Noble Hospital challenges CO-RADS -6 ~Patient fights back to survive without the usage of Ventilator~

Chennai, September 2020: Noble Hospitals successfully cured a COVID 19 patient where the virus involved 100 percent of her lungs without Ventilator, Patient Ms. Hymavathy, 54 F from Nellore, AP who was diagnosed with severe acute respiratory syndrome coronavirus and completely hand washed from a hospital in Nellore post her COVID diagnosis. Mrs. Hymavathy, however didn’t lose hope and moved to Chennai Nobel Hospital, Purasaiwakkam even after knowing that her health condition was 99% not in a position to cooperate & not with much hope of survival. She got herself admitted in a critical condition in the hospital to get herself treated and now post her treatment the patient is COVID free. The Hospital also mentioned that the patient was so determined to get herself cured without the usage of the ventilator.

Dr. Balaji Ravilla Baskaran, MBBS, MS – General Surgery, Noble Hospital said, “Both Husband & wife had symptoms of COVID on 25th Aug 2020, however both of them rapidly worsened in 5 days’ time with Mrs. Hymavathi’s white blood cell count dropping to 1500 and CT taken at Nellore showing signs of COVID. On the 6th day after symptoms started, they both were transferred to care in our hospital in Purasaiwakkam, Chennai. Early Sep 2020 Mrs. Hymavathy was in breathless condition requiring oxygen support and her CT chest after admission showed lung involvement of 19/20 that is almost 95 %- portending a worst prognosis. Adding fuel to the fire, Her markers like serum ferritin being above 1000, c reactive protein above 18, interleukin 6 (IL 6) progressively increased from 4 to 202 over next 7 days & Neutophil lymphocyte ratio ( NLR) increased from 2.35 to 8.5 in the same period – all indicating the worst to come.

She rapidly deteriorated from mask oxygen to Venturi mask oxygenation to high flow oxygen & finally non-invasive mask ventilation – stopping just short of ventilator. The family were counselled about almost certain mortality and high supports required which might be futile in her case. We had not entertained any hope about her survival having dealt with about 1500 cases as outpatients since April 2020, out of which 1000 cases were treated as inpatients & Noble Homecare services. Every fibre of our COVID experience says her “Odds of beating this disease was as futile as expecting the sun to rise in the west.”

Her husband meanwhile made a rapid recovery even though he was more obese & relatively less fit than his wife. Mrs. Hymavathi started to lose her grip on her chances of survival and was on verge of giving up her exhaustive breathing schedule. On 9th day after admission we repeated the CT chest and found 20/20 involvement – that is “100 % of lungs were taken” In spite of best anti virals, immune boosters, nutritional support & chest physiotherapy.
Dr. Manodhini, Senior COVID Care Registrar & Dr. Arun, COVID Physician, Noble Hospital mentioned, “Whenever the family asked the question, “How is my mother?”. Our standard answer was,” If there is no deterioration it is an improvement.” Miraculously over a period of 2 weeks since admission she still persisted with her efforts at breathing

without needing a ventilator. There were days she would appear forlorn but she never wavered or panicked. Her greatest motivation was when we lied to her that her husband is also struggling but he said he will continue to fight the disease only if I assured him that his wife is going be alright. That was great morale booster for her. Then she stopped distressing herself with negative emotions & focussed on the job at hand – “To breath in rhythm with the machines 24/7”. All the while her food habits were spot on in spite of oxygen dropping for those 5 mins when we have to take the mask off for oral intake”.

Today on 25 September 2020, 24 days since admission, the virus has now long gone from the body but the ravages in lung remain but she fights on gamely with a smile & sheer determination. She now walks about 50 meters three times a day without oxygen. She does her breathing exercises three times a day and follows a healthy diet of uncooked food like salads, fruits, nuts and dry fruits.

Patient Hymavathi is a perfect example of a human being who didn’t pay attention to forecasts and believed in herself. She completely cooperated with caregivers and physiotherapist. She never wasted her energies worrying and was never overwhelmed by the situations. We have no scientific explanation about why her inflammatory storm didn’t damage her lungs but did for every other person who had half her lung involvement. Her case is an example to always put human spirit above scientific temper!

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