The skin is the site of evaporation of water. It is our own natural air-conditioner. In the winter when the humidity is low and the air is very dry, the skin becomes itchy because it also becomes dry and, in some patients, very scaly. Certain conditions like diabetes, high fevers, or alcoholism, where the body becomes dehydrated means that the skin of such patients will itch more. As I said in previous columns, it is very important to stay hydrated with water at all times, especially in the cold winter months and the hot summer months. Proper skin care should include emollients (creams or oils) to the skin daily especially after taking a bath or a shower. On the other hand, symptoms of itching can be made worse by exposure to heat. Light weight clothing, airconditioned environments and the use of lukewarm, rather than hot water during showers or baths may alleviate symptoms. Lotions that provide a cooling sensation to the skin such as calamine lotion or lotions with 4 % menthol can sooth the skin and take away the itching.

My sinuses are killing me when its cold out, why is that?

Sinusitis or inflammation of the sinus tracts is very common in the winter months. Many people suffer sinus irritation due to the cold air that goes up the nose and into the reaches of the sinus tracts. The sinuses are areas like little caves in the head. They are not blocked unless there is some swelling or object such as a polyp that can obstructs the sinus and consequently breathing. Chances are the sinus irritation that you experience in the winter time is really not an infection, but just irritation. It is important to note the severity of pain, if any, or whether the mucous is yellow and thick or green coming out in your tissue when you blow your nose. Fever is the defining symptom of a sinus infection. Only 25% of sinus infections are cause by bacteria and require antibiotic coverage. I and other physicians have many patients that demand antibiotics when none should be used. The use of antibiotics inappropriately for “sinus infections” is the leading cause of antibiotic resistance to serious bacterial infections.

What is GERD?

GERD is gastroesophageal reflux disease. It can be a very uncomfortable and serious condition. It’s a form of indigestion. Heartburn, regurgitation, and dyspepsia or discomfort or pain in the upper abdomen can be due to GERD. Acid goes into the esophagus (the tube that goes from the mouth to the stomach) from the stomach and there is some muscle dysfunction at the opening of the stomach (where the esophageal tube meets the stomach). Moreover, many things promote GERD: large meals, gastric stasis from conditions like diabetes where food sits in the stomach and goes nowhere, or acid hypersecretion after something like a big night out with a lot of alcohol. Lying down, bending overf, wearing tight clothes, obesity, fluid in the abdominal cavity from liver disease and even pregnancy all contribute and can cause GERD.

GERD can be treated by elevating the head of your bed, avoiding large meals, stopping smoking, avoiding coffee, alcohol, chocolate, fatty foods, and citrus juices (orange juice or grapefruit juice). Some people use Tums, Mylanta or Maalox or newer agents like omeprazole or protonix to control stomach acidity.

Are airplanes germ infested? Is the air good?

This is an interesting topic. Most airline experts tell us that every cabin on a commercial airliner has filters that clean the air. They have hospital grade HEPA filters which remove 99.97 percent of bacteria as well as airborne particles that viruses use for transport. So airline air is not as bad as you think. There are people who say that every time they fly, they come away with a dry cough and some sort of infection. If this truly occurs, it is probably because the man or lady next to you is ill and has transmitted his or her disease to you directly.

What about the seats on a plane?

Airlines try to tell us that the cleaners who go into a plane between flights actually wash everything down before the next flight. I find this rather extraordinary simply because the turnaround time is so short. I suspect that the cleaners might clean every third or fourth flight. There are many areas on a plane which can transmit infection: the headrest and the tray table stand out in my mind. Imagine you are having dinner on the tray table used to change a diaper on the last route, or that the headrest was used by someone from Peoria who has influenza . Some people make it a habit to bring clean -wipes or Lysol spray with them every time they fly. While I believe that that might be a bit much, it is good to be aware that a person just occupied your seat on a previous flight who might be capable of leaving his or her infectious material behind to infect you.