Covid is here to stay. The stress of the pandemic, the division it has caused in families and communities, and the near collapse of health care systems are only some of the long term effects. Another is Long Covid after a Covid infection.

Some long Covid symptoms include fatigue and exhaustion with exertion. After a COVID infection, notice your body’s needs. If you feel fatigue, then a gradual return to activities is necessary. Try the 4 P’s:

Pacing, Prioritizing – choosing the most important tasks, Positioning – modifying activities to make them easier to do, Planning to conserve energy.

 Long COVID causes physical and mental changes – anxiety, depression, PTSD. The viral effects can be compared to myalgic encephalitis, ME syndrome.

Shortness of breath can be helped using Breathing Exercises, Lung exercises – see video below. A pulmonary therapist can help assess for the need for medication or oxygen.

Sleep and Relaxation is very important for healing. 

Body exercises and tools cand be used to Lower Inflammation.

People with long Covid can develop POTS, fluctuations in your heart rate depending on your posture. 

We talk so often about medical care, but the care of family, friends, and community is essential. Reach out to your loved ones – don’t be shy to ask for help.

Take care

Judy

In the day, our brains are occupied with all the things that need to be done and tasks and people – all the distractions. Look at the red arrow – that is pointed towards your frontal cortex. That is the thinking part of the brain. Where you plan. Where you complete tasks.

At night, that part of the brain is less stimulated. Here it is in blue. The blue shows not much glucose is being used – glucose is the only energy source for the brain. (This brain is a brain of someone with PTSD but it sort of highlights what I’m trying to explain.)

At night the Limbic system is awake. This is the part of the brain responsible for controlling pain. Also sleep. And metabolism and blood pressure and all sorts of things. Now at night, this part of the brain is more active than the cortex.

Also, at night, if you lie there thinking and thinking and thinking (that’s anxiety) then the flight fright fight center (Limbic system) is stimulated. See the yellow? That is the area of pain and inflammation.

Obviously, it’s a bit more complicated than that. Everyone is different. General explanation. Have a look at this section to Lower Inflammation and pain. 

Take care

Judy

Holidays often remind us of what we have missed, lost loved ones, or being alone.

Today I worked on my Anxiety and Depression page while I thought about those of you who are struggling in a world filled with positive and negative events.

Take care.

Judy

When we talk about stress, we talk about the physical and environment and social and mental.

Stressors can be chronic pain, infections, extreme cold, extreme heat, dehydration, poor diet, smoking, alcohol, too little exercise, too much exercise, too happy, too upset, too much work, too little work, too much responsibility or only thinking about yourself. You get the idea.

It’s too easy to blame emotions. These upsets affect the limbic system and contribute to chronic diseases and mental illness.

Take care over the holidays.

Judy

Chronic Exertional Compartment Syndrome CECS this can cause pain in your legs, or your arms, or even your abdomen when you exert yourself. Overexercising can cause swelling in limbs and then pressure on arteries. This can then slows the flow of blood and the muscles become painful.

Here is a great link from Mayo Clinic. CECS.

The diagnosis is difficult as you need to be exercising, then have the symptom, and then immediately have pressure tests done, usually like blood pressure readings comparing limbs.

Take care

Judy

Change can be very difficult. Here are some random tips.

It’s a dangerous place when you start to see people and yourself for who you are.
Protect yourself.
Don’t go chasing windmills. Choose only the battles you know you can win.
Step away from the rest.
Be comfortable with saying no!
Step back from situations – think of yourself as a journalist – how would I report the situation
Notice your body – where are you feeling the tension
When people are being negative = do the 5 grounding technique
Practice using the body to calm the mind

Be curious – not judgmental – about yourself and others.
You may come across as a little standoffish when you are backing off, but you are protecting yourself.

When you use your voice, and this is perhaps new to you, criticizing other people, you may come off to others as rude because they are used to you being a people pleaser and not rocking the boat.

Balance – PEOPLE PLEASERS have a very difficult life. Now is the time to put yourself first

Where should I spend my energy – Do I want to spend my energy worrying about what others think of me?

Emotions too intense to tolerate? Usually you have been triggered. 

When the reaction is overboard or out of proportion to the situation, perhaps you have been triggered. 

Take care

Judy

Thank you, Marilyn, for pointing out a very important condition missing in my website. This website is a community project. Please comment if you see anything missing or something you don’t agree with. The comments don’t appear, but I will answer them in the blog. I can’t always do this in a timely manner, as I am still working as a physician, but I will do my best.

Polymyalgia rheumatica is an inflammatory disorder causing muscle and joint aches and stiffness across the neck, both shoulders and pelvis. It develops gradually over a few weeks to months and often will come with fever, loss of appetite and fatigue. 

The exact cause is unknown, but likely due to genetic markers, or infection, or both. 

Those affected will be over the age of 50, usually over 70 and more often female and of European descent. The episodes are longer than 2 weeks and cause morning stiffness for more than 45 minutes. These symptoms are usually better later in the day, compared to osteoarthritis which can become worse towards evening.

Muscle weakness can occur because of pain. The pain is worse with movement and can radiate through the fascia of the arms and legs and into bursa (these are protective cushions around the joints.) The hands and feet can also hurt. 

Before the diagnosis is made, a good history and investigations need to be performed. Infection, malignancy, and giant cell arteritis, (temporal arteritis causing severe headache, scalp tenderness, later visual loss, stroke, even death) need to be excluded.

Apart from an examination for tenderness and other causes, bloods will need to be drawn: A Full or Complete Blood Count; C reactive protein – which is usually moderately raised, Liver function tests and electrolyte and creatinine testing as cortisone is used in the treatment of PMR.

Additional testing includes:

TSH for fatigue, Rheumatoid Factor and, if positive, anti CCP (anticyclic citrullinated peptides) which are raised in rheumatoid arthritis. CK for muscle disease like polymyositis, and ANA (antinuclear antibodies) for autoimmune disease.

A rheumatologist can be invaluable in excluding disease like RA.

Corticosteroids are powerful anti-inflammatory drugs, more powerful than Non-Steroidal Anti-inflammatories (NSAIDs) but they do carry the risk of more serious long term side-effects, like skin changes, bruising, mood changes, osteoporosis, aggravation of diabetes, hypertension, cataracts, glaucoma, fluid retention and heart failure, and increased risk of infection. A basal bone density test – an X-ray to assess fragility of bones – is important.

Usually 15mg for three weeks, then slowly tapering as tolerated, usually 10% every couple of weeks. Reducing the dose must take place over a long period of time with slow reductions over many weeks.

Vitamin D is vital – a supplement always in winter in cold climates with little sun, and more so with cortisone. Bisphosphonates and other osteoporosis meds can be considered if indicated. Gastric side effects can be decreased using proton-pump inhibitors.

Managing PMR requires medical and self care. The self care is important. Any load – physical or emotional – that overloads the body can increase inflammation. Gentle exercise and stretching, mindfulness, (look for Palouse mindfulness further down the page), restorative breathing, all help towards moving towards healing. 

Take care all

Judy

Physical stress and emotional stress is the biggest reason for inflammation in the body. Inflammation in your bladder (cystitis) in your stomach (gastritis) in your brain (brain fog and dementia) in your heart (SCADs heart attacks). The limbic system doesn’t differentiate (see the difference) between physical and emotional stress.

For example, the ten years before menopause, hormonal fluctuations cause physical stress. SCADS Spontaneous Coronary Artery Dissection – where the walls of the arteries in your heart split – the cause of 30% of heart attacks in women under the age of 50 – all due to added physical stress load on the body.

Last week, I had a patient present with urticaria – her whole body was covered with raised red freakishly itchy patches. She couldn’t cope. The medications, even Prednisone, was not working. (Prednisone is a very strong anti-inflammatory drug).

We went through all the possible reasons, but I didn’t mention anxiety. (My patients are fed up with my talking about anxiety anxiety anxiety). She brought it up. She’d had a disturbing experience before the rash appeared. She commented on my site (comments are hidden) how the rash improved almost immediately with the program below. I reminded her to look at the rash and imagine if this was what was happening on her skin, imagine what is happening inside the body.

Stress doesn’t only affect the body. It also affects the mind. Causing anxiety, depression, inattention, brain fog, . . . the list goes on.

We all have stress. Anxiety is when the stress load is too much and the body is overwhelmed.

Take care. Use your Body to Calm the Mind

Judy

A healthy self image is very important to enjoy a good quality of life. We place far too much emphasis on how we look. Enjoy the body you have. Don’t chase the Kate Middleton and Mylie Cyrus looks. Look to role models that suit your body.

However, if you are obese, it can compromise your health. Living well and nourishing your body is important. But not always easy. Don’t believe it’s only about what you eat.

I’ve always been chubby, not really – since the age of about ten really, but I am happy with my body. It serves me very well. I am also lucky, because I should have been obese. I use food for comfort. To celebrate. When I’m bored. Any emotion that makes me feel uncomfortable has me thinking – fooooood. Especially carbs that are easy to digest because that is what my freaked out brain desires. Chocolate . . .

Luckily for me, my stress response is a Fight (not so lucky for others) response. My limbic system gears up to run, to fight, and my hormones set my metabolism on fire. So I remain overweight, but not obese. Phew!

For those of you who are obese, more than likely, you have a freeze response to stress. Your metabolism is a super saver. It shuts down to hoard calories (kilojoules), storing energy as if you are about to enter the ice age. Or more likely now, global meltdown. Oops now I’ve stressed you out more. Feel those calories bloating up your body.

What to do? Of course, eating healthily is essential. The Mediterranean diet or a combination of Keto and Mediterranean can be found on Diet and Lifestyle. Of course, consult your healthcare provider first. And another obvious ingredient would burning calories – Exercise. But what to do if you don’t have the motivation (because of freeze response)?

I discuss these issues not to help you lose weight, so much as to help you find a path of balance in your life. To find balance, we have to take care of hidden stress or poor self-image problems. What we feel about ourselves and our bodies can be a reflection of hidden issues.

To improve a balanced approach to life, take a look at Ways you can use your body to calm your stress response. These exercises are like body building exercises for the mind. They will make you stronger. Help you concentrate. Help you enjoy a better life.

Remember we are social animals. We need others to balance our lives. Also pay attention to spiritual matters. A healthy mind, body, spirit will keep you strong.

Good Luck

Judy

It’s in the past. I don’t want to dwell in the past. I have to move forward.

These are great sentiments. Living in the moment is very healthy. But do search your body to see if another part of your brain is stuck in the past.

If you’ve had difficulties ‘attaching’ to your mother, or if you mother was distant, or damaged from past traumas, this could be stuck in your limbic system.

Do a body scan once a day. Daily Program. 5 minutes.

Notice – Notice do I fidget a lot – fidgeting or not being able to sit still is like the steam whistling when the water is boiling in a kettle. It is your body’s way to tell you that your are uncomfortable.

I believe we have 3 brains. The thinking part of the brain – Cortex. That’s the part that tells you nothing is wrong. I’m fine. Leave it alone.

The limbic system is the part damaged in trauma. That damage causes inflammation, over-reactions to food, or toxins. Around menopause time inflammation can cause heart attacks – even strokes. Or high blood pressure or diabetes.

The third part of the brain is the celiac plexus in your gut. You can get colitis, irritable bowel syndrome, constipation, diarrhoea, bloating, abdominal pain.

Each of us has a body part or parts that respond differently to stress. I used to be a snot factory, my sinuses poring out disgusting green secretions. Others have fibromyalgia or other problems. Stress switches on the genes that causes these diseases. The more stress, the more likely the disease acts up.

All the more reason to use the body to Calm Down.

Good luck

Judy