On day 6 I called my internist and asked for medication. I told her that I didn’t want to go to the ER or be admitted but that the symptoms were relentless and I couldn’t go on the way I was. She warned me about the potential side effects of HCQ (arrhythmia, retinal damage, and gastrointestinal symptoms) but called it in with the Z-pack and folic acid. Four pharmacies around me were out of it. The frustration from helplessness and the mental fatigue from uncertainty of the next step felt defeating. I am the one who normally gives advice, prescribes medicines, and offers hope, yet I can’t help myself. Then a close friend found a pharmacy in New York City that had HCQ. My husband brought it home, and as I took the first dose my hands shook from fear. I prayed that it would help and not further injure my already ravaged body. The only other thing I was capable of was sleeping for 14 hours a day.
The mental anguish that came with Covid-19 is difficult to put into words. Most would consider me to be a fairly tough, calm, and a cool-headed physician. Those qualities left me and were replaced with uncertainty, anxiety, and indecision. On day 3 of HCQ treatment (day 8-9 of illness), I experienced blurry vision, palpitations, tachycardia, and what felt like an irregular heart rhythm. Was it Covid or the meds? Should I take the next dose? I reached out to other doctors, who offered opinions but just opinions; the literature and articles at that time were not “good-science” quality, although anecdotal stories and homeopathic suggestions flooded the Internet daily.
The days blended together. When April arrived, we were in the middle of the worst numbers in New York. Watching TV made me too anxious, so I stopped. Acquaintances and family members from other states texted me to find out “the true version” of the horror they see on TV. Most of the time, I did not share that I could barely walk or talk but I did say, “Yes, the stories are true.”
Despite the pandemic, consults for wounds keep coming. PI from tracheostomy ties in the pediatric ICU, extravasation in the NICU, a burn, a rash, and nurses with skin broken from masks. During rare moments of subsiding fever, I answered in short sentences: “I am not available but try this…” Sometimes I chuckled because this was the only part of normal that I had left (my phone and email usually never sleep, not even on vacations). So even during this horrible illness, I was still wearing the wound doctor hat. I guess a doctor and a patient can co-exist.
The fevers subsided after day 8-9. I finished the 5 days of the Z-pack and the HCQ. My headaches were mostly gone, and I could walk up and down the stairs (with an hour recovery after). I actually answered some emails. It was amazing how fatigued my brain felt after reading an article for 5 minutes. The other amazing parts were texts and phone calls from my friends and colleagues… closest ones many times a day, others daily and weekly. Their prayers and wishes helped me through the worst moments, as they kept encouraging me despite my daily bad news and my moments of lost faith, fear, and tears. For that I will always be grateful.
I slowly regained small moments in my daily life: cooking simple food, staying awake for more than 3 hours, taking a shower. My sons walked outside with me, first for 5 to 10 minutes and then for 15. It took me 2 hours to recover, although only 4 weeks before I had trained for a half-marathon. To make matters worse my chest was still tight, I felt like I couldn’t take a deep enough breath, my heart hurt, and palpitations came and went. I tried to make an appointment with my internist to get an EKG, but because my cough was still present, all that would be possible was a virtual appointment. The symptoms were always worse at night, further disturbing my sleep.
In the outside world, the evolution of Covid-19 discoveries reported worsening cases after a few weeks of improvement, hospitalizations and death in young people for no apparent reason, small vessel thrombosis due to hypercoagulation, heart injury, strokes, and renal failures. Some evenings my pain and palpitations seemed unbearable, and I started to worry that I was missing a heart attack. I managed to obtain an appointment with a cardiologist and then a pulmonologist. Both said there was nothing too serious that they could see in my test results, yet my symptoms persisted. The inhaler was not helpful and neither were anti-inflammatories.
Week 5 rolled in with an evening of 10/10 pain in both my chest and back. The next morning I was back to see my doctor and was willing to be admitted to the hospital. All I wanted was a diagnosis, an answer, a plan, and an ounce of reassurance that one day it will go away. I underwent a CT angiogram to rule out pulmonary embolus and a hypercoagulability work-up. I tried to be a gracious patient but being stuck 5 times for an IV is maddening. Some of my blood tests couldn’t be run, and I had to go back to the lab. By that time, I had no veins left and black hematomas all over. I was done being a patient and wanted to go back to my doctor role.
During that time I answered every text and email consult, clinging to the moments of normalcy. Clinical evidence was growing in the Covid-19 literature for small vessel thrombi; maybe that was what was causing my chest symptoms. Cases of myocarditis, pericarditis, and cardiomyopathy after Covid-19 were then reported in previously healthy individuals...my symptoms could be pericarditis. Both docs honestly told me that it was not a clear-cut picture. I pray that this injury or inflammation is reversible. A new medication regimen was prescribed. As I write this, I am now on week 7 of this Covid-19 journey.