part0021

Many reports are now being published regarding the slow, long-term recovery of certain patients who were infected with COVID-19 earlier in 2020. This group are the ‘long haulers’ referred to in Chapter 4.

If you are one of the ‘long haulers’, no one really knows how long your recovery will take nor what the long-term impacts will be. It is a new virus and you are, to some degree, one of the guinea pigs. I am too.

Sadly, it is becoming clear that millions of people worldwide continue to suffer from the impacts of COVID-19 many months after they cleared the virus. Two of the common long-term symptoms are myocarditis (inflammation of the heart muscle) and residual lung damage.

As discussed in previous chapters, this can impact exercise performance. In more severe cases, it may impact mobility, such as climbing stairs.

Sometimes the recovery is so slow that it is difficult to detect. As such, many of us get discouraged. Personally, as you may remember from Chapters 8 and 11, I find it useful to occasionally test myself in a standard way to see if things have improved.

This tracking is done through data like heart rate and blood oxygen. If things are clearly improving, even slowly, my outlook and mood improve.

The journey to recovery is long and it will often seem like you are not improving. That can be incredibly discouraging. I recommend monitoring your health data because it can show you the improvement you cannot feel. This is true regardless of whether you have data from before you had COVID-19. These methods have kept me hopeful, and hopefully they can do the same for you.

In the graph below, I have plotted this sort of tracking data taken over the course of my long-term recovery period. It is for me walking at 5,900 feet of altitude, at day 96 and later at day 170 of symptoms.

For comparison purposes, it includes the maximum and minimum values for me from early 2020 and late 2019, prior to COVID-19. These serve as benchmarks to assess my recovery.

When I am back between those maximum and minimum values, I consider myself recovered, at least for walking at an altitude of 5,900 ft or less.

As you can see from the graph, there was some improvement from day 96 to day 170. My heart rate dropped, and my blood oxygen rose toward my values before symptoms.

If the trend continues, I have another 3-4 months to full recovery, at least in terms of walking.

If you plan to do the sort of exercising testing shown above, you need to first consult with your doctor. Together, you can create an exercise plan tailored to you and your recovery.

At first, and maybe for a while, it should involve only mild exercise. I started out walking just 1 mph, built up to 3 mph, and then added an incline of 5%, well below my previous standard of 3 mph at 15% slope.

In addition to any of this type of testing you might do on your own, you should of course undergo testing ordered by your medical team. If you have lung damage, you may well have a pulmonary doctor on your team and occasional CT chest scans, as I did.

I have been surprised by how long it is taking me to recover from COVID-19. My latest CT scan, on day 177 of symptoms, shows that my lungs are almost fully healed. My fasting blood glucose levels are back to normal. My blood oxygen levels while sleeping, sitting, or standing are back to normal.

But my resting heart rate is still a bit high. Also, when exercising, my heart rate is still high and my blood oxygen level is still low.

My cardiologist believes I am simply not quite back in shape. Since day 90 of symptoms, I have been exercising nearly every day for over three months. Apparently, I must have been in horrible shape at the beginning of that exercise period.

In the graph below, I have plotted my steps per day as taken by my Garmin Vivosmart 4 device. From about day 10 to day 90 of symptoms, I did not exercise at all, via walking or any other means. I took only 1,000-5,000 slow steps per day as I puttered around the house.

Eighty days without exercise is certainly a long period. This is by far the longest period I have ever gone without exercising. By the end of it, I had lost 10 pounds of muscle and apparently was in horrible shape.

If you have had a severe case of COVID-19, including 2 months or more without exercise, it might take you quite a while to get back in shape. This is true even if you have no long term or permanent damage.

I am now ten pounds lighter and actually have more muscle mass than before I had COVID-19. Nonetheless, in terms of exercise performance, I am still way off. For mountain biking, I need electromechanical help, as I describe further below.

To fully recover, maybe I just need to work harder. Alternatively, I may have damage that is permanent or will take a very long time to heal. It is hard to say.

COVID-19 is our adversary and I have fought the battle. I am not going to give up until it kills me. If it injures me, resulting in a disability, then I will make accommodations and continue moving forward.

My current disability makes me unable to mountain bike or ski in the local mountains without mechanical aid. That may not sound like much of disability to you.

I wholeheartedly agree that it is nothing compared to, for instance, being paralyzed from the waist down. But these activities are two of my passions. Losing them for me has been as frustrating as a painter with their hand in a cast.

As I describe in Chapter 8, I have accommodated my disability with a portable oxygen concentrator. I have also purchased an Ebike, short for electric bike. It has a motor that adds to my power when I pedal. With both a portable oxygen concentrator and an Ebike, I call it electromechanically assisted mountain biking. It is illustrated with a picture at the start of this chapter.

I am fortunate to be able accommodate my disability while maintaining a version of my passion. That said, Ebikes are currently not allowed on many single-track trails, the most interesting ones for mountain biking. Hopefully, policies will change to fully accommodate disabled mountain bikers and everyone else disabled by COVID-19. Hopefully, we can overcome all our disabilities.

When there is appropriate accommodation by others, I believe nearly everyone can learn to deal with a disability. You may have to make greater sacrifices than others, and certainly more than me. But if you give up, then not only you have lost, but all of humankind has lost.

I have always been impressed with how dogs deal with physical disabilities.

They are not bitter. They just accept their disability and happily move forward as best they can. Pictured below is a dog playing fetch. It has only three legs. It is clearly still happy.

If you are bitter about your disability and do not forgive those you might consider responsible for it, you will do even worse in terms of long-term recovery.

For a daily reminder of how to view the world like a dog, I highly recommend owning one. The chapters in this book contain many photos of our dog Cookie. She has helped us all get through this ordeal.