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Scar a reminder of the days before Hib vaccine

DEAR DR. ROACH: For 58 years, I’ve been walking around with a visible tracheostomy scar on my throat, leading the curious to ask: “Yuck. What happened?” My answers have changed, but usually: “I was 4. A doctor had to cut my throat open so I could breathe.” But now, I don’t wait for the question. My scar has helped me do a show-and-tell about what causes this near-fatal closing of the windpipe and why doctors don’t see kids dying from Haemophilus influenzae anymore. Could you elaborate? — M.A.P.

ANSWER: Haemophilus influenzae (often called H. flu or Hib) is not the cause of influenza (“flu” is caused by a virus). H. flu is a species of bacteria that can cause meningitis, pneumonia and epiglottitis — an inflammation of the epiglottis, the structure that closes your trachea when you swallow.

Before the vaccine became available, epiglottitis was a feared and not uncommon problem. Doctors were taught to rapidly recognize the so that children could be treated quickly, which sometimes meant an emergency tracheostomy. Despite treatment, 3 to 6 percent of cases of invasive H. flu were fatal. You are lucky.

Routine vaccination for H. flu became widespread, and the disease went away. Essentially the only people at risk for this now are those who are deliberately unvaccinated. Without continued vaccination, those days will come back.

DEAR DR. ROACH: In 2008, I had a partial sigmoid colectomy. I have had no recurrence of diverticulitis. The surgeon recommended that I not use laxatives but rather take fiber gummies to keep things moving easily and drink lots of fluids.

I do that, but my flatulence could power all the homes in a small city. It is difficult to control outbursts, which are noxious and embarrassing in the extreme. Is there any other way to avoid hard stools, straining and other situations? — J.S.

ANSWER: I am sorry for your embarrassment, but I agree that getting fiber and plenty of water is the safest and best way to prevent problems. Maybe it isn’t just the fiber, but your diet that is partially responsible for the increased gas. You could try reducing your intake of foods in the cabbage family, onions, beans, corn and other gas-producers. Avoid carbonated beverages and any beverage containing artificial sweeteners such as sorbitol or xylitol. In some people, changing the bacteria that live in your gut (your microbiome) through probiotic supplements and a change of diet can reduce the amount of gas produced.

There are other types of fiber supplements besides fiber gummies that might be better tolerated, or you can get fiber from food.

(Roach is a columnist for the North American Press Syndicate. Write to him at 628 Virginia Drive, Orlando, FL 32803.)

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