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Thursday, September 23, 2010

4.1 Secrets to Prevent Infections/Physician's Notebooks 4 Begins

Physician's Notebooks 4  - http://physiciansnotebook.blogspot.com - See Homepage

Physician’s Notebooks
An Old Doc Recommends to a New Generation
Introduction  (Update 04 Aug. 2021)
A glance at contents will show that Notebooks 4 is about prevention and treatment of symptoms and diseases. It draws the reader deeper into the plan to teach Healthy Longevity, gives facts and hands-on experience. And it includes current interest like bio-terrorism. The chapter on the use of opioids and recreational drugs comes from an authentic 30-year personal drug-use experience.
 Dr Stim, Yokohama


1. Preventing Infection
Infection is caused by living particles - germs - too small to be seen by unaided eye and includes prion (proteinaceous infectious particle that causes slow brain diseases like mad-cow) and the more familiar virus, bacteria, fungus, yeast, protozoa (single cell, moving animal) and and the just seeable tiny worm along with its egg and larva.
   Infectiousness of a germ varies. With highly infectious rabies, a single virus from saliva of rabid animal can kill. With lesser but still highly infectious germ like common-cold or Covid-19 virus, it takes thousands of germs to cause illness. With germ like E. coli (bacteria normally in our intestine) millions must invade to cause disease.
   Whether or not you get infection depends partly on a critical number of the germs. We can’t know beforehand how infectious a germ is, so we should reduce the number of germs we contact. (Avoid germ-laden environment; wash germ away quickly, including body opening, wear face/nose mask in presence of inhaled virus risk.)  Keep in mind your normal immune system will prevent the usual “dirt from floor” from causing infection. And a brief boiling or microwave flash or toaster heating will render food from floor or contaminated water  free of dangerous germ
   In dealing with a germ we must consider the seriousness of its infection. Since the 1950s we tend to ignore dangers of infection because safe food and water, good nutrition, widespread immunization and antibiotics have nearly eradicated previously troublesome or deadly infections. This makes us careless in avoiding germs. People today, too much eat raw food, kiss body opening without proper washing, and prepare food with unwashed hands. But with HIV/AIDS or Covid-19, this could be deadly and, without becoming obsessed we should be sure raw foods are fresh and cleaned and body openings are well washed before we eat one or mouth the other, and should wash hands before handling anything and cover mouth & nose with mask where risk of breathing in deadly virus exists and also use face masks and observe social distancing when instructed.
   About infectiousness, we must consider individual body defense against infection. Defense starts with the body barrier to germ. This means intact healthy skin, and body opening closed when not in use, and only used for natural function.
   Skin is natural barrier to germ, and its oil and sweat mildly germ killing. Over thousands of years, some bacteria got used to life on human skin. When allowed to increase because of infrequent washing or when beard or other unkempt hair growth allows, the germs cause bad body odor and transmit infection. Another consideration is fingernail, which should be kept trim flush with tip of finger to prevent scratch damage.
   Body opening as entry point for infection leads to mucous membrane (MM) the moist surfaces of body openings: it includes lips, mouth, throat, GI tract, respiratory tract from nostril, to lung, reproductive tract from vagina and penis (under-foreskin in uncircumcised men) to the ends of uterine tubes in women and to prostate gland in men, and kidney with urinary tract and bladder. Be especially critical of anything in contact with the MM from breathed air (e.g., for worst cases, anthrax spore inhalation leading to deadly pneumonia, Ebola virus) to food and sex partner.
Reduce germs that may contact body. Hands should be washed regularly and well (Recent introduction of antiseptic alcohol hand rub is good.), especially before preparing or eating food, or before use in sex play. Meat, poultry and fish should be well cooked, and vegetable and fruit we will eat raw, well washed before eating.
   Kissing and hugging as greeting or signifying friendship or love is unhealthy. Serious disease may occur because of kissing. (Infectious mononucleosis, a cause of later deadly lymphoma is “the kissing disease”.) Rarely, one may even catch HIV and die of AIDS from open-mouth kissing an HIV+ person. To increase probability of healthy, happy, long-life, limit mouth-to-mouth kissing to one person who will be your life mate, or, if you cannot manage that, limit to a few who are worthy of the trust. And before you kiss, reduce bacterial content by mouthwash and by lips and genital and anus cleaning. (Alcohol rub for the last)
   Mouth is also entrance for breathed air with dangerous germs (shown by the October 2001 anthrax bacteria spores mailed as powder in letters and killed more then 10 persons). Air is source of infection we use daily  to ignore but with resurgence of TB and now the Covid-19 pandemic, and the Ebola virus, we should redirect attention to how we expose ourselves to germ from air. For prolonged survival, a key principle is breathing air with lowest concentration of germ. Here, avoidance of germ-laden air (crowded, enclosed space) and avoiding close contact with those who are coughing, sneezing or talking  at you is a must if you wish to make old, healthy bones. Surgical mask has proven useful in limiting spread when one has respiratory infection. And it has proved preventive with Covid-19 virus.  Also waiting on lines or in crowds, social distancing (1 meter) is wise. And when not in use, keep mouth closed.
While on body opening, it is important that local defense mechanism against germ is adapted to local function. Thus anus and rectum are resistant to becoming infected by germs that normally live in the intestines but both offer little or no resistance to an infectious germ like HIV, or to gonococcus or syphilis bacteria that gets passed from penis to rectum. So recognize high risk you will encounter when you use part of your body unusually.
If there is question on bacterial contamination of food, then microwaving or toaster heating at least 2 minutes at high KW setting should render food free of contaminating, infectious germs.
   In G.I. tract, the stomach has major function of sterilizing food you eat, which, even with cooking and good food preparation, may have germs. Stomach acid does that job but antacid and acid inhibitors neutralize that protection. During cholera or typhoid epidemic, antacid user has higher infection rate, and it follows that food-born infection like hepatitis is enhanced by antacid. Similarly in vagina and rectum, normal secretion protects against germ. Excessive cleansing, as in chemical douching and giving antiseptic enema, may make more infection by removing protective mucus.
   An important serious source of infection is swimming in contaminated water of lake or river or pond. This usually occurs to travelers in Africa or the Far East. Do not swim in a lake or pond or river. Very serious parasitic infection that destroys the brain or liver can be acquired by a simple swim in a lake.

Friendly germ: Mucous membrane is colonized by germs that have adapted to life in and on human and under normal conditions cause no harm. Friendly germ protects area it lives in or on from infectious germ and to destroy it may produce infection. Example: the severe colitis-diarrhea after a week or more of oral antibiotic. Use antibiotic only for good reason and not longer than 7 days unless your doctor assures you it is necessary and OK.
   Local heat is useful against infection. Gonorrhea infection may be stopped by sitting in hot bath within several minutes after the sex that transmitted it. One should not rely on that, but it is harmless and even if it only works 5% of time you gain by enjoying bath just before and right after sex. Similarly, if you do oral sex, or open-mouth kissing, an antiseptic mouthwash and penis or vulvar cleaning just before and right after the act may prevent syphilis or throat gonorrhea, or even HIV. (Again, don't rely on it)

I summarize a routine that can prevent problem from infection: Daily showering, mouth/hand-washing with gargling (also before and after sex in addition to morning routine). Well-done, cooked food, and hygienic preparation for uncooked food (fruit cored, peeled, and everything well-washed). Attention to hand washing before eating, and before and after urinating and defecating. Be aware that the hand may transfer disease to private part. Also wash when you return home. But try not to become neurotic about the routine. Just be sensible.
   Avoid a person who is obviously ill (Of course, you make exception for a loved one), avoid crowded close-contact place, stay away from cough and sneeze, using surgical mask in high germ-laden breathed air, and keep mouth shut. (Nasal breathing will filter out and kill many germs.)
   Limit antacid to brief use, limit douche and enema to pure water, or at most, to dilute baking soda.

Home: Attention to keeping your living space clean and neat will pay off in more uninfected days of life. All it takes is daily hot water wipe-down of floor and tabletop, airing of bedding, and recycling of personal washcloth through washing machine. Each family member should have only-use personal washcloth and hand towel.
   Using window drape, rug or heavy curtain is not good because it attaches germ and causes or worsens allergies. Best floor cover to prevent infections is easily washed plastic squares or Japanese tatami. And no outside shoes at home will reduce house germs. Also to protect against foot infection and cuts, use personal slippers and if you must go bare (better not) be sure floor is kept clean by frequent vacuuming and wipe down with ammonia cleanser. Finally, stop unnecessary local body-part warmth, like wearing stockings or socks at home (but still pay attention to protecting feet) especially in bed. The local warmth favors fungus such as athlete's foot. 
   Pets are a dangerous source of infection. Treat pet with as much respect for potential-infection as you would a human. What is terrible about worst pet-caused infection is that it is not recognized and thus becomes delayed time bomb. Examples: systemic illness and possibly later leukemia from cat scratch, or a stroke in a 15-year-old boy from toxicara egg of his dog, or a toxoplasma infection a woman gets from her cat but never recognizes as cause of mental retardation and blindness in her next child. If you must have furry pet (better not), keep it clean daily, neat up after it, and be sure it is de-wormed and has all immunizations. Do not take it to bed with you or kiss it or snuggle to it unless you care nothing about your health and life.

Insect: At home, fly, cockroach, mosquito and bedbug; outside, mosquito, fly, lice, tick, and other creepy, crawly thing! No matter where you go, keep in mind that an insect could disable or kill you. Keep yourself insect-sparse, especially at home, and be careful when going on trip to keep exposed skin and body openings protected. If you hike or cook-out, then wear clothing that completely covers skin of lower body against tick bite one gets by walking in high grassy, shrubby area in shorts. And use anti-insect spray especially against mosquitoes.
  END OF CHAPTER. Next, click 4.2 Immunizations

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