Ask the expert

Matt

I recently had severe Pneumonia

I have recently been discharged from hospital after having severe pneumonia and have been recovering at home. I have a secondary infection of pleurisy for which I have been taking anti-inflammatory painkillers, which do seem to be helping.

My sleep has been very badly affected, and since admission to hospital I stopped smoking (3 weeks ago) and have not smoked or drunk alcohol since.

I have elevated liver function results, which I am told is as a result of the large amount of intravenous antibiotics that I had in hospital, and I have been feeling some pain in my chest. I am having follow up blood tests tomorrow.

The question that I cannot seem to get a good answer is about when to return to work, and what to avoid. I ventured out today and encountered people with colds, and this has made me exceptionally paranoid about getting sick again, so I am unsure what to do. I was planning on trying to return to work on Monday to see how it went, as I do get out of breath quickly.

I want the flu jab, but I am told I have to wait a while before I can have this now. Any advice would be useful, as some doctors say return to work when you want, and those in hospital said I have to wait 6 weeks.

26 April 2021

What is pneumonia?

Pneumonia is an inflammation of the tissue of the lungs due to an infection in one or both of the lungs. While it is usually caused by a bacterial infection, it can also arise as a complication of a viral illness such as the flu or Covid-19 (NHS, 2021; Patient UK, 2021).

Pleurisy

Whilst pleurisy is usually caused by a virus it is also a known complication of bacterial infections including pneumonia. Pleurisy is the inflammation of the tissue between the ribcage and the lungs (NHS, 2021).

Treatment for pleurisy will usually focus around treating any underlying infection and managing the pain, usually with anti-inflammatory medications, so it sounds as if you are undergoing the correct treatment (NHS, 2021).

If it is the pain from pleurisy that is having a negative impact on your sleep it may be a good idea to discuss with your GP about any other, additional medications that may help manage this.

It's important to try different positions when resting, in order to find the one that is most comfortable for you. Although it might sound strange, a lot of people will find the most comfortable position may be lying on the side where the pain is emanating from (NHS, 2021).

Symptoms of pneumonia

Pneumonia symptoms can vary in severity from person to person, and you may not experience all of those listed below, but there are some common symptoms that people can experience (NHS, 2021):

  • Coughing often with mucus but that may be dry - mucus will likely be thick yellow, brown, green or blood stained
  • Difficulty breathing or shortness of breath
  • Fever and chills
  • Loss of appetite
  • Chest pain that worsens when taking deep breaths or coughing
  • Fast heart rate (tachycardia)
  • Nausea or vomiting
  • Wheezing
  • Headaches
  • Fatigue
  • Confusion or disorientation; this is most common in elderly people.

While you're likely to continue to experience some symptoms, such as fatigue, chest pain, cough and shortness of breath after the initial infection has been treated, if your symptoms remain severe, you experience a new type of chest pain or the mucus you are producing is of any of the colours noted above (clear and white is usually normal), then you will need to get back in touch with your GP for a further review.

Recovery

As you'd expect, all our recovery times will vary. However, the British Lung Foundation (2021) have produced some general guidance on the timeline of recovery after suffering with pneumonia:

  • After 1 week: Your fever should be gone
  • After 4 weeks: your chest should feel better and you will produce less mucus
  • After 6 weeks: you will cough less and find it easier to breathe
  • After 3 months: most of your symptoms should be gone, though you may still feel tired
  • After 6 months: you should feel completely back to normal.

Pneumonia can be a serious infection and so can take its toll on us physically, and as you can see, can take months to fully recover. You are likely to feel tired and breathless for some time, but this should improve with time (BLF, 2021).

Stopping smoking and limiting your alcohol intake are certainly things that are going to benefit your recovery.

Next steps

You mention that your liver function tests were elevated, likely due to the amount of antibiotics you were given in your hospital stay. The fact that you have not been smoking or drinking since your hospital admission is great and is certainly going to give your liver a better chance to fully recover quickly. I hope that any blood tests you have had since have shown that these results are back within a normal range, but if they aren't then make sure that you speak with your GP about what this could mean, and any further precautions you should be taking. Your GP will likely suggest some further, follow up blood tests to monitor your liver function, as this can take time to fully resolve.

As your immune system has recently been working hard to recover from the pneumonia infection, you are at a slightly increased risk of picking up further infections. While we can't always completely eliminate the chance that we could catch a second infection, the NHS has some good guidance on some things you can do to help prevent this (NHS, 2021):

  • Ensuring good hygiene precautions - this is most important to prevent the spread of infection from person to person
  • Ensure that you are engaging in good hand hygiene; especially after you cough or sneeze
  • If you cough or sneeze into a tissue then try to use a tissue, and dispose of this immediately
  • You may want to avoid large groups or social gatherings where you may be more likely to come into contact with others with potential illnesses

If you are out in the cold weather, this can sometimes increase the feeling of shortness of breath or make us more prone to wheezing and coughing due to constriction in the size of the airway (COPD support, 2021). Due to this, if you are out in cold weather it may be beneficial to make sure you are dressed warmly and potentially cover your nose and mouth to add a little warmth too.

If you are able to, a great way to reduce your risk of further infections, especially respiratory infections, would be to continue to not smoke, and to limit your alcohol intake. Along with smoking, prolonged or excessive alcohol intake can weaken your lungs' natural defences against infections, possibly putting you at a higher risk of developing conditions such as pneumonia again (NHS, 2021).

Vaccination

It is not uncommon for the administration of vaccines, such as that for seasonal flu, to be delayed if you are unwell, especially if you are still experiencing a fever. When we have been severely unwell our immune system will have been working hard to overcome this, and it may not be a good idea to put the extra strain from the vaccine onto our immune system.

According to the Centers for Disease Control and Prevention (CDC) 'Individuals who were hospitalised with an acute illness but who are now well enough to be discharged from a hospital can be vaccinated.' However caution is to be employed with the presence of moderate or severe illness with or without the presence of fever; with this in mind it would be sensible to follow this up with your GP, who can ascertain whether you are currently, or when you will be fit enough to have the flu vaccine. (CDC, 2021).

Returning to work

With regards to when you will be able to return to work, this is quite a difficult question to answer, as each of our individual recovery times will vary somewhat. 

When you can return to work is also likely to be dependent on the type of job you have; for example for physically demanding jobs you may need to have a longer period off. I would say the sensible thing to do would be to follow the hospital guidance and take 6 weeks off; especially as it sounds as if you are still experiencing shortness of breath. If, before the 6 weeks are up, you feel physically capable of working in a safe way then it would be a good idea to confirm with your GP that is would be a good idea for you.

When returning to work it may also be sensible to have a chat with your manager, or company's occupational health department if you have one, to see if there are any adjustments that need to be made, such as a phased return to work for example.

I hope that this has managed to answer some of your questions and I do hope that you feel better soon. If you would like to talk this through further with one of the nurses on the Health@Hand team you can contact us on 0800 003 004, we are available 24/7.

Answered by Health at Hand team.

References

British Lung Foundation, 2021. Recovering from pneumonia. Available at: www.blf.org.uk/support-for-you/pneumonia/recovery. (Accessed 20 March 2021).

CDC, 2021. Seasonal influenza vaccine safety: a summary for clinicians. Available at: Seasonal Influenza Vaccine Safety: A Summary for Clinicians | CDC. (Accessed 20 March 2021).

COPD Support, 2021. Weather and breathing. Available at: Weather and Breathing | COPD Support. (Accessed 20 March 2021).

NHS, 2021. Pleurisy. Available at: Pleurisy - NHS (www.nhs.uk). (Accessed 20 March 2021).

NHS, 2021. Pneumonia. Available at: Pneumonia - NHS (www.nhs.uk). (Accessed 20 March 2021).

Patient UK, 2021. Pneumonia. Available at: What is pneumonia? | Symptoms, Causes and Treatment | Patient. (Accessed 20 March 2021).

Got a health question?

We’re here to help you take care of your health - whenever you need us, wherever you are, whether you're an AXA Health member or not.

Our Ask the Expert service allows you to ask our team of friendly and experienced nurses, midwives, counsellors and pharmacists about any health topic. So if there's something on your mind, why not get in touch now.