Melanie Rozek has been a physical therapist for about 10 years, but the last couple of months have been like no other in her career.
"It's so surreal. I've never experienced anything like this before," she said. "It's scary. You go through the gamut of emotions."
Rozek has been helping COVID-19 patients at Strong Memorial Hospital get their strength back. It can be a slow process. She said it takes just seven days for people to start losing muscle mass when they are sick and immobilized.
"Even if they can start to move their limbs," she said, "if they can roll in bed, start to sit up and hold themselves up, sitting at the edge of the bed, it can not only give them peace of mind in addition to strengthening and the benefits it has for their lungs, it has shown over time that it helps them get better, quicker."
Being on a ventilator is traumatizing, Rozek explained, and the experience often leads to cognitive changes for patients, who may feel confused and disoriented.
Members of a physical therapy team become touchstones for patients as they learn to move and walk again. Rozek recalled one of her first COVID-19 patients, a man in his 50s who had no underlying conditions that would suggest he would need a ventilator if he got sick.
"One of the first things we did with him," she said, "was sit on the edge of bed when he was on the ventilator, and all he really wanted to do was hold my hands, and that felt really powerful to me that I could provide that for this man to have this connection."
Connections like that become even more important when patients can't have visits from family members or other loved ones.
But even after they leave the hospital and return home, Rozek said patients may still experience something like a post-traumatic stress response.
"When you can't breathe, it's scary," she said. "It triggers your anxiety response. And anytime anything becomes difficult in the future ... so, if you're walking to your car, if you're going up stairs and you start to breathe heavy, that can trigger some of those responses in patients who have had this disease or who have had to be intubated."
Rozek's own experience has been anxiety-provoking, too. She said she has become hypervigilant about not spreading the virus.
"I am nervous that if I have been exposed to COVID that I am going to transmit it to my coworkers, to my family, to my cats, even."
But Rozek has also seen some remarkable things, including patients who were not expected to make it through the day eventually make a full recovery.
"This big, bad COVID virus has been deathly," she said. "It has been awful. There are still things to be happy about, because there are patients getting better, and it's exciting to be a part of that."