(Editor's note: This is the second of a five-part series called "Staying Connected," which discusses the different and innovative ways Baylor Athletics is trying to reach and assist student-athletes during the COVID-19 crisis.)
 
By Jerry Hill
Baylor Bear Insider
           
Who says doctors don't make house calls anymore?
           
With the COVID-19 outbreak and shelter-in-place orders, the majority of work by Baylor's athletic trainers, team physicians and other medical and mental health professionals is now being done at home. Kind of a different spin on "house calls."
           
"Thankfully, we've used technology before," said Dr. Laura Irvin, who's in her first year as a primary care sports medicine physician with Southwest Sports Medicine. "Over the weekends, when we're on call, the athletic trainers will do a secure messaging system with us to keep us updated on athletes.

"Obviously, now we're doing a lot more phone calls. I even FaceTimed a couple athletes the other day for video visits. I never thought I would be using FaceTime for that, but thankfully the medical world has been able to allow us to use whatever needed to be able to see our patients and take as best care of them as possible."

This is part of the new – or let's call it "temporary normal" - for Irvin and Dr. David Haynes, one of the Baylor team doctors; along with Carrie Rubertino-Shearer, Assistant AD for Athletic Medicine-Rehabilitation Services; Dave Snyder, Assistant AD for Athletic Medicine – Men's Basketball; Dr. Monique Marsh-Bell, Assistant AD for Mental Health Services; and Dr. Jim Marsh, Dean of Student Health and Wellness and Executive Director of Counseling Services.

"Our biggest thing right now, between the coaches, strength staff, myself, everybody, is we're all just checking in with the guys and just seeing how they're doing," said Snyder, who is in his first year with men's basketball after working with football most of his career. "We're getting very adept at video – a lot of video, a lot of texting and phone calls. It takes away that in-person communication, which stinks in a lot of ways, but the kids are so used to communicating via technology, anyways. You're just having to do it a lot more."

In professions that in a lot of ways demand it, they're having to do their jobs without being face-to-face or hands-on, whether it's mental health counseling, injury rehab or just the overall wellbeing of the student-athletes.

"Something I enjoy about counseling is the face-to-face, and being able to sit with someone and engage with them," Dr. Marsh-Bell said. "So, it's been a transition for me, and I can tell it's also a transition for the student-athletes to be virtual. Because even though we're connecting that way, there's just something different about being able to sit across from someone and have a conversation. Adjusting to that is something we're trying to do on both ends, myself and the student-athletes."

Dr. Jim Marsh said the Baylor Counseling Center, in anticipation of shelter-in-place orders, was already moving toward tele-health and working remotely. Counselors are available 24 hours a day, seven days a week, by calling the main number at 254-710-2467.

"We're doing our regular business hours, 8-5, and continuing to do counseling like we always have," he said. "But, when students are in crisis in the evenings or on the weekends, they can call that number, and we have our staff available on-call, 24-7."

Like Dr. Marsh-Bell, Jim Marsh said the in-person and face-to-face meetings are preferred, "but that choice isn't available right now, and we've had a really strong response."

"There are adjustments, obviously," he said. "From a counseling perspective, there are a lot of non-verbal (communication) and other things you pick up when you're sitting with a person in a room, that are a little harder. Because a lot of times, all you can see is a person's face (in video chats). There are some of those challenges."

Reaching out to more than 200 student-athletes, including the ones she had been seeing regularly, Dr. Marsh-Bell said the overwhelming response has been, "It's strange, I'm feeling something, but I don't really know what it is. I'm not quite sure if I need counseling right now."

She added, "I think there's a feeling of just being safe at home with family and allowing family to be their source of support. Some of the bigger concerns has actually been about adjusting to the online classes and frustrations around that. And then, needing help around scheduling, feeling like I have all this time but I don't have enough time to get things done. Just trying to manage that piece of it."

Baylor University Wellness and the Beauchamp Addiction Recovery Center are also continuing to meet with students and sending out information through emails and video conferences. "Technology has really opened up lots of doors," Dr. Jim Marsh said.

While it's easy enough to do the counseling sessions through Webex, Zoom or just by phone, physical therapy and post-op rehabilitation are more of a challenge.

"Honestly, we're still learning," Dr. Haynes said. "From my experience, it's not a lot different than the Zoom meetings that we all have probably become very familiar with in the last few weeks. I think you can do some medical things. Obviously, doing orthopedic-type exams is certainly impossible to some degree, at least in the traditional sense. I'm sure it will evolve. Right now, I've gotten a lot of use out of just asking them how they're doing, how they're feeling, have they gotten set up with rehab back home?"

Most of the post-op cases involving the Baylor student-athletes were far enough along – at least two to three months – Rubertino-Shearer said the decision was made that "we really didn't need to at this point jeopardize our health and their health and bring them to the athletic training room."

"Some kids were frustrated," she said. "They wanted to have surgeries because it was the end of their season and that had been planned, but the elective surgeries have all been eliminated for the time being. And even before they were completely put on hold, a conversation we had with our physicians was even if they go ahead and have the surgery, how are they going to have the best rehab? Because a lot of times, that's just as important as the surgeries. If all the PT clinics are shutting down, they're not going to get the right care."

TheraBands and foam rollers were sent home either with or to each of the student-athletes, giving them a way to do resistance training and strengthen or enhance the rehab process in different parts of their bodies.

Rubertino-Shearer also encourages the student-athletes to get creative with their rehab and physical therapy, like using a couch cushion or pillow for balancing; filling up backpacks with books for some light-weight training; yoga exercises; and using sand bags for weights.

One of the easiest forms of exercise that she is recommending for "anybody from a college student to my parents to adults" is just taking walks.

"They can go on runs if that's where they were in their rehab," she said. "The challenge is for the ones that weren't able to run yet. I did have a student who didn't have a bike and was really frustrated with wanting to do some means of cardio. That's the difficult thing is if you don't have a bike and aren't in the running phase, really the only thing you can do is walk."

Snyder, who was in Kansas City with the men's basketball team when the Big 12 Championship was canceled, said some of the best medicine at the end of a long season is just rest. "They're just getting more than their fair share of it, for sure, more than they would prefer," he said.

"I think the hardest thing for them right now is not being able to do a whole lot," he said. "There's not a gym for them to go to, they can't go shoot. It's really hard on them. They want to go play. That's what makes them so good is they spend so much time in the gym."

Like the student-athletes, the medical professionals and trainers are missing sports and just the simple day-to-day interactions.

"It's disrupting everyone's life," Dr. Haynes said. "Certainly, one of the things that I love about what I do is the interaction with the student-athletes and all my patients, too. Not having that has just thrown everything off. I have a newfound respect for people who do meetings for a living. It's not my calling, for sure. I absolutely miss the kids. They keep you young, really., And I think that's something that's lost being trapped in a house with my three teenagers. I'm not sure that's an exact substitute."

With no injuries to treat at the moment, Dr. Irvin said it's an odd time, "but I'm just trying to look at the positives and hang out with my kids as much as I can and enjoy this. But, it's been a very odd first year."

Taking that same kind of positive approach, Rubertino-Shearer said, "We're going to be better after all this."

"We're using this time to make us better down the road," she said. "We're working on what the policy is going to look like when the student-athletes do come back here. What kind of measurements are we going to use to assess if they can get back to activity, as well as looking at some of our return-to-play protocols. It's things that, when we're going the way we go when everything is in more of a normal state, you don't have time to get to or you don't have time to do it until the summer. Now, we have the time."

For additional information on mental health services provided for student athletes, you can go to the Mental Health Services link.