Ruben Salazar finds hope through post-ICU support group, as his long COVID persists
“I’m at about 65 or 70%,” he says.
The 45-year-old father of two says his health is slowly improving, but he continues to contend with the physical and mental symptoms of long COVID more than two years after acute infection landed him in the hospital, comatose and on a ventilator.
“It’s been a long journey,” Salazar says. “It’s an ongoing process of me trying to learn what this really is.”
It’s not just the hypertension and diabetes he was diagnosed with while being treated for COVID-19 — it’s the post-traumatic stress disorder he’s dealt with after a week in intensive care, as well as a lingering cough, profound fatigue, memory loss and depression.
Salazar continues to receive care at UCLA Health, where he joined the post-ICU support group recently established by Ravi Aysola, MD, and Rashmi Mullur, MD.
“It helps out because you hear the outcomes of what other people went through,” Salazar says. “They were in the ICU and some of them were diagnosed with critical illness. So hearing their stories helps out a lot.”
Dr. Mullur and Dr. Aysola created the group to help people deal with the trauma that can result from hospitalization in the ICU.
Patients may be admitted to intensive care if they need advanced respiratory support, such as intubation, or support for multiple organ systems.
“We call it the recovery and resilience group,” says Dr. Aysola, a pulmonary-critical care and sleep medicine specialist with UCLA Health and a survivor of critical illness himself. “Individuals who have gone through critical illness don’t just have the organ system that was affected; they have multisystem issues and recovery (that can) be prolonged.”
That has been Salazar’s experience. Even more troubling than the fatigue that prevents him from being active with his kids are some of the mental and emotional issues he’s faced since being hospitalized, he says.
“I’m glad I’m breathing. I’m glad I’m alive,” he says. “But the whole PTSD, I’m still struggling with that. I do get frustrated, you know. I used to have so much patience at one point in my life, and now that’s pretty much gone. I struggle with my kids, my kids’ teachers. Sometimes me and the wife bump heads on certain things that I do. But we’re supporting each other.”
The recovery and resilience group recognizes the emotional and psychological symptoms common in people after ICU hospitalization that might not be treated by their primary care physician or specialist.
“There’s a lot of post-traumatic stress, a lot of anxiety, a lot of depression, a loss of sense of self-worth and esteem and meaning, and a loss of function,” Dr. Aysola says. “Even if it’s not on your conscious mind, it has a residual in your autonomic nervous system, in your response patterns. That’s where learning breathing techniques, recognition of where you hold stress in your body, these types of things, are initial steps in being able to reclaim some kind of control over your life, which is what is lost most.”
The post-ICU group’s two-hour meetings are about connecting with peers and learning practical self-management techniques, says Dr. Mullur, an endocrinologist and education director of the UCLA Health Integrative Medicine Collaborative.
Group members spend the first hour of the meeting sharing about their experiences and the second hour building skills to better cope with stress and trauma.
“We’re really taking a guided approach to incorporating integrative techniques into care, as opposed to saying, ‘Integrative medicine might help you — here’s a referral to mindfulness classes,” Dr. Mullur says. “When you have something as challenging and complex as post-ICU syndrome, it takes a more concerted effort to build the mind-body practices into care in a contained space.”
A new normal
Salazar says what he’s learning in the support group and through his therapist is helping him more easily identify his triggers and tap into techniques to ground and restore himself. He’s still troubled by episodes of forgetfulness, however. Sometimes he can’t remember if he’s taken his medication. And once, in a Walmart, he completely lost track of where he was.
“It was like I had a glitch or something,” he says.
He has returned to work, which provides some normalcy. Though he sometimes feels what he describes as “self-pity” as he mourns the loss of his pre-COVID vitality, Salazar is trying to look at his life through a positive lens.
“I am being optimistic about a lot of things,” he says.
Getting sick “must have been meant for a reason,” he says, “to get in tune with my life or in tune with my emotions. … It’s all a learning process.”
Learn more about long COVID treatment at UCLA Health.