Healing Reflections: Together We Are One by Richard Arndt Pharm. D., R.Ph. & Lori Arndt, P.A.-C

Jan 19, 2021 | Hannah Schlotthauer | @schlohan

"Together We Are One"
Story by: Richard Arndt, Pharm. D., R.Ph. and Lori Arndt, P.A.-C. | Mayo Clinic Health System

Richard, Mayo Clinic Health System

This was a remarkable opportunity to work with an amazing group of colleagues across the enterprise to provide a level of care, that has a phenomenal impact on a patient's progression and outcomes. For those who contract COVID and meet criteria for emergency use for monoclonal antibodies we use, it allowed us the tools finally to able stem the tide. Everyone has seen the impact of what happens to patients as they progress. Health care providers felt this. We felt the fear and pain of being helpless and watching patients and families suffer this tragedy that can occur. Having these two agents provide us with this resource was almost like a golden bullet. I don't think there's many times in your career that you get provided an opportunity to establish something from ground zero, in a pandemic of a novel virus. We were able to bring a group of individuals together with phenomenal leadership to stand up an infusion center to aid our community and colleagues. This was just one of the most remarkable and satisfying achievements I think for a lot of us we've been able to accomplish.

The needs of our patients are important. We're doing this for the patient, we're not doing this for ourselves. We're not doing this for financial reasons. We're not doing this for glory. We're doing this for our prime reason. We were able to get the right people, the right leaders, the right staff, and the support and backing needed. At the same time, we kept quality and safety was never jeopardized.

Lori, Mayo Clinic Health System

I was asked to join the team. We knew monoclonal antibody therapies were going to be approved by the FDA for emergency use authorization in early November. The first was November 9. The next was Regeneron, which I think was November 21. I was asked by Dr. Patel, department chair at the time, to become involved. I'll use her words, ‘but own it’. She wanted me to own it and said this is a project I really need to be a part of, because she was asked to be a part of the vaccine group and had other responsibilities. She asked me to get the infusion center running as soon as possible. We were given about two weeks so we could administer our first infusion before Thanksgiving. Since then, we had phenomenal response from our patients. Not only saying that within 24 to 48 hours, they felt significantly better, but we've been able to keep most of our patients out of the hospital, who otherwise would have been coming in. I don't think that's something people truly appreciate with this treatment. Whether it's the patients that we're giving this drug to, healthcare members, it's something so powerful that we can reduce their risk of hospital admission, reduce their severity of outcomes, and to get them on the path to healing much faster than they otherwise would.

Part of part of this was to establish a physical center to have all the team members involved. My role was to make sure that we could order the drug that patients were being consented for, that we had staff on site, should issues arise or if there should be adverse reactions. At the the antibody therapy meetings in the morning, we would go over various issues and concerns that we'd have. Now there's other drugs coming down the pipeline that we can potentially use. I just remember the beginning of this. I don't think there was a day that I was off for probably one or two months when this first happened. It’s tiring working every day. It's exhausting taking care of these patients, but I don't regret it. There isn't anything about any of this process that I ever regret.

It takes teamwork and patience. That's all I can say. A lot of patience as we have a family at home.

We've tried to explain to our children what we're doing. At ages of six and nine, that's it's hard to comprehend because their life is a mess. They're not seeing their friends. They're not going to school. They can't see grandma and grandpa. It's stressful on them. They don't understand. It’s hard on us, but we have an ability to comprehend what's going on. Like working every day, for weeks on end. Kids ask, are you working again today? It's trying- you're trying to balance that we care so much about our kids, and we love our kids so much. Yeah, we're still trying to do this endeavor, but still trying to separate our work life and our personal life is hard. And we've said, hopefully, one day you'll be able to comprehend what mom and dad were doing. And while we weren't neglecting you, at some points, we kind of were meant for the greater good.

We never left our kids alone, though. We don't need to get social services involved. But um, you know, but that brings up unique challenges. We were both working from home Saturdays and Sundays, but there were days where almost every weekend I was working. The kids would say, “mom's going in again”. If I go in early, I get to come home early. There are payoffs. Our nine-year-old understands more about what we do, and that we take care of people and we want people to get better. We want this to end. But our six-year-old, doesn't really comprehend any of what’s going on.

It's challenging, but I think it comes down to, we have we have a very strong relationship. I think we have an incredible foundation in our marriage; we're friends. We're husband and wife, we have kids, we make it work somehow. And somehow, we are the glue.

We were able to somehow separate some of our personal life from work life and I think we try to make made a commitment with that. Our family is always the most important. It was fun to be able to talk through problems and different perspectives and outlooks and i think that's how we felt as a whole team. We had so many great perspectives that our decisions and our reasonings were concrete. I think we're very grateful how we joke but feel like our marriage became stronger out of this. I think we have a we've always had respect for each other, but I think we have a different kind of respect and admiration for each other.

I was the first to experience COVID. For nine or ten months we had done so well, we were good about where we'd go, who'd we be around. Although I can never confirm exactly where you get COVID, I to care for a sick patient who got sick on me, and it was receiving antibody treatment. The patient had gotten sick from the natural progression of COVID. I had to go in and I assess this individual. I'm wearing all the proper personal protective equipment. I was helping him because he was vulnerable, and he was sick. You do the right thing for your patients. That is likely where I became exposed. That occurred Friday, and the following Wednesday, I had headaches. I started to have just kind of a brain fog, where I had a hard time concentrating. I got tested at the very end of the day. My colleague said, you're fine. You don't have COVID you're fine and that I haven't been around anybody. And that I had done everything right. I'm really in tune. I'm a marathoner. I'm a runner, and I just I feel awful. Sure enough, in the middle of the night, I wake up and it's positive. And then, I had the hard conversation of calling Dr. Patel to say I'm COVID positive and that I had been working alongside of her. This happened to be the morning that she was getting her first COVID vaccine dose. And so, there was the challenge now that, have I just compromised all my colleagues. Luckily, I didn’t, they tested negative. I was fine the first day and then I rapidly deteriorated. I was very short of breath. Incredibly short of breath, like something I've never ever felt before, and fatigue, lightheadedness, dizziness and nausea. And I reached a point where I thought this is not going to go well.

We reached out to our friends and colleagues and said, I'm an otherwise young, healthy person. This was day three of my illness. I'm very atypical, but I questioned, do I go in? Am I being foolish? I don't want to be somebody who goes in too soon and then they send me home. I was reassured to go in and that I wasn't being stubborn or foolish because as medical people, we have a hard time being on the other side. It's very hard for us to say, Okay, I need to go seek help and that I need to be evaluated. We're constantly in the opposite shoes, where we're telling people, this is what you need, and this is what we recommend. I went in, I was admitted, I received Remdesivir. I was able to discharge the following day after two doses and help coordinate my outpatient infusion.

I asked my colleagues to kindly help me, and they did. So that was great that they were able to. Dr. Mohammad put in my order and, and we got it all set up. It was a very humbling experience. It was wonderful to be able to see the hard work that we had put into this and then to be a patient to experience it was amazing. Most of us don't ever want to experience this, you know, this was something that felt very rewarding. It was very comforting. The nurses were phenomenal. It was like a family taking care of you. It didn't feel like this sterile environment. They were warm. They were welcoming. They knew you were sick. They knew you were vulnerable, and they just wanted to take care of you.

It was very poetic in that I received my infusions in the room where I suspected that I had my exposure. So, there was closure. And then I went home, and I got better. Unfortunately, days later, Richard fell sick, only he developed worsening symptoms.

I think that's, you know, we had restrictions in place for families, to keep them safe and to keep our colleagues safe and to reduce transmission. On the other side of the fence you're like, this is ridiculous. You need to see loved ones and be there for our loved ones. Dropping Lori off that morning at the emergency department was very hard. You have two kids in the car, and you're watching her walk through the emergency department doors, and that could be the last time.

You understand why families have gotten frustrated and upset with the organization. And you understand both sides. But we're lucky. We're here. There are so many families-

hundreds and thousands of families who do not have what we have. We have a different appreciation of what families are going through and what they fear and their anguish. It was trying to explain that to two young children is difficult. It's a hard conversation to have. We played it off that mommy had gone to work.

Jackie asked me, ‘so Mom, what jammies did you wear last night and what did you pack’. Thinking I was staying overnight at the hospital working.

Coming home was the best news ever. Lori had remote monitoring where vitals are sent to Rochester which is an amazing system. It’s so well-coordinated what people don't realize and appreciate is this is the number of people behind one action. Lori came home. At some point me or one of the kids was going to get it. That happened on my twelfth day of quarantine.

I'm not someone who can stay at home for very long. I even joked about that with Lori. I'm said watch today is the day that I test positive. I'm going to stay the 10 days at home. I got my test back and started with a cough the evening prior. You start thinking it's a psychological thing and that you're imagining things. But I tested positive that evening and the next day, I was feeling bad. The next day felt like a bus hit me. And I’m someone works out and doesn't have underlying conditions and is otherwise healthy. I went along with the symptoms and the progression and felt terrible, but doable. I hoped I had the milder version. I got to the weekend and Sunday I started feeling a little bit worse and Monday progressed further.

By Tuesday, I could barely put a sentence together without having to stop to breathe. I was having lightheadedness from the migraine from COVID that felt like my head was in a vise grip getting crushed. Being stubborn and not wanting to be on the other side of the fence like Lori mentioned healthcare people can sometimes be the worst possible patients. It took Lori and Dr. Patel to put their foot down. They said you can't even talk on a phone. You can't walk around without feeling having episodes of you passing out. That was day seven or essentially into my progression. I ended up being admitted that afternoon. The people you work with daily, you really get to appreciate them. The next day I started feeling better I think being a patient, you just have such a just a phenomenal appreciation of what our staff do. The nurses I had I knew how busy they were. Yet they took the time to sit and just talk.

Lori and I had a part in setting up the infusion center, but many people had roles. It was phenomenal to see it in place and how well and smooth things ran.

For both of us, I think it's an emotional roller coaster. We try to hide our emotions. But today those bubbled up. But that's okay. We're so grateful for everyone we get to work with, and the organization that we get to work for. The community get to live in is phenomenal. When we got sick, our friends, our colleagues reached out with meals and with helping out with whatever it was, it was an extended family that just jumped in. We're grateful to have been to have gone through this. We have a different perspective for life, for family, for friends, but also for the jobs we do. At the end of the day, it's a collective partnership to take care of a patient. It's not one individual, that's for sure.

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Art by: Nan Wright | Minnetonka, MN

I am a watercolorist living in Minnetonka, MN. I paint with the “limited palette” of the three primary colors, red, yellow and blue. With 3 cool and 3 warm primaries I find I have more flexibility to mix my own choice of colors.

The painting: “Together We are One”

The story written by Richard and Lori Arndt touched me deeply. Dedication to their work and professions, coupled with love for their young family is a delicate balance to achieve, especially during this pandemic. However, together they are doing BOTH amazingly well, and it was an honor to hopefully represent their heartfelt story with my palette and brush.

In planning my part to put their story in a painting, it was a challenge for me to hone in on just one theme. So, I immediately chose to go for ALL of them! Their reference to “teamwork” is depicted by the circle of arms and clasped hands which is the central focal point. This circle represents their diversified staff. Connected together, they work as a team to make a shield from the encroaching Coronavirus hovering all around the outside edges. The billowy white clouds in the center are loosely shaped hearts that represent (to name a few)...hope, caring, patience, inspiration, resilience, empathy, vulnerability, healing, understanding, and insight… which is why I titled the painting:

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For more information about the Healing Reflections gallery or to get involved with the project, contact Sara Martinek.

To discuss the latest on Post-COVID Syndrome, head over to the Post-COVID Recovery discussion group.