Mono is a very common illness usually caused by the Epstein-Barr virus (EBV) that can leave teens and adults feeling like they’re fighting the worst cold or flu they’ve ever had. While mono symptoms mostly disappear in most people after two to four weeks (and it is rare to get the illness again), the fatigue associated with mono can last for an additional several weeks. It may take an extra month or two after symptoms disappear to regain your typical energy and strength. (1,2) Though many individuals may be eager to get back to their usual routines throughout the recovery process, not rushing the recovery process is actually one of the most important steps you can take to not interfere with your body’s healing process. Here are some tips for managing symptoms:
Give Yourself Plenty of Time to Rest
This prescription can be a tough one to follow if you’re used to being active. But getting extra rest is key to recovering when you’re hit with mono, says Hank Balfour, MD, professor of laboratory medicine and pathology as well as pediatrics at the University of Minnesota Medical School in Minneapolis. “Not sleeping enough can make the virus worse.” He recommends getting at least the recommended seven to nine hours of sleep per night that everyone should be getting (and more if you feel like you can) for at least the first week you’re experiencing symptoms. After the first week, Dr. Balfour recommends gradually becoming more active. When you’re not sleeping, you don’t need to completely be on bed rest, says Octavio Ramilo, MD, chief of infectious disease at Nationwide Children’s Hospital in Columbus, Ohio. “There is some risk of ‘deconditioning’ if you become excessively sedentary,” he says. But you definitely don’t want to keep up your typical schedule either. The trick is taking it easier than you typically would. Also be sure to avoid contact sports (no matter how much energy you have) for at least four weeks following the start of your symptoms, as you risk rupturing your spleen (which becomes enlarged when you get mono), Dr. Ramilo says. This complication is serious, requiring immediate medical attention if you notice a sudden, sharp pain in your upper abdomen, and can be fatal if not treated immediately.
Drink Plenty of Fluids
Make sure you drink plenty of fluids to avoid dehydration and to help relieve a fever and sore throat. Doctors recommend drinking at least 12 to 16 cups of fluids (which should include water as well as broth, soup, herbal tea, and other soothing liquids), says Ramilo. (Recommendations from the National Academy of Sciences say the same.) (3) You’ll need to up that quantity if you have a fever. And be sure to avoid caffeine, which can worsen dehydration.
Try Gargling With Warm Salt Water
Gargling warm salt water or drinking tea with honey can help soothe a sore throat. (2)
If You Have a Fever or Muscle Aches, Try Taking an Over-the-Counter Pain Reliever
Over-the-counter (OTC) pain relievers, like acetaminophen (Tylenol) or ibuprofen (Advil or Motrin), can help with pain or fever you experience because of mono. (Remember to avoid giving children and teens aspirin, which has been linked to Reye’s syndrome, a rare but dangerous condition that can cause liver and brain damage.) (4)
Avoid contact sports if your spleen is swollen. Even after symptoms go away, it may take a few additional weeks for the swelling in your spleen to go down, so you’re still at higher risk of rupturing it than usual. In addition to skipping contact sports, don’t engage in heavy lifting or vigorous exercise for at least a month or more after recovering from mono. (For kids, that means no roughhousing with siblings at home either).Try some exercise. “If your doctor has examined you and you don’t have an enlarged spleen, do what you can tolerate,” says Balfour. Light exercise, such as yoga or walking — if you feel up to it — can help you stay active and healthy, gradually building up your strength as you recover.Eat an anti-inflammatory diet. Balfour recommends eating a diet focus on anti-inflammatory foods, which means you should be eating plenty of fruits and vegetables, and avoiding sugar, dairy, and processed foods. It seems to help ease symptoms, he says.Don’t push yourself to get better faster. Recovering from mono takes time and rest. If you try to resume your normal activities too soon, you could end up prolonging your illness and hindering your recovery process. “Listen to your body,” suggests Balfour. “Each person is different; do as much as you can.”Plan for your downtime. Both when you’re still experiencing symptoms and the few months after, you’ll need to spend more time than usual either sleeping or staying off your feet and resting. Plan to have some extra reading material on hand, or movies or TV shows to watch.
At any point, whether you are still experiencing mono symptoms or not, see your doctor or go to the emergency room (ER) immediately if you experience any sudden or sharp pains in the left side of your upper abdomen (which could be a sign that your spleen may be ruptured), if you start having difficulty breathing, or if you are urinating much less than normal (indicating that you’re dehydrated). If you’re unsure about how quickly you should be getting back to your usual activities, talk to your doctor about what’s right for you. (1,2,5) Remember to talk to your supervisor at work (or teachers, if you’re in school) to let them know what’s going on and that you’ll be taking some time off. Ask your doctor for a note explaining that you have to recover from an illness that is temporarily debilitating. Tell your teachers and school that you’ll need an adjustment and allowances in your schedule and assignment due dates so that you can get extra time to complete your work. “We often write to the professors and explain that a student can’t complete an assignment on time,” says Balfour. And remember to ask friends and family for help when you need it — whether it’s picking up groceries, or talking on the phone when you need some cheering up — or to help you in case you need more medical attention. (5) RELATED: Everything You Need to Know About Mono Diagnosis and Treatment Here are answers to some common questions when it comes to mono recovery: Can you work when you have mono? If you have a job that doesn’t require strenuous physical activity or manual labor, it’s up to you to decide whether or not to work and how much you can handle while recuperating, says Eric Johannsen, MD, an associate professor of infectious disease in the department of medicine at the University of Wisconsin School of Medicine and Public Health in Madison, who researches EBV. “We typically leave it to the individual and how he or she feels.” Adds Balfour, “I tell patients to listen to their body, and to stop working for a time if fatigue begins to interfere with work.” Balfour also advises letting your coworkers as well as your supervisor know that you have mono so that your colleagues can understand why you need to rest. As for when to go back into the office, if someone feels up to going back to work, they should do so if they feel well enough. “Mono is not spread by casual contact so there is no reason to stay out of work due to concerns about contagion,” says Dr. Johannsen. But I’m the lead on this really big project coming up. How about if I check in once a day to make sure my team is on track? While it’s fine to check in with work if you feel up to it, Johannsen says only do so if you’re actually feeling up to it. (And it may be a good idea to have someone backing you up at work for when you don’t feel up to checking in.) “I think it’s important to bear in mind that you may not be at your best while recovering from mono,” says Johannsen. “Mono is a legitimate reason to use sick leave.” Emailing might be a good way to stay in contact for some, Johannsen says. “The recovery time can be long, it may be reasonable to do some work from home or to check in, especially if that reduces your stress.” But the situation differs for everyone depending on how you feel and what type of work you do (and the practicality of doing it remotely or not full-time). How long does the exhaustion from mono recovery last? When it comes to exhaustion from mono, there’s some variability. Doctors say exhaustion can typically last for a month or two, but it’s possible for someone to only feel fatigued for a week or feel run down for as long as six months or longer. “A minority of people can have fatigue beyond six months, though even most of them can expect to make a full recovery,” Johannsen says. “Graded exercise programs, where the person sets specific goals for increasing activity, can be very helpful here.” I’m a marathoner. When can I get back to my training? “I recommend that waiting until acute symptoms have resolved and fatigue is decreasing, which is usually at least a month,” Balfour says about returning to typical activity for someone who is physically active. Doctors typically caution mono patients not to engage in any contact sports for up to four weeks after symptoms go away to reduce their risk of rupture of the spleen, but for a noncontact sport (like running) someone can typically return to training after taking it easy for about three weeks, Johannsen says. But, he adds, it’s important to “respect your limits and realize that it may not be possible to return immediately to peak activity.” Is mono a deadly disease? Most people with normal immune systems usually recover completely from mono without any lingering effects, says Johannsen. In a small number of patients — such as those who get mono after an organ or bone marrow transplant, or those with genetic defects in their immune systems — complications from the illness can be more serious and potentially fatal. “The most common serious complication is splenic rupture, which can, of course, be fatal,” says Johannsen. “Throat swelling, leading to difficulty breathing, can also be life-threatening. But generally [most people with that type of swelling] respond to corticosteroids if medical attention is sought promptly.”
