Self-Care Library

Avoiding Traveler's Diarrhea

How Can I Avoid Traveler's Diarrhea?

• Do not drink tap water and do not use it to brush your teeth.
• Do not drink bottled water if the seal on the bottle has been broken.
• Do not use ice that has been made from tap water.
• Do not drink milk or eat dairy products that have not been "pasteurized" (heated to a temperature where all germs are killed).
• Do not eat raw fruits or vegetables unless they can be peeled and you are the one who peels them. (e.g. avoid salsa or guacamole.)
• Do not eat lettuce and other leafy raw vegetables (like spinach), and do not eat cut–up fruit salad.
• Do not eat raw or rare (slightly cooked) meat or fish.
• Do not eat food from people who sell food on the street.

What is Safe to Drink or Eat?

• You can drink soft drinks that are "carbonated" (drinks with a gas called carbon dioxide in them).
• You can have hot drinks such as hot tea or coffee.
• You can drink carbonated or noncarbonated bottled water as long as you are the one who breaks the seal.
• You can eat raw fruits or vegetables that can be peeled, as long as you are the one who peels them.
• You can eat food that is served hot.
• You can eat meat that is well cooked.

Cold/Flu Home Care Guidelines

• Any combination of runny nose, sore throat, and cough is likely caused by a virus.
• Colds and flu cannot be cured by antibiotics.
• In addition, you may experience congested ears, headache, dizziness, swollen glands, and fever.
• There are no medications that will shorten the course of the disease.
• You will get better because the body's immune system will identify the virus and get rid of it.

There are things you can do to feel better while you are sick:

• Get enough rest. If you feel well enough to be up and about, that's all right. You are most contagious for one to four days before you develop symptoms–not while you are ill.
• Drink plenty of fluids. Your body needs extra fluids when you have a fever. Extra fluids help keep the mucus more liquid, which can help prevent bacterial complications such as ear infections or bronchitis. Salty liquids, like chicken soup or bouillon, can help with dizziness. If you have a headache or cough, or are congested, a vaporizer can help you feel better and breathe easier. A steamy shower works well, too. A warm washcloth placed on your forehead and upper cheeks can help relieve sinus congestion.
• Comfort. You may get pain relief from headaches, body aches or sore throat by taking acetaminophen (Tylenol) or ibuprofen. Acetaminophen, when taken as directed, is very safe and virtually without side effects. Ibuprofen may be a more effective pain medicine for some people, though it may cause stomach upset so take with food. Remember that medicines like Tylenol or ibuprofen are not active against viruses and will not help you get over a cold faster, but they may make you feel better while you are sick.
• If your symptoms last two weeks or are progressively getting worse, make an appointment to come to the clinic. Occasionally adults may develop a sinus infection in the presence of a cold, just as an ear infection (much more frequently) follows a cold in children. Sinus infections are caused by bacteria and are treatable with antibiotics.

For a runny nose and head congestion:

• Guaifenesin (Robitussin)–loosens mucus and helps it drain
• Pseudoephedrine (Sudafed)–dries up mucus, can cause excitability so avoid using at night
• Diphenhydramine (Benadryl)–dries up mucus, makes people sleepy

For a cough:

Guaifenesin (Robitussin DM)–If you can't sleep because of your cough, a prescription cough syrup may be helpful.

Always check the contraindications on label of over–the–counter medications before taking. Contact the clinic if you are being treated for a medical condition or if you are taking other medications.

Constipation

Measures to Take for Constipation

• Increase the fiber in your diet by eating whole grains, fresh fruits and vegetables, bran, or if these foods are not available, by using a fiber supplement such as Metamucil, Effersylium, Fibercon, or a similar supplement.
• Equally important is to increase your consumption of non–dairy, non–caffeine fluids such as juice or water.
• Decrease your consumption of constipating foods such as dairy products, white rice, white flour, white bread or bananas.
• Develop a regular bowel habit. Many people who are busy will ignore the urge to have a bowel movement. The urge will eventually stop because the colon will relax. This can lead to a large diameter, painful bowel movements. It is possible to "program" the colon by sitting on the toilet 10 to 15 minutes at the same time daily. Do not strain to have a bowel movement at this time. If you do not have a bowel movement after 15 minutes go about activity as usual, except with the first sensation of needing to have a bowel movement, do so. Within one to two weeks the body will adapt to a more regular schedule.

Caring for Acute Sinusitis

What causes a sinus infection?

Anything that blocks your sinus opening can cause sinusitis. A build–up of mucus makes a good place for germs to grow.

Common causes of Sinus Infection include:

• Colds or upper respiratory infections
• Hay fever or allergies
• Cigarette smoke
• Air travel or underwater swimming

Some sinus infections get better on their own. Some many need to be treated with an antibiotic.

Here are things you can do help a sinus infection:

1. Get plenty of rest. when you go to sleep, try lying on the side that is least congested (where you breath best), because lying down increases nasal congestion.
2. Sip hot liquids and drink plenty of fluids.
3. Apply moist heat by holding a hot, wet towel against your face or breathe in steam. (if you're inhaling steam, be sure to cover your entire face with a cloth or towel first, so you don't burn yourself).
4. Use over–the–computer medicines such as acetaminophen (Tylenol) for pain. Don't use aspirin if you're allergic to it or under age 20.
5. Talk with your doctor before using cold remedies. Some cold medicines can make a sinus infection worse by drying out mucous membranes and blocking sinus openings. Other medicines, disturb your sleep, make you nervous or raise your blood pressure or pulse.
6. If you use a nose spray with a decongestant in it, don't use it for more than three days. If you use more than three days, your nasal swelling may get worse when you stop the medicine. Use a short–acting nasal decongestant (brand names: Neo–Synephrine, Afrin 4 Hour), since long–acting kinds (brand names: Dristan 12 hour, Afrin 12–hour) may slow healing.

How to Care for Dry Skin

Dry winter air and lots of soap combine to cause itchy, irritated skin that is prone to develop rashes.

These simple measures can protect skin from over drying, and decrease itching and irritation:

• Bath once daily at the most, every other day if you are comfortable with the idea.
• Use minimal soap only where essential. "Pits and Private" is the hospital slang for this approach. Definitely avoid the total body lathering of TV ads!
• Use a greasy moisturizer such as Vaseline, Aquaphor, Nivea creme, or Eucerin creme. Put the moisturizer on after bathing and at bedtime.
• Avoid all lotions that contain alcohol; these products will dry your skin.
• Best moisturizers to least moisturizers in order are; ointments, creams, lotions, gels, and solutions.

Bacterial Vaginosis

Bacterial Vaginosis (BV) is the name of a condition in women where the normal balance of bacteria in the vagina is disrupted and replaced by an overgrowth of certain bacteria. It is the most common vaginal infection in women of childbearing age.

Not much is known about how women get BV. While it is more common in women who are sexually active, it also occurs in women who are not sexually active. However, some activities or behaviors can upset the normal balance of bacteria in the vagina and put women at increased risk including:

• Having a new sex partner or multiple sex partners,
• Douching, and
• Using an intrauterine device (IUD) for contraception.

Women with BV may have an abnormal vaginal discharge with an unpleasant odor. Some women report a strong fish–like odor, especially after intercourse. Discharge, if present, is usually white or gray; it can be thin. Women with BV may also have burning during urination or itching around the outside of the vagina, or both. Some women with BV report no signs or symptoms at all.

In order to diagnose BV, a health care provider must examine the vagina for signs of BV and perform laboratory tests on a sample of vaginal fluid to look for bacteria associated with BV.

BV is treatable with antibiotics prescribed by a health care provider. It can be treated in one of several ways. Your health care provider may prescribe pills for you to take by mouth, or a cream or gel to put in your vagina. It's important to use your medicine exactly as it was prescribed. If you are prescribed metronidazole (brand name: Flagyl), don't drink any alcohol while taking the medicine or for 24 hours afterward. Combining alcohol with these medicines can cause nausea and vomiting. Even the small amount of alcohol in many cough syrups can cause nausea and vomiting if you're taking metronidazole. Also, be sure to tell your health care provider about any other medicines you are currently taking. BV can recur after treatment.

Head Injury

Observation Following a Head Injury

Monitor the patient for the following:

• Sudden change in alertness (i.e. decreasing consciousness, more sleepy).
• Sudden or increasing confusion (i.e. cannot remember phone number, address, name, etc).
• Headache that worsens despite medications.
• Increasing nausea or persistent vomiting. 
• Pupils are not equal in size or shape. 

Contact: Health Services (389–6276) or Immanuel–St. Joseph's Emergeny Room (345–2610) if any of the above symptoms have developed.

Treatment

• Have someone stay with the patient at all times to help monitor for the above symptoms.
• Start with clear fluids like water or Gatorade and advance diet as tolerated.
• Avoid aspirin!  Tylenol (acetaminophen) may be used for headaches.  Ibuprofen is not advised initially for headaches in this situation.
• Avoid codeine (or other narcotics) and alcohol (or other mood altering drugs) which make an evaluation difficult or may even mask the above symptoms of an increasing head injury.

Impetigo

Impetigo is a bacterial infection of the skin that appears most frequently in warm humid environments.  Most commonly occurs on the face but can occur anywhere.  Symptoms of an infection include:

• Itching, mild pain.
• Single or grouped red, itchy, scaly areas on the skin.  Some occur as blisters or with yellow crusting.

Impetigo is very contagious and is spread by touch from one person to another. A person with impetigo can also spread the infection from one spot on the body to another by touching themselves. Personal hygiene does not affect a person's likelihood of developing impetigo, nor should impetigo be viewed as an indication of poor hygiene.

Treatment for impetigo is fairly simple: Impetigo lesions should be washed with a mild soap in the morning and evening. Gentle washing will usually be enough to remove the crusts; vigorous washing can delay healing and spread the infection. Antibiotic ointment is applied lightly over the lesions. Occasionally, oral antibiotics are prescribed.

Iron

Iron is an essential nutrient with many important biological functions.  One of its main jobs is to carry oxygen in the hemoglobin of red blood cells.  All of your body's cells use oxygen to produce energy.  If your iron stores are low you may feel tired & weak and you may experience more infections.  Iron deficiency is usually the result of too little iron in the diet, poor absorption of iron from the foods you eat and/or recent blood loss such as from heavy menstrual periods. Those at highest risk for iron deficiency include infants and children, menstruating and pregnant women, and vegetarians.

There are two forms of iron in food:

1. Heme Iron
   • Found in foods like meat, poultry and fish.
   • This form is the easiest for the body to absorb
2. Non–Heme Iron
   • Found in plant foods (legumes, vegetables, grains, fruit), eggs, milk, fortified breakfast cereals and enriched breads, pasta and rice.
   • This form has a low absorption rate in the body, meaning it's less available for the body to use
   • Consuming foods rich in Vitamin C (citrus fruits, broccoli, green pepper) along with non-heme iron containing foods will boost the absorption from these foods.  For example, drink a glass of orange juice with your peanut butter and jelly sandwich
   • Including a little meat, poultry or fish will enhance iron absorption from plant foods.  For instance, add a small amount of ground turkey or lean beef to your bean and veggie chili

Iron Recommendations - Dietary Reference Intake (DRI)

• Menstruating women:  18 mg daily
• Men:  10 mg daily

Your health care provider may recommend an iron-containing dietary supplement if you cannot consume enough dietary iron and your iron stores are low.

Mantoux Test

A mantoux is a test that determines if you have been exposed to and formed antibodies to tuberculosis (TB).

A nurse will administer the mantoux test by giving you a small injection just under the skin of your arm.

To be valid the test must be evaluated by a nurse between 48 and 72 hours (2–3 days) after the injection by looking at the injection site on your arm.

Depending on the appearance of the test site it will be considered "negative" or "positive". A negative test is normal and requires no further evaluation.  A positive test does not necessarily mean that you are ill.  A positive test means you have been exposed to the tuberculosis bacteria at some time and have formed antibodies.  Further evaluation is recommended.  The nurse or doctor will go over the recommendations with you if you have a positive test.

Methods of Improving Sleep Habits

1. Try to establish a regular rising time in the morning. A regular sleeping pattern strengthens the sleep/wake cycle and promoted a regular sleep–onset time.
2. Avoid coffee, cola, tea and chocolate after 2:00p.m.
3. Avoid heavy evening meals. A light snack or a warm drink (non–caffeinated) before bedtime may promote sleep.
4. Wind down for a period before sleep time. Quite activities, such as reading, relaxing in a hot bath or meditating, help promote sleep.
5. Avoid using the bedroom for watching television, doing paper work, eating or other activities.
6. If sleep does not occur after 30 minutes in bed, get up and engage in a quiet activity until sleepy again. A brief, slow walk may be helpful.
7. Avoid taking naps during the day, especially in the evening.
8. Reducing the noise level is also helpful in creating an environment conductive to sleep.
9. Exercise should be avoided just before retiring because it delays sleep.  Daily exercise during the day may help reduce stress and promote sleep.
10. Restrict fluids in the evening and before retiring, to help reduce the frequency of awakening to go to the bathroom.

Pityriasis Rosea

Pityriasis Rosea is a self–limited, mild, scaly skin eruption that occurs most often in adolescents and young adults and lasts from three to six weeks. The cause of Pityriasis Rosea is unknown but may possibly be a reaction to a viral infection. Common symptoms of Pityriasis Rosea include:

• Itching, usually mild but sometimes intense.
• Small red, dry, scaly areas on the abdomen, chest, back, arms, and legs.
• Rash that follows a mild upper respiratory infection.

Pityriasis Rosea may with the herald patch, a one to three inch pink, scaly patch that may go unnoticed. Several days later the herald patch is followed by a pink rash found commonly on the trunk of the body and occassionally on the arms and legs.

There is usually no treatment necessary; Pityriasis Rosea is self–limited and will go away. If itching is a concern, calamine lotion or oral antihistamines may help alleviate symptoms.

If the symptoms have not cleared up within six weeks, make an appointment to see your health care provider.

Preventing Folliculitis

Folliculitis is an inflammation of the hair follicle that usually occurs when hair is clipped below the skin level. Folliculitis is commonly found as small developing pustules after shaving. Sometimes the skin bacteria, Staphylococcus aureus can enter the hair follicle, setting the stage for infection. The following tips may help to prevent this:

• Instead of shaving, consider clipping the hair with blunt point scissors to a length of 1/8 inch (3 mm).
• If shaving, always use a single–edge razor blade. This cuts the hair at the skin line and helps prevent folliculitis. Most double–edged razors are designed to gently lift the hair and cut it off below the skin line.
• Use a shaving cream or gel. This provides a thin layer of lubricant over the skin and helps to prevent abrasion or "razor burn."
• Always shave in the direction of hair growth. Shaving against the direction of growth pulls the hair up from the skin and cuts it off below the skin level.
• To prevent hair buildup around the blade, rinse he razor frequently with cool water. Hot water can heat the blade and cause a burn when placed against the skin.
• Avoid waxing because this causes unnecessary trauma to the hair follicles and tissues.
• Avoid sharing razors with others and multiple use of razors.

Preventing Urinary Tract Infections

A urinary tract infection can be very uncomfortable with its symptoms of frequent urination or burning with urination. There are some measures you can take to help prevent urinary tract infections:

• Drink at least six to eight glasses of water daily.
• Avoid long intervals between urination. Try to empty your bladder every three hours while you are awake, whether or not you feel an urge to.
• After intercourse, empty your bladder and drink a large glass of water.
• Seek prompt attention for excessive vaginal discharge or other signs of vaginal infection.
• Refrain from using any feminine hygiene spray, towelette or deoderized tampons or pads.
• Refrain from the use of bubble bath or other perfumed bath additives.
• After bowel movements, clean the area around the anus gently, wiping from front to back and never repeating with the same tissues. Soft, white, nonscented toilet paper is best.
• After urinating, dry the urethral opening and labia by gently blotting with soft, white, nonscented tissues or cotton balls. Do not rub.
• Avoid wearing pantyhose or tight slacks for prolonged periods of time. Try to wear 100% cotton underwear.
• Avoid wearing a wet bathing suit for prolonged periods of time.
• Symptoms of a bladder irritation may be aggravated by coffee, tea, alcohol, spices, citrus juices and carbonated beverages.

Pubic Lice (Pediculosis Pubis)

Pubic lice, also called crabs, are tiny parasites that breed in the genital area. Lice are usually transmitted by close personal contact such as sexual activity and less commonly through the sharing of clothing or bedding. Symptoms can appear immediately or may not be noticed for months.

Signs of pubic lice include:

• Intense itching in the affected area
• Blood specks on the underwear
• Actually seeing nits (eggs) or lice themselves

Pubic lice are usually treated with a medicated shampoo or lotion with 1% permethrin (Nix, Elimite, or Kwell) or pyrethrin (RID). Treatment for pubic lice is as follows

1. Apply the medicated shampoo liberally to the hair and skin of the pubic area.
2. Work thoroughly into the hair and allow to remain on for ten minutes.
3. Add small quantities of water until a lather is formed.
4. Rinse thoroughly, then towel briskly.
5. When hair is dry, any remaining nits (eggs) should be removed with a fine–toothed comb or tweezers.
6. Re–treatment is not necessary unless live lice are seen seven days after initial treatment.

Sexual contacts and others who may have been exposed should be examined and treated if necessary. Pubic lice will also get on bedding and clothing so it is important that any bedding or clothing worn in the past 3 days be laundered (washing on hot cycle and dried on hot cycle for at least 20 min or dry–cleaned) at the same time you are being treated to avoid reinfestation. Normal vacuuming and cleaning should eliminate the problem from furniture and carpet.  For more information please see the attached link to the CDC website.

Strengthening Your Body's Resistance to HPV (Genital Warts)

• Stop smoking. Quitting smoking is important not only for general good health, but probably also effective for fighting symptoms of HPV infection, such as warts or lesions.
• Cut back on drinking. According to one recent study, even 2–4 drinks per week is associated with an almost double risk of genital warts.
• Avoid "recreational" drugs such as marijuana and cocaine.
• Eat a balanced diet with lots of fresh fruits and vegetables, so that your immune system has all the raw materials it needs to carry out its work.
• Limit your sexual exposure. It's nearly impossible to know if your partner is free of infection, particularly HPV infection. Use a condom. Several studies have demonstrated that latex condoms are successful in keeping out the papillomavirus. Of course a condom does not cover all possible areas that might transmit or be vulnerable to infection, but it improves your odds of resisting infection considerably.
• Reconsider the way you handle stress. If you think it may be taking a toll on your health, experiment with biofeedback, relaxation techniques, regular exercise, or whatever else helps to mitigate the effects of stress on your life.
• Gardasil Vaccine:  Vaccine for girls/women age 9-26 that helps protect against the Human Papilloma Virus (HPV).  HPV causes genital warts and is the most common cause of cervical cancer.  Immunity requires 3 doses over 6 months.  For more information please visit www.GARDASIL.com or download a document containing information on [PDF] Gardasil (8 KiB).

 

Scabies

Scabies is a contagious infection caused by a mite and is spread by close contact with an infected person, bedding, towels, or clothing. The female mite burrows under the skin and lays eggs. Two to four months later the eggs hatch and intense itching occurs, especially at night. Common body areas that are affected are: between the fingers, wrists, elbows, waist line, genitals, ankles, feet, palms and nipples.

Treatment for scabies is as follows:

1. Take a warm soap and water bath or shower.
2. A medicated lotion, which has been prescribed for you, is then applied to the entire body from the neck down, not just to the obviously affected areas.
3. Eight to twelve hours later take another warm soap and water bath to remove the medication.

It is important that bedding, towels and clothing that has been worn in the previous 5 days be laundered (washed and dried on hot cycles, or dry-cleaned) at the same time you are being treated to avoid reinfestation. Close contacts that may be infested should also be checked.

If symtoms have not improved one week after treatment, a follow–up appointment should be made.

How to Protect Your Skin from Sun Damage

• Try to avoid being outside when sunlight is most intense: from 10:00 in the morning to 3:00 in the afternoon.
• Wear a hat, long sleeves and dry, close–knit clothing while in the sun.
• Sunscreen products may protect against common skin cancer. Use a sunscreen with a SPF of 15 or higher and choose a brand that protects against both UVA and UVB radiation (the label will give you this information). Put sunscreen on every part of your body that is exposed, including your ears, lips, nose, neck and hands. Sunscreen products for your lips are available in tinted (like lipstick) and untinted forms. Don't forget the top of your head if you are bald.
• Apply sunscreen at least one–half hour before going outside, so the sunscreen has time to work.
• The risk of sunburn is greater at high altittudes and near snow, sand, or water, so be sure to apply sunscreen before skiing or mountain climbing, even on cloudy days.
• Sunscreen should be applied every two to three hours, after each time you swim and after you perspire a lot.
• Remember: There is no safe tan. Tanning salons and sun beds should always be avoided.
• Get into the habit of looking at your skin on a regular basis. If you notice a change, ask your doctor to look it over.

Sore Throat

Most sore throats are minor, uncomplicated viral infections that clear up within five days without treatment. Although there is no cure for a viral sore throat, various measures help relieve the symptoms and make you feel better. These measures unclude:

• Warm salt water gargles every few hours
• aspirin or acetaminophen every 4–6 hours
• the use of throat lozenges
• increase fluid intake
• increased rest

If your sore throat is caused by a Strep infection (your throat culture for the Strep bacteria came back positive), you will be taking antibiotics. It is crucial that you follow the treatment prescribed for you and take all of the medication, even if you begin to feel much better. Failure to take all of the medication can lead to serious complications such as Rheumatic fever. Following the same relief measures listed above may also help relieve some of your sore throat symptoms.

Tips for Healthier Eating

At the Grocery Store:

• Load your cart with a "colorful" variety of fresh, frozen or canned fruits & vegetables. Include red, orange, and green choices.
• Instead of "white" carbohydrates–select more "whole grain" cereals, breads, tortillas, pastas and brown rice.
• Buy "fat–free" or "low–fat" milk or soy milk, yogurt and cheese.
• Choose lean meats such as "loin" and "round" cuts of beef and pork, "extra–lean" ground beef, skinless poultry, low–fat deli meats, and eggs.
• Select fish, legumes (dried beans) and soy products to use as entrees in place of meat several times per week.
• Buy cooking oil low in saturated fat, such as canola, olive, soybean, corn or safflower oil.
• Choose "light" versions of mayonnaise, salad dressings, cream cheese and sour cream. Use salsa or mustard for flavoring foods.
• Stock up on pantry and freezer items for quick, healthy meals–canned beans, whole grain pasta, brown rice, broth–based soups with vegetables and beans, tomato & vegetable pasta sauces, frozen & canned fish and chicken, frozen vegetables & potatoes.

When Cooking and Baking:

• Roast, bake, broil & grill meats and fish instead of deep–frying.
• Remove the skin from poultry before serving.
• Cook meats on a rack to allow the fat to drip off.
• Use the microwave to prepare fresh or frozen vegetables and flavor them with lemon juice and herbs.
• When sautéing, use a small amount (1–2 tsp) of oil instead of butter or margarine.
• Add more vegetables and less meat to stews, soups, and casseroles.
• Substitute low–fat versions of ingredients when possible (skim milk for whole milk, reduced fat mayo for regular mayo, fat–free sour cream for regular, applesauce for oil in baked goods, etc.).

Tips When Eating Out:

• Don't be afraid to ask for what you want when ordering in restaurants. They want to keep you, the customer, happy!
• Order your meat, poultry and fish dishes grilled, baked, or roasted without added fat.
• Ask for dressings, sauces, and mayo on the side.
• Skip the cheese on anything you order.
• Have your bread without butter or margarine.
• Substitute water, milk, or juice for pop.
• Skip the appetizers or order one for your main meal.
• Choose a tossed salad or streamed vegetables when available.
• Portions at restaurants are big!!! Split the meal with a friend or take half home for the next day.
• At fast–food restaurants, don't order the value meals or "supersize" your order. Buy the small burger & fries or try a baked potato and chili for your entrée.

Smart Smack Choices

• Listen to your body cues and don't snack unless you are hungry!
• Avoid nibbling when you are bored, tired, or stressed–instead, go for a brisk 10–minute walk.
• When snacking, eat "snack–size" portions. If you eat a large snack adjust your meal size accordingly.
• Choose snacks that add to your nutrition needs for the day–fruits, vegetables, milk or yogurt, and whole grains such as:
  • Fruit flavored low–fat yogurt and 2 fig bars
  • String cheese and a medium apple or pea
  • Assorted raw veggies and low–fat ranch dressing
  • A bowl of whole–grain cereal (Cheerios, Wheaties, oatmeal) with low–fat milk and a banana
  • Light microwave popcorn spiced up with chili or garlic powder
• Choose water, skim milk or juice to wash down your snacks.
• Be prepared for snack attacks–keep healthy foods on hand.

Trichomoniasis

Trichomoniasis, or "trich," is a common vaginal infection. It is caused by a single-celled organism that is usually transmitted sexually. Both men and women can have trichomoniasis without any symptoms and pass it on to others without even knowing it.

Symptoms of trichomoniasis infection in women include:

• yellow–green, frothy, bubbly, foul–smelling discharge
• burning on urination
• inflamed external genitalia

Although most men have no symptoms they can transmit this infection to their partners. Symptoms of trichomoniasis infection in men include:

• a slight "tingly" feeling in the penis
• painful urination
• thin, watery penile discharge

Trichomoniasis is usually treated with oral antibiotics. It is important that your partner be treated at the same time you are, even if they show no symptoms.

Note: If you are being treated for trichomoniasis with Flagyl, avoid drinking any alcoholic beverages during treatment.

General Measures for Vaginal Infections

• Be sure to use all the medication as prescribed. Quite often, the symptoms of a vaginal infection will disappear before the disease is fully cured. If you stop taking or using your medication as soon as you feel better, your symptoms may return.
• Men can be infected by these same organisms without any symptoms, so it is important that your partner be treated at the same time if you have trichomoniasis, bacterial vaginosis or chlamydia. Otherwise, you may keep passing the infection back and forth.
• When your symptoms have subsided, you may wish to resume sexual activity. If you do, be sure a barrier (condom) is used until you have both completed treatment.
• If your doctor has prescribed a medication that is inserted into the vagina, you may wish to wear sanitary napkins or panty shields during treatment. If you begin to menstruate, keep using the medication but do not use tampons as they will absorb the medicine and keep it from doing its job.
• Most infecting organisms thrive in a warm, moist environment, so keep yourself as clean, cool and dry as possible. Be sure to use your own towel, and let it dry between uses.
• If your symptoms do not seem to be responding to the treatment, or if the medication seems to be causing additional irritation, be sure to contact your doctor at once.

Wound Care

Keep wound and dressings dry and clean. To remove old blood or drainage use mild soap and pat gently, rinse with water.

Do Not Rub.

Make an appointment to be seen if you notice any of the following:

• Increasing tenderness or redness
• Increasing swelling
• Pus draining from the wound
• Do not keep moist bandages over sutures or wounds.
• If steri–strips were used instead of stitches, keep them as dry as possible. Let the strips loosen on their own. Do not remove. They will loosen in 5 to 7 days. If the strips loosen before the wound looks healed, make an appointment to be seen.

Yeast Infections

Yeast infections are caused by an overabundance of a yeast fungus in the vagina. Yeast fungi always live in the vagina but they don't usually don't cause an infection because they are controlled by the natural acidity of vaginal secretions. But the use of antibiotics, oral contraceptives, and changes in body chemistry can increase the likelihood of a yeast infection.

Symptoms of a yeast infection include:

• thick, white vaginal discharge
• intense itching
• inflamed external genitalia

Yeast infections are usually treated with vaginal creams or suppositories. The medication prescribed for you should be used according to the specific directions given. Even if your symptoms disappear it is important that you complete the prescribed treatment. You should also complete the treatment even if you begin to menstruate, but do not use tampons as they will absorb the medication.