#clots

Thread 🧵: long COVID process

https://twitter.com/drclairetaylor/status/1589369595726823424

Clinical pearls for #LongCovid

Incredibly, it’s been four hours now!

I’ve been lying on this gurney for so long I think I’m going blind.

Wait! Here comes someone who’s actually making eye contact with me.

“Mr. Thornton. I’m Dr. Jones. I’m working the ER today.”

My throat is so parched, I can only croak an acknowledgment.

“Sorry for keeping you waiting so long, but we get homeless walk-ins all the time. We had to make sure you weren’t just another drug user looking for a fix.”

Hello. I’m wearing farmer Jones bibs with suspenders. Do I look homeless to you?

“We get too many folks trying to get in here every day looking for a quick fix when they run out of drugs, so we had to make sure you weren’t one of them. We try to help them but it's reached a point where we are being overrun."

I sat up. Suddenly I didn’t feel too good. It was getting hard to breathe again.

“Hey, Doc!. I’m having trouble breathing. Can you give me some oxygen or something,” I gasped as I laid back down. I had a pale complexion before I ever came down to the VA hospital. Now I was turning a purplish color.

The doctor made a quick gesture to an orderly standing close by and called for a wheelchair, an IV, and oxygen. They whisked me up to the fifth floor and into a hospital bed there. You know, the kind with the flip-down rails running horizontally along each side.

I began to feel much better after they put a nasal cannula in my nose. The nurse pulled a curtain between me and the guy next to my cubicle. I quickly fell into a deep sleep—the best I’ve had in a while.

I woke up the next day feeling much better. Soon a nurse entered the room pushing breakfast food carts with trays, but she didn’t stop by my bed. I wasn’t very hungry anyway.

The nurse pulled the curtain back, and I chatted for a while with the guy next to me. He was a cheery, talkative young man who very nonchalantly told me they were going to cut his foot off in a couple of days. He stepped on a nail, it seems, and it got infected. Turned gangrenous on him. So, now it had to go.

A little later in the morning, Dr. Smith came to see me. We chatted for a while about my symptoms. He said that he wanted to perform a catheter insertion through my right thigh so we could take a look at my heart. I said sure. Anything was better than going on like before. Not getting enough oxygen to your brain is like slowly drowning where you’re gasping for air but not quite suffocating.

When we said goodbye, I lay down thinking about the stress test I had taken the year before and felt a shiver go up my spine.

When I first started displaying symptoms of fatigue, my doctor at that time recommended that I go to the VA hospital in Atlanta and take a stress test. I had no idea of what I was getting into.

So, at the appointed time, I went to the hospital for the test.

Now, you’ve got to understand that parking at the VA hospital in Atlanta is an adventure all on its own. I tried it once and finally gave up after circling the parking deck twenty-eight times. After that, we utilized the Valet Service at the front door of the hospital. That was really great—if you could ever get to it. Sometimes the valet parking line snaked all the way around the hospital, and even out into the main road at times. It took a long time to get to the front door.

I finally made it and took their redemption ticket. I made my way back to the stress-test room where they determine how your heart works during physical activity. They stuck a bunch of cardiac memory loop monitors all over my chest and put me on the treadmill. I can tell you I wasn’t looking forward to the test because of my angina episodes. I did warn them, but they didn’t seem to be too concerned.

We started out real slow, and things were just fine—until they picked up the speed. I started to huff as the speed increased and warned them I wasn’t feeling too good. They poo-pooed that and cranked the speed up.

I was having trouble holding my own and warned them I was “fix’n to go.”

The male nurse hollered, “just give me another minute . . . just a minute more!”

“I’m fix’n to fall!” I gasped. Then I did. Right down on the still rapidly moving treadmill. I slumped to my knees and grabbed the support bars as my knees dragged out behind me.

A couple of male nurses grabbed me and picked me up and off the machine and set me down in a nearby chair.

“We’re so sorry! We thought you were okay,” the nurse stuttered apologetically.

Yeah. Sure. Like I didn’t warn you.

So now you can see why I was a little leery about having a catheter procedure. As it turned out, it wasn’t so bad. They took me down to a special room where they administered the stent through my inner right thigh and up to my heart with a camera.

It was terribly interesting. I was able to see my own heart beating and all the little black web-like arteries and veins that roped to and from my heart.

The doctor--and I forget his name now--seemed surprised at not finding something wrong there.

“Hmmm. Your heart is only twenty percent blocked, and that’s really good for your age,” he murmured, more to himself than to me. He paused . . .

“I think we’re going to send you to the Nuclear Lab to let them take a Nuclear Lung Scan because I don’t see anything much wrong with your heart. For your age, it’s in pretty good shape.”

The next day, I went in for the scan.

He brought the results back and gave me a strange look.

“Well, it looks like you’ve got three clots in your right lung and two clots in the left one.” he paused, “You should be dead. It only takes one to kill you.”

Thanks for the cheery prognosis. Needless to say, they sent me back to the fifth floor and put me on a blood thinner right away.

Later that evening, the doctor came by.

“We want to keep you here a few more days to make sure everything is going okay (with the thinners).

“Okay,” I said. “Hey, Doc. Do you think I can get something to eat? I haven’t had anything in two days.”

He just stared at me for a moment in total exasperation.

Somehow, they didn’t have my name on the patient list for food so the food cart kept bypassing me when it came to the fifth floor.

I lost fifteen pounds during my stay at the VA. Not by choice, I can assure you. I looked forward to leaving.

This was a real scary brush with death. It wasn't my first, and it wouldn’t be my last. Over the next couple of days, I thought about many of the things I had done—both good and bad—over the course of my life.

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