It goes without saying: mental health issues can spawn physical health problems. But let’s dig into one: how can being stressed all the time increase your risk for a stroke?

“Chronic stress, anxiety and depression can all lead to unhealthy factors,” says Brittany Best, BSN, RN, a stroke navigator at OSF HealthCare. “They may not cause a stroke directly, but they will raise your blood pressure, inflammation and blood sugar levels. So they really can raise the risk of a stroke significantly.”

Eating a healthy diet, avoiding alcohol and smoking, being active and mindfulness activities like meditation can help with this risk, Best says.

“Seeing your doctor regularly is one of the most important things you can do to reduce your stroke risk,” Best adds. “They’re going to keep an eye on things like blood pressure and lab work. They can get you on the right track to maintain overall health.”

What if I’m on medication for my mental health? How does that play a role in stroke risk? Best says it shouldn’t be a problem, but follow your health care provider’s directions, and talk to them if you have symptoms.

A recap of stroke basics

If Best has a takeaway message, it’s that 80% of strokes are preventable, and quick action when a stroke strikes can prevent serious brain damage or even death. When spotting stroke symptoms, remember the acronym BEFAST.

• 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.

“Our main goal is getting patients in quickly. Identify their stroke symptoms. Get them to imaging. Get their care started as quickly as possible,” Best says, outlining stroke care at the hospital she works at, OSF HealthCare Saint Anthony’s Health Center in Alton, Illinois. “With strokes, time is very important. Up to two million brain cells can die every minute during a stroke. So it’s very important for the treatment process to go smoothly.”

The care team will also connect people with stroke resources, such as support groups like the one Best manages. Contrary to stereotypes, those support groups are not all doom and gloom.

“It’s a nice place for stroke survivors and caregivers to connect with one another,” Best says. “They can ask questions and listen to guest speakers. It really just provides a nice community for them to not feel alone in their recovery.”

Learn more

Read more about treatment and prevention of stroke on the OSF HealthCare Illinois Neurological Institute website.

Interview clips

Frequently asked questions

Dysphagia, or difficulty swallowing, is a common complication after stroke that can increase the risk of pneumonia, prolong hospital stays and, in severe cases, require patients to rely on feeding tubes for nutrition.

The Phagenyx® System combines temporary nutritional support with gentle electrical stimulation that helps retrain swallowing muscles weakened by stroke. The therapy stimulates nerves in the throat to encourage the brain to restore normal swallowing function.

"We're committed to bringing the most advanced, evidence-based treatments to our patients," says Arun Talkad, MD, director of the Comprehensive Stroke Center at the OSF Illinois Neurological Institute. "The Phagenyx® catheter not only provides temporary nutrition but also stimulates the muscles involved in swallowing, helping patients recover this critical function sooner. Studies have shown it can reduce the need for permanent feeding tubes, which can have a significant impact on a person’s quality of life. This technology adds another important tool to the comprehensive stroke care we provide."

Nearly 800,000 people experience a stroke each year in the United States, according to the American Stroke Association. While paralysis, speech changes and vision loss are among the best-known effects of stroke, many patients also experience dysphagia, making it difficult or unsafe to swallow food, liquids and even saliva.

The Phagenyx® System is one of several advanced therapies available through the Comprehensive Stroke Center at OSF Saint Francis, supporting people throughout their recovery and rehabilitation.

Illinois averages 10 days with temperatures at or above 90 degrees each year, according to the Illinois State Climatologist. 

In typical summer fashion, temperatures are reaching the 90-degree mark this week.

This summer weather puts many people at risk for heat exhaustion and heat stroke. Not only outdoor workers, but kids, older adults and those without working A/C in their buildings could be affected.

Brian Curtis, MD, vice president chief medical officer of OSF Medical Group, says preparation and awareness are keys to staying safe in the summer heat.

“You’ll go from heat exhaustion before you get to heat stroke,” Dr. Curtis says. “Heat exhaustion is where people are cool, clammy, sweating profusely, and they may have some nausea or vomiting. They usually have some severe muscle cramping with it.”

If heat exhaustion is not recognized and treated quickly, Dr. Curtis says heat stroke can then happen.

“With heat stroke, they’ll have dry skin, a temperature of 102-103 degrees, they’ll be confused or passed out,” Dr. Curtis says. “That’s a medical emergency, a 911 call. Whereas with heat exhaustion, you need to get them out of the heat, get them into a cool environment, and get them some liquids.”

Dr. Curtis says hospitals see heat stroke patients every summer, especially during longer stretches of hot and humid weather. He says higher humidity causes our bodies to not be able to cool as easily.

But these dangers don’t just affect outside workers or athletes playing sports in the summer. Dr. Curtis says the main excessive heat victims are middle-aged people, but kids and older adults are more susceptible.

“Because they don’t heat and cool themselves as easily, they’re more prone to get it, and we tend to be more vigilant with them,” Dr. Curtis says.

Heat exhaustion or heat stroke aren’t solely seen outside, either.

“If you get into the mid or upper 90s, we have some people around here who still don’t have air conditioning. You can get heat exhaustion and heat stroke within a building,” Dr. Curtis says. “When people don’t have air conditioning, that’s when you really see a lot of the elderly develop heat exhaustion within their own homes.”

Prevention of heat exhaustion and heat stroke

- Drink plenty of liquids (water, fruit juice, sports drinks)

- Avoid dehydrating liquids like alcohol and caffeinated beverages

- Take frequent breaks

- Get out of the sun and into the shade

- Use sunscreen and avoid getting sunburnt

- Use the buddy system: Keep an eye on each other

Dr. Curtis adds the effects of heat stroke can be long-lasting, or even lead to death.

“People die of it every year, or they have debilitating conditions afterwards,” Dr. Curtis says. “Once you’ve had heat stroke, you tend to be more susceptible to the heat as you go forward. Your body does not regulate as well and so you can be more prone to develop it in the future.”

For More Information

When it comes to extreme temperatures, play it safe. Know the warning signs of heat stroke and take the proper steps to prevent it.

Symptoms of Heat Exhaustion

• Profuse sweating
• Water depletion (causes extreme thirst)
• Weakness
• Dizziness
• Salt depletion (causes muscle cramps)
• Nausea
• Vomiting
• Fainting
• Headache

Symptoms of Heat Stroke

• Body temperature greater than 104° F (main sign)
• No sweating in hot weather
• Neurological problems such as confusion, unconsciousness, and seizures
• Rapid breathing
• Increased heart rate

Video Interview Clips

TV PKG

B-Roll

For most adults, spring and summer thunderstorms bring the annoyance of driving in a downpour.

But others dread this time of year for migraines triggered by the environment.

What are migraines?

Aminat Ogun, MD, a family medicine physician at OSF HealthCare, describes migraines as episodic disorders that cause severe, throbbing headaches, usually on one side of the brain.

The list of triggers is, unfortunately, long.

“Emotional stress can trigger migraines. Moving, changing jobs, other stressful life situations,” Dr. Ogun says. “A change in sleeping habits can trigger a migraine. Skipping a meal. Your diet: wine, aged cheese, coffee withdrawal and foods high in nitrates.”

Other common triggers include hormones, bright lights, loud sounds and changes in altitude. A propensity for frequent headaches can also run in the family, Dr. Ogun says.

You can prepare

Dr. Ogun says not much is known about weather-induced migraines. But most medical professionals agree there is some evidence for migraines caused by changes in barometric pressure.

How can you prepare?

“Up and move,” Dr. Ogun says, tongue firmly planted in cheek.

More realistically, watch the weather forecast. If there’s a chance for a lot of dust or smoke in the air (think areas like California or Arizona), plan to limit time outside.

Stock up on medication after talking with your health care provider. Dr. Ogun says over-the-counter medicine like ibuprofen will help with pain and can even be taken ahead of when you know a migraine is coming.

“They could have a headache diary where they write down what causes their headaches, where the pain is located, how long does it last, symptoms and what treatment helps,” Dr. Ogun adds.

If your migraines are more frequent, feel different, or come with other symptoms like confusion, neck rigidity, weakness in the arms or legs, fever or chills, see a doctor right away. Some of those symptoms may be signs of a heart attack or stroke.

Any head trauma, like a sports injury or a car crash, should also be checked on by a doctor.

Interview clips

Previous coverage

One big headache
June is national migraine and headache awareness month
A good calendar may be able to help you fight headaches
Three steps to help with severe or frequent headaches
When should you see a specialist for your headaches?
Weather changes can be a pain for migraine sufferers

On a cold winter night in December 2019, Deanne Meseck of Rockford, Illinois, couldn’t wait to dig into her store-bought meal of roasted chicken, gravy and mashed potatoes. She had just completed a colonoscopy earlier that day and was famished.

But as she and her husband, Ryan, started eating, her life at age 47 changed forever.

Ryan noticed food was dropping from the left side of her mouth. Concerned, he told his wife to put her arms up, but Meseck couldn’t lift her left arm. And when he asked her to speak, her words were jumbled, so he immediately called 9-1-1. A crew arrived and suspected Meseck was having a stroke.

Meseck was taken by ambulance to OSF HealthCare Saint Anthony Medical Center in Rockford, where she underwent a battery of tests and procedures. The diagnosis came back as an ischemic stroke from a blood clot.

Ischemic strokes, caused by a blocked vessel, account for about 87% of all strokes, and roughly 60% of strokes among people under 50.

Michele Johnson, APRN, is a nurse practitioner at OSF HealthCare, and Meseck’s primary care provider. Johnson says Meseck had a large-sized right middle cerebral artery stroke, that affected half of her brain.

“Anytime somebody goes in for a stroke, you have to look at what type of stroke,” says Johnson. “What was it caused from? Was it from a blood clot? Is it a bleed? Just trying to figure those things out initially, in the emergency room and in the hospital.”

Meseck required surgery to relieve the swelling in her brain. She suffered respiratory depression from pneumonia, which required being on a vent for an extended period. After spending weeks in the hospital, Meseck was moved to a rehabilitation facility, followed by extensive physical, speech, occupational and ophthalmological treatment, some of which is ongoing.

Turning a corner

Johnson says despite tremendous progress, Meseck will always have some limitations. 

“With the contractures (stiffness) of the hands, going back to therapy is important, some speech impediment, some visual problems and the weakness, she has progressed significantly since this all occurred,” Johnson says. “But there will always be some permanent disability.”

Perhaps the hardest part for Meseck was giving up her 26-year career in finance. “They were just really worried about what being in a stressful work environment would do,” says Meseck. "There was no way that I could hold a nine-to-five job.”

While the physical toll was hard on Meseck, the mental hurdles proved equally challenging. She sought mental health therapy, which gave her a new perspective while coping with severe depression.

“I spent a lot of time with a therapist talking about how I lost my identity, and I lost my whole way of life and had to figure out how to be a new person,” she says.  “That was probably as difficult as any physical therapy that I had.”

Meseck filled her days by walking her dog, streaming TV shows and enjoying time with her two-year-old grandchild. But as she worked to heal both inside and out, Meseck, now 53, was searching for an opportunity where she could make a difference, especially for people going through similar challenges.

Giving back

She started attending a local, monthly group for stroke survivors. In 2024, the organizers of the group planned a benefit walk, and Meseck was on board, recruiting friends and family to form a team. But when she found out there wouldn’t be a second walk the next year due to a lack of volunteers, Meseck knew what she needed to do. She and her sister, Shelly, rolled up their sleeves and started planning the second annual walk, which takes place on May 30 in Rockford. Proceeds from the event support a stroke camp for survivors.

Meseck says coordinating this major special event is her new calling.

“I want to motivate people to know that there is life after stroke,” she says. “It may be hard to find it, and you won't be the same as you were, but you can do it. If I can do it, anybody can do it.”

Johnson says the timing is right for Meseck to take on her latest challenge of planning the walk. 

“It is good for her to have a purpose because she was so busy before,” says Johnson. “This does give her joy. It’s important to hear from somebody like Deanne; there are treatments out there and you can live and function. Maybe not the way you did before, but there is life after stroke.”

Meseck says her journey is far from over. She knows that she will always be in constant recovery. And she can live with that.

“It was difficult,” she says. “But I just kept waking up every day saying, 'You know what, I'm here, and there's a reason I'm here.' You have to find a silver lining.”

When to seek emergency help

Call 9-1-1 or your local emergency number right away if you or someone you're with has signs or symptoms of a stroke.

Use F.A.S.T. to remember warning signs.

• Face. Does the face droop on one side when the person tries to smile?
• Arms. Is one arm lower when the person tries to raise both arms? Is one arm weak or numb?
• Speech. Can the person repeat a simple sentence? Is speech slurred or hard to understand?
• Time. Every minute counts during a stroke. Call 9-1-1 or your local emergency number right away if you see any of these signs.

Deanne Meseck interview clips 

Michele Johnson interview clips 

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Pneumonia.

It’s a hard enough word to spell, let alone remember how to prevent and treat it. With respiratory illness season here, it’s time for a reminder about how to avoid this possibly deadly condition.

The basics

Fred Burke, MD, an emergency medicine physician who treats people at OSF HealthCare, says pneumonia is a lung infection caused by a virus or bacteria.

“The most common bacteria that causes it is strep pneumonia [in medical terms, streptococcus pneumoniae or pneumococcus]. The viruses that cause it are things like RSV [respiratory syncytial virus], flu [influenza] and COVID-19 [coronavirus],” Dr. Burke says.

In other words, you could get the flu, and it could progress to pneumonia. The phrase double pneumonia means it’s impacting both lungs. Dr. Burke says people with pneumonia could experience coughing, fever, chills and weakness.

“It can cause a consolidation in the lungs. That interferes with air movement,” Dr. Burke says. “You can also get fluid buildup and scarring in the lungs.” Consolidation refers to inflamed cells that form a mass.

Diagnosis and treatment

Dr. Burke says when someone comes to the emergency department with pneumonia symptoms, a health care provider could do a chest X-ray or CAT scan to confirm the diagnosis.

“If we find it’s from a viral infection, people have to ride it out. There’s no treatment for [the ailment itself]. But we can treat the symptoms. We can give Tylenol for fever or an inhaler for shortness of breath or wheezing,” Dr. Burke explains. “If it’s from a bacterial infection, we give antibiotic medication.”

The person could take antibiotics by mouth for one to two weeks. Or, if they are having trouble breathing, the medicine would be given through intravenous (IV) therapy. Either way, the goal is to stop the bacteria in the lungs from growing.

Another tactic is a bronchoscope, where a pulmonologist inserts a tube down your throat to break up mucus in your airways.

But Dr. Burke cautions: don’t let the guidance of some “ride it out” fool you. Pneumonia is a common cause of hospitalization and death worldwide.

“One complication is sepsis, when the infection spreads to the blood. That can cause organ failure,” Dr. Burke warns. “Pneumonia can also cause respiratory failure [when the lungs aren’t working properly]. Those people might require additional oxygen. Or if it serious enough, they might require intubation [a breathing tube down the throat] or be placed on life support.”



Is it contagious?

Yes, pneumonia can spread from person to person, Dr. Burke says. It’s often transmitted through respiratory droplets (coughing or sneezing on someone), but it can spread on surfaces as well. A child could touch a dirty doorknob then put their hands in their mouth, for example.

That’s why everyday hygiene is important. Wash your hands with soap and warm water thoroughly and often. Cough or sneeze into your elbow or a tissue. Stay home and away from others if you’re sick. These are especially important for people at higher risk for pneumonia: people with a history of strokes or seizures, people suffering from substance abuse, people with a compromised immune system (those with HIV or a transplanted organ, for example), smokers and people with chronic obstructive pulmonary disease (COPD).

The United States Centers for Disease Control and Prevention also outlines the guidelines for the pneumococcal vaccine. Talk to your primary care provider if you have questions about the shot.

“The vaccine comes from evidence-based medicine. Experts have done studies. It’s shown to be very effective in decreasing the severity of pneumonia,” Dr. Burke explains. “I would recommend people take the vaccine.”

Interview clips

Related stories

OSF HealthCare library: Pneumonia
Walking pneumonia strolling into little lungs
Protecting infants from RSV
Can't stop coughing?
Better breathing: How we treat COPD
‘Sepsis does not discriminate’
Do you really need that antibiotic?

On one hand, you're gaining an extra hour of sleep. On the flip side, the days get shorter and we say “hello darkness my old friend.”

In March 2023, health experts issued a wake-up call to Congress to make the change permanent.

The American Academy of Sleep Medicine (AASM) says public health and safety would benefit from eliminating Daylight Saving Time in favor of standard time. The AASM says the switch to permanent standard time would more closely align with the body’s internal clock – our circadian sleep-wake cycle – instead of disrupting the body’s natural rhythm.

There is also evidence that Daylight Saving Time can take a toll on your heart, specifically increasing the risk of heart attack or stroke.

The AASM recommends getting at least seven hours of sleep before and after Daylight Saving Time begins while shifting your bedtime 15-20 minutes earlier each night before the change.

Dr. Frank Han is a cardiologist with OSF HealthCare who specializes in pediatric and adult congenital heart disease. He says poor sleeping habits can impact you negatively later in life.

“The act of waking up earlier without gradually changing your schedule can increase your stress hormones,” Dr. Han says. “If added on with unusual sleep schedules, night-shift work, then years down the road it can result in different kinds of cardiovascular diseases.”

Dr. Han adds it’s not just your sleeping habits that can put pressure on your heart. He recommends being aware of any hereditary heart issues that run in your family, and pay attention to lifestyle choices that can impact heart health.

“If that’s added on to less than optimal lifestyle habits, disturbed sleep schedule, disturbed circadian rhythm and other stressors in the lifestyle like tobacco. All of those factors added together can contribute to the hardening of the heart arteries and heart artery blockages as an adult,” Dr. Han says.

Video Interview Clips

Early menopause (menopause that occurs before age 45) has been found to increase the risk of heart disease. 

According to a study by the American Diabetes Association, that included data from nearly 10,000 postmenopausal women, researchers looked at the connection between early menopause, Type 2 diabetes, and cardiovascular disease (CVD) risk in women. The data showed that women who experienced early or premature menopause had a higher risk of heart disease, especially if they also had Type 2 diabetes.

According to Kathleen Meade, APRN, a nurse practitioner with OSF HealthCare, estrogen helps protect the heart. The drop in estrogen levels that occur during menopause can lead to higher cholesterol, blood pressure and body fat levels — all of which are factors leading to heart disease.

Cardiovascular disease is the leading cause of death among women of all ages. More than 60 million women in the U.S. have some type of heart disease. “For women, heart disease is very serious,” says Meade. “A lot of times we think of the other things that might potentially affect our life and our quality of life, like cancers, but with heart disease, it’s the most prevalent cause of death in women.”

For women who encounter early menopause, these changes happen over a longer period. They increase the lifetime heart disease risk compared with those who reach menopause around the average age of 50 to 52. When hormonal changes occur with menopause, blood vessels can stiffen, blood pressure can rise and cholesterol balance may change, all of which increase the risk of heart disease.

“When women go through menopause, they fail to produce any estrogen,” explains Meade. “Estrogen is a vital link between vascular flexibility, and that would increase their chances of having hypertension. And it increases their risk of plaque buildup, or if they have high cholesterol or hyperlipidemia. So, you put those together, that's what causes the increased risk of heart disease.” 

Besides menopause, other major risk factors for cardiovascular disease for women include high blood pressure, high cholesterol, an unhealthy diet, obesity, smoking and physical inactivity. “Women can take several steps to decrease their cardiovascular risk,” Meade says. “One would be to maintain an active lifestyle. We recommend 150 minutes of exercise per week. Follow a low fat, heart healthy diet. The Mediterranean diet is an excellent way to provide healthy oils and low fat and good protein.” Meade also recommends limiting alcohol and processed foods, increasing fruits and vegetables and getting at least eight hours of sleep.

Tailoring a treatment plan 

Knowing the link between menopause and heart disease can help health care providers like Meade treat her patients more effectively now and in the future.

“You can more individually tailor their care accordingly to when they went through menopause and when you possibly put them on hormone replacement therapy,” she says. “Look at all the other cardiovascular risk factors – address hypertension, hyperlipidemia or cholesterol, look at their sleep patterns, at exercise routines and weight management. We can put all that together to try to reduce their chances of having a heart attack or a stroke.”

Hormone replacement therapy is medicine prescribed to replace the estrogen the body stops making after menopause, which is when periods finally stop for good. This therapy is used to treat common symptoms, such as hot flashes. It’s also been used to prevent bone loss after menopause. Meade says for the best results, hormone replacement therapy should be tailored to each person but first discussed with your health care provider.

Meade can relate to her patients who experience menopause issues. She has traveled along a similar journey. “I’ve gone through menopause, and I'm happy to say that I feel great,” she says. “I generally bring it up in our conversations when the time is right. A lot of times they bring it up, because it does impact our lives in every aspect. I feel like I can walk beside them, help them and give them expert advice and treatment options.”

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

Interview Clips

A potentially life-saving pilot program is launching in Bloomington, Illinois to detect a little-known but surprisingly common genetic condition that can dramatically raise cholesterol levels—and the risk of heart attacks and strokes—even in children.

It’s called familial hypercholesterolemia, or FH. It’s estimated that 1 in 200 Americans has the genetic disorder where the body can’t effectively clear LDL or ‘bad’ cholesterol from the blood.

Darrel Gumm, MD, vice president of OSF HealthCare Cardiovascular Institute says the pilot will identify people who, due to their genetics, might not know they are at risk.

“It’s estimated about 1.3 million people in the United States have it [FH] and 90% of those patients don’t know they have it, Dr. Gumm stresses. “So, it’s a tremendous opportunity for us to step in and find those patients, identify those patients and provide therapies that may prevent terrible things from happening down the road.” 

OSF HealthCare and OSF Innovation are using artificial intelligence (AI) to conduct a pilot program for detecting and treating FH. To identify high-risk patients for this pilot, the Digital Innovation Development team used a two-step approach. First, an algorithm flagged patients over the past 18 months who had concerning cholesterol levels. Then, they applied an AI tool to scanned physician notes to detect clues—such as yellowing of the eyes or hardening of the Achilles tendon—signs a doctor may have observed but not flagged as FH-related.

People inherit FH from one or both parents, and it puts them at risk for cardiovascular events far earlier in life than normal, sometimes even in childhood.

Two Types of FH

According to Dr. Gumm, there are two kinds of FH:

• Heterozygous FH, inherited from one parent, which can lead to early heart attacks or strokes—before age 65 in women and 55 in men.
• Homozygous FH, a rarer and more severe form inherited from both parents, which can lead to strokes and heart disease in teenagers or even young children.

While most people begin cholesterol screenings around age 40, those with FH can silently develop sky-high levels from a young age.

"They can be a very healthy person, think they’re doing great, be a marathon runner and really they could have astronomically high cholesterol that’s not of their fault,” explains Ryan Loudermilk, a strategic program manager in Performance Improvement at OSF Innovation.

The new screening program was launched in Bloomington, starting with support from a strong primary care network involving 9 providers including Richard Ginetti, MD, who is a champion for the effort. It started with 200 patients found to potentially have FH. If testing confirms the diagnosis, individuals will be offered treatment, typically statins, which can reduce cardiovascular risk by up to 80%.

Dr. Gumm says every time someone is identified with FH, outreach will occur to encourage screening for parents, siblings, and children.

“One of the things I love to tell my patients is the best way to treat a heart attack is not have one. Same thing with a stroke. So, even if they’ve had a heart attack and survived it, now we’re going to be aggressive at not letting the second one occur. But here’s a chance to never let it occur in the first place. It’s primary prevention … really fantastic.” 

Education in a Short-Attention-Span World

Understanding FH—and the importance of early detection—isn’t easy in a world flooded with information. That’s why the pilot program teamed with OSF Innovation’s Medical Visualization team, to create for people identified at possible risk, mobile-friendly education designed to meet people where they are.

Loudermilk emphasizes it’s not just a brochure. The visuals use a unique, semi-animated shimmer effect that adds emotional weight without overwhelming the viewer.

“It’s something that can be easily read on their cell phone; they don’t have to log onto a computer. It’s something that’s eye-catching, something that’s straight to the point – what your risks are, why it’s important for you to get tested and checked … thinking about family members, so it speaks to that. It speaks to the ease of this. That’s the other big piece of this.” 

A Simple Test with a Big Impact

The testing process is easy. It’s just a cheek swab with no needles or blood draw. It takes a couple minutes.

The pilot is tracking how many people go on to be screened after the initial outreach with a goal of at least 30%. The initiative will follow not just how many patients test positive, but how many then go on to get family members tested, the true measure of ripple effect success. Additionally, the pilot includes having the Medical Visualization team provide insights about which content drove the most engagement.

The FH pilot is part of a broader effort at OSF HealthCare to advance care through personalized medicine that is specific to a person’s genetic make-up. Loudermilk sees a time in the future where genetic testing will be even easier.

“Where I could see this going – a patient doesn’t even have to come in. These kits could actually be mailed to them, to their house and they could do the check swab themself and get it mailed in. So, those who don’t want to deal with making an appointment and seeing their provider in person, they could do a virtual visit and have the kit sent to them. That’s the future of all of this.” 

If you receive primary care in Bloomington, talk to your provider if you think you would like to be screened for familial hypercholesterolemia.

Dr. Darrel Gumm

Ryan Loudermilk

B-roll-Familial Hypercholesterolemia (FH)

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

Time is brain, in other words. So, remember the acronym BEFAST. If you notice irregularities with your balance, eyes, face, arms or speech, it’s time to call 9-1-1. And, talk to younger people in your life about those signs. Ingold says strokes aren’t just an old person thing. She’s seeing more people in their 30s, 40s and 50s come to the hospital with stroke symptoms.

“The brain has something called neuroplasticity,” Ingold adds. “So the quicker you can start physical, occupational or speech therapy [after a stroke], it impacts those brain neurons. We don’t always get them back, but the brain can sometimes remember how to get your strength back.”

Prevention

Some risk factors for stroke, like your family history of health issues, are unchangeable. But you can spin that into things you can control.

“You can check in with your primary care provider and see how best to fix things,” Ingold says. “Do you need to lose weight? Do you need to eat a better diet? Medication? Exercise? You can watch your blood pressure and diabetes. Small amounts of walking. Walk in your home in the winter months. Do some arm exercises with water bottles or cans of food. All that makes a difference.

“And the most obvious modifiable risk factor is smoking or vaping. We see a lot of patients with a history of vaping. Smoking and vaping are equally bad for you. We encourage you to stop. If you need help, talk to your primary care provider about products to help you stop,” Ingold adds.

Williams today

After a three-day hospital stay, Williams went home with no long-term deficits. She’s now preaching stroke prevention through a healthy diet, active lifestyle, knowing your body and more. For one, Williams now wears a medical alert bracelet. It contains her health information if she’s stricken and can’t talk. She’s also put that information on her refrigerator so her grandchildren will know what to do in an emergency.

Plus, Williams wants others to be empowered, not embarrassed, to go to the hospital with a possible stroke. The mindset of “I felt bad earlier, but I feel fine now. I’ll just waste their time.” is not the way to go, she says.

“I never knew that one of my radio shows might end up saving my life. Or end up saving me from something like paralysis,” Williams says. “I really feel like that conversation with Leslie saved my life and made a difference in my outcome.”

Says Ingold: “I’m very thankful Laura had us on her show. I’m so thankful she listened. I’m so thankful that when we have an audience, they listen. It might not affect them today, tomorrow or even next year. But the fact that they’ve heard it and remember it makes all the difference in the world.

“If I can be a part of that, that makes my heart warm,” she says.

Learn more

Read more about how health care providers prevent and treat strokes on the OSF HealthCare website.

Photos

Interview clips - Laura Williams

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Read more stories on stroke awareness with Leslie Ingold here.

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

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

Myth vs. fact

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

When in doubt

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

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

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

Learn more

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

Interview clips

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A brand-new technology is available for Chicago area patients living with Atrial Fibrillation (AFib).

FARAPULSE is an FDA-approved cardiac ablation treatment, designed by Boston Scientific, to restore and regulate heartbeats and slow the progression of AFib. Now, it’s available in the newly opened Electrophysiology (EP) Lab within OSF HealthCare Little Company of Mary Medical Center.

It’s referred to as a pulsed field ablation, delivering energy to the cardiac tissue that doesn’t injure surrounding tissue.

“It’s completely selective to the cardiac myocytes we’re targeting to treat AFib,” says Dr. William Spear, the lead electrophysiologist at OSF Little Company of Mary Medical Center in Evergreen Park, Illinois. “You deliver the energy, which only takes two and a half seconds, and it targets just the cardiac cells you're focusing on, those abnormal cells that are causing the Atrial Fibrillation (AFib), and it leaves all the other cells around it untouched."

AFib is very common, affecting around 2.7 million Americans, according to the Delaware Journal of Public Health, with an estimated 160,000 new cases each year. Symptoms of AFib include shortness of breath, heart racing, or if you can’t do activities you used to be able to do. It’s when the normal rhythm of the heart is disrupted, and the top chamber of the heart, called the atrium, begins to quiver. When this happens, it makes the heart beat 300-400 times a minute and also results in a very rapid and irregular heartbeat in the bottom chamber, decreasing the efficiency of the heart pump. This can lead to blood stagnating in the upper chamber, then clots can form, leading to stroke, heart failure, or even death.

Dr. Spear calls the new FARAPULSE service “revolutionary.” He adds all the adjacent tissues like nerves, the esophagus or lungs, won’t be damaged in the procedure.

“For the last 20-30 years, the mainstay of ablation has been radio frequency. Radio frequency is very good, but it's more traumatic to the tissue because you're actually burning the tissue,” Dr. Spear says. “With pulsed field ablation, it really leaves the esophagus untouched. We can ablate around the esophagus where the heart meets the esophagus on the posterior side, without having to worry about this major complication which is called atrial esophageal fistula (AEF). This happens because we're not touching the esophagus, we're only touching cardiac tissue.”

Tracy Jendruczek, the Vice President of Surgical and Procedural Services at OSF Little Company of Mary, says FARAPULSE will help community members in nearby areas living with AFib.

“If patients are experiencing any heart concerns or issues they should see their medical provider. From there, a cardiologist will be able to determine if ablation is appropriate for them. If appropriate, FARAPULSE is just another technique to ablate, to help the heart beat normally,” Jendruczek says. “It's a safer technique in that it preserves tissue around the heart, compared to current techniques being used for ablation.”

“It's a very serious problem that faces millions and millions of patients,” Dr. Spear says. “As we age, it becomes more and more frequent. As you get into the 70–80-year range, about 20-25% of patients will develop atrial defibrillation at some point in their life. It's a very serious problem we face as a society, really.”

Dr. Spear notes that many individuals who have AFib are asymptomatic. He says this is a reminder to keep an eye on your overall health, speak with your medical provider, and schedule an appointment with a cardiologist if recommended by your primary care physician.

The FARAPULSE PFA procedure usually takes less than one hour and allows most patients the ability to return home that day.

Video Interview Clips

FARAPULSE BROLL

OSF HealthCare Little Company of Mary Medical Center in Evergreen Park now has CT (Computed Tomography) and MRI (Magnetic Resonance Imaging) perfusion capabilities, which are advanced imaging techniques that look at a patient’s blood flow to the brain.

Rapid AI helps neurovascular and vascular medical teams reduce time to treatment and improve patient outcomes. The artificial intelligence processes the images and gives clinical information to the clinician immediately, so the provider can more quickly decide the best course of treatment for the patient.

Tracy Jendruczek, the vice president of surgical and procedural services with OSF Little Company of Mary, says the addition of CT and MRI perfusions at the hospital is beneficial for the community.

“It’s available 24/7 for any patient that comes in through the emergency department,” Jendruczek says.

Who is eligible for CT Perfusion?

“Patients that might be at risk for stroke or are showing signs or symptoms of having a stroke, would be eligible for a CT perfusion of the brain. This looks at the blood flow to different areas of the brain,” Jendruczek says.

Who is eligible for MRI Perfusion?

“Patients that are eligible may be showing signs or symptoms of a tumor or have had a previously diagnosed tumor of the brain,” Jendruczek adds. “MRI perfusion, like CT, allows us to look at blood flow of the brain, but it’s specific for tumors. It’s looking at the severity and type of tumor.”

What’s the ultimate goal?

The ultimate goal of CT and MRI Perfusions is to expedite treatment for stroke patients.

“The perfusion capabilities will allow us to see the different areas of blood flow so we can quickly determine if a patient is eligible for further treatment. If we’re able to provide that treatment here at OSF Little Company of Mary, we will immediately start treating the patient,” Jendruczek says. “If not, we can more quickly transfer the patient to a place they can receive appropriate treatment.”

Video Interview Clips

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Interview Clips 

Nearly 47 million people are prescribed statins, a class of drugs that help lower blood cholesterol, which can lessen the risk of heart attack and stroke.

But not all patients are taking their statins as prescribed. According to a study led by researchers at Beth Israel Deaconess Medical Center and the University of Pittsburgh, only 35% of people eligible for statins are taking them.

This doesn’t come as a surprise to Nancy Dagefoerde, APRN, a nurse practitioner at OSF HealthCare Cardiovascular Institute. She says people are hesitant because of misinformation about statins, particularly the side effects. This comes from the internet and/or family and friends and can feed already existing fears.

“People worry about muscle pain. That's a common side effect,” she says. “They think it's going to do something to their liver or their kidneys. It's going to cause diabetes; it's going to cause dementia. There's a lot of misconceptions out there and reading that (wrong) information scares people and then they choose not to take the medication and they don't look at the benefits.”

While the chance of developing serious side effects is low, Dagefoerde says there are other options for patients if they do develop muscle pain, including adjusting the dosage or trying another statin. The muscle pain, however, could be coming from another health issue, such as arthritis or a thyroid problem. That’s why it’s important to communicate with your care team.

Statins are typically recommended for people with elevated levels of LDL cholesterol; individuals with known cardiovascular disease, including heart attacks, strokes, or peripheral artery disease, and people with a high risk of cardiovascular diseases. Statins work by blocking the production of cholesterol as it is pulled from the bloodstream preventing damage to organs and blood vessels. Dagefoerde says that 80% of our cholesterol is manufactured in the liver and that is determined by our genetics.

But medication can have a dramatic, positive effect. “By lowering your cholesterol, the patient gets the benefit of reducing their heart attack and stroke risk or any blood vessel risk,” she says. “We could lower their heart attack and stroke risk in some cases up to 50%.”

Statins are important because in many cases dieting and exercise alone don’t lower our cholesterol numbers. “Oftentimes, it’s not going to budge with just diet and exercise so we have to figure out an adequate treatment plan for you,” says Dagefoerde. Still, most medical experts recommend 150 minutes of moderate exercise each week, the same amount of exercise for people who do not take statins.

In some cases, adults who are considered healthy can also benefit from taking statins as an added measure against future cardiovascular episodes. Some patients only take statins a few days a week to get protection for their blood vessels against heart attacks and strokes.

Dagefoerde says the bottom line when it comes to cholesterol issues is to have a frank discussion with your medical providers. Come to your appointment prepared with plenty of questions and ask about your potential risk – even if you haven’t had any heart issues. 

“If your risk is high, then we want to do more preventive cardiology,” she says.  “Let’s treat the cholesterol, the blood pressure, the sugar – and get active and eat healthy. These are all components for overall health and hopefully we can prevent problems down the line.”

Interview Clips 

B-Roll 

The United States Food and Drug Administration recently approved the first treatment for people with liver scarring due to fatty liver disease. It's welcome news for people battling the disease.

How did we get here?

In some ways, it goes back to the obesity epidemic in the United States. Obesity brings an increased risk of fatty liver disease, an ailment that’s treatable but could mean serious complications. Moreover, health experts say isolation during the pandemic led may to increase alcohol intake, another risk factor for fatty liver.

David Rzepczynski, MD, a gastroenterologist at OSF HealthCare, describes the liver as an “extremely important” factory for the body. It performs many functions, like detoxifying medications, aiding digestion and making cholesterol, proteins and amino acids that help the body function. And have you ever missed a meal? You can thank your liver for releasing glucose and giving you energy.

All those “factory functions” make it critical to be watchful of fatty liver disease. As the name suggests, the disease describes an accumulation of fatty cells in the liver. Dr. Rzepczynski says it takes just 5% of cells with increased fat to make a diagnosis, but some obese people have 100% of cells with fat.

Hepatitis C and excessive alcohol use can cause fatty liver disease or are at least linked to it. But you can still get fatty liver if you’re not a heavy drinker, and that’s where your weight comes into play.

“The big driving force of fatty liver disease is what we call the metabolic syndrome,” Dr. Rzepczynski explains. “There are five factors: obesity, diabetes, hypertension [high blood pressure], high cholesterol and insulin resistance.”

Dr. Rzepczynski adds that fatty liver disease may cause pain in the upper abdomen, but it mostly comes without symptoms. So if any of those five risk factors apply to you or if you’re a heavy drinker, don’t wait. Talk to your health care provider about getting your liver looked at.

A doctor will likely start with a blood test, Dr. Rzepczynski says. An ultrasound or biopsy may also be needed. The next step: lose weight.

“It doesn’t have to be getting back to your ideal body weight,” Dr. Rzepczynski says. “Losing 5% of your weight can reduce fat in the liver. Losing 7% will help reverse some of the inflammation associated with fatty liver. And some studies have even shown that losing 10% or more might reverse some of the scarring.”

While it may be a bit alarming, left unchecked, fatty liver disease can lead to a serious condition called cirrhosis, or scarring, of the liver.

“You have normal liver tissue replaced by scar tissue,” Dr. Rzepczynski says. “When that occurs, you have a loss of liver function. You have less liver cells performing their duties.”

Cirrhosis of the liver can cause the organ to fail, making a transplant necessary. Liver issues can also mean an increased risk of heart disease, stroke and cancer, particularly breast and colon cancer.

Learn more about fatty liver disease and other gastroenterology care on the OSF HealthCare website.

Interview clips

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

Telemedicine – seeing a provider by video from home – is a common and useful part of today’s health care landscape. But as Amer Alshekhlee, MD, points out, it’s sometimes not fast. A person will commonly book a virtual appointment days or weeks out.

So how can telemedicine play a critical role when millions of brain cells are at stake in a matter of minutes?

Enter telestroke. It’s a concept in use throughout OSF HealthCare. At OSF HealthCare Saint Anthony’s Health Center in Alton, Illinois, the strategic affiliation between OSF and SSM Health allows telestroke to be seamless. Dr. Alshekhlee, the stroke program director at DePaul Hospital in nearby Bridgeton, Missouri, is one of the doctors who sees people virtually when they come to the OSF Saint Anthony’s Emergency Department with a suspected stroke.

“We see patients quickly. We triage them from hospital to hospital. That provides very quick treatment,” Dr. Alshekhlee says.

“We’ll have a video encounter,” he adds. “We examine the patient. Talk to them and their family. Make a decision on what kind of treatment and where.”

Providers will ask about when symptoms started and their severity. They will likely have the patient demonstrate the BEFAST acronym, a standard way to spot stroke symptoms. Providers will look for problems or abnormalities in balance, eyes, face, arms and speech. The “T” in BEFAST stands for time. In other words, if there is evidence of issues in B through S, it’s “time” to take quick action.

“We have a scale. We score the person, and for example, say ‘these stroke symptoms look very bad’. Then we have to really act on that patient.”

That could mean a transfer to a hospital better equipped to treat stroke. Again, providers will tell you time is of the essence. For example, if you start treatment at the Emergency Department within 4½ hours of the onset of symptoms, you may be able to take Tenecteplase, a blood clot-busting agent that experts say could become the gold standard for stroke care.

On the flip side, for each minute a stroke goes untreated, the brain loses around 2 million cells it cannot recover. Strokes can also have life-altering consequences like vision, walking and swallowing difficulties. They can take years off your life and put you at risk of another stroke.

Learn more about stroke care on the OSF HealthCare website.

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My own car or an ambulance?

Sure, for minor cuts and bruises that require a trip to urgent care, the former may be appropriate.

But for things like heart attack symptoms, stroke symptoms or serious wounds, Kurt Bloomstrand, MD, says the choice is clear: call the ambulance.

Dr. Bloomstrand is an Emergency Department physician at OSF HealthCare and medical director for East Central Illinois EMS (emergency medical services). He and his colleagues have seen an alarming trend lately of people with suspected heart attack coming to the Emergency Department on their own.

“Ambulances and pre-hospital providers are equipped and trained to deal with these emergencies. We can deal with these emergencies at your home or wherever you called 9-1-1 at,” Dr. Bloomstrand says. “We’re bringing the equipment from the ED to you so we can get that treatment started even sooner and bring you life-saving treatment and medication immediately.”

For example, pre-hospital providers on site or in the back of the ambulance can perform an electrocardiogram (ECG or EKG for short), which takes a snapshot of how your heart is working. If problems are found, these providers can call ahead to the hospital and have the person bypass the ED and go directly to the cardiac catheterization laboratory. That’s a time-saving and life-saving step.

On the alternative: “If you drive yourself, there’s no way to monitor you. There’s no way to treat you if something happens,” Dr. Bloomstrand says.

Other possible pitfalls: you may pass out at the wheel from your initial medical event, causing a crash that endangers you, other drivers and pedestrians. If someone is driving you, they will likely be anxious and not drive carefully. That, too, could mean a wreck.

Private vehicles are legally not allowed to speed and go through stoplights and stop signs. An ambulance can safely, saving time.

And it may seem trivial, but if you are driving to the hospital with a serious wound, you will likely make a bloody mess all over your vehicle.

Dr. Bloomstrand has also heard plenty of misconceptions about taking an ambulance.

People who live in a rural area may think, “By the time the ambulance gets to me, I may be worse off, and I could have already been at the hospital if I took myself.”

Dr. Bloomstrand counters that although it might take time for the ambulance to arrive, this time is often faster than the time it would take to get treatment by driving to the Emergency Department.

Others may believe they can’t afford an ambulance. Dr. Bloomstrand says most major health insurance providers cover the care.

Some may think, “I’m not sick enough for an ambulance.”

“It’s your emergency. We’re there 24/7 to help and assist in your emergency,” Dr. Bloomstrand says. “If you feel like you’re having an emergency, you need to call 9-1-1. We can come and evaluate you. Please don’t feel like you’re burdening the ambulance system.”

Others may just fear an ambulance in general. They’re nervous about having a needle in their arm while in a fast-moving vehicle. Dr. Bloomstrand counters by reminding you that paramedics and emergency medical technicians (EMTs) are highly skilled and trained. They have been around the block – literally.

“We deal with this day in and day out. We’re trained and equipped to handle these emergencies,” Dr. Bloomstrand says.

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Model and media personality Hailey Bieber recently revealed that she has been suffering from post-traumatic stress disorder (PTSD) stemming from a stroke in 2022.

“It was so terrifying, so jarring, so discombobulating in every single way that you could imagine,” Bieber told Vogue.

PTSD is often associated with veterans, but it can affect anyone, says Ari Lakritz, PsyD, a clinical psychologist at OSF HealthCare. It describes the development of symptoms following a traumatic event, either through firsthand or secondhand exposure. Secondhand exposure is usually not as simple as, for example, watching news coverage of a violent crime. A more appropriate example, Dr. Lakritz says, is a police officer who routinely investigates those crimes.

Dr. Lakritz describes what may trigger the beginning of a PTSD diagnosis: “Memories of the event. Dreams or flashbacks. Avoidance of stimuli associated with the trauma.”

Those symptoms then change the person’s moods and level of arousal, Dr. Lakritz says. They may feel guilty or unworthy. They are easily startled, irritable and have trouble concentrating. For example, a sexual assault survivor smelling their attacker’s cologne or deodorant may make the person feel anxious or withdrawn.

“This particular set of symptoms can often very much look like depression,” Dr. Lakritz says.

PTSD symptoms can arise right after the traumatic event, or they can appear months later.

Treatment will vary widely depending on the person’s needs, Dr. Lakritz says. Two evidenced-based methods he sees a lot are cognitive processing therapy and prolonged exposure therapy.

Cognitive processing therapy has people challenge or modify their beliefs about the trauma.

“Try to reframe [the beliefs]. Try to make a different end to the story,” Dr. Lakritz explains. “Try to change their thoughts about what happened and about their future and their ability to recover.”

Prolonged exposure therapy “teaches people to gradually approach the trauma in increasingly closer ways,” Dr. Lakritz says. For example, a shooting victim may come to a counseling session and be shown a picture of a gun. Then at a session days or weeks later, they hear the sound of a gunshot. The stimuli increase in intensity as the person learns there is very little to fear now.

Medicine and treatments outside a doctor’s office, like spending time with animals or picking up a new hobby, are also options. The first step, though, is to make an appointment with a mental health provider.

And when it comes to people like Hailey Bieber talking about mental health, Dr. Lakritz says it’s good because celebrities have great influence. But there’s a caveat.

“The more useful part is when they talk about the help they got,” Dr. Lakritz says.

Learn more about PTSD and mental health care on the OSF HealthCare website.

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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.

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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.

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We have all heard the warnings when it comes to stroke: time lost is brain lost. Every minute a stroke goes untreated, the brain loses nearly two million brain cells it can never recover, and every hour of stroke is equivalent to losing over three and a half years’ worth of brain cells. 

While acting quickly during a stoke event is imperative, there are some medical advances that can help prevent a stroke from occurring in the first place especially in those with carotid artery disease.

Carotid artery disease occurs when fatty deposits, or plaques, clog the blood vessels that deliver blood to the brain and head (carotid arteries). These blockages dramatically increase the risk of stroke.

“It can lead to lightheadedness, or feelings of dizziness, or losing consciousness sometimes, but most importantly stroke,” says Dr. Sourabh Lahoti.

Dr. Lahoti is an interventional neurologist at the OSF Illinois Neurological Institute (OSF INI) in Peoria, Illinois. He says a procedure called carotid artery stenting has proven to alleviate the risk for patients with carotid artery disease.

During carotid artery stenting a small catheter is threaded through a blood vessel, eventually reaching the carotid artery. A balloon is inflated to dilate the narrowed segment of the artery and then a wire mesh stent is placed across the blockage. The stent will become a part of the artery wall as a part of the natural healing process, eventually strengthening it, widening it, and helping to prevent future blockages.

Carotid artery stenting is typically done by running the catheter through the femoral artery – a main artery in the groin. It is generally a successful procedure, but because the femoral artery is so large it takes time to close. Patients need to lie flat and still for hours post-procedure and are limited in activity in the days following to prevent complications. Unsuccessful closure can lead to serious bleeding issues.

Dr. Lahoti is the first surgeon in central Illinois to offer carotid artery stenting via the radial artery: something he calls a game changer.

“It is very exciting. And I'm glad to be in a time where the field of neuro interventional surgery is going through this phenomenal, and honestly revolutionary change, because it has completely changed the way we approach cerebrovascular diseases and the way we treat them,” says Dr. Lahoti.

With the minimally invasive radial approach, a small poke is made in a patient’s hand to gain access to the radial artery. The catheter is inserted, and a carotid artery stent is placed in the neck. According to Dr. Lahoti, the radial approach reduces the complications of bleeding, severe bruising and pain. 

“The biggest advantage is that after we are done, we don't have to stitch anything,” explains Dr. Lahoti. “We don't have to put in any device, and the artery in the wrist is much smaller than the one in the leg. And it's very easily accessible. So all we do is put a band across the wrist to save it from bleeding, and the band stays for a couple of hours, and then we are done.”

Carotid artery stenting via the radial artery requires no anesthesia, and the patient is able to get up and walk around following the procedure with no restrictions, other than lifting heavy weight with that arm for a few days.

Conversely, patients who receive a stent through the femoral artery are required to remain in bed for four to six hours after the procedure.

“As soon as we're done, patients can get up. They can walk. They can move around as if they didn't have any procedure at all.”

Not all patients qualify for carotid artery stenting – either through the radial artery or the groin – and some may be recommended for drug therapy or even a carotid endarterectomy, where a surgeon makes an incision on the side of the neck and surgically removes the plaque inside the artery.

Dr. Lahoti says each case is evaluated on an individual level, and the most important thing is getting the blockage addressed and reducing the risk for stroke.

Many people suffering from carotid artery disease don’t know they are affected. Dr. Lahoti suggests keeping up with yearly physicals with your primary care physician, and having open and honest conversations about lifestyle choices like smoking status, diet and activity levels.

For more information on carotid artery disease, its symptoms and treatments visit osfhealthcare.org.

Interview Clip - Dr. Sourabh Lahoti

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.

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