Can't shake C19

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CoronaConcerned

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edit: You will note this is not a request for medical advice.

My wife (60yo) came down with CV, 8 days ago.*
Fever (100°F), upper resp signs, MS pain, headache, lethargy for a few days, RapidTest positive.
She is immunosuppressed (RA; methotrexate & Cimzia).

(I got it at the same time but was fine in 72hrs)
We are both fully vaccinated, from the beginning of the year.

Her fever has left but she still coughs a ton and feels like crap.
We figure it's due to the immunosuppressives (plus she is blood type A+ if that really makes a difference) that she is not recovering.

Her PO2 has never been below 92% (we live at higher elevation). She has mild asthma and the infection has not worsened that.

So we are thinking, besides rest/fluids/nutrition/vitD/ivermectin/asa, what else can be done.

Have heard of monoclonal antibodies or convalescent plasma, but don't know much about it.

The problem right now is gaining access to medical care!
'No Dr. has appointments available' and our mistake might have been to mention being C19 positive? - so now it is feeling like she is being blacklisted, or at least at the bottom of the list as no one wants to see a positive patient in a GP setting (before, getting appointments was no problem - they were hungry for the business). We'll keep at that, but any ideas on how to get help?
She does not feel like the ER is the place for this yet. There is no urgent care within 3 hours of here. There are other reasons to avoid our hospital too (for now), suffice it to say we consider it a last resort (I'd drive her to a city hospital before we went there).

The second question is, how available is the monoclonal ab or convalescent plasma?
Does anyone know at what point these are used, which patients are considered?
This would help direct trying, or not, to get in with a Dr.

*just noticed the Ronafide thread. Maybe 8 days is too early for any of this?
Hell, Texas Governor just got ab treatment and he is not even symptomatic!
Thanks
 
From what I see your name on here is CoronaConcerned and you’re a guest. Seems like this is a brand new account and I’m not sure why you’re asking medical information (not “advice”) on an aviation forum. Must admit, I’m feeling punked here.

Your questions are case specific and you should speak with a physician. Not sure where you are. I find it hard to believe a physician would deny her access because she has Covid (I’m a physician). If that’s true then an ER is a reasonable option. They can assess and then link her with a provider for continued care.
 
Llewtrah381 said:
From what I see your name on here is CoronaConcerned and you’re a guest. Seems like this is a brand new account and I’m not sure why you’re asking medical information (not “advice”) on an aviation forum. Must admit, I’m feeling punked here.
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Just FYI, a "guest" can be a regular poster who is not logged in. Some do this because they are revealing medical information they would rather not have associated with their normal username.
 
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My advice would be to go to the ER now. My brother just went through this and after the C19 was gone pneumonia set in as is quite common. Brother is home and doing fine but doc was glad he came in when he did.
 
Understand why you might want to post anon given the stigma and judgement and downright ugliness that exists in our country and on this forum right now. Sorry you're going through this, hope you and your spouse find the required care and she gets better soon.
 
Recommend that she goes through the doc the prescribes the immunosuppressants. Not at all a doc, but from what I've read, monoclonal antibodies *might* help keep things from getting worse.
 
Regeneron Is $1500 a dose and does help recovery , last I heard it still was EUA only , so that might limit access
 
I'm not a physician. I do work in biopharma.

I think convalescent plasma, which was used to the extent it was available early in the pandemic, has fallen out of favor and isn't seeing much use anymore. The Regeneron antibody cocktail works pretty well, but I can't comment on it's suitability in any specific case. Your wife will have to discuss that, and perhaps remdesivir, with a physician.

Wishing her the best!
 
Llewtrah381 said:
From what I see your name on here is CoronaConcerned and you’re a guest. Seems like this is a brand new account and I’m not sure why you’re asking medical information (not “advice”) on an aviation forum. Must admit, I’m feeling punked here.

Your questions are case specific and you should speak with a physician. Not sure where you are. I find it hard to believe a physician would deny her access because she has Covid (I’m a physician). If that’s true then an ER is a reasonable option. They can assess and then link her with a provider for continued care.
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My apologies for not being familiar with the PoA “guest” function.

Again, as a physician I think she needs to be seen soon - today - especially with her RA and meds. I agree with the idea of having her seen by whoever is treating her for that - or at least calling them and asking where she should be seen if for some reason they don’t want her coming to their office. Her care needs to be coordinated with that physician, one way or the other.

I hope she does well!
 
Llewtrah381 said:
My apologies for not being familiar with the PoA “guest” function.

Again, as a physician I think she needs to be seen soon - today - especially with her RA and meds. I agree with the idea of having her seen by whoever is treating her for that - or at least calling them and asking where she should be seen if for some reason they don’t want her coming to their office. Her care needs to be coordinated with that physician, one way or the other.

I hope she does well!
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Yes at least they should do a “Teledoc” video chat, I thought most doctors set up this feature since last year. If her fever is down but still coughing junk from the lungs it sounds like she is recovering however this is when secondary infection can set in. I’m not a doctor but maybe a prophylactic antibiotic is in order. But preferably be seen in person, I can’t believe her doctor won’t see her.

If it were me as last resort we have a stand alone ER here in town. Extremely convenient, like a doc in a box but with far better diagnostic equipment and treatment options. Also comes with the price of an ER but no waiting, few people use it for some reason. We got excellent care there, both Mark and I for unrelated reasons.
 
When I 'm flying and I need something and ATC doesn't give it to me, if I really need it I give myself a new transponder code that starts with a 7. Same thing here. Urgent care of emergency room, but get some medical help now. Let the medical guys figure out how to contain the infection, get her to the doctors right now. Persistent viral infections can lead to catastrophic outcomes. Good luck.

And if you really don't want medical advice don't come to a pilot board asking for it.
 
steingar said:
When I 'm flying and I need something and ATC doesn't give it to me, if I really need it I give myself a new transponder code that starts with a 7. Same thing here. Urgent care of emergency room, but get some medical help now. Let the medical guys figure out how to contain the infection, get her to the doctors right now. Persistent viral infections can lead to catastrophic outcomes. Good luck.

And if you really don't want medical advice don't come to a pilot board asking for it.
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He already tried to get medical advice from the doctor but was blown off. That would indicate the doctor doesn’t think it’s urgent but his gut says it is, so he has cognitive dissonance and comes here to run it by some people whose opinions he respects just for perspective to help him decide if he is over reacting or his gut is right. Nothing wrong with that, he got some good advice. Now he’s got some moral support to back him up to insist on getting his wife seen.
 
I have had two relatives (opposite sides of my family) that contracted covid that continued to digress. Both got worse and worse. Doctors did not seem to want to do much for them but send them home to deal with it. The first one was about 3 months ago. He was athletic, in great shape, in his 30's, and healthy. He lost 20 lbs. and was getting worse each day. He eventually got fed up with doctors and desperate enough to go down to his local TSC and get some horse wormer (1.87% ivermectin paste) and started taking it using the dosage formula for his weight. On about the third day he turned the corner and started to recover. He is pretty much back to normal now. I had another relative in his mid 50's who got it about a month ago. By the 13th day he had been to his family doctor, and two different hospitals. They always sent him home. He felt he was near death. He finally got in touch via telemedicine with a doctor in Fort Worth. That doctor prescribed ivermectin as well, although I think he got the stuff from a pharmacy intended for humans. He also started treating him for Pneumonia. He started getting better very slowly. By the end of about a week on this regimen he finally started feeling like he was going to make it. He told me that he felt if he would have waited just a day or two more to start this treatment, he would have died. In 2 weeks he had gone from weighing about 160 lbs to 135 lbs, and had zero desire to eat. I don't know what incentives are out there for treatment in this Covid world, but it seems that generally speaking, if it is a cheap treatment, it is not acceptable by the majority of Medical facilities, I guess because their hasn't been enough testing on those therapeutics. I asked my Veterinarian about the horse wormer and he said he thinks it is silly that ivermectin designed to kill parasites could knock out a virus. FWIW searches on the internet have explained that it doesn't kill the virus, but it does stop the proliferation of it, so your own immune system can begin to control and eliminate it. This kind of makes since why the 30 year old recovered much quicker, because he probably had a stronger immune system. Take every thing you hear with a grain of salt on both sides of this issue. To me, it seems that there may be therapeutics that have shown some success in treating this virus that are being blackballed for whatever reason.
 
I can't imagine ivermectin doing a damn thing to a virus, unless there is something big about the underlying biology that we just don't know, and that odds on that are a little long. What is more likely is the folks who took it were about to turn the corner anyway, and perhaps the psychological effects of agency helped. I suppose each could have had a sizable population of intestinal parasites that was slowing down viral clearance. They are @Piper18O's relatives, after all.:D
 
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Piper18O said:
I asked my Veterinarian about the horse wormer and he said he thinks it is silly that ivermectin designed to kill parasites could knock out a virus.
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Just look at the wide range of autoimmune diseases and how many of them have no approved and effective therapies. I've been on multiple chemotherapies from age 10 thu 24 and I've never been diagnosed with cancer...
 
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PLEASE be careful about using medicines “off label” without oversight by a qualified physician familiar with YOUR medical history and practicing in the right field for the medicine. Ivermectin may (but probably won’t) be proven effective but to do so “uncontrolled” is dangerous. I especially worry about doing so in someone with immune compromise (RA) and on meds for it. If it’s indicated for her, it should be prescribed by a specialist and doing so as part of a sanctioned trial, ideally.

And please remember to distinguish between “correlation” and “causation”. Using the logic above, one could conclude football causes cold weather!
 
Llewtrah381 said:
PLEASE be careful about using medicines “off label” without oversight by a qualified physician familiar with YOUR medical historyQUOTE]
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This is pretty sound advice. I will say that the older relative of mine that nearly died had to wait I believe a day or maybe two before he could start this regimen until the fort Worth doctor could get access to all his medical records. That last day before he started the treatment and then the following night was the time he felt like he almost died.
 
Everything we were told.....says that you are not contagious once the fever breaks. So, other than that, my advice is to keep moving and if possible don't sit around. Go on walks as much as you can. This will keep the blood flowing and the coughing and hacking will open up your lungs.

I'm a believer in vitamins.....C, D3, and B complex. Also an aspirin might help keep things flowing.
 
GaryM said:
I'm not a physician. I do work in biopharma.

I think convalescent plasma, which was used to the extent it was available early in the pandemic, has fallen out of favor and isn't seeing much use anymore. The Regeneron antibody cocktail works pretty well, but I can't comment on it's suitability in any specific case. Your wife will have to discuss that, and perhaps remdesivir, with a physician.

Wishing her the best!
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It’s also far, far too late in her progression for CP to have been of any benefit, if it provided any in the first place. (Some evidence said yes, some said no.) Either way, I dispensed enough of it last year to say this: no one is even asking for it this year, let alone infusing it. Best of luck!
 
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I had the regular flu a couple years ago and was sure I was about to die sometime during the second week. Then I turned the corner and recovered, so there is no way to tell if the ivermectin fixed those guys, they might have been about to turn the corner just when they felt the worst which seems typical and also the point you would finally seek help. On the other hand there is a lot of anecdotal evidence that it is effective and there are actual studies:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8248252/

But I don’t know what to believe on any of this; I am totally disgusted by how almost everyone on both sides seem to have lost their rational minds, yes, both sides.

I want to get at the actual truth whatever it is but it seems impossible. You cannot find objective balanced information anywhere. Everyone seems to be in one extreme camp or the other with a political bias or a financial agenda. I cannot believe this country has come to this over a disease that’s killing people.
 
Checkout_my_Six said:
Everything we were told.....says that you are not contagious once the fever breaks. So, other than that, my advice is to keep moving and if possible don't sit around. Go on walks as much as you can. This will keep the blood flowing and the coughing and hacking will open up your lungs.

I'm a believer in vitamins.....C, D3, and B complex. Also an aspirin might help keep things flowing.
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There is evidence pulse D3 helps. If I can believe the studies I saw….
 
Checkout_my_Six said:
I'm a believer in vitamins.....C, D3, and B complex. Also an aspirin might help keep things flowing.
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Our family doctor says the same plus zinc. When I had it last year I took vitamin c vitamin d 3 vitamin B zinc and one more that for the life of me I can't remember the name of it every 4 hours. Mine got knocked out and about 36 hours. One thing I think we have to remember is that this is a virus. There isn't much that we can do for the treatment of most viruses except if at all possible except strengthen our immune system and have it fight it off for us. That is my doctor's philosophy.
 
We have a few in our family who contracted COVID. My wife’s cousin and my sister took the “infusion” (not sure what the med was) and both started feeling better by the next day. My brother-in-law took Ivermectin as a preventative, and so far (12 days in) hasn’t contracted COVID. Just another data point.
 
Piper18O said:
Our family doctor says the same plus zinc. When I had it last year I took vitamin c vitamin d 3 vitamin B zinc and one more that for the life of me I can't remember the name of it every 4 hours. Mine got knocked out and about 36 hours. One thing I think we have to remember is that this is a virus. There isn't much that we can do for the treatment of most viruses except if at all possible except strengthen our immune system and have it fight it off for us. That is my doctor's philosophy.
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Smart doc! I’ve been a believer in the Zinc, D3 and B complex. Knock on wood, I haven’t been sick in quite awhile - hopefully I don’t jinx myself now.
 
Your doc should be able to arrange MAB quickly at a loca hosp or infusion center.
Your wife meets criteria. Key is to take it early- too later not really effective.
Have prescribed it probably 50 times. can really turn it around if timing is right
 
Piper18O said:
Our family doctor says the same plus zinc. When I had it last year I took vitamin c vitamin d 3 vitamin B zinc and one more that for the life of me I can't remember the name of it every 4 hours. Mine got knocked out and about 36 hours. One thing I think we have to remember is that this is a virus. There isn't much that we can do for the treatment of most viruses except if at all possible except strengthen our immune system and have it fight it off for us. That is my doctor's philosophy.
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Also, if you are obese, lose weight and if you smoke, quit! I know people with extremely high BMIs who smoke like chimneys; they complain the loudest about social distancing and others “trying to kill them” with covid.

More than anything else those two things would drastically reduce your risk. Other than your age but there’s nothing you can do to reverse that.
 
Rushie said:
But I don’t know what to believe on any of this; I am totally disgusted by how almost everyone on both sides seem to have lost their rational minds, yes, both sides.
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I’m not sure it’s “symmetrical” ;)
B9D62F7D-186A-4FBA-8AE2-EDE00019759C.jpeg
We should all be careful believing what we want to believe, especially off the internet from someone we’ve never actually physically met.
 
Another thing that seems to get lost is that covid 19 is a coronavirus. The common cold is also a coronavirus. What do you do when you get the cold? You can't just take a pill to knock it out, you have to let it run its course. In other words you have to let your immune system beat it. We do this by getting plenty of rest, eating and drinking the proper foods, all things that help our body fight it off. Sometimes I think common sense medicine or treatment of this virus is far too often ignored or forgotten about.
 
Llewtrah381 said:
I’m a Family Physician, so, yeah…;)
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You would be a good person to ask this question. How much influence do big pharmaceutical companies and their research have on doctors? My cousin is a retired physician, and near the end of his career, he started finally admitting that the influence that drug companies had on him was far greater than it should have been.
 
I think people get caught up in the side effect warnings with out really understanding what they mean. Maybe these warnings should have the official required disclaimers, then a dumbed down version that relates the possibility of getting a said side effect with some reality.
 
Checkout_my_Six said:
my nurse tells me all I need to know bout your kind....lol. :D
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So…”I guess we know which side YOU’RE on”!;)

One takes a history, examines, comes up with a differential diagnosis, determines the diagnosis, and implements treatment, including prescribing any medications needing a prescription. The other helps in that process, to varying degrees based on their education and experience. Both are very important people - with different roles and different frames of reference - and different levels of accountability, as indirectly indicated by their respective malpractice insurance rates.

To be absolutely clear, I mean no insult to nurses or any other medical professionals. As an FP I, too, know my limits and don’t, for example, believe I know more Infectious Disease than an ID specialist, even though my practice and training have given me a solid foundation in that.
 
Piper18O said:
You would be a good person to ask this question. How much influence do big pharmaceutical companies and their research have on doctors? My cousin is a retired physician, and near the end of his career, he started finally admitting that the influence that drug companies had on him was far greater than it should have been.
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You are absolutely correct and, early in my time, I found myself enamored with the trinkets, freebies, and meals. That was even as a military physician. I stopped engaging with them long ago, although it was admittedly easier to do so in the military and when in leadership roles. But you make a very valid point.

BTW: they also have influence on the rest of the staff, to varying degrees, including nurses.
 
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Llewtrah381 said:
You are absolutely correct and, early in my time, I found myself enamored with the trinkets, freebies, and meals. That was even as a military physician. I stopped engaging with them long ago, although it was admittedly easier to do so in the military and when in leadership roles. But you make a very valid point.
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How much ‘influence’ would you say makes it to the Doctor via the patient. “Doc, I heard about [drug] on a commercial on TV. I think I need that stuff.” Now Doc knows they don’t, tells patient. That’s the last they hear from that patient who goes and finds another Doc who gives them what they want and think they need. Doc #1 just lost a paying customer. So how many Docs would you guess say, well, it ain’t gonna kill them so I’ll just go ahead and prescribe it for them.
 
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