Starting over after COVID-19
How one of UF Health Jacksonville’s first COVID-19 patients fought to regain normalcy.
Cathy Hills remembers arriving in an ambulance at UF Health Jacksonville on March 24, 2020, too weak and in pain to understand much of what was happening. Hills, a retired commercial driver, was diagnosed with COVID-19, one of the hospital’s first documented cases.
Hadi Hatoum, MD, a UF Health Jacksonville pulmonologist, was one of Hills’ physicians during her time in the Intensive Care Unit. He administered anticoagulation medication and steroids to help reduce blood clots and inflammation in her lungs.
“In order to maintain adequate support of care, Ms. Hills was put on continuous ventilation and dialysis,” said Hatoum. “Our primary goal was to make sure all her organs continued to function normally.”
After more than a month in the ICU, Hills was given orders to begin rehabilitation therapy. Hatoum says that among his patients who eventually recovered from COVID-19, Hills’ case was one of the most extreme.
The fight for Hills’ life was over, but her journey to recovery was just beginning.
Relearning daily activities
When Hills woke up after her long stay in the ICU, she knew right away something was wrong. She was unable to move. Even something as simple as opening and closing her hands was impossible.
“When I couldn’t move my arms, legs and hands, I thought, maybe I’m just tired,” said Hills. “I didn’t know at the time that I also couldn’t walk or even speak.”
While in rehabilitation therapy, she had to learn how to do these all over again. Laura Tuck, MOTR/L, a UF Health Jacksonville occupational therapist and team lead in Rehabilitation Services, was on the team assigned to Hills’ rehabilitation.
Tuck and her team went to work right away, with their first goal of getting Hills to sit up on the side of the bed on her own. It was very difficult at first, as she couldn’t use any of her back or stomach muscles to hold herself up. Tuck continuously monitored Hills’ oxygen levels, making sure she laid back down whenever her levels started to decrease.
“When Cathy was finally able to sit up on the side of the bed, she was the happiest person in the world,” said Tuck.
Hills had to relearn basic functions such as holding a utensil and eating.
Connecting with family
The next hurdle for Hills was to find a way to see her family, since visitation restrictions were put into effect at this time during the pandemic. The best plan of action was to FaceTime with her family. First, however, she needed to relearn how to speak.
Kaylea Hollingsworth, a UF Health Jacksonville speech therapist, recalls how Hills had a lot of trouble making sounds and swallowing. To help Hills regain her voice and swallow, Hollingsworth used a respiratory muscle strength-training device called the Threshold PEP.
Soon after, Hills was able to speak well enough to FaceTime with her family.
“That was a big win in her therapy,” said Hollingsworth. “When she saw her husband, Earl, they both started crying. This was the first time seeing one another in almost two months.”
After speaking with her husband, Hills had a group chat with 10 family members. At one point in the conversation, Hills got so excited she started losing her voice and her breathing became labored. Hollingsworth had to coach her to calm her breathing so that she could continue conversing with her family.
Hills with two of her therapists at UF Health Jacksonville after being discharged.
Rehabilitation continues
Hills’ routine continued, with the next set of goals centered on hand therapy. This consisted of relearning to use a TV remote, brushing her teeth and holding a utensil to feed herself. Oftentimes during a session, the therapists would perform active-assisted exercises, holding the upper part of Hills’ arm and guiding her hand to her mouth, while she used her own muscles to help.
To assist with Hills’ weakened hand strength, the therapists would slide thick foam onto a utensil or toothbrush to give a bigger grip. Tuck provided a makeshift cell phone stand out of a cookbook holder, so Hills could FaceTime her family without having to hold the phone.
The next phase in therapy was to have Hills stand using a tilt table. Used for patients with poor muscle control, this device is a safe way to get weight through the patient’s body as if they are standing while being completely supported with straps. Hills used these opportunities to FaceTime family, brush her teeth and eat lunch.
After almost three months of therapy, Hills was discharged from UF Health Jacksonville to continue her recovery at Brooks Rehabilitation. She lifted weights every day to strengthen arm muscles, and she eventually progressed from a wheelchair to being able to walk again.
Hills says her experience at UF Health Jacksonville was tremendous. She attributes her recovery to the staff helping her to not give up and pushing her to improve every day.
“There were plenty of times I wanted to give up because of my difficulty breathing,” said Hills. “My wonderful therapists took it upon themselves to help me get to where I am now. I can’t stress it enough — I thank God for the staff at UF Health.”
