Sergio Callejo Salazar nodded as he held back tears when his occupational therapist told him, through a translator, he wouldn’t receive a hospital bill for his nearly three month stay at The Medical Center of Aurora because of his near-death experience with COVID-19.
It started in April with the common COVID-19 symptoms health experts warn about: a fever, aches, coughing. Lots of coughing. Soon, Callejo Salazar was on a mechanical ventilator, now synonymous with critical illness, as doctor’s tried everything they could, including a drug trial, to keep him alive.
Callejo Salazar, 38, doesn’t remember much of his time battling the virus or the therapies that only the sickest people with coronavirus receive. He remembers being really ill at first, a former co-worker telling him to call first responders, arriving at a Denver hospital and then waking up weeks later so weak he could barely stand or talk.
“After I was hospitalized, I can’t remember anything. I don’t remember anything,” Callejo Salazar said. “I’m alive because I’m here in the hospital.”
The Denver restaurant worker is certain he got the virus from his wife, who with much of his family, is currently in Mexico. She recovered on her own, without hospitalization.
It was a long road from the day he arrived at the hospital, April 4, to the day he was released from therapy, June 30.
Today, Callejo Salazar can perform basic household tasks, like washing the dishes, without becoming so exhausted he can no longer stand. He learned how to complete normal tasks again at Aurora’s Spalding Rehabilitation Hospital after being transferred there for a two-week stay on June 16. Speech therapy, physical therapy and occupational therapy were all part of the agenda during his time at the center.
“I took a lot of walks,” he said with a slight grin, sitting on the edge of his hospital bed surrounded by crumpled sheets on June 30, ready to return home.
When he first arrived at Spalding, occupational therapist Lauren Rendell said Callejo Salazar could only stand about 15 or 20 seconds at a time. His heart could easily reach 120 beats per minute while standing, she said. The normal resting heart rate is 60 to 100 beats per minute.
“He had not had a real shower in two months. He only had bed baths and he had worn a hospital gown for two months. So the first thing we did was have a real shower and put on real clothes. And just that, in and of itself is a lot of exercise, endurance,” Rendell said. “He also had not spoken to his family, and he didn’t have a cell phone with him here in the hospital… So basically, that was next on my list of meaningful things to do with him.”
Rendell describes occupational therapy as learning how to live again, so there was a lot of practice completing tasks most healthy people take for granted.
“We’ve been doing a lot of walking and a lot of breathing exercises. Patients who are recovering from COVID-19 their heart and their lungs are so debilitated after this disease,” Rendell said. “You know, we’ve been trying to wean Sergio off oxygen, because he doesn’t have financial coverage for oxygen to use it at home.”
The transition back to life outside the hospital will be a big one.
Callejo Salazar may not have survived the disease had he been older or had an underlying health issue, said Dr. Chakradhar Kotaru, a pulmonologist at The Medical Center of Aurora. Like thousands of COVID-19 patients across the country, Callejo Salazar couldn’t breathe on his own. Doctors put him on a mechanical ventilator and an induced coma, but that was just the beginning.
“That is meant to try and increase how much oxygen they can get into their blood. We tried that with Sergio, but that was not enough,” Kotaru said. “So he was still not able to maintain his oxygen levels in his blood at a safe level.”
That’s when Kotaru decided to try ECMO therapy (extracorporeal membrane oxygenation) on Callejo Salazar. It’s a therapy reserved for the sickest of COVID-19 patients and works by pumping the patient’s blood on the outside of their body when the organs are too weak to adequately do so on their own.
So far, only eight patients at The Medical Center of Aurora have received the treatment, and not every Colorado hospital is equipped to administer it. Most patients, including Callejo Salazar, have been transferred from other hospitals to Aurora to receive the treatment.
“This is an older treatment that has been available for many years,” Kotaru explained. “And when COVID-19 came along, we had no other options to try.” It’s rare that a hospital would have so many ECMO patients in such a short period of time, but Kotaru said it’s a blessing the hospital was already equipped with the technology.
Even more impressive, Kotaru said, is that there’s about a 50 percent chance a patient receiving ECMO survives. At The Medical Center of Aurora, only one patient has died.
Callejo Salazar also received convalescent plasma, which is when a patient gets plasma from a previously sick COVID-19 patient, and he was part of a Remdesivir medication trial, which is now showing some promise in reducing replication of the virus in COVID-19 patients.
Like so many doctors around the world, Kotaru is continuously learning more about the virus. It’s not clear why Callejo Salazar got so sick.
“There have been very surprising aspects to this illness that, for example, you don’t see with influenza, which also makes people very sick from a respiratory standpoint and a pneumonia standpoint,” Kotaru said.
“On top of that, patients with COVID-19 seem to have many other manifestations in other organs, maybe developing blood clots, and all of those are the new things that we are learning about COVID-19 that we would not have expected if you thought it’s just an influenza or a flu-like illness.”
Callejo Salazar, waiting for the final clearance to walk out of the rehab hospital on his own, spoke little about the disease. He wasn’t conscious when he was the sickest.
Instead, when asked about his experience, he pointed to his doctors and his therapists, who kept him alive.
“There was really a whole army of people who were taking care of Sergio and patients like him to keep them alive,” Kotaru said. “So it was challenging, but that’s part of why we do what we do and and when you see somebody like Sergio, coming to the other end and walking out of the hospital and going home, it makes it all worthwhile.”