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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: Last year, I started getting Raynaud’s. I can remember from my youth that my father had it, so it didn’t seem too terrible. It’s not just the fingertips that turn white, but also some of my toes are affected. I asked people who know of it or have it how one gets this. What is the cause? No one knows. So I asked my doctor. Even he said he did not know.
How do I get these episodes, and what can I do to prevent them? – R.S.
ANSWER: Raynaud phenomenon is an exaggerated response to cold or stress that causes color changes in the skin of the fingers and toes. There is a long list of causes of Raynaud phenomenon. Often, no cause is ever found (in which case it is called primary Raynaud, which just means we don’t know what’s causing it).
The most common known causes are the autoimmune rheumatic diseases, especially scleroderma, lupus and Sjogren’s syndrome. Hypothyroidism is an unusual cause, and some drugs can cause it as well. The current thinking is that primary RP is caused by abnormalities in the alpha receptors in blood vessels (alpha receptors respond to adrenaline and similar molecules).
Keeping the whole body – and especially the hands – warm is the first step. Sudden temperature changes can trigger the effect. Warming the hands in warm water at the onset of an attack can stop it. Anxiety makes it worse, so a positive attitude can really affect this condition. Medications, such as amlodipine, may be necessary for prevention in more severe cases.
Dr. Roach regrets he is unable to answer individual letters, but he will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.
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