Travelgirl: Debbie, it seems the home real estate market is booming. Is now a good time to sell your house and or buy a new one?
Debbie Sonenshine: It’s absolutely the right time to sell. Low interest rates and a lack of inventory have driven home prices up. If you are thinking of selling now, the market should reward you. This is a very competitive time. However, there are great houses available and an experienced agent can help you find the home that fits your needs.

TG: What safety precautions are in place for both buyers and sellers?
DS: Prospective buyers and sellers should wear a mask and sanitize their hands before entering a property. As an agent I am now meeting my clients at the home we are viewing, which in the past wasn’t the case. Once one enters a home with an agent, it’s imperative that you socially distance. We, both buyers and agents, should utilize the internet to preview houses and screen them before visiting in person. This minimizes the number of houses you will need to see. It’s also imperative to always check with both buyers and sellers to ensure no one has been ill for the past 14 days.

TG: How do you market a home for sale during the pandemic?
DS: Photography has become a vital asset in selling homes. We’ve enhanced the quality of the photography with the use of drones and Matterport (a 3D camera that allows the digitizing of a building, creating 3D tours, 4K print quality photos and schematic floor plans) and we utilize virtual tours to help buyers more effectively screen properties. In years past it was necessary to visit every home in person and, with virtual tours, that is no longer the case.
   Staging, which has always been extremely important, is now even more vital because we want the house to show its best possible face for viewing. Buyers today are discriminating and they typically don’t want to do a lot of updating. Let your agent guide you in what you can do to get the best return on your investment.

To learn more please visit Debbie Sonenshine’s website – www.Sonenshineteam.com

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Travelgirl: COVID is the new normal. Initially we were wearing gloves everywhere. What’s the current protocol for covering your hands for safety reasons?
Dr. Jeffrey Klugman: Currently the recommendation is for frequent hand washing and/or sanitation. Gloves continue to be helpful as a protective barrier and as a reminder to avoid contact with mucosal surfaces such as your eyes, nose and mouth.

TG: Dr. Klugman, I know many parents will want to know — do you think children should be returning to sports during the pandemic?
JK: This is a difficult and controversial question. While there is clearly some increased risk of COVID infection with participation in organized sports, there are also physical and emotional benefits for children during this time of increased isolation. I believe this is a choice that individual families must make, recognizing that children generally have a mild course if infected but potentially could serve as vectors to infect others in the community. I would recommend to the extent possible mask wearing while engaging in group sports activities and appropriate COVID precautions.

TG: What are the standards in visiting a doctor’s office these days and should all visits be virtual? What are your thoughts on tele-med?
JK: Physician offices should be strictly practicing COVID precautions, which include temperature screening at check-in as well as asking appropriate screening questions concerning exposure risks and baseline health. The entire office staff and patients should be wearing appropriate facial coverings. Waiting rooms and exam spaces should enforce strict social distancing protocols. All contact surfaces should be thoroughly disinfected after each patient’s examination. It would be prudent to contact your physician’s office prior to a visit to ensure they are following these safety guidelines. Many physician offices are adding an additional supplemental fee to offset the significant new costs associated with taking proper COVID precautions.
   Tele-med remains a viable option to avoiding an in-person visit. However, there are significant limitations with tele-medicine. Physicians cannot physically examine a patient and are significantly limited with diagnostic options such as X-rays, office ultra-sound, EKGs, etc. It is particularly limiting for many of the sub-specialties such as hand surgery. There is very little that can be done diagnostically or therapeutically for hand surgery without an in-person evaluation.

TG: How has COVID affected you as a physician, husband and father?
JK: COVID has presented a unique challenge to me as a physician, husband and father. I feel a strong responsibility to provide consistent, high-quality care to my patients through this pandemic. I also feel a responsibility to protect the health of my wife and children. Practicing medicine in the office and surgical setting potentially exposes me to an increased risk of contracting the Coronavirus. To minimize risks, I consistently wear an N-95 mask the entire time I am at work. I wear gloves for any and all patient interactions and practice frequent hand washing. In addition, my office strictly follows the recommended COVID guidelines.   

TG: You treat both adults and children. How do you help children with congenital deformities? 
JK: My partners and I have a special interest in pediatric hand surgery and we are often asked to see children with congenital differences. These patients require specialized care and attention as these often are very unique problems. Time must be spent in discussion with the families so they can understand the medical issues, treatment options to improve function and cosmesis, timing of treatments, and long-term prognosis. Congenital issues affect the child but also have an impact on families. Treatment can include therapy, splints, comprehensive medical work-ups and surgical intervention. Our practice supports a Pediatric Hand Fellowship through the Children’s Healthcare of Atlanta system to hopefully educate future clinicians in how to manage these difficult problems. 

TG: Carpal tunnel is also a problem now that so many people are on computers all day. What is it exactly, and how is it treated? Would you also explain what a trigger finger is?
JK: Carpal Tunnel Syndrome is among the most common problems I treat. Carpal Tunnel is compression of the median nerve as it traverses from the forearm into the hand. Carpal Tunnel is compression of the median nerve as it traverses from the forearm into the hand. The carpal tunnel is a defined space with bone on three sides and a dense ligament forming the roof of the tunnel. When pressure increases in the space, it causes the nerve to become compromised and results in numbness to the thumb, index, middle and part of the ring finger. It can also cause weakness to the muscles at the base of the thumb, which significantly affects fine motor function. Patients who present with Carpal Tunnel Syndrome often require an EMG/Nerve conduction study to objectively evaluate their complaints. Treatment can include a variety of non-operative measures as well as carpal tunnel release surgery, which has a very high success rate in improving symptoms and preventing them from worsening or recurring over time.
   Trigger finger is another common problem. Trigger finger results from inflammation and catching as the flexor tendon glides through the sheath and the first pulley that keeps the tendons adjacent to the bone. In a trigger finger, the tendon becomes inflamed and catches at the first pulley creating a mechanical block, like a truck that’s too big to fit through a tunnel. The solution is to make the “truck” smaller with a steroid injection or, if that does not solve the problem, I can permanently make the “tunnel” bigger with a small outpatient procedure to release just the first pulley. Trigger finger release surgery is very effective with high patient satisfaction and minimal down time. 

TG: Baseball, basketball, soccer, football and other sports spark numerous injuries in professional players and, of course, in children and adults — whether joining in group activities or practicing alone. What are some of the more common injuries you see?
JK: Fractures and sprains about the wrist and hand are clearly the most common sports related injuries. Overuse injuries are also a significant issue. Baseball pitchers, for instance, are exposed to repetitive use injuries. Early presentation with repetitive use injuries can significantly improve long term outcomes. Precautionary measures include proper training and coaching. When dealing with sports-related injuries, appropriate sub-specialty care and early evaluation result in a higher potential for correct initial diagnosis and treatment and optimizes the ability to return to play early and safely. 

TG: On another topic, as women age, they seem to be at a higher risk for hip and wrist fractures. What proactive steps can be taken to avoid injury?
JK: Women are at an increased risk of distal radius wrist fractures primarily due to diminishing bone density. Osteopenia and osteoporosis are the clinical terms to describe this condition that is typically associated with aging. The typical osteoporotic fractures include spine, hip and wrist. Your primary care physician should diligently screen for osteoporosis to optimize early treatment in an effort to diminish risks. In addition, taking reasonable precautions to minimize fall risks would be advisable. (installing railings, safety bars, etc.) Routine precautionary splint wearing is not recommended.

TG: Will you please discuss arthritis? I can remember my mother suffering with arthritis, in pain and coping with the twisted shape of her fingers. Are there any new solutions?
JK: There are multiple types of arthritis such as osteo, rheumatoid, post traumatic, septic, etc. It sounds like your mother had osteo-arthritis. This is a very common problem affecting the hands seen more often in women than men. It is typically a genetically preprogramed process, meaning it affected your grandmother, mother and will probably affect you. Arthritis of the hand can result in deformity, stiffness and pain. Unfortunately, there is no way to prevent this process from occurring or progressing in patients with a pre-disposition. There are options to help with function and cosmesis, which is the preservation, restoration, or enhancement of the physical appearance. Arthritis of the thumb base is a particularly common problem I frequently see that can be painful and functionally limiting. Fortunately, there are good options available to treat this and dramatically improve both pain and function including splinting, steroid injections and surgery.

For more on Dr. Klugman’s practice, go to: https://www.handcenterga.com

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Q: Should I cancel my fall vacation, and if so, what do I need to know?
A: Travel has been adversely affected by COVID-19 with the temporary closure of many resorts, hotels, recreational sites, cruises and tours. Our industry is far from recovered and many destinations are not accepting international visitors at this time. These factors and the increase in COVID-19 cases make it difficult to predict fall travel. If your fall vacation includes a trip to the beach or a cabin in the mountains you can probably plan on going. Travelgirl recommends you take your own beach chairs and umbrellas to the beach. A wealth of hotels and destination sites throughout the U.S. have instituted policies to keep travelers safe; go online or call ahead to see what protocols have been put in place. Several resorts in the Caribbean are now open for business but it’s imperative you check ahead, as the pandemic is forcing changes at an unprecedented pace. Less than three weeks after opening, The Bahamas announced they are closing all airports and seaports to travelers from the United States. Several states within the country are requiring citizens of certain other states to quarantine for 14 days after arrival, and and other states are requiring COVID-19 test results within a few days of travel. 

Q: When will we be able to cruise again?
A: The cruise industry is reeling from the devastating effects of COVID-19. Several lines are selling ships and the once very profitable industry is singing the blues. It’s difficult to determine when we can safely cruise again. Ships are notoriously crowded making it difficult to social distance at sea. The Centers for Disease Control and Prevention has banned passenger cruising in U.S. waters until October 1, due to the rise in Coronavirus cases and many cruise lines have cancelled all sailings throughout 2020. For health reasons, we cannot recommend cruising right now, but stay tuned as this prolific industry identifies ways to keep passengers safe while sailing. We’re confident that in the not too distant future there will be policies in place to maintain safety, while passengers enjoy all the amenities and the unparalleled atmosphere of life at sea.

Q: What’s the best way to make sure your hotel room is clean?
A: Whether it’s your hotel room, your RV or your rental car, the smart decision right now is to pack sanitizing wipes with you and wipe surfaces clean yourself. You may also wish to bring along your own pillowcases and a sleep sheet; there are plenty of options available online at multiple price points. There is still much about this virus that we don’t know, so it’s better to be safe than sorry. When you enter a hotel room, be sure to wipe down the TV remote, the phone, closet/drawer handles and the bathroom faucets. Remember that the CDC recommends using alcohol-based hand sanitizer that contains at least 60 percent alcohol — and keep in mind that if you’re flying, current TSA carry-on rules allow each passenger up to 12 ounces of liquid sanitizer.

Q: I’m flying for work on an airline that isn’t separating passengers, what should I do?
A: If you must fly and your air carrier isn’t practicing social distancing make sure you wear a mask that protects you; take a look at www.sonoviatech.com or purchase an N95 mask. Wear disposable gloves on board and take a few extra pairs in case you head to the restroom; change your gloves when you come out. Don’t eat on board; keep that mask on and try to stay calm. If a nearby passenger appears ill, request a seat change. Once you’ve done all you can, relax and enjoy the flight.
   Also, if you have any doubt regarding your own health, respect others and seek treatment before getting on a plane. If your health is compromised for any reason, it’s probably wise to avoid airports and airplanes at this time.

Q: I have an international trip planned for 2021 and my passport is expired. Is there anything I can do?
A: To say that passport services have been slowed up by COVID-19, would be an understatement. At press time, no U.S. passport agencies are in phase three of reopening. During both phases one and two, appointments are limited and only available for life-or-death situations. The best way to see where things stand is to go to the U.S. State Department website:  www.travel.state.gov. As of Monday, August 3, six passport agencies and centers were in phase two of reopening, and 12 were in phase one. In phase three, appointments will be restricted to travelers with departures happening within two weeks.

Q: What’s the status of the REAL ID deadlines?
A: The rules regarding when you’ll need your REAL ID vary by state. However, since a national emergency was declared because of COVID-19, the Department of Homeland Security has extended the REAL ID enforcement deadline. It was October 1, 2020, but the updated deadline is October 1, 2021. So if you don’t have yours yet, you still have time.

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