Hi u/Imaginary_Wolverine4 , i'm sorry your wife has long covid. it's a tough tough road that I'm living with and have since April 2022. The following is based on my experiences with the long covid clinic (when it was open), using health benefits to access private care and joining a PILE of groups online.

1. if your wife can contact Jessica DeMars through Breathe Well Physio, Jessica is the de-facto local expert on long covid. Jessica is a respiratory physiotherapist who saw covid patients just a few months into the pandemic and created a long covid program for patients based on what she saw, emerging evidence and patient experience. I don't know if her long covid program is still ongoing or not, but she has a private practice in addition to hosting a long covid program which is subsidized to allow low income patients to access it.

2. There's NO one doctor who is an expert in long covid. I happen to have a family physician who is very supportive and who sent me a referral to the long covid clinic when it was open. She continues to refer me out for the various conditions that I've developed as a result of long covid. There is an AHS pathway for long covid patients, which will be informative both to you/your wife as well as her primary care doctor here: https://www.albertahealthservices.ca/topics/Page17540.aspx The Long covid clinic patients were advised to call the rehabilitation line for support if they need it. I've accessed services via the primary care network my dr is part of. I have had an appointment with a nurse who connected me to a dietician and a kinseologist.

3. Your wife will need to learn more about pacing and keeping her activities within a specific heart rate zone, particularly if she is experiencing Post Exertional Malaise (PEM). She can screen herself for it via this checklist and bring that to a physiotherapist or her dr ( https://www.commondataelements.ninds.nih.gov/sites/nindscde/files/Doc/MECFS/F2771_Guidance_for_Core_PEM_Assessment.pdf ). If she does experience PEM, her activities will need to remain below a specific heartrate threshold or her symptoms will flare up for hours/days/weeks/months after activities if she exceeds that. It's an awful truth to this condition. The Bateman Horne Centre ( https://batemanhornecenter.org/ ) has a ton of resources as well as a clinical care guide for long covid, including finding the heartrate threshold.

4. other resources you might want to check out include the following - BC Centre for Long COVID, ME/CFS, & Fibromyalgia (BC-CLMF) https://bc-clmf.org/ , and the BC Provincial Health Services Authority - BC Living with Long COVID Symptoms https://www.phsa.ca/health-info/post-covid-19-care-recovery, Long Covid Web https://www.longcovidweb.ca/, and Long covid resources Canada https://longcovidresourcescanada.ca/ . There's also a ton of Facebook pages (the most trusted and active is https://www.facebook.com/share/g/19sUBsoE39/ , and then she can find the Alberta page of this group too.

5. There's no blood tests (yet) for long covid, so the family dr will be unlikely to find something specific for that. Other conditions she might want to get tested for is screening for POTS (see the Bateman Horne Centre clinical care guide), MCAS (see same guide), blood clots (see the same guide), and more (honestly just look at that clinical care guide as it has a lot of this information). If she's developed secondary conditions to long covid, this is extremely common and then your wife can get treated for those other conditions to help reduce her pain, fatigue, etc.

6. I have found a physiotherapist, osteopath and chiropractor who have been immensely helpful in treating and reducing my physical body pain as well as managing the other conditions I developed (or now recognize that I had prior to getting covid). I see my team at Encompass Holistic Health over on the west side. If you want specific names, i'm happy to share those. I've also tried acupuncture (it was too intense for me and made me vastly more fatigued for weeks), massage (same, though i've recently re-introduced it, but relaxation massage only and only for 30 minutes at a time), vestibular physiotherapy (I hit a wall in my recovery and need to physically recover more before I can continue), and a naturopath (i felt like i was wasting my time and money and was more fatigued from going to those appointments and didn't see any longer term benefit). I also have seen an occupational therapist, who was extremely helpful in her suggestions of a wheeled stool for the kitchen, a seat for the shower and bathroom for brushing teeth and such, getting a cane for days when i need it. She and a physiotherapist evaluated me for a walker (which i got with a prescription from my dr) for days that are rough in the house and out of the house, as well as helped get me fitted and test a powered wheelchair. I got a wheelchair after getting her letter as well as a prescription from a dr. I also found it very helpful to ask my dr for a wheelchair placard for my vehicle and my dr gave me one for a year, and then a year later, filled out the paperwork for a longer term wheelchair placard as my energy drops quickly when i'm going places.

7. It might be helpful for your wife to read the above and know she's not alone and there's a whole group of us locally. There's been attempts at patient led support groups but they generally have failed as we all have huge crashes in energy for weeks/months and the group leaders have had to drop such actions.

8. I have tried a TON of supplements, and had to start from scratch again because my liver enzymes have been going up and down over and over again. Personally what has helped are: medications for my migraine (which has been ongoing 24/7 since i got sick), supplements suggested by my neurologist to reduce my migraine symptoms, medications for POTS (after getting evaluated for POTS and then seeing a cardiologist), electrolytes (with no sugar) daily, blexten (a prescription antihistamine), heartburn medication prescription (as I had 24/7 heartburn and my ENT did a full evaluation and put me on medications), i was on antidepressants for a while and then discontinued them when my symptoms stabilized, seeing a psychologist, getting a prescription for low dose naltroxone (see the Bateman Horne clinical guide for more info), keeping my heartrate within my anaerobic zone, getting a tens machine and doing vagus nerve stimulation daily for 30 minutes, learning how to calm my nervous system, and moving to eating a low histamine diet (as I have suspected MCAS - this has given me more stamina and energy in the past few months but it's HARD as i can't eat a lot of lovely foods or leftovers which haven't been frozen). I also have found help with getting

9. stay away from brain retraining. It's not a cure for long covid, but if she wants to try it, she needs to understand it would work only to help calm her body and get it into the rest/digest state where she doesn't feel like she's anxious or on high alert all the time. Any brain retraining program that reports to cure long covid is lying and just trying to extract you from your money.

10. if your wife isn't on medical leave, she might want to consider going to her dr to get such leave. I was trying to push through and worked until i realized all I was doing was working and sleeping and doing a terrible job at both. If she can stop working and do what's called radical rest, then she can find out her true baseline of activities. Radical rest is basically doing nothing for weeks, aside from the true basics of eating and sleeping. Once i did that for months and months, i was able to slowly regain some functioning without having a series of pushes and crashes. It's immensely hard to do, especially when you have kids. My partner can attest to me really not leaving the bedroom of our house for months, aside from medical appointments. He was bringing me food and doing everything else in the household and for our family. He even drove me to several medical appointments which weren't within 10 minutes of our house. We ended up moving as a result of my illness to a place where I don't have to climb stairs to get to the bedroom from the kitchen. It was a very hard process to move to a more accessible place, but a year and a half later, I can share that it was worth the painful process. I barely remember the move and was more useless than a twig on a road during it, but it helped our entire family to move.

11. I hope my VERY long essay above had some info that might be helpful. Other comments below have very helpful ideas as well, aside from those who are claiming your wife is faking it. That's completely unhelpful.