For 66-year-old Usha Gulati, taking a breath of fresh air and smelling the roses in her garden had never seemed so precious. Taking a walk had never seemed an achievement. Cooking her son’s favourite meal had never been an accomplishment. Nor had she felt this fortunate ever since she contracted COVID on April 22, 2021. A little over a year, she can breathe on her own for half-hour spells a day, the oxygen mask scars a memory of the ordeal that she would rather not recall. And she is learning to walk all over again, one step at a time. For a woman who led an active life and had the world at her feet, she is content with this bubble-wrapped life. “As long as there is life, there is purpose. I am here for my children,” says the strong-willed woman, who has been in solitary confinement at the ICU for almost four months, in home ICU for another four, had a 100 per cent lung damage, lost a husband, and lived to emerge a long COVID warrior. A few days ago, she even celebrated her birthday, cutting a cake and counting her blessings.

THE DREADED DELTA ATTACK

Both Gulati and her husband, residents of Khurja, fell ill during the second wave of COVID-19. After three days of fever, both had to be rushed to the hospital as their oxygen levels dropped. Her husband did not make it as his oxygen saturation dipped all too rapidly. But Gulati, who has been a positive person all along, held on enough for her son Karan to bring her over to Kailash Hospital in Noida. But things looked bleak as even with a C-Pap machine, her oxygen saturation never got past 83 per cent. “The CT scan showed 100 per cent lung damage and doctors wondered where she was breathing from. She was diagnosed with Acute Respiratory Distress Syndrome (ARDS), a condition where fluid builds up in the tiny, elastic air sacs (alveoli) in the lungs,” says Karan, who, having lost one parent, geared himself up to save his mother. He shut down his factory unit and family home, liquefied some assets, rented a room in GK II after moving her to Indraprastha Apollo Hospital, New Delhi. “Experts suggested a lung transplant but her condition didn’t give them much confidence,” he says.

THE SLOW AND STEADY RACE FOR SURVIVAL

Dr Viny Kantroo, Consultant, Respiratory, Critical Care and Sleep Medicine, Indraprastha Apollo Hospitals, New Delhi, who was entrusted with Gulati’s case, decided to take it one day at a time. She put Gulati on a non-invasive ventilator (NIV). “Her ARDS was bad but what had us worried was the weakness in her muscles and nerves, which COVID had impacted severely. Despite artificial oxygenation, she couldn’t breathe as much because she couldn’t use her diaphragm which affected her breathing patterns. But her other organs were healthy despite some hypertension and the fact that she had led an active life helped. Also, unlike other patients in the ICU, who get irritable with all the intubation, Gulati remained calm and beat delirium. Her husband’s death was not revealed to her till she was strong enough to be discharged. We couldn’t risk more trauma,” says Dr Kantroo, who even visited Gulati at her family home in Khurja to monitor her recovery.

“I devised a mental routine for myself during my days in the ICU. I associated each of the 12 hours on the clock with the deities I worship and I chanted the mantra associated with each one of them in my mind for an hour. That’s how I stilled my mind and shut myself off from my disturbing surroundings,” says Gulati over the phone. That’s how she could arrest further deterioration, by calming her mind. Slowly she took to the Non-Rebreather Masks, which are attached to an air reservoir bag, which in turn is hooked to an oxygen tank. It is aided breathing but Gulati could gradually stay off the ventilator, going up to half an hour on good days. She kept a count herself and pushed herself to breathe an extra minute or two from the previous day. Just when things were looking up, they went downhill as she picked up a secondary infection from the NIV machine. That’s when Dr Kantroo moved her to a room with the same equipment and advised Karan to arrange for a critical set-up at home in a sterile atmosphere so that he wouldn’t have to rush his mother to the ER every time. Gulati came out of the momentary trough and prepared for her second confinement at home.

TAKING BABY STEPS AT HOME

Karan followed the doctor’s instructions to a T. He got a semi-oxygen plant set up at their family home. “A normal oxygen cylinder has a 15-litre pressure. This one converts that to pressure equivalent to 60 litres. An uninterrupted power supply meant that we had to have generators in place and maintain a room temperature of 24 degree celsius at all times,” says he.

Gulati was allowed to drink only 750 ml of water per day, put on a high protein diet of eggs, and aggressive physiotherapy. “Her leg muscles had completely given way and they are still weak. There was a point when she could not stand on her feet. Now she can walk around the house, go to the bathroom and clean herself. That has done wonders for her self-confidence. Ideally, I would like her to come to the hospital for good departmental physiotherapy. But she hates the hospital so much that we have kept her to a home routine. She now needs just half to one litre oxygen a day,” says Dr Kantroo.

Today Gulati can stay without artificial oxygen or masks for half an hour, during which time she moves around the house, goes to the kitchen and instructs her daughter-in-law how to cook the dishes she loves. But after that 30-minute break, she has to get back to her bed and rest for a longish spell. Karan has lengthened the oxygen feeder pipes so that she can be a bit more mobile in the house.

But Gulati says she has enough to keep her active. “My physiotherapy routine is such that each hour is slotted into some form of lung-strengthening activity. There are breathing exercises, spirometer exercises, deep breathing sessions, sitting, sidelying and prone positions, cycling, pedalling and plastic weight-lifting. There was a time when I was immobile and needed help to just turn me over. But persistence and dedication to my exercise routine has meant that I can take care of my own body.”

LOOKING AHEAD

Gulati has got 80 per cent of her lung functionality back and has a sound mental health despite the many shocks that her body has gone through. A social person, she now connects with friends and relatives on her cellphone. And talking to people has helped her come out of the stupor she had been accustomed to. “Normally she would cut the cake and neatly arrange the pieces in bowls herself. She couldn’t do that this year. She missed her husband too. Still she took things in her stride and smiled for all of us,” says Karan.

Dr Kantroo is fairly confident that in a few months, she could return to her normal life. The only thing that bothers her is Gulati’s excessive dependence on artificial oxygen when she should gradually wean herself from it and be able to breathe on her own completely. “We will be monitoring her blood clotting tendencies, heart health, sugar levels and thyroid. And she cannot risk a severe infection,” she says. The family has given up travels and luxuries for a quiet life at Khurja. But for Gulati, life is brimming over. Her only indulgence? Watching episodes of Bade Achche Lagte Hain.





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