I’ve treated a number of long Covid sufferers this last year for various symptoms. The one almost consistent symptom across all patients is fatigue; similar in nature to the fatigue in ME/ chronic fatigue or post viral syndrome.
This fatigue is pervasive. Typically, fatigue is addressed through graded exercise. The level of exercise is gradually increased over time. A base exercise level is found and then exercise levels are slowly increased until the patient regains normal function. This is the theory with functional diseases such as chronic fatigue. However, it appears this isn’t working for long covid patients. Each week in bed can lead to up to 10% muscle loss, so it doesn’t take long to become completely enfeebled. Simple tasks such as walking across a room, holding a telephone can all become arduous tasks. Getting strength back involves walking a very fine line of activity vs rest. Too much activity can put a long Covid patient back by a week.
It’s a horrible state to be in and no doubt this will become a more prominent problem as more people succumb to Covid and develop long covid.
Finding the right balance of activity vs rest is essential in long Covid. I’d argue it is in health as well. Most of us go through life with little respect for our health and even less for pacing activity. It’s not that we do it overtly it’s just that we load our lives with too much and so give ourselves no time to reflect on how we feel. No time to check in with ourselves.
If there’s one plus point to come out of the grisliness of the pandemic it’s that many people have taken their foot off the gas. This gives time to check in with our bodies and understand our limits a bit more. Recognising you’re individual and may have more or less energy than your friends and colleagues is important. Working out where your limits are is essential for avoiding burnout and leading an optimal, healthy life.
In Chinese medicine, good health at its crudest level (ignoring bacteria and viruses) relies on a balance between two opposing energies within your body – yin and yang. Yang is expansive, energetic and outward focused, typified by the season of summer and explosive energy. Yin is introspective, passive, resting, typified by the season of winter and relaxation. An excess of one over the other, results in imbalance and illness.
Too much activity at the expense of recovery, rest and introspection may result in burnout. Too much inactivity and introspection may result in depression, obesity and resulting co-morbidities. In order to give ourselves the best chance of health we need to work out our own optimal level of activity. If you’ve had a hard week at work, maybe think about a yoga class rather than a High Intensity Workout (or bottle of wine). Been sat around for days at Christmas eating too much? Increase your yang – get out and run. Temper this with the seasons – winter naturally encourages introspection and relaxation so adjust your activity accordingly.
As spring arrives the time for introspection diminishes and activity levels can increase.