Have you been asked the Five P’s??? – April is STD Awareness Month

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Use protection

Let’s say you are going to Student Health or your private caregiver.  In most cases, they are going to ask you a few questions about your sexual health and sexual practices. These questions are very personal, but they are as important as the questions about other areas of physical and mental health. Your answers are kept in strict confidence. 

So, are you ready to talk about your five P’s?  The five “P”s stand for Partners, Practices, Protection from STDs, Past history of STDs, and Prevention of pregnancy.

Partners

  • Are you currently sexually active? (Are you having sex?)
  • In the past 12 months, how many sex partners have you had?
  • Are your sex partners men, women, or both?

Practices

  • What kind of sexual contact do you have or have you had?
  • Genital (penis in the vagina), Anal (penis in the anus), Oral (mouth on penis, vagina, or anus)?

Protection from STDs

  • Do you and your partner(s) use any protection against STDs? If not, why?  If so, what kind”
  • How often do you use this protection? If “sometimes,” in what situations or with whom do you use protection?
  • Are there other forms of protection that you would like to discuss today?

Past history of STD’s

  • Have you ever been diagnosed with an STD?
  • Have you had any recurring symptoms or diagnoses?
  • Have you ever been tested for HIV, or other STDs? Would you like to be tested?
  • Has your current partner or any former partners ever been diagnosed or treated for an STD?

Prevention of pregnancy (Based on partners noted earlier, conception and contraception questions may be appropriate)

  • Are you currently trying to conceive or father a child?
  • Are you concerned about getting pregnant or getting your partner pregnant?
  • Are you using contraception or practicing any form of birth control?
  • Do you need any information on birth control?

Finally, before you move on to discuss other things with your caregiver, consider:

  • Are there other things about your sexual health and sexual practices that you should discuss to help ensure your good health?
  • Any other concerns or questions regarding sexual health in general?

Student Health Services can offer you expert advice, all the current diagnostic and treatment options, and vaccinations that can protect you long term.  Come see us, and GET YOURSELF TESTED

Roger Miller, MD (OSU Student Health)

Should I get a physical? And what is a physical anyway?

Let's Get (a) Physical!

Students often wonder if they need to have a “physical” on a regular basis.  A physical is a preventive medicine visit, meaning that you are coming in to see your health care provider when you are NOT sick and don’t have any current problems.  It’s a visit designed to assess your risk for certain medical conditions and to come up with a strategy to continue your good health. 

For most college, grad and professional students (i.e. adults aged 18-35), the following physicals are usually recommended.  Why are these examinations recommended while others (like checking your cholesterol level) are not?  It’s because they screen for conditions that are likely to be affecting you, can be treated, and which would create a health problem for you if they were not detected and treated. 

For men who are sexually active, the recommendations are for an annual screening for Sexually Transmitted Diseases (STD’s) – specifically for chlamydia, gonorrhea, HIV, and syphilis.  This is done through a blood and urine sample taken in our lab, but the visit may also include an examination of the penis, scrotum, testes, inguinal (groin) area, and possibly a rectal exam.

For women who are sexually active, an annual pelvic and breast exam is recommended.  This usually includes screening for STD’s (as above), as well as a PAP smear (screening for cervical cancer and HPV), and a physical examination  of the vagina, cervix, uterus, ovaries, thyroid gland, and breasts.

Why don’t we include things like herpes, or HPV in men?  Because we don’t have a good test to screen for them.  Remember, we’re talking about physical exams when you have no problems.  If you’re having symptoms like a sore or bump, we have ways of checking for herpes or HPV, but if everything is perfectly fine below the belt, we don’t have a test that can tell if you have them.  

Check back next week for a discussion of other screening tests and preventive measures that may be recommended and – even more importantly – MAY be covered by your insurance.

Mary Jane Elam, MD
Student Health Services
The Ohio State University

Stressed?? CDC Tips for Coping

Wilce Student Health Center

Overwhelmed?

With the shocking and traumatic events of this week, are you getting overwhelmed by the news coverage?  Perhaps you have family or friends directly impacted? 

The Centers for Disease Control and Prevention (CDC) has posted a number of symptoms to consider as possible danger signs, as well as tips on stress management 

Symptoms of Stress

  • Fear and anxiety about the future
  • Difficulty making decisions
  • Being numb to one’s feelings
  • Loss of interest in normal activities
  • Loss of appetite
  • Nightmares and recurring thoughts about the event
  • Increased use of alcohol and drugs
  • Sadness and other symptoms of depression
  • Crying
  • Sleep problems
  • Headaches, back pains, and stomach problems
  • Trouble concentrating

Tips for Self-Care

  • Avoid drugs and alcohol – in the long run they can create more problems instead of take stress  away.
  • Find support – talk to a partner, family member, friend, counselor, doctor, or clergyperson.
  • Connect socially – make sure that you are spending time with loved ones.
  • Take care of yourself – diet, exercise, sleep, normal routines
  • Give yourself a break if you feel stressed out
  • Stay active – helping a neighbor, volunteering in the community, even taking the dog on a long walk.

If you need additional help, come talk to a healthcare professional at Student Health Services, or contact our Student Life partners at Counseling and Consultation Services, the Student Wellness Center, or the Student Advocacy Center.

Take care,

 Roger Miller, MD (OSU Student Health)

These shoes are made for running!

examiner.com

The weather is getting warmer and spring is fast approaching, so many of you will start running.  Some of you may be continuing your current cardiovascular exercise program while others may be jogging for the first time.  Either way, it is important to know the basic facts about your running shoes.  Exercising in shoes that are worn out from too many miles of usage is one of the leading causes of injury in the lower extremity, so before you hit the road we’re going to give you a test to see just how much you actually know about your running shoes. 

  1. At what mileage should running shoes be replaced?
  2. How much shock absorption is lost after 50, 150, 250, or 400 miles of running on a pair of shoes?
  3. What are some tips to prolong the life of your running shoes?
  4. Where are the best places to buy running shoes?
  5. What are signs of wear to look for on your current shoes?

Click here for the answers.  And check out the Physical Therapy/Sports Medicine page of our website for more information about the services we offer to students.  If you’re having any problems with your muscles or joints, we can get you back on track and help you hit the ground running again!

Pamela Bork, PT
Student Health Services
The Ohio State University

Getting better ZZZZZ’s

photo: www.educator.com

thegeminigeek.com

Surfer on the Beach

lauramuggli.com

Just back from an all-night drive from Panama City?  Ready to get back into your school schedule?  Here in a recent article from Entrepeneur Magazine, the author shares five myths many students believe.  Do you?

MYTH: Sleep is downtime for the brain

  • REALITY: During sleep, your cardiovascular system and brain are doing a lot of work when it comes to creativity, critical thinking and memory. For example, short-term memories get registered and stored in the brain during sleep.

 MYTH: My body will adjust to less sleep

  • REALITY: A 2003 study by researchers at the University of Pennsylvania and Harvard Medical School found that decreasing sleep to six hours or less per night can reduce cognitive performance as much as pulling two straight all-nighters.

MYTH: I can sleep on the weekends 

  • REALITY: Sleeping two hours less a week straight will require you to add extra 10 hours onto two weekend nights of sleep.

MYTH: Coffee is as good as a night’s sleep 

  • REALITY: Caffeine is a useful cure for drowsiness, but it can only go so far. Your body doesn’t get the same benefits from caffeine that it gets from sleep. This means you will think and solve problems slower.

MYTH: Sleeping longer will make me fat

  • REALITY: A 2011 study found that losing sleep slows your metabolism and can lead to weight gain. The brain chemicals that stimulate hunger increase with less sleep. Also, sleep deprivation increases cravings for high-fat, high-carbohydrate foods.

Source: J. PORTER, Debunking 5 Common Myths About Sleep, February 5, 2013, http://www.entrepreneur.com/article/225612

Nighty Night!

Roger Miller MD (OSU Student Health Services)

 

Spring ahead during Sleep Awareness Week!

Better than this?

smyrnavinings.com

 This week  is National Sleep Awareness Week, as we get ready to lose an hour of sleep this coming weekend with the start of Daylight Savings Time on March 10. 

Life in college is unique in many ways, but one way in particular is the constant schedule changes.  In high school, your day likely started and ended at the same time every weekday, except for those outrageously sweet SNOW DAYS! 

In college, your class schedule is different each quarter, and often each weekday.  Balancing that with work schedules, other commitments, and perhaps even a social life just does not leave time for much sleep in a 24-hour day. 

This can lead to sleep problems, which in turn can lead to poor academic performance, depression, irritability, overeating, relationship problems (including sexual dysfunctions), and increased risk for injuries or automobile crashes. 

Here are some suggestions for healthier sleep adapted from Tips for Getting a Good Night’s Sleep, from the National Institutes for Health:

  • Go to bed and wake up the same time each day.
  • Exercise is great but not too late in the day.
  • Avoid caffeine, alcohol and nicotine, especially 4-6 hours before bed.
  • Avoid large meals and beverages late at night.
  • If possible, avoid medicines that delay or disrupt your sleep, and ask your doctor or pharmacist if you are not sure about your medicines.
  • Don’t take naps after 3 p.m, and no longer than 30-45 minutes.
  • Relax before bed (light reading, listening to music, warm bath).
  • Have a good sleeping environment, and reserve the bed for sleep and sex only, not studying or other activities.
  • Have at least 30 minutes of sunlight (or bright light) exposure every day.
  • Don’t lie in bed awake more than 15-20 minutes If you can’t sleep, get up and do something relaxing.
  • See a doctor if you continue to have trouble sleeping.

The medical staff at Student Health Services or your family doctor can assist if you consistently find yourself falling asleep, feeling tired or not well rested during the day despite what feels like adequate sleep at night.

Don’t forget to change your clocks before you go to bed this Saturday!

Roger Miller, MD (OSU Student Health Services)

Have you found your “bliss point”? It’s not what you might think.

SugarStacks.com

prairieecothrifter

Obesity is all around us, and surveys reveal that more and more of us are endangering our future health through poor diet and lack of exercise.  It is our responsibility to control our appetites and activity.  Right?  Well, new information suggests that other forces are also at work. 

In the February 20 New York Times magazine, Michael Moss wrote about his research involving junk food, as part of an soon-to-be published book, “Salt Sugar Fat: How the Food Giants Hooked Us”.  Mr. Moss has uncovered some fascinating tactics used by food manufacturers to keep us hitting the snack aisle. 

  • Bliss point – optimizing each component in a product that the consumer likes to create the highest level of craving,  keeping the food good enough to want to eat, but not so good that you tire of the food.
  • Stomach share – how much each brand can dominate the market versus their competitors.
  • Sensory-specific satiety – design foods that taste good, but avoid any single distinct flavor that would tell you to stop eating.
  • Mouth feel – the positive interaction of food with the mouth in terms of moisture and texture (think chips).
  • Sweet range – the range of acceptable taste that may allow manufacturer to adjust costly ingredients to the lowest acceptable level in order to reduce cost
  • Vanishing caloric density  – ability of food to dissolve or shrink while eating, giving you the impression that you are eating less (Cheetos?)

Each of these factors is considered in the design and marketing of snack foods.  In this way, convenience foods like Lunchables end up including nearly a full day’s maximum amounts of fat, sodium and sugar.  Yogurt, which used to be considered a health food, has become a dessert given the amount of added sugar in each serving. 

For information about healthy eating, visit Student Health Services.  Our providers can advise you and refer you to nutrition services for further assistance. 

Roger Miller, MD  (OSU Student Health)

College Health for Black History Month – Diabetes

minoritynurse.com

Continuing our Black History Month theme of conditions disproportionately affecting African Americans, let’s talk about one of the biggest epidemics in modern medicine: Type 2 Diabetes.

African Americans are almost twice as likely as Caucasian Americans to develop diabetes in their lifetimes (11.8% vs. 6.6%) and much more likely to be obese (36.1% overall, with 42.1% of African American women being categorized as obese). We’re not entirely sure why this is; most likely it is a combination of genetics and lifestyle factors.

Diabetes isn’t just about high blood sugar levels; it comes with many long term complications. People with Type 2 Diabetes are much more likely to suffer heart attacks, vision loss, kidney failure, and strokes. And as if that wasn’t enough, diabetics are also more likely to experience impotence and foot complications that can lead to amputation!

One of the key strategies in fighting Diabetes is prevention. There are a few simple steps you can take to prevent diabetes:

  • If you are overweight, losing 5-7% of your body weight can ward off the development of diabetes – that’s only 10-14lbs for a 200lb person!
  • Squeeze in at least 30 minutes of physical activity 5 days a week – you’re already paying for RPAC membership, might as well use it!
  • Replace high fat, high sugar foods with healthier options – it’s easier than you may think.

For more information on Diabetes prevention, please check out this great program developed by the US Department of Health and Human Services.

If you have already been diagnosed with Type 2 Diabetes, you can help prevent complications with good blood sugar control. Regular visits to your doctor are essential to staying in control of this disease.

If you are overweight or have a family history of Diabetes, please see one of our providers at Student Health Services to talk about Diabetes screening.  You can also get some more useful information here.

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

Why You Eat More Than You Think

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Is this your day?  Overslept for 9 AM class; jumped out of bed, threw on some clothes, brushed teeth and ran out the door to class.  Sat in class until 10:18 and ran to next class at 10:30.  Had a break from 1:00 until 1:30.  Grabbed lunch to go at Market Place.  Wanted to get the salad but had to take it to class so picked the Tuna melt, bag of chips and a diet pop (tuna is healthy, right!).  Ate lunch in class, which ended at 2:30.  Ran home to change- had to be at work at Buffalo Wild Wings by 5PM.  Worked from 5 until 11:00PM. At work, scarfed down some wings and fries and sipped on diet coke throughout the night.  Got home at 11:30, exhausted and starving and too hyped up to go to bed.  Relaxed on the couch with laptop (Facebook, emails). Scoured the refrigerator and found a yogurt.  Ate that first since it’s healthy and you’re trying to lose some of the 20 pounds you have gained in the past year.  Spied the leftover pasta from Noodles and Co. and finished it off while watching the episode of Lost you had taped but it’s OK since you haven’t eaten much all day. Went to bed at 2AM.

This type of routine is not an untypical schedule for many OSU students.  We have become the “Masters of Multi-tasking”, because there is always too much to do.  Unfortunately, this does not always serve us well when it comes to our relationship with food.  Often we are not “in the moment” with our food (or with many other things as well).  This lack of mindfulness prevents us from being aware of our body’s natural signals for hunger and fullness.  It is important to realize that we all came into world normal, intuitive eaters.  Babies are experts at eating; they cry when they’re hungry and they stop eating when they’re full.  They eat exactly what they need to grow and be healthy.  They do not count carbs, protein, fat or calories.  They just eat!

Our body’s natural systems would continue to manage our eating and meet our body’s needs if modern society did not mess with them.  Arbitrary schedules are set up that interfere with intuitive eating and we are constantly bombarded with external versus internal food cues. No wonder we “mess up.”

So what is “Mindful Eating” and how can you re-learn this healthy approach to eating?  Mindfulness is deliberately paying attention to how, what, where and when you eat in a non-judgmental way.  It is using all of your senses – seeing, hearing, tasting and feeling – when you eat.  I call it “yoga with food” – it requires eating without distractions (no TV, Computer, work, studying) in a calm environment, and it requires practice. 

Here are some guidelines to help you implement mindful eating in your life and some web sites with good information that will start you on the path to more natural, intuitive eating.

  • Make eating consistently a priority and give yourself permission to eat. Eat breakfast within 30 minutes of waking and pay attention to hunger cues-usually about every four hours.
  • Keep a food intake diary for a week noting what, where, and when you eat and how you feel when eating.
  • Eat sitting down without distractions, preferably in a calm environment.
  • Turn off the television, computer, or other distracting electronic devices. Music is fine.
  • Eat at a table if possible-not on the couch, easy chair, car or bed.
  • Try not to work or study while eating
  • Slow down! Practice putting down your fork or sandwich between bites. Time a typical meal and add 5 minutes the next time you eat. Enjoy the texture and flavor of the food. Pay attention to your body’s signal of fullness or satiety.
  • Eat when you feel comfortably hungry (not starved) and stop when you are comfortably full (not stuffed).
  • Be aware of emotional triggers for eating-a “craving” is often the result of emotional need.

Remember, food is not the enemy!  There is no such thing as perfect eating, but eating mindfully will make it more pleasurable and satisfying.

If you would like to discuss mindful eating, or any other nutritional questions you may have, call to make an appointment with the Student Health Center’s Registered Dieticians.

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

Center For Mindful Eating

“Mindless Eating”

“Eating mindfully”

The L.A.N.C.E. of Testicular Cancer – Part 1

si.edu

To celebrate the last day of Movember, we’re re-running a two-part post about a men’s health issue that is especially important to male college and graduate/professional students.

The dramatic story of cyclist Lance Armstrong’s cancer survival has raised public awareness of testicular cancer and has made it easier to discuss.  Seizing this opportunity, I want to highlight 5 facts about testicular cancer that everyone must know – the L.A.N.C.E. of testicular cancer.

Lethal.  Most testicular tumors are malignant, meaning that they have a tendency to metastasize (spread) to other parts of the body, like the lymph nodes, lung, and brain.  It is invasion of these other organs, rather than damage to the testicle itself, that leads to serious illness or death.

All men.  Testicular cancer occurs most commonly in Caucasians, but all men are at risk.  The cause of testicular cancer is not known, but there are well-established risk factors:

  • History of an undescended testicle. Even with corrective surgery, an undescended testicle is 3-5 times more likely to become cancerous than a properly descended testicle.
  • A testicle that has not developed properly because of previous trauma, torsion, or mumps infection
  • Family history of a brother who has had testicular cancer.

Numbers.  Testicular cancer is the single most common type of malignant tumor occurring in men ages 15-35.  The incidence of testicular cancer has been increasing in many countries, including the United States.  The American Cancer Society estimates that approximately 8,400 new cases of testicular cancer are diagnosed in the United States each year. 

Curable.  Among all forms of malignancy, testicular cancer is one of the most curable.  If it is diagnosed in an early stage (e.g., while the tumor is still localized to the testicle) the cure rate is nearly 100%.  Even when it is widely metastatic prior to detection, the cure rate with aggressive treatment is greater than 80%.  At a minimum, treatment of testicular cancer requires surgical removal of the cancerous testicle.  Abhorrent as this might seem, it does not typically have any long-term effect on fertility or sexual function, as long as the remaining testicle is normal.  When metastases are present, treatment requires chemotherapy and sometimes radiation therapy or additional surgery.

Early self-detection is critical.  Most testicular tumors are discovered by the man himself, through intentional or inadvertent testicular self-exam, and sometimes even by an intimate partner.  The reality is that testicular cancer discovered during a routine medical examination, or after symptoms have developed, is likely to be much further advanced than one discovered by the man himself.  

If you are worried that you may have an undescended testicle, of if you notice any change in the size or shape of your testicle,  be sure to seek medical consultation as soon as possible.  Next week, we will discuss testicular self-examination.

James R. Jacobs, M.D., Ph.D., FACEP

Director, The Ohio State University Student Health Services

Photo: si.edu