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NHS HIGHLAND GP: Long Covid gave me crippling fatigue and brain fog

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By Carolyn Forsyth

Carolin Forsyth.
Carolin Forsyth.

In October 2021 I caught Covid for the first time. My symptoms were mild, and I survived apparently unscathed.

In the weeks to follow, I gradually developed a host of bizarre symptoms, none of which fitted into the nicely curated diagnostic boxes I’d memorised in 20 years of practising as a doctor. I tried all I could to self-manage before eventually seeking help from my GP. They were as non-plussed as I was and advised there was nothing wrong and to ‘just be patient’.

I desperately tried to go back to work as a GP in the emergency department but suffered from crippling fatigue and brain fog. Several attempts to return to work on reduced hours failed miserably and I had to leave my job with no prospect of return.

After 20 years of working night shifts, I’d never experienced fatigue like it. I couldn’t concentrate and had no short-term memory. I did daft things, like putting the milk in the dishwasher or washing liquid in the fridge. I had chest pain and palpitations and if I stood still for any length of time felt like I’d keel over. I (briefly but terrifyingly) forgot how to drive at a busy roundabout and had to give up driving for a year. Then I was referred to the Covid Recovery Service (CRS).

I can honestly say that the single most important point in my recovery was the day of my CRS appointment. I was able to explain my symptoms to someone who understood long Covid and showed genuine empathy. Assuring me that my symptoms were due to long Covid and Postural Orthostatic Tachycardia Syndrome (PoTS), I realised it wasn’t ‘all in my head’ and there must be something that would help. I left my appointment that day with absolute certainty that I could recover and, with the help of the CRS team, I’m about 95 per cent there.

Having been discharged as a patient, I am now delighted to be part of the CRS team for NHS Highland. The CRS has a psychologist, occupational therapist, physiotherapist, GP and general medical consultant, all with a specialist interest in long Covid. We include our local cardiologist with a specialist interest in PoTS as an honorary team member to whom we can refer patients after PoTS diagnosis. The service focuses on supported self-management and rehabilitation using a person-centred, multi-disciplinary, lifestyle medicine approach.

Our medical consultant has been awarded an NHS Research Scotland Fellowship to conduct research into long Covid and its treatment. The STIMULATE-ICP, the largest long Covid study to date, is an ongoing trial to evaluate long Covid treatment that is only open to patients referred to specialist long Covid clinics. We are now pleased to be able to offer access to NHS Highland CRS patients.

NHS Scotland long Covid services have limited funding which is only secured for the next year.

It is estimated that 10-20 per cent of people infected with Covid-19 will go on to develop long Covid, with a conservative estimate of two million people in the UK being affected. Often a debilitating illness with multiple symptoms, it most commonly affects people of working age with significant reduction in their ability to self-care, earn a living or look after dependants. It is vital to raise awareness of long Covid and promote further research to help understand its cause and how best to treat it. Long Covid continues to have a massive impact on patients, their families, healthcare services and the economy.

Extending access to specialist services will help support more people to get their lives back, just as it has for me.

Carolyn Forsyth is an NHS Highland GP with a specialist interest in long Covid.

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