Early Care Tips for COVID Longhaulers

Mar 8, 2022 | Greg Vanichkachorn | @drvan | Comments (43)

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.

@beebee000

i got covid Dec of 2019, i'm still dealing with this long hauler thing. there have been a few times i thought i was getting better but i was wrong, it's like one step forward then ten steps back...the phlegm i get is still bad, brain fog still bad and the weight thing..every time i can lose a pound, two to three come back,my body really fights me on losing....plus a whole mess of other symptoms, this virus has really messed us up, we just can't give in to it so keep fighting!

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I’m sorry to pry, but you’re the ONLY soul I’ve heard who has had it as long as I have!
When you personally get sick with something else, does it throw you back? Into a flare? I’ve asked drs here, and they look like I’m crazy. Yet one dr told me: this is an opportunistic virus. She isn’t my Covid team ( of course!) but that makes sense to me.

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@beebee000

i got covid Dec of 2019, i'm still dealing with this long hauler thing. there have been a few times i thought i was getting better but i was wrong, it's like one step forward then ten steps back...the phlegm i get is still bad, brain fog still bad and the weight thing..every time i can lose a pound, two to three come back,my body really fights me on losing....plus a whole mess of other symptoms, this virus has really messed us up, we just can't give in to it so keep fighting!

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Same for me...since December 2019 I've had long covid...the tremor started summer of 2021 and has been 24/7, however my PCP wouldn't even acknowledge my condition even though he would prescribe drugs for the tremor...am in the process of finding a new PCP to work with. Hope you're feeling better soon!

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what kind of tremors do you have? the thing that happens to me sometimes, not on a regular basis , is when i'm lying down, i feel like my legs are shaking but they are not moving at all, it feels like the bed is even shaking, but i'm lying still..strange..sometimes my whole body will get these internal vibration/tingling, it gets overwhelming, that can happen when ever it feels like it. i wish i lived closer to a place like mayo clinic (8hrs from me)...i'd try to get into one of the long covid things ..there is nothing here..so i just get through it...

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@bereese

Same for me...since December 2019 I've had long covid...the tremor started summer of 2021 and has been 24/7, however my PCP wouldn't even acknowledge my condition even though he would prescribe drugs for the tremor...am in the process of finding a new PCP to work with. Hope you're feeling better soon!

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Long covid since 12-2019? Sure you got that date right?

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Yes, December 2019 I was sick with covid the whole month...in January no one could figure out what was wrong, but by May 2020 the medical world knew the virus arrived in the late fall of 2019...when the vibration started even my pathetic PCP had to admit he was incorrect!

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@beebee000

what kind of tremors do you have? the thing that happens to me sometimes, not on a regular basis , is when i'm lying down, i feel like my legs are shaking but they are not moving at all, it feels like the bed is even shaking, but i'm lying still..strange..sometimes my whole body will get these internal vibration/tingling, it gets overwhelming, that can happen when ever it feels like it. i wish i lived closer to a place like mayo clinic (8hrs from me)...i'd try to get into one of the long covid things ..there is nothing here..so i just get through it...

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Ever since getting covid in July 2022, I also get internal tingling feelings when I lie in bed at night. I think they actually happen all day, but I only notice them when I’m trying to fall asleep. I can best describe it as a “grumbling” under my skin. It’s always in the places where I’m currently experiencing pain and inflammation (long covid). Makes it very difficult to fall asleep between that and the strong torso jolts I also get as soon as I lie down to go to sleep.

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@car0

I’m sorry to pry, but you’re the ONLY soul I’ve heard who has had it as long as I have!
When you personally get sick with something else, does it throw you back? Into a flare? I’ve asked drs here, and they look like I’m crazy. Yet one dr told me: this is an opportunistic virus. She isn’t my Covid team ( of course!) but that makes sense to me.

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Definitely! I got covid in July 2022, getting the flu in September gave me a major setback with triggering new crazy symptoms (body tingling and heart palpitations) and reactivating some of the old ones (severe pain and inflammation, torso jolts when I lie down, micro-clots on my legs). Being exposed to the flu again when a family member had it a couple months later, reactivated all of those things again, even though I didn’t get any actual flu symptoms that time.

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Thank you for this wonderful article. I have been affected by PCS for a year this month. I feel like I am improving. A few months ago I could not even work out with weights. I have gradually pushed myself and am now on the tennis courts again. I hope this gives others some hope. If you read my prior posts, I never thought I would be able to exercise again. Long haul is a perfect description! But I am reading all positive articles, I refuse to accept this as my life. I am eating healthy, drinking plenty of water, staying positive in every way I possibly can. I believe mindset helps with healing as well. TLC helps which is where these posts come in ... when I started reading these posts and felt like I could possibly help others with my story It made me feel good as well. So again, thank you for this article, it has given me hope. Not just for myself for a full recovery (I know I will have set backs) but for others as well.

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@rjk69

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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Im glad you’re body is allowing you to do these things! I had been an ultra runner before this and now none of those things are options right now. Even doing a simple yoga routine causes a crash like Im recovering from a major race. No amount of self-discipline or willpower or program overcomes it.

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@devo22

Prayers for all of us ! Bob and Kathy you sound like me , with degenerative disk and I have 2 disk herniated . Only 1 Rotator cuff surgery I’m not all impressed with the arm is pretty much useless anything above my shoulder. Now the last few months I have had abdominal pain in my lower left that can increase with intensity to double me over .I’m more constipated every since I had covid back in may. Stool softeners don’t help, eating foods that I have issues with going straight threw me help sometimes , it’s a rare day they work on me like that anymore. So I be on liquid diet we when my stomach is the worst. To slowly eat a little bit of regular foods and see if pain increases before I eat much more . I take pro biotics now at meals seems to help for
Nauseous. I been able to eat something some days with no issues. If the pain wakes me up at night I try s going to be a long few days . Because tramadol is the only strong med they give me . I found out I just curl up in fetal position and drink plenty of water. After 2 days of being in bed . The longest was 10 days I was pretty much bed ridden. I slowly am able to eat a little bit maybe a small cup of food all day , with water between bits . I been on antibiotics for 10 days and that was the only time food went straight threw me . Not endless I took a few bites and hours later have a few more . I had ct scans . X rays, ultrasound next week a lower gi . Nothing conclusive has been found atm . So I’m not sure if you have pain in your abdomen or not .

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I am not a doctor but I know how it feels to have irritable bowel and GERD dominate your sense of wellbeing. My IB returned with my long covid. Have you considered Amitriptyline?
I take it for gut pain and sleep. It works on the nervous system. I also use those Fleet mineral suppositories when I am really uncomfortable. IBGuard is another supplement that calms your gut. My doctor recommended it and I noticed a difference in a day or two. Hope this helps.

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