Tuesday, January 19, 2021

Long term effects from COVID 19

 Being on the front lines and seeing this terrible illness ravage people is not easy. I regularly get frustrated that the population at large just don't seem to grasp the fact that COVID is not just life threatening but even when you have a "mild case" of it, that it can affect you for the rest of your life.

I've recently cared for someone who caught COVID and is now extubated and "recovering".... but is left with permanent cognitive issues because he was starving for air for too long and it starved his brain of the oxygen it requires, leaving him with an anoxic brain injury. Never will he work again because he can hardly talk, can barely move, and the brain injury makes it difficult for him to even respond. It will take him years probably to walk again, with many months of physiotherapy involvement to gain strength. He will need speech-language pathology involved so that he can learn to swallow and talk again. He will need occupational therapy to help with the daily activity of living.... with being able to manipulate a cup, spoon and hair brush. Things that we absolutely take for granted.

I know of two staff members who have caught COVID from work. Both are young and healthy. Thankfully they did not need to be hospitalized but required months to get back to functioning levels. Both state that they have lingering lung issues almost a year after they caught this illness. They say that going up a set of stairs makes them gasp for breath and forget being able to work out, that's just not possible. 

There are many patients that our ICU has cared for who have caught this illness and while they weren't hospitalized because of COVID but because they are experiencing the after effects of this illness - having a stroke or a heart attack. Or experiencing renal failure because their body sent tiny clots to areas of their bodies and caused damage. We've had patients go into DKA because of COVID after the fact because it taxed their system and it couldn't cope with stupid COVID.

But I also wonder about the after effects that COVID will have on the rest of us who don't catch COVID, but still are affected by it because we're wearing these masks for such extended periods of time. I wonder how much CO2 we are rebreathing. If anyone has seen someone whose CO2 has risen, they can attest that these ppl kinda go coo koo. Anyone who is relatively healthy has a pretty good buffer system in play and so their body buffers this rising CO2 - but it has to have lasting effects on our body. I wonder about the kids who have to wear masks for 8+hrs a day when they go to school. Are we going to see issues with psychiatric conditions in 10+ years? Are us adults in 10-15years going to see more psych conditions or dementia/alzheimers? 

I wish that people would stop being so damn selfish and stay home and away from people. Stop visiting anyone, unless they are bedridden and require daily care. Otherwise, stay away. People don't understand or just don't care - or they think "that won't be me" - but with the way the numbers are going - damn right it will be - it will be you.... or someone you love. And then what?! Are you going to turn around and be "20/20 is hindsight, golly I wish I had done things differently".  How is that going to help when you no long have your parent/grandparent/spouse/brother/sister/cousin, etc.... around because you just had to go visit them. 

You and they will survive being apart for a bit. If it keeps ya all alive, it's worth it!

Thursday, January 14, 2021

Taking care of crazy in this crazy time

 There was a mix up in one of my shifts the other week so I ended up going into work late. When I get there I am advised to seek out our teammate and inquire what pt she wanted me to take from her. On the board I saw that one of them was CIWA = ++++work.

And of course when I asked said teammate, she responded with me taking on the CIWA. I joked with said teammate about me seeing what type of teammate she is, giving me that CIWA.... ok, np I shall take up this noble cause.

Then when I opened our charting program, I see on the board that the other pt she could have given me is a recovering COVID pt..... one that I can't even take in the first place. So I would have been stuck with the CIWA anyways. Guess it was just my lot in life for this shift to end up taking this on.

Well so be it....

Then we got into the thick of it.... the CIWA pt telling me that I took away their scissors and how I should give them back and that it was against the law to take them and if I didn't give them back that they were going to sue  me!  Ha, have fun with that one coo koo.

Oh did I forget to mention that this person is bat shit crazy and in 4 point pinel restraints?! Ya person's a frickin crazy and on CIWA! Oh yay!!!


I told them that they could go right ahead and sue... sue away!

Then I was told that I shouldn't lay my hands on them - when my hands were within their eye sight and holding onto the side rail up by their head!

Then I had a colleague come in and "suggest" that we pull said pt up. I was like, hell why not. So away we go and do that, and she turns to me and says "touch me and I'll fuck you up!" - oh goodness we had a good laugh at that one..... she's in 4 point pinel restraints. She aint doing any touching!

A couple of hours of trying to keep her in the friggin bed, then she's all serious when I go in and check on the levels of meds running through the pump and she turns to me all serious and says, "when I get out of here, I'm going to find and kill you". I didn't even deam to respond and simply nodded my head and walked out of the room. No point in even responding to the delusional. Besides, even if she could follow through on that, I am highly unfindable as I have an unregistered phone number and the house I live in doesn't belong to me.... so go ahead and try!

This person was nearly impossible to reorient, but I did try several times. You can only help crazy so much. 

Hell, the person was trying to climb out of bed with 10mg/hr of Versed infusing as well as them getting Valium 10mg IV q1hr PRN.... like I said, crazy!

And that's what I dealt with all night long... it was a long shift to say the least. Thank goodness I don't have to deal with CIWA pts often.