Dlisten to Dr Roach: Could you address the issues that may or may not be a sequel to COVID-19? The problems seem to be common in people who have had COVID-19, but not recognized by all medical professionals.
Dear ACS: Although the probability of dying from COVID-19 is “only” around 1.8% – which means 938,000 deaths in the United States alone due to COVID according to the best estimates to date, including deaths unreported – many people who survive COVID-19 end up with persistent symptoms. The most common physical symptoms are: fatigue or lack of energy, which can be severe; shortness of breath, especially on exertion; chest pain or tightness; and cough. However, many people experience other symptoms, including persistent changes in smell and taste, joint pain, headache, dizziness, lack of appetite, and lack of sleep.
The brain and the mind can also be affected. Twenty-four percent of those discharged from hospital suffered from PTSD, while 18% had new memory problems and 16% had difficulty concentrating. These numbers are even worse when looking at ICU survivors. Forty percent of hospital patients were unable to resume normal activities within two months of discharge.
Among people with milder disease (not requiring hospitalization), about a quarter of people aged 18 to 34 had persistent symptoms, compared to half of people over 50.
I don’t know which doctors you spoke to. The studies are clear, and those of us who have cared for many people with COVID-19 know that the disease can cause persistent symptoms ranging from mild to debilitating in a very large number of people. We don’t know how long these symptoms will last, or even if some symptoms may be permanent due to damage to the heart, lungs, brain, and other organs.
As always, let me implore those readers who have not received the vaccine and are able to do so to please get the vaccine.
Dear Dr Roach: I am an 87 year old male with high blood pressure, high cholesterol and atrial fibrillation. I am still active, except for severe osteoarthritis of the right shoulder and ruptured rotator cuff. I heard from two different orthopedic surgeons. The first recommended a full shoulder replacement as soon as possible. The second told me that because of my age and general health, it would be better to live with the disease. I can take the pain for now. I am confused as to which way to go.
Dear Dr: This is a critical decision, and I don’t have enough information about you to help you much. The key factor is your health: doing surgery is a bit risky, and even in the best of situations, you will have a lot of work to do in post-surgery rehabilitation. Eighty-seven looks like old age, but you could be a very healthy 87-year-old man (high blood pressure, high cholesterol, and atrial fibrillation are not necessarily threats to your health if they are. well controlled), or you might not be in that great shape.
The best person to help you make this decision is your doctor. It could be your family doctor, internist, or cardiologist, but this person should help you balance the short-term risks with the long-term benefits. I have seen several instances where a joint replacement has made a huge benefit to a person’s quality of life. But if you want to do it, you’ll want to do it soon.
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