Post Viral Respiratory Service.
Post viral conditions are symptoms which begin following a virus and there are no other identified causes for them. This includes Post Covid-19 syndrome or Long Covid but can happen following any virus. There are no definite answers as to why some people experience longer term symptoms following a virus but it is thought that following the infection the autonomic nervous system is affected and becomes more “reactive”.
Common reported symptoms include:
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Breathlessness
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Fatigue
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Changes to memory and concentration or “brain fog”
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A faster heart rate than usual either at rest or when exerting yourself-Headaches
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Muscle aches/joint pain-Low mood and anxiety
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Gastro intestinal issues
These pages aim to give you advice to self-manage your symptoms following a virus and ensure you are looking after yourself as you recover. Guys and St Thomas Foundation Trust have kindly allowed us to use their patient information videos.
These are all from the Covid Recovery service but are relevant to all post-viral syndromes. If your symptoms of fatigue and breathlessness persist and self-management doesn’t improve them please speak to your GP and ask for referral to the Harrogate Post-Viral respiratory Service based at Harrogate Hospital.
Breathlessness
Increased breathlessness is a very common issue for people experiencing Post Viral Syndrome and Long Covid. Usually, your doctor will have investigated other possible causes for breathlessness and investigations such as chest x-ray, ECG and blood tests have been carried out. Very often in the case of a Post Viral Syndrome, nothing is found that can be treated with medications and this can feel frustrating and worrying – as if something has been missed. Usually the breathlessness comes from an incorrect breathing pattern.
If your breathing pattern is inefficient, the physical effort of breathing is far greater than it should be and breathing itself feels like hard work, which can contribute to any symptoms of fatigue you might have.
If you have got into a habit of over breathing (chronic hyperventilation), you might have started to breath faster and deeper at rest which means you need to breathe even faster and even deeper during only gentle exercise, and of course this is exhausting. This can be very subtle at rest and you might not notice you are doing it!
Both of these can be improved with help and advice from a respiratory physiotherapist but there are some things you can begin doing for yourself.
This website is written for both physiotherapists and patients. It is a great resource, it explains a lot about breathing pattern disorders and includes some self help videos and information leaflets
Check your breathing pattern:
Sit quietly and calmly. Ensure your body is supported and your feet are flat on the floor.
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Place one hand on your tummy (just above your belly button).
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Place the other on your upper chest (this can be over to one side to allow your elbow to stay low and relaxed).
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You may want to close your eyes to help you relax and focus on what you can feel.
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Simply feel the movement of your breath. Which part is moving most, the top or bottom hand? Which part moves first?
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Ideally, we should have 80% of movement coming from the tummy and just 20% or less in the upper chest. Your tummy should move first. If this is not the case for you, can you try to change the movement? That might take some practice and quite a lot of concentration!
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If it is difficult to breathe mostly into your tummy while sitting down, you may find it easier either lying on your back or in a reclined position.
By frequently practicing the correct movement, it will hopefully become a natural habit when you are not thinking about it.
Are you breathing through your nose?
When resting and when walking at a gentle pace we should ideally breathe in and out through our nose. Nose breathing cleans, warms and moistens the air before it reaches our lungs. It also helps to slow down breathing (avoiding over breathing) and encourages diaphragmatic (tummy) movement, keeping our breathing pattern more efficient. If you tend to breathe through your mouth this could be either a bad habit or due to a blockage.
If you feel your nose is blocked, speak with your GP about investigating this. Otherwise try to form the habit of nose breathing. Initially this can be uncomfortable and you might only manage 2 breaths before feeling the need to mouth breathe again. But with daily practice you could find that you gradually increase the number of nose breaths you can take. If you tend to suffer with a blocked nose you might explore the use of decongestants or nasal washes. We can also recommend humming as this can help to clear the nasal passages – so pick a good tune!
Feeling breathless due to exercise is good!
When people suffer with breathlessness, whether it’s due to lung/heart conditions or in the case of post viral breathlessness, often start to avoid activities which make them breathless and this can lead to reduced fitness levels. Poor fitness will ultimately lead to increased breathlessness and so this becomes a downward spiral. Everyone should aim to do some form of exercise each day (This may be difficult with fatigue issues. Do read the section on Fatigue and Sleep. Occupational Therapists can offer guidance on returning to activities.) Can you manage to move in a way that makes you feel a little warmer and a little breathless? This can be walking, cycling, swimming, gardening, the list goes on. As long as you can still speak a short sentence, the breathlessness should feel it is at a controllable level and you should be able to recover your breathing quite quickly once you rest. We would usually advise you start small and build. Maybe just 5-10 minutes at a time to begin with.
Physical
Activity
