How can we care for ourselves or loved ones at home while facing illness during a worldwide pandemic? Ordinarily, when we experience severe illness, we expect that we will receive life-sustaining care at the nearest urgent care facility or emergency room. Our health care systems are normally quite capable of quickly prioritizing patients’ conditions (triage) according to critical status. We trust that our hospitals are supplied with the necessary resources to cover the cases that present on any given day.
Major medical centers are also prepared for episodes of mass injury as in cases of natural disasters. However, when disease presents at the same time throughout any country (epidemic) or worse within virtually the entire world (pandemic) resources are quickly depleted.
In the case of the current COVID-19 health crisis, we find that we in the United States are minimally prepared to meet this challenge. We do not have sufficient medical supplies – specifically, face masks and N95 respirator masks – nor do we have enough ventilators to care for those whom we anticipate will need this type of support.
We expect that in the upcoming weeks our hospitals, many of which are already filled to capacity, will be incapable of caring for most patients that are affected by severe symptoms of COVID-19. The reality is that many who are experiencing the severest symptoms of COVID-19 will be likely be forced to care for themselves at home.
Be assured that you can survive even severe COVID-19 illness if you must care for yourself at home. The CDC directs that people who have flu-like symptoms such as fever, sore throat, or cough may care for themselves at home much as they would if they had the flu when diagnosed with, or expect they have COVID-19.
It is important to note that fevers, headaches and body aches, although uncomfortable, are actually a sign that our bodies are mounting a healthy response that can effectively disable the virus within our bodies. It is also important to note that not everyone will experience fever (hyperthermia) as a symptom of COVID-19.
In fact, among the older population, there are findings of patients experiencing lower than normal body temperatures (hypothermia) rather than fever when affected by COVID-19.
The CDC recommendation further states that we should seek medical attention if feeling shortness of breath or chest pain. This critical symptom indicates the lungs are being seriously affected by the body’s response to the presence of rapidly multiplying novel coronavirus within the body.
The disease process that ensues seems to have more to do with the type of response the body chooses to launch in response to the viral assault. For many who are already affected by the stress of chronic diseases, the immune system is not nimble enough to mount an effective response. The body works best when immune responses are properly regulated: not diminished nor excessive.
In the most severe cases of COVID-19, it appears the body’s own chosen method of immune response is overly robust. In these cases, the primary defense seems to be a virtually constant flooding of the sinuses with enormous amounts of secretions.
This flow may even increase or spike in volume at night while patients are sleeping. This may explain why patients who were previously feeling stable suddenly report breathing problems or chest pain.
In these cases, the body focuses on flushing the virus out of the sinuses with storms of secretions that range from being thin and incredibly strong like super-strong egg whites to a frothy clear liquid.
Streams of sinus drainage are then poured into the stomach tube (esophagus). If the esophagus is over-filled with large amounts of this drainage or the stomach is full of food, these secretions may quietly drip or spill-over into the trachea and into the lungs. When our bodies recognize leakage into the lungs we often develop a dry cough. If the draining sinus fluid covers the lungs’ tissues it will disable the lung’s ability to receive and process the oxygen necessary for the body’s functions.
Thus the lungs actually drown in secretions due to the body’s immune over-reaction.
COVID-19 may stress other organ systems as well such as the kidneys or the liver, however, since we are not designed to live more than a few minutes without adequate oxygenation, PROTECTION OF LUNG STATUS IS THE PRIORITY FOR CARING FOR ONESELF OR A LOVED ONE AT HOME WITH COVID-19.
The streams of sinus drainage aren’t the only danger to the lungs. The novel coronavirus also affects the cells within our lungs that make surfactant (the slippery substance that makes lungs capable of re-inflating after we exhale).
When these cells are damaged our lungs are not able to inflate properly so as to receive oxygen. When the novel coronavirus attacks these cells our immune system tries to repair the damaged cells and rid the body of the virus within the lungs.
Unfortunately, this repair-response may make the lungs too sticky with mucus and debris rather than allowing them to remain slippery and resilient as they should be.
Another mode of seriously detrimental viral attack is coming into view although not yet widely validated. When copious mucousy secretions flood into the stomach and subsequently the intestinal tract, these secretions may smother the intestinal tract.
It is thought that as the intestines become covered with layers of these secretions the gut’s unique neurological abilities to guide the proper immune system response is hampered.
This may be one reason the body is unable to mount an appropriately regulated response. In a sense when these storms of secretions run amok, the gut is also “drowning.”
Understanding the phenomenon of how the gut impacts the intelligence of our immune system is a fascinating new science that is on the horizon. It appears that combinations of drugs being considered for slowing the immune response may also target the gut.
Applications of this new science may prove to be lifesaving for those who are unable to access the overburdened healthcare system in the upcoming weeks. The following are some strategies for coping with the symptoms of COVID-19 if you are forced to care for yourself or a loved one at home.
Some affected patients report experiencing panic attacks or hallucinations, especially at night as the body works fervently towards maintaining balance. As believers, the foremost remedy for all ills is to PLACE OUR TRUST IN ALMIGHTY G-D and try to stay calm.
Remember that staying calm in times of panic is actually a commandment in the Muslim Holy Book (Qur’an).
CRITICAL COVID-19 ILLNESSES ARE LARGELY DUE TO CELLULAR LUNG DAMAGE AND FLUIDS DUE TO FLOODING FROM SINUS DRAINAGE THEREFORE PATIENTS MUST MANAGE DRAINING SECRETIONS BEFORE THEY BECOME A PROBLEM. EVEN IF YOU START FEELING BETTER, CONTINUE USING LUNG EXERCISE AND SAFETY TIPS.
These techniques can be researched under subjects such as: “Cupping and Coughing” “Pulmonary Physiotherapy” “Chest PT” “Huffing” “Cupping and Clapping” and “Pulmonary Toileting.”
As you recover keep in mind it may take weeks or months for the immune response to regulate properly.
This advice is not intended to take the place of the advice of your healthcare professional. Due to the newness of the COVID-19 disease process, health care practitioners from a wide spectrum of specialties are searching for therapies.
Following you will find new, as well as long-held strategies and tips practiced by nurses and families when caring for their patients without having access to mechanical ventilators or pharmaceuticals.
These days many studies are providing scientific evidence explaining why many time-held techniques are useful.
HOME CARE STRATEGIES FOR COVID-19 SELF OR FAMILY CARE
The CDC guidelines for homecare of COVID-19 patients instruct that the patient be separated into their own room or space in the home if possible and practice physical distancing from others in the home.
The patient should wear a mask if possible when around others. Caretakers should mask when giving care, avoid sharing items with one another in the home, wash hands often, avoid touching the face, clean surfaces frequently, do laundry regularly and avoid visitors.
They also caution that patients should call for medical assistance if they experience shortness of breath, chest pain, exhibit mental confusion, are unable to be aroused, or if lips develop bluish undertones. Be aware that in people of darker skin color lips may develop grayish undertones when oxygen is low.
IN ADDITION TO THE CDC GUIDELINES PLEASE CONSIDER THE FOLLOWING: PROTECTING THE LUNGS and Re-stabilizing The Intestinal Tract “GUT” should be the Focus of COVID-19 Homecare.
1) Practice deep abdominal breathing every hour and whenever you remember. Breathing deeply into the abdomen and then up into the chest may help to oxygenate the lower and upper lungs. If you have a pulse oximeter (available at online pharmacies for about $40) keep your oxygen at 97% or above.
2) Do some form of gentle movement exercise like yoga or rocking your body back and forth regularly. Ask your body what it needs. Listen to your body. Walk around your room or do some gentle dance movements if you are able. Exercise is excellent for keeping the body and lungs in balance.
3) PRACTICE REGULAR PREVENTATIVE LUNG EXERCISES EVERY 2 HOURS THROUGHOUT THE DAY to prevent lungs from becoming damaged. Wake up in the middle of the night TO COUGH AND CLEAR THE LUNGS.
There seems to be a tendency for sinus secretions to become particularly heavy at night. If you are asleep when this is occurring the lungs may become dangerously filled with fluid.
4) DEEP BREATHE AND COUGH TO GET RID OF EXCESS SECRETIONS AND MUCOUS FROM YOUR CHEST AND YOUR THROAT. Cough with your head down so gravity can pull secretions away from the lung entryway. Have tissues and a lined trash bin on hand. Afterward, carefully wash your hands.
FIRST TAKE A FEW GENTLE DEEP BREATHS IN AND OUT – Try to bring air into the abdomen and then up into the chest. Exhale completely.
THEN TAKE A FULL BREATH AND HOLD FOR 3-10 SECONDS, RELEASE THE BREATH
NOW TAKE ANOTHER DEEP BREATH, PUT YOUR HEAD DOWN AND DO A ROBUST COUGH!!! COUGHING DEEP WITHIN YOUR CHEST WITH YOUR HEAD DOWN. You can do this while sitting down if you need to. COUGH! COUGH! COUGH!
SPIT OUT ANY PHLEGM that comes up even if there is only a tiny amount this is good. It may also drain from your nose if so blow your nose completely clear. If you gag on your secretions that is fine.
Gagging on secretions when your head is down may be a sign that you are developing excessive secretions. JUST KEEP YOUR DOWN and LET YOUR SECRETIONS COME OUT! Secretions may need clearing every 2 hours.
MASSAGE YOUR LOWER ABDOMEN and your STOMACH FOR 30 MINUTES WITH DEEP KNEADING MASSAGE. Poke and massage deep into your navel. This can be done seated or standing.
5) If you develop large amounts of secretions TRY SLEEPING FRONTWARD not on your back nor on your side. YOU MAY USE A SMALL PILLOW UNDER THE CHEST OR HIPS whichever allows for comfortable breathing or if you are able you can try to sleep in a front-fetal position like the Muslim “sajda” prayer prostration.
These positions keep the face (sinuses) lower than the chest. Keep tissues and lined trash bag at the bedside next to you for spitting up secretions throughout the night. If secretions flood into your throat at night hang your head down over the side of the bed and let them flow out before you sit up.
Afterward, get out of bed to manage these secretions. You can gag yourself with a finger or gently with the soft end of a toothbrush in the bathroom remember to keep your head down over a lined trash can. Continue for as long as you have to.
KEEP YOUR HEAD DOWN TO GAG AND COUGH OUT SECRETIONS. DO NOT LET FLUID ENTER YOUR LUNGS.
To be continued….