on-going mostly unedited stream of thoughts

100 days of post-covid infection: state of mind, health & writing

It has been 100 days since I tested negative for covid. I know this because I count it incrementally in my morning pages. If I do develop long covid it would be easier if I had a symptom diary. I’ve read of people who develop long covid months after their initial infection – a high profile covid activist recently passed away due to multiple organ failure after developing long covid quite a long while after his initial infection in the first wave – so I am not letting my guard down yet, maybe ever.

I did have two episodes of POTS-like symptoms. One was shortly after testing negative which resulted in me fainting twice, the other was just a few weeks ago. It doesn’t bode well that almost 3 months after my infection I am still suffering from an unusually high heart rate just after waking up. Because of my first episode I was better at managing my second episode, my heart rate eventually calmed down after copious amounts of electrolyte-infused water.

Maintaining an electrolyte balance is an autonomic function, and autonomic functions seem to be compromised after covid infections. I am lucky that I am able to make a slow return to exercise, hoping that some progressive homeostatic stress will teach my body to be on autopilot again. 

I still wonder how many people are getting slowly worse post-infection because they don’t monitor their biometrics and have no idea what are electrolytes or that insomnia and depression are also long covid symptoms. Lack of electrolytes and sleep can cause serious health issues. Glucose and cholesterol numbers are also dysregulated post-covid, so some people suffer from sudden-onset diabetes or a sudden heart attack or stroke. The excess deaths around the world are having a sharp increase from pre-pandemic, but obviously no one is linking it to covid:

Deaths among young Americans documented in employee life insurance claims should alone set off alarms. Among working people 35 to 44 years old, a stunning 34% more died than expected in the last quarter of 2022, with above-average rates in other working-age groups, too. – More young Americans are dying – and it’s not COVID. Why aren’t we searching for answers?

On one hand I keep reading horror stories of people’s experiences with long covid. On the other hand most people I know are seemingly fine going around maskless even on long plane rides, eating indoors, and having a very active social life. I personally know of a small handful of people whose health have been dodgy since getting covid, some with long-term chronic conditions, but nothing as debilitating as I’ve come across online so far. One of the most high-profile cases is @physicsgirl, who had more than two million youtube subscribers, and now she could barely use her phone while lying in bed. What makes a person susceptible to (visible) long covid? Many of these people who are having debilitating symptoms led an active life prior. They are much younger than me and were very active prior. It feels like a terrible lottery at this point.

It is common to read online of people getting infected five, six times – some testing positive every 2-3 months. Yet again in my personal circle, twice across the entire pandemic seems to be the max. My curious mind can’t seem to stop wondering why. Is it because many Singaporeans are vaccinated at least 3x? Is it the all-year-round tropical, humid weather? Is it because we tend to have better ventilated buildings as almost nothing is old here? Is there a genetic difference? Diet? I have a theory that people who can’t stop getting infected were unlucky enough to get infected before vaccines were available, so their immune system has become compromised. 

I have however, read of people in Singapore getting “flu” alot. So perhaps the way the damage is being expressed here is more invisible. People working in medical care tell me there are many more complaints of fatigue and depression. 

But again, no one is going to link it to covid. Worldwide, healthcare systems are still stretched, people are still dying, but the pandemic is “over”. I can understand why we need it to be over. In many Asian countries we lived in a semi-lockdown with numerous restrictions for more than two years. I am someone who has been hyper-aware of what the virus can do, yet I am tired too.

I am constantly calculating my risks. I am honestly terrified of getting reinfected again. I have taken these 100 days to get back to some semblance of fitness – I am running again yay – I am nowhere near where I was before. Seeing my heart rate go berserk while resting is very disturbing. Having doctors repeatedly attribute it to anxiety is very annoying. Feeling like I can’t even walk to the mall without risking the aggravation of my elevated heart rate is very life-draining. One of the things that makes me the most alive is travel, and yet each time I travel I am faced with the possibility of destroying my health.

Long covid kills, either by slowly destroying our bodies until we suffer from some organ failure, or by making life so difficult that it feels like dying is a better choice:

My wife, Heidi, took her own life after a 13-month battle with long Covid that started as a mostly asymptomatic coronavirus infection. Long Covid took her from one of the healthiest, most vibrant people I’ve ever known to a person so debilitated that she could not bear another day on this planet.

My wife had long Covid and killed herself. We must help others who are suffering

I’m having issues with surviving as it is, I am not sure if I can survive long covid. I tell myself that the odds of catching covid locally here in Singapore are not that much lower compared to travelling. Not being on a plane for hours definitely helps, but the virus is so contagious now it take seconds to get infected. I could argue I am possibly safer on a plane because I wear a n95 with the usage of nasal sprays, whereas we go around Singapore with a kf94. I keep half-joking with my partner that it would be really tragic if we get reinfected because we are really so much more careful than the average person – apart from masking we still don’t eat indoors, we have an almost zero social life and we mask even with family, whereas there are hordes of people going around perpetually maskless still in the pink of health.

Yet life is never fair anyway, and my luck with my health seems to be historically dodgy. Unless I am willing to be a hermit or a truly sterilising vaccine becomes available, life will continue to feel precarious for a very long while. My buddhist-leaning self tells me that life is precarious anyway, we are just lulled into believing otherwise with the illusive mundaneness of life.

but, migraine free?

The good news is, I have not had a migraine since my infection. I did have some mild headaches, but they were nowhere near the intensity of my chronic migraines. I am not sure if it is a good thing, because it is hypothesised that migraines are a protective mechanism against oxidative stress. So have I lost my warning system: instead of stopping me in my stress-fueled tracks with a migraine, I am going to sustain oxidative damage unconsciously; or has something changed in me biologically?

I did go on a zero-carb diet during my infection in order to reduce glucose-induced vessel damage and glucose-supported viral replication, and I had a couple of days when I couldn’t eat, so my ketone production was dramatically heightened (~3mmol). Since ketones may repair the myelin sheath, and a damaged myelin sheath may be one of the causes of migraines, perhaps being in a deep ketotic state helped repair some of the damage that was causing my chronic migraines? This is the first time in my life I was in such prolonged deep ketosis – more than 10 days. Or it could be because I’ve been really on the ball with my electrolytes since my fainting episodes. Who really knows? Imagine suffering for more than 7 years of migraines and all I needed was to go on zero carb for a week or so. But it is too early to tell at the 100-day mark.

I am also on a traditional chinese medicine regime since a year ago to balance my hormones (was actually getting a lot better before covid), and right after testing negative I immediately restarted seeing the physician again. I had an elevated heart rate, gut dysbiosis and fatigue issues post-covid which were all slowly alleviated, and I remain in strong belief that the chinese herbs helped greatly in reducing stress on my body and restoring the homeostatic balance. Traditional chinese medicine is not a cure-all or a magic potion, but it is scientifically proven to greatly support our homeostatic health. I think the systemic damage from the virus is far and wide, and we need all the support we can have to heal, especially because our autonomic homeostatic loops are severely disrupted, so healing may be very challenging on its own without intervention.

I also take a supplement cocktail, but it may be problematic if I put the full list here and people may follow it blindly, so it is important to do your own research.

writing on taboo topics

I seem to have a penchant for writing on topics that no one wants to talk about. It started with depression, then suicide ideation, and suddenly recently I realised covid awareness is probably going to be one of these. It is something that the world wants to deny, and it makes people uncomfortable. I’ve written several covid-focused posts in the past 3 years, and even I was like “not again” when I was thinking of a topic to write for this week. The pandemic was meant to be a transient event, no one wants to still linger on it three years on. But it is very much alive, and it is still causing a ton of unprecedented damage. 

It occupies a large space in my consciousness, and profoundly affects my daily and long-term decision-making. Where to go, what to eat, what to bring. So why do I feel wrong writing about it again?

I do believe we should write about the things only our individual selves can write about, from the deep reservoir of all our combined accumulated experiences and learnings. I sometimes worry that my posts get too science-y with all the medical terms and research. Like who wants to read something on heart rate variability and oxidative damage? But it is precisely because of my lived experiences I am forced to learn about these things. No one would take my chronic illness and symptoms seriously (well, apart from TCM because there is a 5,000 year history of dealing with ambiguous symptoms that cannot be explained with a clear-cut textbook condition ). If I did not undertake this research journey myself I would still be deathly sick, and maybe my options would have been botox (not kidding).

I wish more people would do the same: sharing their very individual journey so it wouldn’t feel like climbing mount everest alone when we face difficult circumstances. I myself got inspired into self-quantifying for health because of someone else’s blog post about using a nike fuelband to manage his diabetes.

So I am walking my talk by writing this possibly very boring post to most people. Like the other taboo topics I write about, they may not get very read, but it could be a tiny light in a vast darkness for those who really needed to read them.

And more importantly, it is very much of my lived experience, and it plagues my consciousness incessantly.

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