Dear Doctor: I always seem to get sick when I start a job. Makes sense -- new people, new germs. I started a job in February, then we all had to work from home. I worry that being isolated for weeks puts me back at square one. What can I do to boost my immunity in preparation for going back to the office?

Dear Reader: We’re always happy to have this particular discussion, because the strategies and habits involved in addressing immune health also tend to lead to improved health overall. The immune system plays an important role in protecting us from all sorts of potential pathogens, and you’re not alone in wondering how to give it an edge.

First, let’s clarify the goal. We hear a lot about “boosting” the immune system, but that’s actually misleading. You don’t want an amped-up immune system. That would mean that it’s hyper-alert and reacts -- and overreacts -- to every perceived threat. Rather, the goal is an immune system that’s healthy and balanced and responds in proportion to the job at hand.

One of the most important steps you can take to keep your immune system happy and healthy involve lifestyle. That is, get an adequate amount of high-quality sleep, take part in daily exercise, don’t smoke, limit alcohol use and eat a healthful diet. When you’re chronically tired, depressed or anxious, overweight, eat poorly, smoke, drink too much and don’t get enough exercise, you’re creating internal stressors that can interfere with optimal immune system response.

Diet plays an important role in immune system health. Emerging research continues to link the health and diversity of the gut microbiome with the health and efficacy of the immune system. We urge our patients to get the necessary vitamins and minerals through food, which we believe the body utilizes more efficiently than supplements. Plenty of fresh vegetables, leafy greens and fruit are crucial to getting a range of vitamins and minerals and to keeping the billions of microorganisms that make up our gut microbiomes well-fed. So are nuts, seeds, beans and legumes. Cultured and fermented foods, such as pickles, sauerkraut, yogurt, kombucha, kefir and miso help with diversity.

We know it’s a challenge, but steering clear of added sugar, sugary soft drinks and highly processed foods is also important to both gut and immune health. Recent studies have shown that regular exercise improves gut health. Sleep is also critical to health and well-being. We’ve had a lot of readers asking for help in this area, and we will revisit the topic in a column in the next few weeks.

We understand that, compared to the vitamins and supplements and products that promise instant immune system magic, this advice sounds pretty dull. But our bodies are intricate and interconnected mechanisms. Everything from circadian rhythms, which are affected by sleep, to the gut microbiome, which is affected by diet and exercise, to mood, which responds to all three, play a role in immune health. Focusing on a whole-body approach, with gradual but consistent changes, goes a long way toward building an immune system that’s balanced and ready to work for you.

(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.)

(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 am a 76-year-old man, very active and in fairly good health. I need cataract surgery, but I have learned that serious complications can occur with patients who are on Flomax, as I recently was. Can you explain? I’m at a loss as to what course of action I should follow.

Dear Reader: You’re referring to a possible complication during cataract surgery known as “intraoperative floppy iris syndrome,” or IFIS. As you mention in your letter, it can occur in patients who take -- or have taken -- Flomax, which is the brand name for the drug tamsulosin. It’s one of a class of drugs known as alpha blockers, which relax smooth muscle in the body -- the type of muscle that controls the bladder, the urinary tract, blood vessels and the intestines. Flomax helps to relax smooth muscle by interfering with the action of the hormone norepinephrine. Some medications in this class of drugs can be part of a treatment plan to address high blood pressure. Other types of alpha blockers, such as Flomax, are used to improve the flow of urine in older men with an enlarged prostate.

It turns out that alpha blockers can also affect the muscles of the eye. During cataract surgery, a procedure to restore clear vision when the lens has grown cloudy, the surgeon needs to dilate, or widen, the iris. The iris is the ring-shaped membrane in front of the lens. It gives our eyes their color, and the adjustable center of the iris forms the pupil. Flomax can cause a loss of muscle tone in the iris -- that’s the “floppy iris” in the name of the condition -- which affects how effectively the pupil can dilate. Poor dilation can impede the successful removal of the cataract. It can also lead to additional and serious complications that can threaten vision.

Simply stopping Flomax use prior to surgery may not help. The drug doesn’t cause anatomical changes to the eye, but its relaxing effect on eye muscles can last for years. Several other drugs commonly used to improve low urine flow due to enlarged prostate have also been associated with IFIS, but to differing degrees.

The good news is that there are several ways to reduce risk and improve outcomes during surgery. This includes the off-label use of ephedrine, a hormone and neurotransmitter, which has been shown to improve muscle tone in the muscle that controls dilation of the iris. According to the American Academy of Ophthalmology, ephedrine has been used in cataract surgery with very good results. Surgeons can also adjust surgical techniques, use a blue stain to better view certain areas of the eye and adjust the force of irrigation during surgery. There is also evidence that patients whose eyes don’t dilate well during the initial eye exam may be at increased risk of developing IFIS during cataract surgery.

It’s very important to let your ophthalmologist know of your history with alpha blockers. And, as with any type of surgery, look for a doctor who has experience with your particular situation.

Hello, dear readers, and welcome back to our monthly letters column. We hope you’re all doing as well as possible during these challenging times. We’ve received even more mail than usual, much of it -- no surprise -- virus-related. We’ll address some of those questions here, and the rest in an extra letters column soon.

-- Many of you have remarked upon the wide variety of facial coverings people are using and wonder if they are equally effective. The answer, unfortunately, is no. Coverings such as bandanas and scarves, which have a loose weave and a loose fit, don’t provide as effective a barrier as masks made of tightly woven fabrics, with multiple layers and a snug fit over the nose, under the chin and around the sides of the face. The goal of a face mask is to block the large droplets generated by a cough or a sneeze, as well as the airborne particles, known as aerosols, that we produce as we speak and exhale. That’s also why, although they are more comfortable to wear, masks fitted with valves are largely ineffective at protecting others from exhaled breath.

-- Speaking of face coverings, we had several questions about water temperature for washing reusable masks. “I always thought it was the soap, not the water temperature, that did the work when washing hands,” a reader wrote. “So why do all the articles say to wash your face mask in the hottest water possible?” You’re correct that it’s the molecular properties of soap that penetrate the fatty lipid membrane of the virus and disable, or “kill,” it. Water temperature doesn’t play a role, except in comfort. Guidelines from the Centers for Disease Control and Prevention recommend that people wash their masks with warm water and detergent. Water has to be very hot -- 140 to 150 degrees Fahrenheit -- to kill a virus on its own. What’s equally important when washing a mask is to dry it thoroughly, preferably in the dryer. Damp cloth gives other microorganisms, such as bacteria and fungus, a place to thrive.

-- In a column about chondrocalcinosis, a painful buildup of calcium crystals within the joint (also known as pseudogout), we mentioned that low doses of an anti-inflammatory called colchicine can be helpful. A reader from Kelso, Washington, wrote to say the medication brought her relief. “I have had this condition in my knees, ankles and even my wrists,” she wrote. “I started taking colchicine and had an immediate easing of pain, which finally went away.” We’re glad to hear that you found some relief from a painful condition. It’s important for readers to note that colchicine is available only by prescription. It can have side effects, and should be taken under medical supervision.

As always, thank you to everyone who took the time to write to us. Even though we can’t respond to each of your letters, we do read all of them. As a reminder, we can’t offer a diagnosis, recommend or comment on medications or provide a second opinion. Many of you continue to ask for copies of previous columns. The complete archive is available at uexpress.com/ask-the-doctors.

(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.)