RA and a Pandemic

I just read Wren’s article from 2015, RA’s Secret Symptom, which is about all of the fears we who have the disease struggle with. Today, I am adding to those fears in the face of the coronavirus epidemic (COVID-19).

Annual travel amidst the ongoing pandemic

For the last several years, my husband and I have spent some part of each winter in Florida to get away from the cold weather in our home state of Indiana. Two years ago, we bought a property in a nice, secure, 55 and over mobile home park in southwest Florida. We have been here since early January and planned to return to Indiana after Easter. Enter COVID-19.

We watched as it made its way through Europe. I’m a retired nurse and professor of nursing. I was an active participant in the planning and execution of plans in our community for H1N1 virus several years ago.

Being immunosuppressed with RA, I'm at high risk

Public health people have been waiting for this type of pandemic for some time and here it is. This virus can be spread by people who have been infected but who have no apparent symptoms, meaning that air travel is a huge risk, especially for those of us on biologic medication that lowers our immunity to disease.

The decision: stay or try to head home during all of this?

It takes approximately 21 hours to drive home. My RA limits my tolerance for riding in the car to a maximum of 8 hours per day, meaning we spend at least 2 nights in hotels if we drive. This is in addition to restroom breaks and various other opportunities to become infected. After conferring with my physician, we have decided to stay in Florida in our mobile home park with very limited physical interactions with the outside world.

My son has begged us to go home to Indiana so that I will be near my physicians, the hospital I trust and family. His concern makes me doubt our decision, even though I still think it is sound. It sometimes feels like I’m in one of those disaster movies and someone who is watching is saying, “No, no! Don’t make that decision!”

Trying to avoid the virus as best I can

If I can just avoid getting the virus, I’ll be fine. Unless I do somehow catch the virus. I can advance from mild cold symptoms to full-blown asthmatic bronchitis or pneumonia on a good day. Those illnesses at least respond to antibiotics, steroids and nebulizer treatments. Patients who are critically ill with COVID-19 are advancing quickly to ARDS, or Adult Respiratory Distress Syndrome. ARDS causes the alveoli in the lungs to fill with fluid, greatly disturbing the normal exchange of oxygen from the lungs to the tissue and organs, making breathing with a ventilator a frequent necessity. The death rate is high in patients with ARDS. Add a disease like RA, and a treatment which lowers immunity, and it is like throwing gasoline at a forest fire.

Lowered immunity with RA

Seven years ago, I had minor back surgery and was supposed to be back at work in three weeks. I was fine for several days post-op – until I wasn’t. My husband found me incoherent with a temperature of 104 degrees. I had developed a large abscess in the surgical wound that was infected with methicillin-resistant staph aureus (MRSA). The hospital made one mistake after another after I was re-admitted until I was sent to the Intensive Care Unit with a blood pressure of 70, and my kidneys and heart failing. I lived despite the infection and all of the errors, but that experience is one I definitely do not wish to repeat with COVID-19, and doubt I would live through ARDS.

We have friends here, including one who has RA also. We have enough money and good healthcare coverage. The weather, water and palm trees are beautiful. Many people are in much worse circumstances. God - and the healthcare professionals – save us all.