Advice from a Doctor at Home (Test Pending): Don't Aspirate!

[McCamy Taylor]

Test is not back and there is a 40% chance that even if I have COVID the test will not show it, but I am pretty sure that this must be COVID due to 1) worst cough ever (no lung disease history) 2) low oxygen saturation ( no lung disease history) 3) started with low grade fever and chills, not the high fever of flu 4) fatigue but no severe body aches of the type that comes with flu 5) gradual onset over 12-24 hours (flu is fast) 6) my sense of smell is shot, cannot smell the wisteria, COKE is just sugar water and 7) work at a health care clinic in a large metropolitan area where lots of people walk in with respiratory stuff and where we do not have PPE (except for a face mask I reuse time after time) because face it, no one in the industry has it now.

Anyway, this is anecdotal, may not apply to everyone. Think of it as a case study.

I have stopped eating any solid food, especially solid food with lots of little bits of hard stuff in it like rice, nuts, pepper, crumbs due to every time I do, I spend 15 minutes painfully trying to bring it back up from my airway like a cat coughing up hairballs. No matter how carefully I chew food with lots of little bits, some of it gets into my trachea without me being aware of it and then that triggers a cough reflex from hell.

I have also forced myself to remain sitting or standing after eating even my soft/mechanical mostly liquid diet because if I try to lie back at even a 45 degree angle, I start drowning. And the scary thing is I am not aware of having reflux. I have lost that sensation of taste at the back of my mouth when food tries to come back up. I notice the gastric contents adhering to my airway when I start to gurgle and cough. Then I have to stand up and go gargle and cough and gargle some more to get the slimy stuff off so I am can breathe.

Edited due to almost forget 3) I sleep on a wedge pillow to keep my airway higher than my stomach (less chance of aspiration) and 4) I have given up cough drops--don't need to numb up my throat more than it already is.

Why am I unable to direct the food down the correct passage--the esophagus? I dunno. Might have something to do with the fact that my airway from the back of my mouth down to my throat feels like it has been coating in menthol. It is numb. Why can't I feel myself reflux? Might be the same thing.

COVID is thought to cause a loss of olfactory (smell sensation) due to the virus goes through the top of the nose directly into the olfactory (smell) area of the brain. If it can do that, why can't it affect the nerves that allow us to detect food and liquid as they pass down the back of the throat? Swallowing is one of the most dangerous things that air breathing animals do. We have to keep the food in the GI tract and the air in the respiratory tract--even though they both use the same exit ramp to get to their two respective destinations.

The variable affects of COVID could, in part, be due to loss of airway protection. If people aspirate food or gastric contents they could be setting up lots of little pneumonias.

Here is what the Ct scan looks like in people with chronic aspiration pneumonia

Atelectasis, centrilobular nodules, bronchiolectasis, consolidation and ground-glass opacities occurred more frequently in patients with aspiration than in those without aspiration, with a pronounced tendency for distribution in the lower lobes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5257317/

Here is what a COVID chest CT scan looks like

Known features of COVID-19 on initial CT include bilateral multilobar ground-glass opacification (GGO) with a peripheral or posterior distribution, mainly in the lower lobes and less frequently within the right middle lobe. Atypical initial imaging presentation of consolidative opacities superimposed on GGO may be found in a smaller number of cases, mainly in the elderly population. Septal thickening, bronchiectasis, pleural thickening, and subpleural involvement are some of the less common findings, mainly in the later stages of the disease.

Read More: https://www.ajronline.org/doi/full/10.2214/AJR.20.23034

If you are curious about what all these CT scan findings look like here is an article with pictures.
https://pubs.rsna.org/doi/full/10.1148/radiol.11092149

[thucythucy]

1. Thank you for posting this

and I hope you're well again soon!

Best wishes to you and yours.

[BusyBeingBest]

2. I hope you feel better soon, whatever it is.

That sounds awful.

[BigmanPigman]

3. The care givers at the WA senior home all said that loss of the senses

of smell and taste were what they heard from the infected residents. Also, red around their eyes like red eye shadow.

[Jane Austin]

4. Would a food thickener help you?

My mother had to use that in her later years.

[LakeArenal]

6. My ex chef once had to puree everything.

A whole dinner at once. Steak baked potatoes any veggie. Into the blender. Chef tried it once. Said it wasn't horrible.

[shanti]

20. One of my sons is a chef

and used to work in a retirement home. For some of the residents, the entire dinner would be pureed. Sounds disgusting.

[unblock]

32. Best meal of my life was a 9-course dinner in Reykjavik

Each course was or included something wonderful either puréed or moussed.

Of course, there's a difference between just sticking food in a blender and what a Michelin chef can do....

Point is, an amazing meal doesn't need to require chewing.

[lostnfound]

5. Weird. Some symptoms seem familiar, but much quieter than what he describes. Nt

[phylny]

7. As a retired speech-language pathologist, I would add you should practice pristine dental

hygiene - brush and floss three times a day, use mouthwash if you can tolerate it.

If you are at risk for silent aspiration (you don't cough, you don't know you're aspirating) or for aspiration where you have signs and symptoms of aspiration, and it's just water or your secretions, you stand a better risk of keeping your lungs safe if you have done your best to keep your teeth and mouth clean (bacteria in your mouth might end up in your lungs.)

This is exactly what happened with my father, who was so sick on January 28th that we almost lost him. He never, ever had dysphagia (problems swallowing) but needed speech therapy to help him regain a safe swallow.

For more information, look up the Frazier Water Protocol or Free Water Protocol, meant for patients who are aspirating but want/need to drink.

[McCamy Taylor]

8. Thanks!

[phylny]

9. You're welcome. I can't prove it, but I wonder if my father, 92, had

the virus. He had many of these symptoms - eye redness, loss of strength, non-productive cough, no real fever, pneumonia, body aches - and he tested negative for the flu. It took him a month to regain his ability to breathe unassisted, with bi-pap and c-pap at night, and he was on oxygen (new to him) daily, with two nebulizer treatments daily, and then was weaned to oxygen at night. Maybe it was just the perfect storm of symptoms, maybe not.

And I neglected to say, I hope you feel better very soon!

[deurbano]

12. I think this may have been spreading around for longer than people think.

And I think they are missing people who have the virus but no fever, since it seems like the main screening criterion.

[crickets]

10. Thank you for sharing this, and please get better soon.

[elias7]

11. From one provider to another, hang in there, the odds are with you

Thanks for the description...

[SunSeeker]

13. 40% FALSE NEGATIVES??? HOLY SHIT!

[McCamy Taylor]

14. I know. Insane isn't it?

And yet if that single COVID test is negative employers will rush their doctors and nurses back to work since they obviously "Just had a virus."

[SunSeeker]

16. This is horrifying. I had a friend who just got her negative test results today (it took 8 days!).

Now I realize there is a substantial possibility she might still have Covid-19.

[McCamy Taylor]

23. That's right.

[LAS14]

31. Is this 40% false result because the test was given too soon? Or is the test just that...

... unreliable?

tia
las

[muriel_volestrangler]

39. Where does that 40% figure come from?

The only thing I can see in the OP's links about false negatives is:

RT-PCR screening is now considered the standard laboratory test for diagnosis of COVID-19, but it may yield a false-negative result in some cases. A number of cases with false-negative RT-PCR results were reported in the early stages of the disease, possibly because of inadequate viral material in the sample or technical issues during nucleic acid extraction [8, 30].


Read More: https://www.ajronline.org/doi/full/10.2214/AJR.20.23034

Just "a number" or "in some cases", and that seems to be in China, when it was a new test and they were rushing to work things out.

[Karadeniz]

15. Helpful...thanks!

[Goodheart]

17. I am convinced I had a bout of covid 19 infection back in early March

Here in Louisiana my experience sounds almost identical to that reported by Sean Payton. At the time it was pretty confusing... it didn't feel like the flu (I hsad already had a flu shot) so I told everybody I had a "chest cold". But a cold typically breaks for me after about 6 days, and then the gush of mucus comes pouring out of my sinuses, etc. But that didn't happen. What I had lingered for over two weeks... I slept a lot, didn't feel good, and one night had a few chills... but never really got a serious fever. I am confident my body right now is just teeming with covid 19 antibodies and that I'm now immune. Lucky me.... I didn't die from it.

[Laura PourMeADrink]

18. Wow. 99% of what you wrote is completely over my

non-medical background head. But sense you are on to something that could be very Important to experts.

Kick and tweet!! Absolutely hate that you are going through this.

[TheBlackAdder]

19. Contact a good local vitamin store for elecampane. If they have it, also something called Lung Tonic

.

Both of those are extremely beneficial to lung function and have high anti-infection properties.

My one daughter is 30 minutes away from me and she started to come down with COVID-19 symptoms, including the feeling of drowning. She started taking both elecampane and Herbs Etc.'s Lung Tonic, which I had previously sent to her to keep on hand in case she ran into problems. She now states that the drowning feeling went away and she has a headache of other flu-like symptoms.

This sounds serious and it seems like your options are limited. I would check out getting those items.

.

[LAS14]

29. I'm not into organic living (I buy organic veggies only when they taste...

... noticeably better), but I have had strikingly good experiences with Zicam for allergies and Zicam for colds and Similasam eye drops for an itchy eye. So I am a believer in the potential of homeopathic treatments. And in their safety. I have bought one of each of these on Amazon and we'll start taking them right away.

[TheBlackAdder]

34. These aren't homeopathic, which is more of a sham. They are herbal remedies, used for 100s of years.

[denem]

21. You should be in a hospital.

Regardless of whether the test comes back positive for SARS-CoV-2, the condition you describe is serious enough to require hospitalization. In addition, with COVD-19, the onset of Acute Respiratory Distress Syndrome is sudden enough, that a delay to ICU may be critical.

Patients will be on minimal support, on a little bit of oxygen, and then all of a sudden, they go into complete respiratory arrest, shut down and can’t breathe at all.

https://www.propublica.org/article/a-medical-worker-describes--terrifying-lung-failure-from-covid19-even-in-his-young-patients

[McCamy Taylor]

24. Having worked in many hospitals, I am sad to say I feel safer at home.

ICU care is great. Anything less than ICU is hit and miss due to the high number of patients that are assigned to each nurse. To be safe in a hospital, you have to bring your own family to watch out for you--and they won't let your family in right now.

[denem]

25. I am not meaning to disturb you

but I have read a number accounts of an extremely rapid onset of ARDS. That was how SARS got it's name. Of course you are better placed to make an informed choice.

[McCamy Taylor]

26. I understand and thank you.

Helps that I have a nurse in the home, too. Gives me an added layer of comfort, because if my judgment gets bad hers will still be good.

[denem]

27. Take care

:hugs:

[Hermit-The-Prog]

22. That's the scariest thing I've read yet about covid-19

Aspirating food or drink without realizing it is just terrifying.

Some years ago I pulled a stupid stunt of doing several days of grinding and sanding without a dust mask. The result was me spending the first hour of each day coughing and wheezing. It took a lot longer to clear than it took to clog my lungs. The best way I found to breathe and get the crud to come out was to get on my knees then put my face on the floor -- ass in the air and shoulders as low as possible. What you describe seems to rule that home remedy out.

May you quickly get better. Thank you for sharing your information.

[Victor_c3]

37. I don't know what I'm talking about

But there is a difference in laying on your back and being in the position you described during coughing. I would imagine that what you said might be beneficial, but I’m not a healthcare provider.

I wonder if OTC meds like mucinex or an expectorant might be beneficial. I always have stuff like that on my home, as I never feel like going out to buy it when I’m sick.

[LAS14]

28. Thanks! First hand stories are invaluable. nt

[Runningdawg]

30. As a retired nurse I pose this question -

Did you have an PEC reflux/ upper gastric/ hiatal hernia? My husband was recently diagnosed with HH and he is having a horrible time with reflux and keeping food down. He struggles to stay hydrated because most liquids are like battery acid to him. Other than the loss of sensation you mentioned in your esophagus, how would a patient with a GI condition know it isn't the norm? FYI He is showing no other symptoms.
May you recover quickly!

[McCamy Taylor]

36. Yes I do, and I also have sleep apnea that I think is driven by my gerd.

So I already do everything I can not control my gerd at night.

[LAS14]

33. "soft/mechanical" - What does the "mechanical" part refer to? tia - nt

[McCamy Taylor]

35. Good question. Here is a link

https://www.uwhealth.org/healthfacts/trauma/363.pdf

[LAS14]

38. Thanks. That's a very helpful document, but...

... the word "mechanical" only appears twice. So it isn't explained in the document. "Soft" I understand. "Mechanical" not so much. What would a soft diet be that was not mechanical?

tia
las

[McCamy Taylor]

40. Took ten days to come back. Test is negative

Longest ten days ever. I actually have a pediatric virus human metapneumovirus that seldom makes adults sick but it gave me pneumonia and chest pain and low oxygen in the middle of A COVID epidemic. And it also messed up my sense of smell so remember COVID is not the only virus that can make Mexican Coke taste like sugar water without any nasal congestion. And be on the lookout for this one because unlike COVID you children are more at risk from this than you are.

Oh but still don’t aspirate.