Causes and treatments of Long COVID

By Dr. Robert Groysman

Long COVID has emerged as one of the most complex and challenging medical conditions of our time. Over the past few years, it has confounded patients and healthcare providers alike, presenting a wide array of symptoms that vary from mild to debilitating. Understanding this condition is crucial, not only for those who suffer from it but also for the medical professionals striving to offer effective care.

This book, the first in a comprehensive series examining the causes and treatments of Long COVID, is the culmination of over a year of dedicated work. It brings together the insights and expertise of Dr. Robert Groysman, MD, a leading authority in the field. Dr. Groysman has been at the forefront of treating Long COVID since the pandemic began, and his deep understanding of this condition is invaluable to anyone seeking to navigate its complexities.

 

Designed for both patients and doctors, this book offers an in-depth exploration of Long COVID, breaking down the condition into understandable segments. You will gain knowledge of the risk factors, the underlying causes, and the various treatment options available. Importantly, this book is not just about theory; it’s about practical, actionable strategies that can be implemented in real-life scenarios.

As you embark on this journey through the pages of this book, you will discover not only the science behind Long COVID but also the personal insights that come from years of hands-on experience. My goal is to help you understand what is happening inside your body, why you feel the way you do, and to validate that your symptoms are real and not merely “in your head.” Long COVID is a genuine medical condition, and this book aims to shed light on its many facets.

While treatment options are discussed in detail, I have deliberately refrained from prescribing specific dosages or one-size-fits-all solutions. Treatment is highly individual, and what works for one person may not work for another. This book is meant to serve as a guide, offering a clear strategy that you can discuss with your healthcare provider to tailor the best approach for your unique situation. Natural treatments, though often beneficial, can be harmful if not used correctly, and it is essential to make informed decisions in collaboration with your provider.

 

Dr. Robert Groysman on UK Talk Radio

 

Treating Long COVID

 

Through the experience of treating Long COVID and related conditions for over four years, I have seen the positive impact of a well-structured, personalized treatment plan. This book is designed to help you focus and organize your treatment into a working plan that you can share with your healthcare provider. While all the information presented is evidence-based, it is also enriched by my personal experiences and the lessons I have learned in the field.

This book is more than just a guide; it is a tool to empower you in your journey towards better health. Whether you are a patient seeking relief or a doctor looking to expand your knowledge, this book provides the wisdom and resources needed to understand and effectively treat Long COVID.

The goal of this book is to focus and organize your treatments better.  Most people hunt and peck from social media groups and google for treatments.  This would be similar to trying to construct a jig saw puzzle, but using several different puzzles for the pieces at the same time.  What kind of final result will you get? It just doesn’t work.

Long COVID is similar to describing a multi-car pileup. In each vehicle, people will have diverse injuries.  One will have a broken arm.  Another patient will have a bruised chest.  Another will have burns on the arm.  Despite a common cause, the treatments needed will be very challenging.  Each person’s treatment plan will be unique.  After you have read it, I hope I have succeeded in my goal. Please take a look at the other books in this series, including:

• Volume 2: The Complete Long COVID Handbook: Dysautonomia
• Volume 3: The Complete Long COVID Handbook: Mitochondrial Dysfunction
• Volume 4: The Complete Long COVID Handbook: Gut Dysbiosis
• Volume 5: The Complete Long COVID Handbook: Histamine and Mast Cell Activation

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Introduction to Long COVID

Long COVID, also referred to as Post-Acute Sequelae of SARS-CoV-2 (PASC) infection, Long Hauler’s condition, as well as many other names.  It is a condition characterized by either the persistence or the development of new symptoms following the acute phase of a COVID-19 infection. You must have recovered from COVID-19 before you can have Long COVID.  There is no agreement on defining what this syndrome/illness/disease should be called or how to describe it.  One definition focuses on the symptoms, while another centers around its timing.

These symptoms can last for several weeks, months, or years, significantly impacting your quality of life.  Long COVID includes a broad range of symptoms that can affect multiple organ systems, including respiratory, cardiovascular, neurological, and gastrointestinal systems. This book will review possible causes, mechanisms, testing, and treatment strategies.

Because Long COVID has over 200 symptoms and the presentation of symptoms is variable, I primarily focus on four causes and how much each cause contributes to the symptoms of Long COVID.  It is not productive to chase symptoms of Long COVID.  Chasing symptoms is acceptable in the short term while treating the causes, but I often find it similar to a game of Whack-a-Mole.  You knock one symptom down, and another pops up.

Most treatments provided out there for Long COVID are symptom-driven and generally apply to any chronic illness, such as not pushing yourself, getting mental health therapy, etc.  Despite some of the treatments that I use being experimental, they are evidence-based and are backed by studies and my personal experiences.  I focus on the causes first.  I see this as a unique way to treat Long COVID.  I assign the symptoms to each cause responsible for Long COVID.  Each cause contributes a unique percentage to each patient.  Consequently, it creates a kind of profile for each patient.  No two treatments are alike, mainly because Long COVID is a multifactorial condition.  It would be similar to coming up to a 5-car pileup accident.  Everyone was involved in a car accident, but everyone had different problems.  One has a leg fracture.  Another has a bruise on her forehead.   Yet another’s chest hurts.  A fourth has a bleeding arm.  The last one has abdominal pain.  Even though everyone has had the same car accident, the approach, testing, and treatment for each will differ.  In a similar fashion, I approach the treatment of Long COVID.

By treating the causes, we can resolve each cause’s contribution to Long COVID.  I view the other potential causes as consequences rather than a cause such as autoimmune conditions. While I have seen phenotypes created based on the symptom analysis for Long COVID, they often do not agree from study to study.  Instead, I prefer to examine the causes and what contributes to each person’s symptoms.  My system works.  I have treated many patients using this system, which has proven successful for the last few years.   It is organized and doesn’t rely on fads, hunting and pecking solutions, or looking for the next best thing to try.

Specifically, I examine causes such as:

1. Dysautonomia
2. Mitochondrial dysfunction

• Mast cell dysfunction

1. Gut dysbiosis

Don’t worry if you are unaware of these medical terms.  I will explain how each can cause Long COVID and how you can improve from each one.  There are other theories on other causes, but I will discuss how I treat Long COVID, the related conditions using these four, and how all the different causes are actually consequences of these four causes.

 

Foreword from volume 2 the dysautonomia book

 

Long COVID has emerged as one of the most complex and challenging medical conditions of our time, presenting a wide range of symptoms that can vary from mild to debilitating. Understanding this condition is essential, not only for those suffering from it but also for healthcare providers striving to offer effective care.

This book, the second in a comprehensive series on the causes and treatments of Long COVID, focuses on dysautonomia. It will arm you to better understand how dysautonomia is involved and contributes to long COVID and how to treat it.  It brings together the expertise of Dr. Robert Groysman, MD, a leading authority in the field who has been at the forefront of treating Long COVID since the pandemic began.  His deep understanding of this condition is invaluable for anyone looking to navigate its complexities.

Designed for both patients and healthcare providers, this book offers an in-depth exploration of Long COVID, breaking down the condition into understandable segments. You’ll learn about risk factors, underlying causes, and various treatment options. Importantly, this book is not just about theory; it provides practical, actionable strategies that can be applied in real-life scenarios.

The treatment protocols may take several months to show results, and recovery is unlikely to occur within a few hours, days, or even weeks. However, improvement does happen over time for most long COVID sufferers. This book delves into one of the most critical causes of long COVID: dysautonomia. To fully understand dysautonomia, it’s crucial to grasp the role of the autonomic nervous system. Two primary causes of dysautonomia are consistently observed in nearly every long COVID patient.

Many long COVID and dysautonomia clinics focus primarily on treating Postural Orthostatic Tachycardia Syndrome (POTS), which is just one aspect of dysautonomia and long COVID.  However, the condition is much more complex. This book explores dysautonomia as the central cause and mechanism underlying long COVID. Dysautonomia is not a new condition; it has long been associated with POTS. Conventional treatments typically address POTS symptoms, such as increasing fluid and salt intake, using beta blockers to reduce heart rate, or raising blood pressure. These treatments primarily target tachycardia (a fast heart rate) associated with orthostasis—the changes in heart rate and blood pressure when standing up. However, in long COVID, dysautonomia may present with more than just POTS.

Prepare to dive deeper into dysautonomia, understand how it contributes to most, if not all, of your symptoms, and, most importantly, learn how to treat it. Long COVID is like a multi-car pileup; while there is a common cause, each individual experiences different “injuries” or symptoms, requiring tailored treatments for each unique case.

As you journey through the pages of this book, you’ll discover not only the science behind Long COVID but also the personal insights that come from years of hands-on experience. My goal is to help you understand what is happening inside your body, why you feel the way you do, and to validate that your symptoms are real and not merely “in your head.” Long COVID is a genuine medical condition, and this book aims to shed light on its many facets.

While treatment options are discussed in detail, this book refrains from prescribing specific dosages or one-size-fits-all solutions. Treatment is highly individualized, and what works for one person may not work for another. This book is meant to serve as a guide, offering a clear strategy that you can discuss with your healthcare provider to tailor the best approach for your unique situation. Natural treatments, though often beneficial, can be harmful if not used correctly, so it is essential to make informed decisions in collaboration with your provider.

Through over four years of treating Long COVID and related conditions, I have witnessed the positive impact of a well-structured, personalized treatment plan. This book is designed to help you focus and organize your treatment into a working plan that you can share with your healthcare provider. While all the information presented is evidence-based, it is also enriched by my personal experiences and the lessons I have learned in the field.

This book is more than just a guide; it is a tool to empower you on your journey toward better health. Whether you are a patient seeking relief or a healthcare provider looking to expand your knowledge, this book offers the wisdom and resources needed to understand and effectively treat Long COVID.

The goal of this book is to help you organize your treatments more effectively. Many people search for treatments through social media and online resources, which is like trying to construct a jigsaw puzzle using pieces from several different puzzles at the same time. The final result is unlikely to be successful.  After reading this book, I hope I have succeeded in my goal. Please also explore the other volumes in this series, including:

• Volume 1: The Complete Long COVID Handbook
• Volume 3: The Complete Long COVID Handbook: Mitochondrial Dysfunction
• Volume 4: The Complete Long COVID Handbook: Gut Dysbiosis
• Volume 5: The Complete Long COVID Handbook: Histamine and Mast Cell Activation

About the Author

Dr. Robert Groysman is a dedicated physician with over two decades of experience, specializing in pain management at Southwest Pain Management in Irving, TX. He earned his medical degree from Robert Wood Johnson Medical School and is board-certified in anesthesiology. Dr. Groysman is a member of several prestigious medical societies, including the Texas Pain Society, Spine Intervention Society, and American Society of Interventional Pain Physicians.

Driven by a commitment to advancing patient care for Long Covid, Dr. Groysman explores innovative treatments and multidisciplinary approaches. His journey into treating Long Covid patients began amid the pandemic’s onset in 2020, transforming his practice to address this emerging health challenge. Recognizing the diverse and complex symptoms associated with Long Covid, he has pioneered the use of Stellate Ganglion Blocks (SGB), repurposing medications and supplements, and creating the unique four cause approach to treating Long Covid.  His exclusive four step mitochondrial dysfunction treatment approach has been wildly successful.

Through extensive research and clinical experience, Dr. Groysman has become a leading advocate for Long Covid treatments, particularly addressing issues such as smell and taste dysfunction, anxiety, brain fog, neuropathies, and chronic fatigue. His approach integrates rigorous scientific methodology with compassionate patient care, aiming not only to alleviate symptoms but also to understand and treat the underlying mechanisms contributing to Long Covid.  He was the first to introduce Epipharyngeal Abrasive Therapy (EAT) together with a Stellate Ganglion Block procedure for dysautonomia to the United States.

Beyond his clinical practice, Dr. Groysman is actively involved in medical education and advocacy, hosting podcasts, contributing to medical literature, and supporting a vibrant online community for Long Covid patients. His efforts have positioned Southwest Pain Management as a renowned center for Long Covid treatment, attracting patients from across the United States and around the globe.

For more information about Dr. Groysman and his work, visit covidinstitute.org

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