How Can I Best Recover from COVID-19 & Flu?

How Can I Best Recover from COVID-19 & Flu?

Written by Alana Murrihy, Senior Physiotherapist 

It is helpful to understand that when we are unwell with a virus there are a number of factors working together to create the effects we experience.

1. The virus itself & the resulting immune response.
2. Deconditioning from being sedentary & recumbent:
   • This may be for 7-10 days with something like COVID-19, particularly with the associated quarantine periods at home.
   • This component of an illness has more impact than many understand & it is often overlooked.
3. (Forced) behaviour changes resulting from a physical illness (e.g. poor hydration, nutrition, reduced support/connection & so on).

The key to optimal management & recovery from a virus is to balance rest & recuperation with some maintenance of conditioning as tolerable.

The Challenges:

(See “The Solutions” below)

Remaining Sedentary While Unwell/Deconditioning:

• • • • When we are unwell, we rest (as we should)! We often spend prolonged periods lying down in a recumbent position. This results in a significant decrease in major organ & muscle activity (& therefore overall conditioning). For example, research has found that as little as 48 hours of being sedentary can result in a reduction in blood volume and blood pressure.
      • In addition to the virus itself & the resultant immune response, reduced blood volume/blood pressure is a common culprit that contributes to why we feel unwell during and after having a virus.
      • This drop in blood volume/blood pressure can be accompanied by an increase in heart rate (HR) & cardiac output (CO) to ensure enough blood is pumping & circulating to vital organs. You may notice your heart racing more when you stand up or exert yourself while unwell or recovering from illness/virus.
      • Low blood volume/blood pressure symptoms can present as dizziness, fatigue, shortness of breath, cognitive deficits (brain fog), anxiety (due to adrenaline dumps to keep your blood pressure up) & more.
      • This is exacerbated by resting in a recumbent position when we are unwell & not having the effects of gravity acting on us to prompt our body to maintain blood volume/blood pressure.
      • In addition to being recumbent for prolonged periods when we are unwell, our muscles are also working less & therefore not consuming as much oxygen from our red blood cells (RBC). The body subsequently reduces the production of red blood cells & this can further lower blood volume/blood pressure and exacerbate symptoms.

Difficulty With Nutrition & Hydration:

1. 1. • When we are feeling unwell, we often struggle with basic hydration & nutrition due to a) lack of appetite, and b) lack of energy to prepare meals & drinks.
      • When we reduce our hydration & quality nutrition intake we can experience a more severe illness & longer recovery, including a drop in blood pressure as outlined above.

The Stress Response:

1. 1. • A virus is a physical stress on our bodies and often comes with associated mental or emotional stress (missing work, loss of routine, unable to care for kids, missing a holiday, stopping sport/exercise, and so on).
      • Virus/illness results in an increase in Sympathetic Nervous System (SNS) activity (the fight & flight stress response). It is important that we implement tools to help us reduce SNS drive & move us over to the rest & recovery side of our nervous system, the Parasympathetic Nervous System (PNS).

Poor Sleep/Temperature Dysregulation:

1. 1. • We all know that sleep can be majorly disrupted when we are unwell with a virus. Too hot, too cold, nights sweats, headaches, irritability/restlessness, body aches, and so on.
      • These sleep disruptions (among other things) can be a result of the immune response and the increase in SNS activity we experience when unwell with a virus.
      • We also know that sleep is critical in recovering from a virus or illness and is often hard to manage.

Feelings of Guilt:

1. 1. • We’ve all felt the guilt that comes with being cooped up at home with a virus, while the world around seemingly moves along without us. 
      • “I’m not adding value”. “I’m not achieving anything”. “I’m getting left behind”. “I should be more productive”.
        

Isolation:

1. 1. • Being stuck at home & unwell for days/weeks can be isolating for many people, particularly those with more extroverted personalities who get their energy & joy from being around other people and interacting regularly.
      1. • We have felt this even more over the period of The Pandemic due to quarantine periods and forced isolation from our beloved family & friends.
         • Isolation is an emotional stressor and can further contribute to how unwell we feel & how well/quickly we recover.

The Solutions

(these match the “Challenges” numbered above):

Gentle Conditioning (Balanced With Rest):

1. 1. • It is ideal if we can balance rest & recovery with some gentle conditioning while we are recovering from a virus. Some examples may include:
        1. Light walking (even in the garden).
        2. Deep breathing exercises (for example, inhale through your nose for a count of 4, then exhale through your mouth for a count of 4). This can be performed in lying, sitting or standing to help increase oxygen consumption.
        3. Calf raises to increase muscle oxygen consumption & activate the lower limb muscle pump (important in maintaining blood pressure).
        4. Some light stair work (e.g. step-ups).
        5. More time spent in a vertical position to ensure blood pressure mechanisms are maintained (at least to a degree – mixed with recumbent rest of course). E.g. standing & doing some calf raises while waiting for your microwave meal or hot drink (using the kitchen bench for balance).
        6. Some light resistance exercise can be helpful in activating muscles (and increasing related oxygen consumption & RBC production) to stabilise our blood pressure.
           • Calf raises, squats, lunges, sit-to-stand & leg extensions in sitting are all simple examples of gentle resistance exercises we can do once we feel up to it.

• NB: There may be some days where it is hard to get out of bed, that is fine and completely normal! Listen to your body on these days and respect your needs. If you are experiencing a fever, chest pain or shortness of breath at rest, please note it is not recommended to commence exercises at this time.
  

Hydration (+ Electrolytes) & Nutrition:

1. 1. • NB: Does KIC have an electrolyte partner they could name e.g. Hydralyte etc. or a KIC product?.
      1. 1. • Adequate hydration is critical in recovering from a virus & ensuring maintenance of blood volume & blood pressure.
            • Research has shown that 1L of water prior to midday & 1L over the rest of the day is the best approach for hydration.
            • Blood pressure is lowest in the morning after being recumbent & immobile for 8 hours (while sleeping) so it is often helpful to consume a “bolus”/large glass of water upon waking to kickstart our blood pressure regulation & reduce morning dizziness & fatigue.
            • In addition to hydration & electrolytes, feel free to add a little additional salt to your diet to assist in increasing blood volume while you are unwell (please note this is not appropriate for those with high blood pressure conditions).
            • To ensure adequate nutrition & to reduce stress, it is worthwhile considering support packs from family, pre-made meals & snacks, smoothies etc. (NB: does KIC have a pre-made food partner like YouFoodz or My Muscle Chef etc. or any KIC products to recommend here ?).
            • Research suggests certain nutrients (particularly Vitamin C, Vitamin D and Zinc) can improve your immune function. You can get these through consuming plant and whole foods, so try and incorporate nutrient dense meals where possible. Resist the urge to order those fries from UberEats!

Relaxation Therapies

1. 1. • If possible, it is best to reduce SNS drive (the fight or flight response) that is more active during a virus & move us over to the rest & recovery side of our nervous system (the Parasympathic Nervous System).
      • Relaxation is different for everyone but might involve things like meditation (see KIC App), listening to music or a podcast, reading a book, deep breathing exercises, or simply watching your favourite Netflix show.
      • Take this time to do some things that YOU want to do. Rejuvenate, switch-off, and re-calibrate. Treat rest & relaxation just like any other treatment you are implementing to recover from illness. Remember, your body is busy fighting a virus, which means it is diverting energy and resources elsewhere! Park the guilt and give yourself some grace, it will help your recovery!

Sleep Hygiene

1. 1. • We know that sleep is critical in recovery from a virus/illness.
      • Best practice is to implement some basic sleep hygiene tools such as:
        1. Calm, dark, relaxing environment for sleeping. Some warm light such as lamps & candles are also helpful.
        2. Optimal sleeping temp is 17-18 degrees for most of us. We may overheat or have a fever (hot/cold) when we have a virus so having additional rugs and blankets available to pull on or off is helpful, rather than sleeping in a hot, stuffy room (from blasting the heating). Having a cool shower in the evening can also be helpful to reduce our core body temperature before hopping into bed.
        3. Doing 5 minutes of deep breathing or meditation prior to sleep can be helpful.
        4. We’re all sick & tired of hearing this one, but limiting our screen time in the 60 minutes prior to sleep can be beneficial. Try reading, journaling (the KIC x MiGoals Journal is my personal favourite for this!), or even play a game or do a puzzle at this time instead. Perhaps swap from your phone to a TV that is less harsh and further away if you’re really craving the screen time.

Don’t Be So Hard On Yourself

1. 1. • Feeling guilty that you are not at work, not adding value, not doing your usual movement/exercise or canceling commitments with friends & family only acts to increase your stress response. This in turn will prolong your recovery and negatively impact your mental health. We are so programmed to always be ‘on’ & responsive, this can sometimes be hard to counteract.
      • “I’m not adding value”. “I’m not achieving”. “I’m getting left behind”. “I’m not productive”.
      • Most of these thoughts are ‘stories we are telling ourselves’ & are not rooted in reality (and they just make us more stressed).
      • Being unwell is our chance to shut out some of the noise & focus on ourselves (rest & recuperation).
      • The main tool here is being aware of these thoughts (if they are relevant to you), shifting our mindset, and challenging our own thoughts & beliefs.

Staying Connected (Isolation):

1. 1. • Being unwell at home for days/weeks can be isolating for many people.
      • To ensure you are feeling connected & well supported (on your terms) try to stay in touch with friends & family through video chats, online communications, group chats & so on.
      • If you would prefer to simply tune out & focus on your recovery, that is also fine.
      • Maybe you could also suggest to your employer that you return to work in a WFH capacity for a few days while you completely recover to get reconnected with your network (if you would like to transition back to work sooner than what might be appropriate for you in an office setting). Remember though, this is your time to rest & recover so it is personal preference how you approach things.

Most importantly, please be patient and kind to yourself. Recovery takes time!