Caring For Yourself When You Have COVID-19

In this time of COVID-19, it's easy to find news about how to isolate yourself if you're infected, but challenging to find out how to take care of yourself if you have the virus.  The advice online tells your housemates to wipe surfaces you may have touched, and tells you to go into your room, close the door, and let folks know if you live after you've weathered the illness. Extreme?  Perhaps. But practical advice on how to take care of yourself when you've got COVID-19 is hard to find.  What follows is a compilation of advice gathered from a variety of sources which will hopefully help you take care of yourself or a loved one if you've had the misfortune of becoming sick with COVID-19.  

Reminder: this is not meant as medical advice or a replacement for consulting with a medical professional.  If you experience rapid, labored breathing, mental confusion, or your lips have become a bluish tinge, call your doctor or emergency services immediately.

What's In Your Medicine Cabinet

First let's start with what items you should add to your medicine cabinet before you get sick. Elizabeth Hanes, RN has created a helpful and informative list of medicine cabinet essentials. Here is the basic list.  See the article for further detail.

• Thermometer
• Acetaminophen (Tylenol)
• Ibuprofen
• Antihistamine
• Decongestant
• Multi-Symptom Cough, Cold and Flu Medicine
• Guaifenesin (Mucinex)
Gastrointestinal Remedies
• Electrolyte Replacement Beverage (Gatorade, Pedialyte)
• First Aid Supplies

Another item to consider adding to your medicine cabinet is a pulse oximeter in order to measure the level of oxygen in your blood. This information can help you talk to your doctor about how you're doing. Typically, oxygen saturation for most people is in the 90's, although everyone's baseline may be different.  It's a good idea to measure your oxygen saturation while you're healthy in order to get a baseline. The COPD Foundation has helpful information on using a pulse oximeter in its knowledgebase article, How a Pulse Oximeter Works.
 

Caring For Yourself

Write Down Your Symptoms

In order to track how your illness is progressing, and look for trends in changes in your temperature, oxygen saturation, etc, write down your symptoms day by day. Here are the most common symptoms.

You can find an updated list of symptoms at Canada's Public Health Service

Coronavirus disease (COVID-19): Symptoms and treatment page.

• Fever
• Dry cough
• Fatigue
• Difficulty breathing
• Loss of taste and smell
• Diarrhea or other gastrointestinal issues
• Sore throat

There is some evidence that those infected with COVID-19 also may experience:

• Headache
• Back pain

The hallmark of COVID-19 is the dry cough and fever, which seems to improve after several days, and then can worsen again. Note that fever can be mild in older patients or patients with underlying conditions. The immune system gets weaker as we age or are immuno-compromised, and the fever response becomes less robust.

When measuring your temperature, use the same device each time and take your temperature several times a day. You're looking for a trend in temperature elevation.  If a fever isn’t responding to the use of ibuprofen or acetaminophen, this is a concern, and you should contact your doctor.

If you are in a vulnerable group with an underlying condition, pay particular attention to worsening symptoms such as increased temperature, and do not hesitate to contact your doctor.  One tip is to contact the doctor treating your underlying condition (oncologist, cardiologist, etc), rather than your primary physician, since you may get more focused attention from your specialist.

Back pain can also be a symptom of COVID-19.  Studies have found that around half of hospitalized COVID-19 patients have proteins associated with kidney disease in their urine. If you have other COVID-19 symptoms and develop kidney-area pain, call your doctor. 

If you are experiencing rapid, labored breathing, mental confusion, or your lips turn a bluish tinge, seek immediate medical help.

Ask Friends to Check In On You

COVID-19 has a pattern. Those infected appear to be improving after several days, but then worsen again. This is when Acute Respiratory Distress Syndrome (ARDS) can set in.  Because people who develop ARDS are not getting enough oxygen to their brain or other organs, they can become very disoriented, making it hard to call for help. If you’re sick, let friends know you’re sick and tell them to check in on you regularly.

Many areas in the world have set up adhoc organizations to provide assistance during COVID-19, but because of the adhoc nature of these organizations, they can be difficult to find.  Try contacting your local government office (your council member, etc.), or contact an organization set up to assist seniors such as one you may find via the National Association of Area Agencies on Aging (USA). They may know of organizations local to you that can assist you in setting up these type of check-ins or in arranging for delivery of groceries and medicines, and maybe even pet care.

Get Lots of Rest and Stay Hydrated

When dealing with such a serious respiratory illness, the key is rest. Lots and lots of rest. But also stay hydrated when you're sick, focusing on replacing electrolyte minerals like sodium and potassium. Pedialyte and Gatorade are particularly good for this purpose, but even fruit juice, soda, and other drinks will help as well.

Symptoms of dehydration include headache, dizziness and dark-colored urine. If you’re sick and you stop peeing, contact a medical professional.  At that point you may need IV saline to rehydrate.

Humidity Is Your Friend 

COVID-19 is a respiratory infection, and like any respiratory infection, it helps to keep the lungs humid to clear out the junk.  If you have a humidifier, run it in your room. If you don't have a humidifier, heed the advice of an old-school doctor treating my recalcitrant bronchitis, take two hot showers a day.  You'll be clean and it will help your lungs.

Anxiety and Breathing

Anxiety can worsen difficulties with breathing. Below are several tips to manage breathlessness and anxiety in order to improve the symptoms of COVID-19.

• A tip from Dr. Laura Shoemaker (@LShoemakerDO), Director of Palliative Medicine at the Cleveland Clinic (Cleveland, OH), "When you are short of breath, you may feel anxious and claustrophobic. Looking out a window, even a closed window, can make you feel less anxious, and that by itself can ease your breathing symptoms."
• And Dr. Rab Razzak (@rabrazzak), Clinical Director of Hospice and Palliative Medicine at University Hospitals (Cleveland, OH) recommends the use of square breathing to decrease anxiety and improve respiratory issues.  This gif is particularly helpful in guiding you through this method https://www.destressmonday.org/square-breathing/
• Mindful meditation to help with breathing (Greater Good Science Center, Berkeley University, USA) 
• Managing Breathlessness Using a Handheld Fan (NHS, UK)

 

Breathing Exercise to Help Maintain Lung Function

Maintaining lung function is key in keeping lungs clear in the event of a virus, and diaphragmatic breathing exercises have been shown to help with breathing. The resources below will help to keep lungs clear and improve lung function.

• Breathing exercises from the American Lung Association (American Lung Association, USA)
• Maintaining Lung Function If You Have A Virus - Experts Share Tips (UK) 
• Use diaphragmatic breathing exercises to help with symptoms of COVID (UK)

 

Proning or Postural Drainage to Manage Difficulty in Breathing (aka Sleep On Your Back or Side)

Studies have shown that placing a patient on their stomach, in a prone position, helps increase oxygen levels and manage the symptoms of Acute Respiratory Distress Syndrome (ARDS)

This HealthLine article provides helpful illustrations and descriptions on positioning in order to improve breathing: Postural Drainage: Does It Really Work?

Either way, sitting or sleeping on your stomach or side helps to get more oxygen into your lungs.

Primary Sources of Information

These tips were primarily pulled from the following sources.

• For People At Home With COVID-19 Symptoms, Self Care Is More Than 'Call Your Doctor', Erin Ross, Oregon Public Broadcasting, April 3, 2020 
• Medicine Cabinet Essentials During the Coronavirus Pandemic, Elizabeth Hanes, RN, healthgrades, March 17, 2020.
• Nurses Respond: What you actually need to treat coronavirus,KRON4 News, San Francisco, CA, March 16, 2020.

If you really want to delve into even more information on COVID-19, take a look at the The Coronavirus Tech handbook, a crowdsourced library for technologists, civic organizations, public and private institutions, researchers, and specialists of all kinds working on responses to the pandemic.