Family history includes puzzling advice about oranges

Dr. Keith Roach M.D.

       DEAR DR. ROACH: Sixty years ago, I married into a family that included a woman doctor in the generation before mine. My mother-in-law was always lamenting that she had never understood a little ditty that Aunt Doctor would always say: "Oranges are gold in the morning, silver at noon, and lead at night." 

       I finally solved the riddle. Every night I drink orange juice, I experience sleep disturbances all night. I shifted to orange juice in the morning: No more problems. Years later, I have been in two hospitals and rehab facilities that served oranges or orange juice at night. Changing to morning could have a positive effect on the comfort of many hospital patients. -- G.R.

       ANSWER: From my research, it appears this saying may have been intended to keep people from stealing oranges at night. However, oranges do have acid, which could predispose to heartburn, which might in turn affect sleep. The sugar load in an orange can cause short term high blood sugar, but in some people, the body's response can cause a temporary low blood sugar as well.

       If eating oranges at night doesn't bother you, there is no reason not to stop, but oranges are on the long list of things which might cause sleep disturbance.

       DEAR DR. ROACH: About four days after I got the flu vaccine, I came down with COVID-19. I know the flu shot didn't give it to me, but I am wondering if the COVID-19 kept me from building immunity to the flu. I had a two-week bout with COVID. I'm 84 and thankfully I didn't get the lung damage many people get. Should I get another flu shot? -- J.H.

       ANSWER: I am glad you recovered well from the COVID-19 infection. I do not think you need to get another flu shot. The flu shot should have been able to give you as much immunity as possible to the flu. It is late now in flu season and, probably due to masks and social distancing, it has been very light.

       It is true that severe infections can depress the immune system overall, but in this case I would not recommend a second flu shot. I would, however, strongly recommend getting the COVID-19 vaccine when it is available for you to take. COVID-19 infection gives some protection for 90 days or so, but after that, you could get COVID-19 again. The vaccine provides protection.

       DEAR DR. ROACH: I am an 86-year-old man in good health. My arms, from the wrist to my elbows on the top side, started turning black and blue two years ago. I've been to two doctors: One said he didn't know why; the other said it was age-related. What can I do for this so I can start wearing short sleeve shirts again? -- R.K.

       ANSWER: While an exam is necessary to confirm this diagnosis, the location suggests a condition called "solar purpura." The name suggests that sun damage is a cause of the condition, predisposing to bruising. One study found that bioflavonoids, found in many fruits and vegetables, may help. A topical vitamin A-derived cream, such as tretinoin, may help with the appearance. It is otherwise not dangerous.