Reasons to quit smoking that you might actually care about

photo: nytimes.com

Q: Yeah, yeah, yeah… smoking might give me lung cancer when I’m like 80.  So why should I worry about it now when I can just quit when I’m old?

A: Sure, lung cancer is one of the main reasons to quit, but we know you college (and graduate) students are invincible and don’t really care about little things like mortality, so here are a few other good reasons to quit smoking that might hit a little closer to home:

Tooth Loss

  • It is well known among dentists that smoking dramatically increases your chances of “edentulism” (i.e having no teeth). Smoking causes gum disease and plaque build-up which lead to tooth decay and loss. One study showed that the risk of tooth loss in smokers is more than 4 times that of non-smokers! Think you look cool holding that cigarette? Just think how much cooler you’ll look with dentures. The good news is that the risk of tooth loss decreases with smoking cessation.

Wrinkles

  • Smoking is one of the leading causes of premature skin aging. (One of the identical twins in the photo at the right smokes and has been in the sun more than the other – can you tell which one it is?) Tobacco leads to degradation of the collagen and elastic fibers that keep skin looking smooth and young, leading to premature wrinkles, especially around the mouth and eyes. The mechanisms for this are thought to be similar to the damaging effects of ultraviolet radiation on the skin – so stop tanning too while you’re at it!

Cervical cancer

  • Ladies, did you know that if you have been infected with certain types of Human Papillomavirus (HPV), smoking increases your risk of developing cervical cancer compared to nonsmokers? Researchers are still looking into why this is, but they have actually detected nicotine in the cervical mucous of smokers!  And cervical cancer isn’t one of those things you only have to worry about in the distant future; it is increasingly affecting women in their 20s and 30s. The risk gets higher the longer you smoke, so the sooner you quit the better.

Birth defects

  • It is amazing that in this day and age we still need to tell people to quit smoking before they become pregnant, but unfortunately we still see it all the time. Smoking increases a woman’s risk of premature delivery, still birth, low infant birth weight, and sudden infant death syndrome (SIDS). Since roughly 50% of pregnancies are unplanned, the time to quit is now!

Limb amputation

  • Smoking is one of the major risk factors for peripheral arterial disease (loss of blood flow to the extremities which can lead to tissue damage and amputation). Ok, maybe this is another one of those long term problems you don’t want to think about while you’re young and indestructible, but it’s out there and it affects many people as they get older.

Poverty

  • We know that financial concerns are far and away the biggest stressors for students: tuition, rent, books, fees, not having enough time to study for your classes because you have to work so many hours to pay for them. A pack of cigarettes costs around $5, so a pack-a-day habit costs you $1825 a year! Think about that. How many months of rent or credit hours would that buy? How many student loans could you pay off (or not take out in the first place)? Even if you’re just a casual smoker who only buys a pack on the weekend when you go out drinking, that’s $250 in a year. That would buy you an iTouch!

The thought of becoming a poor, wrinkly, stressed out, toothless, cancer-ridden amputee still not enough reasons to quit?  Check out the CDC’s website for more useful information on the risks of smoking and resources for quitting.  We’ll follow up with another post listing some local resources for quitting soon.

Angela Walker (Ohio State College of Medicine)

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

How to check on your pee

buzzle.com

Order-It-Yourself Testing

The Student Health Center

Q: I am a first year transfer student at OSU, and new to your services. I was wondering if you offer urine screenings?

A: Thanks for your question.  The answer depends on what type of urine screening is desired.  We do three types of urine screening as “OIY (Order-It-Yourself)” tests –

  • drug abuse screens
  • gonorrhea/chlamydia testing
  • pregnancy tests

These are all at your own cost.  For more information on OIY, check out Order-It-Yourself (OIY) Testing at our Student Health web site.  The web site also has a lot of other information, such as our location, hours, and a calendar of events.

If you are interested in some other type of urine screening, you should consider making an appointment with a healthcare provider for an evaluation and discussion of your concerns.  If you see one of our providers, we can order your test right away, and most appointments are available either the same day or within a few days. 

Wish to see a provider outside of Student Health?  Our laboratory can still process most lab orders, if you bring in or the provider sends us a written request. 

Hope this answers your question.  You may also wish to call our Advice/Appointments area (614) 292-4321 and discuss your concerns with our Advice Nurse.

Good Health!

Roger Miller, MD, (OSU Student Health Services) 

What can I do if I think I’ve been given a “date rape” drug?

www.silc.ku.edu

While thankfully rare, incapacitated sexual assault does occur on college campuses.  Womens Services at Student Health has put together some really useful information about what Ohio State students can do if they feel that they were the victim of a “date rape” drug. 

Please check it out.  And remember to be careful when going out to bars or parties or any other place where you might be given a drink from someone you don’t know.  Keep your friends close by to make sure you all get home safely.  

Beth Askue, MS, CNP
Student Health Services
The Ohio State University

Is it OK to share my ADD medicines?

Don't end up like this guy!

ADD medicine

Q:  Is it OK to give my friend one of my ADD pills to help him study for a test?

A:  Before we answer that question, let me ask you another one.  Would you sell that pill to a stranger for $50?  I’m guessing – hoping – your answer is an emphatic “NO.”  Well, from a legal point of view, these two questions are identical.

Most ADD medications (such as Concerta, Ritalin, Adderall, Focalin, Metadate, Methylin, and Daytrana) are Schedule II controlled substances because of their serious side effects and potential for addiction.  They are monitored very closely by doctors, pharmacists, and the Drug Enforcement Agency (DEA).  We’re not lawyers here at Student Health, but we do know that… 

It is a violation of Section 2925.03 of the Ohio Revised Code (Ohio law) to sell another person a controlled substance.  The important thing to remember here is that the legal definition of “sell” includes “delivery, barter, exchange, transfer, or gift…”  

So even if you are just trying to help out your friend – and getting nothing in exchange for it – you are breaking the law.  And we’re not talking about a speeding ticket here.  You are committing a 4th degree felony, which is punishable by 6-18 months in prison and/or a $5,000 fine.  And assuming you are anywhere on or near campus, the felony gets bumped up to 3rd degree and you’re looking at 1-5 years in prison and/or a $10,000 fine.  Not to mention the fact that you could lose your financial aid and/or get kicked out of school.  

Now granted, the odds of someone busting into your dorm room and catching you in the act are very slim.  And unless you really don’t get along with your roommates or neighbors, odds are no one is going to turn you in.  But forget about the legal stuff for a minute.

  1. These medications are addictive and there’s a real chance your friend could get hooked on this stuff.  You don’t want to risk sending someone down that dark road.
  2. While these medications have a calming effect on people with ADD, they are actually central nervous system stimulants so in addition to things like headache, insomnia, anorexia, agitation, anxiety, tremors, vertigo, depression, and nervousness, they can cause life-threatening problems like heart attacks, increased heart rate, increased blood pressure, and heart arrhythmias.  Doctors evaluate people for these conditions prior to starting these medications and monitor them closely while they’re taking them.  Without knowing your friend’s health history, you could literally be putting his life at risk – and no test is worth that much. 

Managing your health is a serious responsibility and that’s especially true if you have ADD.  If you’re taking one of these medications, the best thing to do is keep it to yourself – if no one knows you have the pills, they won’t be able to ask you for one.  And if you have a friend who is taking these medicines, don’t pressure them into giving you one.  It’s more likely to hurt you than help you, and it’ll just put everyone at risk for serious trouble. 

If you have any questions about these or other medications you may be taking, the staff of Student Health Services pharmacy is always available to help!

Jason Goodman, PharmD, RPh (OSU SHS)

Black Out In a Can

nydailynews.com

In November, students were appalled when their beloved “black out in a can,” AKA Four Loko, announced that they would be removing the caffeine from their beverages.  The U.S. Food and Drug Administration (FDA) had sent out a warning letter to four manufacturers of alcoholic caffeinated beverages stating that these drinks were unsafe and subject to seizure. 

What’s the big deal?  What’s so dangerous about mixing alcohol and energy drinks?

Combining alcohol and caffeine creates a “wide-awake drunk” – because of the stimulating effect of the caffeine, you don’t feel the fatigue that you normally do with alcohol consumption alone.  In other words, you don’t feel as drunk as you really are.  So you end up knocking a few more back than you might otherwise and keeping the party going way longer than it should. 

The problem is that your blood alcohol level goes up the same whether your drinks contains caffeine or not; all you’re doing is adding the nasty risks of caffeine intoxication to the already dangerous risks of alcohol intoxication – horrible hangover, insomnia, vomiting, palpitations, dehydration, elevated blood pressure and even cardiovascular failure (otherwise known as death).  Scary stuff.

On top of that, a 2008 study of college students showed that mixing alcohol and energy drinks led to a higher prevalence of being taken advantage of (or taking advantage of someone) sexually, getting into a car with a drunk driver and suffering injuries that require medical treatment. 

If you and your friends are still looking to get a little “loko” this weekend, here are some tips to follow that will hopefully keep you a little safer.    

  • Split the drink with a friend
  • Dilute your drink with soda, juice, or lots of ice
  • Don’t drink on an empty stomach
  • Drink lots of water throughout the night

Alexandra Hinkley
Senior, School of Allied Medical Professions
The Ohio State University

John A. Vaughn, MD
Student Health Services
The Ohio State University

You’ll huff and you’ll dust and you’ll sniff your brain down!

VernonHills.org

According to a 2006 survey, 11% of high school seniors had abused inhalants.  Most users stop by late adolescence so you don’t see too much huffing (or sniffing, snorting or dusting) on college campuses, but since a small percentage of users continue into adulthood you might run into it.     

Inhalants are gas or vapors in common household products that produce a high when inhaled in concentrated quantities. Common examples include glue, keyboard cleaner, spray paint, air fresheners, liquid eraser (WhiteOut), vegetable cooking spray, and whipped cream. 

Inhalants produce their high by quickly passing through the lungs and into the bloodstream, where they travel to the brain and dissolve into the fatty tissue surrounding it.  While the high only lasts a few minutes, the effects – especially with repeated use – can last a lifetime.  Inhalants block the ability of blood to transport oxygen so major organs like the brain, heart, kidneys, lungs, liver and muscles can’t work properly.  For more details, check out the National Inhalant Prevention Coalition and livestrong

It’s also important to know that it isn’t just chronic use that is dangerous.  Up to 22% of people who’ve died from “sudden sniffing syndrome” – a condition where the heart flips into an irregular and lethal rhythm – were first time users.  So trying it just once can kill you. 

If you are concerned about yourself or a friend, get help!  Talbot Hall at OSU East provides alcohol and drug recovery services 24/7/365, and the fine folks at the Student Wellness Center and Counseling and Consultation Service can direct you to other helpful resources as well.

Cheryl Czapla, Med IV
College of Medicine
The Ohio State University

John A. Vaughn, MD
Student Health Services
The Ohio State University

If A-Rod played the violin, would anyone care?

photo: Mark Heayn

photo: wikimedia commons

Yesterday, Alex Rodriguez of the New York Yankees became the youngest Major League Baseball player to hit 600 home runs.  Like so many recent feats in baseball this one comes with the ‘asterisk’ of steroid abuse, which got me thinking about the nature of performance enhancing drugs. 

I’ve never taken care of any professional baseball players, but I have treated more than few musicians for performance anxiety, which manifests itself as a physiologic tremor.  We all have a baseline tremor in our hands of about 10-12 Hz.  Normally, it’s not apparent but many things can make the shakiness very noticeable: caffeine, nicotine, certain drugs, muscle fatigue and – most commonly – excitement, fear or stress. 

For most of us, those shaky hands are just a mild annoyance.  But for a violinist auditioning for a job with a major orchestra – or a spot in the music performance program – it can have an enormous impact on her life.  Luckily there are cheap and relatively safe medications that can blunt those tremors and allow such people to perform to their maximum potential in those situations where their nervous system doesn’t.

In the minds of many sports fans, A-Rod’s use of performance enhancing drugs makes him a big, fat cheater.  So am I helping my patients cheat?

Is a cellist taking a beta-blocker to keep from shaking uncontrollably during a concert the same thing as a pro baseball player juicing up with roids?  It seems unfair to say that treating a medical condition is cheating; after all, you wouldn’t tell a diabetic shortstop that he couldn’t take his insulin before a game or a pitcher with poor vision that he can’t wear his glasses. 

But one could argue that dealing with the pressure of being in front of an audience is an integral part of performing, and that using a chemical substance to enhance your ability to do so is cheating.  After all, a lot of weekend duffers can sink a 12-foot putt on the practice green, but there’s only one Tiger Woods.

So what do you think?  Is taking a medication for an anxiety-induced tremor simply a matter of leveling of the playing field for someone with a medical deficit; or is it giving an unfair edge to someone who can’t handle the heat?

John A. Vaughn, MD
Student Health Services
The Ohio State University

How can I cut back on caffeine without the withdrawal?

wikimedia commons

Q: I’m trying to cut down on coffee as a New Year’s resolution but I get an intense headache on days when I don’t have it.  Is this caffeine withdrawal? How can I make it go away?

A: Congrats on trying to kick the caffeine habit!  You’re doing the right thing.  Caffeine can cause sleep problems, nervousness, irritability, fast heart beat, headaches, tremors, and anxiety (not to mention a light wallet – those daily Grande low-fat lattes get really expensive!)

It definitely sounds like you’re dealing with caffeine withdrawal, which can involve all of the following symptoms:

  • Headache, which is the most common symptom
  • Fatigue or drowsiness
  • Bad mood, irritability, or depression
  • Difficulty concentrating
  • Nausea, vomiting, or muscle pains

Withdrawal symptoms typically hit you within a day of quitting and can last up to a week.  The more coffee you’ve been drinking the worse the withdrawal will probably be, but it can happen even if you’ve only been consuming as little as 100 mg of caffeine per day.  To give you an idea of how easy it is to reach that level, here are the caffeine contents of some common drinks:

8 ounce cup of coffee

135mg

Starbucks coffee, short

250mg

Starbucks coffee, grande   

550mg!!

8 ounce cup of tea (leaf/bag/green)

35mg

12 ounce can of Coke/diet Coke

46mg

12 ounce can of Mountain Dew

54mg

8.3 ounces of Red Bull

80mg

16 ounce can of Rockstar

160mg

16 ounce can of Monster    

160mg

What can you do to make it go away?  Um… drink some coffee.  Consuming caffeine can make withdrawal symptoms go away within an hour.  Of course, the down side is that you’re back to being a coffee junkie. Cutting back gradually can help: try drinking one less cup or one smaller size per day.  Another method could be to mix decaf with regular coffee so that you cut down on caffeine content without cutting back on volume.

And watch out for chocolate or any food/gum/drink that promises an energy or concentration boost – they’re loaded with caffeine.  You even have to be careful of some over-the-counter pain medications.  The reason ExcedrinTM is so good at getting rid of “migraines” so quickly is that its main ingredient is caffeine, and the headache is really caused by caffeine withdrawal.  Stick with Acetaminophen or Ibuprofen if necessary.

Good luck with your resolution!  Here’s to a decaffeinated 2010!

Adam Brandeberry, Med IV (OSU COM)

John A. Vaughn, MD (OSU SHS)

 

Is there anything that will help me quit smoking?

wikimedia commons

Q: I saw your post last week and I think I’m ready to quit smoking.  What now?

A: Congratulations, that’s great news! But before we pop the champagne, you should know that the days ahead are going to be tough, and most people make several attempts before they actually kick the habit for good. So don’t be too discouraged if it takes a few tries to make it stick!

The great news is that there are a TON of resources out there to help you quit smoking.

One of my favorite programs is 1-800-QUIT-NOW (1-800-784-8669). You can call this free hotline and speak to a professional smoking cessation counselor. They can help you get over your fears about quitting, help you set your quit date, teach you coping strategies for cravings, etc. The really great thing about this service is that they can often help you get access to nicotine replacement therapy if you are qualified, whether or not you have insurance. Plus, people who use “quit lines” have been found to be more successful in their attempts to quit!

If you’re not into the idea of calling a quit line, this government website is another great resource. It offers tips for quitting, a savings calculator, a cravings journal and much more!  The CDC website also offers a list of resources to help you quit. 

Closer to home, the staff of Student Health Services is also here to help. In addition to advice and encouragement, we can offer several prescription medication options to help you quit.  All medications have side effects, so be sure to discuss them fully with your health care provider before taking them.  The main options are:

Varenicline (Chantix) works by blocking the effect of nicotine on your brain, so if you relapse and light up, that cigarette won’t give you the same pleasurable effect it used to.  It also helps to reduce withdrawal symptoms.  Varenicline is not covered by insurance and it ain’t cheap (about $120/month), but it does seem to be very effective. 

Buproprion (Wellbutrin) is a commonly prescribed antidepressant that has been found to decrease tobacco cravings and withdrawal symptoms.  Buproprion is much cheaper than Varenicline (it’s on many $4 prescription plans and is usually covered by health insurance) but doesn’t seem to be quite as effective. 

There are also a number of nicotine replacement products on the market these days. You can get anything from patches to gum to lozenges to inhalers. These are typically priced so that a month of treatment costs the same as a month of cigarettes (at about a pack per day). So really, while it seems pricey up front, in the long run you’ll be saving money.  Even though you can buy them without a prescription, it’s always a good idea to talk to your health care provider before starting one of these products.

Good luck!  Please post a comment and let us know how you’re doing!  Who knows, your experiences may help someone else kick the habit!

Angela Walker, Med IV (OSU COM)

John A. Vaughn, MD (OSU SHS)

Reasons to quit smoking that you might actually care about

photo: nytimes.com

Q: Yeah, yeah, yeah… smoking might give me lung cancer when I’m like 80.  So why should I worry about it now when I can just quit when I’m old?

A: Sure, lung cancer is one of the main reasons to quit, but we know you college (and graduate) students are invincible and don’t really care about little things like mortality, so here are a few other good reasons to quit smoking that might hit a little closer to home:

Tooth Loss

  • It is well known among dentists that smoking dramatically increases your chances of “edentulism” (i.e having no teeth). Smoking causes gum disease and plaque build-up which lead to tooth decay and loss. One study showed that the risk of tooth loss in smokers is more than 4 times that of non-smokers! Think you look cool holding that cigarette? Just think how much cooler you’ll look with dentures. The good news is that the risk of tooth loss decreases with smoking cessation.

Wrinkles

  • Smoking is one of the leading causes of premature skin aging. (One of the identical twins in the photo at the right smokes and has been in the sun more than the other – can you tell which one it is?) Tobacco leads to degradation of the collagen and elastic fibers that keep skin looking smooth and young, leading to premature wrinkles, especially around the mouth and eyes. The mechanisms for this are thought to be similar to the damaging effects of ultraviolet radiation on the skin – so stop tanning too while you’re at it!

Cervical cancer

  • Ladies, did you know that if you have been infected with certain types of Human Papillomavirus (HPV), smoking increases your risk of developing cervical cancer compared to nonsmokers? Researchers are still looking into why this is, but they have actually detected nicotine in the cervical mucous of smokers!  And cervical cancer isn’t one of those things you only have to worry about in the distant future; it is increasingly affecting women in their 20s and 30s. The risk gets higher the longer you smoke, so the sooner you quit the better.

Birth defects

  • It is amazing that in this day and age we still need to tell people to quit smoking before they become pregnant, but unfortunately we still see it all the time. Smoking increases a woman’s risk of premature delivery, still birth, low infant birth weight, and sudden infant death syndrome (SIDS). Since roughly 50% of pregnancies are unplanned, the time to quit is now!

Limb amputation

  • Smoking is one of the major risk factors for peripheral arterial disease (loss of blood flow to the extremities which can lead to tissue damage and amputation). Ok, maybe this is another one of those long term problems you don’t want to think about while you’re young and indestructible, but it’s out there and it affects many people as they get older.

Poverty

  • We know that financial concerns are far and away the biggest stressors for students: tuition, rent, books, fees, not having enough time to study for your classes because you have to work so many hours to pay for them. A pack of cigarettes costs around $5, so a pack-a-day habit costs you $1825 a year! Think about that. How many months of rent or credit hours would that buy? How many student loans could you pay off (or not take out in the first place)? Even if you’re just a casual smoker who only buys a pack on the weekend when you go out drinking, that’s $250 in a year. That would buy you an iTouch!

The thought of becoming a poor, wrinkly, stressed out, toothless, cancer-ridden amputee still not enough reasons to quit?  Check out the CDC’s website for more useful information on the risks of smoking and resources for quitting.  We’ll follow up with another post listing some local resources for quitting soon.

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

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