Post Covid Care

 

 

All about Post Covid Care (PCC) :

• Care for post covid patients
• To prevent being victim of multisystem inflammatory syndrome (MIS) including heart, lung, kidney, skin, gastrointestinal organs, brain functions and autoimmune conditions.
• Restores physiology as early as possible to reduce duration and further sufferings.
• The process enables an individual to prevent/ fight against the COVID situation effectively in future days.
• The process includes,
  • Internal medication to relieving minor issues and re-establish vitality.
  • Panchakarma interventions in case of multi systems involvement
  • Diet and lifestyle recommendations to promote healthy living which is key for individual immunity.
  • Psychological support and counselling to overcome anxiety etc.

Long-term complications of COVID positive patients

TIREDNESS OR FATIGUE :

Fatigue can be defined as a condition with feeling of overtired with low energy and desire to sleep which can interfere with normal daily activity.

Ayurveda has explained 2 important terms in terms of tiredness / Fatigue – Shrama and Klama.

Shrama –  “Vyayamai hi karmaabhyaasaihi kriyavisheshaihi karmana Shakti haanihi”.

One feels tired / exhausted at the end of a strenuous physical activity, which is considered as Shrama. According to Ayurveda Vatadosha gets increased in this condition, sometimes associated with Pitta.

There is a other condition known as “Klama” , which need to be consciously considered.

Klama – “Anayaasajanitashramaha klamaha”

Klama is a state where a person feels tired or lethargic without any Physical / Psychological stress.

Chronic fatigue syndrome is a disorder mentioned in western science which defines it as a disorder characterized by sudden onset of severe unexplained fatigue, lasting 6 months or more.

Causes for Klama –

It is mainly due to Ama (undigested / semi-digested food material which enters the system)

Kapha Dosha in turn Rasavahasrotodushti (Impairment in the channels of the body)

Ama can be formed due to many reasons :

• Intake of heavy / indigestible foods
• Repeated intake of food
• Intake of food before the digestion of previous food
• Intake of very cold / spoiled food articles / improper combination of food.
• Intake of food with emotional stress / lack of concentration.
• Even intake of heavy foods in conditions of Agnimandya (reduced digestive fire), Jwara etc.

A main turn vitiated Kaphadosha in the body which is the cause for Klama i.e., a person starts feeling tired without any strenuous work.

This is what happens in a condition of Jwara (Fever)

In conditions of Jwara Ayurveda mainly explains Ama Paachana (digesting of indigested materials) in terms of Langhana (light food / fasting) and Deepana – Pachana Dravya (digestives and carminatives) because Jwara is a signal or a initial stage of illness, if it is treated well a person can be healthy sooner and it can prevent any further complications like any chronic disease like diabetes, hyper-cholestremia, heart disorders, and any other metabolic disorders.

This is what is happening Post Covid fatigue – long lasting tiredness  / fatigue. This can be due to other reasons like psychological factors, excessive intake of medications, improper diet and lifestyle etc.

Before it gets complicated / worsened it is better to be taken care at an early stage.

Ayurveda has a broad line of treatment for a main turn for Klama. It can be taken care in 4 stages

1. Ahara : Ahara plays a very important role, Acharya Charaka says, “Pathye sati gadartasya kinmoushada nishevanam” i.e., for one follows diet there is no need of medicine and for one who does not follow diet there is no use in giving medicine. In a stage of Jwara, Langhana i.e., fasting / light foods are recommended that might be in the form of Poridge, medicated soups or in the form of medicated water. These dietary regimens are general followed or suggested by your Ayurveda Vaidya.
2. Vihara : Complete physical and mental rest is a must in these conditions, bathing, Vyayama, Nasal drops, Oil applications etc are contraindicated in such condition.
3.  Aushadha : When we come to the part of medications, there are a wide range of medications which varies from Churna, Vati, Guti, Kashaya, Asava, Arishta etc. Both herbal and mineral preparations are decided by your doctor after proper examination and diagnosis. There are numerous number of preparations which has got their own level of action and depth of penetrations.
4. Chikitsa : Along with Ahara, Vihara and Aushadha, if needed you might be suggested with Ayurveda therapies. Panchakarma (Purificatory therapies like mainly Vamana (Medically induced Vomiting) and Virechana (Medically induced Purgation) could be suggested after proper analysis.

External therapies like

• Abyanga (Oil massage)
• Dhara (Pouring of medicated liquid over the body in a systematic way)
• Udwartana (Powder massage)
• Sweda (Varies forms of fomentations)
• Lepa (External applications)etc.

could be suggested which may / may not require admission / Hospitalization.

For any further queries please visit your nearby Ayurveda doctor (vaidya) also you can contact us.

FEVER :

Fever and Jwara are 2 different concepts when we look from the eyes of Ayurveda. According to modern concept, fever or pyrexia is a condition of increased body temperature. It could be due to many reasons like any forms of infections like bacteria, viral or any other source or due to non infectious causes like neurological conditions, malignant (cancerous) conditions, reaction to drugs etc.

Post-Covid Fever is a condition not generally seen as fever is a main symptom during the course of viral infection. Post-Covid Fever could be due to any associated secondary causes also. Fever should never be neglected as it may lead to severe complications it may even lead to death. Modern line of treatment varies from Antipyretics, Antibiotics, Antiviral drugs, fluids etc.

In the textbook of Charaka Samhita, Acharya Atreya Punarvasu says to Agnivesha his deciple that Jwara is the most painful disease as it afflicts body, senses and mind. Hence Jwara is also called Vikara, Roga, Vyaadhi and Aatanka.

Main manifestation of Jwara includes increased temperature, Anorexia (loss of taste), Excessive thirst, Body-ache, Heaviness, Depression etc. A very broad classification of Jwara is explained in Ayurveda, like

a) Physical (Sharirika) and Psychological (Manasika) ;

b) Antarvega and Bahirvega (that which shows symptoms outside and that which does not) ;

c) Seasonal (Prakruta) and non seasonal (Vaikruta) ;

d) Santata, Satata, Anyesdyushka, Trutiyaka and Chaturtaka (based on days of occurrence of fever) ;

e) Nija (due to internal cause) and Agantuja (external cause like virus, bacteria, wounds etc) ;

f) Based on the Dosha involvement (Vata, Pitta, Kapha or their permutations and combination).

g) On the basis of presence or abscence of Ama (wheather the disease is associated with indigestion or not may be in the main digestive tract or in the deeper tissues).

h) Nava, Pachyamana and Jeerna jwara (duration of jwara)

Detailed  explanation  about the Symptoms, cause and treatment of each variety of Jwara are available in Ayurveda.

When it comes to the part of treatment, Jwara is the 1st and foremost disease which is considered. As it the main symptom in any other disease or this is the cause for any other disease.

In the first stage of Jwara Langhana or fasting is prescribed also with dietary restrictions like different forms of medicated gruels, soups, medicated water like Shadanga Paneeya. Medications varied from the famous AMRUTARISHTA to different forms of Kashaya, Vati, Guti, Bhasma and wide variety of herbal and herbo-mineral including gold preparations.

Treatment also varies when it is a DHATUAGARA Jwara that is different stages of body tissues. Psychological treatment also plays a important role in Jwara.

To sum up,

It could be taken care in 4 stages

Ahara : Diet covers 90% of treatment in Jwara more than 50 forms of gruels, soups, kashaya, Paneeya are explained and will be considered based on Dosha.

Vihara : A group of indication and contraindications in daily activities are explained. Like brushing your teeth, exercise etc are contraindicated.

Oushadha : As explained earlier will be decided after proper examination.

Chikitsa : In certain cases Panchakarma (Purificatory therapies like mainly Vamana (Medically induced Vomiting) and Virechana (Medically induced Purgation) are done which requires hospitalization. Also some of the external therapies are done if it is necessary.

For any further queries please visit your nearby Ayurveda doctor (vaidya) also you can contact us.

RESPIRATORY

SHORTNESS OF BREATH OR BREATHLESSNESS : Breathlessness or Dyspnea can be defined as an unpleasant subjective awareness of the sensation of breathing. Breathlessness may persist during rest or during exertion varies based on the severity. Main cause of breathlessness includes Cardiovascular disease (related to Heart).

Respiratory causes – Asthma, COPD, Pneumonia, Bronchitis etc.

Other causes might include – Kidney disorder, Anemia, Obesity, Psychological causes.

In the present day situation Post Covid Breathlessness is one of the main symptom people are suffering with. Main symptoms which are experienced and breathlessness on minor exertion, Heaviness of chest Associated cough with it without sputum, Excessive sweating, Chills / Shivering, Variation in blood pressure etc.

Alarming symptoms of chronic breathlessness are

• Paleness of skin
• Bluish discoloration of lips, nails and skin
• BP shoot up / fall
• Unconsciousness etc.

Investigations that could be suggested are

• Oxygen saturation
• BP
• X ray
• Pulmonary function tests
• Further investigation based on organ involved could be carried out.

According to English system of medicine treatment may involve external oxygen therapy. Bronchodilator drugs in the form of tablets or injection or in the form of nebulization. Other symptomatic treatment.

When it comes to the part of Ayurveda breathlessness or Dyspnea could be considered as Shwara roga.

According to ayurveda Shwasa, Hikka and Kasa i.e., breathlessness, hiccup and cough are related to Prana Vayu (A Type pf Vata which is responsible for respiratory related functions). Shwasa could be a seperate disease or it could be secondary due to any other ailment like Rajayakshma (TB). In some of the disease like Atisara (diarrhea) Shwasa could be an alarming sign or emergency. Etiology ot the factors which could worsen Swasa are :

• Exposure to cold and dust, Food habits which are dry, cold, excessive indigestion.
• Excessive fasting.
• Oily and fried foods etc.

Ayurveda has explained different types of Shwasaa like :

• Maha Shwasa
• Urdhwa Shwasa
• Chinna Shwasa
• Tamaka Shwasa
• Kshudra Shwasa

All of which are detailed explained which will be diagnosed by your doctor at the time of examination. Among which Tamaka Shwasa could be considered as Asthma which is one of the leading cause of dyspnea. Symptoms in Shwasa also varies based on the Dosha involved i.e., Vata, Pitta or Kapha.

When it comes to part of treatment Shwasa requires prompt and timely management as it is a life threatening condition. As discussed earlier the part of treatment could be divided into : Ahara – Vihara – Oushadha – Chikitsa

1. Ahara – Avoiding Unhealthy and Unwholesome food is the 1st foremost step to be take. One should avoid all the food items which are mentioned earlier and follow a diet which will be mentioned by your doctor.
2. Vihara – Avoid exposure to cold, heavy work, day sleep, night work, Excessive exercise etc.
3. Oushadha – Medicine varies based on presence or absence of cough, presence or absence of sputum, presence or absence of secondary disease. Some of the well-known medications are Vasakasava, Dashamoolarishta, Sitopaladi churna, Thalisadi churna, Yashti churna etc. There are a wide variety of medications which are prescribed based on the nature of disease and Dosha involved.
4. Chikitsa – When it comes to the part of chikitsa local Snehana and Swedana i.e., application of oil with lavana (salt) to chest and back followed by steam application acts as a emergency treatment but it requires medical supervision and experienced hands.

Along with this as we all know Panchakarma plays a very important role like Oleation, Sudation, other procedures like Dhumapana (medicated smoking), Nasya (nasal drops) etc are selected based on the condition. Vamana (medically induced Vomiting) in conditions of vitiated Sthanika (local) Dosha. Virechana (medically induced purgation). Which requires admission and medical supervision.

To conclude : Before stepping into any treatment procedure your doctor need to decide the actual cause of dyspnea and treatment to the actual cause will always yield a good result.

For any further queries visit your nearby Ayurveda Vaidya (doctor) or also you can contact us.

COUGH :

Cough / scientifically called Tussis can be defined as a voluntary or involuntary act that clears throat and respiratory passage of foreign particles, microbes, irritants, fluids, mucus etc. Post Covid cough is one the main symptom which persists for months even after recovery from COVID infection. Also cough is fastest mode of transmission of infection from person to person.Post covid cough is mainly dry in nature associated with :

• Presence or Absence of fever
• Loss of smell and taste
• Chronic fatigue
• Dyspnea
• Pain may be local chest pain or bodyache

It is hypothesized that chronic cough may be due to neuro-immuno modulation that your respiratory track is hyper reacting or it is in a hypersensitive state. In a post covid cohort study in Italy shows that among 143 patients 53.1 % shows fatigue, 43.4 % – Dyspnea 16 % – had cough even 2 months after discharge from the hospital. (www.thelancet.com). Even though exact pathogenesis of post covid cough is not explainable, your doctor will check for the frequency, severity, urge and hyper sensitivity to irritable.

Investigations are done to rule out – Pathological or structural causes / changes. Modern method of management might include antiviruses, antihistamines, expectorants, antibiotic and anti-inflammatory drugs. Also oral corticosteroids might be used.

Ayurveda approach – Ayurveda terms it as “Kasa” as we have already discussed in dyspnea, Kasa – Shwasa –  Hikka are Pranavaha sroto dushti i.e., these are the disease related to Prana Vayu (type of Vata ) and its channel. It is explained that Kasa occurs due to the upward motion of Vayu. All disease has its origin in digestive system. This is the site where accumulation and aggravation of Doshas (Vata/ Pitta / Kapha) takes place.

It is explained that Kasa begins with vitiation of Apana Vayu (in large intestine ?). Vata eventually flows into circulation (raktavaha srotus) and relocates in Pranavaha srotus (Respiratory tract) additionally it me get mixed with Pitta / Kapha. Leading to this condition of Kasa. Pre-dominal symptoms might include – sore throat, decreased appetite etc.

Basically there are 5 types of kasa explained –

1. Vataja
2. Pittaja
3. Kaphaja
4. Kshataja
5. Kshayaja

Vata – Pitta – Kapha type of kasa are due to vitiation of individual Dosha while Kshataja kasa is due to injury. Kshayaja kasa is due to wasting of bodily tissues in conditions such as tuberculosis etc. Individual type of Kasa has got its own particular manifestations which will be diagnosed by your doctor after proper examination. Management of Kasa requires an understanding of the state of Agni (digestive capacity and present status of digestive system), Presence or absence of Ama (Ama = undigested material), Bala (strength) of the patient. Presence and association of Dosha ( single Dosha / in combination). As we divide the treatment part in 4 divisions.

Ahara – One should compulsorily avoid – fried, oily, cold items, heavy foods.

Vihara – Avoid exposure to cold air/ direct breeze , travelling, controlling natural urges, day sleep and any other factor which is the cause kasa. Also adopt all the measures directed by your doctor.

Oushadha – There are numerous forms of medications explained in the form of food preparations, drinks, medicated ghee, lehyas, tablets, kashayas and fermented preparations.

There are different mode and time of administration of medicines which is specifically and specially explained in Ayurveda based on the Dosha and nature of disease and medicine.

Chikitsa – PANCHAKARMA, There are special drugs, medicated ghee explained specially that could act on Pranavaha srotus. Vamana (medically induced vomiting) – In case of Kapha predominance, Virechana (medically induced Purgation), Nasya (Nasal drops) and Basti (Enema) – if required. Along with this minor procedures like Dhumapana (medicated smoking), different forms of Oleation (in the form of oil applications or oral intake) and sedation therapies (more than 13 types are explained) could be adopted.

Note: During Panchakarma procedures you will require regular monitoring with diet and lifestyle restriction. Hence hospitalization might be required.

For any further queries visit your nearby Ayurveda Vaidya (doctor) or also you can contact us.

 

CHEST PAIN

Chest pain is mostly a possible symptom of underlying disease rather than a separate disease. People might use the term chest pain in various kinds of chest discomforts such as feeling of squeezing, sharp pain or sometimes burning sensation also.

Various cause of chest pain are :

1. Covid 19 / Post covid conditions
2. Heart disease
3. Anxiety
4. Disease of lungs / Respiratory system
5. Musculoskeletal system (related to muscles and bone)
6. Gastro-Intestinal system (related to digestive system)

As we are concentrating on Post Covid chest pain here is the possible explanation. There are few reasons which might cause chest pain during the course of covid infection and even after 4 weeks of Covid after an initial attack of infection achy chest muscles due to strenuous breathing / cough etc and Pneumonia (Inflammation of the lung) in which chest pain is one of the symptom.

One should always differentiate with covid related chest pain and chest pain is due to other causes by presence and absence of additional symptoms and very importantly it should never be neglected as it could be alarming sign of emergency of underlying disease.

Investigations might include :

• Chest X ray
• ECG / Any other Cardiac investigations based on the severity (Generally suggested after eliciting any abnormality in ECG)
• Blood investigations to rule out any possible infections / inflammation

Treatment options depends upon cause of chest pain and however treatment might always involves pain relievers to ease the discomfort.

According to Ayurveda, Chest pain could be due to various causes some of them are explained below :

1. Udavarta : Udavarta is a Sanskrit term which means, Whenever there is a obstruction to the normal path of Vata it starts moving backwards or in a reverse order. Most common cause for this condition is due to suppression or obstruction to natural urges (Vega Dharana) like urine, faeces especially in post covid condition – suppression of Cough, sneezing, breath etc. or due to other associated disease condition and medications. When this vitiated vata dosha sometimes along with other Dosha (Kapha and Pitta) lodges in the region of Chest it can cause any kind of symptom including pain. Symptoms and treatment of individual type is explained in detail in the Ayurveda Samhita.
   • Udavarta Chikitsa – 1st and foremost ideology to normalize the direction of Vata. It could be in the form of Oral medication or in the form of external therapies like oleation, sudation etc or if needed PANCHAKARMA could be recommended.
2. Hridroga (Disease of Heart) : To be more specific with Post covid condition, if at all the person is already suffering from cardiac disorders or if there is a tendency to cause illness in Hridaya condition of covid or the medications used might lead to Hridroga (Disease related to heart). Early diagnosis and treatment can save a person from emergency and permanent addiction to medications.
   • NOTE : For further detailed information please read Cardiology related articles in our website.
3. Hikka (Hiccup) / Shwasa (Dyspnea) / Kasa (Cough) : Chronic hiccup will definitely cause chest pain. Hiccup is due to involuntary spasm of Diaphragm along with other respiratory organs. According to ayurveda – Hikka is originated from or caused due to the obstruction of Pranavaha srotas (Channel of breath), Udakavaha srotus (channel of watery elements of body) and Annavaha srotus (Channel related to food transport).
   • According to Acharya Sushruta
     • Annaja Hikka
     • Yamala Hikka
     • Kshudra Hikka
     • Gambhira Hikka
     • Maha Hikka are the types explained cause, symptoms and treatment of each variety are detailedly explained in Ayurveda classics. Treatment of Hikka and Shwasa are similar as  the cause and manifestations are almost similar.
   • NOTE : For details of Shwasa (Dyspnea) and Kasa (Cough) read earlier articles of Post Covid Care.
4.   MANOVIKARA (Psycological disorders) : Chest pain could also be Psycosomatic in most of the cases. Research says the one in five with covid infections develop mental health issues. The anxiety is compounded by rumors, media and internet, change in lifestyle, routine, economical instability, discrimination etc. Symptoms varies from having tremors, palpitations, chest discomfort and even breathing difficulties. There are various disorders related to MANAS are explained in Ayurveda with very effective treatment starting from Councelling, Oral medications including therapies.

For any further queries visit your nearby Ayurveda Vaidya (doctor) or also you can contact us.

1. • Pulmonary fibrosis
2. PAINFUL JOINT OR MUSCLE OR HEADACHE

Cardiovascular system :

• • Chest pain
  • Damage to the heart muscle
  • May increase the risk of heart failure or other heart complications in the future
  • Fast-beating or pounding heart (also known as heart palpitations)
  • Dizziness on standing
  • Sudden formation of large clots inside the blood vessel even though there is no gross injury

Brain :

• • Strokes
  • Seizures
  • Guillain-Barre syndrome — a condition that causes temporary paralysis.Risk of developing Parkinson’s disease and Alzheimer’s disease.

Psycho-somatic :

• • Memory, concentration, or sleep problems.
  • Depression or anxiety.
  • Difficulty thinking or concentrating (sometimes referred to as “brain fog”).
• New onset of diabetes.
• Symptoms those get worse after physical or mental exertion.