My COVID Recovery

Information and resources to help Nova Scotians understand and manage their health after having COVID-19.

Symptoms After Having COVID-19

You may experience ongoing symptoms after a COVID-19 diagnosis, even if the illness was mild. According to current research, your chances of having ongoing symptoms after COVID-19 are higher if:

  • You are female
  • You are between the ages of 40 to 60 years old
  • You have had mental health problems in the past
  • You have other chronic (ongoing) conditions (like heart disease or diabetes)
  • You experienced shortness of breath during the COVID-19 active (infectious) stage

These risk factors may change as we learn more about COVID-19.

 

Trouble breathing or shortness of breath

Shortness of breath (feeling out of breath) may also be called breathlessness.

It is common to feel out of breath more easily after having COVID-19. Staying calm and learning the best way to manage your shortness of breath will help. Shortness of breath should get better as you use the positions and strategies listed on this website, and you slowly start to be more active.

There may be several reasons why you are having trouble breathing during your recovery:

  • Lung damage during your illness
  • Deconditioning (losing strength and fitness while you were unwell)
  • Fatigue (tiredness)
  • Feeling anxious
  • If you had a lung condition (like asthma or COPD) before having COVID-19, it may contribute to your shortness of breath during your recovery.

Managing trouble breathing or shortness of breath

Try these strategies:

Relaxed breathing

Also known as diaphragmatic breathing, this can help you to relax and get control of your breathing.

  • Sit in a comfortable and supported position.
  • Put 1 hand on your chest and the other on your stomach (belly).
  • If it helps you to relax, close your eyes. If this does not help you to relax, keep them open and focus on your breathing.
  • Slowly breathe in through your nose (or your mouth, if you are not able to breathe through your nose). Then breathe out through your mouth.
  • As you breathe, you should feel the hand on your stomach rise more than the hand on your chest.
  • Try to use as little effort as possible. Keep your breaths slow, relaxed, and smooth.

Paced breathing

This may help you control your breathing when you are doing activities that take more effort or make you breathless (such as making your bed, climbing stairs, etc.).

  • Break the activity down into smaller parts. This will make it easier to do without getting too tired or breathless.
  • Breathe in before you make the ‘effort’ of the activity, such as before you climb up a step.
  • Breathe out while making the effort, such as climbing up a step.
  • It may help to breathe in through your nose and out through your mouth.

Different positions

These positions may help you breathe easier. Try each one to see what helps most.

  • High (raised) side lying:  Lie on your side. Place pillows under your body to support your head and neck. Slightly bend your knees.
  • Forward lean sitting with table: Sit in front of a table with a pillow on it. Lean forward from your waist. Rest your head and neck on the pillow. Rest your arms on the table. Note: You can also try this without a pillow.
  • Forward lean sitting without table: Sit in a chair. Lean forward to rest your arms on your lap or the armrests of the chair.
  • Forward lean standing: Stand up straight. Then lean forward onto a stable surface (like a windowsill or table).
  • Standing with back support: Stand with your back towards a wall and your hands by your sides. Place your feet about 1 foot away from the wall and slightly apart. Then lean against the wall.

Use a Symptom Tracker to record how you are feeling over time.

Resources and supports

Some of this material, including images, has been adapted from an original work Support for Rehabilitation Self-Management after COVID-19 Related Illness. Geneva: World Health Organization (WHO); 2020. Licence: CC BY-NC-SA 3.0 IGO. This adaptation was not created by WHO. WHO is not responsible for the content or accuracy of this adaptation. The original edition shall be the binding and authentic edition.

References

Neuroscience, Rehabilitation & Vision Strategic Clinical Network. Post COVID Task Force.(2021). How to Support Your Recovery and Rehabilitation after COVID-19. British Columbia: Provincial Health Services Authority. http://www.phsa.ca/health-info/post-covid-19-care-recovery

NHS England.(2021). Breathlessness. Your COVID Recovery. Retrieved July 9, 2021, from https://www.yourcovidrecovery.nhs.uk/managing-the-effects/effects-on-your-body/breathlessness/

Post-COVID-19 Interdisciplinary Clinical Care Network (n.d.). Managing Breathlessness in Post COVID--19 Recovery. Alberta: Alberta Health Services. https://www.saot.ca/wp-content/uploads/2021/03/if-ppih-covid-19-support-recovery-rehabilitation-after-covid-19.pdf

Professional Practice Coordinators, IPPL, Central Zone (2021). Supporting your recovery from COVID-19. Patient & Family Guide. Halifax: Nova Scotia Health Authority. https://www.nshealth.ca/sites/nshealth.ca/files/patientinformation/2219.pdf

World Health Organization(2020). Support for Rehabilitation: Self-Management after COVID-19 Related Illness. Copenhagen: World Health Organization Regional Ofice for Europe. https://www.who.int/publications/m/item/support-for-rehabilitation-self-management-after-covid-19-related-illness

Cough

Coughing is common after having COVID-19. Your cough might be dry, or you might find you are coughing up mucus or phlegm (this is called a productive cough). This is normal after a respiratory (breathing) illness like COVID-19.

Coughing is how your body tries to get rid of mucus, but coughing uncontrollably can make you feel worse and very tired.

If your cough is making you feel short of breath and you have wheezing (a high-pitched whistling sound), your primary health care provider may prescribe medication to help.

Managing your cough

Try these strategies:

To manage a dry cough

  • Drink plenty of fluids. They can make a scratchy throat feel better and keep mucus thin, so it is easier to cough up.
  • Raise your head with an extra pillow if coughing keeps you awake at night.
  • When possible, limit, reduce or avoid smoking and exposure to second-hand smoke. Smoke can irritate your lungs and make you cough more. This is very important when you have an illness that can affect your breathing, like COVID-19.
  • Take cough medicine if you have a dry, hacking cough, as it may help to stop your coughing. This should only be used for a short time.
    • Talk with your pharmacist before using cough medicine as it could interfere with other medications you may be taking.
    • Children under 6 years old should not use cough medicine.
  • Soothe a sore throat by sucking on throat lozenges or plain, hard candies.
    • Do not give lozenges to children under 6 years old.

To manage a productive cough (coughing up mucus or phlegm)

  • Controlled coughing comes from deep in your lungs. It loosens mucus and moves it through your airways.
  • If you have been prescribed an inhaler or medication to help your cough, take it before trying controlled coughing.
  • To do controlled coughing:
    • Sit on the edge of a chair with both feet flat on the floor.
    • Lean forward a little and relax.
    • As you inhale (breathe in) slowly through your nose, fold your arms over your stomach.
    • As you exhale (breathe out) through your mouth, lean forward. Push your arms against your stomach.
    • Cough 2 or 3 times as you exhale with your mouth slightly open. Make the coughs short and strong. Gently push on your stomach with your arms as you cough. The first cough brings mucus through your lungs. The next coughs bring it up and out.
    • Inhale again, slowly and gently through your nose. Do not take quick or deep breaths through your mouth. This can block the mucus coming out of your lungs. It can also cause uncontrolled coughing.
    • Rest. Repeat as needed.

Use a Symptom Tracker to record how you are feeling over time.

Resources and supports

Some of this material has been adapted from an original work Support for Rehabilitation Self-Management after COVID-19 Related Illness. Geneva: World Health Organization (WHO); 2020. Licence: CC BY-NC-SA 3.0 IGO. This adaptation was not created by WHO. WHO is not responsible for the content or accuracy of this adaptation. The original edition shall be the binding and authentic edition.

References

NHS England.(2021). Cough. Your COVID Recovery. Retrieved July 9, 2021, from https://www.yourcovidrecovery.nhs.uk/managing-the-effects/effects-on-your-body/cough/

Professional Practice Coordinators, IPPL, Central Zone (2021). Supporting your recovery from COVID-19. Patient & Family Guide, WC85-2219. Nova Scotia: Nova Scotia Health Authority. https://www.nshealth.ca/sites/nshealth.ca/files/patientinformation/2219.pdf

World Health Organization(2020). Support for Rehabilitation: Self-Management after COVID-19 Related Illness. Copenhagen: World Health Organization Regional Ofice for Europe. https://www.who.int/publications/m/item/support-for-rehabilitation-self-management-after-covid-19-related-illness

 

 

Fatigue (feeling tired)

Fatigue is very common after viral infections, such as COVID-19. Fatigue means feeling tired or like you do not have energy. It is different than being overtired or sleepy. It does not get better if you get more sleep or have a day of rest.

Fatigue symptoms after COVID-19 can get worse after activity or effort. Your fatigue may keep getting worse for 12 to 48 hours after an activity. Because of this, you may not be aware that you are overdoing it in the moment.

Fatigue can be caused by many things:

  • While your body recovers, you may need more energy to do certain tasks, even after the COVID-19 infection is gone.
  • It can take a long time to recover from a long or serious illness. For example, it can take months to recover from COVID-19.
  • If you are not getting a good night's sleep, you may wake up with less energy.

Everyone's recovery is different. Some people still have fatigue 3 months after having COVID-19.

Managing fatigue

Try these strategies:

Plan to rest

Planning to rest before you start to feel exhausted can help your recovery. Stopping only when you feel exhausted can lead to more fatigue. Planned rests can lower your need for longer periods of rest (often called a "crash").
For example: If you are exhausted and usually have to nap by 2 p.m. daily, consider planning to rest by 1 p.m. each day.

Rest effectively

A rest should be a break for your body, brain, senses, and emotions. A rest should either give you energy or pause the drain of energy.
Think of a cell phone -- in order to have battery power, you need to plug it in to recharge, turn it off so the battery stops draining, or close some apps or programs so that the battery does not drain as quickly. A rest is your time to recharge.
Consider how and where you rest. Do you need a quiet or dark room? Is your brain resting as well as your body?

Do-Rest-Do

Break your activities into smaller parts. Complete 1 part, followed by a rest. This “Do – Rest – Do” plan can help you complete a task with less frustration, support your recovery, and help you do more throughout the day. You can spread parts of an activity throughout the day, or do them over a number of days.
For example:

  • Clean the sink 1 day, and the toilet the next day.
  • Gather the dirty laundry 1 day. Do the washing and drying the next day.
  • Do 20 to 30 minutes of computer work, then rest.
  • Chop the vegetables for supper earlier in the day, then rest before cooking.

Time of day

Each of us has a time of day when our energy level is highest. This is true, even when you have fatigue. For most people, this is the time of day when their brain and body work best. Use your best hours each day for your most important or challenging tasks.

For example:

  • If you want to have quality time with a friend or family member, plan your visit during your best time of day. You may choose to meet for coffee on the deck at 10 a.m., instead of an evening visit).
  • If you have to complete a form that needs concentration, plan to work on the form for short periods during your "best time of day".

Consider the environment

Your surroundings will change how much energy you need to do an activity. Think of the amount of energy needed to have a one-on-one conversation in a quiet room, compared to a busy or loud environment. 

Reduce stimulation

Try to lower stimulation by:

  • Wearing a baseball hat when shopping in a store with bright or fluorescent lights.
  • Lowering background noise, like a TV or radio, when you need to concentrate.
  • Moving to a quiet, calm environment when reading an information pamphlet about your health.

Think about your body

Poor posture and position use more energy. They can also increase your risk of pain and injury. Consider how to lift, reach, and work safely.

For example:

  • Sit while folding laundry.
  • Use a speaker phone to avoid holding your cell phone to your ear.
  • Carry small grocery bags instead of lifting large, heavy bags.

Use tools and equipment

Tools and equipment can help save energy.
For example:

  • Sit while cooking.
  • Use an automatic can opener.
  • Use an electric mixer instead of mixing by hand.
  • Sit while showering.
  • Set up automatic bill payments or reminders.

Be kind to yourself

You may not be able to do as much as usual because your health has changed. This is OK. Take it slow and do not try to do too much.

Other people may expect you to feel better or be able to do more than you are ready for. This can be stressful. You may feel angry, sad, frustrated, scared or discouraged. This can affect both your physical and mental health.

Use a Symptom Tracker to record how you are feeling over time.

References

Integrated Chronic Care Services(2020).Welcome to the Integrated Chronic Care Service (ICCS).Patient & Family Guide,WX85-2060. Nova Scotia: Nova Scotia Health Authority.https://www.nshealth.ca/sites/nshealth.ca/files/patientinformation/2060.pdf

NHS England(2021). Fatigue. Your COVID Recovery. Retrieved July 9, 2021 from https://www.yourcovidrecovery.nhs.uk/managing-the-effects/effects-on-your-body/fatigue/

 

Trouble concentrating, brain fog or memory problems

Cognition is how effectively your brain is working. Cognitive (thinking) tasks include memory, attention, concentration, planning, and organizing. Cognitive trouble after COVID-19 is common. It may include:

  • Trouble concentrating
  • Slow or 'foggy' thinking
  • Trouble remembering
  • Emotional distress (upset)
  • Trouble organization or planning
  • Trouble making decisions
  • Having less motivation (wanting to do things)
  • Finding it harder to do tasks that need thinking
  • Fatigue after tasks that need concentration or thinking (like reading or listening to the news)

Mental or emotional distress, fatigue, trouble sleeping, anxiety, sadness or depression can all affect our ability to think, concentrate and remember.

It is common to have trouble thinking and concentrating after a long illness and hospitalization, especially after being sedated. Being sedated (having medication to help you relax or go to sleep) or medicated can affect how awake or aware you feel. If you are taking medication(s), ask your pharmacist or primary health care provider if your medication(s) may be affecting your energy and ability to focus and think clearly.

Other things that can affect cognition include:

  • How easily you can communicate. Some people have trouble speaking or communicating after COVID-19.
  • Changes in vision. This is not common.

Research to better understand how COVID-19 affects our brains, memory, attention and focus is still being done.

Managing trouble concentrating, brain fog, or memory problems

Try these strategies:

Do one thing at a time

Multitasking (doing more than 1 thing at a time) requires more energy to complete a task. For example, you may be able to follow a recipe when alone, in silence. But, you may struggle to remember the next step of the recipe if you are having a conversation while you cook.

Paying attention to details and sensory experiences (what you see, hear, smell, feel and taste) can help.

For example:

  • Notice the smell or feel of your soap while doing dishes.
  • When you are thinking about something else, bring your thoughts back to what you are doing in the moment. Notice the colour of the grass, the softness of the sheet you are folding, or the feel of the paper you are writing on.

Set up your environment to help you succeed

Remove distractions and avoid too much stimulation. Noise, lights, clutter, and other people moving or being active nearby can make it harder to think and remember.

For example:

  • Turn off the TV while having a conversation.
  • Find a quiet place to read.
  • When using the computer or social media, only open 1 task or website at a time.
  • Go to a quiet room, when trying to plan an appointment.

Use your brain and body without overdoing it

Keeping both your brain and body active can help you recover after having COVID-19. This can be hard if you have fatigue or brain fog. Add cognitive activities slowly over time. Start by doing activities you are familiar with that are not too challenging. Plan to do a cognitive task for a short time. This can help you keep your brain active without making your symptoms worse.

For example:

  • Start by reading a short article or listening to an audio book.
  • Plan to work on a crossword puzzle for no more than 5 to 10 minutes, then rest.
  • Plan to rest before and after a medical appointment that requires focus, learning and attention.
  • See the Symptoms That Get Worse After Physical Activity page of this website for suggestions to safely start physical activity.

Avoid feeling overwhelmed

It can be stressful to have trouble with concentrating, brain fog and memory. It can be overwhelming to plan, understand, organize and start a task. You cannot think clearly when you are overwhelmed. To avoid this, break down activities into small steps.

For example:

  • Do not write a grocery list, drive to the store and buy groceries all at once.
  • Write a list a day or 2 before you plan to shop. Start by listing and fruits and vegetables you need to buy, followed by a break. Add meat and proteins to the list next.
  • Then drive to the grocery store and shop on a different day.

Remember to adjust your expectations during your post-COVID recovery. You may not able to do as much each day, as you could before having COVID-19. Set realistic goals and expectations based on your current energy and cognitive abilities.

Use supports, tools and reminders

Use supports, tools and reminders that make thinking and remembering easier. These supports may include lists, timers, calendars, reminders on your phone and extra help from family and/or friends.

Use lists, notes and alerts (like a phone alarm) to remind you of things you need to do. Accept offers of support and let people know what they can help you with (like shopping, carpooling, cooking or errands).

Calm your brain

Our brains work best when our bodies, thoughts and emotions are calm. There are many strategies to help with relaxation and lowering stress, while improving your focus and ability to pay attention and think more clearly. These calming approaches include mindfulness, meditation practices, gentle stretching, yoga, reflective journalling, breathing practices and other self-soothing activities.

Learning how to manage your emotions is an important step in your physical recovery. Not only can it lower stress, anxiety, heart rate and blood pressure, it can improve concentration and memory, and lower brain fog. When your brain is relaxed, your body is relaxed.

Consider your "brain battery"

Your brain is always working, but some activities use more brain power than others. Activities that need longer periods of focus or learning can be especially challenging when recovering from COVID-19. Prioritize tasks to make sure you have the brain energy you need to do the most important tasks each day. Plan to do these  tasks when you feel best. This may be after a rest, early in the morning or on a certain day of the week. Remember to plan a brain break after doing a cognitive activity.

Use a Symptom Tracker to record how you are feeling over time.

Resources and supports

References

Integrated Chronic Care Services(2020).Welcome to the Integrated Chronic Care Service (ICCS). Patient & Family Guide,WX85-2060. Nova Scotia: Nova Scotia Health Authority.https://www.nshealth.ca/sites/nshealth.ca/files/patientinformation/2060.pdf

NHS England(2021). Memory and concentration. Your COVID Recovery. Retrieved July 9, 2021, from https://www.yourcovidrecovery.nhs.uk/managing-the-effects/effects-on-your-mind/memory-and-concentration/

Royal College of Occupational Therapists(2020). A quick guide for occupational therapists: Rehabilitation for people recovering from COVID-19. https://www.rcot.co.uk/files/guidance-quick-guide-occupational-therapists-rehabilitation-people-recovering-covid-19-2020

World Health Organization(2020). Support for Rehabilitation: Self-Management after COVID-19 Related Illness. Copenhagen: World Health Organization Regional Ofice for Europe. https://www.who.int/publications/m/item/support-for-rehabilitation-self-management-after-covid-19-related-illness

Feeling stressed, anxious or worried

We all feel stressed, anxious, or worried at times, especially when dealing with difficult situations, like illness and consequences of the COVID-19 pandemic. Some stress and anxiety is normal. If it lasts for a long time or affects your ability to do daily activities, it can be a problem.

People who have had COVID-19 report an increase in symptoms of anxiety.

You can learn more about Feeling Stressed, Anxious or Worried (symptom) and Anxiety (condition) on Nova Scotia Health’s mental health and addictions website. Resources include:

  • Online self-management tools
  • How to the difference between feeling anxious and an anxiety disorder
  • Signs and symptoms of anxiety disorders and when to seek help

Many things can contribute to anxiety symptoms, like traumatic events, genetics, medical issues, or medications. It is too early to say exactly why people who have had COVID-19 have an increased chance of anxiety. We do know that having COVID-19 and the stress of the pandemic both affect the brain. About 1 out of 5 people who recover from COVID-19 report mental health concerns within the first 3 months.

Remember:

  • You are not alone.
  • It is not your fault.
  • There are effective treatments for anxiety.

For many people, mild to moderate symptoms go away on their own, especially if you are experiencing them for the first time.

Managing stress, anxiety and worry

Try these strategies:

  • Many people find they are able to manage their anxiety with stress management, relaxation techniques, exercise, and getting enough sleep. A health care provider may also recommend cognitive behavioural therapy, exposure therapy, and/or medication.
  • Self-management tools are available. Try these free, online, 24/7 resources that are safe, confidential, and reliable:
  • Use a Symptom Tracker to record how you are feeling over time.

Resources and supports

References

Mayo Clinic Staff.(2018). Anxiety Disorders. Mayo Clinic. Retrieved July 9, 2021 from https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961

Feeling sad or depressed

We all feel sad sometimes, especially when we experience loss, disappointment, or deal with difficult situations, like illness or the pandemic. It is normal to feel sad, or what we sometimes call “depressed” at times. If your sadness is very intense (strong), does not go away, or affects your daily life, it can be a problem.

About 15% of people who have had COVID-19 report an increase in symptoms of depression.

You can learn more about Feeling Sad or Depressed (symptom) and Depression (condition) on Nova Scotia Health’s Mental Health and Addictions website. Resources include:

  • Online self-management tools
  • Resources for telling the difference between feeling sad and depression.
  • Signs and symptoms of depression and when to seek help

Many things can contribute to depression, like genetics, stressful life events, medications, and medical problems. It is too early to say exactly why COVID-19 increases the risk of depression. We do know that having COVID-19 and the stress of the pandemic both affect the brain. About 1 out of 5 people who recover from COVID-19 report mental health concerns within the first 3 months.

Remember:

  • You are not alone.
  • It is not your fault.
  • There are effective treatments for depression.

For many people, mild to moderate symptoms often go away on their own, especially if you are experiencing them for the first time.

Managing sadness or depression

Try these strategies:

  • Talk to your primary health care provider. Your symptoms may be related to your COVID-19 diagnosis. You can also call the Mental Health and Addictions Intake Line for an assessment:
    • Phone (toll-free): 1-855-922-1122
  • It may help to reach out to friends and family for support, take part in physical activity, get enough sleep, and eat well.
  • Most people with depression feel better with professional help, medication, psychotherapy, or both.
  • Self-management tools are available. Try these free, online, 24/7 resources that are safe, confidential, and reliable:
  • Use a Symptom Tracker to record how you are feeling over time.

Resources and supports

References

Collier, S.(2021).Could COVID-19 infection be responsible for your depressed mood or anxiety? Harvard Health Publishing. Retrieved July 9, 2021, from https://www.health.harvard.edu/blog/could-covid-19-infection-be-responsible-for-your-depressed-mood-or-anxiety-2021041922391

Nasserie, T., Hittle, M.,& Goodman, S.N..(2021). Assessment of the Frequency and Variety of Persistent Symptoms Among Patients With COVID-19 A Systematic Review.JAMA Network Open, 4(5):e2111417. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2780376

Ries, J. (2020, November 12). People with COVID-19 more likely to develop depression, anxiety, and dementia. Healthline.  Retrieved July 9, 2021, fromhttps://www.healthline.com/health-news/people-with-covid-19-more-likely-to-develop-depression-anxiety-and-dementia

Taquet, M., Luciano, S., Geddes, J.R., & Harrison P.J. (2020). Bidirectional associations between COVID-19 and psychiatric disorder: Retrospective cohort studies of 62,354 COVID-19 cases in the USA. The Lancet Psychiatry, 8(2), 130-140. https://doi.org/10.1016/S2215-0366(20)30462-4

What causes depression?(2019, June 24). Harvard Health Publishing. Retrieved July 9, 2021 from https://www.health.harvard.edu/mind-and-mood/what-causes-depression

Withdrawal from friends and activities

Even the most social person sometimes needs time alone to recharge. For some of us, it is normal to prefer being alone rather than being around people. The pandemic has changed our habits in terms of self-isolating, staying home more and keeping our distance from others. As restrictions lift, it may take time for us to get back to our regular social activities.

If the following symptoms are affecting your life, they may be signs of a more serious concern, like depression or anxiety:

  • Having a strong desire to retreat (hide) from the world around you
  • Feeling very uncomfortable in social situations

About 15 to 20% of people who have had COVID-19 report an increase in symptoms of depression and anxiety.

Managing withdrawal from friends and activities

Try these strategies:

Trouble sleeping

COVID-19 can affect your ability to fall and stay asleep, as well as the quality of your sleep. Recovering from COVID-19 takes a lot of energy. It is normal to need more sleep while you recover.

When recovering from an illness like COVID-19, your body may be less able to recharge while sleeping. This means that you may wake up after a full night of sleep, but not feel rested. You may also have changes in your sleep schedule and routine after having an illness or being in the hospital. 

Common symptoms after having COVID-19 can also affect your sleep:

While recovering after having COVID-19, there may be times when you are not able to fall asleep (insomnia) or wake up overnight. This may last from a few days to a few weeks and can make rest and recovery more challenging.

Your ability to sleep changes based on how active you are during the day. Fatigue and other symptoms that get worse after activity, can make it harder to be active. If you do not move, think or socialize as much while you are awake, it can make it harder to sleep.

Managing trouble sleeping

Try these strategies:

Keep a regular sleep schedule

Try to go to sleep and wake up at the same time each day, even on weekends. It can help to nap when recovering from COVID-19, but napping for too long or late in the day can affect your sleep at night. If you nap, try to do it earlier in the day. Do not nap within 4 hours before your bedtime. If napping makes it hard for you to fall asleep at night, take short naps (no more than 20 to 40 minutes) or rest instead of napping. Everyone is different, and you may have to try different sleep strategies to find what is right for you.

Changing your schedule takes time

An illness like COVID-19 can affect your body’s rhythms and routines, including sleep. There may be even more greater effects after a long illness or hospital stay. If your sleep schedule is “mixed up”, there is hope. Start slowly and be patient. Change your bedtime and wake-up time by no more than 15 to 30 minutes a day. Stay at the new time for 2 to 3 days, before shifting by another 15 to 30 minutes.

For example:

  • If you are going to bed between 2 and 2:30 a.m., try falling asleep at 1:45 a.m. Go to sleep at 1:45 a.m. for 2 to 3 days, then shift to 1:30 a.m.

Consider your environment

Your environment can affect the quality of your sleep. Try the following:

  • Spend time outside in natural daylight each day.
  • Keep the room cool. Most people sleep better in a cool room than in a warm room.
  • Limit noise and light in the room.
  • Limit screen time (smartphone, tablet, TV, etc.) for 1 hour before you go to sleep.

See the Resources and supports tab for more ideas on how to get a more restful sleep.

Increase your activity during the day

When you have fatigue and are not sleeping well, you may feel tired, but not be able to sleep. Being more active throughout the day can help. Slowly add a bit more activity each day. Activities can be physical, social or mental. Remember: do not do too much.

For example:

  • Talk on the phone with a friend.
  • Go for a short walk.
  • Complete a puzzle or play a card game.

Slow down before bedtime

To fall asleep, our bodies and brains must slow down. Make a plan to help calm your body and brain before bedtime. Start 2 hours before you plan to go to sleep. Do not eat or do intense (hard) exercise, difficult tasks or activities that cause emotional distress during this time. Calming strategies (like meditation, gentle stretching or yoga, journalling and deep breathing) can help.

Limit frustration

You cannot force yourself to sleep. If you are having trouble falling asleep, or are waking up overnight, it can be frustrating to lay in bed trying to sleep. This frustration can make it harder to sleep. If you are not able to fall asleep after 30 to 45 minutes:

  • Get out of bed.
  • Try doing something quiet or calming.
  • Do not turn on bright lights or do activities that need a lot of effort (like exercise or brain puzzles).
  • Try a calm, quiet activity (like reading, listening to music or cuddling with a pet).

Ask yourself why you cannot sleep

  • Are nightmares waking you up?
  • Are you waking up feeling breathless?
  • Is pain making it hard to fall asleep?

Many things can affect your sleep. Understanding these can help you, your family, and your health care team find the best ways to work toward better sleep. Using medication(s) and/or supplements for a short time may help.

Use a Symptom Tracker to record how you are feeling over time.

Resources and supports

References

Action for M.E.(n.d.). Managing your symptoms: Sleep Management. https://www.actionforme.org.uk/get-information/managing-your-symptoms/sleep-management/

Integrated Chronic Care Services(2020). Welcome to the Integrated Chronic Care Service (ICCS). Patient & Family Guide,WX85-2060. Nova Scotia: Nova Scotia Health Authority.https://www.nshealth.ca/sites/nshealth.ca/files/patientinformation/2060.pdf

NHS England(2021). Sleeping well. Your COVID Recovery. Retrieved July 9, 2021, from https://www.yourcovidrecovery.nhs.uk/your-wellbeing/sleeping-well/

World Health Organization(2020). Support for Rehabilitation: Self-Management after COVID-19 Related Illness. Copenhagen: World Health Organization Regional Ofice for Europe. https://www.who.int/publications/m/item/support-for-rehabilitation-self-management-after-covid-19-related-illness

Loss of appetite

You may have less of an appetite after having COVID-19. You may be less hungry or have less desire to eat. You may also find that you get full quickly and cannot eat the same amount of food that you used to.

This can happen for many reasons:

  • COVID-19 can cause changes in your digestive tract that affect your appetite.
  • Stress and anxiety can also affect your digestive tract.
  • A loss of taste or smell could make food less appealing or may even make it taste unpleasant.

Loss of appetite and feeling full quickly can become a problem when they affect how much you are able to eat. If you are not meeting your nutritional needs with food or supplements, you may lose weight over time. It is important to eat well while recovering from COVID-19. Good nutrition will help with your recovery.

Managing loss of appetite

Try these strategies:

  • Try eating 6 small meals throughout the day instead of 3 large meals.
  • Try eating larger amounts when you are feeling well.
  • Try to eat something every 2 to 3 hours, even if you do not feel hungry.
  • Drink fluids between meals as much as possible. If you fill up on fluids at mealtimes, you may not be able to eat enough.
  • Try to eat foods with protein (like nuts, seeds, cheese, Greek yogurt, milk, tuna, chicken or lean meats).
  • Do not use foods labelled "low fat" or "low calorie".
  • Consider using an oral (by mouth) nutritional supplement (like Boost® or Ensure®).
  • Use a Symptom Tracker to record how you are feeling over time.

Resources and supports

References

Alberta Health Services. (2021, February). Post-COVID-19: Nutrition for Recovery and Rehabilitation (Adults). Government of Alberta. https://www.albertahealthservices.ca/assets/info/ppih/if-ppih-covid-19-post-covid-19-nutrition-for-recovery-and-rehab-adults.pdf

Nausea and vomiting

Nausea (upset stomach) and vomiting (throwing up) are common with COVID-19 infection. You may have nausea with or without throwing up. You may also have nausea and vomiting while you recover.

We do not know how often this happens or who is at a higher risk. There are many reasons you may continue to have nausea and vomiting after having COVID-19.

COVID-19 causes changes in your digestive tract that can cause nausea and vomiting. Other reasons include immune system activity, stress, anxiety about your condition or side effects from medication(s).

Nausea and vomiting become a problem when they affect how much you are able to eat. If you are not meeting your nutritional needs with food or supplements, you may lose weight over time. It is important to eat well while recovering from COVID-19. Good nutrition will help with your recovery.

Managing nausea and vomiting

Try these strategies:

  • Eat small meals or snacks often.
  • Do not let your stomach get very empty. This can make nausea worse.
  • To lower the risk of vomiting, do not eat too much at once. This will help to prevent your stomach from getting too full.
  • Try to drink fluids between meals.
  • If the smell of food bothers you:
    • Try eating cold or room temperature foods. Warm and hot foods have a stronger smell.
    • If the smell of food cooking makes your nausea worse, try foods that do not need to be cooked (like sandwiches, smoothies, vegetables with dip, crackers and cheese, etc.).
    • Ask someone to help prepare your meals and wait somewhere else while they cook.
  • Use a Symptom Tracker to record how you are feeling over time.

Resources and supports

References

Alberta Health Services. (2021, February). Post-COVID-19: Nutrition for Recovery and Rehabilitation (Adults). Government of Alberta. https://www.albertahealthservices.ca/assets/info/ppih/if-ppih-covid-19-post-covid-19-nutrition-for-recovery-and-rehab-adults.pdf

Zhang, T., Liu, D., Tian, D., & Xia, L. (2020). The role of nausea and vomiting in COVID-19: Did we miss something? Elsevier Public Health Emergency Collection, PMCID:PMC7568482. doi: 10.1016/j.jmii.2020.10.005

Loss of smell or taste

Up to 90% of people who have had COVID-19 have lost part or all of their sense of smell. This can affect your sense of taste. Foods may taste different or have no taste at all.

Losing your sense of smell and taste can affect your appetite. It is important to keep eating and drinking even though you may not feel like it.

Most people's sense of smell comes back within 2 months. For some people, it may take longer.

Sometimes, changes in your senses of smell and taste can affect your mood. You may feel more sad or anxious.

Managing the loss of smell or taste

Try these strategies:

  • Try new flavours, foods, and drinks. They may have a taste you enjoy.
  • Try new recipes.
  • Eat what tastes good, even if it is the same food every day.
  • Eat small meals and snacks throughout the day.
  • If your mouth is dry, it can affect how food and drinks taste. Good mouth care is important.
    • If your mouth feels dry, brush your teeth and rinse with water.
    • Do not use regular mouthwash. Only use mouthwash recommended for dry mouth.
  • Drink lots of fluids, including with meals.
  • If you have a bad taste in your mouth between meals, try sugar-free candy or mints, or chew sugar-free gum .

If the smell of cooking food is affecting your appetite:

  • Try cooking with a microwave or barbeque outside.
  • Ask family or friends to help make your meals.
  • Use a kitchen fan or open a window.
  • Order take-out or buy pre-cooked meals.

If food has no taste:

  • Sour and tart foods (like lemon, lime and vinegar) can help to stimulate (encourage) your taste buds. This may make it easier for you to taste the rest of your food.
  • Eat foods with more flavour, or flavour them yourself (marinate meat, use condiments like barbeque sauce, salad dressing, ketchup, soy sauce, etc.).
  • Try using herbs and spices like mint, thyme, garlic, basil, parsley, oregano, ginger, cinnamon, salt, and pepper when preparing food.
  • Include foods with different colours and textures.

If food tastes metallic:

  • Use glass cookware, if possible.
  • Use plastic utensils (fork, spoon, knife) or chopsticks instead of metal utensils.
  • Eat foods that are cold or room temperature. Heating food causes it to have a stronger flavour.
  • Eat foods with mild flavours (like chicken, turkey, salmon, tuna, tofu). Try drinks with mild flavours (like dairy products and dairy-free alternatives such as soy or coconut milk).
  • Do not eat red meat.
  • Eat fresh or frozen food instead of canned foods.

Use a Symptom Tracker to record how you are feeling over time.

Resources and supports

References

Alberta Health Services. (2011, June). Eating well when you have taste and smell changes. Government of Alberta. https://www.albertahealthservices.ca/assets/info/nutrition/if-nfs-eating-well-when-you-have-taste-and-smell-changes.pdf

BC Cancer. (2020). Food Ideas to Help with Taste and Smell Changes. http://www.bccancer.bc.ca/nutrition-site/Documents/Patient%20Education/Food-ideas-to-cope-with-taste-and-smell-changes.pdf

Lechien, J., Chiesa-Estomba, C., Beckers, E., Mustin, V., Ducarme, M., Journe, F., Marchant, A., Jouffe, L., Barillari, M., Cammaroto, G., Circiu, M., Hans, S., Saussez, S. (2021). Prevalence and 6-month recovery of olfactory dysfunction: a multicentre study of 1363 COVID-19 patients. Journal of Internal Medicine. https://doi.org/10.1111/joim.13209

Speth, M.M., Singer-Cornelius, T., Oberle, M., Gengler, I., Brockmeier, S.J., & Sedaghat, A. (2020). Mood, anxiety and olfactory disfunction in COVID-19: Efidence of central nervous system involvement? The Laryngoscope, 130(11), 2520-2525. https://doi.org/10.1002/lary.28964

Diarrhea and constipation

After having COVID-19, you may have:

Diarrhea:

  • loose, watery poop
  • stomach bloating and pain
  • having to poop more often
  • having to poop urgently (right away)

Constipation:

  • not being able to poop
  • not pooping as often
  • dry, hard poop that is hard to pass
  • pain when pooping

These changes may happen because:

  • You have a loss of appetite (feel less hungry). You may be eating less fibre (whole grains, fruit, vegetables, etc.) and drinking less fluids.
  • You may be taking new medication(s).
  • You may be less active.
  • You may be feeling more stressed.

Diarrhea and constipation can become a problem if they do not go away.

  • Diarrhea can cause dehydration (not having enough fluids) and electrolyte (salt) imbalances.
  • Constipation can cause damage to your large intestine (bowel) and rectum (bum).
  • Both diarrhea and constipation may have a negative effect on your appetite.

Managing diarrhea and constipation

Try these strategies:

To manage diarrhea:

  • Try to drink 1-3 litres of fluids a day. Water is best.
  • Do not drink juice, pop or other sweetened drinks. These can make diarrhea worse.
  • Sports drinks can help to replace electrolytes. Choose low sugar versions. 
  • Do not drink caffeinated drinks like coffee, tea or pop. 
  • Avoid sugar alcohols (like xylitol, erythritol, sorbitol and maltitol) which can be found in sugar-free gum and candies.
  • Eat foods that contain soluble fibre (like oats, barley, avocadoes, legumes, sweet potatoes, broccoli, Brussels sprouts and most fruits). Psyllium fibre is a soluble fibre that can be sprinkled on yogurt or hot cereals.

To manage constipation:

  • Try to drink 2 to 3 litres of fluids a day. Water is best.
  • Include high fibre foods like fruit, vegetables, whole grains and legumes (peas, beans, lentils) at meals and snacks.
  • Choose whole grain breads, cereals, pasta and rice.
  • Eat 1/4 cup of nuts or seeds a day, as a snack or added to a salad.
  • Try adding 1-2 tbsp of ground flaxseed or wheat bran to your food. This can be mixed into yogurt, hot cereal, applesauce, pasta sauce or stews.

Use a Symptom Tracker to record how you are feeling over time.

Resources and supports

References

Alberta Health Services. (2021, February). Post-COVID-19: Nutrition for Recovery and Rehabilitation (Adults). Government of Alberta. https://www.albertahealthservices.ca/assets/info/ppih/if-ppih-covid-19-post-covid-19-nutrition-for-recovery-and-rehab-adults.pdf

Headaches

Headaches are one of the most common symptoms experienced after having COVID-19. Headaches may cause pain in your head, face, skin, bones, eyes, ears, nose, mouth and sometimes in the upper neck. Headaches are caused by muscles and blood vessels swelling or tightening. This sends messages through the nerves to the brain and creates a sensation of pain.

Headaches after COVID-19 are thought to be related to the immune system. Your immune system can become inflamed (irritated) in response to the infection. This inflammation can cause issues with headaches. Research in this area is still being done.

Headaches can range from a mild inconvenience to a major disruption in your day. Talk to your primary health care provider if you are having headaches every day that are affecting your ability to do daily tasks or things you enjoy. They may prescribe medication to help manage your symptoms. For most people, headaches go away over time. If your headaches do not go away, you may need to be referred to a neurological (nervous system) specialist.

Ongoing headaches can affect your mental and emotional health. They may contribute to feelings of anxiety, depression and fatigue.

Managing headaches

Try these strategies:

  • Healthy changes can help to lower and manage your symptoms. Take care of yourself:
    • Get enough sleep.
    • Eat healthy, regular meals.
    • Do not smoke.
    • Drink less alcohol.
    • Lower your caffeine.
  • Slowly add exercise to your daily routine, if you are able. Gentle stretching and movement may help to lower your symptoms.
  • Try a gentle movement class.
  • Track your symptoms. Take note if certain situations affect how often or how bad your headaches are.
  • Avoid extreme temperature changes. For example, stay inside somewhere cool on hot, humid days.
  • Try over-the-counter headache medication, if needed.
  • Rest and relaxation can help to calm you and manage pain. Try spending time in a peaceful, quiet space and focusing on your breathing.

Resources and supports

References

Carfì A, Bernabei R, Landi F, for the Gemelli Against COVID-19 Post-Acute Care Study Group. (2020). Persistent Symptoms in Patients After Acute COVID-19. JAMA. 2020;324(6):603–605. doi:10.1001/jama.2020.12603

Centers for Disease Control and prevention. (2021, April 8). Post-COVID conditions. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html

Marshall, M. (2020). The lasting misery of coronavirus long-haulers. Nature, 585, 339-341. https://doi.org/10.1038/d41586-020-02598-6

Mazza, M. G., Palladini, M., De Lorenzo, R. (2021). Persistent psychopathology and neurocognitive impairment in COVID-19 survivors: Effect of inflammatory biomarkers at three-month follow-up, Brain, Behavior, and Immunity. Brain, Behavior, and Immunity, 94, 138-147. https://doi.org/10.1016/j.bbi.2021.02.021

Nova Scotia Health Authority. (2021). Care and supports for patients with post-acute/Long COVID-19. Rapid Review May 26, 2021.https://library.nshealth.ca/ld.php?content_id=35919290

Poncet-Megemont, L., Paris, P., Tronchere, A. (2020). High prevalence of headaches during COVID-19 infection: a retrospective cohort study. Headache, 60(10), 2578-2582. https://doi.org/10.1111/head.13923

Professional Practice Coordinators, IPPL, Central Zone (2021). Supporting your recovery from COVID-19. Patient & Family Guide; WC85-2219. Halifax: Nova Scotia Health Authority. https://www.nshealth.ca/sites/nshealth.ca/files/patientinformation/2219.pdf

Chest pain, tightness or heart palpitations

Chest pain, tightness or heart palpitations (heart races or skips a beat) can be common after having COVID-19. These symptoms are usually not serious and will get better over time.

Palpitations may happen when you are exercising, anxious or after having a caffeinated drink. Palpitations may last for a few seconds or minutes. Sometimes these symptoms are caused by a heart arrhythmia (irregular heartbeat) related to heart disease or an injury. Tell your primary health care provider if you have any of these symptoms.

There may be several reasons you are having chest pain, tightness or palpitations:

  • Muscle pain (myalgia) – the area may be tender to touch and aggravated (made worse) by movement or exercises using your arms (like mowing the lawn, gardening, doing pushups, etc.).
  • Chest pain with breathing – the lungs are covered with a tissue called the pleura. An infection may cause inflammation and fluid buildup between the pleura and the lungs. When you breathe in, the lungs expand (get bigger) and rub against the inflamed areas, causing pain.
  • Feelings of pain, tightness, or discomfort in your chest, jaw, arms, neck, or back while active, that get better with rest. This may be angina. This happens when the blood vessels in the heart do not let enough blood flow to your heart muscle, especially when it is beating faster during activity.

Managing chest pain, tightness or angina

Try these strategies:

  • Use a Symptom Tracker to record how you are feeling over time.
  • Take care of yourself:
    • Get enough sleep.
    • Eat healthy, regular meals.
    • Do not smoke.
    • Drink less alcohol.
    • Lower your caffeine.
  • Talk to your primary health care provider about adding physical activity to your daily routine.
  • Talk with your primary health care provider about medication(s) to help lower chest pain from inflammation.
  • Talk to your primary health care provider about whether taking part in a cardiac (heart) rehabilitation (rehab) program is right for you. This might be an appropriate option for you.
  • Sign up for a program to learn how to overcome daily challenges, take action and live a healthy life. Nova Scotia Health offers a variety of wellness programs including Your Way to Wellness.

Resources and supports

References

Greenhalgh, T., Knight, M., Buxton, M. & Husain, L. (2020). Management of post-acute COVID-19 in primary care. BMJ, 370. doi: https://doi.org/10.1136/bmj.m3026

Public Health Ontario. (2021, April 19)..Persistent Symptoms and Post-Acute COVID-19 in Adults – What We Know So Far.. Retrieved May 10, 2021 from https://www.publichealthontario.ca/- /media/documents/ncov/covid-wwksf/2020/07/what-we-know-covid-19-long-term-sequelae.pdf

Royal Australian College of General Practitioners. (n.d.). Caring for adult patients with post-COVID-19 conditionshttps://www.racgp.org.au/clinical-resources/covid-19-resources/other-health-issues/caring-for-adult-patients-with-post-covid-19  

Joint or muscle pain

You may have joint, muscle or nerve pain after having COVID-19. One or more areas of your body may ache or burn, or you may feel tired, stiff or sore.

If you were in the hospital during your COVID-19 illness, some of the treatments may have put extra stress and strain on your joints and muscles. These may have caused new or increased joint and muscle problems, or nerve irritation.

Stiff joints and muscle weakness may get worse if you stay in bed for more than a couple of days or move less often, which is common when you have COVID-19.

Managing joint or muscle pain

Try these strategies:

  • Once you are able to get out of bed, do not sit or lie in one position for long periods of time.
  • Change position often.
    • For example, change position every 30 minutes if you are sitting or lying down. This will help prevent stiffness.
  • Think about tasks that will encourage you to change position.
    • For example, get up to use the washroom, grab a drink of water from the kitchen or look out a window.
  • Gentle movement and flexibility (stretching) exercises are a relaxing way to start moving your joints and muscles again. This can help you manage your pain.
  • Try a gentle movement class. Nova Scotia Health offers many online classes (like Mindful Movement).
  • Some people find that heat or ice can help manage their joint or muscle pain. If you want to try this:
    • Always keep a damp cloth between your skin and the hot/cold pack.
    • Do not apply heat or ice for longer than 15 to 20 minutes at a time.
    • Be careful not to fall asleep with a heat source or an ice pack on your skin.
    • Make sure you can feel the heat (from the heating pad) or cold (from the ice pack) on your body.
    • Make sure that your skin returns to normal temperature before applying heat or cold again.
  • Talk to your primary health care provider or pharmacist about taking over-the-counter pain medicine, if that is something that you are considering doing.
  • Use a Symptom Tracker to record your muscle and joint pain symptoms over time.

Resources and supports

References

Neurosciences, Rehabilitation & Vision Strategic Clinical Network,& Allied Health Professional Practice and Education, Health Professions Strategy and Practice(2021, March 23rd). Symptoms: Joint and muscle pain. After COVID-19. MyHealth.Alberta.cahttps://myhealth.alberta.ca/after-covid/symptoms/joint-and-muscle-pain

NHS England (2021). Musculoskeletal, shoulder and back pain. Your COVID Recovery. https://www.yourcovidrecovery.nhs.uk/managing-the-effects/effects-on-your-body/musculoskeletal-shoulder-and-back-pain/

Symptoms that get worse after physical activity

This may also be called Post Exertional Malaise or Post Exertional Symptom Exacerbation.

It is important to get active again after having COVID-19. This can be hard. It is normal to feel tired, short of breath and weak after having COVID-19. After physical activity, you may have extreme (very bad) tiredness or your other symptoms may get worse. This can be worse with physical activity that is too hard or fast. You may feel these symptoms 12 to 48 hours (half a day to 2 days) after doing an activity. This is sometimes called a “crash.”

Activities that cause your symptoms to get worse after physical activity may include things that were easy before having COVID-19, like:

  • A daily activity (like a shower)
  • A social activity (like having coffee with a friend)
  • Walking or other exercise
  • Reading, writing or working at a desk
  • An emotional conversation
  • Being in a sensory environment (with loud music or flashing lights)

You may have been given a small device called a pulse oximeter. This measures the percentage of oxygen in your blood, also called oxygen saturation or “O2 sats.” Place the device on your finger and read the percentage (%) on the screen. Your oxygen saturation may drop as you become more active, even if you do not feel short of breath or unwell. Talk to your primary health care provider to find out what is normal for you.

Note: Your oxygen saturation may be different if you had a lung condition before having COVID-19.

If were not given a pulse oximeter, you do not need to get one unless your primary health care provider tells you to. Paying attention to your body is another way to monitor.

Managing symptoms that get worse after physical activity

Try these strategies:

Add activity slowly over time

  • Start with easier activities, like self-care (showering, dressing), making meals, light chores (like doing the dishes or folding laundry), gentle stretching and breathing exercises.
  • If you are struggling with self-care activities, it may be too early to start physical activity.
  • When you are ready to start, add physical activity slowly over time.
  • If you are struggling with being more active, a personal exercise plan created by a physiotherapist or other qualified health care provider may help.
  • Talk to your primary health care provider for more support.

Monitor your effort

  • It may help to monitor how hard you are working (also called your exertion or effort level).
  • The Rate of Perceived Exertion (RPE) is a scale from 0 to 10. It measures how hard you are working based on your breathing and how hard your muscles are working.
    • 0 means nothing at all, or very little effort.
    • 10 means working very, very hard.
  • When you go back to physical activity, start between 1 and 3 on the RPE scale. As you get stronger and increase your endurance, you may be able to get up to levels 5 to 10.
  • Monitor your symptoms while you exercise and after you finish exercising. Notice how you feel for 12 to 48 hours (up to 2 days) after you are active. If you are exhausted (very tired) or if any of your other symptoms get worse, you may be working too hard. Try to lower your level of effort and keep monitoring your symptoms.
  • Use a Symptom Tracker to write down how many minutes of exercise you did. Also write down the RPE and any changes in your symptoms.
  • Do not push yourself to the point that you feel exhausted or have more symptoms. Pushing yourself and overdoing it can slow your recovery.
  • If you have been advised to check your oxygen levels, and you have been given a pulse oximeter, use it to check your oxygen saturation (O2 sats %) before, during and after your activity. Do this for the first several weeks. Not everyone will need to do this.

Pace yourself

  • Pacing means balancing activities with rest to prevent your symptoms from getting worse.
  • Slowly add to your activity over time. Be careful and pace yourself. Start with low-intensity activities like walking. Start with as much time as you are able. Even a few minutes is a good start. Be patient and do not expect to be able to do as much as you did before having COVID-19.
  • Listen to your body and notice how you feel for 12 to 48 hours (up to 2 days) after you are active. If you are exhausted (very tired), you may be doing too much. Rest for 1 to 2 days between activities.
  • Use a Symptom Tracker to record your physical activity and symptoms over time.

Remember, everyone’s recovery is different. Be kind to yourself.

References

Post-COVID-19 Interdisciplinary Clinical Care Network (n.d.). Managing Breathlessness in Post COVID--19 Recovery. Alberta: Alberta Health Services. https://www.saot.ca/wp-content/uploads/2021/03/if-ppih-covid-19-support-recovery-rehabilitation-after-covid-19.pdf

Professional Practice Coordinators, IPPL, Central Zone (2021). Supporting your recovery from COVID-19. Patient & Family Guide. Halifax: Nova Scotia Health Authority. https://www.nshealth.ca/sites/nshealth.ca/files/patientinformation/2219.pdf

World Health Organization (2020). Support for Rehabilitation: Self-Management after COVID-19 Related Illness. Copenhagen: World Health Organization Regional Ofice for Europe. https://www.who.int/publications/m/item/support-for-rehabilitation-self-management-after-covid-19-related-illness

World Physiotherapy (2021a). Information sheet 3: Fatigue and post-exertional symptom exacerbation. London, UK: World Physiotherapy. https://world.physio/toolkit/world-pt-day-2021-information-sheets-english

World Physiotherapy (2021b). World Physiotherapy Response to COVID-19 Briefing Paper 9. Safe rehabilitation approaches for people living with Long COVID: physical activity and exercise. London, UK: World Physiotherapy. https://world.physio/sites/default/files/2021-06/Briefing-Paper-9-Long-Covid-FINAL-2021.pdf

Loss or grief

Grief is a normal reaction to loss. This may be the loss of a loved one, a relationship, your health, your job, or a dream. The pandemic has disrupted our lives and most of us have suffered losses. If you have ongoing symptoms after having COVID-19, your loss of health can add to your feelings of grief.

You may experience difficult and unexpected emotions, like shock, anger, guilt or deep sadness. The pain of grief can disrupt your physical health, making it hard to sleep, eat or think clearly.

Feelings of grief usually get better over time. We learn to accept our loss and move forward. Grief can become a problem if your emotions are very strong, do not go away over time or affect your ability to do your daily activities.

Managing loss or grief

Try these strategies:

  • It can help to talk about your loss, get support from family and friends, or join a bereavement group.
  • Talk to your primary health care provider to find out if your grief is related to your symptoms after having COVID-19.
  • Call the Mental Health and Addictions Intake Line for an assessment:
    • Phone (toll-free): 1-855-922-1122
  • Try the free self-management tools available here:
  • Use a Symptom Tracker to record how you are feeling over time.

Resources and supports

References

Contre for Addiction and Mental Health.(n.d.).Loss, grief, and healing. https://www.camh.ca/en/health-info/mental-health-and-covid-19/loss-grief-and-healing

Johnson, K.(2007). Grief - Complicated? Or not?.Visions Journal, 3(3), 14-15 https://www.heretohelp.bc.ca/visions/trauma-and-victimization-vol3/grief-complicated-or-not