This is the view from the UT Southwestern Clements University Hospital 12th floor. The 12th floor is the COVID floor, and it is where I spent most of the past couple of weeks.
In an earlier post, Vaccine Emotions, I mentioned "And no, the vaccine isn't some sort of magical COVID shield. It's 90% effective in healthy individuals, likely less in the immunocompromised." I wrote that post back in December when I received my first dose of the Pfizer COVID vaccine. I had been accepted to be part of the National Vaccine Research Study for Transplant Recipients and three months after my second dose of the vaccine I had not yet build up any spike protein antibodies. This did not mean that vaccination was not effective, just that the immunosuppressed may not develop the same response as people with a healthy immune system. Our hope is that the the vaccine did activate Memory T and B cells. I tried to talk my team into a third dose of the vaccine after my 3 month post vax labs came back negative, but they were reluctant to approve it due to lack of data on the effects of a third dose. Thing change rapidly as more information and data comes out, and my Team is now helping us get the 3rd shot.
I have not yet received the third dose because... I was infected with the SARS-COV-2 (COVID-19) virus. I thought I was coming down with a Summer Cold. Standard protocol for me and colds is a steroid taper and antibiotics. So I contacted the Team and went in for a PCR just to verify it was a cold and found that nope, I hit the COVID lottery.
Since I thought I had a cold, I was taking Coricidin HPB. My symptoms while taking the cold medicine were an elevated temperature, cough, upper respiratory irritation, and diarrhea. My SpO2 dropped a bit and when admitted to the hospital I was placed on 2 liters of supplemental oxygen.
I spent 10 days in the hospital, and a hospital stay with SARS-COV-2 (C-19 from here on) is not even close to the my experience with any of my other post transplant hospital stays. My transplant team was in charge of my care, which was a great comfort to me, but I was not on the lung transplant floor. I was on the C-19 floor, as expected. The floor was full and the staff busy. Some of my nurses/techs have been on the floor since the beginning, others came to the floor right out of nursing school. One of the common traits of my nurses was honesty. If you ask a question, you are going to get a direct and honest answer based on experience. I really appreciated this. Personal contact with doctors is rare when you are on a C-19 floor. A doctor never entered my room, all my contact with my Team was via phone or video chat. This is very understandable as my Team sees lung transplant patients on the 10th floor. It would be irresponsible to expose them to any additional COVID risk.
My course of treatment included two treatment cycles of Remdesivir (10 total infusions), a steroid taper followed by pulse steroids followed by my current taper, and
Convalescent Plasma. Why plasma instead of monoclonal antibodies? Well, the monoclonal antibodies were our first choice but this therapy is not approved for inpatient treatment. The hospital and my Team (who are very good at getting approval for off label use of necessary meds) tried to get the treatment approved, but could not. We went with the plasma, and in my case, it appears that convalescent plasma is effective. This highlights how important it is to pay attention to your body, get tested if you have any symptoms, and start treatment early. The effectiveness of either monoclonal antibodies or convalescent plasma is significantly increased if used early on in the course of the disease.
I assume that any transplant recipients reading this have received the COVID vaccine. If someone has received the life saving donation of an organ, and not yet availed themselves of the vaccine, I really would have to wonder why? Pre-vaccine immunosuppressed people had a very hard time with this disease, the vaccine really can and does make a huge difference.
I had some ups and downs while in the hospital, but the end result is that I am home and doing well. I'm taking Nystatin for a yeast infection and will start a couple days of Lasix for swollen legs. I'm on room air and my pulse ox readings are normal and stable. Even my home spirometry remains normal. My hospital CT scan identified potential long term issues and we will be following up and keeping an eye on things.
To give you some idea of just how busy hospitals are on their COVID floors/wards; as soon as my discharge orders came in they started clearing out my room and getting ready to clean/sanitize it for the next patient who had been waiting in the ER.
A bit more in support of the C-19 vax. My wife has Alzheimer’s and we are rarely more than 6’ away from each other. We eat, sleep, sit and shower together. We were also vaccinated together. Even though my suppressed immune system allowed me to catch C-19, my wife did not. Vaccines really do save lives.
Ten days on a C-19 floor give a person plenty of time for reflection, prayer and reading the Bible. I am blessed in so many ways. I have a wonderful wife and live in community that supports the both of us. I am still here 6 years past my expiration date and each challenge we have faced over these years has been met with faith and the skill of my wonderful Team. Like Skillet sings in the song You Ain't Ready, "What doesn't kill me makes me who I am".
If you have any questions about my experience with COVID so far, please ask. I'll do my best to answer in the comments.
Being a lung transplant recipient, with CLAD BOS-3, on Extracorporeal Photopheresis who has had SARS-COV-19, gives me the opportunity to participate in a couple more clinical studies. One of these days I'll have to write a post on all the studies/trials I've been a part of over the years. I've commented in the past that I wanted to be the subject of one of my Team's papers, but now I'm not so sure :)
Have an awesome day my friends.
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