Dear Dr. Roach: I became extremely sick and was taken to the hospital. My physician thought I had regular pneumonia. I was so dehydrated that they couldn鈥檛 find a vein. I was intubated and had trouble getting enough oxygen. I had dialysis. My family was told I probably would not live. They discovered that my illness was legionella, and with treatment I woke up from paralysis.
My recovery has been easy and fast, although I was told it would take a year at the least. I am finished with physical therapy. My blood work and scan show everything is back to normal. But I have scarring in my lungs.
I am a 47-year-old woman. What should I expect for my future? Are my kidneys at risk? Do I have a greater risk of contracting pneumonia in the future? What about my lungs? Is there permanent damage? What about allergy medicines and ibuprofen? I am afraid to have a glass of wine.
C.K.
Legionella is a bacteria that can cause pneumonia. It is classically found in fresh water, such as air-conditioning cooling towers and condensers. It was thought to be the cause of the original outbreak among American legionnaires back in 1976 in Philadelphia, hence the popular name of legionnaires鈥� disease. Once considered rare, increased awareness and better diagnostic tests have led to a greater understanding of this important cause of pneumonia.
It may look just like any other kind of pneumonia, but diarrhea and very high fever are clues that it might be legionella. Liver problems are more common in legionella infections, but the dialysis you received likely was due to kidney failure from severe shock and sepsis.
Intubation 鈥� having a breathing tube inserted into your windpipe 鈥� and paralysis are reserved for only the very most severe pneumonias, and it is really great news that you are recovering so quickly and completely.
Being young and female are good signs for recovery. Since your blood tests are normal, your kidneys apparently recovered completely. There is no reason not to use the same over-the-counter medications you used before the pneumonia, and an occasional glass of wine is fine (but not too much).
Some scarring after pneumonia is common, and this indeed puts you at somewhat increased risk for future pneumonias. A vaccination for pneumonia will reduce the risk of the most common bacteria.
听
Dear Dr. Roach: Why do heart attacks occur mostly in the morning and on Mondays?
J.V.
Your statements are quite true. Heart attacks are three times more likely in the morning than in the evening, and 15 per cent to 20 per cent more likely on Mondays than on other days. Nobody knows exactly why. Mornings are thought to be more likely due to several factors 鈥� increased blood pressure, an increase in cortisone and having 鈥渟tickier鈥� platelets in the morning. There are two main theories for the Monday phenomenon 鈥� the first is back-to-work stress, but recently there has been some evidence that it may be excess alcohol intake over the weekend. These are good arguments for stress reduction and avoiding excess alcohol in the first place.
听
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected].
