DEAR DR. ROACH: I participated in a research study and received the Johnson & Johnson COVID-19 vaccine on Nov. 30. I have lab-confirmed antibodies. Gyms are known to be especially susceptible to the virus spreading, but is it reasonably safe to return to the gym after having the vaccine and taking normal precautions? I haven’t been to the gym in almost a year, and as a 60+ male, I know I need more cardiovascular exercise. — H.C.

ANSWER: It is still wise to use proper social distancing, hand hygiene and masks, even after getting any COVID-19 vaccine. It’s certainly very good news you got the vaccine, and like more than 90% of those who received the Johnson & Johnson vaccine, you have antibodies. However, no vaccine is perfect, and recent data showed the vaccine to be 85% effective at preventing severe COVID infection.

You are right that gyms are a known source of infection. Many people infected and contagious with COVID-19 have no symptoms, and feel perfectly well enough to go to the gym, but pose a risk to their fellow exercisers. Working out leads to heavy breathing, which increases the risk of infection to others. That could put you, and then anyone you may live with, at risk.

Also, YOU could be the asymptomatic person potentially spreading virus. We don’t know for 100% that the vaccine prevents transmission.

For yourself, your family, and others, it’s best to avoid places of risk until the pandemic is under better control. At the time I write this, most of North America is a high-risk zone.

DEAR DR. ROACH: What can you tell me about ganglion block? My mother is 71 and has peripheral nerve damage from chemotherapy about 15 years ago. She is wondering if this type of nerve block would be appropriate for the pain she’s experiencing in her feet. The gabapentin she takes is not working the way it used to, and she is worried about the increasing dose and frequency needed to handle the pain. She was started on pregabalin and that seems to be working better. — A.A.

ANSWER: Neuropathy, a general term meaning “symptoms due to nerve damage,” is very common and highly variable. There are many causes, such as diabetes and nerve compression, but some chemotherapeutic agents — for example, platinum-based drugs — are common causes of pain caused by damage to the nerve.

Oral medications like gabapentin (Neurontin) are the first-line treatment, but their use can be limited by side effects, or they just may not be effective. Blocking the nerve transmission of pain by injecting medication at a junction of nerves — the celiac plexus, stellate ganglion or lumbar sympathetic plexus — is an alternative to medication therapy. It has been used for cancer pain, diabetic neuropathy and other neuropathies. For most conditions, it is only considered if other treatments have not worked, as the duration of pain relief is variable (weeks to years), and a new pain, called “deafferentation pain” may develop as a complication. In your mother’s case, I would suggest that since the pregabalin seems to be working, she give that a good try before considering a nerve block.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

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