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