With news reports about the H1N1 flu all over the place, you may not think about the old “stomach flu” right now. Did you know that there really is no such thing as the stomach flu? If you have diarrhea or vomiting, it is usually not from influenza virus, but rather from another bug that got you. Often these bugs get us from not properly handling our food or from unsanitary conditions in our kitchens. Don’t go blaming the restaurant so quickly because studies show our homes are a breeding ground for bacteria that make us sick, too!
Top places germs reside
The kitchen sponge and/or dishcloth is the number one place for nasty bugs to hang out. Replace your sponge every few weeks, or put it through the dishwasher so the heat can kill off some of the bacteria.
The bottom of the sink is also very high in bacterial count. Just think about the conditions that germs love: Warm, moist environments. Your sink, sponges, and dishtowels are often wet and bacteria love it!
Keyboards, computer mouse, remote controls, doorknobs, etc. I am guilty of this too: You are working on your computer and then you reach for a snack. There is a ton of bacteria on surfaces all over your office and home. Wash your hands every time you go to eat something. The toilet actually has less bacteria than many commonly touched surfaces around your office and home.
Tips to prevent getting sick
WASH HANDS. I can’t emphasize this enough. Wash your hands before you go to prepare food or eat food. Wash your hands after you go to the bathroom. A good rule of thumb is to wash for at least 20 seconds using hot water and lots of soap. Use a hand sanitizer if you cannot always wash in a sink.
Wash all surfaces food will touch before and after you prepare food. Wipe the counter clean before you get the food out, and wash it off after as well.
Wash all produce well. Even if you don’t eat the outside of it (think watermelon, cantaloupe, oranges, etc) you still want to wash it. Once you cut into it or peel it, the outside is getting on the inside with the trail of the knife or your hands.
Always cook meats to an internal temperature of 165 degrees. Use a food thermometer to be sure.
Do not keep perishable food out for more than 2 hours at room temperature. Get all food back into the fridge in 2 hours or less to minimize bacteria multiplying.
Keep your fridge at 40 degrees or less.
Check out this research from the USDA:
Best Ways To Clean Your Kitchen Sponge
Your microwave or dishwasher can make sponges safer to reuse in today’s kitchens.
Heating your used kitchen sponges in your microwave for one minute, or washing them in your dishwasher and leaving them there through a drying cycle, are the most effective household ways to inactivate harmful bacteria, yeasts and molds.
ARS food safety experts who specialize in research on foodborne pathogens, like E. coli O157:H7, looked at several simple, convenient and often-recommended ways of cleaning reusable kitchen sponges. Techniques included soaking sponges for three minutes in a 10-percent chlorine bleach solution, soaking in lemon juice or sterile water for one minute, heating in a microwave at full power for one minute, or washing in a dishwasher—including through a drying cycle.
At the outset of the experiment, they soaked all the sponges for 48 hours at room temperature in a slurry of ground beef and laboratory compounds which allow bacteria, yeasts and molds naturally present in the beef to grow on the sponges.
Microwaving and dishwashing each killed nearly 100 percent of the bacteria, with dishwashing being only slightly (0.0001 percent) less effective.
And, microwaving and dishwashing each killed nearly all yeasts and molds; less than 1 percent (only 0.00001 percent) survived.
Kraft calls the new line “wholesome,” but are they?
Turkey and Cheddar Sub Sandwich seems like it could be a healthy choice, but actually it is filled with fat, sodium and sugar. Here’s a complete list of ingredients that may shock you.
Digging a little deeper
I’m curious now to find out what’s behind the “New Deep Dish Cheese Pizza.” Here’s how it’s described:
You won’t have to dig deep for our Deep Dish Pizza, made with Kraft 2% Mozzarella and 2% Cheddar, deep dish crust made with whole grain, Tombstone Pizza Sauce, Tree Top® Applesauce, Mini Nilla Wafers, spring water and Tropical Punch Kool-Aid Singles.
It doesn’t sound so bad, does it? Low fat cheese, whole grain crust, pizza sauce, applesauce, mini Nilla Wafers, spring water; what’s so bad about that? One more ingredient includes Tropical Punch Kool-Aid Singles. Hmm…what was wrong with just the water? Why add all that sugar?
Okay, I’m digging deeper now to read the ingredients. Well, take a peek, and you decide. The long list of ingredients isn’t healthy. The Deep Dish Pizza is filled with fat, calories, sodium, cholesterol, and sugar.
Read the Ingredients
It’s really important to read the ingredients and not just the label. The packaging and wording are created in such a way to capture your attention and it gives the appearance that it’s healthy, but in fact it is not.
Playing detective
You could actually make a game out of this with your kids. Take them food shopping with you and have them take the “Food Label Challenge Test.” (I just made that up). Show them the package and the front label, ask them if they think it’s healthy or not. Have them read the ingredients, you may be surprised at what you find! The little gumshoes may enjoy the challenge.
So remember, make sure the next time you’re out food shopping, read the ingredients, not just the front label. Playing detective might not be such a bad idea; you may be surprised at what you find in your foods.
*This blog post was originally published at Health in 30*
In a recent interview with Dr. Oz on Good Morning America, Dr. Oz told Diane Sawyer that he doesn’t think any of the proposed health care plans will work. Why? As Dr. Oz told Diane:
“What we haven’t done is get to the very root reality of the flaws we have in the health care system. True health care reform cannot happen in Washington. It has to happen in our kitchens, in our homes, in our communities. All health care is personal.”
Dr. Oz pointed out that the United States has twice the disease that is found in Europe. He believes that we have to find it impossible for Americans to not embrace good health. According to Dr. Oz:
“If I make your workplace conducive to walking at lunch, or working out at some time during the day, or I get people to use the stairs more by creating incentives to do such, then people will start doing it naturally.”
All you have to do is walk around any place USA compared to anywhere else around the globe to know this is true. Or, just note our friends from around the world who are visiting our country on vacation. Striking how much healthier our friends from other parts of the world appear – and act. They seem more vibrant, have more energy.
For these reasons, Dr. Oz isn’t hopeful any of the healthcare reform plans will work. He feels that until people start living more healthy, how the health care system is paid for is really moot. In his words: “The big debate right now in Washington is health care finance. It’s how are you going to pay for it. I don’t care which program we pick. I’ll tell you why. Because none of them are going to work.”
The sad truth is, he’s right. Americans have shown themselves to be very untrustworthy on the health care front with heeding doctors warnings about healthy living. Until that changes, until we find a way to make healthy living more appealing, how the system is paid for isn’t the path to reform.
After listening to President Obama last night, where does that leave us? No where useful. Sure…he talked a good talk about the insurance changes needed for the economics of the system to work but that has nothing at all to do with the true reforms needed in our system for not only personal health care but the actual ability to practice medicine, a topic the President barely covered last night.
I felt President Obama did an adequate job calming the waters of the misconceptions of the bill he is trying to put forward but let’s not mistaken that bill for the type of true health reform our country will need in the end. That type of reform, as Dr. Oz, pointed out, has to come from within each of us and the start of that may be as simple as looking in the mirror and accepting more individual responsibility for our own bodies and what happens to them.
What about savings, you ask? If we all care for our bodies better, we’ll all save by saving ourselves the time and expense of doctor’s visits, prescriptions, procedures, operations, and treatments of all kinds. Those savings will not only be in dollars to our bank account but years to our lives. Doesn’t sound too bad, huh?
*This blog post was originally published at Dr. Gwenn Is In*
We have been inundated with so much information about the 2009 H1N1 that it’s hard to keep it all straight. Here’s my top ten list of what’s most important to know, much of it coming from the website of the Centers for Disease Control and Prevention, which has done a spectacular job of providing timely and useful information:
1) What is the 2009 H1N1 Flu (Swine Flu)?
Different from the typical seasonal influenza virus, this is a new type of flu virus that appeared in Mexico in April, 2009 and soon spread to the United States and around the world. It contains a combination of genetic material found in influenza viruses that infect humans, birds, and pigs.
2) Why are people concerned about the 2009 H1N1 pandemic?
Over the past century, three major pandemics have swept through the world and caused severe illness and death. The most devastating by far was the influenza pandemic of 1918, which killed 40-100 million people worldwide and 500-750,000 Americans at a time when the U.S. population was only about 100 million. The 1957 “Asian flu” caused about 70,000 deaths when the U.S. population was about 170 million. The last pandemic, in 1968, killed about 34,000 out of 200 million Americans.
3) How does the 2009 H1N1 influenza compare to the typical seasonal flu?
Because the 2009 H1N1 virus is new, most people – especially children and young adults – have little or no immunity against it. It is spreading more quickly than the usual seasonal flu but seems to be somewhat milder – though still capable of causing severe illness and death. The typical seasonal flu affects 15-60 million Americans, leading to more than 200,000 hospitalizations. Annual deaths range from 17,000 to 52,000 annually, averaging about 36,000.
The elderly are especially at high risk of seasonal flu, with over 90% of deaths occurring in patients over 65. In contrast, 2009 H1N1 has preferentially affected young adults and children while older patients appear to have some immunity. Only 18% of deaths from H1N1 have been in patients over 65.
For both the regular flu and the 2009 H1N1, certain groups are at increased risk for complications once infected – children under 5, pregnant women, and patients with underlying medical conditions such as suppressed immune systems, asthma, diabetes, neurological disorders, kidney problems, and heart disease as well as adults over age 65.
4) What Can We Expect This Fall?
Flu virus tends to die down over the summer because it survives better when the weather is cold and dry than warm and humid. That’s why during our summer the H1N1 virus spreads to the Southern Hemisphere, where it’s winter. But the virus never really went away in America and is now surging much earlier than with the regular seasonal flu.
In August, a panel of experts prepared an extensive report for President Obama about the virus. While warning that the exact impact of H1N1 was impossible to predict, the panel outlines a “plausible scenario” that included 60-120 million infected Americans, as many as 1.8 million hospital admissions, and 30-90,000 deaths. Others, including the CDC, have suggested that these estimates are a “worst case scenario.”
Unfortunately, the influenza virus is famously unpredictable and the above “plausible scenario” could be way off in either direction. Although the virus is relatively mild now, it can quickly change on its own through mutation and become more deadly. Another way of changing is if two different viruses happen to infect the same cell at the same time. The two different strains could then trade genetic material. Hypothetically, the 2009 H1N1 that is currently sensitive to the antiviral medication Tamiflu could become resistant to Tamiflu if it combines with last year’s seasonal flu strain which was 99 percent resistant to the drug. Fortunately, until now the virus has been stable genetically and it remains sensitive to Tamiflu and Relenza.
5)What are the symptoms of the 2009 H1N1?
The symptoms are very similar to those seen with the regular seasonal flu: fever, headache, fatigue, cough, sore throat, runny nose, and aches and pains. In addition, there may be gastrointestinal symptoms such as nausea, vomiting, and diarrhea.
6) How can you catch H1N1?
Just as with the regular seasonal flu, the virus enters your body through your nose, mouth, or eyes. People infected with H1N1 shed virus starting a day before symptoms begin and lasting up to a week or longer in some patients. An uncovered cough or sneeze in a patient with influenza can send infectious virus-filled droplets into the air. If you touch a surface that’s infected with flu virus and then touch your mouth, nose, or eyes, the virus can enter your body and cause infection.
7) How do you prevent the seasonal flu and 2009 H1N1?
The most effective way is through vaccination – assuming you are in a group for which immunization is appropriate. The CDC recommends vaccination with both the regular seasonal flu vaccine, which is already being given, and the 2009 H1N1 vaccine once it becomes available around mid-October. So far, the 2009 H1N1 vaccine has been shown to be safe in adults; the CDC told me this week that studies in children and pregnant women should be done within about 2-3 weeks. Health officials want to vaccinate at least 159 million Americans. Experts predict there will eventually be enough vaccine for all Americans who want it. But only about 45 million doses are expected to be available with the first batch in mid-October.
Those on the priority list to get the 2009 H1N1 vaccine include pregnant women, people in close contact with infants 6 months and younger, health care workers, those ages 6 months to 24 years, and people ages 25 to 64 with serious conditions that put them at high risk for complications from flu.
Experts stress the importance of covering your mouth with a tissue when you cough or sneeze. Wash your hands often with soap and water or an alcohol-based hand cleaner. Remember: you don’t get flu from virus that’s only on your hands; you get it when you touch your face and give the virus a way to enter your body. Avoid close contact with sick people. And if you are sick with the flu, the current CDC recommendation is to stay home for at least 24 hours after your fever is gone without the use of fever-reducing medication. In some situations, the use of a face mask may be indicated, especially to try to prevent flu in patients at increased risk for complications; click here for the CDC’s recommendations.
8.) Who should receive treatment with anti-viral medication such as Tamiflu and Relenza?
Last week the CDC said that most people who come down with the 2009 H1N1 flu should just ride it out and not take antiviral medications such as Tamiflu and Relenza. Dr. Anne Schuchat of the CDC said the majority of adolescents, adults and children “can be cared for with mom’s chicken soup at home, rest, and lots of fluids.” But she stressed the importance of early treatment with antiviral medications – within 48 hours if possible – for certain patients at increased risk of complications, especially those hospitalized, under age 5, over age 65, or with chronic medical conditions.
A key change in advice from the CDC involves patients at high risk who may have been exposed to the H1N1 virus. Before last week, doctors were advised to give them medication to prevent infection; now doctors are being given the option of “watchful waiting” – observing the patient closely and only starting antiviral treatment if evidence of flu develops.
9) What warning signs should prompt immediate medical evaluation and treatment?
In adults, warning signs include: trouble breathing, pain or discomfort in the chest or abdomen, dizziness, confusion, severe or persistent vomiting, and symptoms that improve but then return with fever and worse cough. In children, warning signs include: trouble breathing, bluish or gray skin color, inability to drink enough fluids, severe or persistent vomiting, change in mental status (e.g., not waking up, not interacting, or being unusually irritable), and symptoms that improve but then return with fever and worse cough.
10) Should I get the 2009 H1N1 vaccine if I think I’ve already had the H1N1 flu?
The CDC told me “yes” – because the vast majority of patients diagnosed with 2009 H1N1 were not specifically tested for the virus. It may have been some other virus that made you ill. And even patients who had positive “quick tests” in the office for influenza A cannot be absolutely certain they had the 2009 H1N1 virus because the kits are sometimes wrong and because there’s a small chance that the strain of influenza A detected was NOT the 2009 H1N1. So the CDC recommends playing it safe and getting the both the regular seasonal vaccine and the 2009 H1N1 vaccine if you are in a group for which immunization is suggested.
For this week’s CBS Doc Dot Com, I discuss very practical advice – especially for parents – about H1N1 with Dr. Thomas Farley, who was appointed New York City Health Commissioner in May 2009 and immediately found himself smack in the middle of the 2009 H1N1 outbreak.
Click
here to watch the interview.
This past December (2008), there was a report in Healthcare IT (Information Technology) News that got me thinking, of all things, about medical situations in outdoor wilderness environments. The substance of the report was that researchers at Vanderbilt University (I worked there in the late ’80s as Chief of the Division of Emergency Medicine) “found that physicians who receive training in a technology-rich environment, but go on to work in a less modern facility feel they can’t provide safe, efficient care.”
The study related to information technology, but is probably applicable to many other modes of technology. As it was reported, the Vanderbilt study included more than 300 medical training graduates. Of those who “were working in an environment with less IT,” some 80 percent reported “feeling less able…to work efficiently, to share and communicate information, and to work effectively within the local system.” The lead investigator Kevin Johnson, MD explained that “going from being a medical student where somebody is always watching after you to a role where you could potentially make a mistake that could actually harm a patient is already hard enough.” But “when you get there and realize that the systems they have are less functional and less pervasive…there is an entirely new set of challenges.”
To all medical students, residency graduates, or anyone else who moves from a highly supervised environment to one where you are on your own, welcome to the club. The whole point of learning how to be self-sufficient is to be able to go it alone when the need arises. What is most striking about wilderness medicine is the notion that one moves to a setting that is austere and resources (people, technology, supplies, communication, etc.) are frequently limited. This can be very unsettling for experienced practitioners, and is even more so for neophytes.
We live in an age of technological imperative. Doctors train in hospitals with large, complex intensive care units. The emergency department is equipped with all the latest gadgets, and specialists are on call 24 by 7 to help out when a difficult or puzzling situation arises. That is not the case in the wilderness, on the battlefield, or out at sea. Expectations change from perfection to doing enough to get the patient to a higher level of care, or just to make it through the hour, let alone the next day.
Think about it. Take your favorite medical instrument(s) and think about how you would practice if you didn’t have access to it. Could you diagnose heart failure without a stethoscope and pulse oximeter? High altitude cerebral edema without a CT scan? Septic shock without a blood pressure monitor, central venous catheter, arterial blood gas measurements, and a battery of laboratory tests? I think the answer is “yes” if you were properly trained.
Technology is good. In fact, it is great. Patients are better off for the ability of health care professionals to apply all manner of diagnostic and interventional devices and techniques. However, I believe that at the same time we are all taught how to do things in the city, we should learn how we must sometimes do them in the country.
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