Emily Delnicki was in her sophomore year in a New York City college when she woke up one morning with the worst stomach pain in her life.
"I had no idea what was going on," she said. "My roommate wasn't there. I could barely stand up. I felt so sick."
The Williamsville native did what most students do when something goes wrong away from home. She called her mom.
Delnicki then went to the campus health center. After a two-hour wait, she was told the staff was too busy to see her. She called her primary care doctor in Western New York, waited for the physician to finish with a patient, and then was told she should go to an emergency room.
"They thought my appendix may have burst," she said.
The wait, confusion and discomfort lasted more than four hours before health providers diagnosed her with a ruptured ovarian cyst that would heal on its own. They sent her home with Tylenol.
"The whole thing was a nightmare," she said.
Delnicki may have saved herself some pain and uncertainty with tools that are available to students who live away from home at college. But in the bustle of preparing for school – particularly freshman year – prep for potential health and safety challenges often takes a back seat.
“Health care planning is not as much fun as deciding how to decorate a dorm room, but it’s much more important when you have a child who is heading off to college for the first time,” said Dr. Richard Vienne, father of three and Univera Healthcare vice president and chief medical officer.
Regional health experts and insurers offered the following tips to prepare for medical and safety emergencies at college.
Many students head to college having only seen a pediatrician through the course of their lives. If they have yet to find a primary care provider who treats adults, the time to do so is now – even if they have to wait to see one at home while on a school break, said Peter Kates, a Univera spokesman.
Students should create a checklist of things they might need at school in case of a sudden illness, including pain relievers, bandages, antacids and antibiotic ointments.
Delnicki, 21, transferred to Ithaca College after her sophomore year and starts her senior year next week. After her health scare, she put together a folder with pertinent medical records.
College students – and parents – may find it easier to put information on their cellphones.
"My phone is like my file cabinet," said Kates, whose daughter will start her senior year in high school next month. He, his wife, and daughter all have emergency contact numbers in their smartphones, as well as lists of allergies, health insurance information and contact numbers for the doctors and pharmacy they use.
Dr. Deirdre Wheat, associate medical director for quality, disease and case management with Independent Health, recommended students also store a photo of their health insurance card – front and back – on their smartphone, as well as contact numbers for a doctor at home and their insurance company's toll-free customer service number. Students also should take the time when they arrive on campus – or beforehand if possible – to store phone numbers for pharmacies and health providers in their college community, as well as the campus emergency number (many are different from 911).
KNOW YOUR INSURANCE
Insurance – whether a student is on a parent's health plan until age 26 or not – often works differently if college and home are in separate regions. Check with your insurance carrier to know your deductibles and copays, particularly if your health plan reverts to out-of-area coverage, officials with BlueCross BlueShield of Western New York said.
If you or your parents aren't sure, call your insurer. You'll also want to check, in advance if possible, which pharmacies and laboratories near campus or your college residence will accept payments from your insurance plan.
Also make sure any health forms required by your college are filed in a timely fashion. At the University at Buffalo and some other schools, for instance, failure to do so could involve the school charging for a separate health insurance policy.
LEAN ON THE PROS
Buffalo Medical Group is among practices in Western New York that has revamped its website and established other computer-based help for patients and prospective patients, whether at home or out of town.
Patients with the Amherst-based practice can download a MyBMGChart on their computer or smartphone to access their electronic medical records, including doctor visit summaries, medication lists and past medical test results. The patient portal – which serves about 135,000 patients – also will for a flat $20 fee allow patients to share information about symptoms they are experiencing and within 24 hours get a diagnosis from a doctor, as well a prescription if needed – including out of town – said Angela Caterina, the medical group's supervisor of IT and applications.
Students also can give their parents access to their medical records in the event of an emergency while away at school, Caterina said.
Many schools also allow, or encourage, students to give access to their medical information for the same reason.
"I think the fuzzy area for students is, 'When do I use an urgent care center?'" said Sue Snyder, director of Health Services at the University at Buffalo. "They're sick, but maybe not sick enough to go to an emergency room. Family is a phone call that they'll make. At UB, we have a 24-hour nurse service that allows students to get advice and recommendations."
The three largest regional insurers – BlueCross BlueShield of Western New York, Independent Health and Univera Healthcare – also have begun encouraging students and others to start with a telemedicine visit if they experience discomfort and wonder if they should visit a student health center, urgent care center or emergency room.
In many cases – think upper respiratory infection, pink eye, or urinary tract issues – a doctor or health professional can see you during a laptop or smartphone conference, ask questions, provide advice, and send a prescription to a preferred pharmacy.
"As a college student without a vehicle, who lived on the other side of campus from the health center, telemedicine would have definitely helped," Delnicki said about her illness in New York City.
Most insurers cover telemedicine visits as they do doctor visits, with those they insure paying the same copay.
Health insurers also have information on their websites and mobile apps to help student members and others order new ID cards, and access doctors, treatment plans and wellness tips.
EXPECT SOME BUMPINESS
"On the first visit to a health center, most students are a little overwhelmed," Snyder said. "This could be the first time they're making their own doctor's appointment. It could be the first time they're going to a doctor without a parent. For a lot of our students, this is the first time they're accessing care in the United States. There could be a language barrier. There's certainly a concern from the vast majority of our students about financial burden – 'If I do this, how much is it going to cost me?'"
Preparation can help improve the experience, Snyder said.
Students often can grow homesick while away at college, she added. The college years – especially freshman year – can ratchet up unfamiliar stress and, in rare cases, contribute to the onset of mental illness. School counseling centers can be valuable in all of these cases, Snyder said, and parents can encourage their children to see such centers as resources.
"Watch for warning signs of someone's behavior that has significantly changed," she advised, including a sense that a student is withdrawing from friends and family. "Early help is good," Snyder said, adding that counseling centers will talk to parents, faculty, staff and other students with concerns, including how they can help someone they believe is struggling.
SCHEDULE A WELL VISIT
Students with diabetes, chronic gastrointestinal issues, asthma, allergies and mental health conditions are encouraged to schedule a well visit at UB Health Services – but all students are welcome to do so. "We would love to see them," Snyder said. "It could save time later if you already feel comfortable coming in."
Where is the health center? What does it look like inside? Who's going to talk to me? What questions are they going to ask? What information do they need? "Those are all great things to learn before you're sick," Snyder said.
BE UP TO DATE ON IMMUNIZATIONS
This is particularly important for students who plan a semester abroad, although all can benefit. UB is among colleges with a sizable international student population and can lead the effort in helping any student prepare for such travel. Snyder said the school – and many others – also offer supplemental health plans that can cover potentially large costs for medical care overseas or to bring someone back to the U.S. for medical care.
"Campuses sometimes have this insular feel but students need to pay attention to their surroundings," Snyder said. "They don't need to take unwarranted risks and be distracted. Keep your head up and off your texting. Take at least one ear bud out of your ear so you can hear what's going on around you. Walk with friends. Call someone as you walk, so someone knows where you are."
If it doesn't happen automatically, sign up for your campus emergency notification system. Most college also offer safe assistance escorts and "blue light" emergency phones across campus.
Parents and students also should try to agree how often a phone call will take place between them – for safety reasons, if nothing else. It's easy for "an expectation difference" to develop otherwise, Snyder said.
Students away from home for the first time can enjoy their independence but also may need to weather temptations that will include poor nutritional choices, staying up too late, or peer pressure to smoke, drink alcohol or partake in illicit drug use.
College surveys routinely show that most college students do not use drugs or drink heavily. Healthy meal options also have become mainstays on college campuses, Snyder said.
Still, choice abounds. It's up to students to moderate their eating, avoid sugar- or caffeine-laden drinks, include energy-building and stress-busting exercise in their weekly routine – and find healthy ways to build bonds on and off their college campus.
"Get out of your own space," Snyder said. "Go to class – because you find like-minded people in class – and participate in class." Engage with students in your classes or living quarters. Join a club or two. Explore what works for you.
What to pack
– Digital thermometer
– Acetaminophen or ibuprofen for pain, fever
– Allergy medication if needed
– Antacids and antidiarrheals
– Contact lens solution and eyeglasses
– Cool mist humidifier for winter months
– Feminine hygiene products
– Heating pad or hot packs
– Portable ice packs
– Prescription medication – and a secure place to store mood stabilizers, sedatives, stimulants or pain relievers
– Topical antibiotic ointment
"This is great for a student to leave home with but also great for a care package to send during the first couple weeks of school," Snyder said.
What to put on your phone
Parents and children should input the following names and contact numbers into their smartphones:
– Emergency contacts
– Primary care physician
– Pharmacy at home
– Prospective pharmacy at school
– Campus Safety (many are different from 911)
– College health clinic
– Local urgent care or emergency room nearest college residence
– College counseling center
Sources: University at Buffalo, Independent Health
TAKE TIME TO TALK
Parents and families are important messengers when it comes to underlining healthy choices that can be made during the college years, Snyder said.
Students are 20 times more likely to move into a healthier drinking pattern if parents in the weeks before college talk with them frankly – including about not drinking.
UB Wellness Education Services and Snyder recommend conversation starters that include:
– “Most students drink to ease social situations. There are other ways, including…”
– “Let’s talk about peer pressure. How can you respond if someone offers you a drink you don’t want?”
– “Alcohol impairs motor skills, thinking skills and consent.”
– “What would you do with your beverage if you want to dance or need to use the bathroom?”
– “Have you ever had to step in or intervene in a situation? How did you feel? What did you do?”
– “What do you think a healthy relationship looks like? How do you think you’d know if you were in a relationship that wasn’t healthy?”
“It’s not too late to have these conversations even when you’re helping your child pack,” Snyder said.
Students and parents can agree to listen, remain patient and be non-judgmental during these conversations.
Twitter: @BNrefresh, @ScottBScanlon