Age: 51.0
Sex: F
Vaccine: COVID19
Symptoms: Frustration tolerance decreased, Full blood count normal, Headache, Heart rate decreased, Heart rate increased
Clinical narrative: MODERNA SHOT CHRONOLOGY: (prepared for my cardiologist first visit)  March 25 9:55 a.m. Second Moderna Shot  March 26 2:26 p.m. temperature was 102.2 ? chills, body aches, headache.  March 27 about 3 am ? woke up doubled over and coughing.  Hard to catch my breath.  Feels like someone has sinched me just under the breast bone ? around my body.  Woke up that morning with my hair slimy like it had been coated in baby oil.  March 27 2:10 PM ? Last night was absolutely awful.  Hard chills every 5 hours.  I took tyleon and the fever would sweat off.  It was terrible like the flu.  I haven?t had chills like that in years or decades.  I am sore from head to toe from the cramping of the chills.  My O2 level was low last night but has slightly improved.  March 28 9:43 a.m. ? I still have mild headache and neck ache.  My abdominal muscles hurt from doubling up on chills on Friday/Saturday.  A few joints are inflamed for the same reason.  O2 levels are better but not quite normal.  My injection arm hurts.  I am tired but not a sick tired.  March 29 ? Note to doctor:  I had my second dose of Moderna COVID vaccine on Thursday, March 3/25 at 9:55 a.m. The fifth day began this morning. I am still very fatigued but better. Minor headache. "Heaviness" in the chest in the center of the breastbone. Stomach pain, but it is much, much decreased from where it was - I mainly feel it now when I bend over, a mild soreness under the center of breastbone. I still have a limited appetite with pretty strong food aversions. I still have muscle soreness from head to toe from the severe chills Friday night or the shot reaction. There is a small red circle at the injection site. I drove a few miles to tennis practice, and I was worn out. I feel like an elderly person slogging through jello. I have progressed from whiny to frustrated. This was SO much worse than COVID. Is this something that I just need to wait out? Or, is there something else that I need to be doing? Friday and Saturday were really ugly. At least it is better than that... I am staying hydrated and taking Tylenol. I am able to sleep. No fever since Sunday. Oxygen levels vary. Often around 92-94 when working on the computer in the recliner. Higher if I am up moving around.     March 30 4:32 p.m. My doctor has asked me to use my rescue inhaler tonight to see if we can address the feelings of chest restriction and low blood O2 levels.  Hope this helps my fatigue levels as well.  March 31 Note to doctor: As of today, I feel about the same as yesterday. Maybe marginally better. I do not wheeze when I take a breath, but I do when I try to completely exhale to use the inhaler. I have attached a link to videos of those two breaths. My O2 levels are slightly higher than yesterday, about 95. I still don't have the right amount of energy. I do understand that this just takes time. I continue to try to stay hydrated. It's been years since I've used an inhaler before yesterday, and that scares and frustrates me. I am not making the progress that I thought that I would make. Would you recommend continuing to use my inhaler every 4 hours throughout the weekend? Something else? Am I doing all I need to be doing to get well? I'm available for a video call or to come in if you think that would be helpful. If I just need to wait it out, I can do that too as long as I know when to check back in if things don't improve.  April 1 Dr. Appointment:  Breathing treatments (2), flu test, Covid test, CBC, Chest X-ray ? Air stoped moving at sholdres when I arrived.  Moved down a few of inches with each treatment.  Flu negative, Covid negative, Chest X-ray clear, no sign of infection on CBC.  Esinophils were higher than last time but not elevated.  Breathing treatments (albuterol) 3x/day and steroids.  April 3 from Dr:  Your white count does not indicate a bacterial infection. We do not need antibiotics. Your eosinophils are normal but higher than before This increase could indicate an allergy component. I will send a brief round of steroids. Your COVID is negative.  April 5 11:43 a.m. ? Steroids and breathing treatments are helping.  O2 levels are still not normal.  Still short of breath.  I did feel up to helping do the dishes, progress.  April 6 - Good morning, I am stronger and able to do a bit more than I was doing before. My chest and voice are still noticeably tight but perhaps not as tight. I still feel awful when I take a deep breath. A few of my coughs as of this morning have finally been productive. The secretions are clear. My O2 level is about the same with 95 when seated and 98 when up and moving. The posture does not seem to change the O2 readings. I am still needing breathing treatments. This morning the treatment felt like it was reaching deeper than it has before today. I have one more day of steroids left. Breathing treatments 3x day: Chest gets tighter/heavier. Voice gets tighter. I used it at 7 am and 1 pm today. It has been almost 7 hours tonight and I can feel some tightening.     April 7 - I just made an appointment for tomorrow morning. My lungs seem to move more air maybe, but I don't feel good. I really want assurance that what my lungs sound like now is OK. My breathing treatments were 7 am and 1:45 pm today. I made it almost 7 hours. Still not making it 8. The appointment is 930 tomorrow morning unless you think it isn't needed. Should I skip the breathing treatment tomorrow morning so you can hear the real deal? My voice is still tight and crappy. Everyone I talk with at work knows I'm not well. I am better, but I am not satisfied with my progress. My coworker thinks I sound worse, but I really do think the lungs may be looser than they were. I really need you to say that you are satisfied with my progress as I am concerned.     April 8 ? Dr. says lungs are much better.  Added meds for bronchiospasm and will evaluate next week.  April 15 ? Lungs are improved.  Stay on inahled steroids for a month.  Do breathing treatments prior to tennis game (had to use rescue inhaler at game on April 13).  BP:130/85HR:93O2:98  Tessalon perles added.  You asked what my O2 saturation was when I was working last night. After cleaning/vacuuming upstairs, the O2 level was 93. Face red, etc. We discussed the report that I found that listed dysponea as a reported side effect. This is the Advisory Committee for Immunization Practices, part of the CDC, report (link below) that discusses this as a side-effect. I thought the one that I was viewing had a February date and more instances, but I can't find it. Thank you for the reassurance today.  April 16 ? I prepared for company and had to rest a lot.  There is a new sweating side effect.  April 22 - I am feeling better today! I waited to write this because it is a distinct change, and I wanted to see how the day went before I commented. I was so frustrated yesterday and planned to say there was little to no change, but today has been so much better! 1. My O2 levels are 98/99 today at rest!!! It was still 95-97 at rest even yesterday. 2. I had the issue with a lot of sweating with small household tasks, but it didn't happen when I vacuumed last night, an improvement. This has been a marked change in the amount of sweating since the shot, but it appears to be more like normal again. 3. My pulse has been really high at rest. It went to 120 on Tuesday night and then dropped to 90s/100s. Yesterday, it was in the 80s all day. Today, it was 63, 72, and 76. 4. I am doing albuterol before tennis matches. I don't have any matches next week and hope to not need it. 5. I had 3 nights in a row that I woke up needing to take some deep breaths through my mouth, but it didn't happen last night. 6. I forgot to take the cough meds one day, and I felt it tighten. So, I am continuing to take those. I still cough on occasion. 7. I think my color is more normal today. 8. I am still doing a steroid inhaler twice a day. I'm still short of breath particularly after exertion like walking to the tennis court area, etc. Deep breaths don't feel "normal." I'm hoping that will all improve. I'll check back in next week or if things head in a different direction.  April 23  - finally seeing O2 levels on 97/98 on a consistent basis starting yesterday.  This beats 91 following the shot and 94/95/96 earlier this week.  My resting pulse was 100+ but it has steadily declined.  It was in the 80s until yesterday and has turned to 70/60s where hit should be.  I have a new sweating issue, but that appears better.  I?m not well and still struggle with big breaths, but I have hope again.  May 1 Climbed stairs and fast heart beat ? 140+.  Took heart a while to settle back down.  May 4 ? Doctor scheduled CT in lungs as a precaution   I saw Dr today as a follow-up to my prescription of Opshena and relayed to him what has been happening since post-vaccine. I asked if the medicine I was taking, Osphena, could be related to any problems. He was very concerned and wants me to clear my ability to continue to take this medication with you as he has reservations about me continuing the medicine due to some of the side effects that could be related to my vaccine response. I am supposed to stop taking Osphena until you clear the side effects and provide an OK to proceed. 1) He wanted to be sure that we had sufficiently ruled out pulmonary embolism since it is a known side-effect. 2) Osphena can cause something called hypersensitivity. He thinks this could have potentially interacted with the vaccine and caused the reactive airways. Hypersensitivity is a 1% known side effect. I don't understand this one enough to elaborate further. He wants to know that both side effects have been successfully ruled out with you so that I can continue taking Osphena.  I still have some labored breathing, and my O2 levels are still low, 95-97. I logged them off and on yesterday in anticipation of a visit. 5/3 at 12:25 p.m. Pulse 90, O2 96 5/3 at 2:07 p.m. Pulse 80, O2 95 5/3 at 7:27 p.m. Pulse 84, O2, 97 5/3 at 8:26 p.m. Pulse 84, O2 95  My stamina is terrible. We moved my daughter out of the dorm on Saturday, and I became fatigued very quickly and struggled to get enough breath to pack while wearing a mask. Went to an art coop for coffee before heading home. On the way out, took us down an industrial flight of stairs (probably 2+ flights) only to find the door locked. So we went back up a flight and over and down a flight. When we made it to the car, my heart rate was 140+. It calmed to the 120s, where it stayed for quite a bit and eventually eased down into the 90s. Within the hour, I was back at a heart rate of the 80s. The O2 level was 93 and slowly climbed throughout the hour.  I am still using inhaled steroids twice a day. I have only needed a breathing treatment once in the last week or so. I still feel the tightness when I take an intentional breath or try to do much of anything other than work from my perch on the couch recliner. Someone explained that these Oxygen levels that I am regularly seeing (95-97) are normal and that some people are short of breath after Covid. My numbers after Covid returned to 98-99, and when I quit watching it in late November, the O2 levels were consistently 99+. So, even if this is not clinically low, this does not match my pre-vaccine condition. I blame some of my fatigue on this, but that blame could be misplaced. Here's hoping the B12 helps!  May 5 ? my heart was racing.  Pulse read 153.  I didn?t believe it so I set a 1 minute counter and counted pulse of 106.  The reading at the end of the minute was 88.  It felt unsteady at the start of the count.  Woke up at 3 a.m. for breathing.  This happened on a few days.  Shoulder pain left side around shoulder blade.  8:33 89 pulse 95 O2 10:57 88 pulse, 95 O2 9:09 p.m. 88 pulse, 96 O2  May 6- CT with contrast with no evidence of blood clots.  Cardiomegally with no indication of scope.  May 7  5:54 p.m. 78 pulse, 97 O2  May 8:  8:12 p.m. 77 pulse, 95 O2  May 9  8:22 a.m. 75 pulse, 95 O2  May 10  10:35 a.m. 96 pulse, 98 O2  11:11 a.m. 79 pulse, 94 O2  May 11  2:16 p.m. pulse 92, 95 O2  10:05 p.m. pulse 73, 96 O2  May 12  6:23 P.m. pulse 80, O2 94  May 13  7:36 a.m. pulse 78, O2 96  8:56 p.m. pulse 82, O2, 95  May 14  7:16 p.m. pulse 80, O2 97  11:25 p.m. pulse 78, O2, 95  May 15  11:06 p.m. pulse 77, O2 96  May 16- woke up during the night last night for the first time in a long time to take a big breath.  That happened a few times early on.  Pulse 79, O2 97  My energy level seems to gain some each week as does the pink color in my face.  My energy level is still below what my normal should be.  Some intermittent chest discomfort on the left side of my chest ? comes and goes.  Could be digestive  By my second cardiology appointment on July 6, 2021, the suddenly racing heart beats, gurgles, and loud pounding heart symptoms had subsided.