Leah Minsky, MPH

Happy National Handwashing Week! We’re full swing into flu season, so it’s more important than ever to make sure you’re washing up to stay well for all the holiday celebrations to come. Hand hygiene is the single most important thing you can do to maintain your health, adopting this habit now will play a major role for your quality of life now and in the future.

Washing your hands regularly with soap and water can protect you from many illnesses caused by viruses and bacteria. Washing removes germs you pick up when you touch people, animals, or surfaces. If not removed, these germs get into your eyes, nose, or mouth and cause illness.

It is important to wash your hands regularly throughout the day and it is essential to wash:

• Before touching any food or eating
• After using the bathroom
• After handling animals or animal wastes

Effective Hand Washing Technique

Follow these five steps every time.

• Wetyour hands with clean, running water (warm or cold), turn off the tap, and apply soap.
• Latheryour hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.
• Scrubyour hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
• Rinseyour hands well under clean, running water.
• Dryyour hands using a clean towel.

Handwashing in the Community

Studies consistently find that less than 60% of people practice hand hygiene after using the bathroom. After using the bathroom, the number of bacteria on our finger tips doubles. That means any person you come in contact with, or surface they’ve touched, can be contaminated with a host of viruses and bacteria that cause a bunch of nasty diseases. For children, handwashing has a huge impact on school absenteeism. When they consistently wash their hands, children miss about 24% fewer days due to respiratory illness and 50% fewer days due to upset stomach.

Children and Hand Hygiene

Children are particularly susceptible to serious infections that are spread by viruses and bacteria. Pneumonia, which can result from respiratory illness, is the number one cause of childhood death. Children have the tendency to put their hands in their mouths, so it is important to wash their hands regularly even if they are not feeding themselves. To wash a baby’s hands you should follow the same hand washing protocol you use for yourself: Lather soap with warm water, making sure to clean between their fingers and under their finger nails, and then dry completely with a clean paper or cloth towel.

Handwashing FAQ

How long do I actually have to wash my hands?

The short answer here is 15 seconds. The CDC recommends 20 seconds. The effectiveness of washing your hands depends on how dirty your hands are and how well you lather and scrub. If you have to make a choice it’s better to scrub vigorously for 15 seconds than lightly for 20 seconds.

How should I dry my hands?

Damp hands are significantly more likely (about 1000 times more likely) to spread leftover viruses and bacteria than hands that are properly dried after washing. Make sure you are using a single use towel to completely dry your hands. It does not make a difference if you dry your hands with a cloth or paper towel as long as it has not been used before.

What about hand sanitizer?

Hand sanitizer is a good option if your hands aren’t visibly soiled with dirt or other substances. Make sure you cover all of your hands and allow the sanitizer to dry without wiping or rinsing it off.

What do I get from washing my hands?

You will avoid every 5^th respiratory infection if you habitually wash your hands. That means 20% fewer colds throughout your life. That 20 seconds at the sink can save you a week in bed.

Meredith Maxwell, M.D., M.H.A.

The holiday season is a great time for enjoying decadent meals and holiday cheer. Unfortunately, for many of us, it also becomes a time for over-eating and weight gain. In fact, the average American gains 5- 10 pounds during the holiday season. Here are a few tips on how to eat mindfully and not overindulge.

What are ways to be realistic this holidays season when it comes to being healthy?

• Don’t try to lose pounds during the holidays, instead try to maintain your current weight.
• Plan time for exercise. Exercise helps relieve holiday stress and prevent weight gain.
• A moderate and daily increase in exercise can help partially offset increased holiday eating. Try 10- or 15-minute brisk walks twice a day.
• Try to not put all of your focus on food – remember, the holidays are a great time to slow down and catch up with your family and friends.

What should you do before heading out to a holiday party?

• Don’t skip meals or snacks earlier in the day to “save” calories for your large feast later on. If you arrive somewhere feeling hungry, you are more likely to overeat.
• Before leaving, eat a light snack to help curb your appetite.

What are tips to not overindulge this holiday season?

• Focus on your loved ones instead of food. Go hiking with your family, play board games, or go to the movies to watch the latest holiday movie.
• Eat slowly and savor the foods that you would only have once or twice a year.
• Make sure your portions are reasonable and try to resist going back for seconds.
• Also, drink alcohol in moderation.

If you are bringing a dish, what are ways to prepare a healthy holiday meal?

• When making desserts, substitute whole-wheat flour for regular flour in a recipe.
• Substitute bananas and applesauce for fat. And use natural sweeteners such as shredded carrots, zucchini or beets to cut down on sugar.
• Make small desserts to aid with portion control.

However, if there is a dish that you love so much around the holidays, such as a family recipe, make it! The original version will make you happy. However, enjoy a small serving to satisfy your craving.

What happens if you overindulge on a holiday party?

• If you overindulge, it’s okay! Don’t consider yourself a failure if you eat more food than you anticipated. Get back on track with your healthy eating habits the next day.

Meredith Maxwell, M.D., M.H.A., attended the University of South Alabama College of Medicine, where she completed her family medicine residency, before joining the Touro Infirmary Health System. She is certified by the American Board of Family Medicine Diplomate.

Lonzie Beamon, Jr, PharmD, BCPS
Clinical Pharmacist, Touro Infirmary

Antibiotics are very powerful medicines that can cure and prevent infections.  Unfortunately, their power has waned over the last few decades thanks to our overuse.  Antimicrobial resistance is on the rise.  Two million people are infected with antimicrobial-resistant bacteria each year and several thousand people die from them.  While newer antibiotics are now available, bacteria can develop resistance to those as well.  What’s worse is bacteria can spread this resistance to others, creating an infection with very few treatment options.  Bacteria become resistant to antimicrobials by pumping them out, breaking them down with enzymes, or changing the antimicrobial’s target so it remains unaffected by the drug.  Here are a few things you can do to be antibiotics aware and reduce the risk of creating resistant bacteria:

1. Wash your hands as often as possible, especially if you are sick! Proper handwashing can reduce your chances of getting an infection in the first place or of spreading infection if you already are.  When washing your hands, use soap and warm water.  Vigorously scrub your hands together.  Be sure to scrub each finger and between them, the backs of your hands, the palms, and the wrists.  Do this for at least 30 seconds.  Afterward, dry your hands with a paper towel and turn your faucet off with that same towel (bacteria might be on its surface).
2. Use hand gel if there is no sink around! Alcohol-based gels are great for disinfecting your hands.  For best results, use a gel that contains at least 60% alcohol to kill any bacteria that might be lurking on your hands.  Keep in mind that some bacteria are resistant to alcohol-based gels so hand-washing if possible is always the better option.  Sometimes hand gels may cause your skin to become dry and irritated.  If this happens to you, try a hand gel that contains moisturizers to prevent dry skin.
3. If you are sick, see your doctor or healthcare provider as soon as you can! You primary care provider can tell you whether or not you have a contagious infection and should stay away from others to prevent the spread of infection.  If you are coughing, sneezing, have a sore throat, or feel body aches all over, you should pay a visit to your primary care provider.
4. If you have a virus like the flu, DO NOT TAKE ANTIBIOTICS!!! This is one of the worst things you can do because the virus is unaffected by the antibiotic and the antibiotic can affect good bacteria in your body that keep the bad bacteria in check.  Antibiotics, while they are very safe and effective at what they do, should only be used when needed.  Some antibiotics can lead to harmful side effects and taking them too long may increase the risk of developing a Clostridium difficile  This is especially true for nursing home and hospitalized patients.
5. If you DO have an infection, finish your antibiotics! You might be feeling better; but, that doesn’t mean the infection is gone.  If you don’t finish your full course of antibiotics, resistant bacteria may not be caught by your immune system and could spread resistance genes to other bacteria, resulting in a drug-resistant infection.
6. Don’t share your antibiotics! Some antibiotics target bacteria that cause respiratory infections while others may target bacteria that cause urinary tract infections.  Using the wrong type of antibiotic for the wrong infection may not treat the infection if one is present and could further lead to antimicrobial resistance.  Antibiotics may also cause an allergic reaction in some people and someone may not know they are allergic to the type of antibiotic you had.  So if someone asks you to share your antibiotics, just say no.  That person should see a primary care provider.
7. Know the difference between a side effect and an allergy! A side effect is an expected reaction to a drug that is not caused by your body’s immune system.  Nausea, vomiting, headache, and other effects like this are not signs of allergy; but they can be uncomfortable.  Saying that you are allergic to an antibiotic might cause your primary care provider to use a different antibiotic that may not be the best choice and could lead to antimicrobial resistance.  However, reactions like hives and swelling of the tongue, throat, or face are signs of an allergic reaction and you should seek immediate medical attention if you experience these while taking antibiotics.  You should list drugs that cause allergic reactions so your primary care provider knows not to prescribe them to you.

Neil Ninan, MD

November 15, 2018 is the Great American Smokeout! The American Cancer Society marks this day annually to encourage smokers to make a plan to quit, or if a plan is in place, to actually stop smoking that day.

Tobacco use remains the single largest preventable cause of disease and premature death in the United States.  Cigarette smoking increases the risk of cancers of the mouth and throat, lung, esophagus, pancreas, cervix, kidney, bladder, stomach, colon, rectum, and liver, as well as acute myeloid leukemia. Some studies also link smoking to breast cancer and advanced-stage prostate cancer.  Smoking also greatly increases the risk of debilitating, long-term lung diseases like emphysema and chronic bronchitis. It raises the risk for heart attack, stroke, blood vessel diseases, and eye diseases. Half of all smokers who keep smoking will eventually die from a smoking-related illness.

Kick Your Smoking Habit

No matter how old you are or how long you’ve smoked, quitting can help you live a longer and healthier lifestyle. According to the American Cancer Society, compared to smokers, people who stop smoking before age 50 cut in half their risk of dying in the next 15 years. Former smokers enjoy a higher quality of life with fewer illnesses from cold and flu viruses, reduced rates of bronchitis and pneumonia and better overall health.

With all the benefits of quitting smoking in mind, overcoming the obstacle of addiction is not easy to do.  The most important first step is to make a commitment to end your smoking habit. The next step involves getting the support and resources you need to be successful.

Some keys to succeeding at quitting the smoking habit are:

• Quitting alone is hard to do. Joining a smoking cessation program or support group is beneficial and necessary for many people. Family and friends can also help you stay on the right path.
• Support: ask your doctor about methods that can help you quit such as classes, medication or counseling.
• Call for help: The Centers for Disease Control and Prevention (CDC) offers a free Quit Now hotline. 1-800-QUIT-NOW
• Nicotine-replacement therapy: gums, lozenges or patches are beneficial for many people.
• De-stress: Find new ways to let out stress and relax, such as exercise or listening to music. Exercise can also help curve nicotine cravings.
• Avoid triggers such as alcohol or coffee.
• Financial benefits: keep in mind the other enjoyable things you could be doing with money saved.
• If you fail, try again!

Click here to access Touro’s online smoking cessation health library for more tools and resources to help you quit.

If you kick your smoking habit now, you’ll enjoy a better quality of life and more years to live it. Stick with it, make that commitment and seek the support you need to be successful.

Neil Ninan, MD specializes in Pulmonary Disease and Interventional Pulmonology. Interventional pulmonology is a relatively new specialty in pulmonary medicine. Interventional pulmonology uses endoscopy and other tools to diagnose and treat conditions in the lungs and chest.

Don’t let heart disease, stroke and other health conditions sneak up on you. Instead, prevent them by seeing your doctor for a yearly well-woman checkup. At your checkup, your doctor will likely suggest health screenings. These tests can help spot potentially deadly conditions before they become life-threatening. Here are six screenings that can help you stay healthy.

Blood pressure

Nearly half of all Americans older than age 20 have chronic high blood pressure— 130/80 mmHg or greater. Getting your blood pressure checked and changing your lifestyle or using medication, if necessary, can reduce your risk for stroke and heart disease.

Cholesterol

This simple blood test—after an overnight fast— measures levels of HDL, or “good,” cholesterol and LDL, or “bad,” cholesterol, as well as triglycerides. These fats iny our blood can affect your risk for heart disease and stroke.

Pap test

This test, as part of a pelvic exam, takes a sample of cells from the cervix to check for cervical cancer. Women ages 21 to 29 should get a Pap test every three years. Women ages 30 to 65 should get screened every three to five years. Cervical cancer and the beginning stages of the disease are treatable if caught early.

Mammogram

This breast X-ray can find breast cancer in its early, most treatable stages. Talk with your doctor about the schedule and imaging that are right for you.

Blood glucose

This simple blood test helps detect type 2 diabetes and prediabetes, which can increase the risk for heart disease and other complications. It’s recommended for adults ages 40 to 70 who are overweight.

Colonoscopy

The doctor will examine your colon, looking for signs of cancer and small growths that can become cancerous, which can be removed during the test. Experts recommend people at average risk should get a colonoscopy every 10 years, starting at age 45.

STAY HEALTHY ALL YEAR LONG

At Touro, our doctors go above and beyond to meet patients’ needs, because we know we’re not just treating an illness, we’re treating a person. Whether you have a bad cold or something more serious, a Touro doctor in your neighborhood is ready to listen to, comfort and care for you. Find your Touro doctor today at touro.com/findadoc or by calling 504-897-7777.