As COVID-19 vaccines rolled out across the country in early 2021, Julie Brown looked forward with hope.
At 50, she wasn’t in the first eligible group, so the mother of three and grandmother of four continued masking and social distancing while waiting her turn.
Then, the supply chain manager came into contact with someone who was COVID-positive. Seventy-two hours later, Julie began feeling ill.
It was the start of a months-long, death-defying journey.
Coughing intensified, leaving Julie breathless. On her third trip to the emergency room, she learned the disease had progressed to COVID pneumonia. Admitted to the local hospital’s intensive care unit (ICU), Julie quickly declined and was placed on a ventilator.
When her condition exceeded the local facility’s capabilities, she was airlifted to a nearby regional medical center and placed on extracorporeal membrane oxygenation (ECMO). The last-chance treatment acts as an external heart and lung, providing oxygen directly to the bloodstream. For three months, Julie survived on the machine. Twice, her heart stopped, but the ICU team brought her back.
Incredibly, as winter turned to spring, Julie’s body rallied. Slowly, the virus loosened its grip and ECMO was disconnected in favor of a ventilator.
Transferred to a step-down unit, her husband of 25 years, Tom, was there when she awoke. “It was just like it was the next day,” Julie said. “I had no memory of the ECMO or my time at either hospital. But Tom was, like, ‘You have no idea what you’ve been through.’"
As he and the medical team filled in Julie, she contended with the physical toll wrought by four months in bed. She had “COVID toes” – painful swelling, discoloration and open wounds that can sometimes affect patients and weakness so profound, Julie was unable to put on her glasses.
A second bout of pneumonia required a return to the ICU and rounds of intravenous antibiotics.
Despite incredible support from Tom, her children, grandchildren, five siblings and a host of “prayer warriors” across the country, depression set in. Told her lungs might never heal, the Browns began investigating transplant programs.
The one bright spot, Julie recalled, came on her 51st birthday. Not only did the nurses bring flowers and sing “Happy Birthday,” she received a slew of birthday cards – many containing her favorite splurge, scratch-off lottery tickets.
“They were actually part of my therapy,” she said with a laugh. “I had tremors, so at first it was hard to hold a coin. But I kept doing it and eventually they went away. I also came out $500 richer!”
Stable once more, but still on a ventilator, she transferred to Select Specialty Hospital – Camp Hill for additional healing and recovery time.
“The first thing I remember is Dr. Cohen,” she said. “He came into the room, sat down on my bed – he was so personable – and said he’d looked at my case. He didn’t think I needed a lung transplant and I could get off the ventilator. It gave me the confidence to try.”
That was the moment, Julie said, everything changed. Dr. Cohen led the hospital team of nurses, therapists, dietitians and pharmacists to create an individualized treatment plan to restore Julie’s independence.
Respiratory therapists got to work, gradually reducing ventilator support. Some weeks, Julie said, it was two steps back for every step forward; the care team never let her give into despair. There was always a hand to hold or reassuring words as she moved through breathing exercises and support reductions.
Simultaneously, physical and occupational therapists deployed a mobility program. Julie was shocked to find herself able to sit, with help, at the bed’s edge, while still connected to the machine. A short time later, she stood.
Nurses monitored vital signs, provided medication and, most importantly, calmed fears. Hospital nights can be long and lonely, and Julie said she is forever grateful for every nurse who spent time with her.
As fall and the holidays approached, recovery picked up steam. She met a key milestone and liberated from the ventilator and, a week later, discontinued airway support in favor of a small tube of nasal oxygen.
Her care team was astounded to discover that despite months of immobilization, Julie’s swallowing reflexes were intact. Within 72 hours, she’d resumed a regular diet. “I had turkey, filling and mashed potatoes,” Julie said with a grin. “My husband brought me a Wendy’s Frosty. It was all so fabulous.”
A week later, she moved to Penn State Health Rehabilitation Hospital, the next step in Select Medical’s care continuum.
There, a physician-led team conducted a new condition and ability assessment. Initially, Julie’s goal was to walk out of the hospital.
However, getting dressed, moving through the morning routine and pushing her wheelchair to the therapy gym left her exhausted. “After a few days, they realized I’d be wheelchair-bound for a while and my therapy changed,” Julie said.
“Occupational therapy did a lot of weights and arm-bicycle sessions and hand coordination games.” She also enjoyed visits from Norway, the hospital’s therapy dog. “We adopted a Black Lab mix, Logan, not long before I got sick and I missed (Logan) so much. It was great to play with Norway and throw the ball,” she said. It really helped with her upper body strengthening.
Physical therapists taught her to use a transfer board, which made getting out of bed or between uneven surfaces easier. They also had her perform lower body exercises and taught her leg movements that she could do in bed.
Julie’s feet remained painful and blistered with still-healing wounds. Nurses carefully applied Vaseline-soaked dressings and bandaged both feet so she could attempt to stand. While she was able to manage brief sessions between parallel bars, full mobility remained elusive.
As Thanksgiving approached, Tom attended training sessions in preparation for Julie’s return home. He learned how to help her conserve energy, set up tasks for her ahead of time and create safe environments for her wheelchair.
On the day before the holiday, Julie was cleared to go home. Tom, her family and friends made sure she did so in style. News crews and a gathering of 30 socially distanced family, friends and hospital staff did a “clap out” for Julie as a limousine waited just outside the hospitals doors to take her home.
Nearly a year after falling ill, Julie is still working to wean from nasal oxygen and continues to receive in-home physical therapy. She’s begun navigating her home with a walker, though it is slow going. The COVID toes and associated muscle wasting resulted in a dropped foot, further impacting her plans to walk. A follow-up podiatry appointment is scheduled soon.
Julie said she’s come to a number of realizations over the last 11 months:
Her family is exceptional. And though they’re a traditional “good, Catholic family,” prayer wasn’t always top of mind. Now, Julie said, a day doesn’t pass that she fails to offer gratitude for her survival.
Nurses and doctors are heroes beyond description, and she is grateful for every one that guided her home.
Patience, Julie said, is the one gift anyone going through a lengthy recovery should give themselves. With so much out of individual control, learning to take things one day at a time is key.
One question remains.
“I don’t understand why people aren’t getting the shot if they can,” she said. “You may still get sick, but you won’t get to the point I did, on a ventilator, on ECMO. Get the shot, take care of yourself.”