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Allergies vs. Cold: What have I got?!

Spring is a beautiful time of year in Mouth of Wilson, VA.  We have lush vegetation here in the Blue Ridge and it is just beginning to reveal itself. Trees are budding and getting their leaves, the grass is being mowed, and flowers are starting to bloom.  As beautiful as it is, it can also have the undesirable effect of causing seasonal allergies. For some of our students, this is a new problem.  They might never have been exposed to this environment before, so allergies are a foreign idea. For others of our students, allergies are an old enemy that wreaks havoc for them every spring and fall.  Many students are currently complaining of sore throats, congestion, and sneezing. It can be difficult to tell if these symptoms are being caused by allergies or the common cold. How can you tell the difference?  It can be difficult, but here are some assessments I use.

The first question I ask is, “Do you have a fever or body aches?”  An allergy does not cause a fever or body aches. The second question is “How long have you had these symptoms?” Colds usually are self-limiting and last only about 7-10 days.  If the symptoms have lasted longer, without worsening or improving, they are usually caused by allergies. The last thing I look for is if there are any patterns related to these symptoms.  “Do you get these symptoms the same time every year?” If so, the patient probably has seasonal allergies. After I have determined the cause of the symptoms, then I can plan how to treat them.

Despite what the name suggests, a person can catch a “cold” at any time of the year.  It is estimated that adults catch colds 2-3 times per year and children even more because their immune systems have not been exposed to as many cold viruses.  A cold is caused by a viral infection and is not “curable.” Antibiotics are not effective in the treatment of colds. Treatment includes addressing symptoms for short-term relief and supporting the body’s natural immune response to help fight the virus off faster. Cough suppressants, analgesics and decongestants can help make you more comfortable if you are suffering from a cold. Getting plenty of rest, drinking lots of fluids and maintaining overall good health can help your body’s immune system fight off cold viruses.  If a complication develops, such as a sinus infection or an ear infection, only then should treatment with antibiotics be considered.

There are several treatment options for allergies, and the choice depends upon the severity of the symptoms.  For my students, I often suggest trying Zyrtec or Allegra first. These are the most effective over-the-counter antihistamine treatments I have found. Of course, if a person can avoid the allergen itself as much as possible, that is very helpful as well. If these strategies are ineffective, it is time to see an allergy specialist or an ENT (Ear, Nose & Throat doctor) for prescription treatment.

If students at Oak Hill are feeling ill, they should see one of our campus nurses.  We are typically in the nurse’s office from 7:00 am to 9:30 pm. We are available in the dining hall during all meals. We also administer medications at that time.  A nurse also visits all of the dormitories for nighttime med call before lights out. After lights out, students should see their Resident Managers for any medical issues. There is a nurse on call for all illnesses and emergencies 24 hours a day, 7 days a week.

Here’s to good health, and thanks for reading!

Betsy Anderson, RN, BSN
Oak Hill Academy Nurse

A Good Night’s Sleep…It’s Elusive

Do you know that feeling you have when you wake up refreshed? You went to sleep at a decent hour, you slept all night without waking, and now you are awake and feel ready to start the day. Did you feel that way when you woke up this morning? No, neither did I. That is the inspiration for this blog topic: The ever-elusive Good Night of Sleep. As adults we know there are a million things getting in the way of our sleep–work stress, family issues, anxiety about responsibilities, health concerns, etc. But, those are adult problems, right? Nothing for teenagers to worry about…right? Unfortunately, many adolescents are sleep-deprived. Problems sleeping is one of the top 3 complaints I hear from my students on a daily basis.

According to the Journal of Clinical Sleep Medicine, the official publication of the American Academy of Sleep Medicine, “teenagers 13-18 years of age should sleep 8 to 10 hours per 24 hours on a regular basis to promote optimal health.” Getting enough good quality sleep leads to better health and educational outcomes such as improved attention, behavior, learning, memory retention, emotional regulation, and mental and physical health. Insufficient sleep increases risk of accidental injuries, obesity, diabetes and depression. In teenagers it has also been associated with increased risk of suicidal thoughts and self-harm.

The CDC (Centers for Disease Control) estimates that 70 percent of high school students are not getting the recommended hours of sleep. Studies have estimated that 11 percent of adolescents have a history of insomnia and children with neurodevelopmental diagnoses such as ADHD have a particularly high risk for sleep disturbances (because of the nature of the disorder and the medications used to treat it).

Although sleep disturbances can turn into a chronic problem, many of them are transient in nature and can be the result of a stressful life event. When a transient sleep disturbance occurs, it is important to address it so that it does not become a chronic issue. The majority of sleep disturbances in adolescents are likely to have behavioral origins and can be successfully addressed with good sleep habits. Once these routines are established, they can benefit an adolescent for a lifetime. This is the time in their lives when their brains are maturing during sleep processes. When your teen experiences sleep disturbances it is important to commit to a consistent sleep plan.

Healthy Sleep Habits (as recommended by the National Sleep Foundation) include the following:
• Go to bed at the same time each night and rise at the same time each morning, even on weekends and during school breaks.
• Make sure your bedroom is quiet, dark and relaxing, neither too hot nor too cold.
• Make sure your bed is comfortable and use it only for sleeping, not other activities.
• Avoid large meals a few hours before bedtime.
• Exercise regularly.
• Avoid caffeine after noon.
• Avoid screen time several hours before bedtime.
• Use relaxation tools, such as meditation or progressive muscle relaxation.

At Oak Hill Academy we do several things to encourage a good night’s sleep for our boarding students. “Quiet Time” starts promptly at 8:30 each evening. During this time students are given an opportunity to be in a quiet, relaxed environment. This encourages their bodies to release melatonin, a natural hormone produced by the brain’s pineal gland that promotes the onset and duration of sleep. We also have a regular lights-out time of 10:30 pm, as well as a regular wake-up time. This keeps our students on a consistent schedule and promotes natural sleep/wake cycles. A few years ago we adjusted our start time for the school day to be 45 minutes later. This change was implemented in response to data and recommendations from several sleep researchers, including the American Thoracic Society. Organizations like the American Academy of Pediatrics, the CDC, and the American Medical Association support later school start times. Structuring the school day and associated activities to be compatible with the natural circadian rhythms of an adolescent’s brain helps achieve quality sleep, the benefits of which are far-reaching.

But what if you can’t sleep? It is hard to conquer the world if you don’t feel well-rested, right? Many people use over-the-counter melatonin or antihistamines to help fall asleep. But pharmacologic intervention should be considered only if a healthy sleep routine is committed to and followed consistently without improvement, or if there is another health issue interfering with sleep. One of the dangerous results of taking medication without professional guidance is that it could cause rebound insomnia when the medication is stopped, producing a chronic issue.

A change in behaviors surrounding sleep is often as effective as using over-the-counter medications–especially if the sleep disturbance is transient in nature. It is important to point out that no hypnotics or other medications have been approved for use by the FDA for sleep problems in people under the age of 16 years. If a sleep medication is prescribed at this age, it should be done with careful monitoring and consideration of benefits versus risk.

We are so close to the end of the school year, when students leave us for the summer. While students are at home, they sometimes do not adhere to a normal schedule and this can throw off their natural patterns of sleep and wakefulness. When they return to school in the fall, they might have difficulty being able to sleep for the first few weeks. Encouraging your teen to stick to a normal sleep schedule during school breaks can go a long way to help prevent this from occurring.

When you lie down, you will not be afraid. When you rest, your sleep will be peaceful.
Proverbs 3:24

Now, go forth and conquer the world – but first, sleep!
Betsy Anderson, RN BSN
Oak Hill Academy Nurse

 

A Boarding School Nurse’s War on Vaping

Today’s guest blog post is written by one of Oak Hill Academy’s school nurses, Betsy Anderson, RN, BSN.  As her life’s work is with boarding high school students, Nurse Betsy is very passionate about health issues that are particularly relevant to teenagers.  

Several years ago I was taking a road trip and my mind was wandering. I was thinking about a law that had been recently passed in Virginia making it illegal for adults to smoke in cars with their children present. As a school nurse, and as a mother myself, I am a strong supporter of this law. I remember looking around as I drove, seeing other people driving or riding in cars, people walking down the street. I looked to see if any of the people I encountered were smoking. …I COULD NOT FIND ONE. The healthcare professional in me felt a small sense of satisfaction. I thought to myself, “You go, America! You are doing it! You are kicking your horrible habits!” Little did I know a new enemy was lurking just around the corner. Vaping.

Although vaping has had a huge increase in popularity in the last two years, the first electronic cigarette (e-cigarette) was invented and patented in the 1960s by Herbert A. Gilbert. The device uses a heating element to turn liquid (e-liquid or e-juice) into a vapor that the user inhales. Mr. Gilbert wanted to market his nicotine delivery invention as an alternative to traditional smoking. But because tobacco companies already had so much momentum in the consumer market, it never took off. Only recently have e-cigarettes exploded in the marketplace. What is alarming to me is that the largest population of e-cigarette consumers are adolescents, and that this number is growing at unprecedented rates. According to the CDC, e-cigarette use in high school students tripled from the year 2013 to 2014. This means that in one year the number of high school students in the United States who vaped increased from 660,000 to 2 MILLION. This number is unbelievable.

Why is vaping so appealing to adolescents? I believe one reason is that the marketing for these products has been misleading for many. E-cigarettes have been marketed as a “safer” alternative to smoking, but there is no real data to support this claim, In fact, studies are continuing to be published that show how very harmful vaping can be. When a people believe that vaping is “less harmful” than smoking, they neglect to consider that it is not HARMLESS. Another reason vaping is so appealing to adolescents is that it tastes good and has virtually no lingering smell. The most popular e-juice flavors in 2017 were Gummi Bear, Cinnamon Toast Crunch, Catch Ya Latte, On Cloud Custard, Muffin Man, and Cloud Candy. Clever names. And they sound delicious, right? And some vapes and supplies are so small and so disguised that it is easy for teens to hide them from their parents and school officials. If a teen is determined to hide their vaping, it is virtually undetectable. The final reason I believe vaping has exploded in the adolescent population is because of its concentrated and addictive quality and the effects of nicotine on the adolescent brain.

The absorption rate of nicotine is increased in the vapor delivery method and the nicotine receptors in the brain are overloaded with stimulation. Studies have shown that nicotine intake from one vape session can be equivalent to smoking 6 cigarettes, depending on the vaping device and e-juice used. When nicotine enters the brain and attaches to a receptor, the reward center lights up and dopamine is released. With continued use, more and more stimulation is needed for dopamine to be released, so users vape more and more. The adolescent brain is even more susceptible to this dependence trigger because the prefrontal cortex, where the reward center is located, is not fully developed until the early 20s. No wonder it is so addicting. Once exposed to this substance, our children will have an incredibly hard time not becoming addicted for life. When teenagers begins vaping, they are 70% more likely to begin smoking traditional cigarettes within 5 years.
Nicotine causes permanent damage to adolescent brains, and can affect long-term development, causing life-long problems with emotional response processing, memory, and reasoning and judgment abilities.

So, what is a school nurse to do? The first thing I have done is educate myself. I recently attended a conference that included a keynote speaker (Dr. Judson Brewer) who addressed addiction in the adolescent brain. One of the main areas he covered was vaping. I have spoken with colleagues. I have read countless medical journals and articles. I have learned so many scary facts associated with vaping that it is impossible to share them all in a single blog post. Vaping is a challenge for schools around the world, and Oak Hill Academy is no exception. We are a boarding school. Our students live here as well as attend classes. This means we must monitor classrooms, dorm rooms, and all other areas for vaping supplies. Teachers, resident life staff and administrative staff are all working together to tackle this very difficult issue. In healthcare, the best treatment is and always has been prevention. Vaping is absolutely a health crisis. I want my students to live healthy, fulfilled lives while they are with me and long after they leave me. That is why I became a school nurse. Children are the future of our world–and their success depends on their long-term health.

In order to decrease teen vaping rates, it is imperative that our students are educated about harmful effects of vaping BEFORE they try it. At Oak Hill Academy, we are currently developing  educational materials to be included in our robust resident life curriculum, and we continue to explore other ways to educate our students.  I ask that you, as parents and caregivers, become part of the team in helping fight this war. Educate yourself about vaping and its harmful effects. Share these facts with your children as soon as possible, and as often as possible.

Here are some excellent resources you can use to do this:

The Teen Vaping Trend – What Parents Need to Know

https://catch.org/lessons/catch-my-breath-middle-school-parent-resources

https://www.safekids.org/parents

Thanks for reading!
Betsy Anderson, RN, BSN
Oak Hill Academy Nurse