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Hiatus Hernia.

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INFECTIOUS DISEASE ANSWERS, ASAP. Please respond only if you are truly qualified to answer these specific questions. Thanks.
I'm a 64 yo male with several potentially serious medical issues including hiatal hernia with reflux-- but no history of any cardiac problems-- who was seen in my PCPs office yesterday for mid-sternal chest pain that lasted for more than 20 hours the previous day.
The PCP had the medical assistant perform an EKG on me, although the pads for the leads were initially sterile, the medical assistant then stuck all of those pads on my chest and legs "barehanded" and also removed them "barehanded." And, while she definitely touched the doorknob to enter the room and then touched other things before applying the electrode pads to my chest and legs, I never saw her wash her hands at any time.
I had been told that the EKG equipment is cleaned "regularly," but, NOT between each patient and don't know if it was done prior to my exam.
After my appt with the PCP, I returned home for a couple of hours before running some errands-- all the while continuing to wear the same t-shirt and sweatshirt that I had worn to the PCP appt. And, upon returning home, 5 hours later, I removed the sweatshirt but continued to wear the t-shirt for another 5 hours before removing it to take a shower-- approx 10 hours after the EKG at the PCP's office. I took a long shower-- making sure to thoroughly clean all skin surfaces-- especially my entire chest and legs where the EKG electrode pads had been attached by the "bare-handed" medical assistant...
Due to the 20 hours of chest pain the previous night, I hardly got any sleep before going to the PCP's office for the EKG yesterday. And, due to the fact that, especially during the "flu season," I am normally very cautious about "germs" in public places, after removing the clothes that I wore it the PCP's office, I placed them in a separate plastic bag to be washed apart from other clothes. And, normally following any medical office visit, I immediately cleanse any area that was touched by med personnel or equipment before leaving the office. And, again, at home prior to taking a shower...
But, for no good reason, I know that I didn't use any hand sanitizer while at the PCP's office yesterday or during the ten hours afterwards when I was still wearing the same t-shirt. And, although I THINK that I did clean my chest and leg areas with hand sanitizer before taking the shower last evening, I was apparently so "sleep deprived" that I don't remember...
And, it wasn't until I awoke this morning after a good night's sleep that I started thinking about "germs" and whether I cleaned those areas before the shower.
After getting a good night's sleep, I awoke this morning and started thinking about "germs" and whether I had properly cleaned my chest and leg areas with 65% alcohol before getting in the shower last night-- and, I couldn't recall whether I had.
MY QUESTIONS:
1) Since soap doesn't kill any germs (and only removes germs from the skin by adding water and friction), did showering just spray any potential dangerous germs all over the inside of my shower stall?
2) And/or worse, did I also "aerosolize" any potentially dangerous germs into the air inside the shower stall while I remained "locked" inside (ie, into my nasal/sinus passages and respiratory tract) and also back onto my skin surfaces, too?
3) And, also, since the shower stall open above 6', spray potentially dangerous germs all over the ceiling, walls and throughout my bathroom and master bedroom (since there's no door between my master bedroom and master bathroom)?
4) Since I was wearing the same t-shirt that I wore for the EKG (that was touching my bare chest for the next ten hours afterwards-- including the last five hours without the sweatshirt on top of it), could I also have "aerosolized" significant amounts of dangerous "germs" into the air while walking around my residence during that time?
I'm not a "paranoid" person. And, I have a fair amount of knowledge regarding dangerous infectious diseases-- esp MRSA. But, I'm seeking an EXPERT opinion to hopefully reassure me that
I'm definitely very upset that I didn't immediately clean off all of the areas of my chest and legs that were touched by the bare fingers of the med asst during the EKG with 65% alcohol hand sanitizer-- and also that I continued to wear the same t-shirt for ten hours afterwards-- despite the fact that the t-shirt had been in direct contact the areas that the med assist had touched with her bare hands for that entire time and, with the sweat shirt over it for five hours, definitely would have become "moist" (to increase the growth of potentially dangerous germs.) Again, I'm usually very cautious.
I definitely was very "sleep deprived" and apparently "lowered my guard." Thanks,
Jon

Category: Infectious Disease Specialist

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Category: HIV- AIDS Specialist
 24 Doctors Online

Hello Jon and thankyou for approaching DoctorSpring with your query.
I have gone through your case and understand your concern.
It is a good thing you do not have any cardiac problems.
Hiatus hernia with reflux does not put you at an increased risk of getting an infection nor does any infection cause any risk of complication of Hiatus hernia unlike conditions like a damaged heart valve where one needs to be more cautious as certain infections can result in complications.

According to the WHO guidelines the nurse has to clean her hands before putting on the pads, which the nurse probably did before approaching you. According to WHO it is not required that the nurse wear gloves when taking the ECG unless there is a potential presence of a highly infectious or dangerous organism , open wound or visible body fluids are present on the patient.

It is a good thing that you cleaned yourself by having a bath. You need not worry about having worn the same T-Shirt for 10 hours.
Whether you did or did not clean yourself with a hand sanitizer as having a bath would be good enough to clear the germs.

1)Showering will not spray the germs into the shower stall. Germs are sprayed around in case of aerosols for example when a patient has a viral infection and sneezes as a result of which the germs are transmitted through those aerosols.

Soap will not kill the organisms but hand washing has been documented as one of the most effective way of preventing spread of organisms, hence having a bath and cleaning oneself is equally effective.

2) Our body already has organisms present inside it. This would mean that you would aerosolized yourself daily. Which is not the case. Having stayed in the closed shower stall would make no difference to your situation.


3) You need not worry as this is very highly unlikely to occur. And depending on the bacteria and virus not all live long enough outside the human body. They usually require moisture to survive. Other factors also play a role like temperature and type of surface. Secondly it is not possible that you would have sprayed the the organisms around.
1)
4) No this could not have happened. Unless you already previously had a respiratory tract infection and were sneezing without covering your mouth , there is no chance that you would have aerosolized germs into the neighborhood while walking. Germs would not have aerosolized from your t-shirt.

Regarding MRSA, it can occur in individuals if they are exposed the bacteria and already have the presence of an entry point in the skin like a open wound or a surgical wound.
It usually occurs in weaker patients who are more vulnerable to infection.
You need not worry , unless you had an open wound. Even if you did just make sure to clean it well with antiseptic and close it with a bandage.

I hope this has helped. You can put this incident at the back of you.
Wishing you good health.
Thankyou.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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