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DEAR DR. ROACH: I was wondering what adult vaccines should be given to enhance the immune system, in addition to improving sleep and diet. – P.P.
ANSWER: Our bodies’ immune systems are designed to protect us from outside invaders (bacteria, viruses, fungi, parasites) as well as internal errors (cancers), and they are very effective at doing so. Unfortunately, the germs and abnormal growths also are skilled at avoiding our immune systems, so there is a constant struggle going on. Giving your body proper nutrition and rest, and managing stress help your immune system perform at its best.Vaccines improve your body’s ability to fight off particular infections, increasing your immunity to very specific bacteria and viruses. The vaccines that are generally recommended for healthy adults are:
- Flu vaccine (yearly);
- Tetanus, diphtheria and pertussis once, then tetanus/diphtheria every 10 years;
- Human papillomavirus (three doses, up to age 26);
- Zoster, the shingles vaccine (once after age 60);
- Pneumococcal vaccine (PCV13 once, PPSV23 once or twice).
Depending on the person’s past history and risk factors, other vaccines – including the measles, mumps and rubella vaccine; meningococcal vaccine; hepatitis A and B vaccines; and haemophilus vaccine – also may be recommended. International travelers may need others. The Centers for Disease Control and Prevention maintains the most recent recommendations on its website at www.vaccineinformation.org.
DEAR DR. ROACH: This may seem like a trivial concern in comparison to some of the matters you address in your column, but it is a concern of mine. My spouse passes gas throughout the night. He claims that he is asleep and unaware of any problems. I say that this is a voluntary activity and that he should be able to control it. Who is right? – D.B.
ANSWER: He is. Passing gas while asleep is entirely involuntary. You probably are doing so also while asleep. If you are really bothered by his intestinal gas, then you can work on some dietary changes, including avoiding carbonated beverages and limiting foods that commonly cause the intestinal bacteria to produce gas, such as beans, bran, cauliflower and cabbage. In some people, excess gas production can be a sign of mild lactose intolerance.
DEAR DR. ROACH: Let’s not shake hands, period. Doctors seem determined to shake hands. I have been half-medicated when the doctor leaned over and insisted on shaking hands. In the ICU, I, another patient and several visitors were visited by several doctors, who came in and had to shake hands with everyone. I did not notice whether they cleaned up. – L.F.
ANSWER: I understand what you are saying, but I am not ready to recommend giving up shaking hands. I can understand not shaking hands with visitors in an ICU, but if I am going to be examining a patient, it’s polite to shake hands. Of course, I wash my hands before and after every exam, and hospitalized patients and their visitors should wash their hands frequently as well.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive, Orlando, FL 32803.
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