Staying Healthy Archive

The ear's self-cleaning system usually prevents wax from accumulating. But wax impaction requires medical attention.

 Image: © monkeybusinessimages/Thinkstock

If you are like 90% of Americans, you assume that wax is something to be cleaned from your ears regularly, and you may have tried using cotton swabs, toothpicks, bobby pins, or any number of other small implements to do the job. However, according to the American Academy of Otolaryngology–Head and Neck Surgery Foundation, you are not only performing an unnecessary task, you are risking hurting your ears and jeopardizing your hearing. The academy's new guidelines on earwax repeated a familiar warning — "Don't stick anything smaller than your elbow in your ear."

Dr. Rachel Roditi, an otolaryngologist at Harvard-affiliated Brigham and Women's Hospital, agrees that there usually isn't much reason to clean one's ear canals: "I advise people that the ear has a lot of self-cleaning mechanisms already and so you usually don't need to do anything. Just let the ear do its job."

Like his father and grandfather before him, the typical American man of the 21st century works for his living. In most cases, though, he works with his mind, not his body.

It wasn't always that way. As recently as the 19th century, 30% of all the energy used in the American workplace was provided by human muscle power; today, the percentage is minuscule. In most ways, the transition from an agricultural economy to an industrial society to today's information age has been a great boon. But something has also been lost.

To help assess your aerobic fitness, here is a minimum standard: See if you can walk up five flights of stairs at your own pace without stopping, using the railing only for balance. The test may seem too simple to be useful, but in the days before sophisticated exercise tests were widely available, thoracic surgeons used this very test to see if their patients were fit enough to undergo lung operations. In modern terms, people who pass the five-flight test have maximum oxygen uptake values of at least 20. That level will get you through surgery and daily life, but healthy people should use exercise to build up to levels two or even three times higher.

It is unlikely that a health club would ask you to use the stairwell for self-assessment, but it might well use a single 12-inch step or bench to evaluate your fitness. With just a little help, you can do it yourself. Ask someone to time you and count for you so you can concentrate on the task at hand (or foot!). At the signal to begin, step up with your right foot, then bring your left foot up beside it. Follow the "up, up" with "down, down" to complete one step. Repeat at a rate of 24 steps per minute for three consecutive minutes. Then rest in a chair for exactly one minute before taking your pulse. Finally, use the YMCA standards (see table below) to see how you stack up.

This list describes your priorities in an emergency situation. Follow these steps:

1. Evaluate the scene to protect yourself and others from injury or danger.
2. Be calm and reassuring.
3. Do not move the person unless he or she is in imminent danger or unless you cannot provide assistance without moving the person.
4. Get help. Call out for someone to phone 911 or, if the person does not need immediate assistance, make the call yourself.
5. If the situation is a choking emergency, perform the Heimlich maneuver (see Choking).
6. Look, listen, and feel for breathing (see Breathing Difficulties).
7. Feel for a pulse to determine if the heart is beating.
8. Control bleeding with direct pressure.
9. Treat for shock.
10. If the person is unconscious, move him or her into the recovery position.

Removing a Fishhook

Never remove a fishhook that is embedded in the eye or face; seek medical attention immediately to have it removed. A fishhook embedded in skin should be removed by a doctor. If you are in a remote area and a doctor is not available, remove the fishhook following the directions in the illustration below. If the fishhook is embedded deeply in tissue, follow the instructions below for a multibarbed fishhook.

A multibarbed fishhook should ideally be removed by a physician. If this is not possible, cut the eye off the shank of the hook, and then push the shank of the hook through the wound, following the path of the hook until the barbs exit and can be grasped with pliers. Flush the area well with running water, clean it with soap and water, and cover it with a bandage.

Adult Recovery Position

This position helps a semiconscious or unconscious person breathe and permits fluids to drain from the nose and throat so they are not breathed in. If the person is unconscious or semiconscious after you have done everything on the Emergency Checklist, move the person into the recovery position while waiting for help to arrive.

Do not use the recovery position if the person has a major injury, such as a back or neck injury