Are personal sanitary habits the key to good health?

   DEAR DR. ROACH: My husband and I are both 74 and in general good health. He never washes his hands when he comes in from working as a public accountant. He doesn’t wash his hands when he sneezes, or after touching meat and poultry when he cooks. He smokes and is a functioning alcoholic. He says it’s not necessary to wash fruit before you eat it and tells me I don’t know what I am talking about. He has been on Lipitor for several years and eats steak almost every night.
       On the other hand, I wash my hands when I come in from work and before preparing meals, and have always washed fruit before eating it. What’s his secret? Does he have strong genes? — T.M.
       ANSWER: Eating well and taking good care of yourself don’t guarantee a long, healthy life. The converse is true as well. I have heard so many stories about Aunt Martha (or Gertrude or Helen), who drank, smoked and lived on bacon until she was 105, but your lifestyle does give you a better chance at living longer and healthier, and of feeling better right now.
       Smoking increases the risk of dying from any cause. A 74-year-old man who has smoked all his life has about the same risk of dying as an 82-year-old nonsmoker. One can do a similar risk analysis with diet. But some people, through a combination of good genes and good luck, manage to live long, healthy lives despite poor lifestyle choices. Even though some individuals will not have the expected outcome, smoking is still bad. So is eating steak every night. Washing (or at least rinsing) produce is a good idea. 

    DEAR DR. ROACH: Why do you need a prescription for a nebulizer? — M.J.M.
       ANSWER: A medical nebulizer machine allows a person at home to use a liquid medicine (especially albuterol) in a mist form that is easy to use, delivering the medicine continuously for five minutes or so. The advantage over a handheld inhaler is that it gives a larger dose and you don’t need to coordinate the timing of breathing and activating the inhaler.
       It does seem redundant to require a prescription for a machine that you need prescription medication for. Medical devices are regulated by the Food and Drug Administration, so it is sold by prescription only. However, a quick look at an online store finds several “vaporizer systems” that include cups for medication, so it is possible to bypass the need for a prescription.
       I do think that a prescription for albuterol remains important. Many people use albuterol too much without having any real control over their asthma, so a knowledgeable provider is critical.   

   DR. ROACH WRITES: A recent column on sudden sensorineural hearing loss generated many letters, most of them about the possibility of a tumor of the nerve that goes to the ear, called the eighth cranial nerve. The most common tumor is called a Schwannoma.
       It would be unusual for a Schwannoma to provoke such a sudden loss of hearing as the reader described. A stroke in that part of the brain, due to a blockage in the artery that supplies blood to the eighth nerve, is a rare event that can look like sudden sensorineural hearing loss. However, enough people wrote in that they were found to have brain tumors causing their symptoms that I felt I should bring up the possibility, and to note that an MRI scan is appropriate for people with sudden sensorineural hearing loss.
       READERS: The arthritis booklet discusses rheumatoid arthritis, osteoarthritis and lupus. Readers can order a copy by writing:
       Dr. Roach
       Book No. 301
       628 Virginia Dr.
       Orlando, FL 32803
       Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
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       Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or request an order form of available health newsletters at 628 Virginia Dr., Orlando, FL 32803. Health newsletters may be ordered from www.rbmamall.com.
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