You can’t exercise the way you used to. You are finished after a day’s work. Or you may have unusual sensations, such as a rapid heartbeat when standing up and sometimes difficulty concentrating.
Could it be a long covid? And if so, how can you find out and get the medical care you need?
A March federal government report estimated that 23 million Americans were affected by prolonged COVID-19, which occurs when people experience persistent and often worsening or new symptoms for more than a month after a COVID-19 infection. Even people who had mild cases of initial infection can experience symptoms weeks later.
Patients and doctors say that many people find it difficult to seek care, doctors dismiss symptoms, not knowing what to do or even giving hurtful advice. For now, there is no cure for long-term covid, but finding the right doctor and tests can give you a better chance of improving your symptoms and learning to manage.
Here are the long-term care strategies recommended by Covid doctors and patients.
It’s been more than four weeks and I still haven’t fully recovered from my COVID-19 infection. Do I have covid for a long time?
Not necessarily. Doctors say that some people take longer to fully recover from a viral illness, but eventually it happens without the need for any special care.
There is no standard definition of long covid. The Centers for Disease Control and Prevention defines the condition as new or ongoing health problems four or more weeks after your initial infection. The World Health Organization defines it as occurring within three months of infection, with symptoms lasting at least two months.
Some doctors say that if you are still feeling sick four to six weeks after COVID-19, you should see your primary care doctor. You may have symptoms that can be explained by something else, such as anemia or fatigue from a thyroid condition, and this helps to rule out other issues.
Common long-lasting COVID symptoms can include cognitive issues, rapid heartbeat when you switch positions, and extreme fatigue, especially after physical or mental exertion.
What if I’m still not feeling better after three months?
This is the time frame when you can look for a long covid clinic or find a doctor who is familiar with long covid and has treated other patients.
“We usually start to worry about people with persistent symptoms about 12 weeks after the initial acute infection,” says David Putrino, MD, director of rehabilitation innovation at Mount Sinai Health System in New York City.
Long COVID clinics, which some medical systems have set up to coordinate specialized care, have varying entry limits. Some, such as Stanford, see patients for three months after infection. Others, such as the Cleveland Clinic, begin seeing patients a month after infection. Mayo Clinic has one program for patients with symptoms one to three months after infection, and another for those whose symptoms persist for more than three months.
Many long COVID clinics currently have months of waiting, so it is worthwhile to try to get on the waiting list as soon as possible.
What kind of doctor should I see?
According to Baker’s Hospital Review, there are more than 60 hospitals and health care systems that have started lengthy COVID clinics and programs. Survivor Corps, a longstanding COVID advocacy group, has a list of centers, as well as “Covid-friendly” doctors.
A good primary care doctor will refer you to specialists based on your symptoms. You want to find someone who has experience in treating postviral diseases, recommends Lauren Nichols, vice president of Body Politics, a patient-advocacy group. Another assistant type of doctor, she says, is an immunologist, who can do more detailed and granular blood work that primary care doctors aren’t usually familiar with.
Are there any red flags I should be aware of when looking for a doctor?
Avoid doctors who suggest that your symptoms are all the result of depression or anxiety, Dr. Putrino says. If your doctor says your tests are normal and the conversation ends there, that’s a bad sign, he says. Reducing symptoms and encouraging a quick return to exercise should also raise a red flag, says Dr. Putrino, because too much physical activity can soon make your symptoms worse.
What tests and tests should I ask my doctor to do?
Most clinics do blood work to look at indicators such as blood counts, vitamin levels, virus reactivation and inflammatory markers. Many centers also perform pulmonary function tests, echocardiograms, and EKGs to look for abnormalities of the lungs or heart.
Physical-therapy evaluations may also be useful. And patients who experience brain fog may undergo standard neuropsychology or cognitive tests.
A tilt table test, which measures changes in heart rate when you go from lying down to upright, can help diagnose whether you have POTS, or postural orthostatic tachycardia syndrome. A common diagnosis in long-term covid patients, it can cause symptoms such as dizziness, extreme fatigue, and large fluctuations in heart rate and blood pressure from small movements or blood pressure on standing.
Often, long-lived covid patients find that many tests return normal, but a good doctor should continue to chase the answers and check if you are still experiencing symptoms. “It doesn’t mean that you aren’t suffering and you don’t have a problem,” says Monica Verduzco-Gutierrez, professor and chair of the department of rehabilitation medicine at the University of Texas Health Sciences Center at San Antonio and director of the COVID Recovery Clinic.
Is there anything I should not do as a new covid patient with a long stay?
Don’t push through it. One of the most common symptoms of chronic covid is post-exertional malaise, which can exacerbate your symptoms – physical, cognitive or emotional -.
Practice energy conservation techniques like pacing. And if you’re going back to work, take it slowly if you can. Ask for accommodation if you need it. A lot of patients go back full time and find they can’t handle it, Dr. Verduzco-Gutierrez says.
“Go back part-time and build up gradually while you’re still recovering,” she suggests.
Is documentation important?
Document evidence of a positive COVID-19 test – even an at-home rapid antigen test – and make sure your doctor puts it on your medical chart. This will help you go to a longer COVID clinic and can help in getting approval for insurance coverage and disability claims.
Documents such as a positive POTS diagnosis from a tilt table test, or a physical therapy or cognitive evaluation, can help with applications for workers’ compensation or disability, says Kristin Englund, an infectious disease physician at the Cleveland Clinic who worked there for the lengthy COVID Clinic. had started. Last year.
Make sure your doctor specifically and objectively measures the severity of your symptoms using established scales, Dr. Putrino says. Instead of placing a subjective note on fatigue they might say, “Patient fatigue was scored objectively using a scale of fatigue severity.”
when will i be fine?
There is no hard data on the recovery trajectory; The path to recovery for the patient varies. It is not normal to make a full recovery if you are sick for more than three months, but some patients report an improvement in their symptoms over time.
New symptoms may occur and old ones may come back. Recovery is not linear, notes Mrs Nichols.
“People should be aware of the roller-coaster effect you can have with this disease,” Dr. Englund says.