You can’t dodge every germ, but many will try

Are all the little things you do to avoid the flu reasonable – or just ridiculous?

Has all the H1N1 flu talk got you buying Purell by the gallon and wishing you could live in a bubble for the next few months?

Well, relax. You can’t avoid all germs even if you want to, and for most of us most of the time, our bodies do a great job fending off microscopic evildoers.

Sometimes it seems there’s little we can do to dodge a cougher or sneezer – when you’re in an elevator, for instance. Or on a plane. Or in a doctor’s waiting room.

“I can hold my breath in an elevator, but you can’t do that in a plane,” says Nina Shik, director of nursing practice and clinical excellence at the University of Kansas Hospital.

But there are still steps you can take. On a plane, ask the flight attendant to bring some tissues for the sneezer. Ask if you can change seats.

Wash your hands, and as always try to avoid touching your eyes, nose or mouth. (Easier said than done: If you have allergies, you probably rub your nose several times an hour.)

Also, never underestimate peer pressure. You can ask the cougher to cover her cough or cough into her sleeve. Be polite about it.

Chances are other people in the elevator or plane or wherever will back you up, says Rex Archer, director of the Kansas City Health Department.

Archer takes a supply of face masks when he flies, and he offers them not only to coughers but also to the people around them.

“I bought a bunch at the hardware store a couple of years ago,” he says. “You don’t have to have real fancy ones.”

Droplets from a sneeze, by the way, can travel quite a distance: 3 to 6 feet.

Still fretting? Here’s a rundown of other germ-avoiding behaviors, from sensible to over-the-top (stop flushing public toilets with your foot!), with comments from Archer and Shik:

•You re-spray and wipe down gym equipment, even if the person before you should have already done it.

“You can’t assume that person has done it or done it thoroughly,” Archer affirms.

•You bring your own mat to yoga class.

Makes sense, Shik says.

•You refuse to shake hands.

“If you’re ill, then absolutely,” Archer says.

Otherwise? Consider another greeting, such as the elbow bump. For someone you know well, there’s the “heinie bump.”

•You use knuckles to touch elevator buttons, ATMs, water fountains etc.

But if you touch your eyes or nose with your knuckles, you haven’t helped yourself any. Try using your elbow.

•You have flu-suffering kids at home wear face masks.

The CDC recommends it. But putting a mask on a child who may be having trouble breathing? “That’s probably pushing it a little bit,” Archer says.

Try separating sick kids from healthy kids.

•You wipe down the handles of grocery carts.

Most stores provide wipes. Plus, Archer points out, a kid with a soiled diaper might have been just about where your hands are.

•You reapply hand sanitizer once an hour.

Depends on what you’re doing. In a work setting with common areas, frequent hand washing or use of sanitizer is a good idea.

•You wear disposable sleeves to sneeze or cough into.

But you have to touch them when you take them off, Shik points out.

•You use paper towels to touch public restroom doors.

“I do that myself sometimes,” Shik says.

But toilets tend to be cleaner than workplace telephones and keyboards. When was the last time you wiped down your phone?

•You refuse to enter the home of someone who’s recently had H1N1.

If the person is still coughing or has a fever, avoiding them is a good idea, Archer agrees.

Still, says Shik, “You could have the same risk at the grocery store or sitting at the movies or in church.”

•You use napkins to touch things at a restaurant, like salad bar tongs and cheese shakers.

If the restaurant’s so grimy it makes you uncomfortable, eat elsewhere, Shik says. Wherever you are, using alcohol hand rub before you eat is a good idea.

•You use your own pen to sign credit card bills at a store or restaurant, not the one they offer you.

You can’t avoid touching contaminated surfaces. Just wash hands frequently and try not to touch your eyes, nose and mouth.

•You refuse to use public restrooms.

“You can use the restroom. You just need to wash your hands when you’re done,” Shik says.

And remember: Wash for at least 15 seconds, get some friction going, and dry thoroughly.

•You use your foot to flush a public toilet.

Yeah, and “then you go home and put your feet on the sofa,” Shik says.

One more time: Wash up after you do your business.

•You keep healthy kids out of school or day care because of flu worries.

No reason to, unless your child has a serious medical condition, Shik says. If you’re concerned, talk with the school nurse to find out how well the school enforces the rule that sick kids go home/stay home.

•You refuse to let your children play in indoor play areas.

Kids are little germ factories, but what are you gonna do? Make sure they wash their hands when they’ve finished playing.