Exhale (Into your Mask)
MEDICAL AND MENTAL HEALTH UPDATE
I love my patients. Being part of their lives keeps me going. And then when one of my patients hand-stitches a “flatten the curve” ornament for me, my heart sings!
I am equally humbled and honored when one of my patients is willing to share their personal story in order to help others. Today I will tell you a TRUE COVID STORY. My patient’s battle with coronavirus reminds us that 1) ongoing vigilance is critical, 2) we need widespread testing of asymptomatic people, 3) and hope is alive.
My patient is a healthy, high-energy professional woman in her early 60s. She’s also a rule-follower. From the get-go, she dutifully followed the MOSH PIT rules: wearing a mask, avoiding crowded indoor spaces, socially distancing, and handwashing.
And like many of us, by July she was beginning to feel self-conscious looking at her reflection on those Zoom calls. Her hair had not been cut nor highlighted since February, and it was beginning to show. Was this her best professional image? Others seemed to have found a way to put themselves back together. She believed that it was time and that it was safe to visit the hair salon.
The salon assured her that every COVID-19 precaution would be taken during her appointment. And indeed she and the hairdresser wore masks during the entire encounter.
But a week later, she developed symptoms that she thought were from food poisoning: a fever and diarrhea. She self-medicated with Tylenol and Pepto Bismol. But when the symptoms persisted she decided to get a COVID test.
She wondered where the illness could possibly have come from if not spoiled food. She had been so careful! She phoned her hair stylist who explained that she and a friend who worked in a bar had started feeling unwell almost immediately after the hair appointment. They both had gone for COVID tests but did not yet have the results.
Hearing her stylist's story, my patient decided to get a rapid COVID test. To her relief, it was negative. However, that same evening, she was notified that the COVID test she had taken earlier in the week was positive.
My patient called me.
In addition to diarrhea she had developed a cough. She was sick, but not sick enough to need hospital care. For the next few days, we spoke frequently on the phone and managed her symptoms at home.
But when I called her to check in on day 8, it was clear something had changed. She was breathless and spastically coughing on the phone—whereas the day prior, she had felt only slightly winded trotting up and down the stairs.
I advised her to seek emergency care. At the ER, her oxygen level was low, and she was admitted to the hospital for evaluation and treatment. Her symptoms escalated, and the intravenous antiviral medicine called Remdesivir was initiated. Despite early intervention, her oxygen levels plummeted, and she could no longer breathe on her own. Fully sedated, she was intubated, and put on a ventilator in the intensive care unit. The newly approved steroid medication called Dexamethasone was started.
For two weeks she was in critical condition.
I spoke to her husband regularly. With limited access to his wife, his nerves were fried. Naturally, he was stunned that someone so healthy and careful could get so sick so fast. Though the ICU doctors did a terrific job of keeping him informed of developments day and night, briefings on FaceTime were not the same as being there.
We waited and waited. And held our breath.
Then suddenly the clouds broke. The medicines started working. My patient started to require less and less oxygen through the ventilator each day.
My patient was taken off the ventilator last week, successfully able to breathe on her own. After a few more days, she was able to go home. The ICU nurses and doctors rejoiced.
Her husband finally exhaled. (I did, too.)
Today she is still exhausted, weak, and mildly coughing. But most of all, she is grateful to be alive. She is a success story. But as she well knows, it was touch and go for nearly two weeks, and if she’d been this sick back in March, she may not have made it. The accumulated knowledge about COVID-19 over five months enabled her team of doctors to bring her back. And she’s paying it forward by enrolling in every study available to help us better understand this disease.
My patient’s story reminds us that we must remain vigilant. The coronavirus is ubiquitous and ruthless. It hides in asymptomatic and pre-symptomatic people who unwittingly spread it to others. If we were able to test asymptomatic people before going to work, my patient and her hairdresser might have been spared.
This story also reminds us that there’s a person—a human life—behind every statistic in the newspaper. Death rates, hospitalization rates, and “test percent positives” are more than mere numbers; they are mothers, fathers, grandparents, sons, and daughters.
I think when you know someone who’s been devastated by this disease, you tend to fasten your mask a little tighter, hug your kids a little harder, and hope a little bigger that science, medicine, and the power of the human spirit prevail.
It’s happening already.
I will see you next week. Until then, be well. (And watch the live Q & A from Monday night with me and Dr. Ackerly by clicking HERE!)