Yeah. I think you said 11 months out of 12 is summer.

DR. ROBERT STRECK
Yeah, that's a long time. It is hard to do some of those outdoor activities.

RON AARON
Well, one of the things folks can do is walk in a mall instead of in their neighborhood.

DR. ROBERT STRECK
For sure.

RON AARON
If you find a mall that's air-conditioned where you can go and spend time walking through there and leave your credit cards at home, it can be a great way to have some exercise and to enjoy it in an air-conditioned environment.

DR. ROBERT STRECK
Good to get out and people watch and socialize too. Staying isolated in your house is just not good for your mental health.

RON AARON
We got about a minute and a half left before we have to say goodbye to you, Dr. Streck. Give us the 411 on what folks need to think about as they get ready for whenever winter comes.

DR. ROBERT STRECK
They need to be thinking about how long they could be in their house without leaving. Are they going to be comfortable in their house if they don't have energy? Having the right clothing, having a supply of non-perishable food, having your medications, and for some people there may be concerns around costs of keeping the house cool enough. There are some government programs out there that people can apply for, for energy assistance to keep their homes either warm or cool. So, I think thinking about those things is going to be critical to staying healthy through the whole year.

RON AARON
One of the things you mentioned that we need to come back to is if you're on any kind of prescription drugs, make sure you have at least five days’ worth of those medications.

DR. ROBERT STRECK
I agree. At least five days. Watch the forecast, be prepared, know what's happening. And when it looks like there's some bad weather coming, make sure that you are ready for it.

RON AARON
And keep your phones charged if you're using a cell phone.

DR. ROBERT STRECK
Yes. Get some of those portable chargers if you have them, charge them before the storm comes. You never know how long the power is going to be out if it goes out.

RON AARON
Go ahead Desarea, you get the last word. Advice that you give patients.

DESAREA MURRAY, NP
Water. Make sure you have water.

RON AARON
So, fill up the bathtub if you have to.

DESAREA MURRAY, NP
Absolutely.

RON AARON
Assuming the bathtub is clean.

DESAREA MURRAY, NP
That, too. Yes. All right.

Well, I thank you both for being with us today. Dr. Robert Streck, we really appreciate your time. Dr. Streck went to medical school at the University of Texas Health Science Center here in San Antonio and completed his residency at Baylor College of Medicine. To you, Desarea Murray, as always, delighted to have you on. Thank you so much. Thanks to you all for joining us today on the award winning Docs in a Pod. I'm Ron Aaron. We will talk with you again soon.

OUTRO
Executive Producer for Docs in a Pod is Dan Calderon. The producer is Cherese Pendleton. Thank you for listening to Docs in a Pod, presented by WellMed. Be sure and listen next week to Docs in a Pod, presented by WellMed.

DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.

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