94 days in a hospital, 5 weeks on a ventilator: a COVID-19 odyssey
When Johtasha Mosley got a sore throat the first week of March, she had no idea it was the start of a COVID-19 odyssey that would span 94 days in the hospital, including five weeks on a ventilator.
The 37-year-old Eastpointe woman was discharged from Beaumont Hospital in Troy on June 19. She returned home amid fanfare, with her family planning a parade down the block this week with a life-size cutout of her and a huge banner.
But Mosley's journey of recovery, and for thousands of other COVID-19 survivors across Michigan, has just begun.
"It’s a long recovery process. It's easy to get sick, but it's very hard to recover," said Dr. Vikram Narula, a physical medicine and rehabilitation physician who treated Mosley at Beaumont Troy.
Michigan has entered a new phase in the coronavirus pandemic as tens of thousands of survivors like Mosley work to recover from the debilitating effects of COVID-19.
The coronavirus can damage the heart, lungs and other organs. In addition to its physical effects, the disease can result in cognitive disability or psychological problems such as post-traumatic stress disorder, Narula said.
"People need to understand the importance of patience, and so does your family — because you’re not going to feel right for months possibly," Narula said.
"You’re going to have really hard days where you hit the wall, and feel like you’re not going to get better. That's the time when family and friends can be very helpful."
As of Sunday, Michigan has had 69,946 known cases of COVID-19, including 6,685 probable cases since the state's first case was detected in mid-March. That includes 252 new cases reported by state health officials on Sunday, along with five additional deaths. That brings Michigan's official death toll from the disease to 6,158, including 246 deaths probably caused by the virus.
Mosley suffered symptoms of COVID-19 for a couple of weeks before she finally was tested and admitted to Beaumont Hospital in Grosse Pointe on March 17. Doctors had previously diagnosed the team leader at Fiat Chrysler's Sterling Heights Assembly plant with an upper respiratory infection, and then with pneumonia.
She was transferred to Beaumont Hospital in Troy several days later when it became apparent she needed a ventilator.
"I cried every day for 94 days," Johtasha's mother, Dianne Mosley, 67, said of her daughter's lengthy hospitalization.
Johtasha Mosley — her friends call her Jojo — recalls little of what happened during her five weeks on the breathing machine. Her sister, Dilanda Mosley, 48, was her medical decision-maker, and remembers it all vividly.
"Every morning at 7 o’clock, (one of Johtasha's doctors) would call me, and during the daytime, I would call and talk to the nurses," said Dilanda Mosely, who kept a daily journal of her sister's condition.
"She had to have blood transfusions because her hemoglobin was really low, she had to have emergency dialysis because her kidneys were failing, she broke out in a body rash as a reaction to antibiotics," Dilanda recalled. "Every medicine they’re giving out for COVID now, she already had had it. ...
"She had a blood infection, she had the COVID in her lungs, she had the infection in her stomach. She coded five times — she almost died five times."
The effects of COVID-19 can be "incredibly variable," according to Dr. Bryan Kelly, a senior staff physician in the pulmonary critical care division at Henry Ford Hospital. Some people are asymptomatic, meaning they show no symptoms though they can spread the disease to others.
About 80% of those with symptoms are moderately affected, meaning they don't need to be hospitalized, Kelly said. It usually takes those people about two weeks to recover, but some can struggle to get back to normal, he said.
"We’re seeing a subset of patients who have not returned to their baseline over weeks, and perhaps months," Kelly said. "That shows that in a group of people, this may become indicative of more chronic damage to the lungs that has to be looked at in a different way."
For people placed intensive care units, it's impossible to know who will fully recover and who will continue to suffer long-term effects of the disease, Kelly said.
"Being in the intensive care unit itself comes with its own risks in a patient with an immune system that is already tasked," Kelly said. "There’s always that risk for secondary infections, other sorts of things that can attack a patient’s body when the immune system is overwhelmed."
On top of the difficulty with breathing, there is a psychological component toll, Kelly said.
"The sleep deprivation that happens in the intensive care unit, the immobilization of being stuck in bed, the inability to maintain normal nutrition — it is such a whole-body injury that there’s so much that goes into rehabilitation."
During her five weeks on a ventilator, Mosley drifted in and out of consciousness.
In her delirium, she had a hard time distinguishing what was real and what was not. Though she has no children, at one point she was convinced she had a baby boy and demanded to go see him.
"When I first woke up, I had a hard time distinguishing between my dreams and reality, but now I'm OK," she said.
Mosley spent a short time at a rehabilitation center. But she suffered severe side effects from a tracheostomy, the surgical opening in her windpipe through which a breathing tube was placed. She found herself back at Beaumont in Troy.
When she begged not to be sent back to the rehab center, Narula, her physician at Beaumont, helped get her admitted to that hospital's inpatient rehabilitation unit — where her recovery began.
"I had aggressive therapy and I transitioned; every day, I got stronger and stronger and stronger," she said. "One day, I went from standing up, to the next day, I was taking steps, the next day, I was walking on the walker."
She still uses a walker and is being treated for psychological aftereffects including post-traumatic stress disorder. But she is confident she will fully recover, with the help of her supportive family — and so is her doctor.
"She’s in a good position to be successful," Narula said. "She’s already successful in my book, but she’ll take it to another level, I can tell."