Dan Nardi was disoriented and weak when he arrived at Magee Rehabilitation in May, so much so the 50-year-old Northeast Philadelphia man couldn’t sit up in bed. He was in the fight of his life.
The coronavirus had wreaked havoc in his body. Dan Nardi had lost about 60 pounds, he needed supplemental oxygen to breathe and his kidneys required dialysis.
“I was anxious to get started with rehab, but when I first got to Magee, I was in a lot of pain and still in bad shape,” Dan said. “I had been lying in bed for six weeks.”
COVID-19 had taken a toll on his memory too. Dan struggled to remember what he ate for breakfast. He couldn’t remember much about his lengthy stay at Thomas Jefferson University Hospital and he still had a long road to recovery ahead of him.
“He Almost Died”
Dan thought he was coming down with the flu. It was the third week of March and the Philadelphia Parking Authority employee was sidelined with a dry cough and body aches. His wife, son and daughter were also ill. The coronavirus was just starting to make headlines in Philadelphia, but when the Nardis spoke to their doctor on the phone, they say he dismissed the symptoms.
“My daughter was in bed all day with a headache. My son was laying down all day with body aches. I was sick too. I lost my sense of taste and smell,” Dan’s wife, Judy, recalled. “Danny didn’t have a fever, but he coughed a lot and slept.”
The Nardis decided to get tested at the drive-through testing site at Citizens Bank Park. Test results confirmed it was COVID-19. A few days later, he struggled to breathe and could barely walk up and down the stairs. That’s when they realized it was time to go to the hospital.
“I was so out of it, I don’t even remember my wife taking me to the emergency room,” recalled Dan.
Later that week at Thomas Jefferson University Hospital, his breathing worsened to the point where he needed a ventilator. He stayed hooked up to the ventilator for 21 days. Doctors and nurses worked around the clock using a number of medications and strategies to help him stay alive.
“It was scary. He almost died,” Judy said. “When he woke up, he couldn’t talk and he needed a feeding tube, but it was so nice to see him wave to the kids on video calls.”
When Dan’s health stabilized and he could breathe on his own, he was transferred to Magee Rehabilitation – Jefferson Health. Magee launched its COVID unit at the beginning of May, comprised of doctors, nurses, therapists and other healthcare professionals who are dedicated to caring for the needs of this specific patient population. So far Magee has treated approximately 30 men and women recovering from COVID.
Rebuilding His Strength and Stamina
As healthcare professionals learn more about the coronavirus and COVID-19, they are better understanding the long-term effects it has on the body. The virus attacks the respiratory system, internal organs like the heart and kidneys, and the brain, causing headaches, confusion, strokes and seizures. After an extended stay at an acute care hospital, the body is in an extremely weakened state and will often require months to recover, with intensive physical and cognitive rehabilitation.
“He was very, very sick when he first came to us,” said Heather Eastty, Magee physical therapist. “It took a day or two before his blood pressure would allow him to sit upright for more than 30 seconds.”
“I just wanted to get better and go home,” Dan recalled.
The Magee care team set out with a multidisciplinary approach, including physical, occupational and speech therapies to help Dan return home and eventually get back to work. Recreational and art therapies provided additional, creative outlets to achieve therapy goals.
“Our goal was to help him regain the strength and endurance he needed to live his life,” Heather said. “We started with his posture and moving his arms. After a few days, it progressed to standing up. Then, we worked on getting him to take a few steps.”
Over the days and weeks that followed, they increased the distance he would walk, then added in general weight lifting and conditioning exercises, like step aerobics, marching in place and squats. They were also eventually able to wean him off oxygen and dialysis.
The respiratory issues and lack of oxygen to the brain impacted Dan cognitively. Magee speech language pathologist, Aimee Aranguren, worked closely with Dan to restore his short-term memory, having him perform activities and various mental exercises.
“It was frustrating not being able to remember the simplest things,” Dan said.
“He told me ‘I need to be sharp in my mind just like in my body.’ Every single day he would want me to challenge him. He wanted extra work and reading assignments,” says Aimee.
Aimee and Dan spent a lot of time re-learning time and money management skills, so Dan could resume managing family finances. By the end of his inpatient stay, he was able to write checks and complete budgeting tasks.
“Cognitive therapy can sometimes make people feel helpless,” Aimee explained. “I tell patients that this is not a reflection of intellect. It is a reflection of how COVID has impacted the entire body, including the neurological system.”
Combating Loneliness and Fear
Despite the physical and cognitive gains, the social isolation took a psychological toll on Dan. He had not experienced the physical touch of another person since his wife dropped him off at Jefferson at the end of March. He wasn’t able to leave his room or interact with anyone other than those on his immediate care team and even then, everyone donned full personal protective equipment (PPE).
“The loneliness was difficult,” said Dan. “I really missed my family. COVID turned my life upside down.”
Staff coordinated daily video calls with his wife, Judy, and their children, Luc Pierre, age 10, and Corrina, age 12. Judy regularly dropped off care packages for Dan and he would go to the window and wave to her on the other side.
The care team introduced Dan to art therapy as a means to express himself and heal emotionally. They brought the art supplies to his room, and art therapist Julie Nolan connected with him through video calls to offer instruction and encouragement.
“The staff at Magee helped me in so many ways,” said Dan. “I said a lot of prayers during that time in the hospital. Although I couldn’t see them in person, the support of family and friends meant the world to me.”
Magee psychologist Nermine Tawadrous, PhD, met with Dan throughout his inpatient stay to help him navigate the loneliness and stress. They also worked to address fears of what life would be like when he was finally able to go home.
“We are seeing a fear of breathlessness in some patients, because of the way COVID impacted their lungs. Patients also express anxiety about leaving the sterile hospital environment and getting back into the community,” Dr. Tawadrous explained. “There is a great deal of worry about reinfection, financial stress from the inability to return to work, and health concerns due to ongoing disability as a result of COVID.”
In recognizing the physical, cognitive and emotional impact of COVID, Dan’s wife appreciated Magee’s holistic approach to her husband’s recovery.
“The staff at Magee is amazing,” Judy said. “There is genuine concern and caring.”
Home at Last
Six weeks after arriving at Magee, hospitalized a total of three months, Dan was finally strong enough to go home. Judy hadn’t seen her husband face-to-face in 12 weeks. She was astonished at the physical changes.
“When I first saw him, I was shocked. He looked haggard and he had lost about 60 pounds,” Judy said. “But I was just so happy to hug him and bring him home.”
As the Rocky theme song played on a loud speaker, Dan made his way out of his room and into the hallway with Judy by his side. Staff lined up, clapping, cheering and offering words of support to the man with the beaming smile wearing a T-shirt that read “COVID survivor.”
“Dan is so sweet and kind. When he left the hospital he was so confident and I knew we did our job right,” said Aimee. “He made it through a traumatic experience feeling stronger and confident.”
As for what’s next for Dan: several more weeks of outpatient rehabilitation. He hopes to return to work at the Philadelphia Parking Authority in the fall. For now, he is taking it one day at a time, focusing on his faith and his health, and enjoying the time reconnecting with his family.
“It felt like such a weight was lifted off my back, like if I could overcome this, I could overcome anything,” Dan said. “But I want people to know that COVID is real. It is a very serious disease. Don’t take your health for granted. You need to protect yourself and your family and wear a mask.”