Nastasia Xavier has developed a routine: she trains with physiotherapists during the day. She talks to her family on the phone and sometimes watches TV. But most days, she spends a lot of time enjoying the view from her hospital window.
“It’s beautiful here,” she said on Wednesday afternoon, admiring the mountains and evergreen trees in the region.
Xavier – a 33-year-old mother of two who lives in the Alaska Pilot Station – was hospitalized with COVID-19 at the University of Washington Medical Center (UWMC) for nearly 50 days.
She got sick towards the end of November, she said. She tested positive for coronavirus on November 24 and was admitted to Yukon-Kuskokwim Health Corporation (YKHC) in Bethel, a hospital serving tribes in southwest Alaska, on Thanksgiving.
It was the worst that she ever felt.
“It was worse than a cold,” she said. “I had to push myself to eat.”
Xavier was at Bethel for about three weeks, but her condition did not improve. Her medical team wondered if she should be taken to a larger hospital in Anchorage.
In mid-December she was placed in a medically-induced coma by doctors in Alaska, which is common in extremely sick patients with pneumonia, said Dr. Kevin Patel, the medical director of the UWMC Medical Intensive Care Unit.
She was out and about for weeks, said Patel, who was the attending physician who was involved in Xavier’s initial intensive care.
On December 17th, she was flown to Seattle.
“She was very, very sick with multiple complications from COVID-19 pneumonia that really caused many of her organs to fail, especially her lungs,” Patel said, later adding that she also battled kidney and heart damage. “Surely most people with this amount of organs affected by COVID-19 are at extremely high risk of short-term mortality.”
Her UW medical team put her on dialysis and extracorporeal membrane oxygenation (ECMO) support shortly after arriving in Seattle, Patel said. ECMO devices, which he said are only used by a handful of health centers in the Pacific Northwest, pump blood outside the body to a heart-lung machine that removes carbon dioxide and sends oxygenated blood back to the body.
The treatment, which UW Medical Center has been using for years, is usually used on the minority of patients because it is a high-risk procedure that is still relatively new to patients with COVID-19, Patel said.
In Xavier’s case, however, she also suffered from additional complications from right ventricular heart failure, which prompted her medical team to implant a right ventricular assist device (RVAD) near her heart to help pump blood.
Her team monitored her condition for weeks, hoping that her efforts would help her stabilize.
When she finally opened her eyes on January 7th, she thought she was in the hospital in Anchorage.
“When they told me I was in Seattle, I said ‘holy cow’,” she said with a laugh. “I’ve never been to Seattle.”
Since then, Xavier has worked with physical therapists, occupational therapists, and speech therapists, Patel said.
While she felt better waking up, her family – her parents, younger brother, and two daughters – were back at their home in the Pilot Station in Alaska. She felt all alone, she said.
“I just miss my home, miss my family, miss my two children,” she said. “I’m just far from home.”
The family has had some difficult months.
Her older brother died of COVID-19 on November 25, the day before Xavier was hospitalized in Bethel. Then her parents and younger daughter – 5-year-old Sasha – tested positive for the virus, even though they didn’t have any serious symptoms.
Fortunately, Patel said, Xavier has made significant improvements since she woke up in Seattle – and will be laid off Thursday afternoon.
“It really is an incredible story,” said Patel, noting how rare it is for such a young and relatively healthy patient to be hospitalized in the intensive care unit with the illness caused by the new coronavirus. With multiple complications from COVID-19, Xavier is close to death, he added.
“It’s so rewarding to see someone get through,” said Patel.