Dear Doctors: My wife and I are lending my parents a hand during the lockdown. They’re in their 80s, and one thing we’ve noticed is how many meds they are taking. They’re from a bunch of different doctors, and some may even be duplicates. How do we get things organized?

Dear Reader: You’re not alone in being surprised to discover how many medications an older parent is taking. As people age, they often begin to experience a variety of ills and health conditions that lead them to seek out specialists. This can result in multiple diagnoses, each accompanied by prescriptions for medications to help manage the problems. If a patient isn’t well-versed in the medications they are taking and there is limited or no communication between their physicians, it is indeed possible for them to wind up with prescriptions that overlap, or that lead to adverse interactions. Taking more pills than one actually needs is known as polypharmacy, which has become increasingly common as a large portion of the population reaches older age.

The good news is that, with just a bit of detective work and a few organizational tools, you can tame the medication tangle. Start by gathering all the medications that each parent takes. Note the name of the drug and its purpose, the dosage, the prescribing doctor and contact info, and the directions for taking it. Be sure to include over-the-counter meds, vitamins and supplements, as these can contribute to adverse interactions. If possible, make an appointment with each parent’s primary care physician for them to evaluate the meds list and, if needed, recommend changes. We know that immediate office visits can be difficult to schedule, so if you have pressing concerns, your local pharmacist can identify problematic combinations. However, don’t make any changes without first checking with a health care provider.

Once the necessary and appropriate meds have been identified, create and print out a master list for each parent. Have them take their own list to each medical appointment and share it with that health care provider. This creates a scenario where the meds list gets reevaluated on a regular basis, which greatly reduces the risk of duplicate prescriptions or an adverse drug interaction. When changes are made, be sure to update the master list.

Meanwhile, invest in weekly pill organizers. They come in a variety of sizes and formats, so you should be able to find one that works best for each parent’s needs. Once you’re filling the boxes, it’s just as easy to set up two or three weeks’ worth of meds as it is to do a single week. Keep all of the medications in one safe location, away from heat, moisture or direct sunlight, and -- this is crucial -- secure from children. It’s also important to keep an eye on expiration dates, which are printed on the labels. Yes, there’s debate over when meds actually expire, but we recommend honoring those dates. Also, review how to dispense of expired meds. Local pharmacies and police stations often have drop-off boxes for that specific purpose.

(Send your questions to askthedoctors@mednet.ucla.edu. Owing to the volume of mail, personal replies cannot be provided.)

Hello again, dear readers, and welcome back to our monthly letters column. You’ve kept our inbox lively this month, so we’ll dive right into your questions and comments.

-- A reader in Oregon, where ongoing wildfires have created dangerous air quality, wondered about masks. “Will our masks that we wear for COVID help us with the wildfire smoke here?” they asked. The answer depends on the type of mask you’re using. The cloth masks we’re using to slow the spread of the novel coronavirus don’t offer much protection from wildfire smoke. Although cloth masks can block the respiratory droplets that the virus travels on, they’re not an efficient barrier against the infinitely smaller particulates in wildfire smoke. That requires the close weave of N95 masks, which remain in short supply. Without an appropriate mask, it’s best to stay indoors with windows and doors closed, and run an air purifier if you have one.

-- The wildfire smoke question actually contains the answer to another reader’s mask question. “How is it possible for a mask to be effective against the virus?” they asked. “The virus is so small that it must be able to fit through a mask.” You’re correct that the virus itself is microscopically small enough to fit through a cloth mask. However, a virus can’t move on its own. The novel coronavirus travels via the respiratory droplets from an infected person’s cough, sneeze or breath. Due to their size, those respiratory droplets can be blocked by a multi-layer cloth mask. When used along with social distancing to stay out of range of another person’s droplet emissions, a mask can indeed reduce the risk of spreading and encountering the virus.

-- A reader from Oklahoma had a question in response to a column about alpha gal syndrome. This is when someone who was bitten by the Lone Star tick develops an allergy to red meat. “Why doesn’t anyone ever mention that gelatin can cause a reaction when you have alpha gal?” they wrote. “I’ve had the allergy for 10 years, and my one and only (allergic reaction) came from consuming gelatin capsules.” Thank you for your reminder that some people with alpha gal syndrome do become sensitized to gelatin, which is a protein obtained from animal byproducts. And, as you mention, gelatin can be present in capsules and is used in some medications as a stabilizer. As with all allergies, people living with alpha gal syndrome need to be alert to all potential triggers.

-- In response to a column that mentioned asymptomatic transmission of the coronavirus, a reader wondered if the terminology should be adjusted. “Doesn’t the term ‘pre-symptomatic’ better describe what is happening?” Actually, both terms are accurate. Some people infected with the novel coronavirus never develop symptoms. If they pass along the virus, it’s asymptomatic transmission. Pre-symptomatic transmission occurs when someone passes along the virus while in good health and then later develops symptoms.

Thank you to everyone for your letters and kind thoughts -- they mean a lot to us. We hope you and your loved ones stay safe and well.

(Send your questions to askthedoctors@mednet.ucla.edu. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: I’m a 38-year-old man, very athletic, and I got really sick with the coronavirus. I didn’t land in the hospital, but it’s been a month and I’m still not 100%. I want to get back to running and lifting weights. Is it safe to exercise after COVID-19?

Dear Reader: We have to begin with the reminder that we’re still in the early stages of learning about the virus and the disease that it causes. That said, a growing body of research suggests that, for some people who have recovered from COVID-19, a range of adverse health effects can continue after the initial disease has run its course. This is particularly true for older patients and those with pre-existing health conditions. There may also be a link between how severe someone’s illness was and their risk of developing more serious complications once they have recovered.

Although we think of COVID-19 as a respiratory illness, it can damage other organs, adversely affect the body’s blood-clotting mechanisms and cause lingering systemic inflammation. Scans of patients who have recovered from COVID-19 reveal damage to the lungs, heart and kidneys, as well as dangerous levels of blood-clot production. Survivors report lingering pain, shortness of breath, so-called “brain fog” and persistent fatigue. Some people experience heart arrhythmias, and some develop hypertension. A number of recovering patients also find themselves dealing with ongoing episodes of depression and anxiety.

When it comes to exercise, the current advice for people recovering from mild or moderate COVID-19, and who were not hospitalized, is to wait at least two weeks before resuming physical activity. It’s not only much-needed rest; it’s also an opportunity to evaluate how you feel being up and about, what kind of activity causes fatigue and at what point you tire. For those who experience a continual recovery in the weeks after being ill, it is considered safe to gradually resume physical activity once the two-week rest period is over. But it’s important to ease back into being active. Pushing yourself post-illness does more harm than good.

Since you report that you were significantly ill with COVID-19, you should check in with your health care provider before working out again. Describe the course of your illness and everything you’re experiencing since recovering. It’s possible you’ll be asked to undergo some diagnostic tests to assess heart and lung function before being cleared for more vigorous activity. Athletes who have recovered from COVID-19 are finding initial workouts to be challenging. In addition to a light cough and mild shortness of breath, they report a dive in stamina. If you experience more severe symptoms, such as an irregular or racing heartbeat, chest pain or tightness, or severe or long-lasting shortness of breath, it’s important to immediately stop what you’re doing and check in with your health care provider.

Athletes are used to bouncing back from a cold or the flu, and the slow trajectory of COVID-19 recovery can be frustrating. But please don’t try to push it. Moving forward slowly and cautiously is your best shot at a full recovery.

(Send your questions to askthedoctors@mednet.ucla.edu. Owing to the volume of mail, personal replies cannot be provided.)