How COVID-19 nearly killed a healthy, 42-year-old father of four

SALT LAKE CITY — He simply couldn’t drag himself away from bed, although his spouse and daughters have been dressed and prepared for an additional day on the “Happiest Place on Earth.” The Tylenol and ibuprofen they’d taken for scratchy throats the evening earlier than didn’t appear to be serving to him in any respect.

So Justin Christensen declared he’d simply keep put. Then the 42-year-old, who usually doesn’t decelerate, pulled the covers up previous his beard and mustache and went again to sleep.

He and Rayna had been planning this journey to Disneyland for months. They needed to take their 4 children on their first actual trip earlier than their oldest daughter left for school.

The clan was in excessive spirits once they left Grantsville on Sunday, March 8, stopping for an evening in Las Vegas en path to Anaheim, California. They have been touring with buddies who personal a timeshare and had gotten them Disney passes, which put the journey inside attain on a decent funds.

Tuesday was excellent. Wednesday, they did it once more. On Thursday, Justin hit a wall. He was simply too drained to rise up. Had they walked an excessive amount of? Or gotten an excessive amount of solar? Considered one of their buddies wasn’t feeling nicely, both. Even their sons needed to lounge within the condominium. So Rayna, 39, and the gals hit the park alone.

By Friday, Justin was clearly sick. Rayna wasn’t feeling nice, both. They lower the journey quick. None of them dreamed that the drive again to Utah could be a part of a for much longer journey to the guts of a world pandemic — with no ensures that everybody would make it dwelling.

A pandemic unfolds

On March 11, the World Well being Group declared COVID-19 a world pandemic. The respiratory an infection brought on by the SARS-CoV-2 virus was spreading the world over, hammering Italy, Iran and South Korea. However the brunt had not but fallen on the USA, and Utah appeared virtually exempt.

Particulars of the illness have been largely speculative, past shortness of breath, fatigue, fever and dry cough. The WHO warned of dire outcomes for the aged, folks with continual medical circumstances like diabetes and anybody immune-compromised. Hospitals and public well being officers deliberate for a surge of sufferers. Many politicians, together with President Donald Trump, downplayed the virus.

Three months later, COVID-19 has killed greater than 423,000 folks, together with about 114,000 within the U.S. — practically the inhabitants of West Jordan. Greater than 2 million circumstances have been recognized within the U.S., together with at the very least 13,500 in Utah, the place 139 have died, largely older adults.

Most individuals expertise gentle signs, if any. There are peculiar signs like lack of style and scent or “silent hypoxia,” the place sufferers lack oxygen however don’t really feel in need of breath. However the virus may also be devastating. Some say they can’t breathe, like a “dry drowning.” Some have gastric misery. Some develop bacterial pneumonia or kidney or liver issues. Blood clots, coronary heart assaults and strokes afflict sufferers as younger as their 30s. Younger kids could have rash, crimson eyes, and swollen palms, ft and glands.

Docs are nonetheless determining to learn how to deal with the illness, which has no confirmed remedy. The problem is nice as a result of COVID-19 assaults sufferers in a different way; care varies even from room to room in the identical hospital. It’s nonetheless largely a matter of managing every complication that arises.

Because the Christensens have been about to seek out out, COVID-19 can change shortly from a distant information story to a battle for survival.

A stunning flip

Three days later, Rayna pulled the black Cadillac Escalade as shut as she may to the door of Mountain West Medical Middle in Tooele. The afternoon was heat for March, 58 levels, however Justin felt chilled. Solely sufferers have been allowed inside, so he handed Rayna his pockets and patted his pocket to ensure he had his telephone. “Name me when one thing,” she stated. “I’ll come get you.” Then she watched his again disappear via the glass double doorways.

She wasn’t apprehensive, despite the fact that Justin had been pacing and panting that morning, in an excessive amount of ache to take a breath. She figured he wanted oxygen and possibly drugs. On the physician’s, each have been swabbed for a COVID-19 check. Justin’s blood oxygen stage was simply 65% — above 90% is regular — so the physician despatched him straight to the hospital. However Rayna didn’t know anyone more durable than her husband, an Iraq battle veteran who drives a semitrailer for a dwelling.

He was robust sufficient to be tender. They’d met at Snow School South in Richfield, twenty years earlier than. She was learning cosmetology. He was turning into a welder — one who wanted a haircut. He charmed her as she snipped away. They ultimately married and had 4 kids: Keyera, 18, Kyle, 16, Kaycia, 14, and Kanyon, 10. Justin grew right into a down-and-dirty dad who wrestles along with his children, however snuggles, too. Even within the robust instances, he nonetheless made Rayna chortle.

So she dropped him off, picked up her personal prescription — steroids for irritation within the lungs — and went dwelling to eat dinner with the children and await his name.

A health care provider known as as an alternative. Justin was on a ventilator. He’d crashed after being admitted with fever, chills and hypoxia. They have been sending him by ambulance to the College of Utah Hospital in Salt Lake Metropolis.

Anxious, she known as, however Justin wasn’t there but. She went on Fb and requested her family and friends to hope for him. All she may do then was wait and fear, as her personal signs bought worse.

Inside hours, Rayna was again on the hospital, disappearing into those self same doorways. She examined constructive for COVID-19. Two days later, she was nicely sufficient to go dwelling.

She remoted in her bed room for 14 days. The nice and cozy grays and whites weren’t as cozy with out him.

Her days have been punctuated by telephone calls from the hospital. She’d brace herself on the sting of her mattress, a pocket book in attain on the fluffy grey fleece, and face an enormous canvas print of a household photograph hanging on the bed room wall. Simply final yr, they’d all posed in entrance of an previous truck, Justin on the middle.

Rayna cried lots throughout these calls. Nurses typically cried together with her.

She was hungry for information, however hated to reply the telephone. Unhealthy information saved piling up.

She’d take a couple of minutes to digest it, to decide on her phrases earlier than telling the children.

As soon as, the physician’s voice was notably grave. You’ll most likely face very robust choices quickly, he instructed her. You’d higher put together.

Are you a father? she requested.

Sure, with 4 children, he replied.

Like Justin, she thought. “Take a look at him as a person, as a husband, as a father, please, when you do something to him,” she begged.

Ivy Ceballo, Deseret Information

Attempting to save lots of him

Justin’s caregivers have been already preventing with every part that they had, however his lungs have been stuffed with sludge and he simply couldn’t breathe. They tried proning — flipping him on his abdomen to take strain off his lungs. They tried hydroxychloroquine, an anti-malarial lengthy shot. However his oxygen stage remained a dismal, harmful 75%. He had hours, possibly a day, stated Dr. Craig Selzman, a cardiothoracic surgeon who helped coordinate Justin’s care. In order that they opted for a extra aggressive measure.

Six days in, Justin was placed on Extracorporeal Membrane Oxygenation, which grew to become for him a form of synthetic lung. On ECMO, two hoses the scale of small backyard hoses feed right into a tube within the neck that goes straight to the affected person’s coronary heart. One hose attracts the blood to an exterior machine that filters out carbon dioxide and provides oxygen, whereas the opposite places it again into the guts, which pushes it to the remainder of the physique. The remedy is fraught with danger, however Justin’s state of affairs was dire.

“I feel if we had waited six hours, he’d have died,” stated Kathleen Stoddard, the scientific nurse coordinator and working room nurse who oversaw a lot of Justin’s care as a result of she’s in command of the ECMO program. She wasn’t even positive he’d survive the process to put in ECMO. It’s sometimes used just for quick intervals due to dangers and potential problems.

Cardiovascular intensive care unit nurses educated to handle ECMO volunteered to take care of Justin in a separate ICU the place COVID-19 sufferers have been remoted. They needed to don protecting gear each time they entered the room, then take it off afterward. It was time-consuming, on high of a labor-intensive job. Usually, one ICU nurse manages two sufferers. ECMO, Stoddard stated, requires two nurses per affected person. One stayed within the room with Justin the complete shift, managing and monitoring the machine.

The group gave Justin medicine to scale back irritation and different medicine to calm the cytokine storm COVID-19 has made infamous, which was making his immune system assault not simply the virus, however Justin’s personal physique. They enrolled him in a scientific trial to see if amniotic fluid would scale back irritation and promote therapeutic. They gave him an experimental drug known as remdesivir.

It nonetheless wasn’t sufficient.

A easy connection

Rayna and the children watched on a display screen as nurses gave them a digital tour of Justin’s small room. His mattress confronted the glass door so the group may watch him and the numbers on his machines. A whiteboard listed notes Rayna had despatched in regards to the form of particular person Justin was so they’d know who they have been treating. Within the mattress, his neck was so swollen it swallowed his sharp jawline.

The telephone calls had been changed when the hospital bought iPads to bridge the space since household couldn’t go to. The nurses hooked up an iPad to his bedside desk and infrequently left the connection open so Justin may hear the sounds of his dwelling life: meals and conversations and the children making an attempt to maintain up with schoolwork. Nurses typically performed his favourite music on Spotify.

On the Christensen home, the laptop computer would keep open on the kitchen desk. The household watched him sleep. They talked to him in spurts, telling him he was an excellent dad, an exquisite husband, a supply of pleasure, because the ventilator made puffy breath sounds within the background. Kyle reminded him he’d promised to show him to repair automobiles. Keyera instructed him a few man she was courting. Rayna stated “I like you” again and again.

They puzzled if their phrases have been their goodbyes.

Every morning, for a number of valuable moments as she woke, Rayna would neglect Justin was 45 minutes away, saved alive by machines. Then actuality would smash her and he or she’d ask God to like her household via no matter was coming. She prayed the docs would know learn how to save him and have the sources they wanted to do it. Then she’d gown shortly as a result of she’d been promised that regardless of the customer ban, if he bought worse and there was time, they’d let her — solely her — inform him goodbye.

She didn’t need to squander seconds preparing.

The children have been scuffling with their very own fears, however tried to make issues simpler for Rayna. Keyera would attempt to encourage her, whereas Kyle tried to be robust. Kaycia often teared up. It was Kanyon who voiced their mutual dread, typically begging Rayna to not inform him any extra. Different instances he’d ask, “Is dad ever coming dwelling?”

Justin gave the impression to be shrinking as Rayna watched. He spent their 19th anniversary in a sedation-induced sleep.

Household photograph

Politicizing ache

A stranger’s anger squeezed the air from Rayna’s chest. Her life had moved additional on-line as she linked with buddies, household and infrequently strangers on social media, because the pandemic shutdown and her husband’s situation carried on. However this message berated her for “spreading the COVID lie.” He requested if she was being paid. She didn’t know who he was or how he knew her husband was sick.

His wasn’t the one nasty message. A girl she’d thought of a buddy stated Rayna was killing her husband by leaving him within the hospital.

The combat for Justin’s survival had develop into fodder for political debate, as America grew aside on questions like whether or not to put on masks or how quickly to reopen sure companies or whether or not the illness was a hoax, one occasion’s conspiracy towards the opposite. A lot of it performed out on social media.

Rayna determined that folks hiding behind keyboards have been typically merciless — particularly anonymously. “Folks used to jot down of their journals — and had a match if somebody learn these non-public ideas. Now loads of it’s spewed on Fb and folks get mad when you don’t learn it,” she stated.

However she discovered kindness on-line, too.

A pair recognized with COVID after taking a cruise reached out to her after somebody shared Justin’s story. Pals and strangers supplied help and luxury. One lady assured her Justin may come off ECMO; her husband had.

That form of help and her personal religion held Rayna collectively. She requested docs to hope for themselves and for Justin earlier than any process. Many promised they’d. Members of the Christensens’ ward in The Church of Jesus Christ of Latter-day Saints supplied prayers and meals and extra. She later discovered {that a} household buddy who labored on the hospital gave Justin bedside blessings. “He confirmed up after we wanted that,” she stated, one other signal of God’s love.

Like Rip Van Winkle

To scale back the variety of tubes in his so-swollen neck, docs modified his ventilator, attaching it via a tracheostomy. Then they may begin decreasing the sedation that had saved him from pulling out the tubes. As he began coming round, Justin didn’t know the place he was; he’d gone to mattress in Tooele and awakened in a close-by city. Like Rip Van Winkle, he’d been asleep far longer than he thought. As Rayna watched, Justin held an erasable marker to a whiteboard and for the primary time in lots of weeks, he spoke his thoughts. “I like you, Rayna,” he wrote, the printing shaky. “How are the children?”

It was a shred of hope, shaky although it was.

Justin had had problems alongside the way in which, growing bacterial pneumonia, which isn’t unusual with ravaged lungs. He had already “been crushed to hell by COVID,” as Selzman noticed it, “then he bought a super-infection on high of it.”

Issues are one motive COVID-19 has been such a puzzle for clinicians, though they’re used to caring for actually sick folks, Selzman stated. “We’re at all times taking part in zone protection.” They deal with edema, irritation, bleeding, nausea, respiration bother — and tackled Justin’s care that manner. Nonetheless, “his lungs have been as unhealthy as they get,” Selzman stated.

ECMO had served as synthetic lungs; with out it he couldn’t breathe, however he remained on the ventilator, too. Docs couldn’t predict how a lot scarring COVID-19 had created or the long-term results.

Even so, Justin was fortunate. He by no means wanted dialysis. His liver saved plugging alongside. His coronary heart required drugs, however didn’t fail. He was younger and wholesome earlier than the coronavirus. He didn’t smoke or abuse alcohol or have underlying illness. And Utah had not been overrun with SARS-CoV-2 infections, so the tools shortages that plagued sizzling spots like New York — the place sufferers needed to share ventilators — didn’t materialize in Salt Lake Metropolis.

Somewhat than an overextended workers, Justin had attentive care from greater than two dozen nurses. Add in docs, bodily and different therapists, chaplains, housekeepers, respiratory care specialists, radiologists and lab techs, amongst others, and simply 100 staffers have been a part of Justin’s care, stated Dr. Nathan Hatton, the pulmonary/crucial care doctor who was Justin’s main physician on the U. He thinks all of them most likely thought Justin was going to die.

As an alternative, he improved, incrementally at first, shifting round within the mattress. He was terribly lonely. He felt confined. He couldn’t go away his room, even to stroll, for worry of spreading the virus, so his caregivers moved furnishings to provide him room to tempo.

In a nine-second video of 1 stroll, a nurse may be heard telling him to do the “Magnificence Queen Wave,” then “wipe a tear, wipe a tear and blow a kiss.” With spouse and kids watching, Justin complied, taking part in it up for his “topics.” He labored exhausting. Quickly, he didn’t want a walker. Days later, nonetheless hooked to the ventilator, he did squats, Stoddard stated.

On Could 3, docs took him off ECMO. On Could 9, docs put in a fair smaller tracheostomy to see how Justin would do, then eliminated the ventilator totally the subsequent day. The outlet in his neck would heal. Lastly, he may eat and drink.

Homecoming

Two days later, Rayna bought up early and dressed for a visit to the hospital with the children. She’s nonetheless recovering from her personal case of COVID-19, nonetheless fatigued. She’s been a stay-at-home mother and should discover a job and determine learn how to steadiness that with the care that Justin nonetheless wants. He gained’t be driving a truck for who is aware of how lengthy. The medical payments haven’t arrived but, however this was a miracle. Earlier than leaving their driveway, the children wrote “Thanks U of U for saving our Dad!” on the Escalade home windows.

Contained in the hospital, staffers have been penning messages of their very own. One wheeled Justin previous dozens extra who lined the hallways holding a poster and cheering him on. He emerged from the hospital like a traveler leaving the airport, however with the cannula in his nostril and an oxygen tank.

He’d misplaced 40 kilos.

At dwelling, Rayna wanders to the window to look at as Justin, nonetheless weak, goes outdoors, trailing 100 ft of oxygen hose behind him, stepping gingerly down 5 steps and onto the garden, the place he lies down to look at clouds float throughout a blue sky.

Ivy Ceballo, Deseret Information