Covid Muscle atrophy

[lynnmarr]

I am so thankful to The Lord that my husband woke up after sedation and cognitively seems to be doing fine. He is still trached and on ventilator. He is having problems with muscle atrophy? He can't move his arms, hands legs or feet. Has anyone gone through this? If so how long did it last and what did they do that helped you?

[Sepsur]

When I woke from a 57 day coma, I could twist my neck, raise my forearms z& thighs approx 3 inches.

There is a whole chapter that can be written on the cause of muscle waste in ICU, combination of inactivity & trauma is the cause - a person can lose 40% muscle in the first 20 days of ICU.

There is a tendency to assume all adverse effects are Covid related.

Cognitive dysfunction, chronic fatigue, thrombosis, telagon effluvium, muscle waste & weakness, delirium are all common legacies of ICU and any critical illness. I say this to assure you that you can find suitable rehab within the normal structure of post ICU treatment. And we who aren’t Covid sufferers have a wealth of experience that is extremely relevant. I fully accept the unique awfulness of Covid and the unique torture that you, as relatives, have had to suffer. My family could sit at my bedside.

Rehabilitation takes an extraordinarily long time.

I was told it would take 10 days for everyday I was in ICU to recover from the effects & that’s if I worked hard.

I had to do extensive physiotherapy.

Overcoming the chronic fatigue was the hardest battle.

I also struggled to control anger, joy & sorrow ( grief is closer to the feeling) this all came back to normal in time. I seemed to have no sense of peril either.

This is not tiredness or laziness - it’s different. It’s an overwhelming, sustained sense of physical, emotional, and/or cognitive exhaustion that is not proportional to any recent activity undertaken, (getting dressed would send me back to bed for 2hrs). I could never fully attribute it to leukaemia ( which I had) or whether it was a result of ICU. Fatigue is most frequently related to cancer and its treatment but it’s also common after chronic illnesses - that includes Covid & Sepsis ( which many of us have had). The fatigue that I suffered was one of the most debilitating problems during rehabilitation treatment on iCU and I think it interfered with my progress and my day to day functional capability massively.

Some critical patients develop a syndrome ( and isn’t just one bloody syndrome after another) named chronic critical illness (CCI) This has distinct ‘symptoms’ e.g. myopathy, neuropathy, loss of lean body mass, a swelling of the entire body due to fluid retention, vulnerability to infection and sepsis, delirium. Fatigue seems to go along with emotional stress and disordered sleep. Some ICU patients get none of this - so don’t assume the worst.

#ChronicFatigue, once discharged, can also be a sign of Post-intensive care syndrome, or #PICS, one of the legacies of critical illness, I had it in the ICU, the wards and and it persisted after I returned home. These problems can feel physical like joint pain, it can be the content of thoughts, feelings, or lack of mindfulness which often overspilled & affected my family. Most obvious presentation is impaired cognition and emotional distress, physical pain, aching joints etc etc

The three defined areas of impairment include :

Cognitive impairment which is when a person has trouble remembering, learning new things, concentrating, or making decisions that affect their everyday life. Cognitive impairment can range from mild to severe.

Psychological impairments are broad and range from mild depression to severe PTSD & sleep disorders.

Physical impairment is a disability that limits a person's physical capacity to move, coordinate actions, or perform physical activities, an impairment of motor skills include standing, walking, going up and down stairs or performing daily living functions like using a knife & fork, climbing or descending stairs etc etc.

The only remedy is physio, physio & more physio.

[FamilyHistorian]

Totally agree with Sepsur. Whilst you can see the loss of weight in your husband you can’t see the loss of muscle. And believe me every muscle in the body is effected. I had a trachy both during and after sedation and had to learn to talk and swallow again.