COVID Recovery. Guiding Tony’s Recovery.
[ photo by Anna Shvets ]
COVID-19 recovery after hospitalization.
Welcome back to the final COVID recovery patient experience. In the past few weeks, I have described a few of my more memorable post-COVID patient rehab experiences. I wanted to finish this series by describing my most recent rehab patient. This gentleman, who I will call Tony (not his real name), was in his sixties. He was still working full-time. He was very active, either walking or swimming several miles a day. He was on one medication to manage his blood pressure and one medication for high cholesterol. He was at a healthy weight. Unfortunately, because he was still working full-time and with the nature of his job, he could not completely isolate from others.
Tony had been home trying to battle the effects of COVID-19 for about a week. His fevers were high. He was having trouble taking in enough fluid, and he was experiencing shortness of breath. His daughter actually brought him to an outpatient center to receive some IV fluids because he seemed so dehydrated. When he arrived to the center, however, his oxygen saturation was noted to be so low that the center sent him urgently via ambulance directly to the ER.
COVID can cause rapid deterioration.
He went downhill pretty quickly from there and was put on a ventilator within the first hour of him arriving to the hospital. His hospital stay extended for just over a month. Fortunately, his kidneys were able to hold their own. He developed pneumonia, making it very difficult for him to be able to be taken off of the ventilator. He ended up needing a tracheostomy placed because he was on the ventilator for so long. He also needed a feeding tube placed at his abdomen (PEG tube) in order for him to get the necessary nutrition. With the necessary antibiotics and nutrition, he started to improve.
After a month on the ventilator, he was able to be taken off of it. He did still have the tracheostomy (trach) and PEG tube in place, however. He was able to work with the physical and occupational therapists. He had a swallow study with the speech pathologist and was started on an oral diet. The recommendations were made by the therapists for him to go to acute inpatient rehabilitation.
Recovery over several weeks allows for discharge to rehab.
Once he was medically stable, he was transferred to my acute inpatient rehabilitation hospital. When I first met him, one of the first things he told me was that he had been training for COVID-19 the past several years! At first I was confused, but then understood what he was saying. Because of his extremely active lifestyle, he had a lot of reserves in his tank in order for him to be able to make a faster recovery. As an aside, I know there have been some people affected with COVID-19 who were very healthy and physically fit that did not have a good outcome, however, those cases are much less common.
Tony was very motivated. On Day 1 of rehab, he was requesting an early start time for this therapies so that he could just get going. I had to make a point to him in explaining that some rest between therapies was okay and actually a necessary part of the recovery process. When he arrived at rehab, he was walking short distances with the walker and the help of the therapists. He needed assistance doing his dressing and showering tasks. Within 10 days, he was able to be up in his room unassisted, though still using a rolling walker. He was able to get himself ready with only a small amount of assistance.
He arrived with the trach tube still in place, but was not needing additional oxygen and I was able to remove the trach tube. A few days after this, he was able to discharge to home. He was doing quite well, so I ordered a course of outpatient physical and occupational therapy to continue to build up his endurance. Just recently, I had the pleasure of seeing him again. He stopped by the rehab hospital just to give the therapists and me an update on how he was doing. He had just completed his final follow up appointment with his pulmonary specialist and was cleared to return to work the following week!
COVID recovery faciliated by rehabilitation.
Again, Tony was my most recent COVID-19 rehab patient. I would love to end the post-COVID rehab patients with Tony. With the vaccine now more readily available, I think I will see fewer of these patients, though I know he will not be my last. I do want to point out a couple of things about Tony’s successful recovery.
The first factor is that I do believe he was fortunate. Some people just do better with recovery than others, and we still don’t know for sure why. The second factor that I believe really played in his favor was his level of health and physical fitness going into this illness. His body had the reserves to allow him to make him a better and faster recovery. I want to highlight this point in that I see it with so many people in rehab after a prolonged illness. More often than not, those that have better outcomes in rehabilitation after a debilitating illness tend to be those that were more physically fit prior to their illnesses. So let us all learn from Tony and start or continue training for a possible future illness!
Share your thoughts on or specific experience with COVID recovery in the Comments section.
© 2021 Jessica Kluetz, DO