Everyone seems to agree that COPDers need to be extra vigilant about catching a bug, especially one that might cause a respiratory infection. And yes, we’ve been bombarded with all the safety steps we can take to decrease our chance of getting sick, especially since last year’s H1N1 pandemic – or was it just an epidemic? In addition to the warning to be sure to get the flu vaccine, we’ve also been advised to wash our hands or use a hand sanitizer often and after exposure to germs. Yet, even as we sanitize, there always seems to be a news item or well-intentioned friend who warns us that if we use a hand sanitizer, we may be creating a resistant strain of germs, lowering our resistance to germs and/or compromising our natural defenses against them. Considering our special vulnerability, we need all the facts and tips we can get. Here are some opinions and interesting facts, but it is up to you and your doctor to discern facts from opinions and decide what is best for you.
Hand Sanitizers, Good or Bad?
Back in 2006, the “New York Times” ran an article entitled, “Hand Sanitizers, Good or Bad?” The author Deborah Franklyn points out two very important things: First, the amount of alcohol in a sanitizer varies depending on brand. They found that some were less than 60 percent alcohol, but claim that the percentage should be between 60-95 percent alcohol in order to kill both bacteria and viruses. Although hand sanitizer containers might look similar, she warns to look carefully at the label. Second, in her words, “Alcohol doesn’t cut through grime well, so dirt, blood, feces or other body fluids or soil must be wiped or washed away first, if the alcohol in the sanitizer is to be effective. In such cases, hand washing with soap and water is advised.” The effectiveness also seems contingent upon how much sanitizer you use. The article points out that according to the Center for Disease Control (CDC), you should use enough sanitizer to get all parts of your hands thoroughly wet and rub until your hands are dry. According to Franklyn, “If your hands are dry within 10-15 seconds, according to the CDC guidelines for healthcare workers, you haven’t used enough.” For more details as well as other interesting points, please see the article at http://www.nytimes.com/2006/03/21/health/21cons.html
No Substitution for Soap?
Flash forward to January, 2010, in the midst of the flu epidemic. In a podcast from Wichita State University, biology lab technician and germ expert Dawn Beckman reminds us that not all germs are bad, and that we need good germs to keep us healthy. She says, “If you ever use the hand sanitizers, what ends up happening is that you can actually end up damaging your good bacteria. And by causing damage to that, that leaves you more vulnerable to the bad bacteria…” The podcast also sites Barbara Almanza, an associate professor at Purdue University, who says, “In terms of the regulations concerning food services, the Food and Drug Administration says that hand sanitizers may be used as a supplement but not a substitute for hand washing.” For a transcript of this podcast, see http://www.wichita.edu/thisis/wsunews/news/?nid=943
So, Do Hand Sanitizers Work or What?
A University of Toronto research article from October, 2009, says yes, they do work effectively against a wide range of bacterial and viral microbes. The author Jenny Hall states that according to James Scott, associate professor at the Dalla Lana School of Public Health, using a hand sanitizer, “reduces the skin burden of bacteria much more effectively than soap and water, and the amount of bacteria on the skin tends to remain lower for much longer than when soap and water are used. It also tends to be less damaging to the skin because it has build-in emollients.” He also says that hand sanitizers with 70 percent isopropanol alcohol are more effective than even 100 percent because it has a little bit of water in it that improves penetration. As for the repeated claim that hand sanitizers are bad because they prevent us from building up resistance to germs, he says, “there is no evidence to support it one way or another.” To see this article, please visit http://tinyurl.com/l6kdvu
You might have noticed that the above suggestions differ depending on the sources of the information – the FDA versus the CDC, for example – or the specialties of the individuals involved. Knowing the different points and noting the suggestions should help you prepare for a meaningful discussion with your healthcare provider. Is it too pushy to ask to read the label on the hand sanitizer in your doctor’s office to see if it has the suggested amount of alcohol?
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Mary, a member from Brooklyn and Boynton Beach Florida, wrote to ask an important question in response to last week’s article on the flu vaccine. She notes that the CDC recommends getting the shot as soon as it is available, but wonders, “If we get the shot early, will it carry through the winter months?” The following “ABC News” report explains that although this was a concern in past years, new data demonstrate that immunity not only lasts well into the spring, but also into the following year! Don’t be shocked, however, if your doctor disagrees.
On September 1, 2010, Germany became the first country to market the medication Daxas (roflulmilast), the once-a-day anti-inflammatory tablet for COPD. It was approved for limited indications (not for every COPDer). It is expected to be available in other countries, including Canada, shortly. Although rejected by the FDA in the United States in the spring of this year, Forest Labs, the company who hold the rights in the United States, will continue to work with the FDA for approval. For more information, visit http://tinyurl.com/2dn8mzo
Every week, there seems to be a new discovery about the benefits of vitamin D. This week’s discovery is that it might help treat reactions to the common mold aspergillus fumigates. Although this article talks about the effects of the mold on individuals with asthma and cystic fibrosis, individuals with COPD can get aspergillus infections as well.
The following article in “The New York Times” cites AARP’s report that the prices for drugs most commonly used by seniors rose 8 percent 2009 and 41.5 percent during the last 5 years, while the consumer price index rose only 13.5 percent. The article is available at http://tinyurl.com/22tar26
The “National Public Radio” (NPR) reports there are already 50 non-profit urban collectives (with 100 more on the way) that help seniors remain in their homes by pooling resources and using volunteers to coordinate and oversee an array of services commonly required by older people. http://www.npr.org/templates/story/story.php?storyId=129086737
The American Lung Association (ALA) announces their “Lots of Helping Hands” program to help caregivers, with, as they put it, “a private, web-based caregiving coordination service that allows family, friends, neighbors and colleagues to create a community to assist a family caregiver with the daily tasks that become a challenge during times of medical crisis, caregiver exhaustion, or when caring for an elderly parent.”
“Consumer Reports” lists 12 common supplements sold for an array of conditions that might cause negative side effects. This report (available to non-subscribers) will give you the details http://tinyurl.com/24v2tfn
The Department of Health and Human Services (HHS) has announced it has named the first two companies with the power to approve Electronic Health Record (EHR) systems. The below article will explain it all http://tinyurl.com/235jso5
Have you ever wondered to what extent you “should” speak up or question your doctor? Are you concerned about “crossing the line,” becoming obnoxious, or perhaps even distancing your doctor? If you are nodding “yes,” you are not alone. This article in “USA Today” discusses the dilemma http://tinyurl.com/398pbcz
Once called “forbidden rice” in ancient China because only the nobles could get their hands on it, black rice rivals pricey blueberries in antioxidants. More information is available here http://tinyurl.com/254y33s
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Until next Friday,
Richard D. Martin, Editor