and good evening.

Welcome.

Thanks for watching PBS Fort Wayne and HealthLine tonight.

I'm Mark Evans, your host and we have a very interesting subject tonight.

It's covid-19 long haulers.

>> I'm not talking about anything in the trucking business either.

It's pretty serious stuff especially if you've had covid-19 and it keeps on lingering.

>> So if you or someone you know has a situation this would be the show to watch.

And we're going to invite your phone calls telephone numbers on the screen at 866 (969) 27 two zero.

It's a half hour show.

We don't step down for commercials because we are public television.

>> So get those calls coming in and we'll get things started by meeting our guest who's back for her second time on PBS Fort Wayne, it's Dr. Sharon.

>> David, welcome.

Thank you.

And Doctor, you are kind of a unique physician physician Physiatrist and also known as a physical medicine and rehabilitation physician assist patients recovering from stroke, spinal cord injuries, movement disorders and you also worked on a neuro team at a long Horler clinic.

So thank you for that and your service in that because I know it was probably a big battle and it's not over yet.

>> Thank you.

What does it mean to be a long hauler?

>> Yeah, so as we know so many people have been diagnosed with covid-19 when symptoms linger more than four weeks.

That's when we we diagnosed a patient with long haulers.

>> So it's four weeks or more.

Are you seeing that often?

>> We are unfortunately we're seeing it quite quite often.

>> Typically long hallers occurs in kind of two subgroups.

We often see it in patients who are elderly who are otherwise a lot of medical comorbidities that have had very severe covid-19 OK the other oh no no no go ahead.

>> I find that interesting.

The other subgroup that we're seeing it very commonly is women in their thirties and forties so who possibly had very mild covid-19 so some of the younger people children we're not seeing the long Halling effect on them as much not as much.

And that's not to say we probably won't correct.

Hopefully.

>> Yeah.

And I know that every day they're finding out new things about covid-19.

We'll discuss that a little further about some of the latest advances and so forth.

>> But who we talked about who typically becomes a long hauler .

>> So what causes the post covid syndrome also known as the long hauler?

Yeah, that's a very good question.

So I when I when I see patients I tried to explain why we even get long callers.

It is so covid eighteen itself.

The molecule itself has this the spike protein this is a protein kind of sticks out the surface COVID 19 that spike protein is what attaches to our cells when it attaches to ourselves.

Our body recognizes recognizes it as a foreign invader and gets ready to attack it.

In essence your body kind of goes into war and it tries to fight covid-19 so your body's putting together this big huge atomic bomb.

>> It's kind of how I used an analogy to fight covid-19 if you think about any war torn country, even if the country wins the war, if a bomb's gone off, there's a lot of leftover rubble same kind of way your body can win the war against covid-19 but you have leftover rubble or leftover inflammation and that inflammation oftentimes is what causes lung .

You explain that so well.

Got it.

Thank you.

We have a call coming in and it looks like it's from David and he wants to know what helps with long haul covid symptoms and I guess we can answer how we can treat the long haul.

>> Yeah yeah.

So gosh this is going to sound like a cop out answer but the the biggest and most powerful treatment for long callers this time give it time.

Over time your body will kind of clear out that inflammation and and you'll start seeing symptoms resolve most of the time.

>> Now we don't have a cure or a pill that says here, take this and your long symptoms will go away.

We don't have that.

What we do have are different medications and different tools and tricks that we can use to help decrease the the symptom effects of long hallers.

>> But the ultimate cure all is time.

Time yeah.

I know in this day and age we expect an instant relief pain and in this particular situation and one of these days maybe you know the research is going on maybe we can say hey I've got some covid symptoms bam you get a pill, it's over with.

>> It's done within a day or two .

That'll be wonderful.

And speaking of the symptoms, let's talk about those are the different symptoms for long haulers than there are for regular covid-19 very good questions.

So it depends sometimes yes.

Sometimes the symptoms are the same with acute or that early covid-19 diagnosis you might have some cough, chest pain, shortness of breath and for some patients those longer linger more than those four weeks and become long haulers.

>> For others they're covid-19 might have been very mild.

>> Maybe they had a little bit of body, a little bit of fatigue but overall felt good.

But then afterwards when they're feeling that the effects of the that leftover inflammation they might come in with some brain fog or some chest pain, maybe some dizziness, lightheadedness, heart palpitations so it it can be the same as the covid-19 acute or early disease or could be something different.

>> OK, that's why you definitely have to see a doctor make sure you get sort of sort it all well.

>> All right, let's me the allergy season I tell you let's talk about the brain fog thing.

You brought that up and I hear that quite often especially you know, in stories come on about the lingering symptoms and the long haulers as we're talking about tonight, it seems that any time somebody talks about that they're talking about the brain fog and so explain what that means.

>> What should somebody how would they identify that if they had brain fog?

>> Very good question.

So the CDC just actually put out some some data for what are some of the most common symptoms that people are referring to when they say brain fog?

One of the most common complaints is decreased memory so they can't remember things.

>> Maybe they walk into a room.

It's like what did I walk in here for ?

Or that goes with only happens to me all the time but but honestly it is more acute memory.

Yeah.

Or if it's a job you've been doing for years and years and years but maybe you log on to the computer and you forget how to do a certain task.

Oh something like that or you forget you you make a list you go to the grocery store, you forget where you put the list even you know things like that.

You forget you're just a bit more forgetful.

That's one of the most common complaints word finding difficulties where it's like oh what's that word I'm looking for ?

>> Oh yeah that's another common one.

So just really brain fog fogginess you can't think clearly you're not as quick as you used to be.

>> Yeah, that's that's in essence what the patients say.

They just feel just not themselves.

OK, one of one of the other things that we're finding is while the complaints are a lot of memory and word finding difficulties when you actually have the patients do testing what we're finding is the actual problem is attention.

So they're having trouble focusing in and paying attention to things and you can you can imagine if you're not able to focus it's hard to remember the things that happened.

>> So a lot of times it's really truly an issue with focus but it's presenting memory or word finding difficulties or just forgetting how to do things.

>> Yeah, you really have to be in the moment for that memory to just stick.

>> So if you've got all this fogginess and distractions and so forth it's going to be hard to memorize things.

>> Yes.

Let's talk and we've got a call coming in as a matter of fact and we're getting that set up as I speak.

>> But I want to talk about too the problems with mood and fatigue of covid and I can understand how people can get tired, you know, just in their bodies are really stressed out and tired just from fighting it.

>> But how does it coming into alter your mood?

>> How does covid do that?

Yeah, a couple of reasons.

One of the big reasons is covid just doesn't make you feel good.

>> Good.

And so you're not able to do the things you love and that can impact your mood, right?

>> Well yeah.

Some of the other things that we're finding is with covid and causing that massive inflammation you can get different organs that get inflamed or just don't quite work right.

>> Your thyroid might be off thyroid hormones help control mood and so if you already had some hypothyroidism for example, that might worsen which can affect oh well that makes sense.

>> That makes sense.

OK, well Susan is calling in.

She's asking to stay off of the air and that's quite all right.

>> She's asking are vexed people vaccinated people less likely to get long term or long hallers Kovik which I think is a great question.

>> Yeah, that's a fabulous question.

So we do know vaccinations decrease the risk for severe covid that initial covid symptoms, those initial symptoms.

But we're not at this point we don't see any trend between vaccinations and those unvaccinated and long haulers.

>> OK. >> I was hoping that the answer would be yeah yeah but that's uh well maybe down the road you know.

Yeah it's still we're still learning about long haul.

>> Yeah and still learning about covid-19 and very true it just just amazing.

>> So when you come across somebody who thinks they have covid-19 or long haulers in what's the best way to do the diagnosis for that?

And while you're at it, how should those covid conditions be assessed?

>> Yeah, definitely want to reach out to your doctor.

There's so many things that can mimic long haulers and long haulers can mimic other things.

And so because the symptoms are so nonspecific, you want to make sure you're ruling everything out before you just attribute it to long hours to talking to your doctor.

Now your doctor can can run certain lab work, blood work.

We can run certain order certain tests like X-rays and C.T.

scans to help rule out some of the other things but really, truly how we diagnose long haulers is by the symptoms.

What you tell us a lot of the other stuff that we do, the blood work in the imaging and the other tests are just to rule out anything else more serious.

>> OK, very good.

And I noticed here you know, of course we talked about some of the symptoms in discussed of course we discuss the mood changes.

There are a couple on here that I didn't realize the one down here changes in menstrual cycles and that's I just heard about that doing this research.

>> Yeah.

Today for the show but I hadn't heard of that one.

Yeah.

Yeah.

Long haulers can definitely affect your your menses, you know again it can cause a lot of massive inflammation so different organ systems that control different hormones can also start to dysfunction and when they aren't creating the hormones that your body needs you can get abnormalities in your thank you for that.

And also can you settle a debate between a friend of sure.

He's saying that when you get covered in I if his doctor told him this or not, I doubt it but that if you lose your sense of smell or taste you probably will never get that back one hundred percent not necessarily .

>> I didn't think so but I want to get that confirmed.

Yeah, not necessarily.

It depends for some for most patients they will get that sense of smell and taste back.

For some though the recovery and getting that back might be a little odd.

You might initially go from not smelling anything to smelling weird things or smelling things that don't even really smell the way they do.

You might be smelling things that doesn't even smell that way and then eventually you can regain some of that that smell .

>> For some people it just takes longer and my sisters we can use her as a testimony that she had it a year ago covid and she's feeling fine now but she says I swear my taste and my smell has not gotten back to normal and she loves to cook so she would probably know that.

>> Yeah.

You know so but we have another call coming in, Dr. David.

We have Mike and Mike go ahead with your question.

>> Go right ahead.

Hi.

Good evening.

Thanks for taking my call.

Absolutely.

I had called it back in January had had really not a very tough time with the symptoms, you know, like the fevers and things like that.

But I never got a bad cough the things that respiratory distress.

But what I did develop was a tremendous amount of inflammation you know, cutaneous manifestations, hypertension and has some late scans showed even some vessel inflammation.

I've read some research where they say that the rubble that you speak to can take up to three months to come out of your system because of the cell destruction that this disease does.

Is that what what the latest is is showing and is there anything new on this so that maybe the word can get out so people don't think that they have other things wrong with them?

>> It's just you have to get through this disease.

That's a good point.

That's a very good question.

Yes.

Three months is not a underestimation.

Usually what I hear patients say is around that six month mark for some hour it's around that six month mark that they start feeling like they're turning the corner and then it's usually around that one year mark where they say I feel like myself again so it can take a while for some.

Yes, it can be three months.

They can start they can progress a little bit quicker and maybe it's that three month mark that they're turning that corner and they're kind of back to themselves.

It's six months but for most of my patients it's usually that six month mark where they're starting to feel some improvement and just it takes a while.

It's long haulers.

>> Right?

Right.

And speaking of the long haulers, if you have that you're not contagious so long haulers.

No, you're not and you're not an active covid where you're contagious but someone who's had covid-19 come out of that infectious phase are in the long hallers phase can get covid-19 again.

So you just want to be careful that all right, if you're just joining us, we have a very special guest tonight, Dr. Sharon David who is a physiatrist special kind of physician that is known to work in physical medicine and rehabilitation medicine for patients and also assist patients recovering from stroke, spinal cord injuries and movement disorders.

She also worked in neuro team at a long Horler clinic.

>> HABITATE was an interesting experience as well.

I was, yeah.

>> And are you still active in that or you still are?

I was going to ask as we Segway into that how are things shaping up?

>> I mean covid is still here for sure and have a long holiday as well for some folks.

But how are things looking on the wide spectrum?

>> Very good question.

We kind of go in flux very similar to what's going on in the community.

So when we're there are there spikes and then we get very, very busy in clinic and then things kind of lull a little bit and we have a few more open slots and then things get busy.

>> So and then once in a while we get a new variant.

Yes.

Yeah.

Go knock on wood out that things are kind of quiet on that front at least for now and I hope they stay that way.

>> All right, Doctor, we have another call coming in is Dean who prefers to be off the air do long?

Uh oh.

There it is.

I do covid long haulers who pass away affect organ donor status.

>> Fabulous class.

Yeah, I never thought of that fabulous question.

No, they do not.

So you can still really yeah.

The function there's no literature to say right now that I know of that if you've had long haulers or covid that you cannot be an organ donor um so you still do that you still have that on your OK let me ask you this funeral directors do deal with patients who have passed away from Koban.

>> Is there a chance that the funeral director of the embalmer I should say to catch covid through that process?

>> Wow.

That's a good question.

Um, you know, we do know covid can become airborne when you aerosolize it that can create it becoming contagious.

>> I don't know the answer to that.

I don't believe so.

I don't think so.

>> I'm sure that they use precautions and yes.

But I'm just curious yeah.

Because of the flurry if you recall there were people dying one after another during the peak of covid and bless their hearts unfortunately.

But you just wonder because I know that the funeral business the funeral industry had to change.

>> There was a maximum number of people to go into the chapel to the funerals themselves.

So but luckily it looks like things are coming back to normal in that respect, correct?

>> Correct.

And they're going to be wearing the proper PPE.

Oh, absolutely themselves and they always do anyway I'm sure even pre covid.

>> Yeah.

Yes absolutely.

OK, well I got to talk in there and shuffle my papers and oh here we go.

One question that did come up in the discussion earlier with caller you were answering how long can long term covid-19 last or long haulers and that's really going to be totally up to the individual.

>> Yes.

Yeah, it is very individualized.

Some patients follow a more rapid recovery course and some most again it takes about a good year.

You can see symptoms for that long but there is there is research and literature to support that patients do resolve and come out of this and I know this might sound like a strange question or even a stupid question, but the reason why I'm asking is I'll get to in just a second how do I prevent long term covid-19 or the long hallers?

>> First of all, don't get covid-19 but is there a way even though you get covid-19 to be able to ward off the long horler to prevent it?

>> Yeah, so that's also a good question.

So what I recommend to my patients is an anti inflammatory diet decreasing the inflammation in your system?

We do know inflammation is one of the huge key drivers for developing long hallers and also if you have severe covid-19 disease you can also that also increases your risk for a long Koller's so decreasing just overall inflammation is one way to do it.

>> Well how do you do that good diet so the mind diet or the Mediterranean diet has a lot of literature behind it which involves a lot of leafy vegetables, berries and nuts avoiding red meat, focusing more on fish, lean chicken that's one way and then again decreasing chance of severe covid-19 ultimately decreases your risk for long hallers one way to potentially decrease severe covid-19 is to be vaccinated.

>> OK, the vaccination we hear that a lot and it's obvious and people have even gotten vaccines and have gotten covid but it's not nearly as severe, correct?

>> Correct.

Vaccines help you stay out of the hospital.

I'm speaking of which there is a question I want to ask you regarding the hospitalization the question was if you have covid and I'm sure it depends on the extent how severe it is but is hospitalization a good thing or can you actually heal and get over it just as well at home following doctor's directions?

>> Yeah, very good question.

Also.

So it really one of the things we determine if a patient needs to be in the hospital or out of the hospital, we look at their vitals, their blood pressure, pulse ox, heart rate those are really the key drivers to if a patient needs to stay in the hospital usually by the time a patient's moving on to that long diagnosis for the most part they're medically stable.

That doesn't mean that they're not struggling battling through the symptoms but they're medically stable and so so usually most of the covid-19 long haulers are at home and they're treating these symptoms at home or maybe at an extended care facility or nursing home if that's where they are.

>> Oh, very good.

And I think we struck a chord with someone when we were talking about food and Margaret just call in with a question prefers to be off the air but does it cause a loss of appetite and absolutely could especially if you lose a taste of scents or smell.

Those are things we use our smell and taste to give our brain feedback that our brain is the one that gives us that hunger source.

So if you're not smelling and you're not tasting, your brain's not getting any input.

It's it's difficult for it to create that that drive that hunger drive also covid can attacks those weak vulnerable areas so if you have a history of GERD oftentimes I hear patients say oh my acid reflux is so much worse or if you have a history of IBS covid loves weak spots and it attacks Texas weak spots and it can some patients tell me their IBS is much worse and that can also decrease appetite?

>> Yeah I would imagine so.

When should I see a doctor about the post covid-19 symptoms?

>> Well when is it time?

I mean when do you finally say OK I've had this long enough yeah I've got to get something done early intervention I can't speak enough about early intervention and so if you are feeling symptoms if it's around that for a week mark and you're still kind of lingering and not feeling yourself, you're having some of the chest pain or shortness of breath.

The fatigue fatigue is so common the brain fog, any of those things it's definitely good to see your doctor.

>> How important is it to get going back to the appetite?

>> How important is it to keep food in your system?

I mean should you eat even if you're not hungry?

That's a good question.

You want to really listen to your body and so if you're having trouble keeping foods down and if you're losing weight if your nausea and vomiting, those are definitely that you you don't even want to weight the four weeks you want to call your doctor.

>> But if your able to eat maintain a healthy weight, you're just not feeling great.

>> That's something that you can probably wait to see your doctor outpatient but it's still something you want to be cognizant of .

>> Oh, Doctor, we have about 30 seconds left if we can maybe present something for our viewers to take home or to you know, to keep them themselves and maybe give more information to other people.

>> So some in a nutshell last remarks about covid-19 long haul.

Yeah, So one of the things I would say is covid-19 the long haul is real.

Some patients come in feeling like they're crazy or making it up or exaggerating.

But my big one of my big roles in covid clinic is to reassure the patient it's not all in your head and these symptoms are real and if you're feeling them reach out to your doctor and seek help.

Early intervention is such a key and success in treating long callers.

>> All right, Dr. Sharon David, thank you for your support and your help in battling this terrific huge battle we have ahead.

>> Thank you.

So comforting.

No people like you're on the front lines absolutely hope to have you back again.

>> All right.

Well, we're going to be back again next week.

Make sure you watch.

And we also have a special show on a couple of weeks.

That's what we want to watch.

It's about youth mental health and that's here on PBS's Fort Wayne's HealthLine until then, good night and good