Month: September 2009

Can I get treated for ADD at the Student Health Center?

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ADD medicine

Q: Does Student Health Services provide evaluation and treatment for ADD/ADHD, and if not, can you refer me to a reliable provider in the Columbus area?

A:  As we mentioned in a previous post, the management of Attention Deficit (Hyperactivity) Disorder – ADD or ADHD – is tricky because of the dangerous nature of the medications involved, so Student Health Services has to follow very strict guidelines.  Here’s the deal: 

The primary care physicians at Student Health Services can treat you for ADHD if the following are in place:

  • You have documentation of neuropsychological testing on file with us that establishes the diagnosis of ADD/ADHD and includes the name and specialty of the tester as well as the results of the specific tests performed.
  • You do not have other mental health diagnoses such as bipolar disorder, schizophrenia, or psychotic disorders.
  • You sign a medication contract with us.

Does a letter from my doctor back home count as documentation?  No. 

Does a copy of my medical records from back home count?  No.   

But my doctor never sent me for all of those tests.  She just diagnosed me in her office, started prescribing the medicines and I’ve always done fine on them. 

In that case, you’ve got two options: keep seeing your doctor back home for your ADHD or get formal testing done to confirm the diagnosis.

So where do I get this neuropsychological testing done?

Unfortunately, Student Health Services does not offer neuropsychological testing at this time.  Counseling and Consultative Service offers individual and group counseling services for students with ADHD and The Office of Disability Services can assist students with ADHD in obtaining necessary accommodations for academic work, but neither of them offer testing either.

If your doctor can’t refer you to someone back home, we usually refer students to Dr. Robert Bornstein or Dr. Elizabeth Cook at the Medical Center.  The testing usually takes around half a day to complete and costs around $300 out of pocket (be sure to check with your health insurance plan for exact coverage info).

We know this is a huge hassle.  We know that it’s a lot of time and money – two things that most students don’t have a lot of.  And most of all, we know that it sucks to be made to feel like a criminal when all you’re doing is seeking care for a medical condition.  And we are sorry.  But unfortunately, there are people out there who are abusing the system and we only make you jump through all of these hoops to ensure your safety and the safety of the other students on campus.

If you have any further questions about ADHD management at Student Health Services, you’re always welcome to call or make an appointment to speak with us about it.   

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

Does HPV affect men?

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genital wart caused by HPV infection

Q: I heard HPV (Human Papilloma Virus) causes cancer in women, but does it affect men too?

A: Absolutely!  It is estimated that up to 75-80% of all sexually active individuals – men and women – will become infected with HPV at some time in their lives.  HPV is spread by direct contact with infected skin or mucus membranes (such as the vagina, anus or mouth) so even if you’re wearing a condom, the skin around it that is uncovered can be exposed to the virus.  While most men infected with HPV have no symptoms, there are several conditions that can be caused by the virus:

Genital Warts

These can appear as flesh-colored growths on the penis, testicles, groin or anal area. They can be raised, flat or cauliflower-shaped. Warts can be treated with topical medicine or frozen off but they often return.  Warts may clear on their own, but they may also become larger or begin spreading over the skin surface. There are over 100 types of HPV; the types that cause genital warts usually do not cause cancer but it is possible to become infected with more than one type at a time. 

Anal Cancer

A few specific types of HPV are implicated as the leading cause of anal cancer but this isn’t known for sure.  Anal cancer is more likely to occur in men who engage in receptive anal intercourse but both anal HPV and anal cancer can occur in men who have never engaged in this activity.  HPV can be spread to your partner’s anus if you have warts or other HPV types on your penis or in your mouth and you perform insertive anal intercourse or oral-to-anal sexual activities.

Penile Cancer

Penile cancer, like anal cancer, is widely attributed to specific types of HPV.  This cancer is very rare, occurring in only about 1 in 100,000 circumcised males in the US.  In other regions of the world such as South America, Africa and Asia, the incidence of penile cancer is far greater and accounts for up to 10% of all malignant tumors in these regions. Penile cancer affects approximately 7,000 men annually worldwide.

Throat Cancer

Throat cancer has had a dramatic increase in recent years.  HPV can be spread from the anogenital areas to the mouth and throat (and vice versa) via oral sex.  HPV can lead to tumors of the throat, tonsils and tongue.  Oral sex isn’t necessarily safe sex!  You should use condoms and dental dams even for oral sex.

Angela Walker, Med IV (OSU COM)

David Lehnus, CNP (OSU SHS)

Food is an important part of a balanced diet

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Over the summer I’ve seen a lot of students who aren’t feeling well, not a surprise since my job is seeing students who don’t feel well. As I’ve tried to get to the bottom of what’s what, I’ve been surprised and somewhat taken aback by how many of you survive on $2 Happy Meals and $0.99 extra value menu items. While I am loathe to denigrate (or pass up) a $2 meal that comes with a free toy, fast food does not form the basis of a healthy diet.

I concede that the food service isn’t always on the same schedule as hunger. After a long, stressful day in the lab or library, throwing together a soufflé might not be super relaxing. McDonalds, on the other hand is open late and doesn’t require any advance planning.

But it’s not that hard to throw together a healthy meal. Here’s a brief guide to feeding yourself well without spending a lot of money or all afternoon prepping mise en place with an expensive German knife.

First, you have to find the food. Your mom, roommate, friend, or even good old COTA (the local city bus for you out of town newbies) can help get you to fresh suppliers. Along with local groceries, don’t forget the affordable bounty at our local ethnic markets. Three or four are a stone’s throw north on High Street. The North Market and its fabulous Saturday farmer’s market is a brisk 2 mile walk south on High Street. For a comprehensive list of fresh food, check out:

Hungry Wolf’s Guide to Local Food Procurement

Once you get provisions, what do you do? How about salads? Hard-boiled eggs, precut salad bar vegetables, and pre-cleaned greens in bags make a decent salad a breeze. Bulk nuts and dried fruits are great ways to add protein and fiber. Add a side of bread, and you’re running your own Panera. Check out the link below to stretch your salad wings:

Minimalist’s 100 simple salads for the season

Real, live college students commented on their food survival techniques @ 101-Cookbooks:

Dorm Food Ideas

If you have access to a microwave and fridge there’s almost nothing you can’t do. Look for one of the many well-reviewed products on the market that make cooking rice or pasta in a microwave a breeze, and check out these sites:

Eating on $25 a week

Cooking ramen in the microwave

Cooking rice in the microwave

Once you’re an accomplished chef, what are you to do with all those odds and ends you have left? Try the Restaurant Puppy. You enter what you have and the puppy spits out recipes for you to try:

An Ingredient based Recipe Search Engine – Recipe Puppy

So, veteran Buckeye eaters, what do you do? Please post a comment and share your epicurean expertise with the rest of us.

Post voraciously written by Victoria Rentel, MD (Ohio State Student Health Services) with a title shamelessly stolen from Fran Lebowitz

OMG CMB @ SHS!

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Could this be you?

Health care providers can be funny about confidentiality, and by “funny” I mean anal retentive, obsessive compulsive and paranoid.  Not only did our mothers raise us better than to try to get your attention by yelling across a room, “Hey! Guy with herpes!” it’s also the law that we keep your personal health information private.  And frankly, nobody here wants to go to jail over a pap smear confidentiality breach. 

While we’re always mindful of our obligation to protect your privacy, we’re also always on the lookout for new ways to reach you more effectively.  With that in mind, I recently chanced upon an interesting study from 2006 entitled, “Texting decreases the time to treatment for genital Chlamydia trachomitis infection.”

At a sexual health clinic in the UK, patients were divided into two groups. One group received cell phone text messages about their STI testing results (discreet messages like ‘all of your results were negative’ or ‘please call/return to the clinic’ with a phone number).  The control group got the traditional “phone-tag” method.   

The results of the study were interesting. The time to treatment for the texting group was SEVEN AND A HALF DAYS shorter than the traditional phone notification group!  Not only that, but it required a lot less manpower for the clinic staff, which translates into cost and time savings to provide more clinical services.

So here’s my question for you, young Buckeyes.  Would you be willing to have less secure communications with Student Health Services for the sake of quicker notification and treatment? Would you be willing to waive a bit of your privacy rights for the sake of a faster information turnaround?  Post a comment and let us know – we promise we won’t tell anyone…

Victoria Rentel, MD (Ohio State Student Health Services)

News You Can’t Use – School of Rock!

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Raise your goblet of rock!

In today’s installment of News You Can’t Use, a review of a 2006 article in the journal Ear & Hearing entitled, “Hearing in non-professional pop/rock musicians.”  That’s right, garage band rockers, I’ve got something to say to you.  And I’m writing it down because apparently you might not hear me if I told you to your face.

Musicians in the study were evaluated after five years of repeated exposure to loud, intense music. A significant proportion of those who didn’t wear ear protection experienced noticeable hearing loss (6 dB in the 3-8 kHz range).  In those who did wear ear protection, there was some hearing loss compared to age- and gender- matched controls, but it was more modest (2.4 dB). Nearly half of the unprotected musicians reported hypersensitivity to sound and/or tinnitus, a persistent and unpleasant ringing, buzzing, whining, screaming, roaring, or clicking sound.

“Thanks, boring old person,” you say to me, “but what about my music and my freedom?”  As boring and uncool as it might seem, if you want to continue to be free to hear your music, you better plug up your ears when you plug in your amp.  (By the way, orchestral musicians, you tend to have more noise-induced hearing loss than the general population as well and should also consider ear protection.)

Foam and silicone earplugs are inexpensive, readily available, and will provide some protection for your ears. You may feel a little cut off from the outside world, however, kind of like you’re under water.  Flanged musician’s earplugs cost a bit more ($10-15) but will provide better sound fidelity: they attenuate the volume evenly over all frequencies. For even better sound fidelity (at significantly higher cost) you can visit an audiologist for custom plugs made specifically for the needs of musicians.

Victoria Rentel, MD (Ohio State Student Health Services)

Ear Hear. 2006 Aug;27(4):321-30.

What causes a runner’s cramp?

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a bad runners cramp or side stitch

Q: What is a runner’s cramp – that sharp stabbing pain that lasts for a few minutes when you run?

A: That pain you get sometimes while running or doing other endurance athletics, often referred to as a “runner’s cramp” or “side stitch,” is technically called exercise related transient abdominal pain (ETAP) in the medical world. It usually occurs on the right side of the abdomen and is described as sharp, stabbing, cramping, aching, or pulling.

It is extremely common – one research study found that 30% of runners in a single 14K race experienced a side stitch – but the reason we get them is not very well understood. There are a few theories as to what causes the pain: friction on the lining of the intestine; a lack of oxygen to the diaphragm; or maybe stretching and pulling of abdominal ligaments. This could explain why side stitches occur most commonly on the right because the liver is a large, right-sided organ with lots of ligaments.

Prevention of side stitches is not an exact science. Some research indicates that avoiding large, fatty meals three hours before running could decrease ETAP by decreasing the pulling on the abdominal ligaments. Taking a quick rest or decreasing exercise intensity can make it stop. Other maneuvers that may also be helpful include: breathing through pursed lips after deep inhalation or bending forward while tightening abdominal muscles. The most proven method, however, has been strengthening of the core muscles and improvement of general fitness.

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

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

Name our new clinic!

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Student Health is constantly searching for ways to improve our services for students, and we’re very excited about a new project that will make it easier than ever for you to take advantage of what we have to offer.

This fall quarter we will be rolling out a new walk-in clinic at the Wilce Student Health Center.  Like the “Minute Clinic” at CVS, our walk-in clinic is designed for the student who needs to be seen for a limited range of acute, minor illnesses without an appointment.

We’re very excited about the added convenience this clinic will offer, but we need your help in making sure we got the concept just right.  We’ve come up with 5 possibilities for the name and we want you to let us know which one you like best.  Visit the poll on our front page and vote for your favorite.  The name receiving the most votes by the end of the day on Friday, October 2nd will become the official moniker for our new clinic!

Remember Buckeyes, this is your clinic so make sure your voice is heard!  Go Bucks!

Who can get a flu shot and how much does it cost?

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We have received many inquiries from students and parents regarding seasonal flu immunization (flu shots) at the Student Health Center – specifically, who can get one and how much does it cost?  Here is what you need to know: 

Any registered student is eligible to receive a flu shot.  Spouses and partners of students are eligible to receive a flu shot only during a mass immunization program.

Students insured under policies other than the Comprehensive Student Health Insurance Plan and dependents of students are expected to pay at the time of service.

The cost for flu injections administered during mass programs, scheduled 2nd floor clinic programs or during pharmacy programs is $25.  This cost is covered in full for students insured under the Comprehensive Student Health Insurance Plan. 

The cost for flu injections administered individually or during an office visit is $36.  This cost is covered at 50% under the Comprehensive Student Health Insurance Plan. 

The cost of immunizations is specifically excluded under the WilceCare Supplement, for dependents insured under the Comprehensive Student Health Insurance Plan and when administered in any facility other than the Student Health Center under the Comprehensive Student Health Insurance Plan.

Details of the distribution and costs associated with administration of the H1N1 vaccinations are still being determined.  Once we have more specific details they will be shared in a future communication. 

Our pharmacy is currently giving flu shots from 8-11am every day – no appointment is necessary.  Click here to see a calendar with the dates and times of our flu shot clinic programs (be sure to scroll to October as well).

Have a great fall quarter!

Susan Henn  (Manager, Patient Relations, Ohio State Student Health Services)

 

Posted in flu

Is it OK to sleep in my contact lenses?

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Take 'em out every day!

Q: Is it OK to sleep in my contact lenses? What if they are a “Night & Day” brand?

A: Even though there are particular designs of lenses that are approved for “extended wear” (the industry term for overnight wear), it is very important to have your eyes examined to ensure that they would be safe for wearing lenses overnight.

The cornea (the clear, outermost layer covering the colored part of the eye) has no blood vessels so it gets all of its oxygen from the outside environment. Even though contact lenses let some oxygen pass through to your cornea, they filter out a significant amount so wearing lenses for a long period doesn’t let your cornea “breathe”. This can lead to significant degrees of inflammation, irritation, redness, and discomfort. 

Additionally, nighttime lens removal, cleaning and soaking in a disinfecting solution (NOT JUST SALINE) is an essential step to maintain adequate eye health for contact lens wearers. This overnight soak removes deposits and neutralizes bacteria and viruses that build up on the lens throughout the day. So, when you wear lenses overnight, they are often contaminated with bacteria that increase the risk of infection. This can lead to a potentially serious disorder called a corneal ulcer, which can lead to blindness.

Because of these serious consequences, we recommend that you only wear your lenses overnight under the guidance of an eye doctor. However, we realize that not all overnight wear of contacts is planned. If you think there is a chance that you might be sleeping in your lenses, stick a lens case in your pocket or purse. If you do forget to take out your lenses, be sure to consult your eye doctor if you experience any redness, discharge, pain, light sensitivity, or reduced vision. Even if you don’t have any of these symptoms, it might be a good idea to wear glasses the next day to give your eyes a chance to “breathe.”

The staff of Ohio State Student Health Optometry Services is always happy to see you about your eye safety concerns.  We’re here to protect your sight and keep your eyes healthy!

Adam Brandeberry, Med IV (OSU College of Medicine and Public Health)

Gregory J. Nixon O.D., F.A.A.O. (Associate Professor of Clinical Optometry, OSU College of Optometry and Student Health Services)

Can you get an STI from oral sex?

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Q: Can I get a sexually-transmitted infection (STI) from performing oral sex?

A: The bullet answer – Yes.  The bullet points: 

  • The rate of genital-oral transmission is generally much lower than for unprotected vaginal or anal sex for all STIs.
  • One big risk from unprotected oral sex is herpes, which causes recurrent painful sores around the lips or genitals. Many people have oral herpes, or “cold sores”, which frequently and inconveniently appear at times of stress or illness. Genital lesions are often more painful and arguably more inconvenient. Risk of infection is greatest when the partner has visible lesions, but transmission can occur even when no lesions are visible. (Ouch.) There is no cure for herpes, but there is medication available to suppress outbreaks and decrease asymptomatic viral shedding.
  • HPV and HIV are also orally-transmitted viruses. HPV commonly causes genital warts and cervical cancer, but can also cause vocal cord polyps. HIV is the virus that causes AIDS. It can theoretically be transmitted through oral sex if there are cuts or scrapes in the mouth.
  • Chlamydia and gonorrhea can cause throat and eye infections. Syphilis can cause painless sores (chancres) that are easy to miss but bad to have. All three can be eradicated with antibiotics.
  • There are a couple of ways to protect yourself and your partner from oral STIs. First, be open and ask questions. While talking about a chancre might be a buzz kill, it might keep you from getting (or giving) “a gift that keeps on giving.”
  • Consider seriously using protection. Dental dams and condoms can be used to decrease risk (but don’t use spermacide-I’ve heard it can kill taste buds). They aren’t absolutely bulletproof, though. If you or your partner have active, oozing lesions just hold hands. Then wash them.
  • If you have questions or would like more information please schedule an appointment with your provider at the Student Health Center.  

Adam Brandeberry, Med IV (OSU COM)

Victoria Rentel, MD (OSU SHS)