Hand washing with soap, water still best
Q. I was in the hospital for serious injuries resulting from an automobile accident. They included a crushed tibia that was a compound fracture. As you can imagine, there was concern about bone infection.
I also had broken ribs and a lung contusion. It was cold and flu season, and I really didn’t want to be sneezing or coughing, so I always asked about hand washing.
One nurse said, “I haven’t been anywhere except the nurses’ station.” I asked him if he had touched anything there, and he responded, “Yes, but I haven’t been in another patient’s room.” I politely asked him to humor me and wash his hands. He did, but he clearly didn’t think it was necessary. I was appalled, since that means I would be exposed to microbes from everyone on the ward.
There was a hand-sanitizer dispenser in my room. Would that be as effective as plain old hand washing?
A. Alcohol-based hand sanitizers can be helpful, but they are not an adequate substitute for conscientious hand washing with soap and water. Studies have shown that just rubbing hands with an alcohol gel does not eliminate C. diff., bacteria that cause serious diarrhea (Infection Control and Hospital Epidemiology, October 2009).
A new study from the University of Virginia found that alcohol-based hand sanitizers are not very effective at reducing cold and flu infections. That might be because airborne viruses are transmitted through coughs and sneezes. Nevertheless, hand washing with soap and water remains the first line of defense against infection, both in hospitals and at home.
Q. Would you please send me information about pharmacies in Canada? I am currently in the Medicare doughnut hole. Just two refills I requested today will cost me $883.72.
A. Between now and the end of the year, many Medicare participants will be in the Part D doughnut hole with you. That means paying 100 percent of the cost of their medications.
Before you order online, recognize that there are unethical Web-based pharmacies claiming to be Canadian. They could be selling counterfeit drugs from anywhere in the world.
We are sending you our Guide to Saving Money on Medicine with information about legitimate Canadian pharmacies and 10 tips for economizing safely. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (61 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. CA-99, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com. It makes sense to verify that the pharmacy you choose is certified by the Canadian International Pharmacy Association, CIPA.
Q. You wrote about a 13-year-old girl with migraines that lasted five days. I, too, used to suffer from such headaches. They’re horrible!
In my late 30s, I started taking atenolol for high blood pressure. It brought the blood pressure down, but more importantly, it was like flipping the off switch on the migraines. I am now 71 and have had no more since then.
Please pass this on so the girl’s father can discuss it with her doctor. My doctor acted as if he didn’t believe me, but it worked really well.
A. Beta blocker heart drugs such as atenolol and propranolol have long been used to prevent migraine headaches (Neurologic Clinics, May 2009). We don’t know why the doctor didn’t mention this secondary benefit from beta blockers.