The Directorate General of Health wanted a multidisciplinary team in each health territory to be able to welcome people suffering from long-term Covid. The Reims University Hospital is certified, a rehabilitation establishment, referent, for the care of these patients.
In March 2021, Gilles Guillet, 50, foreman, at the town hall of Reims, also a confirmed athlete, who traveled up to 150 kilometers by bike on Sunday with his friends, was infected by the Covid-19 virus . When the firefighters came to pick him up from his home to take him to the hospital, he heard a sentence, which he cannot erase from his memory: “Wait, his wife is going to say goodbye to him! “.
He wanted this goodbye not to be a goodbye, so he fought, but the ordeal is severe. Five days a week, for four weeks, he takes part in workshops set up by the multidisciplinary team of caregivers from the University Hospital of Reims. “Cross-disciplinary doctors are needed, also with a psychiatrist“, indicates the head of department, Professor François Boyer.
Everyone is stressed by the recovery, the fact of going out, the fear of catching the Covid again.
The symptoms are indeed multiple. Gilles Guillet, who has not yet been able to return to work, explains: “For 21 days, I didn’t sleep. I had severe headaches, stomach aches. It affects morale, but I am supported by the doctors. Today, with medication, I manage to sleep five hours, interspersed, per night“.
A work of ventilatory mechanics, to understand the breathing is carried out, in group.
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© Marie-Line Fournier FTV.
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A fireball inside
Gilles Guillet, who has always been very active, is still struck by great fatigue and burns to his hands and feet, especially at night. This forces him to take cold showers. “It’s like a ball of fire, inside, that doesn’t want to come out “. The discomfort is difficult to deal with, and people do not understand that fatigue persists. “We enter the invisible handicap“, indicates Doctor Amandine Rapin.
On the verge of tears, but driven by an enormous will, he announces that he will return. “This is my battle. I’m fighting for it. When I fell ill, I was preparing for the French championships U.F.O.L.E.P., in my category. My goal is to come back and get back to work, to find my colleagues, to work again serenely “.
People no longer recognize themselves, because they can no longer do what they used to do, hence the discomfort created by the difficulty of resuming the previous activity.
If he did not sleep for a second, others, such as a member of the rehabilitation group, Antoine Marasco, were literally overwhelmed by sleep. Affected by the Covid-19 virus in March 2020, the retiree still suffers from symptoms. “I am coming back from far”, he said. “I was in intensive care with 89% oxygen. I was on the verge of being intubated. I lost ten kilos “.
Almost a year and a half, after contracting Covid 19, he explains: “I still have extraordinary pains in my legs. I still sleep 14 hours a day, plus naps. It’s very difficult”, recognizes the one who, a former entrepreneur, in the building, was rather accustomed to morning hours. Following the follow-up and rehabilitation program helps a lot. “It gives us back the taste for life“, declares the one who”saw himself lying down, forever“.
Caregivers are mobilized to support patients.
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© Marie-Line Fournier FTV.
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Lack of perspective on sequelae
In the ward of the Sevastopol Hospital, where patients suffering from a Covid long, the caregivers are very attentive to each situation, even if 90 to 95% of the people very classically complain of a muscular weakness, of a very important fatigue in the daily life. “This is accompanied by a series of different symptoms “, explains Doctor Amandine Rapin, specialized in physical medicine and rehabilitation. “People no longer recognize each other. They are wrong. They no longer recognize themselves, because they can no longer do what they did before, hence a discomfort created by the difficulty of resuming the previous activity“.
I am coming back from far. I was in intensive care with 89% oxygen. I was on the verge of being intubated. I lost ten kilos.
Certain problems require individual care, with the intervention of a large number of rehabilitators. Memory and attentional capacities can be affected. Vocalization, swallowing, persistent pain are identified. For each, it is necessary to coordinate the interventions in order to set up a complete program. Caregivers are listening.
“If we have enough hindsight to know the complaints, always the same, we still lack hindsight, to know if there will be consequences, and of what importance. We move forward with them, we adapt to them “, says Doctor Rapin.
Learning to recognize smells is done through an olfactory “training”.
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© Marie-Line Fournier FTV.
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Attention to fatigue
Five minutes of warm-up, then thirty minutes of effort training, on a bike, finally five minutes of recovery, the work in this workshop is very studied. However, discomfort can arise, and the team intervenes immediately. Moreover, precautions are taken. “We’re not going to re-educate them right away. Fatigue is too much. It should not be made worse. It takes a natural, post-Covid recovery time of at least three months before starting “, says Doctor Amandine Rapin.
The goal of the team is to improve the “capital effort”, but then, it will be necessary to organize a follow-up, over several months, with the Sport Health Network, notably. Professor François Boyer, head of the physical medicine and rehabilitation units also indicates: “One of the concerns is brain fog, related to stress or post-traumatic syndrome, or the inflammation carried by the virusThis is one of the questions facing physicians.
“There are differences between patients who have just been hospitalized, in medicine, and those who have been admitted to intensive care, where high dose corticosteroid treatments may have caused problems. Some people with chronic illnesses have seen their condition worsen. They must be re-stabilized “.
Since last July, the Reims University Hospital has been labeled a benchmark establishment for the care of patients with prolonged symptoms of Covid 19.
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© Marie-Line Fournier FTV.
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Impact on professional activity
Losing taste and smell is a problem in everyday life. In the workplace, this constitutes a particular difficulty. Béatrice Ducrocq is second in the kitchen. She caught the Covid in March 2020. “I have trouble breathing, concentrating, a lot of recurring pain in my legs, and I only recognize the smells very closely “. At a “training” olfactif, she tries to find familiar smells. Concentrated, eyes closed, mask down, the occupational therapist, Ségolène Midelet, accompanies her in this particular work.
The smell of morning coffee, that of cloves in a dish that she liked, the patient must try to associate product and smell, by walking, under her nose, in a back and forth movement, small pots used for exercise. The sensations return, on one nostril. The occupational therapist explains that “these are people who can feel isolated, depressed. It’s hard to share memories. There is a loss of appetite or on the contrary, people who are going to put on weight because they eat without realizing “.
For 21 days, I didn’t sleep. I had severe headaches and stomach aches. It affects morale, but I am supported by the doctors.
Ségolène Midelet is also a sophrologist. Once a week, she welcomes patients, in groups, in a workshop, where with dynamic relaxation techniques, specific breathing, the team tries to help them learn to manage the stress, fatigue, pain, sleep disturbances. “Everyone is stressed by the recovery, the fact of coming out, and above all, the fear of catching the Covid again “.
Some of these patients were infected with the virus during the first wave. But, in general, there are many who are not done with the effects of the virus. Currently, it takes two months to integrate the rehabilitation program at the Sevastopol hospital.
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