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The truth about being on a ventilator

Live and Learn | October 21st, 2020

By Ashlee Nordquist

hpr@hpr1.com

I've come to the conclusion that not everyone understands why my brother and I went on ventilators for covid and what that means. As I survived and my brother SO FAR is improving, I can make jokes and talk very straightforwardly about the condition without becoming a wreck. So here's some education.

1) You don't get to pick to be on a ventilator. We didn't pay extra to sleep through our symptoms.

2) Jacob and I both developed ARDS (acute respiratory distress syndrome). One of the requirements to meet ARDS is organ failure. Our organs failing were our lungs. It's not that it was just "hard to breathe." Our lungs were unable to process enough oxygen to keep us alive. Jacob was coughing up "shot glasses" of pinkish water. My lungs were holding the water within their linings so I had no cough and was just endlessly exhausted from low oxygen absorption. That's when a ventilator comes into play.

3) We got ARDS because we had strong immune systems. Our immune systems reacted to the virus so strongly that it decided to also attack the infected tissues in our lungs. That is what is called a cytokine storm.

4) Before going to a ventilator, you go through a variety of oxygen supplements. We had nasal cannulas, higher-powered cannulas, and then the BiPAP. A BiPAP is a dual-level CPAP that you have to wear all the time. It was my least favorite part of the hospital experience. The BiPAP is the last step before the ventilator. They use a BiPAP instead of a CPAP because the lungs are too damaged to handle a constant airflow level.

5) The ventilator is dangerous. There's still about a 50/50 chance of dying while having covid on a ventilator. I had a 12% chance of living as US doctors were still very new to the disease. Forcing air into the lungs at an unnatural rate and pressure is a bad time. If your oxygen is too low for too long, your other organs start failing. All the medications required to stabilize a person and keep them under are very hard on a body and sepsis or complications are common. But if you aren't on the ventilator, you die for sure.

6) The after-effects of the ventilator are ugly. The longer you are on, the uglier it is. Short term memory loss, inability to focus, muscle atrophy, shortness of breath, vocal cord damage, and a high risk of aspirating food and stomach acid are standard expectations that can last up to a year. That's why you have so much therapy after going off a ventilator.

7) Going into a coma while ventilated is also pretty standard. There are different levels of coma where you may still be able to take direction or react to stimulus so for part or all of that journey you are also paralyzed as higher ventilator pressures are extremely uncomfortable and most patients will rip out their own ventilator tubing due to the physical distress they experience while in the coma. Jacob has been paralyzed the entire time. I was for only a week of mine as keeping me slightly alert worked for giving me directions for rolling over/washing me but as I kept trying to sit up while unconscious, my arms had to be strapped down to the hospital bedsides instead.

8) The doctors don't understand why we are getting hit by Covid so hard. Jacob and I, despite our weight, are otherwise healthy, younger adults. Our blood work comes out solid. We have no asthma or a history of lung problems. We're both obese, but most people our size still aren't getting it as badly as we do.

9) Every time you say "you just gotta go out and live your life." Or "I'm going out even if I'm exposed because I'm healthy," you are telling us that you are aware that you are potentially killing people, but because it didn't kill you, you don't give a damn; and that people can be permanently damaged or dead at your hands because their lives matter less than your convenience. And that's monstrous. That's not a joke.

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