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PANDEMIC ALERT LEVEL
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Online Discussion: Tracking new emerging diseases and the next pandemic since 2005; Coronavirus COVID-19 Pandemic Discussion Forum.

From the Frontlines

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Tabitha111 View Drop Down
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    Posted: May 25 2020 at 7:36pm

Gretchen “Awesome People Wear Masks” Winter, MD 

May 24


Well, friends, today was my last shift in NYC after 5 weeks. I’ve worked 28 12-hour shifts in the last 33 days. I head home tomorrow completely exhausted. I am so excited to see my pets & play my piano & ride my bike, but I will miss my new friends & my patients here dearly.

Things have calmed down a lot since I started here, but I’ve still only cared for a handful of patients without COVID. The ICUs are still full and I was in a pop-up ICU the last few weeks. I am worried about people relaxing and allowing a second wave.

These hospitals will still be full with these patients for a long time due to the prolonged courses of COVID, and they will not be able to accommodate a second wave. 

The healthcare workers are exhausted and still haven’t gotten a break, and I’m afraid of what a second wave will do to them. I’m afraid of what it will do to me. I’ve already been pulled to cover more ICU when I get home because there are too many patients. We need relief. 

The trainees are working hours and rotations they never expected, some even working outside their specialties. Education is often an afterthought. There is no time for social interaction nor a safe way to do it, so coping mechanisms are failing. 

This virus ravages the body. These patients are some of the sickest I’ve ever cared for. It’s like caring for an entire team of patients comprised of only the most unstable patients that used to be only a few per team. 

It’s devastating to watch families and friends unable to talk to their loved ones. Unable to sit by their side and hold their hand. Waiting with bated breath for an update call while simultaneously dreading the dismal news. The loss is unimaginable. 

It’s infuriating to see people gathered in groups and refusing to wear masks and spouting anti-science. I have never held such a low opinion of many of the people around me. I am so disgusted by people who choose their own convenience over the health of others. 

I am incredibly grateful for the amazing nurses and physicians and team members I worked with here. They are the definition of resilience and deserve ALL the praise. I am leaving a better person for having known them.

I'm going to take the next few days to try to focus on my wellbeing before I start another month of service at home. I need to find joy again. I need to remember what peace feels like. I need to take care of my body. I need to heal.

I am a different person than when I came here. I feel a deeper level of sorrow & darkness than I did before. I also feel a deeper level of strength & purpose. I hope I will be a better physician & teacher because of these changes. I hope I will still be able to see the light.


Thank you for supporting me on this journey. Thank you for the kind words & animal pics that lifted me up when I thought I couldn’t keep going. Thank you, NYC, for letting me be a part of your fight. Thank you to all the docs & nurses & volunteers who make this work possible.

For those who want to know how to help: Check in with the people around you and be present. Wear a mask and stay home when you can. Promote science over quackery. Care for others the way you would want to be cared for. Love one another.

*****************











'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (1) Thanks(1)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: May 26 2020 at 1:33am





Thanks for the post

Tabitha111

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Everything we hear is an opinion, not a fact. Everything we see is a perspective, not the truth.πŸ––

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I can't thank the dear doctor enough for putting herself out there for my city.  It is not she who should be thanking us letting you be part of the fight.  It is we New Yorkers who are forever in her debt for helping us through this crisis.

Thank you!    

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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: May 26 2020 at 5:32am





Well said WitchMisspelled

And that goes for

 ALL HEALTH WORKERS

EVERYWHERE....

They all deserve medals.....



Everything we hear is an opinion, not a fact. Everything we see is a perspective, not the truth.πŸ––

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: May 29 2020 at 5:56pm

***Folks, even if you think by saying "we are open now" that the virus has gone away..it ain't over....more from the Frontlines today...****


"I realized as we had 3 COVID + patients die today and anticipate a couple more to pass over night...I have severe anxiety about this disease. I really feel like everyone that comes to our ICU that is + dies. We have successfully extubated 1 patient and sent 2 to LTACs with trachs. I think that is all we have for successes (from the ICU).

We are having a surge as we are taking patients from Imperial County as they have exceeded capacity.

31 beds and we have an over flow unit with 8 beds we have been at capacity this week with pts waiting on the floors, in ED and PACU for beds.

I am terrified!!! All I have seen is the bad of this disease. I know there are success stories and recoveries but I am not seeing them so it is taking a toll.

Every cough, throat ache, stomach pain I am overly stressing that it’s my turn. And God forbid I give it to my mom that lives with me and provides my child care for my special needs child.

Please tell me I’m not the only one going crazy over this...AND please tell me I am over reacting..."



***************************************
I’m in the same boat you are. Getting them transferred from El Centro!! We lost 4 in the last 24 hours
******************************************

Completely get how you’re feeling. I saw some bad cases too. The last one was a 45 year old that ended up with a trach and a lot that died.... I had fear every day ...
******************************************************

"Our ICU overflowed to telemetry

15 vents in ICU

And another 7 on tele

Started March, continued through April

Now census way down

Had only 2 + in icu yesterday

Very stressful

Especially still not having proper PPE

Had many staff test +

Several hospitalized

2 vented

One made it home with o2

The other died last weekend, tell me I am over reacting..."


**********************************
Totally feel this. I'm a travel nurse in NYC since the beginning of April, and the idea of it happening again is so so anxiety producing. I have started crying over pictures of idiots in the Ozarks. Our COVID ICUs are full of patients that are going nowhere, or going to LTACs with trachs and pegs and AWFUL pressure sores. It's horrific. The suffering, the stress, the overload of patients that you can't keep up with.

'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (1) Thanks(1)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: June 05 2020 at 11:15am

(She went  to NY to assist in the care of Covid patients. She is a DNP from Pensacola, Fl. I hope that you Find her post helpful)


Day #50


Long post alert!


Here we are at day 50 already! I feel like this adventure is a lot like having a baby. The days are long, but the months go by fast.

Going home hadn't seemed real until I broke out my suitcases this afternoon. I'm all packed up except for five sets of scrubs, travel clothes, a nightgown, and toiletries.

 This morning I had my blood drawn for COVID antibody testing. I'm sure I will be negative....but a girl can hope!! My cousin, Michelle came by with another mother load of home made meals to last until I leave. They are delicious! Yes, I actually stuck a spoon in each container as I unpacked them ☺️.


I thought I would write about the common issues we see in the COVID ICU over and over again.

Every patient is not identical, but they all seem to be variations on this theme. This is the COVID patient requiring ICU, which is the minority of those infected. This is rather technical and really intended for my nurse peeps who are asking for the details. Here are the deets.


These folks come in with cough, fever, weakness, and difficulty breathing. Some require immediate intubation while others smolder for up to two weeks before deteriorating.

They all have a MASSIVE inflammatory response which affects all organ systems.

Below are labs from a patient I took care of a couple of weeks ago. These are classic.

His CRP is 140. The doc rounding was thrilled that day as it was over 300 two days prior. In normal times, CRP is sometimes used as a marker to predict an individual's risk for heart disease. Ten is considered significantly elevated and patients are educated about changing their ways (diet/exercise).
These COVID CRP values are incredible! I was sure they must use different reference values. Nope, they are really that elevated. 

They all have elevated ferritin and d-dimers.

They become pancytopenic requiring blood transfusions FFP, platelets, and PRBC.

They develop elevated liver enzymes thought to be due to inflammation vs drug injury from all the medications given. This patients TBili was over 30. I think his MELD was 42.

They form blood clots and microemboli which cause strokes and loss of digits and limbs.

They require maximum vent support with the addition of nitric oxide.

Pneumothorax development is common due to high levels of PEEP. Lots of subcutaneous emphysema and chest tube placements.

Renal failure is common with lots of them requiring dialysis.

They have labile blood pressures requiring multiple drips. Many are chemically paralyzed and sedated to help facilitate better oxygenation. There have been up to 15 ECMO patients at one time.


Prone ventilation has been utilized frequently. It is amazing how much better some patients oxygenate face down. Many of these patients have spent so much time prone, they've developed decubitus ulcers to the face, ears, chest, knees, and chin. These areas are padded prior to proning.

Special pillows are used to protect both the ETT and the face....but it's just not enough. Many of these patients will need plastic surgery if they survive. It is like nothing I've ever seen.

My previous ICU experience was in a 12 bed unit where each patient had something a little different going on. Some trauma, some bleeding, some respiratory failure, neurosurgery, etc. Not here.....they're all variations on the same thing. It's eerie. We just say, "They have COVID liver, COVID brain, etc."


They are treated aggressively. As the newer research comes out the treatments change.

Initially they received Azithromycin and Plaquenil. Then they received TOCI (tocilizumab - IL-6 Inhibitor). Then we started giving remdesivir. Unfortunately, there is not enough of this drug for everyone, so patients have to meet certain criteria.

We transfuse convalescent plasma. There is a double blinded study going on with this. Although, If you've ever given FFP....you don't have to be a rocket scientist to figure out who is getting the real deal and who is getting the "placebo."


It will be interesting to see what science shows in the years to come about COVID -19. Until then, we are trying to treat something we just don't know much about to the best of our abilities.


Gerald Lehner sent me the article below. Yesterday, I mentioned that those with diabetes seemed to have poorer outcomes. This article shows that to be the case. Thanks Gerry!

https://bgr.com/2020/05/25/coronavirus-symptoms-fever-risk-factors-men-weight-heart-disease/

'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: June 18 2020 at 11:34am

I’m a Critical Care Doctor. I’m Tired, I’m Mourning, I’m Bracing for More.

We’re keeping empty units available. The virus is still here.

https://www.nytimes.com/2020/06/16/opinion/coronavirus-hospital-second-wave.html

By Daniela J. Lamas

Dr. Lamas is a critical care doctor  at Brigham and Women’s Hospital in Boston


June 16, 2020




Rushing into the hospital for an overnight shift, I grab my brown paper bag of personal protective equipment, swing open the door to the coronavirus intensive care unit — and stop short. The patients are gone. The halls that were cluttered just a day ago with ventilator monitors are now empty, silent.


It has been nearly three months since we reconfigured our hospital to care for the Covid-19 surge. And as our numbers fall, from more than 100 critically ill patients to fewer than 20, most of our coronavirus units are closing.


This is good news. But there is no celebration. How can there be?

Nearly 1,000 Americans continue to die every day from this virus, while others dance in crowded clubs and refuse to wear masks in public places.

 We were tragically unprepared for the initial deluge of patients with a virus we still cannot cure. And now, I am not sure how to feel about what comes next.


Each of the empty rooms still holds the memory of a patient. I think of the man who loved sugary sweet iced coffee and the Red Sox. He died with one of our interns at his bedside holding a phone to his ear for his family to say goodbye.

I pause in a doorway, remembering a grandmother with red nails and tattooed eyeliner who had been looking forward to a trip to Florida with her family. She died, too.


When I reach the corner room, I smile about the gamble we took when we decided to extubate a young cabdriver the night before a surgery that would have connected him more permanently to the ventilator. He made it out of the unit. I would like to think he’s home by now.


The first time I walked down these halls, it seemed to me that the very air itself was poison. Those were the days when we were not sure how long we would have to wear each N95 mask. We saved them in Tupperware or in the small basins that patients use if they need to vomit.


At home, a cough could send me into a panic that lasted for hours. I sprinted on my treadmill to prove to myself that my exercise tolerance was unchanged, that I was safe. I still do, on occasion.


I remember the early days, when we had to fight to get our patients tested, and even when we succeeded, we waited days for results to return from our state’s Department of Public Health.

We debated the danger of aerosols and optimal ventilator settings. The public rallied behind us, with hashtags and so many food donations, praising us as heroes even as I hesitated and tried to hold my breath whenever I entered a patient’s room.


A few of these messages of support remain on the wall of the empty unit — a card with a child’s sweet drawing of a heart, a family photograph, a colorful thank-you poster from a local Girl Scout troop. On my way out of the empty unit, I snap a photo of the posters on the wall.


Still, even as I say “so long” to nurses returning to their own units, I am sadly aware that this is not an ending. The numbers of the sick and dying in my city decreased because we were practicing social distancing. And now, cases in areas of the country that reopened more rapidly are rising, with patients in respiratory failure filling intensive care unit beds in Arizona and Texas.


I see photos of the doctors and nurses there gearing up in their P.P.E., and I feel only exhaustion and dread, knowing what comes next — isolated deaths, terrible FaceTime goodbyes. I had believed that the hard-won knowledge of those of us in hard-hit places like New York City and Boston would begin to spread as efficiently as the virus, but now I am not so hopeful.


Just a few nights ago, at home in my own bed, I was awakened by a page alerting me to a patient in the E.R. She was Covid-19-positive, a recent diagnosis.

It continues.

So we keep the closed unit empty and waiting. Though the hospital is filling once again with heart attack and cancer patients and those who are awaiting transplants, we don’t move any of them into these Covid-19 beds. Not yet. We maintain a backup schedule of critical care doctors who will return to work in the event of another surge.


These empty beds remind us that the virus is still here, and if we do not stay far from one another and wear our masks and wash our hands, if we do not continue to sacrifice our desires and do these uncomfortable things, the beds will inevitably fill again.

And if they do, we will be more prepared. My state has ramped up testing and a robust system of contact tracing. Here in the hospital, we are more familiar with the nuances of this disease and its management.


But everyone is tired. The adrenaline of those early days has turned to profound fatigue.


And, of course, there are still people to care for, many of whom have been intubated for weeks. On my recent night shift, I’m relieved to learn that one of our patients, a young and previously healthy gardener who was intubated and comatose the last time I saw him, is finally waking up after nearly 60 days.


His delirium is clearing. Earlier in the day he spoke for the first time in months. It had been so long that he was surprised by the sound. As I do rounds with the team, I pause outside his door and wave. His arms are too weak to return the gesture, but he offers a tentative smile.


I’m still thinking of the long road he and countless others will face as I am on my way out of the hospital in the morning and pass a man heading into the lobby with a rolling suitcase behind him. He is trying to find the labor and delivery unit, he tells the security guard. His wife is about to have a baby. He sounds proud and I realize that it has been months since I last saw a visitor who is not coming for a death.


Outside, the air is humid, the sun so bright that my eyes tear up a bit. It feels like summer.

 There are sirens in the distance and a few other doctors and nurses walking up the hill from the parking lot, but for a moment, there is no one nearby. I loosen my mask a bit and let the stale air fall away before pulling it tight once again.












'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (1) Thanks(1)   Quote BeachMama Quote  Post ReplyReply Direct Link To This Post Posted: June 18 2020 at 3:05pm

This is ever so powerful. 

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: June 18 2020 at 3:11pm

I agree and so beautifully written, brought tears to my eyes.

'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: June 24 2020 at 10:32am

https://www.facebook.com/norine.mungo


Norine Mungo

June 22 at 5:58 PM · 

The Report from Covid Central. 2nd full day at home. Y'all need to keep spreading the word. In a nut shell, I started out some 26 days ago from when we estimate my first exposure.


About 3 days after possible exposure, my eyes became red, almost like pink eye. I used tobradex to heal up. At fifth day, I had a severe asthma attack. No fever, no dry cough. Had several more asthma attacks over the next few days. I have severe asthma, so I thought maybe I was reacting to chemical smells and getting what's called reactive asthma.


One week from possible exposure, a severe asthma attack at work that was almost life threatening. A little cough started just before leaving for home. Vinny had drove me because I was worried about my asthma. On the way home that night I told him I was feeling funny. Like a bit dizzy.


That night, another full blown asthma attack. I'm getting worried. I started getting very shivery. Went to bed, lots of blankets.


Day 8. It's Friday. I'm in bed doubled over in pain. Can't breathe, dry heaving into a bowl. Guts coming out my nostrils. Fever 99.8 , during that day I started into the diarrhea. My gut felt like the alien was clawing its way through my torso. I was already getting blood from the diarrhea. Called my primary dr office that afternoon, he was already gone. Was told to go to urgent care. But I was so sick that I went into the fetal position and started praying. Through the night the fever gained speed. Coughing, that dry coughing hit big time and was relentless.


Day 9 from exposure. I'm a whimpering baby. Can't hardly stand up. Fever fluctuating between 99.8 to 100.8. Coughing with every single breath. Ribs felt pain with every cough. Head exploding with every cough. Diarrhea and dry heaving continue. I feel like I'm breathing in empty air. No oxygen satisfies, just empty air. I call urgent care, they give me an appointment for 11:30 am. Vinny helps me to the car, the most grueling painful walk of my life. Drives me to baycare. I wait in the parking lot till they call me in. At this point, fever, coughing, trying not to pee my pants cause of the constant hacking, pain in my gut, and they are running behind. I sit in total misery, poor Vinny freaking out. We're both wearing masks.


Finally they call me in. Vinny is not allowed to help me. I have to walk in alone. I barely make it to the room. Dr Catherine's good. Fever was 100.6. They tested for reg flu, negative. To rule it out. They did not have covid tests there. They did a chest xray. Lungs are cloudy. O2 was at 91%. Diagnosis, presumptive covid. Sent home with rx for azithromycin and a prednisone pack. 


I muscle through that Saturday, in dire pain, can't eat a thing, causes gagging, can't even drink water. Throat is on fire, from coughing??? Feels like strep. The journey into the night through Sunday, then Monday, absolutely not one minute of sleep.

The pain in my gut makes me want to shoot myself and get it over with. The coughing is so constant that I can't remember a time when I wasn't coughing. Fever keeps fluctuating, and makes me not know when and if I should get to the hospital.


Day 12. It's Tuesday. I'm crippled. I'm close to getting an ambulance. I call the primary care office, but was advised that it would be better to go back to urgent care. I wait and think it through. Nope, by about 1pm, I call it. Vinny drives me directly to the hospital. They meet us at the curb, and tell Vinny to back away and get back in his car. They help me, precariously out of the car into a wheelchair. Vinny is told to leave. I'm now outside waiting for them to push me inside.

The air flowing from the er through the doors chills me so badly that I began shaking like a convulsion. They push me through the doors, some guard looking lady taps my forehead and yells out 99. I'm like 'great' now they will think I'm over reacting. I'm in tears.

They are asking me questions but I'm coughing, can't breathe, and shaking I'm so cold. Finally they put me through a triage area, where they ask more questions. I try to relay all my symptoms as my teeth began hitting each other from shivering.

They swab my nose, a rapid test for covid. I'm placed alone in the chair in a holding area. No contact. Then an orderly comes and gets me, rolls me through the doors and puts me into a bed in er. They pop in and ask more questions about how I'm feeling. Test results are back. Positive for covid.

They roll a portable xray in and take a chest xray. Results, cloudy lungs, pneumonia in the right lung. Fever starts to climb. Now I'm 101.8. My O2 had dropped to 80 %. After being a low grade fever of 99 about two hours prior, I'm told, "We're admitting you to the hospital ".


I pause, frightened to death, will I ever see my family again? I'm trying not to cry. Crying won't help. I don't want to go to ICU. I don't want a ventilator. It takes hours to finally get a bed upstairs. I've received albuterol and they have me on O2. I've no appetite but they bring me some clear broth. I try a little. Oh no, vomiting into my facemask. I call for help. I apologize, I'm so embarrassed. They clean me up. They put a commode by the bed but tell me to ring for help.

By 11pm, the incontinence starts. From everywhere. I've messed the bed again, this time with uncontrolled diarrhea. I want to die from embarrassment. I'm horrified. The pain is getting so bad in my gut and bottom that I'm hyperventilating. The night proceeds filled with dry heaves, asthma attacks, diarrhea, fever, sweats, and I think, ,"Omg, I might not make it. No no no no!"


Day 13, Wednesday. My o2 stays low even on 5 liters of oxygen. They replaced the nasal cannula with a mask. My incontinence continues. I got to the commode, but the bed, sheets, my gown, and the floor now have diarrhea everywhere. I'm screaming in pain, it's so bad now that I'm literally screaming out at the top of my lungs, in between hyperventilating, and gasping for air.

They look at the mess. Diarrhea mixed with blood everywhere. I can hardly get cleaned. I sit there in pain till my legs get numb, cause it just keeps pouring out. Finally, they get me back to bed. I'm completely washed down. I apologize profusely.

They keep telling me it's ok, and that I'm very seriously ill. Still, I just can't believe what I'm going through. No one ever said it was like this. Those that died? You hear they couldn't breathe, and passed away due to complications of covid. I'm thinking, is this all those 'complications.'?


I'm one full day in, they keep asking about shortness of breath. I start lying. No way am I gonna let them take me to ICU, put me in induced coma and ventilate. I don't want to lose control of my situation. So, every time, no, I'm not short of breath really, just my asthma. I'm hoping they are buying it.


The Dr's and nurses talk to me about research drugs etc.. and I say sign me up for anything that might help. Especially when they say it could keep me from ICU. Book'em Dano!


I'm no longer in the hospital for observation. I'm fully admitted and now under treatment. They start the research drug called Remdesivir the next day. It's five days of iv.

 I try to eat a normal meal. Grits and omelet. That was the worst vomiting, went out my nose, into my hair, down inside my gown and went on for almost half an hour. They put me on iv fluid and order clear liquid diet. The diarrhea is now completely clear yellow liquid acid mixed with blood as it burns my insides.

The induced coma is beginning to coax me, but I endure the pain, I'm not going down that road.


Day 14 from exposure. Yeah, two weeks in. The remdesivir is being administered, day one and I'm slowly holding down some broth by evening. O2 remains low, fever keeps fluctuating, I never get to that magical 103 mark. Sure glad I didn't stay home, just cause I didn't make it to that number.


Days 15 through 18, hospital days are now 6 days. Finished the Remdesivir, diarrhea has calmed down. I've gone from IV to clear liquid, to liquid (more solid like protein shakes) and they want to try some solid food.

The fever, coughing, hypoxia, night sweats, chills, abdominal cramps all continue. But for the moment, the acidic diarrhea has calmed down. It was the one thing that was crippling me. I order food but no appetite. They give me antinausea meds. After about 3 non ate meals I get chastised, in a kind way. I'm told that food is medicine. The body needs it.


I begin, with meds at every meal, to force myself to eat a little more each day. On day 6 or 7 hospital days, lost track, they tell me because of my continued fever and symptoms that they believe plasma with antibodies will benefit me. I'm on board.


They do the two hour IV, and monitor my vitals throughout. BP begins to edge up after being low for 6 days.


Days 7 and 8 hospital days, fever seems to have broke. Super wet sweat ensues. I'll take it. I'm eating more, holding it down. Diarrhea has stopped. I'm feeling hopeful. And yet, the hypoxia continues.

I try sitting up, but my ribs and gut are pretty beat up, every breath is painful. I've described it before as having someone with long sharp nails, scrape down on inhale and scrape up on exhale. I know I need deep breaths to try and get o2, but I can't help breathing shallow, to avoid the pain.


Pain, it's all I know now. My life is pain. My joints, skin, head, gut, lungs, all just pain. It's day 9 in the hospital, about day 20 since exposure. I think, ,"Is this what fibromyalgia patients experience? Or Diabetic nerve pain?"


I think of friends who've had those issues and my heart breaks for them. Cause I know I'll beat this, and this pain will subside, but for them, theirs's is insidious. I've lost friends to diabetes. I pray that my organs hold on for dear life.


The Dr and infectious disease Dr decide to give me Dexamethasone. It's day 9. BP still high, O2 still low, can hardly stand up I'm so weak, so I say yes. Yes. Anything!


Day 9 through 12 hospital days. I begin eating in earnest. Pain in skin and fingers and toes begin to subside. O2 stats slowly but surely come up. I'm reduced every 4 hours till I'm on 1 liter, back to nasal cannula.

It's Friday, Vinny had entered the hospital on Wed, and they brought him to my room so we could hug. He's doing better than me, we talk here and there Thursday, and he comes back to my room that night. The nurses had him all wrapped up with shield and all. It helped.

 I tell him about my window. How I watched the sunrise each day, watched the blue sky, the white clouds, the storm with lightning. I tell him that that patch of blue and thinking about my love for him, it kept me sane. He loves the flowers and all the cards. We say goodbye and as he leaves I'm praying he doesn't get as bad as I was. With his heart condition, my fear goes up exponentially.


Friday, I force myself to sit up the whole day. Diarrhea tried to come back, but only the gut pain. No nausea. Fever doesn't come back. I think it's day 3 on the dexamethasone.

There's talk of getting me home so I go without O2 for 24 hours. My sats are at 90%. Sometimes 94%. Good enough. Without O2 two days before, I was still 80 to 87 %. It tells me my lungs are truly starting to transfer oxygen. I'm getting confident. But I still can't stand up very well, legs are toast, and short of breath to get to the bed. But, I did make it to the actual toilet, and I felt like celebrating.


The Drs tell me I'm mostly out of the woods and most likely going home Saturday. They say Vinny will also go home Saturday. I call my poor daughter who was in from Seattle to tell her the news. She's distraught. She thinks she's lost our cat Charlie. I try to help her over the phone. She is dying inside.


Finally I tell her that, though I love Charlie, she is way more important to me than the cat. I tell her I bought Crazy Rich Asians on Amazon and have her turn it on. It's 12 midnight. I turn it on in the hospital tv, we put our phones on speaker, and we watch the movie together. She seems to calm down as the movie progresses. We laugh, we cry, we boo, and then 3am said a tender goodnight. I pray she sleeps. She's already done so much for us.


Sleep does not come for me. I know they'll be in around 4am for bloodwork. Then 5 they do the temps and BP, at 6 I fall asleep for about half an hour. I wake up soaked. Ugh. Slimy cold sweat.

I call the nurse, and they tell me to order breakfast and they will bring in the change at that time. They are still minimal contact. All week, I was alone except for procedures etc. Not their fault. Policy. But a few got to know Norine. I wait for the call from the Hospital Dr, he finally talks to me via the phone. I'm going home. Long recovery to be expected.

They give me the last of the meds including the dexamethasone one last time. But I need pt eval. So Vinny goes home first. Physical Therapy shows up and runs a gamut of tests. I can not get up from a chair without using my arms. I can't sit slowly back down without using my arms. Legs just collapse.

She has me walk a little with a walker in the room. I'm barely able to take steps, legs are lead jello. Heavy and rubbery. Finally I sit down. I'm going home with a walker, and I'll need physical therapy but can't get home help till I'm negative. I'll get help via facetime. Ok. I'm good with that.


They pack me up, and drive me through the hospital. They cleared the floors as I went through. There was no regalia like you see on TV. No, it was as quiet and lonely as my room was for two weeks. I did wave at a few that I saw, leaving the ward.


We get outside, the heat hits me, I'm looking at the sky. The full sky. I say hello old friend in my mind.


While we wait for Lisa, one of the techs made some small talk, said he heard I was a musician. I smiled behind my mask. I sang him, very raspy, Riptide. 

His eyes popped a little, I guess cause I'm an old lady to these young folk. Don't think he saw that coming. He def loved it and wished me well. The two nurses talk about what they're now facing, because the wards are filling up with a surge of covid. I send up a prayer for the staff.


Lisa arrives and they pack my things into the car. We drive home mostly in silence. I'm afraid to breathe near my daughter. She tells me kitty came out and ate. I'm happy for my daughter, cause it would have killed her to lose our cat. No worries, I think, I'm on my way home. Life is good.


Day one back home. The coughing continues, no fever, gut is ramping up, diarrhea is odd, like, just go away. But it's not returned to acidic. I'm starting to have problems with my bladder. Like, bladder infection. I'm so done with this virus.


I get through Saturday to Sunday. Lisa is at a hotel now, totally distancing now that we're both home. She'd Cloroxed the whole house, replaced rugs, bedding, food. She was exhausted.


I tell her when she comes to please bring cranberry juice. The bladder infection is really causing the shiver teeth. I'm like, ok, gut pain from intestines and bladder pain. I sit on the toilet for quite awhile. Why get up. Between the two issues, I always have to go. They day must go on. I pull myself together.


I order to go from olive garden. It's father's day after all. Vinny had not lost his appetite and they also have gluten free for me, so I get a meal that can be picked up by 7pm.

Vinny had chicken parmigiana, spaghetti, minestrone soup and salad. I had gf rotini with sausage and a Toscana soup, and salad. Lisa had lightly beaded shrimp and chicken parmigiana. She sat over at the table, Vinny in his arm chair and me on an edge of the couch. I kept my mask on between bites.

 We watched the 7th episode of the Tampa Bay Ukulele Society Talent Show on YouTube. They'd dedicated the show to me and Vinny. It was so wonderful. Tears many times during the show.


I went back to bed to minimize exposure, and Lisa went back to her hotel. I couldn't sleep again. I put the phantom thread on my iPad, it's a quiet movie, and I laid there watching it. Pain in my bladder really ramping up. I'll need to call my Dr Monday.


Today, 26 days from exposure.

My diarrhea is gone. It's now replaced with what can only be described a puss. I sit in pain needing to go. For very little return. Sorry for the graphics. But you need to know.

My bladder infection is in full bloom. I'd slept about an hour this morning, woke up unable to get a breath in. Soaking wet. Had to bang on the wall for Vinny. He came running. Couldn't find the inhaler. I'm going down this is it. Finally, there's the inhaler, it was in a bag in my meds. I take small breaths in and hold.


I call the primary and set up the teledoc and I saw him at 11:30 this morning. He ordered symbacort, a sulfide for the bladder, and a sleep aid. Tells me to keep eating, it will turn around. I believe him. I'm home after all. I'm alive.


So, though I've gone over many of these things throughout this ordeal, and asked you to spread the word about masks, I think what I need you to know is that the media definitely downplays the full covid nightmare.

It's still going for me. I'm told I can relapse. I'm told it could be months until I'm full strength, if ever. I'm told I'll need more bloodwork to eval my kidneys and liver. I'm told to watch for sharp pain in my chest as in heart. I'm told to call an ambulance if my breathing gets so short as I might not make it to the hospital without help.


I know, time heals all. I'll get there. But I just don't want to see any of you, not one of you, get anything near this bad. We've lost some friends to covid. Some of our friends have lost family to covid. We've got friends right now in different parts of the country who are sick or hospitalized. It's so real now. It's 26 days round about since exposure.


28 days ago I was fine, making tamales, joyful, filled with future thought of things to do, songs to sing, festivals to play. 26 days ago I got exposed. And now I'm almost dependent totally on others. Hard pill to swallow when you're a hard head like me.


Wear the masks. If anyone says otherwise like that one guy, I'll delete and block. Wear the masks. If that kid had worn a mask, maybe, just maybe, I wouldn't be writing this today.


Go donate blood. They will inform you at some point if you have antibodies for covid. If you do, and you're healthy enough, donate plasma. I'm sure the plasma saved my life.

Get checked. It's going to save someone like me. Don't donate only if you know someone with covid. That's not right. We're all humans together trying to make it through a world wide pandemic. Give freely if you have antibodies. The plasma they gave me came from the mayo clinic. Get checked. Donate. Save lives. When I'm well, I'll be checked for antibodies. If they can use my plasma, I'll gladly pay it forward.


Lastly, ( I promise,) all your well wishes, flowers, texts, calls, and prayers were so beneficial. I was alone in my room, with a patch of blue sky, but y'all were there with me. I was never really alone, was I. Y'all had my back. And I believe through your thoughts and prayers, that the staff, the Drs, the Respiratory therapists, they all fought with everything they had in the arsenal, because somehow, you buoyed them up as well.


Some of the stand out Staff. Two nurses named Jessica. Tabatha, a nurse tech who was so kind to me I cried. A nurse named Kristin? Maria from house keeping who remembered me from two years ago when I was in with the flu.

Lou. From Respiratory. What can I say about the calm wonderful soothing Lou. Omg, I'll never forget Lou. Dr Bruno, Dr Mang, Dr Cochrane, my undying love. And to those that were so wonderful but I was just too sick to remember their names, each and everyone of them, all encouraging, all very sharp, they protected me.


Baycare Medical, start to finish, what an amazing group. My insurance, Devoted, checking with me along the way, making sure I was comfortable and explaining away my fears of financial disaster. Devoted, they are still following up tomorrow with nurse triage to take care of my home needs.


A lot of people invested in my return to health.


God's Blessings, stay safe, keep away from everyone, wear masks, donate plasma, and spread this story. The America we know, they don't know this. They all need to know. Protect the vulnerable. We're worthy of a full life too!!!


Ever Strumming,

Norine Mungo

Tampa Bay Ukulele Society

Board of Directors

Event and Performance Coordinator

Every Day, It's An Ukulele Day!!

'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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https://www.yahoo.com/lifestyle/took-one-person-one-errand-050138571.html

It Took One Person, And One Errand, To Infect My Entire Family With COVID-19
by Alix Atwell

June 24, 2020

I wake with a start to flashing lights, blue and blinking against the darkness of my bedroom. Numbers. My body feels heavier than normal, like I have a weighted blanket on, but I don’t. It’s on the living room couch.

 The base of my skull aches. So does my lower back. 88, 88, 88. It’s not changing. That number is meaningful. I know it. Oh, yes. It’s the year I graduated high school. Now orienting myself, I realize it’s also the number flashing on my trusty pulse oximeter. Alarmed, I force myself to sit up.


Damn! “The doctor told me to sleep on my stomach but I keep waking on my back.”


My body has been trained to back sleep. I’ve used a cervical traction pillow for 10 years now. It’s been a godsend. I’m a nurse. I herniated a disc in my neck on the job years ago while manipulating equipment and my tired body working a double shift.

 I started my nursing career in the ER and ICU but transitioned to labor and delivery a few years in. After lifting and moving patients, day in and day out, something was sure to give. It did. My neck snapped, or cracked, or shifted. An MRI would prove all three. My body screamed “enough.”


Was it the same silent internal scream that woke me just now? “Enough!” “Enough sleep.” “88 is too low!” “Wake up and die alive!” My late mother used to say that phase to me when I had watched too much TV or slept long into a Sunday afternoon, as teenagers are supposed to do. “Wake up and die alive.” Was she watching out for me now? Did she wake me up?


“But, mum. I’m not dying. I’ve been to the doctor. I’m not even sick enough to be hospitalized. My pulmonologist gave me dexamethasone and azithromycin just yesterday. He ordered home oxygen and instructed me to sleep on my belly. I’m not even sick enough for my insurance to approve same day oxygen delivery. I’m even healthy enough to be up writing this diatribe at 2:43 in the morning. Well, actually it’s fear that’s keeping me awake. But shhh..don’t tell anyone. At least writing will distract me from my thoughts.”



So, I sit up, prop pillows that in turn prop my oxygen level up to a healthy 97% and I breath in deep and deliberate. My headache fades. My back pain eases. I lean over and grab my computer and write for the first time in three long months.


* * *


It’s in me. First it invaded my husband, then my two children. Now me. That seems to be the order of business in my house. It’s as if my body decides it cannot get sick until the others are on the mend.

In 2017, it was influenza A. My husband brought it back as a souvenir on one of his many work trips to Japan. 2018 brought us Influenza B. “Are you serious? We all got flu shots!” Now it’s SARS coV-2 (aka COVID-19.)


This time, the fated souvenir came from a trip to the gas station and Home Depot. My husband hadn’t been out of the house in weeks. Since quarantine started, I had insisted on being the only one to go out and get food and supplies.

After all, as a nurse of 27 years, I knew sterile technique. He retorted “You’re being paranoid and controlling” — traits I openly admit to. I got them from my mother. “You forget. I worked in a genetics lab. I also know sterile technique.”

He was right. He was smart. He was a trained scientist who now worked in biotech. He probably knew germ theory better than I did. He donned his mask, armed himself with Purell and headed out. It had been so long since he left the house or did anything normal. He was itching for a change of scenery. Who could blame him?


It was May 1st (May Day) in Illinois and everything was blooming.

 My husband had developed bad allergies since our move from California three years ago. That evening, I recall commenting on his eyes. Wow, your eyes are really bloodshot and swollen. Your eyelids are so puffy. Do they hurt?” “Damn allergies,” he said. Where are my drops, Hun?” “See, you should have let me go out instead.” I smirked while handing them to him.


I am an armchair epidemiologist. In high school, I had pipe dreams of working at the CDC with Anthony Fauci. My mom was earning a biology degree and was writing a paper about a new scary retrovirus called HIV. I was hooked.

Later, I busied myself reading about outbreaks of Ebola and Dengue fever, SARS and MERS while eating popcorn and sipping on juice boxes alongside my two kids while they played with blocks and watched Super Why and Caillou. When the news struck of a novel virus spreading in China early in January 2020, I devoured every news article I could. This was the one we were waiting for.


The lockdown was no surprise to me. I took the initiative and canceled our spring break trip to California, even though a dear old friend had planned my 50th birthday party where 40 of my dearest friend and family were set to attend. This was weeks before the government advised against non-essential travel “in an abundance of caution.” Friends thought I was an alarmist! Some still do.


I turned 50 a week into quarantine. Everyone was still adjusting. No one had their acts together yet. There was no car parade or zoom party for my milestone COVID birthday.

I transitioned to middle age with little fanfare. The only card I received in the mail was my AARP card. Strangely, that was also the last month I menstruated. (I know, TMI.)

 It would seem my current event stress tolerance had finally reached a tipping point that kicked me into menopause. It didn’t take long for the compounding COVID -19 pounds and the absence of my-bimonthly dye job to make me look the part of middle age. Now months into isolation, with 88 blinking back at me, I feel the part too.


88 is an ominous number for those of us in the medical field. With a pulse ox. of 92%, I would place a nasal cannula (low flow oxygen) on my patient. But at 88% I would choose a non-rebreather face mask (high flow oxygen) instead because if their oxygen level remained that low, they could sustain permanent organ damage.

 I know medicine practices change rapidly and that I was trained old school. Things that were once routine, like bed baths and enemas and now even hand holding, are now passé. I can roll with change, but I honestly did not foresee that a day would come when a sudden oxygen saturation of 88% would buy you a home oxygen machine rather than a hospital bed. We have entered post-modern COVID times. The old rules no longer apply.


More honestly, I’m scared. But I can’t show it. I have an 11-year-old daughter who was crying yesterday as I left for my doctor’s appointment. When I grabbed my car keys and bag my dogs seemed concerned too. I had packed a little bag thinking 88 might be the magic number that would buy me a hospital staycation. “Mommy, you have to come home. I can’t go through what I went through with daddy. I can’t. It was too hard.”


It’s been a tough few months for all of us, but my daughter in particular is struggling the hardest. She is not adjusting well to the sequestration, the home schooling, or having to go cold turkey on a pretty serious chipotle addiction.

My 14-year-old son, on the other hand, is thriving. “I’m an introvert, mom. I was built for this!” He retreats to his bunk bed lair where he is now master of his destiny in Minecraft Dungeons, Stardew Valley and the Binding of Isaac. He has been asking to be homeschooled since the 3rd grade. He finally got his wish!


Things changed dramatically for us when their dad came down suddenly with flu-like symptoms on May 4th. (May the 4th be with you!) We took the proper precautions. He was banished to the guest room for days. While he sweated it out alone, my two kids tried to navigate the news and their emotions between classroom zoom meetings. They missed a few. Who gives a shit!


I busied myself sterilizing door knobs, faucet fixtures, countertops and anything else in sight. My son came out of his lair a bit more often for hugs and food and clung to the dogs like a toddler does his blankie.

My daughter busied herself sewing double-ply cotton masks for local essential workers, and baking fancy treats like coffee cake and macaroons. She learned to make homemade Frappuccino’s (vanilla, strawberry, matcha) and whipped coffee frappés. The strawberry ones are to die for.


My husband’s symptoms strangely and suddenly disappeared 4 days later. After a negative nasal-to-brain swab, and zero respiratory involvement, the docs insisted he was safe.

He couldn’t have had it but even if he had, as long as he was symptom free and 7 days out from symptom onset, he was not contagious. So, on day 8 he rejoined us. The dogs, the kids, and the short order cook (me) were so happy. But the advice was wrong.

Two weeks to the day of his first symptom, my husband crashed.


It was a Monday. He was working from home at his cool new suction standing desk sipping coffee and feeling fine at 10 am. He came into the kitchen, where I was homeschooling the kids at 10:30 saying his legs felt funny.

“Honey, I don’t feel quite right. I feel like my knees are going to just give out underneath me. I’m going to lie down for a bit.” Less than an hour later his lips were blue, his face mottled, his hands and feet cold and yellow, like day-old dead. He had rigors (that’s nurses speak for vigorously and uncontrollable shaking–basically, shivers amplified–and is the tell-tale sign for full blown sepsis, way more ominous than an 88% oxygen saturation)


But his temperature was normal? So was his mentation? First murder hornets, now a zombie apocalypse? My brain couldn’t compute what I was seeing. By the time it took me to find my phone and reach the doctor, his fever was 103.1.

We grabbed his phone, his charger, the keys and a couple of homemade masks, and drove the two miles to deposit him on the doorstep of the local hospital. Like a desperate mother depositing a newborn she loves dearly but is ill-equipped to care for, I left and soberly waited word.


My husband was in the ER for 6 hours before they admitted him. They ran a slew of tests and labs. He would send me random texts and photos of his monitor between lab draws, his EKG, being whisked off to cat scan and x-ray and his cat naps.

Before his transfer, a very kind nurse filled me in on his status and lab results. His numbers were really off. D-Dimer, 15. Ferritin, 1681. PCT 16. C-reactive protein 10.8. Magnesium 1.4. LDH, 439. AST, 445. AST, 314. Lymphocytes 3%. She read these off with a deadpan voice, but I had worked ER and ICU.

The numbers she was reporting were WACK. He was REALLY SICK. SHIT. She informed me that they sent off a nasal swab for COVID, gave him ibuprofen, oral antibiotics, IV magnesium and were sending him up to a COVID unit “just in case.” Since he had zero respiratory symptoms and an elevated PCT which usually indicates a bacterial infection, it was unlikely.


It was a long night.

 I called the night nurse for an update just before her change of shift. She said my husband’s blood pressure was very low and she was contacting the on-call hospitalist for directives. Not long after, the night shift nurse practitioner, who was on call upon his admission and was just ending her shift called. “His blood pressure fell to a dangerously low 60/40, but was now up to 80/60 with half a liter of fluid.” (If 88 vs. 92 is the difference of an oxygen mask or a nasal cannula, a blood pressure of 60/40 vs. 80/60 is the difference of a med-surg bed or an ICU bed. He wasn’t pumping enough blood to keep his organs alive!) I panicked.


I knew from my experience, septic patients whose blood pressures drop dangerously low need multiple liters of fluid to perfuse their organs, not the equivalent to two cups of water. I started screaming and crying on the phone. Not my best moment.


“Oh my god, he’s going to die. Do something!”

She calmly explained, they couldn’t give him more because COVID patients have a tendency to shift fluid into their lungs and this could make him require a ventilator. She continued. ”Strangely, COVID patients actually tolerate low blood pressures and low oxygen saturations extremely well. She reassured me that he was fully awake, talking clearly and was actually feeling ok. We’re acting cautiously for a reason. We’ve got him. He’s going to be OK.” I was terrified, but reassured. I thanked her and hung up the phone.


After that, communication became spotty at best. The day shift nurse didn’t return my calls two days in a row. Andy called between rests but he was sick, and fatigued. I didn’t want to scare him with questions. He wouldn’t have the answers anyway and asking would just feed his anxiety. He was being so brave. Like many men, he isn’t usually a stoic patient and he doesn’t do hospitals well. He nearly passed out when I cut my finger at his 35th birthday and required stitches. He was a comforting catatonic during the bloody delivery of our first child.


I gave him what he needed, a loving wife and a good cheerleader. But there was no one there to give me what I needed. Information. Communication. Reassurance.


It wasn’t until a physician friend kindly offered to make a few calls and look into some things that I was included in the loop of communication and got any follow-up lab values and test results.

 It was now late Wednesday. The infectious disease hospitalist of this suburban Chicagoland hospital had diagnosed him with typhoid. TYPHOID? Why? Because he had a negative COVID nasal swab (did I mention he had no respiratory symptoms) and he had diarrhea and a high fever. He had seen it  hundreds of times before. He was trained overseas.


But he had failed to call me to get a detailed history of my husband’s present illness. He failed to note the complete lack of any GI symptoms until antibiotics were started and he was non-plussed when I informed him of my husband’s swollen eyes three days before first symptom onset, even after I faxed him a Lancet article stating up to 50% of COVID cytokine storm patients don’t present with respiratory symptoms, a JAMA article citing unusual but statistically significant cases of COVID-19 patients gaining transmission through the eyes with negative nasal swabs and elevated PCT’s, and research directly linking elevated PCT levels to severe COVID-19 infections. (I kept myself busy while waiting for word at home.)


As a nurse, I am very concerned with the state of hospital care in the time of COVID. I know it is an extremely challenging time for all, but we must do better. My husband was too ill to give a complete history. Without family allowed at the bedside or included in the intake, even by phone, compromised hospital patients in the time of COVID have no voice and no advocate.


This compromises care and can lead to misdiagnosis and inappropriate treatment.


Dr Typhoid placed him on multiple broad-spectrum IV antibiotics which only further exacerbated my husband’s hospital induced diarrhea.

The dogged doctor then proceeded to decrease the blood thinner he was placed on that would save his life if it were COVID. Thankfully, the night shift hospitalist, the nurse practitioner who reassured me days earlier that “she had him,” was working that evening, noticed the change, corrected it immediately and insisted on stat scans at midnight to ensure no clots had formed in his legs or lungs during the subtherapeutic dosing.

She called me to get approval and to inform me she was on it! But what does that say about a hospital when the doctors do not agree on the diagnosis or treatment plan?


Miraculously, by Thursday, my husband’s labs were normalizing and his fever was down. He was even able to Zoom attend his son’s 8th grade graduation ceremony! All cultures came back negative too so I requested a COVID IGM and IGG before discharge. I thought, without a positive culture, there still was no definitive diagnosis. With great reluctance, Dr. Typhoid ran the IGG but said the hospital didn’t have the capacity to run an IGM.


IGG shows an immune system that has had, and recovered from an infection. It takes over 2 weeks of fighting an illness for the body to produce it. The IGM shows up first, during the earlier stages of fighting off a disease–it shows up about a week into the fight. A person can still transmit the disease to others at this stage. His COVID IGG came back negative.


They sent him home on Friday to recover. His discharge diagnosis in his chart was “Typhoid Sepsis-NOT COVID.”

 They sent him home with food preparation instructions. Dr. Typhoid insisted that even IF it were COVID, patients are not contagious if they are afebrile and are 7 days out from first symptom onset. Therefore, no isolation was necessary.


I know that is the current company line, but that conclusion does not sit well with me. I do not see the data to back it up. I did not trust Dr. Typhoid’s advice, and our own personal history, with my husband’s symptoms returning so suddenly and profoundly 14+ days in seemed evidence to the contrary. I desperately wanted my husband home and safe, but I did not want to risk infecting me and my kids. We were still asymptomatic. Or were we?


Just hours before I was set to pick up my husband, my son’s nose turned on. Like a faucet! He went through two full boxes of tissues in two hours. There was snot everywhere! His eyes glazed over. I took his temperature, 99.7.

“Mom, my stomach hurts too.” Ugg! What do I do now? I could sequester him and my husband in the back room but my husband needed his rest. He would be too sick to care for my son on his own. Would it even be possible for me to care for them without contaminating my daughter without home PPE? And in reality, the cat was likely already out of the bag. If my son now had symptoms, my daughter and I were surely already exposed.

She and I have compromised lungs. This was not good. With great reluctance, I decided the only practical course of action was to ride the wave together. Sometimes practical logic sucks. At least we would all have each other.


Where was I? Oh yes, Friday May 22nd. My youngest sister’s birthday, my husband’s hospital discharge day and the start of my pediatric rotation.


The next couple of weeks consisted of TID temperature checks (that’s three times a day for non-hospital folk) and nightly pulse oximeter checks. A neighbor was kind enough to lend me her spare when Andy first got sick. The stores were out and Amazon was on back order

For the next two weeks, there was not a day that went by without one kid or the other having a temp. Just under 100, not high enough to call the doctor but not low enough to breathe a sigh of relief.

One kid had a bad headache one day, the other woke with diarrhea and nausea the next. Both were acting in their typical sick style. My son, uncharacteristically cuddly, my daughter ornery as a tired old mule.

Throughout it all, I cleaned, cooked, worried, mowed, ordered from Instacart, worried, and went on walks around the neighborhood with my husband to build up his lost stamina.

A week ago today, 20 days after my husband’s hospital discharge and my kids first symptoms, I mowed the lawn. I started coughing when I went to bed.

Coughing after mowing is not abnormal for me. I have bad lungs from a sick building I used to work in. They are sensitive to fumes. But afterward, my lungs felt like they were on fire. That was odd. I grabbed the pulse ox. 89! “That can’t be right? Can it?” I sat up and took a few deep breaths and it jumped to 97. “That’s more like it,” I thought. I poured myself a finger of Barenjauger, a yummy honey liquor every medicine cabinet needs, sipped it to quell my cough, and went to sleep.


I felt fine the next day. The kids were finally afebrile. Andy was back working at his standing desk. It was gorgeous out, sunny and warm with low humidity. I decided to take advantage.

I trimmed the hedges, took some nature photos and cut some flowers from my garden. Later that day, I celebrated a niece’s High School graduation via Facetime. YAY! We were back to pandemic normal! But that night, the same thing happened. A burning cough and a low pulse ox. This time I kept it on. It stayed low when lying on my back but was up to normal if I turned on my side or sat up.


I spent the weekend in denial. “I’m not getting sick. I’m not getting sick.” I made pancakes. I did laundry. I accompanied my husband on his daily recovery walks, but when he declined to take the hilly street to the right, I didn’t push him this time. I was feeling winded already.

I attended another niece’s college graduation party–go Banana Slugs! But now I was sipping Barenjager in the afternoon to hide my pesky dry cough from my Zoom family. My energy was good. I didn’t have a fever, but my lower back and legs ached. Maybe it was just from the yardwork. Sunday evening, I got an oxygen reading of 83. Now I was scared.


I spent Monday morning calling local urgent care centers to see who could do COVID testing, x-ray and labs. I called my primary care physician and my pulmonologist call lines and was directed to messaging systems where I could text symptoms and set up virtual encounters. It took COVID to finally bring healthcare into the digital age! 

It was late afternoon before I spoke with a live body but gratefully, I secured an appointment for the following morning with my pulmonologist who was equipped to see COVID patients, could do the dreaded nasal swab and take an x-ray. By this time, I was short of breath coming up stairs and easily fatigued doing household chores. A mild but present pressure and tightness in my chest accompanied me wherever I went. I watched impatiently a blinking 90, waiting for morning to come.


I had an early morning appointment. I arrived early and called from the car so they could gown up as instructed. “Enter through the side door, the one with the large pink COVID warning on it.” Within minutes of my arrival, my vitals, chest x-ray and nasal swab were done. It really wasn’t so bad and was over in a second. Why are people making such a big deal of it?


My doctor was fantastic. As a Chicagoland pulmonologist, he was now far more familiar with the disease process than he would like to be. Luckily, his PPE, diligence and up-to-date knowledge has kept him disease-free so far, knock on wood.

He stood in full garb, hand on the door, 6+ feet away and told it to me straight. You have COVID. Whether the test comes back positive or negative, you have COVID. You will feel worse before you feel better. You will not feel like yourself for at least another 2 months, if not longer. You are infectious. With what I am seeing, your family could be shedding virus if they live with you, even if they have no symptoms and have recovered from it.

 He prescribed me meds and oxygen and gave me instructions. But he prefaced them. “These are just supportive measures. We have no treatment. And you are the healthiest COVID patient I have seen here yet, likely that’s because you are here early in your course, so take care and call or text with any questions or changes."  And with that, I was sent home.


That was yesterday. My headache is now gone and my oxygen blinks reassuringly at 97. I will not sleep soundly until I get my oxygen tank … but by that time, the steroids will likely have kicked in. Oh well. My doctor forewarned of the fun involved there! But I am grateful. I am home. I have a plan.

 I am the last one to get sick in the house so I get company through my illness. I have the tools to monitor myself and the meds to support my body in healing. I have no idea what tomorrow will bring. The only certainty right now, other then the pending sunrise I am about to witness, is that I will not be choosing Dr. Typhoid’s hospital should I require further services.


Epilogue:


It turns out that the delay in my home oxygen delivery was because COVID is not currently a qualifying medical condition on ANY insurance.

I had to pay out of pocket to receive it but even that required upper management approval. It seems home oxygen requires a chronic condition like COPD or congestive heart failure.

Home management is best for non-critical cases of COVID. It frees up much needed hospital resources, keeps cost to a minimum and keeps healthcare workers safer. COVID is not currently considered a chronic condition; however many people are suffering months long debilitating symptoms. They even have a name. Long haulers.


The day after I wrote this, my daughter relapsed. She had a high fever, chills, weakness, uncontrolled shaking, a rapid heart-rate and stated “the air feels thin!” She required an emergency room evaluation because our local pediatrician office has a policy of not seeing COVID patients.

I was not allowed to take her because I had symptoms. My husband was a rockstar! Her symptoms resolved as quickly as they came. The experts at Lurie reassured us that children handle the waves of COVID symptoms far better than adults and she was safe, for now, to ride it out at home.

 The very next day, my husband’s symptoms returned. Fever, chills, body aches and malaise. They are now long haulers too.


Seven days after my test was performed, my doctor called with my COVID swab result. Positive.

Validation leaves a bitter taste in my mouth. If my husband had gotten proper testing and safer instructions. my kids and I may have been spared. We are convalescing side by side, me with my oxygen and steroids, my daughter with her breathing treatments and Tylenol.

My husband is pushing himself, working from home, between bouts of symptoms. My dear son is helping out around the house, taking care of the dogs and he even made us cupcakes.

There are a lot more COVID stories out there. I believe ours will have a happy ending. I just don’t know how many more chapters there will be till we get there. But we have each other. We have a roof over our heads and friends that deliver meals and supplies. We have access to treatment. We are the lucky ones.













'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (1) Thanks(1)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: June 25 2020 at 7:11am

I’ve Been Sick With COVID-19 For Over 3 Months. Here’s What You Should Know.

“One hundred days later, I’ve learned there is nothing ‘mild’ or predictable about this disease.”

by 


Ann E. Wallace, PhD
 
06/24/2020 
Guest Writer

https://www.huffpost.com/entry/sick-coronavirus-symptoms-what-to-know_n_5ef0d697c5b68f12e4e526e1

Today marks my 100th day being sick with COVID-19. My symptoms began on March 17, two days after I published an essay on HuffPost Personal about facing difficulties getting my 16-year-old daughter Molly tested for the virus.


Despite the strict criteria for testing in my home state of New Jersey at that time, Molly and I were finally both tested on March 22 because we were deemed high-risk: me, because I have multiple sclerosis, and Molly, because she had been displaying symptoms for two weeks and was therefore a health risk to me.


Back then, two weeks sounded like a very long time to be sick with COVID-19.


We had no idea.


From the start of our journey, I’ve shared our experiences on social media and via various publications in the hopes of helping others navigate the uncharted waters of this virus. Reliable information about everything ranging from risk factors to testing facilities was difficult to find in March, so I knew that whatever I learned could be valuable to others.


Since I started speaking out publicly, many people have reached out to me with concerns about their own health. Others, who are sick with COVID-19 themselves, wanted to relay their own experiences. As the rates of infection begin to surge again around the country due to many states reopening businesses, as well as individuals and groups who refuse to wear masks and practice social distancing, I want to share four somewhat common and, honestly, remarkably upsetting sentiments that I’ve recently encountered.


1. “I’m afraid to tell people that I have COVID-19.”


We need to drop the stigma that comes with having COVID-19. Shame serves no one, and, if you are sick, you may need a large network to support you. I know this firsthand: For week upon week of my illness, I was not capable of preparing a meal or doing a load of laundry. Even speaking was difficult because it required oxygen I did not have. Three months in, simple tasks can still make my oxygen levels drop and leave me short of breath. Now is not the time to choose privacy; even though you should not be near other people while you’re sick, you may need them to provide you with food or medicine and run errands for you.


More important, because COVID-19 is a novel coronavirus, we are all still actively learning about it, and any new information we receive can be hugely important ― that includes scientific studies, but also personal anecdotes too.


If you’re too embarrassed or ashamed to tell your story, you could be missing an opportunity to help others.

You never know whose life you might affect, or even save, by sharing your experience. If you’re too embarrassed or ashamed to tell your story, you could be missing an opportunity to help others. I have had many health problems throughout my life ― from fighting ovarian cancer in my 20s to being diagnosed with MS before I turned 40 to, now, COVID-19, which caused me to spend my 50th birthday in the emergency room. I study, teach and write about illness, and I live by the belief that our stories matter.


2. “My COVID test was negative. Now what? People don’t believe I’m sick.”


First, it’s important to understand that as many as 15-30% of COVID-19 tests performed may return a false negative. What’s more, many experts believe that tests are most reliable when done between three and six days after symptoms first appear. Many people, especially in areas where tests are not readily available, are unable to get tested that quickly.


If you suspect you were infected or have symptoms, do not delay in getting tested. A positive test result will make your life easier in a multitude of ways, from securing priority treatment, sick leave from work, inclusion in long-term medical studies that may help find a vaccine or better treatment for the disease, and, quite frankly, the right to be “counted.”


But, if your test comes back negative, do not assume the test is correct. By the time my daughter was tested, she was on day 15 of her symptoms and her test results were negative. By that point, she had already shed most, if not all, of the virus, even though she had another week of symptoms to fight through. Fortunately, none of our doctors believed her test results, but we might have been tempted to believe it if my test (given the same day as Molly’s, but on day five of my symptoms) had not been positive.


I know many people who have “presumed positive” cases, who had symptoms and were aware of having been exposed to COVID-19, yet who were not able to get tested or received negative test results. Absent a definitive test, other possibilities need to be ruled out, but do not hesitate to push your health care provider to do that work.


3. “It’s been two months. No one believes that I’m still sick.”


I’ve been fortunate that no one in my network has doubted that I’ve been sick for this long. For three months, I have been sharing my story online, and I suppose my friends don’t think of me as the type to orchestrate such a finely wrought long con.


The fact is that many COVID-19 patients are sick for months, and they are struggling to educate others about this reality even as they are navigating daily life with a terrifyingly relentless, debilitating and deadly disease. Believe them. Their stories are true and they are more common than you probably expect.


Due to the lack of robust scientific information about COVID-19 or the difficulty of finding reputable sources for it, patients are sharing their experiences and compiling data through online support groups, such as the Body Politic COVID-19 Support Group and the Long Haul COVID Fighters on Facebook. It is becoming increasingly clear that those experiencing the long course of this disease, dubbed “long-haul” patients, tend to be younger and otherwise healthy. Even though I have MS, my autoimmune disease does not limit my life. Prior to contracting COVID-19 I was active and fully ambulatory, worked a demanding job, and was fortunate to have what I consider above-average stamina.


I recently joined the Long Haul COVID Fighters group, where there are over 4,000 members who have been sick for 80 days or longer. Others in the group are marathoners, dancers, fitness buffs and parents of young children. These are not the types of people we hear about as being especially susceptible to COVID-19.


It’s time to dispel the myth that the coronavirus is just a bad flu that only kills older individuals who were near death anyway and that everyone else recovers quickly. Neither of those claims is true. Those who do not survive COVID-19 cannot be easily lumped together or dismissed. What’s more, there is a huge swath of people who fall in the middle of these extremes and who are sick from four weeks up to several months.


Most of us long-haul patients have been diagnosed with “mild” or “moderate” cases because we don’t need intubation or prolonged hospitalization, but don’t be misled by that. Just two weeks ago, I was in the ER for the fourth time with reoccurring flulike symptoms and an uncomfortable tingling in my arms and legs. A few days later I had the energy to work in my garden for several hours, but two days after that I almost passed out before breakfast. When I checked my blood oxygen using my fingertip oximeter, I saw my level had dropped to 88.


I learned early in my illness that oxygen saturation is measured as a percentage (100 is perfect) and that any reading below the low 90s might warrant a trip to the emergency room for supplemental oxygen. After weeks of dropping levels, I was able to get an oxygen concentrator at home, so I can now turn on the machine, insert the nasal cannula tubing, and rest on my couch until my level has rebounded. For me, there is nothing “mild” or predictable about this disease, even three months in.


If you see your employer or friends doubting or denying the long-haul course of this disease or the long-term effects, please speak up. We need your voices and your advocacy. No one who is sick should have to worry that their boss or spouse or doctor doesn’t believe them.


4. “My doctor said I have a mild case and to rest at home, but that was a month ago and I’m not getting better. I’m really worried.”


My final point ― and it’s an important one ― is that if you or anyone you know is sick with COVID-19, you must be vigilant about seeking out and demanding the best health care.


It may not be easy to make appointments or get medical tests where you live right now. In different regions, healthcare professionals may be still, again, or newly inundated with patients.


I cannot tell you how many phone calls I have made in the past three months figuring out first how to get tested and then how to get the other tests and services that I need. The nurse case manager at my doctor’s office has helped with these calls as well. Even with her help, it hasn’t been easy. We have even been told conflicting information by different people at the same facility. In fact, in April I lost valuable time when I followed a hospital’s very specific instructions and went to an ER for a preauthorized CT scan ordered by my doctor, only to have the ER doctor decide that I didn’t need it and send me home.


Two weeks later, I got the test at a different hospital as an outpatient. A nurse met me, with my oxygen tank in hand, at the curb, put me in a wheelchair, covered me a sheet from head to toe, and wheeled me directly into the CT room. I could not enter the building unescorted, I could not use the restroom, I could not see where I was going, but I got the test.


The point is you need to be vocal and persistent about what you need, even if you aren’t entirely sure what that is. COVID-19 can seem or start off mild but it can worsen quickly and become deadly in just a matter of days, so be proactive. Your primary care doctor should be helping you. If he or she is not, I cannot say this firmly enough, you need to find a new doctor.


COVID-19 is nowhere near done with us, and our leaders and neighbors are not necessarily making decisions with your health as their top priority. If they were, we would have widespread free testing, health care support, and contact tracing in every town in the nation. If they were, we would not have people coming to blows or worse over mask-wearing requirements or closed bars and restaurants.


Until that changes, be prepared to advocate for yourself and your loved ones. It could be a matter of life and death and your life is surely worth it.


Ann E. Wallace, PhD writes of her experiences with cancer and MS, motherhood, love, and the realities of living in contemporary America. She has a new poetry collection, “Counting by Sevens,” available from Main Street Rag. Her recently published pieces in journals such as Mom Egg Review, Wordgathering, Snapdragon, Riggwelter, and Rogue Agent, can be found on her website AnnWallacePhD.com. She lives in Jersey City, New Jersey, where she is an English professor at New Jersey City University. You can follow her on Twitter @annwlace409.



'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (1) Thanks(1)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: June 29 2020 at 1:41pm

Interesting convo I am passing along....



Laura Mac I cannot specifically speak to your above question, but I will state that in our COVID ICU we are seeing a lot more patients under the age of 40, with many severely ill patients in their 20s right now.
  • Jeanie Ross
    Jeanie Ross do you think the virus is changing to be more serious to a younger age group?
  • Laura Mac
    Laura Mac I think we can’t rule out this is the age group that is more complacent in their actions and appear to be taking more risks with naivety to the fact they can become ill. I am in Arizona, I’m not sure how it is with the younger individuals in other states right now.
  • Tess Dowers
    Tess Dowers Definitely seeing younger and younger patients in San Diego
  • Jo Gabriel
    Jo Gabriel man, I can't prove it, but I swear the darn thing mutated. πŸ€¬πŸ’”
  • Laura Mac
    Laura Mac Jeanie Ross that is a good thought, it’s very odd.
  • Ronald Cahill
    Ronald Cahill Jo Gabriel it's not the same virus that originally hit Wuhan. So it has mutated once. Why not again?
'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: June 30 2020 at 6:03am


 Please read and share. It's what he wants. I wish I could highlight the whole thing! Please read to the end....


Brandon Bikowski  https://www.facebook.com/brandon.bikowski 

June 27 at 1:34 PM

This week I was one of the COVID doctors in the hospital. Before I went on service, I had planned to share my experiences when I got home after my last shift. That didn't happen because I was mentally and emotionally exhausted after being at the hospital for 15+ hours.


I am going to try to break things down so that the general public can understand, because I want everyone, not just my fellow healthcare workers, to be as scared as I am.


This is going to be long, but hopefully will be worth the read for someone.


For references purposes, I am a Hospitalist, which is sort of like your primary care doctor when you're in the hospital. We manage your chronic medical conditions and most of your acute issues in the hospital and consult specialists when we need additional help with complex decision making or a specialized procedure to be performed. We are also the primary point of contact for your nurse on most issues.


I live in Arizona, the current COVID-19 hot spot. Arizona never really closed. 

Any level of closure that we obtained was the result of petitions with thousands of signatures from physicians. Despite pretty much being able to do anything you wanted to do except get your hair/nails done or eat out at a restaurant (carry out stayed open), people protested the state being closed.

The state reopened immediately when criteria were put out to guide how and when states should reopen. To be clear, Arizona did not meet a single criteria for reopening. In addition, masks were not mandated. Governor Ducey avoided mandating masks and made it the responsibility of city Mayors to make any mandates. Mandatory masks were just implemented a few days ago.


As you have almost certainly seen in the news, the rapid reopening without mandated masks has been catastrophic. In a couple of weeks we have gone from a few hundred cases per day to around 3,500 cases per day. A few weeks ago, I was working at the COVID-free hospital designated to be the primary elective surgery campus within the network. The past few days, our recently reopened COVID Unit has been near or completely full. I shared the patient's on the unit with one other hospitalist.


Before I went on service this week, I read anything and everything I could to prepare myself to be the COVID doc. I was up to date on all of the latest recommendations. I was a little nervous, but felt like I was armed with the information that would allow me to help my patients.


I quickly learned that there is no possible way to prepare for how to treat a COVID patient. There is no rhyme, reason, or pattern. There is no possible way to predict what will happen with your patient.


In my sign out to the doc taking over for me today, I prefaced the individual patient sign outs with, "one slightly improving, one with less oxygen requirements but possible new liver failure developing, everyone else getting worse."


I have never seen anything like this. None of us have. We have no idea what we are doing.

We are sharing evidence from small studies that could help and utilizing treatments that we think and hope are helpful. Of course, we also thought hydroxychloroquine was helpful a couple of months ago. So, we're hopefully helping people, maybe hurting them, and trying our best. We are flipping people on their stomachs while wide awake on a machine pushing oxygen into their lungs to try and help; this is called the prone position, and it works, but you're stuck in that position for as long as we can keep you there. The longer the better.

Anyone on supplemental oxygen is receiving dexamethasone based on the European study that came out last week. We were using Remdesivir, but a patient I admitted two days ago is the last one that will receive it from our current stockpile. Convalescent plasma from patients that had COVID, recovered, and donated plasma is being administered, but studies suggest that antibody concentration diminishes by up to 90% within 2-3 months, so who knows if that's even doing anything.


I realized in the past two days that oxygen saturation numbers that you see on the machines are completely worthless in many COVID patients. So, the one thing we thought we knew, that COVID causes profound hypoxia, was true, but it's actually much worse than we thought.

In order to figure out if you are hypoxic (low blood oxygen levels), a needle is stuck into an artery in your wrist as often as is needed. It hurts. A lot. I will have a needle stuck into your artery as often as I need to. I'm sorry, I know it hurts, but it's for your own good.


In any other time, most of my patients would already be intubated on a ventilator. We are managing so many critically ill patients on regular hospital floors. If we sent everyone to the ICU that would normally be there based on their current status and put them all on ventilators, all resources would be depleted in a day.


The patients I cared for the past few days were the most miserable, uncomfortable, terrified patients I have seen in the past four years.

I sat with them while they cried because they are scared that they will get worse and get intubated and die without ever seeing their loved ones again. I can't comfort them by saying they'll get better soon, because I don't know that they will. All I can tell them is that we're doing everything we can and I really hope they improve.

I held a patients hand while she cried and screamed, "oh my god, I'm going to die, aren't I? I'm dying" when I told her we couldn't give her more oxygen without intubating her and putting her on life support. I then tried to comfort her children over the phone after I informed them they were not allowed to come in to the hospital to be with her. They asked if someone could be there to comfort her if she is going to die.


Many of my patients were young. Many have no underlying conditions that predispose them to a bad outcome, yet are one bad blood oxygen reading away from needing to be intubated.


COVID does not care who you are.


I am scared and you should be, too.


All of that is to send the following message:


Please, please, stay home if you can. If you need to go out, WEAR A MASK! Do not touch your face. Wash your hands and sanitize often. I can't promise you won't end up in the hospital with COVID even if you do all of these things, but I promise it's the best shot you've got.


P.S. THANK YOU to all the amazing RNs, RTs, PCTs, Pharmacists, Pharmacy techs, lab techs, physical, occupational & speech therapists, social workers, case managers, environmental service workers, and everyone else that makes it possible to care for these patients in the best way we know how. You don't get enough credit. You all are the real MVPs.


______________________________________


ADDENDUM: To be clear, COVID-19 is caused by a virus. This is a PUBLIC HEALTH CRISIS. It is not, never has been, and never will be a political issue. Politics have played a huge role in getting us into this mess, and it's time to cut them out. COVID doesn't discriminate, and it definitely doesn't care who you're going to vote for. When you see/hear/read anything related to COVID-19, pay attention to who is posting the information. If it is not coming from a medical professional, question your source.


______________________________________


ADDENDUM-2: I am so incredibly shocked at how widely this has been shared. Thank you all! Please continue to share! Since people are reading this, I would like to use this platform to ask you to PLEASE talk with your loved ones about your wishes.

If you have an advance directive, please bring it with you if you are unfortunately in need of hospitalization. If you do not have an advance directive, it's time to get one. If we do not know what you would like to be done, we assume that the answer is everything. If your loved one or listed MPOA is unaware of your wishes, they will likely also err on the side of doing everything. Help them to make those very difficult decisions by making your wishes known. Do not wait until you are in the hospital, because it may be too late. Please look up what it means to be "full code" vs "DNR/DNI." Know what you would want done to you.

'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (1) Thanks(1)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: July 03 2020 at 12:09pm

I keep seeing reports that "deaths are down" like this is becoming less serious and then I read stories like these and think...so what that deaths are down, just being on a Covid ward sounds frightening and horrible! I don't want to end up there, even if I do survive...its all just so scary.


“How many more are coming?” What it’s like inside hospitals as coronavirus grips Texas’ Rio Grande Valley


https://www.texastribune.org/2020/07/02/texas-coronavirus-hospital-rio-grande-valley/


The surge in coronavirus cases has slammed hospitals in the Rio Grande Valley. Additional wards have opened. Doctors and nurses pull extra shifts. And the stream of sick people, some gasping for air, keeps growing.

JULY 2, 2020


At midnight in South Texas, nearly every bed is full in a low-slung building housing some of the sickest COVID-19 patients near the U.S.-Mexico border.


Many patients in this unit, a hospice center at Doctors Hospital at Renaissance remade into a coronavirus ward, are sedated, intubated and attached by a tangle of cords to the whirring and beeping machines keeping them alive.


Some are in individual rooms; dozens more are lined up in a vacated bay divided into a grid by curtains to separate beds.



“How many more are coming?” a nurse asks around 11 p.m. No one can be sure.


Some of these patients will go home and complete their recoveries. Others will leave to be buried.


The Rio Grande Valley has seen a surge in coronavirus cases, and the patients arrive daily. At least 10 were brought here from the emergency room Wednesday. More than a dozen the day before that. Some nurses tend to three patients each, instead of the usual two, and pick up extra hours. A lead nurse who clocked in at 6:45 a.m. Tuesday was still working past 10:30 p.m. Another, on her fourth 12-hour shift, said she’d seen things she will “never unsee.”


“We're getting more and more and more, and that's the problem,” said nurse Apryle Pelshaw. The blaring alarm that signals a patient needs to be intubated or is having a medical emergency sounds in her sleep.


[...]


“We can handle small surges and clusters; it's not a big deal. But when you get this continuous surge ongoing hour after hour — you see these patients and they are all coming in with the same symptoms huffing and puffing, some of them are gasping for air and some of them are confused because of the lack of oxygen, and they're elderly and they're young and they're distressed and they're agitated, and then there are no family members around,” Madi [Dr. Jamil Madi, medical director of intensive care at Valley Baptist] said. “It is draining.”


[...]


Most of the patients Tuesday were elderly, some with underlying health issues common in the Valley, like diabetes. Several members of one patient’s family had already tested positive for the virus. Another woman’s daughter called Pelshaw around 8:30 p.m. asking to say a prayer for her mom.


“Do you have any idea what room she's in, ma'am?” Pelshaw asked over the mechanical whirring and the beeping of the intravenous pumps.


Pelshaw’s wing had the sickest of the sick, 23 patients, 17 on vents, each kept in an individual room with an IV pole outside in the hallway, so nurses can make adjustments with minimal exposure. At the center is the hospice’s break room — once a place where elderly residents visited with family members. It now holds shelf after shelf of supplies — tubes, lubricating jelly — and five ventilators in a corner. There’s a case of refrigerated medications in what was once the “kids room.”



The patients who are slightly less ill are in a cavernous wing on the other side of the building, their beds arranged in rows and separated by high blue and white curtains. Many were prone and unconscious Tuesday night.


Nurses worry about the mental toll the pandemic is taking on their colleagues. About eight patients have died in the last two weeks, leaving hospital staff to break the news to family members who were not allowed to visit the infectious disease wards in person.

[...]



Late Tuesday in the DHR Health coronavirus ward, medical staff members tried to put a needle into the artery of one of nurse Christian Ramirez’s patients. Her blood pressure dropped, and Ramirez rushed to adjust the medications. He watched her blood pressure stabilize, standing amid discarded gloves strewn on the ground in the frenzy.


“She didn’t deserve this,” he said of the patient, who had patches on both cheeks holding her endotracheal tube in place. “My other two patients don’t deserve this.” All three needed critical care, two on ventilators, one on a nasal cannula and “maxed out on oxygen.”


The patient’s blood pressure suddenly shot up, and Ramirez darted to adjust her medications again, the green light of the machine reflecting on his face shield


The people that wind up in this coronavirus ward are seriously ill and “require a lot of attention, a lot of medications,” said Veronica Gomez, director of the unit. Two or three typically need to be intubated each shift. One doctor said he’d intubated five patients in one morning.


On top of that, nurses have become the patients’ entire support system because family members aren’t allowed in. They’ll help connect patients and family by phone, and “we can hear the anguish on the other side of the phone line,” said Gomez, who’s been a nurse for almost 20 years.


Not long before midnight, word came that a patient would be transferred over in an ambulance. One of the critical patients in the former hospice building had improved enough to move to a bed in the emptied bay. Their old room was being cleaned. A woman traipsed out with bagged-up trash. Ramirez began moving in supplies.


Another patient was on their way. Ramirez would be there to treat them.

***
(photos in story are especially poignant)

'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: July 04 2020 at 6:29am

from Dr Rick Loftus, MD. yesterday, update about Covid-19:

I'm in a hotspot hospital in a hotspot region (Coachella Valley, Inland Empire, CA).

We just converted the entire second floor of our hospital to COVID-19 care yesterday, July 1. We have 65 inpatients with COVID-19 in a hospital with 368 beds.

It is the same at our other 2 hospitals in the Valley.

We spent yesterday deciding the ethical way to divide up limited remdesivir (30 patients' worth) for the hospital patients.

My 20 incoming interns for our IM resident were exposed to COVID 2 weeks ago during their computer chart training; apparently 100% of our computer trainers had COVID19. One intern tested positive 7 days later and I insisted we re-test them all again, as there are almost certainly other cases with minimal symptoms.

 I raided my household and took my entire supply of face shields to the hospital for the residents to wear on their first day, and I paid $1000 of my own money to equip all of my residents with medical-grade face shields. I require all residents to wear a surgical mask or N95 with face shield if they are within 6 feet of another human, patient or coworker.


Roughly 20% of our inpatients die. Only 30% of our ventilated patients survive. (We try to avoid ventilation at all costs. Some people insist on being full code and decompensate despite high flow with face mask, proning, dexamethasone, antibiotics, and a cocktail of famotidine, zinc, Vitamin D, Vitamin C, NAC, and melatonin--we throw everything we can at each case, so long as it won't hurt them.)


My administrative assistant, who sits adjacent to the interns, just went home with COVID symptoms. Her test is pending.


In the Southwest, we are experiencing catastrophic exponential growth. I have had multiple families--siblings, parent-child, spouses--admitted with COVID-19.

I had a 31 year old come in satting 78% on room air; he had been sequestering himself in his bedroom for a week to avoid infecting his elderly parents, with whom he lived. His sister, the only person he saw outside his immediate household in the 10 days prior to onset of fever, cough, and dyspnea, had also had fevers but had tested "negative" at our other large hospital so he thought it was safe to visit her. (Sigh. The Quest PCR test is about 80% sensitive, we think--it had emergency approval, so sensitivity data was not required. The Cepheid rapid COVID PCR test is 98.5% sensitive but is in short supply due to limited reagent availability.)


I'm glad some of you are sheltered from what unbridled COVID-19 looks like. It's a hell show. This is *July*. What do you think my hospital will look like in winter?...


This is real.

Doctors in places with proper public health responses will see few cases in their hospitals--like UCSF--but let me tell you something: The laws of physics and biology don't change. If you're in an unaffected region, an introduction and poor governance and low use of physical distancing and masks will give you an exponential increase in no time flat (i.e. 2-4 weeks). That's pandemic math.

And 20% of the population infected needs a hospital. You *will* run out of beds with an unbridled pandemic. There is almost ZERO pre-existing immunity to SARS-CoV-2. There may be some "priming" of T-cell responses due to exposure to other "benign" beta-coronaviruses, but we have no idea if that explains the 20-40% of people who seem to get minimal symptoms. Asymptomatic infected persons, however, can, and do, spread COVID to those who die from it.


By the way: I've seen scary looking CT scans of the lungs that look like terrible interstitial pneumonia in a patient who had ZERO symptoms and SaO2 94% on room air. She came in for palpitations and the intern overnight got a chest CT for cardiac reasons. We didn't know it was COVID until her test came back 36 hours later. So "asymptomatic" does NOT mean "no biological activity." The virus replicates furiously in people who feel fine. Kids can spread this as easily as grown ups, even if they feel okay.


Related: I've talked to two previously healthy patients ages 32 and 44 who are 3 and 4 months, respectively, post their acute COVID. They continue to have cough, nightsweats, fever, fatigue. How many survivors have "post-COVID syndrome"? We don't know. Less than 20% but we're not sure. I've asked my hospital to allow me to establish a post-COVID clinic to care for and study survivors. Both NIH and UW are planning similar efforts based on my dialogues with them.


Autopsies show anoxic brain injury in many patients who died of COVID, not to mention microthrombi throughout the lungs and megakaryocytes in massive infiltrations in their hearts and other organs. People get heart failure, lung fibrosis, and permanent kidney injury from COVID-19. This is a disease of the vascular systems, and it can affect any organ, with lungs and kidneys being especially at risk.


In early May, thanks to lockdown, our census of 55 came down to 10 COVID cases, and for a brief moment, I actually had hope that the worst nightmares I had about COVID, as a biohazard virology-trained hospitalist, would not come to pass. Then we re-opened, without test/trace/isolate systems anywhere close to adequate. Eight weeks ago my county decided to make masks "optional," despite 125 doctors begging them not to do that. Now we're worse than we were in April. And it's getting worse every day.


You wanna see if COVID is real? Come walk on my COVID ward with me. It's real. Hearing people talk about it as if it's an exaggeration is, well, rage-inducing, honestly. Denial is the most common reaction to a pandemic. Denial is how the US will wind up with 1.1 million deaths instead of 30,000. I saw AIDS denialists get killed by their belief that HIV "isn't real, it's a pharma conspiracy of the medical industrial complex." Yeah, right, if you say so. I watched patients with those beliefs die.


The hardest part about this is, every new case I treat exposes me. I have assiduous hot zone technique. But no technique is bulletproof. If you keep exposing me to case after case, eventually, the virus will get through my defenses. I'm a 50 year old hypertensive. I don't expect to do well if I get infected. For now, I keep going to work.

I'm one of the few pushing forward on COVID clinical trials, basic science, public health messaging, and diagnostic studies at my hospital. I feel a responsibility to keep going. I wake up with nightmares every morning at 4am. But I'm going to keep going for now. I feel very alone a lot of the time. People are not taking this seriously, and it's costing lives. -R


"Everything we do before a pandemic will seem alarmist. Everything we do after a pandemic will seem inadequate. This is the dilemma we face, but it should not stop us from doing what we can to prepare. We need to reach out to everyone with words that inform, but not inflame. We need to encourage everyone to prepare, but not panic." — Michael O. Leavitt, 2007


--

Richard A. Loftus, MD


"Never be afraid to raise your voice for honesty and truth and compassion against injustice and lying and greed. If people all over the world...would do this, it would change the earth." --William Faulkner

'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: July 04 2020 at 8:46am

https://threadreaderapp.com/thread/1279155358666305541.html


Dani Oliver  July 3, 2020

Hey, so, I got #Covid19 in March. I’ve been sick for over 3 months w/ severe respiratory, cardiovascular & neurological symptoms. I still have a fever. I’ve been incapacitated for nearly a season of my life. It's not enough to not die. You don’t want to live thru this, either. 1/

I am not unique. Support groups have sprung up all over the internet because medical science doesn’t know what to do with the hundreds of thousands of Covid patients who don’t get better in the (utter and complete bullshit, and they know it) CDC guidelines of 2-6 weeks. 2/

The CDC is also refusing to add widely-reported, terrifying symptoms to their lists. So here’s a grab bag of what patients like me are experiencing, so you know: Extreme tachycardia. My heart rate was once 160 while I was sleeping. Chest pain, like someone’s sitting… 3/

...on your sternum. Back and rib pain like someone’s taken a baseball bat to your torso. Fatigue like you’ve never felt before in your life. Fatigue like your body is shutting off. Fatigue so bad that it would often make me cry because I thought it might mean I was dying. 4/

GI problems, diarrhea to severe acid reflux. I had diarrhea every day for two+ months. Unbearable nausea. Also: Inexplicable rashes. For me, little broken blood vessels all over my body. For many of us, a constant shortness of breath that doctors can’t find an explanation for. 5/


 

Neurological symptoms. I had delirium & hallucinations. Many report tingling all over their body, an internal “buzzing” or “vibrating.” Also, insomnia & chronic hypnic bodily jerks. One symptom so weird that I thought it was just me, but it turns out it’s so many of us… 6/

was waking up in the middle of the night, gasping for breath. I also experienced tremors while trying to sleep, like someone was shaking the bed. Also: many report a “hot head.” Mine literally radiated heat, despite not hitting a high fever. Then, there’s the confusion… 7/

The “brain fog.” I couldn’t read or make sense of text at times. I couldn’t remember words. I’d stare at my partner at a loss for what I needed to communicate, or how to do it. Also: thickening of the blood, clotting. Weird, inexplicable changes to the menstrual cycle. 8/

Everyone knows the lung stuff already, so I won't elaborate. But it doesn’t just go away. I wake up every morning & when I breathe in, it feels like someone is crinkling plastic in my chest. And these are just the symptoms. I’m not even touching the physical damage done… 9/

...to patients’ organs and bodily systems. I’m also not touching the mental component of this, which is compounded by the very virtue of not knowing if it’ll eventually kill you. But long-term covid sufferers all report the same thing: that the recovery is non-linear. 10/

You’ll wake up feeling better and assume, like would be true for the flu or a cold, you’re on the mend. But then... you get worse. & then you're feeling better again! & then you’re bedridden, worse than before. It makes no sense. You start to think you’re losing your grip... 11/

or maybe it’s all in your head. It isn’t. Thousands & thousands are experiencing these cycles. At some point, I realized that this was causing a trauma response in my body, which only seemed to worsen recovery. And I’m someone who’s learned over the years how to tend to... 12/

their mental health needs pretty well. This experience is a whole other ball game. It is terrifying what it did to my mind. There are parts of the experience I am well aware I've blocked out in order to function, and times my partner has to remind me of things I've shut out. 13/

There's so much we don't know — including if these physical damages are permanent or, for some, will lead to chronic illness. But one thing we do know is this isn’t the fucking flu. Those of you taking risks (yes, you in masks, as well), please, please weigh them against... 14/

...experiences like mine. It's not "well, a tiny fraction of people die, and most people are better in two weeks." This is simply untrue. So many of us have suffered for months. Ask yourselves: is going to get a coffee, or getting a haircut worth being debilitatingly ill... 15/

...for 4+ months of your life? Or, is it worth condemning someone else to this experience? Tending to your critical needs (grocery, medicine) is a necessary risk. So is fighting for the lives of others (protesting, organizing). But I promise you, the risk is too great... 16/

...for a birthday party. Or a fucking bar night. Or visiting your fav restaurant. Good lord, I cannot stress this enough. Please. Wear a mask. Stay home as much as you can. And know that the recovery times associated with this illness are wrong. That people are suffering. 17/

If you made it this far, thanks for reading. Please tell others about long-term Covid patients.. /end


The responses to this thread are overwhelming, & so kind, & I'm so sorry if I can't get to your DMs right away. So many people with similar experiences. Check out @edyong209's Atlantic piece, which links to some of the support groups. You are not alone.

COVID-19 Can Last for Several Months

The disease’s “long-haulers” have endured relentless waves of debilitating symptoms—and disbelief from doctors and friends.

https://www.theatlantic.com/health/archiv

'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (1) Thanks(1)   Quote Dutch Josh Quote  Post ReplyReply Direct Link To This Post Posted: July 04 2020 at 9:25am

Tabitha111-thanks for the good frontline-info. It is shocking, Covid19 is killing people on a massive scale. Children here in NL are supposed to be not spreading the virus. Also the tendency that "if you do not have any symptoms you can not spread the virus" is basic-and very wrong-in how we deal with Covid19 here in the Netherlands. 

For the moment we have a "break" in this part of Europe. With the stupidity widespread this pause will not last that long. 

We cannot solve our problems with the same thinking we used when we created them.
~Albert Einstein
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: July 05 2020 at 7:18am

Kali Clark Dayton

As an ICU Nurse Practitioner, I see a lot of confusion about the announcements made concerning hospital "capacity". We are hearing that areas like Texas, Arizona, and California are overwhelmed with COVID19, but then hospital administrators publicly announce that they have thousands of beds still available. This is being confused with "capacity".


Bed count is the physical space to store dying bodies. It does not equate to a community's CAPACITY to keep those bodies alive, treat them humanely, or restore any quality of life to them.


We are starting to try to turn away patients and are panicked about the sudden volumes showing up. This is not for a shortage of space or even beds (yet). Some hospitals have converted their parking garages into "ICU"s. It is fairly easy to find a place to place to put people. (Some hospitals have patients in their hallways. Yet look- they're on a bed! It's all good!) It is not as easy to build the army of trained humans to keep the sick ones alive.


Please observe the following insights:


88% of patients on ventilators in NY died. Clearly this is a lethal virus. Yet level of critical care provided greatly impacts overall mortality rate as well as preservation of function.


Thanks to social distancing, in *most places* if you are admitted to an ICU with COVID19 (or any other critical illness) and require a ventilator you will still have:


-A helicopter available to fly you to facility capable of holding on to the thin thread keeping you alive


-Ambulances available to rush to your home when you cannot breathe or your family finds you unresponsive.


-A modern ventilator made with the capability of adjusting for your personal lungs needs and capacity.


-A dialysis machine dedicated to you as well as a nurse to run it safely and effectively.


-ECMO (lung bypass machine) if you need it and are expected to survive it. This requires a huge specialized team to successfully pull it off without expediting death.


-Medications available


-An expert ICU nurse that is dedicated to you or one other patient depending on how sick you are.


-An expert respiratory therapist that manages your tenuous respiratory needs/ventilator. You will share them with 4 other patients on ventilators max.


-Other supportive staff (generally 6 needed per patient) available to turn your limp body to lay face down when your lungs fail so severely that is the only other thing we can do to get oxygen into your body.


-A critical care pulmonologist that has years of experience even after 3 years of critical care fellowship following 2 years internal medicine residency.


-An acute care nurse practitioner or Physician assistant that has years of critical care experience and oversees every little detail of your care along with up to 12 other patients' care.


- Critical care pharmacist expert ensuring the mix of medications are appropriate for you and your organ function.


-Physical therapists that get you moving on the ventilator so that once your lungs are better you will have the muscles to breath on your own and hold your own head up. If you are lucky you will be in an ICU that tries not to break your brain or body during such an infection and physical therapy will actually help you preserve the capacity to walk.


-Occupational Therapy will help you maintain the strength and mental capacity to do all the things you take for granted now- brush your hair/teeth, put on your socks, put on your own underwear, etc.


-Protective equipment to keep healthcare workers alive and functional to keep you alive


-Rehabilitation services that will help your limp body rebuild the strength to get yourself to the toilet or car weeks-months after getting off the ventilator.


***Open all the precautions all at once and allow everyone to be infected in a huge wave. Though NY has exceptional population concentrations, the potential to "exceed capacity" lies within all communities.


***When hospitals tripled in admissions and the severity of illness was overwhelming with staff falling sick in the masses, everything changed. In NY, this meant:


-Ambulances and paramedics were spread so thin people were dying at home. Quickly they stopped performing CPR in the field as it was assumed futile. Texas is reporting ambulances being occupied for over an hour outside hospitals as the ERs are too flooded to accept more patients. This impedes them from running to the other calls they constantly receive.


-1 nurse (often of other specialties thrown blind into an "ICU") to 4-13 patients on ventilators


- 1 respiratory therapist (if ICU was fortunate to have one) to 20 patients on ventilators


-Ventilators that may be 20-30 years old or old meant for use for a few hours- not weeks. These machines are not soft on the lungs and do not have the sophisticated capacity that advanced ventilators have that actually help lungs heal.


-Inadequate dialysis machines mean that patients share machines and no one gets adequately dialyzed.


-Medication shortages that could impact your care and prognosis


- Inadequate staff available to continue safety parameters such as a second witness to high-risk medications. Lethal medication errors occur with good nurses that are overloaded and over-fatigued caring for an impossible patient load.


-Shortage of equipment such as feeding tubes or ambu bags. This becomes life-threatening for people on breathing machines that will not be able to eat for weeks to months. Shortage of ambu bags make it impossible to give rescue breathes during life/death moments.


-NO physical or occupational therapy


-Possibly no critical care pulmonologist overseeing your care. If you do have one you share them with 13-130 other patients. It may be down to a hospitalist, medical resident, cardiologist, etc to adjust your ventilator off of a youtube video.


-Likely no accessible pharmacist. Nurses are mixing a lot of the medications for the first time in their careers. Throw back to 30 years ago- but without the training or safety checks.


-Not enough masks, gowns, gloves. Your needed nurses and doctors get sick and potentially die themselves. This hurts your chances of having someone available for you or the next person.


-The poor quality of ventilator and the lack of human presence at your bedside will require you to be deeply sedated and paralyzed so that you don't take out the breathing tube that is keeping you alive. This will likely lead to sleepless weeks+ traumatizing hallucinations worse than your reality and you will later "wake up" to find your body has less strength than a newborn. If you survive complications of deconditioning, you will face a lifetime of post-ICU dementia from brain damage from the medically-induced coma. 


When we work together to keep reigns on the rate of transmission of COVID19 then we help ensure that there are beds, equipment, and PEOPLE to keep you and your loved ones alive and even functional. This should not be politically driven. It must be driven by human instinct to care for and protect each other.


One of the best precautions to prevent suffering in such circumstances is to review advanced directives with your loved ones. Having realistic expectations for care available depending on status allows us to make educated decisions during critical illness.


On my podcast, I was honored to interview Dr. Dixie Harris, a critical care pulmonologist from Utah. She shares her experience being part of the relief efforts in a community hospital in NY. It is nice to hear real inside information from those that lived it.


https://anchor.fm/restoringlife/episodes/Episode-41-Crisis-Culture-During-COVID19-ee6i08

'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: July 05 2020 at 7:23am

July 2, 2020


WARNING - VIEWER DISCRETION ADVISED


A video from inside DHR, sent in anonymously.

'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Usk Quote  Post ReplyReply Direct Link To This Post Posted: July 05 2020 at 8:14am

Video of list of symptoms after you recover

https://youtu.be/d9y9o6Dy5jI

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: July 05 2020 at 10:02am


'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (1) Thanks(1)   Quote BeachMama Quote  Post ReplyReply Direct Link To This Post Posted: July 05 2020 at 1:33pm

I wish I could share the DHS video on Facebook! 

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Post Options Post Options   Thanks (1) Thanks(1)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: July 08 2020 at 1:41pm

Be sure to watch the youtube video in this story- Tabitha


Window into virus surge:
By NOMAAN MERCHANT

today July 8, 2020

https://apnews.com/c63bbec344cd39d4a2dc4603409b5ebf

HOUSTON (AP) — A few weeks after more than 100 people attended her husband’s funeral, the widow herself was on the brink of death.


Her oxygen levels had fallen deadly low due to complications from COVID-19, and her heart stopped. Ten people, each in two layers of protective equipment, surrounded her hospital bed. Two climbed on opposite sides of the bed — one pressing on her chest, the other on her abdomen.


At the foot of the bed, Dr. Joseph Varon called out a rhythm: one-two, one-two, one-two.


“Keep on pumping!” he yelled.


But they couldn’t save her.


At least 10 people who were at the funeral later developed coronavirus symptoms, according to her daughter, who fell sick herself. Most people weren’t wearing masks. Her daughter says her mother told her she wished they had been more careful.


“We didn’t take precautions like we should have,” the daughter said. “We just got totally caught up in the moment.”


Now, the 66-year-old Latina woman’s death is a grim warning for Texas, which has seen a surge in the number of people testing positive for the coronavirus since it began aggressively loosening restrictions in May.

Hospitalizations due to COVID-19 in the state have more than doubled in the last two weeks, and Texas is reporting, on average, more than four times as many cases each day as it was a month ago. It surpassed 10,000 new confirmed cases in a single day Tuesday.


Air is pumped by hand as medical personnel try unsuccessfully to save the life of a patient. (AP Photo/David J. Phillip)

Medical student Diego Montelongo closes his eyes briefly as he watches others attempt to save the life of a patient. (AP Photo/David J. Phillip)

A blanket is pulled to cover the body of a patient after medical personnel tried without success to save her life. (AP Photo/David J. Phillip)

Nearly 80% of the state’s hospital beds are in use, and intensive care units are filling up in some of the nation’s biggest cities, including San Antonio and Houston, where leaders are warning their health facilities could become overwhelmed in the coming days. In all, Texas has recorded more than 2,670 deaths and more than 200,000 confirmed cases of the virus.


While rising case numbers partly reflect more testing, Texas has a positive test rate of 13.5%, more than double the rate from a month ago.


“We’re going to get into situations like Italy did, like Spain did, like New York did just a couple of months ago,” said Varon, board chair at United Memorial Medical Center, a small north Houston hospital.


United Memorial has been rapidly dedicating more and more space to virus care. Now, 88 of 117 beds are devoted to such patients — and Varon says the hospital may soon turn over the entire facility to treating those with the virus. Outside, long lines of cars wait hours for tests.


The hospital has taped off three separate wings with a sequence of large tarps and gates. Assisting Varon is a team of nurses and volunteer medical students. Anyone seeing a patient with COVID-19 is required to wear two sets of masks, gowns, gloves, shoe and head coverings, and a face shield.


Varon has worked more than 100 days with barely a rest and normally sleeps just a few hours a night. When he isn’t seeing patients or trying to obtain more hospital supplies, he does media interviews to encourage people to wear masks and take the virus seriously.


Dr. Joseph Varon, center, visits with Dorothy Webb, left, and her daughter, Tammie, while making his rounds inside the Coronavirus Unit. (AP Photo/David J. Phillip)

Dr. Joseph Varon notifies the family of a patient who died. (AP Photo/David J. Phillip)

“People need to see this so they can understand and won’t do stupid things,” he said, standing in the widow’s hospital room. “Every day, we have stuff like this. Every single day.”


The Associated Press, which spent Monday inside the hospital, is not identifying the widow because it was unable to speak to her before her death and is withholding her daughter’s name to protect the mother’s identity.


The widow entered the hospital in late June — about a week after the funeral for her husband, who died from liver cancer.


Around 10 a.m. Monday, the widow’s oxygen levels fell dangerously. Varon decided that she needed to be placed on a ventilator. Like many doctors, he has tried to use alternatives to ventilators because of the relatively low survival rate of people on the machines.


When the ventilator failed to restore her oxygen levels, medical staff ran to bring a second one just in case there was a problem with the first. Varon also ordered shocks to her chest and injections of epinephrine, a hormone that stimulates the heart.


LaTanya Robinson, who has COVID-19, talks about her condition. (AP Photo/David J. Phillip)

“Every effort that you can imagine, everything that has been written, we did, and yet we were unsuccessful,” he said later. “The problem is with COVID, that’s what we’re seeing.”


For most people, the virus causes mild or moderate symptoms. But it can cause severe symptoms in and be fatal for others, especially older adults and people with existing health problems.


Next door to the widow was LaTanya Robinson, who was breathing with a machine providing high-flow oxygen through her nose and could see hospital staff running into the widow’s room as they tried to save her. Monday was the first day Robinson felt well enough to have a conversation about her illness.


The 51-year-old says she cared for her adult son when he got the virus. Both she and her husband eventually caught it. While her son and husband’s symptoms were relatively mild, she went from feeling tired and struggling to move to hardly being able to breathe.


Robinson says she was held in an urgent-care center for two days before being moved to United Memorial because the first available hospital beds were in Corpus Christi and Lufkin, cities at least a two-hour drive away.


Texas leaders say there are still 12,000 available hospital beds statewide — about 23% of total beds. But Robinson’s case shows that even if the sprawling state still has spare capacity, that may not accommodate people in cities where the virus is surging.


Robinson’s son had recently spent time outside the house and his girlfriend had gone out with friends. She thinks one of them may have originally gotten the virus and infected her, but isn’t certain.


Asked what she would tell people outside the hospital about the virus, she said: “The only thing I can do is to live to be that example for them. You don’t take anything for granted.”




United Memorial, already near capacity, could soon be filled, Varon says, as he braces to see what Fourth of July celebrations might bring. Some people gathered for the holiday even as Texas Gov. Greg Abbott instituted new restrictions on outdoor get-togethers and required mask-wearing indoors.


After Varon’s team did three rounds of compressions on the widow, he stopped them. “Thank you, everybody,” he said. The 10 people around the bed filed out of the room, one of them sighing. The machines around her continued to beep.


A few people worked to prepare her body for the undertaker and placed a sheet over her.


Varon called the widow’s daughter, expressing condolences first in Spanish, then English. He repeated that he had done everything he could and to call if there was anything she needed.


When he hung up the phone, his bluish gray eyes were filled with tears.


“That’s the one thing you don’t want to do when you’re a doctor,” he said. “But you’ve got to do it. Somebody has to do it.”


The body of a patent who died inside the Coronavirus Unit at United Memorial Medical Center is covered in sheets. (AP Photo/David J. Phillip)


'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: July 10 2020 at 7:32am

I found this story very moving- first posted by our own DutchJosh. Wanted to share with anyone that might have missed it.~~Tabitha

https://www.volkskrant.nl/nieuws-achtergrond/op-de-dag-dat-het-rivm-nul-doden-meldde-stierf-verpleegkundige-boy-ettema-aan-corona~bf67bcd7

google translate- translated from Dutch to English;



Thomas Borst and Maud Effting 5 July 2020, 5:02 PM


OSTUUM BOY ETTEMA (1978-2020) On the day RIVM reported zero deaths, nurse Boy Ettema died of corona


Boy Ettema, a surgery nurse who worked in the Covid department, was healthy, cycled a lot, was not overweight and was only 42 years old. However, he died of corona on the first day that RIVM reported zero deaths.



For RIVM it was a question of statistics, of simply adding up all reports. And they never came that day. But for Boys' family, the RIVM statement came as a blow to the face.


It felt as if the death of Boy, a surgery nurse who had worked in the hospital's covid ward for many weeks, was ignored. As if he didn't matter.


It was the reason that Boy's brother called Thomas de Volkskrant. Because the ice-cold statistic with those zero kills - that's the big story.


But there is also another reality. Boy Ettema is the youngest healthcare provider in the Netherlands who died of corona at the age of 42 - a total of thirteen died. He was healthy, cycled a lot, was not overweight and did not smoke, his girlfriend said.


It is mid-May when the surgery nurse returns home from his covid service at St. Antonius Hospital in Nieuwegein in the evening. That day he helped a critically ill patient who had unexpectedly coughed in his face. He felt something in between his glasses and mask.


"I have the idea," he said anxiously to his girlfriend, who is also a nurse, "that I was infected today."


At home they have been kept apart for weeks. They don't meet anyone and she does the shopping. Boy warns everyone to watch out. "Even if they arrange things differently at work, please stay at home," he tells his brother.


Two days later, he wakes up on a Tuesday with a high fever and headache. He sees flashes before his eyes. The stuffiness doesn't start until a few days later. "I'm deathly ill," Boy says to his brother Thomas. "But don't worry too much. It will be fine.'


His brother Thomas had previously asked him if he would do those covid services. "It has to be done," Boy replied. He felt it his duty to contribute. He sends cheerful photos of himself in his corona gear to his friends and family.


That nice brother


Boy Ettema is a striking appearance in the surgery department of the St. Antonius Hospital. His laughter is loud, he talks a lot and makes contact with patients quickly. Sometimes they ask specifically for "that nice brother".


If there is a difficult patient, Boy is put on it.


At home he is cheerful, gentle and caring, says his girlfriend Lizahn (31), whom he proposed to last March and with whom he was engaged. Boy doesn't care about money, stuff or status; he prefers to spend time with nature, with friends, reading newspapers and books, doing fun things. He is concerned about inequality in the world. At the age of 35, he studied nursing after studying sociology. It turned out to be a golden move. He wanted to mean something to others, his brother says.


He is at home for days, where he is getting sicker. His girlfriend Lizahn calls the GP post three times. "I said Boy was getting exhausted," she says. "But the doctor brushed us off and said, well, he still speaks full sentences. We could come in with a fever of more than 41 degrees. I felt we weren't taken seriously because Boy was still young. "


On day eight, Boy says, "This is really not good."


Within fifteen minutes they drive urgently to his own hospital, where Lizahn can see him that day. "I'm scared," says Boy, lying in bed panting. It's all he can say. His blood still contains 80 percent oxygen.


Lizahn: "He knew exactly how it could go. He has taken so many people to the morgue himself. His greatest fear was the ICU. "


The following night she is woken up at half past four with his telephone number. In the picture is a nurse. "It really is no longer with Boy," he says. "We have to intubate him now."


Then she sees Boy lying there, gasping for breath. He says he loves her. And that he is afraid. He has to cry, but it only makes him more anxious. Lizahn can say just a little before the nurse takes the phone. Lizahn drives to the hospital as fast as she can, but when she arrives, he is already asleep.


This isn't really happening, Lizahn thinks. She feels that he can walk around the corner laughing any moment.


His brother Thomas arrives without being able to say anything to his brother.


Heart lung machine


The nurse is in his own intensive care unit for sixteen days, while his lung pictures get worse and his family hardly sleeps anymore. Doctors and nurses at the ICU skip breaks, work longer, do everything for their colleague.


Lizahn and her family receive extra visiting hours. It always seems to go better, but he always gets a backlash. "I thought a thousand times he was going to make it, and a thousand times he would die," says brother Thomas. Because his lungs can't make it, he is put on the heart-lung machine, where the blood gets oxygen outside the body and blood thinners are needed.


It is June 22 when Lizahn receives a call from an ICU doctor at a quarter to five in the morning. "He said it was a good idea that I would come and asked if I wanted to call his parents and brother," she said. "Then I knew: this is wrong. I've worked here long enough to know that. "


That night Boy had a massive cerebral hemorrhage with major brain damage as a result. He doesn't respond to anything anymore. The doctor says that the state of his brain can no longer be reconciled with life. There are tears in his eyes. That morning he struggled to enter the department, he says. Lizahn drops to her knees when she hears that. "This just can't be true," she says.


"Then you know," says his brother Thomas, "that your brother is dying."


It is three o'clock in the afternoon when the doctor switches off the heart lung machine and the other devices in the presence of family and friends. In the room, someone plays Guns N 'Roses on the guitar: Boy was a fan of punk and hard rock.


While his girlfriend Lizahn is holding him, his heart beats for another two minutes. In the room it becomes very quiet. Nurses cry in the hallway. Afterwards, Lizahn barely manages to leave him.


Boy's motto was memento mori - remember to die. "He was always aware," says his brother Thomas, "that life could just be over."


The next morning, Boy's father reads the news. "Zero corona deaths for the first time," it says.

*******

'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (1) Thanks(1)   Quote Dutch Josh Quote  Post ReplyReply Direct Link To This Post Posted: July 10 2020 at 7:37am

Tabitha111-thank you for re-posting, how did you get out of the google translate "block"-copy and re-posted/parked it elsewere and then move it back by copy-without the "translate block"? 

We cannot solve our problems with the same thinking we used when we created them.
~Albert Einstein
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Post Options Post Options   Thanks (0) Thanks(0)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: July 10 2020 at 8:08am

I always copy and paste into notebook...then select all from notebook and copy, then paste onto this site. Its the only way that works for me that doesn't cause a big white block or weird looking text.

'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Dutch Josh Quote  Post ReplyReply Direct Link To This Post Posted: July 11 2020 at 9:59am

Music fitting for the story; [url]https://www.youtube.com/watch?v=BKiwbpRvh84[/url] (In Dutch with English subtitles)

We cannot solve our problems with the same thinking we used when we created them.
~Albert Einstein
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Post Options Post Options   Thanks (0) Thanks(0)   Quote BeachMama Quote  Post ReplyReply Direct Link To This Post Posted: July 12 2020 at 10:58am

Wow. These stories are all moving, but Boy’s was especially painful to read. :(

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Post Options Post Options   Thanks (1) Thanks(1)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: July 12 2020 at 1:24pm

Wendy Cutaio https://www.facebook.com/wendy.palmer.988 

July 8 at 2:29 PM

I haven't said much on FB about the fact that I am recovering from COVID-19. My issues started a month ago and as of now, I am still testing positive, a month later. I am hoping to finally get a negative result by the end of the week, fingers crossed!


During my COVID battle, I did spend a few days in the hospital. I had NO idea how sick I had become.

My symptoms began on June 11th with GI symptoms. I thought nothing of it, bought some Imodium, and went about my day seeing my hospice patients in St. Pete.

The next day, I felt better, and again went about my day seeing my patients. June 13th, I woke up feeling fine. Within an hour of waking up, I began to have a little cough that became a constant cough pretty rapidly.

I then began to worry about COVID. 


Within a few hours of the cough coming on, I began to have the body aches and started feeling like I had the flu. By that evening, I felt really bad and began taking Tylenol for the pain I was having and for the really bad headache that came on suddenly.

I noticed that I was getting short of breath but not bad. I didn't eat or drink much that day due to not feeling well. The next morning, June 14th (Sunday), I went to the CVS to be tested. I didn't feel horrible but still didn't feel that well. I still didn't eat much and slept all day after being tested.

That evening, my temp was 101.8, and that was with 1000mg of Tylenol in my system.

Come Monday morning, June 15th, I was really sick and just wanted to sleep until the pain and malaise went away. I stayed in bed, not able to eat or drink without it going through me. I continued with the Tylenol for the pain/fever throughout the day. Monday night into Tuesday morning is when things really went downhill.

I remember waking up during the night needing to use the bathroom. I remember scooting to the foot of the bed to get up....and BOOM, that's mainly all I remember.

I do remember hearing a loud crash and things clanging around the camper. I remember waking up on the floor not having any idea of what was happening to me. I remember struggling to focus and barely having the strength to get up to the toilet. Next thing I remember is waking up on the bathroom floor in the fetal position.

Again, I remember thinking, "WTH is happening to me"?

I again struggled to get up. When I did, I remember blood dripping to the floor and me not understanding where it was coming from. I was so confused and knew I had to get help but my phone was at the head of my bed in my camper, which at this time, felt like it was a mile away.

From there, I don't remember much except for the paramedics arriving. I don't remember calling 911 but I do remember saying that I needed help and that I thought I was going to die if someone didn't come quickly. I remember being so scared and fearful but not aware of what was going on, kind of hard to explain what I mean.

I remember getting in the ambulance and seeing the clock, it was 3:30am. I remember the EMT asking me questions that I couldn't answer. My BP was 79/49 and my heart rate was 36. IV placed quickly and fluids started in ambulance. EMT said the blood I was seeing was from nose/laceration and that I probably had a broken nose from one of my falls.

I don't remember the ride or arriving to the hospital. I woke up in ER to only see the eyeballs of people caring for me.

Rapid COVID test run and of course my test was positive.

My labs showed severe dehydration and my d-dimer was elevated (meaning could clot easily). It was discovered that I must of had a few falls. I had the laceration between eyes, large goose egg on back of head, bruising on the top of my head, and bruising behind my right ear.

I had scratches on my left shoulder and my right shoulder was bruised. I remember NONE of these falls, only hearing a "crash" the one time.

I was transferred to the COVID unit, no visitors allowed.

I had X-rays, CT's and MRI's done, checking for anything and everything that could go wrong with COVID. The COVID was in my bronchioles and I did have small patches of pneumonia bilaterally. I had minimal shortness of breath and never required oxygen, thank goodness!

I was treated with an IV steroid (Dexamethasone) and lots of IV fluids, which seemed to work. I was in the hospital for 4 days and then able to go home to my camper.

Thankfully, my amazing hubby had my camper cleaned and sterilized while I was in the hospital. I stayed at the camper for a week before finally getting to come home.

My recovery has been slow but good. I am finally feeling myself again. The hardest part was and still is, getting over the falls I had.

 I was having frequent headaches and still have a lot of pain from the nose injury. But, I am so thankful that I never struggled to breath. I couldn't imagine having that as well as feeling as bad as I felt. God definitely had his hand on me and my family during this time.

I didn't take COVID lightly. 

I did what I was supposed to do to protect my patients and myself.

It is unknown where I was exposed but somewhere I got complacent with what was going on. Wear your mask out in public....to protect others from you and you from others.

I had no idea I had been exposed to COVID and I worked 1 on 1 with my hospice patients and their families a whole week before I found out I was positive. I am so thankful that NONE of my patients have tested positive after me. That means that wearing a mask IS effective.

If you don't care about you getting COVID, that's fine. But, think of others and protect them. You could be a carrier and never know. Trust me, I am proof of the unknown and how fast life can take you by surprise.
*****


'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: July 13 2020 at 12:05pm

 I am now paying the price': Grayson County sheriff, family test positive for coronavirus 

KENTUCKY
Norman Chaffins

https://www.facebook.com/Stormin276/posts/10207806920288915

To All My Friends and Family,

I make this post while I have been laying in bed unable to move for the past 6 days so please bear with me.


Yes, Lauren, Greyson and I are Positive for the corona virus. Greyson and Lauren have had mild symptoms with low grade fever, coughing and fatigue while mine have been more severe.


We traveled out west near the end of June and while the incubation period, according to the experts, is 2-14 days, we likely contracted it while we were out there.

We traveled via RV to the two states with the lowest number of Covid cases at the time (Wyoming and Montana) in the nation. Its important to note that we had less contact with people while out West than I had here in Grayson County just going about our regular duty and day.

When we returned on Saturday, July 4th, I had a low grade fever of 99 which is not unusual for me especially after returning from a long trip with a significant altitude change.

At the time, neither my son, nor my wife had any symptoms. As the weekend went on Greyson went to a friends house (they have been notified) and he developed a cough. Out of abundance of caution we picked him up within a couple of hours of him arriving. (Again, the family has been notified).

 My symptoms started to worsen. Neither myself or Lauren had any close contact with anyone else either here at home or at my work. If we did come in contact with someone, they were notified by the GC Health Dept. or other reporting agency.


I am going to share with you my symptoms and at the end I will explain why. 

As I said before, it started out with a low grade fever. On Monday, I lost my sense of taste and smell and developed a severe headache...a severe headache that stayed with me until today. All of us also got tested on Monday. We received the positive results on Wednesday morning.

By late Wednesday morning my symptoms were Fever 100.3-100.9, severe headache, ear ache, intense stomach pain, nausea, bone and joint pain, cough, sore throat, severe knee pain and inability to sleep.

I started vomiting on Saturday.

Each day after first diagnosis the symptoms intensified. Since Monday the 6th, I have not slept for more than two hours intermittently per day. What’s really weird is that Friday I started to hallucinate by seeing frightful images on my ceiling in my bedroom. I couldn’t sleep long enough to have a nightmare.

The only drugs I took were Tylenol for fever and Phenergan the last couple of days.

I assume the hallucinations were from lack of sleep and pain. I could get no relief from the headaches and body aches and began to think that I may be taking a turn for the worse. The only symptom I have not had is trouble breathing.

The worse thing during this is that when one symptom starts to subside I would develop two different ones. It is almost like someone is controlling them and taking turns turning them up and down as a sick joke.


Ladies and Gentlemen, I have had the flu (A and 😎. I’ve had the Mumps (on the pancreas), chicken pox, measles, broken neck, and had total knee replacement. If you were to combine the painful effects of all those into one, it would not touch the hell I experienced the past 6 days with this corona virus. There is no comparison. Nothing that i know of or have ever experienced compares to it.


I consider myself a tough guy. But I am telling you that It brought me down QUICK and there is nothing I can do about it. I am not in control and at times think I am losing it.

As I type this I can feel a fever coming back.

I’m telling you this because I want you to wear your mask.

Not because I am the Sheriff, not because the Governor said so, and not because the business tells you to. I want you to wear a mask because I do not want ANYONE to have to go through what I went through. I want you to wear a mask because I don’t want my kids or grand babies to get sick. I want you to wear a mask because it’s just the right thing to do. It may not 100% guarantee that you won’t contract it, but wearing a mask will certainly reduce your chances.


Please understand this: I am not telling you to wear a mask. We are not going to fine you or insist that you wear a mask. As your friend, I am asking you to wear a mask when you are around others and when you go out into public at least until there is a vaccine.

We maintained our distance as much as we could, but did not always wear a mask...I am now paying the price. One thing that is worse than battling the virus is battling the heaviness of the burden that we could have infected someone else.


Lastly, thank you for all the phone calls and prayers sent out on our behalf. We love our friends and family so much. Please, if you are going to go negative on me and judge me or my family, please go to Topix for that. I will not be making anymore posts or answering questions regarding this until we are clear of this virus.

 God Bless each of you!

***


'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: July 13 2020 at 2:59pm

Must watch ..only 2.5 minutes.  An inside look at a Texas Hospital overwhelmed by coronavirus patients. 

'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (0) Thanks(0)   Quote WitchMisspelled Quote  Post ReplyReply Direct Link To This Post Posted: July 13 2020 at 4:29pm

Houston's Mayor is asking the governor to shut down for two weeks.  What he thinks two weeks will do is anyone's guess.  

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Technophobe Quote  Post ReplyReply Direct Link To This Post Posted: July 14 2020 at 2:32am

My guess:  "Look as if they tried - giving a reasonable excuse for failure!"

ERCD
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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: July 14 2020 at 3:45am

In Sri Lanka 

The government says shut down for 2 weeks....

Then they extend  that......week by week  

It helps psychologly......

I don't know if that's the plan...... 

Here in Melbourne they called a 6 weeks lock down........

But we seem to have more of an idea what to do........


.

Everything we hear is an opinion, not a fact. Everything we see is a perspective, not the truth.πŸ––

Marcus Aurelius
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Post Options Post Options   Thanks (0) Thanks(0)   Quote WitchMisspelled Quote  Post ReplyReply Direct Link To This Post Posted: July 14 2020 at 4:56am

You know, Carbon, Cuomo did that to a degree.  But he explained why.  Gave us the data.  Gave us the ramifications and although life didn't go on, lives did.  That being said, New Yorkers had Trump's number way back in the 1980's where the rest of the country saw a slick "business man" on TV.  We, for the most part, knew Trump was a con man and a crook.  That's why Cuomo's daily briefings were the highest watched in the tri-state and The Apprentice was among the lowest.  

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Post Options Post Options   Thanks (0) Thanks(0)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: July 14 2020 at 10:29am

Sharing  a random story of  a young mother who has passed with Covid 19- it is not only the elderly!~~Tabitha

The story of Mary “Cherry” Santiago, a devoted mother and friend, who died at 44 after fighting Covid-19 in Evanston, IL.

https://medium.com/wake-up-call/mom-44-lost-to-covid-19-before-sons-hs-graduation-6e7717c2ae82 



Mary “Cherry” Santiago was fun-loving and passionate about many things. But her two sons, Alexander and Aiden, were at the top of that list. Just after Alexander graduated from Evanston High School this year, he received a surprise gift in the mail — a longboard.

The gift was from his mom. Tragically, she was not around to give it to him. Santiago had died of Covid-19 at the age of 44 just a few weeks earlier.

“Knowing her, because her boys were her life, she probably thought, ‘I better get this done just in case they keep me in the hospital for a little while,’” her cousin Leah Bardfield told us. “And now it’s sad that he’s opening it and his mother’s not around.”

Santiago was born and raised in Evanston. Hence, she was a Chicago “sports fanatic,” says her best friend Kymberly Thompson.

As an only child, Thompson said, “She was very, very close to her father, who was a major Cubs fan. She’d been watching the Cubs since before she could probably remember.”

When The Last Dance aired, Santiago donned her Bulls jersey and dedicatedly watched each episode. Her cousin said she had such an “outgoing spirit”: “She’d be the first one to crack a joke and say hello to everybody.”

Thompson and Santiago met in high school. They stayed as close as sisters, texting every day and bonding over a shared Filipino heritage. Just weeks before Cherry passed, Thompson was visiting her in Evanston, and they got Filipino food. That was the last time she saw her.

“I do have the entire timeline, from when this whole thing started and we were like sending each other pictures of masks,” Thompson told us. “It was funny. It was like, ‘Yeah, this isn’t serious.’ And then it got real because we started hearing things and then it got closer and closer to home to the point where, boom, here we are.”

Santiago’s symptoms started with a low-grade fever. She was exposed to someone who eventually tested positive for Covid-19 on April 11th, and started to feel sick six days later. Her temperature skyrocketed, so she got tested at a drive-in testing center.

She received her positive result a few days later and was told to quarantine. But her symptoms escalated to that she could barely walk up the stairs without extremely labored breathing. She decided to check into the hospital on May 6th.

“They’ll probably admit me for a day or two, but I need to be home with the boys for Mother’s Day,” she had told Thompson.

Santiago was put on a ventilator at the hospital, and her oxygen levels began to fluctuate. Thompson told us: “She texted me ‘Good morning, Kap,’ which is short for Kapatid, which means ‘sister’ in the Philippines. “She said, ‘Here’s the harsh reality: I don’t know when I’ll be able to go back home.’”

Santiago died on May 12th, two days after Mother’s Day. When Thompson heard, she said: “I almost lost it in a public place.”

“She is the other part of me,” she said. “She’s the one that kept me going, the person I talked to about everything every day. It’s a void that I know won’t be filled. I’ve never been that close to somebody in the way that we were close.”

Thompson flew out to Chicago soon after Santiago passed, to spend some time with her boys.

“I just want to be in the house with them…I want to cook for them on their mother’s stove,” she told us. “I want us to laugh together, cry, and look at pictures. And then I want them to recite poems and we’re going to release balloons at the lakefront.”

Santiago was buried on July 11th.

“Her kids are going to be so well taken care of,” Thompson said. “But they’re two little boys who lost their best friend.”

****


'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (1) Thanks(1)   Quote Tabitha111 Quote  Post ReplyReply Direct Link To This Post Posted: July 16 2020 at 2:43pm

“Call Us If You Get Worse”: What Covid-19 can do to a “healthy” person.  https://medium.com/@poletti.anna/call-us-if-you-get-worse-what-covid-19-can-do-to-a-healthy-person-8990f3fabf84 

anna poletti

Jul 14 · 


“I am pretty sure I have it.”

I started saying this to colleagues and students around the 9th of March 2020.


I had a strange, hot pain in my lungs. It was the shape of a horseshoe — it ran down the outside and along the bottom of my lungs. I could breathe fine. I was still able to deliver a two hour lecture, ride my bike, talk to people in meetings, walk to the supermarket; but I was a bit more tired at the end of the day.


Then again, I thought to myself, I am always tired at this time of year. Winter was ending in the Netherlands, I was almost half way through what is the busiest time of my working year at the university.

I am a 43 year old woman with no pre-existing health conditions. I can go eighteen months without needing to talk to a doctor. This year, I had been to my GP once. At the end of February, I had had a low grade urinary tract infection that needed antibiotics. The five day course of medicine worked fine, but when that infection cleared up, I was still a bit run down. Or so I thought.

At this time, the Dutch government was advising us to stop shaking hands (the Dutch shake hands with everyone), to wash our hands regularly and to cover our mouths if we coughed.


I was not really coughing — I would give a pathetic little single cough once or twice a day, and my chest was not feeling congested, there was no phlegm to be cleared. It just felt an electric blanket was running on the highest setting inside my chest. I had never felt anything like it.

My symptoms did not match the list on the National Institute for Public Health and Environment website that were considered warning signs of Covid-19: a fever over 38 degrees and shortness of breath were key things to look out for.


But just to be on the safe side, I stopped meeting people in person, and went to the supermarket once a week. When I went, I wore latex gloves and kept my distance from other shoppers. I was not coughing, or sneezing or sniffing. I could still walk to the shop and carry my shopping home then, a twenty minute walk each way. By 16 March, The Netherlands was in ‘intelligent’ lockdown.

Once this happened, I was working from home. I was conducting my last few classes via Microsoft Teams, attending management meetings, and quickly trying to redesign my courses for online delivery.


As the month progressed and the fire kept burning in my lungs, I was getting more tired. I would wake up around 7.30am after nine hours of rest feeling OK, but by 11.30 I needed to sleep. I was checking my temperature twice a day and it was fine. The most mundane work tasks that required focused concentration — writing emails, listening to other people talk in meetings — started to exhaust me. And I was hungry. I am of a slim build with a fast metabolism. I was eating four meals a day instead of my usual three. This is a good sign, I thought, my immune system is fighting.

“This thing wants control of my lungs.” I said to a friend over the phone in Australia as April drew near.


By late March all I could do was lie in bed, nap, read and eat. I drank a lot of fresh ginger tea. I drank it all day. The fire in my lungs kept raging, I was only breathing into the very top of my lungs, I could not take a deep breath. I was not sleeping as well I usually do, and when I was very tired (usually in the afternoon) I had developed a spectacular case of tinnitus. I would lie in my bed listening to the phasing of the high pitched frequencies in my ears with curiosity and trepidation.


When a friend would call to check how I was while he was on his evening walk, I would sometimes have to ask him to repeat what he was saying three times because I could not hear his deep voice over the screaming high notes in my head. I was worried. I had not occupied physical space with another human being for three weeks. And my body was getting very weak.

On the 28th March, after a particularly stressful night, I called my doctor and he agreed to send me to a respiratory clinic to have my lungs checked. There was a triage clinic in a gym at a high school two blocks from my house. I walked to the clinic very slowly. It was the first time I had left my house for two weeks.


I sat alone in the gym for ten minutes, waiting to be seen. When the medic came to get me, she wore full PPE. She checked my temperature (normal), the oxygen saturation of my blood (also normal) and listened to my lungs. She could hear the infection there. “I think it is coronavirus,” she said. “But I cannot test you. You can still walk, and talk. Go home and rest and call us if it gets any worse.” The Dutch only started widespread testing in June, so to this day I have still not been tested for the virus.

When I spoke to my doctor the next day, he advised that one version of coronavirus seemed to be doing this — giving people a long running lung infection that could last up to six weeks.

“So you probably have another three weeks or so to go,” he suggested. “The good news is that from what we know now, if you have had the infection for three weeks or so, it is unlikely that you are going to get worse and end up in hospital. But you need to monitor your temperature and breathing. Get a lot of rest.”

I took sick leave from work and lay in bed with shortness of breath, burning lungs, ringing ears and total exhaustion for another three weeks. Time was a blur. I was not coughing. People would drop off groceries every few days. I could barely stand in my open door and have a conversation with them. I was just too tired. My lungs burned and burned. I read a lot. I napped. I ate.

Ten days after my visit to the clinic, still with burning lungs and shallow breathing, I called the emergency doctor. I described my symptoms. He looked at the notes from my visit to the respiratory clinic.

“They think I have Covid-19,” I said. It was 2am. I was awake in the middle of the night. I was scared.

“I am sure you do.” He responded. “Your symptoms are consistent with it. But you can speak in full sentences to me on the phone, so I am not too worried about you. Take some paracetamol and try to rest. Call us if you cannot walk to your toilet, or if your breathing gets worse, or if you have a fever for more than two days.”

My doctor’s prediction was right. I had burning lungs, exhaustion and shallow breathing for a total of six weeks. By the middle of April, the burning started to subside and was replaced by a tightness in my chest and a weight on my lungs.

I started coughing; after walking up the stairs in my apartment too fast, or if I talked in an animated way to a friend on WhatsApp for too long. Sometimes I would cough in the shower, after breathing in the steam. But I was not coughing anything up. There was no real congestion.

 I was so weak I could not walk around the block. Breathing was hard work. On the 23rd of April, I was sent back to the respiratory clinic and checked again. No temperature. Oxygen saturation fine. This time, the medic could not hear evidence of an infection in my lungs when she listened to them.

“I hear no infection now,” she said thinking this would reassure me.

“So why can’t I breathe? Why am I coughing?” I asked her, crying with frustration.

“We don’t know. There may be some inflammation there. I will give you a steroid to inhale, that might help.”

I started inhaling a steroid twice a day that is prescribed to asthmatics. It is not given to treat asthma attacks, but provides long term support and treatment for the inflammation that causes asthma.


I described my new symptoms to friends who are asthmatic and they sounded very familiar to them. Having never had any lung problems before, I was having to learn to control the anxiety that not breathing well can cause.


 I visited my doctor and he also listened to my lungs and confirmed they sounded “fine.” He sent me for a chest x-ray to see if my lungs were damaged. He said he thought I might have bronchial hyperactivity caused by my immune system continuing to fight in my lungs even though the virus was gone.

“Your lungs look perfect,” he said when he called with the x-ray results later that day.

“We think you can expect about a six-week recovery. You had the infection for six weeks, and the healing takes about the same amount of time. Get a lot of rest.”

After the burning pain was replaced by these new symptoms I spent May and the first half of June trying to regain some strength and giving in to my total exhaustion.


My lungs would get tired and ache after walking for ten minutes, or talking for more than twenty minutes. I would fall off a cliff into total exhaustion with seemingly no warning and have to spend a day in bed. But slowly, with two steps forward and one and a half steps backward, I was able to regain enough strength that I could take a walk with a friend (at half my usual pace), and sit with them and talk. This part of my recovery seems consistent with recovery from pneumonia, but I was never diagnosed with pneumonia.


Around this time the media started reporting on “long haul” cases of the virus. It was reassuring to see that I was not alone. The medical profession started to consider whether people like me were actually patients that needed ongoing care.


As June progressed, my fitness continued to improve but my lungs were still aching, and my chest was still tight. I was back at work, and an hour long video consultation with a student would no longer send me to bed to sleep, but would leave me with sore lungs and the feeling that I had worked an eight hour day. Bone crushing fatigue was replaced by tiredness.


I realised I was doing something I came to think of as “covid breathing.” Short, shallow gasps. After six weeks of healing, and twelve weeks since the problems started, there was little real improvement in my lung strength. I talked it over with my doctor, who suggested I see physiotherapist who specialises in lung rehabilitation.


Two weeks ago, someone showed me how to breathe. It is a strange experience to have to relearn how to do a thing that you never had to learn in the first place.


As July begins, I am almost able to breathe normally, but only when I give it my full attention. When I walk, sometimes I can breathe properly but sometimes I have to stop and “reset” my breathing. If I think too much while I walk, the shallow breathing returns. It requires all my attention on my body to breathe normally, no matter what I am doing.


I am unable to talk and breathe properly, so any conversation leaves me tired and I have to limit the number of conversations I have each day, and how long they go for. I have to ask people to talk to me and not expect a response so I can sit and listen to them and breathe.

As I type these words for you I am shallow breathing.


My physiotherapist tells me I have to keep focusing on breathing to retrain my body. At some point, she thinks (and I hope) breathing normally will become a habit and I won’t have to concentrate too hard to do it.


I am writing this essay because none of my Australian friends and family know anyone else who has had coronavirus. It took so long for me to get consistent medical attention because I have been regarded as a ‘mild case’ while frontline medical professionals are busy managing an epidemic.


I cannot describe my symptoms and their meaning to you as though they fit a profile. The last four months have taught me, over and over again, that we should believe the medical professionals when they tell us that they do not know or understand how this virus behaves, what impact it has on our bodies, and what we can do to treat it when we catch it. I am not part of a medical study because the medical researchers have been, understandably, busy trying to identify how this virus kills people.


I am writing to you because we are four months into the pandemic and we are all tired and some people are wondering, because they lack direct firsthand experience of anyone with the virus, whether there is really anything to worry about.

You don’t know me, and I don’t know you, but I want you to know that this virus does not just kill people — it can give healthy people a chronic illness that lasts for months.


I caught the virus very early, and I can’t tell you how long it takes to recover from it, because I have not recovered. I am telling you about my experience with Covid-19 so far to help you keep your strength during this period of uncertainty and restrictions.


I don’t want to scare you, this situation is scary enough, and many of us are anxious or depressed. Some of us are bored. I want to tell you some of what happened to me to help you find the focus and energy to keep following the advice and measures put in place to help slow the spread of the virus.


And I want you to know that a ‘mild case’ of this virus can turn a healthy person into a very unwell person with chronic health problems. I want you to know that if that happens to you, at the moment, there will be very little targeted support from health professionals. They will be kind to you, when they have time and if they are not exhausted from months of stress from working during a pandemic, but they will not be able to do much more than say: “Call us if you get worse” and “We don’t know what this virus does to your body.”


I have a long way to go, but after four months I think it might be possible that I will make a full recovery. Medical researchers have a long way to go too.


The discipline and patience they are using to understand the virus is not that dissimilar to what I have to draw on now, and what you have to draw on as you continue to face restrictions to your personal freedoms, the worry that you might lose your job, the stress you feel that your postcode might be the next one where an outbreak of the virus occurs. Perhaps it would help us to recognise that we are all long haul cases.

***

'A man who does not think and plan long ahead will find trouble right at his door.'
--Confucius

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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: July 16 2020 at 3:50pm

ABC News: I'm a doctor on Melbourne's coronavirus front line. Suppression has failed — we need an elimination strategy now.

https://www.abc.net.au/news/2020-07-17/coronavirus-melbourne-doctor-suppression-or-elimination/12462518

Everything we hear is an opinion, not a fact. Everything we see is a perspective, not the truth.πŸ––

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Post Options Post Options   Thanks (1) Thanks(1)   Quote ViQueen24 Quote  Post ReplyReply Direct Link To This Post Posted: July 17 2020 at 5:18am

Thank you, Tabitha, I am going to send this off to a friend of mine who just doesn't get it.

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Post Options Post Options   Thanks (0) Thanks(0)   Quote carbon20 Quote  Post ReplyReply Direct Link To This Post Posted: July 19 2020 at 3:53pm

ABC News: Intensive Care Units working tirelessly, learning from experience, applying new treatments in the battle against COVID-19.

https://www.abc.net.au/news/2020-07-20/intensive-care-units-icu-coronavirus-covid19-victoria/12467050

Everything we hear is an opinion, not a fact. Everything we see is a perspective, not the truth.πŸ––

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Post Options Post Options   Thanks (0) Thanks(0)   Quote ksc Quote  Post ReplyReply Direct Link To This Post Posted: July 30 2020 at 1:34am

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