Coping with Loss: A Provider’s Story
Dr. Jessica Apfel, PsyD is the Behavioral Health Director at TVHC and is graciously sharing with staff the impact of COVID-19 on her family with the hope to inform. Dr. Apfel’s parents were both infected with COVID while living in New Jersey. Her mother died the morning of March 28th. This is Dr. Apfel’s story as told to Drea Chavez:
Dr. Apfel: I’m not sharing my story as much as I’m sharing the progression of the virus and how it presented itself with my parents.
I want to hopefully help providers or other folks know the variety of how the virus presents itself, and the barriers in place for family and friends of loved ones who might get sick.
The progression of COVID-19 was very different for both of my parents, who lived in the same house back home in New Jersey. Both in their early 70s, with no major chronic health conditions.
My father was the first to get sick. He started with a fever and ended up having a fever for about 11 to 12 days straight, which ranged from 100 to 103.
At about day 7 of my father being sick, he got tested for COVID. There was a huge delay in results, which there still is back east (in New Jersey). He was encouraged to get tested by his PCP because a lot of treatments are limited unless you have a positive test. After the fever, he developed a cough and shortness of breath on day 8. He had an at-home oxygen monitor, and on day 12, which was Tuesday, March 24th, his oxygen was low so he called his PCP who told him to call the ambulance. The ambulance came and got him, and about halfway through the ride, he never made it to the hospital; his oxygen stabilized, so they just brought him back home.
Then on day 13, which was the next morning, his oxygen dropped again. He called his PCP, and given what happened the previous days, the PCP told him, “if you feel well enough, drive yourself to the ER, I will let them know that you’re coming.” So he drove himself there, was admitted into the ER and held in isolation. He stayed there until the following Monday (March 30th), which was day 18 of him being sick.
They let him out Monday night and sent him home with an oxygen tank, and he now has an in-home aide. That’s where his status is right now. That’s his progression.
With my mother, she actually didn’t even develop a fever until she was hospitalized, which I believe was the night before she passed. That was the first time she actually got a fever.
It was around day 7 or 9 of my dad’s sickness that my mother started to experience a cough and shortness of breath, and that weekend she also began falling. Her doctor told her to get tested.
The same day that my dad drove himself to the ER, which was Wednesday, March 25th, I called the ambulance to get my mom because she wasn’t picking up the phone. The ambulance came and took her to the hospital. She was tested for COVID-19 and of course, they still had to wait 2 to 3 days for the results, which were positive.
That night of Wednesday, March 25th, I got a call from the hospital that my mother’s health started to decline rapidly, and she had to be intubated and placed on a ventilator.
She was in the ICU from very early the next day, which was Thursday, March 26th. While in the ICU, she had low blood pressure, kidneys weren’t working properly, and the ventilator was set as high as it could possibly go, but her lungs were still not filling with air. She passed Saturday morning on March 28th.
The progression looks very different from person to person. The progression was so rapid with my mother, it completely blindsided all of us. We were all surprised that my dad was doing so much worse, because he is generally healthier than her. Again, this is a man in his early 70s with a fever of up to 103 for 12 days straight.
But my mother didn’t have that. She didn’t have any of that.
The barriers are very frustrating. I couldn’t go home (to New Jersey). Even if I went home, I couldn’t go to the hospital. So there’s a barrier there because the hospital wasn’t allowing any visitors. They wouldn’t even let my father, who was two floors above my mother in the same hospital, see her even though he was positive as well.
Besides grieving the loss of my mother and hoping my dad gets better, and not being able to see my mother, not being able to see my dad, there are the logistical barriers with the funeral homes.
The funeral homes are completely overwhelmed, so there is a delay in the burial process as well. All these barriers add to the frustration, and I imagine that with the virus spreading and with the death toll increasing, barriers are going to come up for our patients and our staff.
I just want to share in any way. I’m an open book, and any questions people have for me, I’m more than willing to share.
Drea: Although it was probably apparent your mother had COVID, they still wouldn’t give her specific treatment until her test came back?
Dr. Apfel: Right. PCPs are not allowed to prescribe or give any sort of treatment unless the patient has a positive COVID test. Again, this is back east, and right now, it’s very bad there in New Jersey.
The doctors are also completely overwhelmed, even when we were trying to talk to people at the hospital, they didn’t know what was happening. To be honest, I don’t doubt that the second my mother passed, they had to give that ventilator to another patient.
And then with my father, he couldn’t even get a doctor to talk to him. They were so busy, he was just sitting there in the hospital waiting for test results. When they finally did give him the test results, they gave him the results from three days before, when he went in the first time because they were just completely overwhelmed.
I honestly think my mother got there just in time because they ran out of ventilators the day after she got there. The hospitals back east are completely overwhelmed, and there was no way for us to see my parents. Luckily my father had his cell in isolation, so we were able to call and talk to him. It’s hard to think about it. My dad was treated like he was diseased, the hospital staff would not let him see my mother because they didn’t want him walking through the hallway with the worries that he might infect somebody. That is the only reason they wouldn’t let him see her. He was already positive, so it’s not like he could have got it from her.
And then there were other challenges, in terms of trying to sanitize the house before my father came home.
We also can’t have a funeral service for my mom because they just aren’t allowing any. I’m still trying to push through all the paperwork to the funeral home and the crematory because they are so backed up and overwhelmed.
The barriers are very frustrating, you can’t see them, you can’t give them a hug, this all adds on to the grieving process. Grieving the loss of my mother, a parent, or a friend or a loved one – not just for me but for any of us going through this.
Drea: Many of us have elderly or seniors in our families, who just won’t stay home. What advice do you have for people like that, who we can’t make them stay home?
Dr. Apfel: Yes, it’s so hard because there are a lot of people like that. Staying home in and of itself is really difficult and depressing. especially if you are a senior and you don’t get out that much. Just staying home all the time can take a toll on mental health.
Although we can’t force people to stay in the home, we can really try to make sure that they are taking all the precautions when they are out -washing their hands, carrying sanitizer, having masks with them. I think it’s really difficult to understand the gravity of COVID.
Where I live in the Berkeley area, there are people who are making homemade food and dropping it at the door of seniors, and trying to watch out for folks so that they don’t have to worry about going out.
The whole idea of social distancing isn’t going to stop the virus, it’s just going to slow the spread. It’s about trying to stay safe so we can at least get through flattening the curve until there is a better understanding and a treatment.
I feel like all we can really do is inform people, and hope that folks take the precautions seriously to slow the spread. At least the Bay Area and California are more on the forefront of social distancing and sheltering in place. Other states are going to take a lot longer.
I have family and friends in other states who weren’t taking this seriously until my parents got sick.
One of the things that some of my patients struggle with is trying to cope with our rights being taken away. Even though it’s for the common good, our right to assemble and things like that are temporarily on hold. For some folks it’s hard for them to take it seriously, whether they want to just defy the order or they don’t understand the gravity.
I also try to limit my news, but with the projected potential numbers of death, everyone is going to be impacted by this – either by a sick family member or friend, or a death. I’m not saying this to scare people, but just inform.
If folks are going through COVID with a family member or a friend, I am happy to have them reach out to me and share my experience with them.
*Interview edited for content and brevity