Vitamin D basics

Maddy Draper, APRN, a health care provider at OSF OnCall, says vitamin D is a nutrient our body needs to produce calcium. Calcium helps create strong teeth and bones. So logically, not having enough vitamin D leads to brittle bones (a risk for greater injury after a fall), plus muscle aches and pains. Others with a vitamin D deficiency may not show symptoms. Either way, a provider may order a blood test to confirm the issue and then may advise you to take a supplement. This is usually in pill form and can be prescribed or bought over the counter by itself or as part of a multivitamin.

“Or the provider may just talk about vitamin D-rich foods first before starting a supplement,” Draper says. “High fat fishes, egg yolks, some cheeses and mushrooms.”

Draper adds that pregnant women, babies (especially babies who are breastfed), the elderly and people with darker skin often lack vitamin D.

On the flip side, Draper says it’s rare, but a person can get too much vitamin D. Symptoms include nausea, vomiting and heart palpitations (feeling like your heartbeat is fast, pounding or otherwise irregular). You may also suffer kidney damage.

Summer sun

Here’s advice to commit to memory: Draper says research shows 10 to 15 minutes of sun exposure three times a day can get you a healthy amount of vitamin D.

“You want to protect your skin while doing that,” Draper adds. “Sunscreen and protective clothing like a hat and sunglasses. There’s not any research showing that sunscreen or clothes will prevent you from getting the vitamin D you need.”

Experts say your sunscreen should have a sun protection factor (SPF) of 30 or higher, and you should reapply every two hours. Clothing should be lightweight and light colored (Dark colors absorb more sunlight, leading to quicker heat illness.) Stay hydrated, and watch for redness and blisters from sunburns and suspicious moles that may be skin cancer. See a provider right away if you have issues from getting too much sun.

Another thing to note: Experts say a specialized lamp can help with seasonal affective disorder, a mental health condition often seen in the winter due to decreased daylight. The same logic does not apply for vitamin D. You need natural, not artificial light to get the vitamin D you need.

The bottom line

Draper says most people don’t have to worry about getting too much or too little vitamin D.

“The average person will get it through the sun,” Draper says. “If you live in a cold and dark environment, you’re at higher risk for vitamin D deficiency. People farther away from the equator are higher risk.”

If you have symptoms of too much or too little vitamin D or just have a concern, talk to your primary care provider.

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Heat exhaustion vs. heat stroke: Know the difference

Illinois averages 10 days with temperatures at or above 90 degrees each year, according to the Illinois State Climatologist. 

In typical summer fashion, temperatures are reaching the 90-degree mark this week.

This summer weather puts many people at risk for heat exhaustion and heat stroke. Not only outdoor workers, but kids, older adults and those without working A/C in their buildings could be affected.

Brian Curtis, MD, vice president chief medical officer of OSF Medical Group, says preparation and awareness are keys to staying safe in the summer heat.

“You’ll go from heat exhaustion before you get to heat stroke,” Dr. Curtis says. “Heat exhaustion is where people are cool, clammy, sweating profusely, and they may have some nausea or vomiting. They usually have some severe muscle cramping with it.”

If heat exhaustion is not recognized and treated quickly, Dr. Curtis says heat stroke can then happen.

“With heat stroke, they’ll have dry skin, a temperature of 102-103 degrees, they’ll be confused or passed out,” Dr. Curtis says. “That’s a medical emergency, a 911 call. Whereas with heat exhaustion, you need to get them out of the heat, get them into a cool environment, and get them some liquids.”

Dr. Curtis says hospitals see heat stroke patients every summer, especially during longer stretches of hot and humid weather. He says higher humidity causes our bodies to not be able to cool as easily.

But these dangers don’t just affect outside workers or athletes playing sports in the summer. Dr. Curtis says the main excessive heat victims are middle-aged people, but kids and older adults are more susceptible.

“Because they don’t heat and cool themselves as easily, they’re more prone to get it, and we tend to be more vigilant with them,” Dr. Curtis says.

Heat exhaustion or heat stroke aren’t solely seen outside, either.

“If you get into the mid or upper 90s, we have some people around here who still don’t have air conditioning. You can get heat exhaustion and heat stroke within a building,” Dr. Curtis says. “When people don’t have air conditioning, that’s when you really see a lot of the elderly develop heat exhaustion within their own homes.”

Prevention of heat exhaustion and heat stroke

- Drink plenty of liquids (water, fruit juice, sports drinks)

- Avoid dehydrating liquids like alcohol and caffeinated beverages

- Take frequent breaks

- Get out of the sun and into the shade

- Use sunscreen and avoid getting sunburnt

- Use the buddy system: Keep an eye on each other

Dr. Curtis adds the effects of heat stroke can be long-lasting, or even lead to death.

“People die of it every year, or they have debilitating conditions afterwards,” Dr. Curtis says. “Once you’ve had heat stroke, you tend to be more susceptible to the heat as you go forward. Your body does not regulate as well and so you can be more prone to develop it in the future.”

For More Information

When it comes to extreme temperatures, play it safe. Know the warning signs of heat stroke and take the proper steps to prevent it.

Symptoms of Heat Exhaustion

• Profuse sweating
• Water depletion (causes extreme thirst)
• Weakness
• Dizziness
• Salt depletion (causes muscle cramps)
• Nausea
• Vomiting
• Fainting
• Headache

Symptoms of Heat Stroke

• Body temperature greater than 104° F (main sign)
• No sweating in hot weather
• Neurological problems such as confusion, unconsciousness, and seizures
• Rapid breathing
• Increased heart rate

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It can cause panic for parents, but it doesn’t have to.

Emily Isom is talking about head lice, something she sees often as a mother and a certified medical assistant in pediatrics at OSF HealthCare.

The good news for parents: in most cases, your child doesn’t have to miss school and can be treated with over-the-counter remedies.

Lice basics

Isom says lice (the singular form is louse) are tiny insects that sit on your scalp. They typically spread when you share objects like a comb or hat or when you have head-to-head contact with someone. Itchiness is the primary symptom, and the infestation usually lasts seven to 10 days.

“If someone ignores it, it can lead to infections and open sores,” Isom warns. “The insects are going to keep biting the same spot, and the person is going to keep scratching the spot.”

The lice can also lay eggs and multiply, Isom says.

Isom suggests parents and teachers be vigilant about lice. Check your child when they get home from school or anytime you notice they are scratching their head excessively. Use a fine-toothed comb and a magnifying glass to look for sores, bleeding, pus and the insects themselves or their eggs. The eggs are called nits and are white in color.

“For girls with long hair, it can take a long time,” Isom says with a smirk. “Start at the scalp and go down to get the nits and lice onto the comb. Clean the comb, and go back through another section.”

Treatment and prevention

You can take your child to their pediatrician if you feel it’s needed. But for a mild first case of lice, Isom says over-the-counter products at home, like the Nix® or Rid® treatment kits, may do the trick. If your child isn’t getting better, has a repeat infection or has significant symptoms, definitely talk to your pediatrician or an urgent care. They may advise a virtual visit so lice don’t spread. Isom says she often sees doctors prescribe Natroba™, a shampoo that kills lice.

For prevention, keeping a clean home goes a long way.

If you already have a case of lice in your home: “Spray the couches, bedding and floors with sprays that are for lice. You have to vacuum. You have to bag every stuffed animal for at least two weeks to suffocate the lice. Take the sheets off the bed every day and dry them on high heat until you know the lice are gone,” Isom says. Stray clothing should also be dried on high heat.

All that work may lead you to believe that kids with lice should be isolated for a while. Not so, Isom says.

The United States Centers for Disease Control and Prevention says if a child has lice, they don’t need to leave school early. Once they start treatment, they can return to school. Isom suggests checking with your child’s school to see how it handles lice.

Misconceptions

There’s a lot people get wrong about lice, Isom says.

• They’re the result of poor hygiene.
  
  Isom says that can play a role, and she recommends you wash your hair daily (Fairy Tales is a good shampoo brand for kids, she says.) But, Isom says anyone can get lice.
  
  “Dirty hair or clean hair. Lice can go to both,” she says. “But if you have dirty hair, lice won’t like that. With clean hair, there are no oils and buildups of hair products. The lice can more easily attach themselves.”
   
• Lice can jump from person to person.
  
  No, they typically spread from sharing items or close contact.
   
• I need to call an exterminator.
  
  Not needed, Isom says. A thorough clean of your home should be fine.
   
• I heard that an at-home remedy like an essential oil will work.
  
  “Stick to what’s proven,” Isom says, referring to over-the-counter or prescription products. She’s even heard of some people putting flammable material in their hair, an obvious risk for a fire.
   
• Lice carry diseases.
  
  Isom reiterates that constant scratching can lead to wounds and infections. But she says lice are not like the flu or COVID-19.
  
  “It’s a pest,” she says.

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Busting hygiene myths

This is part two of a two part story on hygiene myths. Click here for part one.

From health care providers to websites to advice passed down through generations, there are a lot of ways to get health care information, especially tips for minor ailments you can treat at home.

Awad Alyami, MD, a pediatrician at OSF HealthCare, breaks down some common myths.

• Myth: When I shower, bathe or wash my hands, really hot water is best to kill germs.

Fact: Really hot showers can feel good, but they may burn your skin. Dr. Alyami recommends setting your home’s water heater at 120 degrees or less. Then, when you use the shower or sink, warm, but not hot water is best.

Dr. Alyami adds that a cold shower after a sweaty summer activity is OK because it can reduce the chance of heat rash. But frequent cold showers can irritate your skin.

• Myth: Q-tips are meant for cleaning your ear.

Fact: “The ear is a self-cleaning oven. Most everything inside the ear will come out on its own,” Dr. Alyami says. “When we put anything inside the ear, we are pushing everything from the outside to the inside, especially earwax. It makes it harder for the ear to clean itself.”

Using Q-tips and similar devices can lead to injuries to the ear canal or eardrum, Dr. Alyami adds. Instead, during your shower or bath, gently clean and dry the outside of your ears. If your ears look or feel off (pain or itchiness, for example), see a provider.

“We can clean you safely in the office,” Dr. Alyami says.

• Myth: For cuts and scrapes, apply antibiotic ointment like Neosporin until it heals.

Fact: You can apply the ointment once after cleaning the wound and then again after the wound is healed. But doing so often can lead to contact dermatitis, a bad skin reaction.

• Myth: The “five second rule” is OK for eating food that’s fallen on the floor.

Fact: Dr. Alyami puts this one to rest once and for all: Don’t do it. Always eat off a sanitary surface.

He even says that research has shown that bacteria from the floor can attach to food in as little as less than one second. Eating dirty food can lead to vomiting and stomach illnesses.

Interview clips

Summer may be winding down, but health care providers want you to know that heat rash can happen year-round. Luckily, most cases resolve on their own with simple steps.

Maddy Draper, APRN, a provider at OSF OnCall, says heat rash (also called sweat rash or prickly heat) usually occurs in a hot or humid setting. This could be the summer heat or a year-round activity like the sauna or gym. Or, Draper says, using certain things on your skin – like bandages, medicine patches or thick lotion – can contribute. Either way, the result is clogged ducts trapping sweat under the skin, leading to a rash.

“It’s either raised, red bumps or blisters filled with clear fluid or pus,” Draper explains.

Draper adds that heat rash is more common in infants and young kids, but it can affect all ages. She says providers typically see the rash on a person’s midsection – front and back. It can also crop up on your arms and legs, especially where patches of skin come together, like your armpit. Sometimes the rash will be itchy.

“There’s no cure for it. It’s just getting back into a normal, less hot environment. Wear less clothing. Get the sweat off your body,” Draper says.

Don’t pop the blisters, as that can lead to a bacterial infection. Don’t use rubbing alcohol or peroxide on the rash, and don’t scratch the itch.

In other words: “Just leave it alone,” Draper says, and most cases will resolve in a few hours.

When to see a health care provider? If you develop a fever, if the rash persists for a couple days or if it looks different (such as red streaks up your arm), visit your local urgent care. In rare cases, blocked ducts can cause sweat glands to stop working. That makes it harder for the body to cool itself, and you can be prone to overheating.

Heat rash prevention involves many of the “hot environment” safety tips you’ve heard before.

“Stay in cooler environments,” Draper advises. “Everyone likes to be outside in the warmth, but try not to prolong those exposures. If you feel symptoms [of heat illness], come inside and cool off.”

During those breaks, drink water or a sports drink, wipe off sweat and change out of damp clothes. Also, remove bandages or patches when doing something that makes you sweat.

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High school athletes across the country will soon feel the heat when teams begin practices for several sports including football, cross country and soccer. 

Health experts say it's important to stay safe, especially when it comes to practicing during the grueling August temperatures. 

According to the National Center for Catastrophic Sport Injury Research, heat stroke is the third-most common cause of sudden death among high school athletes behind cardiac arrest and traumatic brain injuries.

Dr. Faheem Ahmad, a family practice physician with OSF HealthCare, says athletes can experience anything from feeling tired because of heat exhaustion, to symptoms of heat stroke, which can include fainting, loss of consciousness and a body temperature above 103 degrees.

“The summer heat is very dangerous for so many different reasons, and it is important to know and identify those risk factors associated with heat related illnesses, particularly the athletes, their coaches and the staff who work with them," Dr. Ahmad says. 

Other signs of heat stress include headaches, nausea, body pain, muscle cramps and dry mouth. Dr. Ahmad says hydration is key, so take frequent water breaks and drink sports drinks with electrolytes.

Health Highlights Video With Chyrons

Health Highlights Video Without Chyrons

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

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

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

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

From garage to gurney

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

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

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

Randy coded at the hospital, adding to the urgency.

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

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

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

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

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

Lessons learned

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

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

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

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

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

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

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

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

“It could save your life,” Dawn says.

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

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

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

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

Learn more

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

Interview clips - Dawn and Randy Isham

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