Ice or Heat

photo: wikimedia commons

Q: I’ve heard of using both ice and heat after an injury. How do I know which one to use?

A: Ice and heat are both mainstays of treating orthopedic injuries (sprains, strains, pulls, even broken bones).  In general, a good way to figure out which one to use is to decide if the injury as acute or chronic. 

Acute injuries are ones that happened recently – think ankle sprain.   They usually cause pain, swelling and bruising (bleeding under the skin) in the area affected.  We usually recommend using ice after an ankle sprain or a pulled muscle.  Ice causes vasoconstriction – it makes the blood vessels clamp down – so it reduces blood flow to the area and decreases swelling and inflammation.  The cold temperature also numbs the area, which helps with pain.

Chronic injuries occur are slow to develop and have been around a while.  They usually result from overuse injuries – think muscle strains, tendonitis, and arthritis.  Heat is good to use before taking part in activities that involve chronic injuries because it increases tissue elasticity and promotes blood flow.  If you’re sore after taking part in those activities, you should switch back to ice for the reasons mentioned above. 

Never ice or heat an injury for longer than 20 minutes.  Prolonged ice exposure can cause tissue injury and even frostbite.  Heat should never be used for extended periods of time; you don’t typically get any extra benefit after 20 minutes and prolonged heat exposure can lead to burns.  Moist heat, like a warm washcloth, is a safer option than a heating pad because they are less likely to cause burns.

Adam Brandeberry, Med IV (OSU COM)

John A. Vaughn, MD (OSU SHS)

Enough with the Frickin’ Flip Flops Already!

You would not believe the number of students I see at the Student Health center complaining of foot, ankle and back pain that I can diagnose before I even walk in the exam room.  Do I have ESP?  X-ray vision?  Super Medical Spidey Sense?  No.  I hear the pitter patter of their feet walking down the hall and I know exactly what the problem is.  Two words… two cute, tiny, terrible words… Flip. Flops.

I hate flip-flops.  Hate ‘em!  Yes, they’re affordable.  Yes, you can get them in any color to match any outfit.  Yes, they’re fashionable and look cool with jeans that are 6 inches too long.  But they are terrible for you!  Terrible!

Flip-flops offer no arch support (yeah, I know Crocs and some other more expensive brands say they do, but I’m not buying it).  They don’t have the heel cushion or shock absorption that normal shoes do.  They may be fine when you’re running around on the beach or popping out to the store, but when you wear them all day, every day – especially when you’re hiking around campus with a 40-pound backpack – you’re setting yourself up for some serious pain: stubbed toes and blisters from cheap plastic, sprained ankles, broken toes, heel pain from plantar fasciitis, leg pain and low back pain.

I know you won’t listen to me – I’ve seen students walking on the oval in flip flops with a foot of snow on the ground! – but at least try to wear them in moderation.  Give your feet and back a break and throw on some sneakers every once in a while.

Angela Walker, Med IV (OSU COM)

John A. Vaughn, MD (OSU SHS)

The Real Big O

About one third of students here at Ohio State are Overweight or Obese.    The good news is that we’re no worse off than other universities across the country.  The bad news is that things may get a lot worse after graduation – almost twice that many people (63.4% to be exact) are overweight or obese in the general population!  Wow!  Why?

It’s a simple answer to a very complicated problem: too many calories and not enough activity.

In a recent survey, only about 60% of Ohio States students reported eating the minimal recommendation of 5 or more servings of fruit and vegetables a day.  And only 40% said they took part in intense cardio or aerobic activity in the last week.  We’ve got to correct this balance between calorie intake and expenditure if we’re going to keep Buckeye Nation fit, and luckily we are surrounded by resources right here on campus to help us! 

Campus Dining Services lets you see the nutritional content of food served at Ohio State here.  Take a few minutes to see how many calories you’re actually taking in – you might be surprised.

If you need help coming up with a healthy eating plan, you can consult with registered dieticians here at Student Health or with our friends at Student Wellness.

And while the RPAC is the crown jewel of campus physical fitness, there are many other awesome facilities and programs here at Ohio State: 5 indoor facilities, 20 outdoor facilities, more than 60 organized clubs dedicated to fitness, 15 intramural leagues each quarter, and more than 50 PE classes per quarter.  You can learn more about them here

As great as these facilities are, we know that they can be intimidating – you don’t know where to go, how to use the equipment, or you feel like the super-buff regulars might give you a dirty look.  If that’s the case, then start off with something you already do every day – go for a walk! 

Rec Sports has some great maps for walking/jogging trails on campus that range in distance from 1.0 to 4.6 miles.  Grab your iPod or a friend and hit the road!

College is a watershed time in your life, so try to shed (pun intended) those old habits and gain new healthy ones.  What you learn during your time at Ohio State will shape the rest of your life and we want you to make the Big “O” at Ohio State mean “Outstanding” in every way.

Jo Hanna Friend D’Epiro, PA-C, MPH (OSU SHS)

Pink Eye Panic

Photo 1

Allergic conjunctivitis

Q: My eyes were gooped up this morning and my roommate is freaking out.  Do I need antibiotic drops?

A:  Not necessarily.  It is common for us to wake up with some crustiness in the corner of our eyes. This is primarily caused by our tears drying on our eye lids overnight.  However, crustiness associated with any of the following symptoms should prompt you to seek medical attention as soon as possible:

  • Eyes that are stuck shut in the morning
  • Eyes that are red, irritated and watery
  • Burning sensation
  • Vision changes
  • Sensitivity to bright lights.

I know that just saying the words “pink eye” is enough to send people screaming down the street while spraying antibacterial lotion at you over their shoulder, but it’s important to remember that not all goopy eyes are infected.  Take a look at the photos to the right.  One is “pink eye” caused by a viral infection and the other is caused by allergies.  Can you tell which one is which?  (Answers below)

Allergies, dry eyes and other irritants can cause the same symptoms and they are treated differently.  And the “pink eye” kind of eye infection that spreads like wildfire through daycares is much less common in adults.  You should obviously avoid touching your eyes, wash your hands frequently and come in to get checked out, but you don’t need to be in quarantine.

A great way to prevent bacterial build-up on the eyelids and prevent infection is to wash your eyelids and eyelashes regularly by performing a “lid scrub.” With your eyes closed, rub gently along the eyelashes for about 30 seconds with a soft wash cloth moistened with warm water and diluted baby shampoo.  You can also use a specifically formulated eyelid scrub that can be found over-the-counter (Sterilid and Ocusoft are two brands we recommend).  If you wear contact lenses, be sure to take them out beforehand. 

Performing these lid scrubs once a day – along with wearing sunglasses – will help you maintain healthy eyelids and keep you seeing straight for years to come!

Nazreen Esack, OSU College of Optometry

Julia Geldis, OD (OSU SHS)

photo 1: virus infection          photo 2: allergies


Why is my poop green?

Q: Why is my poop green?

A: Green poop is usually caused by your diet – as they say, what goes in must come out.  Green vegetables like spinach and broccoli contain large amounts of chlorophyll, a green pigment that can remain in the stool as it passes through your system. Artificial dyes from things like soft drinks and candies can also cause your stool to be weird colors.  Blueberries and Pepto Bismol can turn your stool black.

Another potential cause of green poop is bile. Bile is a greenish/yellowish chemical stored in our gall bladder that helps us to digest fat.  It is usually broken down in the intestines and gives stool it’s normal brown color.  But if stool moves too quickly through the intestines – like when you have diarrhea – it can pass through unchanged and give the stool a greenish color.

There are some infections, such as Salmonella, that can cause green poop but they are usually associated with severe diarrhea and abdominal pain.

Unless you’re having other symptoms we don’t usually worry too much about the color of poop.  The only exception would be black or red, which can be a sign of bleeding in your gastrointestinal tract.  If you ate a big piece of Red Velvet cake the night before, it’s probably OK.  But if you see red or black in the toilet bowl, and/or you are having other symptoms (abdominal pain, fever, weakness, diarrhea, nausea, etc.) be sure to come in and see us.

Adam Brandeberry, Med IV (OSU COM)

John A. Vaughn, MD (OSU SHS)

Icky Feet!

The latest in foot care technology?

To everything in primary care there is a season. Winter, for example, to me will forever be associated with runny noses, the flu, and the smell of Purell.  Summer is filled with poison ivy and sunburn.  Autumn brings allergies and sports physicals.

Spring for me is feet.  

As soon as the flip flops and sandals come out, patients start showing me their flakey and discolored toe nails; cracked dry heels; and their athlete’s foot. If you have a fungus among us-either in the toenail or the skin-then you need to see us for some of our prescription mojo.  But those dry, rough heels? You can deal with those yourself.

Dry skin on your heels is just a build-up of a lot of dead tissue, and it needs to come off. You’ll need a little elbow grease and a good, thick emollient. Go to your local grocery or big box store (i.e. Target) and pick up something to grind that tissue away, preferably something with two sides like sandpaper: a coarse side and a fine grit side. In fact, you can use actual sandpaper!  Ideally, 60-grade aluminum dioxide sandpaper on a sanding block, which basically makes a giant emery board.  It’s cheap, one package lasts forever, and it gets the job done.

Gently attack those rough, tough, thick areas on your heels, a little at a time. Wash off the powdery stuff that is left with soap and water in the shower, or soak your feet for 10 minutes or so in warm water.  When you’re done, apply a very thick emollient, like petroleum jelly, Eucerin (in the tub), Aquaphor, or something with lanolin. If you have time, throw on a thick pair of cotton socks for a few minutes to let that stuff work its magic.

Do this a few times a week and after a month or so you’ll have feet worthy of your finest gladiator sandals!  If you’ve been toiling away at foot perfection and it just isn’t working, come on in to see us.  We’ll set you up with a lotion that will help eat away that dead skin.

If you’re diabetic, have problems with your circulation, or have open wounds or pain in your feet – don’t try this at home.  You should have a foot specialist take a look to make sure nothing more serious is going on and you don’t do any damage to vital structures.

If you have questions or aren’t sure about the low down on your feet, get on the horn and make an appointment with your health care provider – we’re here to help you out. 

Victoria Rentel, MD (OSU SHS)


Shouting “Smoke!” in a crowded theater

Which of these phrases gets your pulse up? 

  • “Wanna grab a smoke?”
  • “Look at that disgusting ashtray right by the door.”
  • “Man, can you believe how far I have to walk to smoke a cigarette?”
  • “Ooooh, that cigarette smoke is coming in my window!”
  • “Gee is taking away my rights!”
  • “College students should be smart enough to not smoke!”

People feel strongly about smoking.  At least in cycles.  It is somewhat like a presidential election – every few years, people declare their intentions to fight for smokers’ rights, or to fight for a ban on all tobacco.   It’s one of those things that never goes away.  Yet the issue is a hard one to resolve.  Even the USG candidates and President Gee disagreed in the Lantern on what should be done. 

Perhaps we can agree on:

  • Nicotine is an addictive stimulant. Once you start using it, it is hard to stop.
  • Burning tobacco leaves and inhaling the smoke, or using any of the new smokeless versions exposes the user to multiple health risks.
  • For a lot of nonsmoking people, being around tobacco smoke is irritating and bad for their health too.

This is not a new debate for OSU, or across the country for that matter. Reducing tobacco use has been a prevention priority since the 1964 report from the Office of Surgeon General, which first described the hazards.  It has even recently come under regulatory control by the Food and Drug Administration. 

So, should we discuss this issue again?  Do we do something about it?  If doing something, what?  Give us your comments. 

Breathe easy.

Roger Miller, MD (SHS Preventive Medicine) for BuckMD


Ride with the Pelotonia Student Team

Buckeyes Riding to Beat Cancer!

Did you know that 1 in 2 men and 1 in 3 women will be diagnosed with cancer?

Help change this startling statistic by riding with us on August 21st in Pelotonia! Pelotonia is a grass roots bike tour with one goal: to end cancer. In its inaugural year, Pelotonia raised $4.5 million for life saving cancer research at The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute.

Thanks to our generous sponsors, every dollar raised by riders goes directly to cancer research.  As a Buckeye, the registration fee is waived and your fund raising minimum is only $500. All funds must be raised by Friday, August 13, 2010.

Every rider will receive a Pelotonia rider jersey, goodie bag, food, drinks, entertainment, transportation and overnight lodging at Ohio University if they do the two-day ride.  Ohio State students also get a 10% discount and another 10% re-contribution towards your fundraising at Roll: bike stores. 

To register, visit here and contact about submitting the completed registration form!

Thanks and Go Bucks!

I stepped on a nail. Do I need a tetanus shot?


Q: I stepped on a nail and am wondering if I need a tetanus shot.  My last shot was 5 years ago.

A: You should probably get a tetanus shot in this case.  Tetanus vaccines are given to children in the USA with a series of 5 childhood shots called the DTaP.  The vaccine covers diphtheria, tetanus, and pertussis.  A booster that contains vaccines to all three diseases is given between the ages of 11 and 18.  After that, it is recommended that adults get the Tdap booster vaccine every 10 years, and sooner (every 5 years) if there is an injury. 

Puncture wounds from objects like nails and bites are most susceptible to infection with tetanus. However, you can also get tetanus from any exposure to soil, including minor cuts, scrapes, and burns, and sometimes with no injury at all. 

Once the tetanus bacteria get into your tissues, it starts creating toxins.  These toxins interfere with nerves, which leads to spasms, contractions, and respiratory failure.  We take this disease seriously because it is potentially deadly but very preventable.

It is important to take care of a skin wound to prevent infection.  The first steps should be to clean the wound with soap and water.  Use an antibiotic cream and keep the wound covered with a bandage until it scabs over.  Remember to change the dressing daily or it becomes wet or dirty, and seek care if the wound is getting more red or painful, or if you have other concerns. 

FINAL SUMMARY – if you get hurt, consider getting a tetanus shot if it has been more than 5 years since your last booster, and keep your tetanus protection up-to-date every ten years. 

We provide the tetanus vaccine and many others here at the Student Health Center, so you can always come in and see us to get one.

Adam Brandeberry, Med IV (OSU COM)

Roger Miller, MD (OSU Preventive Medicine)


Flashes and floaters and Eyes, Oh My!

Have you ever seen flashes of light or weird little floaters in your vision? Wonder what causes them, and if they’re something to worry about?  Well wonder no more my friends!

Your eye is composed of a gel-like substance called the vitreous that helps maintain the shape of the eye and acts as a “shock absorber” to protect the fragile retina. As we get older, the vitreous begins to liquefy and deteriorate, and the contents of the vitreous clump together. These clumps of vitreous can appear in your vision as “spots,” “cobwebs,” or “floaters” and may vary in size and location. These floaters tend to appear as moving spots in your vision and can come and go throughout the day.

Floaters are quite common and usually harmless, but they may lead to other more serious conditions, such as retinal tears or detachments. It is important to see an eye care professional immediately if you experience any of the following:

  • sudden onset of floaters
  • loss of vision that accompanies the floaters
  • numerous or large floaters
  • floaters associated with trauma to the eyes or head
  • a sudden increase (or “shower”) of floaters
  • flashes of light

Flash of light are a little more worrisome.  They are caused by stimulation of the retina, which can be due to many things:

  • a retinal tear or detachment
  • a posterior vitreous detachment (common)
  • migraine headaches (common)
  • rapid eye movements (very common)
  • retinal infections or inflammations (rare)
  • central nervous system disorders (rare)

If you see any flashes of light it is very important to see your eye doctor right away to make sure you don’t have a retinal tear or detachment; if left untreated they can result in vision loss. 

If you have any concerns about your vision, you can make an appointment with Student Health Optometry Services – we’re happy to check you out.

Tia Tucker, OPT IV (Ohio State College of Optometry)

Julia Geldis, OD (Staff Optometris, SHS)