DEAR DR. DONOHUE: I contracted a staph infection that was difficult to cure. It was resistant to penicillin. During the treatment period, I read a report in Time magazine that discussed resistant staph infection that’s spreading throughout the country. Reports like that worry me. I attend a local gym six days a week where they supply a bactericidal spray to clean the equipment after use.

What would you recommend to avoid further infections? Is the use of a bactericidal spray doing more harm than good by killing all but the most highly resistant germs? – P.M.

ANSWER:
People can greatly lessen their chances of acquiring disease-causing germs by simply washing their hands frequently. Plain soap and tepid or cool water are all that are needed. Washing time should be approximately 20 seconds, about the time it takes to sing “Happy Birthday” twice if you’re not a fast singer.

I don’t want to turn people into compulsive hand washers. We’re given far too much information that makes us needlessly worry, when we are actually quite hale and hearty people. A sensible approach to avoiding germs is all that’s necessary. Germ phobia is overkill.

Pat your gym’s owners on the back. Using the bactericidal spray is a good idea. It’s not going to spawn super germs.

When penicillin first appeared, it killed almost all staph germs. In time, they learned how to escape penicillin’s action. Scientists made a few changes in penicillin and came up with a new penicillin. It was called methicillin. Things went swimmingly for a while, but then the staph learned how to dodge methicillin. These germs are MRSA – pronounced “mersa” and meaning methicillin-resistant staph aureus. They are difficult to treat, and they have begun to appear in everyday places, when they used to be found only in hospitals. There are antibiotics effective against them. The problem of resistance, however, is a daunting challenge.

DEAR DR. DONOHUE: I am an ex-smoker who smoked for 21 years. I have been smoke-free for 15 years now.

My question concerns chest X-rays. My family doctor says that chest X-rays for lung cancer detection are basically worthless unless you have symptoms that need to be addressed. I had always understood that a person should have a chest X-ray at least once a year for early lung cancer detection, especially if he or she is a smoker or an ex-smoker. Can you enlighten me on this issue? – A.M.

ANSWER:
Three large studies have shown that screening for lung cancer with chest X-rays, even in smokers and ex-smokers, has no benefit. X-rays don’t pick up lung cancer at a stage when removal of it improves the chances for survival.

However, current and ongoing investigations with spiral CT (computed tomography) scans make it look like these scans could be a good lung cancer screening technique for those at high risk for it. These scans can detect cancers too small or too indistinct to be seen on chest X-rays.

As yet, no official recommendations have been made. Two large studies are evaluating the worth of using spiral CT scans as a screening tool. A third study, whose results were just published this past October, presented evidence that the scan has great potential.

DEAR DR. DONOHUE: Several years ago my wife was thrown by a horse. Her back was painful for several weeks until she, by accident, touched an electric fence and got a jolt. After that, her back was almost normal. Recently, she was having a mild but chronic backache. Again she accidentally touched the electric fence, and her back was immediately better. Is there any way to get the same effect under controlled conditions without having to grab an electric fence? – F.K.

ANSWER:
F.K., that is truly shocking. I can’t explain it, and I can’t even hint that it might be safe for others. It makes me cringe to think about it. I don’t know anyone using this technique under controlled conditions.

I looked your town up on a map and found it. I’m coming to visit you and your wife. I like you both very much.

DEAR DR. DONOHUE: My sister is not one to talk about her health. I know she hasn’t been feeling well, and she looks like the wrath of God. She casually mentioned to me that the doctor thinks she might have bacterial endocarditis. What is that, and how serious is it? – J.N.

ANSWER:
Bacterial endocarditis is an infection of the heart lining and the heart valves. It’s a serious illness, one that requires hospitalization with intravenous antibiotics to kill off the bacteria. If it isn’t treated, it can destroy heart valves and put a person into heart failure.

Your sister’s doctor must be waiting only temporarily until the results of tests become available. An echocardiogram, a sound wave picture of the heart, can often show colonies of bacteria clinging to heart valves. The echo can also give valuable information on how well the heart is pumping.

Blood is sent to the laboratory to grow any bacteria that might be in it. The bacteria get to the heart through the circulation and as long as they are on the heart valve and heart lining, some are carried pretty much constantly through the circulation.

Bacterial endocarditis is almost always treatable. If valve damage is severe, that too can be taken care of.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com


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