The unremitting adventure of COVID recovery
Dr. Annie Li is a pediatric emergency psychiatrist in NYC. In this deeply moving essay, she describes her experience with COVID-19 as a patient, a mother, and finally as a therapist for other families dealing with the same menacing and unpredictable disease. She also describes her coping mechanisms: connecting with others, meditation, and of course writing.
By Dr. Annie S. Li
Published, CONDITIONS, KevinMD.com, May 22, 2020
COVID-19 is taking a toll on my mental well-being in a way I had not expected. I have a rather high distress tolerance. I am a pediatric emergency psychiatrist. Now I am a wounded healer battling anxiety and fears from the constant unknown taking place inside my body.In early March, before New York State went on pause, I woke up to an intense headache, followed by malaise, chills, throat soreness, and low-grade fever. The CDC guidelines explicitly stated then that without symptoms of cough, shortness of breath, fever, and travel or exposure history, COVID testing would not be indicated. My doctor ordered a viral respiratory panel. When the results came back negative, they presumed me to have COVID. I remembered being better by day five, but then took a turn south the next morning. The shortness of breath came on. I frequented the bathroom throughout the day. Ten days in and I had to pry my crusted, red eyes open with my fingers. For two full weeks, I stayed at home to recover. With improved energy, I chronicled my experience. I returned to work. Weeks later, I became the first wave of healthcare workers eligible for serology testing. My COVID antibodies came back positive.
Five weeks into my convalescent phase in mid-April, I woke up at 4 a.m. to an intense burning sensation in my chest. I gasped for air as a wave of nausea came on. The pain shot down to my left arm and fingers. I only saw white light. In a panic, I looked for my phone, intending to call 911. By the time I found it, the contour of my room reappeared into my vision. My breathing slowed. The pain subsided. I got out of bed, walked into the kitchen, and poured myself a glass of water. What just happened? Too scared to alarm my husband and children, I convinced myself it was a bad panic attack and headed back to sleep. A week later, the same thing happened. That morning, I spoke with a few of my physician friends. The consensus: I ought to go to the ED.
My chest X-ray, EKG, D-dimer, troponins, white cell counts all came back normal. Maybe it was just a bad panic attack. Unsettled, I reached out to my cardiologist colleague who saw me right away. An echocardiogram revealed no structural damages, but he was aware of coagulopathy concerns in COVID, namely microvascular thrombi. He started me on thromboembolic prophylaxis with rivaroxaban. Another caution he highlighted: No strenuous physical activity. Weeks removed from the media hyped symptoms, I was finding out that other insidious aspects of COVID lurked for those with a mild case.
Amid my cardiac spells, I lost loved ones to this terrible illness. One family member had a prolonged hospital course. Another died after exhibiting mild COVID symptoms a few weeks earlier. My beloved family cried, mourned, and said goodbye without the proper rituals. It broke me. My children witnessed me grieve. I couldn’t shield them from it.
That all added to my sense of inadequacy as a mother. I love my children. It was very trying to meet their needs. I yelled to break up a fight. I bargained to get them bathed. Remote learning dropped to a lower spot on our immediate priority list. The kids littered my living room with Play-Doh, dolls, Lego pieces, crayons, papers. I was too tired to clean it up.
Then there was work. Patients came into the pediatric ER with behavioral complaints because things at home had reached a breaking point. The pandemic exhausted parents. Teens complained of the restrictions. Some were doing destructive things either to others or themselves. Trying to meet their needs was a challenge. We had transitioned to telepsychiatry when the hospital refitted its infrastructure to meet the COVID surge. Workflow implementation and remote care delivery came with a sharp learning curve. It was a daunting process.
With the chest pain improving, I thought I was on the mend. Yet with each passing day, I was becoming more sloth-like as fatigue and lightheadedness hampered on my productivity. A flight of stairs left me panting at the top. I scared my husband and kids when my legs gave in, and I stumbled to the floor. Why was I fainting at home in the middle of the afternoon?
The unremitting nature of COVID recovery has left me vulnerable and fearful. A moment of improvement, followed by onset of an unprecedented symptom, has been traumatizing. Even with the best practice of cognitive reframing, I couldn’t calm my hypervigilance. I have an abundance of support from colleagues, friends, family, and my therapist. It’s been a blessing. I practice love and kindness through meditation, writing, healthy eating, and gentle yoga. Distraction came in streaming Disney+ with my daughter and singing Taylor Swift songs with my preschool son. Some days, all of it just doesn’t seem enough.
I am taking notes, asking questions, and reading up on the literature. In a physician COVID group on Facebook, I crossed paths with others enduring the same struggles. That has provided tremendous relief. Some around me, and others in the public, are questioning whether this is all real. I cannot expect them to understand, nor would I ask them to validate. In sharing my experience, I hope to foster a sense of connection and belonging for those recovering from COVID. Sometimes knowing you are not alone in overcoming mysterious symptoms can make a world of difference.
