Beware the Wolf: a Choose-Your-Own-Adventure Halloween tale

Prologue

You feel your blood coursing through your veins. Your heart is beating out of your chest. Your body flinches as it resists the millions of synaptic impulses commanding you to run, to fight, to do something – ANYTHING. Your autonomic nervous system is on red alert. You’re riding the runaway freight train of an adrenaline surge – a common symptom for those with Long COVID and ME/CFS.

This tale is true, at least in part. Beware the truth, ye of faint heart.

Chapter One: It’s Devil’s Night

It’s the night before Halloween: Devil’s Night. You’ve been enjoying a virtual Halloween gathering while carving a pumpkin at your kitchen table. The vacant eye-holes have been narrowed to perfection. The wicked face is taking shape. As you begin to bring jagged, snapping jack-o-lantern teeth to life you notice your face is feeling hot and flushed. Your heart is pounding with a ferocious “Free-me! Free-me!” rhythm. You check your Garmin wearable: heart rate is 125bpm. That’s higher than your 30% heart rate reserve limit. You’ve been monitoring your heart rate and keeping it less than 30%HRR to avoid post exertional relapses, so this could spell trouble. You decide to take a break from the activity. A brief rest on the couch brings your heart rate down to the 80s and you’re experiencing major FOMO. You get up and get back to the pumpkin carving and laughter. Soon after returning to the Zoom social, your ability to follow conversation vanishes. You’ve clearly pushed beyond your limit. It’s time to log off. As you say goodbye to friends and put away your unfinished pumpkin, you notice something startling in the periphery of your vision. Lurking in the corner of the room and hidden within the shadows is a tall, hairy beast. Your mouth drops in horror as you quickly shut your eyes to quell the rising fear and wish away the beast. A moment later you open yours eyes and steadily exhale, readying yourself to face your demise. Instead, the shadows are empty. The beast is gone.

You make your way upstairs to bed, but not so fast! The evening of excitement and fun has your autonomic nervous system kicking into overdrive. The hairs on your neck stand up as you climb up the dark stairwell. You sense a watchful eye following your every slow move. It’s still watching as you sit at the top of your stairs for a rest. Bedtime may not be uneventful, tonight.

Chapter Two: Beware the Wolf

Close your eyes and recall how your body feels when you are panicked or anxious. You’re on edge. Your body is on fire. You’re coursing with sensations. These words describe a body in fight-or-flight mode. And that’s what happens with an adrenaline surge. A haywire autonomic nervous system causes a full throttle fight-or-flight response.

You’ve made it to your bedroom and finished your nighttime routine. Despite a continual sense of being watched, you slip beneath the sheets and ready yourself for sleep. You are in desperate need of rest after an evening of energy expenditure. As your lashes brush your cheeks, your body suddenly tenses. That feeling has intensified and you’re suddenly very aware: someone is watching you. Something is lurking and it’s close. Your eyes blink open. As your vision adjusts to the darkness, the outline takes shape. There it is in the corner of your room: a giant, snarling werewolf. It stands, enveloped in shadows, watching you. Waiting. Salivating. Muscles rippling beneath its fur. All you want to do is crawl out of your skin and run. The intensity of your restlessness is nearly unbearable. But where can you go that a werewolf can’t follow? So far, it’s only watching from a distance. It hasn’t moved from its spot in the corner. Maybe you’re imagining things. Rest is a high priority, right now, so you try your best to wind down and settle in for some sleep. The problem is the werewolf still won’t leave. Every inch of your body is trembling and begging for movement. Your mind is uncaged and running rampant in your head. You’re not feeling scared or worried about anything in particular – that werewolf is just a figment of your imagination – but this adrenaline surge is a full-body experience. The autonomic nervous system leaves nothing untouched. Your mind pleads: make. this. stop. The surging adrenaline isn’t physically painful, but the level of discomfort in your body is a type of anguish that is difficult to endure.

What will you do? Choose your own adventure.

Will you Give in to Fight-or-Flight? Or Keep Calm and Carry On?

Chapter Three: Choose well, my dear.

Adventure Option 1: Give in to Fight-or-Flight

You can no longer endure these coursing sensations as the werewolf lingers in the shadows. You spring out of bed with lightning speed and scold the werewolf into submission. It cowers and then dissipates – evaporating into the shadows. All that’s left is your own shadow splashed across the corner of the room as your bedside lamp glows behind you. Well, that’s much better, isn’t it? If your body is screaming at you to move, you might as well listen. You decide to continue on this thread: movement is the answer. You grab some disinfectant wipes and attack the grime on the bathroom counter. Cleaning and decluttering eases your mind. Next, you get out the vaccum. After that you start a round of body weight exercises using your bedroom surfaces. As you move and physically work out the uncomfortable sensations of a few minutes ago, you feel relief set in. It feels good to move. You glance at your wearable: HR 160bpm. That’s not a good sign, but maybe it will be ok. They always say physical activity and exercise are good for your body, so why stop now? If you just do a little more and work out these jitters, you’re certain you’ll sleep better. Ten minutes later, you ease back into bed. The adrenaline surge has lessened. The werewolf hasn’t returned to the shadows in the corner. You’re sure sleep will come more easily, this time. As you close your eyes and drift off, the glowing red eyes watching you through your window go unnoticed.

It’s still dark when you wake. You swear something furry brushed across your face a moment before. Maybe it was another vivid dream – you’ve had a lot of those since becoming infected with COVID-19. You check the time: 6:00am. Maybe you will feel refreshed this morning, after all! You don’t recall waking in the night or tossing and turning. You stretch contentedly and hear yourself groan as you yawn. Wait… that wasn’t you groaning! You look to the shadows in the corner. Glowing red eyes grow larger and larger as the tall, hairy, snarling werewolf emerges from the shadows. It’s bigger and more horrifying than you recall from the night before, and this time it’s not just watching you – it’s moving towards you! Your breath catches in your throat. You want to run, but you’re not sure you can get away this time. You realize your body is heavy with fatigue and post exertional symptoms, but that’s not the only problem. The werewolf has leapt onto your bed, further weighing you down. As it licks it’s white, fanged teeth, long strands of drool soak your face. You can no longer hold the werewolf at bay. It leans forward for a taste of your flesh. This is going to be a long, hard day after all…

Adventure Option 2: Keep Calm and Carry on

You aren’t sure how you will endure another moment of these sensations or the werewolf lingering in the shadows. You contemplate getting up and scaring it off. You think briefly on how wonderful it would feel to do some physical activity or exercise, but it’s no longer true for you. Activity and exercise aren’t safe for just anyone. With this illness and others like it, pushing beyond your limit and utilizing exercise can cause you harm. You’ve been there and done that, and you’ve learned. Instead of giving in to the urge, you decide to use techniques that calm your autonomic nervous system. You can use breathing, meditation, tactile distraction (like your spouse rubbing your back) and a dose of melatonin may not hurt, either. You start with some basic box breathing. As you finish the last cycle of inhale – hold – exhale, you do a quick body scan. The symptoms haven’t lessened, yet. Your mind is still racing. Your body remains restless. Your desire to crawl out of your skin persists. Your mind is screaming “Make this stop!” A check of your wrist wearable shows your heart rate is cooperating at a closer-to-normal resting rate, though. Your eyes dart to the shadows in the corner – is the werewolf still lingering there? You realize the beast is no longer visible. Where could it have gone? What kind of werewolf leaves of its own volition? Usually they need a strong scolding, at minimum. Your eyes travel down towards the floorboards and then you see it: standing in the shadows is the hairy, snarling beast! But it’s not exactly tall and menacing… The werewolf now stands three inches tall. It’s snarls are now high pitched, mouse-like squeaks. Your calming autonomic nervous system seems to have shrunken its power and size into a fuzzy, almost cute, whisp of a thing. If you keep using your calming strategies, perhaps symptoms will lessen, too! You grab your headphones, open your Headspace app, and press play on a bedtime sleepcast. As the calming soundscapes and gentle guided meditation and story lull you to relaxation, you drift off into dreamland.

Your eyes flutter open as your spouse opens the curtains to reveal warm, morning sunlight streaming through the window. It’s a beautiful morning! Your sleep was a bit restless. You feel tired. But that’s par for the course with Long COVID. So far, you don’t notice evidence of a bad crash of post exertional symptoms. That could still be coming, but you know you took the right steps last night to care for your body. You managed to soothe your autonomic nervous system and stop the adrenaline surge in its tracks. You look around your bedroom. No shadows. No werewolves. It’s a new day.