San Antonio Express-News (Sunday)
Positive changes can help prolong life and improve health
Q: If you would recommend one good thing to do to prolong your life and have good health, what would it be?
By the same token, if you were to recommend not doing something because it is very bad for you, and there is no health benefit to it, what would that be? A: The second question is easier, because of all the things people do to themselves that hurt them (and there are a lot), smoking probably causes the greatest harm to the greatest number of people. Smoking reduces the amount and quality of life so much that it has to be the top answer (and for smokers, in almost all cases, the most important thing you can do for your health is to quit smoking).
Your first question has many good possible answers, and if you asked 10 physicians, you would probably get at least nine different answers. However, I am going to say that committing to a regular exercise program is the one good thing to do to prolong your life.
Taking an hour a day, or even 20 or 30 minutes a day, to do something for your physical and mental health has many benefits by itself, including reducing heart disease and cancer risk, giving a better sense of confidence and wellbeing, and improving strength and balance.
However, it’s my experience that when a person really sticks with their exercise regimen, they are usually able to increase their performance over time (maybe walking or jogging longer or faster, lifting more weights and getting stronger, or becoming more adept at sports). But what is really interesting is that people tend to improve other habits. After running 2 miles, you’re more likely to think a bit more carefully about what you are eating. You’re less likely to choose unhealthy
habits.
I can’t argue with people who say that changing your diet is the best thing to change your health for the better; neither do I argue with those who recommend mindfulness, better relationships with friends and family, stress reduction, better sleep, cutting back on alcohol, or a host of other changes.
For any given person, one particular habit may be easier to start, and any can be the key to changing multiple factors. Small changes in numerous behaviors may have a greater overall benefit than a dramatic change in just one behavior.
I’ll sneak in one more answer to your second question. I see many patients, friends and family spending a great deal of money on supplements just to prevent disease. These are seldom bad for you, but they aren’t usually much good either. You could instead spend your time, money and energy on making other positive changes.
Q: For the last few years, my wife puts in her earbuds and listens to talk shows while she sleeps. This seems like an unhealthy idea.
A: I agree with you. Earbuds while you sleep could damage your ear, and although listening to some music before bed helps some people fall asleep, I’m not sure that talk shows are the optimal choice. But it’s the earbud part I really recommend against.
Q: I went to the hospital and was diagnosed with appendicitis. I’ve been sick for three days. My surgeon said that although the CT scan showed a ruptured appendix, he wants me to take antibiotics for a week or so, and then come back in six to eight weeks for surgery.
I don’t want to wait! Wouldn’t it be better to get this done now? I’m in pain, and I’m worried I will get a very severe infection. Why do I need to wait? Why don’t they operate? I always thought that when you have appendicitis, they operate right away.
A: The optimal treatment of acute complicated appendicitis is changing. In cases like yours, where the body has partially or completely walled off the infection, giving antibiotics and waiting for the inflammation to reduce make the operation safer. Of course, if a person is unstable, or if the perforation is free, that requires an emergency surgery. Observation by a skilled surgeon is still necessary for a period of time on antibiotics to make sure the person is not in need of urgent surgery.
I spoke with one of my surgical colleagues who noted that operating immediately in a case like yours may require removal of part of the colon, because there is so much inflammation that extensive surgical dissection is required. Giving the body a chance to wall off the infection and the antibiotics time to kill the bacteria means that when they do the surgery later, it is easy and with less risk of complication.
I understand you want the problem solved right away, but you are likely to have a better long-term outcome if you postpone the surgery.
Q: What would you recommend for tinnitus? Can any vitamins help?
A: Tinnitus is the sensation of sound when there actually is none. Many people describe a ringing sensation, but buzzing and hissing are well-described. Tinnitus is almost always associated with hearing loss.
Medications are not particularly effective in the treatment of tinnitus. Although some prescription medications show limited benefit in specific situations, I don’t treat tinnitus with medications. Vitamins and supplements have been tried, but the data on gingko biloba, melatonin, niacin, zinc, copper and manganese have failed to provide convincing evidence of benefits.
Depression and anxiety are common in people with severe tinnitus, and these should be treated. Treatment leads to an improved quality of life. Two modalities have been proven effective for many people with tinnitus: tinnitus retraining therapy, which includes the use of external sound generators (often for one to two years); and cognitive behavioral therapy.
I recommend the American Tinnitus Association at ata.org for more information.
Q: Can someone use hand sanitizer after using the toilet?
A: I recommend washing hands after using the toilet. Although hand sanitizers are good at killing bacteria, they don’t clean the hands, and some infections, especially C. diff (Clostridioides difficile, a serious diarrheal illness), have spores that are highly resistant to killing and need to be washed off. That takes soap, water and time — at least 20 seconds. Alcohol-based hand sanitizers can’t kill C. diff spores.