My Covid Part 2

Dark and imposing Norfolk sky

9th June 2020

What I am sharing here is my own post-Covid experience, and my learning from this. I hope parts of it may be helpful to you too. Please ignore what doesn’t fit for you and take on what does.

I am now 9 weeks on from having had Covid-19. I have never had a test – I asked for one when I had the virus and they weren’t available even to NHS staff in my area (Norfolk) at that time. However, I had all the classic symptoms and on the two occasions I called 111 and spoke to two nurses and a duty GP, they all confirmed it was almost certain I had the virus. 

My experience is similar to many others: I was quite unwell but able to stay home with the reassurance of a prescribed inhaler in case I needed to be hospitalised (it’s a 30 minute drive away and ambulances were running on a 1-2 hour delay at that time). For more details of this phase of the virus see my previous blog here.

As I started to improve my symptoms abated and then seemed to return with force every few days. It was draining, and still a little bit scary. What would happen next? Would I get a ‘cytokine storm’ which I had read about, when your immune system seemingly goes haywire, or viral pneumonia, or something else (worse)? No-one really knew, data was being collected but we were all still learning. 

Intermittently I still had fatigue, muscle pain, tingling in my fingers and toes, headaches, over-salivating, sore throat, catarrh, and a tight chest with a strange feeling – someone else online compared it to glass shards in your lungs and I recognise that although the feeling was not as extreme as that. 

Unexpectedly I also had bouts of depression. I know this because I resumed daily walking locally when I could, and I know the point on this route when I normally feel the endorphins, the sense of wellbeing kick in. It didn’t happen. I felt anxious, uncertain, and powerless. Even though I could see logically that my trend line was going in the right direction, at the times when I relapsed it didn’t feel like it.

After around 5 weeks I went to my GP for another reason. He asked me how I was and I told him. The fatigue was uppermost at this time: I would do something in the morning, some office work from home for example, and would have to nap for 30 mins or an hour after lunch just to continue functioning. I don’t do napping, and it was infuriating. If I had clients (I divide my time between garden photography, writing and psychotherapy) I would need an hour to recover between zoom sessions.  My GP ordered a bunch of blood tests. 

Time passed, just under 3 weeks. I went for the blood tests, and the following day they all came back normal. I went back to see my GP and explained my theory, derived from monitoring my life since Covid, trying to be aware of what was going on both inside and outside my body, what activities seemed to trigger symptoms more than others. My speculation was that every time I put my body under any stress at all, it felt like my immune system went into overdrive and delivered all these unpleasant symptoms unnecessarily. He nodded in agreement. Then he said quietly: “You need to retrain your body”. This was my turning point. 

I realised that up until then I had been a victim. I had felt powerless and frightened (terrified at times) of this thing that was being done to my body (and mind) by this alien, unknown, potentially lethal virus. And even when my rational brain knew I no longer had the virus, it felt like I was still under attack. 

By this one comment, “You need to retrain your body”, my GP put me back in the driving seat. I could be active in my recovery, I had agency in how I could feel – even if it often didn’t feel that way. 

As a psychotherapist I have been very interested lately in the advances in neuroscience and how they relate to recovery from trauma. The link between mind and body, between mental wellbeing and physical health, has always seemed to me to be way stronger and more inextricably interwoven than western medicine (the ‘medical model’) had previously allowed. 

In particular, I have recently been interested in the role of the vagal nerve which runs from our brain stem to our gut, taking in most major organs along the way. Amongst other functions, it takes sensations from our gut, and transmits them to our heart and brain. Stimulating the vagus nerve has been shown to have a calming effect by slowing heart rate and lowering blood pressure. Crucially for post-Covid sufferers, it also inhibits inflammatory cytokine production, in other words it calms your over-active immune system. (A high level of cytokines, incidentally, has also been linked to symptoms of depression.)1

In trauma, this leads to the idea of two types of processing aiding recovery: top-down processing via the cortex – making meaning out of disregulated memory (eg flashbacks) by creating a narrative – and bottom-up processing, from body to mind, via breathing meditation, yoga, mindfulness and similar activities. Diaphragmatic (belly) breathing directly impacts the vagal nerve, sending calming messages to our heart and brain, which in turn calms down our internal feelings and responses. 

For me, when I get stressed I subconsciously tense my belly muscles. By turning my attention to noticing when this starts to happen and using belly breathing to pause the process and unlock the muscles, I have seemed to be able to calm my post-Covid symptoms. It doesn’t always work of course. But like any other muscle training, the more I use this technique, the easier and more natural it becomes, and hopefully as I continue, the more effective it will become. Is becoming. 

I am also attempting to do a five minute mindfulness meditation most days, and also to limit my intake of news and social media which is likely (highly likely at the moment) to press my anger buttons and raise my stress levels and bodily tension. We are lucky enough to live near the coast, so weekend walks on the beach are also part of my personal treatment plan. A small amount of Pilates and/or yoga. Daily local walking. Talking to friends and family on zoom and facetime. Feeling loved and nurtured, and loving and nurturing others.

Healing works from the body to the mind and also from the mind to the body. Decrease the anger, and I decrease the stress, which calms my body, which calms the symptoms. Increase the outgoing compassion and loving, and I increase the healing. It seems to be working.

So my learning from this experience is that taking some small control in my own recovery was a game-changer. Doing healing activities, and refusing to be defeated by my own disregulated immune system, but rather retraining it gently to understand that my body is actually ok now. I hope that yours soon will be too. 

Hopeful sunny beach and sky
  1. https://www.psychologytoday.com/gb/blog/the-athletes-way/201607/vagus-nerve-stimulation-dramatically-reduces-inflammation

What helped with Covid-19

This is a post about the things that supported me through my bout of Covid-19. I was one of the lucky ones. I didn’t need hospitalisation, I was able to stay in the comfort of my home. But it still had its scary moments.

What follows is what helped me. We are all different so that doesn’t necessarily mean everything will help you, but I hope at least some of it does. Feel free to take what you will, and ignore the rest. And share the link, tell people you think might benefit.

  1. The brilliance of our NHS staff. The system may have been systematically underfunded and undermined but the people are amazing: compassionate, patient and full of reassurance. They deserve better. In particular:
    • The doctor who gave me facts, support and reassurance which I trusted. Who took time to explain symptoms, helping me to understand what was happening. And listened to my anxiety and prescribed an inhaler just in case.
    • The NHS 111 nurse who took the time to talk to me as a human. I cannot tell you how much difference that made. 
  2. People.
    • my husband, who looked after me, cooked, cleaned and gave me regular back massages in a particular place which seemed prone to pain and knotting. 
    • My family and friends who checked in on me, talked to me, sent me positive thoughts and wishes. 
  3. Self-help.
    • Doing breathing exercises as recommended by a doctor and nurse at Queen’s Hospital.  https://www.youtube.com/watch?v=HwLzAdriec0&feature=emb_title Who knew that your lung alveoli in your back played such an important part in breathing? I definitely felt better when I did this exercise.
    • Vitamin-C. This is anecdotal, although there is a study in China currently underway, which hypothesises that high doses of vitamin-C can reduce damage to the alveoli and protect against other kinds of damage. (Ref: https://clinicaltrials.gov/ct2/show/NCT04264533 ) A herbal throat spray also eased the scratchiness and coughing.
    • Paracetamol: I was lucky in that I wasn’t in a great deal of pain, but once I understood that my bouts of shaking were caused by fever spikes, I dosed with paracetamol in the early evening, when it seemed to be worst, and at other times as I started to recognise the signs of an attack. 
    • Distraction: when my anxiety levels crept (or rocketed) higher, reading, TV (so much crappy TV), and on sunny days just watching and listening to the birds in the garden.
    • Pilates: exercising was counter-intuitive, in fact one of the nurses suggested bed-rest. Somehow though I felt that keeping my body moving just a bit would help. The gentle stretching of a very few basic pilates exercises – and it was very, very gentle – felt good. My muscles relaxed and breathing, an integral part of the exercises, became naturally deeper and easier. 
    • Walking and fresh air: just getting up and walking slowly around the garden every so often, felt helpful. Listening to the birds singing their hearts out.

Crucially, using these remedies gave me at least the illusion of some kind of control. I was taking some agency in the fight  – and it did feel like a fight – rather than lying back and letting it happen.

I learnt the importance of listening to my body, trusting myself to move around gently and stretch, walk and sit or lie when I needed to.

And of course, the interconnectedness of mind and body. Before it happened I had a great deal of anxiety around getting the virus, both for myself and for my husband. Once it did happen I was conscious of the importance of trying to maintain a positive attitude, a strong and clear intent to get better. Don’t get me wrong, during the waves of attack this nasty bug kept mounting, I veered from anxious to scared to relieved and back to scared again. I tried to keep in mind a need and want to keep living and a determination to do so. This sounds melodramatic when I read it back now, but that’s how it felt. 

The other part of this interconnectedness was to nurture a sense of healing. For me that meant letting go of the (bad) news, the tales of mismanagement, lockdown transgression, mad statements by crazy so-called leaders. I stopped watching or listening to anything that made me angry. Good news was ok, no news was even better. Being in the moment, right here, right now: the sun is shining, I can see blossom from my window. And the birdsong – did I mention the birdsong?