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.

DEAR READER » 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.

DEAR READER » 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.