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At our clinic (Jersey Sports and Spinal) we are seeing runners who cannot train as hard, get dizzy for 10 to 15 minutes after moving quickly between standing and lying or turning their head rapidly. We have previously unaffected clients now reporting debilitating headaches and associated dizziness.
We have seen post-op patients develop crushing fatigue after developing covid in hospital and clients who have to sleep after reading half a page of a book.
We have seen previously fit and able people struggle to get out of bed before 11:00 and who have had to change their whole office or university working patterns.
We have clients who are just plain exhausted and can’t even get in and out of a chair easily or manage the stairs at home in one go but then can’t sleep and don’t know why they feel like this.
Perhaps you are suffering from long covid.
If you have had covid and recovered quickly, have you been left with dizziness, blurred vision, memory loss and concentration issue (aka brain fog), fatigue, muscle or joint pains, shortness of breath or headaches?
These are just some of the symptoms that may still plague you after you test negative on your lateral flow.
So why talk about covid? Isn't it all over? No it isn't. We know that people have sadly died from covid-related symptoms. We have heard all about "small" group of people developing long covid. But what about the other group, those in-betweeners, who have developed covid and "recovered" and still have long covid symptoms.
Is this you? Don't despair. There are rational reasons and ways you can help yourself.
When I travelled to London the other day. I confess I felt some confusion when I walked into the airport. The mask-wearing signs are up and the staff all wore masks but you would be forgiven for thinking that masks are no longer necessary for air travel. And it seems you are right.
They aren't needed on some UK journeys. I'd say less than a third of people in the airport and plane wore masks. That's not a lot considering that we have had two years of constant reminders to build up a habit. I understand that for many others, they are completely over covid. The fact that most people are vaccinated and therefore left (relatively) unaffected by a short period of illness or the inconvenience of having to work from home for one to two weeks whilst they are isolating is helping this groundswell of feeling.
Working as I do in a medical environment, I haven't yet felt the benefit in the relaxation of the rules. Gloves gowns and masks are still the de-facto uniform of the day. Honestly, I think that when masks come off, I will struggle to recognise some of my clients!
Pictured: Nigel Mann, a Physiotherapist and Certified Modified Pilates Instructor at Jersey Sports and Spinal Clinic, says medical wear is still part of his day-to-day.
Still, in Jersey, the way we deal with covid is gradually changing. This month was supposed to mark a significant shift in our relationship with covid. However, in the news last week was the announcement that, as numbers are on the rise again, this will be understandably delayed.
For many, the symptoms of covid are mild; a cold and headache for a few days and a loss of taste or smell that quickly returns. Instead, I want to highlight the plight of those who have recovered fully and returned to normal life and are NOT normal.
This is the misunderstood and 'forgotten' group, mainly because we are still coming to terms with the effects of the virus.
It usually takes 15 to 20 years for new ideas to fully seep out into medical practice and covid marks a milestone in co-operation and data sharing in medicine to stop the virus in its tracks.
Recent articles in The Guardian and Time magazine have compared the symptoms of long covid to ME, fibromyalgia, or chronic fatigue syndrome.
It is, in my opinion, a grossly under-researched area of incredibly debilitating illnesses that have far-reaching effects on an individuals' life. I have seen many clients with these symptoms in my 25 years of clinical practice and, in truth, the options for treatment have not changed much in this time.
The UK Office of National Statistics estimates that 2.4% of the UK population have symptoms lasting more than four weeks after recovering from covid. That's about 2500 people in Jersey based on 2019 population estimates.
Long covid sufferers can have up to 200 different symptoms. Classic symptoms include brain fog, extreme tiredness, shortness of breath, heart palpitations, chest pain or tightness and problems with memory and concentration.
There are a number of secondary symptoms considered to be symptoms of your nervous system, such as headaches, numbness or tingling, loss of taste or smell, bone and muscle aches, dizziness, blurred vision and tinnitus (ringing in the ears). These symptoms mimic a condition known as PoTS (Postural tachycardia syndrome).
One popular theory is that both the brain and the Vagus nerve are affected during covid.
The Vagus nerve is responsible for all sorts of things including regulating the heart and breathing rates, blood pressure and digestion. As it is not working as well as normal, dizziness and nausea are common. These appear to respond well using similar management strategies to treating PoTS although medical advice should be sought first.
One other theory is that there is inflammation (swelling) around major organs in the body during covid. In some people, even when you have recovered, the body continues to fight the virus even though it isn't there. Symptoms such as breathlessness and fatigue when walking or exercising and joint pains have been reported.
In addition, many people have reported other symptoms including; depression, anxiety, chest pain, insomnia, variation of heart rate and blood pressure and gastrointestinal complaints. These are thought to be a result of your immune system responding to the virus.
As a physiotherapist, I have had a long-term interest in headaches and conditions that affect the body e.g., hypermobility and rheumatoid arthritis. At the clinic, we are seeing an upswell of people reporting these symptoms post-covid and it is great to see that Jersey Hospital now has its own long covid clinic that you can be referred to by your GP.
To try and pin down one single cause may be impossible, but it is right to discuss your symptoms with your GP. There are lots of medications that can help short and longer-term issues. You may benefit from being referred to see a specialist by your GP to offer you more specific help. Remember that you can go directly to a physiotherapist without a GP referral but it is worth seeing your GP if you have other symptoms or concerns.
At the clinic, amongst other things, we are helping manage fatigue and breathlessness by adapting exercise and training programmes.
Avoid 'boom and bust'
Making a diary of your symptoms and working out when you feel most tired and how well you sleep, your naps and your caffeine intake can help.
Try pacing (spreading out) your more strenuous activities. This can really help. Watch out for the classic 'boom and bust' behaviour. Typically, this means that you do too much in one day and spend the next two or three days recovering from it and then do it all again. Or it may be that you do too much in the morning and end up needing to sleep all afternoon.
Physiotherapists can manage headaches and dizziness with hands-on treatment and advice. A theory in headaches and migraines sufferers is the link between the messages that come from the cranial nerves at the top of the neck and the intensity of headaches.
Both the Cranial and Vagus nerves talk to the brain via a fancy interface called the trigeminocervical nucleus (think of it as the volume controller dial on your phone). It is this that is thought to create headaches, facial pain and dizziness. The louder the volume the more intense the headache etc. Physiotherapy helps to turn down the volume.
I have no doubt that for the majority of us, getting and recovering from covid is just an inconvenience. For those that have issues, know that there is help out there. We know more than we did a year ago and the medical world is heavily invested in finding out what the long term issues are and how to help them.
If nothing else good comes from covid, then at least the recognition of and research into long-term chronic fatigue conditions and PoTS is good for all those out there all struggling to cope with invisible illnesses.
Long covid:
POTS:
Cervicogenic headaches:
