COVID-19: best practices if you have symptoms

We’ve all heard plenty of sound advice from medical professionals about what to do to avoid exposure to covid-19 in hopes of not getting sick. What happens if you do get sick? I feel like I’ve read a lot of fairly general instructions, but nothing as specific and clear as this information shared on Twitter by a nurse. I can imagine that many people who have symptoms (or think they might have symptoms, which probably most of us do from time to time) panic a little and everything you’ve heard about what to do next flies out of your head. If that were me, I would be following these guidelines to the letter:

“What I have seen a lot of are recommendations for how to try to avoid getting COVID in the first place — but what I have NOT seen a lot of is advice for what happens if you get it.
You basically want to prepare as though you know you’re going to get a nasty respiratory bug, like bronchitis or pneumonia. Just have the foresight to know it ‘might’ come your way!

1. Things you should actually buy ahead of time:
– kleenex
– acetaminophen (Tylenol)
– whatever your generic, mucus thinning cough medicine of choice (check the label and make sure you’re not doubling up on acetaminophen)
– honey and lemon can work just as well
– vicks vaporub for your chest is also a great suggestion

2. if you don’t have a humidifier, that would be a good thing to buy and use in your room when you go to bed overnight. (you can also just turn the shower on hot and sit in the bathroom breathing in the steam)

3. If you have a history of asthma and you have a prescription inhaler, make sure the one you have isn’t expired and refill it / get a new one if necessary

4. have your favorite soup on hand

5. stock up on whatever your favorite clear fluids are to drink – though plain water is fine; you may appreciate some variety

SYMPTOM MANAGEMENT
a. if you have a fever over 38C / 100.4F, take Acetaminophen rather than ibuprofen
b. hydrate (drink!), hydrate, hydrate
c. rest lots. even if you are feeling better, you may still be infectious for 14 days and older people and those with preexisting conditions should be avoided
d. ask friends and family to leave supplies outside to avoid contact.
You may not NEED TO GO TO THE HOSPITAL unless you are having trouble breathing or your fever is very high (over 39C / 102F) and unmanaged with meds. 90% of healthy adult cases thus far have been managed at home.

bedtime

THE PARADOX OF PORN: Alphatribe interview

My book The Paradox of Porn: Notes on Gay Male Sexual Culture continues to attract favorable media coverage over time and across the globe. The April-May-June issue of Alphatribe, the slick magazine published in Belgium for the international gay-male kink/leather/fetish community, features an interview with me conducted by Mark Boyd, who writes:

“The Paradox of Porn is a unique book, an essential reflection on porn and gay male sexuality that any kinkster or fetishist will gain from. While writers like Jack Rinella and John Preston have given the scene how-to guides on being an effective master or a willing sub, Shewey’s work evokes the writings of philosophers like Susan Sontag and Roland Barthes who use a style of thinking out loud in fragments in order to get to the heart of the matter. And there is a definite need for this in understanding gay porn.”

You can read the whole article online here, bearing in mind that the magazine’s website is distinctly NSFW.

alphatribe interview 1

 

 

COVID-19: musical interlude

I’m assuming you’re equipping yourself with lots of useful information about riding out the covid-19 pandemic in healthy ways. I will post things from time to time that I find especially valuable, in case they haven’t cross your path. Someone shared this video with me that I now play at least once a day, as a way of remembering that however far apart we have to be right now, we can choose to be “for each other.”

COVID-19: practical info on testing/treatment

In this new world we find ourselves living in, we’re learning ways to keep ourselves safe and healthy while the covid-19 pandemic sweeps the world. Stay home as much as possible. In public keep six feet apart from others. Wash your hands frequently. I would also add: be careful about your media consumption. Obsessively watching TV news reports or endlessly clicking around online will ramp up your anxiety in short order. I recommend that you limit yourself to 15 minutes at a time, maybe twice a day, and then find other ways to occupy yourself.

There’s a lot of information and misinformation flying around. As the pandemic spreads, the scene on the ground can look very different depending on which part of the world or which part of the country you’re at. I do want to share this lengthy set of guidelines that directly addresses issues of testing and treatment.

Howard Grossman is one of the longtime medical heroes of NYC’s gay community, having served people living with HIV/AIDS for many decades. Here are his common-sense recommendations for this time, with an addition I haven’t seen elsewhere: No Hooking Up. Doctor’s orders. (It takes a gay doc to have the balls to say that directly. He knows to whom he’s speaking.)

“Guidance we put out for our patients today: Many people are inquiring about Covid-19 testing and here is some guidance:

1) Current testing for Covid-19 is taking up to 7-9 days to come back from Quest. So testing will give us no immediate information and make no difference to recommendations for therapy

2) If you have symptoms of fever, chills and severe fatigue a test will not change your therapy

3) If you have those symptoms stay at home and isolate. Do not go to work, do not come to the doctor’s office and do not go to urgent care. If you have the virus you will only spread it around.

4) Whether it is Covid-19, the flu or a cold you will treat it exactly the same. Over-the-counter cold and cough medicines, Tylenol (acetaminophen) every 4 hours for fever (maximum dose 4000 mg/day and include any that is in the cold medicine), fluids (including Pedialyte to maintain electrolytes) and bedrest

5) If you have high fevers (over 104 degrees) that don’t resolve, shortness of breath or chest pain with difficulty breathing go directly to the Emergency Room at your nearest hospital. They are set up to rapidly isolate patients and treat with oxygen as needed and do the appropriate radiological procedures such as X rays. Do not go to a doctor’s office or urgent care.

6) If the newly described 45 min point-of-care test becomes available then widespread testing to know the epidemiological spread of the virus will make more sense but right now the current test will make no difference for you.

7) One reminder for many of our patients—social distancing from others can be stressful and difficult but it will make a huge difference in the course of the epidemic. None of us has natural immunity to this virus so a majority of us will probably get it. The question is when and whether the health care system will be able to handle it. If everyone gets sick at once it will overwhelm the system as is happening in Italy and potentially millions will die in the US. If we flatten the curve and spread the infection rate out over time, then the health care system will be able to focus on the sickest patients, have the equipment and supplies to do it, and not have to ration care. We may also delay things until there is a treatment or a vaccine. You can make a difference, each and every one.

8) To that end, please refrain from “hooking up.” Chatting on social media dating and hookup sites won’t endanger anyone. Continuing to meet up for sex will only put everyone at risk. PrEP won’t protect you from Covid-19. Please consider that.

Please share these facts with your neighbors and family. Remember, every time someone goes for testing who does not need it medical personnel will be using up personal protective gear that is in short supply.

Testing needs to be reserved for those already sick where it could change their therapy depending on what is found.”

RESOURCES: Psychedelic integration

Psychedelic integration is the process by which experiences with sacred medicine can be incorporated over time into one’s life in a way that benefits the individual and the community. Integration is one of the key concepts that animates the current reawakening of interest in the use of psychedelics for healing and personal transformation.

Just as proper preparation – attention to the set and setting — can determine how a person navigates the powerful and sometimes challenging experience of teacher plants and master molecules, skillful integration can help turn a jumble of images, sensations, disorienting and sometimes emotionally difficult moments into a coherent and meaningful exploration. It is the process through which the work is sealed, a sacred pause to ground the insight that’s gained, a way to capture the essence of the session before adding another big experience.

In December 2018 I completed a year-long training in psychedelics-assisted psychotherapy at California Institute for Integral Studies. After being suspended for three decades, renewed clinical research has shown that psychedelics can have a profound impact in treating a variety of mental, physical, and spiritual ailments. Based on the research that has already been done, it looks likely that these treatments will be approved for general usage in the near future, and at that time I will be available to work with patients who can benefit from these treatments. Meanwhile, I have training and experience in psychedelic integration therapy, helping individuals who use psychedelics for their own personal/spiritual growth to process their experiences in a safe environment.

Besides the treatment of concrete mental and physical ailments such as trauma, anxiety, and substance dependency, it seems clear that psychedelics also have potential for addressing the core spiritual and existential challenges of cultivating freedom, compassion, self-acceptance, and facing death without fear, which are values near and dear to my heart.

psychedelic illo by Adam Psybe
illustration by Adam Psybe

Sacred medicine ceremonies can release a backlog of emotions, and once the dam bursts, the emotions continue to surface after the ceremony when everyone’s gone home. For people with histories of trauma, the symptoms can get a lot worse when they start coming up. In that vulnerable state, it can be valuable to have someone in your life with whom you feel free and safe to talk through your experience, if not a close friend then a therapist.

After a ceremony, it’s important to rest, hydrate, nourish your body, and spend time in low-stimulation environments, especially in nature. Meditation is a useful tool for being still and paying attention to the emotions and sensations that emerge in the wake of a psychedelic journey. I’m available to help you cultivate practices for self-care and grounding, such as yoga, aquatherapy (warm baths, cold showers, swimming, surfing), acupuncture, physical touch (massage or simple holding/cuddling), and emotional awareness. It’s a good idea to pay attention to diet, gravitating toward comfort foods (warm soups and stews, root vegetables, beets, burdock root, dandelion root tea) and steering clear of those stimulants and psychoactive substances (alcohol, caffeine, nicotine, amphetamines) that counteract the process of slowing down, grounding, and listening to the natural rhythms of your body.

The job of integration is to be present and to hold onto the perspective that an inner healing intelligence is at work while the process of healing unfolds.

Please note: Psychedelics are currently illegal outside of FDA-approved research settings. I do not recommend clients ever self-administer medicines of unknown quality as they can have serious psychiatric and medical ramifications. However, I do recognize the need for clients to process mystical experiences with a knowledgeable therapist. I also work with clients returning from indigenous contexts outside the US who have participated in sacred plant ceremonies. And I support the movement for cognitive liberty and those endeavoring to change the laws to make these medicines safely and affordably available to those who can benefit from them.

LET’S TALK ABOUT SEX: Performance anxiety

It’s a big day in a man’s erotic life the first time he loses his erection in the midst of a sexual encounter. It can feel like a tragic self-betrayal, a terrible humiliation, proof that he’s broken and can never have sex again. The good news is that if he’s lucky and he hangs in there, he gets to the red-letter day when he discovers that he can lose his erection AND stay connected to his partner. In fact, that’s where the good stuff begins.

It takes some maturity, some practice, some support, and a little bit of a leap of faith to view erectile dysfunction simply as a mechanical failure, not a comment on your masculinity or a referendum on your worth as a human being. It’s a life-changing experience to realize that being a wonderful lover isn’t just about what you do with your penis but what you do with your hands, your mouth, your voice, your sense of humor, your energy, and your heart.

Erections are great and fun and super-pleasurable. But it’s exhausting and challenging to operate under pressure to Perform Like a Porn Star, constantly worrying – to put it bluntly – about your dick: is it big enough, is it hard enough, am I doing it right, am I going to come too fast, am I taking too long? Performance anxiety is the enemy of erotic intelligence, at least the way I understand it, which is the ability to be present for pleasure, to tune into your partner and what’s going on right here right now, without getting wrapped in trying to make something specific happen.

It’s not just men who struggle with performance anxiety. Social media has ramped up perfectionism for all of us. We spend a lot of time fixated on Getting It Right. We’re constantly tailoring our appearance and our behavior for each other’s approval. It’s an existential challenge to let all that go and leave reserve performance anxiety for people who are onstage performing.

In my work and in my life, I’m all about healing through pleasure, learning for myself and teaching other people how to turn down the volume on Pressure to Perform and be present for pleasure.

In workshops or in sessions when we’re focusing on intimacy, sometimes I will have partners spend time gazing into each other’s eyes, exploring the notion of the eyes as gateway to the soul, “into-me-you-see.” This can be beautiful, and it can also feel really vulnerable. We take in A LOT of information visually, and we live in a culture that has become hyper-focused on evaluation, stirring up equal amounts of judgment and fear of being judged.

So if we’re working on cultivating the capacity to be present for pleasure, sometimes it makes sense to close the eyes, to turn down the volume on incoming visual stimulus.

If you want to practice being present for pleasure right now, one way to do that is to let your eyes gently close and go inside. With your eyes gently closed, the idea is to take a moment to breathe, go inside, and take a break from processing visual information, judging and being judged.

As you let yourself breathe, bring your awareness to the way gravity works on your body. Let your face muscles rest, let your jaw soften, let your shoulders rest. Feel your buttocks on the seat of your chair, your feet on the floor. You don’t have to change anything or do anything special. Just take a moment to breathe and make space for what happens when you withdraw the sense of sight. Do things quiet down inside, do they rev up, do they stay the same? Try it now and just let yourself notice what happens.

Part of erotic intelligence is expanding your awareness of your own body. Notice the temperature of the air in the room against your skin. Notice the places where your clothing touches your skin, whether it feels soft, constricting, comforting, annoying. Notice what sounds you’re aware of in the room right now. Notice which sensations are pleasurable, what you’d like more of, what you’d like less of.

With a trusted sensual partner, closing your eyes or using a blindfold can be a simple tool for cultivating erotic intelligence. Removing one sense can heighten others. Light touch and pleasant sounds can be amplified, as can tastes and fragrances. The uncertainty of what happens next can create a luscious experience of anticipation and seductiveness. Nothing to do, nowhere to go, but be right here right now, taking in whatever sensory information is available.

Screen Shot 2020-01-24 at 2.26.38 PM

Note: this was part of a talk I gave November 9, 2019, as part of “Sessions Live,” Esther Perel’s online salon for sex therapists and coaches.

Media: BOYS AND SEX on Fresh Air

Journalist and author Peggy Orenstein has spent many years writing about the inner lives of girls in a series of best-selling books. In recent years, she turned her attention to young men and interviewed teenagers and college students for her new book Boys & Sex: Young Men on Hookups, Love, Porn, Consent, and Navigating the New Masculinity. NPR’s Terry Gross interviewed her recently for the radio show/podcast “Fresh Air,” and it’s worth checking out. What she says about how boys are socialized not to talk about their feelings and the distorted ideas about sex they get from watching porn apply equally to men of all ages. I’m looking forward to reading the book (which just the New York Times’ best-seller list), but this interview is a tantalizing preview.

boys-and-sex