PhysicianMom.com

Karyn January Cheng

noreply@blogger.com (ellhwang) — Sun, 27 Apr 2025 04:34:00 +0000

I’ve struggled to find the right words for this. I had intended to share these thoughts on January 31, Karyn’s birthday, but I couldn’t bring myself to do it. I felt that once posted, I’d have to fully accept that Karyn is no longer part of my tangible world. Still, I struggle to comprehend that my roommate from college, who has been there for so many milestones in my life, is truly gone.

There is so much I will miss...
Her sparkling bright eyes dancing as she breaks into a huge, warm smile...
Her contagious laugh erupting spontaneously over the silliest little things...
All her nuanced, varying facial expressions — of which her quizzical looks and excited expressions stand out the most in my mind.

I will miss receiving Christmas cards and birthday cards written with the most perfect, beautiful handwriting — it really should be patented into a computer font. I remember glancing over at her exquisite notes while sitting next to her during lectures. Gaping in awe, I felt compelled to write neater myself.

Karyn had a knack for finding treasures — small, thoughtful gifts that always felt handpicked for your soul. Simple, yet deeply meaningful.

Other fond moments that stand out:
Waking up to the sound of her conversing with her family of seals in "stuffed animal language" every morning...

Curling up to watch Beaches (the 1988 musical comedy) on my tiny 13" TV-VCR combo, perched atop our lofted dorm beds, sipping sweet hot drinks, laughing and crying together in the soft dark...

I can still recall bits and pieces of conversations from the countless talks we had — sharing stories about growing up, about our extended families and the black sheep among them, about high school prom, about boys, and about our dreams for the future...

She was there for all the significant occasions in my life — present during my highest highs and a solid support during my lowest low as well.

Later, even when life pulled us to opposite coasts, we made time to reconnect, to share meals, to make memories. Those who know Karyn know — every trip promised amazing food! Our last plans were disrupted by Covid and I'm most heartbroken that we were not able to squeeze in just one more adventure together... we were aiming for 2025... so you see... I am still really not yet completely accepting that our journey here has come to an abrupt pause... ... ...

Well, they say pictures speak a thousand words, so here are a few snapshots…

a glimpse of her silliness... this was during college...

MIT graduation in 1997...

my wedding day in 2002...

She was one of the first folks to visit after I had my firstborn in 2007

afternoon tea in Chicago

yummy breakfast

one of my very favorite dinners ever... Mexico 2018

I miss you, dear friend... ... ...

I miss your light, your laughter, and your love.

Until we meet again...

Mother's Day Haikus

noreply@blogger.com (ellhwang) — Sun, 12 May 2024 11:25:00 +0000

Long time no write! So honest truth... the struggle is real with mothering teenagers...

Felt like writing some haikus...

Today is a day

To appreciate mothers

Shower them with love

Not an easy task

This role of being a mom

So many demands

Although there is stress

Sometimes tears and frustrations

But still there is love

So hug your mother

On this day and every day

Let her know you care

Happy Mothers Day

May there be more smiles than frowns

More laughter and joy

got these from work!

With a Thankful Heart

noreply@blogger.com (ellhwang) — Thu, 23 Nov 2023 13:34:00 +0000

Many milestones and changes this past year... So thankful for all of these and so much more...

Celebrating my dad's 80th birthday
Commemorating my parents' 50th Wedding Anniversary
My firstborn hitting Sweet 16
Privilege to serve with Wrightstown Family Medicine for 16 years
New opportunity to reach the neediest populations at Dedicated Senior

HAPPY THANKSGIVING, EVERYONE!!

The LORD is my strength and my shield;

in him my heart trusts, and I am helped;
my heart exults, and with my song I give thanks to him.

- Psalm 28:7

Chapter Ending

noreply@blogger.com (ellhwang) — Wed, 10 May 2023 11:23:00 +0000

It is with a very heavy heart that I announce that my time at Wrighstown Family Medicine is coming to an end. After July this summer, I will be transitioning to serving the medicare advantage population closer to Philly.

Meeting Paul Caracappa and joining him in his vision to make a lasting impact on the surrounding community has been a true honor and privilege. Not only do we strive to offer the best medical care to our patients, but we also endeavor to offer comfort and a hope that is eternal. Forming close relationships with both the staff as well as the patients has been the most meaningful part of my entire time at Wrightstown Family Medicine. We have shared joys and sorrows, triumphs and setbacks... laughed, cried, and celebrated together...

So why the transition? Honestly, it was not something I foresaw coming but when it came to my attention that doctors were needed in a more underserved population treating the elderly, my heart was pulled. I remember why I decided to go to medical school in the first place.

In high school, I used to drive my grandfather three times a week to a hospital in Trenton. It was hard watching him struggle with high blood pressure which led to him needing kidney dialysis. Then he had a stroke which required us to call 911. I still remember how helpless I felt riding in the front seat of that ambulance, but that is when I decided to go into medicine. I wanted to be able to help folks like my grandfather.

The medical road is a long one and I am grateful for the support and encouragement of my collegaues and friends who have helped me along the way to become the doctor that I am today. Being at Wrighstown for the past sixteen years has been a true blessing. Words cannot do it justice. Although it is with sadness that I go, I am also exctied and ready to face the new challenges, experiences, and opportunities that is to come. In the end, leaving Wrighstown Family Medicine is not just a farewell, but a reminder of the power of relationships and the impact we can have on others. It is a celebration of God's faithfulness. So, here I am closing one chapter of my life and getting ready to start a new.

postcard we sent out 16 years ago when I first joined the practice!

Happy 2023!

noreply@blogger.com (ellhwang) — Sun, 01 Jan 2023 19:28:00 +0000

This is the first year that we let our kids stay up for the actual Ball Drop in Times Square. In years past, we would celebrate the countdown with countries in other time zones so that our kids can get to bed by a decent hour. Fussy kids are no fun... but neither are fussy adults. Being more disciplined with sleep is one of my goals for 2023.

Most are familiar with how sleep can benefit your mood and immune system. Did you know it can also help with preventing weight gain? Few theories out there but one thought is that ghrelin, a hormone that makes you hungry, is increased with less sleep. At the same time, leptin, a hormone that tells you that you are full, is decreased. There are also studies that suggest lack of sleep promotes prediabetes which can then lead to diabetes, as well as worsen sugar control for those who already have diabetes.

So the reasons are many... but I find it super hard to do. The wee hours before bedtime is the only "me time" I really get and unfortunately, as the kids get older this time has shrunk. They used to all be in bed by 8pm at the latest. Now, it is a real struggle to get my middle schooler in bed before 10p. My high schooler is on her own... sometimes she is up even later doing homework. I suppose I will have to brainstorm ways...

Well... happy new year, everyone!

Night Before Christmas 2022

noreply@blogger.com (ellhwang) — Sun, 25 Dec 2022 08:13:00 +0000

It is that time of year again when we're getting a lot of sick calls... sinus infections... strep... flu... covid... you name it! And yes... they are all contagious. Stay healthy, everyone!

All's quiet in the Kim household...

our second daughter baked the cookies herself

we finally got a gas fireplace

“For unto us a child is born, unto us a son is given: and the government shall be upon his shoulder: and his name shall be called Wonderful, Counsellor, The mighty God, The everlasting Father, The Prince of Peace” (Isaiah 9:6).

Merry Christmas!

KDramas

noreply@blogger.com (ellhwang) — Tue, 08 Nov 2022 19:26:00 +0000

It has been a while since I posted. Covid hit my life like a cyclone spinning all the different components out of place and even now as things settle, it is just not the same. We are all adjusting to the "new normal"... whatever that means. I imagine work in particular has worn me down quite a bit and I am tired of thinking and talking... especially if it is about Covid. Compound that with the kids all growing a little older and our two girls reaching adolescence, my heart is lamenting how the parent-child relationship has changed. The challenge has made me emotionally exhausted.... but more on that in another post.

So what do I want to write about if not about Covid or parenting? I decided that I'll throw in a post about KDramas. It is the one piece that got thrown into my mix during Covid that has been a fun distraction and escape. With that said, it is only a temporary and fleeting reprieve. Scripture is still the only true sustainable fuel that fills my empty mental and emotional tanks. I need to remind myself of familiar passages such as:

But those who trust in the LORD will find new strength. They will soar high on wings like eagles. They will run and not grow weary. They will walk and not faint. (Isaiah 40:3 New Living Translation)

Come to me, all you who are weary and burdened, and I will give you rest.

(Matthew 11:28 NIV)

Now a little about my momentary diversions... here are a few dramas that stood out to me. For diversity, I'll pick from different genres.

Crash Landing on You

This is a lighthearted romantic comedy and since it is one of the first KDramas that drew me in, I have to mention it. The chemistry between the two main leads is cute and they ended up dating for real afterward, even getting married and expecting their first child. Furthermore, the soldier sidekicks were hilarious and added an important element. I ended up rewatching it with my kids, who also really got into it. The contrast of everyday life that was illustrated between North and South Korea was what made this drama unique.

Mr. Sunshine

The beautiful cinematography, superb acting, and gripping storyline all consumed me during this watch. The back story of the three male leads and their roles were so cleverly woven together, it left a lingering impression. The love story was subtle but pulled at the heart. This drama was engrossing and deep and caused me to think about it for days even after finishing. I even got my mom hooked to watch it. There are definitely more graphic violent scenes so I did not show this to my kids.

Hotel Del Luna

If you like a little bit of scary mixed in with humor and romance then this drama is a must-watch. I generally do not like horror movies but this drama has just enough humor in it for it to not be categorized as a true horror movie. It is more of a fantasy romance with a fascinating storyline that had me on the edge of my seat wondering how it was all going to end. There was only one scene where I had to plug my ears and peek through my fingers to watch... (the closet scene!) Finally, I have to mention the music because the soundtrack for this drama is exceptionally moving.

Vincenzo

This drama is back to a bit more lighthearted and fun but throws in some kick-butt action and mafia scenes. I actually really like lawyer shows and this is one of several that I've enjoyed (maybe because I'm in the medical profession, I don't really like watching medical shows). What stood out to me was the humor and action. There is a bit of violence and gore in some of the scenes but just as how Hotel Del Luna was not an outright horror movie due to humor, I feel this is not just an action movie due to the humor. There is a tinge of romance but I feel it was not the main draw.

Kill Me Heal Me

This has become my new favorite KDrama and Ji Sung has become my favorite Korean actor. He plays a character with dissociative personality disorder and displays seven different personalities remarkably well. The storyline is captivating and this is a drama I will want to rewatch. However, it is not on Netflix. You can watch it on Viki if you get the Viki Plus Pass or on Kocowa which is free but has a lot of interruptions with advertisements. Hoping it will come to Netflix soon.

Well, that is it for now. I'll post something more useful later. Maybe...

So this will be FAREWELL and not GOODBYE....

noreply@blogger.com (ellhwang) — Sat, 28 May 2022 17:51:00 +0000

My office manager of 17 years from work is retiring. This post is a tribute to all that she has done for the office, staff, patients, and myself...

Here are her answers to some common questions.

When did you start working at WFM?

1. Started WFM in 2005

I came along side Dr. Caracappa to fulfill and assist his passion and plan to begin the exciting inception of Wrightstown Family Medicine with our 1st patient on 12/15/2005.

What did you enjoy most about your time with WFM?

2. My greatest joy and pleasure while working at WFM was to see how God worked in and through the doctors, myself and our staff to assist in the healing of our patients physically, mentally as well as spiritually!

I was the audience of endless personal success stories over these 17 years.

What will you miss the most?

3. I WILL greatly miss being the "MOMANGER" (a name the staff gave me) of the

office to have the honor, privilege and pleasure to love on, unite & assist my staff in any way I could.

What will you not miss the most?

4. I will NOT miss being in a closed office setting moving forward with freedom to enjoy travel to enjoy outdoor nature and God's fingerprints all around us each day!

What are your plans now?

5. The next step and great passion with excitement of retirement for me will involve more time with our 2 adult married children and 6 grandchildren!

My husband and I purchased a Motor Home last November and sold our home in December in preparation of this next step.

Our plan is to travel out West and around our amazing USA in our home on wheels!!!!

Any parting wisdom you want to leave to our staff and/or patients?

6. I'm known for my "Momanger isms" of which I will leave you with just one...

DO YOUR BEST

PRAY IT'S BLESSED

AND GOD WILL TAKE CARE OF THE REST......

So this will be FAREWELL and not GOODBYE....

===

You will truly be missed. Thank you for all that you have done and may God bless you and your family as you embark on your next journey!

Happy Mother's Day

noreply@blogger.com (ellhwang) — Sun, 08 May 2022 19:37:00 +0000

To all the mothers out there... hope you feel loved, honored, and blessed... not just today but every day!

Our local community experienced a heart-wrenching tragedy recently that has hit me especially hard because it involves a mother. I am still sorting out my jumbled emotions and thoughts... I have no words...

but I will hang on to these words that offer me some peace and hope to hold on to...

"May the God of hope fill you with all joy and peace as you trust in him, so that you may overflow with hope by the power of the Holy Spirit." (Romans 15:13)

"He will wipe every tear from their eyes. There will be no more death or mourning or crying or pain, for the old order of things has passed away." (Revelation 21:4)

"Let your unfailing love be with us, Lord, even as we put our hope in you." (Psalm 33:22)

So it has been way too long since I've last posted. So much has happened in the "Covid World" since... one of the best things is that we now have medication that we can prescribe in the outpatient setting. Make sure you contact your doctor if you test positive to see if is right for you. Also, if you haven't done so already, you can order free home tests here.

Happy Mother's Day, everyone!

My baby is growing too fast...

CDC Covid Quarantine and Isolation Guidelines

noreply@blogger.com (ellhwang) — Wed, 02 Feb 2022 12:38:00 +0000

Guidelines keep changing and can be confusing... so here I'll try to break down the most recent recommendations to the simplest form...

"I got exposed to someone with a positive Covid test... now what?"

If no symptoms and up to date with vaccines or had confirmed covid in last 90 days

no need to quarantine but wear mask for 10 days
can test on Day 5
watch for symptoms for 10 days

If no symptoms but not up to date with vaccines

quarantine 5 days at home (mask around family members)
mask for 10 days while watching for symptoms
can test on Day 5

If yes symptoms regardless of vaccine status or previous exposure status

test on Day 2-3
isolate 5 days at home then wear mask for full 10 days

If yes symptoms and very sick

test on Day 2-3
isolate 10 days and contact doctor before ending isolation

"I just tested positive... now what?"

Regardless of vaccine status:

no symptoms

isolate 5 days then wear mask for

yes symptoms

isolate 5 days then wear mask for full 10 days

yes severe symptoms

isolate 10 days then contact doctor before ending isolation

Omicron Variant...

noreply@blogger.com (ellhwang) — Sat, 01 Jan 2022 18:51:00 +0000

Hello 2022!

Wishing everyone good health for this new year as we are in the midst of another Covid surge...

So last time, I was writing about the Delta Variant... although there is probably still some Delta in our area, Omicron is becoming more dominant. The last week at work has been pretty crazy! Honestly, the last thing I feel like doing after work is to think about Covid... that is why it is taking me so long to write anything on this blog. Plus, the information pretty much changes almost daily so what I write today may not even be valid tomorrow. With that said, here are bullet points with a few of my personal observations:

Omicron seems to be more contagious... I've noticed more so than ever before that if one family member is sick, almost everyone else in the household gets sick or tests positive

side note - home tests do not catch covid as accurately as the pcr

if positive - no need to retest
if negative - may not necessarily mean no covid so talk to your doctor about it if symptoms persist etc.

Severity of sickness varies but follows a fairly predictable pattern depending on vaccination status

Vaccinated and Boostered - these folks, if they have symptoms at all, usually have a sore throat and maybe some mild congestion or runny nose... report very little fatigue and aches...
Vaccinated but not yet Boostered - these folks can still get fatigue, fever, body aches in addition to the sore throat and congestion, but the worse of it usually only lasts a few days or less... and not weeks and weeks...
Not Vaccinated - these folks seem to follow the pattern of Covid infected folks similar to back when this whole thing started and we didn't have vaccines yet. So in addition to sore throat, congestion etc the first week, folks may feel better as if getting over it but then feel worse again... I usually find myself checking up on these folks more often and ordering the IVIG treatment for them if they qualify...

Now, ofcourse based on one's underlying health and medical conditions, how fast and sick someone gets with Covid will still vary regardless of vaccination status.

However, this is the analoigy I like to use. We are at war and Covid is the enemy. Whether you are a strong warrior or someone totally unskilled in fighting, you are fighting with your bare hands without the vaccine. Vaccinated folks are fighting with a shield, a sword, and maybe some bow and arrows. The boostered folks have more weapons at their disposal as their old weapons get damaged or lost in battle.

What about folks who have had Covid already? I am not too sure, but maybe I see it like this. These folks beat their first battle against the enemy, but here comes more troops from a different enemy and although the experience from the first battle may help more so than if never fought in any battle... having more weapons at hand may still increase the chance of winning with less battle scars.

Now even with weapons, one may get slashed, beat up, hurt, and even lose... but at least the chances are higher to win than fighting completely weaponless. Then there are those folks who really cannot get vaccinated for underlying health reasons. So going back to my battle analogy, maybe these folks can not pick up a sword or shield because say they only have one arm or something... their chance of survival then would increase if the folks immediately surrounding them are heavily armed and willing to fight the fight for them.

That is my two cents without getting into any details about the science, politics, or whatevers floating out there regarding the vaccine... and regardless of vaccine status, my practice and I will do our best to meet needs and direct care the best we know how with the limited and ever changing information at our disposal.

Truly hope you all stay well and safe in 2022. Happy New Year!

Delta Variant

noreply@blogger.com (ellhwang) — Mon, 05 Jul 2021 06:10:00 +0000

It's summer! Hope everyone had a good 4th of July. Things are beginning to feel a little more "normal". The mask mandate has lifted and there seem to be more social gatherings.

So to answer a few common questions I've been asked lately...

What is the delta variant that everyone is talking about?

It is also known as lineage B.1.617.2. It is a version of Sars-CoV-2, the virus that causes Covid-19 that has evolved or mutated over time. This particular variant was first detected in India December 2020 and in the US March 2021.

What is the big deal about it?

This variant is more contagious than other variants. It potentially can cause another Covid surge in the US.

Does the vaccine protect against it?

Yes.

Which states have the variant?

There are 5 states where it is spreading the fastest: Missouri, Arkansas, Nevada, Colorado, and Utah.

Is Covid over yet?

The number of cases, hospitalizations, and deaths in the US are relatively low right now but there are some hot spots where vaccination rates are low. So... not quite over yet... we'll have to see what happens...

Being a Mom

noreply@blogger.com (ellhwang) — Mon, 10 May 2021 14:48:00 +0000

This is a day late but... Happy Mother's Day to all you moms out there. I want to give a special shout-out to my mom (who I still call "mommy"). Words cannot describe the deep gratitude and love I feel... no list would do justice to all the things that I'm thankful for.

Below is a picture of the cover of a scrapbook that my kids have been drawing in since 2014 (thanks I believe to my sister who gave the idea to my husband)... on top is my gift this year... has each of the kids' names engraved on one of those rings. I received something similar in the past but unfortunately lost some of the little trinkets... so this is great. It reminds me what a blessing and privilege God's given me to help guide these little hearts... but not so little anymore... So every day I pray for wisdom and grace. I am humbled all the time at how far I fall short... at the same time, I am reminded to not measure with my own standards... 

To be honest, being a mother is the hardest thing I've ever had to do... SATs, MCATs, residency, boards...q3 call in the ICU... they do not even come close! Though challenging... and may sound cliche, I would not trade it for the world and am truly grateful for this honor to be called "mom"...
So as a side note, I find it fascinating that the word "mama" (meaning mother) is so similar in many different languages. For example, in Chinese, you would say "ma" or "mama" when you address your mother. It is pretty much the same in Taiwanese except the tonation is slightly different. In Korean, you'd say "o-ma"...

What do you all call your moms? Mother? Mom? Ma?  Who else out there calls her, "mommy" like I do? 😅

Covid Vaccine Common Questions

noreply@blogger.com (ellhwang) — Wed, 21 Apr 2021 04:30:00 +0000

Happy Spring! Sure has been a while... but I've been getting a lot of questions about the Covid19 vaccine lately, so I will try to put together some basic information. Please refer to the cdc website for more details.

First, here is a table summarizing the three vaccines that have been available in the US:

What are the possible side effects?

In the arm where you got the shot...

pain
redness
swelling

Throughout the rest of your body...

tiredness
headache
muscle aches
fever/chills
nausea

Can you get Covid from the Covid vaccine?

No. There is no live virus in the vaccines. The symptoms you get is your body getting antibodies ready to attack a simulation so that when the real deal comes, it can conquer it. That's the whole point. The symptoms are usually mild to moderate and will go away in 48 hours.

What about the J&J vaccine and blood clots?

So on April 13, the CDC and FDA have recommended a pause in the use of the J&J vaccine. There were 6 reported cases of developing a rare and severe blood clot after getting the vaccine. 6.8 million people have already been vaccinated with the J&J vaccine, so 6 out of 6.8 million is extremely rare. Experts are still investigating the cause of the blood clots and there may be underlying conditions that predisposed those folks who developed that reaction. A second meeting about all this is scheduled for April 23, so stay tuned...

Contact your physician if between days 6 and 13 post-vaccination you develop:

headaches
leg pain
abdominal pain
shortness of breath

Is it still recommended to get a Covid19 vaccine?

Yes. You can review your personal case with your doctor, but in general, the benefits of protection from Covid19 with these vaccines outweigh any potential side effects that may occur.

What about the timing of getting the vaccine?

So here are a few scenarios where one should wait...

If test positive for Covid, you should wait until all symptoms resolve and meet the criteria for discontinuing isolation.
If treated with convalescent plasma or monoclonal antibodies for Covid, then you need to wait 90 days before getting the vaccine.
If you got any other vaccines recently, then you should wait 2 weeks before getting the Covid vaccine

What are the benefits of the vaccine?

Helps prevent severe infection from Covid19
Helps prevent hospitalization from Covid19
Helps prevent death from Covid19
Helps prevent the spread of Covid19 in asymptomatic people

The bottom line is that vaccines are key to stopping pandemics.

How can we get back to "normal life" sooner?

get vaccinated (as long as not contraindicated)
wear masks (though vaccinated folks can now potentially unmask indoors with other vaccinated folks)
social distance with those who don't live with you (6 ft apart and avoid crowds)
wash hands (should always be doing this anyway)

For more specific questions and details, you can check out the cdc website above or discuss with your physician.

So on another note... my family just came back from a little getaway up to the Finger Lakes. My husband and I had visited this area the second year after we got married. Funny, how traveling with four kids changes the ambiance of the trip!

from 2003...

quiet, serene, relaxed... gentle ripples of a lake...

now in 2021

not so quiet, energetic, adventurous... rushing rapids of a waterfall...

My Google Classroom

noreply@blogger.com (ellhwang) — Fri, 29 Jan 2021 03:05:00 +0000

So I had a total lightbulb moment last week and I'm so excited about it that I have to share! Honestly, it has been really frustrating for me to not be able to stay organized and on top of all the things that my four kids are doing... whether it be school, music, sports, household stuff etc! I've tried printing out excel sheets... I've tried a huge dry erase board sectioned off for each of the four kids.... I've tried putting everything in google calendar and using notifications. I tried setting reminders on Alexa. None of it worked super well or lasted long... but I think I found a solution!

For a while now, my kids have been doing this virtual school thing and they have become very familiar with google classroom. A couple of months into distance learning last spring, my oldest created her own google classroom for her siblings and cousins. Not long after that, my youngest also started his own google classroom. I really did not pay much attention to any of this but would hear about it from my sister from time to time about how my seven year old was giving tests etc. We just thought it was cute and funny. Then just last week, it dawned on me... I can create a google classroom! Those who know me know I love excel files and lists... well, this google classroom thing is a total game-changer for how I'm managing this household!

These are some of the ways I've been using my classroom...

Linking a daily devotional for them to read, reflect, and respond... the classroom allows group comments so all can share or private comments to me where I can respond back. This really has been awesome! It was too hard before to do devotions every night with each child separately but now they can read it in their time, respond to me and I can write a thoughtful response back.
Putting in daily tasks for them to "mark done" instead of feeling like a broken record asking them over and over again and then forgetting what their answer was after I asked them... so things like putting away laundry, getting outside for exercise, twenty minutes of reading, etc.
Attaching links to websites tailored to each kid from their different extracurricular activities (like chess.com or MIT scratch)
Attaching a link to the Compassion children we sponsor. Now my kids can read and learn more about them as well as make google docs and submit them back to me so I can send it out. I was the one doing all the correspondence before
Attaching links to each others school projects etc. so they can see each other's creative works. Since school turned hybrid this fall, my kids have had plenty of projects that involve using a flipgrid to tape STEM projects they've built or video editing project reports for social studies. In the past, I'd open up my laptop and play the videos for everyone while they were all eating but it would be sporadic and often interrupted... now they can watch when they have a moment and even comment something encouraging to one another

There is more but I will not list them all. Just one more thing...

These are pictures taken from my kid's bathroom this morning when I walked in there.

this so bothers me...

is this so hard to do? took me 5 seconds...

So this is what I posted today:

Just saying...

So that is my exciting news. Oh... AND I got my first dose of the COVID-19 vaccine!

Good Bye 2020 and Hello 2021! Hope with the Covid Vaccine...

noreply@blogger.com (ellhwang) — Mon, 04 Jan 2021 16:14:00 +0000

So 2020 is now behind us... may 2021 be a better year.

Despite the challenges and many difficulties and disappointments that may come to mind when I think of the past year, I have to say that the blessing for me was time to just "be still". I have the first part of Psalm 46:10 on my bathroom wall:

"Be still and know that I am God"

This past year, I really was forced to be still... at least physically still. I'm still working on how to be mentally still. Here are a few images that come to mind when I reflect back...

puzzles... and more puzzles...

virtual playdates...

kids learned to cook...

drive-by celebrations...

My family also had a chance to make some music together. Here are a few clips for your entertainment...

So what images will 2021 bring? Hoping with the Covid vaccine, we will be able to return to more in-person gatherings sooner than later. So my thoughts on the vaccine? Without going into too many details about the how and why... I'll answer three main questions here that I am getting asked a lot.

Do I think the vaccine is safe to get? Yes

Do I plan to get the vaccine? Yes

Do I recommend my family and patients to get the vaccine if they have no contraindications? Yes

Happy New Year, everyone!

Should I Get a Covid-19 Antibody Test?

noreply@blogger.com (ellhwang) — Tue, 15 Dec 2020 04:45:00 +0000

So another super common question that our patients ask is whether or not to get a Covid-19 antibody test. My thoughts...

Well, first have to explore the reasons behind the testing.

If you are a confirmed positive Covid patient who has recovered and you hope to donate plasma, then you can consider the test. However, the quality of the test varies. You can see here FDA's updated list of different tests being offered by different companies and how their performance varies. You would have to check what is being offered in your area.

If you are a confirmed positive Covid patient and hope to have antibodies so you don't get sick again, you may want to reconsider whether or not you really want this test. First of all, the test may not be accurate and your result may be either:

false-positive - tells you you have antibodies but really you don't, so you'd have a false sense of security
false-negative - tells you you do not have antibodies but really you do

However, even if you do have a true positive antibody to Covid-19, there is not enough evidence to guarantee that you will not get re-infected. So from a practical point of view, regardless of the results, you still have to practice all the same social distancing guidelines as anyone else.

If you are not a confirmed positive Covid patient but think you had it, the same rules above apply.

I get it that a lot of people want to know if that terrible cold they had back in January or last November could have been Covid. In fact, I want to know myself! However, I am personally waiting for more evidence to come out and for a more accurate test to be available in my area. Based on the limited data I've seen so far from the antibody testing that our office has ordered, I do not have much confidence in the accuracy or value of that particular test. Plus, since it does not change the management of care or the advice we give, I find little use for it.

As always, contact your physician for a more in-depth discussion. You can find out more about antibody testing in your area and whether or not you are a candidate for it.

So what is the best way to prevent getting sick?

practice social distancing (mask and 6 feet apart!)
wash your hands frequently (avoid touching your face)
get adequate sleep (sleep sleep sleep!)
eat healthy (vegetables!)
exercise (even if just 15min a day!)
decrease stress (carve time for yourself daily)

Stay safe, everyone! It's beginning to look a lot like...

How Long To Quarantine? When to Covid test? It's Thanksgiving!

noreply@blogger.com (ellhwang) — Wed, 25 Nov 2020 23:49:00 +0000

So I'm sure everybody is reading about the recent spike in Covid cases. From my experience, it truly just hit that second weekend in November when I was "the doc on-call" and it has been a domino effect ever since. Calls started to come in from patients requesting testing as well as from the lab reporting positives back to me.

Back in the summer, we may get requests for Covid tests because folks were traveling and needed a negative result so they can enter another state or fly to some exotic island getaway. Few scattered calls came during August and September when college students went back to campus and we saw a small spike in that age group then. However, about a week after Halloween and Election Day, requests for covid testing due to positive contact or symptoms started to pour in. What's more, a lot of these tests are coming back positive.

So the big question everyone asks is, "How long do I need to quarantine?" Especially with the holidays around the corner, everyone is trying to decide what to do about family gatherings and travel. I will attempt to summarize it here as I feel like I'm having this conversation multiple times a day and every single day for the last 3 weeks. However, there are two things to note:

1) guidelines change constantly and the CDC is actually in the process of officially decreasing the length of quarantine after positive exposure

2) everybody's health and situation is different, so definitely consult with your physician for individual guidance.

Symptoms of Covid can include all or only some of the following... but the first three symptoms seem to be consistent with most of my patients who end up with positive results. Fever, cough, and shortness of breath only in the more severe cases but I haven't been seeing those symptoms in the younger folks as much.

sore throat
headache
congestion
body aches
fever / chills
cough
loss of smell
GI symptoms (diarrhea etc)

If you have symptoms or just don't feel good -> self-quarantine for 10 days starting from the first day of symptoms REGARDLESS of a positive or negative covid swab.

If you do not have symptoms but you were in close contact (unmasked and less than 6 ft apart) with a confirmed positive -> self-quarantine for 14 days starting from the first day of the last contact REGARDLESS of a positive or negative covid swab

Why regardless of results you might ask? It is because there is a possibility for a false negative test or you just tested too early. There is a 14-day window from exposure to symptoms and during that period, even if you have no symptoms, you are potentially contagious. In fact, most folks who are getting tested because they were around someone else who now tested positive will tell you that the person who tested positive was not having symptoms at the time they were together.

CDC is considering shortening the 14 days to 10 days because it is hard for folks who feel well to stay quarantined, so they are hoping for more compliance if the time is shortened. Stay tuned.

Now if you insist on testing for covid then timing is important.

If you have symptoms -> test on day 3 or 4 of symptoms

If you do not have symptoms -> test around day 7 from the last day of close contact with a confirmed positive covid case

If you did not have close contact with a confirmed positive covid case and...

yes symptoms -> test on day 3 or 4 of symptoms
no symptoms -> chances are your test will be negative and hard to interpret if by chance it is positive then quarantine 10 days from day of positive covid swab

So for details and more specific counseling, you should seek out your physician.

Happy Holidays everyone! Stay safe and smart. Despite the crazy year... can you think of things to be thankful for?

Back to School in the Midst of Covid

noreply@blogger.com (ellhwang) — Mon, 07 Sep 2020 12:48:00 +0000

Happy Labor Day!

Today is the day before our school year begins. As both a mom and a physician, I've been pondering a lot about the challenging endeavor to best educate the kids this fall. There are many blogs and articles about this out there so I don't want to rehash everything, but the main questions being asked include...

Is it important for children's mental health to interact in person with peers? yes

Is it important to prevent the spread of Covid19 to protect the health of teachers and family members who may be more at risk? yes

Is it important to provide the resources for all children to have access to learning? yes

Is it important to be sensitive to one another's fears and feelings and to be respectful, forgiving, and gracious? yes

The bottom line is that the rate of infection varies from state to state and even region to region here in the United States. Therefore, the decisions of how to do school are being made by local government and educators taking into account those basic questions and I'm sure many more.

In our particular region, the numbers are currently low. Although we want to do everything to prevent those numbers from spiking back up to where they were in the spring, we also want to balance the benefits that would come from in-person learning to students and families. As a sort of compromise, our district is offering a choice for families to pick either 100% virtual learning or a hybrid model where two of the five days would be in person with social distancing measures in place. Again, not to rehash what all those measures are and the reasonings for them... I do want to give credit for the decision-makers because this is no easy task. No matter the final decision, there is sure to be those unhappy with the outcome.

We are promised that the model for virtual learning this fall will look different than it did in the spring. Well, we shall see.

So whether a family is choosing to go with the public school system with 100% virtual vs hybrid model or 100% in-person at a private school or 100% home school... "Happy Back to School"!

Is Telemedicine Here to Stay?

noreply@blogger.com (ellhwang) — Tue, 14 Jul 2020 12:51:00 +0000

I recently submitted an article to MIT's department of athletics in response to their request regarding alum's involvement in COVID-19. Life has been busy and with so many things going on in the news... it has been hard to find time to process, think, and blog. Honestly, by the end of the day, my brain just wants to vegetate. Well, here is what I sent them... I feel it summarizes life since March...

Dr Ellen H Kim ’97 was a four year starter on MIT’s field hockey team during which they won their first ever New England Women’s Eight Conference Championship in 1994. She also made All-Conference team and the National Academic Squad her senior year and graduated with a degree in biology and a minor in music. She went on to receive her M.D. from Drexel University College of Medicine and then completed her residency in family medicine at the University of Pennsylvania, where she served as chief resident. Dr. Kim currently works in private practice at Wrightstown Family Medicine in Newtown, PA and is mom to four kids ages 6,9,10, and 12.

These last few months have been challenging, simultaneously transitioning a busy outpatient practice to essentially all telemedicine while managing four kids ages 6,8,10, and 12. Supervising their “distance learning” was a bit painful. Fortunately, my seventh grader was fairly independent, but the younger ones were easily distracted and needed more direction. The concern was not so much the volume or difficulty of the schoolwork, but so many hours in front of a screen affected their emotional lability and grumpiness. Keeping track of the different zoom calls was a whole other undertaking. My husband, Dr. Joseph Kim, MIT Class ’98, runs his own consulting and CME company, also had to work from home. Imagine the craziness of all six of us accessing our respective laptops and computers to participate in numerous zoom meetings throughout the day!

Our dining room turned into a temporary classroom for my kindergartner, third-grader, and fourth grader.

My seventh grader distance learning from her room.

My fourth grader submitting homework online

My medical practice cares for a wide range of patients from newborns to great grandparents. We wanted to stay available and offer medical care and treatment to those who need it. However, it was necessary to protect the more vulnerable and not contribute to the spread of COVID-19 that was sweeping through our region. Many who live in our county either commute to New York City for work or have grown children who left the city to quarantine with their parents. There were also folks who returned from travel overseas or returned home from college, which all played a part in our rising infection rate.

Our office hosted a Friendsgiving luncheon for some of our patients in Nov.

At the end of March, the sudden surge of positive COVID-19 cases in our area resulted in schools emergently shutting down. We faced a similar urgency in our practice to separate the exposed with those not infected. During those early days, I recall the frustration of trying to help direct care when there were no concrete guidelines. Disappointed at the lack of testing availability, we felt somewhat helpless but pushed on to formulate treatment plans. We endeavored to help our patients and steer the course of their illness to recovery. Our goal was to ward off the need for emergency room visits which may ultimately result in hospitalization and even ICU admissions.

In order to prevent the healthy and especially the more vulnerable patients from contracting COVID-19, and to not be the vector of transmission ourselves, we converted our practice to mostly telehealth services online. Fortunately, we were able to do this without needing to ever close our doors. Of course, there were some bumps as we switched to conducting interviews virtually rather than face to face. The adjustment was both on our end as well as our patients’ end and it certainly took some getting used to.

At the end of the day, telemedicine provided us the ability to offer care to those needing routine maintenance for their medications and address new issues not related to the coronavirus, while also delivering care to those exposed and fighting COVID-19. It has been busy but rewarding to be able to meet needs. To avert hospital overload and to prevent medical staff burn out, it was crucial for us to help curve ER visits by treating sick patients from home. Telemedicine gave us the means to do so but we also had a physician available for in-office urgent cases that are not sickness related.

Information for COVID-19 constantly changes and recommendations still get revised as research and new data pours in. As primary care, our job is to filter out what is relevant and apply it to the care of our patients. This global pandemic is not yet over and although we are now seeing more patients face to face for in-office visits, telemedicine is still available. It is essential to have for those who may be more high risk, and convenient for those who do not need to come in person or those who have a hard time getting transportation. Some form of telemedicine will likely be here to stay even as the pandemic resolves. Given the way things look, that resolution may still take some time.

My little hockey player giving a virtual presentation about the sport to her class

Teacher Appreciation Week

noreply@blogger.com (ellhwang) — Thu, 07 May 2020 04:50:00 +0000

When first we heard

No more school...

We shouted and danced

And thought it'd be cool!

But soon we discovered

This is no fun

No place to go...

Where can we run?

We miss our friends

We miss our classroom

It is not the same

Meeting up on zoom

But learn we must!

On our chrome books all day...

Oh, come on... really?

Is there no other way?

Thank you, teachers!

Thank goodness for you!

If you weren't there

What would we do?

Thank you for your time

Your devotion and care

Our appreciation and love

We want to share

We are lucky to have you

What more can we say?

Stay safe and healthy!

See you soon, we pray

Staying Home During the Covid-19 Pandemic

noreply@blogger.com (ellhwang) — Thu, 09 Apr 2020 04:31:00 +0000

Anytime you turn on the television or internet these days, I'm sure you are getting plenty if not too much information about Covid-19. Boy have things escalated and changed since my last post written in the beginning of March! Instead of re-hashing what's already out there, I figured I'd focus this post on our "new normal" and some of the blessings in disguise...

Some snapshots of our lives so far...

sibling chess matches

lots and lots of puzzles...

haircut in the garage

tae kwon do zoom class

Sunday church service

This week is Spring Break so I had a chance to step away from work and just be with my family. Since we cannot travel this break as we usually do... decided to be creative and just "pretend" we are on vacation anyway!

Kids are sleeping outside in a tent as I type...

Personally, taking a break from going anywhere and having all outside activities cancelled has been a nice change of pace for me. Here is a list of some things I'm thankful for...

being able to wake up at around 8a (or later...) every morning because no need to get my middle schooler to school... before had to wake before 7a and not being a morning person... it was super painful
in fact, no morning "rush" at all... before had to get the 4 kids out of the door during the weekday... was always the most stressful 90 minutes of the entire day!
actually having time to go for a walk or run in the neighborhood... before I was either at work or in a car driving someone to sports or music lessons or something... by the time i got home and got the kids to bed I was exhausted...
actually having time to cook meals and having fun doing it... before I relied on my mom and my au pair to prep most of the meals because I was either at work or in a car driving someone to sports or music lessons or something...
even having time to bake and make desserts... yum! ... and fun! ...before I was too tired from the day to want to do any of this even if I did have the time...

eating meals together... like all three meals... every single day... hm... now that I think about it, not sure this one counts as a blessing... lol. There are moments I suppose where good memories will be made along with the crazy. Like today for instance, at dinner time we were all singing at the top of our lungs... different songs from different musicals... was a blast!
watching movies... lots of them... I'm a movie person because I like escaping into a different reality. What better way to not think about the negative news all day long then to disappear into another world. So we make popcorn, snuggle up with blankets on our beanbags in the basement and watch movies together. We kind of started this tradition last summer when we went through all the Harry Potter movies. Now we have also finished all the Avenger movies in order, went through some DC Comics, even showed my kids the original Superman with Christopher Reeves, then on to the Dark Knight Trilogy... Ip Man 1 2 and 3 (looking forward to Ip Man 4!) ...and now going through X-Men series...
having "daddy" home... before he would travel at least two or three times a month so having him home everyday is a plus...

All in all... I'm grateful for the slower pace of life. I feel more rested. What's more, it's amazing how much gas I'm saving. Usually, I have to fill my tank about twice a week but now I think I've gone almost 4 weeks without the fuel gauge indicator moving much at all.

Next week, I'll be back to work. Right now, that means Telemedicine. We cannot risk spreading the virus to the vulnerable who can get very sick and end up hospitalized, intubated, etc. So the "stay at home" advice is truly to combat an invisible enemy... to protect those in our community most susceptible to falling severely ill... to prevent overwhelming the hospitals and medical staff in our communities. It may sound redundant and over stated... but truly... please stay home!

So what to do during this time? Many creative ideas out there on the internet on how to not be bored... but keep in mind these main things to stay healthy:

Eat well - with all the extra time and easy access to the kitchen, may be challenging to avoid binge eating, snacking, grazing... may be tempted to fill up on sugars, chips, carbs... so don't forget your fruit and vegetables
Exercise - try to get outside for fresh air and exercise daily... make it part of your routine
Relax- important to find your own space and have some "alone" time... if necessary may need to do this outdoors but it is important to have a moment in your day to evoke the relaxation response
Sleep - perhaps this is the most important of them all... but get your sleep! sleep will boost your immune system, improve your mood and energy, sharpen your mind and focus... cannot emphasize enough the importance of sleep... below are some tips I posted a while back on some tips to improve sleep:

routine routine routine...

develop a bedtime routine about 1 hour before bedtime to wind down

induce physical relaxation

take a hot shower or soak in a warm bath to relax the muscles

give yourself a body rub with a moisturizer that has a pleasing but not super strong scent

can try lavendar scented candle, room spray or essential oil

avoid increasing stress right before bed

avoid the news right before bed

avoid hard conversations

write down your worries and put it in a box if need be to address in the morning

shut down all electronics at least 30min but the longer the better before bedtime

minimize sound

use white noise if needed

try ear plugs

go to bed and fall asleep before the person snores next to you

exposure to light

flood yourself with natural sunlight during the day

avoid blue light at night (computers, cell phones, ipads etc)

if need to use night light, use red light

exercise

don't do it too close to bedtime

but regular exercise during the day helps

watch what you eat

certain foods actually may help (like cherries, milk, bananas, turkey, and even not too sugary carbs)

avoid foods that cause heartburn (like burgers and tomato based foods or spicy foods)

avoid foods that are high in sugar

watch what you drink

avoid caffeine of any type past 4pm

avoid alcohol too close to bedtime (less than 2-3 hrs prior) as this may initiate sleep but disrupts the maintenance of sleep

avoid too many drinks of any type past dinner as this may cause the need to go to the bathroom during the night

in small quantities certain herbal teas may help

minimize disruptions

avoid sleeping with a pet

sleeping with small children can also be disruptive

so what to do if you just can't get the worries out of your head?

try thinking of a story or play a movie in your head that would not evoke a strong emotional response, that way while you are thinking of that, other thoughts have a harder time creeping in and it is much easier to fall asleep when imagining things that have no emotional tug than dwelling on worries, things that happened during the day, or things that you plan to do in the future...

what NOT to do if you wake up in the middle of the night...

look at the clock (cause then you're doing math and that wakes up a part of the brain that otherwise would not be activated at this time...)
get up and go to the bathroom (I know this one can be hard and may not be possible for everyone, but truly if you get up you are now using muscles and again that wakes up another part of the brain that normally is not active at this time

Well, stay healthy and well, everyone. If you start to feel sick, develop a fever and cough, or just need to get checked, do reach out to your physician. Despite everything, lots of encouraging stories out there as well. We can get through this!

...rejoicing in hope, persevering in tribulation, devoted to prayer - Romans 12:12 (NASB)

Corona Virus Update

noreply@blogger.com (ellhwang) — Wed, 04 Mar 2020 02:37:00 +0000

So here is my update to my previous post about the new corona virus that started in China...

Credit: NIAID-RML

What is COVID-19?

That is the new name given to the new strain of corona virus that was first discovered in Wuhan, China.

What are the symptoms of COVID-19?

most common symptoms

fever
fatigue
dry cough

other symptoms

aches and pains
nasal congestion
runny nose
sore throat
diarrhea

Is it serious?

usually starts with mild symptoms and 80% of folks who are infected will recover like getting the flu or bad cold
1 out of 6 folks may get very sick and develop difficulty breathing (usually folks who already have chronic conditions and weakened immune systems)
2% of those infected have died so far

How widespread is it? click here for latest map and update from NY Times

at least 71 countries are affected so far
116 cases in the US with 9 deaths so far

How do I catch it?

from droplets of someone who is infected expelled on cough or exhale

if you touch a surface that has the droplets on it
if you breathe in the droplets after someone coughs or exhales

no studies yet suggest that you can catch it just from the air
very low risk of catching it from someone who is not sick

however symptoms are mild in the beginning and person may not know they are infected until their symptoms are more severe

symptoms may not show up until up to 14 days after exposure

How can I prevent getting it?

regularly and thoroughly wash your hands with soap and water
maintain at least 3 feet distance between yourself and anyone who is coughing or sneezing
avoid touching your eyes, nose, mouth
make sure you and the people around you follow good respiratory hygiene

cover your cough/sneeze with bent elbow
throw away used tissues immediately

stay home if you feel unwell
call your doctor if you have fever, cough, difficulty breathing
follow instructions from local health authority

** these are great guidelines everyday anyway and should be practiced ALL the time to prevent the common cold, flu, pneumonia, sinusitis, and GI bugs, etc!

Who benefits from wearing a face mask?

those who have symptoms have COVID-19
those caring for folks who have symptoms of COVID-19
health care workers caring for individuals with fever and cough

**if you do not have symptoms or caring for anyone with symptoms, it is not recommended to wear a mask

For more detailed explanations and Q&A's on this topic you can read it here on the WHO website.

So what is the bottom line?

do not panic
stay up to date on the latest recommendations from reputable sources
use common sense
there is a growing list of countries that have travel restrictions... but stay up to date and consider whether non-essential travel is worth the risk, click here to check the cdc website for travel advice for your destination (remember - this may change in a day)
if you get sick and are not sure what to do, call your doctor

New Corona Virus Affecting Chinese New Year Celebrations

noreply@blogger.com (ellhwang) — Sat, 25 Jan 2020 13:13:00 +0000

Today is Chinese New Year! It is the year of the Rat. In many parts of Asia, Chinese New Year celebrations (also known as Spring Festival) is observed for about two weeks. For more interesting facts about this holiday, you can read it here.

Some of you may know that large-scale festivities have been cancelled in China due to trying to contain the outbreak of a new coronavirus. In addition, the country is restricting travel during this busiest travel time of year. So this is a pretty big deal. So far, there have been 41 deaths and about 1,300 confirmed cases in China. There are only 2 confirmed cases in the US.

I feel for the overwhelmed healthcare workers trying to contain and treat. Many are unable to go home to their families to celebrate this holiday. Here is a photo from an Insider article showing medical staff in a Wuhan hospital holding up Chinese New Year signs.

So what is it?

Coronaviruses are a large family of viruses that can cause respiratory illnesses like the common cold. Usually the symptoms are mild or moderate but can spread to cause pneumonia and bronchitis. MERS-CoV and SARS-CoV were two types of coronaviruses that caused more severe symptoms. Now we have this 2019-nCoV that is also causing more severe symptoms.

How do you get it?

from the air (infected person coughs or sneezes)
from personal contact (touching or shaking hands with infected person)
from objects or surfaces (then touching your eyes, nose, mouth before washing your hands

What are the symptoms?

fever
cough
shortness of breath
no runny nose, sneezing, sore throat, diarrhea (specifically in this 2019-nCoV)
symptoms may not appear until up to 14 days after exposure

How do you treat it?

rest (sleep is your best weapon)
fluids
humidified air
medicines to control symptoms (tylenol, motrin, cough medicine, inhalers if needed etc.)
there is no specific anti-viral treatment
call your doctor if not improving or if worried

How to prevent it?

wash hands often for at least 20 seconds with soap and water or alcohol based hand sanitizer
avoid touching eyes, nose, mouth with unwashed hands
avoid close contact with people who are sick
stay home if you are sick
cover cough or sneeze with tissue then throw out tissue
clean and disinfect frequently touched objects and surface

Many of these treatments and preventions apply to all viruses that can cause respiratory illnesses. However, if you have recently travelled to China within two weeks of symptoms, you must let your doctor know.

Happy Birthday, Joe!

noreply@blogger.com (ellhwang) — Wed, 15 Jan 2020 16:23:00 +0000

2020 didn’t start off so smoothly for me. My youngest stepped on my iphone which resulted in me not having access to my phone for a while. Nothing like experiencing what it is like to be without to realize how much I depend on this little device. Sad to say, I truly felt lost and disoriented. When a trip to the nearest Apple store that night could not fix the problem... (because it turns out it is not just the screen that cracked but whatever it is underneath)… my very capable husband ordered a part from Amazon and decided to attempt the fix himself. Glad to say it worked. This here was his crazy work station!

So this post is dedicated as a “shout out” to my handyman husband! It is his birthday today. All last week, he was on a business trip. Whenever Joe is away (which unfortunately is a fair amount) …often the words out of my mouth are “wait for daddy to fix it”!

Now whether it is replacing an entire kitchen faucet because the old one was leaking and dripping… or helping our oldest fix her digital radio clock because the time was wrong (…and I didn’t have the skill or patience to figure it out) …my husband gets to use his mechanical engineering degree from MIT for these practical daily issues.

On top of it all... aside from "fixing things" around the house, Joe uses his tinkering skills to transform broken lightsaber toys into wall lamps. Can you tell that he is an avid Star Wars fan?

So happy 2020, everyone! Hope your year has started off better than mine.