Speaker 1: It's the start of the pandemic in and David Petrino
Speaker 1: is scrambling. He's the director of Rehabilitation Innovation at the
Speaker 1: Mount sign A Health System in New York, the city
Speaker 1: that's about to become the global COVID nineteen hotspot. It
Speaker 1: was grim. We had a countdown for the number of
Speaker 1: days before we ran out of beds, you know, And
Speaker 1: that was something that we were just managing with my
Speaker 1: team while we were testing out clever ways of turning
Speaker 1: bipad machines into ventilators, building our own ventilators, building a
Speaker 1: remote patient monitoring out to track acutely all patients, chasing
Speaker 1: down PPE. David does what he can, but it's mostly
Speaker 1: distributing face masks and medications. The reality is doctors don't
Speaker 1: know much about COVID or how to fight it. The
Speaker 1: most they can do is try to prepare. I was
Speaker 1: meeting people on the street who had boxes of ten,
Speaker 1: you know, in n and I was immediately rushing that
Speaker 1: off to whichever friend at whichever hospital needed most. There
Speaker 1: was just all sorts of crazy stuff going on in
Speaker 1: the early phase of the pandemic. The pandemic just gets
Speaker 1: worse and worse numbers continue to rise, and every part
Speaker 1: of the healthcare system becomes strained. People were getting COVID
Speaker 1: symptoms going to the hospital, they're being told, look, we
Speaker 1: don't have beds and you're not sick enough, go home
Speaker 1: and come back if you're worse, which is a really
Speaker 1: terrifying thing to say to someone who is sick with
Speaker 1: an unknown illness, with an unknown disease. Course, you know
Speaker 1: how much sick of do? At what point do I
Speaker 1: come back? So David and his colleagues start thinking about
Speaker 1: a way they can monitor COVID patients safely from their homes,
Speaker 1: and they settle on the idea of creating an app.
Speaker 1: My team has a lot of expertise and remote patient monitoring,
Speaker 1: so we developed an app in something like or thirty
Speaker 1: six hours, launched it. We said, here's a hotline. If
Speaker 1: you're having symptoms, call this number. The app proms uses
Speaker 1: to answer simple questions like whether they have a fever
Speaker 1: or a cough. David says, pretty soon hundreds and then
Speaker 1: thousands of patients are being monitored this way. Then around
Speaker 1: mid April, as strange pattern emerges for all, we started
Speaker 1: seeing this cluster of people who were expressing different symptoms
Speaker 1: patients report diligently on the app. At first, they were
Speaker 1: predominantly complaining of headaches, fevers, and shortness of breath, But
Speaker 1: suddenly they are symptoms more. Now they were talking about
Speaker 1: dizziness and fatigue, and I can't seem to exercise the
Speaker 1: way I used to, and you know, there's something about
Speaker 1: this that can't shake. And my heart feels like it's
Speaker 1: beating out of its chest, and you know, arms are tingling,
Speaker 1: my feet are going blue, you know, all of these
Speaker 1: very odd symptoms. What was immediately striking to me was
Speaker 1: just how similar all of these how random these accounts were,
Speaker 1: but really similar, David says. What's also bizarre is that
Speaker 1: almost all of these patients were never hospitalized. A common narrative,
Speaker 1: in fact, is yeah, I got it. I was fine,
Speaker 1: you know, I was more or less asymptomatic, um, you know,
Speaker 1: and I didn't think there was anything to worry about.
Speaker 1: And then two weeks after my symptoms went away, I
Speaker 1: got hit with this. What David is describing Harold's the
Speaker 1: start of his journey into trying to understand long COVID.
Speaker 1: He would go on to search for ways to help
Speaker 1: the millions of people across the world dealing with symptoms
Speaker 1: months after their coronavirus infection. Many patients are caught in
Speaker 1: a sort of medical purgatory where their problems aren't understood,
Speaker 1: much less treated, and the advice they get is well,
Speaker 1: not always reliable. If anyone tells you that they know
Speaker 1: what's going on, they're lying to like, don't trust that person.
Speaker 1: That's the one person you can't trust is the person
Speaker 1: who tells you categorically they know what's going on. And
Speaker 1: I've certainly seen a lot of clinicians doing that. As
Speaker 1: scientists rushed to figure out the causes of long COVID,
Speaker 1: some health providers aren't waiting for answers. There are already
Speaker 1: finding ways to help patients now. I'm Jason Gale, chief By,
Speaker 1: a security correspondent and a senior editor at Bloomberg News
Speaker 1: from the Prognosis podcast. This is breakthrough and they told
Speaker 1: my family she's not going to make it, and so
Speaker 1: you need to come in and say yo, goodbyes. Billie
Speaker 1: McCarthy could it bad case of COVID? Back in February
Speaker 1: this year, Kelly is a fifty one year old grandmother
Speaker 1: from a town in Massachusetts amount twenty miles southwest of
Speaker 1: Boston called Foxboro. Soon after falling ill, Kelly couldn't move.
Speaker 1: I couldn't even get out of bad. My husband's like,
Speaker 1: I have to throw you over my shoulder. You're going
Speaker 1: urgent care, which is good because when I got there,
Speaker 1: my oxygen was below seventy, which I guess is bad.
Speaker 1: Kelly's condition deteriorated fast once she got sick. It got
Speaker 1: so bad that she had to be introbrated and put
Speaker 1: into an induced coma. She couldn't breathe on her own. Eventually,
Speaker 1: she was given a tracking ostomy so a tube could
Speaker 1: be inserted directly into her windpipe, but the prognosis was
Speaker 1: still grim, and doctors thought Kelly would need a double
Speaker 1: lung transplant. That wasn't needed in the end, and after
Speaker 1: two months in three hospitals, she was eventually released. But
Speaker 1: the second chapter of Kelly's COVID story was just beginning. Hospitals,
Speaker 1: medical tests, and chronic disability have turned her world upside down.
Speaker 1: Kelly's main deficits are neurological. She can't feel her fingertips,
Speaker 1: and she's suffering memory problems. Kelly's doctors are familiar with
Speaker 1: her symptoms but she says it's not always so easy
Speaker 1: for long haulers to get good medical advice. I go
Speaker 1: over to the COVID clinic um to meet with all
Speaker 1: the people there, because if you go to a regular
Speaker 1: doctor with you know this is the problem, they're gonna
Speaker 1: look at it like a normal symptom of a normal thing.
Speaker 1: Kelly is referring to an outpatient clinic at that bring
Speaker 1: him in Women's Folking Hospital in Boston. It's been four
Speaker 1: months since she was discharged, and Kelly goes there for
Speaker 1: follow up treatment. Today she's sitting in the park across
Speaker 1: the street after seeing her doctor. Her recovery, she says,
Speaker 1: is still touch and go, like today, I'm having a
Speaker 1: good day, yesterday and Saturday or terrible. I can't grasp
Speaker 1: the words I need. Um, I get confused what I'm saying.
Speaker 1: It's almost my brains working way over time, and my
Speaker 1: mouth isn't working nearly fast enough. The problem extends to
Speaker 1: her short term recall and cognition. I forget things all
Speaker 1: the time, Like I'll look at one page and then
Speaker 1: I'll look to another page to put what it was
Speaker 1: I saw on this page, and I have to keep
Speaker 1: flipping back and forth several times. I've even been known
Speaker 1: to write it on my hands so I don't have
Speaker 1: to keep flipping by. These are having a monumental impact
Speaker 1: on Kelly, who before COVID was an insurance claims adjusta
Speaker 1: working out who is what after an injury? And I've
Speaker 1: never been the poster girl for for Strong Memory ever,
Speaker 1: but this is like this, This is what makes it
Speaker 1: difficult to go back to work because I have to know,
Speaker 1: I have to be on the money, so to speak. Um,
Speaker 1: Because if I'm talking to an attorney about their clients
Speaker 1: and their clients injuries and how much you know, the
Speaker 1: whole big picture is worth and to negotiate, if I
Speaker 1: can't remember every little pod and peanut, then it's gonna
Speaker 1: be hard to negotiate with them. Oh, your your client
Speaker 1: broke is lead. No, actually they sprain their thumb, but okay,
Speaker 1: you know, and I can't do that one. It's one.
Speaker 1: It's embarrassing too. It's bad for the company to have
Speaker 1: people like that trying to settle claims there. It's embarrassing. Um,
Speaker 1: you know. So it's just like I can't do and
Speaker 1: I hate to say this, I can't do anything important
Speaker 1: because I can't I just can't yet. Kelly says that
Speaker 1: her neurological issues also affect her driving. Get easily distracted,
Speaker 1: and then I'll notice my car is going like this,
Speaker 1: or I'll be walking and I'm shaking, and that sort
Speaker 1: of goes into the car with me. I almost hit
Speaker 1: a car on this eat the other eggause I didn't
Speaker 1: even see it till I was right there. And that's
Speaker 1: when I went home. And what road today. The symptoms, too,
Speaker 1: came manifest at all hours. Another source of Kelly's distress
Speaker 1: is the difficulty she has sleeping. A lot of that
Speaker 1: has to do with the six weeks she spent in
Speaker 1: a drug induced coma. Although heavily sedated, she was still
Speaker 1: able to connect with some aspects of being intubrated in
Speaker 1: the ICU, but not make sense of them. And this
Speaker 1: delirium generates persistent nightmares, awful awful, awful nightmares. And but
Speaker 1: I wasn't so sedated that reality wasn't coming in, so
Speaker 1: like things were coming in from my reality, mixing into
Speaker 1: the dream and making it worse. Hell. He says that
Speaker 1: early on, fear of these nightmares kept her from falling asleep.
Speaker 1: I was afraid I was going to have the dreams.
Speaker 1: And I was having the dreams that I was having
Speaker 1: in the column, and now my dreams are if I
Speaker 1: start having a weird dream, a wake up and beating
Speaker 1: on my husband, they're trying to put me in a
Speaker 1: colma again. No they're not, they're not. No, go to sleep, Okay,
Speaker 1: so I do, but it's a weird feeling. Think about
Speaker 1: this from the doctor's point of view. Your patients are
Speaker 1: coming to you with a slew of conditions that may
Speaker 1: not even seem related. Their short term memory is failing,
Speaker 1: they're having horrible nightmares, they shake. It's hard to imagine
Speaker 1: where to start. But David Petrino, the starting point for
Speaker 1: understanding how to treat long COVID is the patient data
Speaker 1: coming in on his app. There's a pattern emerging that
Speaker 1: offers some clues. For instance, these long haulers share some
Speaker 1: common features. What we're seeing is a medium age of
Speaker 1: forty two. Um. About of the patients who come to
Speaker 1: us are women, So I'd say it's about fifty fifty
Speaker 1: two people who had like some sort of significant medical
Speaker 1: history versus just fit and healthy and used to run
Speaker 1: marathons and keeps in good shape. And all of these
Speaker 1: sorts of things. In the fall of David and his colleague,
Speaker 1: doctor z gan Chan, set up a rehabilitation service for
Speaker 1: COVID survivors at Mount Sinai. They call it the Center
Speaker 1: for Post COVID Care. But at first they need to
Speaker 1: figure out which patients will see which clinicians. So David
Speaker 1: says to his colleague, Hey, here's what we're gonna do.
Speaker 1: If you're examining someone and they've got a bunch of
Speaker 1: symptoms and you can scan them, take their blood, look
Speaker 1: at their organs and say, this is the proximate cause
Speaker 1: of your symptoms. This is it. We we know what
Speaker 1: this is um and it's because of COVID, but we
Speaker 1: can see it. It's on a scan you take them.
Speaker 1: If you have someone showing up with a laundry bag
Speaker 1: of symptoms and you can't see a single thing on
Speaker 1: their scan that would explain all of these symptoms, that
Speaker 1: to me is what we're going to call post acute
Speaker 1: COVID syndrome PACKS. And that was that was the term
Speaker 1: we we coined in April, and we said we're calling
Speaker 1: it packs, and they'll come to us and off we go.
Speaker 1: Patients with medically explainable ailments are managed by pulmonologists, cardiologists,
Speaker 1: and other relevant specialists. But then there are the long
Speaker 1: haulers whose symptoms can't be easily explained. David knows their
Speaker 1: conditions fall under a broad umbrella of needs, so he
Speaker 1: brings together a team of doctors and allied health practitioners
Speaker 1: with different expertise. They work with him to come up
Speaker 1: with strategies to help manage their patients specific problems. There's
Speaker 1: a cardiologist who specializes in how viruses affect the heart.
Speaker 1: There's a nutritionist who helps patients with food sensitivities. A
Speaker 1: couple of physiatrists. These are medical doctors who treat pain.
Speaker 1: And there's a doctor of physical therapy and she is
Speaker 1: focused entirely on, you know, treating people who have close
Speaker 1: concussion syndrome, again, something that looks very very similar. You've
Speaker 1: got heart palpitations, you've got difficulty with exercise and exertion.
Speaker 1: Then there's Josh Dunt's formal naval special oms guy who
Speaker 1: disarmed bombs for a living. He tells David that some
Speaker 1: long COVID patients are displaying symptoms of something it's seen
Speaker 1: in the military. It's called hypercapnia, which means a lack
Speaker 1: of carbon dioxide in the blood. It can be the
Speaker 1: result of deep or rapid breathing and can cause a
Speaker 1: tingling sensation in the limbs, as well as a normal heartbeat,
Speaker 1: muscle cramps, and anxiety. For this, he had seen this
Speaker 1: sort of symptom cluster before UM and it had taken
Speaker 1: the form of hypercapnea in in You know, fighter pilots
Speaker 1: who had pulled too many g's and we're having a
Speaker 1: physiological response to that, and their CEO two would drop,
Speaker 1: get heart palpitations, they get dizziness, they get these attacks.
Speaker 1: Josh tells David to test patients carbon dioxide levels. Sure enough,
Speaker 1: a large proportion of our patients were hypercapnic. Josh works
Speaker 1: in a breathing regiment to increase patients CEO two tolerance.
Speaker 1: It involves changing the duration of inhalations and exhalations, with
Speaker 1: the net effect of expelling less carbon dioxide. David says
Speaker 1: he doesn't know the underlying cause of patient's hypercapnea, but
Speaker 1: the technique helps. Again, this leads back to pat physiology,
Speaker 1: and it's it's a bit of a blank slate, but
Speaker 1: we know that when we increase people's SERO two levels,
Speaker 1: an edge comes off of symptoms. In most cases, figuring
Speaker 1: this out has given patients a way of controlling their symptoms.
Speaker 1: David says that if they feel an attack coming on,
Speaker 1: they can rein in these manifestations faster by focusing on
Speaker 1: their breathing for a couple of minutes. Psychologically, that's a
Speaker 1: big big deal, you know, just being able to say
Speaker 1: I have control over this, as opposed to I have
Speaker 1: almost fainted and I have no idea why, you know
Speaker 1: like that, that is a horrifying feeling to be somewhere
Speaker 1: public and feel like you're going to pass out and
Speaker 1: have no understanding of what's happening to your body. You
Speaker 1: don't want to go to the emergency department for the
Speaker 1: fifth time because you know they're just gonna test everything
Speaker 1: they've already test, give you an I V for hydration,
Speaker 1: and then send you on your way with probably a
Speaker 1: five grand bill. Pulling together a team of specialists with
Speaker 1: wide ranging skills and knowledge is one thing, but getting
Speaker 1: these experts to work collectively to actually help long haulers
Speaker 1: is another. One of the first things David needs to
Speaker 1: figure out is how exactly he's going to offer the
Speaker 1: kind of coordinated holistic care patients need, and then he
Speaker 1: needs to work out how that's going to be delivered.
Speaker 1: Many of his patients are so debilitated that frequent face
Speaker 1: to face therapy sessions just aren't an option. What was
Speaker 1: alarming to me was how, because the medical system is
Speaker 1: really hyper specialized here, um, how many people would just
Speaker 1: be bounced from specialist to specialists without anyone offering a
Speaker 1: treatment or anyone offering a plan. And it was almost
Speaker 1: like a game. You know, Oh, you got sent to me. No, no, no,
Speaker 1: you've got g I symptoms. You know, here's the gastro intrologists.
Speaker 1: You get to the gastro intrologists. Oh, you've got a headache.
Speaker 1: That's a neurology problem. If you go to the neurologist,
Speaker 1: patients typically have to wait three weeks for a specialty appointment.
Speaker 1: Many aren't working, and their insurance is running out, and
Speaker 1: all of this is compared outting their stress. Often by
Speaker 1: the time they made it to our clinic, they're so overwrought,
Speaker 1: um that it's it's a miracle that they're still standing,
Speaker 1: let alone managing this highly debilitating condition. There are no
Speaker 1: established practices and protocols to follow with long COVID patients
Speaker 1: aren't fitting into neat boxes. David finds that you have
Speaker 1: to start with the basics. It's trial by error and
Speaker 1: there are no guarantees of success. He says, being upfront
Speaker 1: and telling patients that from the outset is actually a
Speaker 1: source of comfort, just being able to say, you know what,
Speaker 1: this is what we think is going on. And we
Speaker 1: would always lead with so much uncertainty, like there was
Speaker 1: no this is what's happening to you. It is, here's
Speaker 1: what we think is going on. It's an entirely novel virus.
Speaker 1: I can tell you that I've spoken to a thousand
Speaker 1: other people who have symptoms just like yours. Here's what
Speaker 1: we think is happening, and here's how we're gonna manage
Speaker 1: a few things in the moment. And if these things
Speaker 1: don't work, come back to me, because then we're going
Speaker 1: to try these things. It's really leading with vulnerability. But um,
Speaker 1: all of the patients that we saw which just would
Speaker 1: appreciate it so much to just be like, thank you,
Speaker 1: thank you for not being overconfident, thank you for not
Speaker 1: dismissing my symptoms, thank you for taking a multi system approach.
Speaker 1: David takes that same level of honesty into the two
Speaker 1: clinics he runs of along Haulers in New York City.
Speaker 1: The centers are essentially big, open rooms with various pieces
Speaker 1: of equipment ranging from you know, robotic tilt tables that
Speaker 1: allow us to you know, specifically calibrate exercise for the
Speaker 1: very very severe cases all the way out to treadmills
Speaker 1: for the people who are getting to the point where
Speaker 1: we can start pushing them. There are also devices for
Speaker 1: taking patient measurements, blood pressure cuffs, wholes eximters, and instruments
Speaker 1: to check for hypercapnia. We've got a set of things
Speaker 1: called friends All goggles which allow us to measure the
Speaker 1: vestibular system, your balance system that can identify autonomic nervous
Speaker 1: system problems occurring in patients when they go from sitting
Speaker 1: to standing. For example, the autonomic nervous system being part
Speaker 1: of your nervous system that does all of the things
Speaker 1: that you usually don't need to think about. You know,
Speaker 1: when you should feel hot, when you should feel cold,
Speaker 1: when you should sweat, when your heart should beat, when
Speaker 1: you should breathe, and when that gets disordered, that's when
Speaker 1: all of these odd symptoms start to emerge. Changing body
Speaker 1: positions is often one of the biggest ways to stress
Speaker 1: the autonomic nervous system. David says it's quite a challenging
Speaker 1: thing logistically to get all of the blood vessels to
Speaker 1: open and close and blood pressure to regulate as you're
Speaker 1: moving from sitting to standing. That's actually a really challenging
Speaker 1: thing to do. That Your body does automatically until a
Speaker 1: virus or something or some form of trauma knocks it
Speaker 1: out of balance, and then all of a sudden it
Speaker 1: forgets how to do that. Rehab isn't slow and often
Speaker 1: frustrating process that takes easily days. We start with prehab,
Speaker 1: which is breathwork, so you know, first things first, we
Speaker 1: just make sure that everyone is working on just getting
Speaker 1: their blood gases in a place where they feel like
Speaker 1: they have their symptoms under control. David says that it
Speaker 1: sounds really basic, but it changes to the way you
Speaker 1: breathe and the natural rhythm of your breath have different
Speaker 1: effects on the body. We heard about the technique for hypercapnia,
Speaker 1: but there are others. You know, there's one one protocol,
Speaker 1: for instance, it's called box breathing, which is one of
Speaker 1: the fastest ways to regulate your parasympathetic nervous system. So
Speaker 1: we'll bring your heart right down, it'll bring your blood
Speaker 1: pressure down, and he'll do it quickly. Um. And so
Speaker 1: you know, finding the right breath work protocol for the
Speaker 1: right set of symptoms can sometimes be a bit of
Speaker 1: trial and error, but these things have measurable physiological effects
Speaker 1: and so they can be really powerful. After breathwork, patients
Speaker 1: moved to the first step of the rehab program. In
Speaker 1: most cases, it involves line flight on your back, so
Speaker 1: you're fully recumbent and we just getting gentle leg movements
Speaker 1: going at this point. In most cases, our patients aren't
Speaker 1: their heart rate isn't stable enough for us to use
Speaker 1: heart rate as a guide, so we actually use a
Speaker 1: scale called the Boord scale, which allows you to rate
Speaker 1: received exertion how hard you think you're working. And you know,
Speaker 1: if you think of the scale of you know, once
Speaker 1: ten where well zero to ten where zero is nothing
Speaker 1: and and tenders maximal as hard as you could possibly
Speaker 1: think you're working. Um, we don't let anyone exceeded too
Speaker 1: from their patients move slowly into a more upright position
Speaker 1: and the intensity gradually increases. We get them to a
Speaker 1: point where we actually can use their heart rate as
Speaker 1: a guide. Their heart rate has started to regulate. It's
Speaker 1: not racing all the time and ramping up and ramping down.
Speaker 1: It's starting to regulate, so we can now use it
Speaker 1: as a guide to you know, um, paced the exercise
Speaker 1: the way that we want to. We're now calling it exercise.
Speaker 1: David says that up until this point, the goal of
Speaker 1: the rehabilitation is to slowly condition the autonomic nervous system
Speaker 1: so it gets used to being challenged. What we're trying
Speaker 1: to do is just stress the body enough that the
Speaker 1: that the body has to react. So your heart rate
Speaker 1: needs to read is up. Maybe you need to breathe slightly,
Speaker 1: you know, slightly more. Your respiratory rate might increase by
Speaker 1: one breath per minute. You know, we're talking very little. Um.
Speaker 1: Your body temperature may change slightly, but you're not really
Speaker 1: doing anything difficult. The center tries to help patients within
Speaker 1: the limits of what their insurance will cover. David says
Speaker 1: that usually means capping sessions at two a week, and
Speaker 1: if someone is quite severe, it will be three times
Speaker 1: a week. We tried to do from home where possible
Speaker 1: because um, you know, you just heard what I described right,
Speaker 1: Laying flat on your back and moving your legs. All
Speaker 1: of that is blown out of the water. If I'm
Speaker 1: asking you to leave your apartment and come see me
Speaker 1: in Manhattan, you know, like, that's that's exertion. So you know,
Speaker 1: we we do our absolute best to try to to
Speaker 1: reduce burden on the patient, both financial and physical. Somewhere
Speaker 1: around day one, patients are typically able to work at
Speaker 1: their maximum heart rate. They're on a treadmill or a
Speaker 1: bike or whatever is comfortable for them, and they're getting
Speaker 1: a workout, and that's usually the point where we're like, okay, well,
Speaker 1: these are all your triggers, these are the behaviors, these
Speaker 1: are things to avoid, these are the things to encourage.
Speaker 1: Keep going with the exercise. Every day. There are graduates
Speaker 1: from the program, which is encouraging. I'd say we've at
Speaker 1: this point successfully discharged a few dozen, so probably fifty
Speaker 1: or sixty to the point where they're happy to move on.
Speaker 1: We're happy to let them go. Um. But then yeah,
Speaker 1: there's a large number of people just still in ongoing rehab.
Speaker 1: But for some their symptoms come back after months of treatment,
Speaker 1: and David says that raises questions about the long term
Speaker 1: trajectory for long haulers. Some of our patients who have
Speaker 1: been discharged for the longest their experience relapses. So, you know,
Speaker 1: we need to understand the path of physiology to understand
Speaker 1: how long is this going to be going on for?
Speaker 1: How long are people are going to be symptomatic for.
Speaker 1: Is this something you're gonna have to manage for your
Speaker 1: entire life, or is this something that you're gonna have
Speaker 1: to manage for the next five to ten years. Or
Speaker 1: is this something that we can rehabilitate and we'll just
Speaker 1: charge you and you will never have to think about
Speaker 1: it again. So these are all open questions right now.
Speaker 1: Unlike ASMIR on diabetes, long COVID isn't a chronic disease
Speaker 1: doctors and researchers have known about and studied for decades.
Speaker 1: It's been around for just over a year and a half.
Speaker 1: There's not the accumulated wisdom of published medical studies to
Speaker 1: guide treatment. A lot of it, David says, is about
Speaker 1: learning from patients. So I remember, you know very well, thinking, wow,
Speaker 1: you know, this is someone who was told at some
Speaker 1: point that her family were told that she's not going
Speaker 1: to make it, or they were told that she might
Speaker 1: not come off the breeding machines who might mean the
Speaker 1: long transplant at some point. This is Dr carlord Ismail.
Speaker 1: He's the medical director of the pulmonary division of the
Speaker 1: outpatient tour Ambulatory section where Kelly McCarthy is going for treatment.
Speaker 1: Colored began seeing Kelly in the summer. At the start,
Speaker 1: he found it hard to match his new patient with
Speaker 1: her recent medical history. Here she is walking in clinic
Speaker 1: on her own feet h and having a conversation with
Speaker 1: me that she was in an actually a very cheerful mood,
Speaker 1: much like David's work. Colored describes his approach to helping
Speaker 1: Kellys seems to management that's based on listening to the patient.
Speaker 1: For example, for her memory problems, Kelly's is a neurologist
Speaker 1: a taking images of her brain to look for anything
Speaker 1: else that could be affecting her. But Carlin says, if
Speaker 1: they can't find an underlying cause, they have to use
Speaker 1: the tools available to them. We will probably rely on
Speaker 1: things like neurologic rehab, things that help with memory, memory exercises.
Speaker 1: But there's no telling whether memory exercises and other forms
Speaker 1: of neurological rehab will help the fact is there's still
Speaker 1: a lot of uncertainty around treating Kelly and patients like her.
Speaker 1: It's hard to know. Again, we don't know what's causing it,
Speaker 1: so it's hard to tell how long it's gonna last.
Speaker 1: Kelly says she gets a lot of comfort from the
Speaker 1: case she receives that that bring them in Women's COVID
Speaker 1: Recovery Center, but the ambiguity of getting back to normal
Speaker 1: ways on her. Is it ever going to be normal again?
Speaker 1: Am I ever going to be able to be me?
Speaker 1: And I don't feel like me so and I don't cry,
Speaker 1: but I don't feel like me anymore. It's taking things
Speaker 1: from me that are the most important to me, you know.
Speaker 1: Even as one pandemic of infectious disease rages on another
Speaker 1: scourges accumulating in its way, Long COVID is leaving behind
Speaker 1: a mysterious, pernicious, and ultimately unvaluable wave of chronic, debilitating
Speaker 1: disease that may take years to understand. Treatments don't have
Speaker 1: to wait. That's it for this episode of prognosis Breakthrough.
Speaker 1: On our next episode Long COVID's Legacy, we'll meet too
Speaker 1: best friends who together are navigating the persistent loss of
Speaker 1: smell and what it means for long haulers now and
Speaker 1: in the future. It's been a very very fruitful friendship.
Speaker 1: And then obviously when I got the very sad news
Speaker 1: that Alex was diagnosed with COVID, she Facebook message me.
Speaker 1: I think the message it a bit of fun news.
Speaker 1: I have COVID, so it'll be right, I said, you'll
Speaker 1: get it back. Inside I was panicking. This episode of
Speaker 1: Prognosis Breakthrough was written and reported by me Jason Gale,
Speaker 1: with help from John Leleman. So for Foes is our
Speaker 1: senior producer. Carl Kevin Robinson Jr. Is our associate producer.
Speaker 1: Our theme music was composed and performed by Hannes Brown.
Speaker 1: Rick Shine is our editor. Francesca Levy is the head
Speaker 1: of Blemburg Poadcasts. Be sure to subscribe if you haven't already,
Speaker 1: and if you like this episode, please leave us a review.
Speaker 1: It helps others to find out about the show. Thanks
Speaker 1: for listening.