Category Archives: Nurse Practitioner Answers FAQ
Did you know almost half of all pregnancies in the United States are unplanned? Did you know approximately 50% of these unplanned pregnancies occur in women who say they were using some form of contraception? There are many birth control options available to women today.
Though the birth control pill is widely used and generally considered safe, many of our college students report difficulty remembering to take the pill at the same time every day. Some women don’t like the side effects of the birth control pill. Other women have certain medical conditions that make it unsafe to use hormone contraceptives. College women are asking for safe, reliable, hassle-free birth control options that are 99.9% effective. Read the rest of this entry
At our Student Health and Counseling Clinic, we typically see many students throughout the school year with common colds, coughs and flu symptoms. In 2005 and again this past 2010-2011 school year, we’ve seen a significant number of students with cough symptoms that suggest Pertussis, or “Whooping Cough”.
Pertussis infection is a highly contagious respiratory tract infection which can be quite serious, especially in infants under one year of age who are not fully immunized. Pertussis is often referred to as the “100 day cough”. It is successfully treated with antibiotics. Read the rest of this entry
Many of our students travel abroad in association with school-related studies and projects as well as for business or recreation. We are frequently asked about recommended travel immunizations.
Our policy at CSUSM Student Health and Counseling Services is to refer students to one of the local Travel Clinics where they can obtain not only specific CDC-recommended immunizations and/or disease prevention medication, but they can also obtain an individualized assessment of their own health risks as well as suggestions for a healthy travel experience abroad.
If you are involved in a Study Abroad program in association with CSUSM, a good place to start this process is by obtaining a course information sheet on travel itinerary and immunization recommendations from your instructor.
What does a Travel Clinic consultation typically include?
1. A questionnaire specifying travel itinerary and duration of visit;
2. Individualized health history including chronic diseases, medications, allergies as well as current immunization status;
3. CDC recommendations for country-specific immunizations;
4. Updates on new and emerging diseases;
5. Information and counseling about principles of healthy international travel including personal protective measures;
6. Answers to your travel-related questions and resource information about travel insurance, contingency planning for unexpected illnesses such as travelers’ diarrhea, motion and altitude sickness prevention, insomnia, traveling with disabilities and other travel concerns;
7. Immunization and vaccination administration.
When Should I Make an Appointment with the Travel Clinic?
The sooner the better!
The purpose of immunizations is to stimulate your body’s own immunity, and this process often requires a few weeks to establish optimum protection. If you need many immunizations, it may be desirable to get required immunizations in 2 or more visits, to reduce immunization side-effects. Although it may be best to obtain your immunizations several months before departure, you will still benefit from immunizations given closer to your departure date. If you are under the care of a Physician, Nurse Practitioner, Psychologist or Psychiatrist for management of a medical or psychiatric illness, or if you are receiving contraceptives or other medications, you may want to make an appointment with your Provider to discuss your travel plans as well as to discuss options for obtaining a prescription for a larger quantity of medication to last your visit abroad.
What Websites Could I Access to Inform Myself of Travel Information?
3. CDC Health Information and International Travel Book, also referred to as “The Yellow Book”.
Please call SHCS for resource information regarding low-cost Travel Clinics in your area or to schedule an appointment with your medical provider to discuss and plan for your health and medication needs abroad. We will be happy to help you.
1. Have you ever felt the need to CUT down on your drinking?
2. Have people ever ANNOYED you by criticizing your drinking?
3. Have you ever felt GUILTY about your drinking?
4. Have you ever taken a morning EYE-opener to steady your nerves or get rid of a hangover?
The above CAGE screening questionnaire is one of many tools created to help you and your medical provider determine if you have an alcohol problem. Two or more affirmative answers to the above questionnaire may indicate a problem with alcohol. Any single affirmative answer deserves further evaluation. (Mayfield D, et al)
College is a time of life when alcohol plays a part in many social situations. It is well known that college freshmen are at a statistically higher risk for alcohol-related problems than other college levels. Students who live away from home for the first time, live in dorms, or join fraternities or sororities often add to this risk. Some of the problems resulting from excessive drinking include alcohol-related motor vehicle accidents and falls, STDs, assaults, rape-by-intoxication, poor grades and failed relationships. Other risk factors for alcohol-related problems may include a family history of alcoholism, other substance abuse history, cultural factors or a personal history of emotional or psychiatric disorders.
In our student health clinic we have encountered students with a variety of alcohol-related medical and mental-health problems such as irritated stomach or esophagus related to excessive alcohol ingestion and/or vomiting, bruises and sprains that the student can’t explain, STDs due to unwanted sexual experiences as well as anxiety or depressive symptoms which result in missed classes and poor grades.
When Medical Providers evaluate a student with symptoms related to excessive drinking, we will take a careful history and conduct a physical exam. We will ask you about your drinking history and problems you’ve encountered with your drinking. It may be necessary to do blood or other lab tests, depending on your medical health status.
We will discuss our findings with you and work with you to make suggestions and generate a plan for getting you the help you deserve for any alcohol or other substance-abuse issues you have. We have Counselors who can help you discuss your issues and assist you in developing a behavior change program to fit your individual needs. We have a Health Educator who can suggest on-line self-assessment tools and outside resources. We also have a staff Psychiatrist available if necessary.
We understand the pressure and stress our students face in college, particularly during the current economic recession. Student Health and Counseling Service is committed to supporting your educational goals by providing medical and counseling services that are aligned with your individual needs and circumstances.
If you are concerned about your drinking habits and want more insight and support, please call us for an appointment: (760) 750-4915. We look forward to talking with you.
You may also check out “College Drinking-Changing the Culture” on-line resources to help you make healthier choices, Alcohol Screening which provides online self-assessment, or visit SHCS website and scroll down to Alcohol and Substance Abuse section for more health links and information.
Mayfield D, McLead G, Hall P. The CAGE Questionnaire. Am J. Psychiatry 1974: 131:1121.
Is this a mole…or melanoma?
I have a headache…could I have a brain tumor?
I’ve been tired lately…maybe it’s a sign of AIDS!
Students frequently come to our clinic for medical evaluation after they’ve searched the Internet, talked with their roommates or read magazine articles related to their symptoms. Sometimes these resources are helpful, sometimes they are anxiety-producing. It is often difficult for people to be objective about their own health concerns, making it difficult to put this information into the proper perspective.
The term “cyberchondriac” refers to anyone who uses the Web to obtain health-related information. Whether you’ve got a sore throat, a back ache or a rash, looking on the Web for information about your health concerns has been getting easier over the last few years. More and more Americans are going to the Internet for answers to their medical questions.
It is important to keep the following points in mind when you search the Web for medical information:
1. Are the articles written by reputable health professionals?
2. Are you looking at a commercial site that is trying to sell their products?
3. Are you aware that on-line medical information is for the general consumer and not tailored to the unique individual?
4. Have you considered bringing your questions about the information you obtain from the Internet to a Medical Provider to discuss?
It is important to remember that even a few hours reading at medical site is not the same as obtaining individualized assessments of your health issues by a Medical Professional.
Currently there are many search engines available for people wanting to learn more about their medical conditions. The following sites are among the top 10 most useful medical-related sites, according to the Medical Library Association. We often refer our students to these sites:
1. Medline Plus: this medical web site can be accessed by CSUSM students using our campus website. It is considered one of the best places on the Web for consumers, yet not well-known by the average person. The information is written in layperson’s language offering many links to credible organizations.
2. Familydoctor.org: this site has an A-Z index of conditions, easy-to-understand descriptions and diagrams as well as a guide to over-the-counter medications.
3. Healthfinder.gov: this site offers links to carefully selected Web sites from more than 1,500 health-related organizations.
4. Mayoclinic.com: this site also offers an A-Z list of diseases and conditions in clear layman’s language.
5. CDC.gov: The Centers for Disease Control and Prevention offers up-to-date, evidence-based information on many medical and disease conditions as well as Public Health issues.
In addition, please check out our CSUSM Student Health and Counseling Service web-site where you can find pertinent health information and links to other resources and services.
We encourage your interest in educating yourself about healthy living. If you have questions or concerns about your health, we invite you to schedule an appointment with one of our Medical Providers, our Health Educator or Counselors so we can partner with you in good health.
“You need to go to the Emergency Department because we think you have appendicitis.”
“Your PAP results were abnormal, and you will need to see a Gynecologist for a colposcopy.”
“You fractured your ankle skate-boarding, and you’ll need to see an Orthopedic surgeon.”
These are the types of scenarios that we often see in our student health clinic and need to refer out for management by a medical specialist. Your basic student fees typically do not cover such conditions. Without health insurance, whether you have your own policy or are covered under your parent’s policy, you may face high out-of-pocket expenses for these services.
Many of our students expect to get 100% of their health care needs met by our college health center and are surprised to discover this is not true. If you are a student at CSUSM, $65.00 of your fees automatically goes to the student health center every semester. This entitles you to see medical providers, counselors and a health educator for no additional fees although some lab services, medications and medical devices are provided at low cost to our students. We do NOT accept private insurance.
Your health fee does cover care of minor illnesses and health problems such as upper respiratory infections, bronchitis and asthma, headaches, urinary tract infections, rashes and minor sprains. In addition, you can receive your routine PAP exams and STD checks, contraceptive counseling and immunizations. You may consult with our Health Educator to discuss weight concerns, family planning and nutrition counseling.
We share your concern about the costs of medical care and medications, and we try to help our students get the best care at the best price. This year we brought the Family PACT (Family Planning, Access, Care, Treatment) program into our health clinic to provide no-cost family planning services to qualifying low-income students, both men and women. Some of these no-cost services include STD screening, PAP exams, contraceptive counseling and contraceptives.
We strongly encourage our students to have health insurance. CSUSM offers a Domestic and International Student Health Insurance program at reasonable rates. Remember, the best time to get health insurance is before you need it! Nobody plans to get in a car accident or fracture their leg, but if this happens to you, you will have health insurance if you need it. Remember to always carry your insurance card in your wallet.
If you’d like to learn more about our basic student health services, visit our website: www.csusm.edu/shcs. To see if you qualify for the Family PACT program, call the Student Health and Counseling Service to schedule an appointment with our Family PACT coordinator. To learn more about our supplemental Domestic and International Student Health Insurance option or to enroll on-line, please go to: www.CSUhealthlink.com.
Do I…weigh myself every day
skip at least one meal a day
count calories and fat grams every time I eat
exercise excessively or compulsively
self-induce vomiting after I eat
abuse laxatives or diet pills to control my weight?
Am I on my way to an Eating disorder?
According to NEDA (National Eating Disorders Association), eating disorders -such as anorexia nervosa, bulimia nervosa and binge eating disorder-include extreme emotions, attitudes and behaviors surrounding weight and food issues. People with eating disorders often use food and the control of food in an attempt to compensate for feelings and emotions that may otherwise seem overwhelming. Eventually, however, dieting, bingeing and purging will damage a person’s physical and emotional health.
Anorexia Nervosa is characterized primarily by self-starvation and excessive weight loss. Symptoms include a refusal to maintain a normal body weight, intense fear of weight gain or being “fat”, body image disturbance and loss of (3) consecutive menstrual periods.
Bulemia Nervosa is a cycle of binge eating followed by compensatory behaviors such as self-induced vomiting in an attempt to undo or compensate for the effects of binge eating. Symptoms include regular intake of large amounts of food accompanied by a sense of loss of control over eating behavior, regular use of inappropriate compensatory behaviors such as self-induced vomiting, laxative or diuretic abuse, fasting and/or obsessive or compulsive exercise and extreme concern with body weight and shape.
Binge Eating Disorder (BED) is recurrent binge eating without the regular use of compensatory measures to counter the binge eating while feeling out of control, ashamed or disgusted over the behavior. Symptoms include frequent episodes of eating large quantities of food in short periods of time, feeling out of control over eating behavior, eating when not hungry or eating in secret.
If you think that you may be developing an eating disorder and want to discuss your concerns with a medical provider or counselor, please call the Student Health and Counseling Center for an appointment: (760) 750-4915
We welcome the opportunity to discuss your concerns and help you get the appropriate treatment.
There are some changes in testing recommendations for the annual women’s wellness visit that are approved by ACS (American Cancer Society) and ACOG (American College of Obstetrics and Gynecology).
WHAT HAS NOT CHANGED?
All young women who have ever been sexually active need annual testing for sexually transmitted infections (STI’s) which involves a vaginal exam by a medical clinician. By age 21, women who have not been sexually active are recommended to have their first pelvic examination. Statistics show that young women are at the highest risk for contracting STI’s, like Chlamydia, which can cause illness and infertility if not treated properly (with antibiotics) and in a timely manner. These infections often are present without symptoms of vaginal discharge or pain, so screening tests are necessary.
WHAT HAS CHANGED?
A woman’s first PAP test in now recommended at age 21 or within 3 years after she becomes sexually active, whichever occurs first. The PAP smear is a screening test for cervical cancer, a cancer caused by longstanding persistent infection with the Human Papilloma Virus (HPV). This virus is sexually transmitted and is usually transient, with most infections being cleared by the woman’s own immune system in 6-24 months.
Cervical cancer occurs only in the rare case an HPV infection becomes persistent and does not get treated and resolve. The peak occurrence of HPV infection is in women in their early 20’s and the peak occurrence of cervical cancer is 15 years later, in the 4th or 5th decade of life. Delaying cervical cancer screening 2-3 years after initiating first sexual intercourse, allows these transient HPV infections and minor associated cell changes to resolve, sparing the woman stressful testing and treatment. (Adapted from University of Maryland)
Our clinic will be starting the FPACT program next week, Feb 11, 2008. This program provides no-cost family planning services to low-income men and women, including teens. Family PACT provides access to family planning services as well as education, counseling and treatment to protect your reproductive health. If you are interested in finding out more about the FPACT program, please call Student Health and Counseling Services at (760) 750-4915 to schedule an appointment with our FPACT coordinator.
Health promotion and disease prevention is an important part of our service credo. Preventive services include offering Gardisil vaccine to eligible students. Gardisil is a vaccine that helps protect against diseases caused be the (4) most common types of HPV. Gardisil is a series of (3) immunizations given over a 6-month period and has been on the market for women age 26 and under for over a year. Studies on males will be completed in 2008. We will notify our students when Gardisil is available for men.
If you have questions or concerns about any of the information above, please call our clinic to schedule an appointment with one of our medical providers, our Health Educator or our FPACT coordinator.