DEAR DR. ROACH: Recently, I underwent breast cancer surgery at my local hospital. Imagine my surprise when I found several staff members who weren’t wearing masks in the operating room. Later I learned the policy is that staff do not have to mask up until the field is sterile. In your opinion, is this good disease control management? It certainly made me feel unsafe.

— P.T.

ANSWER: The surgical team wears masks in the operating room to reduce the risk of the patient getting an infection. This is only part of the routine to reduce surgical infections, which also includes careful hand-washing, clean garments and cleaning the skin with a surgical cleanser. Together, with careful surgical technique, surgical infection rates have dropped dramatically.

Certainly, the most important time to be wearing a mask is after the skin is prepped. I did read a study that didn’t show a difference in surgical infections depending on mask use in the operating room.

These studies largely came before the pandemic. Now that COVID is here to stay, it is reasonable for staff to be wearing masks around patients all the time, at least when there is COVID activity in the community. For operations with older patients and operations that involve implants, or when COVID or other respiratory viruses are active, it is particularly important for OR staff to wear masks around patients.

DEAR DR. ROACH: I am a 79-year-old male with two coronary artery stents placed in late 2021. I am on 20 mg of atorvastatin for cholesterol control. My last lipid panel showed an LDL level of 75 mg / dL. My clinical lab indicates that the desirable range is 0-99 mg / dL.

At my last cardiology visit, my cardiologist said he would like my LDL to be under 70 mg /dL. He told me to double the atorvastatin to 40 mg. However, that produced terrible gastric acidity.

Since 75 mg / dL is just about in the mid-range for the lab, I think I should continue to take 20 mg of atorvastatin once in the evening. Does this seem reasonable?

— W.W.

ANSWER: In my patients with known blockages in their arteries, I try to push down their LDL levels below 70 mg /dL. Most people can achieve this with high-dose statins. Stomach acid is not a common side effect of statin use; in fact, some studies have shown that statins improve reflux symptoms. However, if you aren’t tolerating it, there are at least three other options.

One is to live with your LDL at 75 mg / dL as it’s pretty close to 70 mg / dL, like you suggest. Alternatively, you could try another statin. Finally, you could try a second agent in addition to your 20 mg of atorvastatin.