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Long Covid Recovery - by Robin McNelis

September 12, 2021

Long Covid Recovery - by Robin McNelis

I took up running in 1999 when I got a job as a Cardiac and Respiratory Physiotherapist, completing in my first marathon in London 2001 (3.36 aged 28) then doing every London until 2019 through the Good for Age entry system. Like many athletes, my times started to slow as I approached 40, so I changed my training, used breathing techniques to optimise my performance and started using Elivar products with great success.  This fuelled me to a series of post-40 PBs including my best marathon times of 2.48 (2014 & 2016) and 2.49 in 2019 aged 46.

2020 proved to be a different year for us all!  On March 15th I completed the Brentwood Half Marathon in 1.24 just as Covid-19 was emerging.  I was in good shape and like many people thought if I were unlucky enough to contract the virus, I would be in a good place to fight it off with minimal effects.  A week later we were all screened at work and I tested positive despite having no fever or cough, just fatigue and headaches.  A few days after that I was struggling with the stairs at home, so a considerable drop in physical ability.

Eventually I swabbed negative and was allowed to return to work, but I just didn’t feel right so I pushed for tests.  I was able to run slowly but was not getting the normal reactions to exercise which I related to my consultant.  It turns out that I had a pulmonary embolism (blood clot on my lung) and then pericarditis (inflammation around my heart).  Having been treated for these with medications, I was allowed to return to gentle running by late June 2020 – 5k in 30 mins rather than 20miles at 7min/mile seemed gentle, how wrong was I!

By August I was unable to run because of breathlessness and worsening fatigue so had a full review including blood tests, heart and lung scans and lung function tests – all of which were normal.  I was then diagnosed with Chronic Fatigue, one of the emerging presentations of what is now called Long Covid.  Disappointingly I was told there was no magic cure, no quick fix. The way forward was going to take a long time and involve lifestyle changes and crucially I had to minimise Physical, Cognitive and Emotional exertion.

The irony was not lost on me that I had been prescribing and promoting exercise for most of my career and now I had been diagnosed with one of the few conditions that exercise makes worse.  I set about planning and pacing all activities in my day, optimising sleep and trying to do gentle forms of exercise that would not have a detrimental effect on flaring up my symptoms, so Qigong and walking at 2-3mph on the flat it was.

Another key component was optimising hydration and nutrition.  Like many people with fatigue, I realised that I had increased my sugar and caffeine intake which was giving short term gains but making things worse in lots of ways overall, so I looked for alternatives.  As a typical marathon runner, I looked towards things that had helped me when competing so replaced sugary foods, tea and diet coke with Elivar Endure mid-afternoon as energy levels started to flag.  One thing we do know about conditions like this is that foods that cause spikes in blood sugars bring you crashing down with a bang, so Endure’s formulation to optimise slow release of energy worked really well.

When being diagnosed with Chronic Fatigue, my consultant had warned against using alternative/complimentary therapies as first line treatments before I had employed all the lifestyle management techniques to establish a sustainable baseline at which I could live without symptom exacerbations.  Once this had been achieved, I was recommended some supplements that, although not backed with strict scientific studies, had shown benefit anecdotally with many patients suffering other fatigue conditions.  One of these was co-enzyme Q-10 so the natural place for me to source this was Ubiquinol Plus and Sustain Plus by Elivar.  Since the symptoms of Long covid are variable and open to multiple trigger factors, I was recommended that any supplement I try:

  • be done so in isolation,
  • be tried for at least 3 months.
  • be paused for 1 month to see any impact that may have on symptoms.

Having followed this plan I can report that I am definitely better when I am taking Ubiquinol Plus and Sustain Plus and seems to have complemented the lifestyle changes I have made.

Overall, things are now (July 2021) heading in the right direction and although I am not back running yet, I am walking at considerably faster paces over longer distances than I have since September 2020.  It became obvious to me that the heart rate that my lactate threshold was hit had dropped significantly, way more than you would expect just by inactivity.  This was confirmed on exercise testing which was devised by myself and CP&R of Harley Street to determine my Lactate Threshold Heart Rate and keep below this level as much as possible through the day to promote recovery and prevent further damage to whichever mechanism was causing symptoms.  I am delighted to report that initial findings on my results and others have shown an improvement in Lactate Threshold Heart Rate by increasing volume of activity whilst keeping intensity (heart rate) low.  The exact mechanism for this is currently unclear but when conventional training methods aren’t working, it’s always worth trying something new.

Robin McNelis is a Clinical Specialist Physiotherapist (Cardiac and Respiratory) at The Wellington Hospital, London.  Before Covid-19 he had completed 30 marathons and one Ultra (50K) and is a qualified athletics coach.






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