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DEAR DR. ROACH: In a recent column, you wrote that there is no risk for the family to molt after receiving the COVID-19 vaccine. You failed to mention that according to the Centers for Disease Control and Prevention, grandparents could catch COVID and spread it even after being fully immunized. Plus, according to the CDC, they could be contagious and have a viral load, before they even start showing symptoms. Isn’t the only way to make sure they’re not contagious to get tested? – DI
ANSWER: The topic of this column was shedding after a vaccine, and it is true that there is no risk of COVID-19 shedding from the vaccine. However, you are correct that it is possible for a vaccinated person to have an active and asymptomatic infection.
New data on the age of the delta variant show that asymptomatic people vaccinated can indeed be infectious. For this reason, wearing a mask remains important, especially around people at high risk of complications from COVID-19. This includes people who have been vaccinated.
It is very important to note that the risk of an asymptomatic infection spreading from a vaccinated person is much lower than from an unvaccinated person, simply because a vaccinated person is much less likely to contract COVID-19.
DEAR DR. ROACH: I am an 83 year old female. Two years ago I was diagnosed with diverticulitis. He comes and goes. My doctor recommended that I see a surgeon, who recommended a sigmoidoscopy. I don’t see what the benefit is. I had two CT scans that showed diverticulitis. The surgeon said he wouldn’t operate on me.
Do you think I should have the sigmoidoscopy? Is there a risk in this procedure? The doctor said I would be sedated, and I am very reluctant to do so. – PS
ANSWER: All procedures involve risk. A sigmoidoscopy is usually less risky than a full colonoscopy, but there is still a risk of damage to the colon, and even moderate sedation, by itself, is risky. The probability of benefit must be weighed against the risk of harm.
In your case, I think I can guess why the surgeon wants you to do the sigmoidoscopy. There’s really no doubt about the diagnosis – the CT scans you’ve had are final. My best guess is that the surgeon wants to make sure there is nothing else there, especially cancer. The risk of being diagnosed with colon cancer after diverticulitis is considerably higher than expected, especially in someone with recurring symptoms, as you have had before. Unless you’ve had a colon exam within the past year, such as a colonoscopy, the guidelines recommend evaluation. Authorities recommend a full colonoscopy, but I suspect your surgeon wants to look more specifically at the area of the colon with the diverticula, which is usually the sigmoid colon. As I noted, a sigmoidoscopy is less risky than a full colonoscopy.
This is my guess, but I recommend that since you are reluctant to undergo the procedure, ask the surgeon why you need it. The surgeon shouldn’t get upset that you ask him. It’s our job to explain why we recommend what we do, and why we recommend it over the alternatives.
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Dr Roach regrets not being able to respond to individual letters, but will fit them into the column where possible. Readers can email their questions to [email protected] or send mail to 628 Virginia Dr., Orlando, FL 32803.
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