Healthcare professionals go to great lengths to protect themselves against COVID-19. Still, the virus has managed to infect even the most vigilant providers.
Kay Ball, PhD, RN, CNOR, CMLSO, FAAN, the long-time nurse planner for this publication, contracted the virus in April. Thankfully, Ball has returned to her home and is in recovery. In this Q&A with Same-Day Surgery, Ball shares her symptoms, how she was treated, and lessons learned. (Editor’s Note: Ball provided her answers to these questions in writing. The transcript has been lightly edited for clarity.)
Same-Day Surgery: What were your earliest symptoms and when do you think you were infected? Was it before state shelter-in-place orders, or did it occur in a healthcare setting?
Ball: My first symptoms appeared around April 2 when I lost my appetite, had a non-productive cough, and an occasional headache. I hardly ever have headaches. My temperature was normal, but a couple days later it went to 100.3°F. Soon, the temperature went down again. I also had a right lower abdominal pain that persisted in the mornings.
I became infected after the stay-at-home orders were issued for Ohio. My husband and I were very careful when we had to go to the grocery store: we used our masks and gloves regularly. When I became infected, I wasn’t wiping down the groceries, so I may have contracted the virus then. Other than that, we just didn’t go anywhere and we never met with anyone as we tried to avoid the virus. My husband and I are in the elderly range of ages but we work out in our basement gym every day and are healthy people. My husband also tested positive for COVID-19, but was asymptomatic.
Same-Day Surgery: Where were you treated during your illness and recovery?
Ball: On April 10, my husband drove me to a hospital emergency room (ER), per instructions of our family doctor, because my right lower abdominal pain became more intense. I started to think it could be appendicitis or something with an ovary. My other COVID-19 symptoms were cough, headache, and fatigue.
Being a nurse, I didn’t want to take up a hospital bed that could be used for a COVID-19 patient, so I was reluctant to go to the ER — as most healthcare providers are, sometimes. The CT scan didn’t show anything that could be causing the pain, but the ER doctor looked at my chest X-ray and told me that my COVID-19 test probably will come back positive, as I had viral pneumonia.
He sent me home with the instructions to return immediately if my breathing became labored. I really hadn’t paid much attention to my breathing before, but now I realized I had very shallow breaths and avoided taking a deep breath because it caused me to cough.
When I got home, I slept in another room because my husband hadn’t been tested yet for the virus. All through the night, I took my pulse oximetry reading, which was in the low to mid 80s. The next morning, my family practice doctor sent me back to the hospital, and I was admitted with COVID-19.
I was placed on the COVID-19 floor in isolation. That was the very difficult part of hospitalization. I was given hydroxychloroquine twice daily for five days, was told to lay prone for 20 minutes five times a day to allow the alveoli to function better, was placed on oxygen, was told to use the incentive spirometer regularly, was given a sub-Q injection of a blood thinner every evening to prevent blood clots, and also was given vitamins and any lacking minerals, like magnesium. I underwent an ECG and blood work daily, and my vital signs were monitored continually.
My appetite slowly returned, but most of the time the food was cold by the time I received it. The sherbet and ice cream tasted very good, though. On the sixth day, I was released with a prescription for vitamin C and was told to continue to take my regular medications, including vitamin D-3, a baby aspirin, and blood pressure medications. I continue to use my incentive spirometer and regularly note my vital signs and pulse oximetry. After four weeks, I slowly was getting better.
Same-Day Surgery: From the perspective of surgery center patients, staff, and operations, what would be your recommendations about how much diligence they should put into preventing infection as the pandemic enters what many infectious disease experts believe will be a new phase of outbreaks in the fall?
Ball: The Association of periOperative Registered Nurses (AORN) has written amazing guidelines and statements about reopening your operating rooms (ORs) and what should be done to prevent the spread of this and other viruses in the perioperative environment. (Editor’s Note: Learn more here.)
Listen to what AORN and other professional organizations are saying, along with the Centers for Disease Control and Prevention and local health department suggestions and mandates. We will be establishing a new normal as we go along. Look at what the research is noting, and pay attention to the data about new cases and best treatments.
All during the month of April, while I was fighting COVID-19, I also authored a survey that AORN put online to a sample of our members to complete about the effects of surgical smoke exposure. The results are being analyzed now and will be available soon, but I was a bit surprised at the number of participants who noted that COVID-19 has driven their hospitals and surgery centers to implement smoke evacuation as a mandated and regular practice to avoid the spread of this virus.
Same-Day Surgery: How are you feeling now, both physically and emotionally, and how long did it take you to recover?
Ball: Currently, I am doing fine. We actually went camping over Memorial Day weekend, but I did struggle a bit with walking long distances. I had to sit down for a bit and catch my breath. My O2 saturation was only 87% when it should be between 95% and 100%, ideally. I guess I still have some residual respiratory problems, but I’m sure that will subside as I continue to take deep breaths, use my incentive spirometer, and monitor my oxygen saturation.
Same-Day Surgery: Do you have any other thoughts or lessons learned about your experience?
Ball: I was blessed to have survived COVID-19. One of the most powerful lessons I learned was that friends and family make such a difference in recovery. Their prayers and good wishes, along with great medical care, had the prevailing influence on my life.
We need to be extremely careful in decreasing the transmission of this nasty virus in the future. We need to wear our masks in public places to protect and respect everyone else.
We need to wash our hands often, follow the rules of social distancing, and pay attention to what our governors and health departments are suggesting.
This virus could very easily mutate and become even more virulent in the future. Being alert, focused, and having to do things that are not in our lifestyles or practices will determine if the virus wins or not.