As a physician who manages patients in the ICU, I provide care for a broad range of patients in the medical and surgical categories, including patients with sepsis and COVID. Even though our hospital provides more than adequate PPE, the possibility of contracting COVID remains significant, and recently happened to me. I hope telling my story will benefit others and inspire efforts to develop better treatments for this treacherous disease.
Initially, I thought I had a cold that wouldn’t be anything serious. However, I felt an obligation to be checked for COVID before seeing patients. After my nose was swabbed I said to myself, “Now I know what patients experience when I order a COVID test, and it is not fun!” To my surprise my test was positive. My wife was also positive. After a week of self-quarantine, I was admitted to the ICU; I was weak, slow to respond and severely dehydrated. Like some of my patients, I had COVID and the infection led to sepsis. I received IV fluids, antibiotics and all of the medications that the available evidence at the time justified.
I really missed my wife. I felt isolated and cut off from everyone outside of the medical personnel. She could not visit. We talked on the phone a lot, and I was relieved to learn that her symptoms were minimal. Unfortunately, things got worse for me.
My oxygenation dropped to levels that were incompatible with life. I was given high-flow oxygen at the highest settings possible. I experienced delirium and required sedation. I had shaking chills, abdominal pain and difficulty breathing. I felt terrified, miserable, and lonely. I was fortunate to have nurses who did all they could to ease my suffering. The respiratory therapists were vigilant. My doctors worked diligently and put a lot of thought into every medication, test and supportive measure. I felt that I was getting the best care possible. At the same time, I knew that in spite of everyone’s best efforts, death was a strong possibility.
My medical team discussed possible intubation. With my chest X-ray showing severe lung damage from the virus with pneumonia and my age of 73, I knew that after intubation I could be entering a pathway to death and that even if I survived, rehabilitation would be long with an uncertain outcome at best. I decided that if intubation was recommended, the procedure would be the only chance I had left and that I would go for it. Fortunately, I did not need to be intubated.
Over the next few days, my oxygen requirement steadily decreased and my other symptoms subsided. However, there was another surprise. When I tried to get up, even with the nurses standing near to help, I couldn’t stand. I had always been able to help others. Now I felt helpless. This helplessness shocked and frustrated me.
Over the next few days of a total 11-day ICU course, I progressed quickly to the point where the physical therapists advised my physician that I could be discharged to home. I was on cloud 9000 when I called my wife, and she told me she would meet me in the parking lot. The nurses then put me into a wheelchair to take me to her. My joy shattered as I was wheeled through our unit reserved for COVID patients, and I heard the sobbing of visitors whose loved ones were dying. I resolved that after discharge I would focus my energies on doing all I could to alleviate the suffering caused by this cruel disease.
My recovery has not been problem free; although I still am working through the challenges, I am thankful to and will never forget all of the health professionals who cared for me in spite of the risk to themselves and who recognized the signs of sepsis early enough to save my life. I am now even more acutely aware of the nexus between COVID and sepsis. Every health professional needs to be.
-Dr. Simpkins is the president and chief innovation officer for the Vivacelle Bio, Inc in Fort Wayne, Indiana.
To kick off Sepsis Awareness Month this September and expand your knowledge, register today for a one-hour webinar at 2 p.m., EDT, September 3. Amesh Adalja, MD, FIDSA, senior scholar from Johns Hopkins University Center for Health Security, will discuss the role of emerging infectious diseases, including COVID-19, which can lead to sepsis. Dr. Adalja will cover the historical relationship between sepsis, coronaviruses and other pathogens; assessing the need to escalate care; identifying at-risk patients; host-based diagnostics; and improved patient management strategies. This webinar is hosted by the Sepsis Alliance and sponsored in part by the Solving Sepsis Program in BARDA's Division of Research, Innovation and Ventures (DRIVe).
