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New Year’s Resolutions

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At the beginning of a new year, many of us resolve to take better care of ourselves.  This often includes a desire to eat more healthfully.  How to accomplish that can be confusing.  There are numerous “experts” and guidelines.  They sometimes conflict and often do not seem to be practical or helpful.

The types of foods we consume can have a huge effect on how we feel and think.  Sugar intake has markedly increased over the past few decades.  This correlates with a significant rise in obesity, diabetes, heart disease, hypertension, and other health problems.

It appears highly likely that reducing sugar intake can have a big effect not only on how we feel and look now, but also reduce our chances for numerous chronic diseases in the future.

This does not mean that you have to “diet” or be hungry.  I would encourage you to eat when you are hungry and include a diverse range of foods such as unprocessed meat, fish, chicken, nuts, vegetables, and fruits.

However, try to avoid sugar and foods that cause a rapid elevation of blood sugar levels.  Examples of foods to avoid include the following:

  • Processed grains such as breads and cereals
  • Foods and condiments containing sugar
  • Sweets (e.g. candy, soda)
  • Potatoes

Eating healthfully can be a challenge.  However, it can make a big difference.  Please make an appointment at the Student Life Student Health Center (614-292-4321) if you would like more information.

Submitted by Matthew Peters, M.D.

Cholesterol: the Good, the Bad, the Ugly

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Q: I have heard about “good” and “bad” cholesterol. What’s the difference and how do I know which one I’m eating?

A: Way to be a buzz kill on Thanksgiving week!  Just kidding – great question.  Let’s begin with a little chemistry lesson.

 

 

Fat doesn’t dissolve in water and blood, so it has to get chauffeured around your body by cholesterol.  There are two main types of cholesterol: high density lipoprotein (HDL, “the good guy”) and low density lipoprotein (LDL, “the bad guy”).

HDL acts like a scavenger or vacuum cleaner, picking up cholesterol and transporting it back to the liver, where it is processed and put to many necessary uses like building cell walls and membranes, bile acids and hormones.

On the other hand, LDL picks cholesterol up from the liver and drops it off throughout the body. This is especially problematic in blood vessels where the excess cholesterol can form plaques. The blood vessels around your heart (“coronaries”) are the diameter of spaghetti; a little plaque in them can mean a lot of trouble, like a heart attack. Too much plaque in the vessels supplying your brain can mean a stroke.

How do you know when your LDL is too high? Unfortunately, high cholesterol has no specific symptoms so a blood test is the only way to find out.  While healthy eating and exercise can go a long way towards keeping your cholesterol in check, high cholesterol can have a genetic component so you should talk to your doctor about when you need to start screening.

Certain foods, like trans fats, can actually increase LDL and decrease HDL. On the other hand, fatty fish (like salmon), walnuts and oatmeal can actually decrease LDL.  If you’re a smoker, quitting can also improve the amount of HDL in your blood (among a host of other improvements to your health). To see more tips on cholesterol and what you can do to improve yours, check out the websites below:

American Heart Association

U.S. National Institutes of Health

The Mayo Clinic

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

Victoria Rentel, MD
Student Health Services
The Ohio State University

Medical Mythbusters: The turkey made me do it!

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There are a lot of traditions at Thanksgiving; turkey, pumpkin pie, football games, shopping, and of course “the nap”.   At my house dinner usually begins around two.  After the meal has been blessed, the football fanatics fill their plates and head to the family room to cheer on their favorite teams.  The non-football inclined take their plates to the table and kibitz.  About an hour or so later a quick glance into the family room usually reveals that the football fanatics have transitioned to “the nap”.

The fanatics, of course, would argue that the turkey made them sleepy.  Turkey contains an amino acid called tryptophan.  Tryptophan helps the body produce the B-vitamin niacin which in turn helps the body produce serotonin.  Serotonin acts as a calming agent in the brain and plays a key role in sleep.  Hence the myth that turkey makes you sleepy.

But… tryptophan works best on an empty stomach and let’s face it, at Thanksgiving, no ones’ stomach is empty!  The turkey is competing with the potatoes, veggies, rolls, and deserts and only a small part actually makes it to the brain to produce serotonin.

The more likely culprit for the after dinner nap is a combination of things.  You have on a new fall sweater, dressed up for the relatives, which is making you a bit warm.  It’s the middle of the afternoon and the sun is shining through the windows causing you to squint a bit, i.e. close your eyes.  You’ve just consumed an enormous meal of 3000+ calories with significant carbs, and more than likely you’re a bit sleep deprived.  All of these together have the perfect makings of a nap!

So, don’t blame the turkey for that after dinner rest.  Instead, give thanks this Thanksgiving for the blessings of a wonderful meal eaten with family and friends and for the opportunity to catch up a little bit on your sleep.

Submitted by Tina Comston, M.Ed.

Meningitis B

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It seems like every year there are several outbreaks of meningococcal infections on college campuses across the country. This disease is caused by a bacterium called n. meningitides which can infect both the brain and the blood. Although meningococcal infections are rare even with treatment this infection can be deadly in 10-15% of patients. Those who survive can experience permanent disabilities like amputation, hearing loss, brain damage, kidney damage, and scarring from skin grafts. As a student at The Ohio State University you are required to be vaccinated for meningitis before you can live in university housing. This vaccine covers meningitis type A,C,Y, and W-135. It does not cover meningitis B which causes nearly half of meningitis cases in patients aged 17-22. There are currently two vaccines on the market for meningitis B, Trumenba and Bexsero. Both vaccines are approved in the United States for patients aged 10-25 for the prevention of meningococcal type B infection. Although the medication is approved for 10-25 the Advisory Committee on Immunization Practices and the CDC give these recommendations.

These vaccines are recommended for patients ten years and older who:

  • Are at risk due to a type b outbreak
  • Have a damaged or removed spleen
  • Have an immune system condition known as “persistent complement component deficiency.”
  • Are taking eculziumab (Soliris)
  • Routinely work with N. meningitides.

There is an additional recommendation that the vaccine may be given to anyone aged 16-23 with a preferred age of vaccination being 16-18. This allows patients and their healthcare providers to determine if they want the vaccine.

Both vaccines require multiple doses. Bexsero is a two dose series with the doses being administered at least one month apart. Trumenba can be a two or three dose series depending on your risk level for meningococcal B infection.

 

Michael Kowalczyk

PharmD candidate 2018

Migraines… Ouch!

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Did You Know?

In the U.S., more than 38 million people suffer from migraines with 5 million of those being chronic migraine sufferers. Migraines occur most commonly in women, young to middle-aged adults, low income groups, and Caucasian people. Migraines can be quite debilitating and cause you to miss class or work which can then turn into additional financial, school, or emotional stress.

 

What is a Migraine?

A migraine is a recurrent throbbing headache that typically affects one side of the head and is often accompanied by other bothersome symptoms. Migraines often last longer and are more painful than normal headaches. Some symptoms migraine sufferers may experience in addition to headaches are nausea, vomiting, light or sound sensitivity, fatigue, dizziness, vision changes, and aura.

 

What Triggers Migraines?

Migraines can be triggered by a number of things but the most common cause is stress or anxiety. Other triggers of migraines include hormonal changes in women, foods, overuse of medications, environmental changes, depression, or obesity.

 

How Can You Treat Migraines?

It is an awful feeling when you feel the start of a migraine coming on, especially when you have a big exam the next day that you need to study for. It is a good idea to take an over-the-counter medication when you feel a migraine starting. Some options include ibuprofen (Motrin® or Advil®), naproxen (Aleve®), acetaminophen (Tylenol®), or a combination medication containing acetaminophen, aspirin, and caffeine (Excedrin®). However, it is not a good idea to be taking these medications every day or else it can have a rebound effect and cause your migraines to be even worse (known as a medication overuse headache). Sometimes, a migraine will not be relieved by a medication over the counter in which case you would want to see your doctor. He or she may prescribe you a medicine to help treat or prevent your migraines. Some other ways to help treat migraine symptoms without medication include drinking plenty of water, laying down in a dark and quiet room, light massaging of the head and neck, and using pure grade essential oils.

 

How Can You Prevent Migraines?

If you have been suffering with migraines, it is important to keep a “headache journal” and log the severity and location of your migraine. You should also log what activities you were doing and what foods you were eating that day. It is also a good idea to log what you did, if anything, to help relieve symptoms of your migraine. Keeping a headache journal can help you and/or your doctor better understand the trends of your migraines and notice any triggers that cause them. If you notice a trend in triggers, it is a good idea to avoid those triggers. Since stress and anxiety are big triggers for migraines, it is important to maintain a healthy lifestyle with skills to practice stress management. Some ways you can manage stress include exercising daily, eating a balanced diet, staying hydrated throughout the day, meditating or practicing yoga, or other activities that help release endorphins and relax your mind.

 

Lindsay Ecclestone, PharmD Candidate 2019

The Ohio State University College of Pharmacy

 

Resources

Migraine Statistics. https://migraine.com/migraine-statistics/

Expedited Partner Therapy (EPT): A Way to reduce Sexually Transmitted Infection (STI)

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Expedited Partner Therapy (EPT) is a strategy to treat the sex partners of persons diagnosed with sexually transmitted infections. When clinicians use EPT, they give the prescriptions to their patients who were just diagnosed with Gonorrhea (GC), Chlamydia (CT) or Trichomoniasis (Trich) and also give another prescription to the patient’s partner(s). This allows partners to receive treatment quickly and interrupt the spread of STI’s and reinfection.

The prescription can be provided if the three following conditions are met:

  1. The intended recipient is a sexual partner of the prescriber’s patient.
  2. The patient has been diagnosed with chlamydia or gonorrhea or trichomoniasis.
  3. The patient reports to the prescriber that the sexual partner is unable or unwilling to be evaluated or treated by a health professional.

Frequently Asked Questions:

Q: Is there an EPT for any other sexually transmitted infections (STIs) besides Gonorrhea, Chlamydia or Trichomoniasis?

A: No. EPT was legalized in Ohio on March 23, 2016 exclusively for Chlamydia, Gonorrhea or Trichomoniasis infections.

Q: How can I get a prescription for my partner(s)?

A: A separate prescription for your partner(s) must include (if known) the sexual partner’s name, date of birth, allergy information and address. However, if the prescriber is unable to obtain the partner’s name and address, the prescription must instead include your name and address, along with the words “expedited partner therapy” or the letters “EPT.”

The prescription for EPT can be provided for up to 2 sex partners. The cost of EPT will not be covered by most insurances.

Q: What are the benefits of EPT?

A: Studies have shown that patients whose partners received EPT were 29% less likely to be reinfected than those who simply told their partners to visit the doctor.

EPT is a very effective method of preventing reoccurrences of STIs. If your partner does not have access to health care or is unwilling to get tested or treated, please contact the SHS Women’s clinic.

Essential Oils for Stress and Anxiety

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Essential oils are commonly used for a variety of reasons, but is there really any benefit to aromatherapy? Studies have shown that certain smells can be associated with both negative and positive emotions and memories. For example, the smell of a dentist’s office can bring anxiety to some patients but may be overcome with use of essential oils to block the negative smell. Lavender, on the other hand, is a common essential oil used as a calming agent and its use has been studied in a number of patients experiencing different types of stress and anxiety with beneficial results.  These studies found that stress and anxiety and their associated effects were decreased with the use of lavender. Overall, people experienced better sleep, lower heart rate, and lower blood pressure when exposed to lavender aromatherapy.

It is recommended to use these oils via a diffuser rather than by mouth or inhalation. Some topical formulations are manufactured and are mostly safe when used as directed but stop use if any reaction occurs.  Overall, essential oils are associated with minimum side effects when used as directed and for short durations. They act quickly with no possibility of dependence, tolerance, or withdrawal.  If only diffused, these oils can be used in addition to prescribed medication with no interactions.  If you have any questions ask your primary care provider or pharmacist before using essential oils.

 

-Erin Coddington PharmD Candidate 2019

 

Malcolm BJ, Tallian K. Essential oil of lavender in anxiety disorders: Ready for prime time? The Mental Health Clinician. 2017;7(4):147-155. doi:10.9740/mhc.2017.07.147.

 

“I never get sick… I do not need the flu shot”

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Are these your thoughts when asked if you will get the flu shot this year?

Everyone’s immune system works differently so some people get sick more often than others. Just because you “never” get sick does not mean you are invincible from getting the flu. Influenza is spread by respiratory droplets (from sneezing, coughing, or even just talking) which can directly or indirectly be spread from person to person. If an infected person sneezes and then touches a door handle, you are at risk of getting infected just from touching that same door handle. All it takes is one infected individual on campus to be able to spread it to many, many others.

 

Why should you get vaccinated against the flu?

Influenza is a potentially serious disease that can lead to hospitalization and sometimes death. Each flu season is different, and influenza can affect people differently, but millions of people get the flu every year. Of those millions, hundreds of thousands of people are hospitalized and thousands or tens of thousands of people die from flu-related causes every year. An annual influenza vaccine is the best way to help protect yourself and others against the flu. Vaccination has been shown to have many benefits including reducing the risk of flu illnesses, hospitalizations and even the risk of flu-related death in children.

 

How do flu vaccines work?

The flu vaccine contains dead strains of the influenza virus. When vaccinated, these injected dead viruses cause antibodies to develop in the body about two weeks after vaccination. These antibodies provide protection against infection with the viruses that are in the vaccine. Therefore, if you are exposed to the flu later in the season, your immune system will be ready to defend you from getting infected with the virus. A lot of people claim that they get sick right after receiving the vaccine. It is scientifically impossible to get the flu from the vaccine since dead viruses are injected and it takes two weeks for your body to develop antibodies. The reason some people may feel flu-like symptoms after getting the vaccine is because your body’s immune system is triggered when injected with the vaccine but that is a risk with any vaccine you receive.

 

Who should get vaccinated this season?

Every person over the age of 6 months old should get a flu vaccine every season. The reason you need to get a vaccine every year is because each year, the strains of viruses are a little bit different. Therefore, a new vaccine is created each year to protect you against the projected strains of influenza for that given year.

 

 When should you get vaccinated?

You should receive your flu vaccine before the flu begins spreading in your community since it takes two weeks for your body to develop the antibodies necessary to protect you. The CDC recommends that people get a flu vaccine by the end of October each year.

 

Where can you go to get vaccinated?

You can get your flu shot conveniently right on campus at the student health center! Flu shots are available at the pharmacy located on the ground floor. In addition, you can get your flu shot at your doctor’s office, clinics, health department, or at any retail pharmacy.

 

Lindsay M. Ecclestone, PharmD Candidate 

 

References

https://www.cdc.gov/flu/protect/keyfacts.htm

https://www.cdc.gov/flu/about/disease/spread.htm

 

Combatting the Freshman 15

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Make healthy choices to avoid the Freshman 15

Make healthy choices to avoid the Freshman 15

Welcome to college! The next 4 years will be the best years of your life. There’s nothing like leaving home for the first time, jumping into the bliss of independence and making bad decisions. You’ll be able to stay up as late as you want, over sleep your alarm, and consume way too many empty calories while tailgating the football games. College seems amazing! You have access to all the food you want and no parental supervision….I mean come on who wouldn’t want to have a late night slice of pizza, three servings of ice cream at traditions or even a warm chocolate chip cookie when you’re finished with lunch. But if you’re not careful the dreaded freshman 15 can catch up to you real quick and those brand new jeans you just bought, to look good at the game next weekend, will no longer button. So here is some advice on how to avoid gaining those extra 15 pounds no one wants to admit to gaining.

  1. Hire someone to smack that cookie out of your hand you pick up at the dining hall after every meal.  Since most students have no self control over the delicious sweets that are put in front of them, you can put someone else in charge of keeping your diet more healthy.
  2. Set an alarm for 5 minutes before a huge exam. This way when you wake up late and freak out that you’re not going to make it to your exam on time it forces you to run to class. You’ll realize how out of shape you are and get yourself back into the gym.
  3. Speaking of the gym, you may join a club sport to play recreationally since you use to play in high school. After practice you’re going to want to sit down and eat with your friends. Remember starting left bench is not the same as actually playing in high school. You can’t expect to eat the same and lose weight.
  4. In high school you were probably use to your parents cooking you dinner every night, making sure it was somewhat healthy…well in college they’re not here to cook your meals. So if you live close enough, go home to have them feed you. That way you won’t have to worry about consuming 1,000 calories from a loaded potato pizza from the PAD.
  5. If you don’t live close enough, it’s time to start paying attention to what you are eating. Everything has calories. Maybe you should rethink your order of an asiago cheese bagel with cream cheese, a cookie and a large buckeye mocha latte. If you eat that every morning I can promise that you will not be able to button your pants in a couple of weeks.
  6. Dining halls have so much delicious carb heavy food. Who wouldn’t want to eat pasta, with broccoli cheese soup and churro cupcake every single day? I can tell you it feels really good walking around feeling extremely full and bloated…But maybe try adding some plants into your diet. A good fresh salad (not smothered in ranch, bacon and cheese) or a side of vegetables instead of french fries can taste delicious and help combat that disgusting bloat you’ve been feeling for the last 4 days.
  7. Remember that water is your best friend. The first sign of thirst is hunger. You may have no insight as to whether you’re hungry or thirsty. Next time your stomach is growling after you consumed gross take out Chinese, try drinking a full glass of water. You maybe more thirsty than hungry (since we all know Chinese food is filled with salt and MSG).
  8. Water is also essential for keeping our body healthy. Granted a nice refreshing pop or juice can taste delicious at times but depriving your body of water can do more harm than good. Water has this magical power to make you feel full, especially when bored. Try increasing your water intake to 8 glasses a day. Rule of thumb is you want your urine be light yellow to clear. So when you go to the bathroom next and your urine is bright to dark yellow, you know you’re not drinking enough water.
  9. It is inevitable to not feel stressed while taking 12 credits and going out every night. I mean why would you start studying for a test now when you can put it off until the night before and cram. Try to eliminate getting too stressed out. An increase in stress can lead to stress eating as well as increased hormones. This can ultimately lead to weight gain and acne you haven’t seen since you hit puberty.
  10. Make sure you are getting enough sleep to be productive. It may not be a good idea to go see “IT” if you know you’re not going to sleep for the next 10 days. Many times when you’re over exhausted you start grabbing for sugary substances to keep you awake. This does not help with trying to avoid gaining weight.
  11. But when you don’t sleep enough, energy drinks always sound like a great idea. Next time you grab one why don’t you flip the can around and look at the calories. With over 200 calories in a Monster energy drink, you may want to rethink grabbing those empty calories. Opt for some black coffee or tea. But if you have to have that energy drink maybe try grabbing for one of the sugar free or low calorie ones.
  12. When all else fails just go out and buy bigger clothes. Your student loans will really appreciate being spent on new clothing that one day you’ll have to payback at 5% interest.

Remember as a student it is really easy to fall into a bad routine since it’s a lot of people’s first time away from home. While many people joke about gaining the freshman 15, it happens to the best of us. Just be conscious about what you consume. You are probably not working out as vigorously as you did in high school, so you can’t eat the same way. College can be a stressful at times. Find ways to cope with stress whether it’s meditation, exercise or a hobby. It is best if you don’t turn to food during the stressful times. And if all else fails, go talk to someone about getting healthier. Take advantage of the registered dietitian at Student Health Services. They are here to help discuss your diet and encourage you to make the lifestyle changes you want to make. And if scheduling an appointment with the registered dietitian doesn’t fit into your schedule there are other options available on campus at the wellness center in the RPAC. You do not have to gain the freshman 15…it is up to you.

Dayna Gewolb, PharmD Candidate Class 2018

 

Can I drink beer while on medication?

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OSU football is in full swing, and this may mean an increase in alcohol consumption during the months to come. There are many drugs that interact with alcohol to some extent. These interactions can either metabolize medications and decrease the medications effectiveness, or can have the opposite additive effect and increase the risk of toxicity.

Here is a limited chart of studied alcohol-drug interactions and the risk/warnings of combining the two, be sure to ask your pharmacist about any drug-drug interactions before taking your medication:

Common OTC/Prescribed Medications Clinical Effects Recommendations
Pain Medications:
Acetaminophen (can be found in multiple OTC/prescribed drugs) Acute alcohol use in large amounts can increase risk of liver toxicity Do not consume >3 alcoholic drinks/day while taking this medication
Aspirin (Excedrin), ibuprofen (Motrin) and naproxen (Aleve) Increased risk of gastrointestinal bleeding Do not consume >3 alcoholic drinks/day while taking this medication
Codeine, hydrocodone + acetaminophen (Norco, Lortab, Lorcet, Vicodin), oxycodone + acetaminophen (Percocet, Endocet) and tramadol (Ultram) Co-ingestion may lead to respiratory failure, increased dizziness, sedation and can potentially be fatal Avoid alcohol consumption while on these medications
Antidepressants/Seizure medications:
Amitriptyline (Elavil), imipramine (Tofranil), clomipramine (Anafranil); and bupropion (Wellbutrin/Zyban); phenytoin, perampanel (Fycompa) Increased risk of sedation, dizziness, fainting; may also increase risk of seizures; may cause psychiatric effects Minimize or avoid alcohol use, speak to your doctor/pharmacist about alternatives
Diabetic medications:
Glyburide (Diabeta), metformin (Glucophage) and insulin therapies May cause vomiting, nausea, headache, muscle or stomach pain and visual disturbance. Unpredictable effects while on insulin may occur Avoid heavy alcohol consumption (>3 drinks/day)
Antihistamines:
Diphenhydramine (Benadryl, ZZZquil) and doxylamine (Sleep Aids) Increased risk of sedation and dizziness Advise against alcohol consumption, speak to your doctor/pharmacist about alternatives
Antihypertensives:
Amlodipine (Norvasc), nicardipine (Cardene), nifedipine (Procardia), atenolol (Tenormin), and metoprolol (Lopressor, Toprol XL) Increased risk of dizziness and fainting

 

 Advise against heavy alcohol consumption (>3 drinks/day)
Antimicrobials:
Doxycycline (Vibramycin), ketoconazole, metronidazole (Flagyl), and isoniazid May decrease effectiveness of medication, as well as increase risk of vomiting, nausea, stomach pain. Isoniazid and alcohol may cause liver damage Advise to avoid alcohol on all antimicrobial agents ask your pharmacist about interactions with your medications

 

Next time someone hands you an alcoholic drink and you are taking medication, ask yourself… is it worth the risk?

 

Justin Corpus

PharmD Candidate 2018

References:

  1. Alcohol and Drug Interactions. Pharmacist’s Letter/Prescriber’s Letter. December 2015.