We spoke with the owner and also the medical director of a local assisted living facility that was struck by COVID. They are very grateful that nearly all of their patients were able to pull through after a very grim beginning when the outbreak first hit Country Life Assisted Living. The facility staff, residents, and families saw how deadly and tragic the COVID-19 virus could be as the first two residents who contracted COVID were sent to the hospital, and both sadly passed away.
“It’s never easy when we lose a patient. We see them daily and they become like family to us,” said Chelsae Urrabazo, the Administrator/Owner and Nurse at Country Life Assisted Living.
That is part of the reason why she knew she had to explore different treatment options she had heard researched, and the families of residents at the facility seemed to agree.
“Families were asking me to keep their loved ones here, and to treat them at our facility rather than just transferring them to the hospital,” Urrabazo said. “I called up my medical director right away, and said ‘I want to try this.’ It is always going to be impossible to say what led to someone’s recovery with something like this, but I believe in it, and I think we definitely saved lives.”
“Dr. Neel helped us get the dosing for Melatonin on all of our patients started. All families were on board with this treatment as they are all local families in Medina County and know Dr. Neel personally or have read about his success with Melatonin in The Devine News,” she adds.
Urrabazo says it has been a rewarding experience to research this, implement it, and to see patients recover.
“We researched this, had multiple conversations with Dr. Neel who made himself available to us day and night, and I believe in it. There is some really good research out there that shows melatonin prevents the cytokine storm, and it’s important not to get to that point, because that’s when you really get into trouble. There is one article in particular published by the National Institute of Health that I think everyone should read,” Urrabazo said.
That article is titled, “Melatonin Inhibits COVID-19-induced Cytokine Storm by Reversing Aerobic Glycolysis in Immune Cells: A Mechanistic Analysis.”
“As of August 23rd, our facility is now COVID free….Our first positive case was on July 18th. During the COVID outbreak, we worked with our facility medical director, Dr. Ricardo Montemayor, the epidemiologists from Metro Health in San Antonio, Texas Health and Human Services, and consulted with Dr. Richard Neel in Castroville,” Urrabazo adds.
“We followed Dr. Neel’s suggested dosing of 1mg/kg for each patient that was COVID positive. The negative patients received a daily evening dose of 40mg since they were suspected of having a possible COVID exposure. We did the Melatonin for his suggested course for seven days. Also, we had all patients on the following supplements once daily: Vitamin D3, Zinc, and Airborne Supplement with Vitamin C. We monitored these patients very closely, doing vitals and pulse oximetry readings every 2 hours.
We do believe we did see good results from these treatments. Still, this virus is very unpredictable. There are not many studies out yet to show what is the most effective way to treat COVID patients, especially patients with underlying conditions such as geriatric patients,” Urrabazo said.
“Our facility had 16 patients. Twelve tested positive. All recovered, except our first two COVID patients who never received the treatment regimen, and one additional patient on hospice care, whose cause of death was not COVID,” Urrabazo said. ” We did also have one other patient who was hospitalized before we began treating with melatonin. She received a plasma transfusion while in the hospital and then began melatonin to complete her recovery with us. Working with hospice patients, we know time is precious. We did lose that patient who had gotten a plasma transfusion weeks after she made a full recovery from COVID. She passed away from unrelated causes. However during that time frame after she recovered, she was able to see her family again and spend final hours with them.”
In the beginning, one patient was transferred to the hospital and tested for COVID there. That was the first positive to come from the facility.
“We soon got a phone call that I never expected to get, telling us that the patient we sent to the hospital was COVID positive,” Urrabazo added. “One additional patient was transferred to the hospital before we began the regimen.”
“The ten patients who tested positive after that were all treated with this regimen, and all but two patients, who were on hospice care, recovered. In addition, four of our other patients remained negative throughout the entire process. We do weekly testing per Texas Health and Human Services, and the CDC’s guidelines, and Metro Health deemed us COVID recovered as of August 23rd. The management team, patient care providers, nurses, and doctors all worked tirelessly around the clock to care for our patients. Our hospice companies; Kindred Hospice and Good Sheppard Hospice were crucial in caring for our patients as well. Everyone stepped up and did an excellent job.”
“I could not be prouder of what we did during this pandemic. We know this experience has prepared us to deal with this situation should it arise in the future since COVID does not seem to be going anywhere. Flu season is right around the corner. I will say that our assisted living facility is trained and well prepared to handle these viruses should they arise.”
An interview with Internist Ricardo A. Montemayor, MD….
Dr. Ricardo A. Montemayor has over 30 years experience in Internal Medicine. He currently practices in San Antonio, is also the Medical Director for Country Life Assisted Living outside Lytle, which spoke to us about the alternative treatment plan they implemented after losing two patients to COVID.
“I am always a skeptic, so I won’t tell you I’m completely sold on an idea until I see a randomized, double-blind trial with sufficient power to say it definitely works,” Dr. Montemayor said. “But I am certainly comfortable saying I feel it’s safe to try melatonin in the doses that Dr. Neel is generally recommending which is 1 mg per kilogram.”
“I would myself try to take melatonin before I would do a plasma transfusion,” Dr. Montemayor said. “Everything in medicine is risk versus benefit. I think the risk to benefit ratio for a disease like this, favors trying melatonin.”
Working in a clinic that treats thousands of cases, Dr. Montemayor states, “I have told patients about the research on melatonin, and left it up to them. I would estimate that around 1/3 to ¼ of my patients have used it. I know that some of my patients continued to spike fevers even while using it, and it’s hard to say if and how much it is helping without a randomized, double-blind trial. But overall, I don’t see any significant harm happening in those patients who are using the melatonin. This is a new disease….and we have nothing else to treat this disease until you’re in the hospital, so why not try it?”
And of course the jury is still out on the treatments we are using in the hospitals too, he said, pointing out that The U.S. Food and Drug Administration just recently issued an emergency use authorization (EUA) for investigational convalescent plasma for the treatment of COVID-19 in hospitalized patients, and all the controversy over hydroxycoloquine.
Montemayor adds, “In melatonin, research suggests there is a mechanism for controlling inflammation and in preventing an overreaction to infection, but there’s still a lot of research that needs to be carried out.”
In regards to the Outbreak at Country Life Assisted Living located right outside Lytle, Dr. Montemayor states, “I think Country Life did a phenomenal job of controlling what could have been a potential disaster.”
“We generally are seeing the highest mortality rates in a population like this—in patients who are 80+ years old and on Hospice care. In a group of 10 people in a very brittle state, who are 80+ years old, you can generally expect 2 or 3 to pass away,” Montemayor adds.
By Kayleen Holder
Editor