My Long COVID Treatment Strategy

July 15, 2024

This is an overview of what I did to treat my long COVID. My main symptom was fatigue, but I consider myself recovered now. 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. I believe if I had eliminated allergens sooner it could have helped me recover faster.

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 stopping 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.