Is it safe to go back to work in nursing home if husband has diabetes?
Q
I’M 68 years old and work in a nursing home. I have been on methotrexate tablets for more than a year but in March I had a call from my doctor to stop taking the tablets immediately due to coronavirus and have been in isolation from that time.
I would like to go back to work but I am concerned about my husband, who is 74 and has Type 2 diabetes. Am I safe to go back to work?
A
METHOTREXATE is mainly used to treat autoimmune conditions where inflammation is caused by the body’s own immune system attacking healthy tissue, for example rheumatoid arthritis, psoriasis or Crohn’s disease.
Because it reduces the activity of the immune system, this does mean that it can put you at increased risk of a severe infection from any virus or bacteria, including Covid-19.
However since you have now been off the tablets for more than three months your immune system should have returned to normal.
Being over 70 and having Type 2 diabetes does mean your husband is also more at risk, especially if he is overweight, but not enough to be in the very high risk group. People who work in nursing homes should be given PPE (personal protective equipment) to wear, to protect both themselves and the vulnerable residents and this means it should be safe for you to return to work.
But you should be careful to wash your hands frequently, especially as soon as you come home.And the best way your husband can reduce his chance of a severe Covid-19 infection is to shed any excess weight he is carrying and keep his blood sugar levels under control.
Q
I AM a 65-year-old man and five years ago I was diagnosed with a 20mm acoustic neuroma. It is now 28mm. I have lost only a small amount of hearing in the affected ear and my balance has only been affected slightly. I have severe tinnitus which I find very uncomfortable.
I have at times severe trigeminal pain which is at present being controlled by taking carbamazepine. The tumour is close to the brain stem and I am due to have an operation.
Do you think I should have the operation and is my age a factor? A AN ACOUSTIC neuroma is a non-cancerous, usually slow growing tumour that develops on the nerve that connects the inner ear to the brain. Symptoms are caused by its effect on the nerve fibres that control hearing and balance and can include tinnitus, or ringing, in the affected ear, unsteadiness, or loss of balance, dizziness and hearing loss.
This is usually very gradual, although in some cases it can be sudden, and again only occurs in one ear. It is usually diagnosed with a brain MRI scan. Small tumours may not need any active treatment and can just be monitored by repeat scans to check the rate of growth. Surgical removal is usually recommended for larger tumours that are causing troublesome symptoms.
Your tumour is causing tinnitus and also appears to be putting pressure on the trigeminal nerve, which carries sensory fibres to the face, leading to severe pain. Unfortunately as the tumour grows this is likely to get worse, which is why surgery has been recommended in your case.
Sixty-five really isn’t that old and I do not think this will be a significant factor in your recovery. Most hospitals are now asking patients being admitted for elective (non emergency) surgery to self-isolate for two weeks beforehand and are then tested for Covid-19 infection.This means the risk of catching the virus in hospital is now extremely low. I do not think you should be concerned.
Q I AM 84 and have an incessant and very painful carpal tunnel problem which started late last year and unfortunately painkillers do not
help. I was referred in early January and given an appointment for March. This was put back to early April. I then received a letter informing me this was cancelled. I’ve had no communication since.
I do not doubt thousands of others have far more painful conditions but could I ask if you have any idea when we may look forward to treatment and relief from these conditions when the pain is with us throughout the day? A LIKE all GPs, I am getting constant calls from patients who had either outpatient appointments or operations cancelled earlier in the year, when all hospital resources were diverted to looking after those with Covid-19. Most were sent letters saying that their treatment would be rescheduled but have heard nothing.
Hospital services are starting up again but it is a very slow process and there is now a huge backlog.
In general, those with urgent or severe problems are being prioritised, and less urgent issues, such as joint problems are often way down on the list.Worse still, I have had some patients who seem to have been “lost” from a hospital waiting list so I think it is worthwhile contacting the hospital to see if they can give you an estimate of your waiting time.
The letter you received should have a contact telephone number at the top, so start with that. If you can’t get any information, then ask one of the administrators at your GP surgery if they can chase the hospital for you.
If the pain in your wrist persists arrange a telephone appointment with your GP and see if there is anything more that can be done for you in terms of pain relief.