Zinzi
Tags: Covid 19, Brain Fog, Isolation, Health Systems

One week was all it took. The bridge between now and then. Between certainty and incertainty. Between the past and the future. Between health and disease. Just one week and then everything changed.

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Zinzi blinked, trying to dislodge the words that were stuck in her mind. She closed her eyes for a moment to arrange the words so that she could form a sentence. “Caleb,” she said to her husband, “Jeph needs..” but the words got stuck in her throat. She pointed her frail finger at Jeph’s diaper but the fog was so thick the words got lost in there.

“What about Jeph?” Caleb asked.

She tried to point again but her hands trembled; her index finger swung like a pendulum and instead pointed at his mouth. “Jeph has eaten already,” Caleb inserted words into her unfinished sentence.

She took exaggerated offence to his response. Because she couldn’t form words fast enough to tell him off, she scowled and took her fist to the couch, startling him. She closed her eyes and gripped the side of the chair. “Babe ever since you left the hospital, you have been so irritable,” Caleb said. And he was right. Well, partly so. It was more of frustration than anger. She was just recovering from the physical scourge of the illness only to realise her mentation had been affected as well. Everything in her life was moving in slow motion. Her movements, her thoughts. Even Jeph their year old son was too quick for her.

Two weeks prior, Caleb had come home feeling unusually tired. He had been working from home since the inception of the nationwide lockdown but then had been required to report physically to the office. One board meeting was all it took and he started to feel as if he had been run over by a track. “I am so exhausted. I feel exactly the same way I felt when I had that blood infection,” he told Zinzi. A few days later, she accompanied him to hospital where they ran a panel of blood tests that turned out normal. He was sent home with some meds to quell his symptoms which had barely started to wane, when Juliet started to feel the same way.

Being pregnant and in the third trimester, she was not going to take any chances so she wasted no time in seeking medical care. Any other time, she would have bought into the blood infection vibe but Kenya had just announced that they were in the second wave of the Pandemic so it was likely that they could have gotten infected. A nasal swab later, she was called into the lab where a lady disclosed her positive results to her. “Don’t worry. Just rest, hydrate, eat a balanced diet and keep a positive attitude. You will be ok.” Because she knew of friends who had been infected in the past, she was not too shaken by the results. She called her gynecologist, “Boss I have covid.”

“Don’t we all?”

“ Boss I am serious.” They had a semi casual relationship.

“For real? Man I am so sorry. What are your symptoms?”

“The usual. Headache, joint aches, fatigue. Like I have malaria.”

“So home isolation right?”

“Yeah.” They spoke some more then she called a friend — a medic — who gave her a python list of home remedies to take.

By this time Caleb was beginning to feel better so she figured it was only going to be a couple of days before she too felt well. But as the days progressed, instead of her symptoms waning, they increased. When before she had no cough now she did.

Then she developed difficulty in breathing which became worse on mild exertion.

When they updated their medic friend she said, “I think you should go to hospital. Let them check your oxygen sats.” At the A and E of the nearest satellite clinic, her oxygen levels were between 83–87%. They immediately put her on oxygen and made a decision to transfer her to a hospital of her choice for further management.

You see Juliet’s case was not just any other case. A few years ago she had a pulmonary embolism ( which I wrote about here: https://medroomeyes.medium.com/he-was-startled-from-his-sleep-by-the-sound-of-her-breathing-9d27d99a6ebc?sk=1c0cdf818e2a352e774c93ae3357767e) and she ended up in an ICU, her life hanging by a thread. By God’s grace and timely intervention she survived. Only to get pregnant a few months later, and suffer a miscarriage. She then conceived again and carried the pregnancy to term only to deliver a still born.

The buffet of this medical past was not encouraging to her current situation. Covid in itself was a risk factor to a repeat clot in her lungs; and so was the pregnancy. The pregnancy complicated the management of the covid and the covid and it’s complications put the pregnancy at risk.

By the time they arrived at the hospital, her thoughts were running like charged electrons. Would she reach term? would the baby be ok? would the insurance cover her treatment if she needed admission?

During the transfer, she was off oxygen so she was more breathless than before. They decided to admit her. There was only one problem, they had no beds. So the search for a covid bed began. It was about 9pm when they started to make calls looking for a bed. She and Caleb scrolled down their phonebooks calling anyone they thought could help. A bed was found in one of the elite private hospitals but they were reluctant to take it because of costs; so they continued to search. They exhausted all the hospitals in Nairobi and started to search for beds in nearby counties. One was found in Gatundu, 50 km from Nairobi and Zinzi’s gynecologist was like, “You are not going that far. No way.”

“But now what do we do?” she asked him, her mouth covered by an oxygen mask, her chest heaving.

“We keep looking.” He stayed with them, pacing the corridors making calls until about 10pm when he said, “Found one! Let’s go for it.”

It was in a hospital in Eastlands. They took it. And that was the beginning of the week that changed her life.

First, they waited in the A and E for the bed for six hours which would have been ok except that they couldn’t put her on oxygen before she was keyed into the system. As they waited, she lay in a stretcher in the casualty area taking in her surroundings while Caleb nodded off in a seat next to her. At 4am, Zinzi was finally wheeled to the ward. It was a general ward that was previously a pediatric ward but due to the rising cases, had been converted to a covid ward. There, she found seven other female patients, separated from each other by thin curtains.

She was placed at the far end of the room by the window. Next to her bed was a common sink that was the meet and greet spot. It was only when she settled in that she remembered she had not eaten all evening. An attempt to get food at that time was like oozing water from a stone. “ Please I am so hungry. You don’t have anything? Not even tea?”

“The kitchen closes at some point but we will see what to do.” One nurse told her.

“We are waiting to update your details in the system to be able to get you something.” Another one said.

By the time the food came she was feeling faint. She held her breath and wolfed it down.

When they brought her hospital gown and bedding, they both had huge stains spread across them. “Are these clean?” she asked.

“Yes yes.” And the nurse moved on.

Zinzi barely slept that first night or morning. The breathlessness kept getting worse as dawn approached. Plus there was an old lady across from her who would belt out a scream every few minutes. At first it unnerved her. The way she would yelp as if she was wretching or in intense pain then go silent only to repeat the sound again. Everyone else seemed accustomed to it and in the days to come, she got used to it too.

The following day, the physiotherapy team came for their rounds. She heard them say to one of the patients, “Morning. How was your night? We are here for chest physio.” Then there would be the sound of somebody shifting in the bed and without warning a loud slap! The first time it happened Zinzi’s body twitched. The physio guys would slap those backs as if trying to dislodge a foreign body. And then after a while the patient would wretch, making gurgling sounds as they tried to empty their lungs of clogs of sputum. Thank God she was pregnant they didn’t have to do that to her.

The days were convoluted. And lonely. The only connection she had to her loved ones was through the screen of her phone. And even that was limited because it was exhausting to speak while on oxygen. She would look out the window and her only view was a construction site. Even amongst themselves, they rarely spoke unless when someone used the sink by her bed. The only time she heard another voice in the ward was when it was deathly silent. Something was missing. When she drew the curtain she noticed the old lady’s curtains had been drawn and the periodic shouting had stopped.

“What has happened to Cucu?” She asked no one in particular.

“By the way. I have not heard her groan this morning.” Someone responded.

Zinzi had a bad feeling. Even if they rarely spoke, she felt a silent camaraderie to her fellow patients. They were in this together.

When one of the nurses walked in, she asked, “Where is Cucu? Is she…”

“Oh she has gone for dialysis.”

And when Cucu came back, they sighed because she carried on with the groaning.

The covid ward was unusual. The medical team would attend to them only for a few seconds and leave. When food was served, you had to eat it immediately because if it got cold it couldn’t be warmed. “We don’t take these plates back to the kitchen. That’s why they are plastic. You eat and throw,” one nurse told her. Few words were exchanged between them except for what was absolutely necessary. “Here are your drugs.” or “ Your sugars are high.” or “ Here is your food.” Covid was physical and mental torture but she was yet to see the brunt of it.

Once, when she needed to use the restroom she rang the bell. Because of her level of breathlessness she wasn’t allowed to use it unaccompanied. But no one responded and she really needed to go. So she got up and walked 20m to the nearest bathroom. When she was there, it took considerable amount of effort to sit on the toilet bowl. When she was done she had to give herself a pep talk to rise back up. And when she did, she felt the walls of her chest closing in.

Suddenly she began to gasp for air. How could something that God gave for free feel so impossible to use? She tried to open her mouth wide to trap in some air but the more she did the more she felt like she was losing control. Because the main door was open, she gestured frantically to one of the male nurses who could see her to come to her.

She heard him to say to a colleague, “Leta wheelchair. There is a patient who needs help.” She saw a head emerge into the corridor to glance at her, then the head retreated. Seconds passed without any sign of a wheelchair. And the more she stood there waiting, the more she became more anxious. The nurse she called to, got to her and opted to half lift, half drag her back to bed. All the while she was emitting crackling and whistling sounds from her mouth. When they crossed the nursing station she saw there were other staff there and wondered why only one had come to her aid. It is only later that she came to learn that the staff were afraid to assist her because she had no mask.

When her sugars spiked the nurse came to her bedside and said, “Your sugars are in the 20s so I need to administer insulin.”

Zinzi was not the kind of person to just accept meds without detailed information.

“Why do I need insulin? Did my doctor prescribe it? What are the side effects to me and the baby?”

“Zinzi listen. Do you want to go into a coma?”

Her eyes grew wide and without saying another word she stretched out her hand for the shot.

If Zinzi were to compare her time in ICU when she had the pulmonary embolism and her time with covid, the most significant difference was people. Both illnesses were life threatening. Both times she couldn’t breath. But it hit her at that moment just how quality of care can vary when a health system is overwhelmed. How insurance affords you certain care and comfort that you tend to forget what could happen when that priviledge is stripped from you. How in leading private hospitals you only need to ring a bell and someone is by your side in a snap. How all your questions and concerns are addressed.

By the end of that week, Zinzi stabilised and was discharged from hospital on oxygen. The experience she went through humbled her. Luckily, her insurance covered the cost of her treatment.

Back at home, she thought the worst was behind her but then she started to develop memory lapses. Her cognitive functions diminished and she became slow at everything. Initially she thought it was due to the physical fatigue of covid but a friend shared her own experience and told her about brain fog and covid 19. It affected her so badly she couldn’t align her thoughts to form sentences. Friends and family would visit and she would want to make conversation but her mind would just pause and remain in that state for hours.

She would forget names of items, obvious words and would resort to pointing. Caleb started to finish her sentences but sometimes he would be so off the mark, it frustrated her.

Once she was to have a zoom meeting for work but had forgotten how to initiate a meeting let alone converse with a client. She became incoherent and slow. And it has taken a while for these functions to resume.

Zinzi went on to deliver a bouncing baby girl at term and she is now ok.

*I had many titles for this article but I chose Zinzi because it’s such a unique name that glides easily off the tongue. Plus she has featured on this blog several times her life hanging by a thread. Yet each time, she lives to tell the story.

Zinzi

As narrated to me by Juliet Zinzi Karichu