Author: Erin Pearson

PacMed provider gives parental advice on college-bound teens

Stress abounds for former high schoolers as they prepare for college endeavors and begin to make the transition into adulthood. Parents have their hands (and hearts) full as well, making plans for their beloved offspring to flee the nest in pursuit of higher education. Though parting is such sweet sorrow, Pacific Medical Centers’ Family Medicine Physician Ashu Verma, D.O., is here with advice that will help parents send their kiddos off to college with care and confidence.

College students may have different back-to-school needs than their younger counterparts. Can you tell me what those items may be? What health screenings and/or immunizations should take place prior to students going off to college?

For patients in their adolescent or young adult stage (usually between ages 12 to 18 years old), and parents of adolescents, we encourage openly addressing behaviors, associated questions, and the importance of regular health screenings. The five most common (and important) conversations for both adolescents, and their parents, include: Risky Health Behaviors(alcohol consumption, drugs, tobacco and e-cigarette devices, sexual activity); Physical Activity (engaging in 30-45 minutes of exercise most days of the week, exhibiting healthy eating and dietary habits); Obesity (If a child is obese, consider having their blood pressure and cholesterol levels checked regularly and screen for diabetes); Mental Health (screening for depression and other mental health issues is also very important at this age); and Updated Immunizations (students and parents should keep all immunizations updated. It is also a good idea for the student to keep a copy of their immunization records for future references, as they transition out of the house. This can easily be kept on their phone and should include Tdap every 10 years, Menactra and MenB, HPV, Hepatitis A, Hepatitis B and Influenza yearly).

Are there any health concerns that are unique to college students? If a young person has a health concern while away at college, how should they proceed?

Parents and their college-aged children should become familiar with the health services available at their college, as most colleges and universities have university clinics on campus.

Keep in mind the following: Where is the clinic located? What are their hours? What’s the nearest clinic or doctor for after-hour needs? Do they offer mental health services at this specific university or college? It’s also important that the child know their insurance status and keep a card in their wallet.

How can parents help their children stay healthy from afar while they are enrolled in college?

Make sure your children are aware of their past medical history and the family’s medical history, such as autoimmune disorders, psychiatric, heart disease, or diabetes. They should be aware of any history of asthma, concussions, hospitalizations, surgeries, or allergies to medications. Ensure they know what medications they are taking, the names of these medications, details and the dosage. Also, it would be great for your child to have a small first aid kit that they can keep in their dorm room. This would include Band-Aids, triple antibiotic ointment, thermometer (make sure they know how to use it), sterile gauze/pads of different sizes, adhesive tape, antiseptic wipes, Tylenol or Motrin, and a list of emergency contact numbers and their primary care provider’s details.

Do you have any more healthful tips and suggestions for parents and college-bound kiddos?

Living in a dorm, your child will be exposed to lots of new people in a new and unfamiliar environment. They will probably be using the same showers, toilets, sinks, doorknobs/glasses — and unfortunately, exposed to lots of germs. Be sure to share the importance of regularly washing your hands often, especially before eating or touching your face. The use of antibacterial gels works just as well as washing — share that they can carry a small container in purse or pocket. College is a period filled with fun, excitement, nervousness, and change. However, there are many people available to the student to help in that transition to make sure it is filled with happiness and good health.

PacMed provider discusses most common causes of summer clinic visits

Summertime is almost upon us, and with that exciting seasonal change comes a host of amusing activities enjoyed by people of all ages. Whether living it up on the water or simply relaxing poolside, safety should be a paramount concern for individuals and families of all ages.

Here, Pacific Medical Centers’ Dr. Xiulian Chen examines the summer clinic visit trends of both youth and adults. Read on for tips on how to stay safe while having fun in the sun.

In your experience, what have been the most common reasons for summer clinic visits for youth?
Heat-related illness, food poisoning and gastroenteritis, and sports and swimming injuries are the most common summer clinic visits for children.

Heat rash is a rash caused by blockage of sweat duct and is more common in young children but can happen to anyone. It can look like tiny bubbles, red dots, pimples, or sometimes it can be skin-colored dots. It tends to happen on the neck, chest, head or armpit. Heat exhaustion occurs when a person’s internal temperature rises and causes the following symptoms: nausea, fatigue, weak, heart racing, light-headed, muscle cramps. When the person’s internal temperature continues to rise above 103 F or higher, heat exhaustion leads to heat stroke. The symptoms of heat stroke include: headache, confusion, agitation, rapid breathing, and heart racing.

Summer is the peak season for food borne illness and gastroenteritis, since warm temperatures provide the perfect conditions for bacteria to grow on food products. Cooking outside makes it harder for us to wash cooking utensils and our hands, this allows bacteria to get into our food. Common symptoms for food poisoning include: abdominal pain, diarrhea, vomiting, fever, headache or light-headed from dehydration.

What about adults and military personnel?
Sunburn, heat exhaustion and heat stroke are very common in adults — especially military personnel during training. In terms of water and sun safety, many of the principles discussed above apply here as well. Some of the water safety rules include: swimming with a buddy, avoiding alcohol before swimming, checking local weather forecasts prior to swimming in lakes or the ocean, learning how to perform CPR, and paying special attention to individuals who have seizure disorders (since they have a higher risk of drowning).

What precautions can people take to avoid these issues and accidents?
Sunburn can be prevented by avoiding midday sun, avoiding excessive amounts of time in the sun, using protective clothing and hats, and applying sunscreen of at least SPF 15 according to package directions. To prevent heat-related illness, try wearing light-colored, loose-fitting clothing, drinking extra fluids, and staying in the shade whenever possible. In order to avoid food-borne disease, refrigerate any food that can spoil easily. Store prepared food in cold spaces if possible and avoid letting food stand in the heat for prolonged time. To help prevent water or swimming accidents, it is important to supervise children closely. If you are hosting a pool party, make sure there is a designated person to watch the kids in the pool.

What treatments should be utilized if someone is impacted by any of the issues discussed above?
The treatment for heat rash is to cool the skin down and stay dry. When heat exhaustion happens, move to a cooler place, wet the clothing, or take a cold shower and try to sip on water. The important part of treating food poisoning is to increase oral hydration with fluids with electrolytes. In severe cases, the person may need to go to the hospital for intravenous fluids. The treatment for sports-related injuries generally starts with RICE (rest, icing, compression and elevation).

What else would you like readers to know about summer safety and preparation?
Other things that need more attention in the summer include insect bites and disease spread by insects. Mosquitoes not only can cause an allergic reaction, but also spread bacteria and cause infection. Tick borne disease is not common in Washington state, but if you are traveling to an endemic area — especially military personnel who travel often — always remember to search for ticks when you are in the woods and grassy places. It helps to wear long pants and long-sleeved shirts that are tucked in.

Take precautions as hot weather returns

Warm weather and longer days will bring many Pacific Northwest residents outside this summer for pool parties, barbeques and more. However, increased time outdoors can lead to more urgent care or emergency room visits, as preventable issues including sports and swimming-related injuries significantly increase in the summer months.

Dr. Xiulian Chen with Pacific Medical Centers has outlined the most common reasons why patients end up unexpectedly in the doctor’s office or ER during summer months, as well as what can be done to ensure you and your loved ones stay safe and healthy this summer.

1. Heat-related illnesses

Heat rash: Heat rash is a rash caused by the blockage of sweat ducts. Other names for heat rash are “sweat rash” or “prickly heat.” While heat rash is more common in young children, it can happen to anyone. Often, heat rash looks like tiny bubbles or red dots/pimples on the skin. However, heat rash can sometimes appear as skin colored dots. The most common areas to develop heat rash are on the neck, chest, head or armpits. The best course of treatment is to cool down the skin and stay dry.

To avoid developing heat rash, I recommend wearing loose fitting cotton clothing, so the skin can breathe. Taking a cool bath or wiping sweat with a cool towel will also help. Generally, heat rash resolves in a few days. However, if the rash is associated with significant irritation or itching, or the skin begins to swell or emit pus, you should seek medical attention.

Sunburn: It is important to remember that being outside during the beautiful summer months can come with the danger of sunburn, even if it appears cloudy outside, and those with fair skin are more sensitive to sun damage.

Mild sunburn is generally skin redness accompanied by irritation. However, more severe cases of sunburn can cause painful blisters. Sunburn also increases the long-term risk for skin cancers. Most sunburn symptoms typically resolve in a few days. However, if the sunburn develops severe blistering and pain, go see your doctor.

Sunburn can be prevented by adhering to the following:

• Avoid afternoon sun
• Avoid excessive amount of time spent in the sun
• Wear protective clothes and a hat
• Apply sunscreen with at least SPF 15 and reapply as instructed on the product label

Heat exhaustion: Heat exhaustion occurs when a person’s internal temperature rises and causes the following symptoms:

• Nausea
• Fatigue
• Racing heart
• Muscle cramps
• Lightheadedness

When heat exhaustion does occur, it is important to move to a cooler place, dampen your clothes, or take a cool shower and try to sip water.

Heat stroke: If a person’s internal temperature rises above 103 Fahrenheit or higher, heat exhaustion can lead to heat stroke. The symptoms of heat stroke include:

• Headache
• Confusion
• Agitation
• Rapid breathing
• Racing heart

In the situation of heat stroke, the person should be immediately transported to a hospital.

To prevent heat-related illnesses, I recommend wearing loose fitting, light colored, and breathable clothing and be sure to drink extra fluids if you know you are going to be active outdoors. Also, if possible, try to remain in the shade while outdoors this summer.

2. Food poisoning and gastroenteritis

Summer is the peak season for food borne illness and gastroenteritis, as warm temperatures can cause bacteria to grow on food products. It is also more common to cook outside in the summer, where refrigeration is less available. Cooking outside also makes it harder for us to ensure cooking utensils and surfaces remain clean, as our hands allow bacteria to spread on both utensils and food.

Common symptoms of food poisoning include:

• Abdominal pain
• Diarrhea
• Vomiting
• Fever
• Headache
• Lightheadedness

These symptoms can range from mild to severe, with mild symptoms usually going away within a few days.

The important part of the treatment for food poisoning and gastroenteritis is to increase oral hydration with fluids that contain electrolytes. In severe cases, if you are unable to consume fluids by mouth, you will need to go to the hospital for intravenous fluids.

To prevent foodborne illness, it is important to refrigerate any food that can spoil easily. I recommend storing prepared food in your refrigerator or cooler if possible and avoid keeping food in the heat for long periods of time. Other helpful tips include thorough washing of hands and cooking utensils and to separate your raw meat and fish from other foods.

3. Swimming-related injuries and drowning

Who doesn’t enjoy jumping into cool water and having some fun in the summer? Unfortunately, drowning does happen very often in the summer and is the second most common cause of death in children by unintentional injury during the summer months. Given this, it is extremely important to supervise children closely. If you are going to have a pool party this summer, make sure you have designated an adult to watch the kids in the pool. Parents often get distracted while socializing with other adults and are not always able to pay close attention to their children. By ensuring children are constantly monitored, the chances of drowning are extremely slim.

4. Sports injuries

Common sports-related injuries include injuries from playing football, frisbee, soccer, tennis or hiking. Sprained ankles, sprained wrists, or broken bones are the reasons behind many urgent care clinic visits during the summer months in the Pacific Northwest. Treatment for sports-related injuries usually consists of RICE (Rest, Ice, Compression and Elevation). If you believe you have incurred a sports injury this summer, be sure to go to your doctor’s office to ensure the injury does not worsen.

5. Insect bites and diseases

Another common occurrence during the summer months is insect bites and diseases, including mosquito and tick-borne diseases. In addition to causing allergic reactions, mosquitoes can also spread bacteria and cause more serious infections. An easy way to prevent insect bites and diseases this summer is to wear insect repellent when you are outside.

While tick-borne diseases are not common in Washington, they are present in other states. If you plan on traveling this summer, be sure to wear tick repellent, as well as search for ticks when you are in the woods, brush or grassy places. It also helps to wear long sleeve shirts and pants while outdoors to ensure insects do not have access to your skin.

For more information about summer safety, check out the CDC website where you will find a lot of practical and useful information. Have a fun and safe summer!

Dr. Xiulian Chen is a family medicine physician at PacMed.