Covid-19 has left me gasping for air. Will I ever be the same again?

Most people with Covid-19 are either asymptomatic or develop mild disease, and a few develop severe disease.

Photo credit: Fotosearch

What you need to know:

  • Typically, most people recover within six to eight weeks
  • A few people continue to have symptoms for weeks or months after the disease
  • The long-term complications are not well known

Dr Flo,
I am a 32-year-old man. In August, I was diagnosed with mild Covid-19. I was coughing heavily. Before the Covid-19 diagnosis, I was active in athletics. However, since recovery, I find myself sweating even after a short walk. I get tired easily and sometimes I get chest pains. Could the virus have left me with secondary infections of the heart?

Dear Sam,
Most people with Covid-19 are either asymptomatic or develop mild disease, and a few develop severe disease. Typically, most people recover within six to eight weeks. However, a few people continue to have symptoms for weeks or months after the disease, regardless of whether initially they had mild or severe disease. The lingering symptoms may include headache, confusion, chest pain, shortness of breath, cough, fatigue, loss of smell or taste, body aches, nausea, diarrhoea or abdominal pain. Unfortunately, since Covid-19 has been around for only a few months, the long-term complications are not well known, but it is thought that for a few people it may increase their risk of developing problems in the lungs, heart, muscle, bone, nervous system and mental health. More time and research is required to be able to address this adequately. In the meantime, it would be beneficial for you to be on follow-up by a physician or a chest specialist for supportive management.

Dr Flo,
I always get itchy and feel pain when I pass stool. I also spot blood in the stool and I have an anal swelling. The doctor diagnosed me with haemorrhoids. The medicine I was given do not seem to work as the condition keeps recurring. What should I do?

Dear Nick,
Haemorrhoids, or piles are veins that bulge or prolapse in the lower part of the rectum and anus. The walls of the veins stretch and get irritated, and easily get a tear and bleed. The piles may be on the outside around the anal opening, or may “come out” when passing stool, and sometimes can be pushed back in. These are called external haemorrhoids. If there are far up inside that they cannot be seen or felt, they are called internal haemorrhoids. They can be caused by straining when passing stool, for instance due to constipation or diarrhoea; any activity that causes repeated high pressure in the abdominal region such as a persistent cough and lifting weights. They are also more common in people who stand or sit for long periods of time, and also during pregnancy. Most of the time, they resolve easily with diet and lifestyle changes, and with treatment, though they can recur.
To manage the problem, try and prevent constipation by taking a lot of fluid and high-fibre diet every day, exercise, schedule time each day for a bowel movement, and take your time; use baby wipes instead of toilet paper, and you can also take a sitz bath - sit in warm water for about 20 minutes twice a day to help soothe the injured tissue.
You can take fibre supplements to help with passing soft stools. Laxatives and stool softeners can be prescribed by the doctor, in addition to creams that you can apply or suppositories to help with the healing of the torn tissue. Oral tablets may also be given. Treatment should continue until symptoms resolve.
In case there is no improvement with these measures, surgery may need to be done to remove the haemorrhoids.

Dr Flo,
For close to six years now, my skin has been itching after taking a shower. What could be the problem and what is the remedy?

Dear O B,
You are most likely experiencing aquagenic pruritus, which just means itching caused by water, a kind of allergy to water. Contact with water produces an intense itching of the skin, usually with a prickling sensation, without any observable rash or swelling. The symptoms can last anywhere from 10 minutes to two hours, and it usually resolves on its own.
There is no good reason why some people develop this problem, though sometimes it may be associated with some underlying blood conditions. Showering with hot water for some people actually prevents the itching because the heat affects the cells (mast cells) that trigger the allergic reaction. But, if you take a shower that is too hot and for too long, you can also get itching because of drying out of the skin.
You can use anti-allergy tablets and creams/lotions for the itching, though they do not work very well. Avoid using harsh soaps for bathing, or harsh detergents for your towels, because the chemicals in the soap can also cause the itching; and clean your towel regularly, like once or twice a week, to avoid growth of bacteria on a damp towel.

Dr Flo,
I have been having a smell, whitish discharge from my vagina for about nine months, which makes me uncomfortable. I have not gone to hospital due to financial constraints. Please advise me.

Dear Irene,
It is normal for all women after puberty to have a vaginal discharge. It is a mixture of fluid and cells that help to keep the vagina clean and moist and to prevent infection. The appearance changes depending on the menstrual cycle, and can also be affected by exercise, stress, use of hormonal medication and sexual arousal. The discharge may vary from white to clear, and from watery to thick, at different times of the cycle. It is also normal to have a brown or bloody discharge just before, during or after your periods, or sometimes in between your periods (spotting).
If there is abnormal colour (yellow, green, sometimes white), itching, a foul smell, or thick, chunky discharge, then most likely there is a vaginal infection. The infection may be caused by fungi, bacteria or other organisms. An infection may also cause pain when passing urine or pain during intercourse. Because the infection has persisted for a long time, you should see a doctor and have a high vaginal swab (HVS) and culture done to see if there is infection or the discharge is normal. If it is proven to be candidiasis, you can be put on antifungals for several consecutive months to prevent recurrence. Any other infection will be treated appropriately. Due to the financial constraints, consider visiting a government health facility (some have consultation fees as low as Sh20) or a free/subsidised clinic run by an NGO.

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