Day 1: An ICU Nurse’s Day to Day Home COVID Treatment

I can not 100% say the day of my facial swelling was day 1, but it is 100% the first day I started taking medications to counteract my COVID symptoms. I had joint pain in my knees and hips for 2 days before the facial swelling occurred. How did I treat the facial swelling? I treated it as an allergic reaction at this point. Without any airway or breathing difficulty, there was no reason to visit the Emergency Department (ED). I self-medicated and went to Walgreens. First, I prophylactically took my albuterol inhaler to keep my airways open. Albuterol can prevent bronchospasm, which is common in allergic reactions. Albuterol is a bronchodilator and opens up your bronchioles (the tubes that your air flows into your lungs from). I picked up Benadryl and Claritin from Walgreens and started my treatment. To read more about my day 1 symptoms, click here.

DAY 1 MEDICATIONS	PURPOSE
Benadryl 100mg in AM	Antihistamine = decrease facial swelling
Claritin 10mg in AM	Antihistamine = decrease facial swelling
Albuterol Inhaler 2 puffs in AM and every 6 hours	Bronchodilation = keep airways open

I started with 75mg of Benadryl (the MAX dose of Benadryl is ~ 300mg, so I allowed for a little big of wiggle room & re-doses throughout the day). Two hours after my initial benadryl dose, I took another 25 mg for a total of 100mg Benadryl in a pill form to reduce the swelling. I did not start Pepcid until day 2, which helped to rapidly decrease the swelling. Why didn’t I add that initially? I was trying to see if I could achieve the desired results with fewer medications. Again, my airway was never compromised. I was treating the swelling for cosmetic and comfort purposes. Eventually, I added Prednisone on day 3, a catabolic steroid categorized as a glucocorticoid, as well. This is when I saw effective results with the inflammation, but at this point the other COVID symptoms were in full effect.

What would have happened if I went to the Emergency Department? They would give me Benadryl, Pepcid, and Prednisone for an allergic reaction. Depending on the severity of the reaction, they would give these drugs intravenously (IV) or in a pill form (PO). More than likely, they would administer the medication IV for rapid results.

Why did I choose these medications? They are histamine blockers. Benadryl is an H1 antagonist, blocking histamine at the H1 receptor. Pepcid is an H2 antagonist, blocking histamine at the H2 receptor. Claritin is another histamine blocker, it blocks the H1 receptor and prevents itching, swelling, and other effects attributed to allergic reactions. On another note, Benadryl also blocks acetylcholine, a neurotransmitter responsible for helping memory and learning. Is this why I do not remember my interviews from day 6 of COVID very well? ? ?

Why did my face swell with COVID? It is not 100% understood, but healthcare professionals believe it is due to an overactive immune response. Some people, especially younger individuals, are more likely to have a hyper-immune response with COVID. When this happens, histamine is released, causing facial swelling. When I googled it, I found out there were several others who discovered they had COVID when they panicked and went to the Emergency Department (ED) for facial swelling.

With my extensive medical training and knowledge, I knew I was OK because my airways were open. I did not panic. If I was going to develop breathing problems, it would have already occurred. The best thing for me to do was save myself an unnecessary $1,000 ED visit and self-medicate. If my swelling did not respond to Benadryl, Claritin, and Pepcid, then I would seek help.

The catch 22 of the hyper-immune response is your body attacks its own self, causing some of the long-term side effects of COVID. Lung damage and heart damage are common after-effects discovered long after the virus subsides. Healthcare professionals believe this is due to an overactive immune system that attacks its own self. YIKES! ? ?