DEXTER -- Donna Kraft-Smith was one of many Mainers taken by surprise at the gravity of the COVID-19 pandemic. As the virus was making its way across the nation, Kraft-Smith was busy operating her Therapeutic Body Work Learning Center in Brewer, her own massage therapy practice in Dexter, and planning a road trip with her husband, Henry.
“It didn’t seem like it got real for us in Maine until March,” she said. “Up until then the President was even saying it was a hoax or whatever.” It was not until President Donald J. Trump addressed the nation on March 11, and Maine had its first presumptive case of COVID-19 on March 12, that many Mainers took a more somber look at the pandemic. To Kraft-Smith, it felt like things just “blew up.”
At first, she continued to try to run her therapeutic massage practice, stepping up already stringent cleaning standards. “I am always trying to keep everything as clean as possible, not just with COVID-19, but there are other things that people might transfer to one another,” she said. Then, because she planned to go on vacation, Kraft-Smith stopped seeing clients.
Kraft-Smith has 12 students this year at the Therapeutic Body Work Learning Center. The 500-hour course runs for 14 months during two intensive weekends per month. Fortunately, she decided to cancel the late March session even before Governor Janet Mills ordered the closure of nonessential businesses, effective March 25.
“We could have made that last class, but I really felt it wasn’t a good idea,” said Kraft-Smith. “There were too many of us in a room, coming from all different places.”
Even at home, there was confusion about how to proceed. “We were planning a road trip to Florida,” she said. “My husband and I went back and forth on it, and decided we weren’t going to go because we would pass through so many states and would be stopping at rest areas, gas stations. We decided if things got worse, we would be with people we didn’t know and we would not have a doctor, so it just didn’t make sense to leave -- and within a couple of days, things blew up.”
With her practice and school closed as non-essential businesses, Kraft-Smith continues trying to work with students, who are about halfway through their training. “I am doing some online training, but not everyone can use Zoom, and now they are saying Zoom has some issues. Because some people live remotely, it’s challenging. I’m trying to do some by Facebook and email. But they can only do the academic work; they can’t do the hands-on. We have to wait until a time that becomes safe.”
No students have registered for the new session beginning in September. “In the meantime, I’m expected to pay rent,” she continued. “My space out of Dr. Reddy’s building in Dexter, they said I didn’t have to pay rent until I started again, but the Brewer space, which is more expensive…I could defer rent, but he is still expecting me to pay that [back] rent later.”
Kraft-Smith is hoping that if she doesn’t qualify for Maine’s unemployment program, she might qualify under the new federal program. “I believe I may be eligible for up to $600 a week for up to four months, but the state does not have this site up yet,” she said on April 3.
Henry is retired and draws Social Security, so the couple does have some income. He is also experiencing health issues for which surgery may be required, but “doctors don’t’ really want to have you come in now,” she said. “They are doing a lot over the phone to postpone that. I’m sure a lot of other people are struggling with this now, too.”
Even if Kraft-Smith could work now, she wouldn’t. “I’m not scared to death that I’m going to die from [COVID-19], but I’d rather not get it,” she said. “I have no choice. I have to keep up. If I just go down, it’s not going to work. I am the only one who can go back and forth to town, can walk the dog, can really help him.”
To keep her spirits up, Kraft-Smith is connecting with students and friends on Facebook. “I have that to look forward to, and like everyone else, I’m trying to accomplish things that I don’t usually have time to do because of work. And I allow myself some time to be sad and to be afraid – but then I dust myself off and just keep going.”
Kraft-Smith has also been a yoga instructor, and is certified in Reike. “I practice my deep breathing all the time,” she said. “I’m aligning my body, and doing some stretches – probably not as much as I could, but I have a lot of other things I need to be doing. It’s not just yoga on a mat. Yoga is a lifestyle, so the things I’ve learned to keep myself calm are helping a lot.”
Kaft-Smith said that massage clients unable to see their pracrtitioners should be stretching “always!” and may benefit from online yoga, meditation and exercise classes. But, she cautioned, “When talking about people with a lot of chronic pain and stiffness, sometimes the videos out there are too much. You always have to be mindful of where that place is that your body says ‘that’s enough.’”
She’s also giving some thought to the future. “Eventually this is going to end. It may change my career. I’m thinking about other things I could do. Everyone isn’t going to want to just jump back in and have a massage until they feel safe again.”
There’s also the issue of job loss, and that folks may not be able to afford a massage – or the online classes Kraft-Smith is thinking about offering. “I could teach mediation and yoga online. Self-massage is something I’ve been thinking of offering.”
Kraft-Smith said anyone interested in possible future videos or massage can contact her at mainemassage@gmail.com.
DOVER-FOXCROFT/SORRENTO – When the edge of one of my back molars broke shortly after our world had gone on lockdown, I had visions of more breakage, enormous pain and maybe even a serious infection. I wasn’t sure help was available. Luckily, recommendations from Facebook friends pointed me toward Steinke and Caruso Dental Care, which has offices in Dover-Foxcroft and Sorrento that are open for emergency care during this time. But…did I want to risk exposure to the virus?
I was nervous, but I knew the tooth could become a serious issue. I left a message on their voice mail around 7:45 a.m. that Monday. Dr. Steinke called me back within five minutes, had me on the phone with his office staff by 8:15, and they got me in for care by 8:30. Safety precautions were everywhere. I needed to wait in my car until someone came out to get me – only one patient in the building at a time. My temperature was taken. I was then directed to a hand washing station. After signing some paperwork (and more hand sanitizer) I was escorted by an already masked, gloved, gowned dental professional into the exam room, where my tooth was sealed with a bonding agent. Color me impressed!
“The good news is that we in the dental field have been practicing universal precautions to make both our patients and ourselves safe since the AIDS epidemic in the 1980s,” Hillary Caruso, DMD, recently posted on the father/daughter dental practice’s Facebook page. “It was then we changed dramatically our protocols for infection control, safety and personal protection. Our profession has been a leader in making the medical environment safe for decades.”
Before AIDS, it was standard practice for dentists not to wear gloves and to simply wash their hands, and their instruments, with soap and water between patients. Needles were reused. “That is crazy to think about now,” Dr. Caruso said on April 23.
With the COVID-19 pandemic and state mandate to postpone non-emergent procedures, Steinke and Caruso (and other dental practices) remain open only for emergencies.
“We are staying open to help keep people out of emergency rooms and primary care offices during this time, allowing those practitioners to focus their resources on treating the truly sick,” Dr. Caruso said. “We are limiting treatment to root canals, extractions and sealing broken teeth that are causing pain.” Once the Maine CDC decides it is safe to resume non-emergent procedures, the practice will quickly return to full service dentistry.
There hasn’t been any specific guidance yet from the American Dental Association or the CDC as to what guidelines will need to be in place going forward, Dr. Caruso said.
“All I do is spend time researching best practices,” she said. Because COVID-19 is airborne rather than blood borne, procedures that cause aerosols are not performed at this time. Dental professionals wear surgical hair caps, and masks, preferably the N95 model when available, and a face shield goes over the mask. Because N95s are in high demand for medical professionals in direct contact with COVID patients, regular procedural masks can be used and covered with the face shield, as well.
“What we decided for our office, which has not been mandated yet, was to purchase air purifiers that had been on the market prior to this,” said Dr. Caruso. The machines use UV light and hepa filters to purify the air and kill potential viruses. “We have one for every dental treatment room and also for the reception room. They change out the air up to six times an hour.”
Another purchase was a “dry shield” which guards the tongue and cuts down on the amount of aerosols sprayed during certain dental procedures. These things, as well as all of the safety precautions I experienced, will stay in place when the practice reopens for routine procedures. And patients will be asked to rinse their mouths with hydrogen peroxide, a new protocol added since my visit.
“We all know that there is light at the end of this uncertain tunnel,” Dr. Caruso wrote on Facebook. “We are at work now making sure, when we can get back to treating our patients, it is with the highest standards for health and safety in this COVID-19 world.”
For more information about Steinke and Caruso Dental Care, visit centralmainesmiles.com or call 564-3455 in Dover-Foxcroft or 422-3770 in Sorrento.
PISCATAQUIS – Getting a new program started can be challenging enough without running into a pandemic during early days. Libby Kain was hired as Recovery Coach Site Coordinator for Piscataquis County in December, working through Mayo Regional Hospital (now Northern Light Mayo Hospital). Healthy Acadia received funding to expand existing recovery services for substance abuse disorder from Washington and Hancock counties into Piscataquis, Somerset and Waldo counties, “so I am working through the hospital, but I am subcontracted,” Kain explained.
“The Recovery Coach program is a free, peer-based service for people in recovery or contemplating recovery or affected others – those who have friends or loved ones who struggle with substance abuse disorder,” Kain said. The program uses recovery-positive messaging, provides support and tries to assist individuals in recovery by “helping to remove obstacles and barriers to recovery, by motivating and mentoring, encouraging them, by educating the community, and advocating for [those in or seeking recovery].”
A meet-and-greet community dinner had been scheduled for potential recovery coaches in March, but that had to be cancelled at the last minute due to COVID-19 social distancing guidelines. “Another training was supposed to me in May, a four-day Recovery Coach Academy, but that also had to be canceled,” Kain said.
So for now, Kain is wearing both the coaching and site coordinator hats herself. “As coordinator my job is to oversee the coaches and coordinate in the community. I work with community partners and different organizations to let them know the program is available. A lot of the work I was doing was letting people know about this new program and trying to get volunteers on board so they can be coaches.”
With no volunteers yet trained, Kain, now working from home, continues her community outreach while also working directly as a coach with persons in recovery.
“We did have to make changes, obviously, with the physical distancing and stay-at-home, which eliminated in-person meetings,” said Kain. “I am not in my office. I’m working from home. However, I am still fully operational, still scheduling meetings, using Zoom to video chat or talking over the phone. And I am still able to take new referrals.”
It’s been a challenge, with a program “so new a lot of people don’t know about it,” she said. “Not only that we provide addition support for people in Piscataquis County, but that we want the community to get involved, we want to reduce the stigma and let people know that recovery is possible when people are given supports and are ready to use them. There is so much stigma. People think it’s not possible for them to recover, or that they aren’t worth it. I’m trying to create a recovery-ready community that knows people can and do recover, and I think that’s really important for our community to start thinking about.”
Once it is deemed safe, new in-person recovery coach trainings will be scheduled. For now, Kain is trying to put together virtual training opportunities.
“Safety is the most important thing, but we are safely continuing to provide services,” she said. “Word of mouth can do a lot. A lot of people don’t know what they can do to help, or are not aware of what programs and supports are available close to home, especially during these times. Isolation is really difficult for some people, especially people in recovery. They can call me.”
Kain will respond to voice mail left at 564-1280 or lkain@mayohospital.com. For more about the Healthy Acadia Recovery Coach Program, visit healthyacadia.org.