Abigail Trafford

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Join Post Health columnist Abigail Trafford on Tuesday, Oct. 30 at 2 p.m. EST for an interactive reader discussion about dealing with life in the aftermath of Sept. 11 -- from changes in your daily routine or moods to big questions about changing values and priorities.

The transcript follows.

Editor's Note: Washingtonpost.com moderators retain editorial control over Live Online discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions.

Abigail Trafford: Hello everybody. How are you doing today? We've been warned of another global terrorist attack--somewhere, some how. Everybody is on high alert. Even before this latest announcement, we were all on alert. How do we cope with these new risks? How do we cope with fear? Share your wisdom and experience. We are all struggling to get to the "New Normal." Join us now!

Alexandria, Va.: I thought I reacted appropriately to the murder of 5,000 fellow Americans, but I notice that I am obsessively following the Sept. 11 aftermath on the Web when I should be working. I am doing it now.

Is my reaction common, and is there any advice that you can give me?

Abigail Trafford: I think your reaction is very common. And talking about it on a discussion like this is helpful--to you and to others who are going through the same thing. But you have to set some limits for yourself. Many people I know just make themselves stop and turn off the t.v., or put down the newspaper. They make themselves listen to music--some Vivaldi or Beatles or the Dixie Chicks to take their mind off the Big Subject in our lives. You know the phrase--a watched pot doesn't boil. Well, a Watched Bit Subject doesn't change. You can always check in later.

Washington, D.C.: Life has continued apace here, but every day I've scoured the Post in vain for information about possible contamination of neighborhood post offices. My concern stems primarily from a visit my 9-month-old daughter and I took to our neighborhood post office about 10 days ago---before there was any indication from federal leaders that such mundane activities could be dangerous. The information about our neighborhoods has been extremely slow in coming; last week the Post reported that results from these post offices should be available by the weekend. Now's it the following Tuesday, and we're just now hearing about contamination in the Friendship Heights post office. When will news about the other post offices be released, and why is it taking so terribly long? I really think DC residents are again getting the short end of the stick. And, as usual, no one seems to be standing up for us at the federal level! Second class citizens till the end.

Abigail Trafford: You are absolutely right. We have had a crisis in public communication. We in the press are also frantic to get good and timely information. The federal Centers for Disease Control are getting better at it. But for the first weeks of the bioterrorism threat, the public was not well informed. The problem with getting information about the post offices is that the postal department is slow in getting their testing results and announcing them to the public. As soon as they are released, you will get them. If you are worred that you might have been exposed to anthrax, you should call your doctor. Now your doctor is also having problems getting good information. But at this point, practicing physicians have a better handle on how to advise their patients.

Washington, D.C.: As a patriotic U.S. citizen and as a person traumatized by the killing on Sept. 11 of so many innocent people, I am wondering how I can support my neighbors while voicing my objection to the use of violence to curb violence. As a global leader, the US should, I believe, make wise decisions about foreign policy and constantly monitor and assess the intended and unintended effects of those policies. We must also communicate our good will through dialogue and collaborative effort. Instead we seem bent on the use of violence and revenge as our primary world strategy. I know we have been hurt badly; I know we are suffering. Even so, bombing a country does not seem appropriate. Do you have suggestions for how I might work with others to articulate a non-violent alternative to world affairs?

Abigail Trafford: Many people feel the way you do. It would help to get together with them and talk about your opposition to violence. One of the great things about the U.S. is that we can talk openly and disagree with government policy--and try to change policy, too. If you belong to a church or religious community, you might find others who agree with you. I think you should also write members of Congress and President Bush. It is your patriotic duty.

Bowie, Md.: As I am trained to do, I worked backwards on what paper goods do I receive at home that could potentially carry spores?
My number 2 item was the Washington Post!
So, my question is what has the Washington Post done as a prudent business to avart a Post cancellation scare? One report of printer room worker contamination could start a flood of problems. Do you have a back up printer facility ready? Could the Post be printed elsewhere & trucked in to D.C. area?
Dick

Abigail Trafford: Hi, Bowie. I talked to Ted Lutz, spokesman for the Washington Post about your question. The Post has two printing plants--one in Maryland and one in Virginia. It also has several distribution facilities. The main line of defense is to prevent contamination from coming into the plants. Precautions have been set up to protect the plants--as they have been set up to protect us in the newsroom. If one plant had to shut down--for any reason--the other plant could print the newspaper. Bottom line. I wouldn't worry about anthrax spores on your home delivered newspaper. We're watching it. In a sense all of us reporters in the newsroom are canaries in the mine. We're on alert. At this point--and we're dealing with uncertainty these days--I don't think it's really a risk.

washingtonpost.com: For readers who want to find the latest news, graphics, photo galleries and information about Anthrax alerts and the war, please check out our America at War Special Report section.

Abigail Trafford: Thank you to Eleanor Hong, producer of these discussions at washingtonpost.com. Here is some good information on the anthrax alerts.

Washington, D.C.: Food safety question:

I read that anthrax can be "contracted from ingesting spore- or bacillus-infested food or water, epsecially meat." Are there certain temperatures to cook food to as a precaution against anthrax, or are the spores impervious to the temperatures that we would have at home in our kitchens?

Thank you

Abigail Trafford: Our food supply is very safe. The cases of gestational anthrax in the past have occured from eating farm animals that were sick. It was a private individual thing. These animals were not meant for general consumption. Contaminated meat is very unlikely to supermarket shelves. That's what the experts say.

Washington, D.C.: Ms. Trafford,

With anthrax news breaking everyday, I'm having trouble finding out when there's a public health alert, and what I should do. Is there a central location for all public health alerts dealing with anthrax? Is there a phone number to call with questions?

Also, would it be possible for the Post to publish public health alerts relating to anthrax more prominently? For instance, the request for all mail room people at firms that get mail from Brentwood to get antibiotics was in the middle of an article in Saturday's paper. It was really easy to miss; my wife was the only one (of 5 employees) at her business to find that alert. No wonder no one showed up at the antibiotic distribution centers in Va.

Abigail Trafford: We are all having trouble getting information from one or two reliable sources. I think there are a couple of web sites that can help. One is www.cdc.gov. That's the web site for Centers for Disease Control. Another is www.dc.gov. The CDC team is here at the DC Department of Health. Here are some phone numbers: 866-501-1097 and 888 246-2275. Hope this helps.

washingtonpost.com: For readers, find answers and graphics about Anthrax:

Anthrax Facts: Mail Safety Q & A

Abigail Trafford: Here are some more sources from the folks at washingtonpost.com. Thank you!

washingtonpost.com: For readers, find phone numbers and resources for

Dealing with Grief and Trauma

Abigail Trafford: And more sources!

Washington, D.C.: There's been so much talk about post traumatic stress disorder, and how so many people are suffering from it in various forms. I am from NY and live in DC and even though I didn't see any of the destruction first hand (though I knew a number of people who perished), I can't seem to get on with things. I guess I'm wondering what I can do to try and bring things back into perspective. Thanks.

Abigail Trafford: We're all having a tough time. Most people will not develop post traumatic stress disorder. The real question is whether your suffering is preventing you from functioning throughout the day. If it's interfering with your life, then that's the time to consult a physician or mental health professional. To find a zone of safely in an unsafe world takes time---and trust. Mostly it's common sense things: reach out to people. Take care of yourself, body and mind. Find meaning in what you do. We're all struggling to get to that New Normal.

Miami, Fla.: Hi Abigail,

I keep reading reports that American values have been permanently altered by the events of 9/11 -- with people more family-centric, community-oriented, introspective, and just plain nicer.

But what my collegues at work and I are muddling over is whether these changes are in fact permanent, or simply an emotional by-product of 9/11. How do you see the American mindset evolving as we become more rationally-focused and less emotionally-focused?

Abigail Trafford: Hello, Miami. Are we becoming more rationally-focussed???? Interesting observation. We've heard alot about values in the wake of September 11. There was indeed an outpouring of "good values" or community spirit, love for loved ones, love for country, a cherishing of the spirit. All positive stuff. But you ask the right question: will these changes last? I talked to the rector of St. Alban's parish here in D.C. His Sunday services were packed. . . overflowing after September 11. But he said he wasn't planning to add more seats to the church just yet. . . . . The answer will come in about six months or a year. Much depends on what is happening on the war front. How safe do we feel. How angry. Personally, I'm an optimist.

Boston, Mass.: Hi Abigail,

All of these alerts seem to just increase fear, which probably will lead to stress, then illness. It seems very unfair for people to make statements like "Be on high alert" when they mention NOTHING for us to be alert about. It's like sending the kid to bed without dinner for no reason.

Why aren't they encouraging us to eat well, exercise, relax -- things that would improve our strength and ability to deal with things?

Abigail Trafford: I agree with you Boston. I think it's outrageous to say that a global attack is coming near you and then not tell people what they can do to protect themselves. The public can deal with bad news if 1. there is full disclosure. tell us what you know and what you don't know. 2. there is an accounting of what the government is doing to protect us from this threat. 3. the government tells us what we can do to protect ourselves. But instead we get: high alert. And: go about as usual. There is no usual. The government is foolish if it thinks people can go on with these mixed messages.

Below Dupont Circle, D.C.: My boyfriend and I decided we are going to New York City for the weekend before Christmas. We both lived in the village in the '70's and have not been there in years. We'll stay at the Algonquin, a haunt of mine in grad school, and see a Broadway play.

Abigail Trafford: Bravo for you. Have a great time. I love New York.

Washington, D.C.: I was always a nervous (but coping) flyer, but now I can't even imagine boarding a plane. I may need to travel for work, and the thought of it is unbearable, I won't be able to make myself get on a plane. Any suggestions? Thanks!

Abigail Trafford: Fear of flying is in the stomach, that feeling in the pit of the stomach. It's not rational. It's plugged into a primal part of the brain that gets set off by triggers. The trigger for you is flying. I just flew to Boston and back. It was a hassle, showing id cards at several check points, opening up carryons, etc. but the flight was a dream. I think flying is very safe. It's all relative and Sept 11 has shattered our sense of safety. But I still plan to fly. Maybe you can just try it and gain some confidence. If the discomfort gets too severe, there are therapists who work with fear of flying. Good luck. You don't want to restrict your life this way.

Washington, D.C.: Have you heard anything about access to mental health professionals lately? I have found it to be hard to get in.

Abigail Trafford: this is another crisis in public health: the lack of access to mental health services. One person told me in a previous discussion that the earliest appointment with a pscyhiatrist in the Washington area wasn't until after November 20! Shoring up the mental health system is a priority in this country.

Washington, D.C.: Hi. I have a question that's been eating at me. What are women who have been possibly exposed to Anthrax spores (e.g., postal workers), and who are pregnant or might be pregnant, doing about taking Cipro? This concerns me because I would like to start trying to get pregnant soon, but not if this continues or expands to the point where I might have to go on antibiotics anytime in the next year.

Abigail Trafford: The best thing--always--is to consult your physician. There is a list of drugs that are known to have effects during pregnancy and you obviously want to avoid those. Usually, if one drug is not safe, an alternative that is safe can be used. Since you want to get pregnant soon, I'd talk to your doctor right now about this. I am not a doctor and can't advise you. But it seems to me that you should feel to get pregnant in these times. Antibiotics are very common, well-studied drugs. Your doctor can help you.

Plano, Texas: To protect yourself from bioterrorism, get a Flu Shot. Since 20,000 people die from the flu each year, and only 4 people have died from anthrax, reduce the biggest risk first. Of course falling in the bathroom, and paper cuts are also bigger risks, so you will have to work for awhile to get down to anthrax.

Being hit by Lightning, about 3 million to 1 (100 people)

Being killed or seriously injuried by Shark (30 million to 1)

Anthrax Killing you (100 Million to 1)

Smoking or Air pollution Killing you (1500 to 1)

Abigail Trafford: Thank you Plano! You are so right. We've got to put this in perspective. We live in a sea of risks. We learn to adjust. The problem is that the anthrax risk is new. It's uncertain. It's involuntary. It seems uncontrolable. It has all the features of a risk that scares people far more than many real and immediate risks, such as car injuries and the flue.

Cambridge, Mass.: I heard at a party the other night that produce sales have dropped alarmingly in the last month. Everyone's eating comfort food, or rethinking particularly fascist diet regimes, it would seem, in the wake of 9/11. What other consumer trends are you seeing in the health field recently? What do you make of all this custard-therapy? (I already know what I make of it, and it usually involves whipped cream.)

Abigail Trafford: Ah, Cambridge. The diet games we play with ourselves! Why eat brocolli when you can have whipped cream? And why worry about weight gain when your head is riveted to the September 11 attacks and the realization that life could end tomorrow? But for the vast majority, tomorrow comes. Tomorrow and tomorrow. I imagine we're all going through something of a binge in comfort food. But the experts tell us. Eat a balanced diet. exercise. All that boring never-ending stuff. . . . !

Boston, Mass.: We all hear that CIPRO use is on the rise, and the risks involved with that, but what about other pharmaceuticals? In your opinion, are antidepressants/sleep aids or other drugs also increasing? How does our government assess our prescription drug use nationally? Are there surveys, statistics or other monitoring methods used by insurances companies or pharmacies?

Abigail Trafford: The Post's Medical writer Susan Okie recently wrote a story on the increase in prescriptions for anxiety drugs. Another story reported on the increase in patients seeking pain relief. There is no one on-going public monitoring system of prescription drug use. Some of the information is considered proprietary. But companies, health plans and insurance companies all have private ways of measuring usage. Putting all the information together takes some time. My sense is that there has been an increase in drugs and doctor visits since September 11. this is good news. It may mean than a significant number of people are taking care of themselves.

Washington, D.C.: If our neighborhood post office has identified anthrax spores - do we need to worry about our mail (on the days we get it)? Or would the amounts be way to small to be able to cause pulmonary anthrax. Are standard bills from water companies, credit card, etc. probably okay to handle?

Abigail Trafford: The guidelines are posted on the CDC website. At this point, experts are saying "While it is not possible to eliminate the risk of anthrax, the risk to the general public is low and can be further reduced by being alert for suspicious packages and by handwashington after opening the mail." You are in a special situation because your post office has been found to have anthrax spores. I would go and ask the particular post office. A lot depends on what was found, where, how much. What the potential is for having it carried on regular mail.

Sterling, Va.: Abigail, I am now seriously addicted to searching for news/analysis on the internet regarding terrorism and the war. Spend all day at work scouring the internet, which dramatically decreases my productivity. Any suggestions?

Abigail Trafford: Give yourself some breaks. I'm glad you're on washingtontonpost.com. . . . but you need some down time. None of us can stand it all the time. Block in news time on your calendar and fill in the rest of the day with other projects that engage you. Make yourself go to another work station so you aren't in familiar surroundings. Maybe that would keep you off the news search.

Laurel, Md.: Is it OK to feel helpless and afraid? Or better to be angry and aggressive?

Abigail Trafford: We are all feeling helpless and afraid and angry and aggressive. To me, what's important is to not get stuck in any one emotion. It's not good to feel helpless all the time--or angry all the time. But shifting from one strong feeling to the next is common in these times. As Steve Hyman, director of the National Institute of Mental Health once said: "What makes us at risk is our humanity."

New York, N.Y. Re: Free Speech: Actually, our ability to speak freely is being attacked as our privacy has been compromised with the anti-terror (or should we say, "spy on America") laws just enacted.

Your phone call may be monitored, your e-mails may get read, and your house may get visited by agents without your knowledge -- all part of Ashcroft's new powers. The FBI, did you know, now can access your medical, financial, mental health, and educational records. There is also a broad new definition of "domestic terrorism" that could target people who engage in acts of political protest and subject them to wiretapping and enhanced penalties.

There are some freedoms left, but speech is profoundly limited at this point. Watch as they dismantle the Constitution before our very eyes.

Abigail Trafford: All of us need to be alert to these restrictions. There are sunset provisions in the laws. We have to be vigilent. I'm with you on this.

Undisclosed location: I am honest-to-God worried that we have the enemy right here in front of us--the Bush-Cheney regime. Everything the team does seems to indicate they want world domination, control of oil, and will tolerate no dissenters in the ranks. I'm especially worried now that our homes can be searched without warrant, our phone calls listened to, and our e-mails read with only a vague hint of "suspicion". They seem to be genuinely against people, conversation, discussion and all about our patriotic duty to do whatever Bush dreams up with his advisors. There is lots of evidence to support this -- just search the web for Bush, Oil, CIA and see what you find.

I feel like I am like the Jews in Nazi Germany, watching Hitler make his first moves and seeing everyone else going along with his plans.

Right or wrong, this is very stressful. The more I read, the more I find a long history of rather nasty actions by the Bush group.

How can I calm down? Can I go about my daily business while thinking our leader is out to get us?

Abigail Trafford: Again, stay vigilent. From afar I think the Bush-Cheney administration is trying to do the best it can to find the perpetrators of the September 11 attacks and prevent future attacks. It's up to us to be on guard--against the threat of terrorism and also against the danger of eroding what we most care about in the U.S. This is just the beginning of the beginning.

Abigail Trafford: Our time is up. thank you all for your wonderful stories. Join me again next week, same time same place.

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