Ask an expert: Baton Rouge’s Best Doctors answer some pressing questions

How harmful is working a desk job, sitting for hours and staring at a computer screen?

Skin care is exploding in popularity. But how effective are beauty products at changing our skin?

Are antibacterial gels effective at keeping germs off skin? Do they have the potential to cause bacteria-resistant superbugs?

How effective are vitamins and supplements?

Can you “grow out” of allergies or develop new ones?

Live music is such a big part of our culture in south Louisiana. But how damaging is it to your ears to regularly attend concerts?

How important is it to get lab work done every year?

Exactly how bad for you is that daily cup of coffee?

How harmful is working a desk job, sitting for hours and staring at a computer screen?

“Studies found the average adult spent almost seven hours a day sitting in 2016. That can take a toll on your body. Extended periods of inactivity—two hours or more at a time—can lead to larger waistlines, increased blood pressure, high blood sugar and abnormal cholesterol levels. There are a few things that can help, though:

• Take at least two five-minute breaks each hour, walking and stretching. Smart watches are making it easier to be active. Set alerts to make sure you’re moving enough.

• Resist always communicating via email or text. You could get in some decent steps just by walking to another department or floor.

• Pay attention to ergonomics. Look into your desk height, chair support and the distance of your monitor and keyboard.

• Get an annual physical so you can catch any issues or changes in your numbers early.”

—Dr. Brad Gaspard, family medicine physician at Baton Rouge General

Skin care is exploding in popularity. But how effective are beauty products at changing our skin?

“Most products fall short of their promises—and can cost a substantial amount of money. There are some cosmeceuticals (non-prescription cosmetics with pharmaceutical active ingredients) that do help. Because of the cost, though, it is best to get advice from your dermatologist to figure out which products are best for you.

We frequently combine a cosmeceutical in the morning with a nighttime prescription retinoid (which is not the same as a retinol). Both products offer anti-aging and improvement in skin tone, texture and color.

There’s nothing wrong with starting and establishing a good routine at an early age. As you get older, that routine will change because our skin’s ability to hold onto moisture and collagen gradually decreases. Just remember that heredity plays a big role, and you won’t see changes overnight. And, of course, skin care must always be used in combination with sun protection.”

—Dr. John B. Brantley, dermatologist at Calais Dermatology Associates

Are antibacterial gels effective at keeping germs off skin? Do they have the potential to cause bacteria-resistant superbugs?

“The only antibacterial products that seem to have any success are alcohol-based hand sanitizer gels. Alcohol is a highly effective antiseptic that breaks down proteins and disrupts cell membranes, killing most bacteria, fungi and viruses on the spot.

Since these microbes are destroyed on contact, there is no risk of causing bacteria-resistant superbugs.

This is not true of triclosan, an anti-bacterial agent found in consumer products such as soaps and detergents that has been shown to cause microbial resistance. The FDA issued a rule in 2016 that over-the-counter antiseptic wash products containing antibacterial ingredients such as triclosan can no longer be marketed to consumers.

Ultimately, though, the best way to reduce germs is to wash your hands thoroughly with soap and water. Alcohol-based hand sanitizers don’t work well on dirty hands because they can’t penetrate the grime like soap does. If there is no soap and water available, then hand sanitizers with an alcohol content greater than 60% are the best alternative.”

—Dr. Karen Ann Muratore, family medicine physician at Ochsner Health System

How effective are vitamins and supplements?

“Many Americans, including more than 70% of those over age 65, take them regularly. The dollars spent on these products annually is in the billions. Unfortunately, there is insufficient clinical evidence to suggest they actually provide any benefit.

In fact, research studies have found that multivitamins do not reduce the risk of heart disease, cancer or mental decline. Nutritional experts recommend a healthy diet rich in fruits, vegetables, whole grains and low-fat dairy products rather than vitamins.

In the case of a measurable vitamin deficiency, though, replacement supplements are necessary.

Iron deficiency is the most common, which can cause anemia. Iron supplements are taken orally, or through IV infusion in severe cases. Vitamin B12 is another common deficiency seen in patients who have poor GI absorption or follow a strict vegetarian diet. Vitamin B12 is replaced through high-dose oral supplements or intramuscular injection. Vitamin D deficiency can affect pediatric skeletal development and bone density in the elderly leading to fractures. It is replaced through oral supplements.”

—Dr. Christopher Gaurisco, internal medicine physician at Ochsner Health System

Can you “grow out” of allergies or develop new ones?

“Allergic reactions to food can occur at any age. The most common food allergens are cow’s milk, egg, peanut, wheat, soybean, fish, shellfish and tree nuts.

Most children will outgrow their allergies to milk, egg, soy and wheat by adolescence. Peanut, tree nut and seafood allergies tend to persist through adulthood, but between 10% and 20% of these allergies slowly resolve after prolonged avoidance. Repeat allergy testing by allergists will identify when the allergy has resolved and determine when it may be safe to reintroduce the food into your diet.

Sinus allergy—recurrent episodes of sneezing, itching and runny noses or stuffy noses—may occur throughout the year or seasonally. These reactions are triggered by exposure to allergens such as pollen, dust, cats and dogs.

Symptoms usually appear during middle childhood or adolescence, although all ages can be affected. Up to 20% of allergic children may see sinus symptoms decrease during childhood, but most sinus allergy sufferers will continue with symptoms until middle age or longer. New sensitivities can develop at any age, especially with a change in environment.”

—Dr. L. Ben Gaudin II, board-certified allergist at The Allergy, Asthma & Sinus Center

Live music is such a big part of our culture in south Louisiana. But how damaging is it to your ears to regularly attend concerts?

“It depends on the intensity of the sound and the amount of time you’re exposed to it. Sound is a form of energy and power, and when you get above certain levels, your body won’t be able to defend itself.

Decibels (dB) measure sound intensity. Normal conversation is around 60 dB. An office may be around 70 dB. Once you get above 80 dB, sound can become damaging. There are wide variations in how loud concert halls and events turn up their systems. The average concert might be 110 to 120 dB, and some have sound systems turned up to 130 dB. That’s the equivalent of standing next to a jet engine. There’s no way you can safely listen at that level without losing some hearing, unless you put in ear protectors.

Prolonged or even short-term exposure to loud sounds tears up the ear’s nerve endings. Once the damage is done, hearing can’t ever be completely restored. You may not notice it in the moment, but if your ears are ringing afterward, that is usually a symptom of permanent loss.

A good way to think about it: If you’re standing next to somebody at arm’s length during a concert and can’t speak in a normal conversational tone, the sound is probably greater than
120 dB. The sound is loudest at the source, so move away from the giant speakers. Believe it or not, you’re going to hear better when you’re a little farther away, anyway.

Wearing a good quality earplug can also diminish the sound by 25 or 30 dB, bringing the noise to a much safer level.”

—Dr. Daniel Wehrmann Nuss, Chair of Head and Neck Multidisciplinary Cancer Care Team at Mary Bird Perkins — Our Lady of the Lake Cancer Center , Professor and Chairman of LSU Department of Otolaryngology — Head & Neck Surgery

How important is it to get lab work done every year?

“Lab testing is generally done yearly during a patient’s wellness visit. The frequency and types of labs ordered, though, depend on the patient’s age and risk factors for certain conditions.

Even though guidelines vary, we typically check for diabetes starting at 40 to 45. But, if someone has risk factors for diabetes such as obesity or family history of diabetes, heart disease or hypertension, these conditions are tested at an earlier age. Cholesterol testing varies based on age and risk factors for heart disease and stroke.

A test called PSA (prostate specific antigen) may give an indication for prostate cancer. It is not routinely recommended by all guidelines, but it should be discussed by the doctor and patient. It’s generally done between the ages of 50 to 69, but this may vary based on family history and ethnicity.

In meeting a patient for the first time, I like to discuss their medical history, including family and social history and symptoms prior to lab testing. Once established, the patient usually gets lab work done a couple of days prior to the appointment, so I will have the results to discuss at the appointment.”

—Dr. David Fontenot, internal medicine physician at The Baton Rouge Clinic, AMC.

Exactly how bad for you is that daily cup of coffee?

“For years, we’ve been warned to avoid coffee for fear it could stunt growth or increase the risk of heart disease. However, recent research revealed that coffee drinkers are not actually at any higher risk for heart problems than non-coffee drinkers.

In fact, coffee may even help you live longer. People who drink coffee regularly may be less likely to die prematurely due to some of the chemicals in coffee that reduce inflammation, helping slow down the metabolic processes that drive aging.

But before you go drinking 12 cups of coffee a day, remember moderation is key. Drinking up to three to four 8-ounce cups of coffee per day is considered a safe and reasonable amount.

If coffee isn’t your thing and you need some alternative ways to boost energy, try eating a diet high in fruit and vegetables, getting adequate sleep and exercising regularly. Exercise causes your body to release hormones that can make you feel energized. We usually recommend at least 150 minutes of aerobic exercise a week. And we lead by example, so keep in mind that if you practice a healthy lifestyle, it’s more likely that your children and grandchildren will.”

—Dr. Wayne Gravois, family medicine physician at Baton Rouge General

This article was published as part of our Best Doctors cover story in the June 2019 issue of 225 Magazine.

Click here to see the full list of the 2019 Best Doctors in Baton Rouge.