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Dear Dr. Roach: I am wondering how safe "energy drinks" really are. My daughter is a recovering alcoholic, sober for three plus years, but she has at least five of these drinks a day.

Can they be good for her, or are they another addiction?

N.N.

Dear N.N.: I've recommended against energy drinks in previous columns due to the whopping amount of sugar they contain.

However, I am going to add another reason: Using this large a number of energy drinks constitutes a potentially dangerous caffeine intake. There has been at least one related death — a young man consumed seven or eight energy drinks and suffered a heart attack.

This obviously is a rare event, and caffeine is generally safe at reasonable doses, but "at least" five a day is way too much caffeine. Depending on the brand, five cans would contain perhaps 800 mg of caffeine (about a half-gallon of brewed coffee), and 270 grams of sugar (over a third of your entire day's recommended calories and over a week's worth of sugar).

I can't comment on "addiction," but I certainly would strongly recommend that she reduce her consumption.

Dear Dr. Roach: Our issue is with doctor's offices and germs. My husband won't see a doctor because he says they are some of the "germiest" places around. After his last visit to the dermatologist, he said he wouldn't go back because the doctor didn't wash his hands or change gloves before examining him.

I asked a doctor once to wash his hands, and he got very defensive, to the point of being rude, and I didn't feel comfortable seeing him again.

Also, what about skin diseases, such as rosacea, lupus, etc.? Can these be transferred via stethoscopes, equipment or incidental contact? What can I do to reassure my husband that he won't get a disease at the doctor's office?

R.

Dear R.: It is certainly reasonable to expect that your doctor's office be kept clean, and you have every right to ask your doctor to wash his or her hands before an exam, if you haven't seen him or her washing hands in front of you. I don't blame you for being uncomfortable about seeing the defensive doctor — infection control is part of our business.

However, it is impossible (and unnecessary) to keep the surfaces truly sterile, since diseases that are transmitted in the doctor's office most often come from hands, or occasionally are airborne, such as during flu season (which is why you may be asked to wear a mask if you have a cough or sneeze). One exception is C. diff, which is why it is such a problem in hospitals. Washing your own hands is a good idea when leaving the physician's office, but you don't want to go overboard worrying about acquiring diseases in the doctor's office.

Email questions to ToYourGoodHealth@med.cornell.edu.

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