Weight loss drugs like Ozempic and Wegovy are more popular than ever, leading people to seek options that are quicker, cheaper and involve less prying questions than a traditional in-person doctor visit.

But here’s a statistic that should give you pause: Casey Zaring, RPh, PharmD, a clinical pharmacist at OSF HealthCare, says a 2023 audit by the U.S. Food and Drug Administration [FDA] found 95% of online pharmacies were not legitimate. This leads to concerns about getting bilked out of money or taking a counterfeit drug that could bring serious side effects.

“It skips a lot of checks and balances,” Zaring says of the online outlets. For one, he says, these websites typically don’t have a pharmacist check your full medical history to make sure you’re getting the right drug.

Legit or not?

Some red flags to look for when deciding to buy prescription drugs online:

• Is the website based outside the United States?
  
• Do you start on one website and get pushed to another to complete the transaction?
  
• Does the site guarantee you cost savings? Zaring says it may look like a deal up front, but the final price tag might not be so good. Or, you might unintentionally sign up for auto-renewals. Zaring recommends first checking to see if your insurance will cover a medication.
  
• Have other people or agencies flagged the outlet for possible problems? Zaring recommends the websites safe.pharmacy and BeSafeRx to check if the pharmacy is registered with the National Association of Boards of Pharmacies and complying with the law.
  
  “How we know an online pharmacy is legal is they require a prescription by a licensed practitioner. You have a pharmacist review things, and the consumer has access to a pharmacist to ask questions,” Zaring explains. “Look for the outlet to be based in the United States and have a license in your state. Some online pharmacies will provide medications for patients even though they don’t have a license in the patient's state.”

Another law pharmacies have to follow is the Drug Supply Chain Security act. Zaring says this ensures all medications are logged and accounted for as they move from the manufacturer to the distributor. This makes sure all medications in the supply chain are legitimate and safe.

“In December 2025, the Food and Drug Administration warned about fake Ozempic,” Zaring recalls, noting what can go wrong if laws aren’t followed. “It looked almost identical to real Ozempic. It had lot numbers and expiration dates. But what they had done is created a syringe that looked similar and put on fake stickers.

“What pharmacists do then is go through and scan every medication that enters the pharmacy to ensure it’s directly from the manufacturer,” Zaring adds.

Consequences

Zaring says pharmacists’ biggest fear with these websites is someone putting something non-legitimate or harmful in their bodies. Is the syringe sterile? Has the drug expired? Is the dose correct? Is it properly diluted? Is it interacting with my other medications? Ingesting fake medications could lead to infections or other serious side effects.

Speaking on weight loss drugs: “If something is off by a decimal point, it’s a tenfold error. It can cause lack of movement in your gastrointestinal tract, obstructions and gallbladder attacks,” Zaring says. “If a person isn’t aware of the risks and talking to a pharmacist, they can upgrade their dose too quickly and cause more adverse effects like dehydration. Also with some of these online websites, there’s not continuous monitoring by a health care provider. No labs, check-ins or follow ups.

“The cost saving may be up front, but at the back end there may be an overall greater cost of having to see more health care providers because of adverse reactions or infections,” Zaring also warns.

If you’ve done business with an online pharmacy and have concerns, Zaring recommends talking to your primary care provider or a pharmacist at an in-person, well-recognized business. You can even bring the medication for them to inspect. You can also report pharmacies to the FDA at the BeSafeRx website.

Learn more

Read more about how OSF HealthCare pharmacists bring medication to you safely on the OSF HealthCare website. Some OSF HealthCare locations also have retail pharmacies that can be used regardless of whether you’re an OSF patient.

Interview clips

Frequently asked questions

We all get thirsty from time to time. But it’s not just that feeling that can mean you’re dehydrated – when your body doesn’t have enough fluids. There are lesser known signs you should know to avoid a possibly life-threatening situation, says Awad Alyami, MD, an OSF HealthCare pediatrician.

“You get less perfusion to tissues and organs,” when you’re dehydrated, Dr. Alyami says. “That can cause organ damage.

“Perfusion refers to fluid, nutrients and energy your organs need to function,” he adds.

Unfamiliar signs

Take note of these things to keep an eye on for possible dehydration, especially if you are at high risk. For example, if you work an outdoor job in warm weather or if you look after someone who can’t fully care for themselves.

• You’ve suffered burns. This means there is less skin tissue doing its job of keeping you healthy.
   
• Peeing isn’t normal, such as expelling less urine.

“When you’re hydrated, your urine should look yellow, pale yellow or sometimes almost transparent like water,” Dr. Alyami explains. “When you become dehydrated, your urine will become less in volume, and the color will be darker. It goes into an orange color. It can have a smell, also.”

• Crying without tears
   
• Skin changes, such as eyes appearing sunken in
   
• Fast heart rate
   
• Deep, heavy breaths

“When you’re dehydrated, your blood can be more acidic. You’ll try to get rid of some of that acid in your breaths,” Dr. Alyami says.

• Bad breath
   
• Headaches
   
• Muscle cramps
   
• Food cravings
   
• Sudden weight loss. Dr. Alyami says one kilogram (or around 2.2 pounds) of weight loss means one liter of fluid loss. So if someone has lost two to four pounds quickly and unintentionally (for example, not because of a diet and exercise program), it’s cause for concern.

What to do

Dr. Alyami says while dehydration can be serious, recovering doesn’t have to be. Rest and drink fluids. Water or Pedialyte are go-tos.

“If the dehydration is because of decreased oral intake, the person might just need pain medicine so it’s less painful to swallow while eating and drinking. If they are losing fluids from vomiting, we can give them medicine to stop vomiting,” Dr. Alyami says.

If those steps don’t work, Dr. Alyami says the person would likely get intravenous (IV) fluids in a hospital emergency department.

“You’re probably going to be there for at least a couple hours. [Health care providers] want to make sure you can take fluids and keep them down before you go home,” Dr. Alyami says. “Sometimes the dehydration is severe enough that we need to replace those fluids over one to two days.”

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Don't sweat it

• First, be honest with your provider about what you’re eating and drinking. They are the experts, so they can work with you to come up with a diet that fulfills you physically and emotionally.
   
• Practice moderation. Don’t have sweet and salty treats around you all the time.
  
  “Don’t go to Costco and buy in bulk,” Adcock says with a smile. “Have just enough to get you through the day.
  
  “Don’t sit down in front of the TV and mindlessly snack,” she adds. “It helps to have portioned servings that are within your meal plan.”
   
• Avoid impulse buys, too. We’ve all seen the rack of candy bars in the grocery store checkout area. If you’ve planned, for example, for a sweet treat with dinner, go for it. If not, resist the urge to just grab the candy for candy’s sake.

• Not all sweets are created equal.
  
  “Anything that’s highly concentrated in just sugar and has zero nutritional value,” is what you want to avoid, Adcock says. “Even fruit juice – that’s kind of a ‘sugar bomb.’ While it does have some nutrients, you’d be better off eating the fruit in its whole form.”
  
  Berries, melons and grapes are good “whole food” options, Adcock says. And dark chocolate is better than regular chocolate, she says. But soda is one morsel to avoid. Replace it with sugar-free beverages.
  
  Another option: “If chips are what you’re after for that crunch, start with a handful of baby carrots. Then finish with 17 chips, which is a typical serving,” Adcock says. “It’s going to fill you up. The carrot has the same crunch as a potato chip, but it has far more nutrients, far less calories and way fewer carbohydrates.”

Know the signs

What should people with diabetes watch for to know if sweets are wreaking havoc on their insides? First, you should always monitor your blood sugar level as advised by your provider. The latest technology is a continuous glucose monitor, which is a patch on your skin with a filament that pricks you every few minutes. Know what numbers are normal for you.

Aside from that, watch for nausea, vomiting, chills, shaking and just a general sick feeling, Adcock says.

“You need to take a dose of insulin that you typically would. Or if you’re not on insulin, let your provider know your blood sugar is high,” Adcock says. “If you’re just feeling blah after overeating and your blood sugar is high, just monitor your blood sugar every half an hour to an hour. After four hours if it’s not coming down, that would be a time to say, ‘Hey, maybe this is more serious.’ Or if you’re having those flu-like symptoms with high blood sugar, then absolutely go to the emergency department.”

Learn more

Read more about preventing and treating diabetes on the OSF HealthCare website.

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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.

Interview clips

You’ve likely heard of bronchitis, an illness that impacts the larger lung airways and leaves you feeling short of breath and just generally yucky.

This fall and winter, here’s another respiratory illness with “bronch” in the name to be aware of, especially if you have young kids: bronchiolitis. It’s an ailment that Awad Alyami, MD, an OSF HealthCare pediatrician, sees often this time of year.

The basics

Dr. Alyami says bronchiolitis is an infection of the bronchioles, or the small airways that branch out in the lungs.

“When they become infected, there is a lot of mucus. It makes it harder to breathe,” Dr. Alyami explains.

Other symptoms include fever, runny nose, cough and dehydration. Bronchiolitis is “easily spread,” Dr. Alyami says, through respiratory droplets, like when you cough. The illness is most common in children, especially kids under two. Other high-risk groups include babies born prematurely, with chronic lung disease, with heart disease present at birth and with immune system deficiencies.

“There are also environmental risk factors, like babies who are exposed to smoke and babies who attend day care,” Dr. Alyami adds. Attending day care, he explains, will expose a child to illnesses, no matter how clean the place is.

Cause, diagnosis and treatment

Dr. Alyami says other viruses like influenza and COVID-19 can cause bronchiolitis, but respiratory syncytial virus (RSV) is the most common cause.

“You need to see a doctor if your baby has trouble breathing at any time,” Dr. Alyami advises. “Or if your baby is younger than three months and they have a fever. Or if they are older than three months and they have a fever for more than three days. Or if the child has signs of dehydration, like if they are making fewer wet diapers than normal.”

Unlike the flu and COVID-19, there is no test for bronchiolitis. But, a health care provider may swab your nose anyway to see if you have another virus. Other tests like a chest x-ray may be done. And the provider will also examine you and ask about your health history to come up with a diagnosis.

Treatment involves making you feel comfortable until symptoms resolve.

“One of the most important things is nose suction as needed,” Dr. Alyami says. “When we suction the nose and keep it clean, it’s easier to breathe.”

A bulb suction is the most common device to do this. When you’re really stuffed up, you can use nasal spray or drops to make the secretion thinner. Then, use the suction. You can also use a humidifier if your home’s air is dry. Dr. Alyami says these devices and medicines are widely available in retail stores.

You can treat the fever with over-the-counter medication. Drink fluids to stay hydrated.

“Typically, day three to day five are the peak of symptoms,” Dr. Alyami says. “After five days, they start to improve. Symptoms can last seven to 14 days. And typically, the cough lingers for a little longer.”

In serious cases, your child may have low oxygen and need to be admitted to the hospital. There, doctors will use an oxygen tube inserted into the nostrils to help breathing. In rare cases, a doctor will put a breathing tube down the child’s throat.

Prevention

Want your child to avoid all this? Preach healthy habits, especially in fall and winter when respiratory illnesses peak. Wash your hands thoroughly. Cough and sneeze into your elbow or a tissue. If you’re sick, stay away from others.

Dr. Alyami adds that since RSV is the main cause of bronchiolitis, you should look into the RSV vaccine. This cold weather season, the vaccine is available for certain groups, like older adults, infants and pregnant women. Talk to your primary care provider if you have questions.

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With temperatures cooling, Awad Alyami, MD, an OSF HealthCare pediatrician, says we’re approaching the peak season for sore throats. Many cases have time-tested treatments, but some can have serious complications.

Dr. Alyami says a sore throat is an infection that causes inflammation in your throat. They’re annoying and painful, bringing symptoms like difficulty swallowing or talking and swelling of glands and tonsils. Causes can include tonsil stones, heartburn and allergies. But most commonly, causes break down into two groups: viral and bacterial.

Viral infections

Dr. Alyami says many viruses can cause sore throats – the common cold, influenza, coronavirus and others. Dr. Alyami says if your sore throat comes with coughing or a runny nose, that’s a sign it’s a viral infection. You can start treatment at home with over-the-counter medicine like Tylenol and ibuprofen. You can also gargle salt water and, generally, stay hydrated. Water is good for all ages, and Pedialyte can help hydrate kids.

If your symptoms include fever and neck swelling, it’s a more serious situation. You should see a health care provider.

Bacterial infections

The main bacterial infection that causes sore throats is group A streptococcus (commonly known as strep or strep throat). Strep throat may bring the hallmark sore throat symptoms, but you should also watch for fever and white patches toward the back of your mouth.

“This is a bacterial infection that’s common in kids,” Dr. Alyami says of strep throat.  “About 30% of sore throats are strep, and about 70% are viral. It’s a big deal. We need to treat to prevent complications.”

The most common complication is dehydration, Dr. Alyami says.

“The sore throat is so bad, the child doesn’t want to eat or drink,” he explains.

Other times, untreated strep throat can lead to abscesses, or pus pockets.

“If that abscess gets big enough, it can go toward other structures in the body that are very important. That infection can spread and progress very quickly,” Dr. Alyami says. Life-threatening conditions like difficulty breathing can result.

Dr. Alyami says providers can diagnose strep throat with a throat swab. They treat strep throat with 10 days of antibiotic medication, either injected or taken orally. He says most kids will take the medicine orally unless that’s troublesome. For example, some kids have a tough time swallowing pills due to throat pain.

Prevention

It’s advice you’ve heard before, but it’s worth repeating. Dr. Alyami says good hand hygiene goes a long way to preventing sore throats. Wash your hands thoroughly, and keep them away from your face.

Early detection is also key.

“If the child is sick, especially with symptoms that could be strep, it’s better to get them to a health care professional early,” Dr. Alyami implores. “They can get checked and isolated for 12 to 24 hours before they start antibiotics.

“If you’re sure about what they have, it’s better to just bring them in and get them checked,” he adds. Or, a virtual visit is an option.

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We’ve all been there. That uncomfortable feeling in your gut. The annoying stomach pain. The bloating and the difficulty of having a complete bowel movement. No matter what you do or what you try, you just can’t go.

You might be constipated.

Many times, it’s a temporary setback. Maybe it was that late night pizza or one too many hot dogs that has you backed up. But for others, it can be a chronic problem due to diet, medication, lack of exercise or dehydration. Sometimes, constipation can be a sign of something more serious.

Constipation usually means three or fewer bowel movements a week, says Breanne Gendron, a nurse practitioner with OSF HealthCare.

“Constipation is usually defined by discomfort in their abdomen because they haven't been going to the bathroom and having bowel movements as often as they should,” she says. “Some people have bowel movements every day. Some people have bowel movements every third day, and that's their normal.” 

There are plenty of reasons why people get plugged up from time to time. Certain medications can play a role in constipation. Pain medications, calcium supplements and some antidepressants have an influence.

Opioids bind to receptors in the intestines, which slows down the movement of food and waste (stool) through the colon. Additionally, opioids also increase water absorption in the intestines, making the stool harder and more difficult to pass.

There are other factors that can impact bowel movements such as travel, stress, a lack of activity or anything that interferes with your normal routine.

“The most common cause of constipation is dehydration, lack of activity and not enough fiber in your diet,” says Gendron, who adds that fiber provides bulk to stools, making them easier to pass. “It’s easy to add fiber powder to your coffee in the morning. But when you have fiber without hydration that can cause issues; so, it's about making sure that you're getting 40 to 60 ounces of water every day.” 

There are also non-diet and exercise-related causes of constipation. Structural changes such as a tumor or hemorrhoids can cause constipation and so can stress and anxiety.

Constipation can frustrate anyone, from young children to older people. Children between the ages of 5 to 12 will complain to their parents of stomach pain due to a lack of regularity. As for older adults, the digestive track tends to slow down as we age.

“I can say 30 to 40% of people over the age of 65 have constipation issues,” Gendron says. “So, it is a common thing that older people deal with. As we age, we have to have a plan. That means getting more active, drinking more water, eating fiber or adding a fiber supplement to their life.” 

Making changes 

Becoming regular again usually boils down to dietary and lifestyle changes. Gendron says the fiber goal should be 25 to 30 grams each day. Some of the best foods that help with fiber intake include beans, leafy vegetables, oatmeal, nuts, berries and apples.

Take time for at least 30 minutes of exercise a day. Walking is great way to kickstart your bowels. And establish a routine. Get in the habit of going to the bathroom at the same time each day. And never put off the urge to go.

If you’ve tried all these things and still feel stuck, talk to your medical provider, who might order an x-ray for a closer look.

“I usually recommend some combination of over-the-counter options,” says Gendron. “MiraLAX® is safe because it's not absorbed systemically. It just pulls fluid into your bowels and helps things move along.” 

Constipation is considered chronic when the problem lasts three weeks or longer. Gendron says that many people end up in the emergency department with constipation due to the length of time and discomfort they experience.

So, if your constipation does not go away through diet, hydration and exercise, or your symptoms become worse, such as blood in your stool, fever or vomiting, it’s time for medical intervention.

For more information on constipation and other gastrointestinal issues, visit the OSF HealthCare website.

Interview Clips

A group of about 40 participants in a recent training session at the OSF HealthCare Athletic Training Center at Illinois State University braved high humidity in the domed field to get a refresher on emergency procedures for medical emergencies during high school practices or sporting events.

As part of a collaboration, athletic trainers from ISU and OSF HealthCare gave high school trainers and master’s degree students from ISU’s Athletic Training program a refresher on critical skills. The timing was planned to be aligned with the start of practices and the Illinois High School Athletic Association (IHSA) sports season on August 11.

Joe Whitson, former athletic trainer and OSF HealthCare manager of the office that provides physician athletic trainers, says they simulated some of the most common conditions trainers see on the field.

“We had various stations going on, whether it was splinting and spine boarding, treatment of the spine-injured athlete. Dr. Rai, one of our sports medicine physicians, was here as well to help supervise. He was here giving pointers, walking around the stations, also working with our athletic trainers, giving them pointers and tips on skills that they can utilize out in the clinical field.”

OSF provides athletic trainers to seven local high schools, which were represented in the training. Whitson says the training helped reinforce how to identify symptoms of various conditions.

“Hitting tips on hydration, hitting tips on how to recognize the difference between sickle cell anemia, heat stroke and rhabdomyolysis. Unfortunately, with the increase in high school participation, high school athletes participating in sports, obviously, the incidence of these types of episodes are increasing as well.”

Rhabdomyolysis is a serious condition where damaged muscle tissue breaks down, releasing its contents into the bloodstream.

Whitson says every year there are headlines of student athletes who have issues and are admitted to the hospital due to some of these conditions, so it was important to go over related symptoms and emergency procedures, not only to know how to respond, but also how to prevent medical emergencies.

High school athletes want to perform at their highest level, and in many cases, they’re pushing for a college scholarship, so Whitson says it’s important for coaches to have support from medically trained professionals.

“That’s really a benefit that we've been able to provide here at OSF within the community, to be able to have those athletic trainers as resources, so that the coaches at all of our high schools have a resource to be able to lean on that’s clinically and medically trained to be able to handle those types of situations.”

The training emphasized communication as participants switched off playing roles, serving either as the lead practitioner, a medical assistant or the athlete. The training even highlighted infant CPR in case of a situation that might occur in stands.

Whitson stresses the IHSA has put safety standards into place to prevent injuries and medical emergencies and he says athletic trainers provide education around those protocols.

“The athletic directors obviously are in charge and kind of house enforcement of some of those things for student athlete safety. And that's the great thing where these athletic trainers from OSF, are able to come in and be able to educate the athletic directors, the student athletes, the coaches, and give those speaking points that are critical to be able to take care of them.”

ISU’s athletic training department has been hosting emergency training events for several years to make sure its staff is ready to handle emergencies that arise. This year, under a new collaboration with OSF HealthCare, it was the first time it was open to other community members.

Joe Whitson

B-roll for OSF-ISU train the trainers for medical emergencies

We’re approaching the late summer-early fall period when respiratory illnesses begin their annual upswing. The latest news from federal health officials concerns a new variant of COVID-19, NB.1.8.1. Some people impacted have reported severe sore throats, almost like there’s a razor blade in there.

Fred Burke, MD, an emergency medicine physician who sees patients at OSF HealthCare, says illnesses like COVID, RSV and the flu will always be around. It’s just a matter of taking precautions to avoid serious illness. So, what’s the level of concern with this new COVID variant as we begin to make fall plans?

The razor’s edge

Any sore throat is an annoyance. But Dr. Burke says you should monitor severe cases closely.

“You’re less likely to want to eat or drink, which can lead to further dehydration,” he says.

You can manage sore throats at home with Tylenol or ibuprofen, chloraseptic spray, warm tea and throat lozenges. Dr. Burke says if you have trouble keeping food or fluids down, feel lightheaded or dizzy or have trouble breathing, see a health care provider right away.

COVID precautions

Dr. Burke says this new COVID variant isn’t linked to as much severe illness as other variants. But, he says it’s more easily spread.

“The average healthy person might get through it with some [figurative] bumps and bruises and little to no symptoms. For people with comorbidities or who are immunocompromised, the virus might be a little bit more detrimental,” Dr. Burke says.

Getting vaccinated and practicing good hygiene are two big tools to avoid serious illness, he adds. Wash your hands and high touch surfaces, like doorknobs, often, don’t cough or sneeze into the open air and stay home and away from others when you don’t feel well. If you’re in a crowd, especially if you have a comorbidity like diabetes, Dr. Burke says you should consider wearing a mask.

“If you’re going to have a gathering, whether at home or somewhere else, you can also recommend people take a home test to make sure they don’t have COVID prior to going,” Dr. Burke suggests. Those at-home tests can usually be found over the counter at a pharmacy.

For vaccines, recent preliminary guidance from the U.S. Food and Drug Administration recommends the shot this fall for people 65 and up. For others, the shot is recommended for people who have a compromised immune system or a comorbid condition like obesity, heart disease, high blood pressure, lung disease or depression. The website for the U.S. Centers for Disease Control and Prevention, meanwhile, has a broader recommendation. When in doubt, Dr. Burke says to talk to your primary care provider.

Learn more

Explore other resources to keep yourself safe from COVID on the OSF HealthCare website, blog and newsroom.

Interview clips

Migraines are a part of life for many. From stress to dehydration to a woman’s menstrual cycle and even more serious issues such as a stroke, the headaches can pop up often. And they’re something you should know how to manage.

Amber Oberheim, APRN, a primary care provider at OSF HealthCare, says migraines can often be treated with ibuprofen (Advil is a common brand name) or naproxen (Aleve), plus lifestyle changes including better sleep. But, an online search will also yield plenty of non-medicinal, at-home remedies. Experts will remind you that these aren’t cure-alls. But it’s important to know what works and what doesn’t.

Myth vs. fact

• A cold or warm cloth on the head and neck: Stick to cold, Oberheim says.
  
  “One of the theories for why migraines happen is vasodilation, or increased blood flow to your brain,” Oberheim explains. “So we talk about using a cold compress over your eyes, on the back of your neck or at the top of your head. That cold sensation constricts blood vessels, thereby decreasing blood flow.”
  
  Oberheim adds that there are even migraine caps that stay in the freezer until use. Those are available over the counter at retail outlets.
   
• Rest and deep breathing: Oberheim says there’s no guarantee that your migraine will be gone when you wake up from a nap. But, she says rest and deep breathing can’t hurt. Take a break in a cool, dark room, and avoid screens and loud noises.
   
• Caffeine: It’s good general advice to ingest caffeine in moderation for heart and mental health. But, Oberheim says a soda might help with that headache.
  
  “We look at medications in Excedrin Migraine [pills]. Caffeine is one of them,” Oberheim says. “Caffeine has been proven to be effective sometimes in early management of migraine headaches.”
   
• Supplements: There’s a lot to choose from in this aisle of the pharmacy. And experts warn that you should choose with provider guidance since supplements aren’t regulated like others under the eye of the United States Food and Drug Administration. However, Oberheim says some research has shown that taking vitamin B2 (also called riboflavin) and magnesium daily can help with the number of migraines.
   
• Massaging your head: It’s a tactic some of us learned when we were kids. Massaging your temples (the area between your eyes and the top of your ears) could help with head pain.
  
  “I don’t think there’s any data that would support that. I think it’s more of a comfort,” Oberheim says. “When you’re experiencing pain and you can have a sensation that’s not pain somewhere on your body, it might help lessen the pain.”
  
  For example, Oberheim says when her patients are getting a blood draw through an IV in their elbow, a provider might scratch their upper arm (between the point of pain and the brain) to “confuse” the pain signal and lessen the discomfort. The same logic applies to rubbing your head during a migraine.
   
• Taking a shower: It depends, Oberheim says.
  
  “I could see if stress or muscle tension is creating a headache. Taking a warm shower or bath to relax might help,” Oberheim says. “However, if we’re thinking about a classic migraine with the theory of increased blood flow to the brain, taking a hot bath or shower might actually make it worse.
  
  “It never hurts to try, but I think it’s going to be patient-specific,” she adds.

When in doubt

Oberheim says some people have a history of migraines and know how to manage them. But if the headaches suddenly increase in frequency or intensity, you should see a health care provider. Also, talk to a provider if you have questions about starting or changing at-home treatment. The provider can determine what works for you. You don’t want new medications to negatively interact with drugs you’re already on, for example.

“Often, a migraine can last for longer than a typical headache. It can be accompanied by symptoms like nausea, light sensitivity and noise sensitivity,” Oberheim says, warning of the dangers if migraines are not treated quickly. “There are certain types of migraines that can also affect your vision.”

Temporary decreased function of your limbs is another rare, but possible side effect, Oberheim says.

Learn more

Read more about how to spot and treat a migraine on the OSF HealthCare website.

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When it’s hot outside, people tend to reach for the water. But too much of a good thing can be a problem.

It’s called water intoxication and it’s making news. Recently, a young woman died from drinking too much water in a short amount of time, and a young boy was hospitalized after doing the same thing.

“Water intoxication comes from drinking too much water," says Elizabeth Clay, a nurse practitioner with OSF HealthCare. "And it can lead to some severe symptoms. You can get a headache, disorientation, confusion, nausea, vomiting – it can even be fatal.”

Other serious symptoms include muscle weakness, increased blood pressure and double vision. 

“The amount of water that a person should consume is going to be individualized," says Clay. "But overall, your kidneys can only handle so much. And that's between 0.8 and one liter. So, you really don't want to be taking in more than that per hour in water.”

Water intoxication can affect anyone. But it’s a problem that is especially common in people who participate in sporting events, military training or working outside.

“Dehydration can play a major role in water intoxication because when a person feels that they're getting dehydrated, they may try to overcompensate and may drink too much water at one time, and your body can't handle that," says Clay. "So, you'll start to get these symptoms whether it's nausea, vomiting, confusion – just disruption of your brain activity – and that comes from that depletion of sodium. And so, your cells inside your brain are holding on to that water and it causes swelling inside your brain and that can lead to some serious complications.”

Clay suggests taking frequent swallows throughout the day rather than chugging a bottle of water at once. Also, eat a healthy diet to get the needed electrolytes. And don’t drink just water. Sports drinks like Powerade and Gatorade, as well as coconut water and cow's milk are full of electrolytes.

There are no guidelines as to how much water a person needs each day. Some people still follow the 8x8 rule, which recommends drinking eight 8-ounce glasses of water a day. Still, it depends on certain factors like body weight, the amount of physical activity you get and the climate where you live.

"So, if you can, stay indoors and out of the sun during this hot weather," says Clay. "But if you must be outside – if you've got training or some sort of physical activity that maybe your job or work requires – just want to make sure that you're getting those electrolytes and that water that you need. Just don't overdo it.”

 If you begin to experience symptoms after drinking too much water, call 9-1-1 immediately. 


 

Interview Clips 

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A survivor of a 2019 heart attack, Randy Isham was already on notice.

But Randy and his wife Dawn, retirees in Mansfield, Illinois, couldn’t predict the chaotic events of May 24, 2023. An ambulance took Randy to OSF HealthCare Heart of Mary Medical Center in nearby Urbana, and the man was soon fighting for his life due to a second heart attack.

“I’m glad to be alive,” Randy puts it plainly.

The Ishams and their OSF care team have now joined the chorus of heart health advocates, urging others to know when everyday exhaustion or dehydration is something more serious, especially if you have a history of heart issues.

From garage to gurney

On May 24, Randy was assembling a table in the garage when he began to feel weak but had no pain.

“When I touched his arm, it was a cold sweat,” Dawn recalls. “That’s when I got concerned that this didn’t seem right. Let’s call 9-1-1.”

It was in the ambulance that first responders determined Randy was having a heart attack. That’s when the flow of oxygen-rich blood to the heart is narrowed or blocked. Heart cells begin to suffer damage and die, and the heart no longer works how it should. Serious, life-long health issues or even death can result.

Randy coded at the hospital, adding to the urgency.

“It means there is no pulse. The heart stops. There is no blood reaching the brain and the whole body,” explains Tariq Enezate, MD, one of Randy’s OSF cardiologists. “When that happens, you need to know why and act fast.”

As the hospital pastoral care team and other Mission Partners (employees) kept Dawn informed, Randy was fighting for his life. He was without a pulse for 20 minutes, Dawn says, before Dr. Enezate’s team was able to revive him. Along the way, they removed a blood clot stemming from plaque buildup that they believe was the source of the heart attack. They then put in a stent. Randy is up to three stents, he points out, after his 2019 heart attack. It’s something he can speak about with relative ease now, but the nine-day hospital stay was no laughing matter.

“It could have gone either way,” Dawn says. “They wanted me to call the family in.”

Dr. Enezate describes the scene: “I had to go inside his heart while they were doing chest compressions. I was able to open [the blocked area in] his heart. At that moment, blood flow started back to the heart, and his pulse came back.

“Minutes mean muscle,” during heart attacks, Dr. Enezate adds. “The faster you restore flow in the artery and put a stent in, it’s better for the patient. It relieves their pain. It decreases the risk of complications.”

Lessons learned

Dr. Enezate calls Randy his miracle patient, and the Ishams agree.

“It was lucky he made it,” Dr. Enezate says. “I think the fact he came in early helped him.

“When we saw him coming back, that moment I can’t describe. It’s worth the world for all of us,” he adds.

Dr. Enezate’s affirmations “just gave me a nice warm feeling,” Randy says.

“Everybody there treated me like I was the only patient they had,” he adds, noting daily visits from Pastor Dave Jassman gave the couple strength.

Randy is back at home, doing well and receiving care typical for people who have suffered a major heart event, like therapy through OSF Home Care and cardiac rehabilitation. And he and Dawn are back at the healthy lifestyles that became the norm after Randy’s 2019 heart attack. Exercise is good, but no long work periods in the summer heat, for example. You’ll find Dawn cooking fish instead of steak. A tough, but necessary adjustment, Randy chuckles. Recipes from the American Heart Association also help.

“I used to think I was invincible, but I realize I’m not anymore,” Randy says.

The Ishams are also urging others to research trusted sources and learn not just the signs of a heart attack, but how to tell the difference between those signs and everyday pain like Randy thought he had on May 24. And don’t hesitate to call 9-1-1 when something is wrong.

“It could save your life,” Dawn says.

Dr. Enezate says the classic symptom of a heart attack is chest pain. Some people describe it as an elephant weighing on their chest. You may also be short of breath, sweat, feel anxious or feel like you’re going to pass out. Or you may have no warning signs, and suddenly you’ve collapsed.

“If you have symptoms and you’re not sure why, call [a health care provider] for advice,” Dr. Enezate advises.

What about prevention for people who’ve had a heart attack?

Practice healthy habits, Dr. Enezate says. Don’t smoke. Take medication as directed by your provider. Control risk factors like diabetes, blood pressure and cholesterol. Exercise and eat right.

Learn more

Read more about how to care for your heart on the OSF HealthCare website.

Interview clips - Dawn and Randy Isham

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A veteran urologist, Uwais Zaid, MD, has heard the comparisons.

Pain from a kidney stone is like giving birth.

“It’s true,” says the man who provides care at OSF HealthCare in Alton, Illinois.

“It’s horrible. They just can’t get comfortable. They’re writhing around in pain,” Dr. Zaid says of people suffering from a calcification-turned-blockage in the urinary tract.

“When the kidney gets obstructed, everything gets swollen upstream. That causes everything to get stretched out,” Dr. Zaid explains. “And it hurts a lot. Your body responds with severe pain in the flank area. It’s a sharp, stabbing pain.”

Other signs: you suddenly start feeling an urgency to urinate or your urine is anything but clear or yellow.

All those unpleasant symptoms are why prevention of kidney stones is key. It starts with what you put in your body.

Drink plenty of water, Dr. Zaid says. Doctors even recognize a “kidney stone belt” in the southern United States where people deal with sweltering weather and dehydration.

Avoid excess salt and sugar in your diet. That means cut back on soda and sweet tea. Too much meat, nuts and leafy vegetables can also cause problems.

“Other risk factors include a family history of kidney stones. Chronic diarrhea can cause dehydration and a loss of electrolytes,” Dr. Zaid says.

For small kidney stones – less than five millimeters across, or about the size of an eraser on the end of a pencil – a provider may see if the stones can pass out of your body through the urethra on their own. Medication can help with that.

But for trickier stones, there are several ways doctors can intervene. Dr. Zaid says providers can blast sound waves at the kidney stone from outside the body to break the stone apart. A doctor can send a camera through the urinary system, find the stone, use a laser to fragment it and remove the pieces. For larger stones – two to four centimeters – surgery involves an incision through your back to reach the stone, break it apart and remove it.

If you have symptoms of a kidney stone, don’t try to tough it out. Your symptoms may subside, but there may still be issues that could turn serious. Instead, see a doctor right away. They will perform a CT scan or ultrasound to find the cause of the pain, then develop a treatment plan.

“If the kidney remains obstructed for several weeks, that can lead to kidney damage,” Dr. Zaid warns. “If the kidney stone causes urine to get infected upstream, that can lead to sepsis, which is a life-threatening infection.”

Learn more about kidney stones on the OSF HealthCare health library and the OSF HealthCare blog.

Interview clips