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I get sores on my tongue. Could it be cancer?

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Mouth sores can be painful, annoying and unsightly. Some appear inside the mouth – on the gums, tongue, lips, cheeks or palate (roof of mouth).  Others, like cold sores, can appear outside the mouth, such as on and around the lips, under the nose and on the chin.

Mouth sores can be caused by bacterial, viral, or fungal infections or oral cancer. Some other causes include:  extreme sensitivity to ingredients found in some toothpastes or mouth rinses; medication, cancer treatment side effects or reaction to therapy; or certain specific skin, oral or systemic diseases.

Some people may experience occasional discolored, painless spots in their mouth. Most are harmless and will disappear or remain unchanged.  However, some sores or spots can be serious and need attention of your dentist or physician.  That’s why regular dental checkups are so important.  Have your dentist examine any mouth sore or spot that fails to heal within two weeks.

Laurie Smith, RDH

How do I know I need to have my wisdom teeth removed?

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Generally, wisdom teeth emerge in late teens to early twenties. Frequently the eruptions of these teeth are blocked by soft tissue, bone or adjacent teeth and are considered impacted.  Removal of wisdom teeth is necessary to prevent decay of adjacent teeth, possible infection, cysts or tumors, jaw pain or crowding of other teeth.  Most wisdom teeth need to be removed but a policy of watchful-waiting can be adopted for those that are not cystic, painful, or erosive to adjacent teeth.

If you have pain with your wisdom teeth or just want them evaluated, call the Dental Clinic at the Wilce Student Health Services to make an appointment with a dentist for consultation. After doing an oral exam and taking an X-ray, your dentist can evaluate your wisdom teeth and discuss whether or not they should be removed.  A referral can be sent to an oral surgeon for further evaluation.

Laurie Smith, RDH

Allergies versus colds – How to tell the difference?

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Spring is in the air (although it’s snowing as I’m writing this blog), which means prime allergy season has begun! The common cold is also still prevalent in the ever-changing weather of Ohio.  Here are some facts about the differences between two similar presenting diseases and some tips on how to treat them! ALLERGIES Students may be more likely to develop allergies while attending college.  This could be due to living in a different region that has different pollens in the air and students may be exposed to different allergens.  Allergy symptoms occur quickly after exposure to an allergen and will last as long as you are exposed to the allergen.  Common symptoms include: runny or stuffy nose, sneezing, wheezing, and watery or itchy/dry eyes.

Common causes of seasonal allergies: pollen, dust, dust mites, food, animal dander, and mold

COLDS

Colds are caused by a virus, and very rarely are caused by bacteria. They mimic the same symptoms as allergies, but may also include fever, sore throat, and body aches.  Colds develop over several days and usually your body can clear the virus within several days to a week. Warning signs that you may have a bacterial infection (NOT the common cold) are vomiting or diarrhea along with fever and body aches and other common cold/allergy symptoms.  If you have these symptoms it’s important to see a doctor and stay hydrated!

Both allergies and the common cold have the same over-the-counter (OTC) treatment choices and non-medication related recommendations to help alleviate symptoms.

Common OTC Treatments:

  • Non-drowsy antihistamines – reduce symptoms of allergies like runny nose, itchy/watery eyes
    • Ex. Claritin (loratadine), Zyrtec (cetirizine), Allegra (fexofenadine)
    • Counseling tips: take daily during allergy season to prevent and reduce symptoms
  • Nasal steroids – helps reduce nasal inflammation, nasal congestion, runny nose and sneezing
    • Ex. Flonase (fluticasone), Nasacort (triamcinolone)
    • Counseling tips: requires a few days of treatment to notice effect on symptom improvement, and needs to be taken on a daily basis to continue to work
  • Nasal decongestants – helps reduce nasal congestion (stuffy nose)
    • Ex. Afrin nasal spray (oxymetazoline)
    • Counseling tips: should only be used for 3-4 days
  • Oral decongestants – helps reduce nasal and chest congestion
    • Ex. Sudafed (pseudoephedrine)
    • Counseling tips: do NOT use if you have high blood pressure without asking your doctor first
  • Artificial tears/saline solution – helps relieve dry or itchy eye irritation
    • Ex. Visine products, Artificial Tears
  • Pain relievers – reduce headaches associated with allergies or virus
    • Ex. Tylenol (acetaminophen), Advil (ibuprofen)
    • Counseling tips: don’t use more than the recommended dosing; be aware these ingredients may be in other OTC products and will count towards your maximum daily dose!
  • Cough drops – helps relieve cough associated with nasal drainage

 Non-Medicine Treatment:

  • Avoid allergens as much as possible!

 

  • Use a humidifier in your home to help with congestion
  • Wash hands/face often during pollen season
  • Avoid rubbing itchy eyes, try and use a cold compress instead to relieve symptoms
  • Avoid wearing contact lenses during pollen season to reduce eye irritation
  • Close windows/doors at home when pollen count is high

If you ever have questions about which OTC products can help your allergies or reduce the symptoms associated with a cold don’t hesitate to talk to your pharmacist or doctor!

Lindsey Glaze, PharmD Candidate 2016

Genital warts? Cervical cancer? We’ve got an HPV vaccine for that!

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In fact there are three vaccines all of which target the Human Papillomavirus (HPV) which can cause health problems such as genital warts and cancer. So which is the best?

The three vaccines were developed at different times and target different strains of the HPV virus.

  • Cervarix – protects against types 16 and 18
  • Gardasil – protects against types 6, 11, 16, and 18
  • Gardasil 9 – protects against types 6, 11, 16, 18, 31, 33, 45, 52, and 58

Here’s the breakdown on the HPV types:

  • 6 and 11 – not cancer causing, but are responsible for 90% of genital warts
  • 16 and 18 – cancer causing responsible for 70% or cervical cancel, 50-60% of mouth/throat cancer, and 80% of anal cancer in the US
  • 31, 33, 45, 52, and 58 – cancer causing responsible for 15% or cervical cancer, 4-9% of oro-pharyngeal cancer and 4-11% of anal cancer in the UA

Gardasil 9 was approved by the FDA in December 2014 and is licensed for use in females age 9-25 and males 9-15.  It is also licensed for immunocompromised persons and for men who have sex with men through age 26.

Current recommendations by the Advisory Committee on Immunization Practices) ACIP include:

  • Females:
    • Vaccination for those aged 9-26
    • All three types of the vaccine can be used
  • Males:
    • Vaccination for those aged 9-21, but new data is suggesting it should be available for those aged 16-26
    • Recommended for those who have sex with men and immunocompromised men through age 26
    • Gardasil and Gardasil 9 can be used
  • All:
    • Dosage schedule includes 3 doses, with the second dose 1-2 months after the first and the third dose 4 months after the 2nd and 6 months after the first
    • If the dosage schedule is interrupted, the series does not have to be restarted
    • If you do restart and are unsure which vaccine you received, you can use the new vaccine safely

Ryo Choi-Pearson, M. D.

What are some symptoms of Chlamydia?

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My friend was recently treated for Chlamydia which got me to wondering.  What are some symptoms of Chlamydia?

Good question.  Chlamydia is the most common bacterial sexually transmitted infection (STI) in the US with more than 1.44 million cases reported to the CDC in 2014.  More than half of these occurred in women aged 15-25 years.

The symptoms of Chlamydia may include abnormal vaginal discharge, vaginal irritation, pelvic pain, abnormal vaginal bleeding, dysuria, painful sex, and/or contact bleeding.  OR there may be no symptoms at all.  In fact, it is very common not to have any symptoms.  That is why routine screening tests are important for sexually active women.

Annual screening is recommended for all sexually active women who are:

  • less than 25 years of age
  • 25 year or older and have a new sex partner, more than 1 sex partner, a sex partner with concurrent partners, a sex partner who has an STI, or if you have had a previous history of Chlamydia

Early detection of Chlamydia is important as serious consequences can result.  These may include:

  • pelvic inflammatory disease (PID)
  • chronic pelvic pain
  • ectopic pregnancy
  • infertility

The treatment of uncomplicated Chlamydia is easy enough with a single dose of antibiotics.  However, this easy enough treatment will only be effective if your partner is Chlamydia free, so, and  I CANNOT STRESS THIS ENOUGH, sexual partners must be evaluated and treated as soon as possible to prevent re-infection.  Both partners must abstain from sexual activity (NO SEX OF ANY KIND) until 7 days after they have been treated.

The Ohio State University has various resources available for STI testing.

  • An appointment can be scheduled with a provider at Student Health Services.
  • An Order-it-Yourself (OIY) lab for detected Chlamydia can be completed at the Student Health Services Laboratory.
  •  Free STI testing is offered by the Student Wellness Center.

Ryo Choi-Pearson, M.D.

 

Are you asleep yet?

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The Wall Street Journal says that thermostat settings (the temperature in the room where you sleep) may be more important than light and bedtime to ensure a good rest.

Setting the thermostat to around 65 degrees Fahrenheit is good for sleep.  The body’s core temperature needs to drop by 2 to 3 degrees Fahrenheit to initiate sleep.  This prompts the brain to cool down.

During sleep, people’s bodies try to lost heat from hands and feet.  Put on socks if your feet are too cold.  If you are too hot, try sticking your hands and feet out from under the covers.

It’s best to wear light breathable clothing to bed, such as cotton.  layers of bedding that can be easily removed are ideal.

Pat Balassone, CNP

How do I know if I have frostbite?

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ehow.com

Q: I was out in the cold in tennis shoes for a long time. When I came inside my toes were blue and hurt really bad for a few hours. Did I get frostbite?

A: Frostbite occurs when tissue freezes.  The condition mainly affects the fingers, toes, ears, cheeks and nose, but any body part can freeze – even your eyeballs!  When exposed to prolonged cold temperatures, blood flow is decreased to the extremities and diverted to more vital organs, like your heart, lungs and brain.  Unfortunately, this leaves the vulnerable areas even more at risk.

There is a spectrum of severity in frostbite.  Superficial frostbite occurs when the areas of the skin close to the surface freeze. There is often a burning sensation, numbness, or tingling.  Affected tissue becomes cold and white, but maintains some of the elasticity of normal skin.  This type of frostbite can be serious, but is potentially reversible with no loss of tissue or function.

The deeper the freeze, the more serious the disease.  When there is more extensive damage the tissue becomes white and hard, sometimes with superficial blood blisters. Sensation in the tissue is either absent or profoundly decreased. There probably will be loss of tissue, and sometimes surgery is required.

Frostnip is a cold injury to the tissues that is different from frostbite.  In frostnip, superficial tissue becomes cooled, but is not cold enough to freeze.  Skin is usually pale and numb, but recovers fully with gradual warming.

People with frostbite should be seen by a physician as soon as possible.  The area involved should be elevated and gradually warmed.  No rubbing! Clapping, rubbing, or slapping those cold frozen fingers together is only going to cause more damage to already stressed tissue.

Of course, the best way to avoid frostbite is to listen to your mother (and Dr. Vicki) and wear your hat and gloves. Minimize your exposure during severe weather. Be extra careful if you’re sick, have diabetes, vascular disease, or you smoke. Be wary of cold weather and alcohol. Stay warm out there, Buckeyes!

Victoria Rentel, MD (OSU SHS)

Reviewed by Tina Comston, M.Ed.

Suggestions for a Good Nights Sleep

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To get a good nights sleep:

  1. Go to bed at the same time every day.
  2. Have coffee, tea, pop, and other foods with caffeine only in the morning.
  3. Avoid alcohol in the late afternoon, evening, and bedtime.
  4. Avoid smoking, especially in the evening.
  5. Keep your bedroom dark, cool, quiet, and free of reminders of school, work, or other things that cause you stress.
  6. Try to solve your problems before you go to bed.
  7. Exercise several days a week, but not right before bed.
  8. Avoid looking at phones or reading devices that give off light before bed.  This can make it harder to fall asleep.

Because of the limited benefits and substantial risks of sleeping pills, Consumer Reports advises that sleep drugs should be used with great caution.  The American Academy of Sleep Medicine no longer recommends sleeping drugs as a first-choice treatment for chronic insomnia, opting instead for cognitive behavioral treatment (CBT).

Patricia Balassone, CNP

Are you getting enough?

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Sleep, that is.

Sleep is more important than you think.  Most people don’t function well with less than 7 hours of sleep.

Sleep deprived students more readily reach for candy and desserts.  The so-called ‘freshman 15’ may be related to widely changing patterns of sleep (sleeping different hours each night) and abbreviated (too little) sleep.  Lack of sleep makes the body less sensitive to insulin increasing the risk of obesity and Type 2 Diabetes.

Sleep deprivation affects brain functions including memory, emotion, and regulation of appetite.  Poor sleep can, under certain circumstances, lead to depression severe enough to be diagnosed as major depression.

Without enough sleep, the immune system cannot work as efficiently to fight off illness.

Sleeping pills provide only modest benefits.  People fall asleep between 8 and 20 minutes faster when taking prescription drugs for sleep.  Often, people end up functioning worse the next day – so drowsy that they cannot drive safely.  Sleeping pills can pose other dangers, too, like falls, dizziness, and fractures.

So if your roommate (not you) is in a bad mood, crabby, has decreased energy, poor judgement, and is gaining weight, maybe they just need more sleep.

More later on how to get a good night’s sleep.

Pat Balassone, CNP

Medical Mythbusters – Do you really lose 80% of your body heat from your head?

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ew.com

True or False:  80% of your body heat is lost from your head.

FALSE!!

I love this one. My mother must have used it on me a million times growing up to get me to wear a hat, which I would not do since I grew up in the 70s and my Farrah Fawcett hair would have been ruined.

Where did this “80%” come from? Apparently from a weak US military study done in the 1950s that examined heat loss from Arctic volunteers dressed from neck to toe in survival gear. Duh, their uncovered heads lost more heat than the rest of their bodies. Were I to go outside in the bitter cold naked (as awful as that image is to contemplate) 100% of my body heat would be lost from my whole body. A slightly higher proportion of the heat might be lost from my head thanks to the greater blood supply to the head and face, but the head doesn’t have a lock on heat loss.  If you go outside in a pair of shorts you’re going to lose a lot of heat through your legs.

What my mom was worried about, of course, was the dreaded frostbite, of Jack Frost nipping at my nose. What exactly would put my nose (or ears or toes) at risk?

Environmental: Prolonged exposure, extreme cold, damp cold, high altitude. During severe cold, frostbite can develop in a matter of minutes. Everything that is exposed is at risk.  Feet and hands are affected most frequently, but ears, noses, cheeks, and even corneas are also at risk.  I challenge you to find a hat for your cornea.

Poor underlying health and/or altered mental status: Prior cold injury, alcohol use, tobacco use, malnutrition, diabetes, peripheral vascular disease, and severe mental health all limit the body’s ability to respond to any severe stress, including cold temperatures. Of note, prior cold injury can quadruple the risk of a subsequent cold injury.

Clothing: Inadequate clothing obviously increases exposure. But constrictive clothing that limits blood flow to the extremities, toes, etc. also increases risk of cold injury.

Being male: Whether this is because of some kind of genetic susceptibility or because males tend to spend more time outdoors isn’t clear.  African American males appear to be at special risk.  During both the Korean and Falkland Wars, there was a higher prevalence of frostbite in African American men than in other similarly attired races.

The bottom line? Mom was right, especially if you’re a male who likes to train for marathons during sleet storms at very high altitudes in super tight clothes while crazy drunk and smoking like a chimney.  So…

  • Minimize exposure, especially if it’s extremely cold and/or damp. Higher altitudes (like ski trips) warrant even more caution.
  • Wear sensible, warm, non-constrictive, layered clothing.
  • Stay dry.
  • If you’re going to be out in the cold, avoid drugs, alcohol, and tobacco.

Victoria Rentel MD (OSU SHS)