Ask the Doctors 12/20 | The speaker’s review

By Eve Glazier, MD, and Elizabeth Ko, MD

Andrews McMeel Syndication

Hello dear readers, and welcome back to the continuation of our monthly letters column. They’ve been keeping our inboxes full, so let’s dive right in.

• We continue to receive questions about post-COVID-19 exercises. Some people have fully recovered and are cautious. Others, like this reader, face persistent symptoms. “I have ongoing effects from COVID-19, like shallow breathing and brain fog,” they wrote. “In terms of physical activity, what do you recommend to get back to normal?” Individual response to COVID-19 infection varies. This means that a return to exercise will be unique to each person. It is also a daily offer. Do your usual activities, but start small — a short walk or jog, just a few reps with lighter weights — and stop before you feel tired. This is important because overexertion can set you back. Data shows that a return to physical activity after COVID-19 can take longer than after the flu, so please be patient. Expect an adjustment period of at least several weeks while learning what your body is capable of.

• A recent long-duration column on hyperbaric oxygen for the treatment of COVID-19 raised this question from a reader. “I received high pressure oxygen treatment for long COVID at a Florida hospital,” they wrote. “If it’s available there, why isn’t it available for patients in clinics? Will the Food and Drug Administration approve high pressure oxygen therapy for long COVID?” You are correct that hyperbaric oxygen therapy for long COVID is not FDA approved. It’s a so-called off-label use, and that plays a role in the limited availability. However, the treatment shows promise, so clinical trials on its effectiveness and safety are underway. This is an important first step in gaining broader approval. Meanwhile, long COVID patients who wish to try this approach should always consult their doctor first. It is also important to only seek treatment from a qualified provider.

• Colonoscopy preparation is a recurring theme in this column. A reader with a family history of colon cancer wonders about alternatives. “I’ve been trying to prepare for a colonoscopy for the last three years but it just won’t stick,” she wrote. “My father had colon cancer at 34 and my mother survived breast cancer. My Cologuard test was positive and now I’m scared. What can I do?” Cologuard is a non-invasive test that looks for signs of colon cancer in a stool sample. After a positive result, patients are strongly advised to have a colonoscopy. Several types of prep solutions are currently available. Newer products contain fewer amounts of liquid than before and are better tolerated Another newer option is sodium sulfate-based tablets, which have received FDA approval for colon cleansing two years ago. Given your family history, we urge you to see your doctor to discuss all of these options.

Thanks, as always, to everyone who took the time to write. We look forward to hearing from you and will continue to reply to as many of your letters as possible.

Submit your questions to askthedoctors@mednet.ucla.edu.

https://www.spokesman.com/stories/2022/dec/20/ask-the-doctors-1220/ Ask the Doctors 12/20 | The speaker’s review

Brian Ashcraft

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