Ask an NP: Prof. Christian Simmers on How to Fall Back, Stay Healthy
Assistant professor Christian Simmers is a nurse practitioner at UVA Student Health and Wellness who, in her clinical work, sees dozens of UVA students each week. She offers commonsense advice about how to get and stay healthy in this back-to-school season, which poses some unique health risks to college kids, many of whom are new to Grounds.
Dorm room wellness essentials
“Advil and Tylenol, for sure. Unless you have a medical contraindication to taking these, they’re great for aches and pains and fever reduction. Antihistamines are important, too. Allergens don’t just crop up in springtime! Fall allergens plague many of us, and antihistamines can provide major relief. Invest in a thermometer, so you’re not guessing whether you have a fever.
“And finally, home COVID tests are important to have, too, so you know what you’ve got and how to behave if you test positive. Remember COVID is still circulating and if you’ve got it, you need to avoid contact with others, stay home from class, and get rest. Masking is important in public spaces for five days after you are fever-free, which gives the virus levels time to drop and be less transmissible to others.”
Hats off to skin care
“I advocate that people wear sunscreen all the time—summer, fall, winter, spring—and always remind people to think about covering their heads. A lot of young people forget to do that! A good hat is essential because, even if you have a nice head of hair, which is a little protective, sun damage to your scalp is easy to get. Ditto with the tops of your feet, even in fall, even as it gets cooler.”
“My rule for my kids is, if it has wheels and moves, you must wear a helmet."
Riding things with wheels
“My rule for my kids is, if it has wheels and moves, you must wear a helmet. Whether you’re riding a scooter up to a neighbor’s house or on an ATV—which are terrible, by the way—you must protect your head. In my practice, seeing students who have electric scooter accidents is enough to make me want to ban them all together. Even when they’re doing all the right things, like wearing helmets, obeying traffic signals, and going the speed limits, you can still hit a pot hole and face plant or get hit by a car. A helmet’s an easy to prevent head injuries . . . but there’s a lot more of your body that’s exposed and it’s an unfair fight if you get hit by a car.
“If you can avoid scooters, please do. And if you use them, never, never ride with someone who’s impaired, or if you’re impaired yourself.”
From ticks to spider bites: Keeping bugs at bay
“There are definitely ticks on Grounds! When it comes to them, the best prevention is to wear long clothes that cover the body. There’s mixed reviews about bug sprays, and whether they work, and they tend to potentially run the risks of having side effects and so aren’t always the safest. Some folks rub DEET all over themselves and swear they’re fine . . . I’m a bit more cautious with things like that, though, because while you don’t want to get a bug-borne disease, you don’t want to get sick from chemicals, either. There’s evidence that DEET, for instance, may cause some long-term neurological effects with prolonged exposure. There are all-natural sprays, of course, that may be good alternatives. My rule of thumb is, if you can pronounce the ingredient list, it’s probably a good sign.
"You don’t always know whether a bite comes from something virulent, but a lot of times, the body’s reaction is your clue."
“If you go hiking, do a really good skin check afterwards: between the toes, at joints, and get a good friend to check your head. Ticks can’t transmit disease unless they’re attached for 24 hours or longer, so getting them off quickly and efficiently is key.
“And if you find one, the first thing to do it to try to remove it in one piece. There are mixed reviews about whether you should save the dead tick or freeze it and bring it with you to your provider . . . I’ve never, in my practice, sent a tick off to be tested because if you suspect a tick bite, I’m going to treat you in the same way, regardless. Testing ticks is also kind of expensive, and the treatment for tick-borne diseases is doxycycline, which is a well-tolerated antibiotic. So, if you have a tick bite and no symptoms, you just take one dose and you’re done. If you develop symptoms, though—maybe muscle aches, a rash, or a fever—you stay on the antibiotics for 10 days to two weeks.
“There’s a lot of stuff on TikTok about developing an allergy to mammalian meats after a tick bite . . . but not a lot of data that says we can prevent it, other than preventing tick bites to start. And we don’t, typically, automatically test patients for the alpha gal allergy, because it tends to be a diagnosis of exclusion. There’s some very advanced allergy testing we can do that’s really expensive. Usually, if you have an allergic reaction to food, we try to put you on an elimination diet to try to figure out what it is, especially if you’ve had a tick bite or presumed exposure, and you seem to be reacting to meat.”
“With the return of students come the return of parties, and alcohol is often a part of these. If you’re planning on drinking, hydrate really well, before and during any alcohol intake, especially when it’s hot, as it sometimes can be in fall. Alcohol dehydrates you, so it’s critical that you keep your body well-watered. Students also need to ensure they’re in safe spaces, and travel in groups. Watch out for one another!”
Tending bites . . . and when to worry
“Spider bites are definitely more common in the summer and fall because people are spending more time outside, so exposure risk is greater. I tend to worry less about the bite and more about the body’s reaction to it. You don’t always know whether a bite comes from something virulent, but a lot of times, the body’s reaction is your clue. A more aggressive spider bite usually elicits a bigger reaction: bigger than, say, a mosquito bite will. If you develop flu symptoms after a bite, if could be something scarier, like West Nile virus or another bug-borne virus. If you get a lot of itching, swelling, or if there’s drainage coming out of the bite, you definitely need to seek care, and potentially get some antibiotics.
“In the short run, apply ice, use an over-the-counter pain medication if the bite site is painful or tender. If starts having signs of infection, with purulent (puss-filled) drainage or gets super swollen, that’s a sign there’s infection under the surface. If it’s just a little itchy, or there’s swelling with clear drainage, you can use a hydrocortisone cream to take care of it.”
Alcohol use
“With the return of students come the return of parties, and alcohol is often a part of these. If you’re planning on drinking, hydrate really well, before and during any alcohol intake, especially when it’s hot, as it sometimes can be in fall. Alcohol dehydrates you, so it’s critical that you keep your body well-watered.
“Students also need to ensure they’re in safe spaces, and travel in groups. Watch out for one another!”
Going barefoot
“It’s very poetic to run through the grass, especially in summer and fall, which is lovely, but, after you do those kinds of things, do please check the bottoms of your feet to be sure you didn’t cut yourself or step into something or that there’s worms trying to burrow under your skin. Certainly, if you have diabetes, your feet should be covered all the time. Check carefully for ticks and bites and things like that. If you’re hiking, wear proper footwear: it hurts a lot less to get bitten by a snake through a closed toe shoe.”
Giving yourself grace
“I hope students will, now that summer’s waning, give themselves some grace and time to recalibrate, now that they’re back. We’re all starting something new, and together, which is different than what we were used to: give yourself space and grace to adjust to the changes.”
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Ask an NP is a regular feature from UVA School of Nursing that features faculty experts on a range of clinical topics. The series supports the School of Nursing's 10-year Strategic Plan, Our Extraordinary Future, and goals 2 ("Co-Create and enhance partnership to improve health and healthcare") and 4 ("Cultivate trust and equity in all that we do.")