James Navarro, 52, is grateful to be alive after spending about 65 days and counting battling COVID-19 at Bothwell Regional Health Center.
Navarro, who has lived in Sedalia for 16 years, was Bothwell’s second patient to be hospitalized due to COVID-19. He tested positive for the virus on April 21 after a number of his coworkers at ConAgra in Marshall also tested positive.
After he was tested at Fitzgibbon Hospital in Marshall, Navarro isolated himself at home without any symptoms. Staff at the Pettis County Health Center periodically checked on him while he was at home.
“On a Sunday I started having trouble breathing,” Navarro said. “I called the health center and they came over and checked on me and decided to call an ambulance.”
Navarro made sure the Pettis County Ambulance District was aware he was positive for the virus, and they transported him to Bothwell’s Emergency Department. He was put on oxygen and immediately transferred to a protected room in the Critical Care Unit (CCU).
Katie Touchstone, a registered nurse in the unit, took care of Navarro from the day he was admitted to the hospital. She said the hospital was prepared for patients with the virus by ensuring there was enough personal protective equipment and fitting all medical staff for N95 masks. In the CCU, Touchstone’s supervisor set aside two negative pressure isolation rooms for COVID patients. The rooms keep contaminated air from flowing out and posing a risk to other patients and staff.
“We were ready when he came in,” Touchstone said. “We foresaw the need for protective equipment and masks before the outbreak even reached the United States. We had a good system of rotating our masks, and we had some reusable, washable gowns. No one ran out of any equipment.”
In his first few days in the hospital, Navarro’s medical team tried hydroxychloroquine, an immunosuppressive drug used experimentally for COVID-19 treatment. In mid-June, the Food and Drug Administration revoked emergency authorization for hydroxychloroquine and chloroquine saying the evidence shows the recommended dose is unlikely to be effective against the virus.
When his condition worsened, doctors made the decision to put Navarro on a ventilator.
“As the virus progresses, it becomes really hard for a patient to breathe, and the muscles tire out,” Touchstone said. “The ventilator provided extra oxygen and pressure to help him breathe.”
While on the ventilator, Navarro received a plasma infusion. The treatment is part of a national clinical trial to determine if convalescent plasma can benefit a person fighting the virus. Convalescent plasma is acquired from people who have recovered from COVID-19 and contains antibodies, which are capable of fighting the virus that causes the illness. Bothwell was one of more than 2,000 hospitals that participated in the trial.
Studies show that if the convalescent plasma treatment is going to work it will take about one week. About five or six days after Navarro received the infusion, his condition improved and he was weaned off the ventilator. He was on the ventilator for 19 days and remembers nothing of his experience due to being sedated.
“The last thing I remember is calling the ambulance,” he said. “I woke up a month later, and I’d lost 25 pounds.”
Touchstone and others who provided Navarro medical care remember everything. Navarro was treated by several hospitalist physicians on staff at Bothwell.
“Dr. Kristofik was the first hospitalist to see him,” Touchstone said. “She came and prepared us (nursing staff) for what he looked like before he was transferred to the CCU. Because our hospitalists don’t see patients outside of the hospital, both doctors were able to stay really updated on his care. They were at his bedside the entire time and were very diligent and worked well with us.”
Touchstone said she has been a nurse for a while and “you get experienced knowing what ‘better’ and ‘worse’ looks like.”
“With Mr. Navarro, we just didn’t know,” she said. “It was shift to shift and day to day. There were times when his situation was very serious, and although there was never a time we thought death was imminent, there were many moments when we were just unsure which way he would turn.”
The turning point in Navarro’s care was when the ventilator was removed, Touchstone said.
“When he came off the vent, so many of us came to his window and waved and smiled at him,” she said. “He didn’t understand why we were happy, but we were all so excited to see that happen.”
Navarro was transferred from CCU to Bothwell’s swing-bed program, which is for patients between acute and long-term care. While there he received respiratory, occupational and physical therapy to help him breathe, use his hands and to walk. Navarro was discharged from Bothwell on July 1 and said he’s ready to go back to work and to take care of himself and his dog again. Because the virus is so new, it’s not known if his lungs will fully heal.
“This has changed my whole life,” he said. “I was a healthy man before this happened. I don’t drink or smoke, but I don’t know if I’ll ever be 100% again. I am trying my best to push myself every day to get better.”
For Touchstone and her colleagues, it has been gratifying to see his progress.
“Mr. Navarro is a really, really nice man,” she said. “Some patients come in for one or two days, but when you have a patient like him who went into a rapid decline and we literally had to sweat to make him better, you get really connected. I know that everyone who took care of him and who is still taking care of him feels the same. We’ve just put our hearts and souls into him, and we want him to get better.”
Navarro, who lives alone, said he is thankful for everyone who took care of him while he was in the hospital.
“Everyone at Bothwell was wonderful,” Navarro said. “I couldn’t see a lot of their faces, but I heard their voices. They took care of me, and I’m grateful for them.”