Friday, September 15, 2017

Health Tips: Flood Water Dangers

"Water, water, everywhere,
And all the boards did shrink;
Water, water, everywhere,
Nor any drop to drink."
― Samuel Taylor Coleridge, The Rime of the Ancient Mariner

Hurricanes Harvey and Irma have recently flooded Texas, Florida and surrounding states, causing an estimated $200 billion in damage (similar to the costs of Katrina in 2005). Images of people wading, swimming and boating through city streets are all over the news. But flood waters are not just damaging to property, they are a potential health hazard as well.

Flood water mixes with everything it covers, including sewage, animal waste, pesticides, and a host of chemicals normally carefully contained. Bacterial counts in flood water are often extremely high, and this poses a risk for skin infections and digestive issues if the water is swallowed. Mosquitoes thrive in stagnant water, and the viruses that they carry (such as West Nile or Zika) can blossom after a flood. Wet carpets, floors, and wood promote mold growth which can lead to respiratory problems for those living in homes damaged by flood waters.

If you are living in a flooded region, there are some things you can do to protect your health:
  1. Stay out of moving water. Did you know that just 6 inches of moving water can cause you to lose your footing, and two feet of it can carry you (or your car) away? People often over-estimate their abilities in navigating through flood waters (both in cars and on foot).
  2. Wash your hands - if you have been exposed to contaminated water, keep your hands as clean as possible.
  3. Avoid injury when walking through flood water. Brown water may conceal sharp objects that can cause injury. Sturdy boots may help prevent cuts, while waterproof gear like fishing waders can protect open skin.
  4. Beware of downed power lines or chemical spills. When live electrical wires or power lines contact water, there is a risk of electrocution for those in contact with the water. Take caution and treat all electrical lines, wires, equipment and fixtures as if they are energized until proven otherwise.
  5. Beware of gas leaks. Immediately evacuate buildings if a gas leak or odor is detected.
  6. Keep wounds dry - Try not to get flood water in existing wounds, cuts, or scrapes. If the water is in contact with an open sore, wash it right away with soap and water and see a doctor immediately if it shows signs of infection such as increasing redness, warmth, pain, or pus.
  7. Keep kids out of the water - make sure they don't play with toys that may have been in contact with the water, nor play in it.
  8. Extra vaccines aren't really necessary. Although dirty water can spread cholera, malaria, and Hepatitis A, these are essentially non-existent in the United States. Tetanus lives on dry surfaces (not flood zones), so contrary to popular belief, vaccines are not urgently helpful post Irma and Harvey.
  9. Get out of wet clothes quickly. Rinse your body entirely after exposure to flood water to reduce your risk of infection or chemical injury.
  10. Seek medical attention immediately for any infections or unusual symptoms such as upset stomach or diarrhea. Flood waters may contain bacteria including E. coli, Vibrio species, Salmonella, or Shigella. Unfortunately, there are no vaccines for these infections.
  11. Mold proof your house. When you return home to a flood water damaged house, remove items that can promote mold growth (carpeting, wall paper, and clothing). Be sure to wear equipment like shoes, gloves, and an N95 dust mask when removing material that may contain mold.
  12. Check your pets. Dogs and cats don't realize that flood water is contaminated and and are at high risk for infection. If your pet looks sick, take them to the vet as soon as possible for treatment.
I hope you're not dealing with the aftermath of Irma or Harvey, but if so, please take good care of yourself! Feel free to email your health tip suggestions to me at:
If you have any questions about flood water dangers, please log into your account and send us your question. We are here to help.

P.S. How to help Irma victims:


Dr. Val Jones MD - Health Tip Content Editor
Reviewed and Approved by Charles W. Smith MD, Medical Director on 9-13-2017

Friday, September 8, 2017

Health Tip: What To Do When The Air Quality Is Poor

I'm interrupting our skin tips to discuss air quality. I live in Washington state, near the Oregon forest fires, and my city is covered in an ash cloud right now. So I suppose this topic is top-of-mind for me… and any of you in California, Oregon, or Washington state are probably reading this with burning eyes, sore throat and a cough. You may wonder why we are having all these fires when we just had such a wet winter… well, the extra rain caused an explosion in forest and grass growth, providing lots of tinder when the summer dryness came.

How Do We Define Air Quality?
In the United States, air quality is a measure of the amount of 5 pollutants in the air on a given day. The Environmental Protection Agency (EPA) has developed an air quality index which gives us a quick sense of how polluted the air is. The values range from 0-500.

0-50 Good
51-100 Moderate
101-150 Unhealthy for Sensitive Groups
151-200 Unhealthy
201-300 Very Unhealthy
301-500 Hazardous

The five pollutants include: 1) ground-level ozone, 2) particulate matter, 3) carbon monoxide, 4) sulfur dioxide, and 5) nitrogen dioxide.

Right now in my city the air is in the "very unhealthy" range!

What Should You Do If The AQI Is Unhealthy?
The most important thing is to avoid going outdoors, and to limit how much outdoor air you breathe. This means no exertion (heavy exercise increases your breathing rate) or prolonged time outside.  In the case of particulate matter (from burning trees and grass) a face mask may reduce some of the particles being inhaled into the lungs. Face masks are often sold at hardware stores. It's important to choose the right kind (they have "N95" or "P100" or "NIOSH" printed on them) to protect from particles.

People at special risk for injury from poor air quality are those with heart or lung disease (including COPD and asthma), the very young and very old. It's probably obvious that dirty air can trigger asthma attacks and injure delicate lung tissue. Inflammation from irritating particles may cause shortness of breath requiring more inhaled medication or even a trip to the Emergency Department. But what may not be obvious is that poor air quality can increase the risk of heart attacks and irregular heart rates!

If you are in an "at risk" population (significant heart or lung disease) and you can get out of the area if the air quality is very unhealthy, that may be the best thing. A short vacation to an unaffected city could save your life.

Tips To Be More Comfortable In Bad Air
If you can't get away from the pollution, here are some tips to reduce your symptoms:
Dry Eyes - flush the eyes with artificial tears as frequently as you like. If you have an allergic reaction to the particles, try an over-the-counter anti-histamine eye drop.

Cough - if you're coughing, this indicates that you have irritation in your respiratory tree from the particles. Try wearing a face mask (described above) to reduce your exposure. Cough drops or cough syrup may reduce the irritation.

Difficulty Breathing - this is an ominous sign that probably should be treated by a physician. If you have asthma or COPD, it's ok to use your rescue inhaler more frequently but ultimately you need to find a way to get out of the triggering pollution.

Chest Pain - if you experience chest pain when the air quality is bad, you should see a physician at once to make sure you are not having a heart attack. Heart attacks and irregular heart rhythms can be triggered by pollution.

I hope the fires end soon, and that you all are staying safe... Take good care of yourselves!
References Your Lungs Respirator.pdf

If you have any questions about air pollution, please log into your account and send us your question. We are here to help.

Dr. Val Jones MD - Health Tip Content Editor
Reviewed and Approved by Charles W. Smith MD, Medical Director on 9-6-2017

Thursday, August 31, 2017

Health Tip: Anti-Aging Strategies For Facial Skin, Part 1

If I asked you how to improve the size or shape of your muscles, you would probably say 'lifting weights,' and you'd be right. Muscles grow when they are first broken down with forceful exercise, and then they repair themselves in an effort to meet the repetitive challenge. Interestingly, the skin operates on the same principle – to see an improvement in it, you have to trigger that change with an external stimulus. Optimal skincare takes work, especially as we age.

The Big No No's
Now, before we talk about skin creams, procedures, and medications, we need to address the elephants in the room. There are some lifestyle choices that do irreparable damage to skin. Avoiding these 3 things is the foundation of youthful skin:
  1. Do Not Smoke
  2. Do Not Drink Alcohol in Excess
  3. Do Not Get Sunburned (minimize the skin's exposure to UV radiation)
What Happens To Skin As We Age?
It's important to understand what happens to our skin as we age before we choose a strategy to restore a more youthful appearance.  The skin is made of three layers: the outermost (or surface layer) is called the epidermis, and the middle layer is called the dermis, and the deeper fatty layer is called the hypodermis. Most of the aging changes occur in the middle layer.

The dermis contains a large amount of collagen and elastin protein fibers, which give skin its elasticity.  Collagen is produced at a slower rate as we age, and can be slowed down even further by exposure to UV radiation (from the sun) or smoke (from cigarettes, cigars, etc.) The "glue" that holds the collagen and elastin together is called hyaluronic acid, and this glue is also manufactured at a slower rate as we age. The result of less hyaluronic acid is dry, scaly, and wrinkly skin – sort of like what happens to a grape when it loses its water content, it becomes a raisin.

The epidermis tends to become dry as well, with less oil production to capture moisture. The turnover rate of our skin cells slows down (by as much as 50%), causing a dull, rough skin surface. Older adults take longer to heal from wounds to the skin, and those who undergo dermabrasion may take twice as long as young adults to recover.

Skin changes in pigment cells called melanocytes result in uneven coloration. Both dark spots (the result of erratic melanocyte activity triggered by UV radiation over time) and light spots (caused by a decrease in the number of melanocytes as we age) are signs of sun damage and associated aging. Normal immune cells (called Langerhans cells) in the epidermis become more scarce over time, allowing irregular cells to grow unchecked and become cancerous.

In summary, our skin loses elasticity and moisture, slows down its natural turnover, and loses its melanocytes and immune cells over time. The result is a kind of deflation of youthful dermis, with dry, rough, discolored, and sometimes cancerous skin!

The good news is that there are many treatments available to slow this process and rejuvenate aging skin. In my next health tips, I'll discuss products and treatments that can assist with the following:
  1. Removing the dry, dead layer of outer skin
  2. Increasing skin cell turnover
  3. Hydrating the healthy skin
  4. Stimulating collagen production
  5. Reducing redness
  6. Reducing dark spots
  7. Reducing wrinkles

If you have any questions about anti-aging strategies for skin, please log into your account and send us your question. We are here to help.