June 25 Like most physicians, I am bad at scheduling my own doctors visit. This year, despite COVID craziness, I had made an appointment with a new PCP to get Singulair refills (my allergies were a killer, and a drippy nose behind an N95 is no joke). I loved my new PCP! She connected with me on a personal level. She dealt with all my concerns without making me come in for another problem visit. Her MA offered an overdue tetanus shot, which I willingly received. I woke up around 1 a.m. with rigors – teeth chattering almost bone-breaking rigors. Hubby and I have been sleeping in separate rooms since COVID, to avoid both of us getting sick at the same time, so I got a Tylenol and took my temp – 99 degrees. I fell asleep an hour later, teeth chattering and body aching. I woke up the next morning feeling lousy. I made it to the bathroom and nearly passed out. I asked hubby to stay out of the room and get me coffee and a thermometer: 100.4 degrees. Under normal circumstances, I would not have batted an eyelid. But this was no ordinary day. I had reintubated a COVID positive patient exactly 14 days prior, and I had been working till five days prior. I called my phenomenal new PCPs office to ask for a COVID-19 PCR. They ordered it, and I drove myself to the urgent care where the test was administered. That was an experience. I had to curbside call for check-in. A nurse in a paper gown, surgical mask (no N95), face shield, and a scrub cap escorted me into an exam room and administered the nasopharyngeal swab. It was not painful, just uncomfortable. I drove home and went to bed. Fever hovered at 102 degrees most of the day. I emailed my boss to let her know. How could I have COVID-19? I wear an N95 and eye protectors for all regular patient interactions, and CAPR for all COVID positive patients. Then how could I have contracted COVID? I had purchased a Dyson air purifying fan that was advertised to capture 99.97 percent particles of 0.3 microns in size, that I ran all day despite feeling cold, and I kept the windows open. I felt mentally broken towards the middle of the day due to isolation. Being alone in a room without much interaction really takes a toll. And I was in my own room with family nearby that checked up on me often. How did my patients in the hospital feel? June 26 I went to bed early. Like the night prior, I woke up at 1 a.m., with myalgias. The temperature was 101 degrees. Popped a Tylenol, went back to sleep. Woke up the next morning: 100.4 degrees. I was starting to feel certain this was COVID-19. I had downloaded a pulse ox app from Apple and checked my vitals all day. I did a 30-minute online yoga flow. Yoga is good for everything. I answered patient messages via Epic. I reached out to friends – I wanted to make sure my kids had somewhere to turn to if hubby got sick as well. Fever was mostly 101 to 102 degrees all day. June 27 Woke up with no fever. I felt much more energetic today. I did a 50-minute yoga flow. I glanced at my arm, where I had received the tetanus shot. Even though the arm had been tender, I had not looked at it in 3 days. It was erythematous, 4 by 4 inches in diameter, indurated, with satellite lesions. I had never experienced a vaccine reaction, so this surprised me. I wonder how bad my arm had looked on day 1 when I woke up with rigors? This was why I had fevers! I called urgent care to check on results. Since it was the weekend, they were not back. I was ready to come out of self-isolation. June 28 Today was a hard day. It was Sunday. One more day till results, which I was sure would be negative. I ran 30 minutes on my elliptical. I found it hard to be productive. I was in a mental funk. June 29 Today was the hardest day yet. Day 5 in self-isolation: I have been fever-free for over 48 hours. Yet my test results are not back. I spent the day making multiple phone calls to my phenomenal PCPs office. I sent her several MyChart messages. The lab informed her that LabCorp has a turnaround time of 3 to 7 business days. I canceled two bronchoscopies I had scheduled for tomorrow. Those patients were pre-procedure tested on Saturday at a different location, and their results were in. The MA called me at 4 p.m. to let me know that the results were still pending. She asked me to keep calling LabCorp since she was assured that the results would be out later tonight. I have called twice already at 5 p.m. and 7 p.m. Today I reflected on the American health care system. As a physician, I strive to provide the best care. With a broken system, the care is fractured. As competent as my PCP was, here I am, five days out, not able to take care of my own patients, who depend on my dependability. As of today, there are more than 10 million reported cases of COVID-19 worldwide resulting in over 500,000 deaths. This pandemic has caused the largest global recession since the Great Depression. The U.S. response has been nerve-wracking to watch. Three months into this disaster, continued lack of PPE, inadequate testing, and contact tracing remain problematic. Most frustrating of all is the politicization of universal masking. Economic recovery will only be achieved through 3 measures: universal masking with social distancing, efficient testing and contact tracing, and lastly, providing health care workers all the tools they need to do their jobs. By the way, I called again at 9 p.m. PCR results are in: negative! Rizwana Khan is a pulmonary and critical care physician. Source
