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Preventing and treating earwax blockage

For many, remote working has brought on new issues. For one, many have noticed that wearing earbuds all day has highlighted the amount of earwax they have. EW! Have you noticed your earwax more than usual? What is earwax anyway? How can you prevent an earwax blockage (hint: don’t use a Q-tip!) and what does the color of your earwax mean? Let’s talk about this kind of gross, kind of weird substance that we all have in our ears.

In this article:

  1. What is earwax?
  2. Earwax colors: what does yellow, orange, dark brown, black, bright red, or white earwax mean?
  3. Earwax blockages
  4. Earwax, hearing aids and the elderly
  5. Side effects of earwax
  6. How to treat an earwax blockage

First thing first, earwax is normal and healthy

Earwax, also referred to as cerumen, is a thick, waxy substance produced by the ear to protect and clean the canal. It helps block the canal, preventing dust, bacteria, and other particles or objects from entering, as well as coats the delicate skin, protecting it from water and moisture. Earwax also cleans the canal by picking up any stray hairs, dust and bacteria that it naturally funnels out of the canal as you chew and talk. It can sometimes be seen as lumps or clumps in a range of colors as the edge of your canal or at the tip of your ear buds! 

According to Harvard Health, tests have shown that cerumen has antibacterial and antifungal properties and that if your ears don’t have enough earwax, they’re likely to feel itchy and uncomfortable. So earwax is part of a healthy ear! Let’s talk more about your earwax.

Earwax colors – what does yellow, orange, dark brown, black, bright red, or white earwax mean?

Cerumen (aka earwax) comes in many colors. Remember, wax is healthy so don’t panic! The color of your earwax can vary:

  • Yellow or orange earwax is likely to be a softer wax and is very normal and healthy. This wax generally is funneling out naturally and can be wiped easily.
  • Earwax that appears to be dark brown or black is likely to be old, more solidified wax. As the wax sits, it collects skin cells, bacteria and dust particles and can take on a darker appearance. If you are unsure if the wax is black or red, try wiping the wax onto a paper towel. It should appear more yellow/gold in color vs. true black or red. Very black or red wax when swiped on a towel can indicate dried blood, indicating older damage. 
  • Bright red earwax can actually be blood and can indicate damage in the canal or ear. You should have bright red earwax checked out, especially if accompanied by pain, changes in hearing or smelly drainage.
  • White flaky earwax is likely to be dry, hard wax. This can be in a ball or also more flaky. Sometimes there is flaky wax packed into the canal.
  • Watery, creamy, smelly earwax can indicate an infection in the canal. If you are experiencing this type of wax, you should have it checked out, especially if you are also experiencing pain.

Earwax blockage

Earwax can pile up and cause a blockage or embarrassing clumps of wax in your canals. In this case, you may notice lots of wax, a thicker darker wax, or feel like you have muffled hearing at times. Blocked ears due to wax usually do not have pain as a symptom and the muffled feeling shouldn’t last long. Some people just naturally have more cerumen than others, and some people with wax blockages have them because they block the wax from naturally cleaning itself out by using earbuds or poking q-tips in their ears. 

Using a Q-tip or earbuds can actually push that wax back into the canal. If you are someone that naturally has lots of wax, this can cause a backup rather quickly. It is important to try and give that wax a chance to move on out naturally! If the wax can’t get out on its own, it will continue to be produced by the body and ultimately get backed up, sometimes hardening in the canal.

Hearing aids and earwax blockage

Those that wear hearing aids often have wax blockages, as the hearing aid blocks the wax from naturally moving out of the canal. It is important to keep an eye on the wax, especially with daily hearing aid use. Wax can damage your hearing aids so be sure to check them for any clumps of wax. 

Another cause of earwax buildup is thought to be related to age. The elderly tend to have problems with earwax buildup. As you age, you tend to develop more wiry, thicker hairs in your ears, which traps more wax. This trapping of wax can cause the wax to build up and cause bothersome blockages.

Side effects of earwax

Too much earwax can be bothersome, but it can also become a real problem. Besides the obvious effect of muffled sounds, blockages can cause earaches, infections, and other problems such as loss of hearing. According to Harvard Health, if the wax gets lodged in a certain way, it can cause a cough by stimulating the branch of the vagus nerve that supplies the outer ear. 

It is important to see your provider or specialist for your earwax problems if you are also experiencing any of the following symptoms:

  • Pain
  • Cold symptoms
  • Foul odor
  • Frequent blockages by earwax
  • Chronic ear disease
  • History of an eardrum with a tear or hole in it
  • Only one ear with good hearing and that ear is the one with the earwax buildup

Chat with a nurse first if you are unsure about your symptoms or are having any pain.

How to treat an earwax blockage

Soft earwax is easier for the body to naturally remove. Sometimes just simply rinsing your ears in the gentle shower stream is enough to dislodge earwax. Wiping the outside edge of the canal is ideal. 

Q-tips often pack the earwax back in, especially when the ear is full. We generally recommend to avoid Q-tips! As good as they may feel, letting the wax out is the best option. Free that earwax!

In some cases, you will need to use an earwax softener such as Debrox drops, mineral oil or another softener. If you are not having pain and have no history of ear problems, you can also add a few drops of hydrogen peroxide and water into your tilted ear. After letting it sit, you can then tip your head to see if the wax will drain out. You can then let the gentle shower stream rinse the ear or use a bulb syringe to gently flush the ear. If you experience any pain or attempts to flush is unsuccessful, you may need to see a healthcare provider. 

Hopefully you are successful and a great big lump of wax pours out and your blockage resolves. Once that happens, don’t wait for your earwax to back up again. Give your ears a break from your earbuds, rinse them in the shower (your ears that is) and wipe wax with a tissue instead of packing the wax back in with Q-tips! 

Still have questions about your earwax or another general health question? You can chat with a nurse within seconds if you are unsure about your symptoms or experiencing any pain. Nurse-1-1 is here to help!

The opinions expressed in Nurse-1-1 Health Center Blogs are solely opinions of the writer. Other than information received directly by you from your personal provider, the health center blog should not be considered medical advice. Read more.

Why is My Child’s Poop Black (or Red, Green, Yellow…)?

Hi everyone, Nurse Kim here. Let’s talk about kid poop. 💩  Green poop, yellow poop, orange poop, purple poop. Everybody poops. 

Some poop looks abnormal, but can be totally fine. Have you ever seen a poop that looks wormy? 🐛 It was probably from the banana you fed your baby last night 🍌. Think banana bread. There. Now stop endlessly googling worm poop! 

And I don’t care about green poop, or the rainbow poop your kid may have the day after his first birthday (frosting anyone?) 🌈🎂 We also don’t need to see a sample of last night’s brown poop or squishy yellow poop. We know corn 🌽  comes out whole, and so do seeds and berries.

So when should we worry about poop?

In kids, we really care most about white poop, red poop or black poop.

Black Stools in Children

Now black poop has to be black. Think black crayon 🖍. If it looks like coffee ☕️  grounds, we should talk. Dark poop means that there can be bleeding in your digestive tract. The darker it is, the higher up the in the GI tract the bleeding was likely to occur. 

If you noticed poop looking like black tar, coffee grounds, or black spots or specs then it’s time to discuss this with a medical provider. If you ate blueberries as a snack or black beans for dinner, then take a deep breath and look again the next time they poop. If you still think the poop is black and it isn’t from particles of food, then bring that babe 👶🏼  in and we can test the poop… This time, save the sample! You can put the sample in a small tupperware or keep it in the diaper—most providers just need a small smear to check for blood. If specific tests are needed, you may be sent home with specific instructions and containers.

Kids and Constipation

Kids love milk 🥛 and cheese 🧀. Dairy food can cause constipation, especially if you eat or drink excessive amounts. Lots of hard, large poops that are tough to push out can cause kids to get little tears around their bum. These are called anal fissures and are common in constipated preschool and toddler aged children. When a child has an anal fissure we can sometimes see little streaks of blood in their poop. Blood in the poop can be very scary. Take a deep breath and take a look around. If you see a little crack (on their bum hole) and you know their poops have been hard, this is likely the source of blood. Changing their diet by introducing more fruits and fiber, while giving them less dairy, can help immensely to soften up poops.

To soften stools in children, think “P” fruits—peaches 🍑, pears, plums, and prunes. A little Aquaphor or Vaseline applied topically can help soften up the skin, too. If you do these things and still see blood after a day or two, have someone check this out at your doctor’s office. If it’s just chunks of tomato skin 🍅, no worries. We won’t judge.

If you see a lot of blood (like blood filling the toilet bowl or diaper, or dripping blood), or your child also develops a fever or vomiting, you should be seen by your medical provider right away. 🚑

Red Stools in Children

Red jelly poop and a cranky baby can be serious. Did you drop a glob of raspberry jelly on the diaper? Yes? Phew. Then relax! 🤣  Does your baby cry off and on all day, seem uncomfortable, not herself, or did you notice a jelly-like reddish poop? Then it’s time to head on over to see your doctor or go to the emergency room.

Poop that looks like jelly can indicate that your baby has intussusception, which is basically one part of your intestine telescoping into another and causing a blockage. It’s very rare but is most common between the ages of six months and three years. The pain usually comes and goes. If this is what you are seeing, then get that cranky kid looked at. 😫

Speaking of cranky babies…

Have you noticed red specks or blood in your newborn baby’s poop? She isn’t that happy little bundle you once imagined snuggling up on you? Your sweet smelling little human is spitting up and now smells like Swiss cheese? First, remember that “all babies cry”. You can always put that babe down in her crib while you take a few deep cleansing breaths or a quick break, even if she is crying. Remember, never shake a baby. Call a friend! Friends love holding babies! Ok, back to poop!!!

Your newborn baby has red specks in her poop. Newborns don’t eat skittles so I think it’s time for a visit with your primary care provider. Your baby might have a milk protein allergy or sensitivity to whatever they are drinking. If you are breastfeeding, it’s possible you will need to change your diet. Formula or breastmilk should be the only drinks you give your newborn. Fed is best. So feed that baby, but let’s also get her pooped checked. Bring a poop sample, or simply wait five minutes—you know that newborn is about to poop again! Your provider can test the poop for blood and figure out what’s making your baby such a sad mess.

White Stools in Children—Why It’s a Problem

Lastly, let’s talk about white poop. The liver makes a dark-colored digestive aid called bile, which helps give poop its brownish color. 💩 White poop can indicate that this bile isn’t being made, or isn’t reaching the poop. Problems with the liver, small intestine and gallbladder can cause the poop to look white and needs to be addressed by a medical provider right away. But first, let’s take a closer look at the poop. Is the poop really white? Or just light brown or yellow? Did your child drink massive amounts of milk yesterday 🥛? Could it be the new antibiotic she is on or the antacid he just started? Don’t panic, worrisome white poop isn’t common. If it really looks white (think white crayon), call your provider and be sure to save that poop.

Whatever you do, don’t search on Google for poop.

Ask a nurse first—just snap a pic and show us! Nurse-1-1- can help answer your questions about kids’ stool colors, and a range of other health issues, as well. You can instantly chat with a nurse from your smartphone or computer. Seriously, our average response time is under 8 seconds.

You know your child best. If you are worried that something is wrong, it’s ok to get checked out at your pediatrician’s office! You are the parent after all. You’ve got this! You are doing a great job. One day you will miss talking about their poop! 💩

The opinions expressed in Nurse-1-1 Health Center Blogs are solely opinions of the writer. Other than information received directly by you from your personal provider, the health center blog should not be considered medical advice. Read more.

General health screenings every man should know about

Men and women need different types of health screenings. Knowing what to expect and when will help keep you on track to know when you need to make that next in-person appointment. 

Men and women have some of the same preventative health needs but also some distinct tests and screenings. Some providers suggest that if you are under the age of 49 years and have no chronic illnesses or ongoing health issues or concerns, you only need a checkup every 3 years. If you have any health issues or are 50 years old or older, this suggestion increases to yearly visits.

Screenings are dependent on a few things. Some are related to age and lifestyle but others have to do with your past health history and that of your relatives. Let’s hope Grandpa lived long and healthy. Talk to your provider about what is most appropriate for you. Routine screenings can be different for everyone but one thing to keep in mind is that these tests, screenings and lifestyle changes are meant to help prevent disease! Don’t delay taking care of your body. 

What health screenings do men need and when?

Aortic Aneurysm

An Abdominal Aortic Aneurysm (AAA) is when the wall of your aorta, which is the vessel that connects your heart to the bottom part of your body, becomes weak and thin, can bulge and then can burst. AAA is usually silent and causes immediate death.

Those with a family history of AAA should be screened as well as anyone with any risk factors, which includes anyone ages 65-75 who has ever smoked. According to Harvard Medical School, a small history of smoking can increase your risk: even a total of 100 cigarettes over the course of your lifetime can be enough risk to trigger the need for the test. Chat with your provider to see if your history indicates you are at risk for AAA and need to be screened. 

The test is a one time abdominal ultrasound to determine if you have any weakening or bulging of the aorta. If there are any concerns with your ultrasound, regular ultrasounds will be suggested to monitor any weak spots. If your aorta looks healthy, this may be the only test you will need. 

Diabetes

Screening for type 2 Diabetes is done by simple lab tests:

  1. Hemoglobin A1C is a test that determines your average blood sugar over the last two to three months. This is a nice test to see how your blood sugars have been over time. 
  2. A fasting glucose test measures how much sugar is in your blood at the time of the test, after not having anything to eat overnight. 

Both tests can indicate if you have normal levels, prediabetes or diabetes. Knowing how your sugar levels have been and how they are with no food on board will indicate if you need a lifestyle change or medication to manage your sugar levels. Type 2 diabetes often has no symptoms and with early detection, you can minimize any long term complications.

The American Diabetes Association (ADA) recommends that adults age 45 and older get screened for type 2 diabetes every three years by their health care provider. More frequent screening is recommended if you are overweight and have any risk factors including:

  • Family history of diabetes (a parent or sibling with the disease)
  • Sedentary lifestyle
  • African-American, Hispanic-American, Native-American, Asian-American, or Pacific Islander ancestry
  • History of blood glucose problems
  • High blood pressure
  • Cholesterol problems
  • History of vascular disease

Some groups suggest that starting screening at a younger age has benefits. The American Association of Clinical Endocrinologists recommends that high-risk adults get screened annually beginning at age 30. Discuss these important and simple screening tests with your provider, especially if you have any risk factors. 

Blood Pressure

Blood pressure measures the pressure in your arteries as your heart pumps blood to the body (circulation). It is important that these numbers are within normal limits to keep your heart from being stressed. High blood pressure is when these numbers are consistently too high. Having high blood pressure that is consistent can damage your circulatory system and put you at risk for heart attack and stroke (heart disease). 

Getting blood pressure checked yearly is recommended for all adults, even with a history of normal blood pressures. This is especially important for men, as men are more likely to have high blood pressure than women (47% of men versus 43% of women). Talk to your provider to see if you can do this at home, or you need to come into the office for a blood pressure check each year. If you have a history of high blood pressure or have any risk factors such as obesity, diabetes, high cholesterol, alcohol use, older age, high salt diet, or a sedentary lifestyle, then it is recommended to have your blood pressure checked twice per year. 

People with high blood pressure usually will need a yearly checkup to be sure there are not any other complications being caused by the high blood pressure, and that the high blood pressure is not getting worse.

Cholesterol

Cholesterol is a waxy-fatty substance found in the blood and in the cells of your body. Your liver makes cholesterol and you also get it from foods that you eat. A cholesterol test determines how much cholesterol and the types of cholesterol in your blood. There are two main types of cholesterol: low-density lipoprotein (LDL), which is sometimes called “bad” cholesterol, and high-density lipoprotein (HDL), or sometimes called “good” cholesterol. A cholesterol test will measure your total amounts of cholesterol as well as both the LDL and HDL. Abnormal levels of these types of cholesterol can determine your risk for having buildup of plaques and blockages in your arteries and indicate higher risk for heart disease. 

The American Heart Association recommends that all adults 20 or older have their cholesterol and other traditional risk factors checked every four to six years. This may be done more frequently depending on your health history and family history, so be sure to discuss this plan with your provider. After age 40, risk can increase and your provider can calculate this risk based on your medical history, as well as determine how frequently you need your Cholesterol checked. 

Colorectal Cancer

Cancer of the colon or rectum is called colorectal cancer, or colon cancer for short. It is important to screen for colorectal cancer as risk increases as you age and can come with minimal symptoms. Polyps are usually the first sign of a problem, and with screening, can oftentimes be removed before they have become cancerous. 

It is suggested to have colorectal cancer screening after age 50 and then regularly thereafter. The type of test and frequency can be discussed with your provider based on your health history and family history of colorectal cancer, as well as overall risk. Those with family history or those found to be at higher risk will have screenings at a younger age.

Testing comes in different forms. Depending on your risk, history and age you may need one or all of the following tests:

  1. Stool test: Either a smear of stool (poop) or a full bowel movement to test for any tiny blood that isn’t visible to the naked eye. Blood in the stool can indicate a problem with the colon and will trigger more testing. This can be done in the office or can be mailed in and should be done yearly.
  2. Flexible sigmoidoscopy: Your provider will put a short, thin, flexible, lighted tube into your rectum to check for polyps or cancer inside the rectum and lower third of the colon. This test can be done every 5-10 years based on your results, history, and frequency of other stool tests that you may be getting.
  3. Colonoscopy: This is similar to flexible sigmoidoscopy, except a longer, thin, flexible, lighted tube is used to check for polyps or cancer inside the rectum and the whole entire colon. During the test, the doctor can find and remove most polyps and some cancers. Colonoscopy also is used as a follow-up test if anything unusual is found during one of the other screening tests. This is usually done as a day procedure with some sedation or general anesthesia every 10 years (and more frequently if you have risk or family history of colorectal cancers).

Prostate Cancer

The prostate is a part of the male reproductive system and is located just below the bladder and in front of the rectum. The prostate is about the size of a walnut and surrounds the urethra (the tube that empties urine from the bladder) and produces fluid that makes up a part of semen (sperm). As you age, the prostate becomes larger. This type of health screening is important to ensure your prostate is healthy. 

A digital rectal exam (finger in the rectum) used to be considered a helpful screening tool to detect prostate cancer, but the CDC reports that it is not as reliable as once thought. A more reliable test, a blood test called a prostate specific antigen (PSA) test, measures the level of PSA in the blood. PSA is a substance made by the prostate and is usually higher in men who have prostate cancer. If your PSA is abnormal, your doctor may recommend a biopsy to find out if you have prostate cancer. 

Screenings versus diagnostic testing: why preventive screenings are important

Health screenings can seem overwhelming, but remember: the purpose of health screenings is to look for a disease before symptoms appear, so they are important to get scheduled on the calendar. Diagnostic testing is then used once a person has symptoms. Health screenings are an important part of healthcare because the ultimate goal is to keep you healthy before a problem arises. Health screenings give providers a jump start on your health. As a patient, your job is to make good lifestyle choices that decrease your risks of disease for a healthy life!

A healthy lifestyle includes how you feel mentally and physically. Caring for your mind and body are both important. Be sure to talk with your healthcare provider about your mental health too. Eating a healthy diet, exercising and taking time for your mental health are all important in a healthy body. Feel free to chat with a nurse first with any concerns or questions and make sure you have that checkup appointment on the calendar. Remember to check out our general health screenings article and our women’s health screenings article for those females in your life to be sure you aren’t missing anything important for optimal health.

The opinions expressed in Nurse-1-1 Health Center Blogs are solely opinions of the writer. Other than information received directly by you from your personal provider, the health center blog should not be considered medical advice. Read more.

General health screenings all women should know about

As a young female or one that might be in the midst of childbearing, doctors visits are plenty. But what happens in our middle age years? There are important health screenings that every woman should be getting. Knowing what to expect and when will help keep you on track to know when you need to make that next in-person appointment.

Men and women have some of the same preventative health needs, but also some distinct tests and screenings. Some providers suggest that if you are under the age of 49 years and have no chronic illnesses or ongoing health issues or concerns, you only need a checkup every three years. If you have any health issues or are 50 years old or older, this suggestion increases to yearly visits.

Screenings are dependent on a few things. Some are related to age and lifestyle but others have to do with your past health history and that of your relatives. Let’s hope Grandma lived long and healthy! Talk to your provider about what is most appropriate for you. Routine health screenings can be different for everyone but one thing to keep in mind is that these tests, screenings and lifestyle changes are meant to help prevent disease! Don’t delay care. 

What health screenings do women need and when?

Breast Health

Breast screening is extremely important for early detection of breast cancer. The mammogram is now thought to be the best screening test to detect breast cancer early. The CDC reports that while knowing your breasts, doing self exams, and getting routine clinical breast exams in the doctor’s office can be helpful in the early detection of abnormalities, it does not lower the risk from dying of breast cancer. It is important to talk with your provider about when is most appropriate for getting a mammogram. 

A mammogram is an X-ray of the breast and the best way to detect breast cancer early. Regular mammograms can lower your risk of dying from breast cancer due to early detection. This test is recommended every one to two years depending on who you ask: the National Cancer Institute advises all women age 40 and over to have a mammogram every one to two years, while the American Cancer Society recommends yearly mammograms starting at age 40 and continuing for as long as a woman is in good health. Whichever way you go, getting a mammogram every one to two years is the key to early detection. 

Those with family history, dense breast tissue, or other risk factors should discuss when screenings should start. For example, if your mother or sister was diagnosed with breast cancer at a young age, oftentimes you may be recommended to have yearly mammograms starting a few years before the diagnosis of your affected family member. Den’t delay care! Early detection of any potential issues is best for optimal health.

Cervical Cancer

The American College of Obstetricians and gynecologists (ACOG) recommends getting screened for cervical cancer at age 21 and then every three years thereafter. Screening starts with a pap smear to look for abnormal cells, as well as a Human Papilloma Virus (HPV) test, which checks for the HPV virus present in 99% of cervical cancer cases. An abnormal test result does not diagnose cervical cancer but can detect precancerous cells or presence of the virus that will prompt more testing and biopsies of the cervical tissue. Getting checked regularly is very important for early detection of cervical cancer.

Osteoporosis

Screening for osteoporosis should start at age 65. Oftentimes there are no obvious signs of osteoporosis until you fracture (break) a bone. If you have a bone break at an early age that doesn’t involve trauma or a high fall, earlier testing is usually recommended. 

Screening for osteoporosis involves getting a bone density test (DXA) of the hip or spine. This test is like an X-ray and the only test that will determine if you have osteoporosis by detecting how dense your bone is. The test can help predict how strong your bones are and if you need any special precautions, or need to take any supplements or medications to strengthen your bones.

Diabetes

Screening for type 2 Diabetes is done by simple lab tests:

  1. Hemoglobin A1C is a test that determines your average blood sugar over the last two to three months. This is a nice test to see how your blood sugars have been over time. 
  2. A fasting glucose test measures how much sugar is in your blood at the time of the test, after not having anything to eat overnight. 

Both tests can indicate if you have normal levels, prediabetes or diabetes. Knowing how your sugar levels have been and how they are with no food on board will indicate if you need a lifestyle change or medication to manage your sugar levels. Type 2 diabetes often has no symptoms and with early detection, you can minimize any long term complications.

The American Diabetes Association (ADA) recommends that adults age 45 and older get screened for type 2 diabetes every three years by their health care provider. More frequent screening is recommended if you are overweight and have any risk factors including:

  • Family history of diabetes
  • Sedentary lifestyle
  • African-American, Hispanic-American, Native-American, Asian-American, or Pacific Islander ancestry
  • History of blood glucose problems
  • History of gestational diabetes or a baby weighing over nine pounds 
  • High blood pressure
  • Cholesterol problems
  • Polycystic ovary syndrome 
  • History of vascular disease

Some groups suggest that starting screening at a younger age has benefits, but the American Association of Clinical Endocrinologists recommends that high-risk adults get screened annually beginning at age 30. Discuss these important and simple health screening tests with your provider, especially if you have any risk factors. 

This is especially important for women who were diagnosed with gestational diabetes (diabetes while pregnant). Although gestational diabetes goes away after giving birth, this diagnosis can increase your overall risk of developing type 2 diabetes in your lifetime. According to the CDC, about 50% of women with gestational diabetes go on to develop type 2 diabetes. 

It’s important to know that diabetes increases the risk of heart disease (the most common diabetes complication) by about four times in women but only about two times in men. Women also have worse outcomes after a heart attack. Woah, time to get that screening!

Blood Pressure

Blood pressure measures the pressure in your arteries as your heart pumps blood to the body (circulation). It is important that these numbers are within normal limits to keep your heart from being stressed. High blood pressure is when these numbers are consistently too high. Having high blood pressure that is consistent can damage your circulatory system and put you at risk for heart attack and stroke (heart disease). 

Getting blood pressure checked yearly is recommended for all adults, even with a history of normal blood pressures. Talk to your provider to see if you can do this at home, or you need to come into the office for a blood pressure check each year. If you have a history of high blood pressure or have any risk factors such as obesity, diabetes, high cholesterol, alcohol use, older age, high salt diet, or a sedentary lifestyle, then it is recommended to have your blood pressure checked twice per year. 

People with high blood pressure usually will need a yearly checkup to be sure there are not any other complications being caused by the high blood pressure, and that the high blood pressure is not getting worse.

Cholesterol

Cholesterol is a waxy-fatty substance found in the blood and in the cells of your body. Your liver makes cholesterol and you also get it from foods that you eat. A cholesterol test determines how much cholesterol and the types of cholesterol in your blood. There are two main types of cholesterol: low-density lipoprotein (LDL), which is sometimes called “bad” cholesterol, and high-density lipoprotein (HDL), or sometimes called “good” cholesterol. A cholesterol test will measure your total amounts of cholesterol as well as both the LDL and HDL. 

Abnormal levels of these types of cholesterol can determine your risk for having buildup of plaques and blockages in your arteries and indicate higher risk for heart disease. Heart disease was once thought to be more common in men but almost as many women die of heart disease each year as men. In fact, heart disease is the leading cause of death for women in the United States, killing 299,578 women in 2017—or about 1 in every 5 female deaths according to the CDC.

The American Heart Association recommends that all adults 20 or older have their cholesterol and other traditional risk factors checked every four to six years. This may be done more frequently depending on your health history and family history, so be sure to discuss this plan with your provider. After age 40, risk can increase and your provider can calculate this risk based on your medical history, as well as determine how frequently you need your cholesterol checked. 

Colorectal Cancer

Cancer of the colon or rectum is called colorectal cancer, or colon cancer for short. It is important to screen for colorectal cancer as risk increases as you age and can come with minimal symptoms. Polyps are usually the first sign of a problem, and with screening, can oftentimes be removed before they have become cancerous. It is suggested to have colorectal cancer screening after age 50 and then regularly thereafter. 

The type of test and frequency can be discussed with your provider based on your health history and family history of colorectal cancer, as well as overall risk. Those with family history or those found to be at higher risk will have screenings at a younger age. Screening is very important with any risk factors, as there has been an increase in this type of cancer by 2% each year from 2007 to 2016 in those younger than 55 according to American Cancer Society. They also state that the lifetime risk of developing colorectal cancer is about 1 in 23 (4.4%) for men and 1 in 25 (4.1%) for women, making it important for both men and women to think about.

Testing comes in different forms. Depending on your risk, history and age you may need one or all of the following tests:

  1. Stool test: Either a smear of stool (poop) or a full bowel movement to test for any tiny blood that isn’t visible to the naked eye. Blood in the stool can indicate a problem with the colon and will trigger more testing. This can be done in the office or can be mailed in and should be done yearly.
  2. Flexible sigmoidoscopy: Your provider will put a short, thin, flexible, lighted tube into your rectum to check for polyps or cancer inside the rectum and lower third of the colon. This test can be done every 5-10 years based on your results, history, and frequency of other stool tests that you may be getting.
  3. Colonoscopy: This is similar to flexible sigmoidoscopy, except a longer, thin, flexible, lighted tube is used to check for polyps or cancer inside the rectum and the whole entire colon. During the test, the doctor can find and remove most polyps and some cancers. Colonoscopy also is used as a follow-up test if anything unusual is found during one of the other screening tests. This is usually done as a day procedure with some sedation or general anesthesia every 10 years (and more frequently if you have risk or family history of colorectal cancers).

Screenings versus diagnostic testing: why preventive screenings are important

Health screenings can seem overwhelming, but remember: the purpose of a screening is to look for a disease before symptoms appear, so they are important to get scheduled on the calendar. Diagnostic testing is then used once a person has symptoms. Screening is an important part of healthcare because the ultimate goal is to keep you healthy before a problem arises. Screening tests give providers a jump start on your health. As a patient, your job is to make good lifestyle choices that decrease your risks of disease for a healthy life!

A healthy lifestyle includes how you feel mentally and physically. Caring for your mind and body are both important. Be sure to talk with your healthcare provider about your mental health too. Eating a healthy diet, exercising and taking time for your mental health are all important in a healthy body. Feel free to chat with a nurse first with any concerns or questions and make sure you have that checkup appointment on the calendar. Remember to check out our general health screenings article and our men’s health screenings article for those males in your life to be sure you aren’t missing anything important for optimal health.

The opinions expressed in Nurse-1-1 Health Center Blogs are solely opinions of the writer. Other than information received directly by you from your personal provider, the health center blog should not be considered medical advice. Read more.

Middle-aged checkups and preventative health

As you age, it may seem like you can skip regular checkups and just visit the doctor when you have concerns or are sick. However, it is important to have regular visits with a primary care provider or general physician for preventative health reasons.

Getting a routine checkup will help determine which health screenings you may need done so that some health issues can be caught early on. Many health issues can have no symptoms and be caught with a simple screening such as a lab test.

If you have family history of certain diseases, you may also benefit from some extra or earlier screenings. As you age, you still need certain vaccinations to keep you protected from some preventable illnesses. Keeping up with yearly health maintenance is important, so don’t skip it!

Getting ready for your checkup

Going to a checkup can feel overwhelming. Before you go: 

  1. Make a list of questions that you may have so you don’t forget to ask while you are with your provider 
  2. Similarly, keep a list of symptoms or worries that might be keeping you awake at night 
  3. Brush up on your family history so that your provider can help identify if you have any risk factors for disease or need any additional testing. Family history of some health issues such as heart disease, diabetes, stroke as well as certain cancers can increase your risk and warrant extra discussion, lifestyle changes or testing. 

Talking to your doctor about lifestyle changes and preventative health

Be truthful about your lifestyle. Your provider needs to know the truth about exercise, your diet, drug and alcohol use and sexual history. Knowing more about you and your body will help your provider to determine which tests are most appropriate and could help identify disease. Your specific plan of care will directly be related to your lifestyle. 

Thinking about your long term plan and risk for disease is important to review not only with your provider, but with yourself. Write down your goals for health and try to make small goals that you can try to achieve. Whether it is cutting down on alcohol use or taking daily walks or exercise, lifestyle is an important piece of the healthcare puzzle.

Common testing for middle-aged adults

Regular exams and testing can catch some health problems early or before they start. Common testing and concerns for adults include the following:

  • Breast and Cervical Cancer 
  • Cholesterol
  • Diabetes
  • Colorectal Cancer 
  • High Blood Pressure
  • Immunizations
  • Oral Health for Adults
  • Prostate Cancer 
  • Skin Cancer
  • Sexualy Transmitted Disease
  • Osteoporosis 

Discussing these topics with your primary health care provider can help catch some health care issues early. Men and women have different needs and testing requirements, and age can determine when you get some of these tests. Read about the tests men and women should have in more detail in our men’s health screening article and women’s health screening article. Health history and provider preferences are varied, so it is important to have a plan that meets your needs for preventative health care. 

Preventative health that everyone needs

Besides the age and sex specific care you may need that is broken down in detail above, there are a few tests that everyone can benefit from in staying healthy. Whole body care including mental and physical health is key to keeping healthy and detecting disease early.  

Oral Health

Taking care of your teeth and mouth is important. Try to brush your teeth after each meal or at least twice per day. Everybody should also be flossing daily and get regular (every 6-12 month) teeth cleanings. These cleanings will remove plaque and help prevent tooth and gum disease. our dentist will also check for mouth and gum cancer while they are in there.

Eye Exams

Get those eyes checked! From age 30-39, two eye exams are recommended to be sure you aren’t in need of glasses or tweaks in your current contact prescription. If you already have glasses or eye concerns, you might be recommended to be seen yearly.  Check with your eye doctor to see when they prefer to have you back in for another checkup. At age 40, an eye appointment to check for any early eye disease or issues is recommended. Glaucoma and macular degeneration are two age related diseases that can be detected with eye screenings. If you have any vision changes or difficulty seeing normally, don’t delay getting those eyes checked!

Skin Exams

Based on your risk factors and history, your provider may recommend annual skin exams. You can track moles that might be concerning and also screen for skin cancer regularly with these exams. Discuss with your provider how often you should be getting your skin checked out.

Sexual Health

Each time you have a new sexual partner, it is important to have screenings for HIV, Hep C and other Sexually Transmitted Disease (STI) such as Chlamydia, Gonorrhea and HPV. Of course if you have any symptoms of STIs, you should be seen sooner. Read more about STIs for men and women and what your next steps should be.

Mental Health

Mental health is just as important as physical health. Make sure to talk to your provider or reach out for help if you feel like sadness, anxiety, or other overwhelming feelings prevent you from going about your normal, daily activities. Some primary care providers will automatically provide mental health screenings for middle-aged patients, but not all. Getting to know your doctor and feeling comfortable talking to them will help them to identify any concerns early. 

Vaccinations

It is important to keep up with your vaccinations as an adult—they aren’t just for kids! Some vaccinations are important to be sure to get, and some will depend on your health history.  Vaccines not only prevent disease, but also help protect others. Here are a few you should be sure to discuss with your provider:

  1. All adults should get an annual flu shot in the fall or winter to protect themselves and others
  2. Anyone over the age of 65 might need to be vaccinated with pneumococcal vaccines. There are different types, so talk to your provider about which one might be right for you based on your health history. 
  3. The Tdap vaccine is a combo vaccine that includes tetanus (for when you get those rusty cuts) and pertussis (whooping cough) coverage. It is required every ten years as well as with every pregnancy.
  4. Anyone over 50 years of age should have the varicella zoster (shingles) vaccine
  5. Chat with your provider to see if you need any other age and health history specific vaccines  

Discuss your short and long term plans for testing as well as your lifestyle changes and concerns so that you know what to expect for your preventative health planning each year. Chat with a nurse first if you have questions about which test you might need or what your healths screenings might mean for you. We are here to help and know that staying on top of your preventative health can be very overwhelming. We care and are here for you!

The opinions expressed in Nurse-1-1 Health Center Blogs are solely opinions of the writer. Other than information received directly by you from your personal provider, the health center blog should not be considered medical advice. Read more.

Eye strain and screen usage – what you need to know

With an increase in remote learning and working, the sales of blue light blocking glasses have skyrocketed and ads are filling our computers and social media feeds. But are they helping our eyes and helping to reduce eye strain? 

Some blue blocking glasses claim that blue light from computer screens can cause eye disease and glasses are needed to keep the eyes safe. However, before you order an expensive pair of eyewear, read on. 

The American Academy of Ophthalmology (AAO) states that blue light doesn’t cause eye disease or digital eye strain and that sleep issues can be managed without these expensive glasses. So how can we decrease our eye symptoms that can occur with increased screen usage without having to purchase yet another gadget? When should we be worried about eye strain and how can we manage it?

Sunshine, UV rays and blue light

According to the AAO, the small amounts of blue light coming from your computer screen won’t cause eye damage, and some blue light from the sun is actually healthy. However, UV rays from the sun can cause eye damage. Be sure to wear UV rated sunglasses to protect your eyes when you are out in the sun and wear a hat or sit under an umbrella to limit your exposure to those UV rays. 

What is digital eye strain and what causes it?

Your long days in front of the computer will cause eye strain. Although eye doctors state this won’t cause eye disease, it can certainly cause some temporary discomfort. 

The following symptoms of eye strain are called digital eye strain or computer vision syndrome (CVS): 

  • Watery eyes
  • Headaches
  • Blurry vision 
  • Dry eyes
  • Neck and shoulder pain

These symptoms occur while we stare at screens for long periods of time. Increased use of computer, e-reader, tablet and cell phone use cause these symptoms, which can worsen with longer use. 

The good news is that these symptoms can be reversed with a few simple changes! Of course, you want to be sure that there isn’t a more serious health problem that is causing any of these symptoms. Be sure to discuss these symptoms with your health care provider or ask a nurse first if you are looking for help deciding who can best address your symptoms. 

How can I alleviate my eye strain?

There are many things that you can do to minimize symptoms of eye strain. According to the AAO, taking frequent eye rests will help alleviate symptoms. Just 15 minutes of rest whenever you are on the computer for more than 2 hours can improve symptoms. You can also follow the 20/20/20 rule. Every 20 minutes look away from your screen and look at an object 20 feet away for at least 20 seconds. This will give your eyes a needed break.

Blinking is another way to keep your eyes comfortable. Staring at your computer screen can cause dry eyes, and blinking more often will help lubricate your eyes. According to the AAO, we blink less when we stare at our screens and devices. Our normal blink rate is about 15 times per minute, which can be cut in half when staring at screens causing our eyes to dry out. You can use artificial tear eye drops to lubricate your eyes when they are feeling dry or simply blink more often. Try taking a blink count on your next Zoom meeting. See if you can up your blink game! Your eyes will thank you. 

Taking a look at your positioning can also help your symptoms: 

  1. Ideally, your computer screen should be 15 to 20 degrees below eye level from the center of the screen and about 2 feet away from the eyes
  2. Positioning your screen so you are looking down slightly can also help  reduce light glare and symptomsPull down the shades or use a lower wattage bulb at your desk to help improve your glare
  3. Get comfy in your chair and make sure you are well supported. Plant those feet on the ground! Proper computer posture can help alleviate symptoms of eye strain, as well! 

How does blue light impact sleep?

Blue light is known to disrupt sleep when used before bedtime. A National Sleep Foundation Poll found that Nine of 10 Americans reported using a technological device in the hour before bed. AAO recommends avoiding blue light from screens 2-3 hours before bedtime in order to minimize sleep disruptions. During the day, the blue light keeps us stimulated and awake so open those window shades and get that computer work done. But research shows that blue light before bed can suppress melatonin, enhance alertness, and push your circadian rhythm sleep cycle out, making it harder to get a good night’s sleep. (Circadian rhythm is a 24 hour cycle in the body responsible for many functions, most commonly known for your natural internal sleep/wake process.)  

The National Sleep Foundation reports that more than 60% of Americans report various types of sleep problems each night. Make sure that your screen use isn’t the cause of your fatigue and any disruption to your sleep cycle. We need all the uninterrupted sleep we can get as good sleep helps to achieve optimal health. 

If you must use your phone or computer right before bed, darken the light on the screen or use a shield on your computer screen to help decrease sleep disrupting blue light exposure before bed.

Get your eyes checked

If you are in need of an updated prescription for eye glasses, your eye strain symptoms are likely to be worse, especially if you are spending hours on a computer screen or use screens daily. Getting a regular eye exam can help ensure that your eyes are healthy and that you have appropriate eyewear for prolonged computer use. 

According to American Optometric Association, in most cases the symptoms of CVS or Digital Eye Strain occur because the visual demands of a screen exceed the visual abilities of the individual to comfortably perform them, causing eye strain symptoms. Making sure you have the appropriate eyewear prescription will help to ensure that you aren’t demanding too much from those hard working eyes. 

Uncorrected vision and some people with different types of vision issues or focusing issues (farsightedness, astigmatism, presbyopia, problems with eye coordination etc.) may need more breaks than others, and in some cases, special glasses for computer screen use. The text on a screen is oftentimes different than that on paper. It is harder to see, as the screen isn’t as sharp and there may be glare.. A regular eye exam is very important to eye health and can make your screen use more tolerable with less symptoms of strain. 

Chat with a nurse first if you are having any symptoms and get checked out to be sure you don’t have anything more serious going on. We are always here to help!

The opinions expressed in Nurse-1-1 Health Center Blogs are solely opinions of the writer. Other than information received directly by you from your personal provider, the health center blog should not be considered medical advice. Read more.

Cleaning and disinfecting during COVID-19

We have been cleaning and disinfecting frantically since the COVID-19 outbreak. Clorox wipes were wiped out and it became almost impossible to find hand sanitizer. We started to see new products popping up online and in stores and out of desperation started buying off-brand items. Families that once used “cleaner” products began buying anything and everything to clean counters and slather on their kiddos’ hands. 

Let’s take a quick minute to check in and evaluate our cleaning regimens. What should we be thinking about when we clean?

Know the difference between cleaning and disinfecting

You want to be sure that your products are able to kill COVID-19 as well as other common viruses and bacteria; however, you should also have less harsh options for when you just want to wipe a spill.  

Keep a disinfecting spray or wipe that kills a variety of viruses and bacteria in your home handy so you can wipe down counters splattered with meat juice to kill any salmonella or for influenza or coronaviruses that you may have picked up and transferred to the doorknobs. Don’t forget the E. coli and noroviruses that could be lurking on your toilets. 

Disinfecting products that are commonly found at home include: 

  • Disinfecting wipes (Clorox, Lysol or store brand wipes)
  • Isopropyl alcohol
  • Hydrogen peroxide
  • Make your own blend with common household items such as bleach – find the instructions here 

The Environmental Protection Agency (EPA) has the full list of Covid-19 killing products, so be sure your disinfecting product is on their list. The EPA recommends letting the disinfectant sit on your hard surface for 10 minutes in order to kill 99.9% of the germs. It is important to read the labels so you know you are using your products properly and effectively, as some products may have different instructions.

Penn Medicine lists the germ “hot spots” that are high touch and should be included in a daily disinfectant regimen:

  • Cupboard and drawer knobs/pulls
  • Faucets
  • Kitchen and bathroom counters
  • Toilets, especially the seat and handle
  • Refrigerator, dishwasher, oven and microwave handles
  • Remote controls and game controllers
  • Cell phones, tablets and other mobile devices
  • Computer mouse and keyboard
  • Door knobs/handles
  • Table surfaces
  • Staircase railings
  • Light switches/switch plates

The CDC recommends disinfecting these high touch surfaces at least once per day if you are isolated at home because of suspected illness. If they are soiled, be sure to clean them off first. Cleaning involves wiping up soiled surfaces to remove dirt and particles, while disinfecting involves killing bacteria and viruses. Be sure to clean your surface before disinfecting it as most disinfectants work best on an unsoiled surface. 

You don’t have to disinfect your entire home each day if you are healthy, but you do want to clean and disinfect your high touch areas in your home routinely.  If you are looking for something to just clean off your hard surfaces from dust and grime, a simple multi-purpose soap solution or vinegar spray will do the trick. Make sure to follow instructions, don’t mix chemicals and keep the area ventilated.

Hand sanitizers and washing your hands

Keep hand sanitizers handy, especially when you are out and about. It is important to keep the germs at bay when you don’t have a sink handy to use soap and water. While these sanitizers can work well, the FDA reminds consumers to also wash their hands often with soap and water for at least 20 seconds, especially after going to the bathroom, before eating, and after coughing, sneezing, or blowing one’s nose. However, if soap and water are not readily available, then you should use an alcohol-based hand sanitizer that contains at least 60 percent ethanol (also referred to as ethyl alcohol). It is important to use enough of the sanitizer: be sure to cover both sides of your hands and to let it dry completely in order for it to work best. 

When you are at home or nearby a sink where you can wash your hands, you can use soap and water rather than slathering on sanitizer as a way to avoid those extra chemicals. The CDC reminds us that soap is the most effective method, especially when you have soiled hands. So use that nice natural soap to clean those hands and keep from exposing yourself to unnecessary chemicals.

Be aware that there has been a sharp increase in hand sanitizer production that includes the toxin “methanol”. Some companies were taking advantage of increased public use of sanitizer and produced subpar, dangerous products. Methanol is a toxic chemical found in fuel, solvents and antifreeze that is not safe for use in hand sanitizers. If you see this on the label or there has been a recall, it is unsafe to use these products.  

The FDA lists an updated chart of contaminated products to keep an eye out for. Be sure to also check newer brands to be sure they are not on the contaminated list before use. Methanol exposure can result in nausea, vomiting, headache, blurred vision, permanent blindness, seizures, coma, permanent damage to the nervous system or death, so any ingestion or exposure to methanol requires medical attention right away.  

Decreasing your exposure to chemicals 

The EPA lists safe and effective products for different areas of your home and community. Many companies are trying to eliminate chemicals from household products that can cause harm when absorbed or inhaled. Make sure to check your products, follow directions and wear gloves when handling harsh chemicals. 

Also, after using disinfectant products on any food surface areas, you should rinse or wash off the area with water to avoid inadvertently ingesting any harmful substances or residue that may remain.

You can also limit your exposure to chemicals by washing your hands with soap and water when possible instead of using hand sanitizer. Also, be sure to wear gloves when using disinfectants. Check EWG for those daily use soaps and non-disinfectant sprays. Instead of using harsh chemicals while wiping dust and dirt, you can use a more gentle option like vinegar and water and save the bleach for only those high-touch surfaces.

Nurse-1-1 team faves

Nurse-1-1 fan favorites include a more natural option, Force of Nature, which is an EPA registered disinfectant and sanitizer that kills 99.9% of germs including: Staph, MRSA, Salmonella, Norovirus, Influenza A & Listeria when used as directed. It is listed as likely effective on COVID-19. Since this is a new virus, testing is still in progress and is a two step process. This product is listed as having an emerging claim, meaning it’s in the middle of that process.

Another favorite is Lysol Disinfecting wipes, which also have an emerging claim for COVID-19 (if you can get them!) and are a popular option for bathrooms and high touch surfaces within the team.  

Nurse-1-1 also loves Branch Basics for a non-toxic cleanser, especially great for those with sensitive skin. Mrs. Meyers Basil all purpose general cleanser is another great multi-surface cleanser as well as plain vinegar and water with a few drops of lemon for general cleaner. 

Safe use of any cleaning product is important. Make sure to keep them out of the reach of children and follow the directions. Call Poison Control immediately if you have had a chemical ingestion or exposure, and don’t hesitate to chat with a nurse if you have any concerns.

The opinions expressed in Nurse-1-1 Health Center Blogs are solely opinions of the writer. Other than information received directly by you from your personal provider, the health center blog should not be considered medical advice. Read more.

What should I keep in my first aid kit?

How many times have you been skipping through the park, stubbed your toe and wished you had a first aid kit? Been home, sliced your finger on a knife but had no bandaids? You aren’t alone. There are so many options for what you may want to have on hand in a first aid kit. Let’s review which supplies are good to have and what to think about when getting your kit ready.

First, keep in mind that a first aid kit for home and light travel should have basic items, but if you are headed out camping or on an adventure where there is no access to healthcare or emergency care, you may want to be sure you do some research and have more options available. 

What should a basic first aid kit contain?

A first aid kit should be well marked and in a known location. Keep one in the car that you can grab and throw into a backpack or stroller for when you are on an excursion. You can purchase a pre-packaged kit and add to it as needed. You can find some kits come with all you may need and more!

The American Red Cross suggests this list for a family of 4:

  • 2 absorbent compress dressings (5 x 9 inches) 
  • 25 adhesive bandages (assorted sizes)
  • 1 adhesive cloth tape (10 yards x 1 inch) 
  • 5 antibiotic ointment packets (approximately 1 gram) 
  • 5 antiseptic wipe packets
  • 2 packets of aspirin (81 mg each) 
  • 1 emergency blanket
  • 1 breathing barrier (with one-way valve)
  • 1 instant cold compress
  • 2 pair of non-latex gloves (size: large)
  • 2 hydrocortisone ointment packets (approximately 1 gram each) 
  • 1 3 in. gauze roll (roller) bandage
  • 1 roller bandage (4 inches wide) 
  • 5 3 in. x 3 in. sterile gauze pads
  • 5 sterile gauze pads (4 x 4 inches) 
  • Oral thermometer (non-mercury/non-glass)
  • 2 triangular bandages
  • Tweezers
  • Emergency First Aid guide

What’s in a first aid kit?

This list seems long, but each item has a purpose. You want to have something to stop minor bleeding and cover up a cut or laceration. Check your kit to be sure it includes a few gauze bandages, bandaids in a few shapes and sizes and some paper tape to wrap up cuts and scrapes as needed. A longer roll of gauze can come in handy with a larger bleed or to cover a large scrape. 

The next thing you want to think about is having some ointments and creams for the more common issues you may face. Having some single use packs or small tubes of over-the-counter items such as burn ointment (for minor burns), triple antibiotic ointment (for cuts and scrapes), hydrocortisone (for itchy bug bites or rashes) and some alcohol or antiseptic wipes to clean dirty hands before touching your “patient”. A pair of gloves will protect you as well and are important to have in your kit.

Other items to keep handy in your first aid kit

You can also consider some additional tools to help you along if you get stuck in a bind: 

  • A small pair of tweezers can help remove a splinter, bug stinger or tick
  • A small pair of medical scissors can help you cut clothing or tape as needed
  • An instant cold pack can soothe a minor injury or help cool down a person who may be experiencing a heat related illness
  • A nice emergency blanket can warm up a cold or ill patient until help arrives
  • An emergency CPR one-way valve mask in case you need to administer CPR. This provides a barrier for your mouth and the victim during rescue breaths (although with new CPR compression only guidelines, it is less likely that you would need to give rescue breaths).

Medications to consider having on hand

Other items that you could consider having in your kit are over-the-counter Motrin, Tylenol and Benadryl. They sell these in small packages so that you can keep a few tablets on hand, or a few chewables for the kiddos. You never know when you will have a throbbing headache and need Tylenol for the pain, or twist an ankle and could use some Motrin to help decrease inflammation. These are both great to keep handy at home too for that unexpected fever or ache you might experience. 

Benadryl is also good to keep handy. It works quickly to help with a nasty, itchy rash or bite, or an unexpected case of seasonal allergies. Other meds you may want to keep handy include Tums and Pepto for when the occasional heartburn hits!

If you have a person with severe allergies in the home and have been prescribed an EpiPen, keeping your EpiPen handy is a very important part of any excursion and should always be with you or your first aid kit. Make sure to keep this in a bag or purse that doesn’t sit in a hot car, and that comes with you wherever you go. Seconds count when it comes to administering an EpiPen when someone is having an anaphylactic reaction. You should have one in the home that is accessible and in a known location for those who may need to administer it. Using a brightly colored label helps make the EpiPen easier to find. 

Remember to restock your kit after every use and make sure to check your items for expiration dates. Ask a nurse first if you are unsure about your minor injury, but don’t hesitate to call for help if it’s more serious.    

 

The opinions expressed in Nurse-1-1 Health Center Blogs are solely opinions of the writer. Other than information received directly by you from your personal provider, the health center blog should not be considered medical advice. Read more.

Back to school options in 2020

We normally would be looking for the best sale on new backpacks and getting school clothing ready for the fall semester. But here we are waiting for information on what is going to happen next… Will there be school in classrooms? Will it be online? A mix of both? Will I be the teacher? Will the kids get on the bus? 

We all know that things have been changing by the minute, and we never know what the next announcement will be. National, state and local officials don’t agree and neither do parents and neighbors. COVID has taken the country by storm. How will we get through another school year? What will our year look like?

We just don’t know. Nobody has the answers we need. I for sure don’t. But as a mom of three,  I cycle through how September will look for us, on a daily basis. In my mind, scenarios change by the hours. It’s going to be hard. It’s going to be new and unexpected. Here are the options that most of us face in just a few short weeks: full day in-classroom learning, hybrid learning, full remote learning, homeschooling, microschooling, among others. What are these different types of learning options?

Full day in-classroom learning

Full day in-school learning means your school will allow all students and teachers to enter back into the classroom for a full day of school. Entering school will involve new rules like handwashing and face masks to decrease spread of COVID-19. Some schools will follow the CDC recommendation of social distancing 6 ft apart and some will follow the American Academy of Pediatrics recommendation of 3-6 ft apart. Learning will be all in the classroom but may look different than a usual year. Many schools will keep the class in the same room for the entire day, including lunch and specials such as gym and art. Some will have classes outside. Teachers and students will likely be wearing masks and there may be clear barriers set up around the class. Gone are the days of rug time and group desks. Desks will be facing forward in most classrooms with different setups from what we are used to seeing in the classroom. 

Hybrid learning

Some schools will offer a hybrid learning option. What this will mean is that children will be able to go to school some days and do at-home remote learning on other days. Splitting them up allows for more room to social distance with conservative spacing at 6 ft apart. It also separates the school into separate cohorts to prevent an outbreak from affecting the entire larger group. For many schools, this looks like an every other week in-school option, ½ days in school option, or some variation. This will differ by school. The remainder of the days can be a combination of independent online learning, flexibility of schedules, live classroom instruction video, and one-on-one calls. Some areas may be able to test innovations at home that non-traditional approaches to education can provide, such as theme- and project-based assignments, interdisciplinary units that tap into students’ interests, mastery-based grading, and solving real-world problems. The hybrid learning  option decreases the amount of kids in a school and classroom at one time and allows for a safer school day, knowing there are less children in the space. 

Full remote learning

Many towns are offering full remote learning as well. Parents need to keep in mind that in many towns, this will not be the same experience they had during the emergency shutdown. School systems have learned a lot from that experience and are adapting and creating remote learning plans. States are choosing remote learning platforms that allow for deeper instruction and learning experience. Gone are the days of simply jumping on a zoom call. 

Full remote learning is an option many school systems are offering students, families, and staff who are immunocompromised and students who feel they can thrive in the remote learning environment and prefer a non-traditional school experience. Full remote learning will offer flexible schedules for families who need to make adjustments based on their schedules. 

Students in the full remote learning options will have a curriculum that will align with their peers in the in-classroom and hybrid options. Day-to-day teaching will look different, and students will be provided with a rigorous learning experience that takes into account the social nature of how kids learn. Fully remote learning should also take into account the unique challenges and opportunities of effective online instruction and learning. A proper online learning program will need to prioritize the creation of strong relationships between teachers and students, and between students. 

Classes such as music or band, that cannot happen in-classroom during the pandemic, can proceed online if towns take action to deliver cleaned instruments to students’ homes. At home, wind instruments can be played without face masks, and other instruments can be handled without other restrictions that are preventing many in-classroom options from having music class all together.  

Homeschooling

Homeschooling is led by the parent independently or through a private homeschool program. This option requires unenrolling your student from public school and either enrolling into a private homeschool program or submitting your own plan for homeschooling. Homeschooling allows parents to have some control over their child’s day and curriculum. For some families, this mimics a traditional school day with a classroom-like schedule and for others a more child-led, flexible learning environment. These children can integrate back into public schools at any time, or can homeschool until college. Homeschooling allows for flexibility and provides options for students and families who wish to lead learning in their home. There are many homeschooling resources available for this fast growing option that is legal in all 50 states.

Microschooling or pod-based schooling

Parents who are not ready to send their kids into a school building with many unknowns are getting creative. A new homegrown option for those who can’t rely on the ever-changing and unpredictable school environment have come up with their own plan: micro schooling or pandemic pods. For some who have the resources, this means hiring a retired or unemployed teacher to teach a small group of children. For others, it means parents will take shifts or have a rotating schedule where they support  the remote learning plan. This small group develops with many factors in mind and makes their own rules. Is this a low-risk family? Are they the same age and grade? Do they get along? Do they live close by? How will we discipline and keep these kids focused? For some, the thought of sharing the responsibility is very attractive and for many with limited resources, an alternative option is essential. 

Options for learning

We don’t have all the answers, and going back to school (or anywhere for that matter during the pandemic) is not 100% safe. Wearing masks and distancing yourself helps in preventing the spread of COVID-19.  Many parents and teachers worry that not all students will be able to follow these directions properly.  Unfortunately with COVID-19, it only takes one person to spread their germs and one misstep to catch them. 

We know that not all families have the same options and opportunities for learning. Education disparities already exist, and this gap will only widen with COVID-19. Race, economic status, geographic location and now disruptions in school are all major contributors to disparities in health and also in education.

As the back-to-school plans evolve, we realize that there are limited resources and plans for those without the economic resources or time, who are uncomfortable with in-classroom options to rely on. Many are feeling frustrated and uncertain. One resource is the Families First Coronavirus Response. For some who qualify, this may provide an option for a paid leave to some parents who wish to participate in fully remote learning.

Do what is best for you, your family, and your community

No matter what you decide to do, be kind to your neighbors and friends. Fighting about these back-to-school options will not get us an answer on how to solve this pandemic. Remember, it’s ok to have different opinions. It’s natural to think our way is the best way. It’s fine to discuss, but it’s not ok to tell anyone they are wrong, or that they are making a bad choice. This is a crisis. We are anxious. We are uncertain. What we do know is that each of us is making decisions for our families, communities, teachers, and school staff. We are doing the best we can. Given the options you may be given, you are doing what you think is best. Pat yourself on the back, and press on. You are an awesome parent!

The opinions expressed in Nurse-1-1 Health Center Blogs are solely opinions of the writer. Other than information received directly by you from your personal provider, the health center blog should not be considered medical advice. Read more.

Beat the heat: avoid heat stroke and heat-related illnesses

Summer is in full effect and getting outside for some sun feels oh so good. Summertime is full of fun, but let’s make it safe! Besides lathering up for sun protection and wearing a helmet when riding bikes, we want to make sure you know about heat-related illnesses, too. 

Heat exhaustion and heat stroke occur when the body can’t keep itself cool. More than 600 people in the United States are killed by extreme heat every year, according to the CDC. The good news is that heat-related deaths and illnesses are very preventable. Read on for everything you need to know about heat stroke and heat exhaustion.

How much heat is too much? What exactly is heat exhaustion?

Feeling tired after a day at the beach is a common feeling, but an important one to pay attention to. The CDC defines heat exhaustion as a milder form of heat-related illness that can develop after several days of exposure to high temperatures and inadequate or unbalanced replacement of fluids. Heat exhaustion happens quicker and more commonly to the elderly, children four years old and younger, people with high blood pressure, and anyone working or exercising in a hot environment. 

Signs of heat exhaustion to look out for are:

  • Heavy sweating
  • Paleness
  • Muscle cramps
  • Tiredness
  • Weakness
  • Dizziness
  • Headache
  • Nausea or vomiting
  • Fainting

Heat illnesses occur when the body can’t cool itself off. Typically, when it is hot out, the body will sweat to cool down. However, cooling off can be especially difficult for the body when it is hot and humid. When the humidity is high, it makes it hard for the sweat to evaporate and cool off the skin quickly. Your body continues to sweat and lose water, but it isn’t actually able to reduce its temperature.

How can I prevent heat exhaustion and heat stroke?

The first steps to cool the body during heat exhaustion are hydrating the body and keeping cool. You may notice a fast heart rate and/or fast breathing. With any signs of heat exhaustion, you should immediately:

  • Drink cool, nonalcoholic beverages
  • Rest
  • Take a cool shower, bath, or sponge bath
  • Seek an air-conditioned environment
  • Wear lightweight clothing

It may seem obvious, but it’s worth highlighting: keeping cool and hydrated are KEY to preventing heat-related illnesses. If you can access an air conditioned area, or a shady cool spot on a hot day, make sure to take breaks and do so. 

Make a plan before heading outside

  1. Schedule breaks inside an air conditioned home, or a public location such as a library or community center throughout the day
  2. The cool ocean water, sprinkler and shower are great options to quickly reduce body temps
  3. Prepare cooling towels or ice packs covered with a damp towel for instant relief
  4. Using a fan can help cool the body, but be careful on hot days, as 90 degree heat is still dangerous, even with a fan on. It’s important to drop the temperature of the body, which a fan won’t do in extreme temperatures. Try your best to find some AC on those days!
  5. Bring fluids in a cooler with you (or at least keep them in the shade!) and make sure to drink plenty of fluids on hot days, especially when you are sweating a lot. Drinking water before heading out helps, too!
  6. If you are sweating in the heat, it’s also important to replace the salt, sugar and minerals you’re losing in order to and keep a nice balance of electrolytes in your body. A sports drink such as Gatorade or Vitamin Water can help achieve this. For organic options, check out NOOMA Organic Electrolyte Sports Drink or Roar Organic. FYI, we don’t get any payment for promoting these brands; we just love sharing options. (Of course, be sure to talk with your doctor about drinking sports drinks or excessive amounts of water if you have any medical conditions such as diabetes, high blood pressure, or are on any special diet or fluid restrictions, as these conditions can require a delicate balance of salts and minerals in your body.)
  7. Keeping hydrated is harder when drinking sugary drinks, caffeine and alcohol, so consider limiting these types of drinks on especially hot and humid days

If you notice that your symptoms last longer than one hour, you are vomiting, symptoms are worsening, or don’t improve, seek medical attention right away. Don’t hesitate to chat with a nurse first if you are concerned about your symptoms. Our experts are here to help! Heat exhaustion can progress to heat stroke, which can be life threatening, so don’t hesitate to seek medical attention.

Heat stroke is a medical emergency

Heat stroke is the most serious heat-related illness and is considered a medical emergency. Heat stroke occurs when the body becomes unable to control its temperature: your temperature rises rapidly, your sweating mechanism fails, and your body is unable to cool down. In the case of heat stroke, your body temperature may rise to 106°F or higher within 10 to 15 minutes. The body just can’t cool down. Heat stroke can cause death or permanent disability if emergency treatment is not provided. Call 911 right away if you are worried you have heat stroke.

Signs of heat stroke include:

  • An extremely high body temperature (above 103°F, different than temp from fever)
  • Red, hot, and dry skin (no sweating)
  • Rapid, strong pulse
  • Throbbing headache
  • Dizziness
  • Nausea
  • Confusion
  • Unconsciousness (passing out)

Heat stroke is an emergency. Call 911 right away for medical assistance if you suspect heat stroke. While you wait for help, the CDC recommends these steps to cool the victim 

  • Get the victim to a shady area
  • Cool the victim rapidly, using whatever methods you can. For example, immerse them in a tub of cool water, place them in a cool shower, spray them with cool water from a garden hose, sponge them with cool water, or if the humidity is low, wrap them in a cool, wet sheet and fan them vigorously.
  • Monitor body temperature and continue cooling efforts until the body temperature drops to 101-102°F
  • If emergency medical personnel are delayed, call the hospital emergency room for further instructions
  • Do not give the victim anything to drink 

Stay safe in the sun!

Make a plan for the day and set timers for taking breaks from the sun, rehydrating and putting on sunscreen. It’s easy to forget (or put off) these things but easier with a reminder in place. Many of us love the hot weather, but your body will need to be able to cool off especially in extreme or prolonged heat. Never leave a child or elderly person in a hot car and don’t forget to check on your neighbors when the weather is very hot. And remember, Nurse-1-1 is always here to help. Chat with us about your symptoms, and tag us in your summer fun in the sun! We love to know what our friends are up to!

Kim Liner, PNP

Nurse-1-1 Chief Nurse Practitioner

The opinions expressed in Nurse-1-1 Health Center Blogs are solely opinions of the writer. Other than information received directly by you from your personal provider, the health center blog should not be considered medical advice. Read more.