I May Have Covid-19, But We May Never Know

So, here’s my Covid-19 – related story today.

 

Of course it probably wouldn’t have been Covid-19 related if it had happened a month ago.  But today I got to see what life is like for the amazing folks at Urgent Care and and an ER prepped to the nines for the oncoming wave.

 

So February 26 we returned home to Colorado after 7 days in the Cayman Islands and 4 in New Orleans.  We were in New Orleans during Mardi Gras.  (In my defense, remember how little we’d even heard of this a month ago?  Do you really?  Because I’m not sure I do, LOL.)

 

In the coming weeks I had a fair amount of chest pain.  Then a little bit of a sore throat.  A teensy bit of ear pain.  I was more tired than usual.

 

Of course I have a complicated medical situation…chest pain could easily be costochondritis, or a subluxed rib.  I’ve had a cardiac ablation.  I’m usually sore and tired, even more so after travelling.  Neuromuscular pain and overwhelming fatigue are my day.  So maybe I picked up a little bug.  I was jet-lagged.  And then there was altitude adjustment, and daylight saving time, which always screws people up.

 

But 2 weeks into this, instead of sleeping my normal 10-11 hours, now I’m dragging myself out of bed after 12-13 hours.  11:30am wake-up becomes 12:30, then 1:30.  The chest thing isn’t moving.  My heart is starting to feel sludgy and sloppy sometimes, especially when I lay down.  I sent a message to my PCP on the portal, but no reply. 

 

And then some days I feel clear.  Oh, I’m finally over it, I think.  And the next day always proves me wrong.  Back again.

 

And looming over us, gaining momentum hour by hour, of course, is Covid-19.  Could it be that?  It’s an awkward time to have allergies, a cold, anything which mimics any of the symptoms.   I don’t want to alarm anyone unnecessarily.  After all I don’t have a fever, and only a few coughs here and there.

 

So I call my doctor’s office.  There they offer to book me an appointment at the “respiratory clinic.” (Which really turns out to be Urgent Care, did they trick me on purpose?)

 

At the building I’m issued a mask between the sliding doors and instructed on how to use it.  At the next desk, just inside, one nice lady asks my name while another takes my temperature and places an oximeter on my finger.  We stand there for a short while.  The time begins to drag.  I look up at the nurse.

 

“Sorry,” she says sweetly, “I’m just waiting for your pulse to calm down.  It’s up, it’s down, it’s…”

 

“I have Postural orthastatic tachycardia,” I say simply.

 

“Ohhhhhhh!” exclaims the nice nurse.  “Thank you SO MUCH for telling me that!  That TOTALLY makes sense.  This is normal for you…OK, come here and sit down.”  I’m a little impressed that she knows what I’m talking about.  This place appears to have competence and preparedness oozing from its pores.

 

Pulse drama over, I’m sent out to my car to wait for a phone call.  I turn the car on and off a couple times to stay warm.   Return a few text messages. The phone rings and I proceed as instructed to proceed straight through the brown door marked “Urgent Care.”

 

Here I’m placed in a room and the door immediately closed.  A masked nurse knocks, enters and takes all my vitals and symptoms, and goes out to consult with a doctor.  He comes back in.  “Here’s where it gets a little tricky,” he says, apologetic. “We don’t have a way to deal with heart issues here.  We can take an EKG and diagnostic enzymes, but we won’t have the results until tomorrow at earliest.”

 

“That’s fine,” I say.  “This has been going on for weeks, I don’t think it’s going anywhere.”  And like we’re negotiating over a used car, he goes off to consult the attending physician.

 

And then I’m facing a masked physician.  (I’m secretly grateful doctors of all people, are no longer shaking hands in greeting these days.  He manages to sufficiently introduce himself, anyway.) 

 

“Here’s the problem,” my doctor explains, good-naturedly.  (Is everyone in Boulder good-natured?)  “You checked off enough boxes of concern for pulmonary embolism that I want you to go to the ER.  I looked at your reports from clinic and your blood oxygen is usually 99 or 100, while here it’s 95.  That plus chest pain, your recent international travel by plane, and what you’re describing…too often this could all be early warning signs of something  …bad.  I just can’t wait until tomorrow morning or even later for results.  By then it could be too late.”

 

I mumble something about my oxygen being at 98 in the lobby and maybe their machine is broken but his mind is made up.  He’s calling ahead to the ER.

 

“OK,” I hedge.  “I’ll go over there and see what the situation is.  If it’s crazy, I’ll wait until Monday.”  I hop in the car, change to my distance glasses, proceed 11 minutes away to the very nicely appointed Boulder Community Hospital. 

 

I was there for a mammogram just a few days ago.  (My clavicle is still subluxed from that boob-squeezing, shoulder-wrenching ten minutes, thanks…and now that I think about it, thankfully I didn’t think to mention left shoulder pain - that probably would have only set everybody’s minds even more deeply against my poor, innocent heart.) 

 

This is a swanky place, if you ask me.  Little sculptures in the seating areas, swinging tablet trays on armrests, a water feature in the courtyard features little bronze otters splashing in a replica of a delightful river scene. 

 

Of course that’s the clinical part.  The ER is a little more Spartan.  But clean, quiet and organized.  I see no crowds, no crying babies, no one bleeding.  There’s no wait at the front desk.

 

No excuses.

 

So another masked person checks me in while another takes my vitals.   I hand the masked intake nurse my color-coded, typed list of medications and diagnoses, and he nods appreciatively.  He’s curious about some of my more esoteric medications.   He seems somewhat relieved I’m not wheezing or bleeding profusely.  I can almost physically feel the calm before the storm here. 

 

I’m instructed to a seat away from the people they assume are contagious.  (Damn, another excuse to leave gone.)  A hard-working cleaner is mopping the floor over at the next bank of chairs.  Everything looks the picture of calm and competence.  Damn.

 

Soon I’m escorted back and given a private room where the door is snugly closed.   Someone brings in an EKG machine and my heart is checked, the machine wiped down.  Two others bring in an X-ray machine on wheels, painted like a giraffe, and my chest is scrutinized thoroughly and deeply.  Machine wiped, door closed snugly again.

 

The masked PA enters, but hovers near the door.  He confirms we’ve ruled out things like Pericarditis, and my chest X-ray is clear.  Then, surprisingly, he says, “It’s not unreasonable, based on your history and symptoms, to assume you may have, or have had Covid-19.”  He pauses and looks at his hands.   “But I don’t have any tests.” 

 

And then he’s quick to add,  “Even if you did have it, your symptoms are mild enough to where we’d send you to rest at home..Your oxygen is in the 90’s.  You’re not having trouble breathing.  But please do let us know if you do.  It’s good you came in.”

 

Lastly, the PA and I discuss whether it’s worth it to do a D-Dimer test, which checks for pulmonary embolism.  He’s pretty sure it will be negative, but carefully questions me three more times, does it really not hurt when you take a breath?  He’ll ask me again when he returns.

 

While he’s out I take some experimental deep breaths.  OK, if I’m being honest, it kinda does hurt, especially right at the apex of it.  Kind of a stretchy hurt.  And it’s just a blood test, right?

 

Oh.  It’s another trick!  A nurse comes in and says he’s going to insert my IV.  (IV? For a blood test?  Oh it’s just in case it’s positive, I’m told.  That will trigger a whole cascade of events which require a way in.)  My veins are not cooperating, of course.  I have a growing appreciation for my nurses at the infusion center who do this every other week.  They usually use a vein further down my arm, so I can at least bend at the elbow.  Finally he finds what I swear is the most painful possible spot on my right arm, the cubital vein (left was a no-go,) takes some blood and then I’m told - well, politely expected - to wait there for 90 minutes.

 

Can I go home and wait for the test results?  No, I’m told - for some reason if I leave the hospital and come back, insurance won’t cover.  What?  Argh.  I’d be less cranky if the internet were working.  And if I didn’t see, in my mind’s eye, an invisible teenly little, evil Covid-19 virus sitting on every single surface.  I don’t want to set my bag anywhere, hang my jacket, don’t want to use the bathroom, (but must, at least four times) don’t want to inhale, thinking of those gaps between my face and its sub-par protection. 

 

And am I weakly protecting myself from others, or am I weakly protecting all these brave, cheery, competent and good-natured healthcare workers, every single one of whom will be needed when this wave comes crashing in to shore, from ME?  In a few days, maybe a week or two, this ER will probably be crawling with fevered, panicked individuals.  Big decisions will likely have to be made.  These kind, seemingly relaxed souls taking care of me will be worked to the bone, exhausted and worried about carrying this virus home to their loved ones, or falling sick themselves.

 

I ask most the folks who come in and out of my room how they are doing.  Ready, they say, and nervous.  It’s coming. 

 

Ever try wiping yourself with your non-dominant hand?  You should, really, for a brain-training and coordination exercise.  (Also try brushing your teeth that way – it’s good for you.) I do that, hang out, answer some emails.  Most of them are from people cancelling, delaying or otherwise fretting about dates they’ve rented at one of the houses in Moab.  Our income is completely flattened until this Coved-19 thing blows over. 

 

Well, this is no good for my heart, I think, and turn on some Deva Premal tunes.  I close my eyes and try to be patient.  Abundance of caution, I think.  You did this out of logic, and abundance of caution.  Besides, better to be in the ER today then even a few days from now. 


The PA returns and announces the D-Dimer is negative; I’m free to go.  “But you should isolate, as you probably know.”  Of course I do.  We all do.  Social distancing is the new norm.  Even if the strongest possibility is we probably have some more mundane virus going on, as I believe is probably the case with me today.                                              

 

The IV is a wanker and I can’t wait to get it out.  Finally someone frees me and I’m out the door.  When I get home I immediately strip everything and take a long, hot shower, then wash my phone thoroughly with soap and water.  The bag can wait until tomorrow, and I’m not sure I should wash the down jacket.

 

These people I met today, I must assume they do this every day, and will for who knows how long?  Wondering if that little sticky virus followed you home from the hospital and is clinging, alive and waiting to be inhaled by loved ones, attached to a hair or a keychain or a seam in your underwear.   I have a little bit of awe.

 

Colin has made grain-free pizza and it smells delicious.  My chest still hurts.  I’m not thrilled about that.  But I’ve learned so much today. 

 

Mostly I’ve learned respect for all the people on the front lines, who kindly treated a fifty year old chronic patient like a person, followed protocol to a “T” and patiently talked me into the best care possible for myself, despite myself, and in spite of this huge, looming crisis no one is naïve enough to think we will avert. 

 

The people I met today seemed ready.  Ready to do what they are trained to do, ready to serve with compassion, efficiency and competence, ready to put their minds to work and bodies on the line for the greater good.  I came away confident we couldn’t be in better hands.

 

 

 

 

 

Photos by Emory Collinson        © Niki Naeve 2015