Thread by @DavidLat

1/ A year after #COVID19, I still have greatly reduced cardiovascular endurance, even though I’ve been back to exercise for months. Jogging a short distance at a slow pace sends my heart rate over 170, which never used to happen. #LongCovid #longhaulers

2/ So my internist referred me to a cardiologist, and I had my visit with her yesterday; here’s a write-up of that visit. #COVID #COVID19 #LongCovid #cardio #cardiology #longhaulers

3/ The good news is that my resting heart rate (83) was normal, and my EKG (see below) showed nothing unusual. #COVID #covid19 #LongCovid #longhaulers

4/ But I need to have more tests done. I’m returning in 3 weeks for a stress EKG, which will look at how my heart works when I exert myself, and an echocardiogram or ultrasound of my heart, which can reveal inflammation (myocarditis) or tissue damage.

5/ If the stress EKG and echocardiogram don’t reveal anything to preclude it, my cardiologist will refer me to @MountSinaiNYC’s Center for Post-Covid Care, for cardio rehab. (More about the Center from @cooney_liz of @statnews: bit.ly/3uRLP3N.)

6/ My cardiologist thinks I could have autonomic dysfunction, not uncommon after #covid19. Your nervous system regulates your heart rate, and #covid has “undeniable neurological effects” (see this @sciam article: bit.ly/3bfeEiX). #LongCovid

7/ In my case, my cardiologist thinks that #covid19 basically screwed up the lines of communication between my nervous system and my heart, so my heart goes into overdrive when it really shouldn’t. #covid #LongCovid #longhaulers

8/ The goal of cardiac rehab would be to repair the system of communication between my nervous system and my heart and allow me to exercise again without having my heart freak out. #covid #COVID19 #LongCovid

9/ If the #cardio rehab doesn’t help, the next option would be a drug to reduce my heart rate (e.g., a beta blocker). I would then increase my exercise to fix the autonomic dysfunction, with the hope of discontinuing the drug. #LongCovid #COVID #COVID19

10/ But like pretty much all medicines, the drugs that reduce your heart rate come with side effects (e.g., fatigue), which is why my cardiologist would like to try the cardiac rehab first. #COVID #COVID19 #LongCovid #longhaulers

11/ My cardiologist told me that I’m far from alone in having heart issues post-#COVID19; in the past 9 months, she’s seen many such patients, including folks who had mild #covid cases or never got a positive test (bc tests were so hard to get last spring).

12/ My visit to the cardiologist, a year after my #covid19 experience, is a reminder that we will be living with the effects of #covid for quite some time — even after the #CoronavirusPandemic is a distant memory. #LongCovid #longhaulers

13/ Some additions to this thread, based on common responses and questions.

For starters, THANK YOU for all your prayers, good wishes, helpful advice, and sharing of your own #COVID19/#LongCovid experiences. I'm so grateful.

#COVID #longhaulers

14/ Some ask: maybe it's your lungs? I was on a ventilator, and many vent alums have lung problems.

But when I last saw my pulmonologist, pulmonary function tests were fine, CT scan showed only mild lung scarring.

#COVID #COVID19 #LongCovid #longhaulers

15/ Also, what I'm experiencing now doesn't "feel" like lung trouble, i.e., it doesn't feel to me like #asthma or #COVID19 shortness of breath (e.g., no wheezing). Instead, it feels like my heart is going crazy.

#COVID #LongCovid #longhaulers

16/ Some (trolls?) say: if you're not short of breath, you're not really exercising.

Here's the difference. Exercise that used to be easy now takes me to my maximum heart rate, almost immediately.

#COVID #COVID19 #LongCovid #longhaulers

17/ For example, I never used to hit a pulse/heart rate of 170 for running at a 10-minute per mile pace -- I needed to do more like a 6-minute per mile pace to get my heart racing like that.

#COVID #COVID19 #LongCovid #longhaulers

18/ Furthermore, now even non-#cardio exercise -- e.g., lifting weights -- now takes me to my maximum heart rate. That's new, at least for me.

#COVID #COVID19 #LongCovid #longhaulers

19/ Some have asked: have you gotten or do you plan to get the #Covid19Vaccine?

Yes; in fact, I received shot #1 of @Pfizer on Monday. I'm part of a study looking at #vaccine response of people who already had #COVID19. More here:

https://twitter.com/DavidLat/status/1366418763101396997

20/ Some have mentioned research suggesting that the #Covid19Vaccine might help with #LongCovid.

I'm aware of and following this research; in my case, it's too early to tell. I'm still experiencing side effects (at this point, just headaches/body aches).

21/ Some have said I'm lucky to be getting such great care; I totally agree. My internist and cardiologist are 💯.

And I'm so lucky I have health insurance, which is why I didn't have to pay any of my $320,000 #COVID19 hospital bill.

bit.ly/2XImrPb

22/ I will, of course, continue to tweet about my #COVID19/#LongCovid experience -- cardio follow-up, how I feel when I got shot #2 of the @pfizer #COVID19Vaccine, etc.

Thanks again to all of you for your continuing support and concern!