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www.thevillagenews.co.za
17 February 2021
Surviving the grip of Covid-19
We all heard the news reports about how the healthcare system was struggling to cope, how our hospitals were filled to capacity, how many doctors and medical personnel were either sick or in quarantine, leaving healthcare facilities understaffed and those able to work under immense pressure. Those of us who were fortunate enough to be spared the experience of Covid-19, could only imagine what it was like to have actually lived through those frightening weeks. “When I received my positive test result on 15 December, I was almost relieved. I just thought: Okay, so I have it now,” says Dr Wendy Cooke who, as a medical doctor, always had a higher than average chance of contracting the disease via a patient. She admits that, as a 65-year-old woman with comorbidities (overweight and diabetic) it was a scary diagnosis, and she was “terrified” about infecting her 86-yearold husband. “Also, my mom had died of Covid pneumonia in June and it did make me very aware of my own mortality. Despite being a very positive person, I couldn’t help thinking, ‘What if?’ The news definitely knocked me sideways.” With the new Coronavirus mutation, Wendy says the symptoms are different to those produced by the original variant. “I experienced the same fatigue but had less respiratory symptoms and more nausea and diarrhoea.” A colleague took charge of her treatment, which included Vitamin C, D and Zinc supplements, plenty of fluids and a low dosage anticoagulant. Wendy also had an oximeter so that she could keep an eye on her oxygen levels.
Wendy says it was a huge relief when she started feeling better and was able to eat a little fruit and yoghurt. “I was listening to music in my bed and when I noticed my toes ‘dancing’, I knew I had turned a corner.” She was discharged after a week in hospital but even when she was back at home, she says she was very weak and mostly just slept for the next two weeks. It would be six weeks until she could return to work, even just for a few hours a day. What she is most thankful for is that her husband never contracted the disease.
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Regardless of the tremendous pressure they were working under, no one complained; they were always friendly and encouraging. They made me feel safe and cared for.
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W
hile the number of Covid-19 infections is coming down and we seem to be over the worst of the second wave that crept up on us over the festive season, the second round of South Africa’s bout against the Coronavirus has left many people shaken. It felt different to the first round; this time, most of us personally knew people who had become sick – neighbours, friends, colleagues, family members – and even some who died.
“For the first few days I was doing OK, but the nausea kept getting worse and I couldn’t keep anything down. I felt absolutely terrible. I was put on a drip and anti-nausea medication but by the sixth day I realised that I really needed help. My colleague called the Mediclinic and fortunately they had a bed available. I don’t remember much about the first three days in hospital as I just slept all the time. By then I had a high fever and was often delirious. It was a very scary time and I thought of my mother, wondering if I would be next. I was treated with Dexamethasone and put on low-flow oxygen but fortunately I did not develop serious breathing problems.”
Wendy says the doctors and hospital staff certainly had their hands full during the festive season. “I know more than a dozen doctors who got really sick; also nursing staff, physiotherapists and social workers… everyone was doing their best to cope under very difficult circumstances.”
Another resident who has nothing but high praise for the care he received is Minister Michiel de Kock of the Dutch Reformed Church in Onrus. He and his wife Dawn both contract-
ed Covid-19 just before Christmas, after being in contact with someone who later informed them that they’d tested positive. Although neither of them felt sick at the time, Michiel and Dawn went to the hospital to be tested. By the time they got their results two days later – both positive – Michiel says he had a slight headache and a sore throat. It was 24 December and with several Christmas services ahead, Michiel had to delegate to a colleague and stay in isolation at home with Dawn, who fortunately never developed any serious symptoms. Her husband’s condition, however, went downhill very fast. “On Christmas Day I didn’t feel well at all. I had no appetite – even my son’s chicken pie, my favourite, couldn’t tempt me – and all I wanted to do was sleep,” says Michiel. Within two days he was dehydrated and his oxygen levels had dropped so low that he became disorientated. “Dawn and I both realised that I was in crisis and she called the hospital. We were told that there was a two-hour waiting list and I remember that time sitting in the car in the hospital parking lot on a hot day as the worst part of the whole experience.” By then the Mediclinic was filled to capacity and a sister first came to the car to enquire about Michiel’s symptoms. She then told him that there were other sick people she also had to assess before deciding who to admit. “I certainly would not have wanted her job,” says Michiel who, despite his own unbearable misery, could still sympathise with the impossible choices the sister had to make that day. Fortunately she came back to the car and said he was sicker than the others and would be admitted to the emergency room. “The relief I felt when I was lowered onto a bed in that cool, clean ER is indescribable,” says Michiel. “I immediately felt calm and knew I was in safe hands as they put me on a drip, started to administer oxygen, and took blood tests and X-rays of my lungs. I don’t remember much about being taken to my ward, except for a doctor telling me I was very sick.” Michiel has almost no recollection about the next few days, but he does
remember an incident that left an indelible mark on his soul. A staff member had brought him a glass of fresh water when she noticed tears on his cheeks. “I’m just crying a little bit,” he told her meekly, upon which she fetched a paper towel and gently wiped his tears away. In that moment, in all his frailty, he felt God’s presence in a profound way, says Michiel.
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Non-compliance with mask-wearing and social distancing really upsets me and encouraging people not to have the vaccine is equally ludicrous.
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Writer Hedda Mittner
He also recalls another staff member who sponged him down and remade his bed when his sheets were soaked from the high fever he was running, and yet another who helped him to have his first shower when he was too weak to stand on his own two feet. “I felt such gratitude towards these angels,” he says. “Regardless of the tremendous pressure they were working under, no one ever complained; they were always friendly and encouraging. They made me feel safe and cared for.” Although Michiel still required freeflow oxygen for a total of 12 days, there was such a shortage of beds in the Mediclinic that he agreed after a week to be transferred to SpesCare in Stellenbosch, where he spent a further two weeks receiving treatment while recuperating. “I didn’t want to leave what had become my ‘safe space’ but hospital beds were desperately needed and I realised it was a sacrifice I needed to make,” he says. The road to recovery has been a long one and Michiel is just thankful that cognitive tests carried out at SpesCare confirmed that he did not suffer any permanent brain damage due to a lack of oxygen. “I have so much gratitude for God,” he says, “and for all the people who supported me through my illness, especially my physician and my wife Dawn, for whom this was a very traumatic experience. I have
truly experienced the community of the faithful – through countless calls, messages, prayers, gifts and visits…” Wendy says she, too, was overwhelmed by the love and support she received from friends and neighbours during her illness. “I was gobsmacked by the many ways in which they helped me and also took care of my husband and our dogs while I was in hospital. This experience has really made me appreciate what I have in life; it’s the small things we often overlook that become most important.” With so many people suffering, not only from illness but also job losses, stress, anxiety and poverty, Wendy says this pandemic has made many of us stop and think about how we as human beings had lost our humanity. She urges people to do the right thing and keep everyone safe by adhering to the Covid-19 precautions. “Non-compliance with mask-wearing and social distancing really upsets me,” she says, “and encouraging people not to have the vaccine is equally ludicrous. As a doctor I have seen what terrible damage something as preventable as measles can do to a child. There is so much misinformation about vaccines out there that feeds on people’s fears. “It is essential for everyone to be vaccinated, especially healthcare workers. One always hears about doctors’ responsibilities and patients’ rights, but doctors also have rights and patients also have responsibilities.” Michiel, who still does his breathing exercises and goes for regular walks that are getting longer as his condition improves, also says there are too many people who don’t take this pandemic seriously. “There are still people who don’t realise it’s not only about protecting yourself but protecting other innocent people. How can there still be people who protest about their “right” not to wear a mask? How can anyone be that selfish?” I suppose it’s easy to be reckless for those who have not been personally affected, who have not battled the disease or lost a loved one to it. But the pandemic is not over and there are simple steps that we can all take to limit the spread. It’s not a big ask – simply think a little less about yourself and a little more about your fellow human beings.
Potentially Malignant Disorders and Oral Cancer This past week I was again reminded of the devastating effects of oral cancer (OC) when I consulted a young woman who developed OC at the young age of 19. Over the past months I also had the unpleasant task to inform two older patients that samples I had taken from their tongues were oral cancers. Both had seen a clinician only months earlier, who diagnosed Potentially Malignant Disorder (PMD), but did not place them on a follow-up monitoring programme. So what is a PMD and why is it so important to be monitored regularly? The World Health Organisation classifies all oral lesions with early abnormal changes as PMD. This implies that these lesions may de-
velop into OC. PMD lesions present as white or red areas in the mouth. The only way to monitor the behaviour of these lesions is to see a patient every 3 – 4 months and perform a detailed oral examination. It is not possible to determine whether a lesion is OC without a pathologist examining a sample of the lesion under a microscope. In the case of the two elderly patients above, both had seen a clinician only months earlier, without taking a follow-up sample for the pathologist or placing them on a follow-up monitoring programme. Both patients lost half their tongues and had to undergo extensive surgery to try and save their lives, followed by radiation to control
any potential spread. Had samples been taken earlier, their lives would have been very different today. To diagnose a lesion, a small injection is required, a small sample is taken, and the answer is received within days. If it is a PMD, strict monitoring is required. If it is already OC, the patient is referred to a surgeon to remove the cancer, whereafter strict 3-monthly monitoring is required for life. Early diagnosis can be lifesaving, but only about 57% of oral cancer patients survive 5 years. This is due to the lesions not being detected early enough or samples not taken of all white and red lesions during follow-up. This is essential for young and old patients.
