Transcription:
COVID-19 Recovery

Prakash: Welcome to live grader, a health and wellness podcast brought to you by the university of Maryland medical system. We put knowledge and care within reach. So you have everything you need to live your life to the full. This episode is sponsored by the university of Maryland rehabilitation network.

Offering a full range of physical rehabilitation services. The U S rehab network brings together a committed team of experts from across Maryland to help patients recover from illness or injury, such as stroke, joint replacement, or traumatic injury. The university of Maryland rehabilitation network, bringing world-class comprehensive rehabilitation services directly to your neighbors.

Today, we'll be talking about COVID-19 recovery. I'm precaution hundred and my guests today are Angela Ferrera and Melissa areas, speech language pathologists at the university of Maryland St. Joseph medical center. Angela and Melissa, thank you so much for joining me today. You know, this has been an unprecedented year for everyone confronting the COVID-19 pandemic, particularly individuals who've been diagnosed with the virus.

So Angela, maybe we can get started with you for those who have actually recovered from the virus. What are some of the side effects that they might experience?

Angela Ferrara: So working with these patients, we are noticing and getting reports from them that they are experiencing fatigue, tiredness. They're definitely having some difficulties with concentration and that thought process, headaches. Lots of them are reporting continued headaches. As we know, we have the issue with loss of smell and taste. So that is prolonged in some patients.

In addition, we have been getting reports of dizziness and some difficulty with dizziness particularly during standing. Some people, not as many I would say in the norm, but are experiencing some chest pain, continued difficulty breathing, and some joint pain and muscle pain, post this COVID-19 pandemic issue.

Melissa Arasz: The other thing that people are noticing or experiencing is more on kind of the emotional level of how this is impacting them. And people are reporting kind of increased levels of depression or anxiety, or even what we sometimes will call like a brain fog, where they start to go back to doing things that they were doing before they got sick and they're noticing that they're really struggling with staying focused or problem-solving things as quickly or as efficiently as they were able to do before they got sick.

Prakash: Yeah, I can imagine that you have those physical symptoms, but you also have the psychological symptoms that you're mentioning. Melissa, staying with you for a minute, are the people who were hospitalized with COVID-19 the only people who are experiencing some of these symptoms? And is there one particular age group that's more affected than others?

Melissa Arasz: So we've seen a wide variety of people that are sort of reporting these post-COVID symptoms. So it's not just with people who've been critically ill requiring a hospital stay. We're also seeing this happen with people who have had more mild symptoms that were able to recover at home. And even the degree of the lingering symptoms tends to be highly variable among people.

The other thing I would say is I don't think we've really seen a specific age group that's had more of an impact in terms of these post-COVID symptoms as other ages. So it's all very person or patient specific.

Prakash: And Angela, I want to move on to you now. What exactly can people do to address some of these issues that have been brought up?

Angela Ferrara: We encourage people to reach out to their primary care physician to discuss some of the symptoms that they are still having and some of the post-COVID issues that they're experiencing, They can then go forward and seek rehabilitation through physical therapy, occupational therapy, speech therapy and, for those psychological things, even some support groups and situations where they might be looking at some psychological counseling.

Prakash: So Melissa, I know that there are plenty of places where people can go to get treatment and help, but why specifically should people choose to get their care at the University of Maryland St. Joseph Outpatient Rehab Center?

Melissa Arasz: Our program is somewhat unique in the sense that we are embedded within a wellness center. So in addition to having therapists who are trained with these specialties and cognitive communication and balance and energy conservation, we also have access to guide patients to other professionals within our center, such as people who could help with some of the more holistic approach to recovery, including nutritionist or a dietician. And we even offer support through massage and acupuncture and other things that may help with some of those sort of more holistic needs that patients would have. And we really embrace being a collaborative team. So, you know, we work really well with each other and across disciplines to really support the patient along their entire recovery journey.

Prakash: So Angela, just speaking about that recovery journey, what are some of the things that rehab therapists assess and treat specifically?

Angela Ferrara: During some of the assessments, particularly with physical therapy, they're going to be looking at your ability to safely get around and to do it well and efficiently with good balance and looking at your strength and your endurance and addressing some of those issues with the fatigue.

With occupational therapy, we're going to be looking at your ability to do your daily life activities, so how well you're able to do your dressing and your cooking and your cleaning and all of those things that you were doing independently before, and may still be doing independently, but are experiencing some factors that are impacting your ability to do it as well as you did before.

With regards to speech therapy in particular, we really look at your ability to do some of those cognitive functions that you were doing regarding organizing your appointments and taking your medications and we can work on those higher level cognitive functions for the return to work and the effective management of all of those things needed for home management.

In addition, some things we haven't touched on yet, but we can look at some of the voice changes and potentially some of the swallowing changes that may have occurred from COVID-19 or the interventions required during the care of a patient during COVID-19. And those are some things that they can expect that we might assess and treat in the outpatient setting.

Prakash: So, Melissa, I think one thing that's clear in listening to all of this is that the COVID-19 symptoms are really wide ranging for lots of different people, you know, from some of the physical things that we talked about to the psychological, what other medical professions can support someone's recovery from COVID-19?

Melissa Arasz: A lot of the support that'll come for a person recovering from COVID-19 or even after they've sort of recovered from the initial illness will depend a lot on what their lingering symptoms are. Most of the people that have had an acute care or critical illness requiring a hospital stay will often be followed by a pulmonologist or an infectious disease doctor who will kind of look at recovery even after they leave the hospital stay. They may also benefit from working with a respiratory therapist during their hospital stay, or even after the fact, working on improving their ability from a respiratory perspective.

Some patients also noticed some heart changes or kidney issues as a result of the COVID-19 recovery process. So they may follow with an nephrologist or cardiologist. Also, some patients will experience some changes from a neurologic perspective. So sometimes they'll follow up with a neurologist in addition to, you know, the physical therapist, occupational therapist, and speech therapist who all work within our outpatient rehab office.

The other thing that we have through the University of Maryland St. Joseph Medical Center is a special support group for people who have survived a stay on our intensive care unit. And that also provides a lot of emotional support for people that may still be experiencing some of those emotional side effects of an acute care stay.

Prakash: So Angela, moving to you, are there any success stories that you'd like to share regarding helping people recover from some of the lasting impacts that Melissa was mentioning from COVID-19?

Angela Ferrara: Absolutely. Thinking of that question, there are two particular patients that come to mind. There have been those patients that have come to our facility and required all three disciplines of therapy. And in particular, there was a gentleman that when first arrived was having a hard time doing his normal activities that impacted just his independence, I would say, in the home environment and in the community environment. And we were able as a full team to work together to restore his ability to do his daily functions, including money management and including feeling like he could get up and around his home and outside of his home with good endurance and return to doing some of the passionate things he liked to do beforehand, such as cooking and being out in the community, sharing his time with his family.

So that was a good success story we had as well as another patient that experienced a long-term ventilation and afterward had regained such a great quality of life with regards to swallowing and with regards to voice after having a long-term intubation with the COVID-19 virus. So I think those are two that come to mind that were just really wonderful experiences for our team to be a part of.

Prakash: Yeah, that absolutely sounds amazing. So if someone is listening to this and considering getting their care at the University of Maryland St. Joseph Outpatient Rehab Center, maybe walk us through what a person can expect during an initial evaluation and what treatment looks like.

Melissa Arasz: So, during an initial evaluation, the patient will meet with one of our certified or licensed therapists. And they'll usually conduct a standardized evaluation of some kind, depending on kind of what brings the person into the office. And a big part of that initial evaluation will also be kind of discussing goals for therapy and engaging the person and any care partners or anyone who might come with them to the appointment to really get a deep dive of and an understanding of what are your goals, what do you need to improve to get back to kind of doing what you like to do and feel like is important for your day to day.

And we use the results of some of those standardized testing, as well as our interview with the person and any care partners that come with them to formulate some goals. And then we use that to figure out a treatment plan, like in terms of the frequency and duration of how long they'll be coming for those appointments. And we'll set up some home programming, which would be some exercises or things that we would have the person do, even when they're not coming in for their appointments, so that we can really encourage optimal outcomes for people.

Prakash: And, Angela, I will shift this question to you. You know, it's clear that both you and Melissa are very passionate about helping people who are recovering from COVID-19. Why exactly is that?

Angela Ferrara: So for me personally, COVID-19 was just this new experience in my career that I had never gone through. I had never treated through a pandemic before. And so it was new for many of the staff that we were working together to kind of figure out on a day-to-day basis what did we need to do next?

So it was something that we shared, not only with our immediate coworkers, but just shared in general with everyone around us. And so feeling really passionate about what we were experiencing at the beginning, which was just so new and a little bit overwhelming, and to see the outcomes at the end when we were fighting a virus and things were changing on a day-to-day basis and seeing just such wonderful outcomes at the end and feeling that success as a team and feeling that success to see our patients survive and see our patients leave the hospital and then see our patients return for outpatient therapy. So I just think that this was such a new experience, and a very impactful experience in my career and so very passionate about those patients now that are at home and still experiencing some issues with this virus and feeling like we can support them and wanting to support them through this whole recovery process from beginning to end.

Prakash: And Melissa, you know, as people listen to this, if they are interested in seeking these outpatient rehabilitation services that we're speaking about, how can they get started?

Melissa Arasz: So we would encourage people who are still experiencing any of these symptoms that could be related to their recovery from COVID-19 to discuss them with their medical provider, especially their primary care physician. They could request a referral or a prescription to come and see an outpatient rehabilitation specialist, so for physical therapy, occupational therapy or speech therapy, to really ensure a comprehensive management for their recovery.

Prakash: And just before we close here today, Angela, is there anything else that you would like to share with our audience regarding COVID-19 recovery?

Angela Ferrara: Again, I think I would stress that this is something new for us and that we are trying to help those patients that are at home and maybe they're experiencing things and not realizing it is still from the COVID-19 virus. So having open discussions with their primary care physician about anything that they're experiencing is just something that we're highly recommending to patients just so that they can get all the support and the care that they need.

Prakash:

Well, Angela and Melissa, I think that is the perfect place to end. Thank you so much for joining us today. Find more shows just like this1@umms.org slash podcast. Thank you for listening to live greater. A health and wellness podcast brought to you by the university of Maryland medical system. We look forward to you joining us again.