Leyla Fazleyeva: ‘Recovery after coronavirus was a tough and long process for me’
Tips to recover from coronavirus and why sauna is strictly banned if a person has coronavirus
What specialists to see if complications started to develop after COVID-19? What can a trip to countries with hot weather turn into? What is a visit to the swimming pool fraught with? On World Health Day, which has been celebrated since 1950, answers to these and other questions were provided during a live transmission of the Tatarstan coronavirus taskforce. Rezeda Bodrova — chief visiting medical rehabilitation doctor of the Tatarstan Ministry of Health Care, head of the Department of Rehabilitation and Sports Medicine of Kazan State Medical Academy, doctor of medical sciences — answered questions of head of the taskforce and Tatarstan Vice Premier Leyla Fazleyeva and questions of the republic’s residents.
“Those who had a mild COVID-19 case would like to go back to the pace of life they had before the disease”
Leyla Fazleyeva: Sharing my personal feelings I will say that the recovery after coronavirus was quite a tough, long and uneasy process for me. What is a checklist, so to speak, for us, those who had COVID-19? And is it different for those who had different severity cases? Are there any accurate rules that are characteristic of all categories?
Rezeda Bodrova: Undoubtedly, both the checklist and routing for people who had COVID-19 are different, everything depends on the severity of the case. Medical rehabilitation of such patients who had a severe case, were on a ventilator is longer, is more systemic and consecutive. Such patients have been referred to the second stage of medical rehabilitation since last year, which was set up in Nehama health resort accepting patients with oxygen support.
We recommend inpatient rehabilitation to those patients who had a moderate case have consequences for respiratory organs, complain about general fatigue, exhaustion, sleeping disorder, no appetite, bad memory. Such patients need one or two rehabilitation courses, moreover, a clinical psychologist mandatorily joins the team.
The patients who had a mild COVID-19 case, as a rule, stood home, they complain about general fatigue the most. They would like to regain the pace of life they had before the disease as soon as the temperature goes down. Unfortunately, they don’t manage to do it because the general state of the organism doesn’t allow doing it. We recommend such patients who don’t have serious consequences to recover at home, from the correct regime of the day and, of course, physical exercise.
Here there must be a gradual approach: if you used to run 3-5 km or did intensive exercise for 40 minutes before the disease, we recommend starting with 10-12 minutes of a breathing routine a day and then step by step increase the impact for 3-4 weeks until you reach the level you had before the disease.
We recommend such patients who don’t have serious consequences to recover at home, from the correct regime of the day and, of course, physical exercise
What to do if the sense of smell hasn’t returned
Leyla Fazleyeva: There are a lot of post-COVID-19 symptoms, and everybody has different symptoms, it is said about a loss of memory, shortness of breath. Also, the sense of smell doesn’t return for long. For instance, we are written that a person still cannot feel the smell of meat. Can this state rehabilitate or does it just take time? What will you recommend?
Rezeda Bodrova: Yes, people turn to us both with the loss of smell and taste. We ask why they waited for six months, didn’t see doctors. Some say: ‘We thought it could resolve itself.’
But when we talk about COVID-19, some patients lose the sense of smell and taste, which don’t return after 6 weeks and more, because the central nervous system is affected. Then one should see a doctor. We have the experience of treating such a state with reflexology, there are methods of physiotherapy, which help recover the smell and taste.
Again, it is individual classes. Patients should train these senses with the help of special exercises: for instance, smell or taste with your eyes open first, then with your eyes closed, aromatherapy. A daily complex of breathing exercises, relaxation can help if there is mental and emotional pressure, walking. If the smell and taste don’t come back as a result of this, reflexology, which helps to recover these functions, is used.
Leyla Fazleyeva: We have received a question. What specialists to see to go back to the normal state?
Rezeda Bodrova: Disorders related to the central nervous system prevail in some patients: memory impairment, mental and emotional pressure. Then our multi-disciplinary rehabilitation team, which examines patients in the rehabilitation department, appoints a medical psychologist as the leading specialist. Depending on leading manifestations of the patient’s complications, the team can have different specialists.
If a patient complains about the shortness of breath after climbing stairs to the third floor and higher, the impossibility of breathing freely, we certainly recommend physiotherapy, breathing exercises, breathing equipment. And a coach will be key in this case. A doctor examines the patient, while the coach works with such patients in groups.
If the patient mostly has joint disorders, the joints swell, ache, we invite a physiotherapist, local joint treatment is prescribed to get rid of the swelling, inflammation. Such patients often have difficulties with swallowing, then a clinical speech pathologist or specialist in swallowing becomes key.
It is mandatory to help patients who had COVID-19 in all departments of the medical rehabilitation, it is a multi-disciplinary team. Every department of the republic has a clinical psychologist, therapist, physiotherapist, coach. While in some cases we invite a pulmonologist because some patients start to have new complaints, bronchial asthma gets worse.
Rehabilitation 14 days after discharge from hospital
Leyla Fazleyeva: Are there any methods, rules of breathing routine that one can follow on their own at home? Today the Internet has a lot of such exercises, which should we trust, how to receive treatment with the Internet?
Rezeda Bodrova: Indeed, today there are too many methods: the Strelnikova breathing exercise, yoga elements, there are a lot of recommendations. Given that, we created the section ‘Rehabilitation’ with ‘Help for the Population’ on the website of the Tatarstan Ministry of Health Care as early as six months ago. There is a complex of exercises there, their sequence is shown in photos.
Considering the WHO’s recommendations, we added exercises, unified them. In the end, a complex of exercises that won’t harm a patient was created. If the patient doesn’t have all the above-enumerated complications and he can master all these exercises, we recommend starting with a low impact during the first 3-4 days and gradually increase the number of repetitions.
Leyla Fazleyeva: When can one start the rehabilitation after COVID-19?
Rezeda Bodrova: If the patient has contraindications, some residual complaints, this often happens when 10-15% of the lungs are damaged, we recommend starting 14 days after one is discharged from the hospital. If a person receives treatment at home, he should go to the polyclinic to make an appointment for inpatient rehabilitation.
Leyla Fazleyeva: When can one start training? When can one go to the gym?
Rezeda Bodrova: It depends on the severity of the coronavirus case. In general we recommend starting doing low-impact exercise in the gym not earlier than 2-3 weeks after the treatment is over. The patient should return to the habitual lifestyle at home, he should adapt. If the habitual pace of life doesn’t cause shortness of breath, consequences, it means a person can already go to the gym.
Leyla Fazleyeva: When can one receive a vaccine against coronavirus after COVID-19?
Rezeda Bodrova: If we are generally speaking about those who had a moderate case of COVID-19, the duration of some patients’ rehabilitation lasts from 6-8 weeks to 12 weeks. This is why we recommend thinking about a vaccine in 5-6 months. One should think about antibodies and receiving a vaccine.
The patient should return to the habitual lifestyle at home, he should adapt. If the habitual pace of life doesn’t cause shortness of breath, consequences, it means a person can already go to the gym
Russian sauna during the illness is banned
Leyla Fazleyeva: Can one go to the swimming pool?
Rezeda Bodrova: Here recommendations are also individual. But we have always warned that as soon as you recovered from this disease, you shouldn’t rush to the swimming pool 2-3 weeks later. No way! Because the immune system is weak, and any cooling, a change of temperature can disrupt adaptive reserves, which have just begun recovering.
One can easily catch an acute respiratory disease because of cooling because the immune system was externally impacted, it needs time to recover.
But if more than 3-4 months have passed since the disease and there aren’t consequences, one can start to gradually return to the previous swimming routine. In case of a mild COVID-19 case, sure, you can swim in 2-3 months.
Leyla Fazleyeva: Many resort to the sauna as treatment. Firstly, they “expel the virus”, then recover from COVID-19. What do you think about sauna as a rehabilitation therapist?
Rezeda Bodrova: We categorically don’t recommend taking a sauna during the disease. It is prohibited! Neither do we recommend people who had the coronavirus infection to travel to countries with hot weather. Hot weather, evaporation, loss of liquid, exhaustion... And the infection is fraught with hypercoagulation and thrombosis. This is why we don’t recommend taking a sauna during the first months after the disease. We can’t go to sleep in the evening and wake up in the morning absolutely healthy, in the state we had before contracting the coronavirus infection.
We don’t recommend taking a steam bath for a full recovery to avoid a high temperature, an impact and influence on the cardiovascular system. If the first bath not in a hot environment was fine, one can gradually raise the temperature.
We can’t go to sleep in the evening and wake up in the morning absolutely healthy, in the state we had before contracting the coronavirus infection
Leyla Fazleyeva: In conclusion, our taskforce has received such a message. ‘I don’t want to receive a vaccine, it’s better to catch the disease, have immunity. We have had the flu, cold all our life, and nothing awful has happened. I don’t believe in your coronavirus. The most important thing is to stay in bed, drink more water, and you will be fit as a fiddle’. But my impressions don’t coincide with this opinion for some reason. How would you comment on this?
Rezeda Bodrova: I think a young man has written this. But I want to say that, unfortunately, this infection, as the world practice has shown, has dangerous consequences that develop not only in the elderly but also in the young. Young people whose appearance suggests they don’t have health issues, have a healthy lifestyle are often taken to the hospital. Even they at times have a severe case with up to 80-95% lung damage.
This is why all recommendations around the world say now that only a vaccine can guarantee at least a mild case. Of course, there is some percentage of infection, around 10-15%, that’s to say, the vaccine doesn’t provide a hundred per cent protection, but our vaccine has the highest guarantee you won’t fall ill.
If vaccinated patients catch the virus, they will have a mild case. Those people who consider the coronavirus infection is not a serious disease, they don’t know all the statistics and all the information doctors have when they attend patients with a severe case, which leads to death. I support a vaccine and advise everybody to receive it.