Season of Long COVID Part 2- Lifestyle Treatments


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Hi everybody Dr. Julie McLaughlin here with another Functional Medicine Friday. So here at McLaughlin Care, we like to share lots of different information with you with Wellness Wednesdays, and Functional Medicine Friday. So I hope you enjoy it. And if you do be sure to share it with your friends. So we're going to be talking about again, the season of long COVID this is part two.


Hopefully you've seen my part one and we have some other ones coming up as well. As many of you know, that I myself have long COVID. And I've been dealing with this for about six months, and I've done lots of research and lots of studying on this and lots of trial and error. And I've finally come up with some things that are working.


So I want to share that with all of you in case you experience or someone in your family experiences it or your friends, because it is not fun and there's not easy answers to be found. So let's talk a little bit about the timeline of COVID. So acute COVID the first two weeks are when we typically have symptoms. If your symptoms are gone after those two weeks, you had acute COVID.


If you have symptoms up to 12 weeks, you now have post acute COVID. If you have symptoms greater than 12 weeks, that's considered chronic COVID or long COVID or post acute COVID sequella anything that's longer than 12 weeks. Now, it doesn't matter if you had your initial symptom even to be asymptomatic or mild, you can still get long COVID is not only the patients who have severe symptoms or hospitalized.


Now the most common symptom with long COVID is that the symptoms always change. There's 50 symptoms or more that are common to patients with long COVID, but the, you can guarantee those symptoms always, always change. And so, right when you're getting used to one of those miserable things, they go away, but another one comes back and you can only hope it's a less intense one, but they are always changing throughout the entire course of this.


So for my last six months, my symptoms have been all over the place changing, and it makes you think what the heck is going on, but it's really, that's the way the long COVID works. Sometimes you can be more sick at 12 months than you were at six months. So it's not like a regular infection or a condition where it gradually gets better over time.


You can really send some different things and twists into this progression. So the average long haul COVID patient has 20 symptoms and there's 39 million plus people who have had COVID SARS in the United States, and that number is growing. And about 30% of those people have long COVID.


And like I said, it doesn't matter if you were in the hospital intubated, or if you had no symptoms, you can still get long COVID. So one day you will tell your story of how you overcame the storm. And it will be part of someone else's survival guide. So I'm hoping to give you guys a little survival guide of mine that I've learned along the way.


So it affects the sickest and the healthiest people. So this is one of the craziest things is that it's so random of who is affecting. And we're really looking at what's causing this long COVID. But if you're sick, we know if you had pre-existing conditions, you can get it. And in the healthiest people, because you haven't had a lot of things wrong, your body can create something called autoantibodies.


That we're going to talk about a little bit more here, and that can make you more susceptible as well. So when we look at this, there's a varied immune response from COVID-19 auto antibodies, which is an immune system protein, it mistakes the target, the body's own tissues and starts shooting inward, right?


So our body starts attacking ourselves, which is similar to an autoimmune disease. So it's looking like long COVID is a new form of an autoimmune disease. So people have low levels of these auto antibodies attacking itself, have little to no COVID symptoms, but the sickest people will have elevated autoantibodies from other autoimmune diseases or chronic illnesses, but the healthiest people have no auto antibodies.


And so when your body starts shooting, you're going to be more susceptible. So this is a study in the development of the ACE2 auto antibodies after SARS COVID infection. So ACE2 is a receptor and an auto antibody is affected by COVID. So these ACE2 receptors are located on every or almost every organ or tissue in our body. You can see they are everywhere.


So that's why some people get symptoms. Maybe they get a rash because it got affected on their skin. Maybe they got it in the GI. Maybe they got kidneys. Maybe they got it in the brain. So wherever that virus attacks you at the location of these ACE2 receptors, that's where you're going to get your symptoms.


So according to the American heart association, one of the biggest problems with COVID is not the virus itself, but the inflammatory cytokine storm that occurs as a robust and very vigorous immune reaction to the presence of the virus. So the way your body responds is really the problem, not just the virus itself. So when we look at this, we have an acute infection. We have a proper inflammatory response.


We have an antiviral state where our body goes to kill that virus, your immune cells activate and the IFN upregulates, and it's all balanced because your body's able to fight it off. But when we go into this viral infection, our body is not able to fight it off and that chronic infection just continues to persist. So the question is to auto antibodies produced during COVID-19 lead to an autoimmune disease later in life.


And we need more research on these autoantibodies that contribute to COVID and COVID long COVID soon. So the impact of COVID on life activities, 78% of people with long COVID have fatigue with a high severity score, at least 63% have mild brain fog or memory impairment, 40% have a modest to severe shortness of breath, right? And that's on this breathlessness score.


Scale is 62% of people haven't had had to change their employment as a result of their symptom status, which is really, really scary. Many of you know, I haven't been able to adjust patients. I've only been able to do tele-health because of these long COVID symptoms. So what can we do to see if we have immunity to this? Now I'm going to explain this.


And it goes for people with COVID people who have had vaccines, people have had COVID and the vaccine and people have never had vaccine or COVID. So when we look at the antibodies, there's two different types. There's the SARS cov two total antibody anti-nuclear capsid. So if you have this antibody right here, that means you had COVID right? Because the vaccines are only showing up.


If you have a spike protein here. So anti SARS, Kobe spike, protein, reactive IgG antibody, it will show up positive in someone who's had COVID along with the nucleocapsid. But if someone only had the vaccine, it would show up here. Now, the thing I know for sure is these immunities don't stay forever. They decrease, and they decrease at a different rate for every single person.


Some people don't keep them at all. Some people keep them for three months, six months a year, but it varies. So when we test this, then we know where you are specifically on those antibodies. So when we look at the phases of COVID, we have the prevention phase, the infection phase, the inflammation phase and the recovery phase. And we have to work through each one of those because our symptoms are different.


So the seven main engine issues with long COVID are going to be central nervous system, dysregulation, something called pots, or posterior like posture or the pediatric hypertension. So when you stand up, maybe your blood pressure drops or you get a little bit dizzy, brain fog, stress, anxiety, depression, and neuroinflammation effects, auto immunity. Is this a flared old auto immune condition?


Or is this a new one? It affects Mike you microvascular damage. Cause it causes tissue hypoxia in your brain. And in other organs, it could also expand the Bible burden on other viruses that may be dormant in your body. Like Epstein-Barr chronic fatigue, HSV, parvo, or mycoplasma.


We can also get things called fibrosis in the lungs, the kidneys, the liver, and the heart, and this causes loss of functioning in those organs. And that's tested through something called TGF beta. It also can cause barrier damage. So that's why it affects the gut. And it has neurogenic effects. So is the inflammation of the mass cells where histamine is released in part three of our COVID series, we're going to be talking more about these mass cells.


So these are some tests that we use in our office for assessment and progression of long COVID. And you can see there's some typical ones like a chem screen and a CBC, but we do some advanced testing because we're able to monitor it better and see if the treatments are actually improving, because sometimes we try things, but we don't know if it's improving or placebo or not.


We don't guess we test. So with Hmong COVID there are a few lifestyle management tricks that you can do as well. So the first thing is I want you to start singing that's right. I want you to start singing because it relieves stress. It stimulates your immune response. It exercises your lungs. It enhances your memory and mental function. I want you to work on some breathing exercises.


There's an excellent program. Online is called stasis and they're using it at Mount Sinai in their long COVID program. And that is an excellent program for breathing exercises compression. We want to have compression socks or pants of at least 20 to 30 pounds per pressure in the legs and the abdomen.


That's going to help with the low blood pressure and with the high rapid heart rate, we want recumbent exercises in months, one to four, you should only exercise in a horizontal position, the recumbent bike or rowing machine, or even better yet swimming. If you're swimming, your body is getting 90 pounds of pressure from that water and your symptoms that are cardiovascular are really going to improve. You want to have a pulse oximeter.


If your pulse oxygen drops below 90, you need to go to the ER ASAP. So you want to monitor your heart rate, right? I have a little Fitbit that I monitor my heart rate on. So we know we do it during cardiac exercise, but we also need to monitor it because minimal exertion can really raise up a person with long Covitz heart rate. You want to have progress and motivation, right?


So we want progress, not perfection. So write down a list of things that you want to resume in your life and tape it to your bathroom mirror and read it every day. Read it, especially on the days that you're not feeling like going to the gym or doing your breathing exercises, it will help motivate you to get back to your normal life.


And the progression unfortunately is very, very slow. And sometimes we think we're just not getting better. So if you write it down, you'll see, there are some things that are improving meditation and hypnosis are great. There's an app called reverie and memory training on the app called luminosity it's really, really helpful for factory training.


So if you're losing your taste or sense and smell, you want to use some essential oils and do some olfactory training. When you sleep, you want to sleep on your stomach. I know I'm a chiropractor and that's not good for your back, but it's good for your lungs. And it's good for long COVID. So we call it prone, sleeping, or they'll call it pony. You want to avoid alcohol and you want to eat a low histamine diet and say, what foods are low in histamine, sleep hygiene, get as much rest as you possibly can and allow your body to heal, increase your salt intake. I know it's crazy. It doesn't seem like health, right? It doesn't seem like science, but if you get up to 10 grams of salt every day, it's going to help with your blood pressure.


And with your heart rate, increase your fluids. You need to drink two to three liters of water a day. Along with that increased salt to increase your blood volume. We want to avoid caffeine because caffeine increases our heart rate and anxiety. You want to eat small frequent meals. You're going to have less problem with the pots.


If you're eating smaller meals versus larger meals, it is a huge trigger for long COVID. It causes vasodilation in diverse the blood flow from the organs. So air conditioning's important. Stay cool, take cool showers and cool baths. You can even put the palms of your feet or the palms of your hand in ice to get that temperature cooling in.


I know for the longest time, if I took a shower, it would just flatten me for a couple of hours because of the heat and the stimulation in the nervous system from the water. So be really careful with that exercise. At four months, you can begin to exercise like an upright bike, but do it very carefully and monitor your oxygen, heart rate, and your blood pressure.


At month five, you can begin a little bit more. Maybe you're going to do the elliptical or the treadmill. So now supplements for long COVID. That's a huge big conversation. And we're going to talk about that at another time I promise, but for now I am still dancing. The storm has changed directions and life is looking forward. We're going to have improvements.


I'm not where I was, but I'm better than I was. So it's a journey, not a destination. Give yourself gratitude for the small daily wins because you deserve it. And this is not an easy condition to overcome. So that's it for part two of the season of long COVID I'll see you next time.



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