I am sure each of us knows someone that has contracted the COVID-19 virus, perhaps even lost someone to it. Most of the population who contracts the virus does not require hospitalization. When should you consider a trip to the emergency room, and what should you expect?
I have learned much over the past week as my sister tested positive as well as four other members of our family in Arlington, Texas. Most of my family is at home as the virus runs its course however, my sister has been extremely ill requiring two trips to the emergency room.
Some back history on my sister, she is 60 years old, has no thyroid, and Sarcoidosis, a serious pulmonary disease. The first couple days she felt awful, and had literally every virus symptom, by day three her oxygen saturation level was 93% (normal is between 95% – 100%,) when resting and would fall to 88% when she would walk less than ten steps to the restroom.
If you are unaware, an oxygen saturation level below 90% is considered low, also called Hypoxemia. When your oxygen level drops into the 80’s your brain isn’t able to send the proper amount of oxygen throughout your body and can cause many issues.
The first trip to the emergency room with my sister ended up with her being sent back home because her oxygen level did not drop below 90% for a sustained period although it never exceeded 93%. At 90% it is extremely difficult to breathe and your chest feels incredibly tight, not pleasant to say the least.
Within two days her fever was back, and she had an ashen color to her skin, therefore her primary care Nurse Practitioner wanted her on oxygen at home. Sounds easy enough right? Not so much when it is a Saturday. Her NP also happens to be my best friend thus when she was unable to find oxygen, she called me asking if any of my resources could help, again sounds easy, but every single avenue I explored came up empty!
Most durable medical equipment (DME,) companies are closed on the weekend, and the few I found open no longer carry oxygen. I tried specialty pharmacies, most also closed on the weekend, and even called a few hospital pharmacies with no luck. I am still completely in awe that should a patient require oxygen on the weekend there appears no feasible way to secure such an item.
What happens then? Well in my sister’s case you keep her as still as possible and pray, literally pray that she makes it through the weekend. On Sunday she collapsed in her bedroom after the short trip back from the restroom, my nephew had to pick her up off the floor and get her back in bed. Monday morning arrived and her daughter took her to a hospital in north Texas for the antibody infusion that is supposed to help immune deficit patients recover more quickly from the virus.
Several hours after receiving the infusion her oxygen level dropped to the 70’s if she walked at all and stayed in the 80’s at rest. Back to the emergency room Monday evening where she was admitted and immediately put-on oxygen. I FaceTimed with her on Tuesday, her color looked good and her voice was much stronger! Amazing what two liters of oxygen can do for a Covid positive individual with a pulmonary disease!
In my opinion, our healthcare professionals have got to be trusted to do what is in the best interest of their patients, knowing when a guideline should be challenged. Currently to be admitted to the hospital for COVID-19 a patient’s oxygen level must be consistently below 88%. Now what you need to understand is that such a guideline did not consider a person with underlying conditions like my sister.
What course of action should one take knowing you or your a loved one needs to be admitted to the hospital? After speaking to many healthcare professionals, the best advice “do not take no for an answer!” Play hardball! Tell the hospital staff any underlying health issues and come with a chronological timeline of everything that has occurred since testing positive.
If you still meet opposition, particularly on the weekend (including Friday evening,) then make sure that you are sent home with medications and oxygen that are needed. The hospital will tell you for Medicare or Private Insurance to pay for oxygen; the 88% level must be met. Had I known they sent my sister home without oxygen, I would have advised to refuse to leave without it, worst case scenario you pay out of pocket.
