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.
Answer: 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: I recently went to my dentist. He noticed that the enamel on the back of my upper teeth, especially the front, is wearing away. He asked me if I experience acid reflux. I said I don’t think so, because isn’t that something I’d notice?
He then asked if I feel refreshed after waking up from eight hours of sleep. (I’m a new mother, and babies are next-level exhausting.)
He said to try an experiment: Take a Pepcid at night and if I start to feel more refreshed, then I’m probably having acid reflux that prevents me from going into deep, refreshing sleep. Do you recommend this? — H.C.
Answer: I admire your dentist for noticing the enamel loss and considering the diagnosis of gastroesophageal reflux disease. Dental enamel can be lost in an acid environment, so it’s a reasonable thought. However, it is normally severe acid reflux accompanied by frequent acid taste in the mouth that leads to tooth damage. There certainly are cases of asymptomatic GERD, but I think tooth damage is unlikely without further symptoms.
Repeated vomiting, especially in people with a history of an eating disorder, is a much more common cause of enamel loss than GERD, and that may be a possibility.
I would not recommend a medication trial because there are no reliable symptoms. (I agree with you that poor sleep in a new mom is not always due to reflux.) If GERD is really a concern, a diagnostic test, such as a 24-hour pH monitor or an endoscopy, would be my preference before considering a long-term course of treatment.
Readers may email questions to ToYourGoodHealth@med.cornell.edu.