COVID-19 Diary, Part 2: 'I feel like my knees are going to just give out underneath me.'
Editor's note: Alix Atwell is a nurse, amateur photographer and aspiring writer with experience in both emergency rooms and intensive care units. She, her husband, Andy, and two children moved to Barrington from California three years ago. What follows is her harrowing tale of how her entire family has been living through COVID-19 in recent weeks. This is the second installment of her three-part COVID-19 diary, told in her own words.Second of three parts
It's been a tough few months for all of us, but my daughter, in particular, is struggling the hardest. She has not adjusted 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.
Read COVID-19 Diary, Part 1: 'I'm scared, but I can't show it'
He has been asking to be home-schooled since the third grade. He finally got his wish.
Things changed dramatically for us when their dad came down suddenly with flu-like symptoms on May 4.
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.
I busied myself sterilizing doorknobs, faucets, 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 coffee cakes and macaroons. She learned to make homemade Frappuccinos.
My husband's symptoms strangely and completely disappeared four 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 fever-free and seven 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 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 cup standing desk, sipping coffee and feeling fine at 10 a.m. He came into the kitchen, where I was home-schooling 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 the day-old dead.
He had rigors (that's nurse-speak for vigorous and uncontrollable shaking), which is the telltale sign for full-blown sepsis. That's way more ominous than an 88% pulse ox reading.
But his temperature was normal. So was his mental activity. 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 2 miles to deposit him on the doorstep of the hospital.
I left and soberly awaited word.
My husband was in the ER for six hours before they admitted him. They ran a slew of tests and labs.
A very kind nurse filled me in on his status and lab results. His numbers were really off. From my experience in ER and ICU, those numbers told me he was REALLY SICK.
She informed me they were sending him up to a COVID unit “just in case.” Since he had zero respiratory symptoms and an elevated procalcitonin level, which usually indicates a bacterial infection, it was unlikely.
It was a long night. I called the night nurse for an update just before 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.”
He wasn't pumping enough blood to keep his organs alive.
I panicked.
I knew from my experience that septic patients whose blood pressure drops dangerously low need multiple liters of fluid to perfuse their organs, not the equivalent of 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!” I screamed.
She calmly explained that COVID patients have a tendency to accumulate fluid in their lungs and this could make him require a ventilator. She added that COVID patients tolerate low blood pressure and low oxygen saturation extremely well.
She reassured me that he was fully awake, talking clearly and was feeling OK.
Andy would call between rests, but he was sick and fatigued. I didn't want to scare him with questions. 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 party 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.
I read an article in the Journal of the American Medical Association citing unusual but statistically significant cases of COVID-19 patients gaining transmission through the eyes with negative nasal swabs and elevated procalcitonin levels, and research directly linking those levels to severe COVID-19 infections.
Miraculously, by Thursday, my husband's labs were normalizing and his fever was down. He was even able to Zoom-attend his son's eighth-grade graduation ceremony.
Just before discharge, his COVID immunoglobulin test came back negative.
Ride the wave together
They released him home on Friday. The doctor explained that even if it were COVID, patients are not contagious if they are not feverish and are seven days out from the onset of the first symptom. Therefore, no isolation was necessary.
I desperately wanted my husband home and safe, but I did not want to risk infecting my kids and me. 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 tissue in two hours.
There was snot everywhere.
His eyes glazed over. I took his temperature - 99.7. “Mom, my stomach hurts, too.”
What do I do now? I could sequester him and my husband in the back room, but my husband needed his rest. Would it even be possible for me to care for them both without contaminating my daughter without home PPE?
In reality, the cat was likely already out of the bag. If my son now had symptoms, my daughter and I surely were 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 doesn't work. At least we would all have each other.
So, it's Friday, May 22. My youngest sister's birthday, my husband's hospital discharge day and the start of my pediatric rotation at home.
The next couple of weeks consisted of temperature checks three times a day and nightly pulse oximeter checks.
A neighbor was kind enough to lend me her spare one when Andy first got sick.
For the next two weeks, there was not a day that went by without one kid or the other having a temperature 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. My son, uncharacteristically cuddly, my daughter ornery as an 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.
Twenty days after my husband's hospital discharge and my kids' first symptoms, I mowed the lawn.
I started coughing when I went to bed.
Read COVID-19 Diary, Part 1: 'I'm scared, but I can't show it'