When Amy Tenenbaum graduates from Dalhousie University on Friday, she's hoping she has the strength to walk across the stage to get her diploma.
Tenenbaum's life has changed dramatically since testing positive for COVID-19 in January. The 22-year-old — who is from Rhode Island — is one of several hundred people in Nova Scotia currently experiencing symptoms of long COVID. She's so weak, she uses a wheelchair whenever she has to leave her home.
"I can't walk more than a few minutes without gasping for breath and having really high heart rates and chest pain," she said. "At 22, I'm not really able to leave my house or do anything without help."
Tenenbaum became sick in January as the Omicron variant spread rapidly through the province. She and her roommates all experienced some common symptoms and recovered quickly. She returned to class and resumed her job as a server.
In February, she started having dizzy spells and feeling weak. One night, while walking home from a friend's house, she collapsed.
"My heart rate shot up almost 200 beats a minute. I had to sit on the street. I thought I was having a heart attack."
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Battery of tests confirms long COVID
That was the first of many trips to the emergency department as her condition deteriorated. She went through extensive testing, ruling out other illnesses and conditions.
Doctors told her she's dealing with long COVID. She was shocked to learn that even a mild case could lead to serious problems.
"My life totally changed. I can't work the job that I used to. I can't see many people, many of my friends, just because I'm trying to be safe," she said.
"I am hypertensive. So I have the blood pressure of a middle-aged man with heart disease. I have asthma. I have post-exertional malaise. So just any inability to exert myself at all without feeling sick for days, chest pain, difficulty breathing. That's the brunt of it."
Last fall, a team from Nova Scotia Health started proactively calling patients three months after their initial COVID-19 diagnosis to ask whether they had lingering symptoms.
Approximately 50 per cent of patients over 16 years old reported having one symptom. Ten per cent had some sort of functional impairment such as brain fog or muscle weakness.
300 Nova Scotians receiving extra support
The post-COVID team now works with those patients, offering access to health specialists and support groups to aid in their recovery.
Ashley Harnish, the health services manager with the team, says it's a common misconception that all long COVID cases come from those who were sickest to begin with.
"We know now that's actually not the case, that people can present with post-COVID who may have managed all of their acute illness in their communities or within their home," she said.
Harnish says there are approximately 300 Nova Scotians receiving extra support because of long COVID, but she believes there are more patients that haven't been identified.
Part of the issue, she says, is teaching health-care providers what to look for. Long COVID is still a new condition, and their understanding of it is constantly evolving.
"It's not just as simple as, 'I have a persistent cough,'" she said of the symptoms. "Nova Scotia is really dynamic. So we have to be responsive to help patients."
Long road to recovery
Harnish says some patients require specialist referrals, while others are benefiting from physiotherapists or occupational therapy.
"They're working with the patients to see what's most pressing or urgent for them," she said.
Tenenbaum knows she has a long recovery ahead. She's still too weak to walk down the street to the bus stop.
She's learning to listen to her body, and rest as much as possible. She's joined online support groups to connect with others grappling with long COVID.
Her roommate, Sofia Nicolls, helps as much as she can with groceries, cleaning and going for walks in the neighbourhood with the wheelchair.
Nicolls says it's been shocking to see the change in her friend.
"It's given me a new perspective on how serious this can be, especially at any age," she said. "I think for a lot of young kids it's, 'Well, that wouldn't happen to me.' But it can and it's serious and should be a serious thought in people's heads."
Tenenbaum was hoping to go to graduate school in the fall. Instead, she's going to move home with her parents and study part time online.
She's hopeful that by stepping back for a while, she'll be able to make a full recovery.