Hello, dear readers, and (yes, it’s mid-February) happy 2020. We hope the new year is treating you well. You’ve filled our mailbox with some very interesting questions and quandaries, including how to follow through on New Year’s resolutions. We look forward to tackling that topic -- and many more of your questions -- in the coming months. Meanwhile, onward to your most recent thoughts, tips and suggestions.

-- A reader from central Florida, who just recently caught up with a column about the growing role of nurse practitioners (also referred to as NPs) and physician assistants (also known as PAs) in primary care, wanted to add to that conversation. “Where we live it’s pretty rural, and if we didn’t have nurse practitioners at our local clinic, we wouldn’t have health care,” she wrote. “They make a difference to my family and all the people in our community.”

-- A column about hemorrhoids continues to get a lot of response, both from older adults and new moms. A reader from Ohio says when her hemorrhoids flare up, she knows she’s been slacking off on getting enough salad and fruit into her diet. “I use a drugstore cream, and that helps, but I also start eating a lot more from the produce section,” she wrote. “It takes a couple of weeks, but the episodes always end.”

Another reader, writing from Indiana, had this succinct advice: “Blackstrap molasses, taken orally.” While this approach to hemorrhoid relief isn’t supported by scientific research, there’s no downside to trying it. Blackstrap molasses is rich in minerals such as iron, potassium and magnesium, as well as B vitamins. It’s a byproduct of sugar production, though, so take it in moderation. (And it has a powerful and slightly bitter flavor.) About a tablespoon or so can be mixed into hot water as a drink once or twice a day, and it can be used in cooking as a flavoring or a glaze.

-- A column about a study that linked depression to certain missing microbes in the gut continues to generate a lot of interest. Researchers found that people living with chronic depression lacked two types of microbes, known as Coprococcus and Dialister. Many of you have written to ask how to bolster these populations in the gut. Although increasing the numbers of specific bacteria in the gut is beyond our abilities at this time, you can boost the general health of your gut microbiome with a few simple habits. Eat plenty of fiber from a variety of sources, add fermented foods to your diet, cut back on sugar, cut out processed foods, avoid unnecessary antibiotics and get enough sleep and exercise. These steps may represent a significant dietary shift for some of you, but it’s worth it. We now know without a doubt that a diverse and robust gut microbiome is tied to overall good health and immune function.

Thank you to everyone who took the time to write. We love hearing from you and look forward to continuing this conversation with you next month.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: Is it really that important to walk around during a long flight? I always take a window seat when I fly, and I pretty much stay put because it’s so hard to move around in a plane these days.

Dear Reader: Experts suggest walking around during flights because of the risk of developing a blood clot in the legs, which can be life-threatening. While you’re seated, your legs are bent, and gravity is at work. Over time, your blood flow can become restricted enough to encourage the formation of a blood clot.

When a blood clot forms in the deep veins -- the vessels we can’t see through the skin -- in the lower leg or the thigh, it’s a condition known as deep vein thrombosis, or DVT. And although it’s commonly associated with air travel, deep vein thrombosis is a risk for anyone who stays seated in one position for hours at a time. That includes a flight of about four or more hours, a car trip, a bus ride or even a long session of sitting still at your desk.

Many people who experience deep vein thrombosis won’t even realize it occurred because the clot that formed will dissolve on its own. The risk arises when the clot, or a piece of it, breaks free and travels through the bloodstream. The clot can then become lodged in an artery in the lungs and block the flow of blood, a dangerous condition known as pulmonary embolism. Not only can this result in damage to the lungs, the reduction in oxygen levels can cause harm to organs and tissues throughout the body.

Symptoms of DVT include unusual warmth, swelling, cramping or pain in a thigh, calf, ankle or foot, often on only one side of the body. The pain associated with DVT sometimes may be felt only while moving or walking. There may also be a change in skin color, which can become unusually pale, or perhaps take on a blueish or reddish hue. These symptoms can appear days and even weeks after a clot has formed.

Symptoms of a pulmonary embolism include chest pain that increases while inhaling deeply or while coughing, rapid heart rate, dizziness, sweating, panting and blood in the sputum (saliva). If you have any of these symptoms, seek medical help. A physical exam and simple tests can determine whether a blood clot is the cause.

The good news is that you can take steps to avoid DVT while sitting for extended periods. First, stay hydrated. Drink lots of water, but no alcohol. Wear loose and comfy pants. Avoid crossing your legs at the knee. While sitting, do in-seat exercises, such as wiggling your feet, contracting your calf muscles, and lifting and stretching (as much as you can) your legs. Even better is to stroll up and down the aisle for a few minutes every hour, taking care to consciously stretch your legs and engage the large muscles. We understand that you prefer to stay seated, but DVT is a serious condition, and your health and well-being are at stake.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctor: I was helping with Thanksgiving dinner when the paring knife slipped and sliced my finger. My aunt said to clean the cut with rubbing alcohol, which we didn’t have. I’ve always heard you’re supposed hold it under running water. How do you fix a cut?

Dear Reader: Your aunt isn’t alone in thinking that a cut should be cleaned with rubbing alcohol, but that’s not a good method. Rubbing alcohol is a clear liquid made up of approximately 70% denatured ethanol or isopropanol, and it is used topically in medical settings to clean injection or surgical sites. It’s highly effective due to its chemical properties, which break down the fat-based external membranes of bacteria, killing them. But in these cases, the alcohol is used on skin that is intact. When applied to an open wound, rubbing alcohol can cause tissue damage and actually slow the healing process. This also holds true for hydrogen peroxide, another common go-to disinfectant.

Instead, the best way to clean a cut is to apply a mild soap and hold it under a slow stream of cool or cold running water. Leave it there for at least five minutes. This gently cleanses the wound, and the cool water temperature causes the capillaries to constrict, which helps to slow bleeding. By doing this, you accomplish the first step of caring for a cut -- or any type of wound -- which is to stop the bleeding.

A cut may continue to bleed after you have finished cleaning it. If this happens, apply firm and steady pressure. Be sure that the cloth or gauze you use is completely clean, otherwise you risk reintroducing debris or potentially infectious materials into the wound. If the cut is deep enough and the blood soaks through the cloth or bandage, don’t remove it. You risk dislodging the clot that has begun to form. Instead, add a fresh and clean absorbent layer, and resume applying pressure to the cut.

When the bleeding stops, apply an antibiotic ointment. This helps to prevent infection and to keep the wound moist and lubricated. This last is important to optimal healing, and brings us to another myth about wound care. Despite what you may have heard, you don’t want to “air out” a wound. This encourages the formation of a scab or a crust, which can crack open and become infected. Instead, continue to use the antibiotic ointment, and keep the wound covered with a clean bandage. Once healing has progressed enough that the wound has closed and a scar has formed, continue to keep the area clean and intact.

While it’s safe to treat most minor cuts at home, get professional medical help for cuts with ragged rather than clean edges, when it’s deep enough that bone is visible, and when significant bleeding persists. Any type of puncture wound, which has a high risk of infection, should also be seen by a medical professional. Fever, red streaking, swelling, yellow or green pus, and excessive fluid are signs of infection and require immediate medical care.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)