Ready or not, winter is here. 

For adults, snow – especially the heavy stuff – also means lots of shoveling, which can lead to an assortment of health-related problems if you’re not careful and properly prepared for the winter season.

“Every year, thousands of people end up in an emergency department due to things happening when they’re shoveling snow," says Amy Henderson, a family practice physician assistant for OSF HealthCare. "These include falls, sometimes people experience heart attacks from extraneous activities, back injuries amongst other things. So it’s really important to take some caution when you are going to be shoveling snow, and the snow is coming.”

Among the people at the greatest risk of experiencing potential issues while shoveling are the elderly, people with a history of back problems as well as people who have suffered a heart attack or other serious illness. Henderson says to check with your doctor first if you have any concerns about your health.

“If a person develops any chest pain, sharp, radiating arm pain, jaw pain, those are all signs and symptoms of a possible heart attack," says Henderson. "If those symptoms do not improve with rest after a short amount of time, it’s concerning. My advice would be to seek immediate medical attention if you’re concerned at all about a cardiac event or a heart attack; in this case it’s always good to play it safe than sorry.”

Safety is key when it comes to snow and ice. Henderson offers a few basic tips before getting started with shoveling your sidewalk or driveway.

“One of the most important things to do is wear the appropriate clothing to stay warm and avoid frostbite," says Henderson. "Also, stretching prior to going out and doing this activity is important so I recommend stretching 5 to 10 minutes before you go out in the cold. I also recommend staying hydrated because you’re doing physical activity.”

Other important tips include:

• Lift with your legs, not your back
• Push (don’t) lift the snow
• Stay low to the ground
• Shovel more frequently
• Take breaks if you feel winded
• Be aware of ice
• Go inside to warm up in order to avoid frostbite

The same suggestions apply when using a snow blower. Many people are injured every year by pushing their snow blower, twisting their body or reaching into the snow blower.

The bottom line when it comes to snow shoveling, Henderson says, is play it safe, take your time and be sure to let your loved ones and friends know what you’re up to in the event something does happen. And don’t be afraid to ask for help.

“If you really should not be shoveling snow, or you’re at higher risk, I recommend trying to find someone else who can do it for you, whether that’s a neighbor or a family member. I highly recommend that," adds Henderson. "It’s not worth the broken hip or the hospital follow up. Another thing for people who are at higher risk is to bring a cellphone. If you do fall, you’re able to call somebody.”

Before you bundle up and head outside to shovel your driveway, make sure you follow proper safety measures to avoid injury. If you or a loved one experiences severe injury, heart attack, or other medical emergencies while shoveling snow, call 911. 

For more information about snow shoveling, visit OSF HealthCare.

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A potentially life-saving pilot program is launching in Bloomington, Illinois to detect a little-known but surprisingly common genetic condition that can dramatically raise cholesterol levels—and the risk of heart attacks and strokes—even in children.

It’s called familial hypercholesterolemia, or FH. It’s estimated that 1 in 200 Americans has the genetic disorder where the body can’t effectively clear LDL or ‘bad’ cholesterol from the blood.

Darrel Gumm, MD, vice president of OSF HealthCare Cardiovascular Institute says the pilot will identify people who, due to their genetics, might not know they are at risk.

“It’s estimated about 1.3 million people in the United States have it [FH] and 90% of those patients don’t know they have it, Dr. Gumm stresses. “So, it’s a tremendous opportunity for us to step in and find those patients, identify those patients and provide therapies that may prevent terrible things from happening down the road.” 

OSF HealthCare and OSF Innovation are using artificial intelligence (AI) to conduct a pilot program for detecting and treating FH. To identify high-risk patients for this pilot, the Digital Innovation Development team used a two-step approach. First, an algorithm flagged patients over the past 18 months who had concerning cholesterol levels. Then, they applied an AI tool to scanned physician notes to detect clues—such as yellowing of the eyes or hardening of the Achilles tendon—signs a doctor may have observed but not flagged as FH-related.

People inherit FH from one or both parents, and it puts them at risk for cardiovascular events far earlier in life than normal, sometimes even in childhood.

Two Types of FH

According to Dr. Gumm, there are two kinds of FH:

• Heterozygous FH, inherited from one parent, which can lead to early heart attacks or strokes—before age 65 in women and 55 in men.
• Homozygous FH, a rarer and more severe form inherited from both parents, which can lead to strokes and heart disease in teenagers or even young children.

While most people begin cholesterol screenings around age 40, those with FH can silently develop sky-high levels from a young age.

"They can be a very healthy person, think they’re doing great, be a marathon runner and really they could have astronomically high cholesterol that’s not of their fault,” explains Ryan Loudermilk, a strategic program manager in Performance Improvement at OSF Innovation.

The new screening program was launched in Bloomington, starting with support from a strong primary care network involving 9 providers including Richard Ginetti, MD, who is a champion for the effort. It started with 200 patients found to potentially have FH. If testing confirms the diagnosis, individuals will be offered treatment, typically statins, which can reduce cardiovascular risk by up to 80%.

Dr. Gumm says every time someone is identified with FH, outreach will occur to encourage screening for parents, siblings, and children.

“One of the things I love to tell my patients is the best way to treat a heart attack is not have one. Same thing with a stroke. So, even if they’ve had a heart attack and survived it, now we’re going to be aggressive at not letting the second one occur. But here’s a chance to never let it occur in the first place. It’s primary prevention … really fantastic.” 

Education in a Short-Attention-Span World

Understanding FH—and the importance of early detection—isn’t easy in a world flooded with information. That’s why the pilot program teamed with OSF Innovation’s Medical Visualization team, to create for people identified at possible risk, mobile-friendly education designed to meet people where they are.

Loudermilk emphasizes it’s not just a brochure. The visuals use a unique, semi-animated shimmer effect that adds emotional weight without overwhelming the viewer.

“It’s something that can be easily read on their cell phone; they don’t have to log onto a computer. It’s something that’s eye-catching, something that’s straight to the point – what your risks are, why it’s important for you to get tested and checked … thinking about family members, so it speaks to that. It speaks to the ease of this. That’s the other big piece of this.” 

A Simple Test with a Big Impact

The testing process is easy. It’s just a cheek swab with no needles or blood draw. It takes a couple minutes.

The pilot is tracking how many people go on to be screened after the initial outreach with a goal of at least 30%. The initiative will follow not just how many patients test positive, but how many then go on to get family members tested, the true measure of ripple effect success. Additionally, the pilot includes having the Medical Visualization team provide insights about which content drove the most engagement.

The FH pilot is part of a broader effort at OSF HealthCare to advance care through personalized medicine that is specific to a person’s genetic make-up. Loudermilk sees a time in the future where genetic testing will be even easier.

“Where I could see this going – a patient doesn’t even have to come in. These kits could actually be mailed to them, to their house and they could do the check swab themself and get it mailed in. So, those who don’t want to deal with making an appointment and seeing their provider in person, they could do a virtual visit and have the kit sent to them. That’s the future of all of this.” 

If you receive primary care in Bloomington, talk to your provider if you think you would like to be screened for familial hypercholesterolemia.

Dr. Darrel Gumm

Ryan Loudermilk

B-roll-Familial Hypercholesterolemia (FH)

Heart-wrenching data to consider for marijuana users was recently released in two separate studies.

In the journal JACC Advances, researchers found that cannabis users under 50 were in grave risk of severe cardiovascular events, even though these participants were relatively healthy individuals.

This is on par with what Michael Grzeskowiak, MD, a cardiologist with OSF HealthCare Cardiovascular Institute, has seen in recent years. Dr. Grzeskowiak says he’s seen more young people having heart attacks.

"They found that those that use marijuana had a six-time increase of heart attack. They had a four-time increased risk of stroke, and in general, they had a three-time increased risk of dying from heart attack, stroke or any cardiovascular disease," Dr. Grzeskowiak says.

To add to the startling news, JAMA Cardiology released findings at the American College of Cardiology’s Annual Scientific Session that chronic marijuana smoking and THC-edible use is associated with endothelial dysfunction. This means the cells in the endothelium, the thin layer of cells inside our blood vessels, don’t work properly. In turn, this can block blood flow to your heart, causing a heart attack.

This meta-analysis took 12 previously published studies that collected data from over 75 million people, with an average age of 41.

Add inflammation from marijuana use to inflammation built up from ultra-processed foods, alcohol and a sedentary lifestyle; it’s a recipe for disaster.

"Inflammation, in general, in our current Western diet affects us a lot. A lot of the things I see in cardiology are due to that and if we fixed a lot of things in our diet and lifestyle, heart disease would go down," Dr. Grzeskowiak says. "Unfortunately, it's been the leading cause of death for 100 years."

Outside of work, more than 25% of the U.S. population live sedentary lifestyles, according to the Centers for Disease Control & Prevention (CDC). Additionally, roughly half of the American diet is made up of ultra-processed foods.

This comes as 48 states plus Washington, D.C., have legalized marijuana for medicinal use, and 24 states allow cannabis for recreational use, and nearly 200 million people worldwide are regular marijuana users, according to a United Nations report in 2018.

"It's concerning. A lot of people have the perception that marijuana is safe. It's natural and it's being legalized in many states for either recreational or medicinal use," Dr. Grzeskowiak says. "The common perception is that marijuana is better than tobacco and alcohol and is safer. But more studies are coming out that are making us take a pause on that thought and show that maybe there are some risks involved."

With this clear data on the risks that marijuana use brings, it adds another important topic for doctors and patients to discuss. He encourages patients to be upfront and honest about their marijuana usage with their doctors.

For overall heart health, Dr. Grzeskowiak says it's important to make healthier choices in terms of diet, exercise and lifestyle. 

He calls sodas and most juices "liquid sugar," and says if you just cut out one drink a day, in one year you'll lose up to 12 pounds. 

Aside from commitments to 150 minutes of exercise per week (which is recommended by the American Heart Association), focus on the "little things." If you're on the second floor for work, take the stairs more often. 

To learn about the services offered at OSF HealthCare Cardiovascular Institute, or to get in touch with the OSF cardiology team, visit the OSF HealthCare website.

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Hello darkness, my old friend

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.

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