Dr. Lingadevi Thanasekaran
Covid 19 is caused by the new coronavirus which spreads rapidly among people of different age groups right from adults to children and elderly population. As the pandemic continues , we have learnt that people affected by Covid 19 can present with a variety of symptoms such as fever, cough, headache ,sore throat, fatigue, body aches, difficulty in breathing ,altered taste and smell. These symptoms might appear two to 14s after contact with someone who had corona virus.
The severity of Covid 19 can vary from very mild to severe .While majority of people have mild to no symptoms, few people can present with severe life threatening symptoms requiring Intensive care. People with co morbid conditions like Diabetes Mellitus, Heart problems, Asthma, Chronic Obstructive Pulmonary Disease , Kidney problems should be more careful and follow social distancing measures to prevent acquiring COVID 19. Our web page is aimed to help you recover from Covid illness. Covid -19 symptoms can sometimes persists for weeks to months.
While most patients recover completely within few weeks, some of them might continue to experience persistent symptoms including fatigue, shortness of breath, joint pain, chest pain, cough and fever.
As per WHO, recovery time appears to be around two weeks for mild infections and 3 to 6 weeks for severe disease. We have to remember that regular follow up is required to watch out for heart attack, heart failure, clot in the lungs, lungs fibrosis, stroke and seizures. Many people might develop chronic fatigue syndrome. Returning to baseline health might be a gradual process but don’t lose hope.
Post Covid Discharge
Being recently discharged from covid is not an easy task in itself. We have come across patients and their relatives finding it very difficult to cope with life, post discharge from hospital or post covid isolation at home.
Coping with physical and psychological challenges now that you are at home
You may still have physical and psychological difficulties even after being discharged. Although you might feel completely happy and relieved to be back home you might still have breathing difficulties, cough, feeling lethargic and tired. Some of you may still be very anxious, or depressed, or have Post traumatic Stress Disorder (having disturbed sleep and nightmares or flashbacks of your hospital stay or remembering an experience of a covid positive patient dying in the bed next to them).
For some being very unwell in Intensive Care can be a near life -death experience and having to deal with the after math of a lengthy hospital stay can drain one emotionally, physically and financially.
ICU patients can present with deliriums, hallucinations (seeing or hearing things that are not there) or delusions (strange beliefs about what is happening in the hospital). They can have difficulty differentiating what is reality and what is not. It can be because of their illness or because of being in an unfamiliar environment, or because of the medicines given to them in the hospital which can make them confused. These symptoms are usually temporary but can be quite upsetting to be understood by the carers, attenders and relatives.
Understandably you will be worried whether you can go back to being fit and healthy as before. Remember right from the time of discharge from the hospital it is going to be a slow but steady process and at no time should you lose hope. We, the healthcare team are there to provide you with all the support and encouragement to make you as well as before.
Remember to be positive at all times, as it goes a long way in healing.
Make sure you look after yourself too
Establish a Routine
- Prioritize your work schedule/Day to day activities
- Eat healthy food
- Sleep well. Adequate sleep boosts your immunity.
- Exercise daily. Ensure that you are doing 30 minutes of exercise 5-7 days / week
- Speak to your friends and family via phone, video calls.
- Try out a new hobby
- Do yoga
- Watch light hearted shows in television and stay happy and relaxed.
- Arrange appropriate follow up with the doctor via teleconsultation, if you are reluctant to go for in -person follow up.
Be patient, with yourself and your near and dear ones. Remember we are all in this together. Accept the new normal and don’t overload yourself. Consider this as an excellent opportunity to spend quality time with your friends and family.
Post Covid breathlessness
Breathlessness may occur for many reasons but can make one feel scared, anxious, Panic and thus limit the daily activities.
Tips to manage breathlessness
- Pace and plan your activities but try not to rush or do things at a faster pace.
- Sit in a chair and take enough rest between and after your day to day activities to save your energy.
- If you are breathless during activity, stop and lean forward on a chair for example when you feel breathless. This can reduce the work of upper body and help you to recover your breath quickly.
- If you are too breathless lying on your back while sleeping then try to sleep in one side supported by pillows and with your head end elevated.
- Be patient and understand that you are going to have some good days and some bad days. So don’t feel sad by comparing how good you were in the pre covid days.
Techniques to control your breathing
- Practice while you are sitting down put one hand on your chest and the other hand on your tummy
- Slowly breathe in and out through your nose with your mouth closed or if it is too hard then breathe in through your nose and out through your mouth.
- With every breath out you will start to feel relaxed and calm.
Your symptoms after your stay in intensive care unit:
PICS (Post intensive care syndrome) is a term used when people experience a varied range of symptoms from anxiety, depression, mental, emotional and physical ill health post discharge from ICU.
As a patient in Intensive care you might have found it difficult to establish good one to one communication with the health care professionals because of your ill health, being on medicines which can cause sedation, the PPE (personal protective equipment) staff had to wear whilst looking after you.
You might also feel fatigued, which commonly occurs after any viral infection or severe disease but always remember that all these are just temporary and the symptoms will improve over the course of time for some people it might just take weeks to months but for some it might take 3 to 6 months. Being patient is the key.
Why is exercise important
One has to remember that after severe Covid 19 viral illness and long hospital stay, muscles in the body will become weaker than normal and you might feel tired and lethargic so it is important to be as active as before and exercise regularly. Exercise will make you feel healthier keep you alert, and help you regain your muscle strength.
Exercise also helps to improve your mental well being.
You might experience mood changes, depressive thoughts and problems with your sleep. Follow the 3 P s principle-Pace plan and prioritise when carrying out your day to day activities.
Pace – Giving adequate time and spacing out between activities so that you don’t over do things, but instead take life one step at a time.
Plan – Plan your work or activities by following a structured time table to follow so you are mentally active at all times
Prioritise : Prioritise your day to day activities.
Don’t worry, remember you are not alone. Because you were faced with a frightening near life death situation in hospital, your body responds to any such association when you think about it, talk about it or dream about it in a similar anxiety state.
This reaction is normal and it will gradually improve over time. You might need to see a counsellor to help you with removing anxious thoughts and reassuring you.
Tips to control your anxiety
- Relax and do meditation.
- Sharing your emotions with people whom you trust will help in speedy recovery. Contact your health-care provider or speak to a support group where similar post covid recovery patients come to. Remember a problem shared is a problem halved.
- Once you share your experience or listen to the support group members expressing their experience on how they have mastered their post covid recovery you will realise that you are not alone dealing with the aftermath of covid. It will give you a sense of reassurance and improve your confidence in dealing with life’s challenges. After illness it is normal to feel sad, tearful or frustrated. Learning to manage your mood and coping with frustrations is important.
Changed Sleep architecture
Either at home or hospital due to fear of covid-19, people are having problems with sleep. In hospital it is difficult to get a good night sleep either due to lack of proper daylight, noisy environment, sleeping in hospital bed might be uncomfortable, and medications which are given might affect the quality of sleep.
Following good sleep hygiene measures helps.
- Have a schedule planned for the day.
- Eat healthy diet and exercise regularly.
- Avoid beverages, caffeinated drinks after 3 pm.
- Do not go to bed until you feel sleepy and if you are not able to sleep within half an hour try not lie in bed twisting and turning until you get sleep.
- Avoid exercise, watching television late at night.
- Do not use phones in your bedroom.
- Ensure that the bedroom is providing a calm relaxed environment for you to go to sleep.
- Maintain a sleep diary.
Not being able to see your family and friends while in hospital can be very stressful for everyone. Unfortunately Covid dictates such unprecedented social distancing measures which can be very stressful and depressive both to the patient and their relatives. It will take time to adjust to the new ‘ normal’. Further lack of basic human touch due to social distancing and limited communication due to health -safety norms can further affect your mood during the hospital stay.
Covid can also cause financial worry due to loss of job / loss of pay, and having to pay the hospital bills etc. All these emotional and financial worries can cause a strain in relationship. Don’t allow all these to bring your moral down. There are many tele communications and counselling services which can offer you help and support so ask them for guidance and advice. Remember that you are not alone in fighting this pandemic.
“This too shall pass” please remember at all times.
Dr.Vijayalakshmi Thanasekaraan MD (Gen. Med.),DTCD
Emeritus Professor of Pulmonology
Advisor and Senior Consultant of Respiratory Medicine
Sri Ramachandra Institute of Higher Education and Research, Chennai
Dr.Lingadevi Thanasekaran, MBBS, MRCP (UK)
Senior Consultant Physician
Ethics committee Member, SRIHER
Coordinator for Sri Ramachandra Centre for Women’s advancement
Faculty for Medical Counselling in BACME