Recovered from COVID but Still Tired, Chest Tight, Heart Skipping Beats, Sleepless, No Appetite? Doctor Luo Dalun’s Complete Guide to Post-Illness Recovery — Don’t Rush Back to Work

Patient search terms: no energy after COVID / chest tight after COVID / shortness of breath after COVID / heart racing or skipping beats after COVID / palpitations after COVID / dizzy after COVID / no appetite after COVID / can’t sleep after COVID / lingering cough after COVID / dry mouth and bitter taste after COVID / COVID recovery tips / relapse after overexertion

Corresponding medical names: post-viral fatigue · premature beats · myocarditis screening · qi and blood deficiency · Shaoyang-pattern insomnia · residual cough after infection · post-illness recuperation (shan hou)

Opening: the questions in the live stream quietly changed

Recently Doctor Luo Dalun noticed a very interesting phenomenon: ten days ago, a week ago, when he went live, the comments flooding the screen were all asking “what do I do about a fever?” But in the past couple of days, the most-asked questions have become — “the fever is gone, but what about the cough?” “What about the no-energy feeling?”

💬 Note from Doctor Luo: It seems my followers are all the same group of people — as if you all got infected at the same time by agreement. The rhythm is interesting — you’ve crossed the fever hurdle, and now you’re facing the pile of troubles that come after the fever breaks. Today let’s specifically talk about this recovery (shan hou).

This illness really can’t be taken lightly

Doctor Luo Dalun usually comforts everyone: this illness is like an exterior-contraction (wind-cold) illness — it’s enough to handle it the way Chinese medicine handles exterior-contraction diseases; no need to be afraid. But he also repeatedly stresses — it really is different from ordinary flu or a common cold.

💬 Note from Doctor Luo: After all, it is a plague that swept the globe and lasted this long: it spreads extremely fast, and it has its own characteristics — as I explained yesterday, it produces blood stasis (yu xue). So the recovery after infection really needs you to take good care of yourself.

The “recurrences” the ancients spoke of: this pandemic confirmed every one of them

Ancient Chinese medicine said it long ago: after an exterior-contraction illness, after a serious illness, if you don’t recuperate properly, there will be all kinds of “fu” — recurrences. Fu, the character for “again.”

The first kind is called “lao fu” — relapse from overexertion. What does it mean? You think you’ve recovered because the fever broke, so you go back to work exhausted, burn the midnight oil, write copy, do heavy labor — whether mental or physical labor, especially physical labor, it can trigger lao fu.

💬 Note from Doctor Luo: In the past, nobody believed this; they thought it unscientific. But this pandemic has truly taught everyone a lesson — with the internet spreading news fast, we watched with our own eyes what lao fu looks like: two marathon enthusiasts agreed to go for a long run to “recover,” and after the run, both of them died — this is no joke, they really passed away; another person played ball and ended up straight back in the hospital. Some had triggered myocarditis — you don’t know it’s there, and a little overexertion causes an accident; others simply had their illness come back worse.

The second kind is called “fang lao” — relapse from marital intimacy. In the past it was said that after a cold you shouldn’t have sex, that there would be yin-yang jiao (yin-yang crossing) and yin-yang yi (yin-yang exchange), constant recurrence, even life-threatening danger.

💬 Note from Doctor Luo: This time friends really reported online: a couple was intimate once — the man thought that since the fever had broken he was fine — and he died. When the body’s functions are at a low ebb, forcing yourself to do something exciting — combined with a fragile heart and insufficient kidney qi — a person can suddenly lose control. These are not empty words; they are what people themselves reported. So what Chinese medicine talks about really exists.

Besides lao fu and fang lao, there is also shi fu — relapse from overeating — one binge meal and the illness comes back; and some people relapsed after taking a bath. Every kind of “recurrence” the ancients described has been confirmed in this pandemic.

Recovery rule number one: no overexertion — treat it like sitting the month

So after COVID, what deserves the most attention? First, do not overexert yourself.

💬 Note from Doctor Luo: Everyone says it’s like sitting the month after childbirth (zuo yue zi) — it truly is; you have to protect yourself. After this great battle, the body is actually depleted of qi and blood. At this time you must nourish slowly and stop consuming. Especially people with heart problems — one bout of overexertion can really cause an accident.

How do people with heart problems nourish themselves? Activate blood and unblock the collaterals, tonify upright qi, tonify heart qi, tonify heart blood: for heart qi, ginseng (ren shen) can tonify qi; for heart blood, eat Yu Ling Gao (Jade Spirit Paste) to nourish the blood, or drink a little donkey-hide gelatin (e jiao). Nourish slowly and bring the qi and blood back.

Chest tightness and shortness of breath: it’s not “blockage,” it’s “deficiency”

After testing positive and recovering, if chest tightness, shortness of breath, or a racing heart appear — Doctor Luo Dalun reminds: a racing heart and chest tightness with shortness of breath must be looked at separately.

💬 Note from Doctor Luo: So-called chest tightness and shortness of breath are usually insufficient upright qi (zheng qi bu zu). It’s not qi blocked inside — it’s deficiency. At this time you need to support the upright qi — take a little Bu Zhong Yi Qi (Tonify the Middle and Augment Qi), ginseng slices, or Yu Ling Gao to nourish the blood; at the same time combine it with some collateral-unblocking medicine, such as Tong Xin Luo capsules, Xue Fu Zhu Yu (Drive Out Stasis in the Blood Mansion), Nao Xin Tong, or drink a little san qi powder (Panax notoginseng). Nourish the upright qi and it will slowly get better.

A skipping heart: be alert for premature beats and myocarditis

A racing, skipping heart is another situation. Feel your pulse — it beats along and then “skips” a beat — that is a premature beat (zao bo).

💬 Note from Doctor Luo: Quite a lot of people develop premature beats after COVID. Premature beats are an important sign of myocarditis; it’s recommended to go to the hospital and get a cardiac enzyme panel (xin ji mei pu) to see whether there’s a trend toward myocarditis. In the end, many people died of this illness because of myocarditis — many middle-aged people died of myocarditis; the elderly mostly died of pneumonia. If your heartbeat is irregular, it’s best to get it checked — that’s being responsible for yourself.

How does Chinese medicine regulate it? Use Zhi Gan Cao Tang (Honey-Fried Licorice Decoction), also called Fu Mai Tang (Pulse-Restoring Decoction) — this is Zhang Zhongjing’s formula from the Shang Han Lun (Treatise on Cold Damage), for “cold damage with a knotted and intermittent pulse and a racing, fluttering heart” (mai jie dai, xin dong ji) — that is, an abnormal heart rhythm, a skipping pulse.

💬 Note from Doctor Luo: The Shang Han Lun was originally written to treat plagues — in Zhang Zhongjing’s time, two-thirds of his family died in a plague, so he studied desperately how to treat epidemics. In this formula sheng di (raw rehmannia) is used at 30 grams or more, and the effect is excellent. When I was studying and exhausted, with qi and yin both deficient and very obvious premature beats, I copied the formula out of the textbook, drank one dose and was basically cured; two or three doses and it was fine. All the herbs in this formula are extremely mild, with no toxicity, so you can use it with confidence.

Dizziness: qi and blood deficiency — nourish slowly with yam

After the illness, do you feel dizzy and floaty? Most of the cases Doctor Luo Dalun has seen are qi and blood deficiency (qi xue kui xu).

💬 Note from Doctor Luo: Many of you may not have had an exterior-contraction illness for a long time. In the past, after a serious exterior-contraction illness — after a high fever burned out or after pneumonia healed — people really would feel dizzy when walking — that swaying, floating feeling. At this time you need to slowly regulate the spleen and stomach and build up the upright qi: drink some water boiled with yam slices, yam paste, and take Bu Zhong Yi Qi to lift the qi up a little and nourish qi and blood. Don’t be in a hurry — this is a matter of slow nourishment. When qi and blood are sufficient and can rise upward, the dizziness naturally disappears.

No appetite: Jiao San Xian and Si Ni San — let the spleen and stomach wake up first

Some people have their fever gone but no appetite at all — they don’t want to eat anything. At this time you can use some Jiao San Xian (“Three Immortals” roasted digestives — roasted hawthorn, malt, and medicated leaven), ji nei jin (chicken gizzard lining), and similar medicines that aid digestion, open the appetite, and rouse the spleen and stomach qi; there are also bai kou ren (white cardamom kernel), stir-fried cardamom and other spices — put a little in your cooking and it will also rouse the spleen and stomach qi.

💬 Note from Doctor Luo: Some friends also wrote in saying they used Si Ni San (Four-Ni Powder) — one use and they were better — this can also be recommended. Si Ni San is just four herbs: chai hu (bupleurum), shao yao (peony root), zhi shi (immature bitter orange), and honey-fried licorice — it soothes the liver and regulates qi. During illness, the qi mechanism was knotted in the middle burner, so the appetite wouldn’t open; once the qi mechanism is unblocked, the spleen and stomach wake up. Many formulas that regulate the qi mechanism are ultimately built on Si Ni San as their base.

How to nourish the spleen and stomach? Doctor Luo Dalun has always recommended millet porridge and yam porridge (yam and millet powder cooked together) to slowly nourish the spleen and stomach.

💬 Note from Doctor Luo: At this time, absolutely don’t pile on rich meat and fish all at once — that’s too aggressive. The spleen and stomach must recover slowly; when the spleen and stomach recover, the body can recover — this is a very important matter; you must nourish slowly.

Insomnia: pathogen entering the Shaoyang — Chai Hu Jia Long Gu Mu Li Tang

Can’t sleep after COVID? This troubles many friends too. What’s going on? The pathogen has entered the Shaoyang — the evil qi went inward and entered the Shaoyang, and this can cause insomnia.

💬 Note from Doctor Luo: What did Zhang Zhongjing use in the past? Chai Hu Jia Long Gu Mu Li Tang (Bupleurum plus Dragon Bone and Oyster Shell Decoction). I’ve talked about this formula a lot — what was it originally for? It was for the emotional problems that appeared during plagues: the qi mechanism not flowing, liver qi not soothed, liver and gallbladder disharmony, irritability, and so on. In fact, using it now to regulate insomnia works especially well.

This formula is built on Xiao Chai Hu Tang (Minor Bupleurum Decoction) as its base — chai hu (bupleurum), huang qin (skullcap), ren shen (ginseng), plus ban xia (pinellia), then gui zhi (cinnamon twig), fu ling (poria), long gu (dragon bone), mu li (oyster shell); if the stools are dry and bound you can add a little da huang (rhubarb), and if not bound, no need. It contains qian dan (lead oxide) — a heavy metal, toxic — nobody uses it nowadays; just remove it.

💬 Note from Doctor Luo: In Japan, this formula is sold ready-made in pharmacies — Japanese regulations say Zhang Zhongjing’s formulas don’t need approval, so they can be made into patent medicine directly. Unfortunately, our country doesn’t have that — in the birthplace of Chinese medicine, in Zhang Zhongjing’s hometown, you can’t buy this medicine as a ready-made product. All our good things get made by foreigners, and then we run to Japan to buy them back — what a pity. I generally use 6-gram doses, just a slight adjustment and it works.

Lingering cough: no rush — adjust slowly

Still coughing a little? Doctor Luo Dalun explains in particular: a fever needs to be treated urgently, a sore throat needs to be treated urgently, but this cough — don’t be too urgent.

💬 Note from Doctor Luo: A fever must be brought down quickly, otherwise the pathogen keeps going deeper and may slowly develop into pneumonia; a sore throat means the exterior pathogen is fighting with you, so treat it promptly. But a cough is different — coughing a few times a day, or in a few short spells, just adjust it slowly.

How to adjust it? Get some chen pi (aged tangerine peel), su ye (perilla leaf), and jin yin hua (honeysuckle) and steep them in water to drink; peppercorn boiled in water works too; some people steam an orange with salt — cut open the orange, sprinkle in a little salt, poke it with chopsticks, steam it and eat it — that also has an effect; you can also boil 30 grams of yam with 3 grams of niu bang zi (burdock seed) and drink the water.

💬 Note from Doctor Luo: As long as it’s not the kind of cough full of phlegmy sound, with rumbling in the chest, a few dry hacks are nothing to worry about. Take it slowly; there’s no rush.

Dry mouth and bitter taste: Xiao Chai Hu granules — drink them a few more days

Some people still have a lingering dry mouth and bitter taste — that means the Shaoyang pathogen hasn’t dispersed, and the qi mechanism is still knotted there.

💬 Note from Doctor Luo: Just drink some Xiao Chai Hu granules for a few days and it will basically resolve. Once the fever is gone and the throat doesn’t hurt, these small recovery problems can be handled one by one, slowly.

Closing: when upright qi resides within, evil cannot invade

Finally, Doctor Luo Dalun sums up the core of recovery in a few sentences.

💬 Note from Doctor Luo: Everyone must rest well, make sure your upright qi is sufficient, and be able to nourish and supplement the upright qi — don’t let the dead embers flare up again, don’t let the upright qi become depleted and give the exterior pathogen a chance to come back. At this time cultivating qi and blood is absolutely critical: tonify qi and nourish blood, protect the spleen and stomach, protect the smooth flow of qi and blood. And don’t overexert: when bathing, keep the room warm, turn on the electric heater, and don’t let yourself get cold the moment you step out of the bath — your body’s ability to regulate body temperature is diminished right now; or put the bath off as long as you can. And don’t get greedy and binge on food — every binge harms the body.

💬 Note from Doctor Luo: The ancients were really not talking nonsense — this pandemic has confirmed every “recurrence” they described. Let’s nourish our upright qi to sufficiency, clear out and drive away the residual enemy, and as the body slowly recovers, your constitution can even be better than before. Tomorrow, let’s continue with the pandemic topic.

Compiled from Doctor Luo Dalun’s health lecture series (post-illness recovery edition).