John Peers has worked as a nurse in mental health care in East London since 1989 in Tower Hamlets and Newham. A well-known figure to many in the Trust, he was the union shop steward for Unison, and later on, for Unite. After a lifetime of work in the NHS, it was a huge shock to John, his family, and his colleagues and friends, when he became severely ill with coronavirus and his life hung in the balance. In this blog, John describes what happened and how the drama unfolded.
It was Monday morning and I arrived at work just after 7am. The corridor where my office is was very quiet. I think home working had started to apply so I was very much alone but expected colleagues to arrive later.
At 8.30, I joined the daily online Webex call to the Trust’s COVID Pandemic Gold Command. It was during that call I noticed I had a niggling cough and had the initial thoughts that it might be coronavirus. After the call, I decided I could just as easily do my work from home so home I went.
The following day I worked from home. The cough was persistent but I had no other symptoms. In the afternoon I was on a call with senior manager and was producing a spreadsheet. It was whilst doing that piece of work that I started to feel light headed and was struggling to concentrate. Shortly afterwards, I developed a high temperature. I took paracetamol but suddenly I felt so weak, I went to bed.
After a couple of hours, I felt much better and resumed normal living. Later in the evening, I started to feel unwell again. I had a temperature of 39 degrees (A normal temperature is around 36.5) so took another dose of paracetamol and as it was my usual bed time, I went to sleep.
Around 4am I woke and realised I was not getting better so I called NHS111. I went through the initial screening and then spoke with a doctor. The doctor advised that based on my symptoms, I should go to the Royal London Hospital and get checked out. She didn’t think an ambulance was necessary but at that time of the night I had no means of getting there. The doctor advised against me driving, or taking a taxi/Uber. My wife could not take me due to the need to stay with the kids. It was a frustrating conversation as I was being told to go to A&E and then having no means to do so. I decided I would go later that day as we could arrange child care and my wife could drive me there.
Getting Progressively Worse
I went back to sleep and woke at 7am feeling quite well. My temperature was 38 but my head was clear and I thought I was over the worse. So I decided against going to A&E and so carried on with my normal working day until around 2pm when my temperature went up again and I was feeling weak and light headed.
Over the next couple of days, I progressively got worse. My temperature remained high - up to 39.5. I naively took the view that this was as bad as it gets and it’s just a matter of getting over it. On Friday, my wife had become unwell, had a high temperature and general feelings of being unwell. She spent long periods asleep in bed. I believe the source of our illness was my wife’s workplace which had affected a number of staff at the same time. The timings were consistent with the known incubation periods. Later that Friday, I realised my own health was deteriorating and that I was struggling to maintain safe levels of alertness. I rang NHS 111 and that resulted in them sending an ambulance.
The ambulance crew established my temp was a staggering 40.5. I was struggling to walk so was taken in a chair to the ambulance. My last clear memory was being wheeled through the hospital double doors with the word COVID-19 in big letters. From this point, I think I suffered retrograde amnesia and have no coherent memories of events over the weekend.
Hazy Recall and Vibrant Dreams
My wife, friends and records from social media show that I was in regular contact with them. All seems normal and appropriate until Tuesday when a doctor advised that I be intubated as I was not responding to treatment. I had been put on a CPAC mask the previous day but was only managing 87% oxygen saturation. (Normal levels would be 95%-100%) It was expected that I would be on a ventilator for a couple of weeks. In my COVID-19 disturbed state, I managed to transfer all my savings and current account money to my wife. I can only think my action was meant to be a supportive one. In reality, it caused my wife great distress. I was put in a induced coma on Tuesday evening. I would be 25 days before being woken.
Over this period I had a number of fantastic dreams and nightmares which were different to more usual dreams as they had a start and ending, seemed well structured and are still easily recalled. They included my travelling to Laos, being put on a barge on the Mekong and transferred to a hospital in Thailand under the care of Dr Ken Jeong (an Amercian actor) who acted out his Mr Chow character. (from the film, The Hangover). Another involved a Halloween concert in hospital with Disney’s characters in attendance. Another involved being transferred from ward to ward across the world. Others involved my wife moving home and being distant from me which even now are painful to recall. During my period of delirium, I referred to elements of these dreams as though they were reality.
Based on accounts from my wife and friends during my ICU stay, it was confirmed I had COVID-19. I then went on to develop Pneumonia, then kidney failure, then Sepsis all in sequence. I had also developed blood clots in my lungs which were identified as being the major block to my recovery. Due to the pandemic restrictions, no visitors were allowed to the hospital. The Consultants would ring my wife every evening with a progress report. I gather most of those conversations were limited in reassurance and towards the end of my stay were in reality preparing my wife for the worst.
Vulnerable and Isolated
My wife had become quite unwell herself on the day of my own admission and suffered serious ill health for about a week. We have two children aged 10 and 8. This was a dangerous period. I was incapacitated and the children were in reality left to fend for themselves which they did admirably. I don’t know what could have been done differently as we had no immediate family nearby and all options had seemingly overwhelming obstacles. My employer and close friends went on to be very supportive once they had been made aware of both our conditions. It was later confirmed my wife too had COVID-19.
My wife had told my eldest child that if she could not be woken to dial 999 and get help.... that sentence breaks my heart.
25 days later, I had made a remarkable recovery such that the doctors felt I could safely be brought out of the induced coma. I then spent a further five days in ICU.
The ward staff arranged a video call with my wife and children. I have seen screen shots of that call. My kids were also on that call and looking at the number of tubes going in to me and my general poor state, I’m not sure it was such a good idea for them. Again I have no memory of that period.
My medical notes record that I entered a period of delirium of which I have bits of memory. I was living out the dreams/fantasies I experienced whilst unconscious. Some were amusing, some unnecessarily hostile to those who had done nothing but show me love and care. I had disagreements about my admission to hospital and events with doctors and kept demanding second opinions. In my head, I had a very clear recollection of events that had no basis in reality.
Doctors and others kept asking the same formulaic orientation questions: Do you know the date? Do you know where you are? I became quite flippant in my answers – “I’ve no idea but I came in in March”, “I am where you put me”, “You asked me that yesterday, nothing has changed but it’s a day later”.
I was transferred to a medical ward which turned out to be a gastroenterology ward. I later got the impression from the ward consultant that I was not entirely welcome there by him.
Angels Come in All Guises
As is sadly too common, the ward was very dependent on temporary staffing so consistency of nursing was a bit hit and miss. My named nurse who I would see three or four days a week was the definition of an angel. All the major milestones of my stay on that ward occurred when she was present. Nursing is a tough job under normal circumstances, the challenges during the peak of the pandemic created endless numbers of NHS heroes.
The enthusiasm of occupational therapist and physiotherapists was a joy to be near. They were gentle but firm in helping my recovery and rehabilitation. I had acquired drop-foot in both feet which will take months to recover from.
During that initial period on the ward, I was still quite confused. My eyesight was poor and I found it very difficult to concentrate. I was desperate to speak to and see my wife and children. My wife and a friend had tried to get mobile devices to me but technical problems delayed that option for a couple of weeks. The ward offered use of their phone which I did but it was quite restrictive. A couple of weeks later, this was finally resolved when my apple devices had been set up for my use.
One major frustration post ICU was that somehow it had been identified that I had a swallowing problem which resulted in me having nasogastric tube feeding continuing for three weeks after I left the unit. The speech and language therapist created a care plan involving me being given five drops of water per hour! I disputed this with all and sundry to no avail. Eventually, I had a swallowing test which proved I had no swallowing problem and never had.
On my return to the ward, I over indulged (with some encouragement from my angelic nurse) in drinking and ordering food. No one has ever been able to explain to me the source of this misdiagnosis. My progress on the medical ward was consistent but frustrating as I wanted nothing more than to be home with my wife and children. That day finally came and home I went late on a Sunday afternoon.
I am making good progress, hobbling around using crutches due to footdrop. I am told it will be months before normality returns. My wife had a much harder time than I. All I had to do was sleep through it all.