Victor and Paula – Experiences of intensive care with COVID-19
After contracting Covid in the middle of the second wave of the pandemic in the UK, Victor spent 5 weeks in ICU and 1 week on the ward between mid-January and the end of February 2021. He was ventilated and continues to recover at home.
Time of interview May 2021
Working as a black cab driver, Victor felt reasonably protected by the measures put in place for his protection: a shield between the passenger and himself. As such, he had not been terribly worried about his health before he contracted Covid.
In the first week of January 2021, Victor came home from work fatigued, in a mood that was untypical for him, and with no appetite. He went straight to bed and took the next day off work. It was his son Rob (24), who lives with his parents, who suggested they all get tested. Only Victor’s test came back positive – the one for Rob and Victor’s wife Paula came back negative. Victor remembers little from that time. Looking back, this will have been due to his low oxygen levels.
Paula remembers that he came home tired and went straight to bed. Victor deteriorated over a number of days: she could see him struggle with his breathing. On Thursday, she called for an ambulance. The paramedics came and checked on him, but initially did not take him to hospital. Between then and Sunday, Victor said he was doing okay, but he was clearly deteriorating. On Sunday he came down from the room where he was sleeping separately from Rob and Paula and said that they needed to call an ambulance.
The paramedics returned, asked Victor for his name, which he could say, measured his oxygen levels, now much lower than they had been previously, and put an oxygen mask on him. They decided to take him in. Paula was asked to get his phone and charger ready. She enquired how serious the situation was. The paramedic said, “We’re not hanging around.” Paula kissed Victor goodbye, unsure whether this was okay to do considering that he was ill with an infectious disease, and then the ambulance left for the local hospital. This was at 11:25am, and by 2pm Victor had been admitted to a Covid ward.
Paula received daily updates on Victor’s condition from the doctors working in hospital, who called in the evening after their shifts had ended. When they called, Paula could hear beeps from machines in the background. The doctors usually informed Paula of what they were going to do before they did it: for instance, on the Monday, the doctors called to say that they were going to take Victor up to ICU. However, calling beforehand was not always feasible. Doctors had ventilated Victor without calling first, and this meant that Paula had not spoken to Victor before he was mechanically ventilated.
Paula initially shared the information she got on the phone with a friend who lives locally, who listened and gave space to Paula’s emotions and concerns. This friend helped Paula relay the information she was getting from the hospital about how Victor was doing in such a way that Paula could then share it with friends, colleagues and family. She did this through a WhatsApp group, which gave everybody all the information, and the chat history serves as a kind of record of what has happened. People would reply to her either in the group or individually, offering support in whatever way they could. Talking things through with her friend and sharing the information through the WhatsApp group meant that Paula now feels that she has worked through her feelings sufficiently to not require any further emotional support. Other sources of support for Paula were neighbours and her sisters.
Whilst on ICU, Victor suffered from pneumonia, kidney injury, and an infection. He was prescribed antibiotics and blood thinners. Paula found it hard not to be in hospital with Victor. If she had been there, she would have been able to speak to staff more easily – but all this now had to be done over the phone. Paula recalls that doctors in conversations with her never used the word stabl to describe his condition until Victor was on the ward. They generally explained things well, and Paula did not feel the need to look up additional information.
Paula understood that calls in the evening were likely to be updates on how Victor was doing; any calls during the day were likely to be bad news. So, she generally went out and did things during the day. This meant that sometimes, she was out of the house when she got a call. On one such day, when she was in the bank, the doctor told her to prepare for the wors. That was a very difficult day, especially as she could not go to the hospital. Rob refers to this day as “Black Friday”.
Victor was transferred to a teaching hospital in the vicinity, after which communication between Paula and the doctors in hospital improved. Paula thinks this is because they had more staff to call family members at home.
Victor recounts waking up from a coma 2 and a half weeks after he was ventilated. He had experienced terrible delusions that have, in his words, scarred him for lif. He describes these dreams as traumatic as they were so vivid and real to him. He had believed he was in Canada all this time, that he was trapped, captured by a sect, that he was dying, and that he was being held against his will.
When Victor was experiencing these delusions, the nurses had asked Paula to help calm him down, and to convey that he was not held against his will. This is when Paula and Rob were able to FaceTime Victor for the first time, and saw; him for the first time in 4 weeks. To prepare Rob for the call emotionally, Paula had looked up pictures of ICU patients to show Rob what he might see.
Unfortunately, Victor had to be re-intubated as he had a congestion in his lungs. Victor was moved back to the local hospital which Paula found difficult, as it meant she would again be receiving fewer updates.
Once he had been weaned off the ventilator a second time, Victor had difficulty sleeping and spent a lot of time awake in the ICU unit. He remembers that other patients lay really still for days on end, which frightened him. But gradually more and more wires got disconnected, which he took as a sign that he was getting better. He tried to maintain a positive attitude, which he feels that this has played a big role in getting better.
Victor was moved out of ICU onto the general ward. Victor initially struggled with walking: sitting up in the chair next to his bed was arduous and extremely fatiguing. But he always kept thinking about the next stage of his recovery and kept going. He was in touch with Paula and Rob via his phone, and friends texted him and sent him videos – Victor experienced this as really supportive. The messages were uplifting, and helped him figh. Victor was eager to come home. After the results for a brain scan returned showing no damage, he was discharged home, in a wheelchair 10 days after his discharge from ICU. He was clapped out of hospital by staff members.
Victor had online support sessions to help with the paralysis of his vocal cords. He had trouble eating as his tongue had folded due to being pressed to one side by the tubes. He had to build his strength back up and fatigued quickly. Paula helped him get onto the exercise bike. Victor had initially wanted to start training where he had left off but needed to learn to pace himself. He initially did lengths up and down the garden, every day a bit longer and further than the day before.
At the time of the interview, Victor had built his strength up to a level just below where it had been before his hospital admission. He found his process of recovery motivating when recovery was visible, but frustrating when it plateaued after 5 weeks. He wonders whether this is as far as he will improve, or whether it is just slow from here onwards. He feels 20 years older compared to how he felt before his hospitalisation. He works half the hours at work. Nevertheless, his critical illness episode has not changed his positive outlook on life.
There have been difficult moments: for Paula this was when she was not able to see Victor in person, and when she saw how poorly he was on camera, even though seeing him alive was a huge relief. For Victor, the stagnation of his progress in recovering was difficult.
Now, after 12 weeks of recovery at home, the remaining symptoms are a coarse voice due to the tube having pressed against his vocal cords, occasional breathlessness, drop foot, and fatigue. When asked what was most helpful to him in his recovery, he mentions the district nurse who initially came to his house once a day to help with the dressings of the tracheostomy wound, the physiotherapy (who has now referred him to a neurologist for his drop foot and tingling feeling in his foot), and the speech therapist. After some weeks, Victor went back to work. His speech therapist worried that this would mean he would be talking a lot.
Victor is extremely grateful to the NHS staff for what they have done. He would like to see a member of staff from the hospital face-face, which was likely to happen at his appointment that was scheduled for the week after the interview. Victor would like to tell others that if they need critical care, ICU is the best place for them. Paula adds that the message that hearing a loved one needs to go to ICU is likely to be a shock to relatives.