Meghan Rabbitt

<ul><li> You dont achieve greatness overnightand the same goes for scoring rock-solid immunity. Strengthening your bodys defenses requires consistent effort. So take a seat and lets study your new stay-healthy playbook.  </li></ul>

<p>Like most of us, Im doing my damnedest to stay healthy right now. Im <a href="https://www.womenshealthmag.com/health/a31481769/social-distancing-coronavirus/" id="584398fd-a8a5-382c-a3d9-d857d2b7f3f3">  social distancing </a> and <a href="https://www.womenshealthmag.com/health/a31230341/how-long-should-you-wash-hands/" id="78b5807e-2f7c-367e-a964-cca61d8194d7">  washing my hands </a> almost obsessively. Im trying to eat as many vegetables as possible to ensure I'm getting health-supporting nutrients that I'm not exactly taking in via all the stress baking.</p>

<p>Its also not surprising that Ive been bombarded with news over the past few months about how to bolster my immune system. I cant scroll through my Instagram feed without seeing some influencer bragging about an immune-boosting smoothie or a supplement company promoting pills with <a href="https://www.womenshealthmag.com/health/a32133394/what-is-elderberry/" id="aca9568a-e1a5-3ab9-a226-72acedc99a49">  elderberry </a> and citrus.</p>

<p>Time-out, though. Immunity has a PR problem right now. The whole idea that you can power up your immunity in some quick-and-dirty way overnight (and, you know, avoid a <a href="https://www.womenshealthmag.com/health/a31198534/coronavirus-symptoms-vs-cold-flu/" id="96dc5f0a-dbc7-3f96-a821-325ec7cb7e74">  cold or flu </a> ...or <a href="https://www.womenshealthmag.com/health/a31339493/coronavirus-symptoms/" id="b6cef1de-a58c-345c-a00d-6320c6821671">  COVID-19 </a> ) isn't actually how it works.</p>

<p>Think of immunity like this: If youre the star quarterback of your life, your immune system is like that super-jacked lineman whose number-one job is to protect you from all directions. And, separately (but still in that sports realm!), just like how strategic leadership can whip a team into shape, you can train your system to more efficiently pick off any opponentbug, virus, germthat comes your way. But that conditioning takes time and dedication.</p>

<p>So, taking a last-minute, reactionary approach to immunity is the opposite of how you should think about it, says <a href="http://www.drnicoleavena.com/" id="4c810b23-c16e-3532-a753-86c591d2e824">  Nicole Avena, PhD </a> , visiting professor of health psychology at Princeton University. Immunity is a marathon, not a sprint. Because of that, there isnt any fast and easy way to immediately amplify yours. Youve got to take an all-in, holistic approach if youre going keep your immune system in fighting form, says Avena.</p>

<p>Recalibrating your immunity for the long game comes down to the classic health habits you hear time and time again:  <strong> sleep, stress reduction,  </strong> and  <strong> sweating it out </strong> . The key is doing all of these to at least some degree and not expecting one to be the ultimate cure-all. You wont make your immune system healthier in a week by pumping yourself with vitamins because someone close to you is sick, says  , director of the Institute for Immunology at the University of Pennsylvania. But you absolutely can help your immunity by making certain lifestyle changes. </p>

<h1>  In particular, you should focus on these clutch immunity-optimizing habits that all ladder up to those wellness pillars.  </h1>

<p><strong> Nail Your Sleep Routine </strong></p>

<p>Sleepspecifically getting at least seven hours most nightsmight be the Most Important Thing. The best data we have about how to improve immunity is on getting the right amount of good sleep, says Wherry. People who got six hours of shut-eye a night or less for one week were about four times more likely to catch a cold when exposed to a virus compared to those who got more than seven hours, according to a study published in the journal Sleep. (The risk of getting sick was even higher for those who snoozed less than five hours a night.) </p>

<p>Everything you do when youre awakeeating, digesting, working, walking, exercisingprompts your body to release inflammatory cells, says <a href="https://www.uclahealth.org/rita-kachru" id="0373ab77-c670-3b56-a15a-f8eb7072988a">  Rita Kachru, MD </a> , section chief of the clinical immunology and allergy division and assistant professor at the David Geffen School of Medicine at UCLA. Sleep gives your body a break from all of that. Dont get hung up on one crappy night of Zs (or give yourself too much praise for one amazing one, for that matter); focusing on long-term, consistent good sleep habits is the way to go. Your building blocks, right here.</p>

<h1>  If my sleep schedule gets off track, I recommit to consistent wake-up and bedtimeseven on weekends.   </h1>

<p>Mara de la Paz Fernndez, PhD, a sleep researcher and assistant professor of neuroscience and behavior at Barnard College of Columbia University</p>

<h1>  I try to go outside every morning at the same time for 30 minutes or so. Morning light provides the most benefit in terms of avoiding circadian rhythm disruption. If I cant do thator on cloudy daysI put four lamps around my favorite chair and sit in the light for up to an hour.   </h1>

<p>Mariana Figueiro, PhD, director of the Lighting Research Center and a professor of architecture at Rensselaer Polytechnic Institute</p>

<h1>  I make sure to have magnesium-rich foodslike spinach, beans, or nutsin my dinner. Magnesium helps the body and brain relax, which also helps your sleep feel more rejuvenating.   </h1>

<p>Mikka Knapp, a registered dietitian-nutritionist</p>

<h1>  I make sure the temperature in my bedroom is about 65 degrees, which may seem a little cool but is associated with falling asleep faster and sleeping better throughout the night.   </h1>

<p>Rebecca Robbins, PhD, a sleep researcher and co-author of Sleep for Success!</p>

<h1>  Ive learned to improve my sleep hygiene, but Ive also learned that my sleep will be what it will be, and trying to strive for sleep perfection is more exhausting than rolling with the flow of sleep troubles.   </h1>

<p>Megan Roche, MD, epidemiology researcher and Strava running coach</p>

<p>Its well established that stress prompts the release of cortisol, that fight-or-flight hormone that enables you to run for your life. When cortisol is high, your immune system isnt as active, says  , PhD, professor of immunology at the University of Manchester in England; your body sends all of its resources to the thing it thinks is most likely to kill you, and away from other stuff, like your protective network.</p>

<p>Dont stress? Ill just give up now, youre thinking. Stay calm and try this: Instead of attempting to eliminate negativity, refine the way you cope (with the genius advice ahead!)which will make the blues more manageable and mitigate that cortisol response, Davis says. </p>

<h1>  I am a huge believer in the power of gratitude. Its not woo-woo or weirdit works and we have the science to back it up. I start and finish my days by identifying three specific things that I am grateful for.   </h1>

<h1>  When Im really stressed, I hyper-focus on todays goals: what I need to get done today, and a few things I want to get done. Just today. I shared this with a physician I work with and he laughed and said, 'Win the day.' I love how he rephrased what I do, and that's my new mantra.   </h1>

<p>Kevin Gilliland, PsyD, a clinical psychologist and executive director of  <a href="https://i360dallas.com/" id="0e511e26-4df6-372b-a166-f3bfba89cef2">  Innovation360 </a></p>

<h1>  Confess any secrets youre keeping! I know it sounds silly, but research has shown that keeping secrets can prompt you to release more of the stress hormone cortisol, which puts you in a stress state that weakens your immune system. Call your best friend or a therapist and take the weight off your shoulders.   </h1>

<p>Patricia Celan, MD, a psychiatry resident at Dalhousie University in Canada</p>

<h1>  One of the most useful things I do to keep stress in check is to stay in the present moment as much as possible. When I find myself worrying about the future and go down a dark rabbit hole of all the terrible things that can go wronglike    w   hat if someone I love gets sick?   I name whats true right now:    In this moment, my family and friends are healthy   . Its a simple way to take control of my thoughts rather than allowing my thoughts to send me into a stress tailspin.   </h1>

<p>Beatrice Tauber Prior, PsyD, a clinical psychologist </p>

<p>Working out creates inflammation in the body, but its the good kind, says Wherry. Its a little counterintuitive, because exercise actually disrupts your bodys homeostasis, he says. But when your sweat sesh is finished, your bod goes back to its status quokeeping your immunity on its toes in that brilliant way, he says. Research backs this up: Folks who exercise regularly develop more T cells (those destroyer white blood cells) than their sedentary peers, a recent study found. It also helps modulate the stress hormone cortisol, which, when raised, leads to inflammatory activity. </p>

<p>Some experts agree that overtraining (you know, that feeling when youve been pushing yourself too hard and youre feeling it) can hinder immunity. So if youre an everyday athlete, moderate exercise on a consistent basis is the end zone to aim for.</p>

<h1>  I am a runner, and when I start to feel like Im out of my regular exercise routine, I sign up for a race. It gives me a goal to strive for so I stay on track with my training.   </h1>

<p>Jennifer Haythe, MD, a critical care cardiologist at Columbia University Medical Center</p>

<h1>  I am to get 20 to 30 minutes of movement every day. Consistent, moderate exercise allows your body to recover and build immunity quicker than over-exercising or not exercising at all.   </h1>

<p>Lisa Ballehr, DO, an osteopathic physician and Institute for Functional Medicine certified practitioner</p>

<h1>  I use a fitness band to track my sleep and heart rate and based on this, I modify my activity accordingly. For example, if I'm very well rested one night, I'll push myself harder when I exercise the next day. If I haven't slept well, I'll do a low-impact workout and focus more on mindfulness the following day. Using a fitness tracker keeps me accountable when it comes to sticking to healthy lifestyle habits that I know will help my immune system.   </h1>

<p>Ian Braithwaite, MD, an emergency physician at The Royal London Hospital</p>

<h1>  I try my best to still move on the days I dont feel like it. But I also dont try to push my body to the limit if Im not up for it, because I know thatll just deplete my immune system.   </h1>

<p>Kym Niles, certified personal trainer</p>

<h1>  I am to go for a moderately paced walk for 30 to 60 minutes every day. This is the most basic and beneficial immune-boosting exercise that anyone can do.   </h1>

<p>Kristen Gasnick, board-certified physical therapist</p>

<h1>  Rather than sitting at my desk for long periods of time, I set my alarm to move every hour. Sometimes, that movement will be a 30-minute run. Other times, it will be a quick series of yoga poses or a few basic stretches.   </h1>

<p>Jenn Randazzo, registered dietitian </p>

15 Habits To Truly Optimize Your Immunity

<p/>

15 Health Habits That Actually Optimize Your Immunity

<p>Kerri Masutto smiles and then leans down to give her dog a treat. Ive had the bone in my lap just in case he started barking, she tells me.</p>

<p>Im thisclose to asking her to point her computer screen toward her pup so Rocco can join our Zoom call (what can I say? I love dogs), but before I have a chance to ask, Masutto finishes her thought. So, I would definitely recommend a baseline dose of vitamin D every day until you have blood work done to see exactly where your level is at.</p>

<p>In some ways, it feels like Masutto and I are having the kind of Zoom catchup I have with friends and co-workers all the time right now. Except this virtual check-in is actually a check-up: Dr. Kerri Masutto, MD, is an internal medicine primary care physician with <a href="https://www.parsleyhealth.com/" id="8cb05cc1-002c-3e55-aadd-4b4d26293548">  Parsley Health </a> , a medical practice that offers both in-person visits and virtual appointments over video chatlike the one were having now.</p>

<p>If it seems like everyone is embracing telehealth more than ever before, its because we are. The Cleveland Clinic logged more than 60,000 telemedicine visits in March 2020, compared to the 3,400 virtual visits they typically average. Meanwhile, health-tech companies like Teladoc, Doctor On Demand, and Amwell have all reported increases of about 50 percent more virtual doc visits now than before the novel coronavirus outbreak. And Parsley Health told me they had a 70 percent boost in business from January to March 2020 compared to the same time period in 2019.</p>

<p>Curious about the trend, I scheduled a checkup with Dr. Masutto to find out for myself what telemed is all about. Heres what I learned about how to get the most out of a virtual doc visit.</p>

<h1>  1. Use the online paperwork to flag immediate problemsand give the doc a big-picture POV of your health.   </h1>

<p>I spent 15 minutes clicking through Parsleys health goals and symptom tracker questionnaires before my appointment. Annoying? A little. But no more so than the old-school clipboard of paperwork a receptionist might hand youand definitely less germ-y than the iPads higher-tech offices use, which who-knows-how-many hands have touched (and who knows how well theyve been disinfected). </p>

<p>Rather than speed-clicking my way through these questions, I settled in and really thought about themeven putting in questions about stuff Ive wondered about for a while, like why my PMS seems to be getting worse as I get older and <a href="https://www.womenshealthmag.com/health/a19891601/vitamin-d-supplements/" id="2774f5db-0b5a-3673-ad6e-92765a5c78e0">  if I need a vitamin D supplement </a> .</p>

<p>Dr. Masutto gives me kudos for this strategy.  <strong> Even if the reason you scheduled the appointment was to talk about something specificlike a cough or a <span id="673485f9-8dff-3b85-a20d-35421f94eab8" itemtype="link" itemscope="itemscope">  UTI </span> bringing up other concerns you have can help give your doctor a bigger picture of your overall health, </strong> she tells me. And those intake forms are a great way to jog your memory, so you remember to mention that other stuff during your appointment. </p>

<h1>  2. Check security protocolsand that this doc can legally examine you virtuallybefore your appointment.  </h1>

<p>Dr. Masutto is already in our Zoom meeting room on Parsleys private portal when I log in, and after a quick hello she asks to see my drivers license to confirm I am who I say I am. She also asks me what city and state Im currently in. This isnt just get-to-know-you chit chat:  <strong> Telemedicine law requires that you physically be in a state in which your doctor is licensed to practice for your first appointment.  </strong> (In fact, some states require you to see a doc in person for your first visit, and then you can do virtual follow-up appointments.) </p>

<p>After that initial visit, your doc can treat you no matter where you are, though she may not be able to prescribe medication at a pharmacy thats not in a state in which shes licensed to practice.</p>

<p>Now that were in the middle of a global pandemic and more patients need to be seen virtually than ever before, many of these telemedicine laws are changing, says Dr. Robert Segal, MD, a New York City-based cardiologist at Medical Offices of Manhattan, which offers telehealth appointments. </p>

<p>When you call to schedule your appointment, make sure the doctors office youre working with knows where you live and can assure you that your physician will be able to treat you and prescribe medications if necessary.</p>

<p>Also important: Confirm the platform youre using for your virtual appointment is HIPAA-compliant, which includes a host of security requirements to ensure your privacy and safety. The doctors office should really be doing their due diligence to make sure what theyre providing to patients is secure, but it doesnt hurt to ask, says Dr. Segal.</p>

<p>This feels a little over-the-top when I first hear it. After all, the kind of run-of-the-mill health woes Ill talk about with Dr. Masutto dont need supreme secrecy. Then I read <a href="https://www.ibm.com/security/data-breach" id="a8d1f4f7-be51-341d-a5fe-1d13dc76c5bf">  this study </a> , which found that cyber attacks against healthcare providers are on the rise. (In fact, medical identity theft has become a big thing, with security experts estimating your medical information is worth about 10 times more than your credit card number on the black market.) So, I go ahead and confirm with Dr. Masutto that were in a Zoom room that cant be hacked.</p>

<h1>  3. Have a backup plan in place in the event of tech failures.  </h1>

<p>With the basics behind us, Dr. Masutto asks me why Ive scheduled todays appointmentand just as I launch into whats up for me, her face freezes and I get a Your internet bandwidth is poor message in the middle of my laptop screen. Im instantly annoyed and wonder how much time well waste trying to figure out a solution. Then, Dr. Masutto calls my cell and we mute the sound on our video so we can still see each other and keep the appointment on track if internet issues freeze us again. </p>

<p>You definitely want to work with a telemedicine company that doesnt rely on communication through just one portal, because technical difficulties are bound to happenespecially right now, when everyone is using the internet more than usual, she says. </p>

<p><strong> When you book your appointment, ask what the protocol is if you have a connection issue </strong>  and make sure theres a HIPAA-compliant backup in place. You can also ask your doctor at the beginning of your appointment what you should do if the internet gets wonky and you get cut off, says Dr. Masutto. </p>

<h1>  4. Think of your first appointment as an interview for a doc wholl work for you.  </h1>

<p>If youre seeing a new doctor virtually right now because youve got a pressing health concern, use the appointment to handle thatand to gauge if you like the physician, says Dr. Renee Dua, MD, chief medical officer of telemedicine company <a href="https://heal.com/" id="eec5c6c2-38e4-3d53-a0ce-1d4679979ff9">  Heal </a> . Finding a doctor who feels like the right fit is more important than many people think, she says. <strong> You want to find someone you can build a relationship withsomeone you can talk to about your deepest, darkest concerns.  </strong></p>

<p>Dr. Masutto agrees. With telemed, its so much easier to try different doctors because you dont have to carve out half a day to go into an office to meet someone, she says. In fact, Dr. Masutto tells me to think of our first appointment a little like a first date: In the back of my mind, I should be thinking about what Im looking for in a doctor, if I like the person's communication style, and if the vibe between us feels good. </p>

<p>You could even ask your doctor things like, Why did you go into medicine? Or, What do you specialize in?" says Dr. Masutto. "I think a great doctor might also say to you, You know, I have a colleague whod be a better fit for you because she specializes in autoimmune disease. You want someone whos more concerned about being the right doctor for you versus just taking you on as a patient. </p>

<p><strong> If youre seeing your go-to physician, your virtual appointment may feel a little strange at firstbut try to keep an open mind </strong> , says Dr. Masutto. The first few minutes your appointment may feel really different than usual, she says. But theres a good chance youll adjust quickly and notice that your doctor can still cover almost everything shed do at an in-person appointment. </p>

<h1>  5. Get real with the doc about everything thats going on for you, not just your most pressing symptoms.  </h1>

<p>Telemed appointments tend to be a little longer than in-person visits (anywhere from 20 minutes for something acute to an hour for an annual appointment), which means you canand shoulduse the entire time youre allotted and bring up all the things youre worried about, says Dr. Dua.</p>

<p>It isnt just important for me to figure out if you have <a href="https://www.womenshealthmag.com/health/a31284395/how-long-does-coronavirus-last/" id="2a91f3fc-991a-34b0-aafa-7e8e5f5bf612">  COVID-19 symptoms </a> , for example, or something like a sinus infection or UTI, she says. <strong> I also want to know if youre mentally struggling right now, or if your baby is overdue for a checkup or vaccination and youre freaking out. </strong> You might not think these secondary concerns are important, but theyll help your doctor come up with a plan thatll help you take care of you and your familyand put your mind at ease.</p>

<p>The bonus of bringing up this seemingly non-urgent stuff is that it can also help you build rapport with your doctor, says Dr. Masutto. In an ideal world, youd have an established relationship with a doctor who does telemed before a time of crisis, so you can quickly get the advice and support you need when youre already in a stressed situation, she says. But you can still develop that relationship now, even if it has to be on Zoom.</p>

<h1>  6. Be prepared for a virtual physical exam.  </h1>

<p>During my appointment, Dr. Masutto asks me to get a little closer to my computer screen and run my fingers down my neck, from my jawline to my clavicle bones. She asks if I feel any lumps, and tells me shed actually be able to see if my lymph nodes were swollen. </p>

<p>If I had a sore throat, she says she might ask me to turn on the flashlight on my phone and shine it into my mouth so she could see my tonsils. As for a concerning skin rash or bug bite? She could take a look at that in real-time, too, though she also shares a tip:  <strong> For anything physical that can show up on a photo, take a few shots from a few different angles in good, natural light and send those through the doctors secure messaging system before your appointment.  </strong></p>

<p>Just remember that while we can do the vast majority of an exam via telemed, there will be times when a doctor might say, Im sorry, I think you need to be seen by a doctor in person,'" says Dr. Masutto. "You want to trust that your telemed doctor will let you know that if its necessary.</p>

<p>If the doctor you see in person is different, ask them to send your visit notes to your telemed doc. If I send my patient to an urgent care doctor, I like to see the visit notes so I can help my patient explain what he or she found and make sure it fits in our overall plan, Dr. Masutto says.</p>

<h1>  7. Ask your doc to send you her notes after your appointment.  </h1>

<p>As my appointment with Dr. Masutto winds down, Im blown away by how much ground weve covered. Ive been taking notes as she fired off lifestyle and supplement suggestions for me, and its almost as if she can tell Im craving a re-cap when she says, Youll get a message with my notes on everything we discussed, and Ill recommend the exact supplements I like to make life easier for you. </p>

<p><strong> While most telehealth platforms will share notes automatically, feel free to ask for them </strong> , says Dr. Dua. Just be sure you get them through the doctors private portalnot via e-mail. You want to make sure the telemed office is being careful with patient information, which means receiving notes in a HIPAA-compliant way, says Dr. Dua.</p>

How To Get The Most Out Of Telemed Appointments

Rocco! Here, Rocco! Shhh!

The Doctor Will Zoom You Now: ‘What I Learned During My First Telemedicine Session’

<p>"Put your mask in this after you take it off so you can reuse it," she tells me. </p>

<p>Its 8 a.m. and were <a href="https://www.womenshealthmag.com/health/a31481769/social-distancing-coronavirus/" id="62769229-7f56-3c12-ac4c-ebaed8f4635d">  standing 6 feet away from each other </a> in the parking lot of Alfalfas supermarket in Louisville, Colorado, suiting up as if were about to see patients. Except were about to go grocery shopping.</p>

<p>Dr. Taylor-Pilarski is a family medicine doctor with Kaiser Permanente Colorado, and shes got the day off. These days, shes <a href="https://www.womenshealthmag.com/health/a31705728/doctors-appointments-coronavirus-pandemic/" id="9b5ed4b6-9435-3ff4-af66-a938ce686491">  "seeing" patients via telemedicine </a> and shes also on the front lines of the battle against the novel coronavirus, testing patients with symptoms and working shifts at the hospital. "Some of my colleagues have underlying conditions that would make taking care of people with COVID-19 more dangerous for them," says Dr. Taylor-Pilarski, "so Ive volunteered to take care of patients with symptoms."</p>

<p>Thats why the doctor wears a maskand why she gives me one, too. "Im interacting with patients so I need to be extra careful," she says. She reminds that the average person, who isnt a health-care worker and isnt sick, <a href="https://www.womenshealthmag.com/health/a31229708/how-to-prepare-for-coronavirus/" id="4486b9da-abad-39d4-a40c-7a1c8cfb249a">  doesnt need to wear a mask </a> and definitely shouldnt hoard them, because we are in a serious shortage of supplies right now.</p>

<p>Until the novel coronavirus outbreak, food shopping was a mundane task that I could do mindlessly, not thinking twice about it as I'd perused the aisles in my local store. Now, every seemingly trivial outing has become an opportunity to pick up (or even spread!) the virus. "Keeping distance is important," Dr. Taylor-Pilarski notes, "because we know that <a href="https://www.womenshealthmag.com/health/a31646078/coronavirus-infect-people-without-symptoms/" id="f0bc605b-2816-3252-a3c2-86e7bdace1ec">  people can carry the virus even if they have no symptoms </a> ."</p>

<p>Not to mention, there is still a lot of unknown about how long the virus that causes the COVID-19 illness <a href="https://www.womenshealthmag.com/health/a31674258/is-coronavirus-airborne/" id="9b4779f6-3b5e-361e-a1df-1bb3a16ddddd">  can survive on surfaces </a> ranging from plastic to paper to fabricall materials involved in food packaging and/or hauling. One recent study in the <a href="https://www.nejm.org/doi/full/10.1056/NEJMc2004973" id="840a4cd2-caed-3a4b-a1a7-363be2786a35">  New England Journal of Medicine </a> found that the virus that causes COVID-19 was detectable for up to two to three days on plastic and stainless steel and up to 24 hours on cardboard, and less is known about how this virus interacts with fabric. Whew. A lot to think about.</p>

<p>So, there we arearmed with disinfectant wipes as we walk toward the front entrance. "I know it may seem over the top to some people, but my theory is that its better to take too many precautions than too few," Dr. Taylor-Pilarski says. "You dont want to risk you or your family getting sick if you can prevent it."</p>

<h1> The day before we pow-wow in the store parking lot, I get an e-mail from Dr. Taylor-Pilarski with her plan of attack.  </h1>

<p>In her note, she suggests I make a list of what I need for the upcoming week on a piece of papernot my iPhone, as I usually dobecause Ill be leaving my phone in my car. "You want to minimize the number of times you have to leave the house, which is why getting what you need for at least a week is smart," she says. </p>

<p>She also makes sure I plan to travel light: "The less you take into the store with you, the better," says Dr. Taylor-Pilarski, who also suggests I plan on putting my license and credit card in my jacket pocket rather than taking my purse into the store to minimize the number of things you bring into the store with you. (The more you carry, the more surfaces that have the potential to get contaminated with the new coronavirus, given that we're just not totally sure what the virus can and can't live on.)</p>

<p>We decide to meet an hour after Alfalfas opens. "Earlier is better, because thats when stores tend to be cleanestand least crowded, which makes it easier to stay 6 feet apart from others," she says.</p>

<p>She instructs me to bring a mask, disposable gloves, and disinfectant wipes or hand sanitizer. I have disposable gloves stashed in the back of my medicine cabinet and grab a pair, and I also have wipes and a travel-size antibacterial spray in my car. But I dont have a mask.</p>

<p>Shell bring me one from her stash, she says. (She's a doctor, so it's not out of the ordinary for her to have some basic masks at home.) When I ask her what people who dont have access to any of these things should do, she tells me wipes or hand sanitizer is most important. "I know everyone is low on these, but many stores still have wipes for you to useespecially in the morning, before they run out," she says.</p>

How To Go To The Store Safely During COVID-19

<p>Next up: I have to plan my outfit. (I know, I rolled my eyes when I first read this in her note, too.) But Dr. Taylor-Pilarski explains that I should wear something I can toss in a high-heat wash after I get home. It's worth noting that changing out of your clothes immediately after an outing is another extreme precaution that there is little evidence for, but it's something Dr. Taylor-Pilarski (and many <a href="https://www.womenshealthmag.com/health/a31476482/novel-coronavirus-er-nurse-ucla-health/" id="615a21a6-338a-35f7-af94-c4f2add599c4">  other medical pros </a> ) does to be extra careful, so I'm following her lead for the purpose of this story.</p>

<p>She also asks me if I have canvas bags to use rather than the coated plastic reusable totes I keep stashed in my car. Given that the new coronavirus may be able to <a href="https://www.nejm.org/doi/full/10.1056/NEJMc2004973" id="92154848-2b07-3f01-ad5a-5b3185af1b97">  live on plastic longer </a> , <a href="https://www.colorado.edu/mcdb/coronavirus-information/professor-sara-sawyers-decon-station-instructions" id="a67fa400-323e-3e6d-ae26-2ea0cec4c505">  paper seems to be better </a> . "Canvas that you can toss into that high heat wash with your clothes when you get home is best," she adds.</p>

<p>"Also, dont wear any jewelry or a watch, which the virus can land on and make it more difficult to keep your hands clean," says Dr. Taylor-Pilarski. Another who-woulda-thought tip she offers? "Pull your hair back into a ponytail or bun because if your hair is down, youll be more likely to touch your face."</p>

<p>Lastly, she says not to forget to leave a clean pair of clothes and some disinfectant wipes next to my front dooror better yet, the garage entry (if you have one)to minimize the chance of bringing germs into the house.</p>

<p>A trip to the grocery store has never felt so involvedand annoying. But these strange times call for what may seem like strange measures. </p>

<h1>  When we arrive at the store, we park far away from the entrance.  </h1>

<p>We need to for a reason: Itll give us the best shot at staying at least 6 feet away from other shoppers. We are in <a href="https://www.womenshealthmag.com/health/a31646078/coronavirus-infect-people-without-symptoms/" id="a2d710e4-0ac3-3c14-ab8f-cbe16357841e">  full-on social distancing mode </a> , and Dr. Taylor-Pilarski is especially focused on this when she notices a woman in her 60s or 70s walking out as were about to walk in.</p>

<p>"Lets give her a little more space," she says to me, and I realize the mindless way I usually zoom through the grocery store isnt going to cut it now.</p>

<p>We grab carts and, because were wearing gloves, we dont wipe down our handles with the wipes the store has provided. "Lets save the wipes for shoppers who dont have gloves," says Dr. Taylor-Pilarski. "And remember, dont touch your face."</p>

<p>I trail her as she shops, peppering her with questions along the way. "Why are you grabbing produce from all the way in the back?" I ask. She points out, "Lower odds that other shoppers have touched it."</p>

<p>Dr. Taylor-Pilarski scans the store, waiting to walk down one aisle if she sees another shopper walking toward her. Were in the baking goods aisle ("I dont know about you, but Im making a lot more cookies than usual," she says with a laugh) when a young guy approaches, obviously looking for a specific ingredient. Dr. Taylor-Pilarski stops, rather than attempt to maneuver past him, and he snatches the product hes here for and then steps away quickly. </p>

<p>"Did you notice how he did that?" she says. "That was great. I think most people are aware of the importance of keeping as much space as possible between us. But if you see someone getting a little too close, dont be afraid to speak up and say something like, 'Isnt it hard to stay at least 6 feet away from each other?' Its a nice reminder to everyone around you."</p>

<p>When were finished shopping, Dr. Taylor-Pilarski tells me that self-checkout is ideal. "Its the safest way to maintain social distancing and reduce your risk of exposure, as well as the risk of the employees at the storewho we should all be so grateful for right now," she says. </p>

<p>Alfalfas doesnt have self-checkout, so we keep a 6-foot distance from other shoppers in front of us as we wait to put our stuff on the conveyor belt. "If we werent wearing gloves, it would be a good idea to wipe down the credit card machine and any other area that you or your bag will touch with an antibacterial wipe," says Dr. Taylor-Pilarski. "Also, toss that paper grocery list in the garbage before you leave, and say no when asked if you want a receipt."</p>

<p>\"I realize the mindless way I usually zoom through the grocery store isnt going to cut it now.\"</p>

<p>We leave the store, walk to our cars, and remove our masks, remembering to touch only the outside of the mask. I put mine in my brown bag, which Ive left in the trunk of my car. As I go to open my back door to load my groceries on the seat like I usually do, Dr. Taylor-Pilarski stops me. "Its a good idea to treat one spot in your car as contaminated, and the trunk is great for that."</p>

<p>I wipe down the lever that opens my trunk with an antibacterial wipe after Ive closed it. Dr. Taylor-Pilarski says its wise to do that to any surface in your car that you mightve touched after handling the grocery bags without gloves on, like the car door handle or steering wheel. </p>

<p>"Id give you a hug but, well, I wont," she says as we walk back from the garbage can, where weve just tossed our disposable gloves. We get in our cars to drive home. </p>

<h1> Dr. Taylor-Pilarski has also given me simple instructions to follow when I get home. </h1>

<p>With my two bags of groceries, I first take off my shoes and leave them outside to minimize the chances of bringing germs into the house. Next, I change into the spare clothes I left on a chair near our entrance. </p>

<p>As Im doing this, it feels extremeand in fact, theres not a lot of research out there showing its necessary, as I mentioned. But then I think about what a small ask it is. Annoying? Sure. But it takes all of two minutes. And if it cuts my risk of traipsing with this virus in my house by even a fraction of a percentage, count me in.</p>

<p>I also unload everything on the tile floor in our foyer, add my canvas bags to my pile of possibly contaminated clothes, and bring them to the laundry room and start a load immediately, using hot water. Next, I bring my Alfalfas haul to the kitchen and put all of the produce in the sink to wash before storing in the fridge. I also wipe down cans and boxes with an antibacterial wipe.</p>

<p>Finally, I hit the front doorknobs (outside and in), as well as the kitchen counter, fridge handle, and sink handle with an antibacterial wipe as well, and wash my hands like Ive seen surgeons do on TV: working up a good lather, washing halfway up my forearms, and even getting under my fingernails. Im at the sink for a solid 20 seconds. </p>

<p>I remember Dr. Taylor-Pilarski saying that washing my hands like this is also important to do before preparing or eating food, even a few days from now. "And remember to do all of this before you give your husband or kids a hug when you get home," she says. </p>

<h1> While all of the steps may seem like overkill, the truth is, shopping like Dr. Taylor-Pilarski wasnt *that* hard.  </h1>

<p>Hey, that detailed adventure may inspire you to stay up until 2 a.m. to snag a grocery delivery time via Amazon or your local store. But if you leave the house and run errands safely and with proper planning, you can leave more availability open for delivery and curbside pickup services to high-risk groups like the <a href="https://www.womenshealthmag.com/health/a31473784/who-is-most-at-risk-coronavirus-immunocompromised/" id="d5226488-f238-34d8-a624-0e08eda3b59d">  elderly and immunocompromised </a> to take advantage of. (If you do use those services, take the same precautions when it comes to wearing gloves while handling cardboard and wiping down food cans and boxes and washing produce before putting it away. You'll also want to tip using a store app, if that's available, instead of with cash.)</p>

<p>Taking all of these steps keeps me and my household virus-free during a time when experts around the world are asking all of us to be more aware than ever before of contaminating ourselves and each other. And that feels like a small effort with a potentially huge payoff. </p>

I slip on disposable vinyl gloves and a surgical face mask, securing the elastic behind my ears. Susan Taylor-Pilarski, MD, does the same. Then, she hands me a gently used paper bag that once stored coffee beans.

'I Went Grocery Shopping With A Doctor To Learn How To Do It Safely During Novel Coronavirus'

<p>Nobody. Its why most PTSD treatment programs have a high dropout rate. Hell, its why a lot of those suffering from any kind of anxietywhether its a serious fear of flying or an obsessive-compulsive disorder (OCD) that keeps you from using public restroomsdont go to therapy at all. Many people with anxiety avoid therapy because avoidance is part of the problem, Rothbaum says. Its also why she and a handful of other practitioners are getting radical, shortening the course of therapy for conditions like PTSD, OCD, panic attacks, and certain phobiassometimes to three weeks, other times three hours. </p>

<p>Theyre practicing a new, more intense version of exposure therapy. Rather than scheduling weekly hour-long sessions to work on this, a therapist might spend three hours every day for three weeks incrementally increasing a patients exposure to their worst fear. A guy with a debilitating aversion to germs might eat from a shared tub of popcorn with no hand sanitizer in sight. Later that week, he might be asked to put his hands on the floor of a public bathroom without washing them afterward. This approach is short. Its intense. Adopters say its like HIIT for your emotions, and science is finding that it gets the job done. </p>

<p>It may be news to many therapists and anxious people, but condensed courses of treatment for anxiety have been around since the 70s, the brainchild of Swedish researcher Lars-Gran st. As a young psychologist, he noticed that his phobic patients didnt need the 10 to 12 sessions that were typical at the time; he was eliminating their phobias in just four or five. It wasnt a superpower that he alone had; other therapists could get these results if they were willing to revise their treatment.</p>

<p>Most patients come in for 50 minutes and make some progress, but when they come back the following week, they dont start their second session where they ended the firsttheir anxiety has ratcheted back up, says st, now a professor emeritus at Stockholm University. By using intense exposure therapycoaching a patient with a fear of elevators into an elevator, for example, or letting a spider crawl all over someone with arachnophobiahe was able to disprove his patients beliefs about what catastrophic thing would happen if they came in direct contact with whatever it was they fearedusually in two to three hours, but often in as little as an hour. </p>

<p>To prove its effectiveness, st conducted a randomized controlled trial comparing his method to standard cognitive behavioral therapy (CBT) and found that not only did his approach work as well, but 90 percent of his patients who were undergoing intense exposure therapy were either much improved or completely recovered after just one session. Thats the kind of time frame even the most overcommitted people can work with. </p>

<p>Practitioners seeking a better way to help their patients have launched programs based on this research. For instance, Rothbaums therapy for veterans with PTSD requires only two weeks of intense work. The short time commitment has helped lower the dropout rate to about 10 percent from its usual 25 to 50, she says. Thomas H. Ollendick, Ph.D., director of the Child Study Center at Virginia Tech, successfully treats kids with OCD in four days and those with specific phobias (like a fear of dogs or heights) in a single three-hour session.</p>

<h1> Nobody Calls HIIT for Anxiety Easy  </h1>

<p>In theory, any practitioner trained in CBT should be able to work intensively with people who have anxiety disorders. In reality, inertia and scheduling get in the way. Despite no evidence that one 50-minute therapy session each week is the best way to do psychotherapy, its the standard, says Ollendick. We are unsure how this standard evolved. Scheduling two or three hours at a time over the course of a few weeks is tough for most practitioners, although docs say patients overwhelmingly prefer it. </p>

<p>And the work itself is hard. The majority of therapists dont practice exposure therapy because its difficult logistically (how can you treat a fear of elevators if youre in a building without an elevator?), because it makes them feel uncomfortable (exposure therapy is challenging, for both the patient and the doc, says Ollendick), or simply because theyre used to the standard approach. A lot of therapists will talk to you about things unrelated to your anxiety, and while that may feel good, its probably not helping the symptoms youre dealing with, says Rothbaum. Then theres the money thing. Many insurance companies dont cover these intensive outpatient treatments, which can cost upwards of $2,500 a week, even if it would mean fewer hours of therapy than the traditional model. </p>

<p>Still, theres hope. At the forefront of intense exposure therapy are professors and researchers, teaching its methods to their students and publishing studies about the efficacy of this HIIT-style approachtwo important steps necessary for it to really spread. All the quick-results experts say, however, that CBT delivered in the traditional weekly format can still be very helpful for anxiety. In the end, we know that learning to feel less anxious about your anxiety is key, says clinical psychologist Jonathan Abramowitz, Ph.D., of Chapel Hill, North Carolina, no matter how you get there. But its important to note that it doesnt have to take a lifetime on a therapists couch to get that lesson.</p>

<h1> Warp Speed Anxiety Training: Is It Right for You? </h1>

<p>If all you hit all these criteria, you could be a good candidate for a condensed program of intensive therapy. </p>

<ul><li> <strong> Youve got OCD, panic disorder, or a specific phobia. </strong>  Theres no research yet, though, showing that these short, intense treatments work for generalized anxiety disorder. </li><li> <strong> Youre motivated to face your anxiety. </strong>  This approach works by incrementally increasing exposure to what you fear most, so you have to be committed to experiencing the thing that really freaks you out. Youve got to be all in, says Abramowitz. Otherwise youre going to spend a lot of time making yourself miserable, and in the long run its not going to help you. </li><li> <strong> Youre not psychotic and youre able to steer clear of booze and drugs. </strong>  This type of therapy is difficult and can bring up a lot of bad memories, says Rothbaum. We want to make sure patients feel safe when theyre doing this work, not on the brink of a breakdown. And we dont want you slipping into old coping habits and using substances to dampen the distress that will undoubtedly surface. </li></ul>

Barbara O. Rothbaum, Ph.D., has been working with people who have post-traumatic stress disorder, or PTSD, since 1986, not long after the condition became an official diagnosis back in 1980. As executive director of the Emory Healthcare Veterans Program and the Trauma and Anxiety Recovery Program at the Emory University School of Medicine, she has seen it allthe jumpy, sweaty, cant-breathe panic and near fainting that happen when the surf washes over someones waist and theyre sure theyll be s...

HIIT Therapy Is the Fastest Way to Take Down Anxiety

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Meghan Rabbitt

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