WAPO Virtual Summit 2020

Sammy Harbut

On 3rd October, the World Alliance of Pituitary Organisations held their 5th International Summit virtually, due to the Covid-19 pandemic. Originally due to be held in Argentina this year, the decision was made to still bring countries together, and over 130 delegates attended from around the world.

The programme was available in English, Spanish, Russian and Mandarin and included the following presentations:

1. Consequences of Covid in the management of pituitary tumours (Alicia Santos and Eugenia Resmini, Hospital Sant Pau, Spain)

2. Patients and HCPs: An example of Collaboration (Pamela Funes, International Society of Endocrinology, Netherlands)

3. Minor Complications of Surgery (Garni Barkhoudarian, Neuro-Pacific Institute, USA)

4. The Visual Impact of Pituitary Disorders (Lucas Viana, FLENI Hospital, Argentina)

5. Can Adults with Pituitary Disorders take Growth Hormone? (Debora Katz, FLENI Hospital, Argentina)

There were also 3 Q& A sessions, and the day concluded with a round table discussion.

The most significant and relevant of these topics currently was the first one, which is summarised below.

Consequences of Covid in the management of pituitary tumours

The first half of the presentation looked the practicalities of accessing diagnosis and treatment during Covid-19. Themes identified were:

  • On-line visits instead of personal visits
  • Surgery postponed
  • Fewer doctors and nurses available for educational support
  • Delay of diagnosis and treatment
  • Isolation
  • Reduction in quality of life- for patients and ‘burn out’ of medical staff
  • Increase in anxiety and depression
  • Unable to access the hospital for blood tests
  • Could not visit hospital pharmacy to pick up medicines
  • Endocrinology wards transformed into Covid-19 wards
  • Access to wider support services was limited/unavailable

These difficulties led to an increase in pain for many patients- which has a psychological component. Consequently, it is considered essential to provide psychological support in the future through:

  • online groups
  • educational support
  • empowerment of patients
  • help for medical staff
  • link between healthcare and pharmaceutical companies

The power and flexibility of the internet was discussed in terms of how it can be used to patient’s advantage during Covid-19 and in the future. Patients can access support, information and education at home, can network with others to reduce loneliness and it is even possible to access medical appointments. It is anticipated that Telecare will become more widely used, as it provides several advantages as it is an easy/convenient way of having on-line medical assessment whilst remaining at home (although it is acknowledged that appointments in person remain better). Furthermore, it can facilitate online provision of medical training and education, overcome geographic barriers to healthcare, reduce costs, empower patients, and may even prevent hospital admissions.

The second half, presented by Alicia Santos, Clinical Psychologist, examined the effect the pandemic has had on everyone, the importance of recognising loss experienced as a result, and why this is an important step for empowering pituitary patients who have had to adapt to changes and increased anxiety about their health status. She highlights the stages of grief as a result of loss (of ‘normal’ life), and the importance of the grief process to reach a stage of acceptance and adapting to a new reality. Feelings of anger, sadness and fear, and anxiety about the future are usual and normal, but these emotions are also adaptable. She explains that whilst it is not possible to stop these ‘wave’ of emotions, we can ‘learn to surf’, understanding that intense emotions can change rapidly- so a tip to manage them is by counting to 10 during that intense wave.

She commented on the importance of improving/maintaining psychological wellbeing by keeping in touch with others -family, friends, patient organisations etc.- to avoid isolation (which can lead to depression). This bonding with others has the added advantage of improving the release of positive hormones, and putting us in touch with some other, more positive emotions.

Developing healthy habits has several benefits to psychological health by helping to reduce stress. Good ways to achieve this is via diet, exercise and developing a good sleep regime. Taking time to do something enjoyable every day is also important, for even short periods of time engaged in an enjoyable activity can improve mood. It may be necessary to consider your routine and see if the things you do remain relevant and helpful, because they may not as we change over time. Stepping outside our comfort zone may feel uncomfortable, but is usually worth doing.

 

The full Conference, including all presentations, Q&A’s and round table session can be accessed here: https://www.wapo.org/wapo-summit/wapo-e-summit-2020/