Mythbusters – Hand, Elbow, or Hankie

We are constantly told to COVER OUR COUGH or to SNEEZE INTO OUR SLEEVE, but does it really matter?  Is sneezing or coughing into my sleeve really any better than using a tissue, for instance?  Mythbusters decided to put it to the test.  They inhaled some dye and then sneezed, using different barriers, the hand, a hankie, and a sleeve.  The results – SLEEVE!  Not only did this result in the least amount of exposure, but the odds of passing it on to another person through a handshake or by touching another surface was infinitely less.  You can view their test cases below.

 

 

 

 

It’s OK to use your sleeve

Growing up sleeves were a big no-no.  We weren’t supposed to use our sleeves to wipe our noses or our mouths.  We weren’t supposed to stretch out our sleeves. And we weren’t to use our sleeves as rags to wipe things down.  Sleeves were to be – well – sleeves.

The wiping of the nose thing – that’s still good advice, but our sleeves can serve a purpose other than being sleeves.  Sleeves are great for coughing and sneezing.  If you’re coughing/sneezing into your sleeve, you’re limiting the spread of germs into the air, protecting those around you.

Why does your nose run when it’s cold?

The Nose: A built-in humidifier

When I was walking my dog this weekend, my nose started to run.  That got me to wondering why this occurs.  Why does your nose run when it’s cold?

It turns out that this is a good thing.  Your nose is your own personal built in humidifier.   Its job, in addition to odor detection, is to warm and add moisture to the air you breathe before it gets to your lungs.  You inhale the cold, dry air on a wintry day and your nose automatically starts producing fluids to protect your lungs.  Sometimes the nose does a really good job of producing that moisture and the excess drips out.

Another factor in a drippy nose is condensation.  Have you ever been out on a really cold day and seen your breath?  That’s the result of your warm breath hitting the cold air and forming condensation or water droplets.  The same thing happens with your nose.  You breathe warm air out your nose.  It hits the cold air and drips start happening.

If you want to avoid the whole drippy nose thing, try wearing a scarf over your nose and mouth.  Air breathed through a scarf is warmer and moister and will cut down on the drips.

And, if you’re in need of some nose humor:  If your nose runs, and your feet smell, you’re built upside down!

Submitted by Tina Comston, M.Ed.

Nose bleeds – What do they mean and how do I stop them?

nytimes.com

Q: Why do I keep getting nosebleeds and is it serious??

A: First of all, don’t panic! Nosebleeds are very common and are rarely due to a serious medical problem, like tumors, extremely high blood pressure or bleeding disorders.  About 60% of adults experience nosebleeds but less than 10% require medical attention.   

By far the most common cause of nose bleeds is nose picking! The blood vessels in the nose that bleed most often are located in the front part of the nasal septum (the middle part between your nostrils); they are fragile and can bleed pretty easily if traumatized.  Other common causes include:

  • Breathing dry air (i.e. our lovely Ohio winters, running the heater indoors, etc)
  • Sinus infections
  • Forceful nose blowing
  • Seasonal allergies
  • Allergy medications (both pills and nose sprays can dry out the lining of the nose)
  • Snorting cocaine

Here are some helpful tips on stopping and preventing nosebleeds.  Following these simple steps should take care of the vast majority of nosebleeds you might experience.  If they don’t work or the nosebleeds keep coming back, come in and see us – we can do an exam and if necessary, some simple lab tests or a referral to a specialist to rule out more serious causes of nosebleeds.  But again, these are rarely required.

If you are having uncontrollable bleeding, bleeding going down the back of your throat, or are feeling like you’re going to pass out, you need to call 911 get to your nearest ER right away. 

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

My sinuses are hurting!! Will antibiotics help?

photo: ehow.com

click to enlarge

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One of our more frequent reasons for visiting Student Health Services is sinus infection.  You wake up with pain behind the eyes, a congested nose, maybe some ear fullness and irritated throat.  Could this be an infection in your sinuses?  Sure.  Does it need antibiotics?  That is unclear.  Just as we have been learning about many sore throats, coughs, and other upper respiratory illnesses, a recent study shows that antibiotics may not be needed for the majority of sinus infections. 

One difficulty for your health caregiver is that it is difficult to determine whether a sinus infection is viral or bacterial.  Overall, bacterial sinusitis is uncommon, and is the only infection where antibiotics are needed.  However, neither the color of mucus nor the amount of pain separates the two types.   

Most important factors:

  • Fever – temp. higher than 100.4° F
  • More than10 days of symptoms
  • Symptoms that persist despite over-the-counter medicines
  • Multiple sinus infections in the past year

In the meantime, if you have sinus pain this morning for the first time, check out this site from the CDC for some tips for managing your symptoms at home or in the dorm. 

Also, don’t forget good handwashing!

Roger Miller, MD (OSU Student Health Services

Source: JAMA. 2012;307(7):685-692.

Medical Mythbusters – Green Snot!

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ehow.com

sheknows.com

True or False: My snot is green so I need an antibiotic, right?

AFalse!!

This is one of the most tenacious, and frustrating, medical myths out there: that clear snot indicates a viral infection that will clear on its own while green snot automatically means a bacterial infection that requires an antibiotic for treatment. 

This is simply not true! Coming down with a sinus infection is very common this time of year. You may know the symptoms: headache, stuffy nose, nasal discharge, facial pain and pressure, fever, cough and ear pressure. The vast majority of cases are caused by viruses and resolve on their own within 10 days.  The only time antibiotics are recommended is when the infection lasts for more than 10 days, or worsens over 5-7 days.

Many people come to the doctor expecting antibiotics for minor viral infections but keep in mind that not only do antibiotics do nothing against viruses, they are not always benign either. They can have side effects such as upset stomach and diarrhea. More importantly, overuse can lead to resistance, so that if heaven forbid you come down with a serious infection that does require antibiotics in the future, they may not work as well and the infection will be more difficult to treat.

As for the myth of the green snot, microbiologists believe the color comes from enzymes released by your white blood cells (myelo-peroxidases and other oxidases) to break down bacteria and other organisms. These enzymes contain iron, which gives off a greenish color. Also, the longer the mucus stagnates in your sinuses, the more likely it is to look green when it comes out. So when your sinuses are clogged up during a sinus infection, it is more likely to stagnate and appear green, just as your early morning snot will be more green just from sitting in your nose all night. The only kind of snot that deserves antibiotics is purulent (think pus) mucus coming from your nose or throat.

Remember, most of these infections clear on their own with a little TLC. Over the counter products such as pseudoephedrine (“Sudafed”) or my personal favorite, the neti pot are usually effective at alleviating the symptoms while the infection runs its course.   

If your sinus infection has been going on for more than 10 days, or it’s been getting worse over the past week, be sure to contact Student Health Services to be evaluated.

Angela Walker (OSU COM)

John A. Vaughn, MD (OSU Student Health Services)

photo: sinusinfocenter.com

A new way of looking at – and treating – sinus problems!

A neti-pot in action!

I just came across a great article in the New York Times about chronic sinusitis. 

Sinus problems are one of the most common issues we see at the Student Health Center (any primary health care provider will tell you the same) and for those people who suffer with them chronically, they can be one of the most frustrating.  Literally tons of antibiotics, antihistamines, and decongestants have been prescribed and for a lot of people, they don’t seem to do much. 

But there are some scientists out there looking at new theories of what causes this problem and how to treat.  I encourage you to check out the article to learn more.  Obviously, if you are having problems with your sinuses, be sure to see your primary health care provider for evaluation.  But in the mean time, this article should give you some good ideas.  Here’s the best one:

The most effective first-line intervention, said Dr. Palmer, is nasal irrigation using a neti pot or saline irrigation bottle, which helps flush out mucus and any inflammatory bacteria or allergens in it. “If you took all the people who say they have chronic sinusitis in the world, and you put them all on nasal saline irrigations, a big proportion would not have any symptoms anymore,” he said.

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

When a little night-time grinding is NOT a good thing!

blogesaurus.com

Q: I’ve been waking up with jaw pain and headaches lately.  What could be causing this?

A: You’re probably grinding your teeth.  Teeth grinding – or bruxism – is a very common problem. We used to think it was just caused by misalignment of the teeth or jaws, but we now know that it can also be related to stress, anxiety, depression, changes in sleeping patterns and even diet.  Sound familiar?    

So how do you know if you’re a bruxer?  It can be hard to figure out on your own since most of the clenching and grinding happens when you’re asleep.  You could ask your sleep partner or roommate if they’ve ever noticed you doing it.  If that’s a little too weird for you, you could just come in to the student health center and see one of our fabulous dentists – they can take one look at the wear and tear on your choppers and tell if you’re grinding away or not.  Other signs that may indicate you’re grinding your teeth include:   

  • Jaw pain or tightness which can lead to difficulty eating
  • Headache
  • Earache
  • Oversensitive teeth
  • Indentions in the tongue or damage to the inside of the cheek
  • Pain in your temporomandibular joint (the area right in front of your ear where your jaw hinges)

If you are a bruxer (we just love saying that word), there are some things you can do to give your jaw and pearly whites some relief:

  • Your dentist can fit you with an oral mouthpiece that will protect your teeth and decrease the amount of tension in your jaw while you sleep.  You can try one of those squishy mouth guards you find at sporting goods stores, but they don’t work as well.
  • Stress reduction can go a long way! The more relaxed you are while you’re awake, the more relaxed you will be while asleep!
  • Warm compresses applied to the jaw can help relax muscles.
  • Jaw exercises can also help to loosen up those muscles!
  • Cutting back on the alcohol and caffeine will also help.

Click here to learn more about bruxism, or make an appointment to see one of the dentists at the Student Health Center.  We’re always happy to help.

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

Salvatore Paul Lowry, DDS
Student Health Services
The Ohio State University

I’ve never had this many colds. Is something wrong with me?

sheknows.com

The Columbus Dispatch ran a special health section about colds and flu this weekend which included a number of fairly well-done pieces. I found a few informative bits myself, and am going to use this quote from local primary care provider Donna Donati, MD: “Colds spend four days coming, four days here, and four days going.” For those of you keeping score, that’s 12 days. I’d add a few days at the end, actually, for nasal congestion and cough to resolve completely.

It’s pretty typical for the average adult to have five or six colds through the course of cold and flu season, which, if you’re keeping score, means SIXTY-plus days of viral misery. In other words, two-plus months of snot does not necessarily mean you’re dying or have a “weak immune system” (a common complaint). It means you’re normal.

For more great information from the Dispatch on how to handle cold and flu season:

This year’s flu vaccine

How to wash your hands

Sick at work? Health experts say ‘Go home’.

Vitamins? Zinc? Soup? Everyone has a ‘cure’.

Fighting patients’ pleas for antibiotics

Your head says cold but your body says influenza

Can you jog when your nose runs?

Victoria Rentel, MD
Student Health Services
The Ohio State University

Ladies and Gentlemen, Start Your Sneezing!

ehow.com

I know spring is finally sprung when I walk outside, anxious to soak up some warmth and sunshine, then sneeze and rub my itchy eyes.  Behold the heavenly aroma of the hyacinth… and the cough and wheeze which follow.  I gravitate, lighter than air (if you knew me, that’s saying something) towards the crab apple tree in full bloom… and quickly thereafter start the steroids and applying cold compresses to my hives.   Allergy season is here, my friends.   Let the sneezing begin!

Environmental allergies can manifest themselves in a variety of ways and if you’re unlucky enough to have them, you may experience any and all of the following: itchy, watery eyes; serial sneezing; runny nose; popping ears; itchy skin; wheezing and sputtering.

Avoidance of the pollens and other allergens is a very effective way of dealing with allergies – possibly as effective as medication – so you can:

  • Stay inside when pollen counts are highest, generally in the early- and mid-morning.
  • Stay inside when the air quality is especially bad.
  • Keep your windows closed and the air conditioning on.
  • Stay inside when you hear the sound of lawnmowers.
  • Take a shower, change and wash your pollen-covered clothes as soon as possible after playing in the great outdoors.

But can your allergies be controlled without forcing you to live in a bubble?  Fortunately, yes.  There are a variety of over-the-counter (OTC) medications called “antihistamines” that are pretty effective at controlling allergy symptoms.  They’re all fine to use now and then if you can tolerate a little (or possibly a lot) of drowsiness and fatigue.  The older antihistamines like diphenhydramine (Benadryl) are more sedating while newer ones like cetirizine (Zyrtec) and loratadine (Claritin, Alavert) are less sedating.  

For the floodgate that noses can sometimes be, occasional use of a decongestant like pseudoephedrine (Sudafed) can be helpful.  Pseudoephedrine usually has the opposite effect of antihistamines and acts a stimulant so it can keep you awake at night, and raise your blood pressure.  Try to avoid OTC nasal sprays and definitely avoid the OTC asthma medications.

When OTC medications just aren’t enough, ask your health care provider for some help. We have a variety of very useful drugs in our tool belts, and when necessary can refer you to an allergy specialist for testing and possibly desensitization therapy.

So by all means, get out there for a hike, a run, a picnic, to study, or whatever is your pleasure.  But if the great outdoors leave you gasping for breath or struggling for a Kleenex, give us a call.

Victoria Rentel, MD