August 13, 2020

Long covid

Yesterday I took a rare day off from writing and went to bed early. I needed it. I like writing in the evenings, but I just didn’t have it in me yesterday. Work has picked up. I am alternating between video visits and in-person visits, plus I have more Zoom and Webex meetings. I am spending much more time on a computer and my neck is really feeling it. In the “beforetimes”, I had pretty good balance of movement, going from exam room to exam room, frequently reviewing neck care with my many patients who work in tech. I only sat at my desk when I would do my charting in the morning and at the end of the day. That change in routine has finally caught up with me. My neck has been screaming at me for a few days. Now I truly understand why all my tech based patients ask for a standing desk.

Lucky for me, I was able to ask for an ergonomic evaluation and, hopefully soon, will have a desk I can move up and down, so that I can alternate standing and sitting. Also lucky for me, there is an acupuncturist down the hall who happened to have free time at the same time I did. I got a wonderful treatment from Melissa which helped get me through the day and on the road to feeling better!

Acupuncture as complementary medicine will have a huge role to play as people recover from COVID-19. Many of you have heard or read about, or know someone who had COVID-19, and continues to have symptoms months later. In the States, we call them “long-haulers”. In the UK they call it “Long Covid” or “post-acute Covid”. It is not understood why this happens, symptoms vary and can wax and wane. It is often seen in people who had relatively mild cases of COVID-19, or at least they weren’t hospitalized. Patients who were hospitalized with severe symptoms will have their own set of recovery issues, as well as these. This graphic from the British Medical Journal is helpful in describing the symptoms and support a patient might need. Many patient will bump up against the wall of skepticism with their doctors so this graphic and the links can be helpful.

This post-covid syndrome is truly sobering. This is not the flu. Even children can get it. Here are some important points to keep in mind, mostly related to the fact that this is still a new disease, not even a year old. We don’t know how long the symptoms will persist or if they have long term effects. There is variability from person to person and many do recover after a few weeks or months. Many medical providers are looking to the clues we get from helping people with Chronic Fatigue Syndrome or Chronic Lyme disease, which have been really challenging to treat. Multi-modal, integrative approaches seem to work best. Some of the treatments will be medical, some will be self management and life style, like graduated exercise. Some treatments will be from complementary medicine, like acupuncture. Mental Health will also be a big consideration. Already, on-line communities of long-haulers are forming to help each other.

Long Covid doesn’t happen to everybody, just like most people don’t end up in the hospital. Those are still mysteries. Knowing about this gives me a healthy fear of catching COVID-19 and reinforces my desire to remind others to stay safe and sensible. It also leaves me wishing that our president and his advisors took the risks more seriously.

Wash your hands, cover your nose, and stay safe six. Yay for acupuncture.

And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available, and not related to the organization I work for. Thanks for reading.

https://www.bmj.com/content/370/bmj.m2815

https://www.bmj.com/content/370/bmj.m3026

https://www.bmj.com/content/bmj/370/bmj.m3026/F1.large.jpg

https://theconversation.com/im-a-covid-19-long-hauler-and-an-epidemiologist-heres-how-it-feels-when-symptoms-last-for-months-143676

https://www.npr.org/2020/08/10/900710151/what-its-like-when-covid-19-lasts-for-months

https://www.cnn.com/2020/08/10/health/children-long-covid-symptoms-intl-gbr/index.html

https://www.technologyreview.com/2020/08/12/1006602/covid-19-long-haulers-are-organizing-online-to-study-themselves/