Several days ago, one of our regulars here on the blog emailed me — apparently motivated by a mix of solicitude and impatience. I hadn’t posted in a startlingly long time, the unapproved comments were stacking up, and he asked, “You doing OK?”
When I explained that my absence from this venue reflected a lot of things — such as being busy with family, and still dealing with doctors and such in connection with the lingering effects of my having had COVID — he asked, “Could it be long covid?”
Since I was going to see my pulmonologist next morning (Friday), I said I’d ask, but that I didn’t think so.
I was wrong. He said yes, that’s what this was. I had been confused for two reasons. One, I hadn’t really paid much attention to all the stories I’d seen about “long COVID” — which I assumed referred to a continuing, contagious presence of the virus itself — and up to this point the doctor had referred to my problem as “post-COVID.” Of course, I hadn’t worried all that much about what to call it; I just wanted it all to go away. I was tired not only of the symptoms themselves, but the side effects of the remedies (for instance, my difficulties sleeping at night, caused by the long course of prednisone I was on).
On Friday, the bad news was that my lungs — still impaired by inflammation from the long-gone virus — were only working at 67 percent of normal capacity. The good news was that overall, he saw me as having improved considerably, and he took me off the prednisone! Yesterday was the first day I didn’t take it, and I slept like Rip Van Winkle last night, and through most of this morning. It was wonderful.
He also took me off colchicine. I had wondered why I was taking that, anyway — it’s known as a remedy for gout. It can also be helpful with arthritis, I believe. I assumed it was for something he saw in the battery of tests he ran last month (which I repeated several days before this appointment), and which I could not detect.
When I asked, he explained that colchicine is an old, inexpensive drug that helps prevent a “cytokine storm” — which is the phenomenon that leads to so many COVID deaths. Wikipedia defines such a storm as a condition “in which the innate immune system causes an uncontrolled and excessive release of pro-inflammatory signaling molecules called cytokines. Normally, cytokines are part of the body’s immune response to infection, but their sudden release in large quantities can cause multisystem organ failure and death.”
Inflammation like that which had messed up my lungs. It seems that colchicine prevents such a “storm” through the same mechanism that alleviates gout.
The doctor said that I, and many others, had not heard about this use of colchicine because so many were talking about another, extremely expensive, drug that does the same thing. I didn’t write down the name of that other drug, because I was uninterested in anything that cost “$10,000 a dose,” especially since colchicine did the job.
So now, all I’m taking that was prescribed by this doctor is Vitamin D3 (which, I have learned, is actually a hormone rather than a vitamin, but since I don’t fully understand the difference, never mind). And he had me reduce the dosage of even that — from 10,000 units a day to a mere 5,000. He had had me on the high dosage because the standard range is 30-80 ng/mL, and mine was at 17.3 on the first test. He told me last month he wanted to get me closer to 60 than a mere 30. According to last Monday’s test, I was at 55. Satisfied, he reduced the dosage.
So, I’m getting better. The main restriction I had experienced was a lack of stamina. I haven’t done my normal 10,000 steps in a day since before I got the bug. I’ve tried, but I haven’t gotten past 2,000 without feeling great fatigue and beginning to cough again.
The doctor says it’s time to start getting exercise — and to get some sun as well, which I assume would help with the D3 — but not to attempt 10k. He says 3,000 to 4,000 is more my speed.
OK, now you have my update. Which I have shared in such detail partly to explain why I’ve been so unavailable, but also to make a larger point. Apparently, about a fourth of people who get COVID are “long-haulers.” This is a huge part of the effect of the disease on our society. In fact, I waited almost two hours past my appointment time to see him because he was overwhelmed with patients with my condition. This guy is really, really knowledgeable about it, and I think a lot of other doctors are doing what my primary-care doc did — sending their patients to the expert. Which means he’s getting better and better.
Anyway, I say all that for the benefit of those of you who make the mistake of calculating the effect of COVID solely in terms of the number of people who actually die. As tragic as every one of those 6 million deaths has been, and as horrific as they are in the aggregate, that’s not the entire story. There are other things happening as well…