Sunday, May 3, 2020

Equal Time

The article posted below is no substitute for going to the doctor if one suspects a Covid-19 infection.  It is posted for information purposes only and is not medical advice. 

You wore the mask, stayed home as much as possible, and even drank Everclear on a daily basis but still got the CV virus. It's fatal feature is that it attacks the lungs, which is a bad thing.  A retired nurse wrote about how she and her oncologist husband treated the virus at home in The Federalist.

Her recommendations will not beat the virus but they might keep you out of the hospital and away from the dreaded ventilator.  Fewer than 30% of Covid-19 patients survive once they are placed on ventilators.  Ventilators can also cause collateral damage to the patient even if he survives the virus.  Martha Campbell wrote:


My husband Mark and I are both medical professionals: he an oncologist, and I a retired community health nurse. We put all our skills to use in fighting this virus. Here are some of the things we learned that can help you if you or your loved one has just received a positive COVID diagnosis.

Both of us had COVID, and presumably the same strain. But we both had very different courses of the illness. For both of us, the major early symptom was a clear, runny nose, so unusually runny that it motivated my husband to call the Centers for Disease Control and ask about getting a COVID-19 test very early on. Until one of his close co-workers turned up positive, that wasn’t enough to qualify...

My husband’s symptoms ultimately included all the typical ones: fever, shivering, night sweats, shortness of breath, rapid and shallow respiration, and exhaustion. His wasn’t just a dry cough, but sometimes a productive one.

You should always be in touch with your physician to look out for signs that you should transfer to hospital care. But here is what we learned to help us keep out of the hospital...

The key reason people go to the hospital with COVID is difficulty in breathing. When my husband started to feel his breathing become more strained, he asked his doctor to order an oxygen tank that he could use at home. Many people may not realize that home oxygen is even a possibility, but it is prescribed for many conditions and there are companies that provide oxygen with systems meant to be used by non-medical professionals, delivered through simple tubes into the nose. (KF: It says "prescribed."  That means one must contact his doctor. ;-) ).


Along with the oxygen, we got an oximeter to measure oxygen saturation in the blood. It’s the little device they often clip onto your finger in a hospital. They’re available at some pharmacies, and we later learned that the oxygen company had a few as well. Having the ability to monitor oxygen levels at home was key to being able to gauge whether it was still safe to be at home and whether things were getting better or worse.

Another simple technique that is now being employed widely in hospitals, is that of sleeping prone, on one’s abdomen. Many hospitals are trying to keep COVID patients face-down for 16 hours a day, with them sitting up the other eight. * That maximizes the lungs’ ability to work effectively, which is hard on one’s back. For my husband it was particularly uncomfortable because of a previous neck surgery, but by monitoring his oxygen saturation we could see how helpful it was.

When his oxygen was at 92 percent on his back, it jumped to 97 percent on his abdomen. We would have had to double his supplemental oxygen to get that kind of improvement. When he didn’t want to stay in that position, I used several strategies to keep him there....

I gave him a back massage and used a technique I had learned as a nursing student to help clear the lungs of children with cystic fibrosis, hitting his back with cupped hands. It seemed to shake loose some of the secretions, and afterward his coughs were more productive. (KF: Most PT's, OT's, RT's, and even chiropractors know how to do this.). 

Even if the prone position is too uncomfortable to maintain, keep the patient off his back and on his side. If he is in a chair, keep it upright, not leaned back.

A spirometer was another great tool I wish we had started using earlier. It is essentially a plastic tube you suck into, lifting a gauge or ball to hit certain targets. It’s often used in therapy to improve lung function or in recovery from surgery. Somehow, being able to focus on how high he could raise that little blue ball was so much more effective than just saying “breathe deep,” and as Mark has been regaining lung capacity this has helped him dramatically reduce his supplemental oxygen. (KF: They are available on Amazon and don't cost much.)

Equally as important for increasing the expansion and efficiency of the lungs is focused deep-breathing exercise. Try lifting the arms up near the ears and breathing in through the nose and out through the mouth. Do this in a slow and focused way — put your hand on your belly and feel it push out.

Almost any health program will tell you the importance of exercise and drinking lots of water. That goes double if you have COVID-19. COVID-19 sends microemboli (a small particle, often a blood clot) that can become caught in the bloodstream, damaging the heart, kidneys, and other organs. Water is important to prevent emboli and support kidney function.... Rest of article.

*  The Miami Herald reported:
One doctor recommended the man be flipped onto his stomach — and it worked, according to the outlet. He did not have to be put on life support.

Doctors have found that placing severely ill coronavirus patients on their stomachs — called prone positioning — increases how much oxygen is getting to their lungs, CNN reported. ...

 “We’re saving lives with this, one hundred percent,” Dr. Mangala Narasimhan told the outlet. “It’s such a simple thing to do, and we’ve seen remarkable improvement. We can see it for every single patient.”...

A small study of 12 severely ill COVID-19 patients on ventilators in Wuhan, China, published by the American Thoracic Study found that lying face down is better for lungs, Science Daily reported.

“This study is the first description of the behavior of the lungs in patients with severe COVID-19 requiring mechanical ventilation and receiving positive pressure,” Dr. Haibo Qiu said in the study. “It indicates that some patients do not respond well to high positive pressure and respond better to prone positioning in bed (facing downward).”

According to the study, seven patients received at least one 24 hour session of prone positioning and three patients received both prone positioning and life support which replaced the function of the heart and lungs. Three patients in the study died.

“It is only a small number of patients, but our study shows that many patients did not re-open their lungs under high positive pressure and may be exposed to more harm than benefit in trying to increase the pressure,” Dr. Chun Pan said in the study. “By contrast, the lung improves when the patient is in the prone position.”... Rest of article.


11 comments:

Anonymous said...

Interesting article. Both Professionals, but if you are not one or have any doubts dial your PCP for guidance. Thanks for this KF.

Anonymous said...

I have been thinking about asking my doctor to prescribe. There are many benefits to having oxygen. A lot of airports have oxygen bars where you can breath the good stuff for 30 minutes. It is euphoric

Anonymous said...

PCP? I haven't smoked that stuff in at least 25 years. I thought it was an LA thing.

Kingfish said...

Yup. That oxygen bar got James Bond in trouble.

Anonymous said...

This is a fantastic piece written by somebody who knows what she is talking about. I feel better now about what to do if my wife and/or I catch it. Thanks, KF, for posting this.

Anonymous said...

While I cannot say for sure, I'm...dubious. Some of what is contained in this article - at least at the initial onset of symptoms - would lead meds to suspect a possible cytokine "storm" and so, spur a serious effort to seek at least some intervention. OTOH, just because someone is an MD doesn't mean they are particularly well-informed or even intelligent. Do you know what you call the person who ranks last in their class at the lowest-ranked med school in the US? Doctor.

Anonymous said...

Hell of a snag KF.....Wife and I are indebted to ya.

Anonymous said...

1:15 - I don't know what cytokine storm means but I assume OTOH means on the other hand?

Anonymous said...

"PCP? I haven't smoked that stuff in at least 25 years. I thought it was an LA thing." On the off chance you are serious, that means Primary Care Provider. Then again, I also smoked PCP, but a lot more than 25 years ago.

Anonymous said...

Oh great! something new....smh

Anonymous said...

i think I just as soon be hospitalized-


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If you get tired come relax at the Fox News Tent. To gain admittance to the VIP section, bring either your Republican Party ID card or a Rebel Flag. Bringing both will entitle you to free drinks.Get your tickets now. Since this is an event for trolls, no ID is required, just bring the hate. Bring the family, Trollfest '07 is for EVERYONE!!!

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