T1D + COVID-19 Positive—One Nurse’s Story
Editor’s Note: We have a simple goal: tap into the power of the global diabetes community to save lives. Visit coronavirusdiabetes.org to learn more about what you can do as a person with diabetes to keep yourself and others safe from COVID-19 until we’re all safe.
This article was published in April 2020. Coronavirus symptoms can present with various levels of severity, and this first-person account is not typical of all cases.
Ashlee Ernst is a nurse at the Barbara Davis Center for Diabetes in Denver, Colorado. She is 25 years old, has had type 1 diabetes for 15 years and recently tested positive for COVID-19. She took some time to answer questions about her experience and what it’s like to live with chronic illness and contract this virus. This interview took place on Thursday, April 2nd. Watch the full interview here:
Partial transcript below, edited for content and clarity
Why did you get tested initially? Were you showing symptoms or had you been in contact with someone who had tested positive?
Ashlee: So I had started having headaches and I just kind of wrote them off like no big deal. It could be related to X, Y, or Z and then I got a message from a friend they had tested positive and people in their family had tested positive. I knew that I had been in close contact with them in the past week. And so through work they had me call into a health line and they decided to test me because I have type 1, and because I’m a nurse and I was showing mild symptoms.
Can you tell me a little bit more about those symptoms? Did you have a fever?
My symptoms at the beginning just started as a headache and then turned to sinus pressure and then some sinus congestion. I really don’t fit the textbook coronavirus symptoms. I never had a fever and I didn’t have a cough. I really stuck with headache, exhaustion, some sinus congestion and then some shortness of breath after walking upstairs… I think that’s a good reminder for people that Coronavirus shows up differently in everybody. We have those basic or main symptoms that a lot of people are seeing, but it really can present or not present in people and they can still be positive.
Would you normally have even seen a doctor about these symptoms?
I don’t think I would have seen a provider if we weren’t in this pandemic.
Since you’ve tested positive, how have you been isolating yourself? What have you been doing?
I kind of went on lockdown and I haven’t been to work for a couple of weeks. I was thankfully diagnosed on a Monday so I wasn’t at work that day. We have moved to all telehealth pretty much. And so I haven’t been around anybody except the people that I live with. And even they have been on quarantine too.
I was released from quarantine this past couple of days since… it’s been seven days since my first symptom or three days after my last symptom. It’s a very confusing regulations that they’ve put on it. I haven’t seen anybody. I’m doing a lot of FaceTime to stay in contact with people. I have stayed home for the past two weeks now that this is going on.
When do you know officially that you’re clear to go back into society + back into work?
I actually got a call from my health department here locally telling me when I can return back to work as well as our employee health, so I followed their guidelines. They were saying seven days after your first symptom or three days after your last symptom, whatever’s longer. And so mine was seven days after my first symptom because my symptoms were so short, they were only a couple of days. And then I’m supposed to wear a mask for two weeks once I’m out in public interacting with people.
Did you notice any changes to your diabetes management as a result of this?
I was very vigilant and actually it was kind of a blessing in disguise that I was home and didn’t have anything to do because it allowed me to really focus on my blood sugars quite a lot. I wasn’t expecting them to look how they did and in fact I had some of the best days of my blood sugar control during COVID-19. I was shocked by that. And I think that’s something I shared a lot with my type 1 friends is that I was not expecting my insulin needs to stay the same. I was expecting them to increase, but I didn’t see that. I was testing ketones a lot because you can still spill ketones when you’re sick, even if your blood sugars aren’t high. And so I was doing that about every four hours just to be sure I was in the clear.
Some of the symptoms of Coronavirus can also show up as symptoms of ketones. So I wanted to be sure that my headache and thirst and things like that weren’t related to that. I also was pushing fluids. That’s such an important thing whenever you’re sick with anything to be drinking a lot of fluids. And I also made sure that I was keeping carb intake up. So if I wasn’t hungry for a meal, I would have some carbs through liquid or any way just to be sure that I didn’t start getting fasting ketones.
As a nurse, have you seen patients with Coronavirus or have you heard of any of the patients at the Barbara Davis Center who have tested positive?
What we’re seeing is that kids aren’t really being tested for it. Although they might present with symptoms of it, they’re not necessarily being tested. I actually just talked with Dr. Alonso at the Barbara Davis Center and he had seen a patient or two that had tested positive for COVID-19 and they were recovering within a couple of days. Granted that is unique to each person. We can’t expect that to be across the board.
But what we’re sharing with our patients is the best thing you can do for yourself is of course: good hand-washing, remaining at home, away from groups of people, staying with your close contacts and then also just really trying to focus in on good blood sugars. Research has shown for a long time that you handle things better when your blood sugars are in control. So if you can take that extra time to make sure your blood sugars as much as possible or in range, it really does help a lot.
Has there been an increased level of personal protective equipment (PPE) use, what is the protocol like?
Right now at the Barbara Davis Center, most all of our daily visits that we see are all telemedicine. We are still coming into the clinic and doing in-person new onset education and that’s pretty much it that’s happening at the BDC. So most of our staff is working from home trying to reduce contact. We’re constantly wearing masks. But we work really closely with the children’s hospital here and they’re in full PPE and everything and they make sure that the patients are COVID-negative when they come to us for education.
Has anything been more difficult for you? How have everyday things changed after testing positive?
I’m grateful to have a good support system that dropped off groceries to me. And it is definitely more challenging. It was time for me to get my insulin prescription refilled and so navigating that, thankfully my pharmacy did mail order so I set all of that up. But those are extra things we have to think about, not going crazy with the stockpiles, but making sure you have enough food for the next couple of weeks. Making sure you have enough diabetes supplies at home for the next couple of weeks. Being sure that your bases are covered so that you can take the time to really care for yourself.
Is there anything else you want to say to people out there living with diabetes, who might be scared that they’re going to come down with Coronavirus?
I think there’s a healthy amount of fear to have. Be safe, wash your hands, eat well-balanced meals, take care of yourself, rest. Sleep is so important, but we can’t live in constant fear. And so work with your healthcare providers. If you think you have COVID, reach out to them. Ask to be tested, but also work with your diabetes care team.
If you’re struggling with blood sugar management, really reach out to them because they’re probably more than happy to help bring your blood sugars back into target range and then help you with dosing adjustments surrounding illness.
Get answers to more COVID-19 questions—The Latest on COVID-19 From Dr. Anne Peters.