I consider myself a COVID long-hauler.
“Aren’t we all?” you might ask.
Of course, the answer to that is yes. We have all been through isolation for a year, and now, re-entry (which I’m finding is harder for me, but that’s another story altogether). The last half of my long-haul with this pandemic is how I actually got COVID-19.
I should not have gotten COVID-19. I am healthy. I was exercising outdoors regularly and eating well. I had a daily meditation practice. My family stayed fairly tightly locked up during 2020. I am a health care provider, my husband is a scientist, and we took precautions seriously. Our son went to brick-and-mortar school, but was masked, and we felt safe with their procedures. We would occasionally socialize with 2-4 people on the beach, socially distanced.
In September, I found myself with a high level of work-related stress. I was reconfiguring my business model, trying to decide if I could keep my practice open. I was not sleeping well (super unusual for me, therefore a huge warning sign). I had A LOT of mom and wife guilt related to how much I was working. By that point, I had been without hot yoga in a studio for 5 months (significantly decreased sweating, a great way to heal the body). I was having a glass of wine more nights of the week than I thought was healthy. I had gotten so busy that my workouts had cut down from 50-60 minutes to 20-30 if I was lucky. I got up at 5am each day so I could exercise and practice meditation, but instead would work through the time.
My son had been going to a karate class. There were only 6-8 kids, and they each had their own 6×6 mat and punching bag. The class was in the county next door, and that county did not have a mask mandate. I was one of the only parents who would wear one. My husband was wary. The second wave of kids went back to brick-and-mortar school in early October, and by the time COVID ran through the karate studio, the class size had increased to about 16. The only thing I can figure out is that I must have had droplet exposure via eyes, or I touched my nose or eyes while taking off my mask outside prior to the usual hand sanitizing we did after class. 5 days later, I lost my sense of taste and smell. I quickly isolated from the family, and no one else got sick. I felt very tired and “foggy,” but fortunately had a mild course of the virus. I was able to work through my isolation doing telemedicine (silly girl, I should have rested). I binge watched “Schitt’s Creek” at night and took pretty good care of myself for the first time in a couple of months. I had survived. I went right back to pre-COVID living. Sigh.
I think we all have health cups. The cups have release valves. Usually, the release valves work well, and our cups don’t overflow. But sometimes the release valves get clogged. Really great sludge-makers are poor sleep, poor diet, lack of exercise, emotional stress, physical stress from acute illness or trauma (and treatments). We all start out with some clog in the valve from genetics and epigenetics. Healthy living, in most, allows us to continue to eliminate, detoxify and process environmental stressors, psychological stressors, illness, etc. Until it doesn’t work, and the cup starts to overflow.
Which brings me to my pile of books. I have a pile of books that I don’t necessarily read in consecutive order of the pile. Last year, I was gifted a book by a friend who lives with MS. She’s a rockstar cardiologist and all around awesome, intuitive soul on a cool healing journey. I appreciate the information she sends me. I was on a different subject train, so I put that book at the bottom of the pile. It came back up to the top of the rotation last month. I re-read the table of contents, and given the current environment, started reading “The Angel and the Assassin: The Tiny Brain Cell that Changed the Course of Medicine” by Donna Jackson Nakazawa.
To say that my jaw was dropped open for the entirety of the book was an understatement. To say that I actually had a full week during which I questioned whether or not I was doing the right work and started looking at neuroscience PhD programs is the truth. Nakazawa actually mentions being surprised we have not had a modern-day pandemic…and the book was published in early 2020.
Have you heard of microglia? They are clean-up cells, scavengers, of the central nervous system. They “hear” signals from our guts and our immune system. And sometimes, they clean up the wrong things.
The book is how I got turned on to the fasting-mimicking diet again. I had read about it and its effects in MS mouse models, but dismissed it because I’m not a fan of recommending “potions and powders” and the study in humans was small. More to come on that in later blogs.
My husband and son got COVID-19 in early January. It was then that I really began to worry about my physical health beyond, “it must just be from COVID but it’s getting better.” Since my own stint with it, I had remained with cognitive disturbance. I had a significantly hard time with word recall and multi-tasking. I am usually the queen of multi-tasking. Suddenly, doing more than one thing at a time sent me into a panic. I was forgetful. I mixed up some appointments. If I was anxious, it was all worse (of course). It was getting better until January. It seemed to come roaring back when they had COVID-19, and with it, GI issues. I haven’t had GI issues since graduate school, and I suddenly felt like an IBS-Mess, sometimes gaining a pant size between morning and bedtime. After each COVID vaccination, I had such severe abdominal pain that I was brought to my knees. It seemed each time I was exposed to COVID in some way, my body was overreacting…or inappropriately reacting.
The month of January without wine did not help much. My cognitive issues remained, albeit less severe as we got into 2021. My belly issues got worse. I put myself on a low FODMAP diet, which helped a little bit. I looked forward to getting back to Bikram yoga classes and started thinking about infrared sauna appointments. My mood was pretty low. Snappy or tearful at the flip of a switch, and otherwise, as my friend says, like “Flat Stanley.” A couple of times, I just put myself to bed because I couldn’t stand to be awake anymore.
What the hell was going on??
I read more and more about what is now called Post-Acute Sequelae of COVID, or Long Haul COVID, and drudgingly realized that was the problem. The problem hung around because I had yet to: return to regular meditation practice, reduce my stress levels, get back to a healthy and sweaty exercise program, play outside, REALLY clean up my eating, etc.
The 2 things that turned me around were reading “The Angel and the Assassin,” which provided better understanding of what was happening in my nervous system, and going to Costa Rica, where I spent a week mostly outside and truly resting.
I looked to Easter for my own resurrection. I realized that the healthiest behaviors I had were during my COVID-19 isolation. 20-30 minutes of meditation, acupressure, and tapping each day. 30-60 minutes of gentle exercise, either stretching, yoga, or calisthenics, with one virtual Bikram class thrown in that week. Either a smoothie (with vegan protein, chia, turmeric, ginger, cinnamon, and fruit) or oatmeal with chia, fruit and nuts for breakfast; homemade chicken bone broth soup with veggies and rice for lunch; a huge salad for dinner. Lots of water and tea. 8-10 hours of sleep each night.
I decided to make myself an “n of 1” and do a PASC experiment. I would do the fasting-mimicking diet as outlined in their clinical trials, 5 days a month for 3 months, do pre- and post- cognitive testing, eliminate weekday alcohol and limit weekend consumption, get back to Bikram, spend more time exercising outside, and revamp my daily meditation program. I needed my release valve back in order.
Here begins my 3-month journey, the prologue being the longest read (I promise).
April 8, 2021:
Fortunately, I have access to some sophisticated testing because of my work. I did a WAVi EEG with testing usually used for people with concussion. My brain age tested well, 29 (I am 45 ½). My brain waves, however, showed that I had some significant anxiety and depression. As a clinician, I understand the effects these problems can have on cognition as well as GI issues, and vice versa. My colleague and friend, Z, had a heart-to-heart talk with me about the mood stuff. He said I really had to make it a priority to get back into mindfulness work and stress reduction. He mirrored to me what I tell my patients and demonstrate to them daily.
I reached out to L-Nutra, the company that promotes the fasting-mimicking diet for “regenerative and rejuvenating changes” and set up an account as a health care provider. I purchased my first 5-day ProLon kit*. In sharing with one of my closest friends, I learned that she had done one cycle of this and was about to start her second. We decided to do it in concert.
I received my kit and read the directions, wondering how I would go without much exercise for 5 days, which is the recommendation. There are other no-no’s that are important to follow. When one follows a restricted calorie diet like this, one needs to be careful about physical activity. Too much can cause your body to go into an overly stressed state, negating the positive effects of the fasting state. I organized my thoughts for the week, taking out Day 1’s box and thinking, what have I come to? I looked at each package. The ingredients were organic, some imported from Spain and Italy. The teas smelled lovely. I had to look at this as medicine, not food.
April 19: ProLon Day 1
I decided to sleep instead of getting up early and doing gentle exercise. I ate at 10:30AM for the first time. It is now 7:20PM, and as I enter into my soup, I am feeling a little jittery and flaky as I smell my family’s dinner. The lunch soup was satisfying, so I’m assuming this one will be, too. I still have a snack and some tea left. Not so bad today.
Wooooooooaaaahhhh. Woke up feeling light. By noon was feeling flaky and a little “buzzy.” I checked in with my friend around 2PM and learned I should have been drinking the “L-drink” throughout the day. Based on its placement on the postcard, I thought I was supposed to drink it at night. Once I had some, I felt better. Still feeling pretty hungry, and another day goes by that I am glad I did not exercise. My brain feels “hard to steady.” I have so many things to do, but I know I can’t focus to do them right now. I look at this as a lesson in scheduling for the next 5-day fast in a month. That in and of itself makes me look forward to it. It also allows me to let go of some tasks this week and slow down.
Couldn’t sleep last night. Anxious. Heart anxious. Woke up anxious. Had coffee (~1/4 cup) that felt warm in my belly, but felt shakier until I ate the morning L-bar. Had a meeting at 11:15a, and my colleague asked how I was doing and I started to cry. Emotional. The box had the least calories today. I was able to teach yoga and move my body a bit. I felt better. Still not falling asleep well, though. Why?
Whew! Much better. Hungry when I woke up, but then felt better. Day was fine and was actually surprised at lunchtime because I wasn’t hungry. I had 2 bags of olives in my kit, so sort of felt like I had one the lottery. Feeling a LITTLE more clear mentally and very light in my body. I’m not going to lie, I was really interested in a Chipotle commercial last night, and usually I don’t even notice food ads. I did a gentle ½ mile jog and some strength training of mild intensity to release some energy and it actually felt good. I felt an uptick in my mood that reminded me the “old me” was still in there somewhere. As the night approached, I started to get nervous about sleep. I have thought it odd that I have significantly cut down my caffeine consumption this week (from 3 cups during the day to about 1 ½ ) and can’t fall asleep. As I was making the last cup of tea from the box around 8PM, it dawned on me that I recommend spearmint for energy and focus. Duh. Instead, I made my Yogi Tea Stress Relief and Detox teas. Slept like a baby.
The second day of the lowest calories, but I knew I could do it. I had a good day at work planned with various activities outside the norm to provide distraction. I did a 6AM yoga class gently and intentionally. By bedtime, my stomach was growling. I woke up in the middle of the night hungry.
Today I plan to follow the transition day recommendations. I have a lightness in my mind and mood that I have not had in quite some time. Let’s just say it’s more sunshine than thunderclouds. I’m looking forward to cooking a healthy dinner for my family tonight. It’s Saturday, and while there is lots to get done, no one will be devastated if my list does not get completed. This week I have had no: GI issues, headache, dizziness, joint pain.
I’ll be writing about my recovery (yes, I am calling it that) along the way. Estimates about the number of people who will be affected by PASC are frightening in number. Chronic fatigue is already a problem, and experts are suggesting PASC as a cause of a similar syndrome that will affect a large proportion of our working population given the numbers infected, even those with mild illness. Conventional medicine will help. There are research groups forming, and some, like Mt. Sinai, are interested in integrative care. I believe that Integrative Medicine treatment, though, will be at the forefront of care of PASC. Because that is how I practice, I decided to become my own patient.
My release valve likely has some genetic and environmental clogs, but because I’m pretty in touch with Me, I know that the greatest one is stress. That is where my focus will be for weeks in between the next two ProLon protocols.
Now, I will go for a walk outside after I spend some time in meditation.
Ride along with me to see how my care plan works, and please share this journey with others. I am more than happy to discuss my “why” and “how” with you.
*This diet is not recommended for people with serious medical conditions unless authorized by a healthcare professional appropriately trained and licensed to treat these conditions. It is also not recommended for people with certain food allergies, those who are pregnant or breastfeeding, have dietary restrictions, signs of active infection, or are malnourished or underweight.
ProLon is not intended to diagnose, treat, cure or prevent any disease and has not been evaluated as such by the FDA.