Recovery from Coronavirus - A doctor's advice

Three Pillars of Looking after Your Wellbeing

Different people would have different experiences during and after Covid19 illness. Making full recovery from Coronavirus takes time. This applies to both who were admitted to the hospital and who stayed at home.

The length of time to recover will vary from person to person and it is important not to compare yourself to others. People from different age groups, from different ethnicity, having different medical problems would have a different course through the illness. Ongoing symptoms could last for several months after you contract COVID-19, and this can be perfectly normal.

Here we would discuss the 3 things that you can do to help yourself to hasten your recovery. You might need to continue seeing and be advised by your health professional depending on your needs and you should seek their help if you feel your recovery is too slow and you have some particular worries.

Every person, their experience and their health issues are different. You might have none, some or all the post Covid-19 health related issues. These could include the following though this list is not exhaustive.

Post-COVID-19 effects could include -

  • Muscle weakness and joint stiffness
  • Extreme tiredness (fatigue) and a lack of energy
  • Loss of appetite and weight loss
  • Sleep problems
  • Problems with mental abilities – for example, not being able to remember some events, think clearly and being forgetful
  • Changes in your mood, or anxiety or depression
  • Nightmares or flashbacks
  • Post-traumatic stress disorder (PTSD)

Three Pillars of Looking after Yourself after Covid19 Illness

  • Eating well
  • Sleeping well
  • Exercising and Getting Moving Again

 

All three are all very important on the road to recovery. Let us dive deep into each one of them one by one.

Eating Well

Why is it important to eat well after being diagnosed with COVID?

Eating well is important as your body needs energy, protein, vitamins and minerals to help you recover. Having a good intake of protein and energy rich foods supports you with rebuilding muscles, maintaining your immune system and increasing your energy levels to allow you to do your usual activities.

A healthy immune system likes to be in balance. Food can support its ‘normal’ or ‘ideal’ functioning. An immune system which is overactive, can actually lead to problems such as allergies or autoimmune conditions.

A good diet is important for good health. Eating a variety of foods can improve general wellbeing, reduce the risk of conditions including heart disease, stroke, some cancers, diabetes and osteoporosis (thin bones) and help you manage your weight. You need to eat sensibly, choosing a varied diet from a range of foods, not smoking, reducing alcohol intake and keeping active are all great ways to boost your health.

Luckily for us, food-by nature - is handily packaged with mixtures of different nutrients to support a healthy immune system. Eating a variety of different foods helps the body get everything it needs from our diet.

If you are self-isolating and especially if you have symptoms, it is very important to maintain good nutrition and hydration. Make sure you are eating and drinking regularly, even if you have low appetite.

You need to decide which is best for you in your recovery

Follow ‘Healthy Eating’ advice if you are thinking:

“I’m really enjoying my food and have a healthy weight”

“I’m overweight or obese and have a good appetite”

“I’m a normal weight, overweight or obese and I’m eating large portions and gaining weight”

Follow ‘Nutrition Support’ advice if you are thinking:

"I’m really struggling to eat and have no appetite”

“I’ve lost weight and I’m concerned about this”

“I’m overweight or obese but I’m still lacking appetite”

“I’m overweight or obese and I’m struggling to eat and losing weight”

“I’m underweight despite my good appetite”

Healthy Eating

Fruit and Vegetables

Fruit and vegetables are important for vitamins and dietary fibre. You should aim for at least 5 portions each day. These can be fresh, frozen, dried or tinned (avoid those in syrup). It is worth remembering that there should be a wide variety- some root vegetables, some above ground, some stems, some green leaves, some florets, having different colours and cooked differently, some steamed, some boiled, some sauteed and some cooked traditionally. Examples:

  • 1 portion = approximately 1 handful of fruit
  • 1 apple
  • 3 tablespoons cooked vegetables
  • 1 cereal bowl of salad
  • Approx. 1 tablespoon of dried fruit
  • 125ml (4 fl oz) fresh fruit juice

Starchy Carbohydrates

You should aim to have a starchy carbohydrate at each meal. Examples:

  • Bread (2x slices, wholemeal where possible)
  • Rice (1 portion = 2-3 tablespoons cooked rice)
  • Pasta (1 portion = 2-3 tablespoons cooked pasta)
  • Potatoes (2-3 egg-sized or a small-medium jacket potato)

Protein

Protein is important to help with muscle strength and tissue repair. Examples:

  • A palm sized piece of red meat
  • A hand size piece of fish or chicken (if only fish to have 2 portions per week one of which is to be an oily fish)
  • ½ can of beans or pulses
  • 2 eggs

Dairy/dairy alternatives

This is an important source of calcium, protein and energy. You should aim for 2-3 portions per day. Examples:

  • 150g pot of yoghurt
  • ½ pint of milk/dairy alternative kinds of milk i.e., almond/oat/soya milk
  • Small matchbox size of cheese

Oil and spreads

These foods should make up the smallest proportion of your diet. Keep to small amounts of oils and spreads and measure out how much you use. Examples:

  • One teaspoon of oil
  • Try to choose low-fat spreads and use a small amount (5g)
  • Limit fried fast foods and processed meat products such as sausages and pies
  • Aim for no added salt in cooking or at the table, use spices and herbs for flavour instead.

Reduce fat, salt and sugar

Foods high in fat, salt and sugars are not needed in the diet, so if you do choose to include them then try to have them less often and in smaller amounts. If you choose a variety of foods from the groups, you can easily achieve this healthy balance.

Nutrition Support

Often after an illness, you can have a small appetite, or you can feel full more quickly. You may feel as though your stomach has shrunk and you don't have room for the same amount of food that you used to have before being admitted to hospital. This is normal and you can get back to your normal appetite and improve your dietary intake by doing the following:

Add extra energy by adding high calorie ingredients to food and drinks –

Add cheese to

  • Sauces (aim for milky/creamy sauces)
  • Pasta dishes/pizza
  • Soups
  • Scrambled egg/omelettes
  • Mashed potatoes
  • Beans on toast
  • Vegetables

Add Skimmed Milk Powder to

  • Milk: add four tablespoons of skimmed milk powder to each pint of full fat milk and use this in drinks, with breakfast cereals, and in cooking the following
  • Porridge
  • Mashed potato
  • Sauces
  • Custard
  • Milk puddings
  • Creamy soups
  • Milkshakes/smoothies

Add sugar, jam or honey to

  • Cereal or porridge
  • Puddings
  • Hot drinks
  • Milkshakes/smoothies
  • Glaze vegetables

Add ground almonds or nut butter to

  • Porridge
  • Vegetable soups
  • Sauces
  • Smoothies

Other high energy and protein foods include:

  • Cheese and crackers
  • Thick and creamy yoghurt
  • Pot of custard or rice pudding
  • Nuts and seeds
  • Cereal bar or flapjack
  • Mini pork pie, sausage roll or scotch egg
  • Chocolate

Vitamin D

Vitamin D can be found in some foods including fortified foods; however, it is recommended that everyone take a Vitamin D supplement, especially during autumn and winter. Vitamin D supplements can be purchased from your local pharmacy or supermarket.

Taste Changes

Some people experience a change in taste and smell ranging from a bland taste to a metallic or salty taste. To help manage this:

  • Avoid having very spicy/hot foods
  • Use plastic cutlery to reduce the metallic taste
  • Ensure to brush your teeth and tongue twice daily – avoids the build-up of plaque which can worsen the effects of taste changes
  • Regular sips of non-fizzy drinks throughout the day

Mindful Eating

Mindfulness is being aware of the experiences presenting themselves to you. It means paying full attention to the unfolding moment, without judgement, and accepting what it is. This may help you to consider your thoughts, physical sensations and behaviours without reacting automatically.

Mindfulness can help you fully enjoy a meal and the experience of eating — with moderation and restraint.

It means knowing what you are eating, knowing where it comes from, how it is cooked, what should it look like, what should it taste like, how should it be eaten and while eating be with the food and not away sorting the rest of your life. Make eating a pleasure and one of the most important things you are going to do today.

If you can pay the same attention to your food as you would to other parts of your life you are already halfway to the success.

Sleeping Well

Many people recovering from COVID notice that their sleep has changed when compared to their sleep before they became unwell. Some people find it difficult to fall asleep or stay asleep, and others find they wake up earlier than usual and can’t get back to sleep. There are many reasons why your sleep may have changed as a result of COVID.

Going through the illness, being away from the family and loved ones, in a busy noisy strange place, being afraid what might happen, continuation of some symptoms like being in pain, being breathless, feeling nausea, loss of appetite can all effect your life and sleep pattern and slow down your recovery

There are various things you can do to help yourself to improve your sleep. Paying attention to sleep hygiene is one of the most straightforward ways that you can set yourself up for better sleep.

What is sleep hygiene-

Keeping good sleeping habits sometimes known as “sleep hygiene”) can help you get a good night’s sleep. There are things you should do and there are things you shouldn’t if you want to improve your sleep hygiene and thus sleep.

Do:

  • Do try to go to bed about the same time each night and try to get up at the same time each morning
  • Get regular exercise each day, preferably in the morning and by early afternoon. This helps to maintain a good life rhythm
  • Try to be in the sun and sunlight for part of the day as it helps body to recognise day and night and help in maintaining a rhythm.
  • Keep the temperature in your bedroom comfortable
  • Keep the bedroom dark enough to facilitate sleep in long summer days. This again helps to maintain a rhythm.
  • Keep the bedroom quiet and do everything to maintain this around your sleeping time
  • Use your bed only for sleep and intimacy
  • Use a relaxation exercise just before going to sleep or a relaxation tape or listen to light music.
  • Try muscle relaxation to help distress and unwind, e.g., a warm bath or a massage

Don't:

  • Don’t do any heavy exercise just before going to bed
  • Don’t engage in stimulating activity just before bed, such as playing computer games, watching an exciting or heart-breaking television programme or involve yourself in arguments or big decisions. (The word can wait for you to get up!)
  • Don’t have caffeine in the evening (coffee, teas, chocolate, etc.)
  • Don’t have excessive alcohol in the evening or use alcohol to sleep (excess would make you drowsy but it doesn’t improve sleep and might wake you up to go to the toilet)
  • Never ever smoke but if you do, don’t smoke before going to bed – nicotine is a stimulant and will keep you awake
  • Try not to make a habit of watching television in bed, do something less stimulating like reading few pages of your favourite book or listen to your favourite music
  • Do not go to bed too hungry or too full. Have something you love to drink like hot milk or Ovaltine
  • Never take another person's sleeping pills
  • Don’t take long naps or naps in the evening as it would disturb your sleeping pattern.
  • Don’t command yourself to go to sleep. This only makes your mind and body more alert disturbing your sleep.
  • If you lie in bed awake for more than 20-30 minutes, get up, do something different and come back to bed when you feel sleepy

If you still have problems, then it would be worthwhile to discuss this with your health care professional so that they can continue to monitor you and take further steps if necessary.

Exercising- Getting Moving Again

After being in hospital for a period of time, your muscles will be much weaker and wasted and you will certainly be less fit than you were when went in. Being is bed, not properly eating, loss of appetite, going through major operations or procedures might have made you lose weight and thus your muscle mass.

It is important to get back to your previous level of activity or possibly aim for it and to be more active!

  • By being active and starting some exercise you become stronger and fitter. You may notice your tiredness increase and some breathlessness at first, but these should improve the stronger you get; this is a normal response to doing more exercise for all of us.
  • You will feel better in yourself and can do more of the things that are important to you.
  • Regular activity will help to minimise pain and stiffness in joints and will help you regain muscle strength.
  • Being active during the day may help you sleep better.
  • Over time regular exercise will help you manage chronic conditions such as heart disease and diabetes

The more time spent being physically active, the greater the health benefits.

Article By - Dr. Paramjit Singh - I have worked as a medical doctor in England for over 40 years. My philosophy has always been to get the best advice I can get for my patients and pass it on to them to improve their wellbeing. Sometimes this advice is based on my own experience, other times I take it from a book, some comes from ever changing medical guidelines, some from articles written by other doctors and sometime from medical websites.

Reference Links -

https://www.yourcovidrecovery.nhs.uk/your-wellbeing/family-friends-and-carers/

https://www.bda.uk.com/uploads/assets/6a95644d-f8a1-4103-b934da36a7d2c9e8/Homerton-COVID19-Eating-drinking-on-recovery.pdf

https://www.bda.uk.com/resource/healthy-eating.html

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