Anxiety & Panic Disorder

By: James Schaus, MD - UCF Health Center Doctor

Severe anxiety sometimes manifests as physical symptoms. These very real and frightening symptoms are known as “panic attacks,” and the syndrome, “panic disorder.”

Panic disorder is a common condition, affecting approximately three out of every one 100 people. These episodes of intense fear or anxiety often occur suddenly without warning or provocation and the cause or trigger of these attacks may not be obvious. These attacks can last from minutes to hours, and can occur only once in a while or they may occur quite frequently. People have a built-in “alarm system” that goes off when they feel threatened. This alarm starts physical and emotional changes that prepare us to flee or fight the danger that triggered the alarm. In some people this alarm may go off unexpectedly, creating a very strong sense of threat when no danger is present. It is often a terrifying experience associated with several physical signs including:

• Shaking or tremors


• Heart pounding or racing


• Sweating


• Chest pain


• Shortness of breath


• Tight throat or choking sensation


• Nausea


• Cramping


• Dizziness


• Out of body feeling


• Tingling or numb feelings in the hands


• Chills or hot flashes

A person may also have an extreme fear of losing control, going crazy or dying during a panic attack. Many of the symptoms are the same as the symptoms of diseases of the heart, lung, intestines, or nervous system. Just a fear of having a panic attack is often enough to trigger the symptoms. This is the basis for a condition called Agoraphobia. About two thirds of those who have panic attacks have some degree of Agoraphobia. A person who has Agoraphobia finds it difficult to leave home, because he or she is afraid of having a panic attack in public or not having an easy way to escape.

If you think you might have panic attacks, it is very important to see a provider at the UCF Health Center. Several medications can make panic attacks less severe or prevent them altogether. SSRI antidepressant medications such as Paxil and Zoloft are FDA approved to treat panic attacks, and can be used for as long as necessary, sometimes for years. Short-term use of tranquilizers such a Xanax and Klonopin are also FDA approved to treat panic attacks, but they should be used only for short periods of time unless you absolutely cannot function without them. Several kinds of stress reduction counseling are available at the UCF Counseling Center, and are very effective for treating panic attacks. The combination of both counseling and medication is most effective. About 90% of people who receive a form of counseling known as cognitive behavioral therapy experience at least some relief of their panic symptoms. Biofeedback is also effective at preventing and treating panic disorder. There is no need for a person to continue to suffer these terrifying symptoms and we can help you live a more stress-free and secure life.

Genital HPV: Are you Aware?

By: Lisa Malinowski, ARNP - UCF Health Center Women's Clinic Provider

HPV (Human Papillomavirus) infections are common. At least 50% of sexually active people will have genital HPV some time in their lives. Right now it is estimated that close to 25 million people in the United States have HPV infections that cause genital warts and other lesions. Some strands of HPV infection can cause cancer of the cervix. Other HPV strands may cause cancers of the genitals and anus. However, not all infections with these dangerous types of HPV lead to cancer.

Most HPV infections go undetected because they don’t cause warts or other lesions. Even if you don’t exhibit signs and symptoms of the infection, they may emerge later and you may transmit the virus to someone else. The signs and symptoms that do appear vary according to the type of the HPV infection you may have. HPV infections associated with genital warts and related lesions are contracted through sexual intercourse, anal sex and other skin-to-skin contact in the genital regions.

Virtually all cases of cervical cancer are caused by HPV infections. An estimated 10,000 women in the United States are diagnosed with cervical cancer annually, and about 4,000 die of the disease each year. Worldwide, cervical cancer is far more common because many women lack access to pap test screening. Certain HPV infections usually caused by type 16 and 18 can cause cellular changes that indicate the presence of precancerous lesions. These abnormalities are most often detected by a pap test. A pap test is the best tool to detect an HPV infection that could lead to cervical cancer. The American College of Obstetricians and Gynecologists recommends that women begin annual pap tests 3 years after first having sexual intercourse or at age 21. There is no test for men at this point but research is being conducted.

Genital warts are nonmalignant and appear as a flat lesion and/or a tiny cauliflower-like bump. HPV infections of type 6 and 11 cause 90% of genital wart cases. These HPV types are generally not associated with cancer. In women these warts appear most commonly on the vulva but may also occur near the anus, on the cervix or in the vagina. In men these may appear on the penis and the scrotum or around the anus. Genital warts rarely cause discomfort or pain.
There are ways to reduce your risk of being exposed to HPV: limit the number of sexual partners you have as the greater the number of sexual partners the more likely you will obtain HPV; be in a monogamous relationship; always using a condom, which can prevent some but not all HPV transmission.

Another preventative measure is the Gardasil Vaccine which is available to you at the UCF Health Center. This vaccine prevents HPV infections of type 6, 11, 16 and 18. Ideally women should receive this vaccine before they become sexually active. However if you are already sexually active this vaccine can still benefit you. The vaccine prevents women only from contracting HPV infections or types that they have not yet been exposed to. This vaccine is a powerful tool in the fight against cervical cancer. More information about Gardasil can be found at http://www.gardasil.com/. For more information on genital HPV you can visit www.cdc.gov/std/hpv/.

Over-the-Counter Non-Drowsy Anti-Histamines for Nasal Allergies

By: Ted Luna - UCF Pharmacist

Because you can’t always avoid allergens, you may need to use occasional over-the-counter (OTC) medications to alleviate your allergy symptoms.

Sneezing, wheezing, watery eyes and a runny nose are not the only symptoms of allergic disease. Many patients with allergies also report feeling “slower” and drowsy. When their allergies are acting up, they have trouble concentrating, sleeping, and remembering things. For students studying for exams allergy symptoms can be very disrupting to their daily routine. However, there are some medications that were once available only by prescription are NOW available over the counter to help allergy sufferers.

Antihistamines
When you are exposed to an allergen (i.e. ragweed pollen) it triggers your immune system to go into action. Immune cells known as “mast cells” release a substance called histamine, which attaches to receptors in blood vessels causing them to enlarge. Histamine also binds to other receptors causing redness, swelling, itching and changes in nasal secretions. By blocking histamine receptors, antihistamines prevent most of these symptoms.

The older antihistamines, such as Benadryl ® and Chlor-Trimeton ®, can be very sedating for routine daily use. Luckily, two newer non-sedating antihistamines, Claritin ® and Zyrtec ® are now available over-the-counter (OTC) without a prescription. Also combinations of these newer products with decongestants (pseudoephedrine) are now available in pharmacies behind the counter and a signature is required for purchases.

The New OTC Options…..

Examples of non-sedating antihistamines available OTC include:

-Loratadine: available under two different trade names Claritin ® and Alavert ®.

-Cetirizine: available as the product Zyrtec ®.

These antihistamines are taken only once a day and will help alleviate mostly the sneezing, watery eyes and runny nose symptoms. However, nasal congestion symptoms and sinus pressure may require the addition of a decongestant along with the antihistamine.

Examples of non-sedating antihistamines/decongestant combinations include:

-Loratadine/Pseudoephedrine: available as Claritin D-12h ® or Claritin D-24h formulations and also available as Alavert D-12h ®.
-Cetirizine/Pseudoephedrine: Zyrtec D-12h ® is now available OTC without a prescription.

Please consult with YOUR UCF Pharmacist if you need help choosing the appropriate medication for your allergy symptoms. Remember, you now have two locations to choose from…
The main UCF Pharmacy is located inside the Health Center and our new location - Knight Aide - is located in Knight's Plaza, near the Arena.

Don't Bet on It

By: Natalie Mullet, Deputy Director - Florida Council on Compulsive Gambling

March is a big month in the gaming industry. More money is legally bet on March Madness than any other sporting event in the United States. It is also the month that houses Problem Gambling Awareness Week.

Are you gambling on poker, Internet games, slot machines, sports…or do you skip it all together? Gambling often starts out as fun – a bet among friends. But, some people find it hard to stop gambling even when the fun is over. A recent university study showed that 1 in 4 college student gamblers is at risk for developing a gambling problem.

Gambling is everywhere. A person gambles anytime they risk something of value on an uncertain outcome. Most people can gamble with no problem, but others have serious financial, emotion, physical and sometimes criminal consequences.

There are signs that indicate when your gambling is more than a game.

Social gamblers bet only what they can afford to lose. They set a time limit and financial limit and stick to it. They never borrow money from friends or use credit cards to gamble. Social gamblers have other activities that they participate in and have other hobbies that do not involve a bet. Relationships, family and friends come before gambling.

Problem gamblers often lose money that they don’t have. They will borrow money from friends or max out their credit cards, to bet or pay off losses. A problem gambler will often lose track of time once they begin gambling, and may spend most of their time gambling, thinking about gambling, or talking about it. They often develop problems with school, work, family and friends because of gambling.

People with a problem will often develop significant financial problems, may lie or become defensive when questioned about their gambling. They may start to chase loses in an effort to win back money already lost. This may lead to ‘borrowing’ – stealing money from others, using their student loans or spending money they just don’t have.

Know how to make a choice that won’t jeopardize your future. The truth is that gambling can cause the same problems alcohol or drug abuse can.
If you are concerned that you or someone you know may have a gambling problem, there is someone you can talk to anytime. The Florida Council on Compulsive Gambling operates a 24 hour a day, toll-free and anonymous helpline that can help you or your friends or family member with their gambling problem.

Call: 888-ADMIT-IT (888-236-4848), because the first step to getting help for a gambling problem is admitting there is one. We’re here to help and we don’t play games.

On campus UCF, you can talk with any of your UCF Health Care providers, members of the Wellness program, the REAL Project staff and members of the Counseling Service for help and referral.