DEAR DR. ROACH: I am at my wit’s end and hope that you can answer this for me. I am a 76-year-old male. Next week, I’m going to have surgery in my genital area. My urologist told me to wash with Hibiclens starting one week prior to surgery. He then went on vacation, returning several days prior to my surgery. However, I am supposed to start washing with Hibiclens now.
I have watched several YouTube videos on how to use Hibiclens and made several Google inquiries, all of which caution not to use Hibiclens above the neck and in the genital area. Yet the genital area is where the surgery will be performed. I can’t find any reasons why I shouldn’t use Hibiclens in that area. What is going on here? I’m not certain what I should do. — R.M.
ANSWER: There remains controversy about whether chlorhexidine scrubs (Hibiclens) are effective at preventing infections with urological surgeries, but there is some evidence of benefit. Since your surgeon has recommended it, then I’d recommend following your surgeon’s advice.
There is good evidence that chlorhexidine is safe to use in the groin for both men and women, although I ask you to be careful around your genitals, which can sometimes get irritated by the cleanser. We use chlorhexidine scrubs in the hospital daily, so ultimately, it is safe to use.
DEAR DR. ROACH: When doing my daily walk, which of the following would be more cardioprotective: maintaining a uniform speed, or mixing more strenuous intervals with slow recovery segments?
I am aware of the old adage: “The best workout is the one that you will actually do.” However, if the best medical advice is to vary the intensity, then I will actually do that, despite the fact that it would entail some mild unpleasantness. — R.A.
ANSWER: A more intense workout has more benefit from the standpoint of cardiovascular fitness. Whether there is more benefit from the standpoint of living longer is harder to answer, but the evidence is sufficient for recommending a more strenuous workout. Whether that means doing interval training with distinct faster and slower segments, or just overall pushing your walk into a faster pace than you normally do, is up to you.
I absolutely agree with your adage. Do what you enjoy the most, but do something.
DEAR DR. ROACH: I recently heard about a pill that helps with alcohol and tobacco cravings, but I don’t remember the name. — J.S.
ANSWER: I think you’re talking about naltrexone, which is indicated for alcohol use disorder by the U.S. Food and Drug Administration. Studies have also shown that it reduces cravings for smoking and improves quitting rates, although it is not one of the first-line medications for quitting smoking (nor does it have an FDA indication for this).
Naltrexone is not a medication to be prescribed lightly or without careful consideration of its risks. Some people have depression and even suicidal thoughts after using this medicine, and it should only be used by those familiar with treatment of these disorders.
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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 send mail to 628 Virginia Dr., Orlando, FL 32803.
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