Post-COVID-19 exercise routines vary by person


Hello, dear readers, and welcome back to the continuation of our monthly letters column. You’ve been keeping our inboxes full, so we’re diving right in.

-- We continue to get questions about post-COVID-19 exercise. Some people are fully recovered and are being cautious. Others, like this reader, face persistent symptoms. “I have lingering effects from COVID-19, such as shallow breathing and brain fog,” they wrote. “What do you recommend as far as physical activity to get back to normal?” Individual response to COVID-19 infection varies. That means a return to exercise will be unique to each person. It’s also a day-by-day proposition. Do your usual activities but start small -- a brief walk or jog, just a few reps of lighter weights -- and stop well before you feel tired. That’s important because overexertion can set you back. The data show a return to physical activity after COVID-19 can take longer than after the flu, so please be patient. Expect an adjustment period of at least several weeks as you learn what your body can do.

Elizabeth Ko, MD and Eve Glazier, MD
-- A recent column regarding hyperbaric oxygen to treat long COVID-19 prompted this question from a reader. “I got high-pressure oxygen treatment for long COVID at a hospital in Florida,” they wrote. “If it’s available there, why isn’t it available to patients in clinics? Will the Food and Drug Administration approve high-pressure oxygen therapy for long COVID?” You’re correct that hyperbaric oxygen therapy for long COVID is not FDA-approved. It’s what is known as an off-label use, and that plays a role in its limited availability. The treatment shows promise, though, so clinical trials into both efficacy and safety are ongoing. This is an important first step toward getting wider approval. Meanwhile, long COVID patients who want to try this approach should always first consult with their doctors. It’s also crucial to receive treatment only from a qualified provider.

-- Colonoscopy prep, which many people find to be challenging, is a recurring topic in this column. A reader whose family medical history includes colon cancer wonders about alternatives. “I’ve tried for the past three years to do colonoscopy prep, but it just won’t stay down,” she wrote. “My daddy had colon cancer at 34, and my mom is a breast cancer survivor. My Cologuard test came back positive, and now I’m scared. What can I do?” Cologuard is a noninvasive test that looks for signs of colon cancer in a sample of feces. After a positive result, patients are strongly advised to follow up with a colonoscopy. At this time, several types of prep solutions are available. Newer products involve smaller volumes of liquid than in the past and are better tolerated. Another newer option is sodium sulfate-based tablets, which earned FDA approval for colon cleansing two years ago. In light of your family history, we urge you to see your health care provider to discuss all of these options.

Thank you, as always, to everyone who took the time to write. We love hearing from you and will continue to respond to as many of your letters as possible.

(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)