Hello, dear readers! Welcome to the monthly letters column. You have been keeping our mailboxes busy, so we will dive right in.
- A recent column about tonsil stones prompted a reader with chronic bad breath to wonder if this might be the cause. "I have done everything possible, including brushing twice a day, but all the measures taken didn't help cure my bad breath," he wrote. "Is it possible my persistent bad breath is caused by tonsil stones? How would I know?" Tonsil stones can indeed be a cause of persistent bad breath. Tonsil stones are hardened deposits of debris that can become trapped in the crevices of the tonsils. They are formed from food particles, hardened minerals and dead cells, as well as bacteria and fungi. When the contents break down and are acted upon by microbes, they can release a foul odor. A health care provider can identify tonsil stones through a visual exam. You can help prevent them by gargling with warm salt water daily. They can often be removed with the aid of a water pick or gentle pressure from a cotton swab.
- We have written about rabies in the past and the ways in which the virus can be transmitted. We heard from a reader concerned about a recent encounter. "A fox that may have been rabid approached my home and may have licked the door handle," he wrote. "About a minute later, I touched it with intact skin, rinsed my hands and later washed thoroughly. Could this type of contact transmit rabies?" It is possible to become infected from contact with the saliva of a rabid animal. But the virus must enter through a break in the skin or through mucous membranes. In your case, the skin on your hands was unbroken. The virus, which is fragile outside of the host, spent time on a doorknob. Also, the soap you used to wash your hands would have inactivated it. So, the brief exposure that you described was very low risk.
- We recently discussed proper technique for taking blood pressure. We heard from a reader who felt the column was incomplete. "I'm surprised you didn’t recommend manual readings," she wrote. "I’m 70, and my pressure is 120–130/80 manually but rises to about 160/100 on the machine. I get pushback, but manual checks seem more accurate and worth the extra effort." It's true that blood pressure readings can vary depending on methods and technique. If you see significant or ongoing differences between readings, it is a good idea to review with your health care provider.
Thank you, as always, for taking the time to write to us. We love hearing from you. Email your questions to [email protected], or write to us at Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA 90024. Please remember we are unable to offer a diagnosis, a second opinion or comment on medications or treatment plans. We also cannot look at medical records, scans or photographs.
(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
