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

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

Causes

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

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

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

Diagnosis and treatment

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

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

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

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

Prevention

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

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

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Consequences

Some people may see skin care as purely cosmetic. If I’m not a model or television news anchor, I’ll just do the bare minimum.

That’s not the right approach, Oberheim says. Poor skin care, especially in older adults, can lead to persistent bruises and skin tears leading to wounds.

“Sometimes it doesn’t take much. I’ll see patients who have small dogs that jump on them. Even just the clawing from the dog will put a tear in the skin because the skin is so thin and fragile,” Oberheim recalls. “When that happens, we have to make sure to keep the skin clean and dry. If we end up with an infection, that can lead to cellulitis. Cellulitis can lead to other things, including sepsis [a possibly deadly condition where your body responds improperly to an infection]. So we’d need to take precautions and fix the infection with maybe some antibiotics.”

The bottom line, Oberheim says, is if your skin problem isn’t responding to at-home treatment after a few days, see your primary care provider or a dermatologist.

Other conditions

Other skin conditions to be aware of:

• Eczema (also called atopic dermatitis): This causes dry, itchy scaly skin patches. Experts don’t know exactly what causes it. But Oberheim says allergies, asthma and even stress can play a role, and it’s often worse in the winter. She says eczema can affect all ages and appear anywhere on your body.
   
• Rosacea: This causes redness, pimples, broken blood vessels and, in severe cases, a misshapen nose. It most often affects the face and eyes.
   
• Age spots (also called liver spots): Oberheim says these look like “big freckles.” They’re often flat and dark-colored. They’re associated with sun exposure, and so they’re often seen on the head and face.
  
  “They’re usually not super problematic, but they’re not cosmetically appealing,” Oberheim says.
   
• Psoriasis: This causes inflamed, red raised areas of skin that can itch and be painful. This is often seen on the scalp, elbows, knees and lower back.
   
• Poison ivy and oak: Oberheim says she sees these issues often in her clinic. When someone rubs up against the plant or an object that’s touched the plant, they can get a red, bumpy itchy rash with fluid-filled blisters.

Prevention

So, what should your daily skin care routine be? Should you be getting facials at the spa regularly? That’s probably not necessary, Oberheim says. But daily washing and moisturizing is. Look from certain things on skin care product labels: retinol (helps with skin firmness and reducing wrinkles), vitamin C (helps brighten age spots), hyaluronic acid (helps with moisturizing), niacinamide (helps reduce redness), collagen and peptides.

Other things to consider:

• Wear sunscreen of 30 SPF [sun protection factor] or higher when outside, and reapply it every few hours.
   
• Wear protective clothing like a wide brimmed hat, long sleeves and long pants when outside. Wash clothes right away when you get home. Also, know which plants are in your area to avoid the pesky ones.
   
• Don’t smoke.
   
• Drink plenty of water all the time, not just during outdoor activities.
   
• Don’t bathe or shower in very hot water. This can dry the skin.
   
• Try not to itch any skin lesion. You don’t want a wound to open and risk an infection.
   
• Know your body. Watch for suspicious moles or lesions that might be a sign of skin cancer. Experts say you can remember the ABCDEs: if the mole is asymmetric, has an irregular border, has an odd color, has a big diameter or is evolving, see a provider.

Learn more

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

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Mental health challenges in young people

Brittany Algee, APRN, a board-certified psychiatric nurse practitioner at OSF HealthCare, says people Jamie’s age – late teens to mid-20s – have unique mental health challenges.

“It’s the transition phase into adulthood. They’re transitioning into college or a career. They’re starting a family. They have the pressure of being successful. There are financial constraints. They’re figuring out their lives,” Algee says. “They have this unrealistic expectation at 18 to have everything together. It’s very overwhelming.”

That can lead to anxiety and depression, and Algee says social media can make it all worse. Daily, symptoms can look like a lack of motivation, intrusive thoughts, worrying, eating too little or too much, irritability and poor hygiene. Parents should be on the lookout for all these.

“Maybe the child doesn’t want to talk as much. The child is self-isolating. You ask what they did over the weekend, and they say they stayed in bed. Or, they’re not going to class. Maybe the parent is getting a letter saying the child is on academic probation,” Algee says. “Those are red flags to ask ‘What’s going on? Why are we feeling that way?’

“Ask about sleeping habits, too,” she says. “Are they sleeping too much or not enough? Is there substance abuse going on? They could be doing that to self-medicate.”

If parents identify a problem, Algee suggests getting the child in to see their primary care provider, who could provide short-term help like medication while referring them to a mental health provider.

Some other tips from Algee and the Boones:

• Get outdoors to clear your head.
  
  “Exercise. Do some hiking or biking. Find hobbies and things you like,” Algee suggests. “I tell my patients not to wait until you have a buddy to do something you like. Nine times out of 10, you’re going to find some like-minded person you’re going to get along with. So if you want to go hear live music, go do it. There will be people there who like live music, too. That will help you meet new people.”
   
• When talking to a loved one about suicide, Johnny Boone says don’t be afraid to get specific. Ask if they have weapons at home. If so, ask to take them or change the combination to the gun safe, for example.
   
• Be mindful of how you talk about mental health and suicide, too. For example, Anita Boone suggests steering clear of phrases like “committed suicide” or “afflicted with mental health” because the person might feel judged.

Grieving a loss

Since Jamie’s death, Anita and Johnny have been in counseling, and Anita hasn’t returned to her accounting job at the University of Illinois. It’s proof that everyone grieves differently, and there’s no schedule for it, Algee says.

“There are numerous stages of grief,” Algee points out. “It’s imperative that you work through all of those stages. Seeing a mental health professional is going to be very beneficial in helping you get through those stages effectively and process the grief.

“Losing a child is absolutely horrific,” she adds. “It’s not something you can put a timeline on. You’re not going to get through it in a few weeks or years. It’s a void that’s difficult to fill. So just make sure you have resources like a therapist, medication and an overall support system.”

For the Boones, grieving involved changing their routine. Driving through the University of Illinois campus where Jamie once thrived is tough, so they steer clear when they can. A hobby of theirs – camping – is out in favor of a simpler outdoor activity – kayaking. Sometimes the couple talks while on the water. Sometimes they just float and cry.

There are even unconventional ways to grieve, as long as you do them safely. When Anita and Johnny need to get emotions out, they’ll take a baseball bat to a plastic pail in their backyard. Neighbors will peek over the fence, and Johnny will flash a thumbs up to show that no one is in danger.

The Jamie Boone Project

Johnny and Anita are still grieving, but they have turned pain into purpose by founding a nonprofit, the Jamie Boone Project. The pair spends hours toiling in their living room, assembling J.A.M.I.E. bags. It stands for Just A Mental Inventory Everyday. The bags contain things to take your mind off the world (stress balls, fidget spinners, journals and coloring books) and also steps to get long-term help, like information about the 988 Suicide and Crisis Lifeline and the 741741 Crisis Text Line. Johnny and Anita take the bags to schools, hospitals and anywhere else that could use them.

“We know it’s not curative. It’s just one way to get them through the moment,” Anita says. “For example, some people in a mental health slide might struggle to journal about positives in their life. Instead, the J.A.M.I.E. bags ask you to write down three things that didn’t stink today. It could be something as simple as ‘the car started this morning.’”

The couple has also visited schools and had students write what they call S.A.G.E. words. That stands for Student Affirmations of Grace and Encouragement and is a nod to the Monticello High School mascot, a sage owl. Through S.A.G.E. words, students write things they like about their classmates. Johnny compiles the comments and gives them to each child, sometimes at a milestone event like graduation. It emphasizes a simple message, one that’s on a sign outside the Boone home: you matter.

“We always hear the negative things about us,” Johnny says, speaking generally about how words can hurt. “We need to be more intentional. We need to hear positive things. You don’t realize how much you mean to people.”

“I’ve not had anybody not give us positive feedback on all our work,” he adds. “Monticello and the area have embraced us.”

“I think what the Boones are doing is absolutely phenomenal,” Algee says.

Learn more

If you are experiencing mental or behavioral health issues, such as depression, anxiety or addiction to alcohol or drugs, there are resources available.

• The OSF HealthCare website lists resources such as support groups and SilverCloud, an anonymous online platform available to people 18 and up living in an area served by OSF, even if you’re not an OSF patient.
   
• The 988 Suicide & Crisis Lifeline. The lifeline encourages veterans to press one to be linked with resources unique to that group.
   
• The 741741 Crisis Text Line, similar to 988. This hotline’s website encourages you to reach if you simply “need to vent.”
   
• The Substance Abuse and Mental Health Services Administration, or SAMHSA.
   
• The Jamie Boone Project website lists other resources and hotlines.

“Talk to somebody. A professional, a friend,” Johnny urges. “Make a mental health safety sheet. Write down what things calm your spirit and who you can talk to. Anything that will help you get through a stressful situation. When you’re in the middle of the stressful situation, you’re not going to remember that you like to listen to a certain music to calm you down. You need to write it down. And make sure you give a copy to a friend or family member you talk to a lot. That way, they can spot the warning signs.”

“It’s OK to not be OK. You’re not alone. Don’t be afraid to have the hard conversation because suicide does not discriminate,” Anita says.

Interview clips - Johnny and Anita Boone

Interview clips - Brittany Algee

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Additional B-roll

Johnny Boone explains the Jamie Boone Project

Johnny Boone explains the J.A.M.I.E. bags

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Big emotions, bigger solutions

Migraines are a part of life for many. From stress to dehydration to a woman’s menstrual cycle and even more serious issues such as a stroke, the headaches can pop up often. And they’re something you should know how to manage.

Amber Oberheim, APRN, a primary care provider at OSF HealthCare, says migraines can often be treated with ibuprofen (Advil is a common brand name) or naproxen (Aleve), plus lifestyle changes including better sleep. But, an online search will also yield plenty of non-medicinal, at-home remedies. Experts will remind you that these aren’t cure-alls. But it’s important to know what works and what doesn’t.

Myth vs. fact

• A cold or warm cloth on the head and neck: Stick to cold, Oberheim says.
  
  “One of the theories for why migraines happen is vasodilation, or increased blood flow to your brain,” Oberheim explains. “So we talk about using a cold compress over your eyes, on the back of your neck or at the top of your head. That cold sensation constricts blood vessels, thereby decreasing blood flow.”
  
  Oberheim adds that there are even migraine caps that stay in the freezer until use. Those are available over the counter at retail outlets.
   
• Rest and deep breathing: Oberheim says there’s no guarantee that your migraine will be gone when you wake up from a nap. But, she says rest and deep breathing can’t hurt. Take a break in a cool, dark room, and avoid screens and loud noises.
   
• Caffeine: It’s good general advice to ingest caffeine in moderation for heart and mental health. But, Oberheim says a soda might help with that headache.
  
  “We look at medications in Excedrin Migraine [pills]. Caffeine is one of them,” Oberheim says. “Caffeine has been proven to be effective sometimes in early management of migraine headaches.”
   
• Supplements: There’s a lot to choose from in this aisle of the pharmacy. And experts warn that you should choose with provider guidance since supplements aren’t regulated like others under the eye of the United States Food and Drug Administration. However, Oberheim says some research has shown that taking vitamin B2 (also called riboflavin) and magnesium daily can help with the number of migraines.
   
• Massaging your head: It’s a tactic some of us learned when we were kids. Massaging your temples (the area between your eyes and the top of your ears) could help with head pain.
  
  “I don’t think there’s any data that would support that. I think it’s more of a comfort,” Oberheim says. “When you’re experiencing pain and you can have a sensation that’s not pain somewhere on your body, it might help lessen the pain.”
  
  For example, Oberheim says when her patients are getting a blood draw through an IV in their elbow, a provider might scratch their upper arm (between the point of pain and the brain) to “confuse” the pain signal and lessen the discomfort. The same logic applies to rubbing your head during a migraine.
   
• Taking a shower: It depends, Oberheim says.
  
  “I could see if stress or muscle tension is creating a headache. Taking a warm shower or bath to relax might help,” Oberheim says. “However, if we’re thinking about a classic migraine with the theory of increased blood flow to the brain, taking a hot bath or shower might actually make it worse.
  
  “It never hurts to try, but I think it’s going to be patient-specific,” she adds.

When in doubt

Oberheim says some people have a history of migraines and know how to manage them. But if the headaches suddenly increase in frequency or intensity, you should see a health care provider. Also, talk to a provider if you have questions about starting or changing at-home treatment. The provider can determine what works for you. You don’t want new medications to negatively interact with drugs you’re already on, for example.

“Often, a migraine can last for longer than a typical headache. It can be accompanied by symptoms like nausea, light sensitivity and noise sensitivity,” Oberheim says, warning of the dangers if migraines are not treated quickly. “There are certain types of migraines that can also affect your vision.”

Temporary decreased function of your limbs is another rare, but possible side effect, Oberheim says.

Learn more

Read more about how to spot and treat a migraine on the OSF HealthCare website.

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People interested in making an appointment at the new clinic can call 217-337-3500.

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