When Gordon Ramsay raises his voice, it’s usually about an undercooked dish.

But in 2024, the celebrity chef was calling for help after a scary bicycle accident.

“It really shook me,” says the avid cyclist in a June 15, 2024, Instagram post. “Honestly, I’m lucky to be here.”

Ramsay says he didn’t suffer any major injuries, but he’s bruised and on the mend. And he’s again joining health care professionals in stressing the importance of wearing a helmet and biking within your means.

“I don’t care how short the journey is,” Ramsay says.

Biking accidents in the emergency department

Kurt Bloomstrand, MD, an emergency medicine physician who sees patients at OSF HealthCare, has treated people who have fallen off a moving object. It could be a bicycle, scooter or motorcycle. Sometimes it’s a child who’s learning their way. Or it could be an adult who didn’t hit the brakes in time.

“A lot of times what happens is they fall off the bike, put their arm out to protect themselves and injure their arm,” Dr. Bloomstrand says.

“But most importantly, we also see head injuries. We know that people who get in a bike accident have better outcomes if they’re wearing a helmet. People that are not have a higher risk of head injuries and traumatic brain injuries,” he adds.

Those head injuries are not something to take lightly, Dr. Bloomstrand says. Traumatic brain injuries can result in lifelong complications or death.

“When we see people in the emergency department who have suffered from a bicycle accident, we’re going to do a rapid trauma assessment,” Dr. Bloomstrand explains. “We’re going to pay special attention to the head. We’re going to make sure there are no signs of skull fracture or neurological abnormality. Depending on the severity of the injury, we may do a CAT scan [also called a CT scan] to make sure there’s no internal injury like bleeding on the brain. Those internal injuries are life-threatening emergencies that need to be addressed quickly.”

Advice

Check these off your list the next time you get on a bicycle or something similar:

• People of all ages should wear a helmet while biking. Young kids who are learning to ride should also wear knee elbow pads.
   
• Long shirts and pants and closed toe shoes (not sandals) are better than bare skin if you fall and skid on pavement (commonly called “road rash”).
   
• Be alert when riding. Don’t ride while tired or under the influence of alcohol or drugs. If you’re listening to music, consider having one ear free so you can hear your surroundings.
   
• Don’t ride above your means. Choose a speed and terrain that fits your skills.
   
• Keep your bike in good condition and configured to match your height. Your feet should touch the ground when seated. This should be true for all ages. A child should not “grow into” a bike. 
  
  At night, a headlight, reflectors, flag and a horn help you to be seen and heard. Bright-colored clothing also helps your visibility at night.
   
• Look closely before crossing an intersection, and obey all traffic laws. This typically includes riding on the right side of the road. Use universal hand signals: left arm straight for a left turn, left arm bent up for a right turn and left arm bent down for a stop. Make eye contact with the driver of a vehicle before passing in front of them.
   
• One person should ride a bike at a time, and keep both hands on the handlebars. Put items like books in a backpack or basket. Don’t try to carry items and ride.
   
• If you or someone you’re with suffers a bike injury, call 9-1-1 immediately.

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Kren Harmon loves a good success story.

The licensed clinical social worker runs a neurological therapy group for older adults at OSF HealthCare in Alton, Illinois. Attendees might have short term memory loss due to a stroke, Parkinson’s disease or Alzheimer’s disease. Those challenges can also bring mental health concerns. But there is hope. Small group sessions like the ones Harmon runs have been proven to help not only with the seniors’ day-to-day life but also their sense of feeling alone.

“I had a new woman in group who said she had memory loss and was embarrassed. Another woman who’s a veteran of the group didn’t miss a beat. She reached over, touched the woman’s hand and said, ‘Honey we all have that’.” Harmon recalls. “The woman burst into tears and realized she’s not the only one dealing with this.

“That’s why I come to work every day,” Harmon says, beaming.

The fears, and how providers can help

Harmon has heard plenty of health concerns from older adults, and they’re all valid. The senior has moved out of their home and is worried about losing independence. They’re worried their health needs will be a burden on family. They might even be scared of dying.

Enter small group therapy. First, Harmon says, it’s a consistent thing on the senior’s schedule where they can look forward to getting out of the house and seeing people. Harmon says studies have shown more socialization for older adults means less confusion. But more importantly, the group connects attendees with others in their situation so they know they’re not alone. Harmon describes the concept in two terms: commonality of experience and installation of hope.

“We all have these same issues, but there’s hope,” Harmon says, restating what is said in a group session. “We can learn coping skills and accept what’s going on. We can support each other.

“Individual psychotherapy is great, but in group they get the benefit of having each other to lean on,” Harmon adds. “They say ‘This worked for me. You might want to try this at home.’”

A typical session might be a mix of camaraderie, memory tasks (medical term: cognitive stimulation therapy) and specialized topics like handling grief.

“We cover current events. What’s the date? What’s the weather?” Harmon outlines. “We do check-ins. Tell me something new in your life. People like that. They talk about their new great grandbaby.”

Harmon encourages her patients to expand on what they learn in group. The medical term for this is acceptance and commitment therapy. Find a way to exercise that works with your limitations. Explore a new hobby, such as puzzles or reading. Watching television all day won’t cut it, Harmon says.

“You’re never too old to learn a new skill,” she reminds.

Getting involved

If an older adult in your life could benefit from group therapy, Harmon says going through a physician might be the way to go. She’s found that seniors sometimes don’t listen to friends and family. But if their neurologist – someone they know and trust – recommends something, it might carry more weight.

“Having the doctor refer, I’ve found, makes a difference with that generation. When someone in a white coat says it, it’s the best idea ever,” Harmon chuckles.

You can also read more about healthy thoughts and behaviors on the OSF HealthCare website.

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This comes roughly five years after he announced he had been diagnosed with Parkinson's disease (PD).

Within 25 years, the world can expect to see a 112% increase in the number of people living with Parkinson’s since 2021.

A new report in the British Medical Journal (BMJ) links population growth and longer predicted lifespans as two main causes for an expected 25 million patients with Parkinson’s across the globe by 2050.

What is Parkinson's disease? 

“Parkinson’s disease is a movement disorder which causes a person to move less. It happens because the brain is not making enough dopamine, which is the neurotransmitter required for movement,” says Kavya Moravineni, a movement disorders neurologist with OSF HealthCare Illinois Neurological Institute (INI). “Our movement circuits in the brain use dopamine and cause voluntary movement.”

Dr. Moravineni wasn’t shocked to see the estimate in the BMJ. Parkinson's is a neurodegenerative disease, which coincides with natural aging. So, as life expectancy increases, the incidence naturally increases. Additionally, Dr. Moravineni believes there has been increased awareness, and in turn, increased diagnoses of Parkinson's. People are seeking out medical attention earlier as they recognize the symptoms, especially if they have a family history of PD.

Symptoms of Parkinson’s

“Tremor is the most common one. That’s what brings attention to see that something is wrong here,” Dr. Moravineni says. “Patients can have stiffness in their limbs, primarily in their muscles, and they can have problems walking. The typical dragging feet or not moving their arms as much when they’re walking. Stooped posture is another one.”

However, patients can have other symptoms which they don’t initially attribute to something like Parkinson’s disease. This can be the loss of sense of smell, dizziness upon standing or longstanding history of constipation. Sometimes anxiety or acting out your dreams at night can be longstanding symptoms.

The first step, Dr. Moravineni says, is to get a diagnosis. Next would be to decide how to manage the disease. The medical team at OSF INI offers different medication options, as well as discussing different surgical options. One example is deep brain stimulation (DBS).

What is deep brain stimulation? 

"It's an implant that's going into your brain. The idea is that we're using electricity to help with symptoms," Dr. Moravineni says. "To put it simply, the leads that go into the brain will pass electricity into the tissue and neurons. This negates abnormal signaling causing symptoms, so it improves symptoms."

Why deep brain stimulation can replace medication:

"As the disease progresses, the need for medication dosage increases. With that comes side effects. In those situations where the patients are still responding to medications, but experiencing a lot of side effects, deep brain stimulation can help. It's replacing medication while still providing the same benefit," Dr. Moravineni says. 

It can be increased or decreased based on what the symptoms are doing. Younger patients are often "better" candidates for deep brain stimulation. Patients cannot be candidates if they have severe dementia or underlying psychiatric illness that has not been managed. Of if they don't have solid family support. Dr. Moravineni calls deep brain stimulation one of the "next steps" in the process. It is recommended patients have proof of responding well to medication. 

Supportive therapies (speech and/or physical therapy) are beneficial parts of the care journey. 

The Michael J. Fox Foundation says while the BMJ article does not fully articulate the growth of PD, it does shine a light on the need for a cure.

There's no great list of health tips out there that can prevent Parkinson's. However, Dr. Moravineni says a well-rounded exercise regimen can help slow down progression in Parkinson's patients.

Dr. Moravineni adds that there have been increasing amounts of evidence indicating a connection between neurologic diseases and gut microbiome. The Mediterranean diet focuses on healthy habits like drinking less alcohol, eating more plant-based foods and fewer red meats, encouraging a strong and diverse microbiome. In turn, this may help in prevention and/or reduce the severity of certain neurologic conditions.

OSF INI has two physicians, one nurse practitioner and therapists caring for patients in the Peoria area. This multi-disciplinary approach to care helps INI be the go-to destination for patients in the community. 

For more information, visit the OSF INI website.

Video Interview Clips

Preston Patton, who was 6 years old at the time, had just taken some medicine and the family was sitting at the kitchen table in their Pekin, Illinois home.

“Suddenly, he just fell off the chair and was limp. You could tell something was wrong,” recalls Shawn Patton, Preston’s father. “I didn’t think it was a stroke, but I just knew something was wrong.”

Shawn called 9-1-1 immediately. Emergency responders arrived within minutes, and Preston was rushed to the hospital. A scan revealed something few expect to see in a child: a blood clot in the brain. Doctors at OSF HealthCare moved quickly to remove the clot — performing a procedure known as a thrombectomy. Preston would go on to become one of the few children in the world to undergo the life-saving intervention.

Preston’s sister, Carter, played a critical role during the crisis — locking up the family dogs and calling their grandparents while Shawn worked with EMTs to get Preston the help he needed.

A devastating diagnosis

Leading Preston’s care was Sourabh Lahoti, MD, a vascular and interventional neurologist with OSF HealthCare Illinois Neurological Institute (INI), in Peoria, Illinois.

When Preston arrived at the hospital, a team of emergency and pediatric doctors quickly realized the severity of the situation. “He had complete paralysis on the left side of his body. No movement was possible, and the vision in his left visual field was lost. He could not move his eyes to the left, either,” Dr. Lahoti explains. “He had the tell-tale signs of a stroke affecting the right side of his brain.”

The CT scan confirmed that a blood clot was blocking critical blood flow to the right side of Preston’s brain. Dr. Lahoti determined there was no time to lose.

“We had to take that clot out. If we hadn’t, then chances are he would have gone on to develop a very big stroke. This would have not only left him paralyzed potentially for the rest of his life, but it could have been life threatening and taken his life,” Dr. Lahoti says.

A rare procedure, a miraculous recovery

While thrombectomies are more common in adult stroke patients, they remain exceedingly rare in children. Preston was one of the first children in the world to have the procedure done.

“By the time we went on to do this procedure of clot removal, which is called thrombectomy, that clot had further traveled down to a smaller blood vessel,” says Dr. Lahoti. “The further out the clot is, the higher the risk it is to get it out. Because we're getting into very tiny blood vessels in the brain. We decided to take that risk and prevent a lifelong disability.”

‘It was truly magical’

“Soon after we removed the clot, we saw a complete reversal of his deficits. It was truly magical to see that,” Dr. Lahoti recalls. “To have him come in with complete paralysis, and then we did this procedure under anesthesia. After the anesthesia was taken off, he woke up and was able to move his left arm and leg again.”

Prior to this type of intervention, patients — especially children — had few choices.

“Before this therapy was available, patients didn’t have options. The usual course was they were left with paralysis for life, and they were never able to live normally again,” says Dr. Lahoti.

A complicated lead-up

The signs of Preston’s illness began about a month before the stroke. He had a bladder infection that turned into a kidney infection, requiring hospitalization just days before Christmas Eve. He was discharged on Saturday — only to return under emergency conditions.

At the time of the stroke, his heart function had dropped to just 10%, his dad says. His doctors believe a rare complication led to his condition.

“In his case, he had gotten the flu. Because of the flu, there was a cross-reaction of the immunity his body built up for the flu,” Dr. Lahoti explains. “His immune system attacked the flu virus, but also his kidneys and heart, too. Because of that, his heart pumping got really weak, and we think that led to the formation of a clot in his heart. The clot then traveled from the heart to his brain.”

Preston’s father adds that his late wife — the children’s mother — tragically passed away from a pulmonary embolism, making the emergency even more challenging emotionally.

Recovery and Hope

Preston spent a couple of weeks in the hospital, but today, he is thriving and he’s back in school. He’s practicing running and riding his bike and is even thinking about his future.

“He goes to OT (occupational therapy) once a week, PT (physical therapy) once a month now. He’s getting along pretty good,” Shawn says.

“My leg is better,” Preston adds.

“Yes, your leg is getting better. Your hand is going to get better, too,” Shawn reassures him.

Preston has received Botox in his left arm to help regain movement, and while he didn’t play baseball this year, his progress continues.

“Riding a bike, it’s hard to hold onto the handlebars and stuff like that. We just got to keep working hard,” Shawn says.

Perhaps most touching of all is the career goal this experience has inspired in Preston.

He now says he wants to become a nurse — because the nurses cared for him so well.

To learn more about stroke care at OSF HealthCare Illinois Neurological Institute, visit the OSF HealthCare website.

Shawn, Preston Patton video interview clips

Dr. Sourabh Lahoti video interview clips

Tiffani Franada, DO, is a neurologist with OSF HealthCare who specializes in Multiple Sclerosis. Part of her passion is working with patients choosing brain-healthy diets and lifestyle, which prevents neurological diseases like Alzheimer’s, Parkinson’s and Multiple Sclerosis.

The MIND diet

"The MIND diet is a combination of the Mediterranean diet, which is healthy fats, olive oils, fish, fruits and vegetables. And the DASH diet, which is a low-sodium diet,” Dr. Franada says. “It's particularly helpful for patients who live with hypertension (high blood pressure). The two of those combined seem to be very effective at preventing the development of Alzheimer's."

Patients on the Mediterranean diet often have lower levels of inflammatory markers in their spinal fluid. Higher levels are suggestive of Alzheimer's. Patients also perform better on cognitive testing, Dr. Franada adds.

Fiber-rich foods

"In regard to carbs, whole grains are probably best, and they have really good fiber in them. As well as things like legumes and beans which have good fiber levels, which make you feel full for longer," Dr. Franada says. 

The National Cancer Institute (NCI) lists many high-fiber foods here. Lentils, vegetable soups, whole-wheat bread and pasta make the list. As well as fruits and vegetables like apples, apricots, broccoli and Brussels sprouts.

Berries and antioxidant production

"Blueberries are great, really berries of all kinds. They really help that antioxidant production," Dr. Franada says. "For vegetables, leafy greens are really helpful. They have a good amount of folic acid, which helps to reduce homocysteine (amino acid) in the brain. Homocysteine promotes inflammation and shrinkage in the brain, and we want to reduce that."

“Fats are not the enemy”

The word “fat” oftentimes has a negative connotation to it. Dr. Franada says there are healthy fats out there that offer benefits to brain health.

"Fats are not the enemy. Healthy fats are good for the brain. Your brain requires them, like fatty fish (salmon), which have good Omega-3s in them. If you don't eat fish, flax seed is a great alternative," Dr. Franada says. "Walnuts also have great, healthy fat in them. As well as olive oil, which has monounsaturated fatty acids which protects against inflammation in the brain." 

Lean meats, like chicken and turkey, can be good for brain health because there’s healthy amounts of protein and fiber in them, Dr. Franada says.

Don’t dismiss dark chocolate!

"Dark chocolate is great. Dark chocolate has good amounts of antioxidants. Of course, all things in moderation. But a dark chocolate square once a night, not a bad thing," Dr. Franada says. "Also, caffeine! Believe it or not, a cup of caffeine, like coffee or tea, can help with focus, attention and is helpful for the brain."

Dr. Franada recommends having your caffeinated drink of choice early in the morning, right when you wake up, instead of later in the day. Having it later in the day can give you a lot of energy, which leads to you not sleeping well at night. Sleep is also extremely important for brain health.

Foods to avoid

Ultra-processed foods have been trending lately, with health experts giving them more attention than usual because of their negative effects on people’s health. High sodium, added sugars and excessive amounts of bad fat headline are the reasons why we should avoid them, with these elements being linked to diabetes, obesity and cancer.

Obesity is typically part of a metabolic syndrome, where a person has elevated blood sugars, blood pressure and cholesterol. This puts patients at risk for stroke, sleep apnea, Alzheimer's and many other health issues. Those risk factors can put someone at risk for neurological disease. 

"Heavily processed foods are not great for the brain or the heart. Excess sugars, like added sugars, should be avoided as well. If you're going to have sugar, have something with natural sugar in it," Dr. Franada says. "Berries are much preferred to things with added sugars. Also, white bread and processed carbs should be avoided, too."

Effect on white brain matter

"There's some real-world data showing that the Mediterranean diet can prevent white matter changes on the brain, which are little white spots that develop on patients’ brains as they get older. It's also seen in patients with vascular risk factors," Dr. Franada says. "If you follow the Mediterranean diet pretty strictly, you can prevent getting those white spots. They also found people who adhere to that diet have better structural integrity. The left and right sides of the brain talk better to one another."

What about cheat days?

If you exercise five or six days a week and give yourself a “cheat day” where you splurge a bit, evaluate how the food feels in your body. Instead of packing on the calories and going bananas, Dr. Franada recommends reeling it in a bit and focusing on moderation.

"You'll probably start to recognize it doesn't feel so great," Dr. Franada says. "Maybe it's a chocolate dessert at night, or something smaller that you can do to still stay with your healthy diet, just in smaller quantities." 

Dr. Franada cautions against super rigid diets that make you "fall off the wagon" after a few weeks. "You have to find something that's sustainable for you," Dr. Franada adds. 

Video Interview Clips

It’s not Star Wars; it’s brain surgery.

Now, select brain tumor patients in the Peoria area have a minimally invasive, efficient way to receive a diagnosis and get their tumor removed.

NeuroBlate LITT (Laser Interstitial Thermal Therapy)

"NeuroBlate is a means to treat tumors with thermal energy,” says Andrew Tsung, MD, the vice president of OSF HealthCare Illinois Neurological Institute. “It's a laser, which is how the energy is administered, through very small probes the size of a wire. It's done through a very small incision, about the size of the width of a dime. Through that incision we're able to insert the small wire directly to the target. Then we're able to ablate, or get rid of, that tumor and at the same time obtain a biopsy specimen to confirm what we're treating."

How does NeuroBlate work?

"It is thermal energy delivered through a laser beam. We can either fire at the end of a laser, as one would think of laser gun, or we can side fire it and rotate the wire," Dr. Tsung says. "So, it's shooting out from the side, kind of like a lighthouse. You spin the lighthouse around as you pull the probe back. You're able to create shapes as you withdraw from the target." 

Even very sick patients can undergo this treatment because of the technology’s minimally invasive nature.

"We insert it to a target. By taking temperature measurements through the MRI machine and calculations, we're able to control the radius, or the spread of that current through the tumor and stop it at the three-dimensional boundary between where the tumor ends and the brain starts,” Dr. Tsung says.

Eligible patients for NeuroBlate

NeuroBlate, offered at OSF HealthCare in Peoria, Illinois, through Monteris, a neurosurgical technology company, has been recognized as a viable treatment for brain tumors. Roughly a handful of patients have received the treatment at OSF, with more coming down the pipeline soon, Dr. Tsung says.

Potential patients for NeuroBlate could have brain tumors, Glioblastoma (cancerous brain tumor), high-grade glioma, low-grade glioma (growing tumors), or metastatic brain cancer, also known as secondary brain tumors. The size of the tumor matters. NeuroBlate is effective on tumors three centimeters or less. Epilepsy patients can also benefit from this treatment. 

NeuroBlate decreases recovery time drastically

"The patients oftentimes will not require any pain medication following brain surgery, which is quite astonishing,” Dr. Tsung says. “When you make such a small incision, there's minimal disruption to the tissues. The brain itself does not have any pain sensors. That prevents us from using any pain medication. The recovery is quite fast. In patient cases we've done so far, the first patient used no pain medications and was ready to go home by 8 a.m. the next morning." 

OSF HealthCare Saint Francis Medical Center is the only medical center in the Peoria region that offers NeuroBlate.

From the patient arriving to undergoing the surgery and then leaving, the whole process only took 16 hours. Most brain surgery patients are in the hospital for at least two nights and then recover with weight restrictions (in terms of lifting). All of this is avoided when using NeuroBlate. Setup takes three to five hours, but treatment time for he patient is three or less minutes. 

For more information on NeuroBlate and other neurological services, learn more about OSF INI on the OSF website.

Video Interview Clips

NeuroBlate in use (GRAPHIC WARNING)

NeuroBlate B-Roll

"It can present in a variety of ways like vision loss, double vision, weakness, or numbness on one side or both sides of the body,” says Tiffani Franada, DO, a neurologist with the OSF HealthCare Illinois Neurological Institute (INI) who specializes in the autoimmune disease.

"Typically (multiple sclerosis) presents in young patients between 20 and 50 years of age. It's more common in women than men," Dr. Franada says. These events are called attacks or relapses, and they last a few weeks and then they get better. Patients can go awhile without anything, and then they can get other attacks down the line."

The OSF HealthCare Illinois Neurological Institute has launched a clinical trial for patients with nonrelapsing secondary progressive MS (nrSPMS). Dr. Franada and her team are looking for further preventive treatments. The trial, sponsored by Sanofi, uses an antibody called frexalimab, to see if it delays the progression in those enrolled.

"It's a disease state with no current treatment options available,” Dr. Franada adds. "We are actively enrolling right now. The age range is between 18-60 years of age for patients with secondary progressive MS that's not active. This is different than the relapsing remitting phase, which is the most common. This comes after that phase.”

While some patients currently in the OSF INI clinic are candidates for the clinical trial, Dr. Franada and her team are looking to include patients outside the clinic as well.

People interested in the clinical trial can call OSF INI at (309) 624-4000 to learn more information.

Multiple Sclerosis treatment options

There are 20 disease-modifying therapies to prevent disease activity in MS, Dr. Franada says. “Some treatments are given by IV, some are given by mouth, and some are given as at-home injections. It just depends on what is right for that individual."

Dr. Franada says if someone has an MS attack, the team wants to know about it right away. Adding that treatment of MS is more effective when it’s started early.

"There are some acute treatments that can be given, typically in the hospital. But prevention is a mainstay of our treatment course for patients.”  

Prevention tips

"Getting good sleep at night (is important), about eight hours. Getting regular exercise, about 30 minutes 5 days per week. In fact, exercise helps increase levels of BDNF, which is one of the hormones in our body that helps with neurological repair, called remyelination," Dr. Franada says. "The problem in MS is stripping away the covering of the nerve, demyelination, so exercise helps the reparative process. We don't know what the best diet for MS is, but I usually encourage my patients to focus on a Mediterranean diet, which is heart healthy." 

Knowing family history is also important to assess your risk factor of getting the disease.

"The risk for developing MS is a combination of genetics and environment, it's not just one. If you have a family member who lives with an autoimmune disease, or MS, it does slightly increase your risk for developing the disease,” Dr. Franada says.

Hydration is paramount, as is stress reduction. “Exercise is a great way to manage stress.”

"Your brain sits in a pool of fluid, so we want to hydrate as much as possible," Dr. Franada says. 

If you know a family member has MS, there are things you can do to lessen your risk.

"That includes Vitamin D supplementation. If you're low in Vitamin D, it’s critical to supplement that to a normal level. Also, smoking cessation. If you're a smoker, we advise you to quit. But this is incredibly important for patients with MS, because smokers are more likely to develop the disease,” Dr. Franada says.

National recognition of the disease has gone up, Dr. Franada says, which drives more patients to the OSF Illinois Neurological Institute. 

While there is no cure for MS, there are treatment options available to help with day-to-day symptoms (fatigue, pain and cognitive issues).

For more information on OSF HealthCare Illinois Neurological Institute, visit the OSF HealthCare website.

Video Interview Clips

• Dysarthria (pronounced diss-ARR-three-ah): Brim says this common voice disorder could be brought on by a neurological issue, such as the effects of a stroke, Parkinson’s disease or a traumatic brain injury. Muscle issues and medication side effects can also play a role. It all leads to the most common symptom: slurred speech. Brim says to picture trying to talk with a mouth full of marbles. The person’s speech could also be a different volume (too quiet or too loud) and speed (too slow or too fast).
  
  “There’s a restorative approach where we do different types of [vocal] exercises. Try to get that voice to where it sounds better and clearer,” Brim explains. “Then there’s a compensatory approach. For a person with Parkinson’s or amyotrophic lateral sclerosis [ALS] where their voice probably isn’t going to improve in the long run, we might look at an alternative communication device. Or, do we need environmental assistance to help them communicate?”
  
  A communication device could include a voice box to amplify speech or, if someone has lost their voice entirely, a speech generating tablet.
  
  “The [speech generating device] has a bunch of communication presets on it,” such as common phrases conveying hunger or pain, Brim says. “They can have it pre-programmed with their actual voice before they lose it.”

• Dysphonia (pronounced diss-PHONE-ee-ah): This is a general term to describe a voice abnormality, Brim says. Neurological issues and brain injuries are common causes.
  
  “The most common dysphonia people know is spasmodic dysphonia. We really don’t know a specific cause. We assume it’s neurological,” Brim says. “This brings voice tremors. The vocal cords are not abducting or adducting correctly.

“When they’re adducting, the vocal cords are coming together. If you have an adductor-type spasmodic dysphonia, the vocal cords aren’t wanting to go away from each other. They’re wanting to stay together. So there’s a really strained voice. It sounds very harsh, almost like people are trying to force the voice out,” Brim outlines.

“Or you have abductor dysphonia, where the vocal cords are pulling away. The person has a breathy voice because the vocal cords are open all the time. Speech comes out very quiet and whispery. They’re losing all their air in one go,” Brim adds.

Treatment could include voice exercises or Botox injections. Or, if the person has a nodule or polyp on the vocal cords, those can be removed surgically.

“We go over healthy voice habits, such as increasing water intake,” Brim says, describing how she might work with someone after surgery. “Have a humidifier in the house to help increase moisture in the air. Use more of a quiet voice. Try not to yell or project too loudly because that can strain the vocal cords. Try to make your voice sound different but not in a way that causes harm.”

Something else Brim will preach to patients that you might not connect with voice issues: reduce your caffeine intake. Caffeine can increase muscle tension in your vocal cords, she says.

• Vocal cord paralysis: Brim says this is commonly caused by trauma to the throat, such as a car accident or having a breathing tube.
  
  “It’s similar to a bruise or fracture or torn ligament. When there’s trauma to the vocal cord area, there’s damage. And that causes paralysis sometimes,” Brim says. “You can have, most commonly, unilateral vocal cord paralysis, where one doesn’t move. Or you can have bilateral [paralysis] where both aren’t moving.”
  
  Brim says this is often treated with Botox or surgery to get the vocal cords vibrating again. The person would follow up with speech therapy.

There is hope

Brim is up front with her patients: You might not get your voice back to where it was, but you can make improvements. So don’t give up.

“I’d love to wave a magic wand and make your voice great,” Brim suggests with a smile. “But there are other steps we can take so you don’t feel locked in. You don’t feel like no one can understand you and no one can communicate with you.”

Learn more

Read about all the ways medical professionals help restore voices on the OSF HealthCare website.

Interview clips

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Television host Carson Daly is the latest celebrity to try what some call sleep divorce. Couples who sleep in the same bed but are not getting that coveted seven to eight hours of shut eye will slumber with some degree of separation: in the same bed but with separate blankets, in separate beds in the same room or in separate rooms.

Daly called the move the “best thing” for his marriage during a summer episode of the Today Show.

“We both, admittedly, slept better apart,” he said.

The concept is one worth exploring for couples who are kept up by snoring, restlessness, differences in sleep schedule or other nighttime issues, says Nadeem Ahmed, MD, a pulmonologist at OSF HealthCare in Alton, Illinois.

But let’s get one thing straight.

“I don’t like the term ‘sleep divorce’ because it tends to blame other people. It’s not a good word. It brings anxiety,” Dr. Ahmed says.

“I like to use ‘sleep alliance.’ They’re working together. They’re working things out. They want to make sure it’s healthy for both bed partners and the sleep disturbances don’t affect the other partner’s life,” he says.

Have the discussion

Dr. Ahmed says he encounters sleep issues, like snoring, in his practice “almost every day,” and many people are shy about it.

Every case is different. Dr. Ahmed says couples should first talk out their sleep issues and try to find a solution. The partners could try sleeping in separate beds during the week and in the same bed on the weekend so intimacy is not completely lost. Some mattresses have different firmness, temperature and slant on each side, which can help.

If needed, the partners should talk to a pulmonologist or psychologist.

“A lot of psychologists will do similar things that a physician will do. It’s just the comfort level of the person,” Dr. Ahmed explains. “Sometimes they don’t want to go to a medical doctor for the sleep problem. They would rather talk to a psychologist.”

“The idea is to discuss it with some type of professional,” he says.

Dr. Ahmed adds that sleeping separately should be a short-term solution.

“Tell your bed partner this is an issue, and we need to address it. As opposed to just getting mad or feeling crummy or sleepy the next day,” Dr. Ahmed says, “Because it can affect your job, like if you’re a machine operator or have to drive a truck.”

A major cause

Dr. Ahmed says a big cause of the restlessness that leads to sleep alliance discussions is sleep apnea, when people stop breathing during sleep. This can lead to loud snoring or body movement in bed and crabbiness or grogginess the next day.

Dr. Ahmed says there are two types of sleep apnea: obstructive and central. Obstructive sleep apnea is a product of obesity. Central sleep apnea is associated with neurological deficits like a stroke.

“[Sleep apnea] is not fatal because our brains are hard-wired to let you go to a certain time, and then it triggers you to take a breath,” Dr. Ahmed explains.

But, if the condition is left untreated, there is a litany of possible issues: hypertension, cardiac arrhythmia, diabetes, dementia, headaches and frequent urination.

Diagnosis of sleep apnea would involve a sleep study, either in your home or at a hospital.

Treatment options include a mask and machine combination known as a CPAP or BiPAP, a mouth guard or a small device that’s implanted in your body in outpatient surgery. All those options aim to help you breathe normally and sleep peacefully.

“Along with that, we have to stress lifestyle changes,” to rid oneself of sleep apnea, Dr. Ahmed adds. “Eating healthy. Losing weight. Getting exercise.”

Over-the-counter options for better sleep include melatonin, an eye mask, earplugs, thick window curtains, a plush mattress and sheets and a white noise device like a smart speaker. Don’t eat or drink, aside from water, a couple hours before bedtime, Dr. Ahmed also advises.

Learn more

Learn more about healthy sleep on the OSF HealthCare website. If you’re having sleep problems, especially if it’s impacting your daytime life, talk to your primary care provider, a pulmonologist or a behavioral health provider.

Interview clips

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OSF HealthCare blog entries on sleep
 

A January grocery trip for Charlotte Davis turned out to be life-altering.

The Shipman, Illinois, woman was loading food into the back of her van when she says the hydraulics failed, and the back door slammed into her head.

While she didn’t lose consciousness or have any visible signs of trauma, Davis doesn’t mince words: “It hurt really bad.”

Davis says she put up with worsening headaches, garbled speech and weakened memory as long as she could.

“I tried to drive one day. I hit a flower pot, drove through the ditch, missed my turn, forgot where I was going three times,” Davis says. “My eight year old granddaughter told her mom, ‘Please don't let Mawmaw drive anymore. She's scaring me.’”

When a CAT Scan found no brain bleed, Davis wound up at the OSF HealthCare rehabilitation office in Alton, Illinois. She was skeptical at first but now considers herself a prime example of why you shouldn’t just shake off a head injury – whether it’s in a football game or just around the house. Otherwise, serious issues like the brain disease chronic traumatic encephalopathy (CTE) may follow.  CTE is often seen in football players. In July 2022, officials announced the late NFL player Demaryius Thomas had CTE.

Physical therapist Kelly Bogowith cared for Davis at the Alton office.

“All concussions are a form of at least mild traumatic brain injury,” Bogowith says. “So it’s important to make sure that you get assessed and also ensure that you're not playing sports later that same day. A provider can give you education on how long you should be sitting out from sports and other physical activities, as well. And that might even include work.”

“Sometimes with concussions, we may not have symptoms for hours or even weeks afterwards. So it's important to get checked out by your physician, urgent care, emergency department, or athletic trainer, depending on your setting,” Bogowith adds. “But it's not something to shake off. And it can be especially important, too, to not have a second concussion because that can be very dangerous and even deadly.”

Every patient recovering from a head knock receives a specially-tailored plan, Bogowith says. The roadmap could include different types of therapy, like physical or speech language. It will always include at-home activities – stretches for physical therapy or puzzles for speech language therapy, for example. And the OSF HealthCare team encourages you to ask questions along the way.

Davis’ plan started with massages and stretches to relieve tension. She progressed to walking, then running on a treadmill.

“I beat that treadmill,” Davis says, beaming.

She beat the non-physical aspects, too. Davis’ memory and speech improved to the point that when she met with speech language pathologist Ashley Brim at the Alton location, it was a one-and-done.

“[Speech therapy] can range within working on targeting problem solving skills,” Brim explains. “So, either really basic problem solving all the way up to reading paragraphs of information. And trying to figure out information that, most of the time, people don't think about. We can just read it and figure it out. But when you have a concussion, and that is impacting you, it makes it 10 times more difficult.”

“We work on a lot of memory tasks,” Brim continues. “Exercises for working on memorizing word lists, figuring out different ways to help the patient memorize things better. So they associate the word to something else and then they use those associations to be able to remember what has been said to them and chain it all together.”

What people in Bogowith and Brim’s roles don’t want to see: people relying solely on pills to get through pain. That can lead to addiction and side effects. Therapy is somewhat the opposite, Brim notes. It gives the patient ownership of their recovery.

Davis agrees with that assessment and says her determination to see therapy through to the end has paid off in multiple ways. Most notably, she can handle playing with her eight grandkids.

“I want people to know that it's important,” Davis says. “I understand that it's a pain. It's not always convenient. There are always other things people want to do. But if your doctor says to do therapy, I 100% will tell you: go to therapy. You don't know how bad you need it until you actually go.”

For more information on types of rehabilitation, visit the OSF HealthCare website or talk to your primary care provider. OSF HealthCare also offers neurological services.

Interview Clips - Charlotte Davis

Interview Clips - Kelly Bogowith

Interview Clips - Ashley Brim

Previous Coverage

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Preventing concussion in young athletes 

Concussion: More than Just Getting Your Bell Rung

Myths about concussions increase the risk of harmful effects

Taking a Team Approach to Concussion Rehab

Heading Up Health Study on High School Heads