A 67-year-old with concurrent health conditions like myself is not expected to recover easily from COVID-19.
Having treated scores of COVID-19 patients, I now find it strange that I missed the early symptoms when I felt them. My oversight pushed me into a quick trip to COVID hell; it was by God’s grace that I was pulled back from the precipice.
I experienced severe throat itchiness late Monday night (Jan. 11) as I was preparing for bed. I assumed it was my allergic rhinitis acting up, and merely gargled with an oral antiseptic and took a tablet of over-the-counter Benadryl.
Little did I know that my nonchalance would allow the virus to gain a foothold in my body. The rapidly progressive symptoms that appeared the next day—fever, chills, muscle and joint pains, profound weakness, nausea and loss of appetite—were unmistakable: the virus had caught up with me.
My wife, Becky, and Angel, our baby in the house who sleeps with us, had to immediately move to the guest room. More than anything else, I was worried that I might have infected them.
I promptly started the regimen I have been advocating for COVID-19. But for the next four hours, the symptoms became worse. I felt too weak even to reach for the glass of water that was less than a foot away from my side of the bed.
My mind was very active but I had no energy whatsoever. “You can do it, Raffy!” I told myself in an attempt at pep talk, but my muscles seemed to be in a total flaccid state.
At one point our cook asked me through the bedroom door what I wanted to eat. She said she had cooked my favorite “bulalo” (boiled beef highlighted by bone marrow), but I said that just the thought of food made me feel like vomiting. She reminded me that it had been 21 hours since I last ate.
I didn’t answer her. I cried and asked God how I’d get well if I couldn’t even eat.
In the darkness of my bedroom I felt I was in a jungle, and the aches, chills and other symptoms seemed to transform into a cacophony of discordant sounds rising and falling.
It was during moments of decrescendo that I’d doze off. At times I’d be awakened by some pain or spasm, and I’d contort myself to find a position of relief.
Probably due to the high fever, and as a side effect of the high-dose melatonin I was taking, I seemed to be in a constant dream state, as though I were slipping in and out of “The Matrix” film. Much of my dreams I cannot now remember; I just knew I dreamed something.
But some details come back to me as vividly as when I was dreaming them, such as when I found myself in a big place as dark as Space Mountain. Instead of riding in a roller-coaster, I was sliding down a huge, labyrinthine slide and trying to slow my fall by grasping at its sides. I was yelling to God that I couldn’t hold on any longer: “Lord, hindi ko na kayang humawak!”
Came the telepathic reply: “Just let go, and let Me!”
I must have slept fitfully for more than two hours, and it was dark outside when I woke up. I was perspiring profusely, probably from the two soft gels of ibuprofen that I took a few hours earlier.
I went to change my undershirt, and I realized that I now had the energy to get up. I was also feeling hungry. So I texted our cook to ask if she had some bulalo left.
I didn’t eat much, but I was able to finish a small portion of what she served me without throwing up.
The fever was gone and never recurred. The other symptoms were still present, but much more tolerable. I slept well that night and felt even better the next day.
I informed our medical director at Manila Doctors’ Hospital (MDH) and my colleagues at the Professional Regulatory Board of Medicine (PRBOM), with whom I met a few days earlier, that I had experienced possible COVID-19 symptoms that were promptly relieved.
My wife, Becky, told me it couldn’t have been COVID-19 because it’s most unusual for the fever to be gone completely in six hours. “It was just an ordinary flu,” she said. I nodded in agreement.
But as I ate dinner that night in our lanai, and she was safely 5 meters away behind the glass panel, I explained to her that the symptoms were different from any of the bouts of flu that I had experienced in the past.
We decided that I should get tested.
I went to MDH the following day, two days after I experienced the severe symptoms. By that time I was already symptom-free.
The throat and nasopharyngeal swab yielded a positive result.
The blood test suggested that my immune system had taken a big hit—hence the significantly low level of my white blood cells (WBCs). I imagined the thousands of my WBCs that died vanquishing the virus.
There was also residual inflammation in my body, as evidenced by increased serum ferritin.
Talking with God
Noted pulmonologist Dr. Milo Roa and Makati Medical Center director Dr. Bong Javier, warned that I should watch out for a second cytokine storm, or an overreaction of the body’s immune system. I was already asymptomatic, but there could be another cytokine release by the second week, they said.
I’m now on Day 10 as I write this, and by all indications, God has healed me completely, and with a miraculous rate of recovery.
Also to my relief, my wife and the rest of our household have tested negative for COVID-19.
During my illness, I realized that we can actually talk with God, and get answers. Not that I saw His image or any bright light, nor did I hear His voice. Nothing of that sort.
It was like receiving a telepathic reply to my question. Sometimes it came immediately, sometimes not. But once I received it, I just knew it was God’s message. Could it have been just an effect of my delirious state when I had high fever? Possibly, but the fever was completely gone in six hours. And I still got answers to my questions afterward.
Friends and family now ask me if I’ll resume work after what I’ve been through. But it’s a risk I signed up for as a practicing physician.
Three days before I came down with symptoms, Dr. Lumi Ramos, our top cardiovascular surgeon at MDH, told me while we were waiting for the elevator that I’m the only senior consultant still making rounds. I said, “For so long as there are patients we need to see, we can’t abdicate our responsibility.”
I have other responsibilities, too. On top of hospital work, I have administrative, quasi-judicial and quasi-legislative duties as a member of the PRBOM. The days before I developed symptoms were particularly hectic, with an administrative hearing to preside over and an en banc face-to-face meeting with the board members.
The PRBOM is also busy preparing for the March physician licensure exams, and with more than 1,000 questions needed from each board member, my average sleeping time had been 3 a.m. (It might have contributed to the weakening of my resistance.)
We have been happy with our modest contribution as the only regulatory board that administered face-to-face exams in 2020 to more than 6,500 medical examinees, to answer the need for more doctors to help fight COVID-19. But, with all of us in the PRBOM suitable for profiling as high-risk elderly individuals, we may have pushed our luck too far and compromised our own personal safety.
I think we can still maintain reasonable safeguards and play heroics without ending up as martyrs.
Many have asked about my treatment regimen. For nondoctors, COVID-19 is no infection to self-medicate on. You need to consult a specialist immediately. Every minute counts as you don’t want to give the virus time to strengthen its hold on your body.
But I also call on my specialist-colleagues: this may be an opportune time to review and determine up to what extent we can allow the body to heal itself without the use of potent medicines and aggressive interventions.
My complete regimen consisted of high-dose melatonin, Vitamins C and D, zinc, coenzyme Q10, Aspilet and one dose of ibuprofen for the fever.
The fever broke in six hours, with around 30-percent relief in severe symptoms, and progressive improvement until I was symptom-free in 48 hours.
A key factor to success in treatment is to start even without the result of the COVID swab test. Much delay is caused while waiting for the result, and that allows the infection to become more severe.
For elderly and high-risk patients, it’s better to initiate treatment early with natural immune-system boosters than wait for the results two or three days later. Like they say, it’s better to err on the side of caution than on the side of tragic error.
(Dr. Rafael R. Castillo writes a weekly column for Inquirer Lifestyle’s Wellness page. –Ed)