Lindsay Polega’s two-year odyssey with the long-running Covid shows how the medical system fails many patients.
(Jin Xia for the Washington Post) Two years, three Covid seizures and 11 doctors later, no one seems to know why Lindsay Polega is still so sick. She is only 28 years old and it was the picture of her health before her infections. Polega, who graduated from law school last year, now suffers from chest pain, high blood pressure, numbness in the hands and many other symptoms. Her life has become a series of doctor appointments that cross cities around her home in St. Petersburg, Florida: The primary care physician sent her to an immunologist. The immunologist referred her to a cardiologist. The cardiologist referred her to a nephrologist and endocrinologist. The endocrinologist thought she could learn more than one neurologist. But when the neurologist’s examination failed to find any possible cause, Polega was sent back to the immunologist. At one point, one of her doctors – upset by the inability of medical science to explain what was happening – advised her to consider being isolated at home indefinitely in the hope that it could help her avoid the stimuli for illness. I wonder, ‘Will this be the rest of my life?’ said Polega. “I can not stay in my room forever. Not a good answer. It’s not a cure. “ Polega’s discouraging, two-year odyssey speaks to the dysfunction of the US’s healthcare system when it comes to long-term Covid and the challenge of trying to cure a poorly defined disease for which there is no clear cause and no test. and for which the number of documented symptoms exceeds 200. Many of the country’s top medical centers have set up multidisciplinary clinics to see patients over long distances, but proponents say there are not enough to handle the millions that Americans expect. to face persistent issues from covid-19 in the years to come, leaving most of them struggling to navigate a labyrinth of doctors and diagnoses on their own. As people enter their third year of coronavirus, more than 425 million people have been infected, and researchers estimate that between 10 and 30 percent could develop symptoms long after they have recovered from their initial illness. “The team of patients with long-term Covid will experience a difficult and distressing experience with the multidisciplinary, organ-focused healthcare system in the light of the complex and ambiguous clinical presentation,” said Steven Phillips, vice president of science and strategy at Clabobo Crativerative. , a coalition of experts, and Michelle Williams, dean of the Harvard School of Public Health TH Chan, wrote in a recent prospective article in the New England Journal of Medicine. Christina Martin, an advanced nurse at Covid Clinic at Dartmouth-Hitchcock Medical Center in New Hampshire – one of dozens of such centers across the country – describes her work as a general or point guard, helping with immediate care in the right direction. . “Until they come to us, they know something is wrong. “But every test says they’re ‘normal,’ so they start to think they’re crazy,” Martin said. . »
Mystical, controversial Lindsay Polega was part of the first wave of Americans infected with the coronavirus before the nation began closing on March 15, 2020 – before social distance, before masks and before vaccines. He was statistically more likely to overcome the disease without problems, given his age, health and high level of fitness: He ran, swam or attended some kind of fitness class every day. However, the virus threw her out for a month and a half and she never returned to her old self. Her chest pain was just one of the many symptoms that appeared and sometimes disappeared, only to reappear in the following months. Her blood pressure rose during the day, reaching a point of 210/153 – well above 120/70 which is considered normal. Scrolling on her phone caused dizziness, blur and disorientation. She became sensitive to light. Sometimes she was dizzy and heard her ringing in her ears. He had overwhelming joint pain. And he swore he could smell fish, even when he was not around. One day she tore up her car in search of what she insisted was a forgotten and rotten taco fish as her confused friend stared. Post-infectious syndromes, first described in the 19th century, are one of the most mysterious and controversial areas of medical science, with generations of doctors dismissing the symptoms as primarily psychological. It was not until 2006 that the Centers for Disease Control and Prevention launched a public education campaign to raise awareness of such a condition – myalgic encephalomyelitis, better known as chronic fatigue syndrome, stressing that it was “a real disease” and that people with the condition needed “Real medical care”. The researchers also identified increased reports of post-SARS syndromes following the outbreak of SARS in late 2002 to 2003, and after humans became ill with Epstein-Barr virus, Lyme and other pathogens. Now with the long Covid, who has many symptoms overlapping with those of chronic fatigue syndrome, research is finally starting to take off. The National Institutes of Health launched a $ 1.15 billion initiative last year to better understand long-term Covid, which will include 40,000 adults and children. How brain fog can overlap with “brain brain”, Alzheimer’s and chronic fatigue syndrome A leading area of research is the investigation of possible dysfunction in the body’s autonomic nervous system, which controls unconscious functions such as respiration, heart rate and digestion. Another theory is that the virus continues to hide in tanks in the body, creating inflammation that triggers all sorts of symptoms. A third possibility is that the body’s immune system reacts excessively or incorrectly to these situations and attacks itself. A report by the Government Accountability Office, published in March, estimates that up to 23 million Americans are affected by the long Covid, with 1 million unemployed. It suggests that organ damage from the virus and microvascular thrombosis may also be related. But while these ideas bring research to life, scientists say there is a long way to go to interventions and treatments. Patients, researchers are collaborating on the long-running research on Covid By the summer of 2020, Polega realized it was not getting any better. He had already gone to the emergency room three times due to chest pain and fainting, and began to push harder for answers. Polega worked as a lawyer during the day and as a part-time trainer in a kickboxing gym on some nights and weekends, as well as sitting as a dog – a more relaxed program than she did during the school year. But it was still too much. The hypertensive spikes began to intensify, which brought pain to the chest. In some cases, he had to leave work early. Colleagues and members at the gym, where she wore a cardiologist, commented on how high her pulse would be with just a few minutes of activity. It was then that the primary care physician referred her to an immunologist – the first stop of her stay from one specialist to another, a major problem for patients with complex conditions such as cancer and chronic Lyme disease. Polega’s primary care physician had wondered if some of her symptoms might indicate rheumatoid arthritis or another condition in which the body’s immune system weakens and attacks itself. The possibility also made sense based on Polega’s medical history. She was allergic to peanuts, nuts, sesame seeds and pollen, and recent research has suggested a possible link between allergens and the development of autoimmune diseases. In July 2020, the immunologist performed numerous blood tests, according to her medical records. The doctor ruled out lupus and other possible autoimmune diseases, but Polega had elevated inflammatory markers, which explained joint pain. Disappointed, the immunologist referred her to a cardiologist, whom she hoped could have more insight. One of the biggest surprises for the coronavirus when it hit the United States was the discovery that the virus could directly attack the heart and blood vessels and lead to myriad conditions, some rare, others more common, including hardening of the heart walls. , an inflammation of the tissue sac that surrounds the heart, coagulation and stroke. Five months after she was infected with the coronavirus, Nicole Murphy’s pulse rages. Given the frequent and unusual pain in Polega’s chest and the severity of her high blood pressure, she did a thorough examination. Her echocardiogram, an imaging test that looks at how the cavities and valves of the heart are pumped, was good. So did her treadmill test, which looked at how her heart was working under pressure. A calcium CT scan of the heart, which helps assess the amount of calcified plaque in the heart, also came back without any worries. Her doctor prescribed medication for her heart – 25 milligrams of eplerenone, twice a day, to lower her blood pressure. He warned Polega not to get pregnant with the drug, which is commonly used after a heart attack, as it is associated with low birth weight babies. Polega would later remember that moment as the worst of her ordeal. It was the first time she realized how her illness could change the course of her life in ways she had never imagined. She was not yet ready to have a baby, but she knew she wanted children and had recently bought a house with her longtime boyfriend. “I felt like a very big thing, a scary thing, because I thought, ‘And if that doesn’t go away, they will be able to find a safe way to be …
