BreAnne Gendron, NP, knows all about the effects of gastroesophageal reflux disease, or GERD. She eventually had to give up coffee because it caused a burning sensation in her throat.

As a nurse practitioner with OSF HealthCare, Gendron also treats patients who experience GERD in different ways.

“GERD probably feels a little bit different for everybody, but it definitely helps [to understand patients' experience] when you have personal experience with it,” she says. “Sometimes people with GERD have a flare-up and their stomach hurts, but they don't get that acid-up-the-throat feeling. It just causes stomach discomfort. Sometimes it changes bowel movements. Everybody has a slightly different version of it.”

Occasional heartburn or acid reflux is common. But when those symptoms happen frequently – two or more times a week – it could be a sign of GERD and worth mentioning to your health care provider.

Symptoms can include regurgitation, trouble swallowing, a feeling of a lump in your throat, a persistent cough, a sore throat or heartburn that doesn’t improve with over-the-counter medication.

Gendron says people who are 50 and older and overweight are at highest risk for GERD. Heartburn is one of the most common symptoms of GERD. But how do you know if that burning sensation in your chest is simply reflux or something more serious, such as a heart problem?

When chest pain shouldn't be ignored

Gendron says patients will sometimes go to the emergency department because they are experiencing chest pain. While some people may wonder if they are overreacting, Gendron says it’s always better to have potentially serious issues addressed.

“If it’s the first time you're having chest pain, we can't just guess, ‘Oh, that's probably acid reflux,’” she says. “You have to go in and be seen to rule out a cardiac reason, because that's what we do in health care. We rule out the scary stuff, so we can treat the treatable stuff.”

Even people with a history of GERD should pay attention when their symptoms change. For example, if chest discomfort occurs during physical activity, it could be a sign of a heart problem and should be evaluated.

“I would say any time you have activity where you're carrying in the groceries or you're going up a couple flights of stairs and that pain happens, that's not a GERD symptom,” Gendron says. “That's a cardiac symptom, and your doctor can help you figure that out. It's worth a conversation if you're having reflux feelings that are different than normal.”

If you experience new, severe or unexplained chest pain, especially with symptoms such as shortness of breath, sweating, nausea, dizziness or pain that spreads to the arm, back, neck or jaw, seek emergency medical care immediately.

Knowing your GERD triggers

Once anything serious has been ruled out, lifestyle changes can help manage GERD symptoms.

Common triggers can include spicy or fatty foods, citrus or tomato-based foods, caffeine and soda, alcohol, nicotine and heavy or late-night meals.

Gendron says there isn't one diet that works for everyone with GERD. Instead, people should pay attention to which foods trigger their symptoms and make adjustments as needed.

“Some foods will bother people,” she says. “I hear people complain to me a lot about things with tomato sauce, so pizza and spaghetti and things like that bother people with acid reflux. So, you can augment your diet. You can cut back on coffee. You can cut back on your nicotine.”

Medication can also be used to treat GERD when lifestyle changes aren't enough. But Gendron says she prefers to start with lifestyle changes if possible.

For her, that meant giving up her favorite morning beverage.

“I personally had to give up coffee because of this problem. I know if I don't drink coffee, that my whole digestive tract is happier,” she says. “So, people will figure out which foods bother them, and then you have to avoid those.”

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Natasha Noel, MD, is a pediatric cardiologist who’s been treating children with heart issues for more than a decade.

But in the past few years, Dr. Noel has seen a spike in high cholesterol with several kids she cares for. 

“It’s the diet with respect to fast foods, and the climate, especially in Illinois. Our long winter months mean less physical activity for the kids,” explains Dr. Noel. “There is a greater awareness of this condition, and young adults experiencing sudden cardiac death. It all goes hand in hand.”

With those factors in mind, OSF HealthCare Children’s Hospital of Illinois has opened its first pediatric lipid clinic at its location in Rockford at 444 Roxbury Road. The program is led by Dr. Noel, who is board certified in clinical lipidology.

The clinic specializes in caring for children with cholesterol concerns, focusing on lifestyle changes, nutrition counseling with dietitians, genetic testing and lipid testing as needed. The clinic offers in-person and telehealth visits.

The bottom line, says Dr. Noel, adults aren’t the only ones who experience high cholesterol.

“Children can have high cholesterol as adults, and it could lead to early cardiac disease over time,” says Dr. Noel. “But once found and diagnosed, there is management available. So, I say don't delay (seeking treatment).”

Cholesterol and triglycerides are fats, or lipids, in the blood. Dr. Noel says the body needs lipids and cholesterol, but at high levels it could cause damage, especially heart disease as the years go on.

A simple blood test can determine the child’s cholesterol results. It's recommended that children are screened or have their lipid levels checked between the ages of nine to 11, and then again at 17 to 21. However, Dr. Noel adds that if there are specific risk factors, then screening may occur more often or earlier, sometimes as early as age two. 

Genetic testing is important when it comes to diagnosing a familial lipid disorder.

“Screening is needed to identify that something is wrong and abnormal, because most of these kids are asymptomatic. Genetic testing comes in handy if we suspect something inherited like familial hypercholesterolemia,” says Dr. Noel. “It also helps us guide management as needed.”

Risk Factors 

Risk factors include genetics, diet and physical activity. Obesity, diabetes and lack of sleep can also increase cholesterol levels. If cholesterol problems are untreated, it can lead to plaque in the coronary arteries, which leads to cardiac disease and atherosclerosis (the buildup of fats, cholesterol and other substances in and on the artery walls).

Depending on the cause and severity, the treatment plan includes lifestyle and dietary changes, more physical activity and then medication.

Dr. Noel stresses that abnormal test results don’t always mean a child is ill or requires medication. That’s why she encourages daily physical activity at least three to five days a week. Walking, biking and swimming are some of the activities that can lower a child’s risk of cardiovascular disease.

Diet is another important factor. Parents can help their children by encouraging food low in total fat, limiting saturated fats, avoiding full-fat dairy and eating enough fiber. Vegetables, fruits and whole grains are all great options to increase daily fiber intake.

A primary care provider can perform the initial screening and if there is a concern, a referral will be made to a pediatric cardiologist. “I think most of them are comfortable with us taking over that care, especially if medication is needed,” says Dr. Noel.

For more information on cardiology or other child-related issues, visit the OSF Children’s Hospital of Illinois website. 

 

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From misconceptions about symptoms to stereotypes about drugs like Adderall, there’s a lot to parse out when getting treatment for attention-deficit/hyperactivity disorder (ADHD), a neurodevelopmental disorder that affects attention, impulse control and activity levels. ADHD is seen in all ages and can overlap with other issues like depression and anxiety.

“ADHD is different from lack of interest or just not paying attention. It includes emotional dysregulation, chronic impatience, restlessness and constant fidgeting. There’s difficulty managing, planning and organizing things,” says Maghav Sharma, MD, an OSF HealthCare psychiatrist. “That leads to difficulties at home or work. It can cause relationship difficulties or difficulties with bosses. Maybe the person is not completing work on time or are impatient with the result of the work.

“We see symptoms of hyperactivity mostly in kids. They’ll run around their classroom. It’s a common reason why teachers and parents send their students to the doctor to get ADHD treatment,” Dr. Sharma adds. “In adults, that anxiousness and restlessness is not outwardly projected. It’s more inside. A person can feel overwhelmed. They are fidgety, restless or on edge.”

All this is why it’s important to get a treatment plan tailored to your needs. Seeing someone like Dr. Sharma would be a good first step. He says therapy can teach skills, like how to plan and be organized, that can help cope with everyday ADHD issues and, at the same time, help if there are other issues present, like depression. For example, if ADHD is causing you to procrastinate on work projects, you could feel anxious about getting in trouble or sad about missed opportunities to move up the corporate ladder.

“We do quite often see people with symptoms of depression or anxiety, but they have underlying ADHD as well,” Dr. Sharma says. “It’s hard to tell sometimes which symptoms are related to anxiety and which are related to ADHD. So we tend to treat the conditions together. Treatment for anxiety and depression can sometimes alleviate the symptoms of ADHD.”

ADHD treatment “never should be just medication,” Dr. Sharma says. But if ADHD is making daily life difficult, medication can be paired “thoughtfully” with other treatment, he says. Stimulants like Adderall and Vyvanse are often starting options for adults. For kids, health care providers might try methylphenidate (Ritalin is a common brand name). A provider could change your medication if side effects are a problem. They could try a non-stimulant like clonidine or guanfacine.

Lifestyle changes also play a big role in ADHD management, Dr. Sharma says. Sticking to a routine – everything from when you sleep to when you leave for work – can help. Exercise, staying hydrated, eating a healthy diet and getting outside to pursue hobbies or be around others can also help your mood.

Learn more about keeping your mind healthy on the OSF HealthCare website.

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Click here for more stories on mental health care on the OSF Newsroom.

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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The music world was stunned to learn that the recent passing of former American Idol contestant Mandisa was the result of complications from class III obesity. Mandisa, who was found in her Tennessee home in April, was 47.

Class III obesity is defined as a person who has a body mass index (BMI) of 40 or higher or a BMI of 35 or higher and experiencing obesity-related health conditions. In simple terms, BMI is a ratio of height to weight.

“We know the heavier we are, the higher risk we have for things like diabetes, like high blood pressure for acid reflux or sleep apnea, the things that actually are causing damage to our bodies,” says Nicole O’Neill, a registered dietitian with OSF HealthCare.

Obesity is a major problem in the U.S. According to the Centers for Disease Control and Prevention (CDC), it affects four out of 10 people in this country. Class III obesity is on the rise and affects 6% of adults nationwide.

Ideally, a healthy BMI range is 18.5 to 24.9. However, body fat isn’t the only factor of overall health. There’s genetics, activity level, smoking, drinking alcohol and mental health that all have an impact on the chance of developing health problems.

There are dozens of health risks associated with obesity including Type 2 diabetes, high blood pressure, heart disease and stroke.

Mandisa was transparent about her battle with mental health issues, which included turning to comfort foods during tough times. O’Neill works with clients who are going through their own struggles with weight issues and developing a healthy relationship with food.

“A lot of times it really depends on what the root cause of the actual weight gain is,” she says. “Is it someone who's stressed out and is eating their feelings? Then we have to look at that. Is it someone that has an injury and they're no longer able to exercise? In that case, we try to give them modified exercises. We're always going to look at diet though.”

O’Neill says the goal is to create a food plan that balances the calorie load. That includes coming up with well-balanced meals featuring plenty of fruits and vegetables, which have only 17 calories per ounce on average.

“Every person is so different. We have to take an individualized approach with each person,” she says. “What works for me probably isn't going to work for you or anybody else.”

In addition to working with a dietitian, O’Neill encourages clients to seek other professional help as well.

“I recommend people see a counselor because it's important. They're trained to know if you’re depressed or you're anxious. They have the tools to say ‘Alright, when you feel this way, do this instead of turning to food.’”

She adds that it’s important for people to know that it’s never too late to make healthy lifestyle changes. They can include slight lifestyle and diet modifications. And they don’t have to happen all at once.

“It can be small, incremental steps, and that's how most people do well,” O’Neill says. “Take one bottle of soda away and replace it with a glass of water. Take one cheeseburger away a week and add a salad so that they're sustainable changes that feel doable.”

People who think they could be helped by the new class of weight loss drugs should talk to their medical provider about the benefits in connection with a plan to make lifestyle changes. For more information on weight loss, visit OSF HealthCare.

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