It was 3 PM on my second day in the hospital--Christmas Eve- and was due to have a half hour IV infusion of Remdesivir for my Covid pneumonia.
I looked up at the IV bottle.
It was a dark glass container, looking identical to an upside down Kahlua bottle. More bothersome - there were three heads coming off the bottle, each looking like a Satanic face.
Scared, I assumed I was dreaming. But squeezing myself, I knew I was totally awake. I closed my eyes, and looked up again at the bottle being hung. Same vile image. I noted one of the faces looked identical to the character "Anonymous.”
As a physician I knew I was hallucinating. I knew hypoxia or high flow oxygen, of which I was having both, can cause hallucinations.
Yet it was as surreal as it comes, physician or not.
I decided to not look up until the infusion was done, and not ask my nurse about the unorthodox IV she hung.
The next day on Christmas, at 3 PM it was time for my second dose. The nurse came in to hang the IV bag. It took all I could do to look up as she hung it. It was a small clear vinyl bag, used for all IV meds. I was relieved the devilish Kahlua bottle was nowhere in sight.
I summoned the courage to ask my nurse, “was yesterday’s dose put in a different bottle?” “No,” she said, “it was the exact same small clear IV bag.”
I asked her if I had been napping when she hung the first dose. “No,” she said, “you were wide awake; why?”
I decided if I ever wanted to get released, I’d best keep my hallucinations to myself. “Just wondering,” I answered.
This falls into the category of "you know you are sick when.”
I can boil my experience into three unexpected memories. That bottle was obviously number one.
The second was my activities during my nine day stay. I had brought some books to read, planned on watching classic movies, brought a shaver and toothbrush, and some shampoo if I had a shower in my room.
Ok, I had never been hospitalized before. What did I know?
I spent eight days laying on my right side-flat, which produced the best oxygen readings. Flat on my right side, 24/7.
Realize all of my adult life, I was a multi-tasker. Running a busy practice.... Running a business.... Working as a Medical Director.... Husband and raising three boys into men.... Cooking and wine tasting.... And recently I took up gardening and boating, weaving those into the hours I had in a week. The idea of lying down in my bed for even 30 minutes during the day would be my biggest nightmare.
Yet here I was, lying flat for 200 consecutive hours. This wasn't a bad dream; it was torture.
There were a few exceptions. I could sit up to eat. But that dropped my oxygen so it had to be done quickly. One day physical therapy visited and stood me up. To achieve that, they had to crank my high flow oxygen even higher. I had one quick sponge bath. No shower, no shaving, no reading, no TV, and no visitors. My only view was of the nurse’s call button on the rail next to my face.
I knew that position was the only way my oxygen number would stay in the 90’s, allowing the nurses to try to wean the high flow oxygen from the 100% they started me on to the 30% goal-- when they could convert me from high flow to regular low flow. They had mentioned if they couldn't wean me in two weeks, I may be transferred to a "higher level of care". I knew what that meant-- the ICU for possible intubation.
To keep from going crazy, I tried to think of as many bad doctor jokes as I could ...you know, like-
“I’m sorry,” said the doctor to his patient. “You have Covid. We must quarantine you, and you’ll only be fed sliced cheese and bologna.”
“Will that cure me?” the patient asked.
“Well, no,” the doctor replied, “but it’s the only food that will fit under the door.”
“Doctor, there’s a patient in room one who says he’s invisible.”
“Well, tell him I can’t see him right now.”
How did the doctor cure the invisible man?
He took him to the ICU.
That took up about half hour before I realized I’d rather be hallucinating than thinking up bad jokes.
By day eight, they finally managed to wean me from high flow to low flow, but I was still confined to lying flat on the right side position. On day nine, they tried to sit me up. My numbers held in the 90’s. Not only could I read, eat, and watch TV from a sitting up position, but also they said they were sending me home. There were too many people in the ER as sick as I was the week earlier with no beds available. My Italian guilt took over as I realized I was glad there were enough sick people to force them to kick me out of my prison.
That leads to the third unexpected experience being home.
I imagined sitting on the couch watching Netflix, catching up on my medical reading, chatting on the phone with friends and family, and being back to normal in a week or so.
You can stop grinning now.
I was still on 24/7 oxygen, so my nurse/wife Mary was in charge of the slow steady wean. I am still on oxygen now, so I learned this will be a long-term project.
I was given exercises to help build up my strength. Problem is they drop my oxygen numbers plus they exhaust me. I need to use an incentive spirometer every 10-15 minutes to expand my lungs.
So I found recovering from Covid pneumonia is a lot of work. I should have believed my doctors who warned me to measure my recovery month to month, not week to week.
Yet as I recover, I find myself wanting to resume previous activities. When I was first came home, I told my staff I was retiring from blogging. Yet three weeks later, I know I want to go back to some sense of normalcy.
Believe me, writing this blog today is much more therapeutic for me than you.
One of our patients in Laguna Beach is the glass blower from the Sawdust Festival.
He isn't going to believe the special commission I have for him this summer.
I just need to empty out a bottle of Kahlua.
Gregg DeNicola MD
Chief Medical Officer
Caduceus Medical Group, PDQ Urgent Care and More, PDQ Telehealth
P.S. It is an understatement to say I am overwhelmed by the hundreds of cards, emails, and calls from our amazing patients and skilled staff wishing me healing. I tried answering everyone personally, then realized it was an impossible goal.
Reading these well wishes was stronger healing than the Remdesivir. I am truly humbled. Reading them made me realize I have had a career blessed by the heavens and the very best patients in the universe. Believe me the love goes both ways.
Remember to get tested with ANY symptoms and stay home as much as possible. I have been asked where I contracted Covid and I am sure it was from some asymptomatic person I came in contact with at work. I was still seeing patients in the office four days a week and masks are only 80-95% effective. It was a matter of time that a Covid particle sneaked around the masks we were wearing.
In retrospect, I should have stayed home doing video visits only when the numbers exploded after Thanksgiving. Do not repeat my mistake.
Caduceus will not be receiving the vaccine soon, so make best efforts to get vaccinated where you can. If you have had Covid, we advise a monthly antibody test through 2021.
We are now researching what a 2021 check up should entail and will be publishing that in a future blog.