‘Really takes its toll’: North Texas centers offer treatment for COVID-19 long-haulers
The number of coronavirus patients who experience long COVID is hard to quantify, but studies show it is more prevalent among people who have a severe case of the disease.
Scott Amon was getting ready for work one Saturday in June 2020 when he noticed he couldn’t catch his breath.
“I can’t breathe. I can’t catch my breath. I can’t breathe,” the 62-year-old remembers calling to his wife from the bathroom in their Fort Worth home.
The couple called paramedics, who gave him oxygen and suggested he go to the hospital. Within minutes of his arrival, Amon said doctors told him he had tested positive for COVID-19 and that it was affecting his lungs.
All told, Amon’s diagnosis — and other complications from the virus — would require two separate monthlong hospital stays and four months of physical therapy.
Amon is one of thousands of people across the country who have experienced what’s known as “long COVID.” People who suffer from long COVID, commonly referred to as long-haulers, report lingering effects of the novel coronavirus — such as brain fog, fatigue and muscle weakness — for weeks or months after testing positive.
The number of coronavirus patients who experience long COVID is hard to quantify, NPR reported, but studies show it is more prevalent among people who have a severe case of the disease.
To help overcome the challenges of his extended hospital stay and COVID-19 complications, Amon turned to SporTherapy, a physical-therapy center that has been tailoring treatments specifically for COVID-19 long-haulers.
“Getting over COVID and long COVID is about the physical and the mental rehabilitation,” said Brandon O’Malley, a physical therapist at one of SporTherapy’s Fort Worth locations who works with long-haulers. “To get back to a pre-COVID level is emotionally taxing and stressful when you’re completely dependent on a family member or can’t provide, can’t do things you normally could do. It really takes its toll.”
During his first round of illness, Amon was in the hospital for about a month and was on oxygen the entire time. While he was never placed on a ventilator, his blood oxygen level dropped below 80% more than once, bringing him close to even-more-severe illness. A normal blood oxygen level is between 95% and 100%, while anything below 90% requires medical attention, experts say.
Amon said he was home for less than two weeks before he got “desperately sick” again. An MRI and CT scan at the hospital revealed that he had blood clots in his intestine and that the lining around his stomach was inflamed, both caused by his initial illness.
He was hospitalized for four more weeks and endured care that included blood thinners, intravenous meals, antibiotics and twice-daily shots.
“I was like, ‘Am I going to recover from this? Or am I going to be like the ones I’ve heard on the news?’” he said. “I was calling my wife, my daughter, my son … and telling them, ‘I can’t take any more. I can’t take much more of this.’”
But the virus’ emotional toll didn’t end after he was discharged. After his second stay, even basic everyday tasks — showering, going to the bathroom and brushing his teeth — were nearly impossible for Amon to do on his own.
“I had no strength in my legs,” Amon said. “I couldn’t stand up on my own.”
When he began physical-therapy sessions three times a week at SporTherapy in early September 2020 at the recommendation of his family doctor, Amon was using a walker. He was so weak that he couldn’t lift himself up more than a few inches from a sitting position in a chair, and he couldn’t complete a lap around the inside of a clinic on his own.
O’Malley said SporTherapy staff see similar symptoms in many COVID-19 long-haulers.
“Being hospitalized for four weeks takes its toll,” he said. He pointed out that being bedridden can cause muscle atrophy and deceased bone density. “All those changes that occur from being bedridden for that length of time tack on and add onto the effects of the COVID virus.”
While there are unique challenges to treating COVID-19 long-haulers, many of the symptoms they present with are similar to those in people who are hospitalized long-term or placed on a ventilator for other issues, O’Malley said.
And benchmark assessments used for COVID-19 long-haulers remain the same as benchmarks for people with other health problems, he said.
Two of the primary benchmarks used to assess new patients are the six-minute walk test, where a therapist determines how far a patient can walk in that time, and the sit-stand test, where a therapist counts how many times a patient can transition from a sitting to a standing position in 30 seconds.
“We can actually come up with baseline numbers on where they’re at when we first see them that we can track … to make sure that they’re making progress,” O’Malley said.
From there, exercises are tailored to an individual’s needs.
For Amon, common exercises in the clinic included box squats, where he held a kettlebell and practiced moving from a squatting to standing position. The exercise is meant to mimic getting in and out of a chair, on and off a toilet seat or in and out of a car.
Amon also spent time on a recumbent bike and doing an exercise that involved lying on a sliding platform and pushing his body up and down using his legs.
Amon was also given at-home exercises, which included practicing using a balance board.
During all exercises, a physical therapist closely monitors the patient’s vitals to make sure they remain in safe ranges.
Some hope for long-haulers
Therapists determine when a person ends their program based on the individual’s progress toward their personal goals and what normal strength and activity look like.
“Everyone presents a little bit differently for different reasons,” O’Malley said. “It also depends on what their daily functions are. We know there’s people who are chasing around kids or grandkids or doing vigorous labor. Everyone’s affected slightly differently.”
For Amon, physical therapy ended in January 2021, when he was able to walk on his own without losing his balance and do everyday activities by himself. He recalls that it was a big step forward when he was able to step over the side of his tub and into his shower without holding his wife’s arm.
Amon is now back to working at Walmart, a job he got a few months before his illness, to supplement his retirement savings. But he’s still feeling the lingering effects of the disease.
Amon still keeps a chair nearby at work just in case he runs out of breath, and his doctor recommended he see a specialist for potentially permanent lung damage.
“When I came home for good, my neighbors were like, ‘Your intestines were caused from COVID?’” Amon said. “People just don’t understand what it does to you.”
O’Malley encouraged people who think they may have lingering COVID-19 symptoms to look into physical therapy.
“People need to understand that this is happening more and more, and they need to be aware that they can do something about it,” he said. “It doesn’t have to just be a slow, drawn-out process. … There are programs where physical therapists can actually progress that.”