Millions of COVID-19 survivors struggle with physical and cognitive disability long after they’re released from the hospital. Those who were strong before getting sick have the best chance of making a full recovery.

Long Hospital stays weaken the Body

Survivors of critical illness experience marked disability and impairments in physical and cognitive function that persist for years after their initial ICU stay.

CHEST, the official publication of the American College of Chest Physicians

Nearly half of those who survive a stay in the Intensive Care Unit find themselves impaired or disabled by ICU-Acquired Weakness. In 2019, I was one of them.

I had Icu-Acquired weakness

I was struck down by a ruptured arterial aneurysm while on vacation in Amsterdam in May, 2019. OLVG Hospital saved me by quickly clamping the rupture, and kept saving me as my body crashed for the next four weeks. When I finally came out of the fog of illness, I had lost nearly a third of my body weight and the ability to move. After a brief dance career and a lifetime of teaching exercise, I found myself marooned in an inert body. What I didn’t yet know was that I might not have awakened at all had I not been so strong going in.

Physiotherapy got me moving

My Dutch caregivers began giving me physiotherapy right in the ICU. A bed-mounted bicycle moved my limp legs. A cushioned harness and ceiling pulley lifted my sagging torso upright for a few minutes. A speech therapist coached me in chewing and swallowing before the feeding tube came out, and an occupational therapist gave me hand exercises so that I could grasp of silverware and cups. It was weeks before I could hold my iPhone, which felt like a 10-pound weight.

When I left the ICU to complete my recovery in the hospital’s gastroenterology unit, I added daily sessions in the physiotherapy fitness center. Being in a gym was familiar territory, and eventually it felt good to move. The muscle memory came back. I stood. I shuffled. I walked. I got on an airplane and came home to continue outpatient PT with the goal of being able to climb the stairs to our daughter’s apartment. It took me months, but I made it.

Get strong now

When it comes to survival, exercise may be the best weapon we’ve got, and any kind of movement counts. Do squats during TV commercials and hamstring curls while washing the dishes. Toss in a few standing pushups as you’re wiping down the counters. You’ll have a cleaner kitchen and a stronger body.

better in, better out

Holland is among the countries paying special attention to the physical capacity of incoming patients. They call it “better in, better out:” the stronger you are going into a major hospital event, the sooner you’ll make it out. Care IQ, a Dutch healthcare consulting company, markets the concept as BiBo™, encouraging physicians to introduce pre-surgery exercise for their more vulnerable patients. As people are living longer, we all stand a greater chance of becoming those frail persons. 

Next week, I’ll begin a true “better in, better out” story you don’t want to miss: how a friend of mine prepared for elective surgery — a hip replacement! — and what happened.