Wash hands BEFORE using the toilet

I wash my hands before using the WC. I’m a dermatologist. That’s what we do. The reason? The infections you can give yourself from dirty hands touching private parts are probably more likely than those that come from the private parts. This is not to discourage washing hands AFTER using the toilet as well, but the clean skin of, say, a penis is probably less contaminated than the objects you have been touching all morning or afternoon on the subway and at work.

Genitals are not inherently colonized with bacteria. There are exceptions, the so-called carrier state, where bacteria do colonize the genito-urinary skin. The largest potential for introducing infection, however, lies with fecal contamination. The risk there is E. coli (always present in the colon) and other pathogens (Hepatitis A, Norwalk virus, etc). These can be effectively washed off.

Here’s a partial list of how hands can infect genital skin:

     Warts. HPV. Especially genital HPV, the kind that causes cancer of the cervix, penis, and anus. While most HPV is transmitted directly through sexual contact, HPV can definitely be transmitted by hands. This presents big issues when a child has HPV in the anogenital region: could it have been accidental contact from someone’s hands or do we need to call Child Protection Services?

     Herpes. Also famous for being transmitted through sexual contact and vaginal delivery of a baby, the Herpes Simplex Virus (types 1 and 2) can be transmitted manually. Hand contact with active genital or mouth lesions can then deliver the virus to susceptible sites. Broken skin and friction may play a role as well.

     Candida yeast infection. Candida likes warm, moist areas, but an unwashed hand, in the right setting, could transmit Candidiasis.

     Jock itch: by this I mean other fungal infections of the groin and anogenital areas. Many people have this on their feet, and transmission would, in theory, be easy. The first place dermatologists look when someone has fungus in the groin, are the patient’s feet.

     Staph infections. Staphylococcus aureus is the most common skin infection from bacteria. Handling genitals with dirty hands could transmit Staph to the skin.

     Syphilis. This can definitely be transmitted skin to skin, although it is most commonly transmitted to moist membranes (mouth, tongue, vagina, anus) and genitals.

     Trichomonas. Not likely since moist-to-moist is the usual route.

    

So there it is. Something to consider.

Best regards,

THE MYTH OF BOOSTING YOUR IMMUNE SYSTEM

These days, much is made of the need to boost your immune system. Ads for dietary supplements abound in the media. Corporations that stand to profit from the sale of supplements would like to scare you into thinking your immune system is in dire need of an expensive tune up.

The truth is this: immune function is so hard-wired from an evolutionary standpoint that immune deficiency occurs only in the most extreme settings: HIV/AIDS, organ transplants (by intention), some lymphomas, extreme malnutrition and genetic immune deficiencies.

For example: The reason you get a cold or the flu is NOT that your immune system needs a boost, it is that your immune system is reacting appropriately to the virus you got exposed to from your kids or coworkers. With flu and colds, EXPOSURE is the issue, not immunity. If you do catch a cold, you become immune to that particular strain, but there are so many different strains, the next one you encounter could lay you low again.

The real problem in most diseases is OVERACTIVE IMMUNE FUNCTION. Consider the following:

Poison ivy rash: immune reaction to the plant chemical on your skin

Peanut allergy: life threatening immune reaction to peanut ingredients

Hay fever: immune reaction to pollens

Asthma: partially genetic immune reaction to multiple inhaled allergens

Drug reactions: severe immune reactions to many drugs

Hives: immune reaction to shrimp, strawberries, drugs, etc, etc.

Eczema: genetically determined immune skin reaction causing intractable itch

Psoriasis: aberrant immune reaction to numerous environmental exposures

Lupus: autoimmune reaction to your body’s own cells

Ulcerative colitis: genetically influenced autoimmune reaction in the intestines

Rheumatoid arthritis: autoimmune attack on joints and other tissue

ALL ARE A RESULT OF TOO MUCH IMMUNE REACTION!

How about CANCER? It is a common misconception that cancer is related to deficiency of the immune system. In normal settings, trying to boost your immune system will not reduce your chances of getting cancer. Gene mutations are the main cause, combined with certain environmental carcinogens like tobacco and asbestos, to name only two. In the special setting where the immune system has to be suppressed intentionally (as in heart and kidney transplants), cancer becomes a higher risk because the immune system can’t do what it does naturally: to seek out and kill abnormal cancer cells. If it were allowed, it would seek out and kill (reject) the transplanted organ.

Of the top ten causes of death in the world (see graph at bottom of page), only one has a direct connection to low immunity and that is HIV/AIDS caused by the HIV virus which knocks out major immune function. Most of the common killers have nothing to do with low immunity. Heart disease, stroke, lung disease, diarrheal illness: boosting your immunity has nothing to do with them. Too much immune reaction (called ‘inflammation’) is much more often the real culprit. And overeating and smoking play a significant role, too: 5 of the top 10 causes of death are influenced heavily by smoking. Why? Because smoking increases inflammation at the cellular level.

So, in short:

1. Don’t worry about boosting your immune system; living healthy is enough.

2. Understand that you cannot improve on the immune system you were born with.

3. Understand that successful treatments for the diseases listed above consist of therapies that suppress, not boost, the immune response.

Vaccines deserve special mention. Vaccines induce immunity to individual disease-causing viruses and bacteria. Polio, measles, mumps, whooping cough are the most familiar ones. The flu vaccine induces immunity to the influenza virus of that particular year only, so yearly vaccination is the rule.

Shingles is a special case as well. Shingles (Herpes Zoster) develops when there is a reduction in natural immunity to the chickenpox virus. This happens with aging or severe illness. There is no proven method for an individual to avoid reduced immunity with age. Fortunately, there is now a vaccine against the virus, which is given at age 50 to 60 to literally boost that specific immunity.

Best regards,

Related links: 

 http://www.youtube.com/watch?v=Y3hWv26Bs9E
SHINGLES (Herpes Zoster): Baby boomers: there is hope!
"Don't Pick That Mole"--- dispelling the myth
SUN PROTECTION: Myths and truths
Hormonal Acne in Women

FOUR RUSSIANS in four minutes

For all of James's blogposts, books, music, and more, visit his website at

https://www.jameschanningshaw.com

It is humanly impossible to discuss even one Russian composer adequately on a blog post, but have a quick read anyway. Anyone who takes music seriously must know something about these four men.

Stravinsky came first. To be fair, Tchaikovsky, Rimsky-Korsakov, Rachmaninov and many others came before him, but for this discussion, Igor Stravinsky started it all.

Igor Stravinsky 1882-1971

He didn’t invent it; he just tweaked everything that had come before him so it sounded like he invented something new. His invention, sometimes called neoclassical, became 100 years of new music. That’s what great artists do: They tweak conventional thinking, and riots ensue. They blow art out of the water with new beauty, painful at times, but ultimately, lasting, inspirational beauty.

In 1913, Igor Stravinsky instigated riots in Paris with the premiere of The Rite of Spring. Le Sacre du Printemps’ or simply ‘Le Sacre’. This music was so new and challenging that the audience began screaming and booing within minutes; all mayhem broke out in the theater and spilled out onto the streets.

Le Sacre can be uphill listening for novices, so you might try Symphony of Psalms instead, a three-movement piece written nearly twenty years after Le Sacre and possibly one of the two or three best compositions ever composed for orchestra and choir. Intense from the outset, the first movement of full-on symphony and choir requires the wearing of a seatbelt, and the choral lamentations in the third movement leave one either breathless or in tears.

Sergei Prokofiev 1891-1953

Our second Russian composer is Sergei Prokofiev, who, while only nine years younger than Stravinsky, became widely known with Peter and the Wolf and Romeo and Juliette, but there is so, so much more to Prokofiev. Unlike many twentieth century composers, this man had the amazing talent for combining challenging contemporary harmonies with the most beautiful of melodies. You might start with his string quartets. Then try his Concerto for Violin and Orchestra no.1 and no.2. I prefer No. 1, but both are gorgeous. Try also his piano concertos and sonatas. Totally mind-blowing power and beauty.

Dmitri Shostakovich 1906-1975

Dmitri Shostakovich, our third on the list, has become a household name and needs little

introduction. Only fifteen years younger than Prokofiev, he takes music further still. He is known best for his fifteen symphonies, many of which have strong socio-political themes. However, Shostakovich’s essence is more easily uncovered in his other works. My favorite? His Preludes and Fugues for piano. The string quartets are a must listen, as is his Cello Concerto No.1.

Alfred Schnittke 

The fourth and last in this discussion is Alfred Schnittke (1934-1998). Schnittke’s works show influences from all three of the above composers, but he took them further, into new frontiers of harmony and rhythm, while always featuring beautiful melodies that are heart-wrenching at times. In most great works, there is tension and resolve; in Schnittke’s works, tension and resolve often occur simultaneously, creating huge emotional and musical impact. His works even explore early minimalism. Try his Requiem. Try his concerto for piano and strings. Explore his Symphony No. 8. Then move to violin sonatas and piano sonatas. There is much more.

So there. You have four influential composers from Russia who have changed the world of music. Humanity should consider themselves extremely fortunate to have lived in a time when the musical genius of these giants was accessible through recordings, published works, and performances. 

 

Mid-term election madness (Grrrrrrr!)

Remember this date: November 2, 2004. 

Ten years ago. A major turning point in American history occurred that day. It was the day George W. Bush got re-elected legitimately by the American people. On that day, the handwriting on the wall was written: what America wants is God, guns, and greed. Despite that election being close, a majority of Americans, including those who stood to benefit most from affordable healthcare, gun control, fewer tax loopholes for the rich and more regulations on Wall Street, seemed instead to favor ignorance (translate: Creationism and God), the NRA, market driven healthcare, oppression of women’s reproductive rights, military bravado without follow-through, and unfettered abuses by Wall Street.

The historical impact of that election was this: Americans will never be interested in making policy changes to provide an inclusive societal approach to human well being. Instead, the every-man-for-himself approach, answering only to a higher power, and an ever-increasing gap in income inequality, will likely continue. This will lead to a gradual decline in the financial and international stature of the United States. Sound familiar? Rome anyone?

We’ve already seen the evidence.

Despite numerous mass shootings in the last decade, Americans cannot manage to put the lid on ownership of major weaponry. Local candidates choose to please the NRA above their constituents, though most constituents would probably agree with the NRA. Congress, of course, opposes gun laws because Obama is in favor of them.

State laws, pushed through by bible-thumping Republicans, have eroded women’s reproductive freedoms.  Dressed up as  protection of life, defended in the name of God, it is really male-driven misogyny and oppression. The fact that many women vote for this legislation is an astounding example of misguided ignorance and belief.

Job-creators don’t care about creating real jobs for Americans. They care about creating profits for themselves. And they seem only do this if they are allowed to out-source to the cheapest, run-down labor force they can find in the developing world. They fight tooth and nail any tax code changes that might impede that behavior and reduce their profits.

Every person in finance likes to blame the ’08 recession on Bill Clinton’s freeing up of mortgage money to the middle class, way back last century. They accept no culpability for banks figuring out how to game the system, how to make oodles of money and dump all the risk back downstream to unsuspecting homebuyers who shouldn’t have been given mortgages in the first place. "Clinton made me do it", the banks say. Well, it came back to bite some of them, except, of course, the smartest and richest, who figured how to game the new system. Those same gamers still talk of deregulation, fewer taxes and ‘job-creators’ as the solution to all our national and international problems. In a word, GREED.

So America is nearing a midterm election. Obama has lost respect from some of his supporters. Yes, he could have done better. He might have taken advantage of Democratic majorities in both houses during his first two years to change the tax code and start to rein in obscene wealth while funding an infrastructure of well being. Then he could have banished health insurers who are beholden only to investors. He could have brought in the public option, which would have been (and could still be) immensely popular and successful.

Solutions? There will be oases of hope, such as eight years of President Obama; such as Governor Brown’s handling of California recently that brought the state into the black through tax code changes and selective spending cuts. But that can change on a dime. Clinton created a surplus during his presidency the same way. How long did that last after W took over?

If President Obama loses control of both houses in 2014, Republicans will celebrate, having effectively ‘thrown the bum out’. Without knowing it, what they will be celebrating is the unstoppable decline of the United States of America that began November 2nd, 2004, when George W. Bush was given a second term.