My Long COVID Treatment Strategy

July 15, 2024

This is an overview of what I have done to treat my long COVID. My main symptom is fatigue. Read more

Dr. Michael Brode at UT Health Austin has two videos that describe long COVID and how he treats it. I am basically follow this plan.

As Dr. Brode said, avoiding crashes is really important. Read more about about post-exertional malaise.

The 4 Ps

The CRESTA Fatigue Clinic in the UK defines 4 Ps which are slightly different from Dr. Brode’s 4 Ps. I use the CRESTA Ps because I like them better.

  • Prioritize - I have to decide what really, really has to be done. Of those, what must be done by me? Caring for myself is a priority.
  • Plan - I look ahead on my calendar and try to plan for, minimize, or cancel large energy drains.
  • Pace - On an hourly & daily basis, I try to spend my energy relatively evenly over time and stay within my energy envelope. Read more
  • Pleasure - I can find enjoyment, despite the fact I’m sick. In fact, finding enjoyment is an important part of healing.

Pleasure is the P missing from Dr. Brode’s list. I have found focusing on pleasure really important.

The 4 Ps gives me a structure to make decisions about how I spend my energy.

Treatments That Have Helped

My treatments can be summarized as:

  • Test that nothing else is wrong.
  • Rest and pace aggressively.
  • Supply nutrients my particular body needs.
  • Calm my nervous system as much as possible.

Test and Treat

My doctors performed tests recommended by the U.S. ME/CFS Clinician Coalition to rule out other illnesses. Read more

All the tests came back normal except vitamins B12 and D, so I supplement those. Read more

Very late in my long COVID journey I had allergy testing.

Rest and Pace

I believe taking extended medical leave from work, plus careful pacing have made the biggest difference in my recovery. My long COVID doctor said many people recover in 12-18 months, and if I don’t recover in that timeframe, I should make plans to live with the illness for a long period of time. I have done everything I can to give my body the tools to recover in the first year. I decided that no matter what happened with the disability insurance, I would rest and let my body recover.

I track my symptoms and exertion daily. Read more

I “exercise” by moving my body in consistent activities I can easily measure. I am careful to move, but avoid post-exertional malaise. Many of my activities are outdoors. Read more

In everything I try to avoid crashes from post-exertional malaise.

Supply Nutrients

I supplement vitamins that tested low. Read more

I drink enough water every day (about 1 liter per 75 lbs of body weight). On most days I add electrolytes to the first liter. Read more

I try to eat a low-inflammation diet. Eating animal protein consistently and stopped sweets helped. Read more

Calm My Nervous System

I go to counseling. Long COVID is a significant, traumatic experience. Processing emotions is an important part of recovery.

I go to acupuncture weekly, which is another way to calm my nervous system. Talking about my symptoms with a health professional is also helpful. (I did not start acupuncture until I had the stamina for weekly appointments.) Read more

I have a consistent, early bed time with no wake up alarm.

I started using perceived exertion rather than heart rate and HRV to pace myself. Read more

I found long COVID friends in real life and stopped participating in online forums. Read more

I started focusing on what I needed to do to get better, not providing good documentation for the disability insurance company. (This resulted in my health recovering and my claim getting denied.)

I also regularly practice meditation, deep breathing, and time in nature.

Conclusion

You might notice there are no medications listed here. I have a separate article for treatments I declined.

This strategy appears to have worked. Read my latest status.