El Paso Pediatric Opthamologist is in support of opening the economy

I’ve worked with Dr. Violeta Radenovich in the operating room providing anesthesia for her patients for a little over three years now. During that time, I have come to recognize that she is extremely passionate about her patients AND her community. El Paso, TX has gone through two shut-downs since the Covid-19 pandemic started, and we are in the midst of our third. The other day, Dr. Radenovich shared some info with me that I think needs to be shared – so I offered to give her a platform to make her voice heard. Here’s what she had to say:

JT: If you can just tell me a little about your background: your medical training, associations, etc. so that I can get a good background picture for our readers…

VR: Well, I’m Dr. Violeta Radenovich. I am a Pediatric Opthamologist, and in the popular term: I’m an eye doctor for children but is qualified to do eye surgery. I’m a medical doctor. I’ve been in this town 24 years and I trained in Houston. I did my residency training and fellowship and then I came here to practice pediatric opthamology and I’ve been in the community for 24 years.

JT: The other day, we were talking in the operating room and you mentioned – I think you said it was the Pediatric Society of El Paso – that had put out a letter representing all of the pedi physicians from El Paso, but that you were not in agreement with the message that they had sent out. Can you tell me a little about that?

VR: Well, I was not notified of the letter until I read the letter in an email that another friend sent me. Because the Pediatric Society recommended a shutdown of the businesses in town because of the outbreak of Covid. It just got me by surprise because I wasn’t notified and my opinion is that we don’t need a shutdown. Our town is already in crisis. First, because of the virus. Second, because of our economy. We already have 300 business [sic] bankrupt. And then we don’t want, you know, the virus is going to stick around. For sure, we need to take sanitary measurements and some safety measurements to open businesses. But if we’re going to have the virus killing people and then our economy bankrupt, we’re going to be in big trouble.

And as you know, it didn’t work in New York… We have examples… The virus is still around, and then we don’t want our businesses to go down. Just an example: if grandma and grandpa have Covid, and the son and the daughter own a small business, and they’re bankrupt, you imagine what a tragedy in those families? I think that our businesses should keep moving with sanitary measurements and precautions, and I think if the authorities are going to decide that, it has to be with science. Because we have a health task force, a public health task for with Dr. Ocaranza, he’s a Pediatrician and is part of the task force. I know there is not communication between the task force and the judge that gave the mandate of closing the businesses.

JT: Samaniego.

VR: Samaniego. And then also the Pediatricians that signed the letter did not communicate to the pediatric community and also did not communicate with the public task force that is in charge of giving us advice when there is an outbreak, a pandemic in this city. So I believe that we should have better communication between all of us because we are a part of this community and we want this community to succeed. We don’t want this community to, you know, be poorer than it is already. And I think, as I am a pediatric opthamologist, I take care of children’s eye vision, I help them to see better, and I think pediatricians are doing such a great job taking care of the health of the kids. And we should concentrate in that, because that is our purpose. To help children to improve their health. And then also, educating the parents and educating the community with health measures and sanitary measurements how to prevent this.

Because, lemme tell you. The flu killed more people than Covid. And we knew how to handle flu. Lemme tell you, everybody with the hope of a vaccine, I am too. But, we don’t have a good vaccine for the flu! So then, I think until the vaccine comes for this virus, we need to act up now, opening our business, opening our offices to take care of patients, being responsible in the health of our children in El Paso. And I don’t think we have any votes to be deciding to close somebody else’s business.

JT: You mentioned to me that, as far as the distribution of where the infections are being reported as coming from, at least in the city of El Paso, that a quarter of them – 25% of them – are coming from these “Big Box Retailers”. And yet, they’re shutting down the small businesses and saying that the large retailers are essential. You are a small business owner, so how has the shut down of the city affected you in your practice and what have you noticed about how it’s affecting the other small businesses in the community? I think you mentioned already that 300 of them have gone bankrupt already. But what are you seeing, and what are you FEELING, as being not just a physician but an actual small business owner in the city?

VR: Well, as you said, that 25%… I have a Master’s degree in Public Health. You attack the problem looking at statistics. You know, science. So then if 25% of these cases are coming from big box stores, and you’re going to close these small businesses, let’s close it all. You know? Because why we’re going to be giving privileges to WalMart, to other things to be open, while the mom and pop businesses are closed? I’m NOT suggesting that you should close all businesses. I’m not for that, ok? I think we should… because our small businesses gives employment to our local people more than the big corporations. Like, if WalMart closes, it’s not going to be affected because it’s a public… it’s owned by stockholders and the big global people. But if a little mom and pop restaurant is affected, nobody can take them out of bankruptcy, you know? They don’t have anybody to bail them out. So I think, if you set up a law, it should be for everybody.

I’m against shutdowns. I think we shouldn’t shut down. But like, WalMart, when I go shopping there, I see the whole family inside with the strollers, with grandma, with the kids. I think if now, we’re in an outbreak, then maybe we should limit the public that goes there. We should check temperatures. We are doing temperatures in my office and in any other places, we should. You know, the minimal you can do is do that. And then sanitize. Make sure you maintain the place clean and not overcrowded, until the spike of virus goes down, and then we can open up to regular services.

I think I’m all for opening schools. I’m all for letting kids play in the park. Because the outdoors makes this virus less transmissible. So then, I’m not… I see, like you say how is this affecting you in your practice?

Well first of all, we are taking all of the precautions. We have a girl that I hired that checks temperatures at the entrance before the parents get into the elevator. It’s one parent, one child. And the parents get upset that we’re limiting the patient numbers that they come, because the families, you know what? They are big. But we have to do that. So then, we have a questionnaire, where we ask the main questions for Covid. And if you have any of these questions – cough, shortness of breath, runny nose, temperatures, or somebody in your family or you’ve been in contact with Covid patients in the last two weeks – we don’t let them in. You know? And we advise them to go the pediatrician. Also, we don’t say “Don’t come in.” We say, “Ok, you need to go see your pediatrician,” and then “You need to go see your doctor” to see because if you had somebody in contact, you need to know what to follow.

So then, we do that. And then, we have, in our office we have a bunch of signs about cleanliness, we have gels, we wash our hands, we disinfect everything after each patient. And also, we have the seating area, where every so often, we put that you cannot sit here. Or this, like marked seating where they can sit, six feet apart. And we put in the whole floor, my floor is very big, we have benches that they are, if patients need to sit outside, they can do that. And also, they can go to the car and wait. Such a way that we don’t get the crowdedness and we can take care of them.

It has slowed down our flow, but you know what? I prefer to be safe, and to protect my children, and to protect my staff, and to protect the parents in such a way that we all come and we give the services with you know, healthy measures and then we prevent the infection and the transmission of this virus. Also, the number of patients that we see has come down like 30% because patients, you know, panic when they have the virus, they don’t want to come. And I don’t blame them.

And also, my… the cost for business has increased. I’ve spent $35,000 already on PPE. PPE means gloves, masks… Because we have masks. All of us, we wear masks in the office. If we are more than 6 feet apart, we may not wear a mask. But we, employees in the office when we’re with patients, we all wear a mask. And we all wear a mask in the optical. And we give masks to patients. If they don’t bring with a mask [sic], all my patients wear a mask. Parents and kids. Kids under two, no mask. You know? So then, we do that for just precautions. My practice is still offering services, I am not going to shut down. And then I’m going to keep helping children with the right safety measures in such a way that the parents feel comfortable bringing the children here to get their eye care.

(We homeschool our children, but they’re limited to four hours per day, with breaks. Here’s something that blew me away, simply because I take it for granted as it is not a practice in my household … The effect of prolonged on-screen time on children’s eyes … and I was today years old when it really clicked.)

A young child watching movie on laptop in the living room

VR: Well, the other problem is also, you know, they all are coming now because the kids are on the computer you know, how many hours? Six hours straight on the computer in some schools. And so the children are coming with more eye problems. The Computer Syndrome. Blurry vision, headaches, blinking – because if you stare at the computer for a long time, then you’re going to have dry eyes. Ok? And then blurry vision, because if you are focusing on near all the time, when you un-focus and look at a distance, you’re going to be very blurry. And then when you come back to read it again, you’re blurry. So then, blurry vision is a very common complaint. So then, a lot of children now also need glasses. And if they’re on the computer all day, they MUST wear their glasses. So then, they broke their glasses, they don’t have the right prescription, they have to come to see me, no? So then, we open our doors for service.

And we also just, we educate the parents. We tell them, look, for computer, kids 6 and above, they need to take a break every hour. Five minutes to ten minutes to do an activity that focuses their eyesight at a distance in such a way that they can relax their vision. Then also, outdoor playing is so important. So then, we said if you’re going to be six hours on the computer, I don’t want you to go to your iPad when you’re finished with school. I want you to go to the outside. Do jumping jacks. Walk your dog. You know, just play outside with, like we used to play before. Do hopscotch. Jumping ropes like when we were kids. And they have to do at least an hour of outdoor work, and also with sun. Sunlight, ok?

JT: Very important, yeah.

VR: Because we have shown that progressive myopia happens more often when you are doing near activities in excess. If you read six hours a day without taking breaks, if you’re on the computer that close six hours a day, your myopia or near-sightedness will get worse. So then, research has proven that the sunlight, playing outdoors, will decrease the progression of myopia. So then, it’s not only for them to play for their bones, the vitamin D, it’s also for their vision. And…

JT: Ok, I didn’t know that!

VR: Yes. The American Academy of Pediatrics have some guidelines, and if you Google, there is [sic] other guidelines. And I always tell them, under 5, they should not be more than one hour and a half in electronics. Because, you know, electronics have blue light. And the blue light can be toxic to the eye. We think that it can be toxic to your retina if you do it for a lot of excess but later on in life, it accumulates the toxicity. But the symptoms of Computer Syndrome that happens right away is blurred vision, headaches, blinking. We had to start telling the parents also “Watch your children”. If they’re blinking a lot, make sure when they’re staring at the computer that they have to blink. You know?

There is a rule that we learn, the 20/20/20 rule. So every twenty minutes, look up farther than twenty feet, for twenty seconds. Just to relax your eyes and then you can come back to the computer. Some kids have their computer close to the window. Just look out the window for twenty seconds, you know. Look at the trees and then come back and look at your Zoom to relax your eyes. So there are ways that we have to deal with this. I think it is not ideal to have the children doing so much time on Zoom, but we have to do whatever we have to do until the schools open their space.

JT: Well, actually, you started touching on some of the other questions I have. So I’m looking through my list now, like, what did she not answer already! (lol) Are there any specific things that you have started to educate your patients, well their parents, on how to protect themselves and care for themselves if they do get sick? As far as with the Coronavirus? Or how it would affect… Have you noticed any direct correlation between the virus and the children’s eyes or have we not gotten that far yet? Like, where are we with that?

VR: In my office, I have not seen any conjunctivitis that is related to Coronavirus. I haven’t seen…because we screen in the front. But besides that, the pediatricians have not sent me that many pink eyes or conjunctivitis. I think now that we have all this hygienic, we wash our hands, you know? We really learned to be, to have some safety measurements. The kids now have learned to wash their hands all the time before, when they had their hands dirty before they eat, before they touch their nose. So like we used to do before when we were little. You know, so then, we don’t see pink eyes…

Lemme tell you, I think if something good came out from this pandemic is that now our rules of hygiene have improved and also our pink eye and conjunctivitis… Lemme tell you, I think this pandemic, I’ve probably, I’ve [sic] seen two pink eyes. We used to see a lot of conjunctivitis in this time, we used to call it the “Pink Eye Season”. And we used to put our gloves all the time, and wash our hands. And still, when we see a pink eye we always tell the parents, you put these drops. Now, you have to examine them, if it’s an infection and they get antibiotic drops to wash your hands all the time. Also for the child, each time the child touches his eyes to wash his hands. To use his own towel. You know? In such a way that they don’t share the towel because it’s transmissible. Most of the pink eyes in flu season, or in this season, they’re viral. And they’re very contagious. So then, we just educate them to just make sure to wash your hands and don’t share the towels. And then follow your doctor’s instructions for pink eye.

But I have not seen Covid infections or anything. And lemme tell you, when people say there is an outbreak and a pandemic, lemme tell you, we haven’t had that many kids that they canceled for Covid. They have canceled because their mom or the grandma may have Covid. No? But not because THEY have Covid. I believe children may have Covid but the most common cause of transmission is from adult to the child. But still, there is a studies where they said that the viral load of a child is not as high as the adult. So then, the chances of them transmitting the disease is much less. For that reason, they think they should open the schools. Because the kids are not the transmittors… they may be, but they are not the people in high risk to be transmitting the disease. And the ones that are, they call them the “mosquitoes”, are the 18 year olds to the 40 year olds. They can have Covid, and they are not that sick, and then they go back home and give it to grandma, grandpa, the aunt, the uncles. And now that we know that the box stores, especially WalMart, is one of the ones that was causing a lot of the transmissions, I think sanitary measures need to be taken and then, they need to close some of the stores where they need to inspect them and make sure that they are following the guidelines that everybody else is. You know, I just feel that we should open for schools, we should open for businesses. I’m pro-work with safety measures. You know?

JT: Well is there anything else you’d like to say, anything else you’d like to add, to let people know?

VR: Well, I believe that we all are individuals and we all are responsible of our health. And I believe if you have a problem with Covid, you should call your doctor immediately. Because there is supportive measurements for every time you have a virus. Normally, what do we… Doctors, we know how to treat the flu. The flu is, no virus is curable. It has to run its course. But if you have a virus – call it the flu, call it Coronavirus – normally in 3 days you should start feeling a little bit better. You know? And if you don’t feel better? What did we use to do? What we do for the flu is, most of the time you can get an overinfection, then we give you an antibiotic, no? Then if you are coughing, we give you something for the cough. If you are a little short of breath, we give you some inhalers, no? Because you treat bronchitis, we call it bronchitis, you can develop bronchitis with Coronavirus. And then what do you have to do? You have to give them bronchodilators and inhalers with steroids to treat the inflammation. And then, if you don’t get better with that, then you have to go to the hospital. There is no other. But I think when you are sick, you must call your doctor and then demand that you need some kind of treatment. Because if you are sick that you have to call your doctor it’s because you are really sick.

The other thing is, I’m pro vitamins, ok? So then I believe everybody should be taking zinc, should be taking vitamin C, should be taking um, there is two… Vitamin D. Vitamin D3 in higher dose. Because we know D3 and Zinc prevents from getting a viral infection. It won’t cure you, but it will make you more resistant.

And I think if, for education for families, is please do not panic. This virus do not kill people. It’s like the flu. It’s a flu virus. It will kill somebody that is already sick with high morbidities like grandpa and grandma. My father-in-law got the flu 3 years ago at the end of November and he died in March. You know? Because after the flu, he got the pneumonia and then he got worse and worse and worse. So the flu in elderly is bad. So we need to protect our high risk patients: the elderly, the patients with comorbidities, you know – high blood pressure, diabetes, patients that they are sick. And also, obese patients. Because this virus is a little worse in obese, when patients are very, very overweight.

So then, I’m all for prevention but also for treatment. And I think the treatment should rely in our doctors in town. And the prevention should rely also, we should educate our patients to do prevention. But not only us. The nurses, the health practitioners, and also the public health. They should put some in the TV to teach you “wash your hands”, “cover your mouth with your cough”. We should see that more often in our community. And I don’t see that in the radio and the TV. So I think we should all to educate our community and help each other in this times where there is a need to be united and to be helping each other.

JT: Definitely! Well, I thank you for your time. It was very informative. I actually learned a whole lot about you today!

VR: Oh, well thank you. Well, lemme tell you. It’s been a pleasure to work with you. Because, you as a Certified Nurse Anesthetist, you have a more wider, you know, view of health because you are worried about prevention, education. You are worried about our community. I think that you showed me that you are a part of our community helping us with your newspaper, and this kind of information because I think anything good that can help the community to get better, coming from different media… because as you know, the media that we see on TV is not for education. I think you are doing such a great service to the community and also, helping children with giving anesthesia. You are such a great anesthesiologist [sic], you know?

JT: Thank you.

VR: I think that, is seeing somebody that has an integrative approach, to the health and to the body and the spirit… I thank you. Because I learned a lot about you, too!

JT: That is very humbling, thank you!

A pediatric ophthalmologist is a medical and surgical doctor (an Eye MD) who graduated from medical school and specializes in the care of children’s eyes. All ophthalmologists have training in children’s eye disorders, but the pediatric ophthalmologist has additional training, experience, and expertise in examining children, and has the greatest knowledge of possible conditions that affect the pediatric patient and his/her eyes. Dr. Violeta is the only Female, U.S. Residency-Fellowship Training Pediatric Ophthalmologist in El Paso, West Texas and Southern New Mexico! Dr. Radenovich is a proud member of American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, Texas Medical Association, Texas Pediatric Ophthalmology Association, and El Paso County Medical Society.