Recovering COVID patient coping with depression, regrets

Conflicting news earlier this year about COVID-19 vaccinations confused Michele Budd, so she put off deciding if she should get the shot.

Then she got sick and spent two weeks in the hospital.

Budd had been careful, staying separated from co-workers and only seeing immediate family members.

“I just thought we were fine,” she said. “I wasn't really sure about the vaccine yet. It was just so confusing with all the talk in the media about it, so I just didn't do anything. Then I ended up getting the Delta variant.”

At first, she treated it like it was the flu. Budd, who is 57, had always been healthy and active and figured she would get over it. But then it hit her harder fast.

Her symptoms began on a Saturday with painful headaches and she thought maybe it was allergies. She got up and went to the grocery store and started her day.

“By the time I got back, I was so sick,” Budd said. “I was just lying on the couch.”

She was sick all weekend and had a slight fever. On Monday, she called her regular doctor who prescribed antibiotics for an upper respiratory infection and told Budd to get tested for COVID.

“I got tested that morning, and it just went downhill from there, like super-fast,” she said.

Budd and her husband Joey—who also tested positive for the virus—went to an urgent care center on the island. While he received a monoclonal antibody treatment, the medical staff couldn’t give the same treatment to Budd.

“It was because I already had full-blown pneumonia, and my lungs were just full,” she said. "They kept me overnight."

In the morning, she left the urgent care center and went home, but a few hours later, things got worse.

“It was just like something exploded in my chest,” she said. “I mean, it hurt so bad it went from the middle of my sternum, all the way to my shoulders.”

Since her husband was also sick, their adult son picked her up and took her to the UTMB emergency room.

“They had to leave me there in the ER and then I was in the hospital for two weeks,” she said. That was Aug. 4. She wouldn’t see her family again until she went home Aug. 16, the day before her 57th birthday.

When she told doctors and nurses that she wasn’t vaccinated, they didn’t judge her, she said. They treated her with kindness and care.

“It wasn't like they were mad at me anything, they just tried their hardest to get me better,” Budd said. “It was just interesting to see the stress on them as well as what it was on my own family.”

Doctors and nurses at Jennie Sealy Hospital were already caring for many Delta variant COVID-19 patients when Budd was admitted.

“The vast majority of COVID admissions were younger this time around compared to last year, and predominately unvaccinated,” said Dr. Megan Berman, an associate professor of internal medicine at UTMB and one of the doctors who took care of Budd. “This shows how fortunate we are to have effective vaccines to prevent becoming severely ill from this virus. Every unvaccinated hospitalization and death at this point in the pandemic is heartbreaking as it is truly preventable. “

Thankfully, Budd’s condition improved. On her last night in the hospital, Budd overheard an ICU nurse who was helping on her floor talking to one of the regular nurses.

“She was telling my nurse that she just wanted to see somebody that was getting to go home that had a good outcome,” Budd said. “When she turned around to leave, she was crying.”

When patients left the unit and had to go to the medical intensive care unit, they weren’t expected to live, or at least that was Budd’s impression and her fear during her hospital stay.

Going to the intensive care unit does not kill you, said Dr. Shawn Nishi, an associate professor of critical care medicine at UTMB. But even in the best-case scenario, about 60 percent or more of these patients died. During August and September, it was closer to 80 percent, she said.

During this last surge, the medical intensive unit stayed busy. Nearly half of the ICU patients were under 50 years old and all but one or two were unvaccinated, Nishi said.

“We have seen much younger patients coming with severe respiratory failure,” Nishi said. “They progress very quickly to needing mechanical ventilation, and unfortunately the survival of patients once intubated—which are most of our patients in the ICU—is abysmal.”

About a month after leaving the hospital, Budd continued to recover and started working from home for her employer, a Houston-area electrical plant. At first, she found it took her an hour to do one simple task. Emails were exhausting. She still keeps an oxygen tank close by to help with breathing.

She went from being a person who remembered everything and paid attention to all the details for everyone else to not being sure whether she had taken her medicine.

“I still have weird things sometimes that I can't remember,” she said. “I can tell I'm still not all there, emotionally and physically. Your mind just plays some tricks on you and it's just very stressful. It's not like being sick with the flu.”

She can’t remember much about her first few days in the hospital but she does remember some of her dreams.

“I would have horrible nightmares at night,” Budd said. “It was weird, and it was in black and white. These ladies were grabbing me from in the ground and stuffing my throat with my hair, my long hair. I would struggle trying to wake up because I couldn't get away. And then I would hear myself like call or something, and I knew I was dreaming but I couldn't wake up.”

Her mood has also changed.

“I've never been a depressed person, but I felt literally like I didn't want to be here anymore,” Budd said. “And it was just the most horrible feeling, and it would come and go at the weirdest times.”

When she first went back to her hair salon, she took her oxygen with her.

“I still couldn't go anywhere or walk very far,” she said. “It was just scary to be out not knowing if you're going to be able to breathe or not.”

It turned out her hairdresser had also contracted COVID and was dealing with depression herself.

“She just would have these horrible thoughts about ‘what if I just kept driving and not being here.’ It makes me want to cry because I felt the same way,” she said. 

These feelings are not unusual for recovering patients, said Tammy McCrumb, nurse manager of the Post-COVID Clinic on the UTMB Health Clear Lake Campus.

“We have definitely had our fair share of mental health concerns and have seen many patients who have developed anxiety and depression after having been diagnosed and treated for COVID,” McCrumb said. 

Her patients complete several mental health screening questions during their initial evaluation to determine what kind of impact the disease has had on them. 

“Some patients have been more affected than others depending on the extent of their illness,” McCrumb said. “Those hospitalized and those who suffered more severe symptoms tend to be the ones with more of the depression.”

Knowing what she knows now after her time in the hospital and dealing with the lingering effects of COVID, Budd is encouraging her family and friends to get vaccinated.

“My mom went and got vaccinated,” she said. “My whole family and my sister’s family got vaccinated. All our friends who hadn't got vaccinated, they went and got it because they saw what we were going through.”

Budd hasn’t gotten her vaccination yet. She is waiting until her next follow-up appointment, she said.

“If I can change anything, I would take away all the politics and the news media out of this situation and have only the medical people talk to people about vaccinations,” Budd said.