Hopefully, you guys have read My COVID Recovery Plan Parts 1 and 2. That will give you the basis for this program. What I did once I got home was based off the results I obtained from those previous "programs."
But First
I was discharged from the hospital with oxygen and dexamethasone. I was also discharged with some vitamins and minerals too. My oxygen was set to 2L when I came home and the dexamethosone (steroid) was to be taken for 8 days. I was also taking Vitamin C, Vitamin D3, and Thiamine (Vitamin B1) . I added in Quercetin, Zinc, a baby aspirin and Mucinex. I added in the Quercetin and Zinc to help my immune system, the Mucinex to help break up any gunk in my lungs and get it out easier and the baby aspirin since clotting can be an issue with COVID. Also, I was given lovenox injections (OUCH!) in the hospital as a blood thinner and blod clot prevention. (The IV and all of the blood work didn't really hurt but the lovenox injections are painful.)
I was able to speak with my doctor and he agreed with what I was taking and my plan to wean off the oxygen. It is always best to get the doctor's ok before you try anything...starting a new medication or supplement, discontinuing a medication or supplement and definitely when trying to come off of oxygen after your oxygen saturation levels were falling into the low to mid 80s!
You Are Not Alone
One thing that I cannot emphasize enough is to not try to do this on your own. And I mean that from multiple angles/perspectives. You will need to have the support of your family and friends...and in my case, your co-workers! I also suggest having a multidisciplinary "medical" team. My team consists of my Primary Care Physician and my Integrative Practioner, Dr. Jessica Drummond.
Dr. Drummond's plan for me included many new supplements that were aimed at decreasing inflammation and improving Mitochodrial health. Inflammation is part of out Immune System's reaction to a foreign invader and with COVID, sometimes too much inflammation is produced. (Inflammation is tricky...we need some of it to heal. Too much will impair the healing process BUT so does too little!) Mitochondrial health is also essential for our overall health since the Mitochondria are involved in energy production and new research shows they may play a big role in detecting foreign invaders and starting our Immune Response. If the Mitochondria are unhealthy, then the cell is unhealthy. If enough of the cells are unhealthy, then that tissue is unhealthy. If enough of that tissue is unhealthy, then that organ is unhealthy...which means we are unhealthy!
I also started to be more consistent with meditation and breath work per her recommendations. I made sure I was meditating twice per day for 20min and I had/have a program to follow for my breath work. These two activities also help with inflammation and improving my lung function. Meditation and different rates of breathing can activate the Vagus Nerve and lead to relaxation, decreased stress and inflammation, and allow your body to recover. James Nestor wrote a book that describes a lot of this in depth, it is called Breath: The New Science of a Lost Art (amazon affiliate link). The breath work program has two tests that you perform weekly. They are the Max Exhale Test and Breath Holding Test. Luckily, my results are improving each week!
One other tip that Dr. Drummond gave me that was incredibly useful was too move rrreeeaallyyy ssslllooowwwlllyyy. It doesn't sound like much BUT it made a HUGE difference in being able to move/walk more without my heart rate increasing to a level that was too high. Hopefully, this will be helpful for someone else and remember not to tense everything up to move slowly. Yep, I did that for some reason after I had been moving slowly for a while. So, stay relaxed and move slowly!
Quick Detour
My biggest issue wasn't my breathing anymore (but it was a close second), of course the oxygen helped this, but was actually my heart rate. My pulse would increase significantly with just a little bit of walking/activity. Moving slowly really helped as did increasing my electrolyte intake. One thing that I learned later was the steroid was a definite contributor to my sleep issues and the higher heart rate (appears to be how my body responds to it). Both of these issues improved daily after I finished the course of the steroid. The steroid helped a lot with the inflammation and aided in my recovery and I don't think I would be where I am now without it!
Back On Track
I would start my day by drinking 16 ounces of water and electrolytes and start taking my morning supplements. Then I would perform the breath work. I also tried to be outside as much as possible during this time. With the oxygen, I couldn't get out in the sun very often, not enough tubing, but I could sit on the porch. So, I would go outside and watch the sunrise in the morning and sit outside during the day unless I needed a nap (which I did on a daily basis).
I was experiencing some neurological issues. It is hard to describe what I felt but it occured during my hospital stay and after I returned home. I would feel a vibrating feeling and strange sensation in my hands and my head. Due to this and per Dr. Drummond's instructions, I limited screen time and did not try to read much. I needed to allow my brain and nervous system time to heal and didn't need to overly stimulate it. It turns out that these neurological symptoms were made worse by Thiamine (Vitamin B1) I was taking. Normally, Thiamine and the other B Vitamins are great for nerve health. However, COVID can change that and appears to have done so with me. This is why we need to be careful with what we take whether it is a medication, supplement, etc. I also seemed to have issues with anything that increased Nitric Oxide and my heart rate would increase. (These symptoms are no longer present and I stopped taking Thiamine)
During the day, I would make sure that I walked around in the house without my heart rate going too high and my oxygen levels going too low. I also gradually began doing more things around the house like folding clothes (while seated), doing a few dishes, etc. I also used The Breather again once I returned home. I started on level one but was able to increase the levels fairly quickly. It should be noted that I would not increase the levels until if felt easy and there was no symptom exacerbation...heart rate stayed under control and oxygen saturation levels (O2 sats) were good. Often my O2 sats would increase a couple of points while using the Breather despite not being able to breathe through my nose and take advantage of the supplemental oxygen!
I also spent time lying prone to help my lungs and would lie down and rest when I was tired or I noticed any symptom like elevated heart rate. I also gradually turned down the oxygen based on how my body responded. I cut down to 1.5L then to 1.25-1L. After this, I would cut down by .25L as I was able to. I stayed on .25L (approximately) for a couple of days but would spend some time without any oxygen. Initially this time period was 5 min, the up to 30 min and finally up to several hours. However, I was constantly checking my heart rate and O2 sats. If the O2 sats were dropping or the heart rate was increasing, I would put the oxygen back on. (Initially I put the oxygen back on after a specific time period even if my levels were good. No point in progressing too quickly and stressing my system.)
It wasn't too long before I was able to discontinue using oxygen. That was nice! It gets old having the tubing in your nose and feeling like you have a leash on at all times! At this point, I gradually began to walk more while being mindful of my levels (heart rate and oxygen). I was able to begin walking in the yard and getting some sunshine. Then I was able to start walking down our driveway....Then walking up our road like I used to. Now I am able to walk 45min+ without any issues. My resting heart rate has returned to normal and I continue to progress.
Pacing Is Key!!!
The progression I have been describing is known as Pacing. I have been able to do it in a progressive manner since there was no symptom exacerbation. However, this will not be the case for everyone. Also, it is possible that your symptoms may not be exacerbated during or immediately after the activity, but day(s) later. I want to stress that if you have any symptom exacerbation, you MUST back off the intensity and level of activity. If you don't, you will hamper your recovery and it is possible to create more issues.
Part of my pacing program is a return to climbing and lifting weights. I decided to wait at least 10 days from my last symptom, wonky heart rate in my case, before returning to climbing or weights. I also decided that I would start with climbing since I get the movement aspect and some strengthening too. So, yesterday was my first day of climbing in about 7-8 weeks. All in all, I did well and it was great to be moving again. I could tell I haven't climbed in a while as I was holding my breath while climbing and then breathing a little hard after the climb. Much of this resolved when I focused on my breathing. Actually, my breathing was normal at the end of the session and after climbing the hardest problem (boulders are known as boulder problems) that session. Goes to show what a difference it makes to focus on your breathing! My muscles are a little sore today but that is to be expected after such a long layoff. There was no symptom exacerbation so I will plan to climb again later this week, hopefully two more times.
If those sessions go well with no symptom exacerbation, I will begin doing a few weight exercises next week stopping well short of failure. I will keep an eye on things and slowly increase the weight and how close I get to failure based on how my body responds. Eventually, I will get back to where I was and resume my training plan. After all, I have some boulder projects that I would like to tick off my list this fall and winter!
It Is A Journey
As you can see, this process is a journey and not a quick fix. I urge you not to try to do everything just like I have. INSTEAD, use the principles of my progression and listen to your body! It knows what you/it needs and it will let you know how to take care of it. I also encourage you to get your own multidisciplinary team to stack the odds in your favor! I would be honored to partner with you during your journey. You can use the link below to learn more. Until next time...
https://www.healthydesignfxmed.com/work-with-heth-1
About Heth
My name is Heth and I’m a husband, father of three children, Physical Therapist with 20+ years of experience and Certified Functional Medicine Practitioner. I have witnessed the effects that chronic pain, chronic gut issues, chronic stress, etc. has had on my clients and on my loved ones, especially my wife. I have also seen how the conventional medical route is unable to adequately address these problems and provide answers. I have seen the disappointment and sense of helplessness that this can cause. I am sure that you have experienced this too.
However, I always felt there was hope…a different way to address these problems. After all, I learned that the key to treating clients in Physical Therapy is to get to the root cause of the problem, then the symptoms will take care of themselves. This is the same premise in Functional Medicine. I have seen the life transforming effect this can have on quality of life firsthand in my clients and in my wife!
During my career, I have treated athletes looking to return to sport, clients that are trying to recover from neurological insults like a stroke, clients that are attempting to return to their prior level of function following surgery and many other conditions. I have also focused heavily on the Nervous System and the treatment of chronic pain. This led to an interest in staying up to date on research regarding the role of the Immune System and Central Nervous System in pain. It also pointed out the important role that the Autonomic Nervous System and chronic systemic inflammation play in chronic illness.
Disclaimer:
This article is for educational use only. Nothing contained in this article should be considered, or used as a substitute for, medical advice, diagnosis or treatment. This article does not constitute the practice of any medical, nursing or other professional health care advice, diagnosis or treatment. Always seek the advice of a physician or other qualified health care provider with any questions regarding personal health or medical conditions. Never disregard, avoid or delay in obtaining medical advice from your doctor or other qualified health care provider because of something you have read in this article. If you have or suspect that you have a medical problem or condition, you should contact a qualified health care professional immediately. If you are in the United States and are experiencing a medical emergency, you should dial 911 or call for emergency medical help on the nearest telephone.