February 8th, 2021 is the first day that Brian began feeling under the weather with cold-like symptoms. He was certain it was COVID as he has a known exposure and was in quarantine when symptoms developed. For the next few days his symptoms waxed and waned, but were not severe, in fact a few days after falling ill he felt well enough to go outside and blow the drive. A week later, February 15th, instead of his symptoms getting better, they began to worsen as he developed some progressive discomfort with breathing intermittently. He went to the ER Tuesday morning and at the time (barely) qualified for monoclonal antibody treatment, which he received before being discharged to home to monitor his oxygen saturation and continue his course of dexamethasone. The following day (Wednesday), he was progressively becoming more and more uncomfortable breathing room air. He returned to the ER where they performed a chest CT to rule out any clots in his lungs and discharged him home with an oxygen machine and directions to supplement O2 (up to 6L) and monitor sats, return if they consistently fell below 90. At that time he still did not meet the criteria for admission. The next day, February 18th, was a tough day at home with progressive discomfort, especially when he moved around. By the evening, he was requiring 5-6L of O2 and could barely catch his breath if he got up to move around, and his sats were dipping into the 80's. He no longer felt comfortable going without the oxygen long enough to get to the hospital, so he was taken via EMS to St. Joseph's where he was admitted. Because we are living in this crazy season of COVID, he was not allowed to have anyone with him after leaving his home in the ambulance. After admission, he was moved to the "covid-floor" at the hospital and supported with oxygen per nasal canula. The hardest part at this time was the limited communication we had with him as there are no visitors allowed, and the nurses were very busy caring for the patients, often too busy to give updates. We were texting and calling, but it was very hard to get a good read on how he was doing. At this point he was on 15L of O2 per nasal canula but seemed to be doing well. They started the IV remdesivir (antiviral) shortly after admission and ordered convalescent plasma. We were encouraged that he was getting "the big guns" treatments. By Saturday afternoon, he was having more trouble maintaining his sats and was becoming more uncomfortable with the high flow O2 in his nose. He was moved to BIPAP oxygen delivery Saturday evening. Early Sunday morning we received a call that Brian had not had a good night and was being moved to ICU. They wanted permission to intubate him if needed. Several grueling hours later without communication, we found out that they did in fact have to intubate him and he was now on full respiratory support in the ICU. Brian stabilized for several days with the ventilator support, but did start requiring additional support through the ventilator over the next several days. He got a second infusion of the convalescent plasma. By Friday, February 26th, Brian's medical team determined that he would benefit from the use of ECMO to offload his lungs, and hopefully allow them to begin healing. At that time he was moved to the CCU where he remains and is being closely monitored to give his lungs time to heal.
