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Long-Haul COVID-19 Will Be With Us For The Long-Haul

January 16, 2022 By Deborah

woman sitting on floor near window

 

Viruses have a tremendous capacity to drive chronic disease and illness. COVID-19 is no exception. We now have several terms for the condition that causes lingering symptoms after recovering from SARS-CoV-2 or COVID-19 infection. You may know it as “long-term COVID”, “post-COVID syndrome” or “long-haulers”. The NIH (National Institutes of Health) refers to these symptoms as PASC, which stands for “post-acute sequelae of SARS-CoV-2”. This syndrome is getting more and more press, but I still don’t believe it’s getting enough attention. The amount of people that continue to get COVID-19 infections is staggering and is currently driven by the Omicron variant. The CDC’s summary as of January 16, 2022 reports over 800,000 new cases per day, more than doubling the January 2021 peak! The more cases…the more long-haul symptoms. And long-term COVID can occur with mild symptoms and at any age, gender or with no prior illness or health problems. What we know is that long-haul COVID-19 will be with us for the long-haul.

The reason I am harping on this matter is because I believe Long-Haul COVID will be the main health challenge for health care workers, families, our economy and the work force in decades to come. Post-COVID is a multi-system disease that includes physical, mental and emotional symptoms. There are some health care facilities that are addressing these symptoms as real and looking for causes to help treat patients. But others are brushing the symptoms off as being all in their head and “hysterical” reactions to the stress of the pandemic. After going though tens of thousands of dollars of tests, some people are just going home with an inhaler and being told the symptoms will probably “go away” and to give it some time. How frustrating is that?!!!

In a recent meta-analysis, researchers identified nearly 2000 studies that addressed persistent post-COVID symptoms. The 45 studies appropriate for analysis reviewed about 10,000 patients and 84 discrete symptoms. Nearly 3/4 of the patients reported at least 1 symptom that persisted for an average of 2-4 months and some symptoms as long as 6-8 months. The most common symptoms were fatigue (40%), shortness of breath (36%), anosmia or loss of sense of smell (24%), anxiety (22%), persistent cough (17%), ageusia or loss of sense of taste (16%), and depression (15%). So the facts are there, but without much guidance on specific treatments. And yes…you can develop post-COVID symptoms even if you have been fully vaccinated and received a booster!

Integrative medicine is the best solution to recognizing and treating post-COVID syndrome as we are seeing a significant response in improving symptoms and shortening the course of the illness. Integrative medicine prides itself in treating and helping patients when conventional medical therapies have failed. The NIH (National institute of Health) has recognized that integrative medicine can support recovery from post-COVID disease. Restoring homeostasis plays a key role in integrative medicine even when diseases have no clear treatment.

There is clear evidence (and thousands of studies) for selected integrative medicine approaches that can be used to combat inflammation, repair lung injury or dysfunction, replete nutritional deficiencies, reset autoimmune exacerbated conditions, reduce chronic stress and mitigate fatigue. A comprehensive approach combining oriental medicine, functional medicine, homeopathy, intravenous nutrient therapy, nutritional medicine and herbal medicine are introduced in providing healing support and effective treatment in recovering from COVID-19 infection. Individualizing care is essential as each persons symptoms are unique in their own way as well as their course of recovery.

Theories as to how COVID-19 causes long haul symptoms include:

  1. Persistent intermittent viremia causing inflammation resulting in lung, heart, pancreas, and liver end organ damage. Symptoms come and go of having recurring fever, chills, myalgia, fatigue and brain fog.
  2. Severe inflammation occurring outside the brain (in the lungs and elsewhere) signals through the blood-brain barrier that activates the brains immune system. SARS-CoV-2 can directly modulate human gene expression and the patterns seen in COVID-19 patients are similar to patterns seen in patients with neurodegenerative diseases (dementias and schizophrenia). Synaptic signaling are impaired in the excitatory neurons that are important in cognition. This can generate symptoms such as poor cognition, mood disorders, hallucinations and delusions.
  3. Triggers autoimmune reactions to various organs- more likely those who already have autoimmunity or undiagnosed gluten intolerance. It can attack the central nervous system and can re-activate (wake up) latent viruses such as herpes virus or Epstein Bar virus, leading to extreme fatigue.
  4. Wide spread microvascular damage causes micro-clots or endothelial dysfunction. This leads to ischemia, oxidative stress, and inflammation in the brain through the olfactory nerve (nose) where the virus can burrow into nerves and hide genetic material. These reservoirs or “anatomical sanctuaries” become the source of neuro-inflammation.
  5. The body fails to completely clear the virus which continues to cause an immune reaction where the immune system attacks healthy tissue, increasing allergies, mast cell activation, muscle and joint pain and re-activates other viruses.
  6. Neuropathic mechanisms such as autonomic denervation can cause failure of the vasculature of the lower extremities to maintain resistance while in an upright position leading to blood pooling in the lower extremities and causing unstable blood pressure and tachycardia (high heart rate). This is known as POTS (Postural orthostatic tachycardia syndrome).  This condition is thought to have an autoimmune component.
  7. Nutrient depletion occurs, especially those nutrients necessary for mitochondrial function such as glutathione, alpha lipoid acid, CoQ10 and L-carnitine.
  8. Hormonal disruption can occur due to the stress of illness which leads to increased cortisol (stress hormone), adrenal and hormone imbalance. Symptoms can be lack of sleep, and difficulty coping and adapting to stress. Pre-existing conditions start to surface such as gluten intolerance, sleep apnea, pyroluria and nutritional deficiencies.

What we know is that post-COVID will be with us for some time. The sooner we address its significance and initiate treatment, the sooner we can get people back to feeling healthy, more resilient and back to work. Integrative medicine has given us the assurance that the body’s healing system is capable of restoring wellness. It may take longer for some depending on the severity of the illness but we need to trust in the wisdom of the body and its healing power. Colorado Covid Care has experienced clinicians that focus on outpatient treatment of people recovering from acute and long-Covid infections. 

Helpful resources are: Colorado Covid Care and Survivor Corp

 

Reference: Alschuler, L, Chiasson, M petal. Integrative medicine considerations for convalescence from mild-to-moderate COVID-19 disease. www.ncbi.nlm.nih.gov.

Yang AC et al. Dysregulation of brain and choroid plexus cell types in severe COVID-19. Nature 2021 July; 595:565.

Marshall, M. COVID and the brain: Researchers zero in on how damage occurs. Nature 2021 July; 595:484.

Cline, H, Einhardt, A. Postural orthostatic tachycardia syndrome: A conundrum for patients and healthcare providers. The Nurse Practitioner.  Jan 2022: 13-19

Nasserie T et al. Assessment of the frequency and variety of persistent symptoms among patients with COVID-19: A systematic review. JAMA Netw Open 2021 May 26; 4:e2111417

 

Filed Under: Featured, Health, Wellness

There’s a new Shingles Vaccine

January 7, 2018 By Deborah

 

It’s a new year…and with that comes new advances new medical breakthroughs. A new vaccine to prevent against Shingles was approved last month by the Centers for Disease Control and Prevention. This really looks to be a breakthrough, so much so as Dr. William Shaffner, preventative disease specialist at the Vanderbilt University School of Medicine claims that with this new vaccine “the immune system of a 70-or 80-year-old responds as if the person were only 25-30.”

The new vaccine Shingrix, has been shown through international studies to prevent more than 90% of shingles cases, even at older ages. This is a big deal considering that the current shingles vaccine, Zostavax only prevents about half of shingles cases in those over age 60, and is far less effective among elderly patients. The effectiveness of Zostavax drops from 64% for people in their 60’s to 38% for those in their 70’s. Immunity starts to wane 5 years after receiving the vaccine. After 11 years the protection is close to zero! Whereas the new Shingrix vaccine prevented 90% of shingles in those 70 to well past 80.

doctors and nurses photoMost older Americans have acquired shingles (varicella zoster virus) through childhood chickenpox, whether they knew they had the disease or not. The virus stays dormant and then erupts later in life. Different types of stressors are known to increase the risk of eruption, but the risk rises sharply after age 50. Getting shingles is hardly benign. Besides a very painful rash, it threatens to cause vision problems and lingering and debilitating nerve pain, called postherpetic neuralgia, that sometimes lasts months, even years after the initial rash fades.

What makes this new vaccine better?

1. It provides better protection against shingles from the start.

2. It’s protection lasts longer. So far, it remains effective for at least 6 years or longer.

3. It may protect people with compromised immune systems. Those with a weakened immune system due to chemotherapy or transplants, or H.I.V. or taking steroids may be able to get the vaccine where the old vaccine was off limits.

Problems?? First, Shingrix requires 2 vaccines given at least 2 months apart. Second, it tends to be more painful and cause more swelling and redness in the arm for up to 2 days. For those over age 70, 8.5% can experience fatigue, fever or achy joints for 1- 2 days. Lastly, it will be pricier. It may be covered depending on your insurance and medicare coverage.

Is it worth the discomforts or price?  Compared to weeks or years of shingles and its complications…it’s a small price to pay.

Read more….

No Excuses, People: Get the New Shingles Vaccine – The New York Times: “”

Filed Under: Featured, Health

20 things you can stop worrying about (because they won’t matter in the long run) – Hack Spirit

December 31, 2017 By Deborah

meditation photo

These 20 things are a great way to start the New Year.

When the fears of the world drag you down, return to the present moment and practice self-compassion and remember the love that shines through you. Let go…surrender…and trust that the universe has your back.

Find strength in these daily practices that they inspire you to take action from a place of true power.

Be well…

20 things you can stop worrying about (because they won’t matter in the long run) – Hack Spirit: “”

Filed Under: Featured, Health

Top 10 Health Breakthroughs of 2017

December 28, 2017 By Deborah

 

Here are the Top 10 Health Breakthroughs of 2017:

10. We can Unlearn Chronic Pain- Two studies confirmed through brain imaging demonstrated that pain that persists long after a physical injury has healed, is a type of learned behavior. This behavior can be “unlearned” through a variety of non-medical interventions. Cognitive Behavior Therapy (CBT) is one such technique.

9. Gut Health and Degenerative Diseases- A growing body of evidence points to an intimate relationship between the gut and the brain. Researchers have discussed recent findings that support a link between the gut (microbiome) and the brain, specifically neurodegenerative diseases such as Parkinson’s and Alzheimer’s.  Gut microbes of mice with Alzheimer’s-like pathology and healthy controls found that diseased mice treated with probiotics had decreased gut inflammation and boosted memory performance.

8. Sugar is worse than you think. According to newly released historical documents, the sugar industry funded animal research in the 1960’s that looked at the effects of consuming sugar and the risk of heart disease. They then buried the data when it suggested that sugar could be harmful. We now know that sugar promotes obesity, diabetes and heart disease. We also know how addictive it is.

7. Cancer and the Microbiome- We are discovering how environmental factors influence the cross-talk between the gut microbes, intestinal epithelium and our immune system. This is especially true when cancer is present. Now we are manipulating this gut bacteria to improve the activity of anticancer drugs.

6. 3-D Spinal implants- These implants are made from titanium and their rough surfaces and porous structures help them integrate more completely into the body. This 3-D printing technology allows bone to hold onto an implant for people with spine deformities.

5. New Drug for Ovarian and Breast Cancer- The drug Zejula, is a new type of drug called a PARP inhibitor. It allows cancer cells that were damaged by chemotherapy to not be able to repair themselves to cause a reoccurrence. No new drug for ovarian cancer has been approved in the US since 2006.

4. Genetic Advances- Physicians can now find cancer in its earliest stages by detecting DNA from tumors in the blood, even before symptoms appear.

3. DNA Edits to Eliminate Disease- Scientists have successfully edited DNA in human embryos for the first time this year to remove a genetic mutation that causes death. This raises the possibility that families could soon prevent their children from developing life threatening inherited diseases such as Huntington’s, Tay Sach’s, and Cystic Fibrosis.

2. Bioelectronic Medicine-Electroceuticals (devices that use a current to treat ailments) are helping patients who haven’t responded to traditional treatments for epilepsy, Parkinson’s and more. It’s a battery powered device that could be embedded in the skull and connected to the part of the brain that is “glitchy”. For epilepsy, It would function as a cerebral pacemaker and stabilize the misfiring neural links that cause seizures.

1. Personal Robots- Health care robots are now available in patients’ homes to help people manage chronic illnesses such as rheumatoid arthritis, late-stage kidney disease and congestive heart failure. This robot helps monitor medication use, motivates patients to follow doctors’ instructions and connect people with their doctors or pharmacists.

Wishing You a Health Happy New Year!

Filed Under: Featured, Health

Health and Happiness this Holiday Season

December 24, 2017 By Deborah

dove and olive branch photo

As we approach the end of 2017, let us reflect on the year with compassion, forgiveness and truth. Yes, we had many challenges this year with the division of a country with differing political views that may have been filled with frustration, fear and anger. But we also found a hidden deep strength within our country that demonstrated a strong position of “enough” that translated to demonstrations, contacting our local representatives, more women running for office, and expressing our views on social media. Yay!!

So this Christmas season, let us not forget who we are. We are not “what happens around us” as much as “what happens within us” in a way in which we listen to our intuition and stay present to determine how we can make a positive difference for ourselves and the greater good. Stay true to who you are and embody humility and connection with others.

Be that light and shimmering beacon of love. Lean toward the potential positive outcomes rather than all that you expect can go wrong. Choose to seek creative solutions. All the answers are within you. You just have to listen to that inner voice more than the outward loud and misguided voice that we hear everyday.

Let go of control and the fear of not being in control and allow hope to help us move through our problems and choose to perceive them a different way. Surrender to hope and watch the miracles happen.

Wellcast wishes you a hopeful, happy, and healthy wondrous New Year!   Peace ??

Filed Under: Featured, Health

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A Little About Me

Debbie is a board certified family nurse practitioner with an emphasis on women's health. During the past 22 years she has worked in women's health and family practice with a focus on the integration of conventional and alternative therapies.

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