From 1/29/2024 detailing my #Covid19 infection and treatment:

I've been contemplating how to post this. I've been studying #Covid19 since the original outbreak as I was getting my degree in Public Health at the time. Knowing the damage it can cause, I have gone to great lengths to protect myself, family , and patients.
But like I've always taught, the weakest link is not usually in ourselves, it's in others. A family member unintentionally brought the virus home.
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We immediately isolated all household members, but I still caught it while, thankfully, my wife did not. I plan on documenting the progress here.
1st we isolated the carrier when they tested positive. Assigned their own bathroom and given a HEPA filtration system to help keep the virus in that room. The carrier could only leave the room wearing an N95.
Despite this, we had already been exposed and I tested positive 2 days later.
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While 2 of us obviously have the same variant (likely JN.1), our reactions were very different.
The carrier is younger but is physically in much worse shape due to major medical issues. Despite this, they experienced a sore throat, headaches, was mildly feverish w/body aches,, and some congestion. Despite feeling better, they are still testing positive on day 6 so are still isolating and only out of the room with a mask.
I should note that they are vaccinated and boosted.
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We immediately sought and obtained Paxlovid for the carrier. Unfortunately, due to their medical conditions, they could not tolerate the drug and had to immediately cease using it. If they had not started feeling better the next day, we would have sought other treatment options.
On to me, I contacted the link I previously shared for Paxlovid but it was recommended against because I am on blood thinners due to a genetic condition.
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While 2 of us obviously have the same variant (likely JN.1), our reactions were very different.
The carrier is younger but is physically in much worse shape due to major medical issues. Despite this, they experienced a sore throat, headaches, was mildly feverish w/body aches,, and some congestion. Despite feeling better, they are still testing positive on day 6 so are still isolating and only out of the room with a mask.
I should note that they are vaccinated and boosted.
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We immediately sought and obtained Paxlovid for the carrier. Unfortunately, due to their medical conditions, they could not tolerate the drug and had to immediately cease using it. If they had not started feeling better the next day, we would have sought other treatment options.
On to me, I contacted the link I previously shared for Paxlovid but it was recommended against because I am on blood thinners due to a genetic condition.
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They recommended a Remdesivir infusion, not the alternative oral treatment as the oral treatment isn't as effective. I could try to make an appointment late on a Friday going into the weekend or have a visiting nurse come to my house to administer it on Monday. I was in no condition to drive, and having someone else drive a very infectious me in for treatment would have been irresponsible so I opted for Monday.
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This meant having to ride out the worst of it over the weekend. I was able to isolate in another part of the house and overnighted a HEPA filtration system to use.
Working in medicine, I have plenty of equipment to check progress so since I could do little else, I started charting my progress.
Unlike the carrier, I didn't start with a sore throat; I was lightheaded and had a headache. And then the hot and cold flashes started coming.
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I started with a low-grade fever and slightly elevated blood pressure. The next day the fever was almost gone, but my head was pounding. Later my leg joints started to ache, and my fever started climbing. Then I remembered my case studies where often symptoms became cyclic, most often the fever. The next cycle, however, was hellish as my fever spiked to 101.8 and would hover between there and 100.3. Taking showers to regulate my temp felt good but didn't seem to affect it.
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If I had hit 102, I would have called for an ambulance, luckily that never happened. The most effective medicine that seemed to slightly work was Tylenol.
While the fever raged, congestion came in and a slight cough. I went through 2 boxes of tissues in 2 days.
I noted an elevated heart rate of 90-105 at rest, while I normally have a low heart rate of 45-55. My normal 98% O2 stat is still hovering at 94-95.
I also lost my SENSE OF SMELL.
1/
#Covid19 #CovidIsNotOver #PublicHealth #WearAMask #GetVaccinated

2/
Mon afternoon, the nurses arrived for the infusion. My headache and congestion were still really bad, and my BP was severely elevated at 163/110. The Remdesivir infusion takes about an hour and does not affect BP. About an hour after it was complete, I noticed my head was no longer pounding, and my congestion was severely reduced. Granted my head still hurt and my BP was slowly lowering. About 6 hours later it was 132/94 which is still high for me but not at stroke levels anymore.
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That brings us to the present. This is really the first time I could clearly focus (since the head pounding is gone) and write some semblence of what happened down.
The Remdesivir infusion treatment is 3 - 1 hour treatments 3 days in a row. I'm REALLY looking forward to tomorrow's treatment.
Current symptoms are slight headache & congestion, tolerable hot/cold flashes, and still no sense of smell.
I'll add to this thread after the next treatment
(if you read this far, you rock!)
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Woke up today with a pounding headache, on the bright side I slept 5.5 hours in a row even though it took tylenol w/codeine and 2 trazadone to do it. Was surprised to find my temp normal, BP only slightly elevated at 134/94, my HR was back down to 50 Bpm but O2 still hovering at 94-96%.
By 11 AM and after some Tylenol, my BP was elevated to 168/106, just like the previous day. Still have congestion & no sense of smell.
Nurses have already come and gone for the Remdesivir infusion.
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Like before, my headache was reduced immediately following the infusion. Less than an hour later, my BP is down to 132/94. No other noticable changes yet.
Note on previous symptoms that no one tells you about, during the fever stages, I was PISSING MY BRAINS OUT (strict medical terminology). I have never peed that much in my life and was absolutely losing more liquid out than in. Another reason why hydration is important.
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Noting that 2-3 hours after remdesivir treatment, I've gone from normal energy to very tired. I put it down to lack of sleep yesterday, we'll see what happens after tomorrows treatment. Have also sent query to PCP regarding getting a Rx for metformin as it's been shown to reduce the liklihood of #LongCovid the sooner it's administered.
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BP shot right back up again, this time to 151/103. Doubled up on BP meds. Still waiting for the effect. When this happens, I start getting little waves of nausea, so it's easy to tell when it's occurring.
PCP agreed to the Metformin treatment. Here's the journal article for those interested: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(23)00299-2/fulltext
The dose is a 14-day titration, had fun writing up that Rx 🙂
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Double dose of metoprolol worked, BP now at 131/86. I was starting to enter stroke level territory. What scares me is what if I hadn’t been monitoring my own vitals? For someone (me) whose BP is normally low, this is a BFD.
What about other Covid patients who don’t go to get checked? This certainly helps prove why the worlds CV risk levels have all gone up.
If you can, please get a BP cuff for your home.
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Woke up last night for a BR run and realized that I could suddenly smell! Not 100%, but it was there...then I remembered hearing of cases where people got their smell back only temporarily, and sure enough, it was gone again when I woke up 😞
Still waiting for the nurses for todays infusion. Meanwhile, I've been fighting to keep my BP in check. Was 155/103 and is now 139/110.
Congestion had me finish 3 boxes of tissues now.
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I received the Metformin and have started the 14-day titration oral treatment. Since this is a diabetes medication, for an overabundance of caution, I'll be testing my blood glucose before meals. Why not, I've tested hundreds of patients this way, time for them to get some payback 😉
Note that I employed early on a warm water mist vaporizor for my room. Despite this, lips and skin still cracking.
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By the time the nurses arrived, my BP was 172/111 and I stayed up there for the whole treatment. It took approx 4.5 hours of it going down slowly to not be as big a danger.
Consulted with PCP, and he's hoping now the IV treatments are over - I might start normalizing. But if these daily BP spikes keep occurring, we've already lined up a cardiovascular Dr to see me.

Note that I chart my BP almost hourly now.
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Psssst....don't tell anyone but I can partly smell right now, don't want to jinx it 😉
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Day 7, still Covid +. Still waking up with headaches and sore throat. Still congested but not as bad.
I did not have the same exhaustion a couple of hours after the Remsdesivir treatment yesterday.
BP high when I woke up 134/106, post medication it's suddenly down to 117/93. Systolic back to normal for 1st time (yay!) though diastolic still too high. Let's hope the trend continues and don't see that afternoon spike again.
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#Covid19 #CovidIsNotOver #PublicHealth #WearAMask #GetVaccinated

3/
Had plenty of quick hot/cold flashes during this event, but now I seem to be experiencing straight-up hot flashes that last around 30 minutes or so where I'm covered in sweat by the end. Luckily, I have fans handy but whew...😓
I'm pretty sure this is making my wife happy as she already went through "the change", says I can now "relate"...
The afternoon BP spike didn't happen today, I'll take slightly elevated over stroke levels any day.
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Still using Metformin (and no, hot flashes are not a side effect). For people interested in the oral titration schedule:
500 mg on day 1, 500 mg twice daily on days 2–5, then 500 mg in the morning & 1000 mg in the evening up to day 14.
I'm currently on day 2.

To be extra careful, I've been monitoring my blood glucose level and today it's been 86-99 which is perfect, so no worries yet.
To be clear, the published paper did not mention if they monitored BG, I figured rather safe than sorry.
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Still waking up with a daily headache, but I can say for sure that it is not pounding nearly as hard. Like yesterday, BP starts a little high but after the metoprolol today, it is currently 122/83! Hoping this is a new trend.
Just wish my head would stop hurting.
Still on metformin titration schedule, BG still level.
I've now gone through 4 boxes of tissues in 8 days...😷
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Headaches increasing-BP is up to 140/93. Better than previous high but still sucky (another strict med term).
My sense of smell seems to be staying this time (yay!). Thankful for the wicks air fresheners I installed for making it easy to find out 🤧
Congestion also still sucky. Original carrier tested negative 2x & now having a life. My wife visits the outside windows when walking the dog and feels like she visiting a prisoner.
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I can't believe how lucky I am to have the privilege of being able to isolate, insured, being able to afford to miss work while having a med team contact me without asking to work my issues while being supported by a loving family. If this were just 20+ or so years ago I would have had none of those things and would likely have not survived this, either physically, mentally of financially.
It pains me to know that there are many in the U.S. who may never have these options.
#COVIDJournal
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Important note, by 10 PM almost every night this week, I feel almost human. I get a bunch of work done between 10-1 because I can actually think with only a mild headache. I've mentioned cyclic symptoms before and this is one of the positives of that effect. Would obviously prefer the cycle to be earlier but I'll take what I can get.
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Took another rapid test with older ROCHE test, shows positive but faded...no way I trust this test. Ordered fresh supplies and will PCR test tomorrow using home Lucira molecular PCR test that I always keep handy.
The updated test also has Flu A/B included: https://www.amazon.com/dp/B0CL7S9F4P?psc=1&ref=ppx_yo2ov_dt_b_product_details
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Rapid test vs PCR test
On the left is a rapid test from Carestart (never used b4) vs the Lucira PCR. Innaccuate rapid tests are the bane of infections and quite common, it's why we say multiple negative tests spaced out are needed. But if you have a bad test kit, then what? You'll keep getting false negatives unless you get a newer/better test. And of course swab back of throat, cheeks, and nose.
So yeah, still positive after 10 days...☹️
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Had chinese food last night which left me incredibly congested this morning so been coughing my head off (sort of worth it, yum😋 ).
Like previous days, BP starts around 127/89 and slowly creeps up, currently 132/94
For the first time ever, blood showed up on a test swab.

Never thought about it before but it makes sense that for some people this would be common. Haven't heard of this effecting a test but something to note.
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BP has been only getting slightly elevated, currently 126/90 which is a good trend.
Coughing was at it's worst yesterday where I would hack something up approx every 20 min's. Used Tylenol w/codeine to sleep again.
Woke up with slight headache and very sore throat. After breakfast and shower, feeling better.
New rapid test showed positive within a minute. Shows the difference between old vs newer test (used Binax)
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I can't believe I'm still testing covid+ after 12 days!
For people who go out without(even with) a mask after 5 still coughing, they are undoubtably spreading it.
My symptoms get progressively better daily, even if only slightly. Tomorrow I ramp up the Metformin. Impossible to know if it's helping; just have to trust the science. Look forward to getting out of isolation...
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Still testing covid+ (ugh!).

Symptoms improve slightly every day, end of day headache sucks.
Upped the metformin dosage until it runs out in 9 days.

Original carrier gets a monthly blood test due to upcoming treatment. Surprise find, platelet counts went way up after the covid infection- after being stable for months. More evidence that the virus can cause thrombosis and other CV issues.

#Covid19 #CovidIsNotOver #PublicHealth #WearAMask

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Amazon.com: LUCIRA® by Pfizer COVID-19 & Flu Home Test, First and Only At-Home Molecular Test for COVID-19 and Flu A/B, Single-Use, Results in 30 Minutes, Emergency Use Authorized (EUA) : Industrial & Scientific

4/
Tested covid + again, but for first time the rapid test indicator line was slightly faded. I'm going to tell myself that's because the virus is starting to retreat and that I may test neg soon. Note that when I test, I swab the back of my throat, both cheeks, and then nose.

Still slightly congested with a cough and intermittent headache , but I'm mostly sleeping through the night now (yay!).
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Still testing covid positive. Same basic symptoms EXCEPT:

I've been careful not to exert myself as we know that covid+ patients can do more harm than good by pushing themselves. Needed to do some moderate physical activity for about 1.5 hours. By the end, I was nauseous with a headache because my BP had spiked again. I can only hope this condition is temporary.
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Finally tested negative on rapid test and PCR test backed it up (yay!). I have returned all my things back to the bedroom and santized everything in my office.

Aside from the light, congestion, cough and headache, my diastolic BP is staying around 97 which indicates an increased CV/stroke risk. I'll have to continue daily monitoring.
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Here it is over 3 weeks later, and I'm still dealing with congestion, cough, higher BP, and the resulting headache. My energy level and BP IS slowly returning. I'm back to work but I'm pretty wiped out by the time I get home. I still mask at work and in all public places.

Note that we're still seeing patients getting infected with Covid almost daily, just a regular part of our life in primary care now.
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#Covid19 #CovidIsNotOver #PublicHealth #WearAMask #GetVaccinated