PM Pediatrics
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Dr. Christina Johns
Senior Medical Advisor, PM Pediatrics

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A mature African-American man helping his daughter relocate, perhaps into an apartment or college dorm. They are in a parking lot unloading their cars. The young woman is carrying a laundry basket filled with her belongings.

WELLNESS MANAGEMENT FOR THE COLLEGE AGE KID- CRAMMED INTO ONE SHORT SUMMER

It’s the beginning of April, right, so I’m thinking that most college kids away at school will be home for the summer in about 10 minutes. Doesn’t it seem like they get out so early? Hopefully the end of semester means that they’ve had a fabulously successful year and a job/internship lined up for the summer to keep them engaged, occupied, and productive. They’ve probably had enough of dorm food and dorm life that they’re excited to get home and back into their old, familiar room and comfortable bed, and are looking forward to some home cooking. And no doubt you can’t wait to have them back! All will be well with the world. Or… maybe your college kid is living somewhere else for the summer, or traveling. Regardless, you likely have a window of time with them, and part of making the most of it means doing a status check about their wellness.

I’d like to get on your radar today with a health checklist for you/your college age son or daughter. I’m a fan of organized preventive care and I’ve seen important health management fall through the cracks when people try to fit in key medical visits on spring break (but miss the appointment for whatever reason, or don’t have enough time for adequate follow up), so let’s think about it now so that you have plenty of time to knock it all out before they go back to college in August. The time will go by fast. It always does.

My motivation for writing this review is the following:

-dormitories/college living = Petri dishes for germs, and

-it’s a drag to have to manage any kind of healthcare from afar, and

-these categories represent common urgencies/emergencies that I see routinely in my practice.

No doubt you’ve read about dormitory outbreaks of infections such as mumps, mono (Epstein-Barr Virus, or infectious mononucleosis), flu, and even meningitis. Close proximity in living quarters plus airborne virus particles mean that many illnesses can spread very quickly. As you know there are a multitude of viral illnesses (like the common cold) that can only be avoided by typical infection control measures such as hand hygiene, but there are a few that can be prevented by maintaining active immunization status. Alright, there’s our first checklist category:

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INFECTIONS.

  1. Immunizations. Does your child need the meningitis vaccine or an MMR (measles, mumps, rubella) booster? Most schools require the meningitis vaccine before enrollment, and sometimes an extra dose of the MMR vaccine may be needed. Additionally, depending on how old they were when they got a tetanus booster, it may be time for that as well.
  2. Flu shot. The upcoming season’s flu vaccine often comes out in late August/early September, and if you think there’s any chance at all that your college kid might not have the chance to get the flu shot in the fall before about the end of October, then get this vaccine before (s)he leaves for school once it becomes available. There’s a chance that their immunity may wane late in the season since the vaccine generally provides immunity for about 6-8 months, but at least you know they’ll be covered during the months that are typically known as high season.

Next on the list is parents’ favorite topic: sexual health. Being away at college is associated with a lot of freedom and (for many) experimentation with intimacy. Many students have multiple sexual partners during their university years, and while I know this statement is nothing new, you’d be amazed at how many college students I see who have never had their sexual health addressed proactively. Let’s decrease that number right now by talking about what needs to be done as far as:

cartoon bird and bee in love

REPRODUCTIVE HEALTH.

  1. Contraception. Everyone needs a plan. All of ‘em. Even the people who aren’t doing it are gonna be doing it soon (trust me on this), so the discussion needs to be had. If you don’t feel comfortable talking about this, no worries. That’s what we clinicians are here for. You just need to line up the appointment. We will happily kick you out of the room, have a private conversation with your teenager, and develop a plan. Just please, provide us the opportunity.
  2. Cancer Prevention. Both males and females need the HPV vaccine. It has been widely studied and is safe and effective. The earlier that people get it, the better their immune response will be. Penile cancer is on the rise in men. Don’t let your son be part of that statistic, and keep your daughter safe against cervical cancer, too. I’ll say it again: this vaccine prevents cancer. Discuss it with your healthcare professional at the opportunity you’re going to set up in #1 above.
  3. Condoms. Most universities have fairly easy access to condoms, but equipping your child with these doesn’t hurt, and from what the data tells us having access to these does not encourage teenagers to have sex or increase the amount of sex they are having.

Finally, the rest of it. Remember that song, “Head, Shoulders, Knees and Toes…Knees and Toes?”

Well, keep that in mind with this category:

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EYES AND EARS AND MOUTH AND NOSE.

  1. Dermatology. Is the acne under control? Are there any new moles or freckles? Did spring break involve sunburn? In the absence of “out of control” pimples the skin check often gets overlooked. Make it a point to ask your kid about any new skin changes, and get them evaluated.
  2. Vision. It’s less common for college kids to need glasses suddenly, but I still think a vision screen is a reasonable thing to do, especially for any kids who have headaches. The thrash factor of the multi-step process of getting glasses— getting the Rx, going to the glasses store, picking out a pair, picking them up when they are ordered— is elevated when it’s done from a distance so having this NOT COME UP as an issue mid-semester is a real treat. Do it now.
  3. Mental Health. This is a tricky one, because often mental health issues lessen when stressors decrease, and since summer is frequently a more care-free time during the college years problems in this area can be difficult to tease out. That being said, trying to make sure that your child doesn’t have trouble with focusing or the kind of anxiety that interferes with their daily lives and also has a healthy outlet for stress management is important. Having the conversation during the summer break is a GREAT time to talk about this since you’re more likely to get an honest answer, and if you hear something that worries you, to get plugged in with a clinician who can best help manage the situation prior to when classes resume. Not sure how to do that? Start with your pediatrician, and (s)he can help guide you.
  4. Smoking/e-cigs/juuling/alcohol and other substances. Whether it’s alcohol, drugs, marijuana or cigarettes of any kind, a little investigation is warranted to estimate the degree (if any) of involvement with these substances. I know you know they are not harmless, but how are you going to have this important conversation with your child without knowing what their usage status is? Again, uncomfortable having this talk on your own? I refer you to #1 again under Reproductive Health where your friendly clinician will happily have it for you. You just need to make the appointment happen.

I don’t think that there’s anything in this checklist that would surprise anyone, but what DOES surprise people year after year is how hard it can be to get all of this accomplished in a few months’ time. Life just gets away from all of us sometimes, but if you get it all set up before May rolls around, you have the best chance of getting the majority of the list completed plus ample time for follow up should more healthcare visits be required. The components on this list may also need to be augmented or individualized according to a specific teen’s medical needs of course, which adds another layer to the process.

Sending your young adults back to college after a complete wellness check will hopefully optimize their chances for having as healthy a semester as possible, something which I firmly believe will add to their parents’ health as well, since maybe the anxiety level will be ratcheted down *just* a little. And doesn’t it seem like just yesterday you actually were singing “Head, Shoulders, Knees and Toes” with your son or daughter? They grow up fast.

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