Living with Severe Asthma in these Covid Times

I can’t say for sure what its like to work on the front lines of the Covid crisis, as Im no longer working as as RT. But I certainty know now what its like to spend time in a hospital with Covid patients. Most, if not all the images you see on TV and social media of over flowing ERs and ICUs are accurate. Tt’s a surreal and scary scene. Though not as severe as in other parts of the Country, the San Francisco Bay Area is dealing with a lot of the same problems this pandemic presents. God bless the Nurses and other medical staff for coming to work, usually with a smile on their faces.

So, as I mentioned in my last post, I had two asthma exacerbations in the months leading up to the Covid crisis. One in early March and a second one in mid April, April 20th to be exact. At the time of my last writing, I thought I had control of this second more severe asthma flare, but apparently not, because on April 22nd I ended up in the hospital, in the same Intensive Care Unit that suspected and/or confirmed Covid patients were being treated in.

It took a full 24 hours for the results, but thankfully my Covid tests were all negative. Btw, testing negative only means that there was no virus detected on the days the samples were actually collected. It can take from 2 to 14 days after exposure to the virus, for it to actually be detected. So next week I’ll be getting swabbed again. As soon as it’s available, Ill also be having the serology test done that checks for the presence of the actual Covid antibodies, which would then tell me if I’ve been exposed to the virus anytime in the past.

Here’s the time line of events………
March 19th I started experiencing classic asthma symptoms, ie increased shortness of breath and chest tightness. I believe the trigger was probably pollen related, as the tree pollen counts were trending higher and I’d been having hay fever like symptoms a few days prior. I gave it the usual wait 12 hours wait-and-see period, to see my symptoms would reside on their own without additional treatment. By the morning of April 20th it was obvious this want going to be the case, so I bolused with 70 mg oral prednisone and upped my neb treatments as needed to about every 2 hours. It took about another day, but the pred was finally starting to kick in and I started to breath a little easier. The last couple of days had been rough, but I figured I had some control over it and could handle things at home.

Fast forward to the evening of Aril 21st, my symptoms started getting bad again , so I kicked up my nebs to every hour for the rest of the night. I eventually fell asleep, and again woke breathing a little easier. To keep my Pulmonary doctor in the loop, I decided to message him and give him an update on what I had been doing to treat this flare at home. A few hours later I received a call from his secretary advising me that based on my symptoms and my high risk status for covid complications, that he wanted me to be seen in the Respiratory Screening unit and be tested for Covid. I agreed and had my partner take me to the facility in San Francisco.

This is where things started to get serious. The last time I was tested for the virus, I simply drove through one of those drive-thru testing centers, they swabbed my nose and I was on my way. Well, UCSF has a completely different way of determining who gets tested and how that testing is carried out. When I arrived at the Screening clinic, they could see that I was notably short of breath and put a big bright pink dot on my shirt, indicating I was possible Covid.
I told them that it was asthma, but of course they couldn’t be sure, so they had one of their Physician Assistants, examine me. A super nice guy, but I could tell he was concerned about my breathing. He went and swabbed the back of each nostil, plus swabbed both sides of my throat. He said the initial results would be back in 12-24 hours, but in the meantime, that I should have a chest xray, some blood work done and be seen in the ER for a complete work up. My first thought was, there’s no way Im going into a germ ridden ER. He understood my apprehension and assured me I would bypass the tents and go to a special resuscitation room at the back of the Emergency Dept that was completely sterile.

Well, not 5 mins had passed that an Ambulance crew showed up to transport me 150 feet to the hospital. It seemed silly to me to be driven literally across the street, but I understand the reasoning.
From this point on in my Journey, I would not be allowed any visitors. I felt horrible for my partner who was waiting for me in the car unaware that any of this was about to take place, till it actually did.

We were able to communicate via Telegram messenger and phone, but it’s not quite the same. I see now why Covid, or any other serious medical condition in today’s world is such a lonely affair.

So upon my arrival in the ER, they wheeled me directly into the same Resuscitation Ive been in dozens of times, only this time it had a new look.
Introducing the Aerosol delivery room, or as I affectionately refer to it, “The Bubble”. The thing about a severe asthma exacerbation, is that youre almost always gonna require nebulized meds, but until they rule you out for Covid you cant nebulizer treatments unless they’re given in a special tent that filters out any possible Covid 19 droplets in the aerosol. So at first they gave me 12 puffs of Albuterol via inhaler. Of course this didn’t work very well. I was still struggling, so they had to rig up the special tent to give me continuous nebs and eventually bipap and then non-invasive ventilation. ( where you’re basically hooked up to a ventilator via a mask instead of a breathing tube).

I spent about 6 hours in the ED, where my blood gasses continued to worsen despite the non invasive ventilation. I dont remember exactly what time it was, but I was eventually transferred to the ICU into a special negative pressure isolation room. Talk about loud. The fans they use to suck the air out of the room are huge and super loud. You actually have to wear earplugs to damped the sound and save your eardrums. Here’s a brief clip of me ranting about the noise. A couple hours after this clip was taken, I was intubated and put on a ventilator, so it didn’t much matter how loud it was in the room anymore.

The next thing I remember is waking up about a day and a half later with the breathing tube still in. They gave me a pen and book to communicate with. After about being awake for several hours on the ventilator, it was getting difficult to breath again, so I asked to them to put me back to sleep. I stayed asleep that time for about 12 more hours. After waking up the second time and breathing on my own for a couple hours, my ABGs were looking good, so they decided to extubate me (ie pull the tube out).

Except for a brief period of ICU delirium, (probably from all the Precedex) which kept me in the hospital an extra day, I continued to improve and was discharged home directly from the ICU 8 days later.

But like everything else in my life, nothing is ever that simple. Less than 24 hours after being discharged from the hospital, I ended up back in it, for of all things, a kidney stone! No big deal, just very painful. But unfortunately, that kidney stone yielded me yet another unwanted exposure to a germ filled Emergency room.

Medical institutions are taking extraordinary measure and precautions to protect their patients and staff from covid. But lets face it, this virus is probably everywhere right now and Im not totally convinced that we have a true handle on just how contagious this deadly virus is. So please continue to protect yourself and others.