Physical therapy after COVID
COVID-19 is hitting many specialties at Hennepin Healthcare. Physical therapists, especially those who specialize in neuro-therapy, are seeing a lot of patients who are recovering from this new and foul virus. Megan Meyer, a physical therapist who practices in our Clinic & Specialty Center, is one of those providers.
One assumption could be that most of Megan’s patients are elderly with pre-existing conditions, but that is not the case. Explains Megan, “Most of my patients are between the ages of 40 and 70, and yes, some do have pre-existing conditions, but many do not”.
Where are patients coming from? Megan says, “I would say about half come from the ICU, some have and some have not been on a ventilator, and half come from a medical unit. We are also getting referrals from providers who have non-hospitalized patients who are still having problems with strength, fatigue, and balance.” Some COVID patients need inpatient rehabilitation in our Knapp Rehabilitation Center but, once discharged, will likely continue rehabilitation in an outpatient setting.
“Fatigue and diminished strength are the biggest issues these patients face”, explains Megan. “COVID can cause long-term lung scarring, so lungs lose capacity as well as they can have various heart concerns. We assess their mobility and constantly monitor their vitals. Oxygen levels can drop very quickly, and we have to ask ourselves, ‘How hard can I safely push them based on how their heart and lungs are functioning?’ A patient may be asymptomatic, but their oxygen level is dropping, so patients and caregivers must always be aware of that oxygen level – especially at home. We recommend they buy a pulse oximeter, but not all patients can afford them.”
There is also a cognitive (mental) component involved. Some patients who have been on ventilators can get brain ‘fog’. “Your body tries to fight off this illness and work on healing. When it gets fatigued and loses energy, your brain can’t be in charge of all of these tasks, so it starts to also get fatigued.” If there are problems with memory, physical therapy gets speech-language pathology involved, although they are usually working in tandem with their colleagues already.
“This has really hit our neuro population hard. Patients who have MS or who have had a stroke and then get COVID, are seeing reversals in the progress they have made.”
Megan and her colleagues have been referring some COVID patients to psychiatry. “Patients are just plain fearful. They’re fearful of ‘getting it’ again,” (it is unclear if you can or cannot) “and if so, will it be worse? They’re fearful of giving it to family members and others. This creates a lot of anxiety. Some patients will isolate themselves and exist in fear – even being afraid to come in for therapy.”
And what about the vaccine? “I’m hopeful,” replies Megan. Recently having had a baby and still nursing, she is not allowed to receive the vaccine just yet, but she is relying on people around her to get it. Like all of us, Megan tires of this pandemic professionally as well in her personal life. She has had to limit contact with family members having both a father and father-in-law with health conditions.
“Healthcare burnout is real. I’m hopeful that a vaccine will get this pandemic under control, but there is a lot of misinformation out there.”
Megan Meyer, PT, DPT, is a physical therapist who specializes in physical therapy and neurological conditions. She sees patients at the Clinic & Specialty Center.