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“I thank God I’ve come through it”

IU Health Methodist Hospital

“I thank God I’ve come through it”

As a COVID-19 “long hauler,” Sarah Hagan found help through IU Health’s Convalescing COVID outpatient program, working with a team of physical, occupational and speech therapists to regain the life she thought she’d lost.

By Maureen Gilmer, IU Health senior journalist, mgilmer1@iuhealth.org

Sarah Hagan should have been happy to be alive. She had survived COVID-19.

She was grateful, of course, to come out of the hospital May 7 after a 46-day stay, including three weeks on a ventilator. But COVID had taken a tremendous toll on her.

Health problems aside, it had robbed her of her peace of mind, her independence and her freedom.

“It was hard for me because I’m used to doing a lot of things on my own and being on the go,” Hagan said. “A person like myself, when you can’t physically do anything for yourself, that can get depressing. You can’t feed yourself, cook your own food, take a shower, put on your clothes, comb your hair – simple thing like that.”

It was overwhelming at first. But little by little, this woman of faith and former singer in her church choir has climbed back toward a better version of herself, at least closer to what she considers normal.

The mother of two and grandmother of three went directly to a rehab facility when she was discharged from IU Health Methodist Hospital. There, she worked with physical, occupational and speech therapists for 16 days to regain lost function.

Even then, she wasn’t ready to be on her own. Her adult son stayed with her that first night at home, then a friend spent a few days with her. After that, her granddaughter arrived to be her companion for several weeks while doing her schoolwork virtually.

“I WAS WOBBLY”

“Before I left rehab, I was able to get off the walker, but I was wobbly,” Hagan said. “I had to use my cane at home, but I was going out walking almost every day, trying to build my strength back up.”

Her granddaughter’s company made a world of difference in Hagan’s recovery.

“She was a lifesaver. We walked and she helped me. I was teaching her how to cook, so it helped us both.”

What also helped Hagan were intense outpatient rehab sessions with IU Health physical therapists at the IU Health Neuroscience Center adjacent to Methodist.

Hilary Nuest and Priya Gangwani worked closely with Hagan three times a week beginning in mid-June. Recognizing that COVID had caused her acute respiratory failure, they concentrated on improving Hagan’s lung expansion – in effect teaching her how to breathe normally again – and activity tolerance for day-to-day tasks.

One of the activities they worked on was a 30-second sit-to-stand test, measuring how many times Hagan could stand up from a seated position in 30 seconds.

It might seem like a relatively easy test, but it takes a lot of leg strength and endurance to do that quickly, Nuest said.

Hagan was able to do just eight repetitions in 30 seconds. The norm for women in her age group is 15, Nuest said. And her oxygen levels fell into the low 80s. Normal oxygen saturation levels are 95-100%.

By the time she completed therapy, she was up to 10 reps, which might not seem huge, but it represents a substantial gain, Nuest said.

HELP IS OUT THERE

Victoria Hyatt, doctor of physical therapy at Methodist, wants to get the word out about IU Health’s Convalescing COVID Program, with physical, occupational and speech therapists in all of its locations who are trained and ready to see post-COVID patients who are still not able to return to their previous level of function.

“This could be that their cognitive function isn’t what it was so they need to see a speech therapist, or they’re having trouble manipulating objects so they might see an occupational therapist, or they don’t have the strength or endurance to walk to the mailbox or go to the grocery store so they might see us in physical therapy,” Hyatt said.

“We are part of a continuum of care. Sometimes these patients still have needs even after they’ve completed their hospitalization and either rehab or home health. They’re functioning to a point where they don’t need to be in that setting anymore, but they haven’t regained the ability to fully participate in their regular activities.”

That’s how Hagan felt.

Not only did she not have the stamina she used to have, she had lost mobility in her right hand, for which she worked with an IU Health occupational therapist. She also had trouble speaking, suffered memory and comprehension issues and had difficulty eating. She saw an IU Health speech therapist for those concerns.

The long-term effects of COVID-19 are not yet known, but so-called “long haulers” suffer from a range of symptoms for months after they initially beat back the disease. These can include coughing, fatigue, body aches, joint pain, shortness of breath, headaches and brain fog.

Hyatt said IU Health’s outpatient rehab program is designed to sort out which of these or other things a patient is suffering from and work to bring them back to their former level of function.

“This is an evolving illness, and we are still learning the impact it has on people and their physical health and endurance, as well as many other things it impacts,” she said. “We’re trying to capture those patients who still need care after they’ve completed everything else.”

Hagan is glad that she got help, but she admits it was like climbing a mountain for the first time.

“So many tasks that you are used to being able to do and all of the sudden you have to learn everything over again. It’s frustrating,” she said, “but your attitude plays a big part.”

“IT GETS BETTER”

She advises anyone in her situation to seek the help they need and put in the work that is required.

“Don’t get discouraged. Hang in there, it gets better,” she said. “Continue the therapy, listen to the therapists. They’ve seen people in this type of state before. You just have to continue to push your way through.”

Last month, eight months after she first went into the hospital, Hagan said she still has to remember to pace herself.

“Sometimes I try to walk too far or too fast and I get wobbly. Sometimes I feel like crying and saying ‘I can’t.’ You have to be patient with yourself. Take each day at a time. I’m not 100 percent, I can get out of breath easily, but I’m a lot better.”

She credits God and the team of therapists who worked with her for her continued recovery.

“They were so kind and patient with me. They really encouraged me to stay focused and positive, to exercise and eat right. I felt the presence of the Holy Spirit, and I thank God for that. I thank God for my children. I thank God I’ve come through it.”

Hagan, who turned 59 last month, said there was a time when she was hospitalized that she didn’t think she would live to see her birthday in 2020.

“Especially when I woke up and I couldn’t move,” she said. “And then I couldn’t swallow and I couldn’t chew when they took the tubes out of me.”

But now, this grandmother is living life again. She’s in a training program to get a new job, she’s breathing a little easier, and she’s counting her blessings.

Nuest is pleased that her former patient is doing well and encourages others who might be suffering debilitating effects from COVID to seek a referral from their physician for post-COVID-specific therapy at an IU Health hospital or one of the satellite facilities.

At the Neuroscience Center alone, which features a large gym area and specialized equipment, there are multiple therapists ready to step in to help, she said.

“We want to see these patients.”

Photos by Mike Dickbernd, IU Health visual journalist, mdickbernd@iuhealth.org

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