My Covid time

Going past these doors, in a wheelchair for that matter, are proof that your Covid time has come.

Sunday March 22. Some minutes past 11 in the morning.

I step into the shower, shed the blue and green pyjamas and get the water going. It’s one of the things I’m happy about, the shower. The fact that it has water and the ability to heat that water means I can stand under it, feel its warmth, the soap can lather and I can feel clean after.

When I was admitted and they threw a basin and a towel under my bed, that came with the suggestion that there would be a shortage of piped water and I dreaded the idea that I would have to use that to wash myself. That I would have to take a bath, which, after being so used to showering, doesn’t make me feel clean.

This Sunday, instead of the good feeling I feel after stepping under the warm water, my chest starts to heave and I start to cough. Continuously and violently, my throat feeling like it’s the barrel of a gun receiving the shock of the hammer from deep within. It’s a wracking cough and I endure it as I shorten my shower, dry myself and get back in the ugly faded pyjamas. I feel a need to rush under the warm duvet of my uncomfortable bed and the moment I pull the cover up to my neck, commence to shake like a rag doll. My teeth chatter so hard I think I’ll bite my tongue if I don’t place it right in the mouth, my hands and feet feel very cold and of course I cough like my life depends on coughing. That felt like it lasted an hour or more.

Later, when my wife and my brother came to visit, I felt no need to pretend I was feeling better, to raise their hopes. I deliberately failed to wear my specs, which meant I could only look at them through eyes half-shut. I got up briefly to demonstrate that my lungs were doing well by blowing and breathing through the spirometer, felt good showing off my lung capacity was good, but collapsed into a fit of violent coughing.

That Sunday was the second full day of my hospital stay at Meridian Equator Hospital in Nairobi Hospital.

I had arrived at the hospital in the early afternoon on Friday March 19, parking at what looked like an illegal spot and going into the reception, where I showed my referral letter from the Meridian Branch at Nation Centre.

I think the operating principle of most hospitals is that if you are breathing and walking, you can wait, as that’s all I did that afternoon. First, I waited for the receptionist to get to my case and when she eventually did, for the nurse to decide whether I was going to be admitted. A nurse called Makena first came and told me, “We don’t have beds” and walked away before I could say a word and tell her how bad I was feeling. I had been filling the admission forms and just placed them on the empty seat next to me, shut my eyes and leant back. A few minutes later, Makena was back. She asked me to finish filling the forms and go to triage and then remarked as she was leaving, “Tunakuchukua.”

But let me not subject you to any more waiting and start this story at the beginning, Before Covid.

The week of March 8 had been busy, as usual, and I had skipped gym that entire week because of an ingrown toenail that I had hoped would be removed that Monday. But the doctor had other ideas and gave me medicine and advised that I get broader shoes and see him in a week.

That Thursday, I attended Sir Elvis show at Treasure Gardens with a bunch of colleagues and had a really good time. It was my first time attending Sir Elvis and although I’m not a big fan of country music, really enjoyed the performance. You can tell from the way he croons those songs that Elvis has dedicated a lot of time to honing his craft. There is also some happy cognitive dissonance in seeing a black man sound like a white country music singer. I had to leave before my colleagues as my wife was just getting back to Nairobi and we needed to go home together. The following Friday went well enough as we had the usual Friday ‘government lunch’ with colleagues – some very good choma at Sagret – did what needed to be done and then gathered at the bar as usual.

That good week would end quite badly as I woke up on Saturday feeling like the Devil had entered my body and penetrated deep inside my bones, as every part of my body was on fire and aching. I took painkillers and spent that day mostly in bed.
The following day, a Sunday, I headed to the Aga Khan University Hospital branch at Roysambu.

That’s where I realised something was off. Despite the fact that I was feeling crappy, the worst I had felt in perhaps a decade, the bloodwork showed nothing. I literally had to cajole the doctor into prescribing medicine: “I have a headache and joint pain so you need to give me something for that. I have a cough so I will also need some relief for that.” I left with a bag of drugs, feeling like I had just gone through quite the bizarre incident and told a friend as much when we bumped into each other at the Java at TRM.

Nothing had changed by Tuesday so I made a few calls and was eventually linked to a person at KEMRI who I was told could facilitate a speedy test for Covid-19. We agreed to meet in the early afternoon at KEMRI on Wednesday and so I headed out for my second bizarre experience of the week. A number of colleagues, most of whom sit close to me in the office, some of whom had attended Sir Elvis’ show and most of whom we had hung out at the bar, were reporting similar symptoms. Something at the back of my mind told me my Covid time had arrived.

After a 30-minute wait in a parking lot at KEMRI, the man led me through a building, up a flight of stairs and into a lab. As he prepared to take my sample, I looked around the lab. The most memorable things I saw were were four large beakers of dirty water, each on a device that resembled a hot plate, and they were magically stirring themselves.

I recognised a fume cupboard and a pile of cooler boxes, the sort polio vaccinators walk around with, and metal cupboards that appeared to be spilling over with medical stuff. “Did you see someone leave the room when we were walking in?” the man asked me. I hadn’t seen anybody. When I asked what was going on with the self-stirring beakers, he told me they were searching for polio. The existence of the polio virus in a community is best detected by searching for it in sewage. The constant discovery of polio in the sewage, especially in Eastleigh, is the reason any child aged seven and below in Nairobi has had at least two polio vaccines since they were born.

The man then took a swab from my nose and mouth, put them in containers, took my details down on his phone and brusquely asked whether I could retrace my steps to the car. When I asked about payment, he brushed me aside, saying I would pay when the results came in the following day.

They did not come that Thursday.

By the morning of Friday, March 19, I could tell there had been a deterioration in my body. My appetite had gone, there was a certain fiery pain in my chest, and the fatigue had increased. The fever, headache and joint pains had become part of me but the deterioration added to my feeling that things were going quite badly.

I needed to see a doctor fast.
A call to another colleague who had been tested had me headed for the Meridian at Nation Centre.
The KEMRI man had not sent my results but all the colleagues who had reported feeling sick were positive for Covid, so that was a foregone conclusion. KEMRI man had told me on phone that my test failed and would have to be done again.

When I walked up the three flights of stairs after parking at Lifestyle, my body announced quite loudly that I was doing badly. The fire in my chest was intense, I was short of breath and coughing crazily.

Meridian were doing the quick test and when the results came in, including the blood work, the doctor, a short, broad man in a blue jersey, leaned back in his seat and said, “Sasa wewe…” I had, he declared, two types of pneumonia in my body – one caused by bacteria and another caused by Covid-19. I was glad I had come to the hospital. I needed an overnight stay at a hospital for the administration of heavy-duty antibiotics directly into the bloodstream. He filled out the referral forms that would give me access to Meridian Equator Hospital, printed a copy of my results and sent me on my way.

 
The walk back to Lifestyle gave me further proof of the extent of my illness. I huffed, puffed, coughed and felt really weak as I walked. The coughing was accompanied by fire in the throat. As I walked opposite Jevanjee, a girl who was in front of me scampered away fast when I coughed. I was also hungry, and therefore weak, and a sugarcane juice stand just inside the building was my saviour. I grabbed a large container of the sweet stuff and went downstairs to pick the car.

I was wheeled to the second floor of the Meridian Equator Hospital building at a few minutes past 7pm. Past white swinging doors marked ‘Isolation Room’, I was taken to Bed No. 26. It was a room of four beds and one could tell from the cartoon motif on the curtains that this had previously been a children’s ward. So fresh was the bed that when the duvet was brought, it was still warm from the dryer. The bed next to mine was occupied by a middle-aged man named Joseph with a gap between his lower teeth who spoke with a thick Maasai accent. On the other end of the room was another man who sounded like the serious, stern type. He kept the curtains around his bed drawn and he kept updating his friends and family on the phone, speaking Kikuyu with the authority of a man who is used to being listened to, and obeyed. His immediate neighbour was a quiet fellow who kept his mask on at all times and spent most of his time seated on the bed reading or exercising. The room was lit by two flourescent lights that were never switched off.

Inside the converted children’s ward.

My wife had travelled for work on Monday and when I told her I had been admitted, she called every two hours to find out my state. I had to tell her to stop. She advised that I ask her brother to pick up the car. We spoke when he arrived outside the hospital and the nurse advised that he comes up to the floor. A few minutes later, he was standing at the foot of the bed, asking how I was doing. His wife followed a few minutes. They had also procured a few essential items. I would later observe that unlike the scenes described by those who had Covid before me, there was a bit of a relaxed atmosphere around visiting Covid patients. Visitors could come right into the ward, as long as they were masked, the nurses and other staff walked in and out without hazmat suits and the doctor was comfortable to wear just his KN95 mask.

Soon I was hooked up to a drip and given something to eat and a cup of hot but poorly tea. The food in the hospital is among the worst I have eaten and by Saturday evening, I had resolved to only eat the starch, vegetables and a little soup to get me going.

The nurses would start their rounds as early as 5am, administering drugs, pricking fingers to test blood sugar levels, injecting stomachs to prevent the formation of clots and checking the breathing. There were also physiotherapists who came in regularly and engaged us in breathing exercises – stretch your arms out, puff out your chests and take deep breaths, do the breath in and out we do at the gym and after aerobics (which was suddenly quite difficult to do) – and gave us spirometers to test breathing.

The spirometer

When I was about to get admitted, a doctor had come in and spoken to me. While I was under the impression I would get some heavy-duty antibiotics, fight off the pneumonia and leave the hospital the following day, that doctor disabused me of that notion immediately. He told me I would be under the care of a chest physician who would decide the course of treatment and brushed off the idea that I would need antibiotics.
The famous chest physician was a tall, bespectacled fellow who wore a KN95 mask, wielded a black pulse oximeter in his right hand, and had on some heavy cologne. The left hand was almost always on the phone and he would storm into the ward, where his charges were the quiet man in the corner and myself. His main concern at all times was blood oxygen levels (SP02) and his target appeared to be to spend a maximum two minutes with each of his patients. When I asked him on the Saturday when we would begin to deal with the infection in the chest, he stopped, gave me a puzzled look and said, “We treat the symptoms.” He listened to my chest from the back using a stethoscope and advised me to sleep in the prone position, never on my back. On my side if I get tired of sleeping on my back.

The other patient who was under the care of the chest physician was discharged on the Sunday. The doctor had come in, asked him to do a few exercises and praised his oxygen levels before declaring him fit to depart.

That night, I asked the nurse to switch off the lights.
Monday morning I was woken up by my neighbour. He was on the phone, with his correspondent on loudspeaker, and I think he called person after person or was called and they had these long conversations in a rough-sounding language from 5am to 8am. “Unaongea sana kwa simu,” I finally asked him, doing my best to sound polite and smile. “Mimi ni chief huko kwetu Ngong sasa lazima watu wanijulie hali asubuhi,” he replied. He was on oxygen and had been in the ward for two weeks and I figured he was failing to get better because he was wasting a lot of time on the phone. The hospital management was worried about his ability to pay the bills as they called him and I could hear the Credit Control officer, a young girl, suggesting that he find a more affordable hospital as his bills were mounting and his ability to pay wanting.

When the nurse came round, I asked whether I could move to the bed left vacant by the man discharged on Sunday. She agreed and I moved. My new neighbour immediately told me, “That was a good decision. That man can talk.”
The new bed was relatively more comfortable than the old one and I dozed off at about midday.
I was shaken awake one hour later by a man clamping my left ring finger with something. It was the chest physician doing his rounds. My blood oxygen was looking good and he asked me to stand up and do squats. I did 10 and ended with some shadowboxing, to which he joked, “We can run but you can’t catch us because of the state of your lungs.” As he left I asked him, “Can I go home?”
“Yes you can, if the tests come out good. Pray your tests are okay,” he answered rather casually.

About two hours later, as the nurse fixed the drip, I asked him, “Did the doctor order my discharge?” “Yes,” he said. “The process is going on.”
I was picked up from the hospital that evening, joining the traffic on Uhuru Highway to crawl home with the basin, towel, face towel and a bag of drugs from the hospital.

Being in isolation is not as bad as I had thought, although I have the advantage of a large bedroom and enough data bundles and gadgets to keep me occupied. Among the drugs is a powerful sleeping pill that ensures I get more than eight hours of sleep, which I think has aided my recovery. I am now able to effortlessly pull up all three balls in the spirometer when I do the breathing exercises.

The KEMRI results did come. On the Friday as I was waiting for admission, and the man advised that I observe MoH protocols. Someone from the Nairobi Metropolitan Services also called and advised me to do the same.

I compiled a list of five lessons from my time in hospital with Covid

1. You get pricked a lot in hospitals – The first person came at me with an injection in the stomach with a drug to prevent clotting. That injection was repeated several times. Then there is cannulisation, where they insert a cannula in your hand for the drug to be injected into your vein. A nurse with poor eyesight or a hand whose veins tend to go into hiding will ensure that you get pricked a lot of times before they can find the right place. If your cannula comes loose, or becomes painful, it will have to be removed and replaced, and they can’t attempt the same spot twice. Your blood sugar will also be tested and that means getting pricked every morning.

Third cannula of my stay, and the most comfortable.

2. Hospital food is not good – I don’t know whether it’s because of the combination of things happening inside your body and those happening outside, plus the general feeling of being in a disease-laden environment, but hospital food tastes like absolute shite.
3. Your hospital neighbour matters – There are few things worse than a man talking a language that sounds like he is chewing quarry chips for up to three hours every morning from a metre away and you are feeling terrible.
4. You have to impress the doctor – Start by doing as they say, show them some enthusiasm when they do their rounds, and look sharp when they tell you to engage in a physical exercise. Also, ask questions and describe your issues in detail. The doctors can usually tell which patients are serious about recovery.
5. Acknowledge the nature of your disease – Covid is unpredictable. You can wake up today feeling ready to conquer the world but then be down on your hands and knees by lunchtime, your body wracked by a cough. Do not, therefore, rush to announce your recovery. Listen to your body and respond appropriately. If you feel you need to see a doctor, see one.