Q. What happens when you have a heart valve that leaks?

Valves can malfunction and strain the heart. If a valve doesn't close properly, blood will flow backward. This is called regurgitation. If valve flaps don't open correctly, they prevent blood from flowing through them. This is called stenosis.

Advanced valve disease can cause blood clots, stroke or sudden death from cardiac arrest.

For seniors, there is a problem with the flaps of the aortic and mitral valves; they thicken and harden with age, making blood flow more difficult. These changes may lead to complications in people with heart disease.

People with malfunctioning valves who don't have serious symptoms may not need treatment. Medicines can help with symptoms but don't fix a bad valve. Surgery or a less invasive procedure is often needed to correct valve disease.

Q. I see mentions of gluten on food packages. What's that all about?

Celiac disease is a digestive ailment that damages the small intestine and interferes with nutrition. People with celiac disease cannot tolerate a protein called gluten, which is in wheat, rye and barley.

Celiac disease is commonly underdiagnosed because some of its symptoms are similar to those of other diseases. Celiac disease often is confused with irritable bowel syndrome, iron-deficiency anemia, Crohn's disease, diverticulitis, intestinal infections, and chronic fatigue syndrome.

The only treatment for celiac disease is to follow a gluten-free diet. For most people, following this diet will stop symptoms, heal existing intestinal damage, and prevent further damage.

The obvious foods with gluten are breads, pastas, and cereals. But, gluten is also in many processed foods such as frozen French-fried potatoes and soy sauce. Many products such as cosmetics, household cleansers, stamp and envelope adhesive, medicines and vitamins contain gluten.

There are gluten-free substitutes for many problematic foods. Many cities have specialty grocery stores that sell these gluten-free substitutes.

Q. How often should we wash our hands?

Here's a list of some important befores and afters:

Ÿ Before and after preparing food.

Ÿ Before eating

Ÿ After going to the bathroom

Ÿ After changing a diaper

Ÿ After touching animals

Ÿ Before and after treating wounds

Ÿ After blowing your nose

Ÿ After coughing or sneezing into your hands

Ÿ Before and after touching a sick or injured person

Ÿ After handling garbage

Ÿ Before inserting or removing contact lenses

Washing your hands with soap and water works well. Here are the correct techniques:

Ÿ Wet your hands with warm, running water.

Ÿ Rub on soap and make a thick lather.

Ÿ Scrub vigorously over every surface of your hands and wrists for about 20 seconds.

Ÿ Use a scrub brush to get under your fingernails.

Ÿ Rinse completely.

Ÿ Dry your hands with a disposable paper towel or air dryer.

Ÿ Use the paper towel to shut the faucet.
