Month: February 2013

Have you found your “bliss point”? It’s not what you might think.

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SugarStacks.com

prairieecothrifter

Obesity is all around us, and surveys reveal that more and more of us are endangering our future health through poor diet and lack of exercise.  It is our responsibility to control our appetites and activity.  Right?  Well, new information suggests that other forces are also at work. 

In the February 20 New York Times magazine, Michael Moss wrote about his research involving junk food, as part of an soon-to-be published book, “Salt Sugar Fat: How the Food Giants Hooked Us”.  Mr. Moss has uncovered some fascinating tactics used by food manufacturers to keep us hitting the snack aisle. 

  • Bliss point – optimizing each component in a product that the consumer likes to create the highest level of craving,  keeping the food good enough to want to eat, but not so good that you tire of the food.
  • Stomach share – how much each brand can dominate the market versus their competitors.
  • Sensory-specific satiety – design foods that taste good, but avoid any single distinct flavor that would tell you to stop eating.
  • Mouth feel – the positive interaction of food with the mouth in terms of moisture and texture (think chips).
  • Sweet range – the range of acceptable taste that may allow manufacturer to adjust costly ingredients to the lowest acceptable level in order to reduce cost
  • Vanishing caloric density  – ability of food to dissolve or shrink while eating, giving you the impression that you are eating less (Cheetos?)

Each of these factors is considered in the design and marketing of snack foods.  In this way, convenience foods like Lunchables end up including nearly a full day’s maximum amounts of fat, sodium and sugar.  Yogurt, which used to be considered a health food, has become a dessert given the amount of added sugar in each serving. 

For information about healthy eating, visit Student Health Services.  Our providers can advise you and refer you to nutrition services for further assistance. 

Roger Miller, MD  (OSU Student Health)

IUD Insertion Now Available at the Student Health Center!

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managingcontraception.com

What is an IUD?

It is an intrauterine device, also called an IUS (intrauterine system).  It is a t-shaped flexible plastic device inserted into the uterus with 2 strings attached to the bottom of the device that hang into the vagina.

Why don’t more women use the IUD?

The intrauterine device (IUD) is highly effective and widely used by women throughout the world, except in the United States.  Here IUDs are used by fewer than 3% of reproductive-aged women. 

In the 1960s and 1970s the IUD was very popular in the United States.  Due to the defective construction of one IUD – the Dalkon Shield – that was introduced in 1970, there was a high incidence of pelvic infection.  Unfortunately, the Dalkon Shield problem tainted all IUDs and ever since, consumers in the United States have inappropriately regarded all IUDs as a cause of pelvic infection.

Recently there has been renewed interest in IUDs as a reversible, long-acting, and effective contraception.  And with careful screening and technique, the IUD is very safe.

I’ve heard that there are different kinds of IUDs?

There are three IUDs approved by the FDA: the copper IUD (Paragard) and two progestin-releasing IUDs (Mirena and Skyla).  IUDs depend for contraception on the general reaction of the uterus to a foreign object.  In addition, the copper of the Paragard is spermicidal, and the progesterone in the Mirena and Skyla IUDs change the cervical mucus and lining of the uterus.

Why would I choose one IUD rather than another?

The Paragard contains no hormones and lasts for 10 years.  For the first several months after insertion, periods may be longer, heavier or more uncomfortable.

The Mirena works for 5 years and is approved by the FDA to ease menstrual bleeding.  Periods become lighter and less regular and less painful.

The Skyla IUD, approved by the FDA in January 2013, works for three years.  It has a narrower inserter and slighter smaller body.  It may be more appropriate for a woman with a smaller uterus or one who has not had a child.

My friend said that the insertion of the IUD is painful.

You may have mild to moderate pain when the IUD is put in, especially if you have never been pregnant.  Talk to your health care provider about ways to make insertion more comfortable.  You can take Ibuprofen 30 minutes before your appointment to help with cramping.

How do I know if I’m a good candidate for the IUD?

Your health care provider will review your medical history and ask you to have a pelvic exam.  The exam will include tests to rule out cervical cancer and sexually transmitted infection.  This testing is done to lessen the chance of infection at the time of the IUD insertion.   You will want to limit sexual partners and use condoms consistently to avoid pelvic infection with the IUD. 

Are there serious complications with the IUD?

It is possible, although rare, that the IUD could pass through the wall of the uterus during insertion.  The health care provider will know this immediately if it happens. 

The IUD can slip out of the uterus.  Sometimes it comes out all the way and sometimes it comes out only part-way.  You may find the length of the strings becomes shorter or longer, or you feel the plastic of the IUD at the cervix.

And it is possible to develop a pelvic infection.  This is most common during the first three weeks after insertion.

How expensive is the IUD?

The IUD only costs money at the beginning and then you have a 3 or 5 or 10-year method.  You will need to check with your insurance company to see how much of the device and insertion are covered.  The cost is usually between $500 – $1,000.  If you have the comprehensive Student Health Insurance or the Wilce Care Supplemental Insurance, the IUD cost will come out of your $2,000 yearly allowance.

If you have any questions about birth control, come in and talk to the Women’s Services staff at the Student Health Center.  We will help you find the best one for your lifestyle.

Beth Askue, MS, CNP
Student Health Services
The Ohio State University

How long can I leave my contact lenses in?

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Q:  Is it okay if I put my contacts in at 8:45 pm and take them out at 6:00 pm? 

A: The length of time a person can wear their contact lenses safely and comfortably varies with each individual. Each contact lens brand also has its own FDA-approved guidelines for how often you should replace them and how long you can keep them in (i.e. daily wear vs. overnight wear).

Many factors, including certain corneal conditions, tear film instability, dry eye symptoms and eyelid inflammation can lead to a decrease in contact lens wear time for some people. Your eye care professional should be able to tell you the appropriate amount of time you may safely wear your contact lenses based on the type you have.

Because improper use of contact lenses can put you at risk for eye infections and corneal ulcers that have the potential to cause blindness, the US Food and Drug Administration (FDA) has issued guidelines for their safe use:

  • Always wash your hands before handling contact lenses to reduce the chance of getting an infection.
  • Remove the lenses immediately and consult your eye care professional if your eyes become red, irritated, or your vision changes.
  • Always follow the directions of your eye care professional and all labeling instruction for proper use of contact lenses and lens care products.
  • Use contact lens products and solutions recommended by your eye care professional.
  • Do not use contact lens solutions that have gone beyond the expiration or discard date.
  • Rub and rinse your contact lenses as directed by your eye care professional.
  • Clean and disinfect your lenses properly following all labeling instructions provided with your lens care products.
  • Do not “top-off” the solutions in your case. Always discard all of the left over contact lens solution after each use. Never reuse any lens solution.
  • Never use non-sterile water (distilled water, tap water or any homemade saline solution). Exposure of contact lenses to water has been associated with Acanthamoeba keratitis, a corneal infection that is resistant to treatment and cure.
  • Do not put your lenses in your mouth to wet them. Saliva is not a sterile solution.
  • Clean, rinse and air-dry your lens case each time lenses are removed. You may want to flip over your lens case while air drying so excess solution may drain out of the case. Contact lens cases can be a source of bacterial growth.
  • Replace your contact lens storage case every 3 to 6 months.
  • Do not transfer contact lens solutions into smaller travel size containers. This can affect the sterility of the solution which can lead to an eye infection.

If you are experiencing abnormal eye symptoms or would like to discuss eyeglasses or contact lenses, be sure to contact the Student Health Services Optometry Department – we’re here to help!

Julia Geldis, OD
Student Health Services
The Ohio State University

College Health for Black History Month – Diabetes

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minoritynurse.com

Continuing our Black History Month theme of conditions disproportionately affecting African Americans, let’s talk about one of the biggest epidemics in modern medicine: Type 2 Diabetes.

African Americans are almost twice as likely as Caucasian Americans to develop diabetes in their lifetimes (11.8% vs. 6.6%) and much more likely to be obese (36.1% overall, with 42.1% of African American women being categorized as obese). We’re not entirely sure why this is; most likely it is a combination of genetics and lifestyle factors.

Diabetes isn’t just about high blood sugar levels; it comes with many long term complications. People with Type 2 Diabetes are much more likely to suffer heart attacks, vision loss, kidney failure, and strokes. And as if that wasn’t enough, diabetics are also more likely to experience impotence and foot complications that can lead to amputation!

One of the key strategies in fighting Diabetes is prevention. There are a few simple steps you can take to prevent diabetes:

  • If you are overweight, losing 5-7% of your body weight can ward off the development of diabetes – that’s only 10-14lbs for a 200lb person!
  • Squeeze in at least 30 minutes of physical activity 5 days a week – you’re already paying for RPAC membership, might as well use it!
  • Replace high fat, high sugar foods with healthier options – it’s easier than you may think.

For more information on Diabetes prevention, please check out this great program developed by the US Department of Health and Human Services.

If you have already been diagnosed with Type 2 Diabetes, you can help prevent complications with good blood sugar control. Regular visits to your doctor are essential to staying in control of this disease.

If you are overweight or have a family history of Diabetes, please see one of our providers at Student Health Services to talk about Diabetes screening.  You can also get some more useful information here.

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

What STIs can I get tested for at Student Health and which ones are curable?

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Q: Which Sexually Transmitted Infections (STIs) can you test for at Student Health and which ones are curable?

A: If you come to the Student Health Center to get screened for STIs (meaning you don’t have any symptoms or worrisome exposures), we check for the following infections: HIV, Syphilis, Chlamydia, and Gonorrhea. 

How do we do it?  We draw some blood and have you pee in a cup – it’s as simple as that.  The blood test checks for HIV and syphilis, and the urine test checks for Gonorrhea and Chlamydia.  If you have the Comprehensive Student Health Insurance Plan, STI screening is covered once a year.  If you’re on another insurance plan, check with them about coverage.

There are other STIs out there that we can check for if you have specific symptoms or exposures. 

  • Herpes: The only way to confirm that someone has genital herpes is by taking a swab of an active sore. We can do a blood test for antibodies to the Herpes virus, but they aren’t very helpful; they only tell whether or not someone has been exposed to the virus, which doesn’t necessarily mean that they have (or ever will have) active disease.
  • Hepatitis B&C: We can do a blood test for antibodies to these viral infections if someone is at high risk for acquiring them or if they have been exposed to it, but their incidence is so low in the general population that screening for them isn’t useful or cost effective.
  • HPV: There is currently no screening test for HPV. The annual Pap smear that women receive is kind of an indirect test for HPV exposure since it screens for cervical cancer, which is caused by HPV infection, but in terms of checking for exposure to strains of HPV that cause genital warts, there are no tests. The only way to confirm if someone has HPV is if they develop a visible genital wart.
  • Trichomoniasis: Trich (sounds like “trick”) is caused by a protozoan microorganism called Trichomonas Vaginalis. The infection may not cause any symptoms, but since it’s not as common in the U.S. as other parts of the world, and because it usually does cause symptoms like discharge and itching, we don’t routinely screen for it. We can test for that infection by doing a swab and looking at it under the microscope or taking a culture.

In terms of “curing” STIs:

Trichomoniasis and STIs caused by bacteria – Syphilis, Chlamydia and Gonorrhea – are eradicated with antibiotics.   Once they are treated, they’re gone.

Those caused by viruses on the other hand – HIV, Herpes and Hepatitis – are a different story. There are no “cures” for any of these diseases; while antiviral medications can help manage flare-ups or delay the progression of the diseases they cause, once you’re infected with them they stay with you for life.  As they say in med school: What’s the difference between love and herpes? Herpes is forever!

HPV is a special case. The infection is caused by a virus, and can cause serious long term complications such as cervical, anal and throat cancer, but the majority of people infected with HPV clear the virus on their own and don’t suffer any serious health consequences as a result of having it.

If you have any questions or concerns about STI testing, please make an appointment with Student Health Services – we’re here to help!

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

Photo: safesexnoregrets.nt.gov.au

College Health for Black History Month – Sickle Cell

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In recognition of Black History Month, Student Health Services will be dedicating some of our February blog posts to conditions that disproportionately affect people of African descent.

One of the most well known diseases to affect primarily African Americans is sickle cell anemia, an autosomal recessive condition that occurs when a person inherits two copies of the sickle cell gene from their parents.  Unfortunately, people with sickle cell anemia are usually made painfully aware of this condition in childhood.

Sickle cell anemia occurs in roughly 1 in 500 African Americans but sickle cell trait, in which a person inherits just one copy of the sickle cell gene, occurs in about 1 in 12 African Americans! People with sickle cell trait only have painful sickle cell symptoms under extreme conditions such as:

  • At high altitues (ie. flying, mountain climbing)
  • In low oxygen environments (mountain climbing, military or sports training)
  • Dehydration (especially during sports training)

Because several college football players died during training from complications of this condition,  the National Collegiate Athletic Association (NCAA) recommends that college athletes be tested for sickle cell trait.  While it disproportionately affects people of African descent, it can also occur in people of Mediterranean, Middle Eastern, Indian, Caribbean and Central/South American descent (and even rarely Caucasians). People born after 1993 were likely screened at birth for this gene, so if you are a person of African descent born before 1993 and are considering playing college sports, please be sure to discuss testing with your health care provider!

On a somewhat positive note, students suffering from sickle cell anemia may be eligible for special college scholarships, click here for more information.

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

photo: 2med.umich.edu