Early Care Tips for COVID Longhaulers

Mar 8 1:54pm | Greg Vanichkachorn | @drvan | Comments (18)

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.

I wish I'd read this before I started getting back into exercise. I felt good for a few weeks and than relapsed. The weird thing is I feel great when I'm exercising, but 6 hours later crash and find it difficult to breathe and have really sore arms and shoulders. It takes me a couple of days to get any energy back. Anyone else experience this?

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I have had long Covid since New Year Eve when I got Covid. I have listened to you people preach aboutCovid and take the vaccines, and take more vaccines was even your first suggestions for Long Covid. The truth is you still seem to know nothing about Covid and especially Long Covid and how it affects the body. I'm 82 years old and I have worked out since I was 30, 1/2 half hour running, then with age, turning to walking on a treadmill to get my heart rate up to 130, then 1/2 hour of weight training to keep my body in shape and functioning. Al lthis served me very well till Covid. Right away you came out with the vaccines and continually gave us false information about Covid especially inflating the number of deaths. Then you were telling people if they got the vaccine they would not be giving Covid to anyone else. People were screaming at me to get the vaccine, accusing me of spreading the disease so I stupidly got the first two shots. Now I have been totally fatigued after having Covid and once again am working out trying to get back to where I was before Covid and I read your article saying don't push yourself too much and I wonder does the person writing this article truly know anything about working out or are they just another fat person who stands outside the hospital smoking and then sitting in the background with no true knowledge of Covid but trying to convince us of something as if they are the experts. Mayo Clinic has dozens of articles on Covid and in the end they still finally tell us how little they know about any of this. My family doctor is great and she is the first to admit there is very little known in the medical community and they are not aware of how to fully treat any of this. I feel sorry for all the working class who are being forced to take the vaccines or lose their jobs. I also feel sorry for all those people who have to wear masks that are proven to give very little if any possitive effect on preventing Covid. Now of all things I read of doctors, like you, prescribing drugs, even Prozac of all things, to fight these things. Please stop advising and be honest with us until you have gained enough knowledge to factually tell us how to truly fight this disease.

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My advice for early longhaulers is that just because they can’t find something to treat that doesn’t mean something is not wrong.

There are high and lows with getting a diagnosis and using a new medicine or method to cope with the symptoms. Unfortunately it reinforces the symptom slash pain cycle. Hang in there! Initially the drs have to rule everything out. Ruling everything out proves what is wrong. You will also eliminate additional burdens on your body.. a healthy lifestyle will always help improve symptoms. Our body were under a serious attack and it’s stuck in flight mode.

Healing and retraining you mind and body with a helping of spirituality will slowly improve your state of mind. You have to help your parasympathetic show up to the party of life.

We have to accept on some level our bodies have changed it’s like someone pressed fast forward on aging. I went from being 46 to feeling like I’m 86.

Like all life altering events in history we are a black sheep we really stand out from the crowd throughout our recovery.

Try to not focus on the symptoms but focus on functioning and slowly making gains.

It will be 2 years in September for me. But I finally have a grip on what has happened to me.

The viral infection had its greatest impact on my brain. I had the help of Mayo Dr Munipalli and Dr Sletten.

Learned a big word. Psychoneuroimmunology. It really is a thing…

Central Sensitization Syndrome
Cognitive Behavior Therapy with Dr Sletten.

Most importantly you are not alone and it does get better. That does not mean that it is incredibly hard. Keep your head up and try to get better sleep to heal. Function over your feelings and have SMART goals.

Tools I use every day the Whoop to balance strain and recover. It’s made for athletes but I use it differently.

Water lots of it supplements, Cymbalta, Wellbutrin and Gabapentin

I eat a Mediterranean Diet and I go to bed early I exercise with a routine provided by Dr Sletten’s team.

I don’t sleep as much 30 minute naps max I sleep around 8 hours and plan what I do each day and it’s working.

I do all of that to prevent Pushing and Crashing.

I used to push on days I felt I could and I’d lose days.

Dr Sletten is the best.. if you can read this Dr Sletten and PRC team. You should write a book… THANK YOU MAYO

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@djpenz

I wish I'd read this before I started getting back into exercise. I felt good for a few weeks and than relapsed. The weird thing is I feel great when I'm exercising, but 6 hours later crash and find it difficult to breathe and have really sore arms and shoulders. It takes me a couple of days to get any energy back. Anyone else experience this?

Jump to this post

I also had a relapse of my long covid. I hadn't increased my daily activity level, but was not giving my body a chance to rest as I had walked and did my resistance exercises 3 days in a row. It's been 3 weeks and I still haven't returned to where I was before the relapse. I guess I just have to go more slowly and, according to the above article, am probably not hydrating enough. Frustrating.

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@djpenz

I wish I'd read this before I started getting back into exercise. I felt good for a few weeks and than relapsed. The weird thing is I feel great when I'm exercising, but 6 hours later crash and find it difficult to breathe and have really sore arms and shoulders. It takes me a couple of days to get any energy back. Anyone else experience this?

Jump to this post

Yes, my recovery parallels yours. I have been 8 months into the journey and only just now normalizing after cutting back on my exercise and allowing my body to rest. My doctors have been very honest….. they don’t know enough about COVID to effectively treat it and have recommended the shots as they were their only weapons. Should I have taken them…who knows….but I am still here….good food, no sugar or alcohol (easier said then done) moderate exercise(don’t push too hard and overload) I think I am finally making some gains😊. Good luck

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@tomtom75

Yes, my recovery parallels yours. I have been 8 months into the journey and only just now normalizing after cutting back on my exercise and allowing my body to rest. My doctors have been very honest….. they don’t know enough about COVID to effectively treat it and have recommended the shots as they were their only weapons. Should I have taken them…who knows….but I am still here….good food, no sugar or alcohol (easier said then done) moderate exercise(don’t push too hard and overload) I think I am finally making some gains😊. Good luck

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i read a lot of frustration in these responses, as well as anger. i got covid pneumonia june 8 2021 and was hospitalized until august 1. i was sent home on antibiotics, steroids, nebulizers and inhalers. i was able to go home as opposed to a rehab center because i had bathrails and seat in shower as well as help during the day and night. even so i struggled with breathing until i started heart and lung rehab. the covid had damaged my heart, lungs, pancreas and liver. the heart and lung were the last to heal. i say this to remind you that covid attacks the viral organs and so you are dealing with just the lungs in recovery but the heart as well. so i went to 11 weeks of lung heart rehab and 11 weeks of physical therapy. i came off oxygen just last month after a year. i did not get vaccinated. however in my cohort in the hospital was evenly mixed between vaccinated and unvaccinated. in fact it seems that those who were vaccinated suffered the ventilator while the in vaccinated were able to get by on the high flow. my wonderful team at Orlando Health Dr Phillips hospital told me that had i come in 2020 instead of 2021 i would not have walked out. they gad a high death rate. but during a year they learned the right combination of drugs and treatment. thw treatment of covid is a real world learning experience and very few doctors have that experience. most doctors rejected patients with covid. so its no wonder they can not now treat recovery. i have found rehab, oxygen and rest to be more important than any medication. now, a year out i gave come to terms with slow but steady progress . patience is key and recognizing that your life is and maybe will always be alittle less active than before covid. but remember there is still a good life to live.

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