As a data point on the state’s coronavirus dashboard, Nancy Blodgett switched to “recovered”.
And yes, she is at home after being beaten head-on by COVID-19.
But recovered? Not even close.
“Heaven no. “Recovered” is when you can go back to work (and) when you can get to the mailbox without having trouble breathing, “said the woman who lives in Portage in southwest Michigan.
“Recovered,” said Blodgett last week, “is when you get your life back. It will take time. “
As Michigan enters its third month of COVID-19, those most affected by the virus that has infected more than 45,000 state residents are weaned from vents, leaving hospitals and returning home only to find out that the virus can no longer infect them, but this has left their bodies weak and destroyed.
Michigan health officials list 22,686 patients as “cured” of the virus, but this is a loose definition and includes all patients “who are 30 days from the onset of their illness”. While some patients are mostly recovered after leaving the hospital, for countless others, the road to true recovery is daunting and unexplored.
At the start of the weekend, more than 1,600 people remained hospitalized with COVID-19, including 570 on ventilation, according to state data.
“Doctors keep telling me they can’t tell me what’s going to happen,” said Jeff Curtis, 66, of Osseo, who spent three days on a ventilator at Hillsdale Hospital. Nearly a month later, he said that the pain in his arms and legs was overwhelming and that exhaustion was pervasive.
“They can’t tell me what is normal and what is not. It’s too new. “
Doctors know, however, that COVID-19 can trigger a storm of immune responses that can kill cells, injure or even stop the heart, liver and kidneys, said Dr. Sheryl Wissman, chief medical officer of Ascension Providence Rochester, which opened a 12-bed recovery unit on April 22.
At the Mary Free Bed Rehabilitation Hospital in Grand Rapids, Dr. Ralph Wang said that some patients were so hypoxic or starved of oxygen that their brains are now struggling to perform simple tasks – “almost like a slight brain injury “
Some patients, Wang said, have to “relearn walking, talking and going to the bathroom.”
Even if a patient is not hypoxic, it may take a week or more to readjust to “delirium associated with the hospital,” said Dr. Samuel Allen, critical care pulmonologist at Beaumont Health.
“You are in a bed watching the ceiling for 21 days. The light in the corridor is on. Someone has every four hours to check if you are not sleeping (deeply) and you are losing your sense of day and night, “he said.
In the worst case, there is also a serious organ failure.
Researchers in Wuhan, China in January and February discovered that 19% of the 416 patients, nearly 1 in 5, had signs of heart damage, according to a study. Another study found that 36.4% of 214 patients in Wuhan, or about 1 in 3 patients, showed signs of neurological damage. The two were published last month in journals by the American Medical Association.
In addition, New York doctors have reported kidney damage so severe that patients need dialysis, and autopsies of 26 Chinese COVID-19 patients revealed that nine had signs of kidney damage – “direct evidence invasion (of the virus) into kidney tissue. ”
“As people started to recover, we realized that it was different from other intensive care or intensive care,” said Wissman of Ascension. “This is a complete system shutdown. “
Even patients without permanent organ damage may have difficulty for weeks or months, their muscles being weakened by not using it.
“Usually people would be in the intensive care unit for a week or 10 days, and now we have people here, you know, 20, 30 days,” said Wissman.
“I don’t have the breath”
It was a happy moment on April 12 when Curtis was driven by staff from Hillsdale Hospital – moments captured by a video on Facebook.
He wanted to be at home. He wanted to see family. He wanted to return to his 30-foot by 50-foot post barn with his motor tricycle and Honda VTX 1300 motorhome.
But the bright sun and blue sky on Thursday seemed to be cruel teasing.
Curtis, 66, is still on a walker and an oxygen tank nearly a month after leaving the hospital. He didn’t go from his house to his barn just 300 feet away.
“I have a day that seems to be going well, then the next day I can’t get out of bed,” he said.
It takes more than an hour to shower: “I don’t have the breath,” he said.
Now the emotions that once were contained often spread, said the former owner of an asphalt business.
“I go out on my porch every day and cry,” he said. ” It is not me. “
Eric Goedge spent more than a week at Beaumont Royal Oak Hospital, fighting COVID-19.
On March 28, Berkley’s man was transported by ambulance to Beaumont – so weak that he had been unable to leave his own bed for three days. He has never been on a fan, and although miserable, he has been vigilant throughout his stay, said Goedge.
Certainly, then, it would bounce back, he thought.
He was amazed that when he returned home on April 5, he could no longer climb the stairs of his house without getting up by the arms.
The slow return is exasperating, said Geodge, who coordinates the technicians in the telecommunications field. During the past week, he “started to feel pretty close to normal.”
The Rehabilitation Institute of Michigan, part of the Detroit Medical Center, has treated more than a dozen patients transferred from other hospitals for post-COVID recovery.
In addition, he opens an outpatient program for those who return home and realizes that he always takes everything away from the bedroom to the bathroom, said Patty Jobbitt, CEO of the institute.
In both programs, however, clients in therapy must have passed the point of contagiousness.
The Henry Ford healthcare system designated 17 of its 40-bed therapy unit at Henry Ford Macomb Hospital specifically for COVID-19 patients, serving 28 patients from the Macomb and Detroit hospitals in the system in April. (Other patients were still so weak that they were released into nursing homes.)
Detroit Hospital, meanwhile, has extended therapy twice a day, rather than once, and on weekends for its patients, preparing them to go home, according to Henry Olejarz spokesman David Olejarz Ford.
“It was scary. I just cried. ”
Blodgett, 55, went to the emergency room at Bronson Hospital in Kalamazoo on March 26 with what she thought was the flu. After a positive test for COVID-19, things got worse and quickly.
Finally, on April 17, she left Bronson after 21 days of fighting the coronavirus, including nine days under ventilator. She started therapy at the Mary Free Bed in Grand Rapids, which had opened a new 16-bed ReCOVery unit a day earlier – a separate rehabilitation unit for COVID-19 patients.
The longtime logistics supervisor at Humphrey Products, which ironically makes parts for ventilators, was sedated while on ventilator.
But if it can provide comfort and safety for a patient in a life-threatening crisis, it means that unused muscles begin to atrophy – legs, arms, torso, even the chest muscles that help breathe, a said Terry Milnamow, an occupational therapist who worked with Blodgett.
“My legs were Jell-O. I haven’t been in for more than a month, “said Blodgett.
Blodgett also found that the ventilator left damage – destroying his voice and, worse, making him unsafe to swallow. Staff taught him how to use special thickeners for his water and cranberry juice, which made it easier to manage liquids. She decided to skip the coffee for a while.
“I can’t do this,” she said, laughing now. ” It’s horrible. Thick coffee is like something at the bottom of the pan. “
Blodgett was also surprised to see how COVID-19 had anchored his emotional and mental determination in the hospital.
For weeks, his only human contact in a strange hospital room had been the eyes of strangers above the masks and behind the face shields. She had been groggy and provocative in the hospital, firing at a feeding tube several times, which she would never have expected under normal circumstances. “
” I’m not like that. But for days there was this fear of not seeing anyone I knew. It was scary. I just cried, “she said.
For many, showering now requires extraordinary safety planning – plan shower supplies before, organize clothes so they can be put on more easily afterwards, develop a strategy for placing a cane or walker, and a seat to rest frequently, said occupational therapist Chris Boer, who also worked with Blodgett.
He said his patients often told him, “It shouldn’t be that difficult.”
Blodgett agreed: Part of the early recovery is the mental game – pushing forward while allowing yourself to sit and breathe “and pace myself.”
“But every day I am stronger,” she said. “It may take a while, but I will get there. “
Detroit Free Press editor Kristen Jordan Shamus contributed to this report.
To be involved: The Detroit Free Press, Bridge Magazine and Michigan Radio team up to provide updates on Michigan hospitals during the coronavirus pandemic. If you work in a Michigan hospital, we would love to hear from you. You can contact Kristen Jordan Shamus at [email protected], Robin Erb to [email protected] or Kate Wells at [email protected] at Michigan Radio.