Lying on a treatment table, mask on her face, Nadia (the first name has been changed) has her right leg manipulated by Marjorie, one of the physiotherapists from the Cheminots (GHC) hospital group, in Draveil (Essonne). A session that has become daily.
This 43-year-old mother from Grigny was not the victim of a serious road accident. She is a Covid-19 survivor. Hospitalized for twenty days in a Hauts-de-Seine hospital in intensive care, she was transferred on Thursday 30 April to this medical center specializing in follow-up care and rehabilitation.
Of the 153 beds in the structure, a hundred are occupied by Covid patients. “Coming out of resuscitation, there was nothing I could do. Impossible to sit. It was the caregivers who lifted me to wash. "
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Her entire body was bruised by these 20 days during which she remained intubated, lying down 24 hours a day. Once a day, she does exercises in the rehabilitation room of the hospital, usually dedicated to people operated on for example knee or hip.
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“They pick me up around 10:15 am every morning. I ride a bike, a treadmill, so that I can strengthen my legs, ”recounts Nadia in a weak voice.
"Relearn standing, then walking"
Parallel bars, small staircase to practice going up and down, punching bag. Like Nadia, only patients considered to have recovered from Covid exercise daily in this medicalized “gym”. The others, still very contagious, start rehabilitation on their own in their rooms. About 70% of these patients are from Essonne, the rest are sent by hospitals in Ile-de-France, such as Bichat Hospital or La Salpêtrière in Paris.
“Patients need exercise reconditioning. Not all come out of intensive care, but all require rehabilitation ”, presents Abd-Asalam Chaar, coordinating doctor in physical medicine and rehabilitation at the GHC. “First you have to relearn the standing position, then balance, and finally walking. Cardiac adaptation to exercise is also essential. "
Progress step by step
In one week, Nadia already sees her first progress. “When I go to the bathroom, I can get up on my own because I have more strength in my legs. Before it was not possible. She is also followed by a psychologist. Indispensable support to get back on your feet.
“I went through a very hard ordeal. Fear of dying? It was especially the family who was afraid, I was in a coma. I look forward to my recovery as soon as possible to see my 14, 19 and 23 year olds again. And I hope that I will walk normally so that I can resume my work in animation in September. "
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“Each patient has a specific program, which is why the duration of rehabilitation, which is counted in weeks, is very variable. Of the hundred patients affected by the Covid that we have, some will only see the physiotherapist, others will be taken care of by an occupational therapist, a dietician, a psychomotor therapist ... We must progress very gradually. Rehabilitation is not more difficult according to age, but also according to existing pathologies. Diabetes, tension problems, overweight are not facilitators, ”says doctor Abd-Asalam Chaar.
Jean-Jacques, 63 years old: "I feel quickly out of breath"
A rehabilitation that promises to be difficult for Jean-Jacques, 63, who arrives in a wheelchair in the rehabilitation room. After 15 days spent in intensive care, this resident of Evry-Courcouronnes, in addition to losing 10 kilos, suffers from a neurological disorder which prevents him from lifting his right foot properly. Surrounded by his doctors, he manages to walk again by leaning on a walker. "At the moment, I can only do 20 meters," he specifies, as well as 5 minutes of cycling, without resistance in the pedals. "I quickly feel out of breath," says the sixty-something.
It will take a few more weeks for Jean-Jacques to relearn how to walk alone. Others see the end of the tunnel. "I have three patients who are going out next week," says Mouloud Messaoudi, doctor in charge of the musculoskeletal service. Even if they have regained their autonomy to move around, we give them a prescription to continue with the rehabilitation. "
For Mouloud Messaoudi, this new start for his patients is a victory for him and his caregivers. “When our patients come to us, it's on a stretcher. When they come out, it is by walking. "
Rémi, 57 years old: "when I woke up, I could move my hands a little, that's all"
Going home, on his two legs, is what Rémi Frion is about to do this Wednesday, May 6. This resident of Franconville followed his reeducation on the other side of Ile-de-France, at the Groupement hospitalier intercommunal du Vexin in Aincourt in the Val-d'Oise where he arrived on a stretcher after waking up in intensive care in Brest. "The first thing I'm going to do is kiss my wife and my son, I haven't seen them since March 16," he says.
Smiling under his mask, this 57-year-old banking IT consultant returns from afar. Rémi Frion was contaminated by Covid-19 in early March via a friend who did not have the chance to survive. On March 16, he was hospitalized in Eaubonne before being transferred to Saint-Louis Hospital in Paris. His condition deteriorated so much that he was placed on respiratory assistance and then intubated on March 23. But all that, the fifties have no memory of it.
Variable amnesia depending on the patient
"I completely obliterated the entire period between the time I fell ill and waking up," he says. A common amnesia in people admitted to intensive care. It is one of the side effects of medication, although not everyone experiences it the same way. "It's very variable, some remember until the last moments before falling asleep," said Dr. Bruno Philippe, head of the follow-up care and rehabilitation unit (SSR) at Aincourt.
Transferred to Brest under sedation, Rémi Frion finally wakes up on April 9, without really knowing who he is. "During my sleep I invented lives for myself: I traveled in space, spoke to artificial intelligences, usurped identities," he says. It took me over a week to regain my senses. "
Aware, the patient then understands that he is connected to several machines and above all, that he is paralyzed because of the muscle mass lost during his bed rest. "I could move my hands a little, that's all. He who defines himself as "the type of seeing the glass half full" must suddenly relearn to walk, eat and write.
"Patients are traumatized because their bodies no longer respond"
A mission that falls to the staff of the Aincourt hospital. "Here, the doctors are in the background," says Dr. Philippe. Dietitian, speech therapist, psychomotor therapist, social workers, teachers in adapted physical activity, physiotherapists, they do an exceptional job. "
He particularly insists on psychological problems upon awakening, again, which differ from one patient to another. "They are traumatized because their body no longer responds, it's extremely brutal and scary," says the head of the service. The break with their loved ones adds to the emotional charge. "
Rémi Frion begins work on April 24. "The hardest part is not knowing when you are going to regain your faculties," says the father. Hygiene is extremely annoying ... The first meals are a struggle not to tremble. It happened to me to panic because I couldn't cope. You have to accept not to force; we become very patient. "
The psychomotor therapist notably helped him a lot to manage his stress while reclaiming his body. When it comes to walking, the feeling of "feet glued to the ground" quickly disappears. In just a few days, the IT consultant is again able to move around on his own.
On average, it takes a week to relearn how to "stand up", and 12 to 15 days before leaving the hospital. However, people who leave the GHIV rehabilitation follow-up care service are not "cured". "They are no longer contagious but they are not independent in their daily life," said the doctor. Medical support is provided after discharge. However, professionals cannot afford to keep the beds occupied for too long.
"There will be another 15 days to three difficult weeks"
In fact in Aincourt, the 20 places available to the service are full. This Wednesday again, Dr Philippe had to refuse to take charge of a patient who will probably stay another week in pulmonology in Pontoise before joining the SSR.
Usually, however, there are 30 beds that accommodate all pathologies in this service. "We can not manage more for lack of staff, decrypts the manager. Normally, we have 2 nurses who take care of 30 patients, but here we need 2 to take care of 2 to 7 patients. We can't cope, it's frustrating. Since March 25, 82 Covid-19 patients have been admitted to Aincourt compared to an average of 250 annually, all syndromes combined. And Dr. Bruno Philippe concludes: “Here we are at the peak. There are going to be another 15 days to three difficult weeks. "
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