Get a Gold Medal for Vaccine Awareness!

photo: timeinc.net

Go for the Gold

We all need immunizations (also called vaccines or shots) to help protect us from serious diseases. To help keep our local campus community safe, BuckMD and OSU Student Health Services are proudly participating in National Immunization Awareness Month.

Shots can prevent infectious diseases like measles, diphtheria, rubella, and HPV. They can also reduce the number of students who will suffer from influenza each winter.  But people in the U.S. still die from these and other vaccine-preventable diseases.

It’s important to know which shots you need and when to get them. Visit the Student Health Services website for information on the wide array of vaccines we provide.

Here are some general guidelines for the vaccines you need:

  • Everyone age 6 months and older needs a seasonal flu shot every year.
  • Check your records to be sure your have been fully immunized against measles, mumps, rubella, and chickenpox.

Other shots work best when they are given at certain times.

  • All adults need a Td booster shot every 10 years to protect against tetanus and diphtheria, and should consider a Tdap booster to protect against whooping cough as well.  (The “p” in Tdap stands for pertussis, aka whooping cough)
  • First-year students should consider a meningitis shot if they have not had one since they turned 16.
  • HPV vaccines are only licensed up to age 26, and are best received early in your sexual life.

Talk to your doctor or nurse to find out other immunizations you may need. Go to our Events Calendar to get dates and times for our Flu Shot programs, and click on the date you choose to get more information

Here is a comment from a student who came to SHS for their flu shot – the flu shot clinic (was) very efficient and convenient since I did not have to schedule an appointment.”

Roger Miller, MD (OSU Student Health Services)

My sinuses are hurting!! Will antibiotics help?

photo: ehow.com

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One of our more frequent reasons for visiting Student Health Services is sinus infection.  You wake up with pain behind the eyes, a congested nose, maybe some ear fullness and irritated throat.  Could this be an infection in your sinuses?  Sure.  Does it need antibiotics?  That is unclear.  Just as we have been learning about many sore throats, coughs, and other upper respiratory illnesses, a recent study shows that antibiotics may not be needed for the majority of sinus infections. 

One difficulty for your health caregiver is that it is difficult to determine whether a sinus infection is viral or bacterial.  Overall, bacterial sinusitis is uncommon, and is the only infection where antibiotics are needed.  However, neither the color of mucus nor the amount of pain separates the two types.   

Most important factors:

  • Fever – temp. higher than 100.4° F
  • More than10 days of symptoms
  • Symptoms that persist despite over-the-counter medicines
  • Multiple sinus infections in the past year

In the meantime, if you have sinus pain this morning for the first time, check out this site from the CDC for some tips for managing your symptoms at home or in the dorm. 

Also, don’t forget good handwashing!

Roger Miller, MD (OSU Student Health Services

Source: JAMA. 2012;307(7):685-692.

Do I have a bug or not?

My belly hurts!

osumccooking.blogspot.com

Jogging with tunes

 Q: I was wondering if there is a stomach bug going around in the Central Ohio area? I, along with several others, have been experiencing stomach pain and diarrhea on and off for about a week. 

A: As of this posting, there are no unique bugs happening to our knowledge, just the usual episodes of stomach crud.  If you are having these symptoms for more than a few days, you should see a clinician for an evaluation.

Student Health watches for any information on clusters of illness in the community that could impact our students.  Our colleagues at the OSU Medical Center, Columbus Public Health, and Ohio Department of Health provide expert support. 

Meanwhile, with the spring growing season underway, and warmer spring and summer temperatures, it is also the time of year for illnesses related to poor food handling.  I hope that was not the case for you, but here are a few tips from the Ohio Department of Health for all of us to keep in mind:

Start clean

  • Wash hands thoroughly before eating, preparing food, after using the bathroom, changing diapers or after contact with animals.
  • Thorough hand washing is defined as using warm water and washing with soap for at least 30 seconds. In public restrooms, use a paper towel to turn off the faucet and open the door.
  • Wash meat thermometers, counters and utensils with hot, soapy water after coming in contact with raw meat.
  • Wash all fruits and vegetables well, especially those that will be served raw.

Food and Grilling Safety

  • Keep meat and poultry refrigerated until ready to use, and keep raw meats and their juices away from other foods.
  • Meat and poultry cooked on a grill often browns very fast on the outside. Use a food thermometer to be sure the food has reached a safe internal temperature. Whole poultry, 180 °F; breasts, 170 °F; Ground beef hamburgers, 160 °F; ground poultry, 165 °F. Beef, veal and lamb steaks, roasts and chops, 145 °F. All cuts of pork, 160 °F.
  • After cooking meat and poultry on the grill, keep it hot until served – at 140 °F or warmer.
  • When taking food off the grill, use a clean platter. Don’t put cooked food on the same platter that held raw meat or poultry.
  • In hot weather (above 90 °F), food should never sit out for more than one hour.

Some other wise tips

  • Drink only pasteurized milk, juice or cider.
  • Keep your cooler out of the direct sun and place it in the shade or shelter. Avoid opening too often. Pack beverages in one cooler and perishables in a separate cooler.

Adapted from Summer Safety, an ODH Feature last viewed 5/29/12

Have a healthy summer! 

Roger Miller, MD (OSU Student Health Services)

Please tell my girlfriend I didn’t cheat on her!

guardian.co.uk

I was just diagnosed with Mononucleosis and my girlfriend INSISTS that I can ONLY have gotten it from kissing someone. I have never cheated on my girlfriend and never will.  How can I prove her wrong so she calms down?  PLEASE HELP!

Infectious mononucleosis (“mono”) became known as “the kissing disease” in the 1950’s when Dr. Robert J. Hoagland, the chief medical officer at West Point, found that out of 73 cadets who had it, 71 had been involved in “deep kissing” within the past six weeks.  Like other catchy names that have stuck around despite having fairly little to do with the infection they describe – I’m looking at you, ringworm – it tends to cause more trouble than it prevents.

Mono is caused by the Epstein-Barr virus (EBV) which is spread mainly through the saliva of people who have had the infection.  EBV has also been isolated in cervical epithelial cells and seminal fluid, which suggests that it might be transmitted through sex as well.  (But I would suggest NOT bringing that point up with your girlfriend – it’s kind of theoretical and based on a blood test, so it’s really impossible to determine whether it was the kissing or the sex that spread the virus).     

Yes, heavy smooching is one good way to catch mono (they don’t call it “swapping spit” for nothing), but there are other ways to pick it up: sharing cups or utensils or toothbrushes.  Mono isn’t really a super contagious infection, but the virus can be shed in someone’s saliva for months or even years after the infection has cleared up, so it can be spread by people who aren’t actively sick.  Heck, if your girlfriend had mono in the past, it’s theoretically possible that you caught it from kissing her

What it comes down to is that it’s impossible to say exactly where or from whom you got the infection, but you can reassure your girlfriend that your having mono is not definitive proof of infidelity.

I hope this helps convince her that you are an upstanding guy.  If you want a little non-medical advice, I’d recommend sending her the link to this post on a card attached to some flowers. 

Good luck!

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

Get Your GYT On!

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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)

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

Gettin’ a little dirty may actually be good for you

Bing Images

Science has done it again. Dirty pigs are healthier pigs. It has been proven. Don’t ask how, because it involved a lot of fetal pigs (which makes my undergraduate pig dissecting PTSD flare up), poop and blood.  But it also involved a lot of wallowing and I am ALL about science that proves that wallowing is good for you.

Sure, the title – Environmentally-acquired bacteria influence microbial diversity and natural innate immune responses at gut surfaces – scintillating as it is, might not immediately strike you as a defense of all that is good about being dirty. But pull up a chair and consider the dirty details.

Gut immunologists took baby pigs and sent them outside, inside or into a kind of antibiotic-laced biologic bubble. The guts of the outdoor, mud-wallowing pigs were full of healthier bacteria than the indoor pig guts. Not only was there more of the good stuff in outdoor beasts, there was also less harmful bacteria in the chute. Most cool and interesting, though, is that the bacterial composition of the piggies’ guts influenced the expression of immunologic genes: pristine, white-glove pork expressed more inflammatory genes and other icky inflammatory stuff.

I know what you’re thinking. Pigs aren’t human, Dr. Rentel. True. Based on this study I’m not going to build a heated pigsty with a giant HDTV for me and my kids in the backyard. There is, however, a growing, stinking, microbial-filled gooey heap of evidence that human interaction with bacteria is good. Why does the prevalence of autoimmune diseases and allergies keep going up? This study gives some very direct, powerful evidence as to how the cascade of autoimmune badness gets started. Okay, yes, in pigs, but pigs are a whole lot like us.

As my favorite infectious disease specialist in the whole wide world (Dr. George Gianakopoulos) used to say, “Nature abhors a vacuum. Kill the good bacteria and welcome in the bad.”  I’m not saying you should order dirt for take-out tonight.  But skipping the whole-body antimicrobial gel bath every day might not be a bad idea. 

Victoria Rentel, MD (OSU Student Health Services Alum)

BMC Biology 2009, 7:79

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)