Sarah Keil had been diagnosed with COVID-19. Just over one week later, she was at home and began feeling dangerously short of breath. Her husband, Gerald, drove her to the local hospital.
“They had me on oxygen and wanted me to eat,” the 43-year-old said. I had no interest in eating at all. And they kept saying ‘take deep breaths, take deep breaths.’ I couldn’t. From there, I was knocked out, in wonderland. However, I could hear things going on around me.”
For Gerald and their 20-year-old daughter Lexie, it was a terrifying moment. The normally active banker rapidly declined and, with visitation restricted, her family was unable to provide comfort.
Sarah was connected to a ventilator, tracheostomy and feeding tube. She battled a bloodstream infection and two strains of pneumonia.
“After she was admitted to Fairview, I would call the hospital three or four times a day and they would let us FaceTime, but she was sedated and intubated. She was proned one day, it was terrible,” Gerald said. Proned is when a patient is turned on their stomach to help increase oxygen flow.
After nearly a month in intensive care, Sarah stabilized enough for Gerald to consider the next step in care. He chose Regency Hospital - Cleveland West.
Sarah arrived unable to breathe, eat, speak or move. Her family wanted her home, so an interdisciplinary team of doctors, therapists, nurses, dietitians and pharmacists created a plan for success.
Two days after arrival, Sarah’s condition deteriorated.
“The doctor said that she was on 100% oxygen, with a respiratory rate at 60. I thought I was going to lose her,” Gerald said.
Physicians and respiratory therapists fought to re-stabilize Sarah’s breathing. After a scary few days, she improved.
Respiratory therapy began trialing whether Sarah’s lungs had recovered enough to start working on their own. Through breathing, chest and coughing exercises, combined with gradual ventilator setting reduction, she began the long climb back.
Sarah’s biggest motivation was getting home to Gerald and being able to take their Great Danes, Bandit and Molly, and Shorkie Gizmo on walks.
As her mental fog cleared, Sarah connected with one of her respiratory therapists, whose kindness and motivation inspired her to keep working hard. When the therapist went out on leave unexpectedly, she made sure Sarah knew she would be back.
“We became like family,” Sarah said.
Physical therapists began a mobility program, including in-bed exercises, such as sitting up and moving to its edge, before transitioning to a chair. Increased activity built core strength and augmented respiratory therapy.
Occupational therapists worked on skills that improved coordination, dexterity and flexibility. As Sarah grew stronger, she relearned how to groom herself.
“The therapists were all very encouraging, and that was super helpful,” she said. “The physical therapists got me moving and occupational therapy helped me do more things for myself independently. Those have all gotten me to the point of where I needed to be.”
One day, the occupational therapist came in and asked Sarah if she wanted to finally wash her hair.
“It was the best thing, ever,” she said with a smile.
During Sarah’s stay, visitation restrictions eased and Gerald and Lexie were able to cheer her on as she began standing and walking farther each day.
Her doctor stopped by frequently to ensure recovery was on track. Progress was slow, but steady. After three weeks, Sarah liberated from the ventilator – a major milestone.
“I don’t know what changed, maybe it was coming off of the vent. But I woke up that next day and felt like ‘me’ again,” Sarah shared.
Sarah made great strides, but was still weak from the lengthy hospital stay and needed more recovery time. She and Gerald chose Cleveland Clinic Rehabilitation Hospital, Avon for the next step in care.
There, she focused on reaching her final goals – independent breathing and movement.
Physical therapists helped Sarah increase walking distance through strengthening and repetition. In occupational therapy, she used putty to strengthen finger and hand muscles. She also worked with resistance bands and a tabletop arm muscle exercise skate to practice controlled movements that improved arm and shoulder range of motion, strength and flexibility.
Breathing independently proved Sarah’s biggest challenge.
Physical and occupational therapists led exercises in dynamic standing balance and endurance. They also explained oxygen conservation strategies, teaching her to grade activities to ensure she had enough capacity. Simultaneously, Sarah worked on breathing strategies and lung-strengthening exercises with a respiratory therapist.
Over time, she spent time in the hospital’s daily activities area, practicing household tasks such as loading a dishwasher and washing machine.
To reduce anxiety and pass the time, Sarah and the recreational therapist worked on watercolor paintings.
Several weeks later, Sarah was able to walk over 400 feet and navigate stairs while keeping oxygen levels in the high 90s.
Gerald attended a family education session to learn how to safely set up their home to reduce Sarah’s risk of falling and maximize energy conservation. She was also given an individualized home exercise program to continue to building her strength and skills.
Doctors removed Sarah’s breathing and feeding tubes. She was finally free.
Sarah departed for home, grateful for all the support she received during her COVID-19 battle. She was already planning a fun surprise for her favorite furry friends.
“There are these huge cheese sticks they love. I’ll sit on the deck in a chair with them and my husband is going to let the dogs outside,” she said. “They’ll go nuts.”