My month after COVID

It’s been about a month since I came down with COVID-19, after nearly three years of researching the virus.  Since the aftermath is interesting from medical and public health perspectives, I thought I’d continue to share my story here.  It’s one snapshot of recovery.

The main effect I’ve experienced of having had COVID is fatigue.  For the first three weeks after exiting lockdown huge waves of fatigue would hit me.  Sometimes they would hit after I’d done what I used to consider minor or trivial amounts of physical activity: making dinner for the house, vacuuming a floor. Sometimes intellectual work yielded those fatigue tides, like grading for a couple of hours.  At other times nothing would be the cause – sitting on a chair, reading, and suddenly feel like I’ve just chopped wood for ten hours.

This was much worse in early November.  I think it’s less of a problem now.

Yet connected to fatigue is getting more sleep.  Normally I sleep for around 6-7 hours each night. (My quality of sleep is usually fine, thanks to the CPAP machine. I have no problems falling asleep.) Since Halloween I’ve slept 9-10 hours, and many days could easily have slept more.  These are usually deep sleeps without waking or disturbance. My dreams are clear; I can recall one, two, or three upon waking.

To some extent this might be my body catching up with “sleep debt,” since 6-7 hours/night isn’t enough.

Keep in mind that the medical advice for people after infection is not to exercise.  I’ve been following that advice carefully.  My pull-up bar stands neglected in a corner.  My weights gather dust and occasional feline attention at the end of my desk. I haven’t ridden the bike or taken a long walk. The only walking I’ve done is the roughly one mile to my Georgetown classroom from the Rosslyn Metro station, and I’ve been very careful to take that slowly, even pausing to rest.

And this is galling. I feel my muscle tone softening (perhaps mostly in my imagination). At times I feel like an invalid, especially when resting during a puny one mile stroll.  I know it’s the right thing to do, but that doesn’t stop feeling like a lazy slug.  When I drive to the grocery store or HOA meeting one or two miles away, I feel embarrassed.

Crossing the Potomac River on the Key Bridge. This is the center of my walk to class.

I have been eating less. This takes the form of skipping breakfast or dinner or both.  That’s because my appetite is lower.  I’m not appalled by food or anything, just not getting hunger pangs in my gut. Is it because I’m not doing as much physical activity?  Is it a mind game, because I’m embarrassed by not exercising?

There was one bad week when my left ear had problems. It got congested badly enough that I couldn’t hear through it. In face to face conversations I turned my right side to people so I could hear better.  I tried domestic cures: steam, tugging the left earlobe while yawning, exhaling while closing my mouth and pinching the nose shut.  No luck. Friends recommended an audiologist.

I worried about permanent hearing loss, so checked with our HMO.  The nurse on call (on chat, from the Kaiser website) recommended a combination of eardrops to melt earwax, nasal irrigation with a saline solution, and using a neti pot.  This took nearly a week to work, but finally that left ear opened up.  It’s a weird experience, almost like a popping, but more like someone suddenly playing loud noises right next to your head. The ear closed again a few hours later, then opened, then closed, until finally it remained open and I wasn’t going deaf on my left side.

Other post-COVID symptoms I’m not experiencing: joint pain, headaches, organ pain, shortness of breath.  My senses of smell and taste are just ok, but it’s winter, and I usually get stuffed up for the season.

What about brain fog?  I’m honestly not sure.  Most of the time I find myself thinking like I used to, pre-infection… as far as I can tell, which is part of the problem here.  I don’t have good ways of monitoring my cognition.  Externally, I’ve been quietly asking people how I do in conversation, in class, leading video meetings, giving talks. All feedback has been positive, which is a relief.

I feel mentally energized by some events.  Class, for example, is always an adrenaline shot for me. In fact, earlier this month I warned students I might end sessions a little early, due to COVID, but every time went right to the scheduled end and had time for students afterwards.  Clients for presentations have been satisfied.

And yet.  The fatigue gnaws at my mind. I worry that I can’t multitask as much, but it’s hard to assess this. I catch myself making small errors (not sharing apps the right way in Zoom) or having to remind myself of process steps (chopping garlic *before* sauteeing green beans) more than I used to. Are these real problems, or am I just paying more attention because of the COVID context?  I’m honestly not sure.

All of this is the first month post-infection. Looking ahead, I want to start exercising again.   Not my full routine, but some small exercises – a one mile bike ride, the lightest weight.  I have to be careful not to let enthusiasm and remembered capacity lead me to overdo things.

I’m not sure if my appetite will rebuild. I’m at the lowest weight I’ve had since the 1990s – 215 lbs – and like it.  Maybe my appetite will be suppressed long term. Alternatively, ramping up physical exercise will bring it back. Hopefully I can resume my pre-COVID muscle mass and tone, which will add pounds.

Is this something I should talk about with medical or mental health professionals?  I don’t know, and it honestly feels silly to even consider.

My biggest worry is, of course, long COVID. Research on this is still nascent. I’m not sure how my behavior now shapes my chances of coming down with it.  So I’m trying to be very careful.

That’s not really my biggest worry, although it should be.  My greatest anxiety is that COVID will depress my ability to work, and hence reduce my ability to support my family.  As an independent and an American, I don’t have much in the way of public resources to fall back on.  I can give myself days off, but those are days when I could be bringing in revenue. My teaching, workshops, presentations, consultation, writing, and video work are how I pay the mortgage, medical bills, insurance, groceries, debts. So while I try to not make my health worse, I also have to keep a roof over my family’s heads.  How far can I push myself?  What risks am I taking?

Forgive me if this is TMI or too long, or both. I hope these reflections are useful to people experiencing or thinking about COVID.