Tony's wife Carol credits Erika Carter with an idea that helped her husband recover.
It was an inexpensive used guitar with a bent neck, not nearly as nice as the ones he was used to playing, but when Erika Carter handed it to her patient, Tony Chiechi, his world started to change. Tony, who’d been so ill he hadn’t been sure if he was dead or alive at times, says he suddenly felt like he wasn’t even sick.
Tony had spent weeks in the hospital battling COVID-19 when Erika, a critical care technician, found out he was a musician who loved to play the guitar and drums. Soon afterward, she bumped into Charlene Clayton, a recreational coordinator who works with oncology patients.
Erika talked to Charlene about how hard it can be for long-term patients to keep up their spirits in the ICU and mentioned Tony and his battles. Charlene went and found a guitar they use for recreational therapy and brought it to Erika.
Charlene Clayton was the one who brought the recreational therapy guitar to Erika.
Tony, who started at Riverton Hospital and was transferred to LDS Hospital, had been fighting COVID-19 for weeks.
“I remember losing contact with life,” he says. “I wasn’t sure if I was dead or alive because I had no psychological connections. You know, you look over your shoulder and you see all the tubs filling up with mucus and blood and I could hear people saying, ‘He’s in a bad way.’”
He felt he was slipping away and even though he hadn’t given up, he says, “It hurt so bad. I was scared with all the tubes and hoses hooked up to me.”
He started to cry as he remembered what happened when Erika brought him the guitar.
“She asked me, ‘Do you want to play it?’” he says. “For a moment, I was scared. But I reached out and she handed it to me. I put it in my arms and I started playing and everything connected to me. My feet started moving back and forth with the music. And I just remember—it seemed like a crowd—but the doctors were looking on, and people by the doors with two little windows were looking in and for a moment I felt like I wasn’t sick anymore.”
Ryoma Tanaka, MD, says the LDS Hospital's approach that minimizes sedation helps patients in ICU recover faster.
Tony’s wife Carol, who watched him fight to stay alive for more than six weeks, says things changed that day.
“The turnaround came when Erika got him the guitar and gave it to him,” she says. “His eyes lit up and he said, ‘I still know how to play a guitar.’ And from then on, he started getting better. It was unbelievable how the nurses all came to listen to him play. Those who came into his room got dressed with the PAPR things on their heads and they were wearing the gowns and their gloves. On one evening there were three in the room with me and about six or seven outside in the hallway listening to him play, marveling at how he was playing with that vent tube in his mouth. To me, that’s the reason I have him back; it’s because of Erika.”
Tony says it made him feel good to play music that was lifting others.
“It was breaking the monotony a little bit for the nurses as well as the patients, and it brought happiness to me as I was playing that music,” he says. “I played the nicest music I could think to deliver to the people around me, when I was in the ICU and after I left the ICU. That’s what the guitar did for me. I’m not sure I’d have changed my mindset if it wasn’t for that guitar, the music, and people’s support of the music I was playing. It made me feel like a person again.”
Charlene says Tony’s example shows the potential benefits of recreation therapy for patients.
“Can you imagine just being in a hospital room for days and then you get one opportunity to do something you love, something that gives you a sense of normalcy?” Charlene says. “Socially, when people were coming in and listening to him play or watching him play, I think it gave him a sense of pride, a feeling he’s doing a service for others. Cognitively, he’s using his brain again, instead of staring at a wall.”
Tony also said that he’s grateful for his wife, Carol, his daughter, Gina Marie, and his son, Anthony, who supported him as he fought back the virus. And Carol and Tony are quick to talk of their appreciation for the the doctors, nurses, and other caregivers who helped them. Although Tony’s memories are sort of cloudy, he mentioned by name some of those he remembers for the help they offered him, including Ryan Bender, MD, Renato Reyes, MD, James Pearl, MD, and Ryoma Tanaka, MD. He also says physical therapists Maya Ostler, and Angela Hallstrom, along with respiratory therapist Geoff Corey also helped him recover.
Carol says when caregivers talked with Tony they made sure he could see their faces.
“When he couldn’t talk, they waited for him to finish writing whatever he wrote, and then they would respond to him,” she says. “Everyone at LDS Hospital treated him like a person.”
Tony says Lydia Allred, a speech pathologist, played a critical role in his recovery. She patiently taught him to swallow again and speak.
“I cried when I was able to finally swallow my own saliva without choking,” he says. “Once the tubes came out she taught me how to get the food down.”
She told him not to be afraid and to just keep trying, he says.
“I think she needs her own wing in the hospital and a crew of eight to support that program she has,” he says, “because what she does works hand in hand with the idealistic approach they have of keeping people awake at the hospital. She treated me as an individual and you need that when you’re going through what I went through because it’s very easy to falter and slide back.”
Over the past two decades the ICU at LDS Hospital has been using an approach they call “awake and walking” where they, working with patients, try to reduce the amount of sedation they use, according to Dr. Tanaka, the medical director for the LDS Hospital ICU.
He says long-term heavy sedation can have a negative impact on the brain and sometimes by the time a patient’s lungs are better their muscles are still weak and that weakness can last for a year. This approach, which involves keeping people active with physical therapy, has produced better outcomes for patients, even those fighting COVID-19, he says. There are challenges with this approach because if people aren’t sedated, they can get confused and try to pull their tubes out, Dr. Tanaka explains.
“We have to watch them very closely to achieve this safely,” Dr. Tanaka says. “Our team is actually great and the only way to do this kind of practice is to understand patients and their needs and just provide them with compassionate care. Erika is great, as you’ve seen in this example. She understands our patients’ needs.”