Meningitis – Shot or Not?

Get your vaccination

With the tragic death of an OSU student just before break, it is timely to discuss meningitis vaccine.  We are talking about the worst form of meningitis in adults, which is Meningococcal meningitis.  Vaccines have been sought for many years to protect people from this disease. 

This is particularly true after the great success with vaccination against another form of meningitis in infants with the HIB vaccine.  Haemophilus Influnzae B used to be the most common cause of meningitis in children, and now happens in only 2 out of every 100,000 children.

Meningococcal meningitis is present in several forms (or serotypes) that are important to understanding the vaccine.  The current US vaccines protect against Type A, C, Y and W-135.  A fifth type, serotype B, is not included in the vaccine.  Vaccines that protect against B are still in development.  What does this mean for you?  We agree with the US Centers for Disease Control and Prevention (CDC) that all adolescents should be vaccinated before high school, and consider a booster dose of vaccine if they are going to college.  Additional doses are recommended for people with certain health conditions.

However, we must remember that even 100% vaccination is not going to prevent every case of meningitis.  In addition to getting the meningitis vaccine, we should all be practicing good hygiene by limiting contact with people when we have a fever, covering coughs and sneezes, avoid sharing things that can be contaminated with saliva (cups, cans, utensils, smokes of all kinds), and also seeking care for severe headache and fever.   These steps may not prevent all tragic outcomes, as this disease can be very aggressive, but should help. 

Another thought – consider getting your flu shot every fall.  A bout of respiratory infection, including influenza, may increase your risk of meningococcal infection.  For more meningitis information, you can visit our web site  and the CDC Meningitis web site.

Best of Health,

Roger Miller, MD
Student Health Services
The Ohio State University

Exercising with Asthma

Today we have a guest post from our colleagues at the OSU Asthma Center, a top-notch group of clinicians dedicated to keeping Ohio State students breathing easy.

Exercise is important for staying healthy during college and grad school.  But if you have asthma, exercise can be a challenge because it can cause constriction of the breathing (bronchial) tubes and make breathing difficult.  This is referred to as exercise induced bronchospasm (EIB).  EIB is estimated to occur in 80% of asthmatics and up to 20% of people without asthma.  Athletes appear to be more susceptible.

What are the symptoms of EIB?

  • Wheezing
  • Coughing
  • Shortness of breath
  • Chest tightness
  • Excessive tiredness
  • Environmental factors such as humidity, temperature, air quality and pollen count impact EIB

Is there a test for EIB?

Eucapnic voluntary hyperventilation (EVH) is the recommended test for diagnosing EIB.  We can perform this test at the OSU Asthma Center.

Does my asthma need to be under control to exercise?

If you feel that your asthma is not well controlled, you should not exercise.  Be sure to see your health care provider for an evaluation, and if you are experiencing severe symptoms go to the emergency room.

How do I know if my asthma is controlled?

Your asthma is under control if you are able to go to school, work, exercise and sleep with minimal symptoms.  Other indications that your asthma is under good control include:

  • Only needing your rescue medication ≤ 2 times per week during the day
  • Only needing your rescue medication ≤ 2 times per month during the night
  • Your peak flow is greater than 80% of your personal best reading                                        

What can I do to prevent EIB?

  • Talk to your provider about medicines for preventing EIB during exercise. 
  • Warm-up (break a sweat) for 5-10 minutes then rest for 5 minutes before exercise. 
  • Consider exercising indoors on days with extreme temperatures or poor air quality.
  • When exercising in the cold, breathe through your nose as much as possible and wear a scarf or mask over your nose and mouth to help warm the air before it hits your lungs.

What if treatment is not helping?

There are a number of other conditions besides asthma that can cause symptoms similar to EIB, such as vocal cord dysfunction, acid reflux or heart problems.  If you are not responding to treatment, see your health care provider.  The specialists at the OSU Asthma Center can perform testing to establish the right diagnosis and manage your condition.

When do I need to see a specialist?

The following are all situations in which discussing a referral to a specialist with your primary health care provider would be a good idea.

  • Persistent breathing symptoms despite warming-up and preventive medicines.
  • You are unable to reach your exercise goals due to your breathing.
  • You are a competitive athlete and require documentation for use of bronchodilators during competition.
  • You desire formal testing or more education about EIB

For more information about living well with asthma, check out our website and our facebook page!

Cathy Benninger, RN, MS, CNP
The OSU Lung Center

My breasts are lumpy! What Should I do?

I’ve noticed that every once in a while my breasts become super sensitive and lumpy. Should I be worried? 

Let me preface this post by saying that any changes in your breast tissue should be evaluated by your women’s health provider right away. 

What you’re describing sounds like fibrocystic breast disease, a benign condition that is very common, especially among younger women. The changes are thought to be related to fluctuations in hormones throughout the menstrual cycle. Although the pain can occur at anytime throughout the cycle, it occurs most commonly around the time of your period.

Symptoms include dense, lumpy breasts associated with a heavy feeling, tenderness, and even brown or green nipple discharge.  Any nipple discharge – especially if it has blood in it – needs to be evaluated as soon as possible. 

Fibrocystic breast changes have not been found to increase your risk for breast cancer, but they can make it more difficult for you or your healthcare provider to perform breast exams, and can interfere with tests like ultrasounds or mammograms. That’s why it’s even more important for you to perform monthly breast self exams so you’ll know how your breasts normally feel and will be better able to detect changes.  You should always perform your breast self exam at the end of your period – this is when your breasts are typically the least sensitive. 

While none of the following treatments have been scientifically proven to be effective in treating fibrocystic breast disease, many women find relief by:

  • Drinking less caffeine
  • Using a non-steroidal inflammatory drug like ibuprofen (Motrin, Advil) or naproxen (Aleve) for pain
  • Following a low salt diet to prevent water retention

If you are having any breast changes (do you notice a pattern here?), see your women’s health care professional as soon as possible or make an appointment with our Women’s Services department. 

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

Ryo Choi-Pearson, MD
Student Health Services
The Ohio State University

How do I help my friend get out of an abusive relationship?

National Domestic Violence Hotline

Q: My friend has stopped going out because she says her boyfriend won’t let her; he thinks she’ll cheat on him if she hangs out without him.  I barely see her anymore and I’m worried that he’s crossed the line in their relationship. What can I do? 

A: It can be difficult to assess whether abuse is occurring in a relationship, including your own!  Abusive behavior is often hard to recognize and many people may actually believe that it is part of a normal relationship. The first step in knowing if your friend is in trouble is to learn what abuse looks like.

Physical and sexual abuse can be described as any unwanted physical contact.  It might be hard to identify in a friend because victims often hide the physical evidence (bruises, scrapes or cuts) and feel that they are to blame in some way.

Emotional abuse is harder to define.  It can range from verbal insults and threats, to online bullying by text, email or social network stalking.

Abuse is always about power and control, and research has shown that it is much more likely to escalate rather than resolve.  Facts about dating violence:

  • 1 in 4 women will experience abuse at some point in their lifetime.
  • 80% of women stay in abusive relationships.
  • On average, it takes women 7 attempts to leave an abusive relationship. This is explained by a concept called the cycle of abuse.
  • Women ages 16-24 have the highest risk for becoming victims of dating abuse.
  • 32% of college students report being abused by a past partner and 20% report being abused by a current partner.
  • 60% of acquaintance rapes on college campuses occur in casual or steady dating relationships.

Dating abuse is much too complex to contain in a single blog post.  Please see the links below for more information, including links to local resources.  If you are concerned about your partner finding out that you’re looking for help, please use a public computer to access the links below!

The Safe Space    The Red Flag Campaign    Break The Cycle


It’s Abuse   

The Ohio State Student Wellness Center   

Ohio Domestic Violence Network

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

Emily Vargas, GAA
Student Wellness Center
The Ohio State University

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

Ohio State campus meningitis update

After the tragic news of the death of an Ohio State University student last week from meningitis (infection around the brain and spinal cord caused by a virus or bacteria), we would like to share some information about this uncommon but dangerous disease. 

Meningitis causes headache, fever and rash.  Bacterial meningitis is the most dangerous form of this infection. Overall in the U.S., there is one case per 100,000 people each year. 

Many OSU students have been vaccinated against meningitis, but the vaccine is not 100% protective against all exposures to this disease.  If you are in close contact with a friend or family member with this disease, you should discuss your level of exposure with a health-care provider, and find out if preventive antibiotics are needed.  If you have symptoms (headache, stiff neck, high fever, rash) you should seek care even if you have had the vaccine. 

Without close contact, the risk of catching this infection from being in class or living in the same dorm is small. Those who are most likely to be affected include:

  • Household contacts, especially young children.
  • Anyone who had direct contact with the student’s oral secretions through kissing or sharing toothbrushes, drinking glasses, cigarettes or eating utensils, or by being coughed or sneezed on.
  • Anyone who frequently sleeps in the same room as the student, and had direct contact with the student during or just before their illness.

Protective antibiotic treatment should be given as soon as possible after an exposure, preferably within the first few days. In those situations, we would recommend that any student who feels they meet the above criteria for exposure report to Student Health Services, their private doctor’s office, or to an emergency room or urgent care center. The usual antibiotic treatment is a single dose of the antibiotic ciprofloxacin (500 mg). However, each person would need to be evaluated to determine the best treatment for them, which may include no treatment at all.

General questions about meningitis can be posted here as comments and we will respond, or you can contact Student Health Services at 614-292-4321. 

Roger Miller, MD
Student Health Services
The Ohio State University

Do I have to get vaccinations to attend Ohio State?

Allergies, Injections, Immunizations

Q: Am I required to get vaccinations to attend The Ohio State University?

A: Yes.  The Ohio State University does have a vaccination requirement, effective Fall Semester 2015.  The requirement is made of up three (3) components:

  1. New to The Ohio State University – this component applies to those students who are:
    1. A new Ohio State University student – never before attended classes at Ohio State
    2. Attending the Columbus Campus
    3. Taking at least one (1) face-to-face class
    4. Attending half-time or greater
  2. New to Ohio State University Housing – this component applies to those students who are:
    1. An Ohio State University student
    2. New to University Housing on any Ohio State campus – never before lived in Ohio State University Housing
  3. New International Student – this component applies to those students who are:
    1. A new Ohio State University student – never before attended classes at Ohio State
    2. An international student

Based upon your student status, you may be responsible for 1 or more of the above components.

To find out more about the Vaccination Requirement at The Ohio State University, check out the following webpage:


Updated by Tina Comston, M.Ed.

As easy as riding a bike?

Your old childhood friend the bicycle is suddenly hip again!  It’s a healthier, greener, cheaper and more fun way to get around than that gas-guzzling car.  But things have changed since your grade school Huffy-banana seat-riding days, so we thought it was time to test your bike safety knowledge with a little True or False quiz. 

  1. You are more likely to get hit by a car when riding on the sidewalk than in the street.
  2. When riding in the street you should always hug the shoulder as close as possible to allow cars to pass you. 
  3. When riding in a bike lane, you don’t have to follow the rules of traffic. So if the light turns red and there’s no cross traffic, you can blow on through!
  4. Riding a bike home is a safe way to avoid a DUI if you’re too drunk to drive.


  1. TRUE Cyclists who ride on the sidewalk are 2-9 times more likely to get hit by a car! This is because cars aren’t expecting bicycles to be riding on the sidewalks and may not look for them at crosswalks. You run the risk of getting hit at every intersection!!
  2. FALSE This is a tricky one because it depends on the road you’re riding on. If there is a wide shoulder with plenty of room for cars to pass, then by all means ride on the side. But if there is a small shoulder or narrow lanes that would cause a passing car to have to “squeeze” by you, then don’t feel bad about taking up the whole lane. This prevents you and the driver from getting into a risky situation.
  3. FALSE Even when riding in the bike lane, you are still considered to be a “vehicle” on the road and are subject to the same rules as cars (and can get the same tickets). That means no running red lights, blowing stops signs, or making illegal turns.
  4. FALSE If you aren’t able to drive, you aren’t able to ride. Both modes of transportation require that you have the coordination, awareness and alertness to follow the rules of the road. And you can get a ticket for DUI while riding a bike, so just call a cab!

As spring approaches, it’s important to take your bike into a local shop to make sure it’s safe for you to ride.  But it’s equally important to make sure that you are safe to ride it!  Always wear your helmet and check out the links below.  Happy riding!

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

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

Spring ahead during Sleep Awareness Week!

Better than this?

March 7-13 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 14. 

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
Student Health Services
The Ohio State University

Black Out In a Can

In November, students were appalled when their beloved “black out in a can,” AKA Four Loko, announced that they would be removing the caffeine from their beverages.  The U.S. Food and Drug Administration (FDA) had sent out a warning letter to four manufacturers of alcoholic caffeinated beverages stating that these drinks were unsafe and subject to seizure. 

What’s the big deal?  What’s so dangerous about mixing alcohol and energy drinks?

Combining alcohol and caffeine creates a “wide-awake drunk” – because of the stimulating effect of the caffeine, you don’t feel the fatigue that you normally do with alcohol consumption alone.  In other words, you don’t feel as drunk as you really are.  So you end up knocking a few more back than you might otherwise and keeping the party going way longer than it should. 

The problem is that your blood alcohol level goes up the same whether your drinks contains caffeine or not; all you’re doing is adding the nasty risks of caffeine intoxication to the already dangerous risks of alcohol intoxication – horrible hangover, insomnia, vomiting, palpitations, dehydration, elevated blood pressure and even cardiovascular failure (otherwise known as death).  Scary stuff.

On top of that, a 2008 study of college students showed that mixing alcohol and energy drinks led to a higher prevalence of being taken advantage of (or taking advantage of someone) sexually, getting into a car with a drunk driver and suffering injuries that require medical treatment. 

If you and your friends are still looking to get a little “loko” this weekend, here are some tips to follow that will hopefully keep you a little safer.    

  • Split the drink with a friend
  • Dilute your drink with soda, juice, or lots of ice
  • Don’t drink on an empty stomach
  • Drink lots of water throughout the night

Alexandra Hinkley
Senior, School of Allied Medical Professions
The Ohio State University

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

Take it from Ben Franklin, Get Vaccinated!

wikimedia commons

Just came across an excellent and timely essay about immunization in the New York Times written by Dr. Howard Markel, a professor of the history of medicine at the University of Michigan.

Even though Dr. Markel is from that school up north, he knows what he’s talking about.  There are a lot of ill-informed people out there today saying that vaccines do terrible things, cause terrible disease and are a conspiracy by the medical-industrial complex to invade our bodily fluids.  Now, apparently, they also violate the Founding Fathers’ principles upon which our great nation is built. 

But using little things like facts, research and evidence, Dr. Markel proves that once again these people know not of what they speak.  Vaccines save lives.  They prevent horrible disability.  They keep pandemic illness from speading like wild fire through communities.  When people don’t get vaccinated, they not only put themselves at risk, they put you and your loved ones at risk too.  

But don’t take it from me, or even Dr. Markel.  Take it from Ben Franklin, who also lived in a time when there was a lot of vitriol and controversy surrounding vaccination:

In 1736 I lost one of my sons, a fine boy of four years old, by the small-pox, taken in the common way.  I long regretted bitterly, and still regret that I had not given it to him by inoculation.  This I mention for the sake of parents who omit that operation, on the supposition that they should never forgive themselves if a child died under it, my example showing that the regret may be the same either way and that, therefore, the safer should be chosen.

The above photo is of a young girl in Bangladesh who was infected with smallpox in 1973.  6 years later, the World Health Organization officially delared its eradication.  Thanks to immunizations, we’ll never have to see suffering this horrible again. 

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