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

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

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

• My baby needs water in addition to milk or formula.
  
  It’s a common thought, Anderson says. One, adults need water, so people assume infants do, too. And two, formula can involve mixing in water, so mothers think they need to do the same with breast milk.
  
  “Really, breast milk is about 80% water,” Anderson says. “It’s there. It’s complete nutrition. You’re not missing anything.”
  
  Anderson adds it’s actually dangerous to give water to babies under six months. They can overhydrate, leading to possible kidney damage. After six months, Anderson says to talk to a health care provider about introducing water. She says one to two ounces of water per day to help wash down solid food is common.
   
• Breastfeeding will make my breasts sag.
  
  Anderson says breast changes begin during pregnancy and are not solely a result of breastfeeding. Some women will notice their breasts are larger once they are full of milk, but there are more factors at play.
  
  “[During pregnancy], your hormones are changing a lot. Your ligaments are stretching. We’re getting ready for a baby,” Anderson explains. “Then you have your baby, and your milk starts to come in. Regardless of whether you breastfeed or formula feed, you’ll see some breast changes. It was those hormonal changes in pregnancy.

“[Breast changes] can also be related to your lifestyle,” she adds. “Smoking affects your skin health, and you can see that affect the breasts. It can be related to age or a family history [of health issues such as lupus and other autoimmune diseases].”

Anderson also says research has found breastfeeding can actually promote breast health. For example, it can reduce your breast cancer risk.

• I have small breasts, so I won’t have enough breast milk to keep my child nourished.
  
  Anderson retorts with an affirmation we’ve heard since childhood: It’s what’s on the inside that counts.
  
  “Size of the breast is not a factor in being able to breastfeed. What is a factor is the amount of milk glands in your body. We all have those milk glands. Size just relates to fatty tissue,” Anderson says.
  
  The only time size may come into play, Anderson says, is if a woman gets a breast reduction where milk glands are removed. In that case, talk to a health care provider about your options.

Learn more

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

Interview clips

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Mental health medication and pregnancy

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

“Mom! I have to go!”

“Hold it!”

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

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

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

Why do we hold our pee?

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

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

The consequences

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

A few problems, the doctor says.

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

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

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

Prevention and treatment

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

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

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

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

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

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

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

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

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

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“That’s going to change the way we do a lot of major urologic procedures. Instead of using multiple incisions, we use one or two incisions and get the job done that way,” says James Sylora, MD, urologist at OSF Little Company of Mary. “That should increase patient comfort and get them home earlier and back to work sooner.”

According to Dr. Sylora, the single-port robot will now be used for 90% of urologic procedures, such as surgeries to remove all (nephrectomy) or part of a kidney (partial nephrectomy). This is done primarily to treat kidney cancer. This can also be used for benign and reconstructive procedures.

The SP Robot allows the surgical team to access target organs in patients who have previously undergone surgery. Beforehand, scar tissue would have made it more difficult, Dr. Sylora says.

Most patients being treated with this technology have localized prostate cancer or small renal masses. In cases of renal cancer, the single-port robot helps preserve kidney function.

Thanks to this new approach, most patients can return home the same day as their procedure - a major improvement from previous procedures that required multiple days of hospital recovery. The need for pain medication has also dropped significantly.

“Several of the patients take a few Tylenol #3 or extra strength Tylenol as their post-operation pain medication. It’s quite remarkable,” Dr. Sylora says. “I wouldn’t have believed it until I started doing it. And sure enough, it’s true.”

The OSF Little Company of Mary team began using the single-port robot earlier this year and has already treated roughly a dozen patients with promising results.

“OSF has invested in having this new technology. They’re one of the only private hospitals across the country to have invested in this type of technology,” Dr. Sylora says. “They’re staying at the cutting-edge and we’re happy to provide this service.”

The Da Vinci SP system enables robotic-assisted surgery through a single incision, offering a streamlined and less invasive alternative for patients. Its specialized design, flexible instruments and enhanced vision support a new generation of surgical precision and recovery.

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

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Managing kidney failure is a huge task. But doing so while in a hospital critical care unit makes things even more challenging.

Luckily, a lifeline exists in the form of continuous renal replacement therapy (CRRT), a form of dialysis. Normally, dialysis is an outpatient procedure where a machine does what healthy kidneys normally do – remove fluid and waste from your blood. But sometimes critically ill people are in a hospital bed, and their bodies can’t tolerate the stress of normal dialysis.

That’s where CRRT steps in.

“It’s a very slow filtration of the kidneys while they’re in this acute state. Their body may not be able to compensate for that shifting or removal of the toxins and fluids,” says Keely Nelson, OSF critical care nurse manager.

“It’s supposed to act most like what your kidneys are doing all day, every day,” says April Collins, OSF intensive care unit charge nurse. “Compared to [normal dialysis] three times a week with an aggressive pull of toxins.”

“We run it 24/7, generally five to seven days at a time,” says Leah Hawk, OSF critical care educator.

Nelson, Collins and Hawk have overseen the recent implementation of CRRT at OSF HealthCare Saint Anthony’s Health Center in Alton, Illinois.

Someone, generally, would be on CRRT until their condition improves and they can tolerate normal dialysis. Signs providers watch for include producing urine, better blood pressure readings and changing lab values that indicate better kidney function.

“[CRRT] is extremely critical,” for patients, Nelson says.

“During COVID, the patients were so incredibly sick and could not handle aggressive dialysis in the hospital. If we were able to provide [CRRT] during COVID, that would have helped a lot of patients to slowly remove those fluids while providers are hydrating them and giving them medications.”

Nelson adds that CRRT was already becoming more common at hospitals in the past five years, but the pandemic accelerated things. The concept itself is around 40 years old, she says.

Learn more about kidney care on the OSF HealthCare website.

Interview clips - Keely Nelson

Interview clip - April Collins

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No distance too large for the gift of life
“They are very special people”

Quintin Porter is a walking miracle.

He’s battled back from multiple car accidents, cancer, an irregular heartbeat, a torn rotator cuff, carpal tunnel syndrome and more.

But the journey that brings tears to his eyes started with a random text message from an old flame and ended with him ditching his dialysis equipment for a new kidney. And along the way he learned about the technique that made it possible - paired exchange.

“It was kidney or coffin,” says the 56-year-old from Mahomet, Illinois.

Porter’s journey

A former stand-up comedian and radio executive, Porter has no problem recalling what got him to where he is today.

Toward the end of 2019, Porter says his health was “dragging.” His right arm hurt, and he knew something just wasn’t right.

“Your bloodwork is horrible,” Porter recalls his medical team telling him. “You’re at stage three of kidney disease.”

The father of two then went on dialysis, where an artificial filter does what healthy kidneys normally do – remove fluid and waste from your blood.

“You’re tethered to a machine,” Porter describes. “I wouldn’t wish it on my worst enemy.”

Dialysis gave Porter plenty of time to take up new hobbies like bird watching or sketching. Or watching the phone ding with the most important text message he would ever get.

Christy reconnects

The text on March 16, 2022, read, “Can you talk?”

It was from someone Porter hadn’t spoken to in nearly four decades: his high school girlfriend in Glen Ellyn, Illinois, Christy Stott. The 54-year-old retiree from Rockford, Illinois, wanted to catch up. But more importantly, she had seen Porter’s calls for a life-saving kidney.

“I got you. I’ll give you a kidney,” Porter remembers Stott telling him almost nonchalantly.

“I couldn’t believe it,” Porter adds. “It set off a whole bunch of emotions.”

“Sometimes people reach middle age and feel compelled to do something they’ve never done before,” Stott says. “Run a marathon. Write a novel. Something amazing and unexpected.

“I think that’s what this experience has been for me,” she says.

Porter and Stott seemed to be a perfect match if not for one problem: Stott is petite, and Porter is not. A honeybee and a bear, as Porter puts it.

But OSF HealthCare Mission Partners (employees) in Peoria, Illinois, knew another way.

Paired exchange

The nationwide paired exchange program involves a kidney donor and a recipient who aren’t compatible. When you add another incompatible pair, sometimes a match can be made. The donor from one set can donate to the recipient of the other pair, and vice versa. The swap makes a big X. The willingness of everyone to participate allows the process to get a jumpstart and makes optimal use of living donors. It can also significantly reduce wait time, which can stretch into years.

"This one was unusual,” says Dr. Christopher Johnson, a nephrologist with RenalCare Associates and medical director for OSF Kidney Transplant.

“Usually with kidneys, the size isn't the biggest thing. But in this situation, it was such a big difference that we thought we could get a better match for him. Her kidney was perfect for someone her size. It's going to take someone off dialysis and extend their life," Dr. Johnson says. "She's also blood type O. She's a universal donor. But the kidney was smaller than what would be ideal to the recipient. So we knew if we put this into a national exchange, we're going to benefit someone else.

"A lot of times people ask, ‘what's the blood type?’ And they want to know if they're blood type compatible,” Dr. Johnson adds. “I say this every time. I don't care what your blood type is. If you're not compatible, we'll find a trade. What's important about a kidney donor is that they're healthy and able to donate. No diabetes, healthy weight, no cancer or other problems. If there's an incompatibility, we can find a solution."

A research-minded guy, Porter looked into the paired exchange concept thoroughly before taking the leap.

“These nurses work so hard to give you such good, specific instruction that has derived from thousands of hours of treating actual patients,” he says.

So on October 4, 2022, Porter and Stott went to OSF HealthCare Saint Francis Medical Center in Peoria. She to give a kidney, which wound up in the Cleveland, Ohio, area. And he to get one, coming from Eris Diaz, who owns his own cooking business nearly 1,300 miles away in Miami, Florida. But when it comes to saving lives, no distance is too far.

“Of course, there is pain,” with transplant surgery and recovery, Diaz, now 25, says. “But the pain was for a good action and for Quintin’s happiness."

Lessons learned

Porter, Stott and Diaz are doing well in 2023 and are urging others to look into organ donation, either living or pledging to do so after you have passed away.

“I’m so happy for Quintin,” Stott says tearfully. “And I’m fine. I’m better for it. If I could donate again, I would.”

"Donation is important because you're sharing your life with people who need it, and that is beautiful," Diaz says.

“It’s a big sacrifice. But if you had the ability to save someone’s life, wouldn’t you?” Porter asks.

Learn more

Nearly 100,000 people in the United States are waiting for a kidney transplant. Learn more about how you can make a difference on the OSF HealthCare and Donate Life America websites.

Interview clips - Quintin Porter

Interview clips - Christy Stott

Interview clips - Eris Diaz

Interview clips - Dr. Christopher Johnson

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Additional B-roll

Quintin Porter demonstrates connecting to dialysis machine - June 4, 2022
Quintin Porter demonstrates disconnecting from dialysis machine - October 3, 2022

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‘They are very special people’

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

Pain from a kidney stone is like giving birth.

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

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

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

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

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

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

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

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

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

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

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

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

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

Interview clips

Andrew Zasada, MD, can’t help but chuckle when asked about the “latest and greatest” body cleansing fads.

But the internal medicine physician at OSF HealthCare says these whims can turn into anything but a laughing matter.

“When you put stuff that’s not really regulated in your body, you don’t know what’s going in,” Dr. Zasada says. “And if you mix in your regular medicine, too, you’re not doing yourself a favor.”

Dr. Zasada is reminding you to talk to your primary care provider before starting any significant treatment. Don’t believe everything you read online or on a label.

Diatomaceous earth as a cleanse

Dr. Zasada says diatomaceous earth has several legitimate uses in industry. But it’s also seen in powder form as a dietary supplement.

The product comes from ground-up and processed skeletons of algae. It contains silica, one of the main components of sand. There are two types of diatomaceous earth: edible, which contains 2% to 4% silica, and industrial with 60% or more silica.

Dr. Zasada says ingesting silica in small amounts – for example, mixing it in water – is harmless because it does not absorb into your body. But you should never inhale it.

“It causes irritation of the lungs which can be permanent and cause scarring. It can cause you to be short of breath. It’s called silicosis,” Dr. Zasada explains. “It’s similar to what coal miners get when they inhale coal dust. People die from silicosis every year.”

Dr. Zasada says some people claim diatomaceous earth cleanses your digestive tract and improves cholesterol. But he says scientific evidence for and against these claims is “scant at best.”

“There have been a few studies that showed that it lowers cholesterol. But at the same time, we don’t know what else that patient may have eaten because it was a poorly designed study,” Dr. Zasada says. “Was the silica responsible? Was it dietary? We simply don’t know.”

Dewormers and other cleanses

Dr. Zasada says dewormers do what the name suggests – remove intestinal parasites from your insides. He says they serve a purpose in livestock but not humans.

“Some people believe we all carry some type of parasite, and we need to deworm ourselves,” Dr. Zasada says with a sigh.

“If you really think you have an intestinal parasite, see your doctor. The test is simple. If you do, in fact, have a parasite, it can be eliminated.”

Dr. Zasada adds that there’s no evidence that our bodies are loaded with toxins that must be removed. He says that removal happens naturally through our liver, kidneys and bowel movements.

“We’ve been around as a species for hundreds of thousands of years without colon cleanses, and we’ve done pretty well,” he quips.

Interview clips

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.

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

Urinary incontinence is when a person leaks urine by accident.

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

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

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

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

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

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

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

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

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

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

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

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

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Gotta go? Try these six bladder tips

To paraphrase George Carlin: It’s 50% universal.

At some point in their life, many men will have to think about benign prostatic hyperplasia (BPH), commonly known as an enlarged prostate. BPH often means the flow of urine from the bladder is blocked by the prostate gland growing inward, leading to frequent and annoying trips to the bathroom. But BPH can also lead to more serious problems of the bladder, urinary tract and kidneys.

According to the National Kidney and Urological Disease Information Clearinghouse, the most common prostate problem for men over 50 is prostate enlargement. By age 60, more than half of men have BPH, according to the American Urological Association. By age 85, the number climbs to 90%.

Luckily, BPH is treatable.

Ronan Lev, MD, is a urologist who provides care through OSF HealthCare in Alton, Illinois. His practice was recently designated as a Center of Excellence by UroLift®, an organization that introduced a quick, minimally-invasive procedure to deal with an enlarged prostate and allow for an easier recovery with fewer complications such as erectile dysfunction. The Center of Excellence designation is provided to individual physicians who have achieved a higher level of training and experience with the UroLift system. In Dr. Lev’s case, he has performed more than 200 UroLift procedures.

Dr. Lev says minimally-invasive procedures such as UroLift signal a shift in BPH strategy toward bladder preservation.

“In the past, we were very happy about symptoms relief. Everything was focused on symptoms relief. And if you said, ‘I'm feeling better, took a pill,’ that was fine for us,” Dr. Lev says. “What we learned over time is that it was causing some damage to patients because as medications were failing, their bladders were making up the difference. Because the bladder is a very, very strong muscle, and we can’t appreciate how strong our muscle is working.”

Dr. Lev’s message to men: See a doctor if something doesn’t seem right down there.

“Men have a tendency to pare down their issues and say, ‘Oh, it's not an issue. It's not a problem,’” Dr. Lev says. “But if they really think about it, I would say most men compare themselves to yesterday. They don't compare themselves to what it was a year ago. If they would think about that, they would realize that it's a lot worse than they really think.

“If we can do a procedure in the office under very mild sedation and improve your quality of life,” Dr. Lev explains. “When you're 90, every day counts, not what's going to happen in a couple of years. So we if we can improve your quality of life, that's really crucial.”

At OSF HealthCare in Alton, the UroLift procedure will be done on an outpatient basis. However, UroLift is not yet available in every community served by OSF HealthCare. You can learn more about urology and find an OSF HealthCare urologist here.

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