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April 13, 2020

'Our lives are not the same': What it's like to come off a ventilator after Covid-19

Daily Briefing

    After becoming critically ill with Covid-19, David Lat was admitted to the hospital and put on a ventilator for six days. In a Washington Post opinion piece, Lat explains that while he "would not be here today without a ventilator," the treatment comes with "lasting" physical and emotional effects.

    3 ways to bolster ventilator supply—when you can't access more traditional ventilators

    'A turn for the worse'

    Lat was admitted to the hospital for Covid-19, the disease caused by the new coronavirus, on March 16. "I had a number of flu-like symptoms," he writes, "including fever, chills, aches, and fatigue." But Lat, who had asthma as a child and has managed exercise-induced asthma as an adult, says the most serious of his symptoms "was difficulty breathing."

    During his first few days in the hospital, Lat was receiving supplemental oxygen and in stable condition. But on March 20, Lat "took a turn for the worse," he writes, and "[l]ate that night, [Lat] learned that [he] would need to be intubated, or placed on a ventilator."

    Lat writes that he was "terrified," especially because his father, who is a physician, just a few days prior had warned Lat about being placed on a ventilator. "People don't come back from that," Lat's father said.

    Lat, who has a husband and a two-year-old son, started to worry that he would die in the hospital. "I want[ed] to see [my son] graduate from high school, graduate from college," Lat writes. "I started praying the Hail Mary, over and over."

    The intubation period

    Lat writes that his memory of the six days he spent on the ventilator is "hazy."

    "I spent [those] six days basically asleep, under sedation, the ventilator serving as my lungs," he writes, noting, "I remember nothing from this period."

    Eventually, his doctors had to choose between giving him a tracheostomy or removing him from the ventilator and waiting to see if he could breathe on his own. After evaluating his condition, doctors decided to take Lat off the ventilator.

    Fortunately, "[t]he extubation succeeded," and "[w]ith the aid of supplemental oxygen, I could breathe independently again," Lat writes.

    The lingering side effects of intubation

    Lat writes that he felt lucky to be alive, given that about 40% to 50% of patients with severe respiratory distress who are placed on ventilators do not survive. And "[i]n New York City, where I was hospitalized, 80% or more of coronavirus patients who end up on ventilators have died," Lat writes.

    But Lat writes that even for patients who are lucky enough to survive, "[o]ur lives are not the same." For instance, Lat explains that many patients "suffer lasting physical, mental, and emotional issues" after being on ventilators, "including cognitive deficits, lost jobs, and psychological issues, such as depression and post-traumatic stress disorder."

    In Lat's case, the effects were mostly physical. "For me, my lungs must rebuild their capacity," he writes.

    Now, Lat feels winded from even mild exertion. "I used to run marathons; now I can't walk across a room or up a flight of stairs without getting winded. I can't go around the block for fresh air unless my husband pushes me in a wheelchair. When I shower, I can't stand the entire time; I take breaks from standing to sit down on a plastic stool I have placed inside my bathtub," he writes.

    The ventilator also damaged Lat's vocal cords, which has made his voice sound "extremely hoarse," he writes. A speech pathologist told Lat that the damage may not be permanent, but "[o]nly time will tell," Lat notes.

    Regardless, Lat writes that he's "incredibly grateful to be alive. And for that, [he has] the ventilator to thank." He adds, "We need to make sure that every patient who needs a ventilator can get one so that as many of them as possible can survive" (Lat, Washington Post, 4/9).

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