Flu Vaccine (H1N1 and Seasonal) Update

As we near the end of the fall quarter, here are some updates on flu vaccine availability at Wilce:

Seasonal Vaccine

We will complete our seasonal flu vaccine outreach this Friday, November 20, with our final 2009 program in the SHS Pharmacy. Seasonal vaccine will still be available by appointment, at a cost of $36.

H1N1 vaccine

We continue moving through the priority tiers established by the Ohio Department of Health.  Beginning this week, students 24 years and under WITH CHRONIC MEDICAL CONDITIONS will be invited to H1N1 vaccine clinics.  If you are already signed up with the H1N1 telephone system, watch your inbox for more information.  If you have not signed up at 614-514-4161, please do so if you are interested in getting H1N1 vaccine. 

Please call 614-292-4321 or email us at shs@osu.edu if you have questions.

 

Help! I can’t stop farting!

Q: Help! I farted in class and someone heard me!  What can I do to get rid of my gas??

A: Believe it or not, the normal frequency of passing gas is 14-23 times per day!  There are two major sources of intestinal gas: swallowed air and gas produced by bacteria in the colon.  Most people who have problems with gas don’t actually have excess gas in their intestines, but rather an increased sensitivity to normal amounts of gas. 

If you’re farting more often than 24 times a day (that’s not a challenge, guys) or you’re having difficulty keeping it from happening at inopportune times, you should take a look at what you’re eating and how fast you’re eating it. 

Air swallowing is the major source of gas in the stomach.  It’s normal to swallow some air while eating, but drinking carbonated beverages, drinking through a straw, chewing gum and eating too quickly can cause you to swallow an excessive amount of air.  Most swallowed air is released through burping, but what doesn’t come up must go down.

Certain high-fiber and carbohydrate containing foods such as cabbage, Brussels sprouts, asparagus, beans, broccoli, and some whole grains may not break down well in your digestive tract.  When they come into contact with the bacteria in your colon they ferment and produce lots of gas, as artfully demonstrated in the following classic scene from Blazing Saddles

(C’mon – there had to be a fart joke in here somewhere and this is the Mona Lisa of fart jokes!  Question the taste and maturity level of the clip all you want, but I’ll bet you a bottle of Bean-O you laughed…) 

If you’re having uncomfortable amounts of gas and bloating, you can do some things to help.  In addition to avoiding the above mentioned foods and activities, you should:

  • Increase your non-carbonated fluid intake, particularly water
  • Minimize alcohol consumption
  • Eat slowly and chew your food thoroughly
  • Do not smoke or use other tobacco products
  • Keep calm – tension can cause you to swallow air
  • Exercise regularly
  • Avoid dairy products if you are lactose intolerant

Some over-the-counter medications may also help:

  • Simethicone containing products (Maalox Anti-Gas, Mylanta Gas, Gas-X, Phazyme) cause gas bubbles to break up, which may decrease discomfort
  • Bean-O is an enzyme supplement that helps break down carbohydrates and may help if your gas is caused by foods such as beans and broccoli
  • A lactase supplement (LactAid) will help gas caused by lactose intolerance

Of course, excessive intestinal gas may also be a sign of a more serious problem.  If the above steps don’t help, be sure to come and see us at the Student Health Center.

Angela Walker, Med IV (Ohio State College of Medicine)

John A. Vaughn, MD (Ohio State Student Health Services)

We’re Back!

RSS feed

Hello Buckeyes!

Just a brief note to let you know that our RSS feed apparently wasn’t working throughout the month of October.  It has been fixed, so if you are one of our over 4000 subscribers, you should start getting the latest posts delivered to you again.  And if you haven’t subscribed to our blog yet, please do so by clicking on the tiny RSS icon to the left under the word “subscribe” (not the big one next to this post).

We apologize for the inconvenience and hope you keep checking in with us regularly.  And of course, feel free to submit questions or comments any time!

Go Bucks! 

-BuckMD

What is causing my headache?

photo: ehow.com

Q: I get really bad headaches after I study for too long.  What might be causing them?

A: Headaches have many different causes.  It’s hard to diagnose the cause of a headache without talking to a doctor in person, but the headaches you’re describing sound suspicious for tension headaches.

Tension headaches are common.  They are usually described as a squeezing pain anywhere in the head often on both sides.  Tension headaches are caused by a combination of factors but muscle strain, bad posture, sleep deprivation, and stress can all make the pain worse.  Any of these things sound familiar? The best treatment is rest. Avoid cram sessions. Exercise. It is also important not to take pain relievers regularly for tension headaches because overusing them can lead to medication-induced rebound headaches.

Another possible cause for your pain could be eye strain. Have you had your vision checked lately? If your eyesight is not properly corrected, reading can put excess strain on the muscles that keep your eyes focused. This can lead to some pretty bad headaches, sometimes without any obvious vision problem. If you’re worried, contact the optometry clinic at the Student Health Center. Remember, if you wear glasses or contacts you should have a vision screening at least once a year.

There are many other serious causes of headaches. You should see a doctor immediately if you have any of these symptoms:

  • -headache with a stiff neck or high fever
  • -severe headache that comes on quickly, within a few seconds or minutes
  • -headache with loss or “hole” in vision
  • -headache after loss of consciousness
  • -headache after injury.
  • -headache that lasts for several days
  • -headache associated with exercise

Adam Brandeberry, Med IV (Ohio State College of Medicine)

Victoria Rentel, MD (Ohio State Student Health Services)

It’s all about the hair, baby!

photo: canpages.ca

Q: I’ve been shedding a lot of hair lately. Could I be going bald like my dad? Does baldness run in families?

A:  Hair normally grows in cycles that last between 2-3 years. About 90% of the hair follicles on the scalp are actively growing hair at any one time. The remainder are resting or involuting. It is normal to lose about a hundred hairs each day from all over the scalp.

“Male pattern baldness”, or androgenic alopecia, is common to both males and females, believe it or not.  It typically starts as a receding hairline, especially on the sides, and a bald spot in the back. Medical lore used to hold that if your maternal grandfather was bald you would be too, but we now know that genetics is only part of the problem.

The most common cause of pathologic hair loss is stress, both psychological and physiologic: think trauma, dissertation defense, pregnancy, severe illness, significant weight loss, etc. This is called telogen effluvium. It is almost always reversible and usually happens 3-4 months after the stress. 

There are a variety of other medical, pharmacologic, psychological, infectious, environmental and hormonal causes of hair loss.

  • Traction alopecia from crazy tight hair-dos
  • Ringworm in the scalp (tinea capitis)
  • Diabetes, lupus, iron-deficiency anemia, and thyroid disease
  • Trichotillomania, a psychological disorder where sufferers compulsively pull and tear at their hair (and sometimes eat it)
  • Alopecia areata (think Dr. Evil) is a potentially treatable autoimmune disease that causes patchy hair loss.

If you’re worried about your hair-or lack thereof- be sure to visit your primary care provider to talk about it.

Adam Brandeberry, Med IV (Ohio State University College of Medicine)

Victoria Rentel, MD (Ohio State Student Health Services)

Why can’t I be seen right now!?

madmanmints.net

Ok, so you woke up this morning with a sore throat and a cough. You feel hot then cold.

You feel too crappy to go to class, and the cough drops and Dayquil aren’t cutting it.  Thoughts of flesh eating strep, H1N1, and rheumatic fever flash through your mind. You see yourself moaning in a hospital bed and on dialysis.

Aha! The Wilce Student Health Center! What a thought!  And you can get a note for missing class (and even better, that awful Spanish midterm)!

So you dial 292-4321 and wait. And wait. And wait. You put the phone on speaker and start doing the dishes. And wait. You use the bathroom.  And wait.  Oh, the Muzak is so awful.

What is taking so &%@# long!?  You don’t want to wait on hold forever only to be told there are no appointments left.  So what can you do to improve my chances of being seen at the Student Health Center on the same day!?

BE EARLY: Remember, the early bird gets the worm!  Our phones are open at 7:30 am, and we reserve a large block of same day appointments for sick students every day.  The earlier you call (before 10am is best), the better the chance that you’ll find an open spot that fits your schedule.  Unfortunately, you can’t count on coming in at 2 or 3 o’clock and getting an instant appointment.  By 3 pm the phones have been ringing for over 7 ½ hours with hundreds of sick students!

BE FLEXIBLE: We know your schedules are very hectic and often not under your control and we truly do everything we can to accommodate your needs.  We’re now open until 7pm Monday through Thursday (5pm on Fridays) as well as 9am-1pm on Saturdays when there’s no home football games.  But there will be times when our availability is limited and you may have to miss class to see a doctor.  Most professors are pretty understanding when it comes to the flu.

BE SPECIFIC: Have a thermometer on hand and be specific about your symptoms.  Don’t just call and say “I’m sick.”  Check out our website for flu information and the University’s flu website for instructions in dealing with missed classes.  There is just no way we can see every student who develops cold symptoms this time of year.  The guidelines on these websites are designed to let you know when you need to be evaluated by a health care provider and when it’s OK to try some things at home first.  but when in doubt, give us a call.  

BE PATIENT:  Thanks to H1N1, we are in the midst of an extremely busy flu season.  We are being inundated with hundreds of students who are calling or walking into the Health Center every day and while we are doing our best to meet their needs, we realize that some of them are going to have a less than great experience.  But hurling every four letter word you can think of at us won’t help.  We do value your feedback, but please remember that there are appropriate ways for you to give it.  You can fill out the patient comment forms near the main entrance of our building, or speak to our Patient Advocate.

We hope that you won’t need to see us this winter, but if you do, rest assured that we’ll do our best to make it as positive experience as possible for you!

Jonda Hapner-Yengo, RN (Student Health Services)

Is “All Natural” Really “All Good”?

photo: wikimedia commons

I’m a little uncomfortable with alternative and complimentary medicine. 

Before you plot my death by alfalfa sprout poisoning, let me just say that I’m not against any treatment per se – I’m just a stickler for a little thing called “evidence.”

Is saw palmetto good for the aging prostate? No. Fish oil for elevated trigylcerides? Sometimes. Riboflavin, magnesium, and butterbur for migraines? Worth a try. I will, however, not recommend a treatment simply because the words “alternative”, “natural”, “ancient” or “complimentary” are on the label.  It’s all medicine.

A technical point: “alternative,” “herbal” and “natural” supplements aren’t considered drugs by the Food & Drug Administration (FDA). Supplements are considered food, and are therefore not subject to the rigorous approval process or quality control surveillance that prescription drugs are. Providers and consumers have to rely on manufacturers to tell us about their products, often without a wealth of evidence. Suppositions without proof are advertisements, not facts.

I’m not comfortable prescribing a medication on the basis of advertisements. I’m sure there are wonderful treatments lurking out there in fields and rainforests, but I want proof of efficacy and safety before I recommend it. Let me give you a good example.

Many patients have asked me for a natural remedy for high cholesterol, a serious problem for which there’s not a “one size fits all” treatment. I consider a lot of variables: age, other health problems, family history, etc. Once you and I decide on a treatment, I check and recheck to see if it’s working and if there are any problems.

I’m asked over and over about red rice yeast, a so-called natural alternative to a category of prescription medications called statins. In fact, red rice yeast does work… because it is a statin.  It’s identical to a prescription drug called lovastatin, which means it comes with identical risks: hepatitis (liver inflammation), rhabdomyolysis (breakdown of muscle tissue), and myositis (painful inflammation in the muscles). Some commercially available preparations of red rice yeast have bonus chemicals, including citrinin, which can cause kidney failure. 1

Now, who is watching your liver, kidneys, and muscle while you’re taking red rice yeast? Not me. And Google tells me it costs between $14-30 a month. Prescription lovastatin costs $4 a month. So this treatment isn’t safer, cheaper, or more effective. So what is the advantage? Sure, you don’t need to see your doctor to get a prescription, but is saving the cost of a co-pay really worth risking liver or kidney failure?

Before you take any medication – prescription, “all-natural” or genetically engineered from mutated space alien zombie death rays – check out the evidence. There’s pharmacologic gold in them there hills, but like my mama always says, there’s no free lunch. Drugs are drugs, no matter who is selling them to you.

Victoria Rentel, MD (Student Health Services)

1. The Medical Letter, read all about it: Vol 51, Issue 1320, P 71-2, Sept 7, 2009.

H1N1line – trouble with connection

We have heard from a few students who have had trouble getting connected to the H1N1line (614-514-4161) using an out-of-town line.   There is now an alternate telephone number to access the H1N1 System.  It is: 614.292.3581 (614.292.FLU1). 

Both lines are up and working, so you will only need to use the alternate number if you had trouble with the main number.

From a campus telephone: 4-4161 or 2-3581

From the Columbus area: 514-4161 or 292-3581

If calling via Long distance: 614-514-4161 or 614-292-3581

If you are interested in getting the H1N1 vaccine on campus, please use this system to get scheduled for a clinic. SO FAR, over 4300 students have called.

What’s a normal reaction to a bee sting?

This little guy...

caused this in 27 minutes!

Q: I got stung by a bee or wasp about 6 days ago on my index finger and I was just wondering if it was normal for the finger to still be itchy, swollen, and red and blotchy?

A: Your symptoms are very typical for a local reaction to a venomous insect sting.  This is the most common type of reaction and usually resolves on its own in less than a day.  Sounds like you have a “large local” reaction, which can last up to a week and even cause some nausea and fatigue. 

The good news is that even though this is lasting longer than usual, it rarely indicates the type of allergic reaction that can be life threatening.

The best thing to do for this type of reaction is to clean the sting site carefully, apply some ice and be sure that the stinger isn’t sill stuck in there; this would cause venom to be continuously injected into the area. 

The itching, swelling and blotchiness is best treated with over the counter antihistamines:

  • Diphenhydramine (Benadryl)
  • Cetirizine (Zyrtec)
  • Loratadine (Claritin or Alavert)

Diphenhydramine can make you very drowsy, which makes it good for night time use.  You can also apply over the counter hydrocortisone cream (generic, Cortaid) to the area to help with the irritation.

Obviously, the best thing to do for any reaction that lasts close to a week is to come in to the student health center so we can check it out.  Stings can sometimes become infected or cause other serious problems that require professional attention.

John Vaughn, MD (Student Health Services)