Rehabilitation program manages severe coronavirus cases from across greater Montreal
COVID-19 entered Luis Rosales’s life on a winter’s day in February, and he still lives under its shadow. It began with a sore throat and fever and, before long, he was racing to hospital in an ambulance in a struggle to survive.
A doctor at the hospital told him he was putting him in a coma.
“How long will it last?” Mr. Rosales asked.
“I don’t know,” the doctor answered.
Wheeled away on a stretcher, Mr. Rosales began to pray. “I thought, ‘Is this going to be my last day on Earth?’”
Luckily for him, it was not. One day recently, Mr. Rosales was completing his rehabilitation at Mount Sinai Hospital, the final step in an arduous journey before he could finally return home. When he first arrived at the Côte Saint-Luc healthcare facility on June 23, he couldn’t walk or wash on his own, and his body was so weak that he crumpled on his bed “like a rag doll” if he tried to sit up.
Now, after weeks of intensive therapy, Mr. Rosales is able to walk and care for himself, and a future that seemed clouded with uncertainty appears bright again.
“When I arrived here, I felt useless,” Mr. Rosales said in a Mount Sinai physical therapy room. “Now, I feel my muscles coming back to life. I’m advancing every day.”
Mount Sinai, a member site of CIUSSS West-Central Montreal, has played a key role during the COVID-19 pandemic as a respiratory rehabilitation centre for post-COVID-19 patients, including “long haulers” like Mr. Rosales. This is a subset of patients who don’t recover from the disease in a matter of weeks, like most people. They face health problems that last for months, and many emerge from lengthy hospital stays requiring rehabilitation for muscle loss, diminished lung capacity and other debilitating conditions.
Mount Sinai receives referrals for these severely affected COVID-19 patients based on its expertise in pulmonary rehabilitation, as well as for services such as a centralized oxygen-delivery system that allows patients to receive high flows of oxygen. As a result, Mount Sinai has treated nearly 70 post-COVID-19 patients since last fall, referred by hospitals across the Montreal metropolitan region.
“We get the people who are most affected by COVID-19, those who were really knocked out by it,” says Dr. Suzanne Levitz, a Physician who manages the Inpatient Program at Mount Sinai. “We have a track record of results.”
Mount Sinai’s 30-bed, Inpatient Pulmonary Rehabilitation Program is the largest of its kind in greater Montreal. A team of doctors, nurses and other health professionals tackle not only physical recovery but the accompanying anxiety of patients like Mr. Rosales, for whom COVID-19 arrived both brutally and suddenly. Prior to his infection, Mr. Rosales was a healthy father of three who took hour-long walks each day and worked as a forklift operator for a food-processing plant.
After he was infected by the coronavirus and admitted to hospital near his home in Repentigny, northeast of Montreal, he spent eight weeks in a coma and four months in intensive care. He was given a tracheotomy that left him temporarily unable to speak.
By the time Mr. Rosales arrived at Mount Sinai, his weight had dropped from 81 kilos (180 pounds) to 63 kilos (140 pounds). He constantly felt as if he couldn’t catch his breath; a doctor compared the scarring inside his lungs to what a burn victim’s hands look like after they are scorched and begin to heal.
Now, after a therapy regime of exercise, physiotherapy, education and breathing techniques at Mount Sinai, Mr. Rosales is able to use a stationary bike, rise alone from a chair, and walk short distances without a walker; he can also dress and wash on his own again.
“People typically arrive here because they can’t walk and breathe without oxygen. Then they walk out of here on their own power, more confident about managing their lives.”
– Dr Suzanne Levitz
Unlike patients with chronic pulmonary disease, however, he has had to start learning the basics from scratch.
“We’re starting at zero with COVID-19 patients, since everything is new for them,” said Occupational Therapist Sabrina Campisi, who was treating Mr. Rosales recently, along with Physical Rehabilitation Therapist Ivan Rivera. “Education is a big part of it.”
Dr. Levitz says that watching the progress of patients like Mr. Rosales is highly rewarding.
“People typically arrive here because they can’t walk and breathe without oxygen. Then they walk out of here on their own power, more confident about managing their lives,” she says. Patients often express gratitude not just for the care they receive but for the kindness of staff, she adds. “Everyone really puts a piece of themselves into caring for patients.”
Mr. Rosales knows his battle isn’t over. But as he stands poised to return to home for the first time in five months, he feels a twinge of hope. The last time he saw his house, it was framed by snow.
“I know I’ve been given a second chance,” he said, thanking the staff at Mount Sinai for helping him. “It won’t be easy. But at least I’m alive.”
