Healthoughts

Healthoughts compiled by Jennifer Chan, Katie Neith, Monika Guttman and Kathleen O'Neil

Illustrations by Diane Bigda.

fountain dread

You put in a good workout at the gym only to find you forgot your water bottle. When you approach the water fountain, you notice that the person drinking there is slurping and sloshing the water onto the spout. Suddenly, you have second thoughts about getting a drink.

While drinking fountains are generally safe, they sometimes can pose a risk of passing on germs, says a Keck School of Medicine of USC physician who specializes in infectious diseases.

Indoor and outdoor faucets are only as safe as the water coming out of them, says John Leedom, M.D., Emeritus Professor of Medicine. The United States Environmental Protection Agency requires water from drinking fountains to be tested regularly for evidence of contamination. However, a spigot that stays wet, particularly on a leaking fountain, could be harboring bacteria. That is especially true if someone coughed, sneezed or spit on it recently, Leedom says. Avoid fountains that do not look clean, he suggests, and run the water for 15 seconds before drinking to help wash away contamination.

Outdoor drinking fountains often use a seep hole to prevent the fountain from freezing during cold weather. If the water fails to drain properly, dirty water may mix with the clean water that comes out the spout. Regular testing should identify that problem, Leedom says, but also letting the water run at outdoor faucets for 30 seconds before drinking is a good measure.

Finally, the pipes and fittings inside older fountains can pose a risk of leaching metals into the water. Again, Leedom says, let the water run before drinking to flush the pipes.

“I have no scientific studies that would lead me to avoid drinking fountains,” Leedom says. “However, unscientific personal observations, particularly of children at drinking fountains, convince me that considerable mouth-washing, spitting and gargling is routine. It might not be dangerous, but it is not appetizing.”

 

pointing the finger

Fingernails often are clipped, polished and filed for aesthetic purposes. However, they can also signal health problems by changing color, texture and shape.

“Nails can reveal a lot about a person’s overall health,” says David Sawcer, M.D., Ph.D., assistant professor of dermatology at the Keck School of Medicine of USC. “Certain changes in the nails can indicate heart conditions, lung diseases or even cancer.”

A healthy nail bed is pink and the nail itself almost transparent. Unusually white nails may signal kidney or liver disease, while pale nails that easily break may be caused by anemia or indicate a need for supplemental iron or other vitamins and minerals. Almost half of all nail discoloration cases are from fungal infections.

“Nail disorders make up approximately 10 percent of all reported skin conditions. Common complaints are white spots and dry, brittle nails, which are usually nothing to worry about. White spots are often from minor injuries causing tiny areas of disorder or air pockets in the nail plate,” Sawcer says. “Patients who suffer from dry or brittle nails should use non-soap cleansers and remember to moisturize often, including the nails, especially after washing their hands.”

Sawcer says signs to look out for are “yellowish, thickened nails and nails with brown or black discoloration. Injury can cause a blackened nail, but unexplained new black or brown streaks should be checked out right away, as melanoma in the nails can start this way.”

He says, “My general rule of thumb, no pun intended, is that if something has become noticeably different, or is persistently changing, it is definitely worth a trip to the doctor.”

 

stronger than hurt

Bright orange warning labels often adorn prescription medications to alert users about dosage information and possible drug interactions. But when it comes to over-the-counter pain relievers, proper dosage is not as easy to discern for many consumers.

And since both regular and extra-strength over-the-counter painkillers have varying degrees of minor side effects—including gastrointestinal, kidney and liver problems—improper dosage that exceeds the advised amount can be dangerous.

“Start by taking the correct dose as printed on the package,” says Michael Rudolph, Pharm.D., executive director of community pharmacy practice at the USC School of Pharmacy. He notes that the proper dosage corresponds to a person’s weight, age group and response to medication. Anything beyond the advised dosage is a judgment call by the consumer, after evaluating the level of relief provided by a specific dose.

Rudolph suggests that consumers always read the label to help decide which product will work best for their level of pain and avoid using numerous medications for the same problem. For example, acetaminophen combined with caffeine has been shown to provide greater pain relief than acetaminophen alone. According to the American Council for Headache Education, to get the same relief found with a single dose of the acetaminophen-caffeine combination, one would have to increase the equivalent dose of acetaminophen almost by 40 percent.

In addition, Rudolph advises that consumers consult a pharmacist, since individual dosing and interactions of over-the-counter products with prescription medications are a major concern when patients self-medicate.

“A pharmacist is an accessible healthcare provider who can help prevent incorrect self-dosing that may cause other complications,” Rudolph says.

The higher the dose and the longer the drug is taken, the greater the chance of problems, he says. “Regardless of the strength level, use of over-the-counter pain medication is meant to be temporary.”

The American Academy of Family Physicians recommends consulting with a doctor if pain relief is needed for more than 10 days or for treating a fever for more than three days. These may be signs of a more serious problem or indicate the need for a prescription medicine.

 

unsightly vision

It was just more than a year ago that the United States Food and Drug Administration (FDA) reclassified all contact lenses to “medical device” status—meaning they now require a prescription from an eye-care professional to be purchased legally. The reason: Like contacts worn to correct vision problems, decorative lenses can cause a host of eye problems, including conjunctivitis (pink eye), ulcers in the cornea (the eye’s outermost layer), corneal abrasion, infections and vision impairment.

Although no longer sold over the counter, decorative contacts continue to proliferate in such venues as the Internet, swap meets, flea markets and beach shops, according to the FDA.

That is why David Huang, M.D., Ph.D., associate professor of ophthalmology at the Keck School of Medicine of USC and director of the Doheny Refractive Surgery Center, is one of a group of ophthalmologists continuing to educate the public about the proper use of contact lenses—any type of contact lenses—in an effort to reduce risk. “There is a heightened risk of infection if you wear contact lenses overnight or share them with another person,” says Huang. “If the contact lens is not fit properly, it will be uncomfortable—like wearing shoes that don’t fit. I would hope that would lead to the person taking the contact lenses off, but it’s worth repeating the message. If there’s any sensitivity, remove the lenses.”