00:00:00:14 - 00:00:06:16 Dr. Winn I'm Dr. Rob Winn and you're listening to Real Cancer Talk from VCU Massey Comprehensive Cancer Center. 00:00:07:12 - 00:00:34:23 Dr. Sutton All right. Good afternoon everyone, and happy Friday. And welcome back to Facts and Faith Friday. I'm very happy to see everybody today. I'm going to be Rudene for the day. So, I am Arnethea Sutton, I'm one of the faculty here VCU and I work with Facts and Faith Fridays, and we are very excited for the session that we pulled together for you all today that will, we're here to address us ourselves holistically. 00:00:34:23 - 00:00:38:04 Dr. Sutton So we'll talk a little bit about our physical health and our mental health today. 00:00:38:04 - 00:00:54:13 Dr. Sutton we have two individuals that are with us who are not strangers to us. One will provide us some information, knowledge, contacts about for our physical health, the other for our mental. So the first speaker that we have is Doctor Elaine Perry. Like I said, she is no stranger to facts and faith. 00:00:54:15 - 00:01:22:03 Dr. Sutton She, is a board certified preventive medicine physician and she began serving as the health and health director for the Richmond and Henrico Health districts in 2022. And as such, she oversees all local health department activities in both localities. Before I turn it over to her, one of the things we try to do here at Facts and Faith is provide information that is, not only accessible and correct, but also that impacts everyone on the call. 00:01:22:03 - 00:01:45:09 Dr. Sutton And we know that everyone in the call is not in the Richmond or Henrico area. So if you could take a moment and put in the city or county that you live in, that your children go to, school in that you go to church in, because we would love to start to invite on more of Doctor Perry's colleagues across our catchment, so that maybe you can see your representative on these calls in the future. 00:01:45:11 - 00:02:04:16 Dr. Sutton But today we have Doctor Perry with us, and she is here to talk to us today. I know it was about two weeks ago, Doctor Perry, I started seeing, CNN and news articles about a virus. Even when I work in virology, I don't remember how many. We never. We very rarely got positives. But as a human metapneumovirus. 00:02:04:18 - 00:02:19:24 Dr. Sutton I'm sorry. There was like one of the...they were saying, oh, we're going this is one of the summer viruses that we're going to start seeing. And so I thought it would be important. And we felt as a team would be important to have you on just to give us some information about human metapneumovirus, because it's one of those ones is the old one. 00:02:19:24 - 00:02:26:03 Dr. Sutton But we don't really hear much about it. And so now we seem to be hearing about it. So with that, I'll turn it over to you. 00:02:26:05 - 00:02:45:10 Dr. Elaine Perry Okay. Great. Thank you so much for the introduction. And, frankly, it's nice to be with you to talk about something other than Covid 19, right? I mean, obviously so very important. And yes, thank you, doctor Winn, for acknowledging it has not gone away. But it is really nice to, to be talking about something else. So, right, so if we could go ahead and go down to the next slide, please. 00:02:45:12 - 00:03:05:13 Dr. Elaine Perry So this is basically going to be cautious a series of questions. Right. And so things that may be common questions that you're hearing if you're hearing about this and then definitely there will be a little bit of time at the end for additional questions if you should have them. So so what exactly is this human metapneumovirus or HMPN or HMPV, sorry. 00:03:05:15 - 00:03:23:18 Dr. Elaine Perry So this is a virus that can cause both upper respiratory infections. So we think about upper respiratory infections like nasal congestion maybe a little bit runny nose you know cough but sort of upper respiratory infections. But then it can also cause lower respiratory infections. So we think about that is more lower in the airways or even to pneumonia. 00:03:23:18 - 00:03:43:00 Dr. Elaine Perry Right. To the to the tissue of the lungs itself. And it is actually something had alluded to, you know, this has been around for a while. It was officially isolated. They use the term discovery. I think that's so funny because the virus has been around for longer than that. But it officially was isolated and identified and named back in 2001. 00:03:43:00 - 00:04:06:13 Dr. Elaine Perry And that's where it came up with this name. This name of human metapneumovirus. And now this is part of the Pneumoviridae family, with its close cousin, RSV, respiratory syncytial virus, which is another virus that we've been hearing a lot about over the course of the winter. You may remember that, last winter and even into the spring, we were seeing large numbers of RSV, not only in small children, which is where we expect to see it. 00:04:06:16 - 00:04:24:16 Dr. Elaine Perry But then there are also, you know, it can affect older people as well. And so that was a lot of, information about that. So this is related to, you know, so similar to, cousin, so to speak, of the RSV. So if we could go to the next slide. And so what symptoms as a cause? 00:04:24:22 - 00:04:55:21 Dr. Elaine Perry Now it if it, if it is infected, the upper respiratory tract, what you see is again typical things as without there's a lot of cough, fever, you know, stuffy nose, runny nose and sore throat. Now if it's infected, the lower respiratory tract, you're going to have things maybe a little bit more, you know, severe symptoms, wheezing. You can have that overall fever, cough, even some difficulty breathing, you know, getting short of breath, or even to the point where you, someone is having low oxygen levels. 00:04:55:23 - 00:05:18:23 Dr. Elaine Perry And again, this lower respiratory infection at its most serious can lead to, to bronchitis. So we're talking about inflammation, inflammation, infection, some of the airways smaller airways and then pneumonia. The infection more of like the, of the lung tissue itself. Now the most serious severe cases of this can require hospitalizations. And I'll talk more about this in a minute. 00:05:18:23 - 00:05:43:06 Dr. Elaine Perry But this often happens in our very littlest ones. So, you know, six months of age, very small kids under two. But then also when older people or people who have problems with their immune system. All right. So we go to the next slide. So how do we spread. How does it get spread. Again like a lot of our other bad actors that we've been dealing with lately, is person to person to what we would call respiratory droplets. 00:05:43:06 - 00:06:07:01 Dr. Elaine Perry So, you know, we're coughing or sneezing. You know, you've got that respiratory stuff, right, that that's coming out. And that is how this virus has spread like some of our other, other close friends, Covid, flu, RSV, etc.. Along with that obviously comes even when you have that sort of close personal contact as this respiratory stuff is coming out of us. 00:06:07:03 - 00:06:28:01 Dr. Elaine Perry And then the other thing too, is, again, with some of these other respiratory viruses, we talk about if somebody coughs or sneezes and there's viruses or on a surface, and then you go after and you touch that surface and you rub your eyes, your nose, you rub your mouth anyplace that's good at absorbing viruses. That is another way that this can this virus can be spread. 00:06:28:03 - 00:06:54:06 Dr. Elaine Perry Now, typically, in the northern Hemisphere where we are, you tend to see human animal virus more common in the late winter, winter timeframe into the spring. Definitely that it can happen, you know, different times a year, but sort of historically when you look at when we see it. And so what that means is you can have, human metapneumovirus, you can have RSV, you can have flu, all sort of spreading in this same timeframe. 00:06:54:07 - 00:07:13:20 Dr. Elaine Perry And so we talk about it as sort of a respiratory virus season and that's winter into spring. Again, the viruses don't always play by the rules, but sometimes they show up at different times. But in general, that's where you tend to see these all sort of coming together. And so I mean really somebody can actually have more than one of these viruses at the same time. 00:07:13:20 - 00:07:31:07 Dr. Elaine Perry And we do see that sometimes. So maybe someone is already down for the count with flu and then they can get infected with RSV or hMPV as well. So just because you have one doesn't mean that you can't have another one at the same time, unfortunately. All right. Going on to the next slide. So who can get it? 00:07:31:07 - 00:07:56:17 Dr. Elaine Perry So really people of any age, any background and, you know, can become infected with this virus. Now, most commonly we see this in children under age two. Some of the studies I looked at said, you know, depending on different populations and you're looking at, it's estimated that some and sometimes up to 95% of kids will have already been exposed to this virus by the time they turn five. 00:07:56:23 - 00:08:16:22 Dr. Elaine Perry So it can be very, very common in the populations. Now, unfortunately, though, reinfection can occur. So just because kids get it when they're little doesn't mean they're going to be immune for, for a time. And some of that is due to the fact that the immunity doesn't last forever. Some of that is due to the fact that there's different groups of this virus. 00:08:16:22 - 00:08:35:04 Dr. Elaine Perry And so if you got Group one A, and then you get exposed to group B one, you know, you can even still get it, but some of it is just again, as with time off and our immune system doesn't it doesn't protect us from it forever. And so the people that we get most worried about is, again, have severe disease, severe levels. 00:08:35:06 - 00:08:54:23 Dr. Elaine Perry And then people who are older, people have problems with their immune system. And then the other group that we worry about for hMPV is people with chronic lung disease already. So chronic obstructive pulmonary disease, asthma, you know, so people who their lungs are compromised to begin with. If they become infected with this it can make them even more sick. 00:08:54:23 - 00:09:11:21 Dr. Elaine Perry So they may not be more likely to get it. But if they get it more likely to end up being really sick. All right. So if we could go to the next slide, please. All right. So how do we diagnose it? Now the symptoms for this as you saw earlier are very similar to a lot of the other respiratory viruses they get. 00:09:11:21 - 00:09:33:09 Dr. Elaine Perry And so you can't just look at somebody and say oh you've got RSV as opposed to hMPV or you know, flu. It's not that simple. Because they do look a lot alike. There is confirmatory lab testing. Right. So as again, the flu and RSV and, Covid 19, you can do laboratory testing of the the secretions we have. 00:09:33:09 - 00:09:56:13 Dr. Elaine Perry So the infamous nasal swab, right. You collect some of the respiratory stuff and you can do testing. And as with Covid 19, you can either do PCR testing or you can do antigen testing. And those are ways that people will find out that what they, the virus they have is actually hMPV. Now, because this is not a reportable disease, 00:09:56:15 - 00:10:13:13 Dr. Elaine Perry I'll talk more about that in a minute. Often people will have it and not really know because they might not even go to get tested. Right. They may have it just not feel well, you know, they're healthy, they get better on their own. And so they may have it and never really realized that it was what they had, that virus instead of something else. 00:10:13:15 - 00:10:36:08 Dr. Elaine Perry So going on to the next slide, please. So how do we treat it? Well, there's no specific treatment. There's no antiviral medication. There's no specific thing that we would do for hMPV as opposed to other other, viruses. Now, we talk about medical care being supportive, meaning we look at the symptoms that the person has and we try and treat those symptoms right. 00:10:36:08 - 00:10:54:06 Dr. Elaine Perry You know, people are have a lot of runny nose. So we give them something to treat their nasal congestion. Or again, if people are very sick and end up needing to be in the hospital, sometimes, again, that supportive care in the hospital giving them hydration, IB hydration to keep them, feeling better, giving them oxygen to help them breathe better. 00:10:54:11 - 00:11:13:21 Dr. Elaine Perry But again, it really is just depending on the symptoms that the person has is the kind of treatment that that will come up. So going on to the next slide. So is there a vaccine? And no, there is not, not yet. There are clinical trials underway. And, and so stay tuned. That is something that is, is under development. 00:11:13:21 - 00:11:31:02 Dr. Elaine Perry But at this point there is nothing that we can do, from a virus perspective. Now I'm going to take, speaker's privilege prerogative to just I couldn't help myself. I just had to throw in. Right. You know, being public health, we have to throw in, you know, some pro-vaccine, positive public health messages here when we can. 00:11:31:02 - 00:11:57:16 Dr. Elaine Perry And so it's close cousin RSV, actually very recently has had two vaccines that have been approved for RSV. I know that's not the topic today. Maybe another time, you know, shameless plug to bring somebody in to talk about that or something like. But so the FDA, the Food and Drug Administration has approved two vaccines for RSV. And what needs to happen next, as all of you may remember from Covid and we all learned more about the vaccine process than we ever thought we would. 00:11:57:18 - 00:12:28:15 Dr. Elaine Perry But but so the Advisory Committee on Immunization Practice or the ACIP, which is works with the CDC, not the FDA, they're related, but they're going to be meeting next week on the 21st to vote on these two vaccines. And so please do stay tuned, because it is likely we expect, you never know, but that the CDC, the ACIP and then CDC will come out and recommend that, one or both of these RSV vaccines be given to people, getting either 65 or 60 years of age. 00:12:28:15 - 00:12:47:15 Dr. Elaine Perry We're still not sure. But but so just stay tuned on that because it is something that, you know, we did see, we often see RSV and in the winter this last year did seem to be worse. And there are definitely are concerns about people who are older, really coming down with some very significant symptoms for, for RSV. 00:12:47:15 - 00:13:11:02 Dr. Elaine Perry So again, not not one for human metapneumovirus yet. There's one in development, but but keep your eyes on RSV because that's that should be ready to go sooner, maybe even for the fall. You know fingers crossed. So okay next slide please. All right. So why are we hearing about this now? Right. Again, as I just alluded to earlier, you're starting to see articles CNN you know, elsewhere Washington Post had an article about it. 00:13:11:04 - 00:13:30:18 Dr. Elaine Perry And so what's the buzz. Why why are we talking about this now? Well, the CDC at the end of May did release some data from their surveillance. Remember, I said this is not reportable. So this isn't like Covid was during the, you know, the pandemic where people had to report it. And even now, you know, people are supposed to be reporting if they have a positive test, it's not reportable. 00:13:30:18 - 00:13:49:06 Dr. Elaine Perry So what the CDC and state health departments and others do, is there's different ways that we get information. Right. And so it's basically, in this, the data I'm going to talk about right now, the CDC does work with certain labs. The labs will send them the results of the testing that they do. And so they'll say, okay, we did 100 tests for human metapneumovirus this week. 00:13:49:12 - 00:14:06:23 Dr. Elaine Perry Of those X percent were positive. And so the CDC looks at those across the country. And it's not all lab results by any stretch imagination. But they can use it to sort of get an idea. And so what they found, the data they released in May, just a few weeks ago, was saying that in March of this year. 00:14:07:00 - 00:14:33:19 Dr. Elaine Perry And what was the peak of the human metapneumovirus season this year, they had nearly 11% of the specimens that were tested for for hMPV were positive. And this is higher, about 36% higher than we typically see, during the peak of this, of the season for this virus. And so it's definitely higher number of, of people of positive, a high percentage of positive test results of the people that were getting tested. 00:14:33:21 - 00:14:53:03 Dr. Elaine Perry Now we've seen similar patterns with RSV. We definitely saw a similar pattern for flu. You know, we had two years very little influenza circulating in the community. And then this past year we had an early and a really, really high, spike of influenza. And so, you know, there are a lot of reasons why we think this could be the case. 00:14:53:03 - 00:15:15:09 Dr. Elaine Perry Remember, this last winter was the first one that we didn't really have, a very, very robust system in place in terms of, you know, really encouraging the masking and the social distancing and all the things that we had done to help us, protect us from Covid that had been petering out. But I really feel like really like this winter, this past winter was the first one where I think people did sort of, you know, we were back to normal, more or less. 00:15:15:09 - 00:15:36:21 Dr. Elaine Perry Right. There was a lot more travel. People were masking. People were were coming together. And again, because we're so good to happy to be together again after after a few years away from each other. And so that very likely led to some of the larger numbers of these respiratory viruses that we were seeing. And then the other thing too, that you always have to think about is, you know, increased testing. 00:15:36:21 - 00:16:01:24 Dr. Elaine Perry And so there were more tests, there were more testing being done across the board for some of these viruses. And so, you know, as I mentioned earlier, we only know what we know, right? We know that there's a certain amount of the testing that was being done. This was the percentage of those tests were positive and that was sort of the indicator there may be something more going on because you could do more tests and it looks like you have more cases, but it's just that you're doing more testing. 00:16:02:01 - 00:16:18:16 Dr. Elaine Perry It was important here to note was that regardless of the number of tests on that percentage or that number of all the tests being done, there's a higher percentage of tests that we're not we're coming positive. And so if we go to the next slide, you can see what that looks like. From the data that the CDC, the CDC released. 00:16:18:16 - 00:16:49:10 Dr. Elaine Perry And so you have, both PCR testing shown on this, I think that's I think it's showing it was purple and then antigen testing, in blue. And so this is looking at again, information that the CDC collected from certain labs from different laboratories across the country, sending them their information. And, and that you saw that, that that large, increase that the spike in numbers back in the March 2023 time frame where you were getting a higher percentage of tests being positive than than we would normally expect to see. 00:16:49:12 - 00:17:07:22 Dr. Elaine Perry And you can, you know, there's obviously some variability, but but that's one of the, indicators that there was more, human metapneumovirus circulating this past year than we saw. Now, fortunately, it's on its way back down. You can see the numbers are lower more recently, but, you know, again, it's still something that that we have to keep in mind. 00:17:07:24 - 00:17:22:21 Dr. Elaine Perry And be on the lookout for. And so the next slide is the last slide, sort of, you know, again, with everything with public health, how do we stop the spread? Like how do we what can we do? What's actionable from this. Right. So and again, I could not give a public health talk without saying wash your hands. 00:17:22:21 - 00:17:39:14 Dr. Elaine Perry Right. I would put it a whole slide of just wash your hands if people would let me get away with it. But so, so that is so important. And we know that, right. Whether you're singing Happy Birthday or Twinkle, Twinkle Little Star or whatever your favorite song or you know is, it's washing your hands, and, and washing that frequently. 00:17:39:16 - 00:17:56:21 Dr. Elaine Perry And then, that I mentioned earlier, if you're touching surfaces where there is the virus present and then you're touching your eyes, you know, is your mouth, you really try to avoid doing that, you know, when you're out and about and making sure that you wash your hands before you then have to fool around with your contact or do something else 00:17:56:23 - 00:18:20:10 Dr. Elaine Perry with your eyes, nose or mouth. Avoid close contact with people who are sick. Right? So I, you know, I think that that is something, that we really do try and do. I mean, it's tough. Again, we're wanting to be out and about with people. But that is that it's going to be that, you know, that closer contact to their respiratory, their sneezing, their coughing, that is going to, you know, how that's how the disease is spread. 00:18:20:12 - 00:18:46:07 Dr. Elaine Perry And, and so that's why my final, plea, and again, just solid basic public health 101 here is that, you know, if if you do have some people who have these cold like symptoms that I've talked about, you know, at, you know, cover your mouth and nose right when you're coughing or, you know, we're sneezing, coughing into into our tissues or into our, into our elbows. Make sure that washing your hands frequently and correctly. 00:18:46:09 - 00:19:00:08 Dr. Elaine Perry And then the bottom line really stay at home when you're sick and that's, you know, again, I know it's so hard. I know traditionally we were like, okay, you know, I'm tough. I'm going to work through my cold, I'm going to come in and, you know, even though I'm sick, I still have have things I have to do to get out and about. 00:19:00:08 - 00:19:17:16 Dr. Elaine Perry But, you know, if the pandemic taught us anything is that we should not we really should not do that. We shouldn't try and be tough. You know, when we're sick, if we're spreading viruses, we should try and keep those viruses to ourselves at home the best we can. And so, you know, again, just good solid public health messages that really, you know, they do help. 00:19:17:16 - 00:19:28:17 Dr. Elaine Perry They really do help a lot. And so that's all that I have prepared. But I don't know in terms of can I if there's a little time for questions or not or people can put stuff in the chat, I'm happy to to answer them as they come up. Thank you. 00:19:28:19 - 00:19:44:08 Dr. Sutton Thank you so much. We do have time for questions. So like Doctor Perry said if you have any, put them in the chat. Actually I actually have a question I wrote down. And this actually does not have anything to do a human metapneumovirus. But one thing you said kind of intrigued me though. So you put in the plug for the RSV. 00:19:44:08 - 00:20:04:24 Dr. Sutton And it surprised me that you said that the, that the vaccines that they're thinking about rolling out are for older, because it seemed as though, generally speaking, for RSV, we would hear about that amongst the kidx, like the really, really young kids. So is there a reason? I mean, I understand that we usually see, you know, severity of the the virus in older populations, but I think that just struck me. 00:20:04:24 - 00:20:07:04 Dr. Sutton So do you know why they? 00:20:07:06 - 00:20:33:13 Dr. Elaine Perry So a couple reasons. And I'm going to just be very practical and put on my like former, you know, life in some of the work I did with, and working for a vaccine manufacturer. So, you know, to be very blunt, it is a lot easier to do clinical trials in people who are older. It is it obviously, as you can imagine, during clinical trials in small children, there are a lot of, concerns that not that it's not worth doing and not that that aren't looking at it. 00:20:33:14 - 00:20:55:06 Dr. Elaine Perry Right. And there's also work being done in terms of, a vaccine that would give to a pregnant person that that would help protect their, their infant after they’re born. So that work is definitely there and is ongoing. But in terms of the this the, speed or the the ability to get things approved, a little bit more rapidly and then just start to get more real world experience with these vaccines. 00:20:55:08 - 00:21:16:23 Dr. Elaine Perry The vaccine manufacturers, the two vaccine manufacturers, which, these vaccines have been approved by the FDA, you know, did move forward and were able to move forward to get larger numbers of people, you know, the number of people on field trials were more robust for this older population. And recognizing that it is in these older people that very often or that that if they get it that they can also become very sick. 00:21:16:23 - 00:21:36:12 Dr. Elaine Perry And so it's some of it's practical, some of it is there is true enough, like if you really want to protect severe from severe disease, that it really does make a lot of sense. And again, if you're if you're eliminating, if you're reducing, I guess I should say you want to limit it. If you're reducing the spread of the virus in the community, then you're also helping protect others right there. 00:21:36:12 - 00:21:57:17 Dr. Elaine Perry There are vaccines that we can't give to some people because they're immunocompromised. And so we say we protect them, right. Community immunity by vaccinating others. And so the thought is, if you reduce the spread of virus among people, you know, in a certain age group, you know, if if you get good vaccine uptake in the 60 to 65 and up year old, there's going to be less of that virus to circulate in the community. 00:21:57:17 - 00:22:04:22 Dr. Elaine Perry There'll be less chance, you know, grandma won't be giving it to to grand grandchildren. And so that can still help as well. 00:22:04:24 - 00:22:31:11 Dr. Sutton Okay. Thank you. And then I'm a stay on the, the vaccine thing. So I, the, the news cycle, okay, so in the last 24 hours, and I'm springing this on you, but I think you got it. So the last 24 hours, there's been a lot of talk about the Covid shot. And so, like Dr. Winn said, you know, this this Facts and Faith was started, you know, because of Covid, you know, making sure we spread information that is correct and usable. 00:22:31:13 - 00:22:46:10 Dr. Sutton And so, you know, I got a little concerned. And now I see some talks about a change in the vaccine again. Do we need bivalent or are we going to focus on...do you know anything about what's happening about that as we try to stay in the forefront and continue to encourage it, but make sure people have knowledge about it. 00:22:46:12 - 00:23:01:24 Dr. Elaine Perry Right, right. And the Advisory Committee on Immunization Practices or the ACIP is going to be talking about the Covid 19 vaccine next week as well. I think they may have a two day meeting. And, you know, because there's a lot to talk about. And so they will be looking at it. So yeah, at this point there is only the bivalent vaccine, right. 00:23:01:24 - 00:23:18:16 Dr. Elaine Perry That the ones the older the old school ones are gone. Right. We are just giving the bivalent vaccines and they've tried to make it simpler. And basically everybody should get at least one bivalent vaccine, no matter, no matter how many they've gotten, no matter, you know what kind they got before. Everybody should get at least one of this, 00:23:18:22 - 00:23:40:03 Dr. Elaine Perry this newer vaccine. But we know that Covid 19 has been changing, right? We have seen variant after variant after variant. And so what the Food Drug Administration vaccine manufacturers is, is keeping an eye on that, looking at it from a public health perspective, from a manufacturing perspective, let's see that. Let's see what's happening with the virus, because we know that over time our immunity wanes. 00:23:40:03 - 00:24:03:18 Dr. Elaine Perry Unfortunately, our maybe gets weaker, but then also the virus is changing. And so we want to make sure that we're up to date. We're keeping up to date with that. And so the discussion would be if the destination is what makes sense to do. So when we ready to start giving people additional. So you know giving them another bivalent for some people who are already doing that right for older for older people and immunocompromised again. 00:24:03:20 - 00:24:18:23 Dr. Elaine Perry But then do we change the composition of that and say, okay, that the new the bivalent is protecting against these, these strains, these variants maybe we can add something more. And so if we're talking about rolling out a campaign for the fall, what is the composition of that going to be? What are we going to be protecting against there? 00:24:18:23 - 00:24:33:06 Dr. Elaine Perry And so that still is definitely in flux. You know more to come ASAP that that meeting next week I think what will be helpful as well. But you know, it is the general thought is this probably is going to become, you know, you get you go in the fall, you get flu shot, you get your Covid 19 shot. 00:24:33:11 - 00:24:49:18 Dr. Elaine Perry Maybe some folks will be in their RSV shot. Maybe at some point they'll also be getting their hMPV shot, you know. So it's it's that it it's recognized that this is not something unfortunately Covid 19 is not going to be one and down or two. And on the hopes that maybe we get to sort of an annual schedule. 00:24:49:20 - 00:24:53:09 Dr. Elaine Perry It would make sense and it would be similar to what we're doing for the flu. 00:24:53:11 - 00:25:06:04 Dr. Sutton Okay. Well, thank you so much. This has been very informative. And you mentioned that meeting. So we'll have to get you back after the ACIP meeting so that we can get the most up to date information on what's on the horizon. So thank you, Doctor Perry. 00:25:06:04 - 00:25:08:04 Dr. Elaine Perry Oh, you're so welcome. Always happy to join. 00:25:08:06 - 00:25:27:01 Dr. Sutton Thank you. So we are going to shift a little bit. So now we had our knowledge and our physical health. And we are going to shift to another individual who is no stranger here to facts and faith. And that's Doctor Jessica Brown. And she is a licensed clinical psychologist who works as a clinician and educator, a consultant and a speaker. 00:25:27:06 - 00:25:51:13 Dr. Sutton She is an assistant professor of psychology at Virginia Commonwealth University, where she teaches in the area of applied psychology and coordinates undergraduate internship experiences. Her research and clinical work focuses on making mental health accessible and equitable for people in marginalized communities, and equipping mental health professionals to better serve these communities. And I love Doctor Brown's areas of consultation. 00:25:51:13 - 00:26:13:11 Dr. Sutton They focus on it. They include impact of racism and race related stress on mental health, generational and cultural trauma, and the intersection of faith and mental health. I will also add that Doctor Brown is now a member, a real member of facts of Faith, as now she's a part of our team. So you will definitely be seeing her more often as she provides information on mental health. 00:26:13:17 - 00:26:29:11 Dr. Sutton Lastly, I would like to say that she is the author of Making Space at the Well Mental Health in the church. And I will say, I mean, if you want a good read, you better have it. All the real people have that book, I have it, I have a signed copy. So that's your plug, doctor Brown. There you go. 00:26:29:11 - 00:26:34:10 Dr. Sutton It's a really good book. So I'll turn it over now to Doctor Brown. 00:26:34:12 - 00:26:58:20 Dr. Brown Thank you, Doctor Sutton. And I just want to let y'all know I did not pay her for that to do this. If I could have co-host, privileges, that would be great. I have a couple of slides to share. So, the team asked me to come and just talk about. Thank you, Doctor Sutton. Some of what I've been seeing in my practice in terms of, mental health. 00:26:58:22 - 00:27:25:09 Dr. Brown And one of the things that has come up that I think is kind of a, an all purpose mental health skill is the importance of rest. Right? And so I spend a lot of time talking to people about rest and how important it is. Those of you who, might be on social media or kind of keep up with the latest Tricia Hersey’s Rest is Resistance. 00:27:25:11 - 00:27:58:21 Dr. Brown You may have seen people on social media talking about the tough life and how they need to rest. Right? And one of the things I see in my practice is that people have this conceptual idea that they need to rest, but they feel confused about how to really execute that. Right. So I have people who say to me, I know I need to rest, but when I lay down and try to go to sleep, my mind is racing and I can't slow my body down or when I sit down and do nothing, all I can think about is all the things I'm supposed to be doing. 00:27:59:02 - 00:28:28:08 Dr. Brown Or I feel guilty. Right? And and the truth is, we live in a society that really encourages, encourages us to do everything but rest, right? So I wanted to spend a few minutes giving you some ideas and strategies around how to make your rest more restorative because, for instance, if you say you're resting, but the whole time you're actually worrying about the work you could have been doing, you might as well have been doing the work because you're not really resting. 00:28:28:12 - 00:28:46:12 Dr. Brown Right. And so we really want to think about how to get the most out of the time that we have the rest, given the reality that for many of us, we live very busy lives, we're juggling multiple demands and maybe we don't have a whole lot of time. Okay, so okay, I'm just looking at what time it is. 00:28:46:14 - 00:29:11:12 Dr. Brown All right. So the first thing and this may, seem like this may seem like something that is not needed, but I think it can be helpful to just remind ourselves why we need rest. Why does it matter? So first, from a biological perspective, rest is necessary for the health of your body, right? There's a reason that you get tired. 00:29:11:14 - 00:29:44:16 Dr. Brown There's a reason that your body needs sleep to function. And so one of the things that it's important for us to think about is that rest is not something that takes us away from life. Rest is actually a part of the natural rhythm of life. Those of you who have raised children know that one of the first things we do when children are decompensating or throwing tantrums or yelling or screaming or acting out of themselves, right, is we question ourselves do they need a nap or do they need to eat right? 00:29:44:16 - 00:30:20:00 Dr. Brown It's the most basic human functions are a part of what helps us to do the things we need to do in life. And so it's important to think about rest as a part of the natural rhythm of what we do. In addition to that, just as biological human being having a need for rest, we also live in a world where we encounter stress on a daily basis. Whether that be a fight with your partner, whether it's a work related issue, whether it's the community where you serve, there's some kind of conflict that comes up, right? 00:30:20:00 - 00:30:53:02 Dr. Brown We're encountering stress on a daily basis, and our bodies don't distinguish different types of stressors. So if whether, having a financial issue or whether I'm having a work related conflict, my body responds to those kinds of stressors as if I need to run from a bear or jump from a burning building. Right? Our bodies go into overdrive, and you can recognize this if you think about the last time when you were really stressed, you might have felt tension. 00:30:53:08 - 00:31:20:20 Dr. Brown You might have started sweating or felt hot. You might have been hyperventilating. Right? Our body's respond through physical action, even if we're dealing with emotional or interpersonal stressors. And so one of the things that we have to do is to give our bodies time to come down and recover from those stressful experiences, because that same stress related response that prepares you for action in the moment. 00:31:20:20 - 00:31:55:03 Dr. Brown And it's really helpful if you need to run from a burning building or fight or bear it really harmful if you continue to have that elevated level of stress in your body over time, right? The medical professionals on the call can better tell you than I can. The impact of chronic stress on the body and rest with one of our remedies for chronic stress, because it gives our nervous systems a time to recover and return to baseline and so that is both a biological and emotional necessity for our longevity. 00:31:55:05 - 00:32:16:16 Dr. Brown And the final point about rest is it helps to support our emotional wellness. So think about the last time that you were really tired and you had to make a decision. Think about how challenging that was, or think about a time when you were so exhausted that you couldn't find your keys, or you put your TV remote in the freezer. 00:32:16:16 - 00:32:43:22 Dr. Brown Right? We know the cost of exhaustion, and when we are physically exhausted, we're less able to manage our emotions. We're less able to navigate conflict. We have a harder time making decisions. We are also less able to encounter people in our lives with empathy. Right? And so many of you on the call are in professions where empathy is necessary to what you do right. 00:32:43:24 - 00:33:17:14 Dr. Brown And so supporting our emotional wellness also means incorporating a rest practice. So at the baseline, you should work toward having a healthy level of sleep, right? That's important. Yes, sleep is a part of rest. I want to also invite you to think about, in addition to sleep, what are some of the other things you might be able to do that can help you to have really restorative time to come down from the stress of your life. 00:33:17:16 - 00:33:51:22 Dr. Brown So one idea is to think about scheduling nothing time in your schedule. So many of us and I can be guilty of this as well. Many of us schedule every single hour of our day to the point that we might even schedule ourselves out of a lunch break, right? And so what would it look like to in advance, schedule blocks of time in your schedule that you protect as if it were the most important meeting to do nothing, or to do something completely restorative, right? 00:33:52:03 - 00:34:20:18 Dr. Brown For some of us, that might start with simply scheduling a 30 minute lunch break. And during that 30 minute, only eating your lunch right? Not also checking email or sitting at your computer, working through a document, or having a phone conversation with that's work related, right? So you can schedule a time that you then protect so that you can focus on just restoring your body. 00:34:20:20 - 00:34:50:22 Dr. Brown Another way is to really use your breath as a tool. I have to say, I've been a mental health professional for over ten years, and one of the tools that I provide to people most often is teaching relaxing breath right? A great tool. And I'll go through the slide and then we if we have time, I'll kind of lead us on a little practice is breathing that helps you to calm down your nervous system and slow down your body. 00:34:50:24 - 00:35:16:08 Dr. Brown The way we do that is through a process called diaphragmatic breathing. It's basically deep belly breathing. The most of us, when we're feeling stressed, we have a tendency to hyperventilate. So we keep the air up in our chest. Diaphragmatic breathing intentionally helps us to activate our diaphragm and move the air down into our belly. And that process helps our body to connect with calm. 00:35:16:10 - 00:35:41:16 Dr. Brown And so you can use breath as a tool. It could be as simple as setting a reminder a couple of times a day to stop and do ten deep breaths. Here's the trick for belly breathing. Think about when you're laying down on your back. Let's say you're preparing to go to sleep. You automatically when you lay down on your back, 00:35:41:18 - 00:36:04:23 Dr. Brown engage in diaphragmatic breathing. Why? Because our bodies assume that when we're laying down on our back, we are getting ready to go to sleep. Right? So your body has a natural mechanism to calm itself down when preparing for rest. And we can use that as a hack for calming our bodies down even when we're not preparing for rest. 00:36:04:23 - 00:36:23:12 Dr. Brown But we might need to kind of bring our level of stress or activation down. So we'll do a practice in a minute if we have time just using breath as a tool. Those of you who use smartphones are like apps for those kinds of things. They're all kinds of apps that you can use to guide you in deep breathing. 00:36:23:12 - 00:36:44:16 Dr. Brown Or if you want to do a meditation, that's an option as well. And I can make some suggestions for those as well. The next piece to think about, and this is particularly for folks who might have a sense that they want to rest, they desire to slow down, but when they stop, they cannot slow their brains down. 00:36:44:18 - 00:37:17:00 Dr. Brown Some of us who are in that role might need a transitional practice or moment to help your mind and your body shift from work to rest, so it could look like a breathing exercise. It could, also, many of us are probably used to having a task list that we start with at the beginning of the day. Well, let's say at the end of your day, maybe you write a task list down so that you know that the things you need to do will be taken care of, and you don't have to worry about remembering them. 00:37:17:02 - 00:37:51:09 Dr. Brown Right. Maybe it's a stretching exercise. Maybe it's something behavioral where you turn off your computer, close it down, straighten up your paper on your desk. Right. Think about if there's a transitional activity that can provide a line of demarcation between activity and rest. The same is true for those of us who might have trouble sleeping, right? If you've ever had trouble sleeping and you talk to a medical or mental health professional about it, probably one of the first things they told you is think about a bedtime routine. 00:37:51:14 - 00:38:10:14 Dr. Brown The reason for that is because our body's associate all of these different things in the external environment with what we're supposed to be doing at that time. It's kind of like when you used to walk into your grandmother's house and you automatically think about the pound cake she used to make, right? That kind of thing happens to us all the time. 00:38:10:16 - 00:38:36:02 Dr. Brown And so some of us might need to remind our bodies that it's time for rest. For instance, not doing work in bed or not looking at the blue light from your phone or computer for a period of time before bed. Having a relaxing experience like taking a shower or a bath. Drinking cup of tea. Right? And so if you struggle resting in moments that you missed time to rest. 00:38:36:04 - 00:39:04:22 Dr. Brown Think about routines and transitional activities that can help you to make those shifts. And you might be thinking, well, what kind of things should I do? This is where I'm going to invite you to use your curiosity as a guide. So think about in your life and in your daily experience, what are some times when you felt most relaxed and calm, and think about how you can integrate those into your daily experience, right? 00:39:05:02 - 00:39:35:18 Dr. Brown What is most effective in terms of best practices is what is most accessible to you and what works best for you, and so you really have the permission to use your own experience as a guide. And the final piece I'll add as a practice to consider is the practice of detox and do not disturb. So many of you might decide, okay, I'm going to just sit down and relax for an hour, but your phone is ringing the whole time, right? 00:39:35:20 - 00:40:11:04 Dr. Brown Or you're relaxing, but you're scrolling through social media and in five minutes you've seen three articles about climate change. You seen an article about, violent experience that somebody had. Right? And so for many of us, our access to information, while is good, can also be another source of stress. And in those times where we really need to rest and restore, we might actually need to detox in and get some distance from all of the information coming to us and from people who might be seeking information from us. 00:40:11:06 - 00:40:31:12 Dr. Brown Right? It could be something as simple, and this is something that I've done. I don't have my work email on my phone anymore because I would say that I was off work, but I would be checking email. Right? And so think about what boundaries you can set to really protect the time too that you've set apart. And so I want to leave you with this. 00:40:31:12 - 00:40:50:06 Dr. Brown And then we may have time for a couple of questions. Many of us have heard the saying, you can't pour from an empty cup. Right. And so we might operate with this model of pouring out, pouring out, doing all the things. And then we get tired and then we rest, and then we fill up the pitcher. Right. And then we pour out again until the pitcher is empty. 00:40:50:06 - 00:41:11:05 Dr. Brown And then we start the whole cycle all over again. I want to invite you to think about your rest practice as something that is constantly happening, as you're pouring out and otherwise. In other words, excuse me. You don't have to wait until you're tired to rest. You can rest because resting is one of the ways we care for our bodies. 00:41:11:07 - 00:41:40:23 Dr. Brown And especially for those of you who know that you might have certain experiences that will be particularly exhausting or overwhelming, you can plan in advance to rest, with the goal being that we don't have to have an empty pitcher, right? We can actually operate in a state of equilibrium where as we're pouring out, doing work, giving to the community, doing all the things we do, we have also carefully planned opportunities to rest and restore. 00:41:41:00 - 00:41:53:06 Dr. Brown Okay, are there some questions people have or particularly questions maybe about how we can implement these strategies, or what it would look like to do some of these? 00:41:53:08 - 00:41:58:06 Dr. Sutton Yeah, this was amazing. I don't know how many toes you stepped onto. 00:41:58:06 - 00:41:59:23 Dr. Brown I don't know. 00:42:00:00 - 00:42:13:15 Dr. Sutton I mean, I was just sitting here thinking about one of the big ones you said, which I know a lot of us do is the you know, it can be you can not seem so big. But the work email thing, I mean, when last my work emails were not working, they were not pushing to my phone. I thought I was going to lose it. 00:42:13:15 - 00:42:31:16 Dr. Sutton And I know a few of my colleagues who have stopped it. And I, you know, it stresses me out to think about stopping it. But I know it's a good practice. So I appreciate the practical tips and tools that you provided. I want to see if anyone has any questions, because you did say that you could, like, take us through some breathing prompts and that would be great. 00:42:31:16 - 00:42:32:04 Dr. Sutton I think if. 00:42:32:06 - 00:42:32:14 Dr. Brown 00:42:32:16 - 00:42:38:23 Dr. Sutton Walk away from this with things that we can actually practice ourselves, and I'll check the chat. I know we have people saying thank you. 00:42:39:00 - 00:42:55:20 Dr. Brown Yeah, I don't see any questions in the chat. And I'll just a note. I just want to note what you said Doctor Sutton about it stressed you out to not have the email. And I'll say this if you are somebody who is used to being on the go on the go, on the go, when you start slowing down, it will feel uncomfortable. 00:42:55:22 - 00:43:16:07 Dr. Brown That doesn't mean you're doing it wrong. It's just like when you start an exercise routine and the first time you go to the gym, you're sore, right? You're building a muscle that you haven't used before. And so when we're beginning these practices, we really have to think about playing the long game. The feels really iffy you right now. 00:43:16:09 - 00:43:38:04 Dr. Brown But it won't always feel this way. At some point this will feel like second nature to me, and I'll have a piece of my life back that I've given away. Right? And so I think it's important to recognize that that discomfort isn't a reason to stop, necessarily. It is simply a part of the process, with the caveat that if you have a trauma history, it can be a little more dysregulated. 00:43:38:08 - 00:43:45:13 Dr. Brown And so you probably want to do that in concert with a mental health professional who can kind of support you through the process. 00:43:45:15 - 00:43:53:22 Dr. Sutton Thank you. All right. I think we have a minute or two of you want to take us through a breathing exercise that we all may be able to use later on. 00:43:53:24 - 00:44:08:19 Dr. Brown Yeah, we can do a really quick one. Okay. If you're able, wherever you are, you, just put your hand on your belly so that the palm of your hand is right over your belly button. 00:44:08:21 - 00:44:31:11 Dr. Brown And I'm going to tell you the exercise so you can kind of predict what's coming. I'm going to have you to breathe in, for a count of four, and then hold for a count of seven and then breathe out for a count of eight. If the holding for a count of seven is too much, you can stop and exhale whenever you need to. 00:44:31:14 - 00:45:04:01 Dr. Brown But the goal of this exercise is to have your exhale be longer than your inhale. That's the goal okay? And so when you breathe in through your nose, imagine that you're like envisioning the air going all the way down into your belly and filling up your belly like a balloon. All right. So breathe in through your nose for one, two, three, four and then hold that air in your belly. 00:45:04:03 - 00:45:57:11 Dr. Brown Two, three, four, five, six, seven. Now release that air in a woosh through your mouth. Two, three, four, five, six, seven, eight. If you ran out of air, it's okay. Okay, so, let's do it one more time and then I'll kind of take this time. So in through your nose 1,2,3,4, hold 2,3,4,5,6,7. And out through your mouth. And a woosh 2,3,4,5, 00:45:57:13 - 00:45:58:18 Speaker 2 00:45:58:20 - 00:46:31:01 Dr. Brown 6,7,8. Yeah. So that the combination of breathing and through your nose and out through your mouth and focusing on an exhale that's longer than the inhale, is a part of what sends a message to our bodies that it's okay to be calm. In other words, that, physiological process sends a message to your body that you are safe. 00:46:31:03 - 00:46:51:23 Dr. Brown Right. And so it counteract the stressful messages we get. We're under threat. We might have to fight a bear. Right. And if you're, if you, find the air, if the air feels like it gets stuck in your chest, here's the hat. Lay on your back because you have to engage your diaphragm to breathe on your back. 00:46:52:00 - 00:47:10:13 Dr. Brown So if you can't figure out how to get the air down to your belly, just practice when you have a couple minutes laying on your back, put your hand on your belly and practice breathing. You will find that your belly expands without you trying, right? And if you practice that enough, then you get to do it all the time. 00:47:10:15 - 00:47:37:01 Dr. Brown Here's the really cool part. Diaphragmatic breathing is also just like a muscle we work in the gym, so the more we practice it, the better we're able to access that skill. That's really cool because when we can do it, when we're at rest, we're better prepared to do that skill when we are actually stressed. And if we can calm our bodies in the face of actual stress, guess what? 00:47:37:03 - 00:48:01:23 Dr. Brown We have better mental clarity. We're better able to stick to our values when we're making difficult decisions, and the stress doesn't have as much of an impact on us right. So that is like an all purpose skill. It helps when you bring your check in for dinner. It helps when you're fighting with your spouse. It helps when you're having road rage, when in doubt, belly breathing right? 00:48:02:00 - 00:48:22:09 Dr. Sutton Yes. That road rage one. Yes, that is road rage. Thank you so much, Doctor Brown. This was I mean, this is amazing. Useful tips. We love it. So now we all have something that we can practice to help us. We practice it now, then it becomes something that we'll just do habitually when we need it. So thank you so much.