Breathe easy
Dear Lucy: A recent article in my hometown newspaper stated that 2000 mg. of garlic, taken daily for one week would clear up chronic sinus infections better than standard physician-prescribed antibiotics. The article also said garlic has other health benefits. What is your opinion?—Counting on Cloves

Dear Counter: Richard Hillel, M.D., of MIT Medical's Ear, Nose, and Throat Service tells Lucy that he, too, has heard that garlic can clear sinuses, but he knows of no scientific evidence and has no real medical explanation for why it would work. But, he says, if food with garlic is spicy, causing the nose to run and drain, this could feel like relief for clogged sinuses. As for other health benefits, Hillel's colleague, Lawrence Mambrino, M.D., offers the tongue-in-cheek suggestion that garlic breath might render you less attractive company, thereby keeping people away from you—including individuals with colds and other respiratory infections.

Both Hillel and Mambrino advise people with "clogged sinuses" to consult a physician. Mambrino adds that for many cases of sinusitis, treatments such as humidification, steam inhalation, hydration, decongestants, and nasal steroid sprays work better than antibiotics.

Here's to clear breathing—and no garlic breath!—Lucy

To each his own?
Dear Lucy: I am wondering about the issue of sharing towels. I believe you mentioned this a few years ago. I think you said it could spread cold and flu germs as well as hepatitis C or other biohazardous stuff. Is this correct?

I am concerned because I see basketball players wiping sweat from their faces with towels and/or blowing their noses into towels, and then handing the towel to someone else to use. It's disgusting—but is it unsafe?—Concerned Fan

Dear Fan: Yuck! Gross! (Those are medical terms.) Lucy found this question very distressing! However, not wishing her fastidiousness to get in the way of a proper answer to your question, Lucy shook off her squeamishness and consulted with MIT Medical's intrepid and ever-stalwart infectious disease expert, Howard Heller, M.D.

Dr. Heller assured Lucy that there is no risk of contracting hepatitis C, hepatitis B, or HIV from towels containing sweat or nasal secretions unless a towel also contains at least a trace of blood. On the other hand, respiratory viruses that cause influenza (the flu) or colds could be transmitted on a shared towel. Theoretically, herpes simplex (cold sores), cytomegalovirus, and Epstein-Barr (mononucleosis) could also be transmitted in saliva on towels; but practically speaking, Heller says, it doesn't happen.

Lucy feels better now but begs her ball-playing readers to consider the sensibilities of sports fans before blowing their noses into the communal towel. This is one place where one doesn't really want to share, and we are fortunate enough to live in a place where it is possible to have a separate towel for every nose.—Lucy

Ups and downs
Dear Lucy: Which birth control pill will be better for a hormonal imbalance such as polycystic ovary syndrome (PCOS)—Levlite or Ortho Tri-Cyclen?—Perplexed about The Pill

Dear Perplexed: For this question, Lucy went to the experts on oral contraceptives and hormone imbalances—the people in MIT Medical's OB/Gyn Service. OB/Gyn Chief Lori Wroble, M.D., explains that PCOS is characterized by high androgen activity, meaning that you should take a pill with moderate to high estrogen content, because it will decrease circulating androgens by causing excess androgens to be bound to a protein called sex hormone binding globulin. This effect can be further enhanced with a pill containing a low-androgen-activity form of progesterone. Dr. Wroble mentioned Mircette, Desogen, or Orthocept, Demulen 1/35, or Zovia 1/35.

You mentioned two specific drugs: Levlite and Ortho Tri-Cyclen. Although the MIT Pharmacy does not carry Levlite, it does carry Alesse, which is the same medication. This drug contains less estrogen than Ortho Tri-Cyclen and has slightly higher androgen and progesterone. Levlite/Alesse is a monophasic pill (same dose for three weeks); Ortho Tri-Cyclen is a multiphasic pill (different dose each week).

If this seems confusing, that's because it is! And PCOS is a complex endocrine condition for which you deserve the wise advice and one-to-one counsel of a clinician. Lucy encourages you to make an appointment to discuss this and any other gynecologic question with "the pros." You can reach MIT Medical's OB/Gyn Service at 617/ 253-1315. Tell them Lucy sent you.—Lucy