Day 8 (Day 6 of symptoms) The Danger Zone Cue Kenny Loggins

Tuesday 17TH November

On Facebook I post

We enter the Danger Zone.

Woke feeling very hot and SOB at 4 am. Extremely thirsty. Heavy cough, unable to take a deep breath. Run through the Bene Gesserit Litany to make sure it's not panic breathing, caught in the eternal dilemma of not wanting to burden these amazing nurses but wanting to get treated.

Sats were 90 for a while again, temp 38 something, I feel like I'm on a griddle, room is airless

A wonderful lady arrives, starts O2, gives me paracetamol. Drinking like a fish/duck/cow?

I have already decided I am not doing the fear thing. Covid may invade my body it will not control my mind. If I stay calm and treat this with humour it will be so much easier to deal with. Keep light. Be positive. Keep smiling as my mum would say. I had the difficult, awkward, necessary conversations with those I love most yesterday. Feeling oxygen seeping into me, who knew we needed it so much?

The Bene Gesserit litany is from an epic Sci-Fi story Dune by Frank Herbert which I first read when I was about twelve. It’s a great way to find peace of mind when you are frightened.

"I must not fear.

Fear is the mind-killer.

Fear is the little-death that brings total obliteration.

I will face my fear.

I will permit it to pass over me and through me.

And when it has gone past, I will turn the inner eye to see its path.

Where the fear has gone there will be nothing. Only I will remain."

I repeat it every time I feel the fear coming on me. In the long dark hours alone, it is a great comfort, repeat it slowly, carefully, clearly. It becomes a mantra.

I sweat continuously. The sheets become soaked and the poor nurses keep bringing new ones, four or five times a day my bed has to be changed. No wonder I am dehydrated. I have been drinking as much as I can to replace the fluid I am sweating out.

Doctor Sean comes in to my room. “Ok” he says “we need to change your antibiotics as you still have a persistent fever. Your blood sugars are very high so we will continue with the insulin injections into your abdomen, every two hours if they stay high. They are probably high because of the steroids, what I don’t understand is that your sodium is very low, its 128, how much have you had to drink?”

“I have had ten of those jugs” I say

“That’s seven and a half litres!” he says in a surprised kind of way “You will have to go on a fluid restriction, one and a half litres. How much have you had to drink today?”

“One and a half litres” I reply

He looks perturbed “Sips!” he says and breezes out of the room. I decide to not drink anything until the next day. 128 is low for sodium, the normal range is 135-144 mEq/L. If I am going to survive, I need to get my sodium up. I get up every half an hour throughout the next day and night and wash my mouth under the tap in the bathroom. The water is wonderfully cool but I resist the temptation to drink even though I have a fever and the steroids are making my mouth dry and the coughing is making my throat sore.

The cough is a constant companion. Every muscle in my chest wall is aching and my voice is hoarse.

On Facebook I post

Here's a poem what I wrote

Cough cough cough cough

Cough cough cough cough

Cough cough cough cough

Cough fuck off

There's more.......

The nurses are fantastic. Bob is a nursing assistant, I think. He pricks my fingers every hour on the hour, once for blood glucose, once for ketones. He is so busy that he talks out loud each step that he performs to avoid making any mistakes. He is a consummate artist, I rarely feel a thing, he cleans and dries each finger before he pricks it and his system ensures he doesn’t make any mistakes.

Over the next few days, I get more and more from Bob. He is obviously terrified of catching Covid and only a bit less frightened of making a mistake and reluctant to have conversation, but eventually I get him talking. He has a great love of sport. He knows a lot about American basketball, I am a sad disappointment to him as I know nothing of sport in this country let alone America

He is inevitably followed by a nurse, Sister May or sometime student Hachi, from Somalia, with an insulin injection. Then the phlebotomist comes to take blood to check my liver function.

Three times daily one of the nurses comes in to give me my antibiotics, paracetamol and Remdevir. They often offer me wash in the bed but I am having none of it. I will not put them at risk, I put my mask on when they are in the room and minimise contact. I can wash myself quite well by the sink.

Hachi tells me about her nursing experience of Covid. She is supposed to be on her cardiology placement but she tells me how she is learning much more an a Covid ward because they have patients from all specialties. She asks me to write a feedback card for her which I do we have some long chats. I give her some real feedback. She has a great attitude and I tell her

“Three things influence who you are and how well you do in this career, there are lots of factors of course but primarily there are three things that make you the nurse you are. Clinical knowledge, this you can learn, this you can be taught. Experience, this you get anyway, good and bad, you can learn from both, working with a good nurse will teach you a lot but working with a bad nurse will show you who you do not want to be. And thirdly, attitude, your approach, who you are, who you let the world see. Attitude is the most important factor of all. You can learn to change your attitude but no one can ever teach you to do so. You my dear, already have a great attitude and everything else will come with time”

Sister May tells me what it’s like working here “Nurses basically go one of two ways” she says "They are either terrified of catching Covid or resigned to the fact that they will inevitably catch it. I swing from days when I am shaking with fear before I come to work, to days when I might be laying out a body and I am thinking quite calmly, that will be me soon. What really annoys me” she says growing animated “is that one shift in here and you can’t work anywhere else. Once you have been here you are tainted, that’s why we can’t get Agency nurses to come and work here when we have staff off sick. Staff feel guilty taking time off, and if their symptoms are not too bad, they come in and work, isolating themselves from their families when they get home”

That afternoon I post on Facebook

The pain was a surprise. Random joint pains. Covid chisels into your knee in a white, cold, soaring, twisting pain, that just increases over a minute or so to a point where you want to scream and then just goes. 3 minutes later it happens again, the other knee, then an elbow, an ankle and on one memorable occasion my ear. This goes on for about 15 minutes two or three times a day. Covid, full of surprises

I am getting lots of responses to my posts, I try and answer everyone, it gives me something to do and brings me cheer. How do people cope if they don’t have a phone in here? Again, I feel for the elderly

My younger sister, Kath, is a lot of help as she recently survived cancer and her insights into the way the steroids make you feel are very helpful. My good friend Sasha is another font of wisdom where the awful effects of powerful drugs are concerned.

On Facebook I post

Covid magic

Hello Mike, I am ****** I am to be your nurse today. She glides gracefully into the room, loaded with sheets, drugs, water jug and all the other paraphernalia involved with providing care to an unwell infected patient. Her gleaming eyes twinkling with fun, this lovely lady from the Philippines, skips around the room, singing a song of pure nonsense and joy. Her expert eyes don’t miss a thing and she is correcting this, adjusting that, this is her domain and she is a joy to watch as in no time at all she strips the sweat soaked sheets and flashes out a new set in a trice. My bed looks like a big white box with perfect corners. She fluffs my pillows, dances to the door, says "bye then", as if she will never see me again, pauses just long enough to make sure I get the joke and then collapses in giggles in appreciation of her own lightning wit. Amazing. What a tonic.

Later she tells me that she had Covid the first time and chose to keep working. She slept in the garden shed so as to protect her family and every evening her husband would come and sing to her.

On Facebook I post

Fucking Covid

Look what it's done to my hair!

This gets just the response I expect as my very many friends, family and colleagues post 123 witticisms memes and doctored versions of the pic I am compared to Sideshow BOB, Crusty the clown, Father Jack, Professor Emmet Brown, Beetlejuice and even Einstein although this comparison is hotly denied by a consultant friend “No way is he an Einstein!”

Shippy Shipster is responsible for these! My strategy for survival is paying off!

That night a nurse comes into my room while I am snoozing, as she is leaving, I thank her, and she stops and turns saying “That voice! I know that voice! You are a Nurse Practitioner are you not? Do you work at ********?”

I confirm that I do. She is delighted! “You helped me earlier this year when I was your patient!” she exclaims. She reminds me how I helped her, which of course I cannot retell here.

Her name is Momo, she comes from Nigeria “Not the nice bit, the bit where they are always fighting” she laughs. She laughs a lot. She has a wonderful smile that no amount of PPE can contain, we very quickly become friends.

Every time she comes in the room she knocks politely, opens the door a bit, sticks her head in and we both laugh….every time. This joke can never get old! I bet neither of us could explain why it is funny.

Sly Covid

“Morning Michael, just come to clear your bins, I hope that’s ok” I don’t look up. I am responding to one of my many funny supportive friends on FB.

“yeh carry on man” I wave off-handedly

He is always respectful, quick, efficient

And then the horror strikes me. I am having a nebuliser!

Covid is using me to trap another victim.

Covid is loose in the air, borne by countless small droplets each carrying my life saving, oxygen enhancing Salbutamol, a fine mist that fills the room and is easy to inhale.

Panic grabs me. ”Cisco, stop that get out!” He looks at me, confused what has he done wrong. The door opens, my lovely student walks in! “Both of you get out now! Never enter a room with a nebuliser running, it’s not safe, leave please now!”

They both look hurt. Such doleful eyes. The look at each other shuffle from the room. I hate that I have scared them but I will not share this invidious evil with them. I could not bear the guilt.

The nebuliser ends. They enter sheepishly, apologise to me. “no,no,no you don’t apologize to me, you are keeping me alive! Don’t you know about the aerosol risk?

“No Michael”, says Cisco, I have had no training, I am just here to empty your bins”

“Not just anything brother, you are as important as anyone here! No one else can do their job without you do yours!” he looks abashed. I tell them both about how Covid is carried into the atmosphere of the room by the nebuliser

I explain they are never to enter a covid room where a nebuliser is being used. I teach them the universal rule of health care....do not become a victim.

The irony strikes us all at the same time and we all laugh, just staying this side of hysteria.

Cisco shuffles out a thoughtful expression on his face, off to do his thankless, ridiculously low paid job of saving lives with no training at all