Medical Conditions

Social Distancing FAQs for College Students

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Social distancing is the idea of actively avoiding crowds to slow the spread of illness. Specifically, the CDC asks us to cancel any activity of more than 50 people and only hold a gathering of smaller size if you can ensure hand hygiene practices and that people keep at least 6 feet away from others. They want us to do this for at least the next 8 weeks.

The CDC is asking you – yup, you (and me too!) – to stay away from folks. We realize that is easier said than done, and still likely leaves some questions.

Please don’t. If you ignore the guidance on social distancing, you will essentially put yourself and everyone else at much higher risk.

You still have a risk from Coronavirus, even as a young person.

Plus the community needs your help in slowing the virus. People who show only mild symptoms or no symptoms at all can pass the virus to many, many others before they even realize they are sick. So you could infect your older or high-risk loved ones or community members with chronic illness, as well as contribute to the number of overall people infected, causing the pandemic to grow rapidly and overwhelm the healthcare system.

We know social distancing is tough, especially for college students who are used to gathering in groups. But even cutting down the number of gatherings, and the number of people in any group, will help.

Yes.

It’s O.K. to go outdoors for fresh air and exercise — to walk your dog, go for a hike or ride your bicycle, for example. The goal is not to remain indoors, but to avoid being close to people.

You may need to leave the house – for medicines or other essential resources.

There are things you can do to keep yourself and others safe during and after these excursions.

When you do leave home:

  • Wipe down any surfaces you come into contact with
  • Disinfect your hands with an alcohol-based sanitizer and avoid touching your face.
  • Frequently wash your hands — especially whenever you come in from outside, before you eat or before you’re in contact with the very old or very young.

Yes. Stock up to minimize the number of trips, and pick a time when the store is least likely to be crowded.

When you do go, remember that any surface inside the store may be contaminated. Use a disinfecting wipe to clean the handle of the grocery cart, for example.

Wearing gloves is not as effective as washing your hands.

Put your phone somewhere in accessible so that you don’t absent-mindedly reach for it while shopping to avoid getting more germs on your phone.

Put hand sanitizer in your vehicle and sanitize when you leave the store.

When you get home, wash your hands right away. Re-wash after putting away your items.

Those at high risk may want to avoid the store if they can help it, especially if they live in densely populated areas. Ask for someone at lower risk to help you by picking up groceries when they go to the store.

Some places have closed down restaurants and bars for the next few weeks, but if you’re not in one of those places, there are not rules about this yet.

In general, avoid going out to restaurants.

If you’re going to go – choose somewhere that has a lot of space and staff you trust who likely practice good hygiene.

Better yet, opt for takeout.

If you’re concerned for the restaurant’s financial future, purchase a gift certificate that you can redeem later.

That depends on how healthy they are.

People who are sick or returning from recent travel should not visit. If you have vulnerable people in your home, limit visitors.

But if everyone in your home is young and healthy, then some careful interaction in small groups is probably OK. The smaller the gathering of healthy people, the lower the risk will be.

Keep checking in with loved ones by phone or plan activities to do with them on video.

We do encourage you to keep active during this time. Bike rides, hikes, walks, outdoor workouts on your own or with only the people who live in the same home as you are all encouraged.

Playing sports or yard games adds risk. You can minimize that risk by:

  • Ensuring that everyone who plans to play is young and healthy
  • There will be less than 10 people
  • Avoid high fives and huddles
  • Wipe down any shared objects (balls, discs, bats) during breaks
  • Have hand sanitizer nearby for everyone’s use
  • Wash your hands immediately afterwards

I’m worried about isolation. What can I do to make this easier?

Staying in touch with family and friends is more important than ever – just use technology instead of face-to-face interactions. Even imagining a warm embrace from a loved one can calm the body’s fight-or-flight response.

For more tips, see Managing Mental Health During Coronavirus. You can also call CAPS 24/7 at 919-966-3658 for mental health support.

We don’t know and it depends on how well we collectively succeed at social distancing now. Again, current CDC guidelines ask us to do this for 8 weeks.

Social distancing will help “flatten the curve” of the COVID-19 outbreak, thus keeping the number of cases at a level that health care providers can manage and ensuring better care for any infected people. By complying with social distancing guidelines, college students — as well as the rest of the population — can do their part in slowing the spread of the pandemic.

For more details:

UNC’s guidelines to COVID-19 

CDC guidance 

Managing Mental Health During Coronavirus

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People like certainty. We want to know what is happening and when it’s happening. We are hard wired to notice things that feel threatening to us.  When situations feel uncertain or we generally feel unsafe, it is normal to feel stressed. That reaction is there to protect us, and there are strategies you can use to help yourself.

Right now, many of us are worried about COVID-19, “Coronavirus.”

A large part of anxiety comes from a sense of what we think we should be able to control, but cannot. We may feel helpless about what will happen. We may not know what we should do to prevent the spread of Coronavirus or prevent further anxiety. The uncertainty might also connect to similar feelings about other aspects of our lives, or remind us of past times when we felt unsafe or we faced an unknown future.

In times like these, our mental health can suffer, which could show up as periods of:

  • Anxiety, worry, panic
  • Feeling helpless
  • Social withdrawal
  • Difficulty concentrating and sleeping
  • Anger
  • Hypervigilance to your health and body

Coronavirus is a health issue that is being taken seriously at UNC Chapel Hill and around the world. It makes sense to be anxious but don’t let your worry about the virus control your life. We can choose our response to situations. There are effective ways to manage fear and anxiety; many of them are essential to a healthy life and adopting them can improve overall emotional and physical well-being.

  1. Get the facts. Stay informed with the latest health and campus information at unc.edu/coronavirus. For further information see the CDC Coronavirus website.
  2. Separate what is in your control from what is not. Focus on the things you can do:
    • Wash your hands. Remind others to wash theirs.
    • Eat a variety of nutrient dense foods.
    • Move your body every day.
    • Get outside.
    • Although you will want to keep informed, take a break from the news to focus on the things that are positive in your life and things you have control over.
  3. Do what helps you feel a sense of safety. This will be different for everyone, and it’s important not to compare yourself to others.  It’s ok if you’ve decided what makes you feel safe is to limit attendance of large social events, but make sure you separate when you are isolating based on potential for sickness versus isolating because of depression. Stay mindful of your assumptions about others – someone who has a cough or fever does not necessarily have coronavirus. Self-awareness is important in not stigmatizing others in our community.
  4. Get outside, ideally in nature – even if you are trying to avoid crowds. I took a walk in my neighborhood with my roommate. We saw a bit of sun, enjoyed fresh air, moved our bodies and spent quality time together.  Exercise in nature helps both your physical and mental health.
  5. Challenge yourself to stay in the present. Perhaps your worry is compounding—you are not only thinking about what is currently happening, but also projecting into the future. When you find yourself worrying about something that hasn’t happened, gently bring yourself back to the present moment. Notice the sights, sounds, tastes and other sensory experiences in your immediate moment and name them. Engaging in mindfulness activities is one way to help stay grounded when things feel beyond your control.
  6. Stay connected and reach out if you need more support. Talk to trusted friends about what you are feeling. Maintain your social networks using technology. If you are feeling particularly anxious or if you are struggling with your mental health, it’s ok to reach out to a mental health professional for support. You don’t have to be alone with your worry and it can be comforting to share what you are experiencing with those trained to help.

We are in this together, and help is always available.  If you’re feeling alone and struggling, you can reach out to CAPS 24/7 at 919-966-3658.

The content for this blog was heavily influenced by UC-Berkeley and the American Foundation for Suicide Prevention.

It’s That Time of the Year Again…Allergy Season!

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Allergy season is quickly approaching which means we, along with our cars, will be covered in all that yucky pollen. OH! We can’t forget about all of the sneezing, red and itchy eyes, and sinus drainage that can happen either!

Instead of letting allergies take over your life, follow the tips listed below to help control or prevent allergy symptoms in the first place!

ALLERGY PREVENTION TIPS

  1. Neti Pot or Nasal Wash – Rinse your nose and sinuses of pollen daily with a Neti Pot or nasal wash spray to decrease allergen exposure.
  2. Vitamin C – Vitamin C is a naturally occurring water-soluble vitamin that boosts the immune system, and at higher doses it may act as a natural antihistamine. As vitamin C is a powerful antioxidant and anti-inflammatory, it may act as an alternative treatment for allergies. Vitamin C is also found in many foods such as strawberries, kiwi, mango, citrus fruits (oranges and grapefruit), bell peppers, broccoli, and cauliflower.
  3. Dust Mite Covers – Dust mites are insects that live in our bedding, crawl on our skin and eat our dead skin cells. The average bed as 1,000,000 dust mites. Use dust mite covers on your pillows, mattress and box spring to decrease contact with dust mites and keep them from aggravating allergies at night. This material is so tightly bound that dust mites cannot get through.
  4. Reduce Exposure to Allergens – Try to stay indoors as much as possible, wear sunglasses outside to protect your eyes, keep pets out of bedrooms, wash your hands after petting animals, and close windows and doors in your home.
  5. Cleanse Yourself of Pollen – If you have been outside, change your clothes and take off your shoes when you walk through the door so you don’t bring allergens into your home. Also take showers at night and wash your hair to help remove excess pollen.

OVER-THE-COUNTER (OTC) REMEDIES

When purchasing OTC medications, be sure to talk with your pharmacist to help you decide which product(s) would work best for your symptoms. They can also provide you with proper education and administration instructions.

  1. Nasal Corticosteroid Sprays such as Fluticasone (Flonase), Budesonide (Rhinocort), and Triamcinolone (Nasacort) – Help to reduce swelling and congestion in nose and sinuses.
  • They work best when you use them everyday
  • It may take 2 or more weeks of steady use for symptoms to improve
  • Side effects: dryness, burning, stinging, and nose bleeds
  1. Oral Antihistamines such as Fexofenadine (Allegra), Diphenhydramine (Benadryl), Loratadine (Claritin), Cetirizine (Zyrtec) – Help to relieve sneezing, itching, runny nose, and watery eyes.
  • Can be bought as a pill, capsule, or liquid
  • Diphenhydramine (Benadryl) causes the most drowsiness
  • Side effects: dry mouth, constipation, and drowsiness
  1. Decongestants such as Pseudoephedrine (Sudafed), Oxymetazoline (Afrin Nasal Spray) – Help to relieve stuffiness and pressure caused by swollen nasal tissue.
  • Use over a short period, no longer than 3 days
  • Sudafed products are found behind-the-counter at pharmacies and you must be 18 years or older to purchase with a valid ID (driver’s license or passport)
  • Phenylephrine (Sudafed PE) is another OTC decongestant product, BUT it is no more effective than placebo for nasal congestion, so it is not recommended
  • Side effects: insomnia, increased heart rate or blood pressure, nervousness
  1. Eye Drops such as Artificial Tears, Ketotifen Fumarate (Zaditor, Alaway) – Help to relieve itchiness, redness, burning, and swelling associated with eye allergies.
  • There are many types of OTC eye drops including artificial tears, decongestants, antihistamines, mast cell stabilizers, and anti-inflammatory drops
  • Artificial tears are lubricants that help wash allergens out of the eyes.
  • Only antihistamine eye drops are available at The Healthy Heels Shoppe and Student Stores Pharmacy that mainly work to relieve itchy eyes.

It is important to talk to your doctor before starting a new medication. Make sure that a new allergy medication won’t interfere with other medications or medical conditions. Additionally, if avoiding allergens and taking OTC medications is not enough to ease symptoms, make sure to contact your doctor to receive further medical care.

 

References:

 

 

 

How to Not Get Sick

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Have you been sick recently? Have that little sore throat that shows up when you’re just about to get sick? Avoid the #uncplague this Cold and Flu season by using these annual reminders about what to do to not get sick.

Photo (Wash Hands Frequently) by (Fairfax County), Flickr Creative Commons
Photo (Wash Hands Frequently) by (Fairfax County), Flickr Creative Commons

Wash your hands (and stop touching your face).

Illness is often spread by people getting the a virus on their hands from touching someone or something that a sick person has coughed on, sneezed on, or touched, and then touching their face. You may remember from the movie Contagion that people touch their face 2,000 to 3,000 times a day. This might be a bit of an overestimate, but in a recent study, random people touched their face 3.6 times an hour and with the same hand also touched common objects that others had touched. So wash your hands and stop touching your face so much.

When should you wash ’em?

  • Before, during, and after preparing food
  • Before and after caring for someone who is sick
  • Before and after treating a cut or wound
  • After riding on public transportation
  • After using the toilet
  • After using shared gym equipment
  • After handling money
  • After changing diapers or cleaning up a child
  • After blowing your nose, coughing, or sneezing
  • After touching an animal, animal feed, or animal waste
  • After touching or taking out garbage
  • After any other potentially gross things you do that I couldn’t think of

Sleep

We get that it’s difficult – but sleep is critical to keep your body functioning. Getting good sleep is about developing good habits, or “Sleep Hygiene.” Harvard Medical School has a Division of Sleep Medicine website which we highly recommend if you are interested in learning more about sleep. They have listed 12 tips for improving sleep which are amazing. Read them now. Seriously.

Hydrate.

Stop and take a sip anytime you pass a water fountain. Carry a water bottle with you to hydrate throughout the day. Drink a glass of water as the first thing you do when you wake up (on second thought: first pee, then drink the water). Drink at least a glass of water with each meal. There are loads of tricks like these to ensure you stay hydrated. Incorporate at least one into your life.

Drinkmore

When you are really sick, stay home.

Email your professors, let group partners know that you are sick, and tell your coaches that you cannot come to practice. I am as guilty as anyone I know of breaking this rule regularly; there is still part of me that thinks I just need to “tough it out” and work through it. Unfortunately, our society often still rewards or finds it admirable when individuals fight through a sickness, but we need to change this norm. I am not saying take advantage of a sickness. If you have a sniffle or a tickle in your throat I might not advise that you lay in bed all day, but if you truly are sick, you are protecting others by staying home. You also most likely will not get much out of being in class or at a meeting if you are not feeling well.

Get a flu shot

According to the CDC the number of deaths due to the flu has ranged from as low as 3,000 to as high as 49,000 per year in the United States in recent years.

Photo (Flu vaccinations make their way to U.S. Army in Europe) by (U.S. Army Corps of Engineers Europe District), Flickr Creative Commons
Photo (Flu vaccinations make their way to U.S. Army in Europe) by (U.S. Army Corps of Engineers Europe District), Flickr Creative Commons

Get a flu shot. You do NOT get the Flu from a Flu shot. Let me say that again: you do NOT get the Flu from a Flu shot. Some people do get a low-grade fever and headache from the vaccine, but this is just the body reacting to the foreign substance, not the Flu. According to the CDC, vaccines given to children have saved more than 732,000 lives and trillions of dollars over the last 2 decade. There is also absolutely no evidence that the Flu vaccine –or any other vaccines– present significant harm, and the idea that vaccines cause autism is a complete myth. The worst that could happen is that the Flu shot does not provide protection for the strain of the Flu that is being passed around but, even in that case, there is nothing lost by getting the shot. Most people who work in public health will agree that vaccinations are one of the most important innovations of modern medicine and protect not only the individual getting the shot, but others around them.

So each flu season, get yourself that flu shot. The vaccine is available on campus without appointment at either Campus Health Pharmacy or Student Stores Pharmacy, and will remain available through at least January.

Do what you can to stay well, friends. And when you get sick, check out Campus Health’s cold-care guide or make an appointment.

This post was originally published on October 14, 2014 by Jedadiah Wood. It was updated and reposted November 4, 2016.

Peeing in A Cup: The Troubling Roots and Consequences of Healthcare Providers’ Ignorance about Transgender Patients

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Image courtesy of Randrenfrow on Flickr

My phone vibrated as I sat in the waiting room. My partner was texting me from the bathroom down the hall at the clinic where I had accompanied her to treat a rash. “I’M TAKING A PREGNANCY TEST. I AM PEEING IN A CUP” she wrote, in a panic. We weren’t worried she was pregnant; however, because my partner doesn’t have a uterus. She is a transgender woman, and her fear, instead, was that her doctor would somehow find out. The doctor had told Hila to take the test before prescribing a cream that could cause birth defects, and Hila hadn’t told the doctor she was trans because she was afraid of the reaction. Doctors and therapists often didn’t know what it meant to be transgender, made Hila feel like a medical oddity, or dismissed every problem she was experience as a symptom of being trans. From my itchy partner’s perspective, treating a simple rash wasn’t worth the risk of disclosing.

My partner’s experiences of poor care are common among transgender people. Half of trans people reported having to teach their medical providers, a fifth said they were refused medical care, 11% were denied therapy, and most disturbingly, a quarter of trans people reported harassment in medical settings.

This poor, unethical, and downright dangerous care is concerning because lifetime experiences of stress and discrimination have caused transgender people to have higher rates of many health issues than the general population. These same health issues are exacerbated by the poor treatment trans people receive. For example, transgender people who are refused treatment by a provider experience an increase in the lifetime rate of suicide attempts from 41%–already shockingly high—to 60% of the transgender population. Further, the poor experiences that transgender clients have with providers can deter them from seeking care in the future. In one study, a quarter of trans people reported postponing medical care. In another, 43% of LGBT clients who had unhelpful experiences in therapy reported diminished quality of life and a quarter developed a negative impression of therapy in general. Health professionals are therefore complicit in worsening transgender health disparities.spaceball

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Image courtesy Marlan on Flickr

Yet at the root of providers’ incompetence and hostility toward transgender people is ignorance. More than half of health care organizations do not require employees to take cultural competency training that includes LGBT issues and 41% of social work program stated that their programs trained students “slightly well” to “not at all well”  when it comes to providing services to all LGBT individuals. Data on trans people, specifically, is unavailable, as trans people are often overlooked in research. No wonder trans people like my partner educate their providers—no one else has.

Trans Health Resources On and Off Campus

Check out this page for more information about how Campus Health Services supports trans health needs. The UNC LGBTQ Center is another resource to support students in navigating trans healthcare on campus. Finally, the LGBT Centers of Durham and Raleigh each keep a listing of community resources that are supportive of LGBTQ people. See the Durham LGBT Center’s listings here, the Raleigh LGBT Center’s community listings here, and the Raleigh center’s list of mental health practitioners here.

By: Anole Halper

Anole Halper is an intern with Student Wellness over the summer.  They are getting a dual Masters in social work and public health.  Their research interests include sexual violence prevention and LGBTQ health equity issues.

 

The How’s and What’s of Sun Protection

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The best way to defend your skin from damage and long term skin issues is to protect your skin early and often from the sun’s ultraviolet (UV) rays. The most common sun protection method is using a quality sunscreen.t is recommended in a sunscreen?

  • At least SPF 30 (although going above that doesn’t offer much greater protection)
  • Broad spectrum meaning the sunscreen covers both UVA and UVB rays
  • Water resistant is preferable. This is especially important for water exposure or sweating.

How much sunscreen should be applied?

One fluid ounce (enough to fill a shot glass) is the amount generally considered enough to cover exposed body areas, although this varies based on a person’s body size. It is important to apply and rub in to all exposed body areas.

How often to reapply?

Sunscreen should be initially applied 20 minutes before sun exposure and reapplied at least every two hours under “dry conditions” (no contact with water and not sweating).

No sunscreen is truly waterPROOF or sweatPROOF; the sunscreen may be water/sweat RESISTANT. These types of sunscreens work best when applied before getting wet (before being in water or prior to getting sweaty) and should be reapplied every 40-80 minutes if getting wet from water or sweat.

If you are using bug spray, the sunscreen should be applied first, followed by the bug spray; it is best to avoid sunscreen/bug spray combination products because they have different reapplication schedules.

What are the differences between the different sunscreen types – chemical vs. barrier?

Chemical sunscreens (such as oxybenzone) are very popular and work by absorbing and filtering harmful UV radiation from penetrating the skin. This sunscreen type is often colorless and remains as a thin layer on the skin.

Barrier, or physical, sunblocks (such as titanium dioxide or zinc oxide) physically block harmful UV rays from reaching the skin. Barrier sunblock can provide high protection from thsunscreene sun, but a quantitative SPF is difficult to specify. This sunscreen type is more common in formulations for babies because chemical sunscreens can sometimes irritate babies’ skin. Some folks find this sunscreen unfavorable because it does not rub in as well as chemical sunscreens (nor is it supposed to rub in as well in order to function properly!). There are colorful options that can be fun, or you can go for the nose-specific “Dad style” of barrier sunblock application modeled below by The ‘Hoff:

What about parts of my body I can’t apply sunscreen to?

Protect your eyes! Look for sunglasses that promote UV400 protection; these filter out 99.9% of UVA and UVB rays. Lips are not immune to the sun’s rays either; use a lip balm that has SPF protection too.

What about clothing with UV protection?

UPF (Ultraviolet Protection Factor) is similar to SPF in that it is a quantitative system used to describe how much UV protection clothing provides. For reference, most clothing typically has a UPF of ~6, while most sun protective fabrics have a UPF of 30 and others can exceed a UPF of 50! These are great options if you are going to be outside on a boat all day or doing other activities where applying/reapplying sunscreen may be difficult.

What else am I forgetting about sunscreen?

  • Check expiration dates! Yes, sunscreen can expire, and when it does, you will be frustrated and burnt. Expiration date locations on products vary, so be sure to look over bottles before applying! See below for examples of expiration date locations:expiration
  • Apply on cloudy and cold days This is especially important to note for your face when skiing; the white snow can reflect the sun’s rays back up to your face to intensify the damage.
  • Don’t forget the tops of your feet; take off those flip flops when applying sunscreen.
  • Scalps can and do burn. To my fellow short-haired folks: rub in sunscreen to the scalp. If you part your hair, apply sunscreen to the exposed line. Wearing a wide-brimmed hat is a good option or addition for head/scalp sun protection.
  • There are also several makeup brands/products that contain SPF. Give these options a try to protect yourself from your daily excursions into the sun’s harmful rays.

How to treat/manage sunburn if the steps above are not followed?

  • Take cool baths/showers.
  • Apply moisturizer that contains aloe vera or soy to soothe burned areas. You may also apply a thin layer of OTC hydrocortisone to particularly uncomfortable areas to help with redness, itchiness, and inflammation. (Note: do not use hydrocortisone on large areas of the body, not for more than 4 times per day, and not for longer than 2 consecutive weeks.)
  • Drink extra fluids. Water is preferred; alcoholic and caffeinated beverages can actually cause further dehydration.
  • If appropriate, you can also take over-the-counter NSAIDs (ibuprofen or naproxen) to help with pain and reduce inflammation. Be sure to take NSAIDs with food, plenty of fluids, and as directed by the package or your healthcare provider. If you are taking any other medications, ask your pharmacist or healthcare provider to ensure NSAIDs are safe for you to use.
  • Avoid using products that end in “-caine” (such as benzocaine).
  • If your sunburn forms into blisters, do NOT pop the blisters! The blisters are there to aid skin healing and protect against infections.
  • If the sunburn is over a large surface area of your body, or if you are worried an infection has set in, see your healthcare provider to see if prescription medications are warranted.

Can some medications that can enhance sunburn possibility?

Yes! Several medications can enhance sunlight sensitivity of your skin. Check medication labels and/or ask your pharmacist or healthcare provider if medications you take can cause increased risk of sunburn. Examples of common medications that can have this side effect include:  Tetracyclines (e.g., doxycycline, minocycline); Thiazides (e.g., HCTZ); Sulfonamides (e.g., sulfamethoxazole/trimethoprim); Phenothiazines (e.g., promethazine); Quinolones (e.g., ciprofloxacin, levofloxacin). If you are taking any of these medications, be sure to take special care of your skin by wearing sun-protective clothing and reapplying sunscreen with any sun exposure for the entire duration you take the medication and even a few days after your last dose.HHS Sunscreen

Be sure to look for SPF 30+ products available at the Health Heels Shoppe in the basement of UNC Campus Health Services (see photo below) and at the Pit Stop at UNC Student Stores for your sun protection needs.

 

 

John Taylor Schimmelfing is a Pharmacist at Campus Health Services. John graduated from Elon before obtaining his PharmD from the UNC Eshelman School of Pharmacy. He also happens to be a National, World and Junior Olympic jump rope champion, which clearly qualifies him as an expert on all things jump rope related such as whether jump rope is two words or one (it’s two!). 

Sources:  American Academy of Dermatology; American Melanoma Foundation