Coronavirus Game On — How It Went Down and What I’d Do Differently
TLDR: COVID-19 is not always mild or as tragic as the stories you see on the news. It is, ALWAYS, as scary as it sounds. It was hands down, one of the scariest experiences of my life. Here’s my journey and the tips I recommend if you’re going through it. Like any good former college athlete, I lean on a sports metaphor or two, but if you don’t follow sports don’t despair…it’s mostly for the meatheads that need me to paint them a picture if I want them to take this seriously and take action.
I kicked off 2020 in the same way many of us did. I watched football, worked, and hung out with my kids. In February, right after the Super Bowl, I started seeing trends on twitter about the Coronavirus in China, and little did I know I’d soon be way closer to the action that I ever wanted.
On March 25, I was laid out in bed, absolutely beat from fighting a high fever for nine days at home. I woke up that morning to blood in my urine, along with the common fever of 102.4. Throughout the week, I had a cough and bloody phlegm, but still none of the significant breathing problems all the experts warn you about.
I read the news and, at the time, believed that the people who had the hardest time with COVID-19 tend to be those that have another severe condition like asthma, diabetes, or heart disease. New research is even suggesting that obesity may be another risk factor.
🚨News flash: I’m Black, live in the Bronx, I’m damn near 50, and a far cry from skinny.
Once I saw blood in my urine, my big concern was that I had something wrong, and un-diagnosed, with my kidneys or my liver. I wanted so badly for this to be something else, and without the persistent fever, I might have chalked it up to a kidney infection or UTI and kept it moving.
After chatting with the team at Bronx startup Radical Health through their website and speaking with my family, I decided it was too big a risk to stay home given the blood, fever, and cough. At 11 AM, after stalling for as long as possible, I went to the ER at New York City’s Mount Sinai Hospital, where the party got started with an 11-hour wait in the ER, and the party favor was testing positive for COVID-19.
This is something that I NEVER want to go through again. I (likely) have the immunity, and still keeping my ass indoors. That’s how badly I don’t want to see the inside of a hospital again. Below are the top tips I recommend if you or someone you care about, it going through it :
Before you Decide to go to the Hospital: Choose your Play-caller:
Just as in the game it’s super important to know who’s calling your plays, it matters even more in the hospital. In health terms, it’s called a health care proxy — think of how you would want the tough decisions made before you have to make them. It’s scary AF to be alone, in a hospital, making decisions about being intubated and put on a ventilator, while sick and suffering. It’s a lot better (and a LOT less stressful) to have thought about these decisions in advance of needing the information and have designated a person in your life empowered to make these decisions in case you cannot.
Deciding to go to the Hospital and Hospital Intake: Special Teams Wins Games
We all know special teams win games but are often overlooked. Keeping track of your symptoms is the medical equivalent of special teams. Check your symptoms and keep an hourly record. In my case, I had a fever at home for nine days that ranged between 100.1 and 103.1, and a worsening cough for the last four of those nine days. During that time, my 17-year old son kept records of the readings coming from my pulse oximeter, took my temperature, and tracked my breaths per minute.
Study your Plays
Knowing the play ensures that everyone is in the right place, at the right time, to score. So know your plays and when you get to the hospital run your best play. The time to “make your case” is when you first arrive. People get sent home without being tested, let alone admitted every day, and as hospitals get more crowded, this will happen more and more. Intake is the time when you get the most exposure to nurse practitioners and doctors, so have your shit together, and give them actionable information on your current condition. Once you’re admitted, your time with doctors drops to about 3 minutes/day during their rounds.
Getting to an ER bed was pretty quick, but overall, intake sucked. It took hella-long (average is 10 hours) for the COVID-19 test to come back to the hospital, and at most hospitals, they will not assign you a room until they know whether or not you are positive for COVID-19. It’s vital for the hospital to understand because the COVID-19 precautions that they have to take to treat you if your COVID19 positive (you know all the “PPE” you’ve heard about) are the real deal.
Once you’re admitted: Kickoff
Do your research and be prepared with questions for your care team because they’re overworked, and you get very little time with them (see above). It’s mostly them telling you stuff unless you have questions. I was fortunate. I have people, friends, business partners, and colleagues, who consume a metric ton of first-hand information on Twitter and are quite frankly better at synthesizing it than I am. We all share information. This meant that even while I was flat on my back with very little energy, I had people who were texting me information on treatments and studies, and I had several questions ready for my care team. I also had people asking those questions on my behalf when they called in to check on my condition. The ability to ask questions of your care team and to suggest changes to your care regimen is essential.
Treatment: Running the Plays
For better or worse, I had an early start in this game. Upon admission, a ton of bloodwork, an IV with a broad-spectrum antibiotic for the blood in my urine and the heavily recommended and now controversial combo of azithromycin more commonly called a “ Z pack” and hydroxychloroquine. I continued to receive the “Presidential cocktail” for the first four days of my stay. I was given an EKG every other day (…wondering if this was due to the known complications from hydroxychloroquine), and Heparin daily to make sure I didn’t get any blood clots. This course of treatment failed to break my fever, which persisted until midway through day 13 in my case. Yup, four more days in the hospital with a super-high fever. It was on Day 13 when my breathing finally made it to the stage where it was hard even to talk. We needed something to break the fever so my lungs could start to heal. If you are hospitalized for COVID-19, you will have breathing problems at some point (Duh). How you deal with this challenge is one of the defining moments in your journey (and hopefully recovery). Trying to figure out what you have and how you’re progressing is exceptionally challenging when everyone’s journey through COVID-19 is unique. I kept looking for the most common milestones and had almost convinced myself that I had dodged the worst of the symptoms — when it got bad — like cytokine storm bad.
The treatment that ultimately proved useful in breaking the fever during the “cytokine storm” phase was tocilizumab, the anti-rheumatoid arthritis drug. Knowing about and asking for this treatment was essential to my care. I also asked for convalescent plasma but was told that it was reserved for those patients in ICU, which was cool, given that I was in a room, on oxygen, and not ventilated in ICU.
Team Dynamics: There’s Always That ONE Guy…
I had a 77-year old roommate, Ishmael, for a week of my stay in the hospital. He’s the toughest older man I’ve ever seen. When I was short of breath, I would lay there dreading taking my oxygen off for any reason, and I would hear him on the other side of the room, pull his mask off, do his business, and come back and lay there mewling like the Incredible Hulk after he got his ass kicked by Thanos.
I would lay there on the other side of the thin, vaguely plaid curtain that divided our room, listening to him try to control his breathing, and tell myself, “Shit, THAT dude just got fucking handled by the Rona on a trip to the bathroom.” Sheesh. But that never stopped him. He’s old, with a not-huge bladder, and I would hear him do it at least four times a day. I would lay there dreading the ass-kicking I was going to take on my once-daily trip, but after the first 24 hours, I began to think, “Hey, bro, you’re 49. If the 77-year-old can do it, then so can you”. There started our bathroom challenge. Like the OG that he is, Ishmael wasn’t competing, he was just doing what he had to do. But seeing him accomplish what I was scared to try hurt my pride. By day six of my stay, it became noticeably more comfortable to be off my oxygen for the roughly four minutes it took to go to the bathroom. Small victories.
You Can’t Play if You Can’t Breathe (AKA Listen to Your Nurses- They Know Shit)
Proning (also called cooperative proning) works. “Proning” sounds like some fancy shit, but it’s just resting or sleeping on your stomach to let your lungs expand.
It helped improve my breathing, but for the first few days in the hospital, I was still too weak to make it work. When we could turn over, my roommate and I both saw immediate results in increased oxygen, just by shifting from our backs to our stomachs, which helped open our lungs. Who took the time to explain why it works and why we should try it? Not the doctors (no shade, they’re busy). It was our nurse, Eileen.
More studies are coming out every day, suggesting that avoiding ventilation, if at all possible, leads to better outcomes, generally in conjunction with dramatically higher doses of oxygen (as much as 80 liters, according to some). During my stay, there was a point where I was on 15 liters of oxygen per minute, and we weren’t sure if the oxygen was even working. At around midnight, an ICU doctor came to evaluate me for ventilation. She was like the fucking Grim Reaper. No Nonsense. Precise. Scary AF.
Thankfully, I’m still here to tell the tale. I knew I was on the mend when the fatigue began to lessen, and I could start to concentrate. On day seven of my hospital stay (day 16 of symptoms overall), my sense of smell began to return. I still didn’t have much of an appetite, but I began to make a conscious effort to eat at least a little.
Homecoming: Getting Better and Going Home
I was released on Friday, April 3rd, after spending nine days in the hospital. We’ve all seen the super touching videos of hospital staff cheering people who are going home. This is happening — even to regular folk like me. Nurse Eileen broke down in tears when she told me I was the first person they had sent home and not to ICU from the ward in two weeks. I left the hospital in a wheelchair with a cheering staff lining the halls, and for whom I’m sure, good news has been in short supply. I mean shit, all I did was get better. Not like I gave birth while in a coma and got better. Low key, I felt waaaaaay more special two weeks ago, but I can still say it’s an image that is seared into my memory for life. I’m home and feeling better every day, but Rona is the gift that keeps on giving. My lovely parting gift from our time together?
“It can take three months to a year or more for a person’s lung function to return to pre-COVID-19 levels.”
Recovering isn’t always smooth, and I sure as hell ain’t Chris Cuomo, but I’m finding that sharing my experience is one of the ways I can be most helpful to those who are going through it, or worried that they will have to face it at some point soon.
