Through my eyes: long neuro-COVID

The arrival of the virus, SARS-CoV-2, in the UK presented a sudden need to increase the country’s National Health Service (NHS) workforce.

On March 24, 2020, then-Health Secretary Matt Hancock announced that all final year medical students who passed the General Medical Boards (GMC) results for graduation were to be accelerated to graduation to be made available to help in services.

He also urged retired healthcare workers to consider returning to the NHS to help in times of national crisis.

Under the emergency regime, newly graduated physicians could, but without obligation, apply to the GMC for a provisional medical registry entry, allowing them to become first-year founding physicians and start work earlier.

Eager to support my colleagues, I, along with 4,500 other newly graduated doctors, applied for provisional enrollment in the GMC, and more than 15,000 former NHS staff have come out of retirement to serve on the front lines.

Throughout the summer of 2020, I worked in various neighborhoods, including neighborhoods positive for COVID, before starting my official founding position in August.

By November of the same year we were in the middle of a second wave and the UK had entered its second lockdown. COVID-19-related deaths and hospital admissions have risen again.

Like ‘being on a treadmill, I couldn’t get off’
I contracted COVID-19 at work after being deployed to a COVID department. Working in close contact with COVID positive patients and wearing only basic personal protective equipment (PPE), I was not surprised when, the following week, I started feeling unwell and having a PCR test subsequent gave a positive result.

The acute phase of the illness lasted 2 weeks and was comparable to mild to moderate flu: unpleasant but expected. As a fit an
d healthy 35-year-old man with no comorbidities, I naively expected to recover quickly.
In the third week, unless a fever persisted, I mistakenly thought I had recovered. At the start of week 4 I returned to work but did not last long in the service rounds. With a light head and jelly legs, I came home. I now know this is the start of a long COVID.

At home, I deteriorated quickly. I became tachycardia, at 140 beats per minute (bpm), and short of breath, with a respiratory rate of 20 to 24 while resting. My heart rate would increase further, to 170 bpm, while standing and with minimal effort, such as having a drink or going to the bathroom.

I started having cyclic pin and needle attacks in all four limbs and violent tremors all over my body. The shaking was as violent as a seizure, but it wasn’t because I was conscious of it.

The seizures were associated with unquenchable thirst, with or without an urgent need to open my bowels, vomiting, or increased shortness of breath. They came in daily cycles lasting up to 14 hours at a time. I was shaking frequently throughout the night.

“I had a deregulated heart and respiratory rhythm – I think of neurological origin. Physically, it was comparable to being on a treadmill that I couldn’t get off. I know I carry a lot of trauma from this experience.

During those first few weeks, my airways narrowed. I was breathing fast, but I also felt like I was breathing through a straw. From my experience, I recognized the inflammatory narrowing of the airways aided by oral prednisone and fexofenadine (Allegra).
“I was treated like an anxious little girl”
I went to the emergency room, where my symptoms were ruled out and misdiagnosed as anxiety. The clerk I saw heard “cyclic attacks” and “pins and needles”, saw sinus tachycardia on an EKG, and then joined the dots in the wrong order.

He had expected to see a dirty-looking chest x-ray, and when it came back clear, he attributed my symptoms to a long COVID, anxiety, or reflux.

“Despite a long COVID differential, I was treated like an anxious little girl; my concerns were not taken seriously despite being a doctor myself. I told him that he was wrong in his diagnosis and that I felt very bad. But my time was up, he had bad patients to see, and for him I was not bad. A nurse brought a wheelchair and I was escorted out of the emergency room.

We now know that COVID-19 is the root cause of Postural Orthostatic Tachycardia Syndrome, or POTS, a condition in which the body’s autonomic system and therefore its ability to self-regulate is disrupted.

In addition, several studies have also reported on the neurological manifestations associated with SARS-CoV-2, involving both the peripheral and central nervous systems.

At home, the pin and needle attacks, violent body shaking, and shortness of breath continued. I have experienced episodes of impaired consciousness and neurological sleep apnea. My body would wake me from sleep or from the edge of sleep, and after a second’s pause, I was searching for my breath.

It was as if my body forgot how to breathe. It was then that I suspected something was wrong and recognized that I was wrong, even though no one else was. I have no doubts about the involvement of the brainstem. It was then that I felt a sense of impending doom, which I can only describe as an emotion felt as a physical sensation in the chest, pulling you down and pulling you down.
A wide range of hallucinations
Throughout December and January, pin and needle attacks and violent shaking did not diminish in severity, but in frequency and duration. They finally ceased in mid-January when I thought I had gotten over the worst. I was wrong.

Throughout January, February, and March, my right cerebral hemisphere felt numb and inflamed. I also had a huge earache, or pain in my ear. The pain was much deeper than that of a bacterial ear infection, like a “hot poker” feeling deep in my ear. My vestibulo-cochlear nerve was on fire.

“I started having internal auditory hallucinations. I hallucinated 5 out of 7 nights a week for 2 to 3 months. I heard music, bands, news reports, political broadcasts, all coming from inside the ear. Although my sleep continued to be disturbed, these hallucinations were not secondary to sleep deprivation. When I was lucky enough to sleep, I experienced night terrors; vivid and disturbing dreams.

Hallucinations have occurred in addition to COVID-induced tinnitus and deeper brain noise. I have experienced hyperacusis and bouts of vertigo. Unable to tolerate light or noise, I could do nothing but lie in bed with my eyes closed.

I got emotional. For months, I said I felt labile. Subsequent episodes of mood and speech disturbances – which caused sluggishness, stuttering, speaking and more than usual difficulty finding words, although I had that too – I think that they have been misdiagnosed and misinterpreted by the long-standing COVID care team.

Suspecting neuroinflammation, I raised my concerns, but my maternal grandmother had recently passed away, and depression and anxiety go hand in hand, and everyone, naturally, would have mental health issues afterward. to have lived what I lived.
“Not just fatigue”
Throughout the months of April, May and June, my brain did not inflame, but I did not feel well. When I touched my head, the right side was different from the left side.

But rather than being global, this strange sensation was more localized to the right parietal and right temporal lobes. When the right parietal position exploded, I had associated episodes of speech and mood disturbances.

When the right temporal portion exploded, I had severe ear pain and tinnitus. With tinnitus comes a real emotional reaction, because it is something that I do not take well. A subsequent hearing test showed some degree of sensorineural hearing loss, which is caused by damage to the inner ear or the auditory nerve.

Where am i now Ten months later, I’m improving, but I’m still sick.

Neurology has diagnosed limbic encephalitis, and my brain still feels like it’s recovering from that insult. My mood remains fragile; over time, episodes of extreme emotional reactions become less frequent. I would like to believe that the more my brain heals, the more my hearing improves. I still hope the tinnitus sets in completely.

The dysautonomia is improving, but I am still somewhat dysautonomous. For 10 months, I had a resting heart rate of 90-110 bpm that would rise more when standing, at 120 bpm, or minimal exertion, at 160 bpm.

However, 2 weeks ago my resting heart rate – out of nowhere – dropped. I now experience bouts of tachycardia at rest, rather than being constantly tachycardia. Minimal exertion, such as moving around the house, can still trigger tachycardia, and I continue to desaturate randomly.

But the episodes of acrocyanosis, which is poor circulation, or Reynaud’s in my feet no longer occur, and the episodes of nocturia, which is excessive urination at night, are becoming less frequent.

Functionally, I am very tired and struggle with the debilitating effects of post-exercise discomfort. Except for going to the hospital and for the vaccination, I haven’t left home for 10 months.
You physically have the impression that something is wrong at the cellular level, the mitochondria are not functioning properly. A growing body of evidence suggests that microclots and hypoxia secondary to endothelial dysfunction may be responsible.

Most of the time, I manage to prepare three meals a day, change and wash. Between these moments, I actively rest. Some days I can’t always do it. However, at first I couldn’t sit in bed or manage the stairs to use the bathroom, I noticed a slow improvement over time.

I haven’t watched TV or driven for 10 months. I still don’t feel well enough to try to drive.

Although I find it difficult to concentrate and leave the gas or the taps on, I feel that I am starting to get more alert. For a friend, I recently compared it to drunkenness.

When you’re drunk, you don’t appreciate how drunk you are until you start sobering up. I have been “drunk” for months. As time goes on, I sober up and start to reflect on my discomfort.

I am also angry and feeling abandoned by the government, Public Health England and my employer. We did not receive adequate PPE and instead received a false account that this virus was only spread by droplet transfer and therefore hand washing and a simple face mask were adequate.

This despite overwhelming evidence from the start that the virus is airborne, and full protection requires airborne PPE, including an FFP3 mask.

Even now, 1,500 healthcare worker deaths later, according to former Health Secretary Matt Hancock, and with 122,000 healthcare workers on leave with long COVID, national PPE guidelines remain unchanged. It is an insult to the dead and the wounded.

Like others with a long COVID, I still experience a myriad of other symptoms – every few days I have a sore throat, sneezing, visual disturbances such as blotchy vision, blurred vision, or blurred vision. increased floaters, intermittent diarrhea and the rest.

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