Study: Wash reusable grocery bags to avoid bacteria

 

By Kaye Spector

Plain Dealer Health and Medical Writer

 

Those reusable fabric shopping bags may be kind to the environment, but they may not be good for your family's health – if you don't wash them.

A new study, in which researchers randomly tested 84 reusable grocery bags carried by shoppers in Tucson, Los Angeles and San Francisco, found that more than half of the bags were contaminated with food-borne bacteria.

Twelve percent was E. coli, a bacterium that can cause food poisoning. While abdominal cramps and diarrhea are most common, serious – sometimes life-threatening – complications can develop, especially among young people and older adults.

Ninety-seven percent of the shoppers in the study said they do not wash their bags, nearly all of which were made of woven polypropylene.

“If you're going to use these bags, you need to take care of them,” the study's co-author, Charles Gerba, said Thursday. “The last thing you want to do is grow salmonella in your sack.”

The main concern, said Gerba, a microbiologist and professor at the University of Arizona, is cross contamination: a package of meat leaks juice in a bag. The bag is unpacked, then placed back in the hot car trunk until next week's shopping trip, when the bag is filled with vegetables.

By then a horde of bacteria may line the inside of the bag and transfer to the vegetables or your hands and spread elsewhere.

“It's a gamble,” Gerba said.

While unwashed bags might not result in headline-grabbing outbreaks, Gerba said, “Our data says it may be a common risk that might be overlooked.”

Despite the study’s findings, the Cuyahoga County Health Department has not traced any food-borne illness to reusable bags, said environmental health services director John McLeod.

But as more and more shoppers are adopting reusable bags — either for environmental concerns or to stem the tide of household plastic bags — washing the totes is a good habit to adopt, said Matt Carroll, Cleveland Public Health Department director.

“If you can keep E. coli out of your house by washing the bags, then obviously you should wash the bags,” Carroll said.

A thorough washing will kill nearly all bacteria that can accumulate in the bags, said Gerba.

“There’s a lot of different factors that go into bacteria growth: moisture, heat and having the bacteria itself,” McLeod said. “We want to make sure we break that cycle.”

Jeff Heinen, of Heinen’s Fine Foods, says that although they remain a minority, more and more of his customers are taking home groceries in reusable bags.

The local chain has been selling the bags for 10 years. At first they were made of cloth; now they are made of the woven polypropylene. The bags can be hand- or machine-washed in cold or warm water on gentle cycle and hung to drip dry. Do not put the bags in the dryer.

“It’s no different than your refrigerator,” Heinen says. “You want to clean it occasionally.”

Author Gail Sheehy offers advice on the role we rarely see coming

By Kaye Spector

Plain Dealer Health and Medical Writer

 

More than 65 million people – nearly 29 percent of the U.S. population – care for a chronically ill, disabled or aged family member or friend, says the National Family Caregivers Association. In Ohio, there are 1.14 million caregivers.

Typically, this person is a married, employed, 49-year-old woman who spends an average of 20 hours a week caring for her widowed, 69-year-old mother, who does not live with her.

Author Gail Sheehy, whose best-selling “Passages” books have chronicled the life stages of the baby boomer generation, has now turned her literary attention to the role of caregivers.

Her latest title, “Passages to Caregiving: Turning Chaos into Confidence,” describes eight crucial stages, or passages, of giving care to a loved one with a life-threatening illness.

In the book, Sheehy draws on her experiences as a caregiver for her husband, magazine editor Clay Felker, who died in 2008 after battling cancer for years.

We interviewed Sheehy by phone, shortly before her May appearance in Cleveland, sponsored by Hospice of the Western Reserve, to promote her book.

Q: Why did you write this book?

A: I've written five books about passages in life. And I often talk about the wonderful second adulthood that we enter after 50. What I didn't see coming was The Call [from a doctor reporting the diagnosis of a serious illness].

It usually plunges the family member into denial, fear, confusion as you confront doctors who have many different recommendations, many different diagnoses, certainly different treatment approaches.

You don't know the medical lingo, you don't know the insurance situation of your loved one, and you're already trying to balance probably your own work.

This becomes a second job for most of us for which we are not prepared, not trained and not expecting.

Q: How can we prepare for it?

A: My best advice is if you have a sibling, talk to them, have the conversation before the crisis. Send out an e-mail and or a nice card and say, you know, “Mom or Dad is getting older and at some point they are going to need some of our help. How about we all e-mail, 'This is what I'm good at.' ”

The point is to get the conversation started. Because although we'd like to think our siblings are going to be our greatest support, our studies show they are likely to be the greatest stress. If you're the person living closest to the parent who's going to need help and you take on the whole role of primary caregiver, you can be pretty sure your sibling who lives farthest away is going to call you and say, “You don't know what you're doing.” Because they're not on the spot and they probably feel guilty.

Q: Your book talks about creating a circle of care.

A: Nobody can do this alone. The first step is to call your local area agency on aging. There's one in every state and most cities and many counties. They often have a care manager who can begin to assess the situation and tell you what the community resources are.

The second thing is when you are talking to multiple doctors and you're so confused by all their different approaches, try to pick the one you most trust and ask him three questions because you want to see if he will be your medical quarterback:

Will you help me sort through the treatment options?

Will you help me assemble a care team?

And will you address pain and other side effects of treatment?

And if the doctor says yes, you've got your medical quarterback who will help you call the plays. It will make the ride so much smoother.

If you can't find a doctor who's willing to be a partner with you and collaborate with you, you may want to find a geriatric-care manager. That's a fairly new player in the health care arena.

These are nurses or social workers trained in geriatrics who can come to your home or your loved one's home, do an assessment, walk you through the medical lingo and the territory you're in and help you choose a doctor or a hospital. Then, more important, afterward, when your loved one is home from the hospital or goes to rehab, helps you to understand that whole territory, which is so complex and has its own set of rules.

Hiring a geriatric-care manager is not covered by Medicare. It may possibly be covered by your company. But if you have to pay for it, it may be from $85 an hour to even $250 an hour, which is huge, and most people resist paying for a geriatric-care manager. But I'll tell you, a two- or three-hour consult with a geriatric-care manager may tell you more than you need to know about the next year or two of your life than any three hours that you spend with anybody else.

Unless it's an elder attorney. That's the other key person who can help you to understand what your insurance does and doesn't offer, whether your loved one qualifies for Medicaid and what you can get covered under Medicare. That's the professional team.

Then you go to work on assembling the support team. This is something caregivers have to understand: You have to ask for help. You have to realize that you deserve to ask for help. Because you need to keep on working on your own life.

So I say, let your friends know. Also people you work with, people at your church or temple, and maybe even at the local community college if they have a health services major, they may be able to provide volunteers to look in on a parent or a spouse when you can't be there.

Q: Is there a place where caregivers should draw the line?

A: Oh, definitely. One of the biggest dangers is a phase I call Playing God. If you've become really devoted, you've learned the lay of the land, you know the lingo, you've become really good at it. You begin to think that it's you who's responsible for keeping your loved one safe or alive day to day.

That's OK as long as things are going well, and you're winning. It's very satisfying to the ego. But when things go wrong, which is inevitable, some treatment will backfire or the old illness will roar back. Then if you're God, it's your fault, and if you think it's your fault, a crash of guilt will come down on you.

So you have to at some point accept that there is a God, if you believe in one, but you aren't it. No one can control the aging process or the trajectory of illness. And you need to be able to take care of yourself. At the very least you have to get out for at least an hour every day and do something pleasurable just for yourself. And nothing to do with caregiving – no fair calling in for a prescription.

You have to break the cycle of hypervigilance, because that stress hormone cycle, if it's not interrupted, will eventually become completely depleted. And if you fall into caregiver burnout, that's a disease. That's really difficult to come back from. So you need to take precaution before that happens. There's nothing to feel guilty about, because if you get sick there's nobody to take care of your loved one or yourself.

Q: How is caregiving different now, and what are the implications?

A: In our parents' time, not so many women were working. It was just assumed, it was part of socialization, that women would just be available for whoever in the family got sick first or complained the loudest.

We have not acknowledged that there is this enormous free labor pool out there called mostly women middle-aged family caregivers who wrestle with, “How do I do right by Mom or Dad or my spouse who suddenly has a life-threatening illness without sacrificing the resources I will need to keep myself solvent and socially stimulated and healthy into my old age?”

You are expected to take over when somebody comes home from the hospital for a crew of about 24 people who have specialized jobs over the course of 24 hours in a hospital. Suddenly it's all on you.

It's an enormous shock and undertaking. So you have to find ways to enlist the doctor or the charge nurse to help you – before you leave the hospital – learn as much as you can and afterward to get more help at home.

It becomes a negotiation. And what I find is that you actually have to go to the doctor all the time because they know the magic words to use to get things done.

Q: Are boomers demanding a different model?

A: It hasn't been made a major national issue, and I hope this book will start that conversation.

Q: Your book says there are positive aspects to being a caregiver to someone with a life-threatening disease.

A: This is a chance to become more intimate with a parent, even if you've been distant or estranged. You discover each other all over again as different people. You have to make that delicate transition to being more of the nurturer and authority for your parent instead of expecting them to do that for you.

In the case of my husband, we found that facing a life-threatening illness prodded us to make a dramatic change in our lives.

When he got lymphoma, the doctor said, “Because your lymphoma is very mild and inactive, I'm not even going to give you any drug, because they wouldn't necessarily improve your life span. Why don't you two go out and do something wonderful that you wouldn't have dared before and do it together?”

We worked on how to do that for the next year until my husband was able to get to what he really loved about his work without any particular title or setting – which was identifying and shaping young talent.

At the same time, his colleagues, whom he had worked for and whose careers he helped to foster, were searching the different colleges and universities to see who would be interested in having him start a magazine program of actually making magazines and not just sitting in some dusty [department] chair, and University of California at Berkeley jumped at the chance. And we tore up our lives in New York and moved to California to start that new life.

That lymphoma never came back.

A lot about illness isn't just about medicine.

Q: So being a caregiver can be a profound experience.

A: Actually, the caregiver passage is going to be one of the most memorable ones in your life. It will shape how you think about yourself: Am I a good person? Did I do all I that I could? Did I shift some of that responsibility to my sibling or somebody else?

Did I let go at the right time? That's probably the most delicate decision of all.

But that's one that can only be made if you're on the spot with your loved one and talking about where they are, where they're going and what their goals are. To keep following their lead.

If you do that and are able to guide them to a place that none of us know in a gentle and loving way, you're going to walk away guilt-free and feeling spiritually nourished.

Opera singer, a double lung transplant recipient, takes the stage at Cleveland Clinic conference

By Kaye Spector

Plain Dealer Health and Medical Writer

Charity Sunshine Tillemann-Dick went to her first opera, “Hansel and Gretel,” at age 4. She knew then what she wanted to do and what she wanted to be.

She now sings soaring soprano coloratura, delivering difficult passages of high, rapid notes. She mastered the technique after years of rigorous training.

She hasn't let go of her dream, even though she battled pulmonary arterial hypertension for years before undergoing open-heart surgery and a double lung transplant.

Wednesday she takes the stage at the Cleveland Clinic's Patient Experience Summit. She will dedicate her rendition of Gershwin's “Someone to Watch Over Me” to the doctors, nurses and hospital staff who saw her through it all.

The Denver resident began “building a relationship” with the Cleveland Clinic doctors shortly after she was diagnosed in 2004 at age 21.

Tillemann-Dick and her doctors in Colorado and at Johns Hopkins Hospital in Baltimore, Md., tried to treat her condition. But the possibility of a transplant always loomed. She knew she would likely have it done at the Clinic.

“My doctors told me it was the best place to go,” she said.

With pulmonary arterial hypertension, the blood vessels that supply the lungs constrict and the walls thicken, so the blood vessels can’t carry as much blood. The heart has to work harder to force the blood through and pressure builds up. There’s less blood circulating through the lungs picking up oxygen. Patients become tired, dizzy and short of breath.

Pulmonary hypertension was a “daunting prospect” for the coloratura soprano.

“The most important thing is air flow,” she said. “It’s tremendously demanding work.”

Tillemann-Dick didn’t tell many people about her condition so she could keep on singing. She wore a pump the size of a cassette tape strapped to her leg or torso.

“When I sang, it was the only time I did not feel challenged by my physical disability. I had this freakish lung capacity,” she said. “But the truth was I was very sick.”

By 2009, she was having difficulty singing. She had canceled 100 engagements in the course of a year and decided she could not continue.

“I realized I couldn’t maintain my good name as an artist,” she said.

She had the transplant at the Clinic in September and returned home at Christmastime, determined to sing again.

She took tentative steps toward music by humming. After a few weeks, she tried to sing some gentle songs: jazz, folk music. More time passed. She moved on to more demanding music: theater standards. A few weeks later, she was singing her opera repertoire. In March, she began taking lessons again with her regular voice teacher.

“Coming back to Cleveland to sing is really a dream come true, considering I’m not even a year out,” she said in a phone interview during a taxicab ride to the Intercontinental Hotel on Monday morning.

“It’s a miracle and I’m so glad to share that.”