The Recanati twins, age 47, both worked as medical assistants at MercyOne Oelwein Medical Center and both contracted COVID-19 last month. One got better, and the other got worse.

Cynthia Recanati moved to Oelwein on Aug. 1 to be closer to her twin sister, Michele, and soon joined her working as a medical assistant at MercyOne Oelwein Medical Center — Cynthia started in Urgent Care in November. Michele had been in Family Medicine since moving to Oelwein in December 2019 with her 10-year-old son, Brody Reffner.

Cynthia was diagnosed with COVID-19 on Wednesday, Nov. 11; Michele on Tuesday, Nov. 24. While Cynthia experienced mild symptoms, Michele developed breathing problems.

Brody had attended Wings Park last spring and started fifth grade this year at Oelwein Middle School until Sept. 19 when the pair took him to live with his dad and stepmom in Roaring Springs, Pennsylvania, due to childcare concerns with the hybrid schedule.

“She didn’t want him to be in school two days a week here and at home by himself,” Cynthia said referring to the hybrid schedule. “And his dad and stepmom — someone was home all the time in Pennsylvania. That’s why he was there during the school year. She was planning on taking a trip out to see him.”

Because of Michele’s breathing problems, she and Cynthia visited the emergency room on Sunday, Nov. 29. Cynthia said the doctor listened to Michele through her winter coat and said she shouldn’t be out because she could infect someone.

“It’s not like we were going out without masks, we had just gone to a couple of social things,” Cynthia said, such as a Halloween event. “We could have been more cautious and I wish we had been, but the doctors are telling me you don’t know when this is going to happen… That’s what people need to think about too, if you’re doing things like Christmas, maybe you should have people wearing masks if you’re in the same house.”

Michele’s breathing trouble continued.

“Wednesday night, I said, ‘I think you have pneumonia; do you want to go to the ER?’” Cynthia said. Thursday, Dec. 3, “I had taken and dropped her off at the ER,” Michele said. Michele’s primary care provider ordered a chest X-ray and Michele was diagnosed with pneumonia and prescribed medication.

“On Friday, I went to work,” Cynthia said, believing “she was starting to feel better.” When she got home, she told Iowa’s News Now, “she kept saying how hard it was to breathe.”

Michele returned to the ER at MercyOne Oelwein on Saturday, Dec. 5, along with Cynthia and their brother Phil Recanati of Oelwein. Phil, a long-haul trucker, had called his company, and they found a substitute driver to take his trailer load to its destination.

At the Oelwein ER, medical professionals told Michele they were going to sedate her and put her on a ventilator.

“She was talking and understood what was happening,” Cynthia said.

Michele was transferred by ambulance to MercyOne Waterloo Medical Center intensive care, where medical professionals believed she had a brain bleed and decided to send her by air ambulance to University of Iowa for treatment by extracorporeal membrane oxygenation, or ECMO. Whereas dialysis removes impurities from the blood when the kidneys cannot; ECMO puts oxygen into the blood when the lungs cannot, Cynthia explained.

At the UI Hospital, Michele was given two computerized tomography (CT) scans.

“After the first scan, they thought it was a clot instead,” Cynthia said. “They did another CT scan with contrast… They (University of Iowa Hospital) believe she had a stroke that caused the brain clot while in Waterloo.”

“They called me back and told me it didn’t look good, she had a clot, ‘you need to come now,’” Cynthia said. She and Phil left for Iowa City around 12:30 a.m. and arrived before 2 a.m.

“I was with her 29 hours,” Cynthia recalled later.

Cynthia was told neurosurgery would not change the outcome: The clot had starved Michele’s brain of oxygen.

“They did a brain death test to confirm if she was brain dead and she was. I talked to about 12 doctors. They said it was massive, the whole left side of her brain, because after that she hadn’t received enough oxygen or blood... She had lost primitive function, had no gag reflex, it’s not like she was going to come off and be in a vegetative state. She wasn’t blinking.”

Michele has three sons. Her older two work in Idaho. The oldest Tre Cyr, 28, was able to get time off from one of his two jobs and flew out on Sunday, Dec. 6.

“He got the soonest flight possible,” Cynthia said. “Starbucks has been really supportive and great.”

In Iowa City, Michele was kept in a negative pressure room to keep the airborne COVID-19 germs from circulating too much in the room and to keep them from the rest of the hospital.

“We were able to be in the room with her, masked and gloved and suited up,” Cynthia said, noting full hazmat personal protective equipment was required to be donned and doffed upon entry and exit.

Understanding that Michele had lost primitive function, Cyr consulted with his siblings about what Michele’s wishes would be, including their youngest brother, William Rudolph, 21, in Idaho who was unable to make the trip.

“Michele had told him so many times, ‘Whatever you do, don’t let me be a vegetable,’ so he knew what she wanted, we all did,” Cynthia said. “With the approval of me and her 21-year-old brother, he made the decision.”

“We were with her when she passed, on either side of her holding her hands,” Cynthia said of herself and Cyr.

Cynthia said she and Michele were “very close.” Born in 1973, they grew up in the San Francisco Bay area, graduating from high school in San Jose in 1991. Both studied medical assisting at Bryman College in San Jose. Michele graduated Bryman in 1995 and Cynthia in 1997. Michele left California in her late 20s for Oregon, then spent 16 years in Coeur d’Alene, Idaho.

“Two years after she moved to Idaho, I moved up to be with her,” Cynthia said. “I think I was there 14 years and she was there for 16 years. After COVID happened, I was in a salon doing nails; it had been a long time since I was working as a medical assistant. I said, I’m not really working right now, and my kids are adults, so I’m coming up here to be with you.”

Michele had been a medical assistant for 25 years, according to her obituary.

“Michele was more concerned about giving (COVID-19) to other people who wouldn’t be able to survive it and was more concerned about her family than about herself,” Cyr said. “She had told me at one point, ‘It’s really bad out here. She said to me if there was a vaccine she would have taken it.”

Tragically for Michele, the vaccine rollout for health care workers is scheduled to begin later this month. Fayette County’s Gundersen Palmer Community Health is scheduled to receive the Moderna vaccine, pending Food and Drug Administration emergency use authorization approval, which is expected soon. An independent advisory committee to the agency approved the Moderna vaccine for ages 18 and up on Thursday.

“She would have taken the first effing one,” Cyr said.

Cynthia said Michele “was so caring, was so good at her job and really was a people person. The day before they sedated her, she was talking about me and Tre and how much she loved everyone.”

Michele’s son’s cousin, Lexi Recanati, of Oregon, picked up Cynthia’s son, Nicholas Dahl, from Idaho, and they drove to Spokane, Washington to fly to Iowa to visit Michele.

“I think even on Monday the 7th, the day she passed, my oldest son, and his cousin boarded a plane to Iowa from Spokane, Washington,” Cynthia said. “That was just when she had been taken off life support.” They were boarding the plane and Cynthia indicated she didn’t want to drop the stress of telling them they were unplugging her while they were boarding. “So I told them when they got here. They were here for four days.”

Cynthia indicated Brody’s family in Pennsylvania will have “some sort of ceremony so he can have closure. He’s under 18, he wouldn’t have been able to come upstairs and see her.”

Geilenfeld Buehner Funeral Home in Oelwein was in charge of the cremation arrangements. Cynthia said she hopes to do an outdoor service when the weather is better “so we can social distance.”

The obituary notes the twins also have a brother, Mark Recanati in Texas, and Michele has additional nieces and nephews, Amanda, Luke and Ethan.

For those wishing to make memorials, Cynthia said Michele “really loved animals” — she had two indoor cats and an outdoor one for whom they made a cat patio of sorts — and was an LGBT ally in honor of family members, so she suggested causes in those areas.

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