How contagious is hepatitis B?
Dear Lucy: My friend's husband is a hepatitis B carrier. Can I get it by sharing food with him? Can he transmit the disease any time, or only when he is sick? I am scared, and the more I read about hepatitis B, the more confused I get. One article says it is not safe to share a washcloth, but it says sharing silverware and cups is okay. But what if I have a cut in my mouth, and some of his saliva comes in contact with the cut? -Afraid
Dear Afraid: Lucy is no expert on infectious diseases, but she knows that nothing is scarier than the unknown. Having more information often helps us become less afraid, so you are smart to try to seek out the facts.
To help both of us learn more about hepatitis B, Lucy turned to MIT Medical internist and infectious disease expert Howard Heller, M.D. According to Dr. Heller, about 10 percent of individuals who contract the hepatitis B virus (HBV) remain infected for life and become carriers. But Heller stressed that carriers can transmit HBV only through direct blood contact or sexual intercourse. "In theory," Heller says, "if an infected person has blood in his or her saliva or gets blood on a washcloth, and this blood comes in contract with your mucus membranes or gets into a cut, you could contract hepatitis B. But practically speaking, this is very unlikely." Heller emphasized that it is extremely rare for people who live with HBV carriers to become infected, unless if there is sexual or obvious blood contact, so for the friend of a carrier, the risk is even lower.
For more information about hepatitis B, Heller suggests checking out http://www.cdc.gov/ncidod/diseases/hepatitis/b/index.htm. Lucy hopes this information has allayed some of your fears, but if you are still worried, you may want to talk to your doctor about getting the hepatitis B vaccine.. —Lucy
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On the Blink
Dear Lucy: What causes eye tics? I have heard that it could be the result of a magnesium deficiency or too much calcium.—Ticked Off
Dear Tick: According to MIT Eye Service Chief, Robert Gross, O.D., a simple eyelid twitch does not normally indicate any underlying disease or nutritional imbalance and may occur in healthy people of any age. The condition involves fine twitching of the upper and/or lower eyelid(s) of one eye—more specifically, the orbicularis muscle, which is responsible for closing the eye. Episodes are generally brief, lasting seconds to minutes, and come and go for several days or longer.
Though usually benign, an eyelid twitch may be sending an important message nonetheless—and not only to that woman across the room who thinks you just winked at her. Gross notes that this condition is often associated with fatigue, anxiety, nicotine use, or excessive caffeine intake. So, if you often experience eyelid twitching, you might try cutting back on your consumption of coffee, tea, or caffeinated soft drinks. You should also take sufficient "eye-rest breaks" from the intensity of close work. For example, while working on the computer, pause every 15 minutes to spend 20 seconds looking around the room. Learning relaxation techniques to cope with stress may also be helpful.
Hope these suggestions help to keep the twitching at bay, but if it continues to be a problem despite such measures, you should have an eye exam. —Lucy
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Out of step
Dear Lucy: For the last four weeks I have been experiencing a sharp, knife-cutting pain in my left arch. It occurs about two times a day.
I am 55 years old and have been doing low-impact step aerobics three times a week for the last 13 years. I changed from Nike to New Balance tennis shoes three months ago. Also, two months ago, I started doing a low/high-impact aerobic class once a week.
The pain is paralyzing and lasts for about ten seconds each time. What should I do? —Body and Sole
Dear Stepper: First of all, Lucy commends your perseverance and diligence. It's not easy to keep up with a consistent exercise program for 13 years, and you must find this foot pain discouraging.
For an answer to your question, Lucy turned to podiatrist Harry Papazian, D.P.M., of Massachusetts General Hospital, who sees MIT Medical patients by referral. Papazian immediately zeroed in on your comment about the tennis shoes and suggests that you begin trying to address your foot-pain problem with the purchase of a well-fitting shoe specifically designed for aerobics. Tennis shoes and aerobic footwear both protect the foot during quick side-to-side movements, but shoes designed for aerobic conditioning also have extra shock absorption in the sole. This is important, because impact forces from aerobics — especially the high-impact aerobics you've recently started — can reach up to six times the force of gravity.
Papazian also notes that you should probably avoid aerobics for a few weeks to give your feet a chance to recover. If your pain does not resolve with the new shoes and a period of rest, you should seek professional attention. Good luck, and keep exercising! —Lucy
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