When talking about the good and bad of pregnancy, you might have heard terms like postpartum depression or, more casually, baby blues.

It’s critical new mothers get help in this area, says Tiffany Waters, a birthing center charge nurse at OSF HealthCare. She says up to 80% of moms experience the so-called baby blues. But when talking about maternal mental health, experts prefer the umbrella term: perinatal mood, anxiety and depression (PMAD). Perinatal refers to the time between conception and one year after delivery.

PMAD basics

Waters says for two to three weeks after delivery, most women experience hormone changes, a lack of sleep and general stress related to the “new normal.” Having a traumatic birth, like an emergency caesarean section, can compound mental health impacts. Waters says around one-third of women fall into this category.

All these factors can lead to a variety of longer-lasting PMAD symptoms, including brain fog, weeping, sleep changes, anxiety, depression, obsessive or compulsive behavior and even suicidal thoughts.

“There’s no one single cause that leads to a person experiencing these issues. It’s a combination of psychological, societal and biological factors,” Waters says. “There’s nothing a mom has done to get or deserve this experience. The best we can do is help her work through it.”

Screening and treatment

Waters says health care providers should screen a woman for depression and other mental health issues during and after pregnancy.

“There are commonly used tools,” Waters says. “The woman answers 10 questions. It gives us a rating on how their emotional and mental well-being is.”

She’s referring to the Edinburgh Postnatal Depression Scale (EPDS). Each question is scored 0 to 3, with 3 being the response that most signals a possible mental health issue. That’s 30 total points, and a final tally of 10 or higher would warrant further evaluation.

Waters also says research is ongoing into whether certain biological markers in a woman are a sign of mental health issues to come.

“It can be difficult to admit or even recognize that a person is having depression or anxiety symptoms,” Waters says. “There are lots of reasons for that. There’s societal pressure to be a great mom. Moms might feel like if they admit how they’re feeling, their children might be taken away.”

Waters says journaling or talking to a trusted adult can help a mom document the issues she’s facing, opening the door for her to get help.

If a mom is diagnosed with PMAD, a provider will talk with her about resources like support groups, counseling, spiritual care and medication. Daily things like improved diet and exercise and exploring new hobbies can also help. And Waters says mothers should not be afraid to prioritize themselves. It’s OK to ask for a break from daily housework, for example.

Why it’s important

Waters says untreated PMAD can have consequences for the whole family and the people around the family. Substance abuse and domestic violence can increase. But if treated, it means a better life for everyone.

“It will improve the whole family dynamic,” Waters says. “It will lessen stress for everybody and lead to a happier unit.”

Learn more

Read more about pregnancy and birth and behavioral and mental health on the OSF HealthCare website. If you are in crisis, the Suicide and Crisis Lifeline is 9-8-8.

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“I found a lump.”

It’s the unsettling phrase providers sometimes hear from women when they are performing their monthly breast self-check for cancer signs.

But lumps are not the only thing to watch for, says Heather Thompson, an OSF HealthCare breast health navigator who is herself a breast cancer survivor.

Signs to know

Each month, keep these in mind.

• Lumps, the most talked about sign.

“A lot of women, especially younger women, have very dense breasts. Sometimes it feels like a bag of rice with little bumps. That’s just the tissue,” Thompson says. “When you feel a hard nodule, fixed in place or sometimes mobile, you definitely want to get that reviewed.”

• Skin changes. This could be an orange peel skin appearance, flaky skin, irritation or a new dimple.
   
• Unexpected release of fluid or blood from the nipple. For example, if you are not breastfeeding, a nipple discharge would be unexpected.
   
• Unexpected inversion of a nipple.
   
• One breast larger than the other, or generally, any unexpected change to breast size.
   
• Any new pain in breast area.
   
• Tenderness, swelling, pain or lumps under your armpit. This is one some women may overlook since it doesn’t deal with the breasts.

“Your lymphatic system drains to armpits,” Thompson explains. “So, if there’s anything going on in the breast, it’s going to show up in your armpit eventually.”

When and how

Thompson recommends women pick a date each month for a self-check and stick with it. The first of each month, for example. This way, you can put it on your calendar, and it’s easy to remember. And, she says the feel of your breasts will change as days go by. But, choosing the same time each month gives you a baseline feel and helps avoid false positives. Thompson also advises making your chosen date a week after your menstrual cycle ends.

Thompson says many women find it convenient to examine themselves in the shower. Regardless of where, she says a good technique is to move your fingertips in a circle from the outside to the center of the breast, pressing down and feeling for abnormalities. Then, do the same under each armpit. And also, glance in the mirror for a good look at visual signs, such as one breast larger than the other.

Some women have a trusted adult, like a spouse, also feel their breast for a second opinion. Others may take photos during their self-check to show their provider. Both ideas are acceptable, Thompson says.

“When you go to the doctor, they can look at the picture. If the abnormality has changed or gone back to normal, then we know it’s nothing to really worry about. But if the issue has increased in size or looks worse, it’s something to be concerned about,” she says.

What happens next

If you find something concerning in a self-check, call your primary care provider or OB/GYN right away and explain what you found. Thompson says the provider will likely order a diagnostic mammogram, an outpatient procedure at a doctor’s office. The radiologist should read the results on the spot. If a closer look is needed, you may undergo an ultrasound, another way to image the breast, or a biopsy, which takes a tissue sample for testing.

It's important not to panic, Thompson stresses. If you have severe pain or an abscess, you should go to the emergency department. But for abnormal findings on a self-check, that’s not necessary.

“If you go to the emergency department with a lump, they’re going to send you home, and you’re going to have to go through the process of calling your provider.

“Breast cancer is not going to change that drastically in three to four weeks,” Thompson adds. “It’s not going to make that big of a difference. However, you want to get yourself scheduled and be proactive. Don’t say ‘Oh let me watch it for a few months and see if it changes.’”

But do keep track of any changes between when you make the appointment and appointment day.

Why it’s important

Thompson says a monthly self-check goes hand-in-hand with regularly scheduled mammograms as the most important ways to prevent breast cancer. You should talk to your primary care provider or OB/GYN about what mammogram schedule is right for you.

“Typically, we do a mammogram every year to get the breast image,” Thompson says. “But during the year, things can develop that you don’t notice. Some things can develop very quickly.

“By doing a monthly exam, you learn your body. You know how it feels,” she adds. “Each month you may say ‘Well I didn’t remember that there last month.’ So you can address it right away.”

Early detection is key for a better outcome. Conversely, unchecked breast cancer is a major killer in the United States. The American Cancer Society estimates about 43,700 women will lose their life to the disease in 2023.

Learn more

Read more about breast health and breast cancer on the OSF HealthCare website.

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The Sisters’ impact

Sister Leopolda passed away in 1994 at age 81. But the impact she and the other Sisters made on OSF Saint Anthony’s is still felt today.

Sister M. Christine Crowder began at the hospital in the 1960s and worked alongside Sister Leopolda.

“Sister Leopolda was so kind and hard-working but always for the Lord. She was so dedicated,” Sister Christne says. “She would take the most difficult patients. The ones who needed the most care. If we were missing a nurse, she would put an apron on and give out medicine. If a housekeeper called off, she would start scrubbing floors.

“When I was working on the floor with her, I’d say ‘202 would like a pain pill,’” Sister Christine also recalls. “Sister Leopolda would say ‘202 is not a person. Mrs. Jones would like a pain pill.’ That spoke to the respect and dignity she showed to our patients.”

Marci Well then and now

Carol and Marci Well are still not sure of the exact ailment Marci caught in 1972. But she recovered with no lasting effects. And she quickly became intrigued by the medical field. Family photos of Marci as a child show her dressing up as a Sister and “playing nurse.” Now, Well, 54, has been a pediatrician in Canton, Illinois, for more than two decades.

“I had Band-Aids on all my dolls and stuffed animals,” Marci Well says. “It felt like I was destined to take care of people.”

“It really touched my heart when she said that,” Sister Christine says. “It’s so meaningful to hear that one of our Sisters influenced a person to work in the medical field with children.”

Learn more

Read more about how OSF provides compassionate care close to home in Alton here.

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‘Patients were treated like family’

“It was very simple in the early 60s,” Fisher says. “We had one antibiotic – penicillin. That seemed to cure everything, from a cold to syphilis. I couldn’t believe it!”

Progress continued in 1970 with the addition of the hospital’s intensive care unit. The emergency department came in 1983, and the sleep lab opened in 1997.

“Very busy. I liked to be busy,” Fisher recalls.

“[Change] happened slowly,” she adds. “It didn’t happen in a day. It took months or sometimes years.”

The Sisters’ impact

The contributions from Fisher and all the other Mission Partners (employees) at OSF Saint Anthony’s are cherished by the Sisters of St. Francis of the Martyr St. George, who still are visible in the hospital today.

“[Our employees] share the Mission of the Sisters to serve with the greatest care and love. They really take it to heart,” says Sister M. Christine Crowder, who also started at the hospital in the 1960s. “We are really supported by them, and [the Sisters] try to do everything we can to support them.

“With all the growth and advancements, that Mission is still very important and part of our care,” she adds. “That’s what makes OSF Saint Anthony’s what it is today. That Mission and dedication of those first Sisters are still here.”

“There was a very warm atmosphere. It was just different from any other institution. Patients were treated like family,” Fisher says. “People would come back and bring their kids or grandkids and show them off.”

Interview clips - Wally Fisher

Heart rate and blood pressure changes are expected during cardiac rehab, too.

“The top number in a blood pressure reading is your systolic blood pressure. That’s when your heart is beating. It’s the pressure up against the arteries. We want that at 90 to 120,” Herman explains. “The lower number is when your heart is resting. It’s called diastole or diastolic. We want that at 60 to 80.

“If we see elevated blood pressure, we’re going to talk with the person about their salt intake, their diet overall and their exercise,” Herman adds. “If we continually see the blood pressure going higher, we’re going to communicate with the doctor. The doctor may need to add medication. And we want to make sure the person is compliant with the medication.”

If a person’s blood pressure is low, Herman says the care team will ask, among other things, if they’re drinking enough water and if they took too much of their blood pressure medication. Or, Herman says, the person might need to go off their medication.

Bob’s outlook

Weaver jokes that his diet consists of a lot of chicken and vegetables these days. But he’ll take it if it means a new lease on life.

“I sleep better. I can do activities longer before I get winded. Things like yard work or just walking. Minimal things you’d think anybody could do. But after a while, I got winded. Now it’s a lot easier to do it longer and faster,” Weaver says.

“You think about your family. You want to be around more than 62 years,” he adds. “I went to the gym on a lot of days right after work. They weren’t necessarily the same days I had rehab. So I was able to double up the workouts.”

He's telling others to stick with their recovery plan, research your family history and know the symptoms of a heart event. For Weaver, that was a father who had heart disease, coupled with his own chest pain and weakness back in October.

“Just keep at it. If I can do it, anybody can do it,” he says.

Learn more

Read more about keeping your heart healthy on the OSF HealthCare website.

Interview clips - Bob Weaver

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Author's note: This is part two of a four part story on infant nutrition misconceptions. Read part one 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, a certified lactation consultant at OSF HealthCare, cuts through the noise.

• Do I need to change what I put in my body while breastfeeding?
  
  This covers a lot of ground, from a mom’s diet to whether she should abstain from alcohol, caffeine, tobacco and medication.

o    Diet: Healthy eating is always good. But Anderson says new moms generally don’t have to change their diet for breastfeeding. If your diet is heavy on certain things (like garlic or dairy) and you notice your baby is extra fussy, you can try changing your meals. A provider may also want to test your baby for allergies.

o    Alcohol and caffeine: Drink these in moderation and with precise timing, Anderson says.

“Babies are very sensitive to caffeine. If you have a cup of coffee and nurse right away, the baby is going to be awake for a lot longer than normal,” Anderson says.

“That doesn’t mean you have to not drink coffee. Just maybe not add three shots of espresso to your morning coffee,” she adds with a smirk.

For alcohol, Anderson says the drink will filter out of your breastmilk like it filters out of your blood. So after having a couple of alcoholic drinks, wait two to three hours before breastfeeding or pumping.

“The breastmilk isn’t ruined. You just need to give it time,” Anderson says.

But here’s a lifehack if mom feels full of breast milk and wants to pump right after having a drink: Go ahead and pump, and use the milk on your baby’s acne or in their bathwater. Just keep it away from their mouth.

“It’s antimicrobial. It’s antibacterial. It’s moisturizing,” Anderson says, singing the praises of breast milk. “Our babies are in the most perfect environment in the womb. Once they’re born, their world is cold, dark and dry. They can get dry skin, acne or cradle cap [greasy or flaky spots on the scalp]. Breast milk is a great way to prevent or heal those things.”

o    Medication and other health care issues: Anderson says most medication is safe to use while breastfeeding. In fact, it’s important to stay the course – for example, with mental health medication – so you can be the best mom possible. Talk with your health care provider if you have questions.

If you have a medical procedure, also get advice from a professional. For example, Anderson says if you get a hepatobiliary iminodiacetic acid (HIDA) scan for a gallbladder concern, you’ll be radioactive for around 24 hours. Don’t breastfeed during that time. Or if your breasts feel full and you have to pump, dump the milk down the drain.

o    Tobacco: Anderson admits it’s tough to kick the habit. But she reminds moms: infants are very sensitive to nicotine. It can disrupt the child’s sleep and feeding and even interfere with organ development. Secondhand smoke can increase the risk of a respiratory infection and sudden infant death syndrome (SIDS).

If you’re smoking with a new baby at home, do so after breastfeeding, then wait two to three hours before nursing again. Wear one jacket while smoking so you don’t get an odor or residue on a lot of your clothes or the baby.

Learn more

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

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OSF HealthCare is one of only nine organizations internationally to receive this prestigious award in 2024. Recipients are exceptional organizations that successfully ensure educational activities are designed using evidence-based criteria and that outcomes of those activities are measured.

ANCC Accredited Providers who receive the Premier Award™ serve as exemplars in the field of NCPD and have demonstrated excellence in leveraging the award criteria to achieve strategic goals and nursing professional practice excellence. Recipients are awarded for a two-year period.

“What an honor it is to confer these awards to diverse health care and nursing organizations who strive to promote the highest standards of nursing practice,” said Jennifer Graebe DrPH, MSN, RN, NEA-BC, Senior Director of Nursing Continuing Professional Development and Joint Accreditation Programs at ANCC. “This year’s recipients have demonstrated their organizational culture reflects the values that this award represents: shared decision-making, empowerment, interprofessional collaboration and nurturing a culture of diversity, equity, and inclusion.”

Lori Wiegand, DNP, RN, NEA-BC and CNO for OSF HealthCare states “We are honored to have received this prestigious award as it recognizes our nurses’ commitment to provide high-quality patient care and our commitment to nursing continuing professional development.”

The NCPD Accreditation Program was founded in 1974 as the flagship program of ANCC. To date, it remains the largest and leading premiere program in nursing accreditation standards.

Peoria Mayor Rita Ali issued a proclamation at OSF HealthCare Children’s Hospital of Illinois on Thursday, Sept. 12, officially recognizing Sept. 8 as Pediatric Hematology Oncology Nurses’ Day in Peoria.

The day, established in 2010 by the Association of Pediatric Hematology/Oncology Nurses (APHON), is celebrated annually on Sept. 8. Children’s Hospital of Illinois, home to a local chapter of APHON, honors its nurses and staff throughout the week. This year, the celebration featured a Harry Potter theme, bringing smiles to patients and visitors alike.

After delivering the proclamation, Mayor Ali toured the Pediatric Hematology Oncology unit and clinic, where she met the dedicated nurses who care for children with cancer and blood disorders.

Les Mennenga, an OSF HealthCare Mission Partner (employee) and lead educator for East Central Illinois EMS (emergency medical services), runs Bryson Freehill and Andy Lubben through a scenario in a training ambulance. The patient, a manikin named Noelle, is complaining of a terrible headache. Freehill also notices a bulge in the manikin’s belly.

“Is she pregnant?” he asks.

“She is,” says Mennenga, standing by with a tablet that controls elements of the scenario.

And the men get to work.

Becoming a first responder

Mennenga oversees training for the three levels of ambulance responders – emergency medical responder, emergency medical technician basic and paramedic – plus nurses who work in the field or answer EMS calls in the emergency department.

“Anybody who wants to get into the world of EMS has to work with some sort of education facility,” Mennenga says. “We’re one of those.”

There’s no college degree requirement, but plenty of initial and continuing education is part of the job. Plus, you become familiar with medical best practices, all stored on a smartphone app you can access quickly in the field.

There’s no debating that the job is stressful, but it’s rewarding and usually well-paying, Mennenga says.

“We’re going to be on calls where it’s potentially a person’s worst day of their life. We have an opportunity to make a difference,” Mennenga says. “We may see something that’s traumatic. We need to understand who we can turn to talk about that.”

Noelle’s fate

Freehill and Lubben ended up treating Noelle for eclampsia, or high blood pressure during pregnancy, which led to a seizure. No critical errors in their treatment, Mennenga told the pair in a debriefing.

“We tend to do scenarios that are not common in the field or a call in the last year that had an issue with a real patient,” Mennenga says. “So we may find an area where there could be improvement. Now we’ll put it into practice and see if other people have the same issue. Is it something we need to include in initial education?”

If you’re interested in this line of work, Mennenga suggests contacting your local EMS agency or volunteer fire department. Before enrolling in a class, try observing one or doing an ambulance ride-along.

“See the realism of treating patients in the field,” Mennenga says.

Interview clips

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OSF HealthCare and Monmouth College have established the Monmouth College - OSF 3+1 nursing program. Upon approval of accrediting agencies, students will complete a degree from Monmouth College in either biology, biopsychology or health science and human movement in three years. In the fourth year, students will complete the Saint Francis Medical Center College of Nursing’s one-year accelerated Bachelor of Science in Nursing, all on the Monmouth College campus.

“Monmouth College is proud and excited to work with OSF HealthCare and the Saint Francis Medical Center College of Nursing to establish this innovative 3+1 nursing education program,” said Dr. Clarence R. Wyatt, President of Monmouth College.  “Our collaboration puts Monmouth College and OSF HealthCare on the forefront of the sort of collaborations that higher education can and should pursue.  By better serving the aspirations of our students and educating desperately needed health care professionals, Monmouth College, OSF HealthCare, and the Saint Francis Medical Center College of Nursing are contributing to the quality of life of communities throughout our region and state and will do so for many years to come.”

Participants in the innovative program will experience the combination of an exceptional residential liberal arts and sciences college and a high-quality college of nursing.

This program brings together two of the region’s strongest organizations to provide opportunities for students and to address the critical shortage of nurses.

Graduates of the Monmouth College-OSF nursing program will complete two degrees in four years and be ready to pursue their careers in health care and serve a vital need in the region.

To celebrate this occasion, Monmouth College and OSF HealthCare hosted a ceremony announcing the cooperative program on May 9 in the Mellinger Commons of the Center for Science and Business on the Monmouth College campus.

At OSF HealthCare Heart of Mary Medical Center in Urbana, a team of OB/GYNs and certified nurse midwives from Advanced Women’s Healthcare will see patients for well-woman, prenatal and postpartum care at the medical office building on the OSF Heart of Mary campus (1405 W. Park St.). This is in addition to the existing team at the clinic, including nurse midwife Kelli Daugherty, APRN, who sees patients in Urbana and Danville.

Dele Ogunleye, MD, obstetrician and gynecologist, and Brittany King, APRN, will see patients initially, with three other certified nurse midwives (Lindsay Bustle, CNM, Laura Muehling, CNM, and Lilly Ott, CNM) joining the team in the coming weeks.

Clinics with Advanced Women’s Healthcare providers and OSF Mission Partners (employees) will also serve patients in Forsyth (845 US Route 51), with an expected opening in February, and in Lincoln (602 Woodlawn Road), with an expected opening in April.

“This new select service offering is in alignment with OSF’s long-standing tradition of helping women access high-quality, compassionate clinical care where they need it,” said Jennifer Ulrich, interim president of OSF HealthCare St. Joseph Medical Center in Bloomington. “Our relationship and all services offered in our hospitals and clinics align with our OSF Mission, Values and our ethical commitments as a Catholic health care ministry and ensure holistic and caring obstetrics care for all women in the area communities.”

Services at OSF Medical Group – Obstetrics & Gynecology will include typical care offerings at OSF HealthCare locations, such as well-woman visits, prenatal and postpartum care, pelvic floor disorder treatments and general gynecologic care.

“We continue to see a shortage of obstetricians and gynecologists across the nation. This model of midwife care is an answer, allowing for a superior patient experience with more time for each woman,” said Dr. Ogunleye. “We are pleased to collaborate with OSF to expand this service.”

The expanded clinic serving the Champaign-Urbana area is expected to begin February 12. Hours will be Monday through Friday 8 a.m. to 4:30 p.m.

“OSF HealthCare remains committed to women’s health,” said J.T. Barnhart, president of OSF Heart of Mary. “We know mothers want quick answers about their care, and this new collaboration allows well-educated midwives to form trusted relationships with the women they serve.”

People interested in an appointment can call:

Urbana: 217-337-2010
Forsyth: 217-443-5697
Lincoln: 217-828-6111

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The National Institute on Aging says people age 65 and older are at a higher risk for heart attack, stroke, coronary artery disease and heart failure. Now is the perfect time for people 65+ and their caregivers to arm themselves with the information and supplies needed to keep their heart healthy.

Karen Whitehorn, MD, is an internal medicine physician at OSF HealthCare. Of the many risk factors for heart issues in older people, she points to blood pressure as a big one to watch. Dr. Whitehorn says a healthy blood pressure reading is 130/80 and below.

“If you’re on medication, take your medicine every day,” to keep your blood pressure normal, Dr. Whitehorn says. “Exercise and eat healthy. You want a diet that’s low in sodium and processed food. You want fruits, vegetables, fresh whole grains and lean proteins like turkey, chicken and lean pork.”

An annual physical exam is critical, too.

On exercise, Dr. Whitehorn admits mobility may be an issue for older people. She recommends checking with a health care provider like a physical therapist to see what exercises are right for you. Some workouts can be done sitting down. Low-impact cardio like walking is an option.

“But if any exercises hurt, don’t do them,” Dr. Whitehorn warns. “If you walk too far and you’re having pain, stop walking. You might not want to walk every single day.”

Dr. Whitehorn says if you have high blood pressure, check it at least once a day at home. Ask your health care provider what type of home blood pressure kit is best. If you don’t have high blood pressure, check it every six months. Your provider should also check your blood pressure when you have an appointment. But Dr. Whitehorn says don’t worry if that reading is a little high.

“People get nervous just seeing the doctor. They’re already a little upset because they have to come to the doctor,” Dr. Whitehorn says of the phenomenon known as white coat syndrome. “So when you take their blood pressure, it goes up. Normally, the nurse takes the blood pressure first. Then, after the person has been resting for a while, the doctor takes it again. It usually comes down.”

Other symptoms of heart issues include shortness of breath, chest pain and dizziness. Someone experiencing a heart attack might suffer nausea and neck, arm or shoulder pain. If you experience these symptoms, call 9-1-1 right away.

Your doctor may order a stress test to get a better idea if your symptoms are indeed due to a heart problem. Dr. Whitehorn says one type of stress test puts you on a treadmill while your heart rhythm is monitored.

“If the rhythm is abnormal, it might indicate there’s a problem with your heart,” Dr. Whitehorn says.

For people who can’t tolerate walking or jogging on a treadmill, there is medicine to safely increase their heart rate while a health care provider monitors.

If the results of the stress test warrant further examination, a doctor will perform a cardiac catheterization. They will insert a catheter, usually through the groin, and send it up to your heart to take images using contrast dye. This will show if any of your arteries are narrow and what steps the provider will take next, short term and long term.

Learn more about heart care on the OSF HealthCare website.

Interview clips

B-roll

Nearly 75 nurses from across the state of Illinois were provided the in-seat portion for adult/adolescent SANE training in order to become qualified to care for and treat survivors of sexual assault.

“To make sure that we have enough qualified medical providers across the state, the Illinois Attorney General’s Office provides SANE training in collaboration with health systems. OSF HealthCare has been very proactive in making it clear that we would like to host training and work with the Attorney General’s Office to give as many nurses as possible that are interested the opportunity to get the training,” explains Layne Steffen, program manager of nursing quality and safety and the SANE program for OSF HealthCare.

The Sexual Assault Survivors Emergency Treatment Act (SASETA) is an Illinois law that requires hospitals to develop a treatment plan or transfer agreement with a treatment hospital. SASETA also establishes a statewide forensic evidence collection system and creates a reimbursement program for the cost of care and evidence collection for victims who are not covered by private insurance or Medicaid. The law also requires victims to be treated by a qualified medical provider, such as a SANE nurse, who will undergo months of training to become a qualified SANE.

SANE nurses can be trained specifically for pediatrics/adolescents, adult/adolescents, or both. Separate training courses are required to be qualified in both.

“SANE nursing is vitally important to understanding all the dynamics of what has happened to people after sexual abuse and sexual assault. SANE training gets into the neurobiology of trauma as well as some of the forensic elements of collecting important evidence that may be useful in later criminal proceedings,” Steffen says.

Steffen says the in-seat SANE training isn’t the end of training for nurses, but more of a steppingstone during a months-long journey.

“Before the in-seat training, there’s about 16 hours of online pre-work to learn about forensic nursing, some of the basics of anatomy and some of the basics of the neurobiology of trauma,” Steffen says. “The in-seat training gets much more into the details of the holistic care that’s required for the patient.”

Steffen says that in order to be considered a qualified medical provider by the State of Illinois, it can take anywhere from four to 12 months to complete all elements of training which includes involvement in medical forensic exams with sexual assault survivors.  

Sarah Vance is the SANE coordinator for OSF HealthCare Saint Francis Medical Center. She says it’s critical for medical providers to be knowledgeable in what patients are going through.

“It’s important to be able to have someone who truly understands trauma-informed care and be able to have that knowledge to complete a medical forensic exam for someone who has gone through one of the most traumatic events in their entire life,” Vance says.

Vance is certified in providing pediatric and adult SANE care and is one of only 555 people worldwide to hold dual certifications.

“After working as a qualified SANE for either 300 hours or three years, you are then eligible to take a national certification through the IAFN (International Association of Forensic Nursing). That is a board-certified test, which means once you’ve passed, you’re considered an expert in the field,” Vance says.

Vance admits this line of work can be very tough, but the reward of providing potentially lifesaving care to patients helps get her through the dark days.

“For me personally, it’s knowing that the care I give somebody will be remembered for the rest of their life. I’ve completed many kits throughout my career, and many times as I’m walking a patient out the door, I receive a hug from them,” Vance says. “They tell me this is the worst thing that has ever happened to them, but my interaction with them made it so much better and they thank me for it. For me, I know it’s the start of their healing and that’s what keeps me going.”

OSF Saint Francis Medical Center is equipped to complete medical forensic exams for both children and adults who have experienced sexual assault.

Sarah Vance Video Interview Clips

Layne Steffen Video Interview Clips

It’s important for women to keep track of health screening recommendations. Early detection of issues like breast cancer can mean a better outcome.

Since everyone’s situation is different, you should talk to your health care provider about what screenings are right for you and when to get them. But Deena Brown, a board-certified family nurse practitioner at OSF HealthCare, says there are a few screenings every woman should know.

• Breast cancer: Brown says women aged 40 and up should talk to their provider about a yearly mammogram that looks for breast cancer.

For adult women of any age, mammograms should be combined with monthly breast self-checks. Brown suggests doing a self-exam a week after your menstrual cycle. If you’re no longer menstruating, you can choose the same day each month (the first of the month, for example) to help you remember. You should feel for changes or other abnormalities like lumps, bumps, one breast being larger than the other, any nipple discharge and swelling or soreness under the armpit. Make an appointment with your provider if you notice any of those changes.

• Cervical cancer: Brown says cervical cancer screenings typically begin at age 21 and occur every three to five years.

“Those screenings involve a pap smear, which takes a cell sample from the cervix and looks for any abnormal cells that need to be addressed,” Brown says.

• Osteoporosis: The National Institutes of Health (NIH) says osteoporosis is a bone disease that develops when bone mineral density and bone mass decrease or when the structure and strength of bones change. This can lead to a decrease in bone strength and an increased risk of bone fractures.

Brown says women over age 65 should be checked for osteoporosis. The NIH says the screening is typically a simple X-ray, and it should be done every two years.

“If the bone density is low, we can initiate treatment with medication to help increase the strength of the bones,” Brown says. “This helps prevent future fractures and debility for women.”

• Colon cancer: Screenings starting at age 45 can help detect colon cancer and other serious issues. A once-a-decade colonoscopy involves a doctor using a tube and camera to check for polyps or cancer in your colon and rectum. Another option is to take a stool sample at home, send it to a provider and they will look for abnormalities. Talk to your provider about which option is best for you.

How things can change

Brown says some women may need these screenings more frequently or earlier in life based on a family history of a disease or your own history.

“It’s all individualized,” she says.

“There are these screening recommendations, but we like to take a personalized approach to care and help address issues as soon as we can.”

In other words, seeing a doctor isn’t just about treating chronic conditions. It’s about preventing them too. And screenings are the best way to do that.

For more on women’s health services, visit the OSF HealthCare website.

Interview clips

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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

Related stories

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

Nearly 800,000 Americans suffer a stroke each year.

Strokes can have life-altering consequences like vision, walking and swallowing difficulties. They also rank in the top five killers of Americans. For each minute a stroke goes untreated, the brain loses around 2 million cells it cannot recover.

“Getting to the hospital quickly – within four and a half hours of your onset of symptoms – is important,” says Leslie Ingold, a registered nurse and stroke coordinator with OSF HealthCare.

A cutting-edge stroke drug rolled out at OSF HealthCare is already turning the tide for people.

Tenecteplase (TNKase ®) can be used in people experiencing a stroke and who meet certain criteria, such as a specific blood pressure, history of brain bleeds, medications taken at home and how quickly they arrived at the emergency department. TNKase is a clot-busting agent that stands to become the gold standard of this type of care, Ingold says.

“It has a lower cost. It’s something providers can mix much, much quicker,” Ingold says. “And it’s given quickly in an IV push over five to 10 seconds, and we’re done.”

TNKase also does a better job than its predecessor at finding and breaking up clots, and there’s a lower risk of bleeding.

“The quicker we can get oxygen flowing back into that brain tissue, the better recovery the person is going to have,” Ingold says.

Why it’s important

The most common type of stroke, an ischemic stroke (also sometimes called an embolic stroke), is when a clot forms and travels to the brain. When watching for one, remember the acronym B.E.F.A.S.T.

• B is for balance: Watch for sudden loss of balance.
• E is for eyes: Check for vision loss or eyes looking askew.
• F is for face: Look for droopiness or an uneven smile.
• A is for arm: Is one arm weak or numb?
• S is for speech: Watch for slurred, slow speech or no speech. Ask the person to repeat a simple sentence.
• T is for time. It’s the conclusion to the checklist. Time to call 9-1-1 if someone has these symptoms, even if they go away.

Another type of stroke, a hemorrhagic stroke, is when a blood vessel breaks and blood seeps into brain tissue. Ingold says hemorrhagic strokes are typically caused by a traumatic injury, like falling and hitting your head. Uncontrolled high blood pressure is also a cause.

For either type, when you arrive at the hospital, a provider will take some pictures of your brain and decide the best treatment option.

Prevention

Up to 80% of strokes are preventable, Ingold says. Prevention goes back to what any doctor will tell you is key for a healthy life: control your blood pressure, cholesterol and diabetes through diet and exercise. Avoid tobacco, alcohol and drugs. If you have an irregular heartbeat, known as atrial fibrillation, see your cardiologist regularly and follow their instructions. And get established with a primary care provider, too.

Ingold says a stroke takes 3.75 years off a person’s life, on average. And if you have a stroke, you have a 25% chance of having another one.

“We always tell people they really need to be on top of their treatment,” Ingold says. “The signs and symptoms of a possible second stroke may not be the same as the first. In fact, they could be completely different. It just depends on what part of the brain the stroke affects.”

Learn more

Read about stroke care on the OSF HealthCare website.

Previous coverage

OSF HealthCare Newsroom stroke stories
OSF HealthCare stroke blogs

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

B-roll

Additional B-roll

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

Previous coverage

Exploring organ donation
Living organ donation is an ‘amazing gift’
Living organ donation saved my mom's life
The ultimate tribute for the ultimate gift
Making a life-saving decision
‘They are very special people’

Busy days are the norm for Jill Pruitt.

The licensed practical nurse and certified oncology navigator at OSF HealthCare pores over imaging results looking for findings not related to what brought the person there in the first place. Imaging for possible lung cancer may reveal a thyroid problem and a need for a follow up appointment. She notes the appointment in her tickler file and contacts the provider later if it’s not getting scheduled.

A little firmness goes a long way in catching something that could have serious consequences.

“It’s important because if you just catch one thing, maybe that saves their life,” Pruitt says.

“It’s patient-first. I look out for all of them,” she adds.

Pruitt’s above-and-beyond efforts – unique throughout the entire OSF Ministry – shine a light on patient navigators and their importance.

What navigators do

Pruitt says a patient navigator is usually there with someone when they’re diagnosed and through their whole journey. The navigator sits in on consult appointments, helps schedule other appointments, answers questions and more.

“Basically they are the person’s go-to,” Pruitt repeats.

“Often when a person comes in and hears the word ‘cancer,’ they shut down,” Pruitt explains. “They didn’t hear about follow-up appointments, biopsies and other scans.”

That’s where a navigator comes in with a reminder. Where to go. What specialist to see. Write it down. Sometimes people just want to talk, and Pruitt obliges – day or night.

Once a person starts treatment, a nurse may become their main point of contact. But Pruitt and other navigators may still check in.

“They’re always there in my heart,” Pruitt says with a smile.

Looking closer

Pruitt says 50 to 60 imaging reports cross her desk each week. On a spreadsheet, she tracks person by person if anything else needs done. The doctor may have recommended another appointment or test. New patients or people who came through the emergency department may need to be established with a provider.

“We’re all human. Sometimes things are missed,” Pruitt says. “So if I look at the chart and see the procedure is not scheduled, I contact the physician to make sure they put the order in.”

Pruitt makes longer term checks, too.

“A patient comes in in April of 2023 and has a low-dose CT scan,” for example, she says. “Sometimes they need to come back in three, six or 12 months. That all is put into my tickler file for the next year. I go through the file monthly and check if they had the follow-up done. If not, I contact the physician again and make sure that test gets done.”

The doctors are usually grateful for the nudge, Pruitt says.

Pruitt may also notice people are no-showing or canceling the follow-up appointments. Or some people will explain that their insurance won’t cover a follow-up so soon, so they’ll just wait until their next regular visit in six months.

Not a good idea, Pruitt says. Early detection of cancer or any other ailment is key.

“Sometimes the cancer is in such an early stage. Doctors can do surgery and take it out. And then the person doesn’t need treatment,” like chemotherapy or radiation, Pruitt says. It underscores the importance of sticking to your appointments and asking your care team questions.

Learn more

Talk to your health care provider if you think a navigator would help your journey.

Interview clips

You see the phrase as you browse the grocery aisle: helps lower cholesterol.

But have you looked into what that means for you? And more importantly, is this something my children need to worry about?

The answer to the second question is yes, says Tricia Herman, a cardiac rehabilitation registered nurse at OSF HealthCare in Danville, Illinois. And it’s a perfect time to change lifestyles to avoid cholesterol problems as we enter a holiday eating season where you may be chowing down on unhealthy food.

What is cholesterol?

Herman says cholesterol is a fatty, waxy substance that’s responsible for building cells in our body. It also helps produce hormones and vitamin D.

“When we have our cholesterol checked, it’s not just total cholesterol that we’re really looking at. We’re looking at three different levels,” Herman says.

“The bad cholesterol is LDL [low-density lipoprotein]. You can consider it lousy. The good cholesterol is HDL [high-density lipoprotein]. And triglycerides is another level that we take a look at.”

LDL values should be less than 100 milligrams per deciliter. HDL should be greater than 60 milligrams per deciliter. And triglycerides should be less than 150 milligrams per deciliter.

Be proactive at all ages

The average person doesn’t need to memorize those numbers. Herman recommends that when you get your yearly physical, get a blood test to measure cholesterol as well. You’ll need to fast for 12 hours before the test, so Herman says to do it first thing in the morning if possible.

After the results come in, your health care provider will come up with a course of action, if necessary. That may involve follow up lab work or medicine.

What you should think about daily: a healthy lifestyle.

For kids, try for 60 minutes of exercise per day. That could be as simple as walking, Herman says.

And cut down on less healthy food choices like fried or fatty foods, sweets and red meat.

Or as Herman puts it: don’t brake and hit the drive thru because it’s the quick and easy option. Keep your foot on the gas.

“Eating habits are the hardest thing for a lot of people,” Herman says. “It’s the way we were brought up. What was served at our table when we were younger become habits we grow up with.”

Instead, try lean meats like fish or poultry. Bake, grill or broil your meat instead of frying it. Use whole grain bread instead of white bread.

“Create a meal plan for your child that has lots of fruits and vegetables,” Herman says. “Don’t have them eat on the go. Have them sit down and eat so it’s more meaningful and thoughtful.”

The consequences

High cholesterol leads to plaque building in arteries of the heart, brain or legs.

“You’re at risk for stroke if it’s happening in your brain or even in your carotid arteries [in your neck],” Herman says. “You’re at risk for heart disease if it’s happening in your heart. And peripheral artery disease if it happens in your legs.”

Herman notes that high cholesterol often doesn’t come with symptoms until it’s too late. So talk to your primary care provider if you have concerns.

Interview Clips

Previous coverage

What you can eat can help improve your cholesterol

The good and bad about cholesterol

Just call Steve Bugelli and Brad Zorns two peas in a pod.

The men walk in to OSF HealthCare Sacred Heart Medical Center in Danville, Illinois, together and make a beeline for the cardiac rehabilitation gym.

After a vitals check, Zorns, of Oakwood, Illinois, hops on a treadmill. Bugelli, of nearby Westville, steps onto an elliptical.

“You good, Brad?” Bugelli asks.

“I’m ready,” Zorns replies.

Ninety minutes and a good sweat later, the strangers-turned-friends walk back out to their cars side-by-side.

Repeat the routine for the other four weekdays, and it’s easy to see why the men have made tremendous strides in recovering from serious cardiac events.

“It's made a difference,” Bugelli says, the conviction in his voice strong. “Right now, I can get up. Before, I was in the scooter. I couldn't get my groceries. I couldn't do anything. Now, I can. I can go in. I can walk.”

“Rehabilitation is great,” Bugelli continues. “The girls work with you. They work with you at your own pace. You're well-monitored. And it's really helped. It changes your lifestyle.”

Cardiac rehab is a typical, but important part of recovering from something like a heart attack, congestive heart failure, open heart surgery or other cardiac event, says Caitlin Hunt, an exercise physiologist at OSF Sacred Heart who helped start the hospital’s cardiac rehab program in 2020. Hunt and her colleagues Brittney Cromwell and Tricia Herman run the program today.

“My angels,” as Zorns refers to the women.

While we think about building up arm and leg muscles at the gym, your heart is a muscle too, and a pretty important one, Hunt says. She explains that cardiac rehab starts as inpatient phase one, when a patient is still in the hospital. It then progresses to outpatient phase two, where patients exercise two to three times per week over a couple months at the rehab gym. Then, patients “graduate” to phase three (also called maintenance program or community fitness). That’s where Bugelli and Zorns find themselves. There, patients chart their own course and come as they see fit.

“What we do is watch their heart rate and make sure it doesn't get up to a certain level for their age,” Hunt says.  “And then as they progress, we just make it a little tougher for them. Increase their speed or increase their [workout] level.”

Herman, a registered nurse, says OSF HealthCare Mission Partners (employees) also educate cardiac rehab patients on things that go along with working out, like nutrition and managing medication.

Herman adds that the mental health benefits mirror the physical ones. Look no further than the friendship of Bugelli and Zorns, who swapped phone numbers early on in their recovery journey.

“I tried to go to gyms before. You just go in there, and all they want is your money,” Zorns says. “They don't care what you do. I had trouble with my heart rate. They didn't monitor any of that stuff. I go and I'd feel worse after I'd come out.”

Not so at cardiac rehab through OSF HealthCare.

 “Some people may not be able to fully walk on a treadmill for 20 minutes where other people do,” Hunt says. “And then they say ‘well, they're doing that so I can do that too.’ They push each other to be better. They know ‘OK, well you're coming tomorrow. OK, I'll come too.’”

“They've already developed, sometimes, friendships in these classes. Or bonds. Because, ‘hey, I have this and you have this.’ They know about each other's families,” Herman says. “It feels so much easier to come into a community to do your fitness program and keep it up.”

Interview Clips - Steve Bugelli and Brad Zorns

Interview Clips - Caitlin Hunt

Interview Clips - Tricia Herman

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