A Dietitian’s Journey – to Covid and back

It’s been a while since I wrote an update to A Dietitian’s Journey but it’s “time”. A lot has happened since then.  Last year at this time, I wrote one of my last updates about my most recent lab tests and coming to terms with what 55 pounds of weight looks like as compared to a 5 pound fat model I had purchased for use in my practice. Not quite 2 weeks later, I posted the first of several articles about a novel coronavirus that was discovered in Vancouver, in someone who had not visited China. At this point, the virus did not yet have a name — a name we all know too well now, Covid.

How the world has changed since then.

We have all been through many changes. Some of us have had family succumb to Covid, others of us have had people we know live through it, and some of us have had it ourselves.  We’ve all had our movements limited to varying degrees, and have faced shortages of everything from food to bathroom tissue. Some have lost their businesses, their homes and their sense of security due to Covid, while many of us haven’t seen loved ones in what seems like way to long, because it is.

And we’re not “done” it seems.

Even with the two mRNA Covid vaccines that are currently being given, we are being told that it may only keep the person themselves from getting sick, but that they still may be able to transmit the virus. We’ve also become aware recently that the studies are based on a specific timing between the first and second dose — something other than what reality is dictating. We wonder if the arbitrary timings, or the mix and match vaccines will be anywhere “as effective” as studies indicated, or effective at all.

Shifting Gears

In mid-July, after making the decision to close my in-person professional office, I had a photoshoot to get ready to re-launch my Dietetic practice as on-line only. Due to Covid, the photographer wore a mask the entire time. Whenever I went out to get groceries, I too wore a mask and sanitized my hands frequently. Nevertheless, two week’s later I was sicker than I had been in years.  Because of Covid being “a thing” and the unusualness of my symptoms, as I did with my weight- and health-recovery journey, I kept notes about my symptoms and how long they lasted. While I never had a fever or a cough, I found out at the time that only 50% people get either. That’s not what I had thought until I looked it up — in fact all the “warning” information at the time listed fever and cough as ‘first’.

Covid – not what I would have expected

I had symptoms that I didn’t think were ‘typical’  of Covid, including back pain, and a non-stop headache.  While the temperature outside had soared to the mid-30s°C  (~100° F), I had blue lips and just couldn’t stop shivering. The headaches wouldn’t let up, and then there were the muscle aches that had set in. I called my doctor and let him know I was self-isolating but since the line-up for a nasal swab at that point in time was ~ 6 hours, there was no way I was up to doing that. He recommended that I continue to self-isolate for 2 weeks in total and assume that I was positive, which is what I did. The muscle pain and weakness and tingling and numbness in my fingertips left me unable to do much else, anyways. I still worked part days and when I wasn’t working, I was resting. After 3 weeks, I stopped keeping notes, because the lingering symptoms were the same.

Lingering Disability

After all was said and done, what remained was muscle weakness and joint pain. The joint pain I understood having been under the care of a rheumatologist for a year after being diagnosed with post-viral arthritis after contracting rubella in my early 20s. At that point, the pain was in my hands, feet and hips, not my knees, but since both post viral arthritis and reactive-arthritis are both documented post Covid, it made sense.  The lingering muscle pain did not.

I went from being reasonably active and fit in the spring, to finding it difficult to even walk up or down a flight of stairs by August. I expected it somewhat while I was sick, but what I didn’t expect was to have come very close to losing my mobility. This scared me. No one loses mobility that quickly!

The some pieces started to come together. I stumbled across an article about Covid that was written by an MD from UT Southwestern Medical Center in Texas and which indicated that pain and muscle weakness is known to be related to actual muscle damage resulting from the illness [1]. 

“A study published in Emerging Infectious Diseases found that rhabdomyolysis, a breakdown of muscle tissue, may be a late side effect of the virus. During this breakdown, enzymes such as creatine kinase and lactate dehydrogenase enter the bloodstream.”

At the time I was telling friends and family members that it felt as if I had ‘lactic acid build up in my muscles’, except that I didn’t do any exercise. The article resonated. Lactic acid IS lactate dehydrogenase. It was like a bread-crumb trail in which the various pieces ‘fit’.

The Road to Recovery

Once I was well enough, I began to go for walks, even though it was very hard. Just walking the stairs was hard. I forced myself to walk.  My first walks were literally around the block, and were difficult.  I kept at it.  One of my young adult sons kept encouraging me to walk, and would go with me.  As my legs became stronger, walks turned into short ‘hikes’. I discovered I really liked being out in the woods, even though it remained very hard to step up onto rocks, or step down from them.  I dug out my wood hiking staff that I brought with me when I moved from California and put it into service. Wearing winter boots wasn’t working out, so after my first ‘hike’, I ordered my first pair of hiking boots. It ended up being the beginning of several orders in order to get the ‘essentials’.

November 21, 2020 – Hike # 3 – Golden Ears Provincial Park, East Canyon

My hiking stick, along with my fuchsia rain gear has become somewhat of an identifier– but the truth is, without the hiking stick, I could not have possibly begun to hike.

Each week, I pushed myself a little harder and did a little more.

On hike #3 to Golden Ears Provincial Park, I met Jackie and her husband and found out from her about a local ladies hiking group, and joined as soon as I got home. There are no group hikes currently for obvious reasons, but those days will come.

Hike #4, November 28, 2020, Buntzen Lake

On November 28, 2020, I did hike #4 at Buntzen Lake. It was 12 km and was really beyond what I was capable of, but with frequent stops and the encouragement of one of my young adults sons, I did it.

I had to. My son couldn’t exactly carry me back.

I came home exhausted, but feeling very satisfied.  I had almost lost my mobility, but I didn’t.

That day, I felt as though I had ‘won’.

When I got home, I decided to invest in myself and ordered some more essential hiking gear.

Hike #5 – December 5, 2020, UBC Malcolm Knapp & Golden Ears East Canyon

At the beginning of December, I hiked the Red Trail at Malcolm Knapp, but found it too short, so then hiked the Yellow trail, too. I found them easy and there was still time before it would start to get dark. My legs were stronger than they had been in ages, so I drove over to Golden Ears to do the East Canyon again, which was my first real “hike”.

It felt amazing!!

For the first time since I got sick, I felt like “me” again.

December 12, 2020 was hike #6 to North Vancouver, and the Lower Lynn Valley Trail.

We didn’t expect to encounter snow when we set out up the trail, but there was plenty of it about half way up and it got heavier. It made things slippery. I hadn’t yet bought mud or ice ‘crampons’, but I soon realized I would need these next.

Even though it wasn’t that cold, I experienced some numbness in my fingertips — like I did when I had the virus. I tried to ignore it, but found it very disconcerting.

Hike #6, Dec. 12, 2020, Lynn Valley Loop, North Vancouver

I borrowed a pair of heavily insulated gloves, but it took a good hour before I could feel my fingers again. Little reminders like this pop up now and then, reminding me that what I had was nothing like anything I had experienced before.

December 19th was just a local hike along the Coquitlam River, to Crystal Falls.  It had been raining a lot the previous week, and the trail was very muddy. Each hike presents new challenges to my recovering muscles — sometimes trails are rocky, other times made from bark and peat moss, then there is snow and ice, and slippery mud.  Each change in the environment forces me to use muscles that I hadn’t in previous hikes or use them in different ways — and this is exactly what I have needed to recover my strength and mobility.

As I had to do in my first hike at Golden Ears, this trail had streams to cross by stepping on rocks.  It required some degree of co-ordination and agility that I used to have, but had lost. It was perfect “rehab”.

I misstepped and totally soaked one foot, but thankfully the hiking socks I had bought did their job. Nothing was going to deter me.  This was therapy — both for my  body and soul.

Hike #8 January 16, 2021, Jug Island

Hike #8 on January 16, 2021 was the first of the new year. It had been two weeks that I hadn’t hiked and I was apprehensive that I wouldn’t make it. It started out very steep and I almost chickened out.  My son encouraged me that “we are here now” and so I pushed myself on.  It was hard. There were step-ups that I couldn’t do, but I was determined to make myself do them by engaging my core, my knee muscles and my glutes.  When all else failed, there was my hiking stick!

 

There were three ascents on the trail and when I completed the final one, I caught view of the salt water of Indian Arm and Jug Island.  The view was beautiful and so serene.

I made it! 

Of course, I still had to hike all the way back. Again, what choice did I have? I was there and had to go back.  Since there was no way of backing out, I just did it. It felt like I conquered something, even if it wasn’t impressive by anyone else’s standards.

This past weekend I did Hike #9 at Lighthouse Park, in West Vancouver.

We took a wrong turn on the trail and ended up on some other trail than the one we planned but it served the purpose of exercising my legs, knees and glutes.  Then we headed over to the coast to enjoy the sound of the water lapping on the shore and the clear winter sun.

Hike #9, January 23, 2021, Lighthouse Park, West Vancouver

With difficulty, I managed to hike down on the large rocks and between the crevices and when all else failed, there was my trusty hiking stick.

Nothing was going to stop me.

Not the virus. Not the after effects and not my discouragement.

 

 

 

UPDATE (January 31, 2021): Reality and determination are separate things.  I am reluctantly learning to balance the ‘work’ needed to rebuild the muscle that supports my knees, with the ‘rest’ required due to post-viral arthritis in the joints themselves. I am just hoping the latter doesn’t take the year it did when I was in my early 20s, after I contracted rubella.

In a way, my current “health recovery” is not unlike the one I began 3 years ago in March. It requires the determination of doing it as if my life depends on it, because it does.

While I got through half of the pandemic without weight gain, the month long virus and residual symptoms took their toll.

Like many others, I am 19 pounds up — my Covid 19.

Without access to antibody testing, it is officially unknown what I had but presumed to have been Covid. Given the symptoms I had and especially the residual effects, I think it’s reasonable to suspect what it was. At some point, I will know for sure.

Losing My Covid-19

This morning I decided to take pictures of what I look like currently, and have started on a new goal of re-attaining my previous weight by what would have been my father (of blessed memory)’s birthday.

By May 1, 2021 (13 weeks from now) I intend to lose the weight that I gained which is mainly sitting in the worse place possible health-wise — around my middle. 

I am posting this to encourage others that while re-gaining lost weight is not ideal, life happens.

The last year has been anything but normal. Just as I lived my “journey” out in the open from beginning to end — from being an obese Dietitian with type 2 diabetes and high blood pressure, to being normal body weight and waist circumference and in remission of those metabolic conditions, I am doing the same this time. I am not letting my current weight discourage or dissuade me. It is what it is.

If you’ve put on weight during the pandemic — regardless the reason, I invite you to join me on the road back.

To our good health!

Joy

 

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References

Barker, Kim MD, Life after coronavirus: Physical Medicine and Rehabilitation (PM&R) helps patients beat muscle weakness, brain fog,  UT Southwestern Medical Center, June 4, 2020.

Jin M, Tong Q. Rhabdomyolysis as Potential Late Complication Associated with COVID-19. Emerg Infect Dis. 2020;26(7):1618-1620. https://dx.doi.org/10.3201/eid2607.200445

 

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