Surviving COVID-19

Fall 2020

A story of resilience, determination and gratitude

The last thing Bethanne Keep remembers was shopping at the grocery store one day in late-March. The 56-year-old Londoner was stocking up as she was starting to hear of food and toilet paper shortages caused by fears of an emerging virus called COVID-19. Little did she know that six days later she would be so sick that her partner, Grant Dobson, would be calling an ambulance for help. She doesn’t remember the fever, the stomach pain, the vomiting. She doesn’t remember telling Grant that she thought she was dying. She doesn’t recall the paramedics from London-Middlesex EMS coming into her apartment dressed head to toe in personal protective equipment (PPE) because they suspected – correctly - that she might have COVID-19, nor does she recall going into respiratory distress as they were loading her into the elevator outside her apartment. She doesn’t remember being admitted to the Critical Care Trauma Centre (CCTC) at LHSC’s Victoria Hospital.

For the next 28 days, Bethanne would be spared from remembering the trauma of her illness as she was heavily sedated, intubated and on a ventilator, unaware of how lucky she was to have gotten to the hospital when she did. She knows many of these details now through stories her family have told her, recounting phone calls from doctors providing updates on her life-threatening condition, telling Grant that as fragile as her condition was, it was obvious she was fighting.

One of those physicians was Dr. Rob Arntfield, Medical Director of the CCTC. “We were quite concerned about Bethanne given that she had a history of other medical problems and immune suppression related to treatments for those conditions,” says Dr. Arntfield. “Reports we were hearing were that patients with these additional challenges did much more poorly than others with COVID-19.”

In order to effectively ventilate Bethanne to support her breathing, deep sedation was used, which continued throughout her time in critical care. Says Dr. Arntfield, “Ultimately the decision was made, once we could confirm it was safe to do so, to perform a tracheostomy that would allow us to more safely and comfortably awaken her gently out of her coma.”

While Bethanne doesn’t remember the efforts being made by the critical care team to save her life, what she does recall about that time were the dreams. Vivid dreams centered around the same theme – water and drowning. “The dreams I was having felt so real in the moment,” says Bethanne. “In one of them, I drove over a cliff into the water. In another, I thought I had died, and heard a bubbling sound that I thought was my ashes floating on the water. I’m still trying to pick the dreams apart to understand what I was thinking.”

Her next waking memory was being brought out of her coma, after several unsuccessful attempts, and asking a member of the team caring for her where she was. When told she was in hospital with COVID-19, she responded, “Tell my son I love him.”

The following four weeks in hospital are clearer in Bethanne’s mind. She remembers them as the hardest time – physically and mentally – she’s ever been through. Says Bethanne, “I remember thinking over and over ‘my God, I lived’, while at the same time not really believing I had been in a coma. I think I was in denial for a while, but I was fortunate to have had a great medical team around me in the hospital making sure I was never alone if I felt scared, especially when it was time to sleep.”

With her condition stabilized, and a long recovery ahead, Bethanne was transferred out of CCTC, first to a COVID-19 step-down unit, and eventually to the Respirology Unit where she would begin her rehabilitation. When she woke up from her coma, Bethanne initially thought she was paralyzed as she was unable to roll over or move her limbs. “I had lost so much muscle tone while in a coma, I couldn’t sit up or walk or do anything for myself,” says Bethanne. “I hated that. I wanted my independence back. My goal was to make it to the washroom and back without anyone having to help me. I was determined this was not going to be my reality forever.”

It was here that she met some of the health-care ‘heroes’, as she refers to them, who would help ensure she was not alone in her recovery efforts. “From the doctors to the nurses, the physiotherapists, occupational therapists, technicians, PSWs, cleaners – everyone I encountered was amazing,” says Bethanne. “Because I couldn’t have visitors, all of these people became part of my family.”

One of those people was Personal Support Worker (PSW) Jesse Foster, whom Bethanne says went out of his way to help her any time she needed it, offering words of motivation as he assisted her with her physical needs. Says Bethanne, “Jesse always had a way of making me feel better, even on the tough days. He kept reminding me that I was through the worst of the virus, and that I had the strength to come through this. I needed a lot of help, and Jesse and his fellow PSWs were always there to talk and laugh with, never making me feel like a burden to them.”

For Jesse, who has worked at LHSC since 2009, and in a PSW role since 2014, the chance to get to know and provide care for Bethanne was one of the rewards of what was a stressful time as the pandemic grew. “From the moment I met her, I knew Bethanne was prepared to work hard on her recovery,” says Jesse. “For everything she had been through, she had such a positive outlook on life. She went from being what she called a ‘noodle’ in her bed to being mobile faster than many of us anticipated.”

Through intense physical therapy, occupational therapy and strong-willed determination, Bethanne’s strength began to improve, though it was hard for her to see in the moment. It wasn’t until she was shown a photo from her time in CCTC that she realized how sick she had been, and how far she had come. Bethanne credits her physiotherapists, including Maciej Prajs (featured later in this issue), with helping her learn how to re-build her muscles, and get her body moving again. Despite searing leg pain, and a persistent tingling in the lower half of her legs, Bethanne slowly progressed to standing with the help of a lift, and eventually walking short distances using a walker.

“It’s so inspiring to have a patient that shows tremendous motivation and spirit regardless of their medical condition,” says Maciej. “When we met, Bethanne had just come out of the critical care unit. I remember repeating ‘one day at a time’ to her. Our initial interaction was working on sitting on the side of the bed and attempting standing. From clearing herself not even an inch off the bed as initial ‘standing’ on day 1, her rehab continued to progress as she was clearly motivated to get out of hospital. It was a pleasure and the highlight of my day to work with her on regaining strength and endurance. She was the patient that did not need pushing, just simply guiding. It’s definitely one of the ‘feel good moments’ as a therapist when you see such determination and obvious progress. To be honest, COVID-19 didn’t get much attention from either one of us. It was just another reason to gown up/mask up and go get working!”

Bethanne wishes she could remember the names of all those who cared for her during her time in hospital. “It’s funny, but even though this illness was the most difficult time in my life, the memories I have of being in the hospital are about the people,” she says. “I received tremendous care from everyone. Knowing these people were coming into work every day, risking their own health and safety to take care of me was overwhelming. And getting to know them personally, sharing stories with them, really helped me feel more comfortable being there. That’s why Jesse stands out to me. We shared a lot of stories back and forth and got to know each other well. He even asked his mom to make me a surgical cap in my favourite colour – purple – when I commented how much I liked the ones she had made for the staff. He called me a ‘superstar’ and really gave me confidence that I could recover from this horrible virus. He’s got a gift for making you feel better.”

Says Jesse, “I’m fortunate that my role gives me those extra moments to spend with my patients, to talk and share companionship. I learned so much about Bethanne in those weeks she spent on our floor. She is a helper, she does a lot in the community to support others. She was one of the first COVID-19 long-stay patients we had and I think we were as anxious about the unknown as she was. She really was a superstar, and I’m proud of how hard she worked to overcome the challenges she was facing from this illness.”

Following two months in hospital, and months of rehabilitation at home, Bethanne still feels the effects of COVID-19 every day. Her legs are still numb and tingling from the knees down, making mobility a challenge. Her big toe drags – a result of nerve damage, her medical team believes – adding further complication to walking. Breathing has gotten easier, although it has required a high dose of steroids to achieve, which come with their own side effects. And, understandably, the memories of all she has been through still weigh heavily on Bethanne.

“The day I was discharged, as I rounded the corner from my room, the halls were lined with the people who had cared for me while I was in hospital,” says Bethanne. “They were clapping and cheering and hooting and hollering. It blew my mind that all these people took time from their busy days to come say goodbye to me and wish me well. I was crying. They were crying. I felt like I was saying goodbye to my second family. I feel fortunate to have had the outcome I did, even if the issues I still have remain lifelong. I know that there is always someone worse off than I am. I can’t say thank you enough to everyone who, literally, gave me my life back.”

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PSW Jesse Foster