The last 52 days have altered Alethea Brown’s life forever.
On April 6, Brown, a certified nursing assistant (CNA) and frontline worker, awakened to a frightening new reality.
From a terrifying experience that included high fever, extreme fatigue, and uncontrolled coughing fits, Brown has to now adjust to continuing forward with recovery caused by contracting COVID-19.
Though she now has to make use of a walker, undergo daily physical therapy, and may have to rely on an oxygen machine for the rest of her life, Brown said she relishes each new day as a true blessing.
Brown’s COVID-19 ordeal was full of terrifying moments, she said. Even from recognizing the first symptoms, she said it was unlike anything she had experienced before.
“I noticed the first symptoms on April 4 after I got off work,” Brown recalled. “I went to bed and started coughing. That’s when I took my temperature for the first time. It was normal, so I decided to go to work on April 5.
“However, when I came home Sunday (April 5) afternoon, my mom recommended that I take my temperature again,” she continued. “I took it again around 4:30 p.m. for a second time and it read 101.3; then, a third time, it came back 104.
“By Monday morning, I had symptoms of coughing, fatigue, high fever, and shortness of breath,” Brown said. “My mother immediately told me to go to the doctor. I drove myself to Wellstar and was admitted.”
Brown was immediately admitted to the telemetry unit of Wellstar Atlanta Medical Center South in East Point.
Based on the severity of her symptoms, doctors immediately placed Brown on oxygen and started administering antibiotics along with fever medication to stabilize her. This procedure is known as a sepsis protocol.
Next, Wellstar doctors administered the test for COVID-19. Brown said she did not receive an official diagnosis until April 9. However, Wellstar stated the first diagnosis as bilateral pneumonia. The second diagnosis was sepsis, and, finally, COVID-19 was the third diagnosis.
By the next night, Brown’s condition had worsened, including the need for an increase of oxygen. The doctors also decided to transfer to the hospital’s ICU.
Early on April 8 around 4:30 a.m., the ICU doctors called Wendy Bonhart — Brown’s mother — to deliver news of the severity of her daughter’s condition.
“I was terribly frightened for her well being,” said Bonhart, a former registered nurse. “I knew that if she was placed on a ventilator, she would not get off. I felt helpless because you cannot go see your loved ones in the hospital.”
Because of her background, Bonhart knew to ask specific questions regarding her daughter’s care plan.
“In a time of crisis, there are important questions that you should ask,” she advised. “What is the temperature today? Did blood work improve? What are the results of a chest x-ray? These questions are helpful for a patient who is not currently on a ventilator.”
Bonhart also advised families to designate a single spokesperson to speak directly with nurses and doctors. Families should also make use of a group text so that everyone can be quickly updated about the medical results.
“If you have problems communicating with the doctor contact the hospital’s patient services department for assistance,” she added.
Due to her condition, Brown was unable to talk or video chat with her mom. In fact, Brown was unable to speak at all. The symptoms of COVID-19 caused extreme muscle weakness along with pneumonia in her lungs. The high fevers she experienced have also been known to cause disorientation and confusion.
As a result, Bonhart and Brown’s only method for communication was through the phone. Without the ability to speak, Brown patiently listened to her mom on the phone as Bonhart doted her with prayers and words of encouragement.
“The ICU nurses were very helpful in arranging me to speak with Alethea,” Bonhart said.” I made arrangments to speak with the nurses on both shifts.”
On April 9, three days into her 11-day stay at Wellstar, Brown’s results were officially confirmed as COVID-19.
Brown’s body was not responding to any antibiotics, she said. She required lots of fluids and oxygen. Contrary to what had been widely reported on TV news, Brown did not receive hydroxychloroquine or Remdesivir.
By April 11, Brown’s temperature finally broke, allowing her to breathe better. On April 12, Brown’s oxygen intake was reduced to 8 liters of high-flow oxygen as she began a turning point in recovery.
On April 13, Brown was transferred from ICU back to telemetry. She then immediately started physical therapy while in the hospital. The following days, Brown was able to continue a physical therapy regimen with reduced oxygen.
As Bonhart prepared for her daughter to be discharged from Wellstar, she said she became concerned when she encountered difficulty in communicating with Brown’s case manager.
Because of her background, Bonhart knew that the discharge process involves planning for home health care, correct prescriptions of medication sent to the pharmacy, and adequate transportation if needed.
Bonhart knew that her daughter would also need a stretcher and oxygen.
On the morning of April 17, the doctor wrote an order for Brown’s discharge. Bonhart said she had to fight for a medical ambulance, which must have a stretcher and oxygen on board for transportation.
“There was an extremely long delay in getting Alethea home,” Bonhart recalled. “None of the concerns of home oxygen, follow-up home health, or transportation home was addressed until 6 p.m. Alethea did not arrive home until 9 p.m. by ambulance.”
After reviewing discharge instructions, Bonhart said it took two weeks to get a home health nurse assigned to care for Brown as a result of the agency’s failure to provide one.
However, it was when Brown received an invoice from Wellstar that she and her mom were truly taken aback.
Wellstar billed Brown more than $100,000 for services rendered at its facility, an amount that did not include the ambulatory service or the doctors’ charges.
Additionally, though Brown received a diagnosis of COVID-19 and had been treated for the virus for the bulk of her 11-day stay, the medical billing department had not listed it as Brown’s primary diagnosis for care.
The way the bill had been coded, Brown would have to pay most of the charges out of pocket. That was unacceptable, Bonhart said.
“It is important to make sure that you monitor and read all medical statements,” Bonhart said. “It is important to make sure COVID 19 is the primary code for billing.”
Bonhart said she noticed the errors in the statements and politely asked the hospital’s medical billing department to change the primary diagnosis to “COVID-19,” emphasizing that Wellstar would be reimbursed faster by the insurance company with this important change.
After carefully reading through all of the statements, Bonhart also noticed that her daughter’s ambulance bill was coded as “muscle weakness,” not COVID 19. The ambulance bill charged over $1,500.
“You must read all the bills very carefully,” Bonhart said. “It is extremely stressful with dealing with a loved one who has COVID-19 and to read over bill statements.”
With no certainty of the origin of contracting COVID-19, it’s impact has certainly changed Brown’s normal routine.
Today, however, Brown and Bonhart said they are both optimistic about the future as they continue to work together on Brown’s recovery.
“It is a difficult process to go through and it takes a village,” Brown said about having to step into the role of her daughter’s advocate and caretaker. “I am thankful that Alethea is alive to has the strength to keep going.”