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How an OT used her  clinical knowledge to recover

By Sylvia Haycock

As a health care provider practicing community occupational therapy, over the year that was 2020, I had constantly adapted along with all health care professionals. 

In early November, I had the hopeful feeling that I would safely ride out the COVID wave. I was convinced that with my standards for physical distancing and wearing personal protective equipment, I was definitely not going to be a health care provider who contracted COVID-19. Until I was!

When I received the news that I had been exposed, I set out for the 2.5 km jog to the assessment centre and even ran a little faster on the way home. I felt powerful, fierce, happy, thankful, and energized. I went about that day with a smile. After all, the test results would be negative. It was also our twin’s eighth birthday and there was some celebrating to do, COVID-19 style.

Reality: 72 hours later began a very different story. I dragged my body out of bed and drove slowly to my second COVID-19 test, despite offers from my husband to drive. Once back home, I wearily went straight to bed. I stayed there far longer than I wished to. If I am honest with myself, that first week felt very dark and scary.

Physically, I alternated between bed and couch. Cognitively, I lost my edge. Emotionally, I felt defeated.

I could barely look after myself, let alone our kids and my husband, who contracted COVID-19 from me. One of my sons also contracted it. Somehow, our other son, his identical twin, did not. Kids proved once again to be very resilient. Our “village” of close friends, parents, and siblings stepped in to help with groceries, errands, and ready-made meals. Seven days in, I attempted a virtual barre class that caused me to vomit and spend another full day in bed.

Symptoms: My symptoms were vivid, unlike anything I had experienced before. I felt I could pinpoint where the virus was active as it moved to different regions of my body. Sometimes it landed in more than one region at a time, especially during the first 14 days. We had medical consultations and guidance from physicians, a nurse, and public health. The list included: fever, shortness of breath, overwhelming fatigue, muscle and joint pain, loss of sense of smell and taste, blurry vision, dizziness, burning chest, nausea, vomiting, diarrhea, abdomen pain, runny nose, dry cough, chesty cough, sore throat, thick phlegm (the kind that feels impossible to clear), altered temperature regulation of hands and feet, and clumsiness (dropping items).

It seemed that I had every symptom, but I never felt I was sick enough to go to the hospital. They varied in frequency, intensity, and duration on a day-to-day basis. This virus was relentless. It sapped my physical power, robbed me of my ferocity and obliterated me.

How was I going to get completely better?
After the first 14 days, there was a general assumption that I should be “recovered;” but my experience told me differently.

I was going to have to really figure out how to get healthy and return to my physical activities and occupations that meant the most to me—to return to the person I was at my core. I would not accept this inadequate level of function. I knew that this was going to take a lot of work. 

With the loss of my usual coping strategies, such as jogging, cycling and barre classes, I was stumped. This led me to think of the lessons I have learned from my OT practice, from the most stoic clients, after injuries had forced them to make changes to their lives. My symptoms were eerily close to those of my clients that had neurological conditions.

I thought to myself, what if I practice what I have been preaching? Those closest to me agreed and encouraged me. 

My recovery strategies
The goal was to avoid being a “long hauler”—if that was even possible. I focused on my mental health, nutrition, sleep hygiene, gentle movement, pacing, and socializing virtually with my inner circle. I cannot emphasize enough how important these areas of focus were. My mental wellness approach started with downloading a meditation app. To concentrate on my breath, I worked on stringing together a few good minutes, built up to a few good hours, and eventually after several weeks, I could string good days together again. I set small goals. One goal per day, such as writing 10 Christmas cards and aimed to see the humour in it—this was a year I had decided not to write them because I was too busy. 

Every day I chose love. Every day I chose gratitude. My mindset for love and gratitude had developed over the years practicing as an OT (alongside therapeutic yoga instructors, OT leaders in compassion and social workers). Every day I dug deep to find happiness in every area of my life. Operation “over-ride the negative thought train” ensued. I reached out to my village. I used my resources. I was humbled over and over as I accepted, what seemed like, basic help—making simple nutritious meals that we could tolerate. Each morning, I started the day with a calming tea instead of a coffee. After having a shower and getting dressed, I had a nap on the couch. Dieticians and nutritionists in my village guided me to the best combinations of foods and supplements to help me. I kept a structured daily routine and practiced sleep hygiene ensuring I was getting the very best sleep possible every night. 

I was humbled by the fragility of my physical abilities and the fatigue I experienced. To respect it was challenging. Pacing took on a new meaning. I was used to pacing in a five km race (run 10 minutes and walk one…). This was very different as I learned to truly listen to my body. Some OT colleagues and friends helped me to accept my daily limits without judgement, including what seemed to be the “insane” amount of rest that I needed. I became accustomed to frequent, hourly, rest breaks. My OT circle held me accountable.

The importance of movement
Over the past year I had read anecdotes from COVID-19 survivors. What had stuck with me was the message, “to keep moving” and so, I did. Every. Single. Day. Outdoors. If the movement was walking to the garage, or to get the mail, it counted. I moved my body, gently and often. I note that this was a different kind of movement than I have ever experienced. More gentle and thoughtful, more cautious, and less intense. Ongoing symptoms were a reminder to slow down. During recovery week four, after a one km walk, I came home and slept. I felt like I had just run a 10 km race. My muscles were sore enough to use topical analgesic cream. I wondered just how long it would take to get my power and strength back. 

An experience such as this can lead to deep reflections of values and core beliefs. My OT practice experience was now integral. There is a lesson in psychotherapy that teaches that there is always a hope that lives in us. It is there even if we cannot feel it or envision it. Imagine a forest destroyed by a forest fire. After the fire, you cannot see the forest, but the roots of the trees are still very much intact. Your job is to water and tend to it. Over the course of my COVID-19 recovery, I learned to be my own gardener. 

I reflected on previous challenging times in my life and what strategies I used to get through them. I aimed to honour what makes me tick and prayed to a higher power. I listened to music that inspires me. I reminded myself that I needed to show up for me, every day. All my focus had to be on me and my family. I managed as a mother by working as a team with my partner and lowering expectations for myself. I became more mindful and focused on practicing “no judgment” when I could not do all that I wanted to as a mother and wife.

Setting goals
I ate well, slept well, moved gently, paced myself, kept my people close (virtually), and focused on writing my own narrative. I followed my daily routine with vigilance. I delved into my rehabilitation training to figure out how to move forward in the best way I knew how. Like my clients, I set my own SMART goals and slowly increased my tolerance levels. It seemed cliché at times, resting THAT much. Thankfully, I was able to take sick time at work and then have a modified/gradual return to work that matched my abilities daily. My life’s mission, to empower meaningful occupation and maximal rehabilitative recovery for my clients, pivoted to an inward focus. 

Using the Occupational Therapy interventions that I have guided and coached clients with, I recovered and so far have avoided any long-term effects of this virus. On February 14, 2021, nearly three months after the onset of COVID, I completed that virtual barre class, this time with ease. Once again, I feel powerful, fierce, happy, thankful and energized. Now, eight months after onset, I am back working full-time and have received both doses of the COVID-19 vaccination.ϖ

Sylvia Haycock is an Adjunct Lecturer with the Occupational Science and Occupational Therapy Program at the University of Toronto, Faculty of Medicine. She practices full-time as a community Occupational Therapist with Complex Injury Rehab Inc.

This article is reprinted with permission from the Ontario Society of Occupational Therapists. Visit www.osot.on.ca.

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