Month: October 2012

Ready for “M”ovember? Buckeyes4PH needs you!

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Movember

Ohio State has a new student organization known as Buckeyes for Public Health as of October, and they are kicking off their second month with a men’s health awareness activity known as Movember, as part of the international men’s health charity of the same name. 

The kicker is that they are encouraging men to join a one month campaign of mustache growing. 

For real. 

They are shaving guys at the RPAC this evening, then asking them to post pictures every day as they grow a mustache.  As they chronicle their facial hair progress, viewers are asked to make donations in support.  Funds collected are passed on to the Prostate Cancer Foundation and Livestrong.

If you are interested in more information, visit the Buckeyes4PH and Movember sites.  The kickoff “Shave Down”  event is scheduled for Nov. 1, 2012, 5:30-9:00 p.m., at the Ohio State Recreational and Physical Activity Center (RPAC) Amphitheater. 

You can also view the Mo gallery at go.osu.edu/movember.

Of course, if you have questions about men’s health, come visit us at Student Health Services.  We will be happy to assist you.

“Mo”-tivating!!

Roger Miller, MD  (OSU Student Health Services)

 

Few days left to make your choice,,,about smoking

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November 15 – the 37th Annual Great American Smokeout, sponsored by the American Cancer Society, is a day for smokers to take a day off from using tobacco, and for nonsmokers to encourage their friends to do the same.  Are you getting prepared?

If you do plan to quit, you should know that the days ahead are going to be tough, and most people make several attempts before they actually kick the habit for good. So, don’t be too discouraged if it takes a few tries to make it stick!

The great news is that there are a TON of resources out there to help you quit smoking.

One of my favorite programs is 1-800-QUIT-NOW (1-800-784-8669). You can call this free hotline and speak to a professional smoking cessation counselor. They can help you get over your fears about quitting, help you set your quit date, teach you coping strategies for cravings, etc. The really great thing about this service is that they can often help you get access to nicotine replacement therapy if you are qualified, whether or not you have insurance. Plus, people who use “quit lines” have been found to be more successful in their attempts to quit!

If you’re not into the idea of calling a quit line, this government website is another great resource. It offers tips for quitting, a savings calculator, a cravings journal and much more!  The CDC website also offers a list of resources to help you quit. 

Closer to home, the staff of Student Health Services is also here to help. In addition to advice and encouragement, we can offer several prescription medication options to help you quit.  All medications have side effects, so be sure to discuss them fully with your health care provider before taking them.  The main options are:

Varenicline (Chantix) works by blocking the effect of nicotine on your brain, so if you relapse and light up, that cigarette won’t give you the same pleasurable effect it used to.  It also helps to reduce withdrawal symptoms.  Varenicline is not covered by insurance and it ain’t cheap (about $120/month), but it does seem to be very effective. 

Buproprion (Wellbutrin) is a commonly prescribed antidepressant that has been found to decrease tobacco cravings and withdrawal symptoms.  Buproprion is much cheaper than Varenicline (it’s on many $4 prescription plans and is usually covered by health insurance) but doesn’t seem to be quite as effective. 

There are also a number of nicotine replacement products on the market these days. You can get anything from patches to gum to lozenges to inhalers. These are typically priced so that a month of treatment costs the same as a month of cigarettes (at about a pack per day). So really, while it seems pricey up front, in the long run you’ll be saving money.  Even though you can buy them without a prescription, it’s always a good idea to talk to your health care provider before starting one of these products.

Good luck!  Please post a comment and let us know how you’re doing!  Who knows, your experiences may help someone else kick the habit!

Angela Walker, MD (OSU COM Alum)

John A. Vaughn, MD (OSU Student Health Services)

 

Can I get the flu from a flu shot?

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fluvaccine.com

Fall Colors

Q: I don’t want the flu shot because it always gives me the flu.  Is it okay not to get vaccinated?

A: Here are a facts to consider:

1. Injected influenza vaccine is an inactivated viral vaccine, meaning that there is no living influenza in the injection.  Therefore, you cannot get influenza from the vaccine.   This is a commonly held misbelief, in part because people commonly get upper respiratory illnesses in the winter months that they attribute to the vaccine.

2. The influenza vaccine is designed to protect against the most likely flu strains to appear in the upcoming season.  Against those strains, the vaccine is 70-90% effective in prevent infection.  If a different strain appears in the community, which is possible, then the vaccine may not protect against that one.

3. Nearly all vaccines can cause a brief period of low grade fever and body aches in the 1-2 days following vaccination, along with some discomfort in the injection site.  The fever and aches are due to your immune system responding to the vaccine (although the absence of these symptoms doesn’t mean the vaccine didn’t work), so in essence, this is a good thing.

All in all, the benefits of this vaccine greatly outweigh the risks.  Come see us if you have more questions, or are interested in getting the flu vaccine.   It is fully covered for those of you on the Comprehensive Student Health Insurance Plan, and several other insurance plans are covering it, too.  

Check out our Events Calendar for upcoming walk-in flu vaccine programs. 

Good Health!

Roger Miller, MD (OSU Student Health Services)

 

Flashes and floaters and Eyes, Oh My!

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eyehealth.co.uk

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, OD (Ohio State College of Optometry Alum)

Julia Geldis, OD (Staff Optometrist, SHS)

 

Questions about Meningitis Outbreak

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Image of Fungus

Q: I keep hearing about a big meningitis outbreak that has something to do with getting injections at a doctor’s office.  Is this the same as the meningitis we heard about when coming to campus? Does my vaccination protect me?

A: That is a great question.  “Mening”-“itis” refers to inflammation of the meninges, which is the tissue that forms a protective covering for your brain and the nerves in your spine. 

Meningitis is mostly caused by infections.

  • Viral – caused by several types of viruses, is usually less severe, and resolves without antibiotics.
  • Bacterial – caused by a few bacteria, most notably Neisseria mengitidis, which can cause a rapidly progressive and dangerous infection.
  • Parasitic – caused by parasites growing in contaminated water.
  • Fungal – caused by fungus, usually associated with a suppressed immunity.

There are also non-infectious types of meningitis, caused by cancer cells, chemicals, or trauma.

The one on the news lately is fungal meningitis, which was discovered in a number of people who had recently received spinal injections of a particular type of medicine.  The investigation so far is suggesting that the vials containing the medicine were contaminated. 

Fungal meningitis is not transmitted from person to person.  In this outbreak, the only people suspected to be at risk are those who received contaminated injections. 

There are two vaccines that protect us from bacterial meningitis.  Those are the HIB vaccine, which is received by small children, and the Meningococcal vaccine, usually received as a teen or just before college. 

Meningitis starts with a fever and headache, but can progress into severe symptoms including confusion or coma, and can be deadly, depending on the cause. 

If you have concerns about meningitis, or are having symptoms that worry you, come see us for assistance.

Good Health!

Roger Miller, MD (OSU Student Health Services)

 

How much are you willing to pay per pound to lose weight?

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prairieecothrifter

The Food and Drug Administration (FDA) recently approved two new medications for weight loss.

Qsymia, is actually a combination of two older drugs – topiramate (Topamax), an anticonvulsant that helps increase satisfaction after eating, and phentermine, a psychostimulant and appetite suppressant. Using Qsymia combined with diet and exercise for a year led to an average weight loss of 8.4% of total body weight, or about 20 pounds.   

Qsymia is a controlled medication because it has a potential for addiction. Like other psychostimulants (think Adderall and Ritalin), it can cause a fast heart rate and a tingling sensation in the limbs. Other side effects include memory impairment and decreased concentration. Topiramate can cause birth defects as well.   

Belviq, is an entirely new class of medication called a serotonin 2C agonist.  It helps patients feel full sooner and eat less. Belviq was even less effective than Qsymia in helping with weight loss; it led to an average annual decrease of just 5% of total body weight, or about 7 pounds. The side effects from Belviq are minimal, but because older serotonin agents were associated with heart problems, everyone is keeping a close eye on it. 

Information about cost is hard to pin down exactly, but the best guesstimates are that Qysimia will cost about $6 a day and Belviq $8 a day.   

This made me wonder if we should approach these medicines as if they were in a refrigerator case at the grocery store and ask ourselves, “What am I paying per pound?”

When you look at it this way, these two new wonder drugs don’t look so great. Qsymia will run you about $109/pound of weight lost while Belviq will cost you about $417/pound.

To give you an idea of how that compares to other methods that have been around for a while:

  • Weight Watchers = $ 97/pound
  • Nutrisystem = $130/pound
  • Jenny Craig = $131-237.56/pound
  • Weight loss surgery = $235 – 400/pound
  • Diet and exercise = $0/pound!

As you can see, none of them are cheap, and the only one that doesn’t cost you any money costs you a little more in time and effort.  Unfortunately, it’s the only one that really works.  In fact, it’s the main ingredient in those super expensive drugs we’re talking about.  Read that description again – “using Qsymia combined with diet and exercise led to weight loss…”  The problem with diet pills is that not only do you gain the weight back as soon as you stop taking them, but without diet and exercise, they barely make a dent in your waistline.

Because of all of this – the cost, the side effects, the potential for addiction and the lack of any proven long-term benefit – we don’t even prescribe these medicines at the Student Health Center. We’d rather work with you one on one and help you take advantage of the resources available to you here at Ohio State.    

At Student Health Services, we can offer a “well person” exam with any indicated laboratory tests and refer you to one of our registered dieticians. Dining services offers some great online resources to help you keep tabs on your nutritional intake and Rec Sports has many facilities and programs to help you participate in any kind of exercise that you are interested in. 

We want you to succeed at getting to and maintaining your optimal healthy weight. As soon as it is as easy as taking a pill, we’ll let you know.  In the mean time, we’re here to help you do it the right way.

Jo Hanna Friend D’Epiro, PA-C, MPH
Student Health Services
The Ohio State University

I get cold sores a lot. Does that mean I should worry about every little bump below the belt?

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B

A

I get cold sores every month, which I suppress pretty well with medication.  My concern is that I may autoinoculate and spread it to my genitals; in fact, every time I have a pimple, ingrown hair or tear down there I panic!  How does the appearance of genital Herpes Simplex Virus Type 1 (HSV-1) differ from other more benign conditions? Is it unreasonable to end up at the gynecologist every time one of these other things appears? 

Great questions.  Let’s tackle them one by one.

Is it unreasonable to end up at the gynecologist every time something looks funny down there? 

Absolutely not.  The only way to truly find out what you’re dealing with in these situations is by consulting with an expert whose advice you trust.  Sometimes even your doctor won’t be able to tell by just looking – the same problem can look very different in different people, or even at different times in the same person – so she can do other tests to help you figure out what’s going on.

Can you autoinoculate yourself and spread HSV-1 it to your genitals?

Unfortunately, the answer to this one is yes.  People tend to think of Herpes Simplex Virus 1 (HSV-1) as the “cold sore” virus and HSV-2 as the “genital herpes” virus.  But both HSV-1 and HSV-2 are spread by direct skin-to-skin contact, and either can infect the mouth or genitals.  So if you were to touch a cold sore on your mouth and then touch your genitals, you could theoretically cause an outbreak down there.  The good news is that medication lessens the duration and severity of outbreaks (which tend to decrease in frequency and severity over time on their own anyway), so if you are staying on top of your cold sore outbreaks with suppressive medication, the odds of you doing this are very, very small. 

How does the appearance of genital Herpes Simplex Virus Type 1 (HSV-1) differ from other more benign conditions?

This is a tough one.  Like I said, many conditions that can affect the genitals look like Herpes and sorting them out isn’t always as easy as laying eyes on the situation.  That being said, some of the more common conditions do have typical characteristics.

Folliculitis: is inflammation of a hair follicle (“ingrown hair” or “shave bump”).  It happens when hair follicles are damaged by friction from clothing, a pimple or shaving and then get infected with Staphylococcus Bacteria (“Staph infection”).  They are red, inflamed areas that usually look like a pimple and have a hair in the center of it. They can be treated with anything from warm compresses to antibiotics.

Molluscum Contagiosum: are small, painless bumps that are flesh-colored and usually have a dimple in the center.  They may be red if they get irritated.  They’re caused by a poxvirus and are treated like genital warts caused by HPV.

Herpes: typically appears as a group of red blisters or ulcers.  Unlike molluscum, genital warts and (usually) folliculitis, these lesions are VERY painful and can be preceded by flu like symptoms.

There’s a picture of each of these conditions to the right.  Can you tell which one is which?  (Click to enlarge.  Answers below)

This list is far from complete, and again, no one can make a diagnosis from looking at a picture online, so if something doesn’t look right down there, be sure to see your women’s health care provider right away.  If you are a student at Ohio State, you can make an appointment with our Women’s Services Clinic; they’re always happy to help.

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

Answers: A = Molluscum Contagiosum, B = Herpes, C = Folliculitis

I saw a mouse in my apartment!!

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Mouse Hunter

As fall and winter approach, critters will be looking for food and warmth, and they may end up in our homes.  This might not be so bad, if it was a peaceful coexistence, but mice and rats like to chew holes in your cereal boxes, leave their feces on the floor, and raise their little furry families under your bed. 

So maybe you are an animal lover, and willing to clean up after your new companions.  The other drawback of these uninvited guests is the range of infectious diseases they can carry:

  • Hantavirus
  • Rat-bite fever
  • Leptospirosis
  • And others

Hantavirus is an infection you may have heard about this summer, when 9 cases were discovered among campers at Yosemite National Park in California.  3 of those persons died.  Exposure occurs from exposure to  droppings, urine or saliva.  The illness starts with fever and muscle aches, but can develop into a severe pneumonia. 

SO, what to do?  The CDC offers us some timely advice about rodent-proofing our living environments.

Of course, if you do not own the place you are living, you need to consult with the owners about the ways to keep rodents out. 

Ok, once you are rodent-proof, it is time to clean up their mess.  Cleaning up droppings, urine, and dead rodents requires some special handling:

  • Ventilate the area for at least 30 minutes before you start
  • Use a disinfectant or bleach solution
  • Spray the area involved thoroughly
  • Wipe up with paper towels
  • Wear disposable gloves
  • Place waste in sealed plastic bags and remove to an outdoors garbage can or dumpster

More tips are available at Cleaning Up After Rodents (CDC Website) 

Good Health!

Roger Miller, MD (OSU Student Health Services)

Is 5-hour Energy safe in Pregnancy?

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5-Hour Energy

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A sharp-eyed BuckMD reader read our original post on 5-Hour Energy and sent us the following note:

If 5-Hour Energy drinks are no more harmful than coffee, what are the risks of drinking less than a bottle daily during pregnancy?  I have read your site and found nothing specific on risks/side effects during pregnancy.  Are there any risks to the baby?

Good question.  The short answer comes straight from the horse’s mouth.  From the 5-Hour Energy website:

Who should not take 5-hour ENERGY®?

  • Women who are pregnant or nursing.
  • Children under 12 years of age.
  • People diagnosed with phenylketonuria (PKU)

So even though (or more accurately, because) the 5-Hour Energy folks have never had to concern themselves with ensuring that any of the ingredients in their product are safe or actually do anything, they draw the line at selling it to people who are pregnant. 

Like we said in our last post, despite 5-Hour Energy’s promotion of its B Vitamins and medical-yet-natural sounding “energy blend,” the only thing in it that has ever been proven to improve mental alertness is caffeine.  So the question really is, “is caffeine safe in pregnancy?”  And the answer to that question is… maybe.

Some studies have reported an association between caffeine intake and adverse pregnancy outcomes while others haven’t.  These studies are inconsistent because it’s very difficult to control for all the factors that affect a pregnancy, not to mention accurately measure how much caffeine research participants really consumed.  The best we can say is that women who are pregnant or trying to become so should probably limit caffeine consumption to less than 200 to 300 mg per day to reduce their risk of possible adverse reproductive effects

The problem is that because 5-Hour Energy is sold as a supplement and not a medication, the company is not required to disclose their products’ caffeine content.  All it says on its website is that it “contains about as much caffeine as a cup of premium coffee.”  So what does that mean?  According to Energy Fiend, a 12oz Starbucks coffee has 260mg of caffeine while a 10oz Tim Horton’s coffee has 100mg.  So sometimes a cup is more than a cup.

What about the excess of B Vitamins in 5-Hour Energy?  Are they safe in pregnancy?

A can of 5-Hour Energy contains 30mg of B3 (Niacin), 40mg of B6 and 500mcg of B12.  The recommended daily allowance of these vitamins in pregnancy is 18mg of B3, 1.9mg of B6 and 2.6mcg of B12, so one can of 5-Hour Energy gives you way more than you need, especially since you’re more than likely getting enough from your diet anyway.  In general, B Vitamins aren’t dangerous in large amounts because they’re water soluble – once your body has enough, the extra is just excreted in your urine – so other than making your pee more expensive, 5-Hour Energy is unlikely to be dangerous.  However, an excess of Vitamin B3 (Niacin) can produce an uncomfortable flushing sensation.  

When in doubt, talk to your health care provider about anything you’re putting into your body when you’re pregnant or nursing.  If you are a student at Ohio State and have questions about pregnancy planning or other issues related to your reproductive health, you can make an appointment with our women’s services department; they are always happy to help you. 

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