#28: Occupational Therapy for Long COVID, with Amy Mooney MS OTR/L

Occupational therapist Amy Mooney focuses her practice on people with fatiguing diseases like ME/CFS and Long COVID. She joins me to discuss how occupational therapy can be a valuable addition to your recovery program. Finding ways to engage in our lives, to do the things we want to do, is at the heart of occupational therapy.

Amy shares how she has modified her practice to empower people with fatigue, and suggests ways you can engage with an occupational therapist near you.

Amy Mooney
OT4ME.com
Amy is a private practice occupational therapist specializing in therapeutic care for individuals with chronic conditions involving Post-Exertional Malaise (PEM) and Post-Exertion Symptom Exacerbation (PESE). With over 25 years of OT experience, her telehealth practice focuses on conditions like Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), Long COVID, and related co-morbid conditions such as dysautonomia, Ehlers-Danlos syndrome, Mast Cell Activation Syndrome, and Fibromyalgia.
Amy's “Pacing for PEM” guidelines and therapeutic strategies have been featured in national and international conferences, continuing education programs for medical professionals, and paƟent advocacy webinars. Drawing on her extensive background in diverse seƫtings, including schools, home health, and clinics, Amy
brings a comprehensive understanding of paƟent needs to her practice. As a caregiver to a loved one with ME/CFS, she has a deep, personal understanding of the challenges faced by individuals and families in seeking
appropriate care. Her approach is rooted in compassion, focusing on symptom management, pacing strategies, and adaptive interventions to enhance the quality of life for her clients.
Amy has a bachelor’s degree from Loyola University Chicago, a master’s degree in occupational therapy from
Rush University Chicago and is a returned Peace Corp volunteer. Amy calls Chicago home.

Bateman-Horne Center
https://batemanhornecenter.org/

Amy on YouTube with SolveME
https://www.youtube.com/watch?v=w5Yt0BdeeN8

Transcript

Zeest Khan (00:00)
Hi, I'm Dr. Zeest Khan, the Long COVID MD. I'm a physician with long COVID and I've applied all of my medical expertise to my recovery. Luckily, it's working and I want to share what I've learned with you. On this podcast, I help you understand your body and understand the healthcare system so you can move your own health forward.

We've got a lot to talk about, but remember, nothing I say here replaces personalized medical advice from your healthcare team. Let's get started.

Zeest Khan (00:37)
I have prescribed physical therapy as a physician. I have also used physical therapy as a patient. And we talked about ways you can use physical therapy as you recover from long COVID in an earlier episode with Todd Davenport. I have also as a physician prescribed occupational therapy.

but I have not as a patient used it yet. Amy Mooney is an occupational therapist based in the Chicago area who focuses her practice on fatiguing diseases like ME. She has educated me and is here on the podcast to share what she knows about the power of occupational therapy in the treatment of fatiguing diseases.

It is a resource that many of us have access to through our health insurance plans. occupational therapists can be important collaborators in our abilities to live the lives we want and help us understand the practical ways we can make that happen.

Amy is a fierce advocate for children with fatiguing diseases.

As she shares in this podcast, her own daughter has a fatiguing condition that completely changed their lives and completely altered Amy's view on occupational therapy and allowed her to reimagine what occupational therapy can be.

think you're gonna enjoy our conversation and I think you're gonna learn a lot. I certainly did. Here's my conversation with Amy Mooney.

Amy Mooney, MS OTR/L (02:25)
Yeah, I'm really excited about this. yeah, I've been binging all of your previous interviews. So I feel like I'm caught up. Yeah, they're fantastic. And just then I've reached out to some of my colleagues just to say like, hey, do you know, you know, this sounds like you have you, you know, have you been talking to so -and -so?

Zeest Khan (02:27)
Yeah.

I'm flattered.

wow

Amy Mooney, MS OTR/L (02:46)
And it's really fun because it's like, you know, it feels like our information has been trickling in through some of your other interviews. So it's just, yeah. Yeah, it's really nice.

Zeest Khan (02:55)
I love that. I love that it like resonates with people and that it's reasonable messaging. Great.

Amy Mooney, MS OTR/L (03:04)
Yeah, yeah, it all seems like it's been practical information. And I'm just listening to like, you know, Courtney talking about her pacing strategies. I'm like, she is she's you know, she's a rock star. She's doing it. So, yeah.

Zeest Khan (03:11)
Mm -hmm.

Yeah, that's how I felt too. Well, hopefully you'll be able to share some practical resources and practical advice that the listener will be able to use going forward. When I interviewed Todd Davenport, a physical therapist, I got quite a few messages saying, I never thought about working with a physical therapist. I can do that.

Amy Mooney, MS OTR/L (03:44)
Yeah.

Zeest Khan (03:45)
And I'd love people to know what occupational therapy is and that it is a resource available to them. But I know you have a particular view on the way occupational therapy should be best applied for fatiguing illnesses. But before we dive deep into that, can you tell us what occupational therapy is?

Amy Mooney, MS OTR/L (04:09)
Absolutely. So I, it's a philosophy. is something that I have always lived my life with in my, my core being. But when I got to my graduate school level, I realized that, you know, as a healthcare professional, occupational therapy blends medical, it blends psychology, it blends public health, it blends so many aspects of

of our medical communities into one holistic profession. And that just, to me, it's the best of all fields. So it is a medical profession, but we use our activities of daily living to describe what makes up an individual as a unique being. so occupational therapists are not looking at what your profession is or your employment. That's just...

you know, the wrong, the wrong angle of it. We're looking at what are your occupations? What makes you, you? You're a mother, you're a sister, you are a gardener, you are a pickleball player, you know, all of those things that make you, be you, have individual roles. So to be able to be a gardener, you need to be able to, you know, use your body in physical ways, cognitive ways, sensory ways.

that when disease or injury or even disabilities from birth or aging process impact your body, mind and soul, it changes the way you do your occupations. And so an occupational therapist is a healthcare professional who understands how to re -envision the use of your body and your mind to be able to perform those activities.

And so my role has always been, my background has always been working with the pediatric community, with children. And I have specialized in sensory integration therapy. And that is looking at how your nervous system, how your body interprets stimulation or sensory. And I look at how your body takes in light, sound, smells, touch.

Proprioception, where it understands where your body is mapped, joint to joint, and also interoception, which is understanding your feelings of your body internally, understanding when you're hungry, or you need to go to the bathroom, or you're nervous or scared. All of those things happen internally. And so sensory integration is how does a child in school interpret noises and sounds, but realizes how to be able to

filter or adjust or modify so that they can do their occupation in the school, which is to be a student, to be a friend, to be an active learner. So that's to me what occupational therapy is, but it has a different role and perspective for people with ME or long COVID with post -exertional malaise. And that's where

I've struggled as an occupational therapist wanting to engage in the activity. And I've had to learn how to redefine my use of my skills to actually teach rest and interpreting the exertion of post -exertional malaise.

Zeest Khan (07:50)
That is such a phenomenal description of occupational therapy and I wanna take a minute to acknowledge some of the juicy parts that you described. Activities of daily living, when I thought about them as a physician, we abbreviate it to ADLs, activities of daily living.

I thought about it and I know a lot of physicians do as is this person able to get out of bed? Is this person able to walk around their house? What help do they need very similar to physical therapy in being able to move their body? But what I'm hearing you say is that occupational therapy can sort of take the view wider.

and ask what are the activities that compose your life? What occupies your time? What is important to you? And how can we get you to be able to do those things more often and more comfortably? Does that sound about right?

Amy Mooney, MS OTR/L (09:07)
It's that's a perfect description. Yes, it is saying in your life as a mother, you most likely need to feed your children, do the homework with them and transport them. Those are some of the bigger activities of daily living or even instrumental activities of daily living. They have more complexities. A physical therapy therapists would look at how they how you

physically move or how you mobilize within a space, how you walk, how you bend. But occupational therapists will look at what is your environment around? What is the cognitive? How are you figuring out and navigating your space? Are you bumping into materials? Are you dropping? Are you trying to carry something at the same time? What are you going to do when you get there? What's your memory? What is your attention to details?

So there are so many more elements. OT and PT will overlap, but we cover specific things to our profession that are just really unique to the individual. Some people would say, I really need to feed my children. I need to be part of that. And other people would say, you know what? I'm OK if my husband does that.

I will let that piece go because I want to focus in on homework. I feel really strong about teaching my kids math or science. Making a dinner isn't the priority. They will get fed, but it doesn't have to be from me. Where other people would say, no, that's core to my occupation as the mother to be able to make a really healthy, loving meal. And that's perfect.

Now, the idea is how are you going to do that when you have post -exertional malaise? How do you prepare? How do you manage the kitchen? How do you envision doing all of these tasks with the energy that you have? And that's where I think like, that's where prioritizing your activities of daily living is really crucial to

Zeest Khan (11:20)
you

Amy Mooney, MS OTR/L (11:32)
putting your occupations in perspective.

Zeest Khan (11:36)
It sounds like you really engage in a discussion on values. The whole idea behind pacing is to save your energy for the things that matter most to you and do the things, do those things with sort of as efficiently as possible. But like you're saying, that looks different for everybody. So thank you for explaining OT at

a high view. I didn't even ask you to introduce yourself. Can you tell us about Amy Mooney and your, way, why fatiguing illnesses or post -viral illnesses are so important to you? And then maybe we'll talk about how that's affected your practice, because I know that it really has.

Amy Mooney, MS OTR/L (12:26)
Absolutely. So I'm Amy Mooney. I am an occupational therapist. I have been working in this field for over 25 years. We, I have three children, two teenagers and one who is a young 20 year old. We have, we live in the Western suburbs of Chicago. I have unfortunately entered this

community through the blood, sweat and tears of my daughter. When she was nine years old, she developed an illness that we never identified. And, you know, we have struggled to put it into perspective, but realize how it came about won't be answered. We just needed to figure out how she.

manages her symptoms, how she prioritizes her activities, how she does the things that are important to her with as much support as possible. So I've seen this disease up close and personal because I have met so many wonderful people. I've been on the side of being the caregiver for the last 10 years of

of just trying to understand what types of support, what needs my daughter has, but then also trying to change, I guess, my understanding as a professional, how wrong my profession gets it. And there are so many flaws that are just, they keep being repeated and...

You know, I'm one little fish in this big pond who's trying to say, listen to your patients and they will tell you how they need support. But, but it is truly individual based. It is not something that can be mass produced, you know, on a, on a big, big level because each person has their own needs. And it probably seems cliched to say that you have to start with

one person to really understand that person, you will not understand the whole disease. You know, and also it changes from day to day and year to year for each person. So it's really, I guess, reopened my eyes to how we need to do individual care, individualized care plans, because, you know, my daughter is completely different than

you know, the next child and the next parent that, you know, that I'm talking to is, we all have our own stories of what works and what doesn't work.

Zeest Khan (15:23)
we could have a whole conversation about the way medicine with a capital like I like to say, is trying to, people are trying to put progress markers and apply business models, sort of a manufacturing type of mindset to the practice of medicine.

And what you're speaking to is that those are not compatible. For the best outcomes, of course we need some standardized practices so that providers don't go awry. But it is critical to treat a patient and to listen and collaborate with that patient. I have a lot of the same struggles with

the culture of physicians and the way that we approach our patients and approach our jobs, what we think our actual job is. And I know that you've struggled with the same things. You have your own practice now where you have more freedom to provide this personalized care. How did you approach or tailor your

occupational therapy practice to best serve your patient's needs. From what I gather, a lot of your patients are people with fatiguing illnesses, including long COVID.

Amy Mooney, MS OTR/L (17:01)
Yeah, so when my when my daughter first got sick 10 years ago, I I had at the time, you I was an OT in the in the school settings and an early childhood setting. for preschoolers and also I had a private clinic for sensory integration. I I stopped both of those work work experiences. I was full time caregiver and I then.

kind of shuffled to my daughter from clinic to clinic, trying to find out how to get her the care that she needed. And we are in a big metropolitan area. So I was, we had the choice of multiple pain clinic, pediatric pain clinic facilities. And so my daughter was, it was really, really hard. These were really hard times where we were trying to find the appropriate care for her. We would go to,

these clinics and I knew right off the bat that this type of therapy was not going to work for her. It was OTPT for six hours a day, three days a week where she was given intensive therapy. It was great at exercise. And I would pretty much pick her up and carry her home and put her in bed for a couple of days and...

It was just, you know, kind of repeat rinse and do it again. And she couldn't keep up. But the problem with the pediatric population is they don't want the parents to say, this isn't working. Parents lose that authority to be able to say, this is not working because then it's, you know, it can, it's interference. Parents can be judged and, you

other medical professionals can step in and override parents wishes in those situations. So I had to more or less let her fail. And it was awful. It was horrible. And I would sit there in the waiting room and watch other parents go through the same thing and watching their kids in so much pain and so much, and I could pick out who had the same type of illnesses, my daughter.

And so from those experiences, watching what did not work, I sat, you know, over the course of five years of, mean, she didn't have graded exercise that whole time, but it was, why didn't this work? Why does the profession, why does OT and PT not work? And I finally came to the conclusion is that they are wanting these patients, these people to perform. They want to see, they want to witness, they want to observe their

five minutes of active standing or 10 minutes on a treadmill. They want to see something. And the whole problem with post -exertional malaise is it's the after part. It's the consequences of that activity. That's where the sickness is. They can see the crash happening, but they don't see the crash, which is delayed or it can, it's immediate, but the delay is what is so debilitating.

And so I was, you know, sitting there trying to figure out how is it that we miss this? It's so obvious to me because I see my daughter laying in bed for for for weeks. And I finally came to the conclusion that the profession needs to flip. It needs to flip over and not worry about the activity, but worry. Look at the consequences of activity and look at the quality of rest.

what is happening for rest and how do the consequences influence what type of activity is available for that person to perform. And so I built my practice around the idea of when a person can identify consequences of activity such as when you envision, know, if I'm going to go to the store,

That's a physical activity. There's a lot of other stuff involved, but it's mainly physical The consequences are going to be maybe a severe headache or neck pain or debilitating cement like poison fatigue. Those are the things that will happen most often in physical activity.

And this is where it's all individualized, because it's not going to be the same for every person. And for my daughter, we would just identify, like, what does it feel like to do a trip to the bathroom? What does that feel like? Now, what does a cognitive activity feel like? You're going to send an email to a friend. You're going to watch a show. What does that physically feel like to your body? Is it nausea? Is it brain fog?

And you go through those steps of those feelings. And then the final would be the social. If you're going to have a conversation with your siblings, what does that feel like? And so now my focus is kind of assessing, take a snapshot of how you currently feel and what activity would be best suited. If you are already feeling joint pain and fatigue,

then a physical activity probably isn't going to be a good choice. You'd be probably better off doing something, you know, by a cognitive or a social type of activity. So that's where I flip the model. I don't just look at what the activity is and then, you know, then the consequences just happen. I try to look at what the consequences are so that people can make informed, prioritized decisions for what they want to.

what they want to do with their day. and then you prepare and you do things

to give yourself a little, and I like to call it just bubble wrap. Just give those parts of your body the bubble wrap that it needs so that you can do that certain amount of pre -determined activity. that's your preemptive rest. And then after you do your activity, what is your restorative or your recuperative rest? Because you know your joints are going to be swollen or your body is going to be feeling like poison. How do you?

rest? Do you need a weighted blanket? Do you need ice? Do you need, you know, sometimes with a lot of people will have vibrations in internal vibrations. And I like to describe that as almost like you're being dripped with adrenaline is your body doesn't want to let go. So it like it almost electrocutes or it drips that adrenaline in your body.

And that's exhausting. It's such a fatiguing feeling. And so I then try to identify ways that you can get that feeling without it being coming from yourself. So can your partner shake your hips or shake your shoulders or give you deep pressure?

My background in sensory integration therapy has helped me figure out the body is trying to trick itself. It's trying to give itself false energy. So how do you do that in an alternative way? Can you use a weighted blanket? Can you use even a vibrating bed,

Those are all really, really good methods for people that have different types of stimulation So that's how I've changed my practice is I've looked very intensely at what the activity is at core. then also how does your body

rest. How do you recuperate as as well as you possibly can? You are not going to recover. It is not going to be pre -illness level functioning, but at least to get a stable baseline so that when you step out to do another prioritized task or prioritized activity, you're the best suited for it.

Zeest Khan (25:39)
I love this approach so much

and almost everybody I have.

spoken with who's been affected by long COVID does not lack motivation. we have been struggling for a treatment plan. Like what is my strategy? And that's really hard to do by yourself.

when this is the first time you've interacted with a fatiguing illness. So what I'm hearing you say is you work with people to develop a plan so that they can execute effectively and actually meet their goals, which are in this instance, the activities that make up their life so that they can successfully do.

what they want to do. And I think that that's such a helpful resource to be able to think through these problems the way you're describing even at such a granular level. I don't know much about sensory integration therapy. I'm not a patient who has that vibrational discomfort. I know many other people do.

But the way you're describing your practice, you're able to start by, instead of giving instructions, asking questions. And I feel like that's at the core to this idea that you have that we're flipping the field. We're using the skills, but in a way that is more effective and is tailored to this patient population.

Amy Mooney, MS OTR/L (27:16)
Yeah.

I find that my patients at least feel like they've had an aha moment. They don't feel like they're lost in their symptoms. I believe we're putting more order into their complexities because we'll say, let's look at your three most interfering symptoms. I know you have 20.

Yeah, these might be annoying, but are they really stopping you from doing this, this part of your life? You know, they may or may not. And so by just picking the top ones, we can center that focus to say, you know, it sounds like heart rate variability is really, really a difficult thing for you.

Let's look at, know, by standing to brush your teeth, that's making your heart rate go up. So let's reimagine. You want to brush your teeth. You want to have fresh breath. How else can you do it? Can you have your toothbrush sitting at your bedside table? Because it does not need to be at the sink.

Let's think about all of the things that will cause your heart rate to be, you know, really firing really high and try to plan your morning or your day that might have more a bigger window for stability. You know, sometimes even looking at the weather, I find that, you know, people don't necessarily know when

barometric pressures are changing, but they can feel it. So I will say, let's pull out the weather app and look at when a storm, I'm in the Midwest, so we have storms coming through all the time. And so I'll say, let's look at this weather app and see when the pressure really changes, because you are probably going to feel it about a half an hour before it happens. So that would not be a good time to take a shower. And let's put your day in a

a little bit of a schedule so that you can plan if you really the priority is to take a shower how do you do these things on a a wider range knowing that your symptoms are more sensitive or more more fragile at that

particular moment. So I think it gives them a little bit more of predictability. They're not going to necessarily take away all the symptoms, but they can at least start feeling a little bit more control. You know, and I have a lot of patients that are very, very severe. And, you know, we're just talking about how, you know, a caregiver lifts their torso to go on a bedpan.

You know, things that are really, really sensitive to how people just function on a very basic level. is it easier to roll as opposed to lift? Is it better to have your head in elevation or do you need it flat

looking at how they're set up so that their body is most, most supported for their environment, for basic things, feeding, toileting, staying clean and using their whole environment and their caregivers to really help them be as stable as they possibly can.

Zeest Khan (30:59)
Hygiene is such a tender and important aspect of just feeling human and feeling dignity. So it's amazing that you can help someone even with that. So not every occupational therapist has the personal insights into ME. How can...

a patient collaborate with their local occupational therapist. Occupational therapy is usually requires in the states a referral from a doctor, but many times almost always it's covered by insurance. So this is a healthcare resource that people might be able to access affordably. But as you've been speaking to, you want to be able to have the right team member.

What advice would you give patients?

Amy Mooney, MS OTR/L (32:01)
I highly recommend if when you get the referral written to have your doctor write that it is for functional performance for functional activities of daily living for modifications, adaptations. If you're needing work recommendations or school accommodations, be specific. Do not let your doctor write evaluate and treat.

Because a lot of times that's it. They'll just say, OT, eval, and treat. Have your doctor be specific that you need energy conservation, accommodations, modifications. Be specific with what your goals are for having this support. Because that will then guide the OT that picks up your referral to say,

I am not going to put them in a regular old pacing program. They actually need something more specific. I'm not going to just put them in a group setting and just teach them, you know, with my patients that have MS or some other condition that does benefit from just general pacing, because pacing for PEM is different than just general rehab pacing. Pacing for PEM is identifying the

the, like I said before, the consequences of exertion. And it needs extensive activity analysis and, and understanding rest. So my recommendation is that once you have identified an OT or, or PT, that they also have a background in sensory integration. I find that those therapists are the most

open and receptive to figuring out really creative ways to identify what stressors an activity may have, such as if you are going to be taking a shower, what are the smells like? What is the lighting like in the room? The sound of a fan, the intensity of water that hits your body, the positioning, what is your orthostatic triggers or stressors for your body?

All of that is part of what a sensory integration therapist does anyways. For somebody that's neurodivergent, they're going to understand that lights and sounds are very, very intense. And I think if we kind of retrain these therapists to say, like, our bodies are neurologically having difficulties. We need assistance with reinterpreting

the sensory parts of our environment. That's exactly what an SI therapist would be doing.

Zeest Khan (35:02)
and we'd be able to find out if our therapist has that extra training from their bio.

Amy Mooney, MS OTR/L (35:09)
Yes, and I think also calling up specific clinics that are sensory clinics. I think they're typically in pediatric settings, but I think that they can be reutilized for patients that have long COVID with post -exertional malaise and the ME community. So I think by the OT and PT community, the therapist may

hesitate, but I think if you drag them along and say, no, I think you really can learn this. That's what I'm trying to do on my end as a practitioner is I'm doing, you know, workshops and webinars. I'm teaching, I'm doing continuing education for my own profession to say, you guys can do this. This is not outside your realm. You know how to do this type of therapy. You just want to follow the traditional medical model.

You know, OTs, our profession, historically has come from public health. And it was after World War I where all of these soldiers came back injured and they were now needing job training and they were having to figure out how to do this work and live in my community with these amputees and different types of injuries from war. And it's only been recently that OT has been

pushed into the medical model and to be in a hospital setting. And I think that we've all been, you know, all of us OTs have been trained to look at it in a more holistic field, but then we get our first job and we go right into the rehab department. And that's where I think we lose this perspective to say, yeah, these people do live in the homes and I probably need to do some home visits and I probably need to be in the schools.

to find out why this child who keeps complaining that they can't make it through their day. know, I find them on the side of the basketball court, laying down on the court, you know, and they're trying to get through gym class. I mean, it's so incredibly sad because they don't realize that this kid actually has post -exertional malaise. So instead of it being treated as behavioral or maybe deconditioned or something like

like that, it's not. We need to look at what is this child doing at home? And now, you know, are they really sleeping a lot or are they not sleeping at all and now they're coming to school and they're struggling? So I think by teaching the therapists to look at these patients with a different lens, a different perspective, it really will open up and I think

you know, a lot of OTs and PTs want to know how to treat. just, they don't feel confident to treat with, like I was saying, like, you know, not graded exercise, but with more of the understanding, the consequences and the symptoms of the disease itself.

Zeest Khan (38:26)
Yeah, I agree. think medical providers want to help. And I have even recently had an appointment with, you know, a subspecialist physician who has, you know, research grants and is also very kind. And he said he offered me several ideas that were non pharmacologic based. And I followed up with them.

And at the end of the appointment, he said, I'm sorry, I couldn't do anything for you. And so we see as practitioners treatment and help in such a specific way that I think it's so important that you're empowering your colleagues to be like, no, see all this that's in the toolbox that you have, you can use it for more than one thing. You really are providing help.

So I'm gonna link a lot of your work in the show notes, but I want people to know you have free videos available. You've collaborated, I know at least with the Bateman Horne Center that's located in Utah, trying to help occupational therapists be occupational therapists for people with ME.

Amy Mooney, MS OTR/L (39:49)
the idea is that those tools that we know as occupational therapists are, I'm gonna say it again, is helping the patient kind of bubble wrap themselves so that they are cutting down their exertion, that they are cutting down the stimulation. And all of those tools, accommodations for work, accommodations and modifications for schooling, making sure that the individual has as much

support as possible so that they can continue their work. That's that's that is important. People cannot, you know, go without a paycheck. But when that's not possible, how do you document so that they get disability? How do you show that they need support that is just for their daily living? So, yeah, the materials that we have at Bateman Horn is

is out there, it's free. It's available for access off of their website. But they can also, your listeners can reach out to me. can be contacted. I am licensed in multiple states, but I also do just pacing education for caregivers and people with ME and people with long COVID. So.

I'm also available for people that have, you know, some of the comorbidities for Ehlers -Danlos and vascular compression diseases or POTS, dysautonomia. All of those comorbid conditions are part of my training as, know, the last 10 years of really understanding what all the complexities are when people come to seek medical help. There are some supports.

Zeest Khan (41:40)
So your website is otferme .com. I'm gonna link that in the show notes too. You, like you were saying, provide your license in several states, but you also provide care across the globe. You have a completely online practice, which is also very helpful in accessibility. So we're gonna link all of those below. Amy, what else should we talk about that we didn't cover yet?

Amy Mooney, MS OTR/L (42:10)
My heart is with the pediatric community that there are so many kids that are really struggling. Adults, we know, they can speak up for themselves. They can say when they need help. Kids have to go through layers of adults who want to understand this disease. And so for a child to speak up, they've never felt sick before. They've never felt these symptoms before. So it's really confusing for children.

If we can get as many adults out there, if you know that your niece or your neighbor's grandchild or anybody that's suffering, if they show signs that could be long COVID, if they could be post -exertional malaise, whether they meet the diagnosis or not, least help them speak up and find the help that they need. Because we do not want these children to be told that they are

exaggerating, that they don't know how to read their body. I mean, I think that's what's really tragic is we're teaching a lot of children not to be able to trust their own bodies and interpret their own symptoms. When somebody says, you don't know how your body feels, that's, that's altering to how they develop their, the rest of their life. They really question themselves even further. So I think that if we can really

become more aware of what children need, we can start getting help for a lot more people. And that's where I get on my soapbox of kids need, they need to be able to access care too.

Zeest Khan (43:51)
Absolutely. Thank you so much. Amy, what do you think about after this recording, we talk about sensory integration therapy, in the sub stack and send to listeners and subscribers who might want to learn more about that and more about your voice. Yeah, that'd be great. All right. Well, look out for that.

Amy Mooney, MS OTR/L (44:12)
Yeah, I would love it. I'm in. Perfect.

Zeest Khan (44:17)
Amy Mooney, thank you so much for joining me. you've given me so much to think about. You've educated me on a lot. And I think that you have helped. You certainly have helped me view occupational therapy as a resource that might need to be tailored from the way it's traditionally practiced, but that there are occupational therapists who have skills that can very practically impact.

our lives.

Amy Mooney, MS OTR/L (44:48)
I agree. think we have, they are out there. Unfortunately, they might need some learning to do. Like we might need to teach them. But I think that a lot of people are waiting for that information so they can really help and step up. So yeah, and I agree with all of the resources that you have provided on this podcast series is amazing and it's a really good resource for.

from medical providers, but also your patients too.

Zeest Khan (45:22)
Well, the medical system is broken in a lot of ways, but a lot of institutions are standing and we have every right to utilize them for our needs too. So we're doing it together. Thank you, Amy.

Amy Mooney, MS OTR/L (45:35)
Thank you so much for this opportunity. really, really appreciate it.

Zeest Khan (45:39)
It was really fun.

Zeest Khan (45:44)
Wasn't that such an interesting conversation? I learned so many concepts that I want to get familiar with.

including sensory integration, interoception. I want to learn more about the symptom that a lot of people with long COVID have been complaining of and are having a really hard time describing. internal tremors.

I love the idea that Amy introduced of preemptive rest versus recuperative rest. I love those words. I'm going to integrate that into my language.

Because there is a lot more I wanna learn on this topic and more ways that I want to learn from Amy, she has graciously agreed to collaborate with me on a Substack article that is gonna dive in to some of these topics even more and clarify ways that you can better engage an occupational therapist in your area to really meet your needs. So keep an eye out for that.

subscribe to the sub stack if you haven't yet long covid md dot sub stack dot com it is easy and it is free I'm going to leave Amy's links in the show notes below I hope you're feeling well in this moment and if not I hope you start feeling well in the next

Thank you for listening to Long COVID MD. I'm your host, Dr. Zeest Khan. until next time, bye for now.