REVIEW: PhoneSoap UV Sanitizer and Universal Charger

As a hospitalist, the amount of horrific infections that I see everyday is enough to make a person hide underneath a bed and never want to interact with humankind again. MRSA, H1N1, vancomycin resistant enterococcus, C. diff, and pseudomonas—just to name a few. My job is surrounded with the nasty, oozy, crusty, feculent foulness of human sickness and decay! 

To combat this virulence, I diligently wash my hands, use antiseptic foam, and sanitize my stethoscope obsessively so that I don't spread these microbial minions to other patients or bring those nasty gremlins home to my family. But what about my cell phone? There have been some reports from the Wall Street Journal that our phones are a bacteriological house party. Does that prove cause and effect? Not really. But am I going to wait for a double blind, placebo controlled study? Ummmm... No. 

So a couple of months ago, I bought this interesting UV sanitizer from Amazon call the PhoneSoap UV Sanitizer and Universal Charger: 

Before I bought this UV sanitizer, I was using alcohol wipes. But who knows what damage that was doing to my iPhone over time. Now with this gadget, I can FRY, FRY, FRY! those germs and still have a working PDA!

So does this thing really work? Well... who knows? Without taking cultures from hundreds of phones before and after the "treatment", it would be impossible to definitively know for sure. BUT this much I do know:

1. UV light is HIGHLY DESTRUCTIVE to the DNA of bacteria and viruses and fungi. When I worked in a research lab, we used UV lights in our sterile hood all the time to zap away all the baddies. UV light works!
2. The UV lights in this unit seem powerful! I actually have to remove the plastic case from my iPhone because the UV radiation was actually BURING the case!—just think what it must be doing to the germs! Note that the UV sanitizer appears to be perfectly safe for my iPhone and other plastic gadgets (i.e. no frying or burning smell). Not sure why my iPhone case reacted that way, but it was kind of cool (and weirdly reassuring) to know that the UV light was able to do that.
3. There is a light element on both the top and bottom of the unit so that it completely bathes my phone and other small gadgets in the beautiful glow of non-ionizing radiation.
4. My FitBit One also fits inside the case so I can sanitize my iPhone 5 and Fitbit One at the same time.
5. The unit automatically turns on when closed and shuts off when open. That's good because I would not want to subject my retinas to UV light. Also there is a timer that automatically shut off the light after a few minutes.
6. Unfortunately, the unit is too short to fit my watch (which, I suspect, is another harbor of grossness).
7. You need to supply your own charger. The cord tucks neatly into the side.

So in summary, I love how this UV sanitizer brings me some small peace of mind. My kids use my cellphone all the time, and the last thing that I want is for them to pick up a nasty infection from the hospital. So a message of doom to you microscopic legions of pestilence and woe, be ready to meet your Maker! DIE A HUNDRED DNA-FRYING DEATHS!!!! DIE!!!  DIE!!!!  DIEEEEE!!!!  (Insert bug zapper sound effect here... Also insert funny look from my wife).

NOTE: I'm not getting paid for writing this review, I don't work for the company. and I didn't get a free sanitizer (oh how I wish!). I'm only writing this review because I want to make the world a better place... one cellphone at a time.

Lice! Lice! Lice!

What do you do when the Nix (1% permethrin) does not get rid of the patient's lice? Well... Assuming that you are doing all the other stuff (using the lice comb, treating family members, etc.), consider using Elimite cream. "But Dave, the patient doesn't have scabies!" you say. Well Elimite cream is 5% permethrin which is 5 times more concentrated than the permethrin in Nix. And, for me, this tip usually does the trick.

Of course there are many other Lice tips and tricks and medications (and some are quite flammable!). This is just what works for me.

Women's Health Screening Recommendations

The Florida Academy of Family Medicine published a Women's Health Screening Recommendations (last edited 4/23/12). It's an interesting read that summarizes the recommendations made by various organizations such as the USPSTF. Here is the official New Release.  (NOTE: Don't click on the image below to see the recommendations—you will only see the first page of the recommendations—click on the link above instead).

Recurrent Yeast Infections (Vulvovaginal Candidiasis)

This is an awesome tip that I learned from Dr. Jennifer Keehbauch (who is the Associated Director here at Florida Hospital Family Medicine Residency). This tips was given as part of our "Learning Center" teaching series which our faculty personally do for our residents. Enjoy!

Recurrent vulvovaginal candidiasis (VVC) is defined as infections that occur greater than 4 times a year. The most common agent is C. Glabarata which causes 40% of the infections and is associated with increased burning and older aged females. There is usually less discharge and burning with candidiasis caused by C. Glabarata. Also, this organism is less susceptible to "azoles".

The treatment for recurrent VVC is with:

1. Induction - which is 2 x normal therapy. Can use Diflucan 200 mg on day #1 and #3. Or you can use Topical azoles for 7-14 days.
2. Maintenance - which is weekly dose for 6 months. You can use Diflucan 100 mg weekly or clotrimazole 500 mg PV weekly. 

Testing for HSV

This tip is from one of our esteemed residents Dr. Jennifer Stuart:

According to UpToDate, to diagnose an acute herpes infection, viral culture on an unroofed lesion is only about 50% sensitive in diagnosing HSV. A much better (and expensive) test is to order the

HSV PCR 

of the mucosal specimen. The HSV PCR is especially helpful in detecting asymptomatic HSV shedding.

So where does serology fit in? To be honest, I'm not sure. I don't check HSC IgG since I  don't typically care about testing for an previous infection (which may not reoccur). Testing for HSV IgM may be helpful, but in the setting of a very early initial or reactivated infection, it may be falsely negative. 

Testing for Mononucleosis

In day to day practice, I order a monospot to screen for mono. But sometimes, the monospot can give a false negative reading (especially early in the disease). For those times where I need something more sensitive (and more expensive), I will order this:

EBV VCA IgM

Which affectionately stands for Epstein-Barr Virus, Virus Capsid Antigen IgM.

RED FLAG FRIDAY: Joint Swelling

Joint effusions are common. Most often they are related to injury. But if a patient presents with joint swelling AND fever, that combo is a septic joint until proven otherwise. I usually do a STAT referral to an ER who will then do a STAT orthopedic surgery consult! Although other conditions can cause joint swelling and fevers, this is not one to miss or blow off.

Send a culture on EVERYTHING that oozes!

I send an aerobic cultures on EVERYTHING that oozes. I have been surprised many times at what grows out of even innocuous looking infections. The benefits are: 1) if it is MRSA, I can place the entire family on prophylaxis 2) I get to see what kind of resistance patterns are developing in my community, 3) it give me an opportunity to know if my initial choice of antibiotics are correct, and 4) it's easy to do.

RED FLAG FRIDAY: Sore Throats

When someone comes in for a sore throat, I look especially for a peritonsilar abscess. And when I do NOT find one, this is how I document a normal exam: Tonisilar pillars are symmetric and uvula a midline. If there is a peritonsilar abscess—which happens about once a year in my practice—I send the patient immediately to the ER who then consults an ENT doc to do an incision and drainage of the abscess. (I'm not about to stick a scalpel near someone's carotid artery!)

Pediatric Bactrim Dosing

Bactrim suspension is dose at approximately 1 teaspoon for every 22 pounds. This is given twice a day. For example, a 45 pound kid would get about 2 tsp by mouth twice a day. Just be aware of the maximum dose. Pretty cool eh? And no calculators involved!

Don't Be Fooled by a Negative C. Diff. Toxin Test

As family doctors, we are typically pretty good at screening for C.Diff. But just because someone has a negative C.Diff. Toxin Test does not mean that they do NOT have C.Diff. Remember that this test is imperfect and frequently needs to be repeated. Often it is better just to start empiric treatment while waiting for the workup.

Just a fever, doc, nut'in else!

For folks who present with only fevers or malaise, check for a urinary tract infection. In the elderly, UTIs commonly present as just malaise. For children, fever is frequently the only symptom.

Children with vague abdominal pain and fever

Strep throat often presents atypically in young children. Sometimes, the only symptom that I will get is some vague abdominal pain. Other common symptoms such as fever, sore throat, or headache are frequently absent. On exam, the abdomen is benign and the throat may only be mildly inflamed. For these kids, I usually check a rapid Strep test and send a throat culture to the lab. I have been surprised many times!

Obviously, a urinary tract infection is also in the differential.