Fighting COVID-19 and reassessing my priorities
Like most of my colleagues, I began winding down my practice and seeing fewer patients as we learned more about COVID-19 in early March. Shortly thereafter, the sweeping effects of the pandemic became a harsh reality as various government agencies starting issuing shelter-in-place (SIP) orders and imposed bans on elective procedures. These orders were imposed in San Francisco a little earlier than most of the United States.
At the start of sheltering in place, I was working out more and making plans to complete many projects I'd always meant to do. Although I was annoyed at the uncertainty of the entire COVID-19 situation, I also know that the future is always uncertain.
About five days after not seeing any patients, I began feeling tired. I'm normally a very energetic person, so I attributed the exhaustion to simply working out too much, or perhaps some general malaise from staring at my computer screen and doing work that I could do without operating or seeing actual patients. I resolved to exercise less and sleep more.
The fatigue, however, worsened quickly. After another two days, I was averaging 14 hours of sleep each night, had lost my appetite, and experienced difficulty eating or drinking anything. I took some quick vitals, and had no fever, no chills, no shortness of breath, no GI symptoms and no problems breathing – just severe fatigue and possible mild dehydration. I figured it was a severe cold and resolved to drink more water and electrolytes.
The next day, I lost my sense of smell and taste. At this point, I was in the first stage of Kubler-Ross denial. I focused on rehydrating and continued to monitor all of my vital signs, especially breathing.
After another day, I woke up tired after sleeping about 12 hours. I knew I had to go to the hospital. I had no fever and no problems breathing, but I simply could not stay awake to drink enough water, and I had no appetite for any food or water, especially since everything tasted bland.
At the hospital, I had a hard time staying awake and it was tiring for me to walk. After checking me in, the E.R. staff took my vitals, which were still fairly normal with no fever and a saturation of 97 percent on room air. They did some blood tests and a chest X-ray.
My E.R. attending came in about 30 minutes later and confirmed that I had COVID-19. My chest X-Ray showed the diagnostic COVID-19 "ground glass" appearance on my lungs. She did a thorough pulmonary exam, and other than some slightly abnormal sounds at my lung bases, my results were fairly normal. They then did a formal nasal swab COVID-19 test and admitted me to the hospital.
As a patient, I vowed not to be a micromanager physician in the wrong specialty, and just absorbed what the hospitalists and infectious disease specialists told me. My treatment plan included hydroxychloroquine, azithromycin, zinc and hydration.
Patients often can't sleep in hospitals. I was in isolation, and despite the fact that every person entering my room needed PPE, I was prodded or had a talk with a nurse or doctor every three hours or so. I felt tired, but also safe. I was grateful to be monitored in a hospital setting.
The first day in the hospital was the worst, because I started to feel short of breath with even simple movement. Lying in bed was fine, but walking around my room, my pulse oximeter revealed saturation levels in the upper 80s. I was approaching the second stage of Kubler-Ross grief progression, although for me, it was more annoyance than actual anger.
The medical and nursing staff that helped me was fantastic. The doctors were very open about their thinking and treatment plan, and the nurses were encouraging.
I started feeling better my second day in the hospital, and my saturation stayed in the lower 90's with activity and effort. I was also able to catch up with food and water so that I was less dehydrated. I was discharged on my third day, with instructions to continue my medications as an outpatient.
I returned to a state of denial once I was home, trying to jump back into my normal routine. I tried to walk as exercise, which resulted in me needing to take naps after walking for about 45-60 minutes on a treadmill. Nevertheless, I vowed to walk more and slowly rebuild my strength. I still had no smell or taste, so I had to force myself to eat. Drinking water was also a chore. I required a lot of fluid to keep myself hydrated once I was at home.
After about a week at home, I resumed normal sleep patterns, and two weeks after being discharged, I finally felt normal. The CDC suggests two weeks of quarantine after developing symptoms. I decided to spend another two weeks in quarantine after discharge just to be on the safe side.
At the time of writing, it has been nearly four weeks since I left the hospital, and some normalcy is returning. I have about 75 percent of my sense of taste back, so I know I will eventually get rid of my last physical ailment that reminds me of COVID-19.
I am focusing on work projects again, maintaining my professional social media accounts, reconnecting on video with my friends and family, and eliminating negativity in my life.
While recovering at home, I contacted some people about contracting COVID-19 and my recovery. Some people immediately asked me how I contracted it and if it was due to a recent plastic surgery conference I attended. Two people accused me of giving COVID-19 to them, even though I was completely isolated during my earliest days of the virus. Obviously there is a lot of negativity and fear about the unknown in these times.
When I started telling close friends and loved ones about my experience once I was back at home recovering, the response was much more positive, with frequent checks on my wellbeing and multiple offers to help with anything I might need.
I can't thank enough the awesome hospital staff that helped me to get better. I am fortunate – I have health insurance, I went to a great new hospital that has the latest in modern technology and hygiene, and my nurses were phenomenal.
I was not scared of being sick or hospitalized – or even the uncertainty that surrounds COVID-19. I am a Christian, so I put my life in God's hands many years ago. I try hard to focus on what I can control. Good experiences can come from bad experiences, and things are already looking more positive.
Uncertainty does not sit well with most people – if anyone – and COVID-19 is constantly posing new symptoms and presentations. For a disease that took root in December 2019, we have made tremendous scientific strides in the few months since, but we still know very little about it as compared to other diseases.
When will we be able to gather in large groups again? Will we develop herd immunity? How many people have antibodies to COVID-19? Will my antibodies make me immune? How long are you immune? We don't know all of the presenting symptoms, the optimal treatment – or vaccine – and, as of writing this article, California is still under SIP orders and we don't know when we can do elective aesthetic plastic surgery.
Recovering from COVID-19 helped me focus on the things that matter – my family, friends, health, and of course, the projects and procedures within plastic surgery that I truly love. I never took many things in life for granted, but I had some blind spots, and you probably do as well. When I lost my sense of smell and taste, I should not have been in denial about having COVID-19. Fortunately, I exercise regularly and am in excellent health, so the potential complications from taking hydroxychloroquine, such as changes in heart rhythm and prolongation of the Q-T interval, never occurred.
If you strive to have a good foundation in life – maintaining good health, financial security, stable relationships with family and friends – it's easier to deal with the surprises life can throw your way. As aggravating as my bout with the coronavirus was, I did lose 20 pounds in two weeks, so I have a head start on my beach body for the summer.
I'm thankful that I can potentially give my serum to another patient battling COVID-19, and I registered with the local Red Cross after leaving the hospital so I could be in their system. I won't dwell on my experience with COVID-19 – life goes on, and I feel fortunate to be alive. Every day is a new adventure and I remain grateful not only for my health, but to be able to practice in the profession that I love. When we can't control a situation, we can only control our reaction to that situation. Stay positive.