Convalescent

CONVALESCENT (from Latin convalesco - I return to a healthy state) - recovering, convalescence - recovery. The term R. should be understood as such a period of clinical recovery when the obvious signs of the disease have ended, but there is not yet a complete restoration of the body's previous state. Recovery is a conditional concept, since in many therapeutic or surgical diseases, recovery is often only relative. Thus, after operations, destroyed parts usually regenerate only partially, scars form, and the loss of any paired organ entails a vicarious enhanced function of another. In clinical practice, the term convalescence is applied only when a restoration of the body's previous state is expected, for example, for the postpartum period and mainly for cases of recovery after infectious diseases (regarding convalescence after childbirth, see Postpartum period). Convalescence after infectious diseases has its own characteristics and requires special study, since sometimes for a long time, in the absence of visible manifestations of the disease, the body actually contains a number of prolonged disorders of various organs (nervous, cardiovascular systems, muscles, psyche, etc.) and often the pathogen of the infectious disease itself remains in the body (see Bacillus carriage). Of particular importance, both for the recovering person and for those around them, is the period of convalescence after typhoid, cholera, dysentery, scarlet fever, diphtheria, and cerebrospinal meningitis. The period of convalescence after typhoid fever on average lasts from 4 to 6 weeks. During this time, the patient needs a careful diet and protection from intense physical and mental activity. The clinical manifestations of the disease he has undergone are expressed in adynamia, lability of cardiovascular activity, instability of the gastrointestinal tract (frequent constipation), and rapid mental fatigue. For at least 2 weeks from the day the temperature subsides, relapses of typhoid fever are possible, and therefore until this period has elapsed, the typhoid convalescent must remain in bed and follow a careful diet. In approximately 5% of cases, the patient is a bacillus carrier, excreting typhoid bacilli with feces or urine. The basis of bacillus excretion is most often pathological-anatomical changes in the gallbladder and kidneys, usually accompanied by catarrhal phenomena in them and sometimes causing only minimal objective and subjective phenomena in these organs. These organs in typhoid convalescents can be unstable for a long time and, in case of exacerbation of the process, can give rise to cholecystitis, pyelitis, and cystitis. R. after dysentery or cholera also requires special regimen and observation. On the one hand, he is often also a bacillus excretor, and on the other hand, after the disease, for a long time, measured in months, he himself is prone to intestinal disorders requiring a careful diet. In relation to typhus, the period of convalescence can often be prolonged from the usual 2-4 weeks to several (3 to 5) months, since histopathological processes in the body after the disappearance of fever can not only not pass during the period of convalescence but even progress. During this time, the R.'s psyche can be altered in the form of the appearance of capricious mood swings, weakening of memory and thinking abilities (see Infectious psychoses), sometimes there can be pains in the extremities, general weakness, speech disorders, and changes in the cardiovascular system. Bacillus carriage in diphtheria convalescents can continue for a very long time (see Bacillus carriage, Diphtheria). Regarding treatment, regimen, and prevention, see Diphtheria. Scarlet fever R. (see Scarlet fever) often needs medical observation for many months, especially in cases where scarlet fever was complicated by kidney involvement (glomerulonephritis) or heart involvement (myocarditis, endocarditis). Often such an R., after scarlatinal nephritis, having already quite a good urine analysis, after several months can show washed-out erythrocytes and cylinders in the urine. Therefore, hygienic and dietary regimens for him are mandatory for a long time, measured in months. In relation to R. from epidemic cerebrospinal meningitis, particularly careful observation is required. On the one hand, they can give very late relapses of the disease - 3 and even 4 weeks after complete recovery, and on the other hand, they, often being carriers of infection, can infect others and cause entire epidemic outbreaks. The period of convalescence from other infectious diseases also requires special attention from the physician and observance of a strict regimen by the patients (see the corresponding entries).