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Case Study

Advocating with Urgency During Uncertain Times

Published March 24th, 2021

This is the story of a client who came back from the brink of death in his battle with COVID-19. Forty-one-year-old Joseph* had no history of health problems when he, his wife, Elaine, and their daughter came down with COVID-19 last December. While his wife and daughter recovered quickly, Joseph was not so lucky. A few days after his positive test, he had trouble getting out of bed and could only walk a few feet before experiencing extreme shortness of breath. Early in the New Year, Joseph began to experience a high fever and headache. Elaine took him to a tent facility erected outside a major hospital. Joseph was sent home with a portable oxygen kit.

Shortly thereafter, Elaine called Private Health Management and his Care Team assessed Joseph via video conferencing. The virtual exam and a low pulse-oximeter reading convinced the Care Team that Joseph needed emergency hospitalization. As Joseph was sped to the hospital by paramedics, Private Health was in touch with the Charge Nurse, beginning a sustained period of advocacy and care navigation with Joseph’s primary physicians and the healthcare professionals at the hospital where he was admitted. He was treated with the standard COVID-19 protocols: Remdesivir, an antiviral agent for the treatment of COVID-19 and Decadron, a corticosteroid given to patients who require supplemental oxygen. Over time, Joseph was also placed on sedatives and paralysis drugs.

“You can’t go back and change the beginning, but you can start where you are and change the ending.”

C.S. Lewis

The science community has learned a lot about how to treat COVID-19 related illness at different points during the disease progression. After extensive research into the best treatment options for patients with severe COVID-19, the Care Team of PhD research scientists recommended to the hospital physicians that Joseph immediately receive convalescent plasma (CP) – blood plasma that has been donated by someone who has already had the virus in an effort to provide an immune boost. The Care Team also suggested that Joseph be given the drug Ivermectin, as emerging studies were demonstrating that its strong anti-inflammatory and anti-viral activity could provide benefit in COVID-19 patients. Finally, at the Care Team’s recommendation, vitamins C and D were added to Joseph’s treatment regimen given their broad ability to support immune function.

The hospital physician initially said Joseph needed to test negative for COVID-19 prior to receiving CP, and they maintained there was not enough data to warrant the use of ivermectin. However, the continued advocacy from the Care Team, backed-up with emerging data presented by Private Health Management’s research team, convinced the attending physician to change the course of treatment and Joseph was able to receive both therapies.

While these discussions were underway, Joseph’s health deteriorated and had to be intubated and placed on a ventilator. Weeks passed, during which time the Care Team was in frequent communication with the family while ensuring he was continuing to receive the best possible care. This perseverance by all involved appears to have paid off. In early March, Joseph finally started to improve. His oxygen requirements decreased, he opened his eyes, and he nodded in response to questions from hospital staff. Though he still has a long way to full recovery, Joseph continues to make good progress and his family is allowed to visit. He even FaceTime’s with his family and friends every day at 6 p.m.

It is rare for someone who became as ill, sedated/paralyzed, and ventilated for as long as Joseph to recover. And although he is not completely out of the woods yet, early intervention and the power of Private Health Management’s strong advocacy despite tremendous challenges has placed Joseph on a hopeful path to recovery.

* Names changed to protect privacy

* Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

About the Author

Diana Kazempoor, MSN, RN, FNP-C

Senior Director, Clinical Services

Diana Kazempoor, FNP-C, is Senior Director of Clinical Services and the Head of COVID-19 Care Services at Private Health. Ms. Kazempoor is a board-certified Family Nurse Practitioner and has more than eight years of combined advanced practice and nursing experience in Inpatient and Urgent Care settings.