Why is pneumonia still wearing me out?

I WAS diagnosed with pneumonia a week ago. Although my fever has gone, I still have congestion, a cough and fatigue. The doctor has not recommended a chest X-ray to see if it had gone away. I’m nowhere near ready to go back to work. Should I just pay for a private scan to see what’s going on?

PNEUMONIA is an inflammation of the lung tissue caused by a bacteria or a virus. It is potentially a very serious condition.

If you are older or have a pre-existing lung condition, this illness can be more serious and you may end up in hospital.

Thankfully, your fever is gone — it generally reduces 48 hours after antibiotics — but can take a week to settle. This indicates the infection has passed.

It can, however, take as long as four weeks for your chest to stop producing phlegm. Then it may be another two weeks before you completely stop coughing.

Fatigue will remain throughout this period and it might be a full three to six months before you are back to normal.

It is vital that you complete a 10 to 14-day course of antibiotics, and it’s pointless paying for an X-ray. Evidence of the illness will not have cleared in the space of a week. Repeating it would be a waste of money and exposure to unnecessary radiation.

What is well worth paying for, however, is a flu vaccine — and a pneumonia vaccine — as this winter you will be vulnerable.

In addition I suggest taking vitamin D supplements and anything else to strengthen your immune system.

Moving forward, once the cold and flu season starts you need to become obsessive about hand hygiene, as this is your core germ prevention tool.

All you really need to do right now is rest and recover. You need a further full week off work after your antibiotics stop.

In terms of repeating the chest X-ray, this would not normally be done before six weeks have passed, and there is often little need to repeat it if you are not a smoker. If you are, however, it is essential. By all means see your GP again if you have any other concerns.

I HAVE put on a lot of weight in the past two years — two stone, to be precise. I have started exercising and notice that when I’m doing sit-ups there is a dome-shaped bulge in the middle of my tummy.

What can I do about this? Is it dangerous? It’s unsightly!

THIS is called Diastasis rectus abdominis. The extra weight you have been carrying has stretched your ‘six-pack’ muscles. Pregnancy, hypermobility, straining, e.g. constipation, or years of lifting with poor technique, can also contribute.

As it stands, you need to lay off strenuous exercise that causes your tummy to bulge. Avoid heavy lifting and straining. Roll out of bed rather than sit up, and get help working on your core muscles and anterior abdominal wall. You need to engage a physiotherapist for this if you want to get results.

Ultimately the issue here is cosmetic as long as the hernia isn’t excessively large, causing pain or resulting in symptoms such as constipation.

There are options. All of the abdominal muscles are connected in the midline: if this is widened (due to your weight) a gap can arise. This can often be felt around the belly button when you lie flat. If there is a problem, it is usually 2-5cm wide. This weak wall bulges if you stand or strain; the classic dome shape is a tell-tale sign during exertion. Surgery — and, depending on severity, sometimes physio or Pilates — brings these muscles back together.

My advice is to work with a physio to improve the muscles and try to lose weight. Ask your physio or GP to confirm the diagnosis and only engage a surgeon if all else fails. Ultimately you are looking at a cosmetic operation.