Hidden ordeal of weeks in hospital takes a physical toll, writes Eilish O’Regan
Some patients who have won their battle against the coronavirus and have been discharged from hospital are having to learn how to walk again.
The hidden impact on some patients who fought for their lives in intensive care for weeks is forcing them to regain the ability to walk and breathe as normal.
More than 1,400 who caught the virus and had to be hospitalised have been discharged and the after-effects have been severest on those who were treated in intensive care.
They are turning to physiotherapists like Eamonn Ó Muircheartaigh - son of legendary GAA commentator Mícheál - to take them from the zimmer frame to getting back on their feet.
Beaumont Hospital infectious disease consultant Prof Sam McConkey said: "Patients who have been in intensive care can be knackered. If you lie in bed for three weeks your muscles can disappear. The heart and lungs get weak.
"People need to be reconditioned to build the muscles back up and get the confidence to walk again. They need strength and conditioning. They could start on parallel bars or a zimmer frame and take steps trying to walk longer and longer distances.
"Physiotherapists play a huge role. The focus is so often on doctors and nurses in intensive care. But physiotherapists are also at the bedside helping the patient on a ventilator to clear their throat through repositioning and chest physiotherapy."
Eamonn, a physiotherapist for the Louth senior team, added: "Currently we're not sure of the long-term damage Covid-19 has done to affected people's lungs due to the fact that the consultant respiratory specialists in our hospitals are still in emergency mode as they fight to save people's lives.
"Lungs are quite elastic and in a lot of cases there could be irreversible damage caused where one loses that elasticity as its replaced by scar tissue, thereby reducing the lung capacity.
"This may only become apparent post-infection on attempting to return to exercising. That is why it is important to do respiratory exercises as part of your post Covid-19 rehab.
"Many people don't know how to breathe properly and everyone should practise the correct way to take in air which is through the nose.
"It is more difficult to breathe through your nose, but nasal breathing humidifies the air going into your lungs, which helps to reduce irritation to the airway and also helps you to use your diaphragm more, which helps air get to the bases of your lungs more efficiently."
He said it is in the base of the lungs where most of the oxygen we need is taken into our blood system.
"When we are breathless, for whatever reason we tend to breathe fast, shallow with the mouth open and that is the wrong thing to do," he said.
"We need to breathe lightly, slowly and deep and we can control our breathlessness through nasal breathing techniques and diaphragmatic breathing.
"Using our diaphragm and then breathing in through the nasal passages humidifies and warms the air that flows into our lungs which is better than taking air in through our mouth which is colder and irritates the airways thus making us cough."
He said patients who learn how to breathe properly after a bout of Covid-19 will improve their recovery by boosting oxygen delivery to the bloodstream. "It is through oxygen that your body can start to heal and to get stronger.
"If you don't learn to breathe more efficiently you will slow down your recovery time."
Patients who suffer de-conditioning after Covid-19 need to work on muscle strength and endurance to reduce their breathlessness. "We need to get post-Covid-19 patients moving again."
Prof McConkey said it is too early to say if patients who have recovered from the virus have been left with lung scarring. Respiratory physicians will be tracking this in post-Covid-19 patients in the coming months, he added.