Early Care Tips for COVID Longhaulers

Mar 8, 2022 | Greg Vanichkachorn | @drvan | Comments (39)

After visiting with hundreds of patients with Post COVID Syndrome (PCS), we have learned a lot about the early steps in recovery. It turns out, you don’t need us doctors to get your recovery started!  Here are my tips on how to beat PCS on your own.

  1. Allow yourself time to recover

One thing we have seen repeatedly is that patients push themselves too hard while trying to recover. It makes sense. Everyone is so eager to “get back to normal life” after their infection and isolation. It is tempting to just grit your teeth and bounce back to your usual lifestyle. But when patients do this, they experience a flare of their fatigue, shortness of breath, and muscle aches that can last for hours to days at a time.  During this time, patients are forced to rest and feel they become even weaker. Then they try to resume life again, experience setbacks, thus repeating the cycle until they are very demoralized and deconditioned.

So, doctor’s orders: Give yourself time to recover. The fastest way to recovery is to take things slow and easy at first, and then trying to gradually increase your activities. And I’m not talking just about traditional rehab activities. Your regular daily chores count as part of your rehabilitation. For example, if you can do one load of laundry a day without worsening of your symptoms, wait until next week to try two loads. Same for mental activity. Taking a break does not mean its time to write that book you’ve been meaning to get to.

Remember that you are in a recovery from a serious infection.  Because of your symptoms, you won’t be able to do everything you normally would do during each day.  And that is okay. Instead of trying to do everything and failing, focus on things that are a priority. This pacing is the key to getting back to baseline more quickly overall.

  1. Hydrate and eat healthy

During the acute infection, many patients aren’t very hungry. This can be made worse if there are problems with taste and smell. Some patients get used to this and forget the importance of good nutrition. Focus on getting in a good amount of hydration in during the day (2.7 – 3.7L) per day. As for diet, we haven’t found that any diet is best. Only that fad diets and extreme diets will make things worse, especially for your bank account. What I recommend is a balanced, Mediterranean diet. Of course, try to resist processed and high fat foods.

  1. Focus on resistance activity 

When patients try to do some physical activity after COVID-19, they often try activities that get the heart rate up. Like walking and cycling.  This makes sense; people want to get outside or go somewhere after being cooped up for a while.  However, we find that cardiovascular exercise is the most difficult type of activity for patients with PCS.  So instead, start with more resistance type activities, such as band work, light free weights, yoga, or Pilates. Once this goes well, then you can throw in some light cardio.

  1. Optimize your sleep

It is very common for patients to have problems with their sleep after a COVID infection.  This is worse with PCS as many patients will end up taking naps. This can throw the sleep schedule making it hard to get the body back on the right schedule.  It is important to get the best sleep possible.

Start of by making sure your sleep area is ideal. You should have some airflow and most people will sleep better with the room slightly cooler than during the day, around 68-70 degrees.  You also want to minimize electronic distractions; using your phone in bed is a great way to keep your brain stimulated just enough to keep you awake. Of course, try to avoid caffeine after lunch and exercise within two hours of sleep.  Finally, try to work towards a normal day time schedule by waking up at a certain time, getting your meals in, and having a routine bedtime.

  1. Olfactory retraining

Not being able to taste and smell normally totally stinks. About a third of patients have prolonged troubles with taste and smell after the acute COVID infection. Fortunately, most patients will get better within 6 months, and even more within 12 months. If you want to speed things up though, I recommend olfactory retraining.  A great website to help you is abscent.org https://abscent.org/.

I know that it is hard to find care for PCS. Fortunately, the ideal recovery starts with you in your home.

Connect with other people like you and share your recovery tips and successes in the Post-COVID Recovery & COVID-19 support group.

Interested in more newsfeed posts like this? Go to the Post-COVID Recovery blog.

What a fabulous article! This is how I live my life now, 16 months later.Thank you

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@rinadbq

What a fabulous article! This is how I live my life now, 16 months later.Thank you

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Me, too , after 19 months!

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I contracted COVID in late November 2021. Headache, fever, fatigue, muscle aches, diarrhea, fever. Symptoms slowly subsided and began feeling better around Christmas. I returned to the gym as I did almost every day for the last fifteen years. I noticed my cardio fitness level had decreased and I expected that not being in the gym for a month. I noticed my cough returned but more frequent. I went to the doctor and after a chest x-ray, the radiologist noticed an infection in my lung. My doctor started me on an antibiotic and I'm feeling better. I also noticed my cardio fitness level is slowly improving. Thanks, Rob Krok

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I had the same issue when I started PT. I had COVID February 2020. My Pulmonary spec, on Monday just told me it was all in my head, I was depressed and needed alot of heavy cardio PT! My Amyloidosis returned and spread, had surgery and going to sppeech PT, airway compromised. I have GI issues many procedures and test and on a soft/pureed diet, Kidney issues with HBP, and an MRI showed compression of C5 and C5. The list goes on and on, but I'm just depressed and need cardio. At lest you go validation and empathy. Sorry for your Long Term effects, but maybe go slow and can find a good Pulmonary Speciality and do Pulmonary Rehab, something mine never recommended!

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@rjk69

I contracted COVID in late November 2021. Headache, fever, fatigue, muscle aches, diarrhea, fever. Symptoms slowly subsided and began feeling better around Christmas. I returned to the gym as I did almost every day for the last fifteen years. I noticed my cardio fitness level had decreased and I expected that not being in the gym for a month. I noticed my cough returned but more frequent. I went to the doctor and after a chest x-ray, the radiologist noticed an infection in my lung. My doctor started me on an antibiotic and I'm feeling better. I also noticed my cardio fitness level is slowly improving. Thanks, Rob Krok

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Welcome, Rob. You may also wish to join the discussions here:
- Post-COVID Recovery & COVID-19 https://connect.mayoclinic.org/group/post-covid-recovery-covid-19/

When returning to the gym, did you start with resistance training and slowly add cardio? What was and is your routine?

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How do you copy and print this article?

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@feb

I had the same issue when I started PT. I had COVID February 2020. My Pulmonary spec, on Monday just told me it was all in my head, I was depressed and needed alot of heavy cardio PT! My Amyloidosis returned and spread, had surgery and going to sppeech PT, airway compromised. I have GI issues many procedures and test and on a soft/pureed diet, Kidney issues with HBP, and an MRI showed compression of C5 and C5. The list goes on and on, but I'm just depressed and need cardio. At lest you go validation and empathy. Sorry for your Long Term effects, but maybe go slow and can find a good Pulmonary Speciality and do Pulmonary Rehab, something mine never recommended!

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I'm dreadfully sorry to hear of your medical issues. We share somewhat of same complications. Degenerative disc disease in lower spine, I had three surgeries on my left shoulder, torn rotator cuff along with torn bicep and I was diagnosed in 1999 with MS. Regards,
Rob

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@colleenyoung

Welcome, Rob. You may also wish to join the discussions here:
- Post-COVID Recovery & COVID-19 https://connect.mayoclinic.org/group/post-covid-recovery-covid-19/

When returning to the gym, did you start with resistance training and slowly add cardio? What was and is your routine?

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I train four to five days a week. Three of those days is a HIIT routine mixed with sprints, stair master and elliptical machine. I also weight train doing multi joint exercises.

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@colleenyoung

Welcome, Rob. You may also wish to join the discussions here:
- Post-COVID Recovery & COVID-19 https://connect.mayoclinic.org/group/post-covid-recovery-covid-19/

When returning to the gym, did you start with resistance training and slowly add cardio? What was and is your routine?

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Did you receive my routine?

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