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What is acupuncture?

acu.jpgAcupuncture is the practice of inserting very thin metal needles into the skin to stimulate points on the body. Sometimes electrical current is then passed through the needles.  Acupuncture has been used to treat medical conditions and to promote health for thousands of years in China and other parts of Asia. In the United States, acupuncture is a part of complementary and alternative medicine.

Hall Health Center offers acupuncture through its Physical Therapy clinic for orthopedic pain (pain associated with bones, muscles, ligaments or connective tissue) and sports injuries.

What does the research tell us about acupuncture?

Millions of Americans use acupuncture to manage chronic conditions and treat new ones, as well as to improve overall health.  However, the science behind acupuncture is controversial because it is difficult to design large, rigorous studies to test its effectiveness. When investigating whether a treatment method works, it is important to have a "control" group as a basis for comparison. In the case of acupuncture, this may entail comparing true acupuncture to "sham" treatments to see whether any observed improvement can be explained by the placebo effect.

Another aspect of the debate around acupuncture is known as the "nocebo" effect, the converse of the placebo phenomenon. There is some evidence that any skepticism or fear that acupuncture patients have about the practice negates any positive outcomes.

Chronic musculoskeletal pain

Studies have investigated whether acupuncture is effective in reducing pain associated with carpal tunnel syndrome, tennis elbow and low-back, neck and knee pain. Some of this research has found that acupuncture provides pain relief, with study participants who received actual treatment reporting less pain than those of who received simulated treatment. A 2012 study described in this New York Times article reviewed 27 studies that met standards of scientific rigor and concluded that there is strong evidence that acupuncture can help with chronic pain.

Are there side effects and risks to acupuncture treatment?

Few problems have been reported associated with acupuncture treatment. However, needles that are improperly sterilized or inserted could result in infection or organ puncture. Your acupuncture practitioner should open a new set of packaged needles at each treatment and use alcohol wipes on your skin prior to needle insertion.

Acupuncture needles are regulated by the federal government; they must be sterile, non-toxic and labeled for single use.

What to expect from a visit to an acupuncturist

Just like a provider of Western medicine, your acupuncture provider should take care to learn about your medical history and concerns. Your first visit should include questions about your health and health-related behavior. You will also be asked for the names and dosages of any medications, both prescription and over-the-counter.

Your acupuncture provider will then describe the recommended course of treatment and prepare sterilized needles for insertion. You may be asked to fully or partially disrobe. Needles are inserted quickly, and most people report feeling little to no pain. The provider will make sure you feel comfortable and then may leave to room for some time. You might feel energized or relaxed by the treatment.

Your provider may ask you to return for repeated treatments.

Insurance and acupuncture

Many health insurance plans provide coverage of acupuncture visits, including UW's Graduate Assistant Insurance Program (GAIP) and most UW employee health plans. Contact your insurance company to inquire if you have coverage and which providers are in network. If you do not have coverage and cost is a concern, you may be able to find an acupuncturist outside of the University of Washington medical system who offers services on a sliding fee scale based on income.

Additional resources

 


What is altitude illness?

mountain.jpgAltitude illness is a condition which occurs in many travelers making rapid ascents to high altitudes. It is commonly referred to as acute mountain sickness (AMS). It most often occurs at altitudes of 3,000 meters (approximately 10,000 feet) or more. In some individuals, it has been reported as low as 2,500 meters (8,000 feet).

We suspect that altitude illness is caused by the body's reaction to lower levels of oxygen found at high altitudes. The disease may occur several hours to days after ascending to high altitudes. Symptoms range from mild to severe.

Classic, high risk areas of the world for altitude illness include any mountain range over 10,000 feet, such as the Alps, Andes, or Himalayas. In addition, travelers to areas of North American, East Africa, and the polar regions are at risk.

Symptoms of altitude illness

Altitude illness can range from mild to severe.

Mild symptoms

  • Headache
  • Fatigue
  • Sleep disturbance
  • Appetite loss
  • Nausea
  • Difficulty breathing

Severe symptoms

  • Shortness of breath while resting
  • Rapid pulse at rest (>100-110 beats per minute or BPM)
  • Decreased urination
  • Visual changes
  • Severe headache
  • Loss of coordination
  • Mental confusion
  • Productive cough

The last group of symptoms may represent fluid accumulation in the brain (high altitude cerebral edema) or lungs (high altitude pulmonary edema). In these severe cases, the disease can be fatal if not treated rapidly and requires descent to lower altitudes. Luckily, in most travelers, altitude illness is mild and does not become severe.

Asthma does not increase the risk of altitude illness. In fact, people with asthma often do well at altitude since there is less pollution in the air.

Prevention of altitude illness

The best prevention is slow ascent. In general, ascent of altitudes of no more than 1,000 feet (300 meters) per day above 10,000 feet is recommended. Upon arrival at altitude, you should avoid strenuous activity until you fully acclimatize.

Maintain fluid intake to avoid dehydration and follow the maxim, "climb high and sleep low." Avoid alcohol, cigarettes and sedatives (including narcotics).

Use of coca tea or coca leaves

The active ingredient in coca leaves is a mild stimulant that may help you stay alert and hydrated. This may make you feel better at altitude. Unfortunately, it does not prevent altitude illness.

coca.jpgGingko biloba or Viagra™ (sildenafil)

It is unknown whether these two medications are effective in preventing altitude sickness, and therefore, their use is not recommended.

Fitness level

Physical conditioning does not protect against altitude illness. Susceptibility is based on your body's response to altitude and is not reflective of aerobic capacity.

Treating altitude illness

If slow ascent is not possible or if you have a history of recurrent altitude illness, preventive medications may be needed. An example is Mt. Kilimanjaro (19,340 feet), which is often climbed in less than seven days.

Acetazolamide (Diamox)

The drug of choice to prevent altitude illness is acetazolamide. Take this medication 24 hours before ascent above 10,000 feet through 24-48 hours after you reach peak altitude. Avoid this medication if you have a history of sulfa antibiotic allergy, liver or kidney disease, or severe lung disease. Acetazolamide may cause tingling of the lips, fingers and toes, frequent urination, and a metallic taste with carbonated beverages.

Dexamethasone

If you cannot take acetazolamide, dexamethasone can be used. If you've had adverse reactions to steroids or have diabetes, this drug may not be safe for you. Dexamethasone can cause headaches, nausea, dizziness, abdominal pain, and can suppress your immune function if used over a long period of time.

Treating severe altitude illness

If symptoms of acute mountain sickness develop, you should stop your ascent, rest and get adequate fluids and calories. If altitude illness symptoms worsen, rapid descent to lower altitudes should begin as soon as possible. You should also see a medical professional.

Oxygen, use of hyperbaric chambers and medications may be needed.

Additional resources

 

Authored by: Hall Health Center Travel Clinic staff

Reviewed by: Hall Health Center Travel Clinic staff (AT), May 2014


Your guide to staying in tip-top physical and mental condition

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Just as regular maintenance is health insurance for your car, it is also health insurance for your body. Maintaining your health now will prevent you from needing major "repairs" later. Making healthy choices now will save you a lot of trouble in the future.


What is the ACL?

ACL stands for anterior cruciate ligament. It is one of the main ligaments of the knee, and prevents the shin bone from sliding out in front of the thigh bone.

Symptoms of ACL injury

An injury to the ACL happens when the ligament is over-stretched or torn. A tear may be partial or complete. These injuries can occur if you:


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What is the Affordable Care Act?

The Affordable Care Act, also known as Obamacare or the ACA, is a law intended to reform the health care system and make health insurance more affordable.  The law has gone into effect in stages.  For example, a provision that requires insurance to fully cover preventive services (like cancer screenings) was implemented in 2010, while the part of the law that stops insurance companies from denying people health insurance because of pre-existing conditions takes effect in 2014.

If you already have health insurance

Say you've already got health insurance.  How does Affordable Care Act affect you?  Well, there are a couple of ways:

  • If you're insured through a parent, you are eligible to continue to receive that coverage up until you're 26 years old.  That means that you've got more time to figure out the other Affordable Care Act provisions before you need to start arranging for your own coverage.
  • Your insurance now covers the full cost of some services that are meant to prevent illness, including birth control, regardless of whether your plan includes a deductible, co-insurance or co-pays.  These services include things like immunizations (like that pesky measles vaccine you have to get in order to attend college!), pap smears and birth control.  Even if your insurance has a deductible, or an amount that you have to pay out-of-pocket before your coverage kicks in, you won't be charged for these services.  Same thing goes for co-insurance (the percent of a service or visit that your insurance company normally makes you pay for) and co-pays (the amount you pay at your doctor's front desk or when you pick up a medication at the pharmacy).
  • If you're a graduate teaching assistant (TA) or research assistant (RA), and have the Graduate Appointee Insurance Plan (GAIP), expect expanded coverage for preventive care.  Otherwise, your benefits should remain mostly unchanged.

If you already have health insurance, you don't need to do anything new or different, unless your insurance company says so.  Be sure to read about the preventive services that are now fully covered by your plan, regardless of whether you have a deductible, co-insurance or co-pays. 

If you purchase student health insurance through UW

If you buy the Student Health Insurance Plan (SHIP) through the University of Washington, you should expect to find very little changed.  However, SHIP is subject to the same requirements as other health insurance policies, and therefore now fully covers preventive services like birth control and immunizations.  You can read about your benefits under SHIP here.

Please note that SHIP will no longer be offered starting Fall Quarter of 2015. Click here for more information.

If you don't have health insurance

Starting January 1, 2014, the Affordable Care Act will require everyone to purchase a health insurance plan, just like the government requires people who own a car to buy car insurance.  Fortunately, if you're a typical college student without much income, there are subsidies available to lower the cost of private insurance.  If you are low-income, you might be eligible for public insurance, also known as Medicaid, for which you would not need to pay. As you apply for the insurance through an online exchange, you will be prompted to enter income and demographic information. The system will determine your eligibility for Medicaid and subsidies based on this information.

Eligibility information for Washington residents

If you are an uninsured resident of Washington State, you may have two options:

Curious as to how much you might be looking at paying for your health insurance?  Here's a special calculator that estimates your monthly payment for health insurance (though keep in mind that you might be eligible for Medicaid if you earn less than 138% of the Federal Poverty Level).

If you enrolling in private insurance through the Washington Health Benefit Exchange, there are presently only three plans that are contracted with Hall Health Center and other parts of UW Medicine.  They are:

  • BridgeSpan
  • Molina Healthcare
  • Community Health Plan of Washington (CHPW-HIX)

If you find that you qualify for Medicaid (aka Washington Apple Health or DSHS), please be aware that we are contracted with these three plans:

  • Amerigroup Washington (AMG)
  • Molina Healthcare of Washington (MHC)
  • Coordinated Care Corporation (CCC)

If you enroll in one of these plans, you can receive care, including mental health services, at Hall Health Center.  We are not contracted with Community Health Plan of Washington and United Health Care Community Health or have limited services that we are able to provide.

Eligibility information for residents of other states

Depending on where you're from, your home state may or may not have its own health insurance exchange (a website set up to facilitate finding and purchasing a health insurance plan).  You can use the federal government's Health Insurance Marketplace to get routed to your state's exchange.  If your state does not operate an exchange, you can use the federal government's version to buy your plan.

Similarly, your state may not have opted to expand Medicaid eligibility.  Read more here about the Medicaid expansion.

International students

If you are a citizen of another country attending the University of Washington, you are required to enroll in the Student Health Insurance Plan (SHIP). You can read about your benefits here.

Other provisions of the Affordable Care Act

There are other elements of the Affordable Care Act that may affect you:

  • Starting in 2014, insurance companies can no longer reject you or charge you more because you have a medical condition
  • If you don't have health insurance at the end of 2014, you may have to pay a penalty (probably less than $100).  Take a look at this graphic to find out if the penalty could apply to you.

Additional resources

Online

Get help enrolling through a Patient Navigator (a health insurance expert).

Read about insurance and Hall Health.

Check out this cartoon-style infographic on what the Affordable Care Act means for young people.

The federal government's HealthCare.gov website offers lots of resources to help you make sense of the Affordable Care Act.

Washington State's Health Plan Finder is where you'll purchase health insurance if you need to buy an individual (i.e., not employer- or parent-sponsored) plan and are a Washington resident.

If you're not a Washington State resident, the federal government's Health Insurance Marketplace can help you purchase a plan.

 

Authored by: Hall Health Center Health Promotion staff

Reviewed by: Hall Health Center Administration staff, January 2014


An estimated one in ten U.S. adults suffers from depression.  Many people have their first experiences with depression while they're in college.  This article will help answer the following questions:


Picking the right shoe can be a daunting task for any runner.  Popular opinion about what type of footwear is best seems to change every few months.  Are neutral shoes actually better than supportive?  What about barefoot running?  What if you've been told that your feet pronate?


Antibiotics are medications that destroy bacteria or slow down their growth.  You might wonder about why your medical provider prescribes antibiotics for some conditions, but not for others. 

When you might be prescribed antibiotics

If you are diagnosed with a bacterial infection, your provider may write you a prescription for antibiotics.  Bacteria are microscopic organisms that can sometimes cause the following infections:


Hall Health Center has a number of different clinics, each of which is staffed by a variety of medical providers.  These providers, also known as clinicians, have different types of medical degrees.


Not sure whether to use ice or heat after an injury?  Use these guidelines to help you decide.


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