He began to vomit and had lost his appetite. His altered sense of taste made everything taste poorly. His fatigue became extreme and his cough worsened; his blood pressure began to fall. His high fevers came later.
My sister, Irene, and her family moved in with my father after my mother died suddenly in 2015. Since then, her husband and six kids have been an integral part of his life. She is also our office manager and understands a significant amount of medicine. She kept me and Mike informed about how our dad was doing that day. Not good.
I went to my staff hospital and got an IV kit and a liter of normal saline fluid on that Friday afternoon and started a very slow IV drip on my dad. Three days earlier, he started the combination medicine of Hydroxychloriquine and Azithromycin. I had ordered these medications for him on March 20th even prior to becoming ill. I was hearing a lot about that regimen and thought it would be a good idea to have it on hand if needed. He also started taking Zinc and Vitamin C.
My brother and I already were COVID-19 positive, so we were able to care for him without PPE. My sister wore a N95 mask. My wife and two of my kids had left to stay elsewhere on the first day I felt ill. My other two kids were quarantined and stayed far away from me in our house. As it turned out, my family remained that way for 30 days.
While my brother and I were recovering from our own fight against COVID-19, we had to concern ourselves more with my father who was going downhill fast. We all discussed the possibility of bringing him to the hospital. It was the first and last time we discussed it with my father. He made it very clear he was staying home. He said, “I’d rather die at home than go to the hospital.” What he said did not give me comfort because we needed him to be honest with us regarding his ongoing symptoms and his refusal to consider the hospital could cause him to downplay what he told us. At this point he was extremely fatigued, not eating and barely drinking fluids. He hardly spoke a word at a time
due to his fatigue and only opened his eyes if you
asked him. His cough was getting worse and his
Jeremiah Lowney, DO '94 with his father
lung sounds, on exam, revealed diffuse Rhonchi and Basilar crackles, indicating he had evidence of bilateral pneumonia and congestive heart failure, verified by future portable chest x-rays and a rising BNP.
At this point he needed more intensive care and we decided he would get it at home. We ordered home oxygen because he was becoming hypoxic by evidence of the O2 saturation finger monitor. We started him on nasal cannula oxygen and tried to keep his O2 sat between 90%-93%. Next, we began placing him in the prone position as long as he could tolerate. Over the course of the next two weeks we spoke with multiple doctors who confirmed and advised on our treatment decisions. My father also has five brothers who are osteopathic physicians, including a cardiologist and a gastroenterologist. We spoke with several different ICU doctors, who were our friends, and one who was my cousin, Dr. Rich
Leverault, another osteopath. We had started CPAP early on in his illness. Hospitals were avoiding