What I Learned During 10 Days Of Treating Covid Pneumonia
I have been practicing emergency medicine for 30 years. In 1994, I invented an imaging system for teaching intubation, the procedure of inserting breathing tubes. This led me to perform research into this procedure, and subsequently teach airway procedure courses to physicians worldwide for the last two decades.
So at the end of March, as a crush of COVID-19 patients began overwhelming hospitals in New York City, I volunteered to spend 10 days at Bellevue, helping at the hospital where I trained. Over those days, I realized that we are not detecting the deadly pneumonia the virus causes early enough and that we could be doing more to keep patients off ventilators and alive.
On the long drive to New York from my home in New Hampshire, I called my friend Nick Caputo, an emergency physician in the Bronx, who was already in the thick of it. I wanted to know what I was facing, how to stay safe and about his insights into airway management with this disease. Rich, he said, its like nothing Ive ever seen before.
He was right. Pneumonia caused by the coronavirus has had a stunning impact on the citys hospital system. Normally an ER has a mix of patients with conditions ranging from the serious, such as heart attacks, strokes and traumatic injuries, to the non-life-threatening, such as minor lacerations, intoxication, orthopedic injuries and migraine headaches.
Its time to get ahead of this virus instead of chasing it.
What Are The Stages Of Pneumonia
Pneumonia can be classified or characterized in different ways. Health care professionals often refer to pneumonia based upon the way that the infection is acquired, such as community-acquired pneumonia or hospital-acquired pneumonia.
- Community-acquired pneumonia , as the name implies, is a respiratory infection of the lung that develops outside of the hospital or health care environment. It is more common than hospital-acquired pneumonia. CAP is most common in winter and affects about 4 million people a year in the U.S.
- Hospital-acquired pneumonia is acquired when an individual is already hospitalized for another condition. HAP is generally more serious because it develops in ill patients already hospitalized or under medical care for another condition. Being on a ventilator for respiratory support increases the risk of acquiring HAP. Health care-associated pneumonia is acquired from other health care settings, like kidney dialysis centers, outpatient clinics, or nursing homes.
Other classification systems for pneumonia describe the way the inflammatory cells infiltrate the lung tissue or the appearance of the affected tissue .
How Is Pneumonia Diagnosed
A doctor can often diagnose pneumonia based on the symptoms and by examining your chest. But you may need to have a chest X-ray to confirm that you have it.
Sometimes it can be difficult to tell whether you have pneumonia or another kind of chest infection. If its not clear, your GP may do a blood test or take a sputum sample to help decide if you need antibiotics.
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Why Does It Take So Long To Recover From Pneumonia
You can’t see the damage pneumonia causes, but you certainly feel it.
The air sacs in your lungs become inflamed during pneumonia, leading to soreness and pain. If the infection and inflammation progress, your lungs may fill with fluid and dead lung tissue, leading to the green, yellow or even bloody mucus you cough up. This fluid may also affect how well oxygen is able to transfer into your bloodstream, leading to difficulty breathing.
“Once the infection is cleared with treatment, your body still has to deal with removing all of the fluid, damage and debris left behind in your lungs. This can take a few weeks, resulting in a lingering cough and reduced lung capacity,” explains Dr. Lee. “During this time, you may find physical exertion more tiring than usual.”
A more severe case of pneumonia can cause even more damage to your lungs, which can be significant and even permanent in some cases.
“After severe pneumonia, lung capacity is reduced and muscles may be weak from being so ill. Significant weight loss can further contribute to weakness and other health conditions may be aggravated due to the stress placed on the body during illness. These are all things your body will need time to recover from,” says Dr. Lee.
In fact, it may take another several months for you to fully heal and regain strength.
When Do The Symptoms And Signs Of Pneumonia Start
The incubation period for pneumonia depends on the type of organism causing the disease, as well as characteristics of the patient, such as his or her age and overall health status. Most cases of pneumonia begin with symptoms similar to those of a cold or the flu that last longer than the flu and become more severe. The symptoms of pneumonia can occur from a few days to a week following the flu-like symptoms.
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What Causes Pneumonia
Pneumonia can be caused by a wide variety of bacteria, viruses or fungi. Pneumonia is most commonly classified by the type of germ that causes it and by the location where the person became infected.
Community-acquired pneumonia is the most common type of pneumonia. This type of pneumonia occurs outside of a hospital or other healthcare facility. Causes include:
- Bacteria:Streptococcus pneumoniae is the most common bacterial cause of pneumonia.
- Mycoplasma pneumoniae and other atypical bacteria: Other types of bacteria with unique features can cause different types of pneumonia. These include Mycoplasma pneumoniae , Chlamydia pneumoniae and Legionella pneumoniae .
- Viruses: Any virus that causes a respiratory tract infection can cause pneumonia. The viruses that cause colds and flu can cause pneumonia.
- Fungi : Pneumonia caused by fungi is the least common as pneumonia. Fungus in the soil in certain parts of the United States can become airborne and cause pneumonia. One example is valley fever.
Long-term care facility-acquired pneumonia occurs in long-term care facilities or outpatient, extended-stay clinics. Like hospitalized patients, drug-resistant bacteria are found in this setting.
Drink A Cup Of Coffee
Drinking a cup of coffee may also help relieve shortness of breath. Caffeine may help widen the airways, and a 2021 review even suggested that consuming it could help soothe some COVID-19 symptoms and work against SARS-CoV-2.
Caffeines half-life is 3-5 hours, meaning that your body gets rid of half the caffeine content in this time. If caffeine helps to widen your airways, this is the amount of time its likely to have its most noticeable effects.
Chest pain may come on suddenly or over the course of several days. You should expect some chest pain or ache if you get pneumonia. With treatment, any chest pain typically subsides within 4 weeks.
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What Is Covid Pneumonia
Dr. Lee: Pneumonia occurs when a bacterial or viral infection causes significant damage and inflammation in the lungs. The resulting fluid and debris build-up makes it hard for a person to breathe sometimes to such an extent that oxygen therapy or ventilator support is required. Regardless of the bacteria or virus causing it, pneumonia can become very serious, even life-threatening.
In the case of COVID pneumonia, the damage to the lungs is caused by the coronavirus that causes COVID-19.
When COVID pneumonia develops, it causes additional symptoms, such as:
- Shortness of breath
- Increased heart rate
- Low blood pressure
What’s more is that COVID pneumonia often occurs in both lungs, rather than just one lung or the other. Additionally, the widespread inflammation that occurs in some people with COVID-19 can lead to acute respiratory distress syndrome a severe type of lung failure.
Like other respiratory infections that cause pneumonia, COVID-19 can cause short-term lung damage. In more severe cases, the damage can last a long time. In fact, early data is showing that up to a third of COVID pneumonia patients have evidence of scarring on X-rays or lung testing a year after the infection.
How Is Pneumonia Treated
When you get a pneumonia diagnosis, your doctor will work with you to develop a treatment plan. Treatment for pneumonia depends on the type of pneumonia you have, how sick you are feeling, your age, and whether you have other health conditions. The goals of treatment are to cure the infection and prevent complications. It is important to follow your treatment plan carefully until you are fully recovered.
Take any medications as prescribed by your doctor. If your pneumonia is caused by bacteria, you will be given an antibiotic. It is important to take all the antibiotic until it is gone, even though you will probably start to feel better in a couple of days. If you stop, you risk having the infection come back, and you increase the chances that the germs will be resistant to treatment in the future.
Typical antibiotics do not work against viruses. If you have viral pneumonia, your doctor may prescribe an antiviral medication to treat it. Sometimes, though, symptom management and rest are all that is needed.
Most people can manage their symptoms such as fever and cough at home by following these steps:
If your pneumonia is so severe that you are treated in the hospital, you may be given intravenous fluids and antibiotics, as well as oxygen therapy, and possibly other breathing treatments.
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Ask About Cough Medicine
You may be tempted to guzzle cough syrup. But keep in mind that coughing is your bodyâs way of trying to clear the mucus out of your lungs, and you need that to happen. So ask your doctor if you should take any cough medicine. If the hacking keeps you from getting enough rest, you may be able to take the smallest dose that lets you fall sleep. Or try a warm mixture of honey and lemon instead.
When Would I Need To Be Hospitalized For Pneumonia
If your case of pneumonia is more severe, you may need tostay in the hospital for treatment. Hospital treatments may include:
- Fluids, antibiotics and other medicines given through an IV
- Breathing treatments and exercises to help loosen mucus
People most likely to be hospitalized are those who are most frail and/or at increased risk, including:
- Babies and young children
- People with weakened immune systems
- People with health conditions that affect the heart and lungs
It may take six to eight weeks to return to a normal level of functioning and well-being if youve been hospitalized with pneumonia.
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How You Catch Pneumonia
While anyone can catch pneumonia, some people are more likely to come down with illness when coming into contact with the germs. Like many other illnesses, pneumonia is caught through contact with the bacteria or virus that creates pneumonia.
Coughing and sneezing are the most common ways these germs spread.
Its also possible to catch the illness by touching something like a counter or door handle, sharing cups and utensils, and touching your face without washing your hands first.
How To Treat Pneumonia In Covid Know What The Doctor Has To Say
Covid-19 pneumonia treatment requires proper medical attention. Here are some doctor tips to treat it. Read on.
Pneumonia can develop in the lungs when a bacteria or virus causes infection resulting in major damage and inflammation. The fluid and debris build-up on the lungs can make it difficult for an individual to breathe. In fact, oxygen therapy and ventilator support is required if the condition gets worse. No matter which bacteria or virus caused it, pneumonia can make the patient’s condition very critical, even life-threatening. When we talk about COVID pneumonia, the damage to the lungs is caused by the Coronavirus, i.e the virus responsible for COVID-19 disease.
Novel Coronavirus can have an impact on any organ of our body, but the most damage occurs on the respiratory system. Pneumonia associated with the novel coronavirus was earlier named as novel coronavirus-infected pneumonia . However, it was later changed by the WHO to COVID pneumonia. Onlymyhealth editorial team talked to Dr. Ankit Singhal, Pulmonologist, Sri Balaji Action Medical Institute, New Delhi, about the treatment of Covid pneumonia.
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How Is Walking Pneumonia Different From Regular Pneumonia
Walking pneumonia differs from typical pneumonia in several ways, including:
- Walking pneumonia is a milder form of pneumonia.
- Walking pneumonia usually does not require bed rest or hospitalization.
- Walking pneumonia is usually caused by Mycoplasma pneumoniae. Typical pneumonia is most commonly caused by _Streptococcus _pneumonia or influenza virus or rhinovirus.
Apply A Lukewarm Compress Or Take A Lukewarm Bath
Submerging your body in a lukewarm bath might help you bring down your body temperature.
You can also use a lukewarm compress to help cool your body from the outside inward if a bath is not convenient. Although it may be tempting to use a cold compress, the sudden temperature shift can cause chills. A lukewarm compress provides a more gradual, comfortable temperature change.
Chills may come on before or during a fever. They typically subside after your fever breaks. This may last up to a week, depending on when you begin treatment for pneumonia.
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Questions To Ask Your Doctor
- I have a chronic condition. Am I at higher risk for pneumonia?
- Do I have bacterial, viral, or fungal pneumonia? Whats the best treatment?
- Am I contagious?
- How serious is my pneumonia? Will I need to be hospitalized?
- What can I do at home to help relieve my symptoms?
- What are the possible complications of pneumonia? How will I know if Im developing complications?
- What should I do if my symptoms dont respond to treatment or get worse?
- Do we need to schedule a follow-up exam?
- Do I need any vaccines?
Cover Your Mouth And Nose
While the preferred method for covering your mouth when you cough or sneeze is into a tissue, not everyone can get to tissues in time when the urge to cough or sneeze hits. If you have the urge to cough or sneezeand a tissue isnt availablethe next best thing is to cover your mouth or nose with the inside of your elbow.
Coughing or sneezing into your elbow will decrease the chances of your leaving traces of your infection on door handles, faucets, or anything else you touch.
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How Do The Lungs Work
Your lungs main job is to get oxygen into your blood and remove carbon dioxide. This happens during breathing. You breathe 12 to 20 times per minute when you are not sick. When you breathe in, air travels down the back of your throat and passes through your voice box and into your windpipe . Your trachea splits into two air passages . One bronchial tube leads to the left lung, the other to the right lung. For the lungs to perform their best, the airways need to be open as you breathe in and out. Swelling and mucus can make it harder to move air through the airways, making it harder to breathe. This leads to shortness of breath, difficulty breathing and feeling more tired than normal.
Is There A Vaccine For Pneumonia
There isnt a vaccine for all types of pneumonia, but 2 vaccines are available. These help prevent pneumonia caused by pneumococcal bacteria. The first is recommended for all children younger than 5 years of age. The second is recommended for anyone age 2 or older who is at increased risk for pneumonia. Getting the pneumonia vaccine is especially important if you:
- Are 65 years of age or older.
- Have certain chronic conditions, such as asthma, lung disease, diabetes, heart disease, sickle cell disease, or cirrhosis.
- Have a weakened immune system because of HIV/AIDS, kidney failure, a damaged or removed spleen, a recent organ transplant, or receiving chemotherapy.
- Have cochlear implants .
The pneumococcal vaccines cant prevent all cases of pneumonia. But they can make it less likely that people who are at risk will experience the severe, and possibly life-threatening, complications of pneumonia.
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Ginger Or Turmeric Tea
A persistent cough can result in chest pain. Drinking warm tea made with fresh ginger or turmeric root may help reduce this pain.
The roots of both of these plants can have a natural anti-inflammatory effect in the body.
Chop up a thumb sized piece of either root and boil it in a pint or so of water. If a person prefers strong tea, they can boil it for longer or add more of the root. If the flavor is too sharp, they can try adding a spoonful of honey.
Complications Caused By Pneumonia
Pneumonia can sometimes have complications. They include:
- pleurisy where the pleura, the thin linings between your lungs and ribcage, become inflamed, leading to chest pain. If you have pleurisy, you are more likely to develop fluid on the lungs.
- fluid on the lungs – about 1 in 10 people with pneumonia develop fluid around the lung, called a pleural effusion which can become infected. This may require a sample of the fluid to be taken by inserting a needle between the ribs under local anaesthetic, and if infected is likely to need a longer course of antibiotics. Occasionally, a tube is inserted into the lung to remove fluid as well.
- a lung abscess a rare complication thats mostly seen in people with a serious pre-existing illness or history of alcohol misuse.
- blood poisoning, also called septicaemia – this is where infection spreads from the lungs to the blood stream. This can cause low blood pressure and a severe illness that might need intensive care treatment.
- respiratory failure this is where pneumonia causes low levels of oxygen in the blood even in people given oxygen. This might also require intensive care treatment.
The vast majority of people recover from pneumonia and return to good health. However, pneumonia can be very serious and some people with severe pneumonia dont survive, despite the best available care. Those who are elderly or have other health problems are most at risk of severe or fatal pneumonia.
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