Month: July 2010

Is it OK to have sex with my girlfriend if she has mono?

by

buzzle.com

Q: My girlfriend currently has mono and I have already had it. Is it OK if we have sex? What are any risks associated with having sex with her while she has mono?

A: Great question. Seems simple, but really lots of layers.

“Mono” (infectious mononucleosis) technically refers to a syndrome of symptoms – swollen lymph nodes, fever, sore throat, fatigue, etc. – rather than a specific infection.  Most cases of mono in the US are thought to be caused by the Epstein-Barr virus (EBV) but other viruses, such as Cytomegalovirus, can cause mono as well.  But let’s assume that we’re talking about the usual EBV version of mono.

If your girlfriend has typical symptoms and a blood test that confirmed the diagnosis, then she is almost certainly infectious.  EBV concentrates in saliva, so people usually catch it through a cough, sharing utensils, or most famously, kissing.  EBV can be transmitted in other ways.  Although not technically considered a sexually transmitted infection, one published study suggests that EBV can be transmitted through sexual intercourse and that condoms offer some protection.   

Most (not all) healthy people who have had EBV mono develop immunity to it and do not get sick from subsequent exposures, so there is little risk of you getting mono again if you guys have sex.  You will almost assuredly be exposed to your girlfriend’s EBV – so there is a significant risk that you will be re-infected, but miniscule risk that you will develop mono again.

But let’s think about your girlfriend for a second.  Assuming she actually feels up to having sex, is it safe for her?

It’s unlikely that having sex would pose any particular risks.  Mono will sometimes cause a person’s spleen to become enlarged, however, which places them at risk of having a spleen rupture, a true surgical emergency.  In fact, we often tell people with mono to avoid contact sports and certain other physical activities for several weeks to make sure the spleen has had time to return to normal size.  So theoretically, depending on the vigorousness of the sex, there might be a risk of injury to your girlfriend’s spleen.

The severity of EBV mono can range from unnoticeable to severe (sometimes requiring hospitalization), with most people falling somewhere in the middle.  I have no idea where along this spectrum your girlfriend falls, but if she was feeling lousy enough to end up in the doctor’s office, maybe sex isn’t really a priority for her at the moment?  Why don’t you pick up some popsicles for her or offer to take her dog for a walk and reassess the sex thing in a day or two… or ten.

James R. Jacobs, M.D., Ph.D.
Student Health Services
The Ohio State University

Your Taxes and What They Have to do With HPV

by

photo: portalsmag.com

One of my favorite blogs is The Blog that Ate Manhattan.  TBTAM is written by Margaret Polaneczky, an OB/GYN in Manhattan, and is a gold mine of terrific articles about women’s health and, believe it or not, can’t miss recipes.  Dr. Peggy’s daughter is in college right here in Central Ohio (not Ohio State) and this past April, Dr. Peggy wrote a nice post about her visit to our neck of the woods:

An Ohio Country Bike Ride

So what does all of this have to do with taxes?  Well one of the many wonderful things those pesky reductions in your paycheck underwrite is a website for the Office of Women’s Health creatively named Womenshealth.gov.  I can’t say enough good things about this site.  It’s chock full of good stuff and recently featured an interview with Dr. Polaneczky.  As usual, she’s interesting and full of information. You might be especially interested in her spin on HPV infections and the Gardasil vaccine.  Keep in mind that it’s just her opinion – the Women’s Health website has other good resources for information too.  You can find them here:

Spotlight on Women’s Health: Interview with an OB/GYN

Frequently asked Questions re: HPV and Genital Warts

And if you still have questions, schedule an appointment with our Women’s Services department.  They’re always glad to see you.

Victoria Rentel, MD
Student Health Services
The Ohio State University

Student Health FAQs for New Students

by

The Wilce Student Health Center

We know you’re bombarded with a lot of information in a small amount of time during orientation and it’s hard to retain it all.  So we thought we’d put the highlights here on the blog so that you can refer to them when you’re not so swamped.  Feel free to stop in or call if you have any questions.

Insurance  

We reviewed how insurance works at the Student Health Center in a previous post but before arriving on campus you should learn the basics – in-network vs. out-of-network, how co-pays work, etc. – and be sure to bring your insurance ID card with you to school. 

If you are not on the Student Health Insurance Plan, you should definitely consider purchasing the WilceCare Supplement.  For only $187 for the entire academic year, it supplements the health insurance that you already have by providing prepaid coverage for medical care delivered at the Student Health Center.  Routine x-rays, laboratory tests, physical therapy, minor office procedures, prescribed medical supplies, office visits for illness and injury and prescriptions are all covered.

Medical Records

We are under strict rules to keep all of your medical information confidential and we take those rules very seriously.  You’ll need to sign an authorization form for us to release your health information to anyone, including your parents.  An authorization form can only be completed for health services that have already been rendered which means that we can’t honor any requests like, “you can just let my Mom have access to my records for as long as I’m at Ohio State.”

Immunizations

There are no immunization requirements for most students entering Ohio State.  However, there are some program-specific requirements (for instance, health professional schools like medicine and nursing may require you to get certain immunizations) so be sure to check with your program coordinator.

The Centers for Disease Control recommends the following immunizations for all college students: Meningococcal Meningitis for students living in the dorm, Hepatitis B, HPV, MMR, Polio, Varicella (Chickenpox), Tetanus-Diphtheria, and Pertussis (Whooping Cough).  Hepatitis A, Influenza, and Pneumococcal vaccines are recommended for students with specific health risk factors.

All of these immunizations are available at the Student Health Center if you aren’t able to get them before you start school.  If you can get a copy of your Immunization records, that would be really helpful and keep you from getting immunizations you don’t need.   

Allergy Injections

You can get your allergy shots at the Student Health Center while you’re here for school.  You need to submit the required paperwork prior to scheduling an appointment.  You can bring the allergen vials to the health center yourself or have them mailed to our facility.  We will store them for you and we can release them back to you as needed for injections during times away from the university.

Pharmacy

You can transfer a prescription from home to our pharmacy.  All you need is the prescription number and the name/phone number of the original pharmacy – all of which are on the package label.  Our pharmacy is contracted with many insurance companies but not all.  You can stop by or call 614-292-0125 to find out if we can bill your specific insurance.

Enjoy the rest of your summer and welcome to Ohio State!

Is It Really Dangerous to Use My Cell Phone in a Medical Facility?

by

www.photobucket.com

Q: Is It Really Dangerous to Use My Cell Phone in a Medical Facility? 

A:  Good question.  It seems that as soon as you get within 100 yards of a hospital, signs start warning you that your cell phone could single-handedly cause mass casualties: pacemakers will shut down, defibrillators will start firing, EKG machines will miss heart attacks; satellites will fall out of the sky; the coffee machine in the doctors’ lounge will stop working…

And to be honest, I have seen cell phones cause a little static at the Student Health Center.  A couple of weeks ago, a nurse was doing an EKG on one of my patients and when his cell phone rang, it caused the tracing to go a little fuzzy for a few seconds.  So I did a little investigating.

Turns out that there’s probably nothing to worry about.  A recent study done at the Mayo Clinic showed that cell phones didn’t cause any interference with medical equipment in a hospital.  They did 300 tests on everything from pacemakers and ventilators to brain wave monitors and blanket warmers, and didn’t find one instance of interference.  These findings support a previous study done at Mayo back in 2001 that showed that cell phones interfered with EKG’s enough to hinder interpretation about 7% of the time, but the interference was never enough that significant abnormalities would be missed and it only occurred when the cell phone was within 3 feet of the EKG machine.

So if you’re getting an EKG done it wouldn’t hurt to take your cell phone out of your pocket, but otherwise you can feel fairly safe that your cell phone won’t do you (or anyone else) any harm.  Unless of course, you annoy everyone in the waiting room by talking about the last episode of Glee with your best friend at the top of your lungs – the Mayo studies didn’t say anything about how often cell phones cause people in medical facilities to have books thrown at them.

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

Questions About Insurance and the Wilce Student Health Center

by

photo: whig.com

I don’t have the Ohio State Student Health Insurance.  Can I still be treated at the Wilce Student Health Center?

Yes, all enrolled students are eligible to use the Wilce Student Health Center.  

Will my insurance pay for my visit at the Student Health Center?

At this time, Student Health Services does not participate as a network provider with most commercial insurances so you should verify your insurance plan’s out-of-network coverage before seeking care at our facility.  When speaking with your insurance company, it is helpful to give them our tax ID number – 31-1657245 – so that they know you’re talking about the Student Health Center.  Even though we’re all “Ohio State,” in the eyes of insurance companies our practice is separate and distinct from other physician groups and medical facilities associated with the university. 

Can I use my Prescription Drug Card at the Wilce Student Health Center pharmacy?

The Wilce Student Health Center Pharmacy does participate with most prescription drug card programs. You can call our pharmacy at 614-292-0125 to verify that we participate with your prescription card program.

I gave you my health insurance information when I waived the Student Health Insurance Plan. Why do I need to give it to you again?

The health insurance information you provided the university when completing your insurance waiver is currently used for registration and enrollment purposes only. In order for Student Health Services to bill your medical insurance company directly, you will need to register your medical insurance with our office.

Kristen Kelly
Student Health Services
The Ohio State University

Teeth Whiteners: Do They Work and Are They Safe?

by

wikimedia commons: dozenist

Dentist-prescribed overnight bleaching is the most effective method of teeth whitening, but it’s very expensive – anywhere from $400 to $900 per treatment, with multiple treatments often needed.  Over-the-counter (OTC) whitening agents are a lot more affordable, but do they measure up? 

Generally speaking, any peroxide-based product can whiten your teeth.  The ingredients in OTC kits aren’t as concentrated as the ones the dentists use, so they may take longer to work.  Tray-based products and whitening strips are your best bet – they are comparable in terms of side-effects and have been shown to be equally effective in whitening teeth.  As an aside, it’s important to note that most of the studies comparing the different products have been done by the product manufacturers, so take them with a grain of salt.

  • Tray-based: These products use carbamide peroxide as the bleaching agent. Be careful with the products that contain mouthpieces that aren’t custom-fitted. Because these mouthpieces may not fit snugly, some parts of the teeth may be covered by the bleaching agent, while some parts may not, resulting in uneven bleaching. The leaking can also lead to irritation. If the trays do not fit your mouth properly, they can irritate your gums and mess with the alignment of your teeth.
  • Whitening strips: The whitening strips use hydrogen peroxide as the bleaching agent. You typically will see results after a week. Maximum benefit occurs at 2 weeks; using it any longer than that doesn’t seem to add any further whitening effect.
  • Paint-on: These whitening agents come as a gel with a small brush, like nail polish. They use peroxide-based bleaching gel like the tray-based agents and you apply it once a day for 14 days. While the paint-on products seem to be as safe as the whitening strips, they aren’t as effective. 
  • Toothpastes: Whitening toothpastes can help the teeth remain cleaner and therefore look whiter but the stronger ones rely on abrasion to scrub off the outer layer of the teeth – the “newer” layer underneath looks whiter for a while but over time this will actually cause the teeth to lose shine and luster. Aside from the highly abrasive products, the peroxide-based toothpastes are generally safe for daily use although they’re not very effective at whitening teeth. They’re just not on your teeth long enough to do anything, even if you spend a long time brushing. Toothpastes are a decent option for if you’re trying to clean surface stains (e.g. from tobacco, coffee, etc.), but removing deeper stains and changing the color of the internal tooth structures requires professional intervention.
  • Chewing gums: There have been no clinical studies to see if these products actually whiten teeth so despite any marketing claims, we don’t really know if they work or not.

The most common side effect of dental bleaching products is tooth sensitivity.  This should not last more than a week after cessation of the whitening regimen – if it does, be sure to see a dentist.  Gum irritation is more of a problem with OTC bleaching kits, and is mostly due to the bleaching agents leaking around the edges of the mouthpieces.  This stuff not only tastes bad, but it can be dangerous if you swallow too much of it.  OTC whiteners haven’t been around long enough to say what the long term effects of sustained use are. 

If you do decide to use OTC whitening products, use them according to the package directions, stop using them if you experience bothersome irritation, and consult your dentist if you have any questions. 

Kelsi Wilkerson (OSU College of Pharmacy)
Philip Anderson, RPh
Student Health Services
The Ohio State University

Farting – how much is normal and what can I do about it?

by

Q: What can I do for THE BLOAT? After I eat, it’s like I’m pregnant and I fart for like three hours!

A: Few benign things elicit such concern in the exam room as THE BLOAT. The stories from patients, genuinely miserable and clutching their bellies, are eerily similar: 

“I eat, drink, and a few hours later I swell up like a balloon.”

“I am a human zeppelin!”

“My boyfriend thinks I’m pregnant!”

“I have to unbutton my pants until I poop.”

“It’s disgusting what comes out of me.”

“It can’t be normal.”

“The covers nearly fly off the bed.”

“I thought I’d explode.”

There are some uncommon and concerning problems that can cause intestinal distress and gas: lactose intolerance, malabsorption syndromes like celiac disease, Crohn’s Disease or ulcerative colitis, and bacterial overgrowth syndrome to name but a few. But these problems almost always have other, non-intestinal symptoms like rash, joint problems, anemia, or debilitating diarrhea.

Usually though, abdominal fullness and gas are our own fault. We just can’t help it. Every bite of food and every sip of liquid delivers a few milliliters of air to our gut, more if we gulp or chug. Certain foods-beer, broccoli, those beans and whole grains we health care providers just love to tell you to eat-create a lot more air in the colon.

Fun Fart Facts:

  • There are actually people studying how much intestinal gas is normal using argon washout and body plethsymography. (And you think working in your lab sucks…) The best they can determine, about 200cc (a little more than half a can of Coke) in the gut at any one time is pretty typical.
  • The amount of air coming out from the rectum (Look out below!) varies between 500 and 1500ccs a day. That’s right, some people put out almost 2 liters of gas a day.
  • Most people emit their gas, okay FART, 10-20 times a day.
  • We often suggest Beano, simethicone (Gas-X) and activated charcoal, but there’s actually little evidence that they help. Pepto-Bismol, believe it or not, doesn’t decrease gas production but it can make it less stinky.
  • You can actually buy odor-reducing underpants. It’s true. Something to keep in mind for next Father’s Day.
  • Girls fart too!  If you don’t believe us, take it from the MythBusters guys

If your gaseous output is causing you or your loved ones excessive distress, try the following:

  • Eat slowly.
  • Avoid sorbitol (Often found in diet food and chewing gum).
  • For that matter, avoid chewing gum altogether. People who chew gum often swallow more air.
  • Avoid carbonated beverages.
  • For a few days, lay off the cruciferous veggies and legumes.
  • Get some exercise. Skeletal muscle contraction in the belly will help move that bloat along.

If these steps don’t help, or you are experiencing other concerning symptoms, come in and see us.

Victoria Rentel, MD
Student Health Services
The Ohio State University

 

Do cell phones really cause brain cancer?

by

zipline.wordpress.com

In honor of July being National Cell Phone Etiquette Awareness Month – and with San Francisco’s Board of Supervisors recently approving a law requiring cell phone retailers to post the amount of radiation emitted by each phone they sell – we thought it would be a good time to re-run one of our post’s from last year addressing the question of whether or not cell phones cause brain cancer.

Q: I heard that cell phones might cause brain cancer. Is that true?

A: Cell phones work by emitting radio frequency (RF) waves, a form of electromagnetic radiation between FM radio and microwaves. Unlike x-rays or ultraviolet (UV) light, this form of radiation is non-ionizing, meaning that it lacks the ability to damage DNA molecules.

But because cell phones are constantly used in such close proximity to our brains, many people are worried that they might be associated with an increased risk of brain tumors.  There have been around 30 research studies over the past decade that have looked at this issue and most have found that:

  • People with brain tumors do not report using cell phones any more than people who don’t have tumors
  • People who use cell phones more than other people do not have an increased risk of developing a brain tumor
  • In people who had brain tumors AND who used cell phones, there was no correlation between the side of the head that they held their cell phone next to and the side of the brain that the tumor was on

These studies, however, do have limitations. Cell phones have only been around for about 20 years, so the studies haven’t been able to follow people over a really long period of time.  Also, there haven’t been any good studies looking at the effect of cell phones on the developing brains of children. 

For now, it’s safe to say that there is no evidence that cell phones increase your chance of getting a brain tumor.  Further studies will surely be conducted in the coming years but at this point, you’re safe to use all the free night and weekend minutes that you want.

Adam Brandeberry, Med IV (OSU COM)

John A. Vaughn, MD (OSU SHS)