Stinky Pee

Early in my career, I was preparing to see a patient whose complaint was “strong urine.” What could it mean, I wondered as I stood outside the exam room? Smelly? Dark? Painful? Able to leap tall buildings in a single bound? Strong urine and I have since done battle many times. While primary care providers hear a number of common urinary complaints – pain, weird color and frequency, to name but a few – in my experience, “strong” combined with some variation of “urine” almost always means stinky pee.

What does stinky pee mean? Often nothing major. Let’s start with the benign causes:

  • Foods like asparagus can make urine smell. People who eat mostly vegetables can have a grassy odor to their urine.
  • Vitamins in general can make urine a little stinky (and colorful). B vitamins especially can impart a peculiar odor.
  • Dehydration can make urine smell more strongly of ammonia.
  • Certain medications can give urine a different odor and, like vitamins can cause a change in color. Many commonly used antibiotics change the odor of urine as well.

Certain persistent stinky pee issues might be more serious and require the attention of your primary care provider.

  • Foul-smelling urine, especially when it is associated with pain, frequency, urgency, fever, back pain, or an odd color (rusty, red, pink, purple) should be evaluated. All of these things suggest a bacterial infection somewhere in the upper or lower urinary tract.
  • Musty-smelling urine is quite unusual and can be associated with metabolic and liver diseases.
  • Sweet-smelling urine is sometimes associated with diabetes.
  • Urine with a scent of maple syrup can be associated with a serious metabolic disease with a yummy-sounding name: Maple Syrup Disease. Pancakes anyone?
  • Urine that smells like feces could mean that there’s a connection (called a “fistula”) between the rectum and the bladder or urethra.
  • Some vaginal infections have an odd odor that women tend to notice when they urinate.

Many of these more serious issues have symptoms besides stinky pee, but if you have any questions or concerns, make a “pit stop” at Student Health Services!

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

These shoes are made for running!

The weather is getting warmer and spring is fast approaching, so many of you will start running.  Some of you may be continuing your current cardiovascular exercise program while others may be jogging for the first time.  Either way, it is important to know the basic facts about your running shoes.  Exercising in shoes that are worn out from too many miles of usage is one of the leading causes of injury in the lower extremity, so before you hit the road we’re going to give you a test to see just how much you actually know about your running shoes. 

  1. At what mileage should running shoes be replaced?
  2. How much shock absorption is lost after 50, 150, 250, or 400 miles of running on a pair of shoes?
  3. What are some tips to prolong the life of your running shoes?
  4. Where are the best places to buy running shoes?
  5. What are signs of wear to look for on your current shoes?

Click here for the answers.  And check out the Physical Therapy/Sports Medicine page of our website for more information about the services we offer to students.  If you’re having any problems with your muscles or joints, we can get you back on track and help you hit the ground running again!

Pamela Bork, PT
Student Health Services
The Ohio State University

Do I need to have my cholesterol checked?

Do I need to have my cholesterol checked?

For most OSU students, the short answer is NO.  

The good news is that if you are younger than age 35 (for men) or younger than 45 (for women) you would only need to have your cholesterol checked if you have risk factors for heart disease.  If you don’t have risk factors, the likelihood that you have high cholesterol is VERY LOW.  The bad news is, because of that low risk, if you decide you just want to know what your cholesterol is, most insurances won’t cover the cost of the test (because they don’t see any reason you need to have it done).

So what are the risk factors that mean you should have your cholesterol checked, and make it likely that your insurance would pay for it?  These are based on research done by several groups, including the CDC (Centers for Disease Control and Prevention) and the USPSTF (United States Preventive Services Task Force).  The specific risk factors are:

  1. Obesity/ high BMI (body mass index)
  2. A family history of the following conditions (in your biological brother, sister, mother, or father):
  • Sudden Cardiac Death
  • Cardiovascular Disease (like a heart attack)
  • Hyperlipidemia (high cholesterol)

If you decide to have your cholesterol checked even though your insurance does not cover it, your least expensive option would be to have it checked at a Health Fair (sometimes done for free), or to come to the Student Health Center and go to the Registration Desk (first floor) and ask to have it done as an OIY (“Order It Yourself”) test.  You have to pay for it up front, but it only costs $20 and you get a printout from the lab within 15-30 minutes with the results and an explanation of the results.  If you have it done as part of an office visit with one of our providers, you’ll get billed for the lab test (usually at a higher rate) and the office visit, so it’ll be a lot more expensive.

If you have any questions about your risk factors for heart disease and whether or not you need to have your cholesterol checked, you can always make an appointment with us to discuss them – we’re here to help!

Mary Jane Elam, MD
Student Health Services
The Ohio State University

Can a wart on my finger spread to my genitals?

common wart

plantar wart

Q: Can a wart on my finger spread to my genital area?

A:  All warts (or “verrucae”) are caused by Human Papilloma Virus (HPV).  On the hands, they’re referred to as common warts; on the bottom of the feet they’re called plantar warts; around the fingernails they’re called periungual warts; on the genitals or around the anal area they’re called genital warts.

Take a deep breath… I know those 3 little letters strike fear in the hearts of all college and grad students, especially those who are sexually active, but there are over 150 distinct strains of HPV and they all prefer certain body parts and skin types.  For instance, HPV-1 has a foot fetish and causes plantar warts while HPV 6 and 11 prefer to hang out in the “junk yard” and cause genital warts. 

So while you technically have HPV on your finger – which I know is creepy to think about – it really likes the neighborhood and has no plans to move down to the “Short North” so to speak.  I know the blogosphere and wiki-land is ripe with people who swear that they got genital warts from fingers (either their own or someone else’s) – and while the mysterious nature of life (and fear of lawyers) preclude me from “never saying never” – the odds of that really happening are extremely small.

On the surface (ha ha) warts seem like a silly thing to worry about, but they can become a serious emotional issue – the thought of being “infected” by anything can make you feel gross and the fact that they are visible and are spread by skin-to-skin contact can make them especially embarrassing and even affect relationships.  But it’s very important to remember that besides the strains of HPV that cause cervical and some other extremely rare types of cancer, warts are only a cosmetic issue.  They are not a threat to your health or the health of your partners, and they almost all clear on their own within a year or two.

And the good news is that if you don’t want to wait that long, there are pretty good treatment options available at the Student Health Center to get rid of them quicker.  I’ll talk about them in my next post, but for now, rest assured that you don’t need to wear gloves every time you go to the bathroom!

All photos:

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

Getting better ZZZZZ’s


Surfer on the Beach

Just back from an all-night drive from Panama City?  Ready to get back into your school schedule?  Here in a recent article from Entrepeneur Magazine, the author shares five myths many students believe.  Do you?

MYTH: Sleep is downtime for the brain

  • REALITY: During sleep, your cardiovascular system and brain are doing a lot of work when it comes to creativity, critical thinking and memory. For example, short-term memories get registered and stored in the brain during sleep.

 MYTH: My body will adjust to less sleep

  • REALITY: A 2003 study by researchers at the University of Pennsylvania and Harvard Medical School found that decreasing sleep to six hours or less per night can reduce cognitive performance as much as pulling two straight all-nighters.

MYTH: I can sleep on the weekends 

  • REALITY: Sleeping two hours less a week straight will require you to add extra 10 hours onto two weekend nights of sleep.

MYTH: Coffee is as good as a night’s sleep 

  • REALITY: Caffeine is a useful cure for drowsiness, but it can only go so far. Your body doesn’t get the same benefits from caffeine that it gets from sleep. This means you will think and solve problems slower.

MYTH: Sleeping longer will make me fat

  • REALITY: A 2011 study found that losing sleep slows your metabolism and can lead to weight gain. The brain chemicals that stimulate hunger increase with less sleep. Also, sleep deprivation increases cravings for high-fat, high-carbohydrate foods.

Source: J. PORTER, Debunking 5 Common Myths About Sleep, February 5, 2013,

Nighty Night!

Roger Miller MD (OSU Student Health Services)


What can I do about my eczema?

Click to enlarge

Q: What’s the deal with this eczema? It’s even on my face.
A: Eczema, the “itch that scratches”, is a chronic inflammatory skin problem that causes a characteristic red, itchy rash. It commonly occurs on skin overlying joints and other areas that stretch and fold, but can occur anywhere on the body.

The cause of eczema remains a mystery. We know a couple of things, though. It often occurs in families. When one identical twin is affected there is an 80% chance the other will have eczema too. Overall, about 20% of the population in the US has eczema. It typically starts before five years of age, affects city folk more than rural inhabitants, and females a little more than males.

Eczema can be mild and limited or there can be diffuse involvement over a lot of the skin surface. Often eczema is worse in the winter, when skin tends to be drier by virtue of the harsh environment. While we don’t know what causes eczema, we know that the top layer of the skin-the thin epidermal line that protects you from the environment-becomes disrupted. The tissue can’t retain moisture effectively and leaves you susceptible to infection. 

The mainstays of therapy to protect the barrier involve both medication and lifestyle modification. Steroid creams are first line treatments. They work like a charm but can be tricky to use in the long run: they make skin thinner (which restricts their use on the face and neck where skin is already thin); they can cause a rash that looks like acne; can leave skin discolored and can also cause stretch marks.  When we have to use a steroid, we try to use one with the lowest potency for the shortest amount of time necessary to keep the eczema under control.

The other equally important part of treatment has two parts: avoiding triggers and adding moisture to the skin. 

  • Anything that might make already inflamed skin more irritated should be avoided. For example, perfumes, lotions with alcohol base and fragrance, certain detergents, deodorant soaps, or wool clothes can be quite irritating to somebody with eczema.
  • Long hot showers dry the skin (especially in the winter) and they release histamine from the mast cells in the dermis, making you itch and scratch like a fiend, which further disrupts the barrier.
  • Use bland soap without lye base. As noted above, avoid deodorant soaps.
  • A good, thick emollient is key. Petroleum jelly is the gold standard, but it’s hard to use. It stains clothes and bedding and covering your whole body in it is, well, icky and sticky. The thicker the emollient, though, and the sooner you use it after bathing the better. Ointments are generally better than lotions at moisturizing. Eucerin, Cetaphil, and Nutraderm are good products.
  • Antihistamines like loratadine (Claritin) or diphenhydramine (Benadryl) are sometimes helpful in controlling the itch during severe exacerbations.
  • Phototherapy (light treatments) or oral immune-modulators (i.e. chemotherapy) under a physician’s supervision can be helpful with severe chronic disease.

Schedule an appointment here at Student Health Services if you’ve having problems with your eczema, or any other skin problem.

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

Spring ahead during Sleep Awareness Week!

Better than this?

 This week  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 10. 

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 (OSU Student Health Services)

Take a trip with SHS

Gorakhpur, India

Surfer on the Beach


Take a trip with SHS!

Student Health Services sees a lot of students with plans to travel internationally, either as part of one of the many OSU Study Abroad opportunities, other travel associated with academic programs, or recreational travel.  Before you grab that passport and head for the airport, here are some healthy pointers:

  • Plan ahead – Most students plan for months or even years to get ready for international travel. Don’t forget to include health matters in those plans. Some vaccines are given in series over months, so start those early.
  • Get your shot records – Updating any incomplete or expired vaccinations from your childhood is an important part of travel preparation.
  • Talk to your health care provider about your trip – This is especially important for those students with chronic illnesses or prescriptions that they plan to continue while traveling.
  • Do your health insurance homework – Are you covered in Caracas? What is your deductible in Denmark? Is there a co-pay for Tetracycline in Timbuktu? Find out how your travel plans will impact your coverage.
  • Visit a travel expert – Our Student Health Services travel providers are ready to address your needs comprehensively, and offer an extensive selection of travel vaccines and medications. If you plan to visit someone else, make sure they are up to date on the changing health situations around the globe. (BTW, SHS is an Ohio Department of Health-certified Yellow Fever Vaccine clinic)
  • Be Patient! – Travel visits usually take a bit longer than a typical visit to the doctor, as each visit includes a thorough review of your health history, a discussion of your destination country’s or countries’ current health and safety conditions, and orders for all necessary medications and shots. Many students also start their vaccines at that same visit, so we would expect that you would be with us 40-60 minutes at a minimum. (All vaccines are recorded on an official International Vaccine Certificate for your convenience.)

Keep in mind, disease exposures can occur on a 3 month excursion across a continent or during a 5 day trip to a beach resort.  So, come see us before you order your Spring Break airline tickets.  Reduce the risk of having your trip to Cabo result in spending the first weeks of Spring Quarter sick from a preventable illness.

Healthy Travels!

Roger Miller, MD and Pat Balassone, CNP (OSU Student Health Services)