From nurse to patient

Fall 2020

A caregiver’s story of his fight with COVID-19

It was the call Nabila Abdulhaq never thought she would receive. “I’m sorry to tell you, your husband has COVID-19,” shared the voice on the other end of the line. That news, delivered by a nurse at London Health Sciences Centre’s University Hospital – although frightening – was also in some way a small relief after almost two weeks of puzzling illness for Nabila’s husband, Mohammed.

Mohammed Abdalhaq, a 54-year-old London resident and registered nurse by profession, started feeling unwell on May 10, 2020. Feverish, with a sore throat, Mohammed did what anyone living and working in a global pandemic might do – he went for a COVID-19 test. Relieved when that test came back negative, but a swab for strep throat came back positive, it seemed like a course of antibiotics would do the trick to getting him back on his feet.

When his fever continued to climb, in spite of the antibiotics, a second COVID-19 test was performed – also negative. “I was happy when my tests came back negative, but as a nurse, something told me I should still be cautious,” says Mohammed. “The fever was what worried me most. It wouldn’t break.”

With the approach of Eid, the traditional end of the month-long dawn-to-sunset fasting of Ramadan, Mohammed looked forward to the family time the holiday would provide. He was still not feeling himself though, and out of an abundance of caution, he decided to have a third COVID-19 test performed which once again came back negative. Two more subsequent tests in the coming days were also negative.

Still concerned about passing illness onto his family, Mohammed isolated himself in a bedroom at home, not allowing his family to enter his room. If they did need to go in, they wore face masks and gloves.

On what Nabila refers to as “the worst Eid ever,” she went to check on her husband, concerned that he wasn’t communicating with the family. Opening the door, she was terrified by what she saw. “My husband has never been sick before,” says Nabila, “and suddenly he’s having trouble breathing, his fever is getting higher, he’s stopped eating. The uncertainty of what was happening to him was the scariest part.” An ambulance was called once Mohammed’s fever registered almost 40 degrees Celsius, and paramedics took him to University Hospital where he was admitted to the Intensive Care Unit (ICU). It was here that his fears were confirmed – he tested positive for COVID-19.

“When Mohammed was admitted to the ICU, he was a very sick man,” says Dr. Wael Haddara, Chief of Critical Care at London Health Sciences Centre. “As an ICU nurse himself, he understood what was happening to him and around him. When he learned he had tested positive for COVID-19, he knew what that meant.”

What it meant was that Mohammed was in a life or death struggle for survival. Knowing the outcomes for patients who were placed on ventilators were poorer than for those who weren’t, Mohammed was determined not to go that route. Dr. Haddara was in agreement, leading the medical team to try various interventions to avoid ventilation. “Mohammed was placed on very high flow oxygen, receiving 60 litres per minute. A typical nose-pronged oxygen level is 6-10 litres per minute. We tried a non-invasive ventilation mask that fits tightly and provides high concentrations of oxygen. There were several times throughout those first days Mohammed spent in the ICU that we thought he was on the verge of needing to be placed on a ventilator to save his life, but he always came around,” recalls Dr Haddara.

One of the things that helped avoid the need for a ventilator was moving Mohammed into a prone position, meaning he was placed on his stomach rather than his back. This technique was showing promise in patients both at LHSC and elsewhere in the world, and in Mohammed’s case, it turned out to be highly effective. Spending 18-20 hours per day on his stomach, Mohammed had lots of time to think about his family, and when he would be able to return home to them.

What he didn’t know was that once he tested positive for COVID-19, his family was advised to go for tests of their own – and Nabila’s test had returned positive as well. Although Nabila was fortunate to not show any symptoms of the virus during her 14-day quarantine period, it was a burden the family chose not to add to Mohammed’s thoughts during his time in hospital. Instead, the couple’s four children, Rouzan (29), Nidal (27), Farah (23) and Abood (21) took over maintenance of the household, ensuring Mohammed and Nabila could focus on their own health.

“When my mother was diagnosed with COVID-19, and my father was already in intensive care fighting for his life, my first thought was ‘am I going to lose both of my parents?’” recalls Nidal – a concern shared by his siblings as well.

Throughout Mohammed’s hospitalization, his family made sure he knew they were thinking of him with posters for his room and daily phone calls, first to his care team, and eventually to Mohammed directly once he was strong enough to speak. Says Farah, “the first video call was five seconds, but we didn’t care – at least we got to see him. We called at the same times every day. The nurses were always very patient with us, answering questions and sharing information about my dad’s progress. They were incredible.”

After 14 days in the ICU, Mohammed was moved to the Medicine Unit where he stayed four days before being released home, still on oxygen, just in time for a very special celebration – Farah’s wedding. While COVID-19 had changed wedding plans to an intimate backyard affair, Mohammed was thrilled to finally get to hug his children and his wife, and put on his suit to walk his daughter down the aisle.

Looking back now, Mohammed is grateful. Grateful for the family and friends who rallied around him, for his wife and children who had the support they needed to get through this difficult time. Grateful for the medical team at University Hospital who cared for him just as he would care for his own patients. And grateful that although he is not fully recovered yet, he is well enough to be home with his family where he belongs.

As for how Mohammed could have tested negative several times before receiving a positive test result, Dr. Haddara suspects Mohammed’s illness did indeed start with strep throat, leading to the symptoms he experienced, and that the virus was contracted sometime during that illness. “While false negative tests are possible, particularly in the early days of COVID-19 infection, it is uncommon to see multiple false negatives,” says Dr. Haddara. “In Mohammed’s situation, his initial symptoms can be explained by the strep throat diagnosis, and only when the virus load became strong enough did the COVID-19 testing return a positive result.”

Says Mohammed, “this virus is real, and it’s serious. No one should think it’s easy being in the ICU fighting for your life. I still can’t walk far, or climb the stairs without losing my breath, and we don’t know if the damage to my lungs will be permanent.”

But for Nabila, who remained symptom-free and is now clear of the virus, the greatest blessing has already occurred – her family is together once again. “I can never forget the people who have helped us through this experience. Our children were so strong for us. Our friends did everything they could to support our entire family. We will continue forward with positivity and hope and faith – and we will get through this, together.”

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Mohammed Abdalhaq
Mohammed and his wife, Nabila
From left: Abood Abdalhaq, Nabila Abdulhaq, groom Taha Osman, bride Farah Abdalhaq, Mohammed Abdalhaq, Rouzan Abdalhaq and Nidal Abdalhaq celebrate Farah’s wedding the way they hoped they would – together.