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Dear Dr. ROACH: I am a 75-year-old man who is active in many sports, including tennis. About six weeks ago, I had pain on the outside of my elbow, and the Internet told me that it was epicondylitis. I have never suffered such long-lasting injuries, including broken bones. I seem to be not far from resuming physical activity. Can you write about this situation and which treatments are most likely to succeed? — RR Answer: Epicondylitis ("tennis elbow") is a common cause of elbow pain, especially among athletes, so the Internet may be correct. However, there are at least a dozen other conditions that can simulate lateral epicondylitis, so I recommend that you visit a friendly doctor to make sure. Sometimes an ultrasound or X-ray is required to rule out other possibilities; other times, the medical history and examination are sufficient to confirm the diagnosis. If your doctor agrees with your diagnosis, there are several parts to the treatment plan. The first is to stop the activity that caused the problem first. Often, incorrect body mechanics (or inappropriate rackets in tennis) can cause inflammation, and changing your exercise will help prevent this problem. In any case, you need to stop or slow down for a few weeks. If you continue this activity, adding ice later will help. Secondly, get a reaction support, which is very effective. You can buy it at your local pharmacy or online. Anti-inflammatory drugs such as ibuprofen are very helpful. Finally, exercise and intensive physical therapy completed the initial treatment, which is effective for most people. If not, it’s time to reconsider the diagnosis, perhaps some additional tests or visits to specialists, such as sports medicine physicians. Dear Dr. ROACH: I am a 62-year-old woman. Due to rheumatoid arthritis, I have been receiving Enbrel injections every week for 12 years. I received the first dose of COVID-19 vaccine on December 23, 2020, and the second dose of vaccine on January 13, 2021. On January 24, despite wearing a mask, after visiting my parents, I tested positive for COVID-19. Infect. I did not have any symptoms, but I was quarantined for 14 days. On July 17, I attended an outdoor party and was told that someone had contracted COVID-19. I was tested on July 22 and tested positive again. I did not have any symptoms, but was quarantined for 10 days. Yesterday, I did an antibody test with 91% accuracy. I am negative for all antibodies. I will step up the injection soon. Do you have any additional suggestions? — LSC Answer: People who have an immune system disease or are taking immune system suppression drugs cannot get reliable protection, whether it is infection with COVID-19 or vaccination. Although the vaccine may be part of the reason why you were asymptomatic when you contracted COVID-19, you will not get sick if you rely on those around you. The delta variant of COVID-19 is highly contagious, and covering and maintaining physical distance are only partially effective. My best suggestion is to get the third vaccine (maybe the fourth within six months), but as much as possible, make sure that all close contacts are vaccinated. Similarly, the vaccine is not perfect, but getting your contacts vaccinated will greatly reduce the number of COVID-19 you are exposed to, because the vaccine not only greatly reduces infections, but also seems to reduce the infectivity of infected people. And unvaccinated COVID-19 patients. * * * Dr. Roach regrets that he cannot answer individual letters, but will incorporate them into the column whenever possible. Readers can email questions to [Email Protection] or send an email to 628 Virginia Dr., Orlando, FL 32803. (c) 2021 North America Syndicate Inc.

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