How Covid-19 and subsequently Long Covid whacked me - for a good five months and more !!

Email response from one of my Canada-based graduate school's classmates :

    "On Friday, November 12, 2021, 12:14:52 AM GMT+8, 'Ed Castle' via MBM74-G <mbm74@googlegroups.com> wrote:

Did not know that you had gone through the Covid cycle, Bernie. Am glad that you have pulled through and are now at 90% of your former strength.

Your documentation is detailed and gives those who have not gone through the same experience a vicarious feeling of what one experiences when one undergoes a Covid infection. Thank you very much for taking some of your precious time to generate the documentation.

Will pray for your continued progression to 100% of your former strength.

Rest well and keep safe.

Ed"

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Preamble of my email to my classmates and relatives :

    "I must admit that I DID NOT plan to write about my experiences with Covid-19 and much less sharing these with MBM74-ers. Pics that I took were meant for my immediate family members and siblings.

Upon discharge from the hospital, I was desperately looking for writes-up and/or articles about home recovery from covid19. I wanted to prep myself for the challenge. Sadly, never found any. Always got 'how I came back from near death...' or 'How I recovered from the ICU episode...', or 'How and what I have gone through and am saddled with this and that ailments,..' .etc.

On hindsight, if I had chanced upon 'home recovery' stories. I might have been spared the ordeals of the steroid withdrawal syndrome. Ah well, that's history now.

Pray that you guys are all staying healthy to remain staying safe (as we are all in our 70's).
Cheers!

Bernie"

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Summarizing my Post-Covid 19 Recovery Feelings :

    "For keeping quiet until now, my apology to all MBM-74ers and the Professors in general and to my AIM-days' Can-Group members in particular. (They are ReneM. TonydL, Roland, ChitoC and RicoL.) Thanks also to JoeM, TonyV, Boyap, MikeT and Elsa who hitherto did not 'spill the beans'.

According to my wife, I contracted Covid-19 on or about Apr.28th.2021. Was rushed to 'the' government's most advanced infectious disease hospital on May 9th.2021. Was discharged on May 18th. 2021. Stay at the hospital was pretty comfortable with plenty of foods (of strict diabetic diet) and medications. All these cost me nothing. (More about this government hospital in the attached 'Chronology of Events' listing a.k.a. Facts Sheet.)

The 'recovery' at home was by comparison rather torturous – especially the first ten days or so. (Again, read the attached 'Chronology of Events' listing.)

My normal weight during pre-Covid days was about 82.0 kg. By May 25th. 2021, I was down to 72.0 kg! These last few mornings, some five and one half months down the road, I am at around 77.5 kg. :-)

Let me highlight both the 'good' and the 'bad' or the aftermath of my personal Covid-19 misadventure : -

The Goodies

(1) Incidence of morning sinuses down by some 60 to 70%. Intensity of violent sneezing significantly reduced. :-)

(2) No more confusions over 'urgent nature's calls' in the morning. Pre-Covid days, my sensation was … bladder's, bowel's and gas' calls at the same time. Thought it was bladder's call but gas' announced itself instead, or when I felt its was gas', the bowel's took the stage. Utterly unpredictable. Even the Urologist did not believe this! Now, strictly knowing which is which as well as which-next. :-)

The Baddies (or Long Covid, “LC”)

(1) Shortness of breath if I bend down or over something – even for some five seconds. For example, pumping air to my car's tyres or even bend down to pick up loose bits of my grandkid's Lego toys' parts. However, I could walk for some 30- 45 minutes without heavy breathing nor panting at all. How so? (Read Facts Sheet's notes.)

(2) Needing a much longer afternoon nap almost daily. Pre-Covid days, I merely needed 10 to 15 minutes siesta most days. Now, an hour to two is normal if I do take afternoon naps – which I mostly do.

(3) My phlegm on its way out tastes 'sweet-ish' while drinking bottled mineral water or any lukewarm boiled water the taste is freaking 'bitter-ish'. Weird, Pray that this is only some temporary LC effects. (You could learn more about 'long covid' if you google Facebook's 'Long Covid Support Group's' ongoing discussions and rantings.)

By my own reckoning, I think I am now at about 90 – 95% of my pre-Covid health status. This included test results for my heart's conditions as revealed yesterday. Praise The Lord.

Oh, in the Chrono-listing and for privacy purposes. I referred to my wife as 'MW', my daughter as 'MD' and my son as 'MS'

Cheers and please stay healthy to stay safe!

Bernie"

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Full Listing of my Covid-19 'misadventure'  :

    "Bernard's Experience with the Covid-19

The Prologue

Dreaded but not feared. When contracted and progressed hellishly through to recovery, it became ...No way, Jose ! To have Covid-19 again? Never, you dig!

Chronology of Events

( Or, 'Case Facts' as harped on by our Professors in the good old AIM days?)

Almost after three months since our government took cognizance of the pandemic by declaring country-wide full and laterly partial lock-downs, I had been going out almost daily from late June 2020. Masks always on, diligently practising social distancing and deliberately avoiding crowded areas. These became the norms each time I ventured out from home. Generous use of hand sanitizers and regular hands washings became a daily habit. For some 10 months, no Covid-19 so no problems whatsoever!


On or about April 28th. 2021, I went for a drink or two with my jogging friends in a pub in Cheras. Likely contracted the virus that evening.


According to MW (my wife), I started running a fever the next evening.


On May 3rd.2021, a doctor from BP Healthcare was called to our condo to take Covid-19 tests for MW, MD (my daughter) and I. The ladies' test results came out two or three hours later the same night. Mine was only available in the late morning next. Earlier in the day, I was already quarantined in my own bedroom – as 'ordered' by MD.


Test results from BP Healthcare were negative for all three.


According to MW, I was definitely delirious on May 4th. and 5th. 2021. I just paced around in the living room and would neither sit nor lying down for more than 10 minutes. In other words, listless and restless.


For two consecutive days, MD sent me to a local GP's who incorrectly diagnosed me to be afflicted with 'stomach flu'. On morning of May 8th. I was too weak to stay long for and in a Zoom-Meet with my Can-Group buddies. The Meet was initiated by ChitoC. I had to cut short the Meet and MD apologised on my behalf citing me as having had stomach flu.


On May 8th 2021, after watching 'Gravitas' clip on Youtube, MW insisted that MD get both an oxymeter and a contactless infrared forehead thermometer. MD got the needed devices after frantic searches online and at the nearby pharmacies. (Both devices were used frequently by MD to and who did closely monitored my recovery later.)


On May 9th.2021, my oxymeter's reading was down to 90%. MS (my son) was called into consultation via Facetime's by MD. They concurred and decided it was then a 'medical emergency'. At around midday I was sent to the ER of Bangsar Pantai Hospital (BPH).


Actually, thanks to MD's persuasive efforts I was lucky that the doctor at the ER was able to wrestle for me an emergency admission into the Sungei Buloh Hospital (SBH). SBH has been touted to be the most advanced infectious disease specialist government hospital in the country.


Ordinarily, admissions for suspected covid-19 patients in SBH would have to be cocooned into a 'waiting area/ward(s)', As a direct result of overcrowding brought about by all private hospitals' collective refusal to admit suspected covid-19 cases, SBH was inundated with a huge population of suspected covid-19 patients. Most of them have had to wait for days before they could be tested and then the results announced. It was partly because of this delay that contributed to the subsequent increased demand for ICU-beds. By logical extension, increased fatalities of Covid-19 patients. Over weeks, this overwhelmed SBH's resources.


When I was ambulance-sent in the late afternoon of May 9th. from the ER of BPH to the SBH, I was straight away moved into the 'primary observation ward' and NOT the waiting area/ward of the latter. This was so because the ER doctor had done a specific medical status report of my governing conditions (Covid-19's full blown pneumonia) and this was handed over by the ambulance driver at the SBH's Emergency Department entrance. (In retrospect, not being in the waiting area/ward of the SBH was perhaps a blessing for me.) By the time the medical orderly in the observation ward handed me a packet of fried Indian noodles, it was already past 5:00pm. That was supposed to be my evening meal. I only finished half as the noodles were cold.


At about 7:00pm the same day, I was moved to a four-bed large room of the Rehabilitation Ward. I was the only occupant. Here, I was again tested for Covid-19 and the result was positive. Shortly after, I was given a couple of injections and a chest x-ray was taken by a mobile x-ray machine. In the course of the night, the on-duty Nurse quietly checked on me a few times. Each time she asked if I was OK and comfortable. I answered yes and went back to rest/sleep. This was how I spent my first night as a Covid-19 patient in the SBH.


After what seemed like a sumptuous breakfast the next morning, May 10th 2021, I was moved – me, my backpack and the bed all rolled into one movable lot, to a larger rehabilitation ward. This ward was on the same floor as last night's but further into the long hall. The ward had six beds on the left side of the aisle while there were four on the right side. All beds appeared occupied. Here I was given an oxygen delivery canulae and mask. Their uses were for the first time in my life.


The oxygen therapy was most comfortingly effective at night during sleep. Alas, sleeps were with much disconcerting and disruptive coughings. The need for oxygen piped through the canulae was respiratorily inevitable.


Each day duty-Nurses came around and administered a good number of steroid-, insulin- ,anti-coagulant and one or two other jabs. Drawing of bloods not excluded. By the third day, my body was immuned to the pains inflicted by the syringes/needles. It was in this multi-bedded ward that I spent the next four days.


Besides the many daily injections, there were numerous daily takings of oxymeter's oxygen-absorption rate as well as blood pressures readings. Added to these were x-rays taken by the mobile x-ray machine. All performed diligently by trained Nurses who, believe you me, did not utter words of complaints nor raised their voices nor even showed soured-faces. Ah well, even if they did I would not have noticed as they were all garbed in full PPE's.


On the sixth day, May 14th.,2021, I was again moved to another rehab ward. This time, the ward was on a higher floor and supposedly a pre-discharge ward (PDW). Before being moved to the PDW, I was given a CT-Scan of the chest. At this PDW, oxymeter's and BP readings were continued – again twice or thrice daily. However, injections ceased and instead steroids and one or two complements of other drugs were administered orally twice a day. If I recall correctly, I received only two (mobile) x-rays shots during my stay in this PDW. It was here that I finally managed to sleep in the 'prone(d)' position without much difficulty.


On May 18th. 2021, I was discharged from the SBH. Earlier in the afternoon, MD called the PDW's doctor and was duly informed that I would be discharged. She was asked to fetch me from the SBH. MD was in the SBH's vicinity at about 5:30pm and it was raining. The long-awaited 'walking orders' through and from the duty Nurse came only at 8:30pm or so. Poor MD. Anyway, I was so grateful that I saw MD again after some (mildly) worrisome nine days. Reached home by around 9:30pm and, Praise the Lord, saw a relieved wife and an excitedly happy granddaughter. All these with NO huggings. Still the innate fear of me being an infectious bloke!


I took a proper shower once I settled down at home. Oh my gosh … while in the shower, I experienced my first “shortness-of-breath”. Fortunately, there was a stool in the shower cubicle. I sat on it and managed to complete my showering without untoward incidents. Thank God. It was the first time I felt that (my) life was so vulnerable! Admittedly, a great awakening – if you must!


Upon discharge from the SBH, I was given a three or perhaps a four days' supply of steroid pills. While on these pills, sleeps were still attainable although incessant coughings persisted. From about May 22nd 2021 onwards, these coughings became extremely disruptive and energy-sapping at night. These were inspite of injesting cough syrups and strong expectorant every so often. The unbearable part of these coughings was that phlegm or mucus from the lungs could not be smoothly expelled through the throat and out of the mouth. No, not even forcibly. This resulted in an utterly debilitating and involuntary muscular spasm that persisted through the night – depriving me of much needed rest for convalescence.


What rendered the coughings even more damnable was that I had no control over when to rouse up my phlegm or mucus for expulsion. It was the lungs that 'chose' to kick up the phlegm with no prior indicative feelings for nor warnings to me. Most times, lying down on my back would instantly trigger the coughings and followed by the phlegm. Sleeping by 'half-sitting' mitigated the severity of the coughings but not the sensation of having “a lump of phlegm jammed and stuck between your throat and lungs...”. Gosh, the feelings were well nigh intolerable. Incidentally, my late elder brother passed away as a result of long suffering COPD. Only now I realized and appreciated how difficult it must had been for dear him (bless his soul, Amen) to had lived with the constant need to 'clear his throat' and therefrom a short while later gasping for air... It was a very surreal reflection for me.


The worst was yet to come. Well, it came on May 27th. 2021 alright. Prior to these, however ...


Beginning or on about May 23rd. 2021, naps and daily sleep became problematic. Afternoon shut-eyes lasted mere minutes while sleeping at night was saddled with waking episodes every now and then. These disquieting bouts were fewer and far in between spanning May 19th. and 22nd. I had steroid pills these four days!


The waking episodes during sleep were a combination of involuntary coughings and nature's calls for bladder-emptying.


Coughing frequencies were aplenty and of short intervals. These brought about more intense yet prolonged feelings of “more-phlegm-stuck-mid-throat”: The former feeding the latter or, if you like, the latter triggering the former that led to spasms that in turn landed me in a state of prolonged heavy breathing - again and again.


The number of toilet visits mid-sleep became more often. The nagging sensation that the bladder was unable or unwilling to fully empty itself during each visit was tiring both physically and mentally challenging. Consequently, restful sleep was an unreachable state of resting one's tired body.


Somehow I managed to and endured both the 'coughings-till-mild-breathlessness' and 'uncleared bladder' for a hellish four nights. I was adequately blessed (by Him) that MW and MD sacrificed their sleep to and did put hot water and cough mixtures/expectorant within easy reach and took turns to apply ointments and/or medicated oils when I requested for them. Their efforts made my enduring that much less unbearable. MS was literally 'on call in realtime (Ipad's Facetime again)' every night too. He shared his thoughts and feelings with and, of course, recommendations to MD as to what to and what not to do. (On hindsight,the three dearest persons in my life, especially MD, must be credited with saving my life from the now dreaded Covid-19. Lucky me, no doubt!)


From the early morning of May 27th. I was unable to pass meaningful amount of urine nor even move my bowels. Nay, not with even the smallest of volume. At around mid-day, my bodily discomfiture was so intense that I laid down on the bedroom's floor and tried very very hard to forcibly empty my bladder and move my bowel. Both the urine and faeces came but of and in very miniscule volumes. Soon my boxer was wet and soiled (Again, a first time in my adult life.) By about 3:00pm MD decided to send me to the BPH's ER. I weakly cleaned up and had a change of attire and half clutching my lower stomach, off we went.


At the ER, MD narrated to the doctor about what happened to me. He immediately ordered the placement of an in-dwelling catheter into my 'you-know-where'. (Yet again, a first time ever in my life.) No sooner had this been completed, more than or at least 1.5 litres of pent-up urine flowed into the urinal bag. Before the said bag was emptied, I noted the volume of my very yellowish urine filled about 60 to 70% of the urinal. Hallelujah! The extreme pressure against the bladder was gone. The time was, I believe, about past-5:00 pm. So, it was almost some 12 hours that my bladder decided to clamp itself up and clamped it did alright. Sadly though, my bowel was only 'moved completely some six hours later at home just before bedtime. That was how Thursday May 27th. 2021 came and passed for me. In retrospect, this was not a day to cherish but one darn hellish day to remember by.


The next morning, MD accompanied me to see a Urologist back at the BPH. His pronosis was “a stunted prostrate likely due to Covid-19's effect”. He added, it might had been made worst by the sudden stoppage of steroids. Fortunately for me, he said my kidneys were 'all right'. That was a relief, hail doc!


The catheter was by my side throughout a needful albeit inconvenient three days. It was removed on the fourth day – by one of the Urologist's nurses. Yes, it was a she who un-shyly removed the catheter. The shy one was yours truly. Alas, one more time a first ever in my life.


On May 29th. I had a CT-scan done followed by a consultation with a Pulmonologist. He confirmed that my lungs' were adversely affected and he put me back on a steroid regime for two weeks. Perhaps discussions with the Pulmonologist convinced MD that I had 'steroids-withdrawal syndrome' between May 26th and 29th. A very likely cause.


On May 31st. 2021, MD insisted that I keep an appointment with my Cardiologist. I did somewhat reluctantly as I felt I was still weak. The appointment was at the National Hearts Institute (NHI). Locally it is better known in the Malay language as the I.J.N. or Institut Jantung Negara. The outcome of the visitation was a scary remark by my Cardiologist who said, “Uncle, you were lucky that Covid-19 did not wack your heart.” He added, “If it did you would not have survived...”


There was, however, one good finding though. This visit to the NHI for ultra-sound scan, ECG, X-ray and whats-not indicated that my heart's slight enlargement was and showed “...no evidence of significant changes when compared to similar tests first taken five years ago...”


It dawn on me later that my heart's condition was the most worrisome issue for MS and by extension for MD too following my Covid-19 infection. Hence, MD's insistence that the appointment be kept.


For the first three weeks of June, 2021 I kept three or four appointments with the Urologist and perhaps one or two more with the Pulmonologist. Both specialists prescribed medications which I took without fail. Again. Looking back how could I fail when MW and MD took it upon themselves three or four times daily to remind, dispense and watch me swallowed and downed the medications? Hats off to my women!


On Jun 21st and 22nd , my incessant coughing and sleeplessness returned.


On 23rd. MD sent me back to BPH and an X-ray was taken. At the Pulmonologist's clinic later, MD was told that my lungs suffered a secondary infection. MD was very worried and insisted that I be warded the night in BPH for closer observations. The next day I wanted to return home but she said I must stay yet another night. I complied as I was told in late-May by MS and MD that secondary infection by Covid-19 could be dicey and even fatal. My compliance of course minimized the combined anxieties of the three of them. (MD believed that I got the reinfection during one of the visits to the Urologist's clinic in BPH.)


I was isolated in a single-occupant room then at BPH for three days and two nights. Boring? You bet!. Quiet? Nay! Loads of medications every four or five hours' interval – days and nights! Yes, the nurses woke me up even when I was asleep. You guess right … three nurses during day and two at night! Medications' delivery modes? Jabs and supervised ingestions.


Upon discharge from the BPH, the Pulmonologist prescribed a much stronger and longer steroids regime for me – eight course deal where each was of four (or five?) days' duration. The first course was a daily intake of eight pieces then reduced by one piece the next course and so on and so forth until I finished the last course of one piece only daily. This was 'tapering'. (You go figure out how many days it took to get off steroids.)


On July 3rd.2021, I counted that I was taking 12 different medications daily. These were in addition to my so-called 'health and immunity supplements' comprising Vit C, Vit D3, Fish Oil and multiVitamins!! Oh yeah, and a Chinese TCM herbal tea. Yes, yes, added to these were my heart's four daily medicines. (Again, go figure out how many 'pills' per se that I was saddled with on a daily basis.)


July, August, September and October were relatively free of further and/or associated post-Covid-19 complications. Praise the Lord!


Just to satisfy herself, MD insisted that I visit the Pulmonologist again on Sept.15th. And that an another chest X-ray be and was indeed taken. Hallelujah! Satisfactory improvements (see three different reports' conclusions by the radiologists).


Right NOW, my medications included once daily Urief4 (2mg) for prostrate; twice daily Ganaton 50mg (for phelgm reduction) and two times daily Nexium Mups 40mg (for reduction of stomach acidity). Ganaton's and Nexium's were stopped yesterday. I might stop Urief4 in maybe another week's time


Yesterday, Nov.8th. 2021, again MD insisted and sent me to the NHI/IJN for another follow-up check with the Cardiologist. They took a blood test as well as an ECG, The concluding remarks from my Doc was … “,,, all normal, Uncle...”. :-)


---- End of Facts Statement -----


Additional Notes:

( a ) Shortness of Breath

Covid-19 mainly infected the lungs. This caused scarrings. Scarring of lungs invariably hindered the movements of the diaphragm. The diaphragm inflated and deflated the lungs to inhale and exhale, respectively. This was breathing.


Even a smallish scar would adversely and greatly impact upon the diaphragm's movements. Standing upright and with the help of gravity, the diaphragm worked OK, scars notwithstanding. However bending over even slightly and or sqautting restricted the diaphragm's movement parameter considerably. This directly led to breathing difficulties. The aforesaid was my Pulmonologist's explanation when I sought for his opinions.


( b ) Steroids' Treatment Protocols
According to MS, the USA's practice is … generally might be stopped abruptly.

Here in Malaysia, the preferred treatment is … gradually reducing intake (tapering off). This was affirmed by one of my brothers-in-law. He (my age) was a retired Navy medical officer and also the first ever corporate Doctor of the Malaysian Airline System (MAS).


My instance of “steroids withdrawal syndrome” was of utmost freaking
discomfort – to put it very mildly here !


( c ) My enlarged heart

First detected some five years ago during my first visit to the NHI or IJN. Covid-19 appeared to have had inflicted little or no collateral damage. Even if it did it was insignificant. Praise the Lord.

Yesterday's appointment with my Cardiologist I was told that both my blood test's and ECG's results were … normal. Good old Bernie !

----- END OF NOTES ----- "