We’ve been warned that COVID-19 can be more dangerous for people with underlying medical conditions such as type 1 diabetes, multiple sclerosis, asthma, and obesity.
What if you had all of them when you contracted the virus?
A woman from Salt Lake City, Utah, who checked all those boxes, has battled and survived her fight with COVID-19.
What put her on the road to recovery after her family said their possible goodbyes to her over the phone?
Kimberly Ishoy believes it was a combination of advocating for her care while being willing to do all the doctors’ asked.
She also credits attention to her medical conditions, prayer, and — perhaps mostly importantly — an active lifestyle that includes distance cycling and triathlons.
“My new saying is she’s last in the triathlon but first out of the ICU,” Chris Ishoy, Kimberly’s husband, told Healthline. “The doctors have no doubt her fitness helped her through.”
It all started for Ishoy in late May when symptoms concerned her — gastrointestinal distress, a searing headache, an inability to eat (“even water tasted like dirt”), and all-consuming exhaustion.
“I was working from home and it was like ‘Weekend at Bernie’s’ the Kim edition,” Ishoy told Healthline. “I would prop myself up for a call and just get through it, put my head down, and fall asleep until it was time to be propped up for the next one.”
Still, despite some family members having contracted the new coronavirus, Ishoy felt she was battling something else because she had no fever.
She consulted with her primary care doctor by phone, who warned her that if it was COVID-19, things could get worse even if she thought she was getting better.
On June 1, a week later, a fever spiked. Chris insisted on taking Ishoy to the emergency room.
There, her oxygen absorption level clocked in at a critical and dangerous 70 percent. Normal pulse oximeter readings usually range from 95 to 100 percent. Values under 90 percent are considered low.
Ishoy was diagnosed and admitted to the hospital.
Chest X-rays showed pneumonia and blood tests confirmed sepsis. Two days later, she was transferred by ambulance from her community hospital to Intermountain Medical Center in Murray, Utah.
Given her complicated medical history, Ishoy’s family and medical team were concerned.
“When she was diagnosed I told my husband that, oh, this is the worst patient to get this,” Dr. Mary D. Tipton, Ishoy’s primary care physician, told Healthline. “I was very concerned.”
As were her family members, who struggled with the lack of seeing her as she fought the illness.
“If I had known when I dropped her off [at the emergency room] that would be the last time I’d see her for 8 days, I’d have said something more, done something more,” Chris Ishoy said. “I never even said goodbye. If I knew, I would have just told her everything is going to be all right.”
Away from her family and in the hands of the medical team at Intermountain Medical Center, Ishoy was in a fight for her life.
“I got there and the team was waiting for me, ready,” Ishoy said. “They were wearing space suits, like the movie ‘Contagion.’ It was a little overwhelming, to be honest. So I just closed my eyes and said ‘stay calm and go with it.’”
Right away, her road to survival would be a dance between helping the doctors hear her needs and ideas while being open to trying theirs.
“The one thing I knew was that my immune system had to stay strong if I was going to fight this, and my best bet for that is as stable blood sugars as I can get,” said Ishoy, who has had type 1 diabetes for 41 years. “I knew my best bet with that was to keep using my insulin pump.”
She explained her reasoning to the team, which initially wanted to remove the pump and go to injections. They listened and agreed. The pump stayed on.
As her oxygen needs continued to skyrocket (she needed more than 15 liters a day) and her ability to eat stayed stagnant, Ishoy was moved to the intensive care unit (ICU). That sent chills both down her and her family’s spines.
“I was a little afraid to be in there,” she admitted. “Not knowing what is happening and not having control over things, really, you just feel so powerless. And you feel like you lost all your dignity.”
But, she said, she continued to trust in the team.
Sound positive? Her son, Josh, says it was far from calm.
“I distinctly remember the second night she was in the ICU a phone call coming in from her,” he told Healthline. “She could barely speak. All those alarms for her were going off in the background. She was saying her goodbyes, just in case. It was rough. Hearing her doubting the outcome, it was really something. I knew it could turn south. We kept hearing ‘the ventilator is coming,’ so we knew that could be the last time we had a conversation for a long time… or forever.”
Inside the ICU, Ishoy was calling on her experience as a triathlete to dig deep.
A team doctor told her they wanted to place a temporary feeding tube through her nose to help build up some strength. She balked at first and then begged to have a little more time to try to digest something.
By the next morning, she’d forced down some chicken soup and crackers and was nibbling at more, “as horrible as it tasted,” she said.
Still, her oxygen levels were dangerously low. It was then the medical team suggested she try staying on her stomach all night and most of the day.
“Laying on my stomach was painful and difficult,” she said. “Remember, I had IV’s and tubes and my pump and more on me. But after that doctor said it might save me from the ventilator, I said, ‘I’m sleeping on my stomach and whatever I say, even if I beg, do not let me stop.’”
A day later, her oxygen levels began to creep back toward normal.
“No matter what those nurses asked me to do, I did it,” she said. “It didn’t matter if it hurt. It didn’t matter if I could sleep. I did not want to be on that ventilator.”
As she began to recover, doctors, family, and Ishoy herself wondered why and how she seemed to be coming through despite the odds.
One doctor settled on a decision Ishoy made in 2013: To train to ride a bike 100 miles in one day for the JDRF Ride to Cure Diabetes.
“I didn’t do it for fitness,” she said. “I did it to fundraise to find a cure for the next generation.”
Ishoy didn’t let her weight dissuade her and began training, slowly.
“I personally think that we are all created differently, like flowers,” she said. “I will never be a violet or baby’s breath. I am a sunflower, a substantial woman. But I also know ‘fat’ women can ride their bikes 100 miles, so that’s something.”
Once she knew she could ride, she moved on to 5K races and triathlons. She usually finishes last, but she finishes.
What she didn’t know when she started, she said, was that she was helping her body be a warrior in ways she could not even imagine.
“When she mentioned to me ‘I know I don’t look like this, but I do triathlons and 100-mile bike rides,’ I could see that was true,” said Dr. Peter F. Crossno, FACP, FCCP, medical director of Schmidt Chest Clinic and Respiratory Care at Intermountain Medical Center, who treated Ishoy in the ICU. “Her low resting heart rate was certainly a help.”
But, he said, her endurance athlete background also gave her another weapon: determination.
“She did what she had to do and worked hard,” Crossno told Healthline. “She and her family are truly the model patient family. Her motivation to heal was remarkable.”
Crossno also believes timing played a role. Given that they’ve had months to learn about COVID-19, the team was educated. And Ishoy was able to get in on the clinical trial for the drug remdesivir, which Crossno believes helped her progress.
“Had this happened in March, she would not have had some of those benefits,” he said. “She hit the right time.”
A strong heart and healthy body was also at work to assist the medical team.
Still, Ishoy believes there was more.
At first, she kept the crisis private. But then she asked her husband to post on her Facebook wall just to let friends know what was going on.
That post was met with an outpouring of prayer and support that she never imagined could come her way. Many of those supporters were her fellow JDRF Riders.
“The hardest part of this entire experience was being completely isolated from those you love,” Ishoy said. “Social media helped me. It kept me going. The thoughts, the love. One fellow rider even rode to a ‘Kimberly Road’ sign in his area to support me. That outpouring gave me strength. I could look at Facebook and just feel the love and support. People I did not even know were responding and praying for me. It brought me hope. We are all a human family and that sustained me.”
Moved out of the ICU, Ishoy still had more fight to bring, but she realized along with the medical team that her decision to do a charity bike ride contributed to her making it through COVID-19 alive.
“When I was transferred out of ICU the nurses were so happy,” she said. “One of them said she was so thrilled to see this. She said, ‘we rarely get a person out of here this fast,’” Ishoy recalled.
“That’s when I knew something was different about me. Hearing that gave me the confidence that I had done the work and that I can in the future. It’s funny,” Ishoy added. “I remember at first [doing rides and triathlons] worrying about being last. And then I quit worrying about that.”
“I realize now the measure of my success is the ability to fight a deadly virus,” she said. “I may not have gotten the results I wanted [at events], but I got the results I badly needed.”
Ishoy was released from the hospital on June 8.
She’s back home now, but she’s still on oxygen and still quite weak.
She has more time to recover, she knows, but she also knows she’s a distance cyclist at heart. She’s ready.
“I feel good,” she said. “I have a friend who is 75 days in and still recovering and I thought, ‘That’s not going to be me. I’m already ahead of where they are now.’ I’m already past that — and that’s with diabetes, MS, asthma, and some extra weight.'”
As much as she worried, Tipton isn’t surprised at the outcome.
“She’s probably the most dedicated person with diabetes I know,” she said. “It’s a joy to take care of her. Honestly? I learn from her. And she’s a great advocate for herself. And her fitness? When she told me she was going to start doing those rides it was more a statement than an ask. She’s determined. She’s still pretty weak. This has taken a lot out of her, but not from her mind. She’s still our tough Kim.”
Her JDRF Ride coach isn’t surprised either.
In a sport that leans toward tiny folks, Ishoy has made a name for herself not as that first-place finisher, but as the grinder who never gives up.
“Kim is incredibly determined,” JDRF ride coach Tiburon Erickson told Healthline. “She isn’t the fastest or the fittest, but she sets her mind on something and doesn’t stop. She won’t be the first to cross the finish line, but she crosses, and that’s what matters. Her strength and confidence has grown and her goals have gotten bigger. Kim is an inspiration to everyone who rides with her. Honestly? I am not at all surprised she beat these odds.”