The Long, Unseen Recovery

In an article distributed by USA Today, Stephanie Innes of the Arizona Republic writes about the remarkably long recovery period for COVID-19 survivors.

Recovery times for people that have been seriously sick are lengthy — in general, at least three times as long as people were hospitalized, if not longer.

Stephanie Innes, Arizona Republic

Innes writes about a body-builder who was felled by the virus. During his hospitalization, he lost about a quarter of his weight and most of his muscle. Although he has recovered from the symptoms of the disease, his physical stamina has not. The act of standing and sitting one time was initially enough to wear him out. He is beginning to be able to walk.

I go on walks now in the afternoons. That’s just to build my legs back up so that I can start moving around again and I can start getting back again to a somewhat normal life.

Charlie Aragon, Former body-builder, COVID-19 survivor

He has survived, but he is only beginning to recover.

I was there. A year ago, while we were on vacation in Amsterdam, an undiagnosed arterial aneurysm ruptured and my heart stopped. The OLVG Hospital saved my life more than once in the weeks that followed. When I came into myself in the final weeks of my ICU stay, I had lost nearly 30% of my weight and about half my strength. I could barely move. 

I could hardly recognize myself in the mirror.

The body-builder used to look like this. Imagine his reaction to his post COVID body.

It’s called ICU-Acquired Weakness. Muscles atrophy from lack of use.

I was no body-builder, but I was very fit when I got sick. I’d taught exercise for 40 years and had the habit of doing some kind of aerobic activity every day — dancing, walking, jogging, biking, swimming. To be unable to move was a shock.

It was even more of a shock to be told it would take me at least a year to fully recover.

Courage. It takes courage to recover. To believe that your legs will ever hold you up again. That you will walk. That you will jog. That you will run.

Change is an inside job.

Therapy adage

It’s been a year of recovery. The advice of an OLVG Hospital doctor has been with me all the while.

Set small goals. Peeling a tangerine. Turning onto one side. Sitting at a table. Standing up.

And one day, you’ll look up and realize how far you’ve come. Today, I ran two miles.

To the young man in Innes’ piece, and to all the COVID-19 survivors, I am sending an abundance of patience, resiliency, and courage as they slowly make their way back to themselves. Whatever that looks like.

And to the rest of us, perhaps we could use patience, resiliency, and courage as we continue to face down the much changed world we inhabit at this moment, knowing that, step by step, we, too, will make our way back. Whatever that looks like.

Care For Each Others’ Bodies, Minds, and Spirits

I’ve been where coronavirus patients now are. The ICU of the Amsterdam hospital in which I lay for six weeks last year — much of that time on a ventilator — is today filled with very sick people fighting for their lives. For those that survive, the challenges will not be over. Many will suffer from long-term physical, cognitive, and emotional problems resulting from being sedated. It’s called post-intensive care syndrome, or post-ICU delirium.

In Erika Edwards’ recent article for NBC News, she quotes Dr. Amy Bellinghausen at the University of California, San Diego, as estimating that up to two-thirds of ventilated patients may be affected by post-ICU syndrome. Symptoms include physical weakness and post-traumatic stress.

I suffered from physical weakness, dropping from 130 to 95 pounds and losing the ability to move during my six weeks in the ICU. Lying still is a wicked thing: your body needs time to recover, but in being quiet it begins to fade away. It took me six more weeks in the hospital to be able to walk gingerly out of there and onto a plane headed for home, where I’ve slowly regained all of my strength and most of my weight.

I also had cognitive and emotional challenges stemming from being sedated. I had very real dreams in which evil nurses were torturing me and telling me horrible things about other patients. I was certain that the hospital clocks were being changed to confuse me. I was frustrated that my family didn’t understand what was really going on.

I was lucky, though. These thoughts and the nightmares faded away in my final weeks in the ICU, and did not return as I continued to recover. They’re just stories now.

Erika Edwards cites doctors’ observations that the best way for patients to avoid post-ICU stress in the first place is to have their family at their side. That’s what made the difference for me. My husband, with whom I was traveling when I suffered the ruptured arterial aneurysm, our daughter, who flew in from Florida, and my sister, who flew in from Colorado, managed to be with me as much as 12 hours a day. The ICU nurses had to chase them out, telling them to take care of themselves, too. But those same nurses cut my family a lot of slack in bending the narrow visiting hours to let them be with me. They held my hands, they stroked my face, they talked with me, they laughed with me. I didn’t see when they cried. I just knew they were there.

The poor souls who are struggling to live as the coronavirus clamps down on them are bereft of family. This virus is robbing them of a crucial life line.

ICU patients need to have humans around to orient them, to calibrate them, to touch them, to look in their eyes and make them understand what’s happening. But that’s exactly what the COVID patients won’t get because they’re all being isolated.

Dr. E. Wesley Ely, Professor of Medicine and Critical Care, Vanderbilt University

These patients are not alone, though. My Dutch doctors and nurses were compassionate, caring, and steadfast. I am imagining them and their medical colleagues in the world’s ICUs today, doing everything they can to care for their coronavirus patients. The Cleveland Clinic is one such place. A patient who survived COVID-19 thanked his caregivers by asking one of them to write a note on the glass wall they’d used to communicate with him. Here’s some of what he said:

Today I leave this ICU a changed person … not only because of your medical healing and God’s direction and kindness, but also with the fact of knowing that there are such wonderful people dedicated to the care and concern of others.” Here’s a Twitter posting with more.

Mr. Brown, COVID-19 survivor, upon discharge from the Cleveland Clinic

I join the millions of people all over the world in clapping for these brave medical soldiers, first responders, grocery deliverers, post office employees, package mailing staff and all others who are our front line in this pandemic war. God speed.