Dubai: A critically ill COVID-19 patient, who managed to turn the corner, and the doctor who treated him have urged residents not to let their guard down even as the war against the global pandemic crosses a year.
Rey Milo Guevara Orense, 49, a Filipino expatriate, was admitted to the Canadian Specialist Hospital on January 28 and was in the Intensive Care Unit for nearly two months.
An operations manager, Orense told Gulf News he suspects he contracted the virus from a colleague. “This colleague of mine was sick and later admitted to the ICU. I fell sick on January 22 and initially I was feeling a little under the weather. However, when my test results came positive and I had difficulty in breathing, I had to rush to hospital,” he recalls.
Admitted with severe pneumonia
Orense was admitted to the Canadian Specialist Hospital with severe pneumonia and was immediately started on oxygen support. Despite receiving 15 litres oxygen per minute, Orense’ condition deteriorated and he had to be put on Non-Invasive Ventilation (NIV) with oxygen saturation dropping to 84 per cent, explained Dr Hyder Matouk, intensivist and consultant in critical care medicine at the Canadian Specialist Hospita, who described this as one of the most challenging cases this year. NIV is administered through a face or nasal mask with oxygen with positive pressure administered to the patient.
Orense, who is pre-diabetic, showed complications arising out of his raised sugar levels and he continued to be on 84 per cent saturation until February 4. The expected level of oxygen saturation is between 96-100.
Tracheostomy carried out
Orense’s condition continued to vacillate and although he was weaned off the ventilator on February 14, doctors put him back on ventilation by February 17. He underwent a tracheostomy on March 1. Tracheostomy is usually carried out to be able to deliver more oxygen into the lungs of a patient experiencing breathing difficulty. Dr Matouk continued the medicine protocols, while closely monitoring him. Finally, on March 11, after remaining sedated and on mechanical ventilation for a month and a half, Orense was shifted to the general ward and finally discharged on March 16.
Nightmares under sedation
Orense recalled, “When I saw my wife for the first time, I had to ask her if this was ‘real’ as I had been going through several nightmares over the past few days, and my sense of orientation was poor. I am so thankful to Dr Matouk who never gave up on me and the incredibly dedicated staff of health care workers who took care of me and gave me a second chance at life.”
Dr Matouk explained, “Most patients who come to the ICU sometimes experience delirium as they are sedated and are often besieged with fear. Apart from the treatment protocol, our staff has to provide psychological counselling to the patients too.”
Poor muscle tone
Orense, whose muscle tone has deteriorated with the two-month stay on mechanical ventilation, has had to undergo intensive physiotherapy to be able to walk without support. “I feel very fatigued and tired after I have walked a few steps without support and am working on building my strength and stamina. Although I am COVID-free, it will take me a couple of months of rest and rehabilitation with a highly nutritious diet and vitamin supplements to heal and rebuild my immunity.”
Don’t lower your guard
Orense sent out message to the community: “I want to tell people not to get complacent about COVID-19. They must not take this lightly and be mindful of following all protocols and self-isolating at the first instance of sickness. We all have to fight this together and follow all the protocols.”
Dr Matouk added, “People must go in for their complete vaccination dose as that is our best defence against COVID-19. However, once vaccinated, people must not take anything for granted. They must wear the face mask, practise social distancing and frequently sanitise their hands. We have to work together to combat COVID-19.”
Dr Matouk said, “I would say this time, we have more information, are better prepared psychologically to tackle this foe. Although one must concede that research on COVID-19 is still ongoing, there is no definite cure yet and as research papers are published, we add more to our existing knowledge of the illness. However, in terms of antivirals, steroids, blood thinners, we have an idea of what to give when and to which patient.”