If you break a leg or sprain an ankle during a basketball game, health care providers have a good idea what happened and how to treat it.

But if you have daily aches, pains and swelling in your legs, it will require some investigation.

Causes

Aman Khurana, MD, a vascular medicine physician who sees patients at OSF HealthCare, outlines common causes of leg pain. 

• Arterial disease
  
  “The arterial cause of leg pain is when people walk, and they get leg, calf, hip or thigh pain. That can be from less arterial flow down in the legs,” Dr. Khurana says. “When we walk, the muscles are demanding more blood. But because of blockages, blood doesn’t come.” 
   
• Venous disease
  
  “Venous pain brings heaviness, tiredness and fatigue. Varicose veins and leg discoloration are signs of venous disease,” Dr. Khurana explains. “That pain seems to get better when you lay flat or with your legs up.” 
   
• Arthritis, or inflammation of a joint
   
• Nerve issues
  
  “We have large nerves that go down from the back,” Dr. Khurana explains. When those nerves are irritated, it can cause a condition called sciatica. “Then there’s small vessel nerve pain that causes tingling and numbness in the feet.”

Wounds, such as those associated with diabetes, and lymphedema, a condition where fluid builds up causing swelling, can also contribute to these problems.

Diagnosis and treatment

Dr. Khurana recommends seeing a provider at the first sign of leg pain. He says it’s hard for people to pinpoint the problem, and waiting can make it worse.

A provider, he says, could check the blood pressure in your arms and legs to gauge blood flow and run a test to check for vein leakage.

“Veins have valves. When blood goes up, the valve should close. Some valves don’t close right. Blood goes up, and it keeps coming down. That’s how you have the heaviness, tiredness and swelling in the legs,” associated with venous disease, Dr. Khurana says. You could be given compression stockings for this problem.

Other treatments include medication, a device (such as a lymphedema pump that massages the legs and aids blood flow to the heart) or an ablation procedure to stop the blood flow in the problematic vein.

Prevention

How do I keep my legs moving? Dr. Khurana repeats advice many doctors have given. Daily healthy habits that prevent cardiovascular disease will help prevent leg issues.

• Keep your blood pressure, cholesterol and chronic conditions like diabetes in check.
   
• Don’t smoke. 
   
• Exercise and eat a healthy diet to avoid obesity. When your weight impacts your ability to get around, Dr. Khurana says, it’s definitely time to see a provider.
   
• Know your family history of health issues, and bring these up to your provider at your regular checkups.

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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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Carla Richardson of Beverly on the southwest side of Chicago loves it when her grandson tells her, “You’re lookin’ fresh Nonnie!” She jokes, “This is what 77 looks like. But then again, I’m an old hippie.”

Richardson also credits her "fresh look” to her positive attitude and the consistent care she’s been receiving at OSF CompleteCare 55+. The clinic at 99^th and Western Avenue in Evergreen Park opened a year ago this month. It offers a new kind of primary care targeting older adults with ongoing health conditions who are looking for community, hands-on care and 24/7 access to real providers, not chatbots.

For Richardson, the vibe is great.

“They’re glad to see you. You don’t feel like you’re a patient. You feel like you’re going somewhere where someone really cares about you. They keep in touch with you, which is so important. I get texts from Taylor [Taylor Wen, PA, her OSF CompleteCare 55+provider] on MyChart, and it’s just an interaction that is rare.” 

Richardson was diagnosed four years ago with pulmonary sarcoidosis, and she has a history of pulmonary embolism and pneumonia. Plus, she has to be on blood thinners. Frustrated with her previous care, she tried OSF Complete Care 55+ shortly after it opened, and she’s been thrilled with her experience.

“My first experience with Taylor was just phenomenal. She was knowledgeable, patient, and she seemed like she cared. And going to doctors, sometimes you're just a patient number. And I didn't feel that here.”

Wen, a physician assistant, also sent Richardson to get a bone density scan where Richardson learned she had severe osteoporosis – so bad that she had to reduce the weight of her purse for fear it would break her wrist. Richardson is so grateful because she believes knowledge is power.

Staying connected to consistent care

Although she doesn’t consider herself computer savvy, Richardson says she’s learned to use OSF MyChart, and it keeps her connected to Wen.

“It’s easy to use, and it helps me monitor and keep up with my own health issues. I like the fact it reminds me when I have appointments coming up. I’m retired but I’m still busy.” 

Richardson remembers when doctors made house calls and says the care she’s getting now reminds her of that.

“When the doctor would come to your house with his bag. I know it was 100 years ago. But it’s so personal now, here. And you go to other places, and you’re waiting and waiting. And no one really seems to care.” 

The 6,300 square-foot clinic features 12 exam rooms and on-site labs. Sandy Valino Stock, DO, medical director of OSF CompleteCare 55+, says many people enjoy the option to connect digitally 24/7. Virtual visits make it easy to get answers to questions, especially after hours when symptoms aren’t severe enough for emergency care. Richardson says that kind of convenience could save her from long waits in the emergency department, only to be sent home with a quick evaluation and remedy.

Dr. Valino Stock says about half of the people who use the clinic take advantage of virtual visits, while the other half are seen in-person.

“Patients love the virtual concept because they don’t have to miss as much work. It’s just convenient for them,” Dr. Valino Stock shares. “Sometimes it’s a case where the patient comes into the clinic and their loved one wants to be tuned in, but they’re at work. So, they can be virtual during that visit, and they can be present if they need to be.” 

More than half of the clinic’s patients have high blood pressure and/or high cholesterol, one-fourth have diabetes and significant osteoarthritis, and about 10% have heart failure.

But consistent care is helping improve those conditions. For example, almost 80% of patients are now meeting blood pressure and A1c targets, up from 34% and 58% respectively.

The clinic has also seen success in increasing completion rates for screenings such as mammograms, bone density tests and colonoscopies. These preventive steps are often overlooked, but they play a key role in long-term health.

GLP1 medication management is available

As people age, weight management can also become more difficult as metabolism naturally slows. Dr. Valino Stock explains that metabolism typically declines by 1% to 2% each year after age 20. At CompleteCare 55+, more than half of patients are overweight or meet obesity criteria. This is important because extra weight on the body leads to most of the medical conditions being treated.

GLP-1 medications such as Mounjaro or Ozempic are, as Dr. Valino Stock put it, “magical” in helping people lose weight. But the GLP-1 journey requires regular check-ins and medication management.

“We see them monthly for the most part as they’re getting started on these GLP-1s. So, patients have better success at getting healthier, whether it’s controlling their blood sugars or lowering their weight and doing it in a healthy manner where they can maintain their muscle and minimize the side effects.” 

Many who enroll in OSF CompleteCare 55+ are women in pre-menopause and menopause. The outlook for Hormone Replacement Therapy (HRT) for menopause has fundamentally shifted in the past 10 years. Following major reviews, experts now recognize that for most healthy women under 60 or within 10 years of the onset of menopause, the benefits of HRT far outweigh the risks.

“If no contraindications, we can help women sleep better, have a little bit more energy, feel themselves and just continue life because life is very busy. So, if we can help a woman get a good night’s sleep, everything changes for that woman.” 

Beyond direct medical care, digital health care navigators at a “Connect Bar” in the lobby also help with insurance issues, coordinating appointments with specialists and navigating OSF MyChart and other tools to monitor their health. Events such as Tech Tuesday also allow for group sessions to address technology challenges.

Navigators also connect people with resources to address social needs such as transportation to appointments or senior centers or food insecurity. Through educational events with speakers on health topics and partnerships with local organizations, clinic leaders continue to learn more about the needs of the people they're serving.

Additionally, regular outreach efforts keep providers connected. For example, at the OSF CompleteCare 55+ clinic, any community member can access free blood pressure screenings from 10 a.m.-noon every first and third Tuesday of the month.

Learn more here about OSF CompleteCare 55+ primary care.

Video clips with Carla Richardson

Video clips with Dr. Sandy Valino Stock

B-roll-OSF CompleteCare 55+

With age comes physical limitations. But it’s important to stay active, says John Rinker, MD, an internal medicine physician who specializes in geriatrics at OSF HealthCare. When you keep moving, it helps reduce the risk of things like diabetes, high blood pressure, heart disease, obesity, cancer and neurocognitive diseases like Alzheimer's.

In other words, Dr. Rinker says, it’s not fun to live long if you’re not well. Your lifespan versus your health span, as he puts it.

“It really, really pays to maintain exercise and be in good physical shape as you age. It reaps huge dividends on how long you live,” Dr. Rinker stresses.

Guidelines

Each person should have a tailored plan as advised by a health care provider. But regardless of your age, the American Heart Association (AHA) generally recommends 150 minutes of moderate physical activity or 70 minutes of vigorous physical activity each week, spread out over several days. A brisk walk would qualify as moderate intensity (also called zone two training), while running, swimming or riding a bike would be vigorous. Vigorous exercise is associated with a term called VO2 max, referring to maximum use of oxygen. In layman’s terms, you’re breathing hard and conditioning the heart.

“Most of that type of [vigorous] training is at a higher interval. You’re going to get breathing really hard for three to five minutes while you sustain a pace that’s rather difficult. Then you’re going to rest and let that heart rate come back down. Then go back to the hard exercise,” Dr. Rinker explains. “That back and forth with the heart rate really helps to train how well your heart can pump blood to muscles. That’s a really good marker of how well conditioned you are.”

The AHA also recommends two days of strength training per week. That could be lifting weights, using resistance bands or calisthenics, where you use your body weight for resistance rather than equipment.

“I really like the strength training piece,” Dr. Rinker says.

“It doesn’t take a lot as you age to tension a muscle enough to maintain muscle mass. We really find that people who are able to maintain muscle more muscle mass as they age are going to do much better with those health span and lifespan issues,” he adds. “So, the goal isn’t to make everyone a huge bodybuilder. The goal is to decrease the rate of decline as we age.”

On the days you do strength training, aim for 30 minutes per day. Dr. Rinker says if you really want to lean into this area of fitness, consider getting a personal trainer.

Limitations

It’s important to work around your ability and not push through pain, Dr. Rinker says. If aging has brought back or leg pain, skip the treadmill and try swimming or a weightlifting session while seated.

“You want to make sure you’re not going to injure something further. That will create a bigger setback or other deficit that are not going to help you in the long run,” Dr. Rinker says.

The bottom line

From VO2 max to zone two to calisthenics, there are a lot of terms to keep straight. If you don’t want to overthink it, just remember to keep moving. Push yourself with some vigorous workouts if you can, but commit to some form of exercise regularly.

“Most of your day-to-day exercise [as an older adult] should be just basic activity,” Dr. Rinker says. “Think of a brisk walk. Walking at a pace for about 30 minutes where you could still hold a conversation with somebody, but it would be difficult to sing a song.

“If I can just get someone to walk every day, I think they’re going to be in good shape,” he adds.

Learn more

Read more about moving your body safely and aging well on the OSF HealthCare website.

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• YES: moles, blisters, bumps, acne, boils, peeling skin from a sunburn, rashes, poison ivy or similar skin reactions, warts, skin tags and bug bites
   
• YES, BUT: Dr. Kumar says freckles and birthmarks are lesions, but they are not harmful.

In other words: “A skin lesion is any type of abnormal growth. It can happen anywhere on the body. If it doesn’t look like normal skin, it’s considered a growth,” Dr. Kumar says.

Causes for each of these lesions vary. We know acne is due to bacteria, and warts are from a virus, for example. Medications, lifestyle choices (like eating certain food that doesn’t agree with you) and medical conditions (such as diabetes and liver failure) are other culprits. But when the cause is unexplained, health care providers might need to investigate.

“We look at the lesion. The majority of the time, we can tell if something is benign or malignant. If we have questions, we err on the side of caution and do a biopsy,” Dr. Kumar explains. That involves cutting out part of the lesion and sending it off to a lab for analysis. “Biopsies can be done in the office. If it’s a bigger procedure, we have to go to the operating room.”

If the biopsy confirms evidence of a problem, such as cancer, the doctor will remove the rest of the bad tissue. Or, Dr. Kumar says some people come to him with a cosmetic or practical reason. They have a large birthmark or cyst on their face, are self-conscious about their appearance and would like it removed, for example. Or, they wear a hard hat for work, and the hat rubs against a lesion on their forehead, causing discomfort.

Dr. Kumar outlines how he would remove a lesion: “Let’s say it’s on your arm. We clean up the arm. We inject some lidocaine, which is a numbing agent. Then with a knife or other instrument, I’m able to cut it all out. Depending on how deep it is and the size of the lesion, we can glue it back together or put stitches in.” Regardless of the method, Dr. Kumar says most of these procedures are routine for providers with minimal aftereffects for the patient. In complex cases, like if the lesion goes down into a muscle, a plastic surgeon might be consulted.

Prevention

We can’t control if we have things like freckles or moles. But there are plenty of things you can do to help prevent problematic lesions.

• Limit your exposure to ultraviolet rays from the sun or by tanning. In fact, Dr. Kumar would not recommend tanning at all. For outdoor activities, use waterproof sunscreen of 50 sun protection factor (SPF) or higher, and reapply every few hours. Wear long sleeves and a wide brimmed hat.
   
• Wear bug spray when doing outdoor activities, such as hiking, where insects are present.
   
• Wash your body regularly.
  
  “Don’t overclean,” Dr. Kumar warns. “If you scratch your skin, that allows bacteria and other things to get into your skin and cause infections.”
   
• Don’t smoke. Dr. Kumar says smoking changes your skin for the worse, such as developing wrinkles and lesions.
   
• Find the right skincare products. If you use a lotion and it causes a rash, for example, don’t use that product again. Dr. Kumar adds that Vaselines and petroleum jellies are good for moisturizing your skin. But they’re thick and can clog pores.
  
  “Keep it simple. The $100 face cream is going to work the same as the $10 one,” Dr. Kumar says.
   
• Know the ABCDEs of suspicious moles.

o    A is for asymmetry. One half of the spot is not like the other half.

o    B is for border. The mole has an irregular, scalloped or poorly defined border.

o    C is for color. The spot has varying colors, like tan, brown, black, white, red or blue.

o    D is for diameter. Dermatologists say melanoma skin cancers are usually greater than six millimeters, or about the width of a pencil eraser. But they can be smaller, so don’t consider diameter alone.

o    E is for evolving. The mole looks different from the rest or is changing in size, shape or color. Dr. Kumar says you can take pictures to show your provider how the mole has changed.

                           If your lesion has any of the ABCDE red flags or you just have a concern, see a provider.

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Follow enough dermatologists on social media, and you’re bound to come across a viral video of a person with a ton of dead skin on their foot. The provider usually narrates while they chip away – literally – at the problem.

Thankfully, that’s not the norm, says Marc Leonard, DPM, an OSF HealthCare podiatrist. But you should still know the right way and the wrong way to remove foot calluses.

Calluses can occur when you wear shoes that don’t fit well, when you don’t wear socks with shoes, when you have foot bones out of normal position or if you do a lot of physical activity. Severe cases may also be genetic. Dr. Leonard says calluses often occur toward the front and back of your foot, but they can occur elsewhere if there’s a structural issue like a bunion or hammer toe.

Dr. Leonard says some exfoliation of your skin is natural, but you should look into treating calluses if the pain impacts your quality of life. He adds that people with diabetes need to pay close attention to calluses.

“If that callus builds up enough, puts pressure underneath the skin and breaks the skin down, it can cause ulcerations that can lead to infection or amputation,” Dr. Leonard says.

There are at-home remedies for calluses, but Dr. Leonard says to try them carefully and after speaking to a health care provider. A provider may tell you to run a nail file or pumice stone over the callus, sometimes after you get out of the shower when the skin is soft. Never use a device that’s not approved to treat calluses, like a razor. And be gentle and don’t dig too deep into the skin. Otherwise, bleeding can result. A provider may also tell you to wear shoes with more toe room, use shoe inserts or change the way you exercise.

For more severe cases, a provider may do the work for you.

“Here at the office, we’d trim the callus down,” Dr. Leonard says. “We’d try to get the person a way to manage it on their own once we get past the large, painful area. They can then manage it better using that pumice stone on a regular basis.”

Read more about how to keep your feet healthy on the OSF HealthCare website.

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Is your toe sore to the touch? Is the skin around the nail puffy or red? An ingrown toenail may be to blame.

Marc Leonard, DPM, an OSF HealthCare podiatrist, says it’s an issue he sees frequently, but it’s one that’s easily preventable.

Dr. Leonard says an ingrown toenail is when the nail grows into the skin on the nail’s side. Some people get ingrown toenails due to a family history of the problem. They may just have wide toenails, in other words.

For others, it’s a product of how you take care of your feet.

“Bicyclists wear very tight shoes. They clip onto the bike. The shoes are very unforgiving.” Dr. Leonard says as an example. “The person is getting extra pressure on the side of the toes. It can definitely contribute to ingrown nails.”

Dance shoes sometimes have the same effect, he says.

Another culprit: clipping your toenails too low toward the side of the toe. Instead, trim straight across using clippers with a straight, not curved, blade.

Avoiding these risk factors is crucial for people with diabetes, Dr. Leonard warns. While that group is not more prone to ingrown toenails, an occurrence may mean serious complications.

“If their blood sugar is not under control, the infections from ingrown nails can get severe quickly,” Dr. Leonard says. “Sometimes there can also be circulation problems with diabetics.”

Dr. Leonard says some ingrown toenails will resolve on their own. But if a person has to come to a podiatrist’s office, it usually means the site is infected.

“We might trim out the side of the nail. That’s the easiest way to treat it,” Dr. Leonard says. “In other situations, we have to numb the toe and take out the side of the nail.”

If the toe is really inflamed and irritated, he says, a doctor will remove a larger portion of the nail, plus some excess skin and tissue. The person may also be sent home with antibiotic medication to keep the infection down.

For people with frequent ingrown toenails, there’s a permanent solution.

“We’ll actually kill the side of the nail,” Dr. Leonard says. “We’ll put a chemical in the base of the toe to kill the root. That eliminates growth of the nail on the side.”

That’s an outpatient procedure done at a podiatrist’s office. And in the days and months ahead, you would trim the nail normally, Dr. Leonard says. The nail would just be narrower.

Regardless of what happens to your toe, recovery from ingrown nail treatment involves rest and soaking the toe in warm water. You should be back to normal activities “fairly quickly,” Dr. Leonard says.

One more burning question to answer: how often should I trim my toenails?

“For most people, probably once a month or once every couple weeks,” Dr. Leonard suggests. But if you have a history of ingrown toenails or other toe issues, talk to your primary care provider or podiatrist about proper toe care.

Learn more about foot and toe care on the OSF HealthCare website.

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On a low-dose CT scan for lung cancer: “It can catch lung cancer early. Lung cancer doesn’t have defined symptoms like colon or breast cancer,” Huelskoetter says. “A lot of times, you catch those nodules early and monitor them yearly or every six months based on what the radiologist finds. Then we can get you scheduled for routine low-dose CTs.”

She adds that this exam is geared toward smokers, but you can always bring it up with your provider.

What about kids?

Huelskoetter says children should see a provider at least once a year for a physical exam and to get caught up on vaccines, if needed.

“Make sure the provider records their height and weight. The provider will do an eye exam, an ear exam and things like that,” Huelskoetter outlines. “We want to make sure we’re not missing anything. A lot of times, eye problems in children can be caught in school. But maybe the child isn’t school age yet. We can get them in, do an exam and maybe catch something early.”

At home

Health care doesn’t end when you leave the clinic. Warm temperatures during spring can bring a renewed sense of optimism about changing daily habits.

“One thing I always tell my patients: move your body,” Huelskoetter implores. “I’m not saying you need to go to the gym and do pushups, sit ups and deadlifts every day. Just move your body. Start at a pace that’s good for you. If you have a sedentary job or lifestyle, get a step counter or smartwatch to track your steps and see where you’re at.”

For example, Huelskoetter says if you’re at 2,000 steps a day, set a goal of 10,000. But start small. For the first month, aim for 3,000 steps a day. Then increase it to 4,000, and so on. You can accomplish this, she says, through 30 minutes of exercise for five days a week.

“This can lead to drastic improvements in your cardiovascular health, your mental health and your overall physical well-being,” Huelskoetter says. “Your joints won’t be as stiff because they’re used to movement.”

Exercise should be paired with healthy food choices, such as cutting back on processed food.

Spring might also be the time you say, “I’m finally going to quit that unhealthy habit,” like smoking.

Huelskoetter’s response? “Now’s the time. Let’s do it,” she says.

“Again, let’s start small. Get an appointment with your provider, and talk about options,” Huelskoetter suggests. “If you don’t feel you can quit cold turkey, which is extremely hard, there are options like Wellbutrin, Chantix or nicotine patches and lozenges. Sometimes we’ll even do cognitive behavioral therapy.”

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After months of winter, the urge to get outside is hard to ignore, and for many people, that starts with a simple walk.

That includes Paige Linstead, a physician assistant with OSF HealthCare. “A lot of patients have sedentary jobs, as do I,” Linstead says. “So, I try to walk on my lunch, walk my dogs when I get home. I really focus on the calorie aspect of it too, and try to increase the walking speed, the distance that you can cover.”

For years, the targeted goal was 10,000 steps, which originated in the 1960s from a marketing campaign to promote the Tokyo Olympics. While the American Heart Association still recommends 10,000 steps a day, the organization says that just a mile of walking can also provide health benefits.

But now, the prevailing thought is that 7,000 steps a day will still do the trick. Walking improves your cardiac health, lowers your risk for diabetes, improves your circulation, can help improve sleep, decreases appetite and helps with weight management. It’s also enough steps to reduce the risk of dementia, cancer and depression.

“So, 10,000 was the gold standard. It's an easy number for people to say they're going to reach,” says Linstead. “But 7,000 is sufficient for most adults. It's a good goal to help minimize health risks and improve your health.”

It’s especially good for older adults.

Walking is good for heart health

According to a study published in the journal Circulation, older adults who walk three to four miles a day - 6,000 to 9,000 steps - are 40% to 50% less likely to suffer a heart attack or stroke than those who walk a mile (2,000 steps) a day.

This study focused on cardiovascular disease (CVD) risk and the findings were the result of eight studies using data from 20,000 people in the United States and 42 other countries. Their average age was 63 with 52% being women.

“It can improve your cardiovascular health, decrease your risk for diabetes or diabetes progression, help with stability, mobility,” Linstead adds. “It can help with mental health, getting a little bit vitamin D with the sun. Just set small goals for yourself and keep increasing as you can until you can get to that goal of 7,000 steps in a day.”

But if that still seems like a lot, don’t worry. Linstead says the important thing is to get started and work your way up gradually. Start by walking around your block or maybe visiting the local shopping mall.

“Absolutely, any movement is good movement,” she says. “Instead of having a sedentary lifestyle, if you can only get a couple thousand steps in a day, that can help elderly with mobility, stability, mental health, too.”

The Centers for Disease Control encourages people to get in 150 minutes of moderate to vigorous exercise each week. But Linstead says don’t try to squeeze in all 30 minutes at once, at least to start. She recommends breaking up the time into different parts of your day – for example, 10 minutes in the morning, 10 at lunch and another 10 minutes at night might just be the best route to take.

“I think that would be good motivation for people if they had a partner or a group to walk with,” Linstead says. “And you can walk at whatever speed you're comfortable with, the distance that you're comfortable with, but knowing that you have a support system in place.”

Before starting any type of walking program, however, make sure to consult with your medical provider first.


 

Interview Clips 

B-roll 

• Insulin pumps: These deliver insulin into your body to mimic the body’s natural production. This helps keep blood sugar at a healthy level. Adcock says it looks like a cell phone clipped to your midsection.
  
  “We have tubeless ones or ones with tubes. You would choose what works best for you,” Adcock says. “Some people are too active to be connected to that tube. So they would choose something like an Omnipod, which is a brand of tubeless insulin pump.”
  
  How much insulin you need daily also plays a role in which device you choose, Adcock says, because some hold more insulin than others.
   
• Continuous glucose monitors (CGMs): It’s a patch on your arm with a filament under the skin. It reads your glucose every few minutes, and the results are transmitted via Bluetooth to a receiver or cellphone. This can let you know in real time if your blood sugar is too high or too low, and you can take quick action to avoid a serious health issue.
  
  “It’s a big improvement,” from the old way of pricking yourself throughout the day, Adcock says. The con, though, is that the device can be expensive if your insurance doesn’t cover it.

Decisions, decisions

Deciding which diabetes device to use should start with a talk with your health care team and loved ones. Beyond that, lifestyle choices might come into play. Do you not want to carry insulin shots with you all the time? A pump might be the way to go. Or conversely, do you struggle with technology and don’t have someone at the ready to help? Maybe a CGM isn’t the choice for you, and you use the old finger-prick method.

“Make sure you’re not afraid to ask questions of your health care providers. That’s what we’re here for: to help,” Adcock says.

Daily maintenance

Regardless of what you choose, it’s important to keep the devices working properly. If, for example, your CGM stops working unbeknownst to you, your blood sugar could spike or drop, and you could wind up in the hospital. So talk to your health care provider about a backup plan if your primary device fails.

“Make sure you’re using your device correctly and as ordered by your physician,” Adcock implores. “These devices will give you messages like ‘It’s time to change your pump site’ or ‘It’s time to change your CGM site.’ Make sure you’re not ignoring and avoiding those.

“A really neat feature of CGMs is that since they use Bluetooth, you can have a support person also connected. They can review your numbers in real time but not be in the same area,” Adcock adds.

Learn more

Read more about preventing and treating diabetes 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.

Interview clips

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OSF HealthCare is piloting a new clinical intelligence platform designed to help medical providers quickly identify meaningful trends in patient data without interrupting care or adding clicks to already busy workflows.

The platform, called CliniPane, was developed through OSF Innovation and interfaces with a patient’s electronic health record, surfacing key insights at the point of care. Leaders say the goal is to reduce information overload while supporting faster, more informed clinical decisions.

Roopa Foulger, vice president of Digital Innovation Development at OSF Innovation, says the Peoria-based health system’s innovation ecosystem provided end-to-end support to develop CliniPane. That ecosystem includes internal funding through Jump ARCHES and Community Health Advocacy grants and academic research partners at the University of Illinois in Chicago and Urbana-Champaign.

The project also required collaboration with clinicians to understand what information is most useful during patient visits. Foulger says that early groundwork allowed the team to focus on real clinical needs before scaling the technology.

A new way to see data

OSF Innovation Senior Fellow Jonathan Handler, MD, who launched the effort and served on the research and development team, says traditional decision-support tools often rely on alerts or buried menus that can disrupt care or go unused.

“At the end of the day, we just wanted a new way to surface information to help clinicians during the care that they provide without making them do work and without interrupting their workflow.”

Rather than generating alerts, the platform displays relevant trends, such as lab values moving in the wrong direction. That information is directly within the clinician’s view and tailored to the provider’s role and the patient being seen.

“You may not notice that this person has been trending downward and that that’s a sign of something wrong, and by showing it (with CliniPane), we can potentially help them identify the underlying problem earlier so it can get diagnosed earlier and treated earlier.”

Dr. Handler says surfacing useful data can also help providers decide about whether to adjust medication types or doses.

Visual trends at the point of care

Visualization of data via CliniPane is something Dr. Handler sees as an important feature for patients as well. Physicians in the early testing group reported that during patient visits, they anticipated turning their screen around to show patients the same data they were reviewing.

“That might be something really meaningful to help patients to be empowered to participate in their own care, to understand their health and to see the impact of the changes that they make in their own lives and how it can impact their health.”

There are current solutions that can surface insights for clinicians in a patient’s electronic health record but usually not in a way that doesn’t require clicking to new screens or that allows future uses to accommodate external data from things such as smart watches or ever-expanding AI software. Foulger says that’s what’s different about CliniPane. It’s a platform that can be enhanced.

Built to Scale and Adapt

“Any data can come in – whether it’s variable data, whether it’s data from your EMR (electronic medical record), whether it’s data from a remote patient monitoring system we have, and that’s how the structure is. So, we can integrate more data that might be able to generate insights which, at the end from a user experience standpoint, ensures that it’s going to be valuable for the clinician.”

Foulger points out that researchers and developers also spent time collaborating with Information Technology leaders at OSF to ensure the platform securely protects patient data. It was a huge lift, Foulger says, to ensure data goes only to the right medical provider and that only data needed for decision support was provided at every level.

Because of those and other challenges, developers had to pivot many times. In fact, Foulger says there were at least 50 test versions of CliniPane.

“This is almost a new blueprint that we created at OSF in how you need to build these solutions that can fit with the growing needs on the AI side and how it needs to integrate with security.”

Physician feedback

Justin Holschbach, MD, an OSF HealthCare primary care physician in Bloomington, Illinois, has participated in the pilot. He agrees that the visual trend lines available via CliniPane have been helpful, especially for diabetes management.

“So, if we’re talking about diabetic control and an A1C, you were able to just kind of – in the corner of your screen – see whether the line was holding steady, going down or going up without having to click into multiple labs and see that in a different screen and get off of your space in Epic.”

The platform is currently being tested by a small group of primary care providers, with plans to expand access as technical validation continues. Developers say ongoing feedback from physicians is shaping future enhancements and helping determine which data points provide the most value.

Holschbach sees a future with expanded uses of data, and he believes CliniPane will eventually become standard of care, at least at OSF HealthCare. Innovation leaders believe CliniPane could eventually support multiple specialties and even improve patient health outcomes by turning complex data into clear, actionable insights without adding burden to clinicians.

Video clips with Dr. Jonathan Handler

Video clips with Roopa Foulger and Dr. Justin Holschbach

B-roll-CliniPane

• 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.

Interview clips

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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

Have a plan.

It's something any health care provider will tell a person with diabetes. Plan your meals and know your body’s red flags and know how to respond. Then, you’re best able to enjoy meals, whether at home, work or out with friends.

Nikki McBeath, RN, BSN, a diabetes resource educator at OSF HealthCare, agrees. She’s sharing tips for a diabetes-friendly lunch that keep your blood sugar in check.

• Generally, McBeath says to choose foods that are high in protein, fiber and healthy fats. Healthy fats can be found in avocados, nuts, seeds, fish, peanut butter and olive oil. Avoid unhealthy fats, like processed meat, fried foods, full-fat dairy, coconut oil and palm oil.
   
• Take Sunday night to meal prep for the week. Then, you don’t have to think about your food choices. It doesn’t have to be a daunting task, McBeath says.
  
  “With a lot of the patients I see, I recommend going to the store and getting steamable bags of vegetables. It’s super easy. You put it in the microwave for three minutes,” McBeath recalls. “There are lots of simple versions of foods. Get them [at the store], and make them quickly at home. It’s easier than people think. They just have to be on the lookout at the store.”
  
  Simple-to-make bagged chicken is another healthy grocery store choice. In fact, a favorite dish of McBeath’s is garlic chicken, Brussels sprouts and brown rice. The American Diabetes Association also has healthy eating tips.
   
• Eating lunch at a restaurant can present challenges. It’s a limited menu, and there’s temptation to lather your morsels in sauces and dressings.
  
  “Go to restaurants that let you substitute ingredients or ask your meal be cooked a certain way. Ask how things are prepared,” McBeath suggests. “Avoid fried foods. Ask for light or fat free dressing. Be mindful of the extra calories that come with big portions.”
  
  When the waiter or waitress asks about dessert, McBeath says moderation is key. She says most desserts are high in carbohydrates due to high sugar, flour and dairy content.
  
  “Throughout the day, count your carbs. Leave some room [in your carb budget] for something sweet,” McBeath says. “Portion yourself. Have the dessert right after your meal. Don’t wait a couple hours because you might be hungry for more.
  
  “Try substitutions like dark chocolate for regular chocolate or white chocolate,” she adds. That’s because dark chocolate has less sugar substitute.
   
• Busy at work? Constantly on the go? Avoid making the fast food drive-through your second home. Instead, McBeath says you can choose a granola bar that’s high in protein, fiber and healthy fats. And watch the serving size. If it’s one or two bars, make that your meal, not the whole box.
  
  “Pair the granola bar with something like string cheese or peanut butter,” McBeath says. “Adding some fiber or protein can make it more of a meal and give it more of a balance for your blood sugar.”
   
• Know your body’s warning signs. Symptoms of high blood sugar, McBeath says, include dry mouth, increased urination and generally not feeling well. Low blood sugar, she says, is more concerning in the moment. You can feel shaky, anxious, have blurred vision and even pass out. So, always have supplies handy. You can eat hard candy, honey or glucose tablets as prescribed by a provider to counteract low blood sugar. Bring your glucose meter to lunch, too.
  
  “Better safe than sorry,” McBeath says.

Learn more

Visit the OSF HealthCare website for healthy recipes and more information about how to manage diabetes.

Interview clips

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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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Andrew Hade was diagnosed with diabetes two years ago. While the Rockford, Illinois, resident was surprised, he was more shocked when he later found out he also has diabetic retinopathy.

“Retinopathy is a complication of diabetes that affects the back of the eye and can cause vision loss, blurry vision and other complications,” says Pamela Garcia, a nurse practitioner for OSF HealthCare.

Garcia adds that early symptoms of retinopathy include floaters, blurriness, dark areas of vision and difficulty perceiving colors. Mild cases may be treated with diabetes management and more serious cases could require surgery.

It's important for people with diabetes to schedule a thorough eye exam at least once a year. That’s because most patients, like Hade, display no symptoms of diabetic retinopathy until it’s too late.

“I initially was dismissive about the eye test, because, I had no symptoms,” he says. “It's hard to think of something being wrong that's not actually causing things that you're noticing are wrong. So, imagine my surprise when they're like, ‘You need to visit an eye care specialist to make sure this is not a systemic issue that's getting worse.'”

Diabetes

According to the Illinois Department of Public Health (IDPH), 30.3 million people in the United States (9.4% of the population) have diabetes – one-third of these people don’t realize they have it. In Illinois, 1.3 million adults (12.5% of the population) have diabetes, and 341,000 of those people don’t know it. Diabetes is the seventh leading cause of death.

People suffering from diabetes are at a greater risk for heart disease, stroke, blindness, and kidney failure. Diabetes impacts people of all ages and ethnic groups.

But people like Hade are being helped thanks to screening that works to detect diabetic retinopathy.

Vision screening

Three years ago, OSF HealthCare began offering LumineticsCore at eight sites and has since expanded to several OSF locations in Illinois.

LumineticsCore is an artificial intelligence (AI) platform manufactured by Digital Diagnostics, a leading diagnostic health care company. The cameras are used to detect diabetic retinopathy during a patient visit by analyzing retinal images for signs of disease without the need for a specialist to interpret the images.

In the first six months of using this technology in OSF HealthCare offices, 28 out of 100 people with diabetes tested positive, with about a 2% false-positive rate. That’s 28% of patients with diabetes who would have been at risk of losing their vision in the future if not for the screening to detect it early.

Rejanee Evans is an OSF HealthCare medical office assistant who administers the tests in a Rockford-area clinic. She averages about 23 screenings a month in her office. She says the testing is convenient for patients. They can be screened before or after an appointment and the testing takes about five minutes.

“For all our controlled and uncontrolled diabetes patients, we have our machine that consists of four pictures, two of the right eye, two of the left,” she says. “They get the results right after the exam. And if they have diabetic retinopathy, then we will refer them to a specialist where they will start treatment.”

If the results are negative, the patients will be monitored and tested again in a year.

“Some patients didn't even know about it, and it really helps them,” Evans adds. “Some patients say I'm having vision loss, or my prescriptions just aren’t right. Well, a lot of that has to do with diabetic retinopathy. They didn't know that it was their diabetes that is affecting their eyes.”

Garcia says there are ways to reduce the risk of developing diabetic retinopathy. “If you have diabetes, to prevent complications like this, it's recommended that you keep your cholesterol and blood sugars under control, as well as if you have hypertension, keeping your blood sugar under control,” she says.

Hade has simple advice for people with diabetes. Get tested for retinopathy. Even if you don’t have any symptoms.

“Now that I do know, I can take steps to prevent the worst possible result, which is, going blind,” Hade stresses. “I don't want to go blind, so getting the test makes it so I might be able to avoid that. Not taking the test means that I wouldn't know.”

For more information about diabetes care, visit OSF HealthCare. 

Pamela Garcia interview clips 

Andrew Hade interview clips 

Rejanee Evans interview clips 

B-roll

Holiday meals bring candy, cookies and other sweets in bountiful amounts. Most of us will chow down with a promise to return to healthy eating tomorrow. But people with diabetes must closely monitor their intake of sugar and carbohydrates at every meal.

What is diabetes? 

Aminat Ogun, MD, is a family medicine physician at OSF HealthCare. She says diabetes is a disorder that affects how your body uses blood sugar. Type 1 diabetes is when an autoimmune reaction stops your body from making insulin. Type 2 is when the body can’t recognize insulin and use it well. Gestational diabetes occurs in pregnant women.

Dr. Ogun says a sedentary lifestyle can be a big risk factor for developing diabetes, so regular exercise is important. Treatment typically involves medication and lifestyle changes.

Moderation is key 

Dr. Ogun says there’s no magic number of cookies you can eat on Christmas and walk away with no diabetes complications. Your nutrition depends on your age, sex, height, weight and more. Plus, she says the brain needs some sugar to function.

Dr. Ogun recommends small portions. Put just a couple of cookies or chocolates on your plate after the holiday meal. Don’t keep going back for more.

Mix in healthier snacks, like fruits, vegetables, nuts and legumes. Look for “whole grain” or “whole wheat” on the label. If you’re craving sugar, try yogurt with berries or an apple with peanut butter. Artificial sweeteners are another option to satisfy the sweet tooth, as Dr. Ogun says they do not raise your blood sugar level. For example, mix a sweetener powder into your water.

Dr. Ogun says if you rely on insulin, check your blood sugar level as often as your doctor advises.

“You would have discussed with your doctor the amount of carbohydrates you can take,” Dr. Ogun says. “Try to keep to that level.”

Dr. Ogun admits it may be more difficult for children not to gorge on holiday sweets. So, parents need to keep a close eye and provide motivation to eat healthy.

“If they eat a certain amount of vegetables of fruits in a day, maybe reward with a cookie or snack,” Dr. Ogun suggests.

Learn more 

Symptoms of diabetes include increased urination, increased thirst and blurred vision. More serious cases could bring nausea, vomiting and eye, heart and kidney issues. Nerve damage leading to numbness and tingling in your hands and feet known as diabetic neuropathy is also possible.

“We lose sensation in those areas. People may step on a nail and might not feel it,” Dr. Ogun says. “The issue grows and grows and leads to an ulcer, which makes wound healing harder for diabetic patients.

“That’s when we have to consider amputation,” of a foot, for example, she adds.

Diabetes can also be fatal, Dr. Ogun says.

Read about diabetes care on the OSF HealthCare website. If you have questions about this disorder or have symptoms, talk to your primary care provider.

Interview clips

Previous coverage

OSF HealthCare blog entries on diabetes

OSF HealthCare Newsroom stories on diabetes

OSF HealthCare gastroenterologist Omar Khokhar, MD, says it’s a homemade drink that includes a few main ingredients.

“It’s oranges, coconut water and salt. It can be derivatives of each one of those ingredients but that’s sort of the nuts and bolts of it. The thought process is that each one of those ingredients helps with the electrolyte balance in your body once you ingest this mocktail.”

The drink is designed to promote development of cortisol, a stress hormone that influences several systems in the body.

“Cortisol is one of many chemicals produced by a small gland on top of your kidney called the adrenal gland. And so, cortisol plays a key role in metabolism, immune function, blood-sugar metabolism and so any disruption in your cortisol metabolism can have a downstream effect in other parts of your body leading to potential health issues.”

The drink claims to help with something influencers have labeled “adrenal fatigue” and weight loss by increasing cortisol. But here’s the catch — Dr. Khokhar says the science doesn’t back it up.

“Adrenal fatigue has been debunked in 2016 by a meta-analysis, and it is not a true condition. The other pertinent point that people should know is that taking a cortisol mocktail does not in any way shape or form alter your cortisol levels. It has no impact on producing more cortisol or reducing cortisol levels in any way.”

There is a condition known as adrenal insufficiency, which is a serious medical condition in which the adrenal glands fail to produce enough cortisol. Symptoms include nausea, vomiting, low blood pressure, low blood sugar and extreme fatigue. Dr. Khokhar says if you experience these symptoms, see a doctor right away.

If you want to improve cortisol levels in a meaningful way, Dr. Khokhar suggests other approaches.

“There are things that are much more data-driven that can help with that. That includes getting seven or eight hours of sleep. That includes reducing your stress through meditation or other practices.” He also suggests, “That includes eating a healthy diet. Those are things that are maybe more difficult to do but they’ve been shown to improve cortisol levels, whether they’re high or low.” (

Dr. Khokhar says a cortisol cocktail as its being touted likely won’t harm you if you don’t have an underlying condition such as diabetes or high blood pressure that could be impacted by a sugary, salty drink.

On its own, he says coconut water has health benefits because it has electrolytes and hydrating properties. So, it can help with rehydration, especially after exercise or illness, and could also support heart health, blood sugar management, and digestive health. 

Additionally, coconut water and orange juice are a good source of Vitamin C and other antioxidants so benefits worth sipping, even if cortisol isn’t part of the picture. 

Dr. Omar Khokhar

B-roll-Cortisol Cocktail

Diabetes: a recap

Aminat Ogun, MD, a family medicine physician at OSF HealthCare, recaps Types 1 and 2 diabetes and where Type 1.5 fits in:

• Type 1: Dr. Ogun says the body’s immune system attacks insulin-producing cells in the pancreas.
  
  “Insulin is a hormone that brings glucose from food from the blood to the body’s cells for energy. So in Type 1 diabetes, the pancreas isn’t producing insulin,” Dr. Ogun explains. “This type of diabetes is usually seen in childhood and adolescence. It’s sudden onset. Symptoms are increased urination, increased thirst, weight loss and blurry vision. A lot of these people are dependent on insulin shots.”
   
• Type 2: The pancreas is producing insulin, but the body doesn’t recognize it. Dr. Ogun says these patients are typically age 40 and up, and the disease has a gradual onset.
  
  “Management is lifestyle modifications, like a healthy diet and physical activity,” Dr. Ogun says. “And there are medications to help control blood sugar like Metformin and Jardiance®, plus insulin shots.”
   
• Type 1.5: This is also called latent autoimmune diabetes in adults (LADA).
  
  “It’s a slow progressing form of Type 1 diabetes. It’s autoimmune like Type 1, but it’s usually seen in adults,” Dr. Ogun says. Symptoms are similar to Type 2 diabetes: fatigue, nausea and vomiting. Or, Dr. Ogun says some people may have little to no symptoms.

More on Type 1.5

So, if Type 1.5 diabetes can mimic Types 1 and 2, how do providers pin down a diagnosis?

Dr. Ogun says it’s something providers are learning more about and getting better at. She says providers will take a blood sample to look at your blood glucose and antibodies. Providers can also sample your blood or urine to look at your C-peptide level. C-peptide is a byproduct of insulin production, and if it’s low it’s cause for concern.

Treatment is similar to Type 2 diabetes: oral medication or an injectable GLP-1 medication like Ozempic®.

“But eventually once the autoimmune destruction happens, the person will need regular insulin,” Dr. Ogun says. “One good thing is that if you are aware the person might have Type 1.5, starting insulin earlier is a little bit better. Maybe that can preserve some of the cells in the pancreas and preserve some pancreas function.”

Shoring up your diet and exercise can also help.

Prevention

Dr. Ogun says since Type 1.5 diabetes is an autoimmune disease, there’s no bonafide way to prevent it. She adds there is a genetic component, meaning a child of someone with Type 1.5 is at a higher risk to get in themselves.

But, Dr. Ogun says sometimes education can be the best prevention. She says she’s happy Lance Bass has spoken out. Bass is active, fit and has diabetes – a sign that it can happen to anyone, and you should be aware of the disease.

Learn more

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

Interview clips

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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

Ron Carlson had been hampered by various health problems for several years.

The Rockford resident has lived with diabetes for 30 years. Nearly 20 years ago, Carlson had quadruple bypass surgery.

Then in 2022, the retired salesman developed a sore above his left ankle that wouldn’t go away. 

Carlson says it was a significant-sized wound. “When I first looked at it, my concern was, 'Hey, I'm not going to have a foot.' And they said, 'Yes, you will. And we can get through this, but it's going to take a while.' They were absolutely right.”

“They said it was an ulcer that had to heal from the inside. Well, never healed and never healed. Just kept getting worse,” he added. “And so finally, that's what eventually led me to Dr Cox.”

Samantha Cox, DO, is a vascular surgeon with OSF HealthCare, who determined that Carlson needed limb salvage surgery as part of his care plan.

Limb salvage is surgery to repair and restore a limb (arm, leg or foot) that’s diseased or injured. The surgery is an attempt to save a limb instead of opting for amputation.

“When it comes to limb salvage, he hits on all the pieces,” says Dr. Cox. “He's got arterial disease, he's got venous disease, he's got diabetes. He's had a long-standing wound; all those things play into it.”

Dr. Cox says it’s important to take a holistic view of limb salvage when attempting to improve someone's lower extremity vascular disease. Surgery is becoming more common around the world as the number of people with diabetes increases.

Complex case 

Carlson had an extremely complex issue. In addition to his leg wound, Carlson had peripheral arterial disease (PAD), a condition where the arteries narrow and reduce blood flow to the arms or legs and causes pain. PAD can be the result of high cholesterol or diabetes.

“We had to get his blood sugar under control; we had to optimize his nutrition; we had to get into the wound care center,” says Dr. Cox. “We had to fix his arterial disease; we had to fix and maintain his venous disease.”

Dr. Cox performed two surgeries on Carlson to repair the arterial and venous diseases. Then she fixed his wound before sending him to the wound care center for further treatment.

Feeling good again 

Carlson is happy to be back on his feet again.

With help from his wife, Carlson manages to care for his wound daily, including cleaning and changing the dressing. Carlson says his leg looks much better, and the circulation in his leg has improved.

And he has no restrictions. He’s watching his six grandkids play sports and other activities.

“I couldn't really travel anywhere to go see them, to a sporting event or anything like that,” Carlson says. “Just lately, I've been able to make that distance in traveling, for an hour or two hours, whatever it takes to get to where they're going. I can do that now.”

Many people experience leg pain or heaviness, especially as they get older. Dr. Cox says it’s important to have a conversation with your primary care provider to determine if you have a problem and the best way to approach treatment.  

“The sooner you seek help from a professional, the quicker you are going to be on the road to recovery,” says Dr. Cox. “These are very complex issues. We often say when it comes to limb salvage, it takes a village, and it truly takes a village of support for patients to get through these issues, whether it's management of arterial disease or venous disease, as in this patient's case. If it's a matter of wound care, we have resources to help people.”

For more information on vascular programs and services, visit the OSF Cardiovascular Institute website.

Dr. Samantha Cox Interview Clips

Ron Carlson Interview Clips 

B-Roll

Heart disease remains the leading cause of death in the United States. That’s from a new study in Circulation, a journal published by the American Heart Association (AHA).

According to the AHA, 941,00 people died from heart disease in the U.S. in 2022. Cancer deaths are second followed by accidental deaths.

Nancy Dagefoerde is a nurse practitioner with OSF HealthCare Cardiovascular Institute who closely monitors these trends. While the findings weren’t surprising, Dagefoerde says it’s a great reminder to patients and clinicians that heart health remains a top priority.

“It gives us information to talk to our patients about and for the public to see things that they might want to work on,” she says. “I think many people are concerned about other illnesses like cancer, but then we have these reports that tell us heart disease is still leading cause of death.” 

There are several risk factors for heart disease. The greatest risk is genetics, followed by threats that are preventable such as diabetes, high cholesterol and blood pressure, stress, lack of exercise and obesity. Nearly 47% of U.S. adults have high blood pressure, 57% have Type 2 diabetes or prediabetes and 42% have obesity.

And the risks impact all ethnicities, but some more than others.

“For example, many Hispanics are higher risk for diabetes,” says Dagefoerde. “African American women tend to have higher risk for obesity and hypertension. So, we really need to target those risks and realize that these are some things that we can work on to prevent that risk.”

There is, however, some good news.

High cholesterol rates have declined over the past few years. Dagefoerde credits that to more awareness about diet and lifestyle factors, as well as medications used to control cholesterol. And smoking rates are also on the decline. That includes both cigarettes and e-cigarette use.

“I was pleased to see that the smoking rates and vaping rates were down, and not only for adults but teenagers,” she says. “As for cholesterol, we have good treatment plans that are being utilized. Those are two very important things that are exciting.”

While there has been some progress, experts warn that if recent trends continue, hypertension, obesity and diabetes will reach staggering numbers. This will greatly impact people’s health as they age.

Dagefoerde adds that 80% of heart problems can be prevented. It starts by working on lifestyle issues – diet, exercise, sleep, no smoking and limit your alcohol consumption. It starts by educating yourself and working with your doctor to develop a plan.

“Bottom line, know your numbers, know your risks,” Dagefoerde says. “If you have a family risk, then you're going to be more diligent with working on your risk factors. And when I say know your numbers, you want to know your blood pressure, your blood sugar and your cholesterol levels. Those are some things that you and your health care provider can work on and when they make recommendations, listen to them, ask questions and work together on a good treatment plan that you're comfortable with.”

Because heart disease remains the number one killer, more reason everyone should know how to do CPR and be prepared to know where defibrillators are when you’re at a public event. Download the PulsePoint app to see where defibrillators are located.

For more information on heart and vascular services, visit the OSF HealthCare Cardiovascular Institute website.

Interview Clips 

If you see your cardiologist and they throw out the term “heart failure,” your heart might figuratively skip a beat. The heart is a vital organ, and if it’s failing, should I be counting my days?

While advanced heart failure will mean big life changes, Margy Goetten, APRN, a cardiology provider at OSF HealthCare, wants you to know that you can live with heart failure.

What to know about heart failure

Goetten says heart failure occurs when the organ can’t pump blood or relax like normal.

“New heart failure patients may experience shortness of breath. They might have difficulty when laying down. They can’t breathe. Leg swelling and fatigue are also common,” Goetten explains. “But if heart failure is well controlled, a lot of people don’t have symptoms.”

Milder cases of heart failure can be controlled by taking multiple medications – a cocktail of sorts that research has shown to help. Titrate medication, for example, helps with shortness of breath, Goetten says. Managing other health problems and not missing doctor’s appointments are also must-dos.

“It’s really symptom management,” Goetten says.

People with advanced heart failure, called end-stage, are “pretty sick,” Goetten says. She says they often require frequent trips to the hospital.

“Your symptoms are more severe. They come more frequently,” Goetten points out.  “If you miss medications, the symptoms can occur quickly within a day rather than missing medications for a couple days and showing symptoms,” Goetten says.

In addition to medication, end-stage heart failure patients might have a device – an Impella or a balloon pump – put in their heart to help it pump normally. Goetten often sees these people live a “new normal.” For example, they might cut back on long vacation trips in favor of “staycations” where they know their heart care team is just minutes away.

Prevention

Just as the tires on our car wear down with miles driven, our heart wears down with age. It’s inevitable. But healthy habits can help your heart hold up longer. Get on a diet and exercise plan to avoid obesity. Manage conditions such as diabetes, sleep apnea, high cholesterol and high blood pressure.

“Once those are under control, a lot of the symptoms seem to get better,” Goetten says.

Learn more

Read more about keeping your heart in top shape on the OSF HealthCare website.

Interview clips

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Icy roads? Gym too far away? Or are you just not a people person? Cozy cardio may be right for you.

What is cozy cardio?

Clare Spires, an exercise physiologist at OSF HealthCare, says cozy cardio, in simple terms, is a way to make exercise comfortable in your home. It’s wise to talk to a health care provider about what workout is right for you. But generally, cozy cardio offers some freedom. For example, you can work up a sweat with an instructional video or app. Or you can just find a routine that works for you.

Equipment

Spires says you don’t have to rush out and buy equipment. But if you like having something to hold or press your feet to, there are options.

Walking pads have become popular. These are miniature treadmills with just the bottom structure. There are no rails and monitor at eye level like a traditional treadmill.

“Some can do inclines,” Spires says. “You can put it under a desk if you’re a remote worker. It’s just another way to get those steps in during the day without leaving your house.”

A small set of weights can be a welcome addition. Skip the 50 or 100-pound weights, Spires says. Two to five pounders are a good start.

“If you’re doing some bigger muscle groups like biceps and quads, you could add more weight,” Spires says. “But typically, those at-home workouts are made that you can lift weights with something like a soup can or a water bottle.”

Keep that water bottle handy for hydration, too. And a mat can help with balance.

Safety

Gyms typically have safety measures and employees watching out for injuries or emergencies. During cozy cardio, you could be alone in an environment that wasn’t meant for exercise. Think of a cluttered living room.

So, Spires says to do a safety check before each workout. Remove trip hazards like cords and rugs.

“If you could use a little extra stability, maybe work out next to a counter that you can hold onto. Avoid something that’s going to move on you quickly,” Spires advises.

Exercise with someone, if possible. Have a phone nearby in case you need to call 9-1-1. Start slow, and work up to your goals.

How much?

The American Heart Association recommends 150 minutes of moderate intensity exercise or 75 minutes of vigorous exercise per week, spread out over several days. For those with that goal in mind, many do 30 minutes of sweat-building for five days per week. Others do 50 minutes per day for three days. Spires says you can have some cardio days and some weightlifting days. She says it’s good to mix it up.

Spires says when defining “moderate intensity,” think about singing a song while working out. If the strain of the workout means you can’t sing without running out of breath, you’re at moderate intensity. “Vigorous” would be an activity above that, like running.

It’s a process, but Spires says the benefits are worth it. Regular exercise means lower blood pressure, cholesterol, chance of diabetes and chance of heart disease. You might also see improved mood and sleep.

Interview clips

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Food deserts – neighborhoods that don’t have quick access to a grocery store with healthy options – are, sadly, nothing new. They lead to quick stops at the fast-food place or gas station, where healthy food may be at a premium.

But have you ever taken a deep dive into how food deserts can significantly impact a person’s health? And more importantly, what can be done about the problem?

Clare Spires, an exercise physiologist at OSF HealthCare, has some things to keep in mind. Spires also knows about food insecurity firsthand through her support of two OSF programs: Peace Meal, which provides meals in-home or at a central site to people 60 and older, and Smart Meals, which provides a meal kit for a family of four and teaches them to cook.

“We want diets high in fruits, vegetables and fiber and low in saturated fat. Gas stations and fast-food restaurants provide the flip side. They often provide no fruits and vegetables, food high in saturated fat and no good fiber food,” Spires says.

How to navigate food deserts

• Planning meals for the week is key, Spires says. Estimate how much food you’ll need and how much you have to spend.
   
• If you can’t help but go to the eatery or gas station often, choose healthier options.
  
  “I’ve found gas stations are very similar to grocery stores. As long as you stay on the outside perimeter, you’ll stay away from candy and chips that will be down an aisle,” Spires says. “When you walk in, there’s usually some sort of fresh fruit or vegetable right there. Pretzels are really great filling snacks. Nuts are good for you. You have granola bars too.”
  
  One caveat: Spires says to check labels of packaged salads at the gas station. She says they are often heavy on unhealthy preservatives.
  
  At restaurants, opt for a grilled chicken sandwich and water rather than a cheeseburger and soda. Spires also says healthy choices are sometimes hidden on the kid’s menu. Look there for things like apple slices, and make that your side instead of fries.
   
• When you can get to the grocery store, make wise choices. Spires suggests canned fruits and vegetables that have a long shelf life. For vegetables, look for options with low salt. You can also rinse the veggies at home to remove some of the salt. For fruit, look for options that are canned in 100% juice or water, not syrup.
   
• Consider creating a garden at home or advocating for a community garden in your neighborhood. Spires says this allows you to bank up healthy food for the winter. It’s also likely going to be cheaper, she says, given the rising cost of groceries. And working outside provides benefits to your physical and mental health, too.
  
  “It’s a little extra work, but it pays off in the long run,” Spires says.
   
• Talk with a dietitian, nutritionist or wellness expert about making diet changes.

How to help people who are struggling

Spires says everyone can help in the fight against food insecurity. Get to know your community so you know which groups are struggling, such as parents struggling to afford school lunches for their kids. Then, talk to health care groups, social service groups and government groups about changes. For example, it’s not uncommon for residents to encourage their city council to recruit a grocery store to town.

The consequences

Frequent meals from the gas station or drive through can lead to obesity, heart disease, diabetes, high blood pressure and high cholesterol.

“Fast food is notorious for being high in salt. Those foods retain water in our body and can lead to heart and lung problems,” Spires says.

Childhood obesity, Spires adds, is a big problem in the United States and can set kids up for a lifetime of health problems and doctor visits.

Learn more

If you have concerns about food insecurity, contact the OSF hospital near you to see if it offers a program like Peace Meal or Smart Meals. The OSF HealthCare website has healthy recipes.

Social service agencies or schools in your area can also help. Spires says food pantries typically are open to accommodate adults who work different shifts.

Interview clips

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But, after he suffered seizures and a stroke that put him in the hospital a little more than a year ago, Thurman and his wife, Starr, have been on a journey that has led to better management of his diabetes and other health conditions. During his stay at OSF HealthCare Saint Francis Medical Center in Peoria, Thurman was introduced to OSF OnCall Advanced Care, a program offered by the digital health arm of OSF.

The program uses a multidisciplinary team dedicated to providing in-home treatment or digital support for patients with complex conditions such as diabetes, hypertension, heart failure and COPD. The OSF OnCall Advanced Care team treats patients who have been hospitalized and have two or more chronic conditions. The 24/7 digital care team includes nurses, digital health navigators, clinical counselors, dietitians, an e-pharmacist and providers. 

Beth Wharton, manager of Virtual Care Operations for OSF OnCall, says the team treats all issues impacting someone’s health.

“It is more of a holistic approach. It's not just a nurse or a physician looking at numbers. They're really treating the patient for all of their needs.”

People with diabetes are two to three times more likely to have depression than people without diabetes. It can be stressful. Wharton explains that’s why it’s important to have a therapist available as part of the advanced care at home program.

“A lot of patients with chronic complex diseases have some form of behavioral health need, they have anxiety, or they have depression. And so, as you know, coming home from the hospital, sometimes that can be even more amplified. You're now at home and you're trying to manage your care after you've been admitted. So having that resource available is very important. as well.”

Thurman hasn’t used the counselors, but he has talked through strategies for managing temptations. For example, Thurman says riding a motorcycle and trips with friends regularly include stops for pie or ice cream. Before his hospital stint and enrollment in the OSF OnCall Advanced Care program, Thurman says he would have indulged in the sweets.

Now, he still goes for the rides but orders water and simply enjoys the camaraderie.

Program keeps him accountable

Thurman says the care team keeps him on track.

“It keeps me accountable, yeah. If I was left on my own, I probably wouldn’t do it,” Thurman admits. As he recalled his old habits he shares, “If my blood sugar went low, I’d just go grab something to eat real fast and be done with it or if it got too high, I would ignore it,” he says with a chuckle of embarrassment.

Wharton says an important aspect of the program is working with individuals who have diabetes to set goals based on what is important to them.

“We really try to identify with patients what is important with this disease diagnosis, what means the most to you – Do you want to stop smoking? Do you want to reduce your smoking? Do you want to lose weight? How much weight do you want to lose? What do you think is an achievable goal? And then how can we help you get there?”

For Thurman, the team had him focus on concrete, achievable goals – eating more fiber, drinking 64 ounces of water a day and finding ways to exercise. Thurman gets winded and light-headed easily, but he does what he can to join Star while she exercises to short fitness programs that she finds on TV.

Using a tablet provided by the OSF OnCall Advanced Care program, Thurman reports his blood glucose readings three times a day, and he uses Bluetooth devices that transmit his weight, pulse, temperature and blood pressure into his electronic medical record. If his glucose reading is too low, the phone rings almost immediately.

“And if it’s too high, I’ll get a call and I’m glad there’s someone watching out all the time. That’s really nice, a nice feeling.”

The biggest goal for Thurman was reducing his hemoglobin A1C, an important marker that measures a person's average blood sugar levels over the past two to three months. Specifically, the A1C test measures how much sugar is in your red blood cells, which transport oxygen throughout your body. The higher your A1C is, the higher your risk of developing complications. 

Getting off of insulin

For people with diabetes, the goal is usually to keep their A1C levels below 7%. Before entering the program, Thurman’s A1C was at 8.3%. Through support of the Advanced Care wraparound services, Thurman has been able to get that number down significantly – to 6.9%. He is no longer taking insulin but is on Ozempic and lost 50 pounds.

Even though he was reluctant to enroll in the OSF OnCall Advanced Care program at first, Thurman is thrilled he did. And for anyone worried they won’t be able to work the technology, he says it requires a touch-screen tablet that is so easy to use.

“All you need to do is just turn it on and scroll to whatever feature you want to go to, whether it’s blood sugar, your blood pressure or your temperature or whatever, just scroll to it, touch it and it’ll tell you what to do. It’s really simple … simple to use.”

OSF OnCall also has a lower-touch approach for people who want to better manage their diabetes on their own, before it becomes a significant health threat. OSF OnCall Connect Remote Patient Monitoring for Chronic Conditions offers 24/7 digital support with education, self-reporting and monitoring. Currently there are 1,384 people enrolled in the Medicaid Innovation Collaborative remote patient monitoring program – part of a national effort to transform health care and meet related social needs for the millions of Americans who rely on Medicaid.

Since the remote patient monitoring program was launched in June of 2022, individuals enrolled have lowered their collective A1C on average by 1.5% for those with a starting A1C of greater than 9%.

With a need for more proactive management of chronic conditions, OSF OnCall is showing that through programs such as OSF OnCall Advanced Care and Remote Patient Monitoring for Chronic Conditions, there are better ways to engage people with diabetes, like John Thurman, to create a new roadmap for improving health outcomes and defining a more sustainable model of care. 

Beth Wharton

John Thurman

B-roll for OSF OnCall Advanced Care

He was at a Champaign, Illinois, hospital where his five-year-old daughter Gabby was fighting for her life with what was later confirmed to be Rocky Mountain spotted fever as the result of a tick bite.

Gabby died of sepsis, a condition where your body responds improperly to an infection, three days later. The heartbreak led Tony and his family to become intimately familiar with sepsis. They’re now advocates for sepsis awareness, both ensuring health care providers are following best practices and patients are speaking up.

“I remember slamming every object around me,” in the days following Gabby’s death, Tony Galbo recalls. “I said ‘there’s gotta be a law to protect patients, especially children.’,”

Sepsis and septic shock

Many of the things the Galbo family advocates for to this day are already in place at OSF HealthCare.

Kurt Bloomstrand, MD, is chair of emergency services at OSF HealthCare Heart of Mary Medical Center in Urbana, Illinois. He says aside from following established, rigid protocol, OSF Heart of Mary is going the extra mile for sepsis prevention in a couple of ways. One, the hospital is leading the OSF Ministry in continuing sepsis screening and alerts for people after they are admitted (not just in the emergency department). And two, the facility is among the top 10% of hospitals in the country in following sepsis protocol as measured by the United States Centers for Medicare and Medicaid Services (CMS). Those CMS core measures include giving antibiotics and fluids and rechecking a person’s vital signs in a timely manner.

“We’re trying to identify a set of signs called the systemic inflammatory response syndrome, or SIRS,” Dr. Bloomstrand says. “Those include a fever, a fast heart rate, fast breathing and elevated or low white blood cell count. If someone has any two of those with a source of infection, we consider them possibly septic. We want to establish treatment for them very quickly.”

Treatment includes antibiotic medication or intravenous fluids along with continued testing to pinpoint the problem.

“We take this extremely seriously because we know time is tissue. The sooner we get the treatment, the better the outcome.” Dr. Bloomstrand adds. “Any person who comes into one of our emergency departments, no matter the cause, will be screened for sepsis right from the start. When we get your vital signs, that’s screening for sepsis. If you flag positive, there are alerts that go out to our staff. Then it walks us through a very specific sepsis algorithm for treatment.”

What you can do

Dr. Bloomstrand says young kids, older adults and people with serious health conditions like heart disease and diabetes are at a higher risk for sepsis. Your best bet to prevent sepsis is to practice healthy habits and prevent infection in the first place.

• Wash your hands frequently, especially after touching high-germ areas in public like a doorknob.
   
• Avoid touching your face.
   
• Sneeze and cough into your elbow or a tissue.
   
• Stay home when you’re sick.
   
• Treat wounds and bug bites properly, quickly and under guidance from a health care provider. Dr. Bloomstrand notes that pets can also harbor ticks that can cause serious illness.

Dr. Bloomstrand adds that hospital staff are empowered to speak up if they spot a possible sepsis case. But you can also speak up on behalf of yourself or a loved one about what sepsis surveillance is being done.

“It’s appropriate to make sure you are asking these questions just to make sure you’re keeping it at the front of the care provider’s mind,” Dr. Bloomstrand says.

“If we don’t catch sepsis soon enough, it can result in organ dysfunction,” he adds. “There may be long-term complications with their kidneys, such as needing dialysis. If their lungs fail, there may be long-term respiratory issues. There may be brain issues, so they have mental status changes long-term.”

Gabby’s Law

On August 18, 2016, then-Illinois Governor Bruce Rauner came to Presence Covenant Medical Center (now OSF Heart of Mary) to sign Gabby’s Law.

“Senate Bill 2403 requires hospitals to adopt evidence-based protocols for the early recognition and treatment of patients with sepsis, severe sepsis or septic shock that are based on generally accepted standards of care,” the Governor’s office said at the time. “It requires the protocols contain certain components, including those specific to identifying and treating adults and children.”

Tony Galbo recalls many meetings with lawmakers, health care groups and other stakeholders to get the plan the support it needed. And that wasn’t the end. He’s testified before lawmakers in other states and in Washington, D.C., and done countless interviews.

“Sepsis does not discriminate. It does not care about age,” Galbo says.

Interview clips - Tony Galbo

Interview clips - Dr. Kurt Bloomstrand

B-roll

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When it comes to oral health in kids, Emily Isom has seen it all.

Cavities, gum disease and infections, improper tooth alignment and tooth loss come to mind quickly. Not to mention all the missed school time dealing with these issues.

But she’s also seen plenty of young people who are the picture of good oral health. And she’s on a mission to make more of the latter.

“The mouth is the gateway to the body,” says Isom, a certified medical assistant in pediatrics at OSF HealthCare and a former dental assistant.

“A lot of people don’t think about what our oral health can do to us if it’s not being taken care of,” she adds. “It can cause heart disease, diabetes and respiratory infections.”

Everyday prevention

Isom says kids and their parents should commit to daily habits that will improve their oral health.

For infants without teeth, Isom says parents should use a soft, cool washcloth to wipe the child’s gums twice a day. This helps clear bits of food and milk that can lead to bad breath, irritation and cavities.

“Touching their gums will help when they are older. They’ll be okay with brushing their teeth. They won’t fight the parents about it,” Isom says. “So, it’s good to start [oral health care] early."

Older kids should brush their teeth for two minutes, twice a day. Floss once a day. When a child has two teeth that touch, it’s time to start flossing. That could happen from ages two to six.

Before you rinse out your mouth with water, don’t forget about the tongue, Isom says.

“If we do not brush our tongue, bacteria can sit on it. It can get what I call ‘tongue sick,’” Isom says. “Bad breath can also happen.”

Outside of the bathroom, Isom reminds us that sugary and starchy food and drinks are prime suspects in oral health issues like cavities. So, parents should offer those foods in moderation. Isom calls out sticky candy as an example. She says the sugar tends to sit on your teeth for a while. Isom also says starchy food like bread, potatoes, rice, pasta and cereal can sit between your teeth unless you floss right away.

Another must-know for parents with babies: don’t put your baby to bed with a bottle. Aside from a choking hazard, Isom says the constant stream of milk or formula can lead to cavities and corrosion. She also says this can cause infants to be fussy and demand a bottle more often.

It takes some convincing

A mother of a six-year-old, Isom knows that some kids won’t brush and floss willingly. They see it as a chore.

Her response: make oral health fun.

“Make a dental chart. Add stickers to it, morning and night,” Isom suggests. “Give them rewards like a little toy. After each cleaning, they can get a reward. Turn on music or a timer for two minutes [of brushing.] Get toothbrushes with their favorite characters on them.”

Dentist visits

Isom says children usually have regular visits with a dentist twice a year. Others with known mouth issues may go every three to four months. But see a dentist right away if you notice red flags: pain in the mouth, persistent bad breath, discolored gums or teeth, bleeding gums or trouble swallowing.

A regular dental visit usually includes a thorough cleaning of the teeth and gums followed by fluoride treatment.

“[Fluoride] protects the enamel of the teeth,” Isom explains. “It protects your teeth from cavities. It just makes your enamel really strong so you can eat the things you want.”

A dental professional may also perform X-rays on your teeth regularly.

Something else for parents to make sure the dentist has in mind: oral cancer screening.

“Those are huge,” for oral health, Isom says.

A dentist may use their hands to examine your mouth and neck. They could use a light or have you rinse your mouth with a blue dye. Each method looks for abnormal, possibly cancerous tissue.

At the end of a dental visit, you may be sent home with a prescription or just instructions to keep your mouth happy. For example, you may get a prescription mouthwash to help with gum disease.

Learn more

Read more about how to keep kids’ mouths in good health on the OSF HealthCare and U.S. Centers for Disease Control and Prevention websites. If you don’t have a family dentist, talk to your primary care provider about finding one. OSF HealthCare Children’s Hospital of Illinois in Peoria offers dental care for children with special needs.

Interview clips

Related stories

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An early 2023 study has anyone who sweetens their morning coffee or other foods on alert because of what the findings showed.

The study published in the journal Nature Medicine linked a sugar replacement called erythritol to increased cases of blood clotting, stroke, heart attack and death. Erythritol is used to add bulk or sweeten stevia, monk fruit and keto reduced sugar products. It’s a sugar alcohol that can be naturally found in many fruits and vegetables.

The study found those with risk factors for cardiovascular disease, such as having diabetes, were two times as likely to have a heart attack or stroke when they had the highest levels of erythritol in their blood.

While the study is getting attention and causing concern, but OSF HealthCare dietitian Olivia DeLeon says there are many limitations to the study that need to be recognized.

“This was what we call an association study. That means they did find an association between erythritol and increased risk for cardiovascular disease or events, however it was not a causation study. It did not show that erythritol causes cardiovascular disease or incidence,” DeLeon says.

She says the participants in the study also need to be kept in mind.

“These individuals were over the age of 60 and they already had pre-existing, or were at a higher risk of cardiovascular disease,” DeLeon says. “It’s difficult for us to apply that information to the general public and that means more research needs to be done.”

DeLeon adds health experts have reviewed different types of sugar alternatives and have found them to be safe to consume.

“You can always use those other non-nutritive sweeteners such as the FDA-approved Sweet-N-Low, Equal and Splenda. Those are great options to use to limit that sugar intake,” DeLeon says. “But you can also use things like fruit to add that extra flavor without adding extra calories. Instead of a sugar-sweetened beverage or an artificial-sweetened beverage, you can always chop up some strawberries, blueberries, and add that to your water for great flavor.”

DeLeon also recommends having a heart-healthy diet. She breaks down some simple tips of how to achieve this.

“Limiting things such as saturated fats, added sugar, and placing a focus on adding more fiber to your diet. Saturated fats are typically found in animal products, such as meats and dairy, but it’s not that we have to completely cut these food groups out but rather choose the lean option,” DeLeon says. “Choosing that 93% lean 7% fat hamburger more often over the 80% lean 20% fat is a simple way to cut out excess saturated fat.”

DeLeon says adding fruits, vegetables, whole grains and beans to meals is a great way to add extra fiber to your diet.

You can find healthy recipes here.

Video Interview Clips

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

There are many health complications for people living with diabetes including heart and kidney disease, oral health and vision problems. You can add hearing loss to the list.

According to Chris Workman, AuD, an audiologist with OSF HealthCare, people with diabetes are twice as likely to suffer from hearing loss compared to those who don’t. Even people with prediabetes have a 30% higher rate of hearing loss than people with normal blood sugar levels.

“There's about 28 million people in the United States with hearing loss,” Dr. Workman says. “There's 37 million people with diabetes. So, we can surmise that there's a good portion of that 28 million who have diabetes that also have hearing loss.”

The link appears to be nerve damage. All senses rely on good blood flow and nerve function. Dr. Workman says blood vessels feed the nerves, which are crucial to good hearing. According to the Centers for Disease Control and Prevention (CDC), the average person is born with about 16,000 hair cells within their inner ear, which allow your brain to detect sounds. By the time most people notice a change in their hearing, 30% to 50% of hair cells have already been damaged or destroyed. And they do not grow back.

“I believe high blood sugar could potentially affect the blood flow to the inner ear and some of the hair cells which could affect and cause some hearing loss,” Dr. Workman says. “Low blood sugar could cause some damage to the nerve and transmission of the hearing.”

Dr. Workman adds that for the past 10-15 years the audiology field has seen a rise in patients who also have diabetes – including in his own practice. For those patients, especially those who have other comorbidities such as hypertension, screening tests are especially important.

“For those patients, we would recommend following up with an annual hearing test to keep an eye on things,” he says, “We encourage them to diet, exercise and take their medication as needed to get better control of diabetes. Otherwise, they’re prone to potential hearing loss and more severe loss.”

There are many signs of hearing loss.

·         Ringing in the ears

·         A tendency to assume everyone is mumbling

·         Difficulty understanding what people are saying

·         Needing to turn the TV volume up high

·         Struggling to hear in group settings

Dr. Workman encourages patients to talk with their primary care physician to establish a hearing baseline. He also recommends stopping smoking and avoiding frequent exposure to loud noises. In addition to physical changes, hearing loss can also lead to depression or feeling secluded, which can impact your social life and mental health. 

The month of May is National Speech-Language-Hearing Month. It’s a time which raises the importance of taking care of your hearing.

Dr. Workman says the key to better outcomes is early treatment. “I think raising awareness of hearing loss not only impacts the individual with the hearing loss, but impacts family, friends, coworkers. If we can raise that awareness and get them help sooner, we're going to continue their quality of life and transition easier to any type of treatment.”

For more information on hearing loss, visit OSF HealthCare.

Interview Clips 

B-Roll

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

OSF HealthCare held a Blessing & Dedication of the new OSF Center for Health in Galesburg.

This new facility, located in the former Cottage Medical Building, will complement the services offered at OSF St. Mary Medical Center.

“OSF has been a part of the Galesburg community since 1909, growing and responding to its needs as well as those of our surrounding rural communities in alignment with the Mission of our Sisters. We are so excited to be able to continue to expand access to our health care services in Galesburg, furthering our commitment to this exceptional community we are privileged to serve,” says Lisa DeKezel, President of OSF St. Mary Medical Center.

The Center for Health will provide more space for primary care services provided through OSF HealthCare, including family practice and internal medicine; endocrine and diabetes; behavioral health and psychiatry; and occupational health.

“With this new facility, we are proud to be able to serve the diverse needs of this community. Our family practice office will see patients of all ages who wish to establish a primary care physician to address all their preventive and chronic health care needs. Our internal medicine team supports patients 18 and older with routine and complex health needs. Our diabetes and endocrinology team helps to manage and control diabetes, with help from an advanced practice provider team, dietitian, and nurse education,” DeKezel says.

“We are excited about bringing growth to Galesburg through the recruitment of qualified health care professionals,” says AJ Querciagrossa, CEO of the Western Region for OSF HealthCare. “We are actively recruiting for endocrinology, family practice and internal medicine providers.”

A ribbon cutting was held in collaboration with the Galesburg Area Chamber of Commerce.

OSF Center for Health B-Roll

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

B-roll

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In the 2023 State of the Union Address, President Joe Biden renewed a call to cap the price of insulin for people with diabetes.

Five days later, the condition got nationwide attention again when singer Nick Jonas, a type 1 diabetic, starred in a Super Bowl commercial promoting a product that monitors your glucose level.

And a recent report from the U.S. Centers for Disease Control and Prevention predicted a rapid rise in cases of diabetes in young people over the next few decades.

It’s a good thing that influencers and medical professionals continue to preach diabetes awareness, says Uche Allanah, MD, an internal medicine physician with OSF HealthCare. That’s because if undiagnosed or untreated, diabetes can be fatal.

“It’s alarming,” Dr. Allanah says, referring to the number of patients she sees with symptoms or precursors of diabetes.

Prediabetes vs. diabetes

Diabetes is a disorder that affects how your body uses blood sugar, from which our blood cells get energy. Type 1 diabetes is when an autoimmune reaction stops your body from making insulin. Without insulin, blood sugar cannot move out of your bloodstream and into cells. With Type 2, your body still produces insulin but doesn’t use it efficiently. Gestational diabetes occurs in pregnant women. Diabetes symptoms include increased urination, increased thirst, increased hunger and unexplained weight loss.

Dr. Allanah says prediabetes describes when you are at risk for diabetes because your blood sugar is higher than normal. She says a blood test is necessary to diagnose prediabetes because you don’t present with symptoms. In fact, the American Medical Association says of the one in three U.S. adults with prediabetes, more than 80% don’t know they have it.

“It’s important to identify prediabetes because you can stall the development of diabetes and actually prevent a patient from becoming diabetic,” Dr. Allanah says.

Risk factors for prediabetes include obesity, sleep apnea and polycystic ovary syndrome in women. Providers also look at a person’s family history of the disease, and Dr. Allanah says certain groups -- African Americans, Hispanics and Latinos, Asian Americans and American Indians -- are at higher risk.

Dr. Allanah advises everyone to have regular checkups with their primary care provider to keep an eye on the risk factors you can control. Also, practice healthy habits from a young age.

“Eat right. Avoid processed food,” Dr. Allanah advises. “Exercise. A lot of people are sedentary, especially due to the pandemic. People who went to the gym no longer workout. Even now that the stay-at-home orders have been lifted, some people are just not back into their previous lifestyle.”

Dr. Allanah also says a prediabetes or diabetes diagnosis is a lot to handle. Some people may have to learn to safely give themselves shots. Others may have to constantly watch for low blood sugar to avoid fainting. Providers realize this and will be there to answer questions. But Dr. Allanah says it’s not uncommon for someone to see a mental health provider to talk about the emotional toll of the diagnosis.

Learn more

Learn more about diabetes care on the OSF HealthCare website.

Interview clips

OSF HealthCare initially launched LumineticsCore at eight sights, which have been operating for a full year. Based on the successful integration of LumineticsCore at the initial sites, OSF expanded the use of LumineticsCore to 24 additional sites that have now been operating for nine months. Using LumineticsCore, OSF HealthCare has been able to inform 25% of nearly 1,500 patients with diabetes, that they tested positive for diabetic retinopathy (DR). Without convenient access to the exam, many of those patients might not have been tested for DR, the leading cause of blindness for adults in the U.S.

Digital Diagnostics is committed to bringing high-quality AI diagnosis to the point-of-care, starting with the diabetic retinal exam to prevent vision loss and blindness for people living with diabetes. “We are always seeking new ways to innovate and improve access to cutting-edge diagnostics for our patients so we can help them better manage their health conditions, including diabetes which impacts nearly 66,000 OSF patients,” said Mark Meeker, DO, vice president of Community Medicine for OSF HealthCare. 

“Working with Digital Diagnostics allows us to offer an expanded set of services to our patients, while empowering our clinicians to help their patients decrease disease progression through prevention, not just through treatment.”

“The positive impact our partnership with OSF HealthCare is having in the lives of patients’ is exactly in line with our mission,” says Digital Diagnostics’ Senior Vice President of Commercial, Sean Murnane. “Offering LumineticsCore to patients in a setting where they are already comfortable, coupled with the high-quality care offered at OSF, furthers our organizations’ collective goal of improving patient outcomes.”

Summer months often mean the bare minimum when it comes to footwear. Seasonal sandals can be found everywhere – from department to drug stores. But not all summer shoes are created equal.

“As summer months come about, certainly weather changes make people want to throw inexpensive flip flops on and things like that. That can be very dangerous to your feet,” warned Dr. Marc Leonard, an OSF HealthCare Podiatrist.

But a foray with a flip flop doesn’t mean you are destined for foot injuries. Dr. Leonard says to avoid cheaply made flip flops and sandals. He says spending the extra money could be a good investment for your overall foot health.

“I think sandals and flip flops are fine for some people,” said Dr. Leonard. “If you have no foot problems, you’re not diabetic and you have good sensation, probably a well-made supportive sandal with arch support would be just fine. However if you do have those problems, and you are diabetic or you are neuropathic, then those are things have to be cautiously worn.”

Sometimes, however, even the best pair of shoes can’t mask issues that need attention. If foot pain persists, you should seek the help of a specialist.

“Pain is not normal. So if there is pain, if there’s discomfort, if there’s changes in your feet, collapsing to the feet, those are good times to see a podiatrist,” said Dr. Leonard.

And according to Dr. Leonard, there is no perfect pair of shoes, and people should spend time shopping to make sure they have the right fit to start summer off on the right foot.

“Be cautious, try them on in the store, get a good, supportive, well-made shoe, and I think that’s the best way to go about it,” he advised.

Interview clips

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

An injectable prescription medication for adults with Type 2 diabetes is being hailed in Hollywood as a weight-loss drug, too.

Ozempic has been steadily in the headlines for months and became the butt of comedian Jimmy Kimmel at the 2023 Academy Awards when he joked, “When I look around this room I can’t help but wonder, ‘Is Ozempic right for me?”

Ozempic’s website – and its advertising - says the medicine is used “along with diet and exercise to improve blood sugar” and that “you should ask your healthcare provider if Ozempic is right for you.” Rachel Fehl, an advanced practice registered nurse at OSF Weight Management, agrees. She also says to make sure the drug you might take for weight loss is approved by the U.S. Food and Drug Administration (FDA).

“There are a lot of telehealth companies doing weight loss right now. You may notice you can get semaglutide (Ozempic) online for a much cheaper price. It’s going to range (around) $1,200 a month for the actual medication, but there are some pharmacies compounding it for much less. I would not recommend those compounded formulations, they’re not being regulated right now,” Fehl says.

Meta Rask, manager of the OSF Weight Management Center in Peoria, says the clinic focuses on healthy lifestyles, not trendy diets.

“We don’t focus on fad diets,” Rask says. “We truly focus on being healthy and meeting a patient’s needs where they’re at. We then help them figure out what disciplinary team is going to be able to help them meet those goals.”

While the OSF Weight Management Center sometimes does recommend a weight-loss drug alongside exercise and healthy eating, Rask says you need to work with the team to figure out a plan that works for you.

“We have nurses, we have a physician and we have registered dietitians and exercise physiologists,” Rask says. “They work together to meet patients one-on-one to do an assessment. They’re going to find out what that patient is looking for and what their barriers are.”

Fehl adds that everyone’s weight loss journey is different, and so is the response from OSF Weight Management providers.

“For some of our patients, we do utilize FDA-approved anti-obesity medications. Those do include some of the GLP-1 medications, similar to Ozempic, for the appropriate patient,” Fehl says.

Below are some tips if you are interested in beginning your weight loss journey.

1. Control carbohydrates: Specifically processed carbohydrates and caloric beverages. Just one can of regular soda contains more than the daily maximum amount of recommended sugar for men and women. 
2. Prioritize protein: Try to include protein with all meals and snacks. Protein helps us to feel full faster and for longer and can also reduce post meal blood sugar spikes.
3. Schedule Sleep: Getting less than seven hours or more than nine hours of sleep can both contribute to weight gain.
4. Take a break: This applies both to doing activities that reduce stress as well as giving our body a break from food. Find a meditation or breathing exercise you can add to your day to reduce cortisol production that can stimulate fat storage. Try to incorporate a 12 hour overnight fast (unless you have a medical condition that would not allow this). This practice can reduce gastrointestinal symptoms as well as allow for more use of stored fats for fuel.
5. Request a Referral: Ask your primary care provider or other provider for a referral to OSF Weight Management if you need some help getting started. The center’s goal is to help you change your lifestyle to one that allows you to reach your goals and improve overall health.  

Video Interview Clips

Television host Carson Daly is the latest celebrity to try what some call sleep divorce. Couples who sleep in the same bed but are not getting that coveted seven to eight hours of shut eye will slumber with some degree of separation: in the same bed but with separate blankets, in separate beds in the same room or in separate rooms.

Daly called the move the “best thing” for his marriage during a summer episode of the Today Show.

“We both, admittedly, slept better apart,” he said.

The concept is one worth exploring for couples who are kept up by snoring, restlessness, differences in sleep schedule or other nighttime issues, says Nadeem Ahmed, MD, a pulmonologist at OSF HealthCare in Alton, Illinois.

But let’s get one thing straight.

“I don’t like the term ‘sleep divorce’ because it tends to blame other people. It’s not a good word. It brings anxiety,” Dr. Ahmed says.

“I like to use ‘sleep alliance.’ They’re working together. They’re working things out. They want to make sure it’s healthy for both bed partners and the sleep disturbances don’t affect the other partner’s life,” he says.

Have the discussion

Dr. Ahmed says he encounters sleep issues, like snoring, in his practice “almost every day,” and many people are shy about it.

Every case is different. Dr. Ahmed says couples should first talk out their sleep issues and try to find a solution. The partners could try sleeping in separate beds during the week and in the same bed on the weekend so intimacy is not completely lost. Some mattresses have different firmness, temperature and slant on each side, which can help.

If needed, the partners should talk to a pulmonologist or psychologist.

“A lot of psychologists will do similar things that a physician will do. It’s just the comfort level of the person,” Dr. Ahmed explains. “Sometimes they don’t want to go to a medical doctor for the sleep problem. They would rather talk to a psychologist.”

“The idea is to discuss it with some type of professional,” he says.

Dr. Ahmed adds that sleeping separately should be a short-term solution.

“Tell your bed partner this is an issue, and we need to address it. As opposed to just getting mad or feeling crummy or sleepy the next day,” Dr. Ahmed says, “Because it can affect your job, like if you’re a machine operator or have to drive a truck.”

A major cause

Dr. Ahmed says a big cause of the restlessness that leads to sleep alliance discussions is sleep apnea, when people stop breathing during sleep. This can lead to loud snoring or body movement in bed and crabbiness or grogginess the next day.

Dr. Ahmed says there are two types of sleep apnea: obstructive and central. Obstructive sleep apnea is a product of obesity. Central sleep apnea is associated with neurological deficits like a stroke.

“[Sleep apnea] is not fatal because our brains are hard-wired to let you go to a certain time, and then it triggers you to take a breath,” Dr. Ahmed explains.

But, if the condition is left untreated, there is a litany of possible issues: hypertension, cardiac arrhythmia, diabetes, dementia, headaches and frequent urination.

Diagnosis of sleep apnea would involve a sleep study, either in your home or at a hospital.

Treatment options include a mask and machine combination known as a CPAP or BiPAP, a mouth guard or a small device that’s implanted in your body in outpatient surgery. All those options aim to help you breathe normally and sleep peacefully.

“Along with that, we have to stress lifestyle changes,” to rid oneself of sleep apnea, Dr. Ahmed adds. “Eating healthy. Losing weight. Getting exercise.”

Over-the-counter options for better sleep include melatonin, an eye mask, earplugs, thick window curtains, a plush mattress and sheets and a white noise device like a smart speaker. Don’t eat or drink, aside from water, a couple hours before bedtime, Dr. Ahmed also advises.

Learn more

Learn more about healthy sleep on the OSF HealthCare website. If you’re having sleep problems, especially if it’s impacting your daytime life, talk to your primary care provider, a pulmonologist or a behavioral health provider.

Interview clips

Previous coverage

TikTok trend deemed dangerous
Catch your ZZZs
Getting a wake-up call
Chronic fatigue is nothing to sleep on
Slumber hours slump
OSF HealthCare blog entries on sleep
 

From Elon Musk to TikTokers, ongoing social media chatter claims drugs like Ozempic, Mounjaro and Wegovy are the magic way to weight loss.

There’s good news, says Aminat Ogun, MD, a family medicine physician at OSF HealthCare in Champaign, Illinois. Those drugs can help you lose weight when prescribed by a doctor under specific circumstances and paired with diet and exercise.

The more important bad news? There’s no magic, one-size-fits-all drug that will by itself cause you to shed pounds. And if someone on social media is claiming so, they’re wrong.

Dr. Ogun says Ozempic, Mounjaro and Wegovy are from the same family of medicine. They are usually prescribed to people with Type 2 diabetes.

“It increases the insulin in the body, which helps bring glucose into the cells,” Dr. Ogun explains.

The medications also slow food leaving your stomach and suppress appetite.

Once the drugs became more well known, Dr. Ogun says people found, not surprisingly, that weight loss was a side effect and began prescribing them for that purpose under specific circumstances. She says the patient should have a body mass index (BMI) greater than 30 or a BMI greater than 27 with a chronic condition like diabetes, hypertension or hyperlipidemia.

But even if you meet those guidelines, Dr. Ogun says you should talk with your doctor about whether a weight loss drug is right for you or whether simply changing habits can get the results you want.

For one, Ozempic, Mounjaro and Wegovy are expensive and may not be covered by insurance.

Also, the U.S. Food and Drug Administration reports a shortage of Ozempic and Wegovy. So Dr. Ogun says doctors may be less likely to prescribe the drugs for weight loss when diabetics may have a more critical need.

And like any other medication, there is a list of side effects.

“Abdominal pain, nausea, vomiting, diarrhea and constipation are possible,” Dr. Ogun says. “There are also hypersensitivity side effects like angioedema and an anaphylaxis reaction. It’s also been known to cause kidney injury or pancreatitis.”

Lately, the term “Ozempic face” has been trending on social media, describing a hollowed-out appearance due to quick weight loss.

One last piece of advice you’ll hear doctors give over and over: don’t rely on social media for health tips. If you find a tip that might benefit you, talk to your doctor before starting any treatment.

“The good thing about social media is that it allows a lot of people to receive a variety of information all at once,” Dr. Ogun says. “The downside: is it a credible source?”

Find a primary care provider on the OSF HealthCare website.

Interview clips

The Medicaid Innovation Collaborative (MIC) – a partnership between Peoria-based OSF HealthCare and four Federally Qualified Health Centers (FQHCs), celebrated its one-year anniversary by highlighting a long list of milestones achieved. MIC provides a variety of digital care services and personalized support for Illinois Medicaid patients through programs developed by OSF OnCall.

The state-funded, five-year initiative is designed to transform health care delivery to improve outcomes, decrease disparities and reduce costs using sustainable programs.

The FQHC partners in the program include Heartland Health Services (Peoria, Illinois), Chestnut Health Systems, Inc. (Bloomington, Illinois), Eagle View Community Health System, Inc. (Oquawka, Illinois), and Aunt Martha’s Health & Wellness (Danville, Illinois).

To date, MIC has been able to stand up several programs to expand services by:

• Providing pregnancy and postpartum support 24/7 to enrolled patients; featured on this Health Accelerated podcast.
• Offering remote patient monitoring for chronic disease management including asthma, diabetes hypertension, COPD and heart failure.
• In a collaboration with Illinois Central College, training OSF digitally-enabled health navigators to be embedded within communities across the state and FQHC community health workers; within their facilities and co-located in community-based organizations, including homeless shelters. 
• Expanding breast cancer screenings through digital outreach, making it easy for patients to schedule this important test
• Extending health and wellness education with the goal of reducing chronic disease risks associated with diet and nutrition, exercise, unhealthy weight and smoking
• Launching culturally sensitive, easy-to-use communication tools.
• Developing a systematic approach to assessing social determinants of health and tracking data to prioritize patient outreach, optimize workflow and to identify which patients might fit into specific programs. Future work will integrate all information with a patient’s electronic record for providers to have a holistic view of their patients.

Jennifer Junis, senior vice president for OSF OnCall who also chairs the MIC Governance Council, says community health workers embedded in vulnerable communities also screen individuals for social service needs and they’re connected with local resources to provide support for food, transportation, child care and affordable housing, among other factors that contribute to improved health and wellness.

During a day-long session earlier this week, FQHC leaders and frontline employees reviewed progress toward goals outlined for the first year.

Chestnut Health Systems in Bloomington:

•  Began work on a building renovation and hiring for a new dental clinic that will serve Medicaid participants. 
•  Collaborated with a local homelessness service provider/food pantry to organize and implement a Food Pharmacy. Providers at Chestnut screen patients for eligibility criteria and prescribe use of the food pharmacy services. The pharmacy provides fresh and healthy food options often worth hundreds of dollars.
• The CHW program has solidified co-locations for staff at six partnering agencies.

Heartland Health Services in Peoria:

• Built a new team within HHS and the framework to support digital care programs and to provide virtual primary care in homeless shelters.
• Began building trust with leaders and residents of homeless shelters through food and clothing drives and providing COVID-19 rapid kits.
• Hired a digital support manager and community health navigators who have also been trained on tele-diagnostic equipment that can be used to support virtual visits.
   

Aunt Martha's Health and Wellness in Danville: 

•  Trained and hired community health workers.
•  Established monthly Healthy Behavior meetings at the YMCA and Public Library.
•  Educated more than 100 people in the community about resources and how to take control of their health.
•  Expanded training for CHWs on cultural diversity, domestic violence and sexual assault.

Eagle View Community Health System in Oquawka:

• Deployed CHWs who are providing services in three locations in the community.
• Implemented a new electronic health record system (Epic) that allows for better data collection and reporting on health outcomes.
• Hired a new transportation van and hired a transportation director.

Junis says these efforts are designed to wrap a 24/7 digital safety net around patients that is available 365 days a year

“So if you have a question in the middle of the night, you don't have to go to an emergency department, or you don't know who to call. You can reach out to us and it's through text messaging or calls and we're available. So that's really the transformation piece. Is that we're not episodic but we're really meeting patients where they are and where they need us the most, at the times that they need us.”

The effort is expected to lower health care costs by keeping people out of the emergency department or the hospital, the most costly point of care. Savings can also be created by scaling the effort with telehealth providers overseeing care for many patients at a time.

MIC will continue into year two with goals of improving dental care for patients, providing virtual health to residents of homeless shelters, and enrolling new patients in existing MIC programs. Junis says it’s also about improving based on feedback.

“Year two is about optimization, and coordination and collaboration, and really continuing to work together to understand all of our different components of the holistic care of a patient and how we all play such a big role in that.”

Video Clips with Jennifer Junis, Senior Vice President for OSF OnCall Digital Health

Like it was for many people, 2021 didn’t start out great for 47-year-old Betsy Huffman of Bloomington, Illinois. Her new year began with a long recovery from a December 2020 hospital stay connected with complications from undiagnosed Type 2 diabetes.

Huffman then suffered a mild stroke earlier this year. Her follow-up treatment involved trips to a cardiologist and a pulmonologist. It’s difficult for her to discuss without crying. Huffman’s mother also had diabetes, so she knew the difficult lifestyle changes and new medications she faced.  They are changes Huffman knew she’d have to stick to for the rest of her life. That’s also why, admittedly, she kept putting off yet another trip to a medical office to get a dilated eye exam to check for diabetic retinopathy – the number one cause of blindness in the U.S.

Huffman, who is a legal assistant at a Bloomington law firm, experienced blurry vision at times, but chalked it up as a response to new medications. Despite the repeated urging of her OSF HealthCare primary care doctor, Huffman ignored getting her eyes checked for retinopathy – until recently. New high-tech eye testing equipment arrived at her primary care office and after a regular check-up, all Huffman had to do was walk down the hall for her eye exam. An excited care team cheered her on, telling Huffman she could be the first to use the new equipment. Huffman had time off from work so, no more excuses.

“I just didn't want to face it. I don’t know. Being blind is a fear though. That's why I'm glad they did this because like I said it gave me a push because I probably still would not have made that appointment yet.”

Maintaining good blood sugar, blood pressure and cholesterol levels helps prevent diabetic retinopathy and diabetic macular edema. “OSF Innovation regularly seeks to understand the pain points and experiences of our frontline care givers and patients,” explains Becky Buchen, senior vice president of OSF Innovation. “With the knowledge that many patients with diabetes were not getting regular dilated eye exams from an ophthalmologist, our Performance Improvement team within Innovation, in collaboration with our Medical Group, launched a pilot with Digital Diagnostics, a company that received the first-ever Food and Drug Administration (FDA) clearance of IDx-DR, a digital diagnostic tool that can diagnose diabetic retinopathy during a patient visit without the need for a physician or eye care specialist.”

The technology takes photos of the back of retina and uses artificial intelligence to evaluate the extent of damage to blood vessels. The test typically takes a few minutes and in most, but not all cases, doesn’t require eyes be dilated.

Unfortunately, Huffman’s exam showed a positive result for diabetic retinopathy. While she’s scared of what’s to come, Huffman now has a follow-up appointment with an ophthalmologist to establish a care plan to determine next steps in her diabetes management. Huffman has no regrets about getting the IDx-DR exam at her OFS HealthCare primary care office.

“The fact that it was right there and to be able to do it and get it over with … it’s a good thing!”

Michael Mansfield, a medical office assistant with OSF, is passionate about this effort. He recently delivered a report to Kimberly Hart, a patient diagnosed with diabetes within in the past 12 months.

“This is your diagnostic result – no diabetic retinopathy detected, so no referral needed to an ophthalmologist, so that’s great. Next steps, we’re gonna re-test in 12 months,” he tells her. Hart responds, “Ok.”

Hart admits she’s still coming to terms with her diabetes diagnosis and the lifestyle changes it requires, but her results come as a relief.

“That is awesome news. I don’t want to have those diseases related to my diabetes so I’m pretty excited about that and I’m glad you get the results right away. You don’t have to wait, (she laughs).”

OSF HealthCare launched the diabetic eye exams in eight primary care locations starting in May. Among the 147 OSF patients with diabetes tested using IDx-DR, 21% had a positive diagnostic result for diabetic retinopathy.

OSF Innovation finds solution to a growing problem

Dr. Mark Meeker, vice president of Community Medicine at OSF HealthCare, says the number of people with diabetes receiving treatment is growing to tens of thousands across the OSF Ministry. Most primary care providers aren’t proficient in giving dilated eye exams because it isn’t part of routine visits. Yet many patients with diabetes put off going to an additional appointment at a different office to get a dilated eye exam every year or two.

Dr. Meeker says he recently saw a patient who put off getting his eyes checked because he gets docked for every absence from work, even if it’s for a legitimate reason such as a doctor’s visit. So, with busy schedules and work realities, Dr. Meeker stresses it’s important to make exams as convenient as possible. IDx-DR makes in-office testing quick and easy, plus it uses artificial intelligence to diagnose diabetic-related eye damage – so it’s much more accurate than a typical eye exam given in a primary care setting.

He explains, “The AI can see the early changes of diabetic retinopathy that we may not be able to see with our own eyes. If the AI sees that, then, the appropriate referrals can be made.”

Testing in primary care offers a one-stop shop approach for patients, but Dr. Meeker says it also off-loads exams from extremely busy eye doctors so they can focus on treating already-diagnosed conditions. It also helps medical providers know their patients better so they can help them keep their diabetes under control and stay on top of eye care to avoid complications.

Dr. Meeker says seeing is believing for some patients who get to see the photos taken during the exam and potential areas of concern the images reveal.

“So the ophthalmologists have tremendous technologies to treat diabetic retinopathy now with lasers and whatnot. But there's nothing as good as prevention. And the way you prevent it is to tightly control the diabetes to begin with. So as soon as we see those retinopathy changes, if we can really get the attention of the patient to really pay attention to their sugar control, we can decrease that progression through prevention, not just through treatment.”

OSF HealthCare should learn later this summer if it receives a grant that would cover costs for two years of training to expand the new, high-tech diabetic eye exam from eight primary care offices to additional sites in communities served by OSF. Currently the IDx-DR exam is available at:

Diabetic Retinopathy (IDx-DR) exams are currently available at these OSF Medical Group Sites

Betsy Huffman, patient who screened positive for risk of diabetic retinopathy

Kimberly Hart, patient with diabetes who screened negative for risk of diabetic retinopathy

Dr. Mark Meeker, vice president for Community Health, OSF HealthCare