Sunday, March 30, 2008

General Health Topic - New Drug Disposal Guidelines

Hello Everyone,

In a previous post, I wrote about how drug residue is being found in the drinking water in many communities accross the US. In response to this potential problem the bigwigs in Washington came out with new guidelines for disposal of prescription drugs.

Remember, many of the drugs that are found in water are from the drug being ingested by a patient and then being excreted in either urine or feces. The wastewater treatments that are currently available are not designed to remove drugs, drug residues or drug metabolites.

The goal of these new guidelines is to not add more drugs to the water system by following the old guidelines of flushing expired or unused meds down the toilet. In addition, the new guidelines suggest taking the unwanted drugs and rendering them unfit for human use and therefore preventing drug diversion.

Here are the new guidelines:

(Washington, DC)—In the face of rising trends in prescription drug abuse, the Federal government today issued new guidelines for the proper disposal of unused, unneeded, or expired prescription drugs. The White House Office of National Drug Control Policy (ONDCP), the Department of Health and Human Services (HHS), and the Environmental Protection Agency (EPA) jointly released the new guidelines, which are designed to reduce the diversion of prescription drugs, while also protecting the environment.

The new Federal prescription drug disposal guidelines urge Americans to:

Take unused, unneeded, or expired prescription drugs out of their original containers.
Mix the prescription drugs with an undesirable substance, like used coffee grounds or kitty litter, and put them in impermeable, non-descript containers, such as empty cans or sealable bags, further ensuring that the drugs are not diverted or accidentally ingested by children or pets.
Throw these containers in the trash.

Flush prescription drugs down the toilet only if the accompanying patient information specifically instructs it is safe to do so.

Return unused, unneeded, or expired prescription drugs to pharmaceutical take-back locations that allow the public to bring unused drugs to a central location for safe disposal.

Call your local pharmacy and see if they will accept your unused prescriptions. I think that will be better way than adding the meds to a landfill.

As soon I find more information, I will pass it along.


Dr. Paul

Thursday, March 27, 2008

General Health Topic - Dirty Lemons, San Antonio Investigation

Hello Everyone,

The other day I wrote about DIRTY Lemons. The original article that I cited tested lemons in restaurants in the Northeast.

Well, a local TV station and reporter Jaie Avila, saw the article also, (maybe they read my post) and decided to do their own testing. They recruited Dr. Annette Fothergill at the University of Texas Health Science Center to do the testing of restaurants in the San Antonio Texas area. What follows are the results the WOAI News 4 investigation copied from their website:

"We tested lemon slices from 10 restaurants around San Antonio, and believe it or not, half of them were found to be contaminated with either E-coli, or fecal bacteria from human or animal waste. Who knew lemons could be such a magnet for germs? Even some researchers assumed it might act as a natural disinfectant for your drink.

Dr. Fothergill said before the tests, "Citrus fruit is very acidic, so I'm thinking a lot of bacteria won't survive that kind of environment."

Well, the petri dish doesn't lie. All kinds of nasty stuff showed up when the Trouble Shooters took lemon wedges from local restaurants, and had them tested.

We started by visiting restaurants in different parts of the city, where we ordered water or tea with a slice of lemon. Then, as researchers instructed us to, we used hand sanitizer before putting the lemons into sterile plastic bags and taking them to the lab.

Some of the restaurants kept their lemons pretty clean, like the Denny's at 410 and Perrin Beitel. The lemon slice we got at the Village Inn on Southeast Military also got high marks; nothing but some common, harmless bacteria. When we tested a lemon we were served at the Pizza Hut in the 600 block of San Pedro, the petri dish turned bright pink.

"This is an indication of a coliform, Klebsiella species, and it is an indication of fecal contamination," explained Dr. Fothergill.

That could mean the lemon wasn't washed, it was cut with a dirty knife, or an employee didn't wash up after using the restroom.

In a statement, Pizza Hut told us, "We have strict guidelines and this restaurant has very high health department scores. We are committed to providing a clean and safe dining environment for our guests."

We got a similar result from the lemon slice we got at the Sea Island Shrimp House on Southwest Military. Lab tests showed definite signs of fecal contamination. Sea Island said it was surprised by the findings, since it has received 6 perfect health scores and 3 Kitchen Cops Blue Plate awards, but adds, "We always welcome opportunities to improve our company practices and are identifying steps to go above and beyond the FDA and industry protocols."

Fecal bacteria was also present on the lemon wedge we were served at the Thai Corner restaurant in the 8400 block of Fredericksburg Road. The owner told us his "employees take great care in their own personal hygiene, including hand washing...And a dedicated cutting board and knives are prevent cross contamination."

So, who served us the dirtiest lemon? That dubious distinction went to the Hooters in the 8500 block of Wurzbach. The lemon they put in our drink contained 3 different kinds of fecal contamination. "We have a mixture, a nice fecal cocktail here," said Dr. Fothergill.
Unlike the other places, the source of the bacteria is almost certainly human. Fothergill explained, "Quite clearly someone did not wash their hands before they handled lemons and sliced them, and put them on the cup."

We went back to Hooters to ask them about the results. One of the managers told us their policy is that servers use a fork to grab the lemon slice, instead of touching it with their fingers.
John Totin, Hooters Assistant Manager, explained, "So we use forks to put the lemon on to the drink."

The results of our investigation even made an impression on the researchers who conducted the test.

"I have now decided I will no longer put any citrus items in my drinks so I order them without. I don't even want them touching the glass anymore," explained Dr. Fothergill.

Some of the restaurants told us they would be changing the way they do things because of our findings.

Mama's Cafe on Nacogdoches, which served us a lemon containing E-coli bacteria, said it will no longer allow servers to put the lemon slice on the edge of the glass by hand, and anyone who handles them will use gloves or tongs.

That may have you wondering, what are the health department's rules for handling lemons?

Servers can only use their bare hands to handle or squeeze lemons if they wash their hands and use hand sanitizer each time. Even the restaurants admit, that 2-step process is so time-consuming, nobody does it."

As more and more health officials, restaurant workers and consumers become aware of the potential problems, they will demand / force a change in the way food service workers handle our food. My thought is that we should also look at other citrus fruits that are commonly put into drinks. Has anyone thought to test the cherries or olives that they put into drinks? I think the tide has only just started to roll.

I eat at or have eaten at most of the restaurants listed in the WOAI article. Hopefully the restaurants that had problems will take the results as constructive criticism and do what is right.

Just as at the end of my last post, I think I'll go grab another glass of tea....with lime!

Until later,

Dr. Paul

Wednesday, March 26, 2008

General Health Topic - The Next Big Thing?

Hello Everyone,

I thought I would pass along this funny story. As people are living longer and staying active, it could happen. Thanks to my good friends, Harold and Nancy for sending it to me.

Of course, when you stop to think about it, it could be the next big craze. Remember, you read about it here first!

Jacob, age 92, and Rebecca, age 89, living in Florida, are all excited about their decision to get married. They go for a stroll to discuss the wedding, and on the way they pass a drugstore. Jacob suggests they go in.

Jacob addresses the man behind the counter: "Are you the owner?"

The pharmacist answers, "Yes."

Jacob: "We're about to get married. Do you sell heart medication?"

Pharmacist: "Of course we do."

Jacob: "How about medicine for circulation?"

Pharmacist: "All kinds."

Jacob: "Medicine for rheumatism and scoliosis?"

Pharmacist: "Definitely."

Jacob: "How about Viagra?"

Pharmacist: "Of course."

Jacob: "Medicine for memory problems, arthritis, jaundice?"

Pharmacist: "Yes, a large variety. The works."

Jacob: "What about vitamins, sleeping pills, Geritol, drugs for Parkinson's disease?"

Pharmacist: "Absolutely."

Jacob: "You sell wheelchairs and walkers?"

Pharmacist: "All speeds and sizes."

Jacob: "We'd like to use this store as our Bridal Registry."

Sunday, March 23, 2008

General Health Topic - Restaurant Lemons Loaded with Germs?

Hello Everyone,

The latest potential health situation out there is based on a small study that was done in New Jersey. The study tested lemon wedges in 21 restaurants and found them teeming with bacteria.

I don't know about you, but here in Texas where we really enjoy our iced tea and margaritas, most people don't think twice about squeezing their lemon or lime into the drink and then plopping the wedge into the drink.

Health laws in most locations require lemons to be handled just like any other food item, with gloves or tongs. But its common practice simply place the lemon or lime wedge onto a drinking glass with bare hands.

If an employee's hands aren't clean, however, then touching the lemons is likely to contaminate them with bacteria. Also, were the lemons/limes washed?

In the study, the swabs of lemon wedges revealed everything from high counts of fecal bacteria to a couple of dozen other microorganisms -- many of which can make you sick. They found bacteria on the rind and on the flesh of the lemons.

Should we be concerned?

Some folks just freak out knowing that another person touched their food. And while there is no reason to doubt that bacteria was present on the wedges, the actual threat is yet to be determined. Has anyone actually become ill due to the bacteria on lemon wedges?

For me, the importance is to know that there is potential problem that will require more study. Hopefully, bringing this potentially unsafe practice to light will spur restaurant workers to be more diligent in handling our food.

We can also be more pro-active by requiring the restaurants that we frequent to use proper food handling techniques.

Until then, I am going to have another glass of tea. With lemon, you ask?

Of Course! Ok, maybe I'll just squeeze it in and discard the rest.


Dr. Paul

Monday, March 10, 2008

General Health Topics - Drugs Found in Drinking Water

Hello Everyone,

There has been press lately concerning drugs found in drinking water.

Here is a blurb from AOL - "A vast array of pharmaceuticals — including antibiotics, anti-convulsants, mood stabilizers and sex hormones — have been found in the drinking water supplies of at least 41 million Americans, an Associated Press investigation shows."

How do the drugs get into the water?

"People take pills. Their bodies absorb some of the medication, but the rest of it passes through and is flushed down the toilet. The wastewater is treated before it is discharged into reservoirs, rivers or lakes. Then, some of the water is cleansed again at drinking water treatment plants and piped to consumers. But most treatments do not remove all drug residue."

Taken from

For more information click here:

It is hard not to pass drugs into the water supply in that manner.

However, if you have old medications that you need to dispose of, DO NOT flush the drugs down the toilet. Contact your local pharmacist and ask for the most current disposal recommendations for your area. If you have any questions, please contact me and I will get you the correct current information.


Dr. Paul

Saturday, March 1, 2008

How Do Drugs Work - Antibiotics - Aminoglycosides

Hello Everyone,

It's time to get back to how antibiotics work. Today we are going to talk about a class of antibiotics that many people don't know about or hear about often. The reason is that these drugs are given intravenously (IV). So, unless you or a family member have been sick with with an infection that required an aminoglycoside like gentamicin, tobramycin or amikacin, you will not be familiar with them. Neomycin is also an aminoglycoside and is mainly given for bowel prep before surgery.

Mechanism of Action: Aminoglycosides irreversibly bind to the 30S subunit of the bacterial
ribosome, which results in the bacteria being unable to synthesize certain proteins.

Spectrum of activity: gram-negative bacteria

Toxicity: Aminoglycosides can be toxic to the kidneys and can also cause hearing loss. Therefore when a patient is taking these medications, they are monitored closely for the amount of aminoglycosides in their blood. When these antibiotics are monitored properly they can be safely given.

Aminoglycosides are often given with other antibiotics. When combined, they have a synergistic effect. That means that both antibiotics dosed together are more effective than either antibiotic if given alone.

Stay tuned for the next post. Thanks,

Dr. Paul