In Michigan, 23K are ‘recovered’ from COVID. Many still feel like hell.

not recovered

Long after the coronavirus leaves their bodies, some Michiganders continue to fight pain, exhaustion, and life-threatening health issues. (Mandi Wright, Detroit Free Press)

As a data point on the state’s coronavirus dashboard, Nancy Blodgett has moved to “recovered.”

And yes, she’s home after getting whomped full-force by COVID-19.

But recovered? Not even close.

“Heavens no. ‘Recovered’ is when you can go back to work [and] when you can walk to the mailbox and not struggle to breathe” said the woman who lives in Portage in southwest Michigan.

 

“‘Recovered,’” Blodgett said last week, “is when you get your life back. It will take some time.”

As Michigan enters its third month of COVID-19, those hit first and worst by the virus that has infected more than 45,000 state residents are being weaned off vents, leaving hospitals and heading home only to realize that the virus may no longer infect them, but it’s left their bodies weakened and wrecked.

Michigan health officials list nearly 23,000 patients as “recovered” from the virus, but it’s a loose definition and includes all patients “who are 30 days out from their onset of illness.” To be sure, some patients are mostly recuperated after leaving hospitals, but for countless others, the road to true recovery is daunting and uncharted.

As of Saturday, more than 1,500 people remained hospitalized with COVID-19, including 539 on ventilators, according to state data.

“The 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 pain through his arms and legs is overwhelming and the exhaustion, ever-present.

“They can’t tell me what’s normal and what’s not. It’s too new.” 

Doctors do know, however, that COVID-19 can set off a storm of immune responses that can kill cells — a “storm of cytotoxins” — that can hurt or even shut down the heart, liver and kidneys, said Dr. Sheryl Wissman, chief medical officer for Ascension Providence Rochester, which opened a 12-bed recovery unit April 22.

Some COVID-19 patients face “whole-body system shutdown,” Dr. Sheryl Wissman, chief medical officer for Ascension Providence Rochester, said of severe COVID-19 infections. (Photo courtesy of Ascension health system)

At Mary Free Bed Rehabilitation Hospital in Grand Rapids, Dr. Ralph Wang said some patients have been so hypoxic, or deprived of oxygen, that their brains now struggle to perform simple tasks — “almost like a mild brain injury.”

Some patients, Wang said, must “learn to walk and talk and go to the bathroom” again.

Even if a patient isn’t hypoxic, it can take a week or more to readjust from “hospital-associated delirium,” said Dr. Samuel Allen, a critical care pulmonologist at Beaumont Health.

“You’re in a bed looking at the ceiling for 21 days. The light in the hallway is on. Someone is in every four hours to check on you so you don’t get that [deep] sleep, and you lose sense of day and night,” he said.

In worst-case scenarios, there is severe organ failure, too.

Researchers in Wuhan, China, in January and February found that 19 percent of 416 patients, or nearly 1 in 5, had signs of heart damage, according to one study. Another study found that 36.4 percent of 214 patients in Wuhan, or about 1 in 3, showed signs of neurologic damage.  Both were published last month in journals by the American Medical Association.

Additionally, New York doctors have reported kidney damage so serious patients require dialysis, and autopsies on 26 Chinese patients of COVID-19 found that nine had signs of kidney damage — “direct evidence of the invasion of [the virus] into kidney tissue.”

“As people started to recover, we realized that this was different from other ICU or intensive illnesses,” said Ascension’s Wissman.“This is whole-body system shutdown.”

Even patients without permanent organ damage may struggle for weeks or  months, their muscles so weakened from non-use.

Stories from the front  

Bridge Magazine, the Detroit Free Press and Michigan Radio are teaming up to report on Michigan hospitals during the coronavirus pandemic. We will be sharing accounts of the challenges doctors, nurses and other hospital personnel face as they work to treat patients and save lives. 

If you work in a Michigan hospital, we would love to hear from you. You can contact Robin Erb rerb@bridgemi.comat Bridge, Kristen Jordan Shamus kshamus@freepress.com at the Free Press and Kate Wells katwells@umich.edu at Michigan Radio.

“Usually people would be in the intensive care unit for a week or 10 days, and now we have people that have been here, you know, 20, 30 days,” Wissman said.

‘I don’t have the breath’

It was a joyful moment April 12 when Curtis was wheeled by staff out of Hillsdale Hospital — moments caught by a video on Facebook.

He wanted to be home. He wanted to see family. He wanted to return to his 30- by 50-foot pole barn and tinker with his Honda VTX 1300 motor trike and camper.

But the bright sun and blue sky Thursday seemed a cruel tease. 

Curtis, 66, is still on a walker and an oxygen tank nearly a month after he left the hospital. He hasn’t made it from his house to his barn just 300 feet away.

“I have a day that seems like I’ll be OK, and then the next 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, formerly contained emotions spill over often, said the former owner of an asphalt company.

“I go out on my porch every day and cry,” he said. “That’s not me.”

Eric Goedge spent more than a week at Beaumont Royal Oak hospital, fighting COVID-19. 

The Berkley man was rushed by an ambulance to Beaumont on March 28 — so weak he’d been unable to leave his own bed for three days. He never was on a ventilator, and though miserable, he remained alert his entire stay, Goedge said.

Surely, then, he’d bounce back, he thought.

He was stunned that when he arrived back home April 5, he could no longer climb the stairs of his house without pulling himself up by his arms.

The slow comeback is maddening, said Geodge, who coordinates telecommunications field technicians. Just within the past week he’s “starting 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.

Additionally, it is opening an outpatient program for those who go home and realize "it still takes everything out [them] to go from my bedroom to my bathroom," said Patty Jobbitt, the institute’s CEO.

In both programs, however, therapy clients must be past the point of contagiousness.

Henry Ford Health System designated 17 of its 40-bed therapy unit at Henry Ford Macomb Hospital specifically for COVID-19 patients, serving 28 patients from the system's Macomb and Detroit hospitals in April. (Other patients were still so weak they were released to nursing homes.)

The Detroit hospital, meanwhile, extended therapy twice daily, rather than once, and into weekends to its patients, preparing them to return home, according to David Olejarz, Henry Ford spokesperson.

‘It was frightening. I just cried.”

For her part, Blodgett, 55, drove to the Bronson Hospital emergency room in Kalamazoo on March 26 with what she thought was the flu. Tested positive for COVID-19, things got worse and fast.

Finally on April 17, she left Bronson after 21 days fighting coronavirus, including nine days on a ventilator. She began therapy at Mary Free Bed in Grand Rapids, which a day earlier had opened a new 16-bed ReCOVery Unit — a separated rehabilitation unit for COVID-19 patients.

The longtime logistics supervisor at Humphrey Products, which ironically manufacturers parts for ventilators, had been sedated while on a ventilator.

But while that may ensure the comfort and safety of a patient in a life-threatening crisis, it means unused muscles begin to atrophy — legs, arms, torso, even the chest muscles that help with breathing, said Terry Milnamow, an occupational therapist who worked with Blodgett.

“It’s severe deconditioning and a lot of stress on the body,” he said.

Things like walking across the room, climbing stairs or even standing up from the toilet are impossible without help, he said.

“My legs were Jell-O. I hadn't walked in over a month,” Blodgett said.

Blodgett also found that the ventilator left damage — wrecking her voice and, worse, making it dangerous to swallow.  Staff taught her to use special thickeners for her water and cranberry juice, making the liquids easier to manage. She decided to skip the coffee for a while.

“I can’t do that,” she said, laughing about it now. “It's awful. Thick coffee is like something at the bottom of the pot.”

Blodgett also was surprised at how COVID-19 had ground down her emotional and mental resolve in the hospital. 

For weeks, her only human contact in a strange hospital room had been strangers’ eyes above masks and behind face shields. She had been groggy and defiant at the hospital, yanking out a feeding tube several times, something she’d never consider under normal circumstances.”

“I’m not like that. But for days, there was this fear of not seeing anyone I knew. It was frightening. I just cried,” she said.

 Nancy Blodgett, 55, was among the first patients at a new recovery unit at Mary Free Bed Rehabilitation Hospital in Grand Rapids. The unit focuses on patients whose bodies have been wracked by coronavirus. (Photo courtesy of May Free Bed Rehab)

Lingering respiratory issues for COVID-19 patients mean the very act of breathing can be difficult as they struggle against a mental fog and reteach bodies basic tasks, therapist Milnamow said.

“Your lungs aren’t as effective as they were,” he said. “A lot of times, [patients aren’t] limited as much by their muscle strength but by their breathing.”

For many, showering now requires extraordinary safety planning — setting out shower supplies before, arranging clothes so they can be put on more easily afterward, strategizing the placement of a cane or walker and a seat for frequent resting, said occupational therapist Chris Boer, who also worked with Blodgett.

He said his patients often tell him “it shouldn’t be this hard.”

Blodgett agreed: Part of recovery at the start is the mental game — pushing forward while also allowing herself to sit and breathe “and pace myself.”

“But every day, I’m stronger,” she said. “It may take some time, but I’ll get there.” 


Detroit Free Press reporter Kristen Shamus contributed to this report.

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Comments

abe bubush
Sun, 05/10/2020 - 11:04am

A most helpful thing to know would be the contact tracing done on these patients.
There should be a public registry.
But then the privacy conspiracy nuts would hit the ceiling.

Revere
Sun, 05/10/2020 - 7:13pm

"Public Registry"
Wow! You would have loved Nazi Germany!
Why don't you move to china, you pathetic excuse for a human. You're just going to get deported there in the next war, anyway. Dictator xi-winnie-the-pooh will welcome your kind. They will tell you everything you ever need to think!

Paula
Mon, 05/11/2020 - 9:31am

I guess I am one of the "privacy, conspiracy nuts" then because that sounds vaguely like something Hitler would have done to further austrisize the Jews in Germany! Just my opinion...

Sam Kirk
Mon, 05/11/2020 - 10:55am

And I bet you agree with the governor and her lockdown. If so you need to take a long look in the mirror.

Jacob
Mon, 05/11/2020 - 1:19am

One of the significant problems that I have with these articles that talk about this particular element or particular condition is the fact that it confuses what is going on with this virus the question I always ask when I see this is did the virus mutate and we are seeing new symptoms, are we seeing a greater lethality to the virus. Another problem that I have is who is being affected by this virus is people with pre-existing conditions, is it people with immune deficiencies, and or are these people elderly or the young. The reports are all over the place there's no consistency of reporting of information at all. All I'm seeing is irresponsible reporting trying to get that next headline that gotcha story and it is kind of frustrating and it seems to be aggravating everyone else let alone all the academics apparently infusing their own studies and opinions into the matter so that they can get research money a.k.a. pay raise and it gets frustrating. A study done back at the end of March on a population size of 416 patients in an isolated geographic region is not what I consider a wow indicator of a study. I'm more impressed when we see comparisons of data between Italy, Spain, Japan, South Korea, and the United States. The only time that I’m interested in the human interest piece is when a person needs help or it’s a particularly interesting point where people are being affected in their everyday lives by the virus I don’t like seeing articles that confuse rising conditions with human interest pieces for testimonials that doesn’t inform me of anything other than the poor people are suffering. News is not a matter of engineering the public or affecting social condition in its heart the news is about informing the public so that they can make the appropriate educated decisions. News is not about persuasion it is about informing.

Robyn A Tonkin
Mon, 05/11/2020 - 9:14am

I hope the people showcased in this article continue to improve, some each day. I have not had covid 19, but I contracted H1N1 influenza this December. I had a protracted recovery period which included thought process issues. I would get up in the morning feeling pretty much like myself, except for lacking my usual energy--then it would suddenly happen. I would be thinking--planning the day, solving a problem--and the thinking would just stop. I could not hold on to the train of thought. I would just sit in the most uncomfortable limbo, and this would last the rest of the day, unless I did some rote chores and work that physically made my brain respond to a sequence of duties. One day, before this happened, I analyzed what it felt like. I decided that it felt like two parts of my consciousness were involved in thought processing, one part postulating, the other part responding, the initial processer responding to the new information-- sort of tossing the process back and forth. What was wrong, when the problem started, was that the initial response just was not happening. A thought would be put forth, and the response was mis-matched--the thought and its response could not connect up, and the process halted. I contracted a serious infection five years ago, and had to restore my gut to health. The healthcare profession is not a lot of help with this process--the internet can be. Through all the research I did, it became apparent to me that the gut plays a completely necessary and essential role in thought. You need your gut functioning properly in order for thought processes to proceed properly. I realized that H1N1 flu, which supposedly can only influence respiratory functioning, had indeed damaged my gut flora, and I needed the probiotic I have taken for five years to regain my normal brain functioning after the flu, and I also needed a prebiotic. Both of these things are available-- a good national brand of probiotic is in small refrigerators in every pharmacy. I made sure to take a prebiotic and an probiotic every day, and my brain functioning slowly improved and I returned to normal. I have to believe that a disease that has the suite of whole body effects that Covid 19 does must impair gut functioning and health.

All older persons need to have their vaccines up to date--shingrix, pneumonia and influenza. These vaccines not only protect against disease--they do, or can, contain adjuvants. Adjuvants cause a strong immune response to vaccines, and I feel that they boost my immune system overall, in a way that at least lasts awhile. I will be getting the flu shot designed for those over 65 every autumn.

Carl Harry Carlson
Mon, 05/11/2020 - 9:19am

Perhaps the correct term is “survivor.”

Then let the survivor assess when they have “recovered” and if so, how much - 100% , or less, just as patients self-assess pain levels.

Carl Harry Carlson
Mon, 05/11/2020 - 9:19am

Perhaps the correct term is COVID “survivor.”

Then let the survivor assess when they have “recovered” and if so, how much - 100% , or less, just as patients self-assess pain levels.

Sam Kirk
Mon, 05/11/2020 - 10:52am

I would like to know why internally our state is reporting 23k recoveries but the national numbers have a big zero in the recovery category? The national media seems to want to report negative news.

A Yooper
Mon, 05/11/2020 - 10:58am

One of the many issues with data collection to me is how integrated are the hospitals data collection systems? And, who are those collating this data, and to the hospitals have the capability to share data with a central repository? When we talk about patients admitted with already compromised health conditions there are many factors here, e.g., age, pre-existing conditions which most of us have, history of tobacco use and vaping, work in environments with chemical applications, etc. There must be measures instituted to collate all of it nationwide as well. All you health care providers keep up the good work and stay safe out there!

Rick Johnson
Mon, 05/11/2020 - 4:55pm

Another BS fear mongering article......quite writing this trash.....I know several people and have immediate family who work in hospitals all over Oakland Wayne counties and this is far from the truth for the 99% of people. Just plain garbage.

Revere
Tue, 05/12/2020 - 1:09pm

Every single person I know, including employees, who have tested positive and "recovered" from the virus (99% of them had no idea that they were infected) are feeling just fine.
Who are these people who are feeling like "hell"? Is it possible that they feel like "hell" because of their obesity or other health issues? Methinks so.

Revere
Wed, 05/13/2020 - 9:06am

Why is the stock photo for this article a picture of someone's hand with a cheap, chinese-made pulse oximeter from Amazon? These things are gimmicks, they don't even remotely accurate measurements.

Michigan
Sat, 05/16/2020 - 11:27am

I have a relative in another state who now has been very ill for two months. He wasn’t sick enough to be admitted in March, and because of that, he was refused testing in March and April. Still feverish and weak, he was examined, given a chest x ray and told that he had all the symptoms of COVID, including the ‘ground glass’ appearance of his lungs, and was a ‘presumptive’ case, but was not allowed testing because the doctors did not intend to admit him to the hospital.
Now, slightly improved but still plagued by fever, headache, and fatigue, he has been assessed and tested for COVID and it came back negative. Chest x ray is much improved. However, his medical team now will not test him for antibodies because their rule is (Get this) to only give antibody tests to patients who have tested positive for COVID-19.
I suspect there are many more like him, caught up in the garbled mess of different states’ testing protocols, and still feeling the effects of COVID.
No, it’s not ‘just like the flu.’