Reasons to quit smoking that you might actually care about

photo: nytimes.com

Q: Yeah, yeah, yeah… smoking might give me lung cancer when I’m like 80.  So why should I worry about it now when I can just quit when I’m old?

A: Sure, lung cancer is one of the main reasons to quit, but we know you college (and graduate) students are invincible and don’t really care about little things like mortality, so here are a few other good reasons to quit smoking that might hit a little closer to home:

Tooth Loss

  • It is well known among dentists that smoking dramatically increases your chances of “edentulism” (i.e having no teeth). Smoking causes gum disease and plaque build-up which lead to tooth decay and loss. One study showed that the risk of tooth loss in smokers is more than 4 times that of non-smokers! Think you look cool holding that cigarette? Just think how much cooler you’ll look with dentures. The good news is that the risk of tooth loss decreases with smoking cessation.

Wrinkles

  • Smoking is one of the leading causes of premature skin aging. (One of the identical twins in the photo at the right smokes and has been in the sun more than the other – can you tell which one it is?) Tobacco leads to degradation of the collagen and elastic fibers that keep skin looking smooth and young, leading to premature wrinkles, especially around the mouth and eyes. The mechanisms for this are thought to be similar to the damaging effects of ultraviolet radiation on the skin – so stop tanning too while you’re at it!

Cervical cancer

  • Ladies, did you know that if you have been infected with certain types of Human Papillomavirus (HPV), smoking increases your risk of developing cervical cancer compared to nonsmokers? Researchers are still looking into why this is, but they have actually detected nicotine in the cervical mucous of smokers!  And cervical cancer isn’t one of those things you only have to worry about in the distant future; it is increasingly affecting women in their 20s and 30s. The risk gets higher the longer you smoke, so the sooner you quit the better.

Birth defects

  • It is amazing that in this day and age we still need to tell people to quit smoking before they become pregnant, but unfortunately we still see it all the time. Smoking increases a woman’s risk of premature delivery, still birth, low infant birth weight, and sudden infant death syndrome (SIDS). Since roughly 50% of pregnancies are unplanned, the time to quit is now!

Limb amputation

  • Smoking is one of the major risk factors for peripheral arterial disease (loss of blood flow to the extremities which can lead to tissue damage and amputation). Ok, maybe this is another one of those long term problems you don’t want to think about while you’re young and indestructible, but it’s out there and it affects many people as they get older.

Poverty

  • We know that financial concerns are far and away the biggest stressors for students: tuition, rent, books, fees, not having enough time to study for your classes because you have to work so many hours to pay for them. A pack of cigarettes costs around $5, so a pack-a-day habit costs you $1825 a year! Think about that. How many months of rent or credit hours would that buy? How many student loans could you pay off (or not take out in the first place)? Even if you’re just a casual smoker who only buys a pack on the weekend when you go out drinking, that’s $250 in a year. That would buy you an iTouch!

The thought of becoming a poor, wrinkly, stressed out, toothless, cancer-ridden amputee still not enough reasons to quit?  Check out the CDC’s website for more useful information on the risks of smoking and resources for quitting.  We’ll follow up with another post listing some local resources for quitting soon.

Angela Walker (Ohio State College of Medicine)

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

Get Your GYT On!

Click Picture to link

We use a lot of resources from the GYT (Get Yourself Tested) site, sponsored by MTV and CDC.  This is especially true during STD Awareness Month, which is rapidly coming to a close.  One fairly new item on the site is the GYT Party!   Rest assured, this is not a political party.  It is an interactive website, where you hang out, get some information, and listen in on some cool conversations.   You might even learn something!! 

So, come on, join us at the Party!

GYT PARTY

Good Health! 

Roger Miller, MD (OSU Student Health)

Q: I’ve been exposed! When should I get my STD test?

Get Yourself Tested

Use protection

APRIL is STD AWARENESS MONTH

Students come in on occasion with immediate concerns about STDs, especially after an unprotected sex act, or one in which the protection failed.  Their questions?

  • What STDs could I have gotten last night?
  • When would I get symptoms if infected?
  • How soon can I be tested to know that I’m ok?
  • Can I spread this to another sex partner?
  • When is Emergency Contraception needed, if there is a pregnancy risk?

These are excellent questions, and require some discussion with a healthcare provider.  The reason is that STDs can vary from a few days to several months or more in terms of INCUBATION.  INCUBATION means the time needed from exposure to infection.  Getting tested immediately (or the next morning) may be too early to find the bug when it is first growing, but can tell us about your past risks. 

While testing may need to be delayed or repeated, treatment is often given right after exposure, if a partner is known to be infected with an STD.  This is called EMPIRIC treatment for an exposed partner, and can prevent an STD before it starts.

Final points –

  • While we will strive to address all your concerns on the first visit, there will likely still be some unknowns at the end of your visit.  We will establish a treatment and testing plan that is best suited to your needs.
  • Protection is Prevention if used consistently and carefully.  Most condoms fail because of user errors. 
  • Student Health Services is your healthcare provider in the heart of campus.  Come see us for our caring and expertise.   

Good Health!

Roger Miller, MD  (OSU Student Health)

What’s In a (Brand) Name?

altmedicinesecrets.blogspot.com

Shakespeare never had to worry about prescription medications, but he was on to something when he wrote this line for Romeo and Juliet.  The name of the medicine on the bottle you pick up from the pharmacy is often completely different than what your doctor told you she was giving you.  So what’s the deal?  Does a dose by any other name smell as sweet?

For the most part, yes.  Prescription medications have at least two different names, a brand name and a generic name.  Brand names are made up by drug companies and are designed to be catchy and easy to remember to help boost sales.  Generic names are based on a drug’s chemical structure or mechanism of action.  Drug companies can pick any brand name they want, but the generic name must be approved by the FDA.

To be approved by the FDA, the generic medication must go through rigorous testing to verify that the amount your body absorbs is therapeutically equivalent to within 10% of the brand name with regards to dosage, effectiveness, safety, and how it is taken.  Any generic medication carried by your pharmacy will be considered the same as the brand.

Pharmacies will default to the generic version of a drug if one is available because it is usually a lot cheaper.  Generic manufacturers can charge much less because they don’t have to cover the huge cost of researching and developing a new drug.  That’s why drug companies are allowed to keep a new drug exclusively brand name for about 7-8 years after introducing it to the market.  Different pharmacies may use different distributors and wholesalers to purchase these medications, so even generic medications may end up looking different from time to time.

There are some instances where your doctor might want you to have the specific brand name drug.  In this situation, she will write “DAW” or “dispense as written” on the prescription.  If your doctor does this, the pharmacy isn’t allowed to fill your prescription with a generic equivalent even if one is available.  If your doctor doesn’t specify, the pharmacy will use the generic.

Brand name medications are more expensive than their generic counterparts, but there are some things you can do to save some cash.  Always ask your doctor if there is a generic option for the treatment she is prescribing for you.  If not, drug companies will sometimes offer manufacturer coupons to help bring down the cost of your copay.  Ask the pharmacist about this when you pick the medication up or check the drug manufacturer’s website; these discounts are often available online. 

If you have any other questions about the medications you are taking, the pharmacy staff at the Wilce Student Health Center is always willing to help.  Feel free to stop by or give us a call.

Alex Heine, PharmD Candidate, 2012
College of Pharmacy
The Ohio State University

Jason Goodman PharmD, RPh
Student Health Services
The Ohio State University

Have you been asked the Five P’s??? – April is STD Awareness Month

Wilce Student Health Center

GYT - Make your appointment!

Use protection

Lets say you are going to Student Health or your private caregiver.  In most cases, they are going to ask you a few questions about your sexual health and sexual practices. These questions are very personal, but they are as important as the questions about other areas of physical and mental health. Your answers are kept in strict confidence. 

So, are you ready to talk about your five P’s?  The five “P”s stand for Partners, Practices, Protection from STDs, Past history of STDs, and Prevention of pregnancy.

Partners

  • Are you currently sexually active? (Are you having sex?)
  • In the past 12 months, how many sex partners have you had?
  • Are your sex partners men, women, or both?

Practices

  • What kind of sexual contact do you have or have you had?
  • Genital (penis in the vagina), Anal (penis in the anus), Oral (mouth on penis, vagina, or anus)?

Protection from STDs

  • Do you and your partner(s) use any protection against STDs? If not, why?  If so, what kind”
  • How often do you use this protection? If “sometimes,” in what situations or with whom do you use protection?
  • Are there other forms of protection that you would like to discuss today?

Past history of STD’s

  • Have you ever been diagnosed with an STD?
  • Have you had any recurring symptoms or diagnoses?
  • Have you ever been tested for HIV, or other STDs? Would you like to be tested?
  • Has your current partner or any former partners ever been diagnosed or treated for an STD?

Prevention of pregnancy (Based on partners noted earlier, conception and contraception questions may be appropriate)

  • Are you currently trying to conceive or father a child?
  • Are you concerned about getting pregnant or getting your partner pregnant?
  • Are you using contraception or practicing any form of birth control?
  • Do you need any information on birth control?

Finally, before you move on to discuss other things with your caregiver, consider:

  • Are there other things about your sexual health and sexual practices that you should discuss to help ensure your good health?
  • Any other concerns or questions regarding sexual health in general?

Student Health Services can offer you expert advice, all the current diagnostic and treatment options, and vaccinations that can protect you long term.  Come see us, and GET YOURSELF TESTED

My toenails look funky

UpToDate.com

My right big toe nail cracked across in the middle and I noticed that the left big toe is starting to crack too.  It does not hurt but what should I do?

Certain (kinda rare) medical conditions can cause nails to warp or crack, but when you’re talking just the big toes, you’re usually dealing with a fungal infection. 

People tend to get really creeped out when I mention the word fungus, but it has nothing to do with poor hygiene or anything like that.  Fungi are germs that normally live on our skin; they just happen to like warm, moist places so sometimes they overgrow and cause trouble.  If it happens between the toes, we call it “athlete’s foot”; in the groin area, “jock itch”; under the toenails… “funky toe nails” I guess.  (The actual medical term is onychomycosis).

People who swim or whose feet sweat a lot might have a higher chance of getting a fungal nail infection, but we really don’t know why some people get them and others don’t.  

They happen in the toenails a lot more often than the fingernails and usually start on the big toe, occasionally affecting the nails on the smaller toes.  A fungal infection can cause a nail to:

  • Turn white, yellow or brown
  • Get thick, change shape, or raise up from the nail bed
  • Get crumbly and break off easily
  • Hurt

If your infection is mild or doesn’t bother you very much, you don’t have to do anything about it; it probably won’t go away, but it probably won’t cause any long-term problems either.

There are some over-the-counter creams or nail polishes you can try, but honestly, they’re a waste of money.  If you want to have it treated, you’ll need to take some prescription antifungal pills for about 12 weeks.  Your health care provider may order some blood tests before you start the medicine because they can affect the liver. 

But be warned – these infections can be a pain to deal with.  It can take months for a normal looking nail to grow back in, the treatment doesn’t work 25-40% of the time, and when it does, there’s a 20-50% chance that the infection will come back.  

To reduce your chance of getting a fungal toenail infection:

  • keep your feet clean and dry
  • Avoid sharing nail clippers
  • Wear flip-flops or other footwear in a gym shower or locker room

If you think you have a fungal toenail infection, come in and see us.  We can usually tell just by taking a look at it and asking you a few questions.  If there’s any doubt about what’s going on, we may take a small sample of the nail (cutting or scraping) and send it to a lab where another doctor can confirm which germs, if any, are causing the infection.

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

Do I Have To Have My Wisdom Teeth Removed?

www.women3.com

Most of our permanent teeth erupt during childhood, but the 3rd molars (or “wisdom teeth”) show up much later, usually during adulthood.  In fact, the term “wisdom teeth” originated in the 19th century because these molars don’t erupt until people are old enough to have gained some wisdom. 

If your wisdom teeth appear healthy and are in proper alignment, there is no need to remove them.  Your dentist will just monitor them throughout your lifetime.  But if they’re causing you trouble, they may need to be removed.  Symptoms of an unhealthy wisdom tooth include:

  • Pain
  • Fever
  • Inability to open mouth and/or pain with chewing
  • Toothache
  • Sensitivity to sweets, hot and/or cold temperatures
  • Bleeding and/or  swollen, painful gums
  • The sensation of crowding or pressure

If you are having any of these symptoms, come in to see one of our dentists at the Wilce Student Health Services Dental Clinic.  We will perform an exam and take a panoramic x-ray of your teeth to see what is going on.   The x-ray can tell us if your wisdom tooth is crowding the 2nd molar and causing a cavity, or if there are any cysts or tumors involving the wisdom tooth.

Any of the above signs or symptoms would lead us to recommend that you have your wisdom teeth removed.  We don’t remove wisdom teeth at the Student Health Center; if necessary, we will refer you to the oral surgery clinic at the Ohio State College of Dentistry.

If you want to learn more about wisdom teeth, the American Dental Association has a great (and short) video that you can check out here.

Julia O’Neil-Johnson, DDS
Student Health Services
The Ohio State University

How long is my ADD testing good for?

lauramuggli.com

We talk a lot about ADD here at BuckMD.  We’ve talked about whether you can get treated for it here at the student health center (yes), whether it’s OK to share your medicine with your friends (no), and even if there are useful things to do for it besides taking pills (yes).

But we recently received a very good question about ADD that we haven’t covered yet so I think it’s time for a little update.  “Buckeye Mom” asks:

How recently does the ADD testing need to have been done?  We have documentation, but it was completed 8-9 years ago.  Will that be sufficient?

The best thing to do is bring whatever records or documentation you have with you to your first appointment at the Student Health Center and we’ll figure it out.

We know that a lot of students are diagnosed with ADD when they’re pretty young, so in general we don’t worry as much about the age of the testing as much as we do it’s validity and thoroughness.  What that means is if you went through the whole nine yards of neuropsychological testing when you were a kid and you’ve had a history of consistent and appropriate medication management by your doctor at home, that is USUALLY sufficient for us to be able to presrcibe medication for you while you’re at school.

On the other hand, if you’re “testing” consists only of notes from your family doctor saying you have symptoms of ADD and/or a list of previous prescriptions and/or a survey filled out by your 3rd grade teacher, we will require you to undergo a diagnostic evaluation prior to writing any prescriptions for you.  We discuss the testing in a little more detail here

Basically, we look at everyone’s situation individually, so if you want us to manage you’re ADD medications for you while you’re in school, round up whatever records you can get your hands on and bring them in.  We’ll do whatever it takes to get you the best possible care.

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