WALLINGFORD — An increasing volume of research on the coronavirus and experience treating patients’ long-term symptoms is allowing Gaylord Specialty Healthcare to fine-tune its treatments for those with lingering symptoms months after contracting COVID-19.
“We’re learning more everyday about how COVID attacks the body and the fact that it does affect so many organ systems, more so than other types of viral illnesses that we see,” said Dr. Jerrold Kaplan, medical director of outpatient services at Gaylord Specialty Healthcare.
Many of the symptoms that linger are similar to those seen from other conditions. What sets the disease apart, however, is the many disparate effects patients experience and the scale of the disruption to their lives.
Patients have displayed respiratory issues related to intubation with a ventilator, pulmonary symptoms similar to a stroke, cognitive deficiencies — often referred to as “brain fog” — and psychological trauma resulting from being separated from their families while being treated.
“I have people who participated in marathons — Iron Man and Iron Woman events — and now they have heart rates that go up to 150-160 beats per minute after just a few minutes on a treadmill,” Kaplan said.
Because of the many symptoms, the outpatient recovery program Kaplan runs at Gaylord has grown to involve nearly every treatment specialty at the rehabilitation hospital, including speech, occupational and physical therapists, nutritionists, psychologists and specialists in pulmonology and cardiology.
Meriden resident Michael Rajewski worked as a technician manufacturing cranes, but has not been able to return to work since contracting COVID-19 in October. When he was referred to Gaylord’s outpatient program, he suffered difficulty walking, fatigue, memory loss and speech problems, including a stutter so severe he’s had to relearn how to speak.
“When you lose your communication that violently it is very disturbing,” he said. “ … I'm a tough guy. I would never think this thing would wreck me the way it did.”
He sustained a fever of over 104 degrees for two weeks when he first came down with the virus and only recently began coming out of a “brain fog.” Medications typically used for Parkinson’s disease and seizures have helped to control his tremors. Physical therapists have been helping him regain his balance and other therapists are working with him on his memory loss and stutter.
Tammy Spurgeon, a speech therapist who has worked with Rajewski, said techniques and tools used to treat concussions have proved to be effective with COVID-19 patients.
“When we first met he was barely able to utter a sentence...and he's learned how to compensate quite well,” Spurgeon said.
Those sorts of cognitive impacts have taken longer to recover from compared to symptoms addressed in physical therapy. The long recovery can spark anxiety for patients.Improving treatment
Research from around the world has allowed Gaylord to fine tune its longterm recovery program, leading to specialized training for physical therapists and a greater understanding of the cognitive impacts. In many cases, rehabilitation regimens for things like hip replacement are fairly standard, but working with coronavirus patients has shown the value of individualized treatment.
“I think that COVID has been a devastating disease, but it has helped us in the medical field learn a lot about treating patients,” he said.
The quarantine has also pushed the use of technology like telehealth ahead by a decade, Kaplan said. Being able to virtually meet with patients has allowed therapists to get into their homes to see what spaces and equipment they have for practicing recovery techniques and identify possible safety hazards.
The challenges they’re now attempting to overcome are managing the anxiety patients have about their ability to survive and recover from COVID-19, as well as identifying how the virus is able to affect so many bodily systems and prevent it from doing so.
Kaplan said the takeaway has been to evaluate each patient for the widest breadth of symptoms possible, including symptoms the patients might not have recognized as related to the coronavirus.
While there’s not enough data yet to say how the virus causes cognitive impairment, Dr. Jonathan Woodhouse, director of Gaylord’s psychology department, said it’s clear the uncertainty patients feel about their survival and longterm recovery can cause PTSD, depression and anxiety.
“It was terrifying for a lot of people and they did not know if they were going to live,” Woodhouse said, adding that survivors sometimes have flashbacks and avoid healthcare because of the trauma.
For COVID-19 survivors and the general public alike, substance abuse, depression and unhealthy behaviors have become a growing concern throughout the pandemic. Woodhouse recommends everyone do a self-inventory of harmful behaviors that may have become habits during the pandemic.
“It's very important now for people to identify what habits they’ve developed over the past year that are not healthy,” he said.