BreAnne Gendron, NP, knows all about the effects of gastroesophageal reflux disease, or GERD. She eventually had to give up coffee because it caused a burning sensation in her throat.

As a nurse practitioner with OSF HealthCare, Gendron also treats patients who experience GERD in different ways.

“GERD probably feels a little bit different for everybody, but it definitely helps [to understand patients' experience] when you have personal experience with it,” she says. “Sometimes people with GERD have a flare-up and their stomach hurts, but they don't get that acid-up-the-throat feeling. It just causes stomach discomfort. Sometimes it changes bowel movements. Everybody has a slightly different version of it.”

Occasional heartburn or acid reflux is common. But when those symptoms happen frequently – two or more times a week – it could be a sign of GERD and worth mentioning to your health care provider.

Symptoms can include regurgitation, trouble swallowing, a feeling of a lump in your throat, a persistent cough, a sore throat or heartburn that doesn’t improve with over-the-counter medication.

Gendron says people who are 50 and older and overweight are at highest risk for GERD. Heartburn is one of the most common symptoms of GERD. But how do you know if that burning sensation in your chest is simply reflux or something more serious, such as a heart problem?

When chest pain shouldn't be ignored

Gendron says patients will sometimes go to the emergency department because they are experiencing chest pain. While some people may wonder if they are overreacting, Gendron says it’s always better to have potentially serious issues addressed.

“If it’s the first time you're having chest pain, we can't just guess, ‘Oh, that's probably acid reflux,’” she says. “You have to go in and be seen to rule out a cardiac reason, because that's what we do in health care. We rule out the scary stuff, so we can treat the treatable stuff.”

Even people with a history of GERD should pay attention when their symptoms change. For example, if chest discomfort occurs during physical activity, it could be a sign of a heart problem and should be evaluated.

“I would say any time you have activity where you're carrying in the groceries or you're going up a couple flights of stairs and that pain happens, that's not a GERD symptom,” Gendron says. “That's a cardiac symptom, and your doctor can help you figure that out. It's worth a conversation if you're having reflux feelings that are different than normal.”

If you experience new, severe or unexplained chest pain, especially with symptoms such as shortness of breath, sweating, nausea, dizziness or pain that spreads to the arm, back, neck or jaw, seek emergency medical care immediately.

Knowing your GERD triggers

Once anything serious has been ruled out, lifestyle changes can help manage GERD symptoms.

Common triggers can include spicy or fatty foods, citrus or tomato-based foods, caffeine and soda, alcohol, nicotine and heavy or late-night meals.

Gendron says there isn't one diet that works for everyone with GERD. Instead, people should pay attention to which foods trigger their symptoms and make adjustments as needed.

“Some foods will bother people,” she says. “I hear people complain to me a lot about things with tomato sauce, so pizza and spaghetti and things like that bother people with acid reflux. So, you can augment your diet. You can cut back on coffee. You can cut back on your nicotine.”

Medication can also be used to treat GERD when lifestyle changes aren't enough. But Gendron says she prefers to start with lifestyle changes if possible.

For her, that meant giving up her favorite morning beverage.

“I personally had to give up coffee because of this problem. I know if I don't drink coffee, that my whole digestive tract is happier,” she says. “So, people will figure out which foods bother them, and then you have to avoid those.”

Interview Clips

Why this is important

Lindstrom says the liver plays a critical role in our metabolism.

“It helps process nutrients, break down fats and medications and detox alcohol. It’s also important in regulating blood sugar and cholesterol,” she explains.

Fatty liver, where healthy cells turn into fatty cells that can’t do their job as well, is a common problem with the organ. It impacts around one in three people and is the top reason for women having liver transplants in the United States, Lindstrom says. Excessive alcohol use, hepatitis C, obesity, diabetes, high blood pressure, high cholesterol and insulin resistance can all contribute to fatty liver.

“The troubling thing with fatty liver is that most of the time, people don’t have symptoms,” Lindstrom warns. Unchecked fatty liver could lead to liver scarring, liver failure and even death.

Learn more

Read more about gastrointestinal health on the OSF HealthCare website.

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It won’t be long before it’s the Fourth of July and we hear the whistling and thunderous booms of fireworks streaking through the sky.

And while “consumer” fireworks such as bottle rockets, skyrockets and roman candles are illegal in Illinois, according to the state’s Pyrotechnic Use Act, others are considered non-consumer fireworks including sparklers, smoke bombs and party poppers.

But that doesn’t make them completely safe.

In 2023, the United States Consumer Product Safety Commission (CPSC) received approximately 9,700 reports of injuries and eight deaths because of fireworks. And it’s not just injuries that happen on July 4. According to CPSC, 66% of injuries happened before and after the holiday.

Stathis Poulakidas, MD, the burn center medical director at OSF HealthCare Saint Anthony Medical Center in Rockford, says the number of injuries reported is probably low, given the number of people who don’t immediately seek treatment.

“The simplest of fireworks, which anybody would think is a sparkler, can burn up to 1,800 degrees,” says Dr. Poulakidas. “The first thing everybody wants to do is hand the baby the sparkler and say, ‘go ahead. Run around and have a good time.’ But then it falls to their shoes, they burn horrifically. So not even the simplest of fireworks is safe.”

Another problem is the combination of adults drinking alcohol while handling fireworks. Dr. Poulakidas says this lethal mix puts you and those around you at your gathering in danger. “I see more adults than I see children with firework injuries,” he says. “The only children we see are the ones that are too close to the actual fireworks, as the adults are manipulating them while intoxicated. Then the fireworks injure the child.”

According to the CPSC, 41% of the injuries were to the head, eyes, face and ears. Another 35% are hands and fingers; 42% of injuries were burns.

That’s where Dr. Poulakidas comes in. In the burn center, he sees some of the worst injuries because of fireworks mishaps. He calls it the blast effect, which can severely injure intestines, eyes and rupture eardrums, given the proximity of the fireworks and the loud explosion. “We'll see minor burns to the hands, to the face. We'll see digits or fingers get blown off,” he says. “We've seen whole hands blown off and people lose arms.” (2:25-2:36)

And if clothing catches on fire, Dr. Poulakidas says there’s a greater likelihood of second degree burns to your chest, arms and legs, which could lead to treatment options that include skin grafting.  

Bottom line: Dr. Poulakidas encourages people of all ages to have fun this year. But sit back, watch the spectacle and let the experts handle the fireworks. “We want everybody to use good judgment and safe measures to prevent injury,” he says. “Because I think prevention is the key, instead of dealing with an injury after something has occurred.” 

Fireworks Safety Tips (courtesy of CPSC)

·         Never allow children to play with or ignite fireworks, including sparklers.

·         Make sure fireworks are legal in your area before buying or using them.

·         Keep a bucket of water or garden hose handy in case of fire.

·         Never try to re-light or pick up fireworks that haven’t fully ignited.

·         Never use fireworks while impaired by drugs or alcohol. 

 

Interview Clips 

B-roll 

When Gordon Ramsay raises his voice, it’s usually about an undercooked dish.

But in 2024, the celebrity chef was calling for help after a scary bicycle accident.

“It really shook me,” says the avid cyclist in a June 15, 2024, Instagram post. “Honestly, I’m lucky to be here.”

Ramsay says he didn’t suffer any major injuries, but he’s bruised and on the mend. And he’s again joining health care professionals in stressing the importance of wearing a helmet and biking within your means.

“I don’t care how short the journey is,” Ramsay says.

Biking accidents in the emergency department

Kurt Bloomstrand, MD, an emergency medicine physician who sees patients at OSF HealthCare, has treated people who have fallen off a moving object. It could be a bicycle, scooter or motorcycle. Sometimes it’s a child who’s learning their way. Or it could be an adult who didn’t hit the brakes in time.

“A lot of times what happens is they fall off the bike, put their arm out to protect themselves and injure their arm,” Dr. Bloomstrand says.

“But most importantly, we also see head injuries. We know that people who get in a bike accident have better outcomes if they’re wearing a helmet. People that are not have a higher risk of head injuries and traumatic brain injuries,” he adds.

Those head injuries are not something to take lightly, Dr. Bloomstrand says. Traumatic brain injuries can result in lifelong complications or death.

“When we see people in the emergency department who have suffered from a bicycle accident, we’re going to do a rapid trauma assessment,” Dr. Bloomstrand explains. “We’re going to pay special attention to the head. We’re going to make sure there are no signs of skull fracture or neurological abnormality. Depending on the severity of the injury, we may do a CAT scan [also called a CT scan] to make sure there’s no internal injury like bleeding on the brain. Those internal injuries are life-threatening emergencies that need to be addressed quickly.”

Advice

Check these off your list the next time you get on a bicycle or something similar:

• People of all ages should wear a helmet while biking. Young kids who are learning to ride should also wear knee elbow pads.
   
• Long shirts and pants and closed toe shoes (not sandals) are better than bare skin if you fall and skid on pavement (commonly called “road rash”).
   
• Be alert when riding. Don’t ride while tired or under the influence of alcohol or drugs. If you’re listening to music, consider having one ear free so you can hear your surroundings.
   
• Don’t ride above your means. Choose a speed and terrain that fits your skills.
   
• Keep your bike in good condition and configured to match your height. Your feet should touch the ground when seated. This should be true for all ages. A child should not “grow into” a bike. 
  
  At night, a headlight, reflectors, flag and a horn help you to be seen and heard. Bright-colored clothing also helps your visibility at night.
   
• Look closely before crossing an intersection, and obey all traffic laws. This typically includes riding on the right side of the road. Use universal hand signals: left arm straight for a left turn, left arm bent up for a right turn and left arm bent down for a stop. Make eye contact with the driver of a vehicle before passing in front of them.
   
• One person should ride a bike at a time, and keep both hands on the handlebars. Put items like books in a backpack or basket. Don’t try to carry items and ride.
   
• If you or someone you’re with suffers a bike injury, call 9-1-1 immediately.

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Warm weather means more outdoor activities involving alcohol.

The dangers

How quickly can binge drinking turn problematic?

“Very easily,” says Andrew Zasada, MD, an internal medicine physician who sees patients at OSF HealthCare.

Dr. Zasada says for women, binge drinking is defined as five or more drinks on one occasion, like a night out on the town that lasts three to four hours. For men, it’s 15 drinks. That takes into account the differences in how men’s and women’s bodies metabolize alcohol.

Dr. Zasada says the internal issues linked with excessive alcohol use can be devastating.

“It can cause brain dysfunction. It can cause liver disease and stomach ulcers,” Dr. Zasada says. “It’s just not a good thing. It can cause a wide variety of problems.”

Not to mention the outward symptoms like: acne, redness on your nose and palms and dry, wrinkled skin that makes you look older. And drinking during pregnancy can lead to a host of problems for the child, like facial abnormalities and developmental deficits.

“A lifetime of misery” for the little one, as Dr. Zasada puts it.

Safety, recovery

Just like there’s no magic way to prevent or cure a hangover, there’s no magic number of drinks to have on a night out that will make you immune to alcohol problems. But for spring and summer revelers, Dr. Zasada has this advice: take it slow.

“If you’re an average size gentleman, probably a beer an hour is just about the max you can drink,” he says.

Dr. Zasada says are there many ways to help people who are drinking in excess. In the short term, such as during a party, call 911 if the person needs immediate medical attention. If they just need a break, take the person away from the clatter to rest. Take their car keys, and give them some water. A painkiller like Tylenol in appropriate doses can help with that hangover headache the next day.

Long term, a patient’s primary care provider can link them with resources to curb drinking, such as Alcoholics Anonymous or treatment centers. The National Institute on Alcohol Abuse and Alcoholism also has resources. And within OSF HealthCare’s footprint, Illinois and Michigan have phone numbers to call for behavioral health issues.

“If the person is trying to deny that they drink at all; if they are drinking alone when there is nobody else around; if they're trying to hide or cover up their drinking, those are all fairly serious warning signs that this person needs help,” Dr. Zasada says.

Dr. Zasada says it’s never too late to kick the habit of excessive drinking, but sooner is better.

“It's easier to mitigate any problems that have already occurred earlier, rather than wait for the problem to get very, very serious, very bad, and then quit,” he says. “Yeah, you'll get better. But you won't go back to what you were.”

That “getting better” looks like a lot of things.

“You might lose weight. You might lower your blood pressure. It may increase heart health,” Dr. Zasada says. “You'll think clearer. You'll sleep better.”

Interview Clips

Scientists are constantly learning more about cancer – what causes it, how it impacts our body and how to treat or cure it. One study has looked at a possible link between frequent drinking of hot beverages and an increased risk of esophageal cancer.

So should coffee drinkers worry? Not drastically, but you should always be mindful of what you put in your body, says Edie Krueger, MD, [pronounced EE-dee // KREE-ger] a radiation oncologist at OSF HealthCare.

“The science behind it is that there’s thermal injury to the lining of the esophagus, or the tube that connects the mouth to the stomach. The thermal injury causes the cells to become aberrant [not normal, in other words] and grow on their own without any checkpoints. That’s basically what cancer is,” Dr. Krueger says.

So what should people do? Dr. Krueger says if you’re a morning coffee or tea person, that’s fine. But if you drink scalding hot beverages multiple times a day, consider changing habits. Let the drink cool off before taking a swig. The study mentions 65 degrees Celsius (149 degrees Fahrenheit) as a danger zone. That’s about the temperature when you get coffee right out of the pot, Dr. Krueger says. Also, swap the afternoon hot coffee or tea with another drink.

“Things in moderation are fine,” Dr. Krueger says.

Why it’s important

Esophageal cancer is not the most common in America (around 20,000 cases per year, Dr. Krueger says). But she says it’s a “tough cancer to treat,” underscoring the need to know about it and get treatment sooner rather than later.

She says there are two types of esophageal cancer. The most prevalent in America is adenocarcinoma. The other type, squamous cell carcinoma, is the one with a possible link to hot drinks.

“The symptoms, in general, are things like reflux or trouble swallowing - especially trouble swallowing things like bread or tough foods like steak or chicken. Just really hard to get food down,” Dr. Krueger explains.

“Usually, esophageal cancer is treated with what we call trimodality therapy. That’s surgery, chemotherapy and radiation,” she adds.

Avoiding alcohol, smoking and obesity are ways to help prevent esophageal cancer.

Learn more

Read more about cancer care on the OSF HealthCare website. Cancer care at OSF includes the OSF Cancer Institute in Peoria, Illinois.

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As women age, new adventures come. Some, like travel and new hobbies, can bring joy. Others can bring stress.

One of those stressors is perimenopause, the time you’re transitioning to menopause, when you permanently stop having menstrual periods and can no longer get pregnant.

“There’s a stigma around this time of life,” says Lindsay Orr, an advanced practice nurse at OSF HealthCare. “It’s not an illness. It’s just a natural part of aging.”

Perimenopause basics

Orr says during perimenopause, the ovaries stop producing testosterone, estrogen and progesterone regularly.

“Think of it as a short fuse or a fuse that’s not quite connected,” Orr describes. “Every month, the hormones secrete. But ovaries have a shelf life. So some months they work, and some months they don’t. It ebbs and flows during the perimenopause transition period before they go into menopause.” 

Orr says women typically notice changes that signal perimenopause at around age 40. The perimenopause period can be over quickly, especially if you have surgery that impacts your ovaries. On the other hand, Orr has seen some women be in perimenopause for 10 years. Regardless, health professionals define the perimenopause to menopause transition as over when you have not had a period for one year.

Orr says some women can have little to no perimenopause symptoms. For others, the time can bring disruptions to many parts of your life – work, sleep, relationships and more. Sudden hot flashes, mood changes, joint aches, brain fog, trouble with urination, anxiety, disrupted sleep and fatigue are all possible.

“A lack of estrogen can affect bone density,” Orr adds. “So women with smaller frames are more predisposed to bone issues if they fall. Or, a decline in estrogen can have cardio-protective effects. It can increase your risk for cardiovascular issues like heart disease.”

Anorexia, bulimia, high stress, smoking, drinking alcohol and being a high intensity athlete can also make perimenopause come sooner and be more intense, Orr says.

Treatment – proactive and reactive

Orr says if perimenopause symptoms are impacting your quality of life, it’s time to see a provider. Providers can’t make perimenopause go away, but they can help with symptoms. First, Orr asks if her patients are prioritizing what she calls the “four pillars of health”: exercise with resistance training, hydration, a healthy diet with plenty of protein and healthy sleep.

A provider might also recommend a supplement, such as diindolylmethane (or DIM, for short). Orr calls DIM broccoli in a pill. It helps keep hormones at a healthy level. Other supplements that could help include calcium D-glucarate, evening primrose oil, black cohosh and ashwagandha.

Orr also urges women to start the conversation with their primary care provider or OB/GYN before perimenopause hits. Ask what you can do now to lessen symptoms or duration. Be honest about how your body is feeling and what medications you’re on, as new medications could negatively interact with current ones. Orr also recommends women use a smartphone app to track their periods.

“The apps help you be in tune with your body. You go through your day-to-day life and kind of recognize things, but you don’t really put it all together. Then when you put the information in the app, you might say ‘Oh yeah, I am symptomatic. This is happening.’” Orr says. “You can track temperature changes, bleeding issues, hormone fluctuations and sleep. It all plays a role.”

What about pregnancy?

Yes, women can still get pregnant during perimenopause, though it’s not as common as pregnancies in your 30s and younger, Orr says. However, in general, Orr says the higher in age, the higher risk for pregnancy complications.

“Balanced hormones help maintain a good uterine lining for housing a fetus,” Orr explains, noting perimenopause disrupts that hormone balance. “So, a later-life pregnancy would require closer monitoring.” In other words, you’d likely have more trips to the doctor to make sure your pregnancy is healthy.

The bottom line

Orr reiterates: perimenopause is a part of life. Give yourself grace, take advantage of the help that providers can give and recognize that it’s about progress, not perfection.

“Some of the women I see are frazzled, disheveled and anxious. Sometimes they’re upset during the visit. It’s sad to see,” Orr recounts. “Then we start treatment, and I see them three months later. They look like a different person. They’re glowing. They have a zest for life again. It’s rewarding to see.”

Learn more

Read more about perimenopause and menopause and women’s health overall on the OSF HealthCare website.

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Though not one of the most common cancers, Marcie Lindstrom, APRN, says she’s seen liver cancer cases rise in recent years in line with national trends. Luckily, the gastroenterology provider at OSF HealthCare says treatment has evolved, too. And it’s another reminder to know your body and see your health care provider regularly because liver cancer is more treatable when caught early.

The liver: A recap

A primer on what the liver does for us: Lindstrom says the liver sits underneath the right ribcage and cleans toxins from our blood, helps digestion and produces proteins needed to live. In other words, it’s not an organ you can live without like a gallbladder or one kidney.

Liver cancer: Hidden and harmful

Lindstrom says primary liver cancer describes when the cancer starts there, and secondary liver cancer is when it spreads there (medical term: metastasizes), most commonly from the lungs, breasts or colon. Secondary is more common than primary.

“There are multiple causes of liver cancer. A person is at a higher risk if they have a damaged liver,” Lindstrom says. “Things that can cause a damaged liver include alcohol. So heavy alcohol use [is a risk]. Viruses that can infect the liver such as hepatitis B and C [are risks]. And we’re seeing an increasing number of people having fatty liver disease. That puts people at risk for liver damage. That damage can progress to cirrhosis [scarring], and cirrhosis puts you at a higher risk.”

These liver issues can be fatal if untreated. And unfortunately, Lindstrom says liver cancer often comes with no symptoms.

Diagnosis and treatment

That’s where regular visits to your primary care provider, and if needed, a specialist like a gastroenterologist or oncologist come in.

Lindstrom says your provider will go over your risk factors: do you have a family history of liver issues? What’s your own health history, specifically with hepatitis? How often do you drink alcohol? What’s your daily diet and exercise routine?

“If we determine somebody has a lot of scarring of the liver, they should be on regular surveillance looking for liver cancer,” Lindstrom urges. “Every six months, they should get some imaging and possibly a blood test that helps to detect cancer.” The person could also have a biopsy of their liver, where a provider will take a sample of liver tissue and send it to a laboratory to find out exactly what’s wrong.

Chemotherapy, radiation therapy, immunotherapy and liver transplant surgery are possible treatments.

“A liver transplant could be required if the tumor isn’t very large, but there’s a lot of damage or scarring of the liver,” Lindstrom explains.

Prevention

Lindstrom says if it’s caught early, liver cancer can be treated and even cured. Some things to keep in mind to avoid the disease:

• Eat a healthy diet, avoiding things like processed food, high sugar food and high fat food that can lead to liver issues.
   
• Get moving to avoid things like obesity, diabetes and high cholesterol. The American Heart Association says to aim for 150 minutes of exercise per week spread out over several days.
   
• If you do develop chronic conditions like diabetes, see your provider regularly to stay on top of managing the issue.
   
• Know your family history of liver and other health issues.
   
• Limit alcohol or avoid it altogether.
   
• There’s no vaccine for hepatitis C, but there is treatment. There is a vaccine for hepatitis B. The United States Centers for Disease Control and Prevention says the shots are safe, effective and have a schedule. Talk to a provider to see if you’re on schedule or if you need a shot now, for example if you’re at high risk.
   
• Take other steps to avoid hepatitis: practice safe sexual relations, avoid blood-to-blood contact with others and don’t share or reuse needles.
  
  “You have a history of blood transfusions prior to 1992. You got a tattoo or piercing in a less than sanitary situation,” Lindstrom lists as other hepatitis risk factors. “I’d recommend getting screened. In fact, it’s a current recommendation to be screened for hepatitis C at least once in adulthood.”
  
  Lindstrom says providers list 1992 as a hepatitis C benchmark because that’s when blood screenings were developed.

Learn more

Read more about how to keep your digestive system healthy on the OSF HealthCare website. Cancer care at OSF HealthCare also includes the OSF HealthCare Cancer Institute in Peoria, Illinois, which provides comprehensive care for the region.

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When talking about the good and bad of pregnancy, you might have heard terms like postpartum depression or, more casually, baby blues.

It’s critical new mothers get help in this area, says Tiffany Waters, a birthing center charge nurse at OSF HealthCare. She says up to 80% of moms experience the so-called baby blues. But when talking about maternal mental health, experts prefer the umbrella term: perinatal mood, anxiety and depression (PMAD). Perinatal refers to the time between conception and one year after delivery.

PMAD basics

Waters says for two to three weeks after delivery, most women experience hormone changes, a lack of sleep and general stress related to the “new normal.” Having a traumatic birth, like an emergency caesarean section, can compound mental health impacts. Waters says around one-third of women fall into this category.

All these factors can lead to a variety of longer-lasting PMAD symptoms, including brain fog, weeping, sleep changes, anxiety, depression, obsessive or compulsive behavior and even suicidal thoughts.

“There’s no one single cause that leads to a person experiencing these issues. It’s a combination of psychological, societal and biological factors,” Waters says. “There’s nothing a mom has done to get or deserve this experience. The best we can do is help her work through it.”

Screening and treatment

Waters says health care providers should screen a woman for depression and other mental health issues during and after pregnancy.

“There are commonly used tools,” Waters says. “The woman answers 10 questions. It gives us a rating on how their emotional and mental well-being is.”

She’s referring to the Edinburgh Postnatal Depression Scale (EPDS). Each question is scored 0 to 3, with 3 being the response that most signals a possible mental health issue. That’s 30 total points, and a final tally of 10 or higher would warrant further evaluation.

Waters also says research is ongoing into whether certain biological markers in a woman are a sign of mental health issues to come.

“It can be difficult to admit or even recognize that a person is having depression or anxiety symptoms,” Waters says. “There are lots of reasons for that. There’s societal pressure to be a great mom. Moms might feel like if they admit how they’re feeling, their children might be taken away.”

Waters says journaling or talking to a trusted adult can help a mom document the issues she’s facing, opening the door for her to get help.

If a mom is diagnosed with PMAD, a provider will talk with her about resources like support groups, counseling, spiritual care and medication. Daily things like improved diet and exercise and exploring new hobbies can also help. And Waters says mothers should not be afraid to prioritize themselves. It’s OK to ask for a break from daily housework, for example.

Why it’s important

Waters says untreated PMAD can have consequences for the whole family and the people around the family. Substance abuse and domestic violence can increase. But if treated, it means a better life for everyone.

“It will improve the whole family dynamic,” Waters says. “It will lessen stress for everybody and lead to a happier unit.”

Learn more

Read more about pregnancy and birth and behavioral and mental health on the OSF HealthCare website. If you are in crisis, the Suicide and Crisis Lifeline is 9-8-8.

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When watching a basketball game on television, you may hear coaches and announcers say the star player is missing time with a hernia.

A sports hernia is different than a hernia suffered in everyday life, says Raman Kumar, MD, a colorectal surgeon and general surgeon at OSF HealthCare. But each should be taken seriously.

Hernia

Dr. Kumar says a hernia is when an internal organ or piece of fat goes through a hole in the abdominal wall. The most common type – around 80%  – is an inguinal hernia, when a part of the intestine pushes through the abdominal wall in the lower belly (also called the groin). Anyone can get a hernia, even newborns. But Dr. Kumar says they are seen more in older men. Symptoms include a bulge or swelling in the abdominal area and pain when moving.

“A lot of chronic heavy lifting,” can cause hernias, Dr. Kumar says. “Other things weaken the abdominal wall such as diabetes and smoking. Being obese causes a lot of weight hanging down on the abdominal wall. If you’ve had surgery in the past, that’s also a risk factor.”

So be mindful when lifting objects, Dr. Kumar advises. Lift with your knees, not your back, and don’t try to lift heavy items. Get a cart or a partner to help. Eat healthy and exercise to avoid obesity and diabetes. Avoid alcohol and cigarettes.

Dr. Kumar says an exterior wrap known as a hernia belt or abdominal binder can be a short-term solution. But surgery is often the endgame.

“If you have a hole or defect, it needs to be closed,” Dr. Kumar says. “The reason we fix hernias is because we don’t want a loop of intestine or bowel to get into the hernia, twist off and die.”

That would make a person very sick and possibly threaten their life, Dr. Kumar says.

Sports hernia

Dr. Kumar says a sports hernia is a muscle tear in the groin area. They’re seen in athletes due to all the twisting, turning and bending that comes with competition.

“Stretch before you do any type of activity. Work and develop your core muscles, including your abdominal and hip muscles.” Dr. Kumar says. “If the muscles are strong, they are less likely to tear.”

Athletes who complain of groin pain should immediately leave the competition and get checked out by a trainer or doctor. Resting and icing the groin will help, but a combination of medication, physical therapy or surgery will likely be needed to fully heal.

Be proactive

If you have symptoms of a hernia or sports hernia, see a health care provider right away.

“Nine times out of 10, we can determine you have a hernia just based on a physical exam,” Dr. Kumar says.

But for more complicated cases, your doctor may order an ultrasound or CT scan. Then, the provider will develop a treatment plan.

Interview clips

Previous coverage

Hernias: More common than you think

November, December and January bring bountiful holiday meals.

While it’s tempting to chow down, experts are cautioning about how overindulgence can make you feel mentally and physically crummy in the moment, plus open the door to long-term unhealthy eating habits.

Have the right mindset

Andrew Zasada, MD, provides emergency department care at OSF HealthCare. He says avoiding stuffing yourself starts before you sit down for the meal.

“If you come to the meal hungry, you tend to try to make up for not having breakfast. You load your plate up, which is going to cause you to overeat,” Dr. Zasada says. “Instead, have a light snack an hour or two before you sit down to the meal.

“Put the food in one room and sit down in another room to eat. That necessitates you going there rather than having food available for another fill.”

The meal itself

Enjoy holiday meals, Dr. Zasada says. It’s not a race.

Grab a smaller plate, and take smaller portions of each item. Pretend you’re filling the plate up for a child. You wouldn’t take five rolls and two big slabs of meat for a youngster, so don’t do it for your adult self.

Other tips: Chew slowly. Between bites, put your utensil down, take a drink of water and talk to someone. This allows your stomach to fill up and tell your brain that you’re full.

When you finish eating, leave the table, and go to another room. Staying next to the food increases the temptation to keep nibbling.

If you can’t help it

Dr. Zasada says despite our best efforts, sometimes you overeat during holiday meals. Maybe you don’t want to offend your aunt by not having a slice of her famous pie.

If that happens, Dr. Zasada says there are two pitfalls to avoid: Drinking alcohol and lying down right after the meal.

“That opens up the sphincters of your stomach, slows down digestion and increases the chance for heartburn,” Dr. Zasada says.

Try tea or coffee after a meal instead of alcohol. But if you must indulge in a spirit, Dr. Zasada says to wait at least 90 minutes so your stomach can partially empty.

Instead of lying down for that post-meal nap, sit upright, talk to people or play a game. If the weather is nice, go for a walk.

A word on more serious eating issues

Holiday meals may be difficult for people who suffer from eating disorders, such as binge eating (eating a lot in one sitting and feeling you can’t stop), anorexia nervosa (an unwarranted fear of being overweight which leads to things like starvation) or bulimia nervosa (taking unhealthy steps to avoid weight gain like purging your food).

Dr. Zasada says, in the moment, you should have someone you trust who can help you through the holiday meal and check in with you later. Long term, he says these are serious issues that should be talked about with a health care provider.

“Repeated bulimia will damage your teeth. It’s corrosive. You lose electrolytes when you vomit,” Dr. Zasada says. “You become sick. If you do this repeatedly, you will lose weight in an unhealthy way. You will possibly dehydrate. You will start losing muscle mass.

“It’s just not a good thing.”

Bottom line: Don’t get discouraged

Dr. Zasada says one day of extra eating may make you feel bad, but it isn’t going to derail your overall health.

“One day won’t make you fat,” he says.

Get back into your healthy eating habits the next day while enjoying those leftovers in moderation. If you feel you are struggling to maintain a healthy weight or body image, talk to your primary care provider. They may refer you to a specialist like a dietitian or mental health provider. From there, plans could include a diet and exercise regimen, medication or, in rare cases, weight loss surgery.

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It’s the dead of winter, and you need to run to the mailbox or let your dog out. It’s just a minute, you think. A sweater and sandals will be fine.

Not so fast, says Maddy Draper, APRN, a health care provider at OSF OnCall who sees cold weather injuries often. She says exposure to frigid temperatures can have serious consequences.

Types of cold weather injuries

• Frostnip: Draper says this is a mild form of frostbite where exposure to cold temperatures turns the skin pink or red. Your skin may feel burning or numb.

“The numbness typically goes away with rewarming,” Draper says.

• Frostbite: This is a more severe case of cold exposure. Your skin may be numb and appear yellow, white, gray or black. It may feel waxy and have blisters.
   
• Hypothermia: This is when the body’s temperature drops below 95 degrees.

“There are different stages,” Draper explains. “The first is our natural response of shivering. It gets more severe. The person may get confused and have lethargy, memory loss and slurred speech. It can lead to a coma and death.”

Inside, too?

Yes, there’s a risk for these injuries inside, too, Draper says. Notably, there have been cases of infants getting hypothermia.

“The room may be too cold, and they’re not dressed appropriately,” Draper says. “If they’re in a bassinet or crib with just a onesie and it’s cold, that can lead to hypothermia.”

Signs of infant hypothermia are bright red skin and decreased energy. Sleep experts use a thermal overall grade scale (TOG) to suggest how much clothing a baby should wear to sleep depending on the temperature of the room.

Treatment

Draper says she usually sees cases of frostbite and hypothermia sent to the emergency department. Providers will rewarm you with warm water or blankets and may provide warm liquids to drink, warmed oxygen through a mask and nasal tube or heated fluids through an intravenous line (IV) or other methods. Medication can also help with pain and blood flow.

“The hospital has more imaging resources to see the impact of the tissue damage,” compared to urgent care, Draper says.

For frostnip, you can take steps to warm up at home.

“It’s not as fast as possible. It’s not as hot as possible. It’s just that gradual warming,” Draper says. “Get off your cool or wet clothes immediately. You don’t want to stick your hands or feet into hot, steaming water. Just warm water.”

That’s because hot water can burn your skin. And if your skin is numb, you may not feel the burn before the damage is done. If water is not available, you can place your hands in your armpits. And handle the sensitive skin gently. Don’t rub or massage it. If your feet are affected, get off your feet.

Prevention

Draper says older adults, people who work or do activities outside (like hunters or hikers), unhoused people and people with medical conditions (like peripheral artery disease, diabetes and Raynaud’s disease) are at a higher risk of cold weather injuries. Getting stranded in a vehicle without proper protection is also common in the winter. Drinking alcohol or using drugs may lead to you losing consciousness outside. And smoking impacts blood circulation, putting you at a higher risk, Draper says.

Some ways to beat the cold:

• Dress in layers. You can always take a layer off, but you can’t put one on if you leave it at home. Make a hat, scarf, gloves and winter boots part of your wardrobe. Make sure the clothes aren’t too tight to allow for blood circulation. And look for water-resistant garments when buying clothes.
   
• Have winter weather supplies, like blankets, flares, a first aid kit and food, in your vehicle.
   
• Be well fed and hydrated. Body fat, though unhealthy in excess, helps us stay warm. For drinks, avoid alcohol and caffeinated beverages.
   
• During outdoor activities, take breaks and go with a buddy. Keep a close eye on kids who may not realize how cold they are. Come inside to change from wet to dry clothes. Let others know your plans and when you’ll be back. If you’re not back in time, that’s a sign you may have fallen victim to the cold, and help should be sent.

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Emily Isom has a resolution for kids and their parents: pledge to keep your hands clean and away from your face to prevent the spread of illness.

Isom, a certified medical assistant in pediatrics at OSF HealthCare, often sees young people biting dirty fingernails and not washing their hands properly. Here’s a primer:

Nail hygiene

Isom says people of all ages should trim their nails regularly. Once a week for fingernails and once or twice a month for toenails is a good rule of thumb. In between trimmings, watch for dirt and other filthy matter caught under the tip of the nail. Some nail clippers come with a scraper tool to remove that debris. But don’t use your mouth to clean your nails.

“Our nails carry so many germs and bacteria. That’s how people keep getting sick and spreading illness,” Isom warns, referring to putting fingernails in your mouth or on your face. You can also chip teeth and get facial warts and pimples from putting nails on your face, she says.

Some people have long nails, either real or artificial. In these cases, use a nail brush to regularly wipe the nails clean. If you’re at work or school and don’t have a brush, wash the nails thoroughly. Lather warm water and soap on the palms of your hands. Take your fingertips and scratch against the palm of the other hand to get the soap in the fingernail. Do that for 20 seconds. Then, pull down the fingertips to the palm of the same hand and massage the soap in further. Put your hands upside down under hot running water to rinse.

Hand washing

Isom says most people concentrate on their palms when hand washing.

“You need to get in between the fingers, underneath the nails, on the back of the hands, rub your knuckles together and scrub your wrists,” Isom says.

After wetting your hands, scrub all those areas in soap for 20 seconds. Find a song that has a 20-second chorus and hum it while you scrub. Then, rinse under warm water, and dry your hands with a clean, dry towel. Isom also suggests wrapping a paper towel around your hand when touching dirty surfaces on your way out of the bathroom. Use the towel to shut off the faucet and open the door, then throw the towel away after you exit.

If a hand dryer is what’s available, run your hands under the warm air until they are completely dry. Resist the urge to dry halfway and walk out. Isom says that may do more harm than good and attract bacteria faster.

“Bacteria want to live on wet surfaces. They’re attracted to moistness,” she points out.

If a soap and sink aren’t available, Isom says to use sanitizer or wipes that are at least 60% alcohol based. The same process applies – lather or wipe all parts of your hand and wrist thoroughly.

If you have a cut or wound on your hand, like a paper cut, wash with care.

“Get a washcloth wet with warm water. Put soap on it. Then, clean around the cut or wound,” Isom says. “Don’t put [soap] directly into the cut. That could really irritate it.”

Convincing kids

Isom is a pediatrics provider and a mother. So, she knows getting kids to wash their hands and mind their nails is easier said than done. Her advice: make it fun.

“When handwashing, sing the ABCs for 20 seconds. Or have them sing to you.” Isom suggests. “Make a chart. Every time they wash their hands, have them put a sticker on the chart. They are going to fall in love with it and want to wash their hands over and over again.”

And remember Simon Says? Isom says it works with her daughter.

“Simon says don’t touch your face,” Isom says with a smirk.

Learn more

Read more about how to keep your hands clean and prevent the spread of illnesses on the OSF HealthCare and the United States Centers for Disease Control and Prevention websites.

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Breast cancer is one of the most common cancers in the United States, says Heather Thompson. And she would know. Thompson is a breast health navigator at OSF HealthCare, helping patients navigate appointments, insurance and more. And Thompson is, herself, a breast cancer survivor.

But what many in the cancer space might not realize, Thompson says, is that breast cancer can affect men. It’s rare, with 1% of men statistically getting it, Thompson says. But it’s worth knowing how to spot, prevent and treat it.

“There can be severe cases. A lot of times, men don’t notice things or worry about things like women might,” Thompson says. “The cancer is there longer and has a chance to metastasize [spread] and get into their lymph nodes. A lot of times, men will get gynecomastia. That can cause swelling in the breast tissue and a mass.” Those gynecomastia masses can limit a man’s ability to feel a cancerous lump, delaying care.

Breast cancer basics

Genetics (i.e. a family history of cancer), alcohol use and smoking all put you at a higher risk for breast cancer.

So do men need to do monthly self-checks and get mammograms like women are told to? Not always, Thompson says. You should talk with your primary care provider about a plan, especially if you have a family history of breast cancer. That plan could involve genetic testing or blood work to check estrogen levels (since estrogen feeds cancer cells). But day to day, Thompson says to just keep an eye on your breasts. Look for inverted nipples, lumps, redness or achiness.

“Men really do not require regular screening or imaging for breast tissue. That is not in the American Cancer Society guidelines or any other guidelines,” Thompson says. “However, men should monitor their bodies for anything irregular. Then, get it addressed right away. Don’t wait. You might be in that 1%.” Thompson adds that if any type of cancer spreads, it can be fatal.

Treatment for male breast cancer typically involves a mastectomy, or the removal of breast tissue, Thompson says. This could be after cancer is found. Or it could be preventive if you’re at high risk, like the case of actress Angelina Jolie.

“There’s not much tissue that a man has,” Thompson points out, allaying fears that your chest will look significantly different. She says you won’t have a nipple, and your chest will be flat. But that’s about it. “We will still test those lymph nodes during surgery to make sure the cancer hasn’t spread.

“After that, there’s special testing called oncotype,” she adds. This looks at the likelihood of cancer returning. “If it’s a high score, those people sometimes have to have chemotherapy or radiation.”

Changing minds

Thompson knows men can be apprehensive about seeing a doctor in general. But when breast cancer enters the conversation? She’s heard things like “I’m not a woman. I don’t need to worry about that.”

At OSF Moeller Cancer Center in Alton, Illinois, where Thompson works, she sees one to two men per month come in for imaging. Most, she says, are cases of gynecomastia that can be managed by the person’s primary care provider. But some do hear the words “It’s cancer.”

“I tell them they’re not alone,” Thompson says. “Other men have gone through this. We have a roadmap to treat it.”

Learn more

Read more about cancer care, specifically breast cancer care, on the OSF HealthCare website. Cancer care at OSF includes the OSF Cancer Institute in Peoria, Illinois.

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A federal panel recently advised women get a mammogram every other year starting at age 40, rather than 50.

And the American Cancer Society estimates that in 2023, nearly 300,000 women in the United States will learn they have breast cancer. About 43,700 women will lose their life due to the disease.

The headlines are reminders to know your breast cancer risks. While many risks are out of your control, there’s just as much you can control, says Heather Thompson, a breast health navigator at OSF HealthCare.

Major risks you can control

• Active lifestyle and healthy eating: Thompson puts it plainly. If you eat junk, you’ll feel like junk. And any exercise will give you more energy and burn fat. Fat produces estrogen, which feeds cancer cells.

“You want to make sure you’re well-maintained with your weight, even after menopause,” Thompson says.

• Taking hormones: This impacts your ovaries, reducing or adding estrogen. Whether you’re at a routine appointment or you have been diagnosed with breast cancer, talk to your provider about what hormones you’re taking.

“We don’t encourage people who are having menopause symptoms [like hot flashes] to take hormones,” Thompson lists as an example. “We encourage other things to help treat those. It eliminates those estrogen cells increasing.”

• Alcohol and smoking: They are a risk for any type of cancer. But Thompson says one drink per day can increase a woman’s breast cancer risk by 12%. Alcohol is sugary, and that’s a fuel for estrogen.
   
• Night shift work: Thompson says our body expects to sleep when the sun goes down. Night work throws that off.

                “You’re getting artificial light all night. That changes the melatonin that the body naturally makes,” Thompson explains. “When your melatonin is off, it increases estrogen.”

                If you don’t work the traditional day job, see if you can work different shifts so you are not up all night all the time.

Risks you can’t control

• Age: Thompson says women generally develop breast cancer at age 50 and above. 
   
• Family history and genetic mutations: A family history of breast cancer puts you at a higher risk. Thompson says the higher risk is often seen on the person’s mother’s side of the family. For example, your mother and her sister (your aunt) may have breast cancer, and so you’d need to talk to your provider about your risk.

              Some women diagnosed with breast cancer and who have a family history may undergo a genetic test.

“Those tests can tell us if this is something being passed down from generation to generation,” Thompson says.

• Reproductive history: Young women who develop menstruation before age 12 and women who go through menopause after age 55 have an increased risk.

“That gives them a longer time with their ovaries working. They’re producing estrogen,” Thompson says.

• Dense breast: More tissue and less fat mean a dense breast and an increased cancer risk, Thompson says. Usually, the younger you are, the denser your breast is. The density of your breast is something that will be noted on every mammogram result. Thompson says mammogram technology is getting better at finding cancer in dense tissue. An early diagnosis may mean a better outcome.

Takeaways

Make sure your health care provider knows about your circumstances so they can decide on the best preventive care, like a different schedule for mammograms. Some of the information to have handy: a family history of cancer and any physical change you noticed during your monthly breast self-check.

Learn more about breast health and breast cancer care on the OSF HealthCare website.

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Growing up on a farm a couple miles from the clinic where she works, Bethany Huelskoetter, APRN, knows the importance of playing it safe in a rural setting, whether you’re young or old. With National Farm Health and Safety Week coming up, Huelskoetter, a nurse practitioner at OSF HealthCare, says now is the time to review the basics of farm safety.

• Heavy machinery: For big equipment like a tractor or auger, know how to use it before you get in the driver’s seat. Know how to shut the machine off quickly in an emergency. When behind the wheel, know your surroundings. Go slowly and be very cautious in places like driveways where kids run around. Wear fitted, not loose, clothing.

“Machines have shafts and moving parts,” Huelskoetter explains. “You don’t want to have loose sleeves or something that can get caught in that mechanism and cause a catastrophic injury.”

• Driving smaller vehicles: Children and young adults are often found whizzing around a rural property on an all-terrain vehicle or motorbike. That can go south quickly, Huelskoetter warns. A passenger could be flung from the vehicle and get injured or killed.

              Wear a helmet and buckle the seatbelt. Don’t drive too fast, and don’t make sharp turns, especially on loose gravel. Sit in the vehicles the way they are intended. Don’t hang off the back or side. And never operate after drinking alcohol.

• Toxic materials: Farmers and homeowners often handle chemicals like pesticides. Huelskoetter advises reading the label so you know what you’re touching. The label should also tell you what protective equipment to wear and whether the product is toxic to pets.

The American Association of Poison Control Centers website has a national hotline and state-by-state resources for exposure to or ingestion of toxic materials. Huelskoetter says to have that phone number in your cell phone. When you call, someone will ask you basic questions about what happened and tell you what to do. You may be able to treat the issue at home, or the hotline may advise you to go to the nearest emergency department.

• Animal bites: Kids playing in nature may encounter “all kinds of crazy things,” Huelskoetter says. Bites from spiders, snakes and raccoons can happen. The first step, she says: clean the bite thoroughly with soap and water. Then, cover it with a band aid or clean cloth and go to the hospital.

“You never want to mess around with an animal bite,” Huelskoetter says. “Animals’ mouths are very dirty. So you want to start the bitten person on antibiotics quickly.”

Huelskoetter adds that while we view dogs and cats as domesticated, you never know if they have not been vaccinated and are carrying diseases like rabies.

• Heat: Two common heat illnesses are heat exhaustion and heat stroke. Huelskoetter says heat exhaustion generally describes when you overheat. Experts advise to move to a cool place, sip water and put cool, wet cloths on your body. If symptoms don’t improve or you start vomiting, call 9-1-1. Symptoms of the more serious heat stroke include hot, red, dry or damp skin, a fast, strong pulse, headache, dizziness, nausea and confusion. Call 9-1-1 right away. Untreated cases of heat stroke can cause permanent damage to organs or death.

                Some tips to avoid heat illness: Avoid being outside in the middle of the day. Take breaks in a cool area during the day. Keep a cooler full of water and drinks with electrolytes, like Gatorade. Sugar-free sports drinks are a healthier choice                     than the regular ones. Have some healthy snacks, too, like popcorn, pretzels or nuts.

“Whenever your body is sweating, it’s depleting its calories and energy,” Huelskoetter says. “So your body doesn’t just need water. It also needs nutrients to help you keep going throughout the day.”

• Be prepared: Work or play with a buddy. That way, someone is there if you get hurt. If you must go alone, let people know your plans before you leave for the day. Where on the property will you be? When are you expected back? If you don’t return at the right time, that’s a sign for your loved ones to look for you. Keep your phone charged in case you need to make an emergency call. Take a mobile charger with you. And if an emergency happens, call 9-1-1 and take an ambulance to the hospital. Don’t drive yourself or have someone drive you.

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“Mom! I have to go!”

“Hold it!”

It's an exchange you probably had as a kid on long car rides. But Uwais Zaid, MD, says it’s not just a funny vacation story. A person of any age or profession can find themselves holding their urine for a long time.

“In the medical field, we see this all the time,” says Dr. Zaid, a urologist who sees patients at OSF HealthCare. “When you’re rushing from patient to patient, doctors, nurses and technicians might not go to the bathroom as much as they should. They hold their urine the whole day.”

Dr. Zaid is sharing his playbook: why this phenomenon happens, how to fix it and what can happen if you don’t.

Why do we hold our pee?

Dr. Zaid says some people hold their urine simply based on the situation. They’re on a long car ride, and stopping will make them late. Or they might be at a dinner party and don’t want to seem rude by leaving the table.

“Then there’s another subset of people who just don’t have the desire to urinate. There’s something medically wrong,” Dr. Zaid explains. “As we get older, we can get dementia and be forgetful. So sometimes people just forget they need to urinate. Sometimes, you can have lack of bladder sensation from neurological conditions like multiple sclerosis. Or they might have had their bladder stretched for so long due to things like an enlarged prostate or scar tissue in the urethra.”

The consequences

In the short term, holding your pee will make you feel uncomfortable and antsy. We all know the feeling. Dr. Zaid has even heard from patients, “The feeling doesn’t bother me that much. What’s the problem?”

A few problems, the doctor says.

“It does increase your risk of urinary tract infections [UTIs]. Your bladder is almost like a swamp instead of flowing like a river. You have stagnation of urine,” Dr. Zaid says. “It can increase the risk of bladder stones. Also, the bladder is connected to the kidneys. It’s one fluid column. So if your bladder gets really distended, it can back up and hurt your kidneys. You can get kidney swelling.

“And when the bladder is chronically distended, you can get pouches called bladder diverticuli. Those pockets can hold on to urine and be sources for infection,” Dr. Zaid adds. Over time, these pouches can also lead to worse urinary control and even the inability to pass urine.

If holding your urine and not getting treatment for it lead to, for example, the kidney issues Dr. Zaid outlined, serious health problems and, rarely, even death are possible. Dr. Zaid says that shouldn’t scare people into drastically altering their bathroom habits. But it is something to be aware of.

Prevention and treatment

So what should be the best practices when we start thinking about the toilet?

• Before you even head for the bathroom, Dr. Zaid urges you to take care of your bladder and kidneys by staying hydrated. The U.S. Centers for Disease Control and Prevention (CDC) says daily water intake recommendations vary by person. So it’s a conversation you should have with your primary care provider. But, the CDC has general tips about staying hydrated and the dangers of drinking sugary or caffeinated drinks often.
   
• Plan ahead. For example, if you have a long commute, leave early to make time for rest stop breaks, and avoid drinks like soda. If you have a busy day at work, make a promise to yourself that you’ll take breaks to use the restroom. You can set a reminder alarm on your phone to nudge you.
   
• Try the “double void.”
  
  “You get to the toilet. You get done peeing. Wait 30 seconds, and then try to get a little more out,” Dr. Zaid suggests. “But don’t bear down and push because that creates trauma for your pelvic floor.”
   
• For older adults who might simply forget to use the bathroom, make sure they have someone checking in on them. Make sure they are empowered to speak up about their health. Setting an alarm reminder and having a clear path to the toilet can also help.

If someone consistently avoids or forgets to urinate or experiences symptoms like frequent UTIs, discomfort or difficulty emptying the bladder, it’s time to see a doctor.

Dr. Zaid says the first thing a urologist would do is look for anything blocking the urine. For men, this could be an enlarged prostate, scar tissue in the urethra, a bladder stone or tumor or trauma to the bladder area. For women, it could be a prolapse, when the bladder falls through the vagina.

“We can look inside the bladder with a camera. We can do a urodynamic study, which tells us about bladder function,” Dr. Zaid says.

Doctors would then form a treatment plan depending on what’s found. For example, bladder stones could be a “wait and see” situation. Or, a doctor could perform a procedure to remove the stones or break them apart and allow them to pass. Dr. Zaid says this is sometimes done with a laser in a minimally invasive procedure.

Dr. Zaid says in some more serious cases, the bladder stops working entirely.

“It’s something we can’t often fix. It’s really frustrating,” Dr. Zaid says.

Those people, he says, would need a catheter. It could be a short-term one to help drain the bladder or a long-term one to help correct the problem for a while.

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Author's note: this is part two of a story on outdoor water safety. Click here for part one.


More sun and rising mercury mean people will head outdoors to lakes and forests. But something as simple as drinking river water can lead to an illness that derails your spring.

Bethany Huelskoetter, APRN, a family medicine provider at OSF HealthCare, hits the major safety points about leisure time on the water.

• Bug bites: Coat yourself with bug spray to start the day, and avoid hanging out in tall grass where pests can hide. If your bug bite comes with skin tissue damage, chest pain, muscle cramps, sweating or nausea, see a provider right away. Also, watch for a rash in the shape of a bullseye, which is common with tick bites. To remove a tick, use tweezers to get close to the skin, and gently pull the insect out. Avoid twisting and yanking.
   
• Life jackets: Illinois and Michigan outline their life jacket laws. And some additional suggestions from Huelskoetter: for young kids, use a life jacket that straps on like a diaper. Life jackets that go over the chest could come up over the child’s head, and they could slip out or have trouble breathing. And read the life jacket label to make sure it’s right for you based on your chest size and weight.
  
  Huelskoetter also says a life jacket or any wet object has a risk of mold. So, dry the life jackets by hanging them in the sun.
   
• Fire extinguishers: Like life jackets, Illinois and Michigan laws require a United States Coast Guard-approved fire extinguisher on board most watercraft. Boat fires do happen, Huelskoetter says, and a fire extinguisher can mean the difference between a small fire and an explosion.
   
• Dirty water: It’s tough for kids who want to explore, but Huelskoetter says you should keep lake water out of your eyes and mouth. For kids, that could mean wearing goggles.
  
  “There are bacteria, parasites and other microorganisms that can get in your eyes. Also, don’t open your mouth underwater. You don’t want to drink that water,” Huelskoetter says. “If you swim in a lake and your eyes get red or itchy, that’s a sign you might have an infection from an organism in the water. So we want to put you on the proper antibiotic or whatever medication we feel is best.
  
  If you drink the water, gastrointestinal upset can occur. If you have nausea, vomiting or diarrhea, you definitely want to be seen by a provider. We’ll do testing to determine what bacteria or parasite you came in contact with so we can treat appropriately,” Huelskoetter adds.
   
• Alcohol: Drinking responsibly can be a part of your day on the water. But Huelskoetter says the rules are just like on land: A blood alcohol concentration (BAC) of .08% is the legal limit, so be aware if you’re the boat captain.
   
• Fumes: My group is in the open air. How much should we worry about boat exhaust?
  
  Huelskoetter says you should be fine, but make sure your watercraft has good ventilation. You can also buy carbon monoxide detectors made to clip on boats or life jackets. This can be extra helpful if your boat has an enclosed cabin, Huelskoetter points out.
   
• Spoiled food: Of course, you’ll want to eat on your boating or fishing trip. That could include perishable items like a sandwich.
  
  Putting the food and drink in an ice-filled cooler isn’t enough, Huelskoetter says.
  
  “Keeping your cooler covered and out of the sun is going to do wonders. It’ll keep that ice nice and cool,” she says.
  
  “Never eat anything that’s been sitting out, and now it’s hot,” Huelskoetter adds. “Once food reaches room temperature, you want to be careful. You can go by smell, too. If it doesn’t smell right, don’t eat it.”

Getting help

Have a first aid kit for minor injuries. For major injuries like a head or limb wound, gently move the person to land and call 9-1-1. The word “gently” is important to avoid further injury like paralysis.

Experts also point out that cell phone service can be spotty in the wilderness. So you should also have a global positioning system (GPS) device.

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We’re talking about sniffing products like paint, markers or nail polish for a temporary high. You might hear it called huffing, chroming or, in the medical community, inhalant abuse.

Health care providers like Justin Rapoff, DO, an emergency medicine physician who sees patients at OSF HealthCare, are again reminding parents about the serious health impacts of this activity and what to do if your child shows symptoms. It’s especially important for kids to steer clear, he says, because their organs are still developing. An interruption to that development could mean trouble. Young people can also be more susceptible to peer pressure, giving in when other kids tell them to try something.

“Inhalant abuse is common because these are things that are easily found in your house," Dr. Rapoff adds. “They’re underneath your kitchen sink and in your garage and bathroom. These are cheap and easy to find for kids.”

The consequences

There are short and long-term effects of inhalant abuse, Dr. Rapoff says. Among the short-term issues is the general haze the activity will put you in. If you have to, for example, drive a vehicle while under the influence, you could crash or face legal consequences. If you’re intoxicated at work or school, your performance will decline.

“You can have cognitive difficulties and even dementia [later in life],” Dr. Rapoff adds of the long-term impacts. “You can have bone marrow suppression and anemia. You can have abnormal coordination.”

Cardiac arrest, when the heart stops beating suddenly, is also possible.

What parents can do

If your child shows signs of intoxication – slurred speech, nausea, confusion and a lack of balance are big ones – call 
9-1-1 and get them to the emergency department.

“Inhalants hit similar receptors to those hit by alcohol. It causes a similar intoxication, which lasts around two to 30 minutes,” Dr. Rapoff says.

That means you should get the child checked out even if they say they feel better. Dr. Rapoff says providers will likely test the person’s blood, urine and heart. There’s no bonafide treatment for inhalant abuse, Dr. Rapoff says. Rather, providers will treat the symptoms. For example, if the child feels nauseous or is vomiting, providers may give an anti-nausea medication.

What about avoiding an unpleasant trip to the hospital in the first place? Dr. Rapoff encourages parents to talk with their kids about the risks of huffing and, generally, any emotional issues they are dealing with. The young ones may be turning to inhalants to cope. In fact, Dr. Rapoff says studies have shown that when young people abuse inhalants, they are more likely to use heroin or even commit suicide later in life.

Parents should also pay attention to kids’ behavior, especially if they make unexplained purchases of things like hairspray or whipped cream canisters. Keep items that could be misused out of reach. Put things like markers and cosmetics out only when it’s time to use them. Keep things like spray paint and gasoline canisters locked up in the garage.

Interview clips

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If you’re looking for more reasons to switch from cocktails to mocktails, the American Association for Cancer Research (AACR)’s newest study may encourage you to embrace sobriety.

The AACR published its 2024 Cancer Progress Report, showcasing that excessive alcohol use increases an individual’s risk of developing six types of cancer.

-          Certain types of head and neck cancer

-          Esophageal squamous cell carcinoma

-          Breast cancer

-          Colorectal cancer

-          Liver cancer

-          Stomach cancers

The study goes on to say that in 2019, 5.4% of cancers were attributed to alcohol consumption. The AACR’s research suggests that by drinking less, or not at all, it can decrease your risk of getting the above-mentioned cancers by 8% and lessen the risk of all cancers by 4%.

Jeanna Rich is an oncology registered dietitian with OSF Cancer Support Services. She says that part of the reason excessive alcohol can affect so many different parts of the body, is because alcohol touches tissue inside the body at most of these places.

"All alcohol contains ethanol, so one alcohol beverage is not safer than the other because they all contain that ethanol component. That can essentially damage or oxidize healthy cells and create DNA damage,” Rich says. “In regard to breast cancer, alcohol can actually increase the levels of estrogen in our body, it can lead to excessive calorie intake, which can lead to obesity." 

Rich says the increase in estrogen is what increases the risk of breast cancer.

Heavy drinking can lead to poor sleep, malnutrition

“Sleep is essential,” Rich says, noting that late nights drinking oftentimes leads to a poor night’s sleep.

“People who are choosing to drink a large amount of alcohol are not eating or drinking other nourishing items, so then they're deficient in other healthy nutrients," Rich adds. 

From cocktails to mocktails

"Why do people drink? Sometimes it's a social factor, sometimes it's for relaxation like going out to dinner with friends and having a glass of wine," Rich says, adding it’s becoming more common to have mocktails on menus at restaurants. “The sober lifestyle trend is becoming very popular. Especially with the New Year coming up, people like to stay sober for a month and see how your body feels, it does make a difference." 

Rich says other than being trendy and fun, if you make them right, mocktails can have beneficial nutrients.

The National Foundation for Cancer Research (NFCR) has year-round and holiday-themed mocktail recipes here. The NFCR reports that most Americans double their alcohol intake between Thanksgiving and Christmas.

"Some can even include cancer-fighting nutrients like cranberries, teas and mints. So, taking that risk factor away, not only takes away the damage that's going to cause your body, but then it provides you with a cancer-fighting nutritional component that's going to enhance your overall health,” Rich says.

Avoid alcohol completely during cancer treatment

On a cancer journey, it’s important to discuss alcohol with your medical team. Rich says it’s imperative to completely avoid alcohol if you’re under treatment.

"Alcohol needs to be detoxed through our liver. Our liver will choose to focus on alcohol first, versus doing other jobs," Rich says. “We are essentially robbing our body of using our cancer treatment and using nutrition to help keep our bodies fighting that cancer. The overall message is to not drink alcohol during cancer treatment and have that conversation with your health care provider or dietitian, to make sure you understand why you're avoiding alcohol.”

To learn more about nutrition during a cancer journey, visit the OSF HealthCare website.

Video Interview Clips

Author's note: This is part two of a four part story on infant nutrition misconceptions. Read part one here, part three here and part four here.



Bringing a new baby home raises the focus on their and mom’s well-being. Toward the top of the list: what and how the child is being fed.

Whether you choose to breastfeed or use formula, misconceptions about infant nutrition are everywhere. Xandra Anderson, a certified lactation consultant at OSF HealthCare, cuts through the noise.

• Do I need to change what I put in my body while breastfeeding?
  
  This covers a lot of ground, from a mom’s diet to whether she should abstain from alcohol, caffeine, tobacco and medication.

o    Diet: Healthy eating is always good. But Anderson says new moms generally don’t have to change their diet for breastfeeding. If your diet is heavy on certain things (like garlic or dairy) and you notice your baby is extra fussy, you can try changing your meals. A provider may also want to test your baby for allergies.

o    Alcohol and caffeine: Drink these in moderation and with precise timing, Anderson says.

“Babies are very sensitive to caffeine. If you have a cup of coffee and nurse right away, the baby is going to be awake for a lot longer than normal,” Anderson says.

“That doesn’t mean you have to not drink coffee. Just maybe not add three shots of espresso to your morning coffee,” she adds with a smirk.

For alcohol, Anderson says the drink will filter out of your breastmilk like it filters out of your blood. So after having a couple of alcoholic drinks, wait two to three hours before breastfeeding or pumping.

“The breastmilk isn’t ruined. You just need to give it time,” Anderson says.

But here’s a lifehack if mom feels full of breast milk and wants to pump right after having a drink: Go ahead and pump, and use the milk on your baby’s acne or in their bathwater. Just keep it away from their mouth.

“It’s antimicrobial. It’s antibacterial. It’s moisturizing,” Anderson says, singing the praises of breast milk. “Our babies are in the most perfect environment in the womb. Once they’re born, their world is cold, dark and dry. They can get dry skin, acne or cradle cap [greasy or flaky spots on the scalp]. Breast milk is a great way to prevent or heal those things.”

o    Medication and other health care issues: Anderson says most medication is safe to use while breastfeeding. In fact, it’s important to stay the course – for example, with mental health medication – so you can be the best mom possible. Talk with your health care provider if you have questions.

If you have a medical procedure, also get advice from a professional. For example, Anderson says if you get a hepatobiliary iminodiacetic acid (HIDA) scan for a gallbladder concern, you’ll be radioactive for around 24 hours. Don’t breastfeed during that time. Or if your breasts feel full and you have to pump, dump the milk down the drain.

o    Tobacco: Anderson admits it’s tough to kick the habit. But she reminds moms: infants are very sensitive to nicotine. It can disrupt the child’s sleep and feeding and even interfere with organ development. Secondhand smoke can increase the risk of a respiratory infection and sudden infant death syndrome (SIDS).

If you’re smoking with a new baby at home, do so after breastfeeding, then wait two to three hours before nursing again. Wear one jacket while smoking so you don’t get an odor or residue on a lot of your clothes or the baby.

Learn more

Read more about how to have a successful pregnancy and following years on the OSF HealthCare website.

Interview clips

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If you’re looking for more reasons to switch from cocktails to mocktails, the American Association for Cancer Research’s newest study may encourage you to embrace sobriety.

The AACR published its 2024 Cancer Progress Report, showcasing that excessive alcohol use increases an individual’s risk of developing six types of cancer. Certain types of head and neck cancers, esophageal squamous cell carcinoma, breast, colorectal, liver, and stomach cancers were all listed.

The study goes on to say that in 2019, nearly five-and-a-half percent of cancers were attributed to alcohol consumption. The AACR’s research suggests that drinking less—or not at all—can decrease your risk of getting the mentioned cancers by eight percent and lessen the risk of all cancers by four percent.

Jeanna Rich is an oncology registered dietitian with OSF Cancer Support Services. She says part of the reason excessive alcohol can affect so many parts of the body is because alcohol touches tissue inside the body at most of these places.

"All alcohol contains ethanol, so one alcoholic beverage is not safer than the other because they all contain that ethanol component. That can essentially damage or oxidize healthy cells and create DNA damage. In regard to breast cancer, alcohol can actually increase the levels of estrogen in our body. It can lead to excessive calorie intake, which can lead to obesity."

Rich adds that excessive drinking can lead to poor sleep and malnutrition as well.

Video Version With Chyrons

Video Version Without Chyrons

There’s renewed optimism for people with fatty liver disease, sometimes called NASH (non-alcoholic steatohepatitis) or MASH (metabolic associated steatohepatitis). The United States Food and Drug Administration recently approved the first medication, Rezdiffra, that can directly address liver damage as the person makes lifestyle changes.

“This is a gamechanger for anyone who has fatty liver disease with moderate to severe liver scarring,” says Marcie Lindstrom, APRN, a gastroenterology provider at OSF HealthCare. “This can reduce the number of complications that can develop with worsening scarring.”

Fatty liver basics

The liver is an important organ. Experts even call it a miniature factory inside us. The liver detoxifies medication; releases glucose to give you energy; aids digestion and makes cholesterol, proteins and amino acids.

Obesity, diabetes, high cholesterol and excessive alcohol use can lead to fatty liver disease, which Lindstrom says impacts around one in four people worldwide. Left untreated, scarring from fatty liver disease can progress to cirrhosis, or severe scarring. Complications from cirrhosis can include enlarged blood vessels in the esophagus which can lead to life-threatening bleeding, fluid overload called ascites, liver cancer and liver failure necessitating a transplant.

How we got here, where we’re going

Lindstrom says before Rezdiffra, people with fatty liver disease could only make those lifestyle changes to try to get better: control your blood sugar, cholesterol and weight.

“Strictly on the shoulders of the individual,” Lindstrom reiterates.

“We know that people who lose 5 to 10% of their body weight are able to make improvement with fatty liver disease. It is considered a reversible condition,” she adds.

Now, Rezdiffra is an option for people with moderate to advanced scarring.

“It works on thyroid-B receptors in the liver. We normally think of thyroid receptors in our thyroid gland [in our throat], but we do have thyroid beta receptors elsewhere. A lot of them are in the liver,” Lindstrom explains. “The medication works to release triglycerides from the liver. It improves and may even resolve fatty liver.”

It’s a once-a-day pill, Lindstrom says, and there’s no “one size fits all” for how long you need to be on it. Side effects include nausea and diarrhea, but Lindstrom says studies have shown those get better after three weeks. She also says women who are pregnant, are about to become pregnant or are breastfeeding should not take Rezdiffra. There hasn’t been enough study of the drug to see how it impacts those groups.

The bottom line: you can talk to your health care provider to see if Rezdiffra is right for you. Be sure to mention what other medicines you are taking so your provider can see how Rezdiffra might interact.

“If somebody is taking a statin for cholesterol levels,” for example, Lindstrom says. “It’s not that we want them to go off their statin. There are certain limitations to the dosage.”

Learn more

Learn more about how to avoid fatty liver disease and other gastroenterology care tips on the OSF HealthCare website.

Interview clips

The United States Food and Drug Administration recently approved the first treatment for people with liver scarring due to fatty liver disease. It's welcome news for people battling the disease.

How did we get here?

In some ways, it goes back to the obesity epidemic in the United States. Obesity brings an increased risk of fatty liver disease, an ailment that’s treatable but could mean serious complications. Moreover, health experts say isolation during the pandemic led may to increase alcohol intake, another risk factor for fatty liver.

David Rzepczynski, MD, a gastroenterologist at OSF HealthCare, describes the liver as an “extremely important” factory for the body. It performs many functions, like detoxifying medications, aiding digestion and making cholesterol, proteins and amino acids that help the body function. And have you ever missed a meal? You can thank your liver for releasing glucose and giving you energy.

All those “factory functions” make it critical to be watchful of fatty liver disease. As the name suggests, the disease describes an accumulation of fatty cells in the liver. Dr. Rzepczynski says it takes just 5% of cells with increased fat to make a diagnosis, but some obese people have 100% of cells with fat.

Hepatitis C and excessive alcohol use can cause fatty liver disease or are at least linked to it. But you can still get fatty liver if you’re not a heavy drinker, and that’s where your weight comes into play.

“The big driving force of fatty liver disease is what we call the metabolic syndrome,” Dr. Rzepczynski explains. “There are five factors: obesity, diabetes, hypertension [high blood pressure], high cholesterol and insulin resistance.”

Dr. Rzepczynski adds that fatty liver disease may cause pain in the upper abdomen, but it mostly comes without symptoms. So if any of those five risk factors apply to you or if you’re a heavy drinker, don’t wait. Talk to your health care provider about getting your liver looked at.

A doctor will likely start with a blood test, Dr. Rzepczynski says. An ultrasound or biopsy may also be needed. The next step: lose weight.

“It doesn’t have to be getting back to your ideal body weight,” Dr. Rzepczynski says. “Losing 5% of your weight can reduce fat in the liver. Losing 7% will help reverse some of the inflammation associated with fatty liver. And some studies have even shown that losing 10% or more might reverse some of the scarring.”

While it may be a bit alarming, left unchecked, fatty liver disease can lead to a serious condition called cirrhosis, or scarring, of the liver.

“You have normal liver tissue replaced by scar tissue,” Dr. Rzepczynski says. “When that occurs, you have a loss of liver function. You have less liver cells performing their duties.”

Cirrhosis of the liver can cause the organ to fail, making a transplant necessary. Liver issues can also mean an increased risk of heart disease, stroke and cancer, particularly breast and colon cancer.

Learn more about fatty liver disease and other gastroenterology care on the OSF HealthCare website.

Interview clips

In his year-long battle with cancer of the esophagus, Jim Corby encountered many nerve-wracking moments.

But when asked about it, one memory comes to mind for the retired construction worker from Alton, Illinois. One that happened far away from a doctor’s office.

On July 27, 2022, Corby was chosen to throw the ceremonial first pitch at the Alton River Dragons baseball game. Members of care team at OSF HealthCare Moeller Cancer Center in Alton, James Piephoff, MD, and Manpreet Sandhu, MD, were at his side. Also watching was a group of young women Corby coaches on the softball diamond.

“He knew if he didn’t throw a strike, he would never hear the end of it from the girls on his team,” Dr. Piephoff says.

No pressure, Jim.

Esophageal cancer: The basics

Dr. Piephoff, a radiation oncologist, says around 20,000 people in the United States are diagnosed with esophageal cancer each year. The cancer claims around 16,000 lives in the U.S. each year.

There are two types. The most common (around 70% of U.S. cases) is adenocarcinoma in the lower esophagus. The other type is squamous cell carcinoma, typically above where the airway separates into the lungs.

Both types are associated with excess smoking and drinking, something Corby found out the hard way.

“I smoked two-and-a-half to three packs of cigarettes a day,” Corby says. “The day I went in for surgery, I threw them out the window. I haven’t smoked since.”

Obesity is also a risk factor for adenocarcinoma.

“Obesity leads to increased risk of gastroesophageal reflux disease,” Dr. Piephoff explains. “It’s the acid churning up in the lower esophagus that leads to the risk of developing what’s called Barrett’s esophagus. That’s a precancerous condition.”

Screening isn’t common for cancer of the esophagus, so Dr. Piephoff says it’s important to watch for symptoms, which can mimic those of heartburn. See a doctor if symptoms won’t go away.

“Know your body. Don’t be afraid to talk to your doctors about it. Don’t try to minimize your symptoms,” Dr. Piephoff urges. “If there’s a change you notice, you need to convey that to your doctor.”

On treatment, Dr. Piephoff says he typically sees a person go through chemotherapy and radiation to shrink the cancer followed by surgery to remove the tumor. During surgery, instruments are sent down the throat and not through the chest, meaning an easier recovery for the person. Early detection could mean surgery only.

“There are some patients who are not able to have surgery because of medical conditions like a bad heart or bad lungs,” Dr. Piephoff says. “They get treated with radiation and chemotherapy without surgery.”

Immunotherapy is also a part of the treatment plan for some people. This involves changing how your immune system works so it can fight cancer, according to the American Cancer Society.

Jim’s journey

Corby says he started having pain in his midsection last year when he ate. Treatment for heartburn and acid reflux didn’t help. An ultrasound and CT scan didn’t get his doctors any closer to a solution. All the while, Corby says it hurt so much to eat, he started losing weight.

In September 2021, doctors examined Corby’s esophagus with a camera.

“The doctor came in and sat down, which I knew was not a good sign,” Corby recalls.

“That day was when my life changed,” he says.

The exam found a cancerous mass in Corby’s lower esophagus. The next few months were a whirlwind.

“It happened real fast,” Corby says.

“They got me here [to Moeller Cancer Center] to see Dr. Piephoff and Dr. Sandhu. They came up with a program to try to get me going,” Corby says. “I went through chemotherapy and radiation first. Then they sent me over to St. Louis, and in January I had surgery.”

The surgery to remove the cancer preceded a nine day stay in the hospital where Corby says he couldn’t eat or drink aside from the occasional ice cubes or water sopped from a sponge.

Sometime later – Corby can’t remember exactly when – he was back at OSF Moeller Cancer Center meeting with Dr. Sandhu.

“She said ‘Your scan came back. You’re cancer free.’” Corby says.

“I couldn’t believe it,” Corby adds. “How many times do you hear about people who have cancer who die? You hear more of that than you do cancer free.

“The odds were against me 100%, but I guess I beat the odds.”

The first pitch

Corby’s first pitch at the River Dragons game went – where else? – right down the middle of the plate, eliciting a cheer from his support system and all the fans learning his story for the first time. For Corby, it was a sigh of relief. No need to worry about razzing from his softball players.

“I got lucky,” Corby says, fighting back happy tears.

Learn more

Visit the OSF HealthCare website to learn about cancer treatment. This includes the new OSF Cancer Institute in Peoria, Illinois, which will serve the entire OSF service area will the latest treatment, education and more.

Interview clips - Dr. James Piephoff

Interview clips - Jim Corby

Terminology

David Rzepczynski, MD, an OSF HealthCare gastroenterologist, says it’s important to first lay out some similar sounding terminology.

• Diverticulum (singular) or diverticula (plural): These are the bulges that form when an inner part of the colon sticks out through a weak spot in the colon wall.
   
• Diverticulosis: This is the name of the condition when the bulges occur.
   
• Diverticulitis: This describes when the bulges become inflamed.

Causes, symptoms and diagnosis

Dr. Rzepczynski says diverticulosis occurs when your colon is trying to push stool forward, and the organ is not as bulky as it should be. The diverticula bulges then form.

The condition has been more common in people over 60, but Dr. Rzepczynski says health care providers are seeing a rise in cases in people in their 40s and 50s.

Diverticulosis can run in families. It’s also tied to your lifestyle.

“A diet that has more red meat, less grain and less fiber might put you at a higher risk,” Dr. Rzepczynski says.

Smoking, excess alcohol and obesity are also risk factors.

Symptoms of diverticulosis include abdominal pain or constipation. But it often comes with no symptoms and is found during a colonoscopy.

Treatment

Dr. Rzepczynski says in mild cases, a provider may tell you to change your lifestyle, such as getting more fiber in your diet. This makes bowel movements smoother.

“Often, people will look to use fiber supplements,” Dr. Rzepczynski says. “The amount of fiber intake from supplements pales in comparison to what you can get from your diet.”

Also, eat a healthier diet overall. Dr. Rzepczynski says there used to be a myth that nuts, popcorn and seeds would get lodged in the colon bulges. He says studies have shown those foods are not a risk factor.

Other lifestyle tips: exercise and cut out tobacco and alcohol.

Dr. Rzepczynski says more serious cases of diverticulosis can come with two complications. One is bleeding.

“You could have a blood vessel on the outside of the diverticulum. If it ruptures into the diverticulum, it could cause sudden bleeding from the rectum,” Dr. Rzepczynski says.

Dr. Rzepczynski says bleeding from diverticulosis is not common. He ballparks it at around one in 2,000 cases. People on blood thinning medication who develop diverticulosis have a higher risk of bleeding.

While unpleasant, Dr. Rzepczynski says most bleeding cases resolve on their own.

The second, more serious complication is diverticulitis, or when the diverticula bulges become inflamed. This happens when there is a tear in the diverticulum, and bacteria from stool leaks. And it can lead to a host of other problems: pockets of pus known as abscesses, issues passing stool and a urinary tract infection.

Symptoms of diverticulitis include pain in the lower left abdominal area, abnormal bowel movements, nausea and vomiting. If you have these symptoms, it’s important to been seen by a health care provider quickly. A doctor may order a computed tomography scan (commonly called a CT scan) to diagnose diverticulitis.

Dr. Rzepczynski says it’s not common for diverticulosis to progress to diverticulitis, and most cases of diverticulitis can be treated at home with oral medication. But, he says 12 to 15% of diverticulitis patients spend time at the hospital. Treatments there include antibiotic medication through intravenous therapy (IV) and surgery. If surgery is necessary, a doctor will drain any abscesses then remove the inflamed area of the colon.

“They’ll try to reconnect the colon at that time,” Dr. Rzepczynski explains. “But if the surgery is done on an emergency basis, sometimes the person may have a colostomy where part of the colon is coming out through the skin. That’s a temporary measure.”

A colostomy comes with a bag on the outside of your body that collects the waste that would normally leave your body via a bowel movement.

Dr. Rzepczynski warns that surgery isn’t a permanent fix. He says around 15% of diverticulitis patients who have surgery end up with another bout. It reinforces the importance of lifestyle changes. You should also get on a colonoscopy schedule as advised by your health care provider.

Learn more

Read more about how to avoid diverticulosis on the OSF HealthCare website.

Interview clips

Cancer can impact anyone, and the numbers show cases skewing younger.

Recently, the American Cancer Society reported that for the first time colon and rectal cancers have become leading causes of cancer deaths in younger adults. 

Overall, lung cancer remains the leading cause of cancer death among men and women of all ages. Prostate cancer is second for men, and breast cancer is second for women. Colorectal cancer is third for both men and women. 

Another study suggests that certain cancers are being diagnosed more often in younger adults in the U.S., and the spike is due, in part, to adults and especially women in their 30s.

The study published in the journal JAMA Network Open, looked at 17 National Cancer Institute registries with more than 500,000 cases of early-onset cancer, or cancers diagnosed in patients under age 50, between 2010 and 2019. The study showed early-onset cancers increased during that time by an average of just over a quarter of a percent (.28).  

In 2019, breast cancer had the highest number of incidences of early-onset cases. Gastrointestinal cancers and cancers of the urinary system and the female reproductive system are right up there as well.  

Peggy Rogers is a nurse practitioner in genetics and medical oncology for OSF HealthCare. She sees similar trends among her patients.

“For women, they are the caregivers in the family, and they tend to worry about everyone else besides themselves, and maybe put off seeking care sooner," says Rogers. "But women also encourage their husbands to seek and visit with their provider. So that’s a positive. But in general, I would say we have to keep talking.”

 Among gastrointestinal cancers, the most common early-onset cancers were found in the colon, rectum, stomach and pancreas. The fastest-growing incidence rates were found in the appendix, bile duct and pancreas.

“I think the nuance that we found is it's more common to find gastric cancers, which I don't think people realize, and I don't think people are aware of, the signs for gastric cancer can be as simple as abdominal pain and nausea or feeling full quickly, and they may need medical attention sooner," says Rogers. 

Some of the reasons for increased cancer rates in adults under age 50 include:

·         Drinking alcohol in excess

·         Smoking tobacco

·         Eating a Western diet (prepackaged foods, fried foods, processed meats, high-sugar drinks)

·         Being obese or overweight

·         Being exposed to environmental toxins

“We are concerned that obesity is an epidemic, and it's not just overconsumption of food and inactivity," says Rogers. "It’s the types of foods that people are eating, which is processed, it's quick, it's easy, but it's not the most beneficial.”

To lower your overall cancer risk, Rogers recommends maintaining a healthy weight, increasing your exercise, trying to eat five to nine servings of fruits and vegetables each day, limiting processed foods, not smoking and drinking in moderation.

Colonoscopy screening is usually recommended starting at age 45. People with family history may have to start earlier.  And pay attention to potential symptoms such as blood in the stool, abdominal pain, changes in bowel habits and unexplained weight loss. 

Rogers also recommends having conversations with your physician about your health. And for younger people who don’t have a provider, it’s important to find one. 

“I think working towards having a visit at least once a year to establish with a provider – establish goals for their health care – is very important and sometimes family history is contributory and why people get cancers," she says. "So those are discussions that you can have with your primary care provider. Maybe they need a referral or their family member that's been affected with cancer should consider a genetic risk assessment to further look at what may be contributing to some of the cancers in the family, even at early onset.”

For more information about cancer, visit OSF HealthCare. 
 

Interview Clips 

B-roll

The Beverage Information Group reports beer sales have slumped in recent years. Alcohol brands such as Heineken are paying attention to what marketers believe is more than just a passing fad by creating no alcohol beer and spirits. Also called “elective sobriety,” the choice to abstain is not brought on by addiction issues, but rather a desire for a more productive, healthy lifestyle.

The “sober curious” movement includes people drinking less in general and it is qualifying as a movement supported by recent research from the well-known Nielsen research company. It reported 47% of American adults said they wanted to drink less alcohol last year and the company predicts the trend will continue.

OSF HealthCare’s Medical Director for Behavioral Health Dr. Samuel Sears says moving away from alcohol consumption is a positive trend supported by new medical research showing even moderate alcohol use is not good.

“The literature for a long time pointed toward low-and-moderate alcohol use being potentially protective whereas the newer literature is starting to question whether that’s true and that really not using alcohol is probably the healthiest thing available to somebody,” he shared.

Long term drinking also increases the risk of developing diabetes, strokes, hypertension and depression.

Dr. Sears added, “There are increased cancer rates associated with alcohol use, worse for the more you drink so these are very good health choices in terms of making that switch.”

There  are increasingly more options on store shelves and in restaurants for anyone who wants to extend a Dry January into the rest of the year. Dr. Sears is excited about increased options for his patients on antidepressants who should not be drinking alcohol because it depresses the central nervous system.

“When you’re activating that GABA system while you’re on medication for something like depression or anxiety, it’s actually impairing that medication’s ability to work by sending signals further downstream and really negating some of the benefits you’re getting from your medication otherwise. So, from a mental health standpoint, there’s a very good reason to stay away from or minimize alcohol use,” he emphasized.

Whether it’s temporary temperance or a more permanent choice, Dr. Sears says not drinking alcohol helps people avoid other unhealthy behaviors: binge eating unhealthy food, not sticking to an exercise routine, and irregular sleep brought on by alcohol which reduces the all-important rapid eye movement (REM) sleep. The more you drink before bed, the more pronounced the effects according to research.

Dr. Sears is also optimistic the culture shift will make it easier for health care providers to talk with their patients about alcohol use.

He stressed, “This is a general health concern and something that really we would encourage primary care providers to be talking with their patients about because it does impact basically every aspect of a person’s health over their lifetime.”

Always check to make sure you are not taking medication that will interact badly with alcohol.

Interview clips

B-roll

The Fourth of July holiday usually brings plenty of opportunities for the 3 Fs: fun, food and fireworks. That’s why it’s even more important to remember your ABCs: always be careful.

According to the Consumer Product Safety Commission, on average, 250 people go to the emergency room every day with fireworks-related injuries around the July 4th holiday. Most fireworks are illegal in the state of Illinois, but even the legal ones are risky.

“About a quarter of all ER visits are due to legal fireworks in the state of Illinois,” said Dr. Ben Kemp, OSF HealthCare emergency room physician. “Sparklers, for instance, can be relatively dangerous if used inappropriately: given to children who are too young to handle them, or lit in a way that they shouldn’t be, which we see occasionally where people wrap a lot of fireworks together or light them in a way where they cause a larger fire and can be potentially harmful.”

Dr. Kemp continued, “Never light a firework in your hand, obviously that can explode unexpectedly, quickly and you can get blast injuries to the hand or burn injuries to the hand and be very harmful. And also burns to clothing – clothing lights on fire and you can get burns to other areas. Facial injuries too – so a firework goes off in somebody’s face and you get injuries to the eye, the face and can be rather harmful and something we have to deal with.”

Dr. Kemp reminds everyone when using sparklers or other legal fireworks to always have a hose or bucket of water nearby, do so in a wide, open area and to make sure young children are kept at a safe distance. He also says be careful when it comes to alcohol use during festivities.

“Anytime somebody is drinking too much in the heat there is the risk of heat illness,” he warned. “Obviously drinking and driving is a terrible thing that we don’t want to see on a holiday, something us and law enforcement are very concerned about. And certainly mixing alcohol is a recipe for injury as well.”

The July 4th holiday is also a time for picnics. The Illinois Department of Public Health says each year about 1 in 6 Americans get sick from food poisoning, so you want to make sure you prepare, cook and store any food properly.

“You want to make sure things are cooked appropriately. Food sitting out for hours at a time, so something that’s got mayonnaise on it that’s sitting out for 2 or 3 hours, those sort of things can be at risk to cause gastroenteritis or food borne illness,” said Dr. Kemp.

And what would a summer holiday be without water activities, whether in a pool, lake or river? Again, safety is key. Drowning is the third leading cause of unintentional injury death, with children most at risk. Water-related injuries are something emergency department physicians don’t like to see come through the door, because an ounce of prevention can go a long way.

“Always ensure that you’re in a safe environment to dive into the water or jump into the water. Making sure little ones are well supervised when they are swimming or have appropriate floatation gear on,” advised Dr. Kemp. “The tragic things are when a little one is unsupervised and gets into a pool or a young, healthy person dives into a shallow pool of water and injures their neck. Those are things we don’t want to see.”

Check out more tips on fireworks safety, water safety and food safety for a safe and happy 4^th of July.

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Nearly 800,000 Americans suffer a stroke each year.

Strokes can have life-altering consequences like vision, walking and swallowing difficulties. They also rank in the top five killers of Americans. For each minute a stroke goes untreated, the brain loses around 2 million cells it cannot recover.

“Getting to the hospital quickly – within four and a half hours of your onset of symptoms – is important,” says Leslie Ingold, a registered nurse and stroke coordinator with OSF HealthCare.

A cutting-edge stroke drug rolled out at OSF HealthCare is already turning the tide for people.

Tenecteplase (TNKase ®) can be used in people experiencing a stroke and who meet certain criteria, such as a specific blood pressure, history of brain bleeds, medications taken at home and how quickly they arrived at the emergency department. TNKase is a clot-busting agent that stands to become the gold standard of this type of care, Ingold says.

“It has a lower cost. It’s something providers can mix much, much quicker,” Ingold says. “And it’s given quickly in an IV push over five to 10 seconds, and we’re done.”

TNKase also does a better job than its predecessor at finding and breaking up clots, and there’s a lower risk of bleeding.

“The quicker we can get oxygen flowing back into that brain tissue, the better recovery the person is going to have,” Ingold says.

Why it’s important

The most common type of stroke, an ischemic stroke (also sometimes called an embolic stroke), is when a clot forms and travels to the brain. When watching for one, remember the acronym B.E.F.A.S.T.

• B is for balance: Watch for sudden loss of balance.
• E is for eyes: Check for vision loss or eyes looking askew.
• F is for face: Look for droopiness or an uneven smile.
• A is for arm: Is one arm weak or numb?
• S is for speech: Watch for slurred, slow speech or no speech. Ask the person to repeat a simple sentence.
• T is for time. It’s the conclusion to the checklist. Time to call 9-1-1 if someone has these symptoms, even if they go away.

Another type of stroke, a hemorrhagic stroke, is when a blood vessel breaks and blood seeps into brain tissue. Ingold says hemorrhagic strokes are typically caused by a traumatic injury, like falling and hitting your head. Uncontrolled high blood pressure is also a cause.

For either type, when you arrive at the hospital, a provider will take some pictures of your brain and decide the best treatment option.

Prevention

Up to 80% of strokes are preventable, Ingold says. Prevention goes back to what any doctor will tell you is key for a healthy life: control your blood pressure, cholesterol and diabetes through diet and exercise. Avoid tobacco, alcohol and drugs. If you have an irregular heartbeat, known as atrial fibrillation, see your cardiologist regularly and follow their instructions. And get established with a primary care provider, too.

Ingold says a stroke takes 3.75 years off a person’s life, on average. And if you have a stroke, you have a 25% chance of having another one.

“We always tell people they really need to be on top of their treatment,” Ingold says. “The signs and symptoms of a possible second stroke may not be the same as the first. In fact, they could be completely different. It just depends on what part of the brain the stroke affects.”

Learn more

Read about stroke care on the OSF HealthCare website.

Previous coverage

OSF HealthCare Newsroom stroke stories
OSF HealthCare stroke blogs

Christina Reifsteck knows the statistics all too well.

Law enforcement officers may not live as long as people in other professions. The job requires you to be in a constant state of hypervigilance for up to a 12-hour shift. The resulting stress may lead to serious heart issues.

But Reifsteck, a sergeant with the Rantoul, Illinois, police department, her colleagues and OSF HealthCare are trying to change that.

Rantoul police have partnered with OSF HealthCare Occupational Health and OSF HealthCare Cardiovascular Institute to have OSF provide heart screenings and the necessary follow-up appointments for officers.

“We wanted to make sure our officers have a better knowledge of what is going on inside their body,” Reifsteck says. “Sometimes you can’t see the problems.”

For Reifsteck, that need for knowledge played out on a gray February morning at OSF HealthCare Heart of Mary Medical Center in Urbana, Illinois. With monitors attached to her body, she walked, then ran on a treadmill while OSF Mission Partners (employees) observed her heart rate on a screen. It’s known as a stress test.

“The treadmill started out slow, and every couple minutes it got faster, and the incline raised higher,” Reifsteck recalls. “You did feel like at the end you were getting a workout. But it felt fine.”

“With the stress test, we try to identify someone’s functional capacity and if they demonstrate any evidence of impairment of blood flow to the heart,” says Alaa Ujayli, MD, an interventional cardiologist at OSF HealthCare Cardiovascular Institute in Urbana.

Down the hall, Reifsteck got pictures taken of her heart.

“We look at calcification of the coronary arteries, which is the beginning of plaque disease,” Dr. Ujayli says.

Reifsteck got reassuring news that her test results looked good. But a follow-up appointment with a cardiology provider was on her calendar for two days later.

“See where we are and if I need to make some lifestyle changes,” Reifsteck says. “First responders function better when they’re healthy.”

Dr. Ujayli agrees.

“Cardiovascular disease is a preventable illness,” he says. “If we establish preventive measures, we have a significant impact on the progression of the disease.”

Those measures include medication, talking with a dietitian to change eating habits, consistent exercise, better sleep habits and avoiding smoking and alcohol. Mental health care like meditation and visiting a counselor are also helpful for everyone, but especially first responders. More serious heart issues may require a procedure in the hospital.

Learn more about heart care on the OSF HealthCare website.

Interview clips - Sgt. Christina Reifsteck

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The pros and cons of social media are well documented. It allows you to connect with friends and pursue passions, but bullying and misinformation can be rampant.

But can frequent social media use lead to changes in brain development during the formative adolescent years? A recent study suggests so, but much more investigation is needed, says Karna Sherwood, MD, a neurologist at OSF HealthCare in Alton, Illinois.

The study tracked 169 sixth and seventh graders and found those who habitually checked social media were more sensitive to rewards and punishments. To view it a different way, kids who constantly refresh Facebook hoping the likes on their post will go up may be more impulsive to seek out real-life recognition.

“At a certain point, 10 likes or 20 likes are no longer gratifying enough,” Dr. Sherwood says. “And then you have to find another way to get even more likes or more appreciation.”

That “another way” could lead to risky behaviors such as substance abuse. But Dr. Sherwood says more study is needed to conclusively make the link. Just how much does our life in the digital realm affect our life away from the device?

“A follow up study would certainly investigate if [frequent social media use] has an effect on rates of anxiety and depression,” says Dr. Sherwood. “Could this affect addiction? And what interventions could be taken to nullify those behaviors?

“As a society, if we want to raise happy and healthy people in an age where we are getting better technologically, what steps do we need to take?”

Until then, Dr. Sherwood has some good advice no matter your age or number of Twitter followers.

“Until you get the rest of the information, it’s better to have some degree of regulation,” and restraint with social media, Dr. Sherwood says.

Learn more about how the brain works on the OSF HealthCare website.

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Previous coverage

Tackling pediatric mental health

Bullying and the era of technology

Is social media impacting your mental health?

Kids' screen time: How much is too much?

It can be an embarrassing ailment, but experts say it’s time to talk about it.

Urinary incontinence is when a person leaks urine by accident.

Uwais Zaid, MD, a urologist at OSF HealthCare in Alton, Illinois, says urinary incontinence can wreak havoc on a person’s social life and intimacy with partners. In other words, you can’t go out and have a good time with friends if you don’t know when you’re going to suddenly “go.”

“It can be associated with medications. It can be associated with aging,” Dr. Zaid says. “It can be associated with certain surgeries. A lot of our cancer survivors, whether they're from prostate cancer, cervical cancer, uterine cancer…they can have effects to their urinary control.

“Things as normal as having children,” Dr. Zaid adds as a cause.  “Over time [childbirths] can wreak havoc on the pelvic floor and on the urinary sphincter, and you can have urinary accidents as a result.”

While incontinence is often associated with older people, Dr. Zaid says all those precursors apply to any age.

Dr. Zaid says urinary incontinence breaks down into four groups.

• Stress: This is when the bladder sphincter does not work as well. Simple things like coughing, sneezing, laughing or bending over could provoke a release of urine.
• Urge: “When the bladder has a mind of its own,” Dr. Zaid remarks. This is when you have to go and you just can’t make it to the bathroom in time. Dr. Zaid adds that hearing or seeing certain triggers like running water or jingling of keys as you rush to enter your home might provoke urge incontinence.
• Overflow: This occurs when your bladder is full. This is the opposite of urge incontinence, Dr. Zaid says, and is associated with infections and kidney issues.
•  Functional: This applies to someone who may have normal bladder control but can’t get to the toilet in time due to physical limitations like arthritis.

A health care provider will ask you about your symptoms and health history to see which type of urinary incontinence is ailing you. Testing would typically follow. Each type of incontinence, generally, has its own treatment plan.

• Stress: A provider may recommend pelvic floor physical therapy as treatment. For women, a small device can be inserted to stop leaks. Surgery is also an option.
• Urge: You may be told to cut back on caffeinated food and drink, spicy food and alcohol. Medicine and surgery are also options.
• Overflow: “That's where we need to make sure we're not missing anything like a blockage - for women, a prolapse and for men, an enlarged prostate.” Dr. Zaid says.  “A stone in the bladder. A tumor in the bladder. And we also need to make sure the kidneys are functioning okay.”
• Functional: Since people with this type of incontinence may have a normal bladder, external solutions are necessary. For example, keeping your route to the bathroom clear of obstacles like chairs and doors. For older adults with physical limitations, have a walker handy for when the need to go arises.

Other tactics include urgency suppression, when you distract yourself from thinking about urinating. You could take long, relaxing breaths or sit completely still.

Timed voiding is when you schedule times to urinate. Dr. Zaid says this can work in both directions. If you are urinating too frequently, set a timer on your phone to go every hour. Then when you get comfortable, you can increase the time. If you are holding on to your urine too long, set a plan, get comfortable then decrease the time.

The bottom line: if something seems off about your bathroom visits or if friends or family remark “You’re sure in there a lot,” see a doctor.

“If you’re chronically wet down below, it increases your risk of fungal infections and skin breakdowns,” among other serious health issues, Dr. Zaid says.

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Previous coverage

Gotta go? Try these six bladder tips

Tackling any task – from a child walking to an adult learning a new job – starts with a first step. The same goes for taking care of your mental and behavioral health, but even the experts admit it may be daunting to ask for help. During the holiday season where some people may experience loneliness and depression, experts are reminding you there are resources to bridge the gap between “what do I do?” and “I have the care I need.”

Katie Koeller is a behavioral health navigator (BHN) at OSF HealthCare in Alton, Illinois. BHN is a free, ministry-wide service at OSF HealthCare, but you don’t have to be an OSF HealthCare patient to use it. The program helps people in areas like depression, anxiety, drug or alcohol use, and problems with work, school, or relationships. The BHN talks to the patient – either at a provider’s office or over the phone – about what care they need, and they point the person to that care as close to home and as soon as possible. The BHN also checks the patient’s insurance coverage to see how it lines up with the care needed.

“We would do an intake,” Koeller explains. “So we'd ask questions, making sure that they're not in a crisis situation at the time and see what their symptoms are. And then that way we can better judge what they would be suited for as far as counseling, psychiatry, substance use treatment, whatever it may be.”

Koeller notes the treatment could be out-patient (the typical office visit) or in-patient (live-in treatment). She says a BHN will also check-in with the patient via phone call or message on OSF HealthCare’s secure online portal. Koeller says it’s usually three check-ins over a month, but each case is different.

“Some people just decide maybe it's not what they need, maybe just talking with somebody like me and just getting educated and feeling like they have that opportunity or just the knowledge about the community resources is enough,” Koeller says. “Because then they were like, ‘Well I can decide later on if that's what I need.’  But for the most part, I feel like a lot of patients are appreciative and do really like the service and find it helpful.”

Koeller, a BHN for three years, says even if the patient is on a good path, the BHN tells them they can always call back if they need more help.

The tendency to stay quiet about mental health is still an issue, Koeller says. But she’s seeing another roadblock to care.

“A lot of people just feel like they don't have time for it. I've heard a lot of people say that ‘I can't take off work for it.’” Koeller says. “I feel like a lot of people don't consider it to be [a crisis]. You don't want it to get to that [crisis] point. So they kind of push it back like it's not as important as my physical health.”

But in reality, Koeller says, mental health does impact physical health. In other words, if your mind hurts, your body may hurt, too.

Koeller also notes that some insurance providers can help with transportation – getting a ride to a counselor appointment, for example. Telehealth – a digital appointment with a provider from home – is also an option that’s growing in use. OSF SilverCloud is another resource designed for workplaces. These are some of the many things a BHN can check on and, at a minimum, educate the patient on what’s available.

Patients who are experiencing a mental or behavioral health issue can contact their primary care provider or – if you live within OSF HeathCare’s footprint – use the behavioral health navigator program. If you’re in a crisis situation that needs a first responder, call 9-1-1. If it leans toward a mental health crisis, call the National Suicide Prevention Lifeline at 9-8-8.

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