Dear Doctors: How long does COVID-19 last? I got sick with it, and it was like a bad flu, but I didn’t need to see a doctor. It’s been more than a month since I tested negative, but I still don’t feel well. I tire easily, and I just don’t feel right. Do you think this is long COVID? Should I go see my doctor now?

Dear Reader: We’ve heard from a number of readers who, like you, are struggling as they recover from COVID-19. The trajectory is as you have described -- mild or moderate illness followed by a recovery that doesn’t follow the familiar arc of recuperating from a cold or the flu.

It has become clear, in three years of dealing with COVID-19, that the infection affects everyone differently. This includes the severity of the initial illness, the specific symptoms that someone may develop and the way in which they recover.

When COVID-19 is not severe, the illness can take several weeks to run its course. Some people bounce back immediately. But for others, some symptoms drag on. These often include fatigue, brain fog, heart arrhythmia, lack of stamina, headache, body aches and breathing issues. This has come to be known as long COVID.

But as more people contract and survive COVID-19, a clearer picture of how people recover from the illness has begun to emerge. As a result, a new term -- “medium COVID” -- is beginning to enter the conversation. It’s being used to describe the first two to three months of a protracted post-COVID recovery.

It’s impossible to predict whether lingering symptoms will persist for weeks, months or even longer. That makes it important to let your health care provider know what is happening, So, yes, do make an appointment to see your doctor.

It’s also important to prepare for the appointment. Write down a concise history of your experience with COVID. This includes the date you tested positive, the symptoms you experienced while you were ill and the date you tested negative. Also include any medications you may have used while you were sick. Create a separate list of the symptoms that continue to persist and when they occur. If some are worse than others, put those at the top of the list. Explain how they affect your daily life, and if certain activities, situations or times of day make them worse. If you have undergone any tests related to post-COVID symptoms, let your doctor know, as these can be helpful.

If you are allowed to bring someone to your appointment, consider asking a family member or friend to join you. They can help you record the information your doctor gives you. This includes prescribing medications and how to use them, recommending certain types of therapy and requesting additional screenings or tests. A companion can also help you to further process the information after the appointment is over. This can be particularly helpful when exhaustion or brain fog are among the post-COVID symptoms that are affecting your life.

While there isn’t a cure for lingering COVID, it’s possible that some of the symptoms can be managed.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: What causes nasal stuffiness when you don’t have a cold or allergy? My nose sometimes gets stuffy when I lie down, then clears up when I stand. Blowing my nose yields nothing. Even when I have a cold, it will open up if I exercise. What can help when you have a stuffy nose?

Dear Reader: The stuffy nose you have been dealing with is called rhinitis. “Rhino” refers to the nose, and “itis” indicates the presence of inflammation.

In addition to congestion, symptoms of rhinitis include sneezing, nasal itching, reduced sense of smell and a runny nose. The condition can be classified as allergic and nonallergic rhinitis. As the name plainly states, allergic rhinitis arises from an immune response to the presence of an allergen. Nasal inflammation with no apparent cause is referred to as nonallergic rhinitis. Being stuffed up from a cold or the flu also falls under that category.

The nasal cavity is served by a dense and complex network of blood vessels. It is also lined with a thin layer of mucus that keeps the tissues moist and flexible, and which contains immune cells that defend against foreign invaders. When something causes the blood vessels in the nasal passages to become inflamed, they swell up. This leads to congestion that can range from mild to severe. When the tissues swell, they also slow the flow of mucus. As mucus accumulates, it can contribute to stuffiness.

It also appears that certain immune cells within the nose can trigger an inflammation response, even when infection or allergens are not present.

Nonallergic rhinitis has a wide range of triggers. They include potential irritants such as perfumes; cleaning products; secondhand smoke, smog or other air pollutants; spicy foods; hot beverages; changes to the weather; hormonal fluctuations; pet dander; dry air; and certain medications.

While nonallergic rhinitis can also include an overproduction of mucus, it is not always present. When congestion is due mostly to swelling and not to an abundance of mucus, as in your case, blowing the nose brings no relief.

As many people with a chronic stuffy nose know, lying down can make things worse. That’s because while you’re upright, gravity helps your sinuses drain. But when you lie down, the effect is negated, and congestion occurs. Elevating your head -- whether with pillows or by sitting or standing up -- increases nasal drainage, often quite quickly. The increase in blood circulation that comes with light exercise can also widen the nasal passages, which makes breathing easier.

If your doctor has ruled out allergy, infection or sinus problems as a cause, there are steps you can take to get relief. Using a humidifier can be helpful, as can saline sprays. You also can use a daily saline rinse, but, as we have written in previous columns, always be sure to use sterilized water. Antihistamine sprays and decongestants can reduce symptoms, but their effect is temporary. Some people find that external nasal dilator strips, which manually open the airways, make breathing easier. They can be particularly helpful when sleeping.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: Several years ago, I began sweating on my forehead. It gradually became more profuse, until my entire head was soaking wet. My internist diagnosed hyperhidrosis. An antiperspirant he suggested worked, but only briefly. What is the cause of hyperhidrosis? Is there any treatment?

Dear Reader: Hyperhidrosis is a disorder in which the sweat glands become overactive. The result is excessive perspiration that is not associated with exercise, temperature or any other typical triggers. Parts of the body that are commonly affected include the palms of the hands, armpits, soles of the feet, chest, the head and face. This last type of excessive sweating is known as craniofacial hyperhidrosis.

For the majority of people, hyperhidrosis does not pose a serious health threat. However, it can be uncomfortable and embarrassing, and it can interfere with quality of life.

Excessive sweating linked to a known cause, such as menopause, Parkinson’s disease, low blood sugar or an overactive thyroid gland is known as secondary hyperhidrosis. When it arises with no clear cause, it is known as primary hyperhidrosis.

The reason this disorder occurs is not fully understood. However, it is believed to be linked to a glitch in the workings of the sympathetic nervous system, which oversees the body’s fight-or-flight response and acts as its thermostat. Genetics may also play a role. It appears that when someone has primary hyperhidrosis, the brain is sending signals that activate the sweat glands, even though the conditions that would require the cooling effects of sweat are not present.

When it comes to managing the disorder, the antiperspirant your internist recommended is a common first-line approach. So are medications known as anticholinergics, which interfere with the electrical signals the body uses to activate the sweat glands. Beta blockers, which are medications that mask the physical manifestations of anxiety, are also sometimes prescribed. In some cases, patients opt for an endoscopic surgery called thoracic sympathectomy, in which certain nerves associated with sweating are severed.

Nerve impulses associated with sweating can also be muted with the use of Botox. That’s the product name for an injectable protein made from Botulinum toxin, which is a neurotoxin. Botox injections have come to be widely used in managing primary hyperhidrosis when topical treatments have failed. The treatment works by blocking the nerve signals that instruct the sweat glands to become active. It takes three to four days for the results of Botox injections for hyperhidrosis to become evident. Depending on each person, as well as the area beating treated, the results last for up to six months.

According to the International Hyperhidrosis Society, people who receive Botox injections have found excessive sweating decreases by more than 85%. Side effects of the treatment can include pain, swelling and bruising at the injection site. Although Botox is widely used for many types of hyperhidrosis, at this time, it has been FDA approved only for excessive underarm sweating. When used for other areas of the body, it is an off-label use.

With the failure of the antiperspirant to bring you relief, your internist can advise you on whether oral medications, Botox injections or surgery may be an appropriate next step.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)