Another Post COVID-19 question

[Carrie Hardy]

Hello Everyone,

I have an ER nurse that contracted COVID over the Christmas holiday, caring for an elderly patient that was dying and had COVID-19 as well.  She was started on Thymosin alpha and has been using it since Jan and other supportive measures (vitamin D, zinc, quercetin, etc).  She is still having some dyspnea.  We have tested and rule out DVT and lung fibrosis.  She has seen pulmonology with PFTs that show a decreased lung capacity but not either restrictive or obstructive.  She is an admitted “mouth breather” and so it is suspected that she has relied on her accessory muscle for normal respiration that there needs to be some rehabilitation and this has been started (graded exercises with monitoring via pulse oximeter).  Her L&I doctor is suggesting that there might be a phrenic nerve dysfunction and wanted to know if there are peptides that might be helpful.  My first thought was cerebrolysin but this is impossible to obtain.  Any thoughts?  Thanks in advance

[William Seeds, MD]

@dr-carriehardygmail-com hello Dr. Hardy!

Had a chance to ask this Q in passing to Doc Seeds. He says:

Hopefully they’re using incentive spirometer that works on improving respirator muscles. intercostal muscles, and expanding the diaphragm to improve lung capacity.

For people like this over time, they need to do more nose breathing, b/c it makes them work hard to get the air in but also it brings in more O2. If you’re having trouble getting Cerebrolysin, TB4 in high doses is another option.

30 Iu’s twice a day for 6 weeks. Keep me posted — Doc

[Carrie Hardy]

Hello Keren and Dr Seeds

Thank you Keren for passing this along to Doc.  We are going through the retraining for nose breathing.   Thanks for the info on TB4.  Luckily I still have some of this in office and I will get her started on this as well

Carrie

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