I'm not a doctor, so I would wait for anyone with more knowledge to chime in, but even the flu can create heart complications if exercising too soon. https://www.dw.com/...the-heart/a-16309687

And since it looks like covid19 might affect heart as well, maybe your doctor is right.

Your doctor is right, in fact, why do you have to do any training right now anyway? Find another hobby for awhile, one that keeps your HR under 70..

I hope you plan to only run INDOORS.

Aren't there also suggestions that it can also aggravate and reduce lung function?

Dude, just chill out for a bit and kick the thing properly. There's going to be no racing for a while.

[caveat: I'm not a doctor or any sort of medical professional]f

https://elemental.medium.com/...rything-2c4032481ab2


First thing that popped up when I googled Covid and Blood.

Oh and run with a mask please, somewhere there's no people, I don't think you can pass it on to other animals except cats, stay away from the big ones.

I tend to agree with the hypothesis of the article (actually had sent this hypothesis to elder relatives in my network who have things like hypertension and diabetes), which is why you hear people saying that it felt like they went to altitude and were sucking wind constantly.

Best of luck to Renfrew. I am sure you will come out OK from all this.

I don't know how the medical system works in South Africa. But, here in the US...if I received medical advise from my Doctor that I wasn't sure about, I'd ask my doctor for a referral to get a second opinion...specifically to a "specialist" of some kind for the issue at hand. However, I would follow his/her advise until such time that I have a more informed opinion.

Thanks very much to everyone for the replies. I fully appreciate those comments that have urged caution and made the good point that there is nothing to train for now anyway. Funnily enough, I was actually training for the Quarantine Backyard Ultra, which is on 11 July. But that's out of the window now.

My problem is that I get very depressed when I don't run/cycle and so was hoping to hear some anecdotes from people who have managed to get back quite quickly. But I take the point that there is good reason to be hyper cautious with this virus and that there is no benefit in rushing things. I will just have to buck up and be patient.

And I did also want to take the opportunity to assure those of you who made comments on the question of social distancing: it would not have crossed my mind to leave my property to exercise while positive. What I had in mind was either running on a treadmill or using my Kickr/Zwift.

Slow down relax and smell the roses my friend. Tri will be there waiting.

Unless you're aiming for chronic fatigue syndrome you might want to take it easy for a while. You don't want to cause anymore unwanted long term symptoms. Best to take things very slow for a while.

I have a friend that had Covid-19 a month back. They took a week off and had some tightness in their chest, fever and coughing, but then went back to riding their mountain bike daily by the second week. They are now fine and fully recovered. I don't know if I would have ridden outside like they did simply because I wouldn't want to be a spreader of the virus like that.

Then again, you hear the horror stories where people feel fine one day and then their immune systems start going haywire and things go downhill quick. So it is all a bit of a gamble.

I managed it unsuccessfully, but am 54 not 42. From all accounts that I've seen, people's response to this virus is highly variable. You might be fine keeping some light exercise and only ramping up again once you've been symptom free for a couple weeks. I went through several cycles of taking a break, then starting up again. Here I am three months later with a cough still. Would it have been any different had I completely taken a break for a month or two at the outset? That I can't answer, unfortunately. But there are people that were more severely ill and have fully recovered and are back to where there were before becoming ill with it in a much shorter window of time. Best of luck to you.

Agree with the rest suggestion - no clue where your doctor got the 6 weeks of low HR so it would bear researching. Pulmonary symptoms may take up to 5-8 days to develop after onset of infection. AFAIK the clotting issues are with moderate/severe cases with most people being asymptomatic or mild eg self limited viral illness.

Good luck.

There could be something to continuing to exercise a little to regulate the immune system. I AM NOT A SCIENTIST OR DOCTOR. This is conjecture. The body likes consistency and stasis...so if you usually exercise daily, your body could be expecting that.

---

"The person on top of the mountain didn't fall there." - unkown

also rule 5

I've given some more thought to your inquiry about managing a Covid illness. And what I realize now, more than three months into my own battle with the virus, is that you don't manage a Covid infection. It manages you. I'm sure you can do things to make it worse. But you can't necessarily approach it in a way that you are assured to bounce back to your previous level of health in any given timeframe or even at all. There's a very real possibility that your mild condition could persist into the indefinite future, or at least for several months. And you may begin to experience cardiovascular, pulmonary or neurological impacts from this illness that you have yet to see. I've read of people having a mild illness for several months and then crashing with a severe case of it and ending up in the hospital.

Sooo, that said, don't push it. Don't push it at all. If you want to do some light activity, okay, do that. I'd recommend walking, perhaps 10-15 minutes to start, with maybe a minute of jogging mixed in here or there. Take way more rest days than you'd ordinarily take. Way more. Do some light activity. If you feel good, do some the next day. Then take a day off. Take another day off. Watch your eating, eat as healthfully as you can. Avoid alcohol. Get plenty of rest. If you need naps take them. As much sleep as your body wants. Be kind to your body.

If in a few weeks, you have no lingering symptoms, then by all means, consider gradually working your way back into the training. But definitely don't push it yet.

F(&ck sake, do we really have to say this?? Stay indoors.

You have a highly contagious disease, that may not affect you, but will certainly affect others.

Stay indoors.

If have a treadmill, cool, otherwise...

Stay indoors.

Oakie, you clearly have an insatiable desire to virtue signal on the internet. Either that, or you have somehow managed to learn to write (admittedly imperfectly) without learning to read. In my first post, I mentioned my treadmill. In my second post, I expressly dealt with the issue of social distancing. This thread has nothing to do with the question of whether it is desirable for me to exercise outdoors with Covid 19. Clearly it is not.

This is excellent advice. Thanks so much!

This comment, and the one above from nightfriend, really sum it up for me. I could be fine if I start again next week, or I could unleash something unexpected. So, the best advice seems to be to be conservative in the short/medium term and then only ramp it up in a couple of weeks, once enough time has passed.

This is an odd conclusion - I'd suggest the best advice is probably the advice given by your Doctor as opposed to an assimilation of a limited number of personal experiences from strangers on the Internet.

I feel your pain, if I had to take an enforced break for 6 weeks it would drive me mad.... however, it is the right thing to do. The simple fact is that like many of us here, you are adicted to exercise, giving up exercise is probably as hard as a smoker stopping smoking. However, we know that smoking is bad for us and we believe that exercise is good for us.... except in this case it is not, continuing to exercise may be bad for your recovery and long term health.

A triathlete I know had Covid in March, in one of the first outbreaks in Europe. He was not seriously ill, and recovered at home, however, he was only able to return to exercise very gradually. 4 months on and he looks great, we did a fun triathlon last weekend, and it was clear that he is fully back to speed. You are just 42, Covid is going to knock you back for 3 or 4 months, but its a blip, you will have recovered any lost fitness easily by the end of the year

Sorry to hear about your diagnosis.
I am a doctor, am one of our COVID leads at my major tertiary hospital and also on our national COVID taskforce.
COVID-19 is a highly variable disease. It sounds like you have been fortunate enough to so far be at the much more milder end of the spectrum, in fact there are probably a fair few on this forum with similar symptoms who by virtue of either not having access to testing or there not being concern for COVID in their area, do not actually realise they are also COVID +ve.
I think your approach is very sensible at this point in time. With your current symptomatology I would also agree with the advice to avoid any form of high intensity exercise. I get what it is like to be an injured or sick triathlete, we have all trained through the flu and various other disorders before and overall if your symptoms are mild with COVID then you can probably take the same approach. You may find yourself obviously a lot more tired than normal and unable to maintain a pre-COVID level of exercise intensity for the same relative heart rate. I would advise a cautious approach, keep the intensity low, keep the duration low (runs between 30-45 mins, rides less than 60-75 mins). You will lose fitness over this period but the mental health benefits from some exercise are generally underrated.
Listen to your body, if it does not feel right, if it feels too hard etc then just stop and rest for another day. Sick patients with COVID tend to behave in certain ways, it sounds like you will almost certainly avoid being very sick with it, but you don't want to add much in the way additional stress on your immune system at present.
Good luck and let us know how you go. Feel free to DM me if needed.

Below is a link to what the american college of cardiology currently recommends and why. Basically in hospitalized patients they see significant cardiac effects in about 25% of people. There’s concerns about what this could mean in asymptomatic people and mildly to moderately symptomatic people who exercise heavily and stress their heart. While not much evidence, they have proposed return to play guidelines included in the article.

I too get depressed when I don’t exercise. But it might help to understand the reasoning behind the recommendations and what to expect. Might be good to forward on to your doctor for a discussion.

https://www.acc.org/...ovid-19-pandemic-era

I’m not dispensing medical advice, just giving you current guidelines and recommendations to discuss with your doctor. Best of luck!

great reference
thanks

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Brian
“Eat and Drink, spin the legs and you’re going to effin push (today).” A Howe

https://www.thesun.co.uk/...vivors-struck-by-me/

This is the outcome that you want to avoid. Unfortunately, there are more than a few infected with the virus that are heading down this path. So, whatever it takes to bolster your immune system and help your body handle the virus and return to full health, that's where you want to be focused. Hope you are doing well.

I would listen to the doctor who is not an athlete over the athlete who is not a doctor. I hope you get better either way!

With or without a Covid diagnosis, the fact that you find not training for six weeks intolerable is a problem. Sounds like something you might want to seek some help on. I wish you all the best for a speedy and healthy recovery.

Tim

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http://www.magnoliamasters.com
http://www.snappingtortuga.com
http://www.swimeasyspeed.com

This is my story - don’t do it , take off a full month minimum

https://www.triathlete.com/...e-after-coronavirus/

6 weeks without active exercise should be intolerable for a human living in modern society's because we don't move much in modern society like our ancestors did. Some people need more motion, some can live with less, but modern living is not at all normal for humans as far as evolution is concerned. If the guy is an office worker now on work from home and barely moving, he probably wants and craves some motion (because that's just part of being human). If he's working on a farm or in constructruction, then what you're waying is probably valid.

I would err on the side of caution for a few weeks, but keep moving/running conservatively if you feel fine (sounds like you do for the most part). A colleague of mine is 42 years old and was just admitted yesterday to the hospital as his symptoms grew worse after a week of fighting covid. My colleague's mother in her late 70s also tested positive but is completely asymptomatic with no issues.

I agree. I go bonkers without getting some physical activity for more than a couple of days unless I'm flattened by an illness.

Good story and great info, thanks for sharing this.

There’s a big difference between not training and moving. But semantics aside, my experience is the triathlon community has an issue around training.

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http://www.magnoliamasters.com
http://www.snappingtortuga.com
http://www.swimeasyspeed.com

Well you are projecting your view that the triathlon community has an issue onto him without knowing what else he may or may not be doing for normal human activity. When I go on business in a European city between hotels, trains, subways and walking, I may do 15000 steps of walking just getting around. If I go to Houston on business, I may only walk 2000 steps total. So if I am in Europe or Japan, I don't feel I want to do additional exercise (although I may still choose to only to help adjust to jet lag faster). If I am in North America, espeically on a day at home just going to my office, I feel a desire to exercise just because my body is expecting more motion. But I could go for a walk with my family and be perfectly content.

Generally when I am sick, I just stop till i get better, but on the "recovery end" of an illeness, I do get itchy to go exercise and move again. Its pretty normal for humans to move around. All the people out jogging, biking, walking, hiking during Covid19 who are otherwised couped up on work from home or unemployment from home is a testament to the need of our species to move around.

This seems to be a tricky aspect of Covid for typically active people experiencing mild symptoms. That urge to get back out and return to an exercise routine with symptoms that don't feel that bad can really get us. For those of us who are used to recovering from the occasional illness and reintroducing ourselves to training as the illness wanes, the potential severity of this virus can be really deceptive in how mildly it presents.

...and in support of what SnappingT is alluding to, I think most triathletes are generally smart enough to feel out when to return from small stuff. When we have big stuff covid19 or anything else we should defer to medical staff, but I don't think it's a bad psychological state for an athlete to want to get going. Businessmen want to get going quickly, artists do, researchers do, politicians do and even race horses do. It's a pretty common trait for those who really enjoy what they do. It's a problem when it becomes self destructive.

But for a performer of any kind to have the mindset of doing what they do, it's fairly normal mental state.

The OP doesn't know how to cope with not training. I understand this, and it is also the reason why taking a break from training now is so important. It is better to plan for a healthy future than take unnecessary short term risks.

I think we are in a agreement that for major illness (and this generally categorized in that group), you don't want to play around pushing things during and starting too early on the recovery swing.

But based on limited information, I don't think any of us know if the OP is incapable of dealing with not training (that's what you said, but he did not explicitly say that). He just says he likes training as it helps him avoid being depressed (but we don't know if its clinical depression or he's using the world lightly.

There is limited data on this virus right now to the degree to which it affects people as many carrying on with day to day life, without any clue they are carrying it while others are at the other extreme in hospitals on ventilators, so he MAY be asking in that context of those on the extremely mild end that is so mild that its almost undetectable. But I don't know. Many here may have had mild cases already and not even noticed anything and carried on with life including training. As more data emerges on who all have antibodies, maybe the base of knowledge will be wider for the medical recommendations. For now, it seems to basically be "if you have it, stop everything" which makes the most sense given how little everyone knows about it.

Are you effing insane? The guy tested positive the morning he posted about having training withdrawls. It's ridiculous and so are you. His doctor said keep the HR below 100 for 6 weeks. That means NO TRAINING.

The OP needs to listen to his physician carefully and get a re-evaluation after 6 weeks. Any other course of action will likely have long term health consequences. This isn't something to screw around with and you're not a doctor Dev.

He needs to listen to his doctor. I'd say get a second opinion in many cases, but it's not like any other doctor would tell him otherwise. He needs a break physically. Mentally he needs an evaluation, if taking a few weeks off is such a difficult thing. Everything happens for a reason. Take a break, rest, do other things and come back healthy. Any other advice is reckless. You need to take this seriously and listen to your doctor.

Hey I fiigured by your somewhat animated response towards me here and on the thread about races where swims are at the end, it must be someone who already has a history with me, so OK, now I get your responses after checking that you changed your profile from mwanners. Now we can move ahead knowing who I am discussing with.

The doctor said keep heart rate under 100 bpm. Not sure why the doctor picked that number. Maybe it should be lower than 70. We don't know his rest heart rate and how much headroom he has at 100. And we actually don't know if he has a problem of any kind related to training other than a statement he made on this forum. For all we know he could be BSing us.

But at 100 bpm, I could be swimming, cycling and running every day, but that does not mean its a good idea (I personally would just go walk and stretch and do some light yoga to keep the body doing something at an ultra low intensity).

Really the doctor does not definitively know the long term, but they can project (no doctor knows definitively since the data is all new and we don't know what becomes long term and what the body regenerates....well until long term happens several years from now). I would question the doctor if he randomly gave me a cap at 100 bpm. Why 100 bpm? Why not 70 bpm?

This is what the OP posted.

:My doctor is not an athlete and is very conservative. He wants me to keep my heart-rate below 100 bpm for the next six weeks! The thought is absolutely intolerable to me. So, what I am wondering is whether any of you carried on running in the first few weeks of a Covid diagnosis, and how it went. I appreciate that, in the short-term, it would be prudent to avoid anything high intensity. But I was hoping to carry on working out in the aerobic zone, as long as my symptoms stay mild. I would love to hear from anyone who has managed this successfully."

I believe he is questioning if his doctor really knows what he is doing or erring on the convervative side (the latter is probablly a good thing). By asking on here, he's probably trying to get to what other docs around the world have prescribed and maybe he just wants confirmation that his doctor is correct.

Have a look at this text from the article that UKKINNY posted from his own experience:

For those who were asymptomatic, guidelines recommend light exercise for two weeks and close monitoring of symptoms. Those with mild to moderate symptoms, like Stephen Day, are advised to take an additional 10 days to two weeks of total rest after all their initial symptoms resolved, which might end up being four weeks off. That turned out to be accurate for Day. Anyone who has been hospitalized, though, needs to use extra caution.
“What we’re worried about is myocarditis,” Roberts said. Myocarditis, inflammation of the heart muscle caused by the virus, can weaken the heart, and cause arrhythmias that can be fatal. “It’s hard to tell who has had scarring of the heart muscle. Muscle aches, one of the symptoms of COVID, is the virus attacking the muscles, and if it’s attacking the skeletal muscles, we can assume it’s attacking the heart muscle too.”
Since it’s hard to tell who has experienced myocarditis and how that will affect the individual patient long-term, Roberts agreed with other experts that anyone whose symptoms were severe enough to require hospitalization should take extra time off from exercise and have cardiac testing before resuming training. If myocarditis is confirmed, the most conservative paper recommended three months of no exercise, cardiac testing, and careful monitoring by physicians as training is resumed.
While there’s no hard data on weakening of the immune system post-COVID, as Day experienced, it aligns with what’s known about other viral infections, Roberts said. The good news there is that it’s temporary, like the lapse in immunity after an intense workout.
Further confounding athletes’ return to training is that three or four weeks of total rest will result in some deconditioning. So is that feeling of being totally unfit, as Day described, deconditioning or a sign you’re not ready to work out?
“That’s part of the difficulty. There are not great markers,” Roberts said. “My guess is, if you exercise and feel fine the next morning, that’s okay. If you’re still tired the next day, if your heart rate or your morning pulse is high, you’ve probably done too much.”
Both the RTP guidelines in the German Journal of Sports Medicine and JAMA Cardiology recommended that athletes who have had mild to moderate viral symptoms have an electrocardiogram before returning to hard training. “This is controversial. I tend toward doing the study [ECG] if there is a symptom, but others would disagree,” Roberts said.
The red flag symptoms Roberts is talking about are chest pressure or pain, feeling like you can’t get your breath, racing or erratic heartbeat, or feeling like you just can’t get going, very heavy, for a few minutes at the start of exercise. If you experience any of these symptoms in your return to training, Roberts recommended being evaluated for possible myocarditis.

His doctor gave him very specific instructions with a specific target maximum HR. If he wanted to question the guidance the time to do that is in the office.

An internet chat room on endurance sports is not the place to obtain a second opinion regarding a Covid19 medical diagnosis and activity levels. In terms of myocarditis, I think you proved my point. You don't want to develop it under any circumstance and no it's not worth the risk. I would absolutely listen to my doctor on this one. There are too many unknowns. His doctor was pretty specific and I would think he knows his patient.

Hi -

As always, YMMV, but here is our experience to date with this virus. My 22yo daughter, a former d1 college swimmer and extremely fit, was diagnosed two weeks ago with the virus. She has asthma, so we have been worried about what would happen when she contracted it.

For 10+ days or so she had a headache, nausea, burning nose, and fatigue, and after a week or so a slight cough. She was talking about being able to resume working out again in a couple of days, but was still sleeping a LOT and feeling pretty lousy. But we were hopeful.

Then without warning the cough dug in, her chest hurt, her 02 dropped and it became harder to breath.

Today is Day 14 and she is in the ICU. They are monitoring her inflammation markers in concern of the dreaded cytokine storm. Her lungs are clear in terms of the covid glass effect but she has pneumonitis/bronchitis and her blood work has been wonky. She is stable and we are hopeful, but the doctors warned her it can go south fast and without warning.

My husband, an ironman, and my youngest daughter, a college swimmer, are also positive. My husband has a fever but insists he feels ok and talked about working out the other day as well. As the only allegedly healthy human in the house I shut that one down fast lol.

See the thing about viruses is, your experience depends on how your immune system responds to it. There is supportive care, and things that you can take or do to try to HELP your immune system fight back, but it really boils down to you vs virus. Six weeks of your life, or at least until you test negative, is a small investment to make to help your immune system fight the virus. Because once it gets a toe-hold, you have NO control over how it goes from there.

Just my .02.

I am new to Slowtwitch and not entirely sure what the etiquette is when it comes to replying to posts. There have been several that came in since I last posted to which I have not directly responded - I just wanted to say that I am grateful to everyone who has taken the time to write. In this case, I felt that I just wanted to say a special thank you for taking the time to post despite all that you are going through. And, even more importantly, I am sure that everyone reading this is holding thumbs that your daughter improves rapidly and recovers fully very soon. All the very best!

Thank you for your kind thoughts! And please, be patient and cautious in your approach to dealing with this stupid virus. A relatively short break now is worth it to enable you to maximize your longer term health. IMO, lol.

I found this article to be very interesting.

https://theconversation.com/...lication-ards-136922

He has done a bunch of research on exercise and its protection for non-progression to ARDS.

I have read on these pages 100s of times that, 'you shouldn't exercise when you are sick." I have had a very hard time finding anything that offers convincing evidence that exercising while sick is actually bad for you.

My 76 year old father tested positive two weeks ago. He called me after finishing a 25 mile bike ride to tell me that he had tested positive but felt fine. He eventually developed a bit of a cough but has essentially sailed through to this point, exercising throughout.

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----------------------------
Jason
None of the secrets of success will work unless you do.

If this doesn't give you pause nothing will, so go for it and see what happens.

https://www.cyclingweekly.com/...onavirus-race-459193

Funnily enough, it was this very article that prompted me to ask the question in the first place. Having read this article, my concern was that not exercising could actually do more harm than good. It corresponds with my own personal experience of illness, long before Covid entered the picture, as an asthmatic. Because I am asthmatic, I get upper respiratory infections quite often (whether it is because of the asthma or the asthma medication is another interesting side issue). My experience is that I actually struggle to clear the lungs for longer if I refrain from exercise. I appreciate that this is a different issue to what is flagged in this article, but because that was my prior experience, the article seemed very important to my position.

A lot of people have made reference to experiences (either their own or loved one's or that they have read about) of people with pretty severe symptoms. It has never been my premise that a person in that position should, despite feeling poorly, be encouraged to exercise. I have always accepted that if I felt fatigued, feverish etc, it would be reckless to push through and exercise. My question was based on the fact that I have had extremely mild symptoms, no fatigue and oxygen levels of no lower than 97% throughout (I have a finger oximeter that I have been using). In that context, I wondered whether it would actually be counterproductive to rest entirely. From everything I have learned since posing the initial question, there does not seem to be a definitive answer to this question. But what does seem very clear to me is that it is not massively helpful to refer to the experience of very sick people, including people who were sick and got even sicker with time, and use that experience as evidence that people with very mild symptoms are at risk of deteriorating if they exercise. (And a big thank you to Amnesia for guiding my thinking on this.)

As someone experiencing very mild symptoms, what I have taken from all of this is:

(a) Many people with mild symptoms may be able to exercise with Covid and not suffer any ill-effects.
(b) Some people with mild symptoms may suddenly deteriorate in due course (and after a period of time in which they probably thought they were in the clear), and exercise may or may not play a role in this (although no-one here, or elsewhere that I have seen, has presented evidence that exercise is to blame).
(c) Although there is no clear answer to this, I feel uneasy about refraining from exercise for weeks at a time when I otherwise feel well, because I am worried about giving up the other protective benefits of exercise.
(d) From tomorrow, I plan to experiment with some low impact Zone 2 work, building up slowly every day and stopping immediately if it makes me feel worse. As time passes, my load will naturally increase in parallel with how I am feeling.

And sorry, to be clear, the article to which I am referring in the previous post is the one posted by wannabefaster. The article posted by WFPB Athlete does not, unless I am missing something, seem to take this issue further at all. It is not even clear from the article whether the athlete was Covid positive.

You're intelligent and you've done some research and gotten some feedback. Let me tell you how I'd look at it.

The cyclist was racing and redlining. You don't plan to do that.

The lady who's daughter is a swimmer and had an exercise induced relapse is very correlative to your situation and realistic.

In the end, I'd listen to my doctor. They're conservative for a reason. It's not always just a non-athlete perspective. They look at the illness and not the individual. Our systems are all the same. Some will react to illness better than others, but that is a total unknown. They have to be fact based.

What is a few weeks of exercise worth to you. Is it worth months of no exercise if you have a setback or potentially years or a lifetime? Common sense says sitting out a few weeks may actually do your body and immune system a lot of good, so you can come back when ready stronger and most importantly healthier. It's a simple cost\benefit analysis and you have little to gain by doing some weak ass training now with a compromised immunity. Heal and and come back when the body is ready.

Dunno about you but 100 HR let's me do all three sports as well as weight training at a low Z1 effort.

And I'm from NYC and was one of those people that had it very early, pre-lockdowns, maybe even December, and never even realized it. Didn't slow down my training at all.

On this though, I'd play it safe if I knew. The doctor may know something about OP's condition that we don't that makes it riskier. Maybe. Not all doctors know their patients well. Mine doesn't see me enough to know me well.

Everyone can react so differently that it's still tough to know what to do, so it's entirely possible that the doctor is giving "lowest common denominator" advice. I wouldn't be shy about questioning it to him/her or other doctors. 6 weeks seems extreme and well beyond the guidance of other medical advice I've seen given by other doctors.

The fact that you are so willing to take a first opinion as the final opinion and so against seeking further medical guidance is a mistake for literally any non-trivial medical diagnosis. Maybe 6 weeks is right for OP. But I'd feel better about that if I heard it twice from different doctors.

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Too old to go pro but doing it anyway
http://instagram.com/tgarvey4

Just a general statement and question for everyone involved in this conversation. And by no means am I trying to hijack the op thread. I got my covid-19 diagnosis in May as I have posted on here about it. But this thread makes me wonder if I should go get checked out before returning to really hard exercise. My symptoms were relatively mild with the exception of three days of really high fever and an elevated heart rate as well as a loss of taste and smell. There were other things but we don't need to go into all the details. As my diagnosis took almost a week from the onset of symptoms till I was confirmed positive I continued to work out finding it unlikely that I was going to have it. With that said I was only running 30 to 40 minutes at a time with some zone 2 and zone 3 mixed in. After I found out I was positive my first thought was that this should help keep my lungs and airways open but after reading this post I wonder if I should go have my heart checked. I have returned to working out after a short break and I'm starting to add back intervals.......
If I was to reach out to my family physician and tell him that I would like to have my heart checked what kind of doctor and what specific tests would I request?

This is just terrible advice.

To the OP: one of the pro tour cyclists, Colombian sprinter Fernando Gaviria, had the virus. He was out for months, if he can, you can. Just take the time off, just not worth it gambling with your health.

I believe what Renfrew is saying is that with his asthma, mild exercise MAY actually help him dealing with various illnesses. This MAY be wishful thinking on his part, or it may be valid. None of us know enough about him and I believe what he is saying his doctor does not know enough about this virus' effects on active people who get a mild to asymptomatic case (there have to be lots of asymptomatic people hammering through not even knowing they have it) that he wants to read more, hear from others and what their docs said etc etc. The 100bpm limit is plenty of head room for many of us to do all three sports, so I'd say its actually too high if the doctor wants him to do nothing. Or maybe the doc knows the patient well and is thinking, "I won't be able to get this guy to obey me, so I will tell him 100 bpm and he can go jog or spin, since for other patients 100 bpm would be walking to the bathroom....so I will keep him inside that"

you might be right. it might be terrible advice. or it might be that your advice is terribly uninformed, which would not be an indictment on your advice, rather just a function of how much we don't know about this particular virus.

i suspect the conservative approach is probably the wise approach. but i don't know. do you? because, if so, i'd like to see the citations. i have no citations for you. therefore, i'm not comfortable giving advise with demonstrative authority.

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Dan Empfield
aka Slowman

Just google Sports Cardiology and Coronavirus and that will lead you to studies and advice from Sports Cardiologists on how and when to return to sport after having coronavirus.

don't tell me. tell the people who're giving certain advice here. if you're going to give your opinion, based on nothing - which is what i would be doing if i gave an opinion - then fine. everyone is welcome to do so. but if you're going to castigate people (and there's a lot of castigating on this thread), then i'd like to see the citations. or, your background that qualifies you to give demonstrative, conclusive advice.

we have heard from one doctor. "I am a doctor, am one of our COVID leads at my major tertiary hospital and also on our national COVID taskforce." the OP now has the advantage of his advice.

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Dan Empfield
aka Slowman

Are you suggesting that the part in bold is bad advice. This seems to be the advice most in the medical community are giving given we don't know much YET about the long term....and I closed that sentence with "which make the most sense given how little everyone knows about it".

So I believe people are conflating the desire to understand what SHOULD be the proper protocol with the options of what a person does now given no known definitive protocol exists YET. It seems what we should do to be safest is rest. Meanwhile, searching for what the various paths out of an illness is a good area to advance scientific understanding.

The article that UKKINNY posted with the doc from Twin Cities Marathon discussing areas he is concerned about is very sensible. We have ex pros friends who raced when ill and had long term heart complications, so its seems to be a good area to be concerned about. the OP's doc putting a 100 bpm lid on activity takes care of extreme load on the heart from my vigorous exercise.

What some athletes are able to handle and deal with for example during and coming out of chemo and coming out healthy is completely different from an 80 year old with a lifetime of smoking, and the docs may permit more activity for young and robust if it helps them on their next round of chemo.

So the discussion is around trying to gain more knowledge on a topic. Shutting down a discussion when there is no definitive path YET does not get us to better understanding. The entire world are guinea pigs on this right now.

It may just be that the OP's doc's lid of 100 bpm send up being standard protocol for all in 5 years. Or there may end up being wide range of 'return to work/plan/life' for the infected depending on what range of symptoms they show on what days and intervals in between with no deterioration. It took a long long long time for the medical community to come to any consensus on concussions and even there lots of it still has individual variances, but return to play protocols are pretty solid now.

What's the return to work/play protocol for various degrees of Covid19? I believe this is essentially the OP's question.

On the Gaviria front, he got it at the UAE tour, doing daily 4-6 hrs stages in the desert for a week, while he was expected to be set up for stage wins in the sprint finishes, after long haul travel, so what may have got him lightly may have hit him harder (we don't know) due to the stress his body had at the time. It sounds like he did several stages with the virus before he knew it. I do hope he makes a great recovery. What the Twin Cities Marathon Doc implied on stress on the heart probably is a big concern. I'd guess Gaviria would have unknowingly dug himself a big hole potentially racing that hard with the virus.

I believe like the case for concussions, there will be some major and serious research on return to play from Covid19. Why? Because pro soccer, football, hockey, rugby etc etc players will all get this. There is a lot of money at stake with respect to players getting back on the field and competing for their team once "better" so given all the money at stake, there will be a decent amount of fairly thorough research that will emerge over the next 2 years. The first problem is getting players off the field if they have Covid19 so they don't screw up the entire team, but the bigger problem is how will they get them back (Euro soccer leagues are all largely playing now).

So we'll get a lot of good answers over the next 6 months to 2 years. Right now the conservative approach makes sense, but it may not be the best one. Lots more data and studying to come in the future. Even once we have a vaccine, a lot of people will get this thing and many of us may have had it (we may know with good antibody testing) so I am genuinely interested in how this field advances.

I see your plans for moving forward with some Z2 work, and of course you are in the best position to decide for yourself what approach to take. It looks like you are going to remain very aware of your physical condition and symptoms and adjust accordingly, which is smart. Some parting thoughts which you are welcome to consider or ignore:

• Add more recovery than you typically take for the training load while you still have symptoms
  
• Consider noting your symptoms and severity on a daily basis and your fatigue level so you can look back and evaluate wellness and progression
• Keep an eye out for new symptoms or things that change in your body that you might not think are related and that are easily dismissed or ignored. A few examples that I've seen people mention: elevated or depressed heart rate; blood pressure changes; heart palpitations when you sit / lie down / rest; hot flashes but temperature remains normal or low; tingling sensation in your arms / legs / hands / feet; random pains in muscles, joints, etc. that aren't training related.
  

Check back in and let us know how things are going in a few weeks. Wishing you a speedy recovery, and best of luck.

Given the seriousness of this virus and potential long term effects what would it hurt to go back for a quick check up before resuming a normal fitness routine. Let your physician determine what if any tests are needed. He might want to check lung function with a spirometer. He might check your blood, blood cell count, vitals, etc. What's the copay $20? I'd go for it even if I felt okay. Erring on the side of caution is wise. On the other hand if you feel fine it's really up to you. If it's on your mind go get a check up and you can put it behind you.

You might think about a referral to a sports cardiologist - - a growing field, so you may not have access to one. Then, perhaps a referral to sports medicine. COVID and heart stuff and returning to sports is HOT now in those fields, with ongoing and newly published research, the American College of Cardiology is really on it and and there are recommendations out.

I am not basing it on anything other than simple logic, not sure that requires citations. First he states that probably the right thing to do is to be conservative and take it easy, ok (most medical professionals would agree on this, are they misinformed?)... then he adds that most of us can't stay seated so might as well do something which is probably not the right thing to do. If anything, we should be encouraging him to take it easy. Many of us have been there, pushed ourselves while having a virus and instead of taking a few weeks or months to recover ended up taking years.

3 cousins (same immediate family) tested + for COVID. They were all pretty sick for 2-3 days, then almost back to normal. One is 51...he was mowing the lawn by day 4 & aside from a slight fever was pretty much normal. Depends on your ability to fight this thing off. We are not all created equal. None of them are athletes, and could lose a pounds--it doesn't strike everyone the same. Good luck Renfrew!

Thank you!

It seems to be one of the ten commandments of exercise: thou shalt not exercise when sick.

I think that this is one of those things that gets repeated over and over and over until most people just accept it as the truth. I have looked and looked and looked and I have been able to find very little scientific data out there to reinforce this long held "truth".

It is my belief (supported only by my anecdotal experience) that exercise, and even hard exercise, can accelerate the healing process when you are sick. It would be a really cool study to conduct.....


ETA: There is some pretty good research out there on myocarditis and exercise and actually a position paper on return to exercise after myocarditis. If you are ill and have cardiac symptoms, it is likely very wise to be very cautious about return to exercise. These are not the people I am talking about. I am talking about folks with standard respiratory/viral infection and not feeling well..... My outside of the box theories on exercising while sick are just that; my theories. You are responsible for making your own decisions. I don't want to hear about some lawsuit because, "wannabefaster told me I could exercise while sick." Proceed with caution ;-)

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Jason
None of the secrets of success will work unless you do.

here is what you wrote: "This is just terrible advice." what was the terrible advice? as well as i can tell, pretty much in sync with advice from the only qualified person on this thread.

i don't mind you using simple logic. but your logic is the logic of a novice. like my logic. dtoce, sphere, amnesia, they are not novices. dtoce is both a cardiac specialist and a front-line COVID doctor. and an athlete.

what i have read on this topic is that it might be okay to gently exercise. a walk. maybe a very easy run. depending on your symptoms, specifically, if you are asymptomatic below the neck, i can't find guidance that says go to zero if you are asymptomatic. can you?

but there is a separate issue: your ability to communicate this disease to another. the runs i'm doing right now are in a national forest, on a trail that has zero traffic. zip. zero. no other people. i drive to a spot, park my truck, run, get in my truck, go home. never see another person. if i did see another person in the distance, i would (if i had this disease) step well off the trail, well in advance of encountering another person close up. so, i'm going to infect what? a squirrel? a pine tree?

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Dan Empfield
aka Slowman

Not to hijack the thread, but a nice aside since this thread and your insightful response gets at the heart of a book I just finished. The book is The Death of Expertise and it's all about how lay people believe and argue that their opinions have the same weight as an expert. The book points out, for a variety of reasons, that those opinions aren't the same and that's why you want to listen to experts.

Tim

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http://www.magnoliamasters.com
http://www.snappingtortuga.com
http://www.swimeasyspeed.com

are you insinuating that my opinion is not equal to yours on swim training? ;-)

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Dan Empfield
aka Slowman

Every. Slowtwitch internet thread ever. These cv19 threads are just the worst examples of it.

I'm really fed up with it.

WFPB/ Upstaterun

Definitely think I will get a check up and push for getting the ticker checked

Certainly won't hurt and you will have peace of mind as you slowly start pushing your body again. I'd probably do it myself just so I would be at ease resuming a normal routine. Remember our activity levels are not typical of the average person.

I posted this at the end of the first page of this thread. For the record I’m a sports medicine physician who competes in triathlons. Everyone offering opinions and personal stories should review the link from the American college of cardiology. It reviews what limited evidence there is, why physicians have concerns, and also guidelines on getting back into activity. Again I’m not offering any medical advice to anyone on the internet but I am providing a good resource for anyone interested in what the current recommendations and why. For anyone who has a covid diagnosis and wants to know how to get back into exercise I would print this up and go to your doctor and discuss it.

Previous post:

Below is a link to what the american college of cardiology currently recommends and why. Basically in hospitalized patients they see significant cardiac effects in about 25% of people. There’s concerns about what this could mean in asymptomatic people and mildly to moderately symptomatic people who exercise heavily and stress their heart. While not much evidence, they have proposed return to play guidelines included in the article.

I too get depressed when I don’t exercise. But it might help to understand the reasoning behind the recommendations and what to expect. Might be good to forward on to your doctor for a discussion.

https://www.acc.org/...ovid-19-pandemic-era

I’m not dispensing medical advice, just giving you current guidelines and recommendations to discuss with your doctor. Best of luck!

And of course the link changed.... hold on I’ll find a new link/reference

Here:

https://www.acc.org/...ovid-19-pandemic-era