Post-Surgery Symptoms and Infection Risks in Elderly Care

Q: Post-Surgery Symptoms and Infection Risks in Elderly Care

Dear Ms. <br>Hs：<br>1. <br>The primary mode of transmission for COVID-19 is through direct contact with respiratory secretions or droplets containing the virus. <br>The estimated incubation period is mostly between 1 to 14 days, with the most common duration being around 5 days.

Please consult a doctor for your questions?

Hello, Dr.
Hsiao.
Last week, my grandfather had surgery for a liver tumor at Taipei Veterans General Hospital in Neihu.
I occasionally help take care of him.
After the surgery, he stayed in the intensive care unit for two days before being transferred to a general ward.
My grandfather decided not to spend extra money on a private room and told my dad to opt for a shared room.
When I visited him, there was a foreign patient in the next bed undergoing chemotherapy for bladder cancer.
He seemed to have an infection, possibly a cold, as he was coughing and had a fever but wasn't wearing a mask.
My grandfather was wearing a mask, but he would take it off while sleeping.
A few days later, he was discharged and came to stay at my house.
He started to have occasional coughs and a lot of phlegm.
He is currently taking 1000 mg of antibiotics.
My aunt also provided him with some traditional Chinese medicine, which has helped reduce the coughing, but he still has phlegm.
For the past three days, he hasn't had a fever, but today I started to feel some discomfort in my throat with a bit of phlegm.
I don't have a fever, but it feels somewhat like a cold.
It started to hurt a little around noon.
Drinking more water has helped, and I took some cold medicine prescribed by an ENT specialist, which has made me feel a bit better.
However, sometimes I feel a tightness in my chest, possibly due to anxiety.

I would like to ask the doctor if pneumonia is contagious and if I could develop pneumonia just from being around someone who might have it.
The doctors during my grandfather's hospitalization mentioned that the patient next to him might be on the verge of pneumonia, but I’m not sure how accurate that is.
They advised that my grandfather should be discharged quickly to avoid infection, which could complicate things further.

I’m also concerned about whether my symptoms could indicate COVID-19, as I feel strange wearing a mask while taking care of my grandfather at home.
It feels like I’m treating him as if he were a virus, which makes me feel sorry for him since other relatives are not helping.
If my sore throat persists on Monday, I plan to visit an ENT clinic, but I’m unsure if a stethoscope can detect normal lung sounds.
Should I inform the clinic in advance about my grandfather’s recent discharge? Although I think that at over 80 years old, if he had COVID-19, his symptoms wouldn’t be so mild, I’m still a bit worried.

Could you please let me know if my concerns are valid? Thank you!

Hs, 20~29 year old female. Ask Date: 2020/05/16

Dr. Xiao Yongxun reply Family Medicine

Dear Ms.
Hs:
1.
The primary mode of transmission for COVID-19 is through direct contact with respiratory secretions or droplets containing the virus.
The estimated incubation period is mostly between 1 to 14 days, with the most common duration being around 5 days.
Clinical manifestations primarily include respiratory symptoms such as nasal congestion, runny nose, dry cough, fever, and fatigue, which are typical of upper respiratory infections.
A minority of patients may present with loss of taste or smell or unexplained diarrhea.
Older adults or those with chronic illnesses have a higher risk of developing severe conditions such as respiratory distress and pneumonia.
2.
If the patient is elderly, has chronic diseases, cancer, respiratory conditions, or compromised immune function, it is advisable for caregivers to wear masks and wash their hands before and after contact with the patient to prevent the transmission of infectious diseases.
Besides the caregiver's self-protection, the main goal is to avoid transmitting viral or bacterial pathogens to patients with weakened immunity.
3.
Based on your description and the medical standards of Tri-Service General Hospital, I believe your grandfather is unlikely to have COVID-19; in other words, your grandfather would not transmit COVID-19 to you.
However, as a young person with normal activity levels, it is uncertain whether you might contract the virus elsewhere.
Although I personally believe you are also unlikely to have COVID-19, this remains speculative.
4.
I recommend that you discuss your concerns in detail with your family physician or attending physician.

Reply Date: 2020/05/16

More Info

Post-surgery care for elderly patients, especially those who have undergone significant procedures like liver tumor removal, requires careful monitoring and understanding of potential complications. Your concerns about your grandfather's health after surgery are valid, particularly in light of the potential for hospital-acquired infections and the challenges faced by older adults in recovery.

Firstly, it is not uncommon for elderly patients to experience respiratory symptoms after surgery. This can be due to several factors, including the effects of anesthesia, prolonged bed rest, and the potential for exposure to infections in the hospital setting. The cough and phlegm you describe in your grandfather could be a result of these factors, especially if he was in close proximity to another patient who was exhibiting respiratory symptoms.

Regarding your concerns about pneumonia, it is important to note that while respiratory infections can be contagious, not every cough or cold leads to pneumonia. Pneumonia can develop as a complication of a respiratory infection, particularly in older adults or those with weakened immune systems. If your grandfather was exposed to someone with a respiratory illness, there is a possibility of him developing similar symptoms, but it does not necessarily mean he will contract pneumonia. The fact that he is on antibiotics suggests that his healthcare provider is taking precautions against potential infections.

Your symptoms of a sore throat and cough could be related to a variety of factors, including allergies, a common cold, or even anxiety about your grandfather's health. It is wise to monitor your symptoms closely. If they persist or worsen, seeking medical advice is a prudent step. Informing the healthcare provider about your recent exposure to your grandfather, who has just been discharged from the hospital, is essential. This information can help them assess your risk and determine the best course of action for your care.

As for your feelings about wearing a mask around your grandfather, it is understandable to feel conflicted. Masks are a protective measure, especially in situations where there is a risk of respiratory illness. While it may feel uncomfortable, wearing a mask can help reduce the risk of transmitting any potential infections to your grandfather, particularly given his recent surgery and weakened state. It is important to prioritize his health while also considering your own comfort.

In terms of monitoring your grandfather's recovery, it is crucial to keep an eye on his symptoms. If he continues to have a productive cough, especially if it is accompanied by fever, shortness of breath, or changes in his sputum (such as color or consistency), it would be advisable to contact his healthcare provider. They may recommend further evaluation, such as a chest X-ray, to rule out pneumonia or other complications.

Lastly, regarding your question about whether a stethoscope can detect lung issues, yes, healthcare providers often use stethoscopes to listen for abnormal lung sounds, which can indicate issues such as fluid in the lungs or infection. If you do visit an ENT specialist, it would be beneficial to mention your grandfather's recent hospitalization and any symptoms he has experienced, as this context can aid in a thorough evaluation.

In summary, your concerns are valid, and it is essential to remain vigilant about both your grandfather's health and your own. Communication with healthcare providers, monitoring symptoms, and taking appropriate precautions can help ensure a safer recovery for both of you.

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