Henry Budzynski, a 65-year-old airplane mechanic, is one of a small segment of society that is the most vulnerable to the coronavirus: those whose immune systems are compromised. He is undergoing cancer treatment and says, I cant afford the virus right now."

He stays home as much as he can, but every Wednesday, Henry Budzynski drives to a doctors office in Mechanicsville, where an inch-long needle is stuck into his skin just above his belly button, and a shot of chemotherapy is injected into the fatty tissue around his stomach.

Because of the cancer called amyloidosis that inhabits his body, his immune system is 40% to 50% the strength of a healthy persons. Later this month, after he checks himself into the 10th floor of the Massey Cancer Center for a high dose of chemotherapy and a stem cell transplant, his immune system temporarily will cease to exist altogether.

The timing undergoing such a procedure during a pandemic isnt ideal, but he has no other choice.

Budzynski, a 65-year-old airplane mechanic, is one of a small segment of society that is the most vulnerable to the coronavirus: those whose immune systems are compromised. Should he contract COVID-19, his body would be less prepared to fight off the virus, and he would be less likely to survive. Chemotherapy, certain types of cancer and organ transplants can cause ones immune system to be weakened.

I cant afford the virus right now, Budzynski said.

But the immunocompromised are also, in many ways, the most prepared to combat the pandemic. They were comfortable with social distancing before there was a name for it. Theyre adept at keeping their hands clean and watching what they touch.

Its been months since Budzynski stepped foot into a Lowes, Home Depot or Food Lion. When its time to buy groceries, he drives to the store with his wife, Rosemary, and waits in the car while she shops. Riding in his vehicle, which he designated a clean space, is off limits to everyone but Rosemary and their daughter.

Wednesday is a milestone in Budsynzkis treatment. After a year of weekly chemo shots to different points on his abdomen, this will be the final injection. His upcoming treatment, he said, should extend his life another 20 years.

While Budzynski cant afford to wait out the pandemic, other cancer patients have decided that COVID-19 poses a greater threat than their cancer. Surgery often means entering the same building where the virus is treated and interacting with potential vectors.

Even if COVID patients are corded off, the virus can still spread. One study by the U.S. Centers for Disease Control and Prevention found that the coronavirus could be found on half of the shoes of medical staffers. The virus was even discovered on hospital floors not walked by COVID patients.

Thats all my patients need to hear, said Dr. Kelly Hagan, a hematologist-oncologist with the Virginia Cancer Institute.

One of Hagans patients, an 88-year-old woman, was recently diagnosed with breast cancer. In a normal world, her surgery would have been scheduled immediately. Instead, she asked to delay it until July or August, and Hagan accepted. Six months ago, the doctor said, such hesitancy never would have been tolerated.

Hagan has found herself asking questions shes never asked in her career: Are some patients better off without immediate treatment? She examines the cancer, and how aggressively it spreads. She asks herself if the patient can survive two months without intervention. She studies the comorbidities, or risk factors, of the patient.

These questions, she said, involve the art of medicine more than its science.

Dr. Eric Douglas, with his dog, Jayden, could not visit hospitals even before the pandemic. He has a disease that causes cancerous cells to replace his disease-fighting white blood cells. A cold can spiral into pneumonia

Dr. Eric Douglas couldnt visit hospitals even before the pandemic. The cancer inside him, Waldenstroms macroglobulinemia, causes cancerous cells to replace the disease-fighting white blood cells that make up his bone marrow. A simple cold can spiral into pneumonia.

Disease can overtake his body without any explanation for its origin. In 2015, he nearly died of septic shock, and he doesnt know why.

His cancer forced him to leave his career in anesthesiology, but Douglas, 64, accepted the transition as an opportunity to remake himself. He went back to school and earned masters degrees in theology and religion. He now teaches part time at Randolph-Macon College and is on staff at New Hanover Presbyterian Church.

When the pandemic reached Virginia, he pulled down the stairs to his attic and retrieved two boxes of surgical masks he had stored in his home. He had purchased them during the 2009 swine flu epidemic, and he strapped one over his ears recently when he drove to UPS to mail a package a sweater knitted by his wife for his 1-week-old grandson he had not yet met. He sat in his Toyota RAV4 and waited until every customer left the building.

When he returned to his car, he wiped down his hands with sanitizer and drove home. But his children were upset when they found out he had taken a risk by leaving the house, so he hasnt gone anywhere since. Once a week, hell sit in his car, turn the key and let the engine idle for five minutes just to keep it running.

Among those who cannot delay his next procedure is Jerry Deans, 71, who was diagnosed with prostate cancer in 1999 and has undergone a litany of treatments since.

Later this month, hell lie on a table for 30 minutes at the Sarah Cannon Cancer Institute in Henrico County while a focused beam of radiation is projected into the T12 vertebra of his spine and his left hip. If all goes well, he wont feel a thing, and he wont experience a single side effect.

But waiting was never an option. Putting off radiation would mean risking his bones fracturing and his spine collapsing.

It needs to be done, Deans said. Its not an emergency, but its pretty urgent.

Because the cancer institute is in a separate building from the hospital, he wont be treated under the same roof as COVID patients.

When the pandemic struck, Deans was undergoing chemotherapy treatments. He began taking precautions in January, wearing gloves and no longer hugging others, long before they became common practices.

When the radiation therapy is behind him, he and his wife, Patsi, and his dog, Zoey, will take their camper north to the Potomac River for a small vacation. Patsi and Zoey, he said, are his hugging partners.

Isolation might be the hardest part for Angela Bowman, 61. She misses having physical human contact, and theres a new baby in the family she hasnt met yet. Before the pandemic, shed walk the malls at Short Pump or Virginia Center Commons and window-shop. She enjoyed going to the grocery store and finding a good sale.

Her friends will bring her groceries and leave them on the front stoop, or she might sneak into a grocery store on the way home from her chemotherapy treatment for non-Hodgkins lymphoma. Her friends have reliably called and visited in creative ways.

Two friends parked their car in her driveway, and called on the phone so they could speak to her and see her at the same time. Another came for coffee and sat on the back deck, a good distance away.

For Jim Price, 65, life in lockdown is familiar. He learned to social distance in 2013, when he had a liver transplant. Thats when he realized the importance of washing his hands and avoiding touching public doorknobs.

For Jim Price, 65, life in lockdown feels familiar. Its similar to the summer of 2013, when he received a liver transplant and spent the next eight weeks at home. Few visitors were allowed to enter his home, and if they did, they were all asked to scrub their hands in Purell, which had been purchased in bulk from Costco.

In the years since, he has become adept at washing his hands longer and more often. He keeps small containers of hand sanitizer in his car. He avoids touching public doorknobs whenever possible.

To help his body accept its new organ, Price takes an anti-rejection medicine that suppresses his immune system. For the past two months, he has lived life the way he did after his transplant, staying home, watching Bonanza or The Andy Griffith Show on television and reading fiction by authors like Dean Koontz. He also works full time as a lumber salesman.

You get this gift, this opportunity to stay alive, Price said. So you want to limit the number of opportunities to screw up.

Thanks to the coronavirus, healthy people are seeing the world from the perspective of someone whos immunocompromised, said Faith Jones, 38, who was diagnosed with lupus when she was in college.

Because of her condition, shes prone to developing pneumonia. When she felt feverish and stopped breathing normally last month, she went to the University of Virginia to be tested for COVID. The test came back negative.

She wants people to know that when they stay at home, they arent just protecting themselves. They are protecting people like her, and they are protecting the elderly.

Its not just about you, she said.

The residents of Deltaville in Middlesex County have taken the pandemic seriously, said Anne Cooper, 68. The customers at the local market generally wear masks, and at the hardware store theres a Purell station and a sign that says Use it or leave. Campgrounds have remained closed to keep outsiders away. The average age in Middlesex, she said, is 58.

Cooper administers chemotherapy pills at home for her breast cancer, twice every morning and twice every evening. She visits the market once a week, but its easy to avoid crowds in Deltaville, she said.

Twice a week, she receives physical therapy for the sciatica in her spine that causes hip and leg pain. She waits in the parking lot until her name is called, walks directly to the treatment room and interacts only with the therapist attending to her.

Still, in the back of her mind, she wonders who the therapist has interacted with and what germs he or she might have caught.

Sometimes, it scares me that Ive survived cancer for 17 years, and this might kill me in four months, she said. I leave it in the hands of the Lord.

Originally posted here:
Those with compromised immune systems are the most vulnerable to COVID-19. They are also the most prepared. - Richmond.com

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