With the objective to accelerate cancer detection and care for residents in the greater West Central Illinois region, OSF St. Mary Medical Center (Galesburg) now has access to leading-edge technology, allowing medical providers to scan a person’s lungs and get a biopsy on the same day.

On Thursday, February 5, board-certified pulmonologist Usman A. Cheema, MD, OSF Medical Group (Galesburg), performed a bronchoscopy utilizing the hospital’s new Intuitive ION robotic system, a minimally invasive way to biopsy a patient’s lungs and get answers more efficiently.

"Robotic bronchoscopy has become the way of the future in terms of lung nodule diagnosis. It allows us to biopsy very small nodules (dense areas of tissue, or spots)," says Matthew Sehring, DO, managing medical director, OSF Medical Group, Galesburg. "We can biopsy lung nodules that were not able to be biopsied previously because they were too small. It also allows us to biopsy nodules that are far out on the edge of the lungs that were difficult to reach before.”

The goal of the Ion technology is primarily to diagnose lung cancer early. However, it also gives patients with non-cancerous lung nodules peace of mind.

"We are hoping to diagnose lung cancer while it is very small, at a very early stage, and provide patients with the opportunity for either surgical or radiation cure of their cancer. That's our number one goal," Dr. Sehring says. “So, for our patients who do have lung nodules, we want to provide them with a diagnosis, whether it is cancer or something else.”

If a person has a history of smoking or a family history of lung cancer, Dr. Sehring says it’s important to get screened. Screening remains the greatest tool to catch lung cancer early. Some nodules used to be biopsied using a needle from outside the body. The robotic bronchoscopy allows the team to biopsy from the inside in a safer way, preventing possible complications. When a lung nodule is diagnosed at an earlier stage, it is much more likely to allow for curative treatment.

"A lung cancer screening is very simple. It's a low-dose CAT scan of the lungs. Most lung cancer screenings are covered by insurance. It's a two-minute scan," Dr. Sehring says. "You get scheduled for a CAT scan. You come in and there's no contrast or IV required. You come in, get your CAT scan, and it's usually read within 24 hours."

If cancerous nodules are found in the patient's lungs, they will be referred to our multidisciplinary lung cancer team for further evaluation and treatment. This includes a surgeon who decides if the lung nodule can be surgically removed. There is also a medical oncologist who can advise if chemotherapy or immunotherapy is needed. Lastly, a radiation oncologist is part of the team and can provide radiation treatment if necessary.

The addition of robotic bronchoscopy is the second instance in the last six months that OSF St. Mary Medical Center has acquired leading-edge technology to enhance its minimally invasive robotic surgery services. In August 2025, the da Vinci 5 surgical system was added, expanding access to minimally invasive, robotic-assisted surgery in the greater Galesburg area.

“Robotic surgical technology can improve safety and outcomes during complex surgery. Combining the best technologies with personalized treatment and care for our patients reinforces our Mission of serving with the greatest care and love,” says Rachel Stomberg, MSM, vice president, Operations and Special Projects. “Only at OSF can residents of Galesburg and the greater West Central Illinois region have access to the expertise of our Mission Partners and Physicians in finding the health care they need right here close to home.”

To learn more about the health care ministry at OSF St. Mary Medical Center, visit www.osfstmary.org.

Rafael Marquez, MD, a minimally invasive gynecologic surgeon with OSF HealthCare and assistant professor of clinical obstetrics and gynecology at the University of Illinois College of Medicine Peoria (UICOMP), performs a range of procedures designed to help women heal faster and return to their normal routines.

“Some of the procedures I perform at OSF include minimally invasive hysterectomies, excision of endometriosis, ovarian cystectomies, operative hysteroscopy as well as repair of pelvic organ prolapse,” Dr. Marquez says.

What “minimally invasive” means

Minimally invasive surgery is the ability to perform operative procedures using small incisions, Dr. Marquez says.

 “What that means for patients, is they can expect to go home on the same day as their surgery. Benefits of minimally invasive surgery include improved post-operative pain, faster return to normal activities and normal recovery times,” he adds.

Common conditions Dr. Marquez treats

The most common conditions Dr. Marquez treats include endometriosis, uterine fibroids and pelvic organ prolapse (POP).

“Endometriosis affects about 10% of reproductive-aged women. Uterine fibroids are very common. By menopause, you can expect about 70-80% of women will have been diagnosed with a uterine fibroid,” Dr. Marquez says. “Although only 30-50% of those patients have symptoms due to fibroids.”

Systematic pelvic organ prolapse (POP) occurs in roughly 3-6% of women, though examinations show up to 50% may have some degree of prolapse, even without symptoms.

While these conditions are not life-threatening, Dr. Marquez says they can significantly affect quality of life. “Providing these minimally invasive procedures can help change lives for the better,” he says.

When to talk to your OB/GYN

Unending pain and heavy bleeding are two symptoms that deserve attention. Dr. Marquez stresses the importance of open communication between patients and their OB/GYN.

“These are things your OB/GYN should be in constant communication and evaluation on to discuss if something like endometriosis or uterine fibroids are going on,” he adds.

Endometriosis and uterine fibroids mainly affect women of reproductive age (ages 15-49), while pelvic organ prolapse becomes more common with age, though it can still affect younger women.

Prevention and treatment

Maintaining a healthy weight, prioritizing regular exercise, avoiding chronic constipation and straining and not drinking alcohol or smoking can help lower the risk of pelvic organ prolapse.

As part of a patient’s continuum of care at OSF HealthCare, some of the conditions Dr. Marquez treats could also be treated using pelvic floor therapy, a therapy that focuses on the three layers of muscle supporting the pelvic organs against gravity. OSF has specially trained pelvic rehabilitation specialists who can help patients through this process.

OSF HealthCare offers comprehensive treatment options for a wide range of gynecologic conditions, including:

• Endometriosis refractory to medical therapy (Stage I-IV)
• Interstitial cystitis / painful bladder syndrome
• Chronic pelvic pain
• Uterine fibroids
• Intra-uterine abnormalities
• Abnormal uterine bleeding
• Ovarian and fallopian tube surgery
• Pelvic organ prolapse (POP)
• Urinary incontinence

Learn more or schedule a consultation

Patients interested in learning more or seeking a surgical consultation with Dr. Marquez can call 309-308-3300.

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• YES: moles, blisters, bumps, acne, boils, peeling skin from a sunburn, rashes, poison ivy or similar skin reactions, warts, skin tags and bug bites
   
• YES, BUT: Dr. Kumar says freckles and birthmarks are lesions, but they are not harmful.

In other words: “A skin lesion is any type of abnormal growth. It can happen anywhere on the body. If it doesn’t look like normal skin, it’s considered a growth,” Dr. Kumar says.

Causes for each of these lesions vary. We know acne is due to bacteria, and warts are from a virus, for example. Medications, lifestyle choices (like eating certain food that doesn’t agree with you) and medical conditions (such as diabetes and liver failure) are other culprits. But when the cause is unexplained, health care providers might need to investigate.

“We look at the lesion. The majority of the time, we can tell if something is benign or malignant. If we have questions, we err on the side of caution and do a biopsy,” Dr. Kumar explains. That involves cutting out part of the lesion and sending it off to a lab for analysis. “Biopsies can be done in the office. If it’s a bigger procedure, we have to go to the operating room.”

If the biopsy confirms evidence of a problem, such as cancer, the doctor will remove the rest of the bad tissue. Or, Dr. Kumar says some people come to him with a cosmetic or practical reason. They have a large birthmark or cyst on their face, are self-conscious about their appearance and would like it removed, for example. Or, they wear a hard hat for work, and the hat rubs against a lesion on their forehead, causing discomfort.

Dr. Kumar outlines how he would remove a lesion: “Let’s say it’s on your arm. We clean up the arm. We inject some lidocaine, which is a numbing agent. Then with a knife or other instrument, I’m able to cut it all out. Depending on how deep it is and the size of the lesion, we can glue it back together or put stitches in.” Regardless of the method, Dr. Kumar says most of these procedures are routine for providers with minimal aftereffects for the patient. In complex cases, like if the lesion goes down into a muscle, a plastic surgeon might be consulted.

Prevention

We can’t control if we have things like freckles or moles. But there are plenty of things you can do to help prevent problematic lesions.

• Limit your exposure to ultraviolet rays from the sun or by tanning. In fact, Dr. Kumar would not recommend tanning at all. For outdoor activities, use waterproof sunscreen of 50 sun protection factor (SPF) or higher, and reapply every few hours. Wear long sleeves and a wide brimmed hat.
   
• Wear bug spray when doing outdoor activities, such as hiking, where insects are present.
   
• Wash your body regularly.
  
  “Don’t overclean,” Dr. Kumar warns. “If you scratch your skin, that allows bacteria and other things to get into your skin and cause infections.”
   
• Don’t smoke. Dr. Kumar says smoking changes your skin for the worse, such as developing wrinkles and lesions.
   
• Find the right skincare products. If you use a lotion and it causes a rash, for example, don’t use that product again. Dr. Kumar adds that Vaselines and petroleum jellies are good for moisturizing your skin. But they’re thick and can clog pores.
  
  “Keep it simple. The $100 face cream is going to work the same as the $10 one,” Dr. Kumar says.
   
• Know the ABCDEs of suspicious moles.

o    A is for asymmetry. One half of the spot is not like the other half.

o    B is for border. The mole has an irregular, scalloped or poorly defined border.

o    C is for color. The spot has varying colors, like tan, brown, black, white, red or blue.

o    D is for diameter. Dermatologists say melanoma skin cancers are usually greater than six millimeters, or about the width of a pencil eraser. But they can be smaller, so don’t consider diameter alone.

o    E is for evolving. The mole looks different from the rest or is changing in size, shape or color. Dr. Kumar says you can take pictures to show your provider how the mole has changed.

                           If your lesion has any of the ABCDE red flags or you just have a concern, see a provider.

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Scientists are constantly learning more about cancer – what causes it, how it impacts our body and how to treat or cure it. One study has looked at a possible link between frequent drinking of hot beverages and an increased risk of esophageal cancer.

So should coffee drinkers worry? Not drastically, but you should always be mindful of what you put in your body, says Edie Krueger, MD, [pronounced EE-dee // KREE-ger] a radiation oncologist at OSF HealthCare.

“The science behind it is that there’s thermal injury to the lining of the esophagus, or the tube that connects the mouth to the stomach. The thermal injury causes the cells to become aberrant [not normal, in other words] and grow on their own without any checkpoints. That’s basically what cancer is,” Dr. Krueger says.

So what should people do? Dr. Krueger says if you’re a morning coffee or tea person, that’s fine. But if you drink scalding hot beverages multiple times a day, consider changing habits. Let the drink cool off before taking a swig. The study mentions 65 degrees Celsius (149 degrees Fahrenheit) as a danger zone. That’s about the temperature when you get coffee right out of the pot, Dr. Krueger says. Also, swap the afternoon hot coffee or tea with another drink.

“Things in moderation are fine,” Dr. Krueger says.

Why it’s important

Esophageal cancer is not the most common in America (around 20,000 cases per year, Dr. Krueger says). But she says it’s a “tough cancer to treat,” underscoring the need to know about it and get treatment sooner rather than later.

She says there are two types of esophageal cancer. The most prevalent in America is adenocarcinoma. The other type, squamous cell carcinoma, is the one with a possible link to hot drinks.

“The symptoms, in general, are things like reflux or trouble swallowing - especially trouble swallowing things like bread or tough foods like steak or chicken. Just really hard to get food down,” Dr. Krueger explains.

“Usually, esophageal cancer is treated with what we call trimodality therapy. That’s surgery, chemotherapy and radiation,” she adds.

Avoiding alcohol, smoking and obesity are ways to help prevent esophageal cancer.

Learn more

Read more about cancer care on the OSF HealthCare website. Cancer care at OSF includes the OSF Cancer Institute in Peoria, Illinois.

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• Lordosis: This refers to the normal, c-shaped curvature of the lower back.
   
• Kyphosis: This is the normal curvature of the upper back.
  
  In each case, the term itself doesn’t indicate a deformity. But the curvature can become abnormal, prompting a spine physician to take a look and possibly recommend lifestyle changes.

Bonafide spine disorders include:

• Scoliosis: This curvature of the spine brings back pain “from muscles having to compensate to hold the spine and body in the right position,” Dr. Syed says. Sometimes, nerves get pinched, leading to chest, abdomen or leg pain. Severe cases could bring paralysis. Or, a lung could get pinched, leading to impaired breathing. This is called thoracic insufficiency syndrome.
  
  Genetics, nutrition, muscle imbalance and lifestyle can all contribute to getting scoliosis. Your spine can also naturally worsen with age.
  
  “The discs start to thin. The spine starts to tilt. That puts more strain on the joints. They tend to overgrow, twist and change in size. That creates a domino effect. You get this spine that’s really twisted,” Dr. Syed explains.
  
  Dr. Syed adds that most scoliosis cases can be addressed without surgery. The person can change their lifestyle, notably getting on an exercise plan that strengthens the muscles that support the spine. In severe cases, a surgeon would put screws, rods or plates into your spine or make cuts in the bones.
  
  “It pulls the spine into the correct space, frees up the nerves from the pressure on them and gets the spine to heal in that position,” Dr. Syed says.

• Ankylosing spondylitis (AS): Dr. Syed says this is an inflammatory condition in various joints due to the body’s immune system not working properly.
  
  “Normally, your spine is made up of a bunch of repeating segments. They move relative to each other. That’s how you bend and twist,” Dr. Syed says. “In AS, the joints start to become solid bone because of inflammation. That leads to very stiff, brittle painful bones. People are predisposed to fractures with minor falls. Those people we typically see, unfortunately, in trauma settings. They have brittle, stiff spine that doesn’t have any bend or give. They have a fall, and the spine breaks.”
  
  Dr. Syed says a rheumatologist could put an AS patient on an immune-modifying medicine to prevent inflammation.

Prevention

Keeping a healthy spine comes down to “fundamental good behavior,” Dr. Syed says.

• Avoid activities that could injure the spine. That could be everyday things like heavy lifting or career choices like a contact sport.
   
• Maintain a healthy weight through a healthy diet and active lifestyle.
  
  “You don’t want to be too skinny or too big,” Dr. Syed suggests. “That puts either too much strain [when you’re overweight] or not enough muscle to support the spine [when you’re underweight].
  
  “It’s like Goldilocks,” Dr. Syed adds, referring to the “not too hot, not too cold” fairytale. “You want to work out but not too intensely that you’re crossing over into injury.”
  
  Walks or light jogs could be the things for you, he says.
   
• Avoid smoking.

Learn more

The OSF HealthCare website has information on orthopedic health. The OSF Illinois Neurological Institute also provides comprehensive care.

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Though not one of the most common cancers, Marcie Lindstrom, APRN, says she’s seen liver cancer cases rise in recent years in line with national trends. Luckily, the gastroenterology provider at OSF HealthCare says treatment has evolved, too. And it’s another reminder to know your body and see your health care provider regularly because liver cancer is more treatable when caught early.

The liver: A recap

A primer on what the liver does for us: Lindstrom says the liver sits underneath the right ribcage and cleans toxins from our blood, helps digestion and produces proteins needed to live. In other words, it’s not an organ you can live without like a gallbladder or one kidney.

Liver cancer: Hidden and harmful

Lindstrom says primary liver cancer describes when the cancer starts there, and secondary liver cancer is when it spreads there (medical term: metastasizes), most commonly from the lungs, breasts or colon. Secondary is more common than primary.

“There are multiple causes of liver cancer. A person is at a higher risk if they have a damaged liver,” Lindstrom says. “Things that can cause a damaged liver include alcohol. So heavy alcohol use [is a risk]. Viruses that can infect the liver such as hepatitis B and C [are risks]. And we’re seeing an increasing number of people having fatty liver disease. That puts people at risk for liver damage. That damage can progress to cirrhosis [scarring], and cirrhosis puts you at a higher risk.”

These liver issues can be fatal if untreated. And unfortunately, Lindstrom says liver cancer often comes with no symptoms.

Diagnosis and treatment

That’s where regular visits to your primary care provider, and if needed, a specialist like a gastroenterologist or oncologist come in.

Lindstrom says your provider will go over your risk factors: do you have a family history of liver issues? What’s your own health history, specifically with hepatitis? How often do you drink alcohol? What’s your daily diet and exercise routine?

“If we determine somebody has a lot of scarring of the liver, they should be on regular surveillance looking for liver cancer,” Lindstrom urges. “Every six months, they should get some imaging and possibly a blood test that helps to detect cancer.” The person could also have a biopsy of their liver, where a provider will take a sample of liver tissue and send it to a laboratory to find out exactly what’s wrong.

Chemotherapy, radiation therapy, immunotherapy and liver transplant surgery are possible treatments.

“A liver transplant could be required if the tumor isn’t very large, but there’s a lot of damage or scarring of the liver,” Lindstrom explains.

Prevention

Lindstrom says if it’s caught early, liver cancer can be treated and even cured. Some things to keep in mind to avoid the disease:

• Eat a healthy diet, avoiding things like processed food, high sugar food and high fat food that can lead to liver issues.
   
• Get moving to avoid things like obesity, diabetes and high cholesterol. The American Heart Association says to aim for 150 minutes of exercise per week spread out over several days.
   
• If you do develop chronic conditions like diabetes, see your provider regularly to stay on top of managing the issue.
   
• Know your family history of liver and other health issues.
   
• Limit alcohol or avoid it altogether.
   
• There’s no vaccine for hepatitis C, but there is treatment. There is a vaccine for hepatitis B. The United States Centers for Disease Control and Prevention says the shots are safe, effective and have a schedule. Talk to a provider to see if you’re on schedule or if you need a shot now, for example if you’re at high risk.
   
• Take other steps to avoid hepatitis: practice safe sexual relations, avoid blood-to-blood contact with others and don’t share or reuse needles.
  
  “You have a history of blood transfusions prior to 1992. You got a tattoo or piercing in a less than sanitary situation,” Lindstrom lists as other hepatitis risk factors. “I’d recommend getting screened. In fact, it’s a current recommendation to be screened for hepatitis C at least once in adulthood.”
  
  Lindstrom says providers list 1992 as a hepatitis C benchmark because that’s when blood screenings were developed.

Learn more

Read more about how to keep your digestive system healthy on the OSF HealthCare website. Cancer care at OSF HealthCare also includes the OSF HealthCare Cancer Institute in Peoria, Illinois, which provides comprehensive care for the region.

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When watching a basketball game on television, you may hear coaches and announcers say the star player is missing time with a hernia.

A sports hernia is different than a hernia suffered in everyday life, says Raman Kumar, MD, a colorectal surgeon and general surgeon at OSF HealthCare. But each should be taken seriously.

Hernia

Dr. Kumar says a hernia is when an internal organ or piece of fat goes through a hole in the abdominal wall. The most common type – around 80%  – is an inguinal hernia, when a part of the intestine pushes through the abdominal wall in the lower belly (also called the groin). Anyone can get a hernia, even newborns. But Dr. Kumar says they are seen more in older men. Symptoms include a bulge or swelling in the abdominal area and pain when moving.

“A lot of chronic heavy lifting,” can cause hernias, Dr. Kumar says. “Other things weaken the abdominal wall such as diabetes and smoking. Being obese causes a lot of weight hanging down on the abdominal wall. If you’ve had surgery in the past, that’s also a risk factor.”

So be mindful when lifting objects, Dr. Kumar advises. Lift with your knees, not your back, and don’t try to lift heavy items. Get a cart or a partner to help. Eat healthy and exercise to avoid obesity and diabetes. Avoid alcohol and cigarettes.

Dr. Kumar says an exterior wrap known as a hernia belt or abdominal binder can be a short-term solution. But surgery is often the endgame.

“If you have a hole or defect, it needs to be closed,” Dr. Kumar says. “The reason we fix hernias is because we don’t want a loop of intestine or bowel to get into the hernia, twist off and die.”

That would make a person very sick and possibly threaten their life, Dr. Kumar says.

Sports hernia

Dr. Kumar says a sports hernia is a muscle tear in the groin area. They’re seen in athletes due to all the twisting, turning and bending that comes with competition.

“Stretch before you do any type of activity. Work and develop your core muscles, including your abdominal and hip muscles.” Dr. Kumar says. “If the muscles are strong, they are less likely to tear.”

Athletes who complain of groin pain should immediately leave the competition and get checked out by a trainer or doctor. Resting and icing the groin will help, but a combination of medication, physical therapy or surgery will likely be needed to fully heal.

Be proactive

If you have symptoms of a hernia or sports hernia, see a health care provider right away.

“Nine times out of 10, we can determine you have a hernia just based on a physical exam,” Dr. Kumar says.

But for more complicated cases, your doctor may order an ultrasound or CT scan. Then, the provider will develop a treatment plan.

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Hernias: More common than you think

November, December and January bring bountiful holiday meals.

While it’s tempting to chow down, experts are cautioning about how overindulgence can make you feel mentally and physically crummy in the moment, plus open the door to long-term unhealthy eating habits.

Have the right mindset

Andrew Zasada, MD, provides emergency department care at OSF HealthCare. He says avoiding stuffing yourself starts before you sit down for the meal.

“If you come to the meal hungry, you tend to try to make up for not having breakfast. You load your plate up, which is going to cause you to overeat,” Dr. Zasada says. “Instead, have a light snack an hour or two before you sit down to the meal.

“Put the food in one room and sit down in another room to eat. That necessitates you going there rather than having food available for another fill.”

The meal itself

Enjoy holiday meals, Dr. Zasada says. It’s not a race.

Grab a smaller plate, and take smaller portions of each item. Pretend you’re filling the plate up for a child. You wouldn’t take five rolls and two big slabs of meat for a youngster, so don’t do it for your adult self.

Other tips: Chew slowly. Between bites, put your utensil down, take a drink of water and talk to someone. This allows your stomach to fill up and tell your brain that you’re full.

When you finish eating, leave the table, and go to another room. Staying next to the food increases the temptation to keep nibbling.

If you can’t help it

Dr. Zasada says despite our best efforts, sometimes you overeat during holiday meals. Maybe you don’t want to offend your aunt by not having a slice of her famous pie.

If that happens, Dr. Zasada says there are two pitfalls to avoid: Drinking alcohol and lying down right after the meal.

“That opens up the sphincters of your stomach, slows down digestion and increases the chance for heartburn,” Dr. Zasada says.

Try tea or coffee after a meal instead of alcohol. But if you must indulge in a spirit, Dr. Zasada says to wait at least 90 minutes so your stomach can partially empty.

Instead of lying down for that post-meal nap, sit upright, talk to people or play a game. If the weather is nice, go for a walk.

A word on more serious eating issues

Holiday meals may be difficult for people who suffer from eating disorders, such as binge eating (eating a lot in one sitting and feeling you can’t stop), anorexia nervosa (an unwarranted fear of being overweight which leads to things like starvation) or bulimia nervosa (taking unhealthy steps to avoid weight gain like purging your food).

Dr. Zasada says, in the moment, you should have someone you trust who can help you through the holiday meal and check in with you later. Long term, he says these are serious issues that should be talked about with a health care provider.

“Repeated bulimia will damage your teeth. It’s corrosive. You lose electrolytes when you vomit,” Dr. Zasada says. “You become sick. If you do this repeatedly, you will lose weight in an unhealthy way. You will possibly dehydrate. You will start losing muscle mass.

“It’s just not a good thing.”

Bottom line: Don’t get discouraged

Dr. Zasada says one day of extra eating may make you feel bad, but it isn’t going to derail your overall health.

“One day won’t make you fat,” he says.

Get back into your healthy eating habits the next day while enjoying those leftovers in moderation. If you feel you are struggling to maintain a healthy weight or body image, talk to your primary care provider. They may refer you to a specialist like a dietitian or mental health provider. From there, plans could include a diet and exercise regimen, medication or, in rare cases, weight loss surgery.

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Thoracic outlet syndrome is a group of disorders that occur when blood vessels or nerves between the neck and shoulder become compressed. The condition can cause pain in the shoulders and neck, as well as numbness in the fingers. While rare, affecting roughly 10 in every 100,000 people, the condition can have a significant impact on daily life and, in severe cases, cause serious complications.

Bringing advanced treatment to Central Illinois

Burhan Hassan, MD, a thoracic surgeon with OSF HealthCare, leads the new effort. Dr. Hassan has been with OSF for five years and performs more than 100 robotic-assisted lung procedures annually.

“We felt that this was an area where services weren't offered in the Central Illinois region,” Dr. Hassan says. “Our patients have had to travel far, sometimes as far as three or more hours, to go to nearby states and get it taken care of.”

Offering this complex procedure locally gives patients the option of receiving the same advanced level of care found in major metropolitan centers.

How surgery works

When surgery is recommended, rib resection (removing the first rib) is the first standard of care. The minimally invasive procedure removes abnormal bones or tissue causing compression in the thoracic outlet.

“Surgery involves removing the first rib, removing the scalene muscle and doing neurolysis. Which is removing the scar tissue along the brachial plexus,” Dr. Hassan says.

Dr. Hassan adds the surgery is safe, effective, and usually has quick recovery time.

“We do it robotically and it takes about an hour and 15 minutes,” he says. “It's an overnight stay for the time being, but we're planning to offer same-day discharges soon.”

Who is at risk?

Thoracic outlet syndrome affects a range of patients but is most common in people between the ages of 30 and 50. It can be either congenital (present at birth, often due to an extra rib) or occurs later in life.

“Weightlifters and baseball pitchers are at risk. Pitchers because you have to have strength in that arm. If you have an extra rib, you are prone to it. You will get TOS regardless. But for people who do a lot of exercises, you are at risk for it as well,” Dr. Hassan says. “One category, which is also big, is trauma. When patients get in accidents and their ribs are moved a bit north, it can cause compression, too.”

Common causes include repetitive motions from sports or jobs, trauma from car accidents, pregnancy, or anatomical differences like an extra rib. Sometimes, the cause is unknown.

Recognizing the symptoms

The symptoms of TOS depend on which structure is compressed (a nerve, vein, or artery). The three types of cases are:

• Neurogenic (about 95% of cases): Tingling or sharp pain, loss of sensation in the inner arm, or hypersensitivity.
• Venous (around 4% of cases): Swelling or engorged veins in the shoulder or arm.
• Arterial (about 1% of cases): Loss of pulse or a cold hand when turning the head or raising the arm.

Other signs include difficulty turning the neck, issues after shrugging shoulders, or passing out when looking to one side due to arterial compression. The last sign was the case for the first patient – a woman in her 70s – seen at OSF.

Physical therapy is typically the first line of treatment for thoracic outlet syndrome. If symptoms persist, Botox injections may be tried before surgery is considered.

For neurogenic patients, surgery is effective about half the time. For venous patients, surgery tends to be highly successful. Arterial cases may require a collaborative approach, combining rib resection with bypass surgery performed alongside vascular surgeons.

TOS care is multidisciplinary, often involving vascular surgery, neurology, physiatry, physical therapy, orthopedic surgery and pain management.

Designing care for the most complex cases

Currently, OSF HealthCare has seen its first TOS patient, with 10-12 additional cases planned in the future. Dr. Hassan anticipates performing 20-25 cases annually once the program is fully established.

While TOS is rare, first rib resection surgery is considered a growing technique, and procedures are expected to increase over time.

By expanding access to advanced robotic-assisted thoracic surgery, OSF HealthCare continues to position itself as a leader in innovation and patient-centered care, ensuring people in the region can receive expert treatment for the most complex cases right here in Peoria, and in surrounding areas.

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September is Prostate Cancer Awareness Month. It's a reminder that the disease is manageable when caught early.

Uwais Zaid, MD, a urologist who provides care at OSF HealthCare, is urging men to get screening appointments on their calendar at the right time. That’s critical, he says, because some people who develop prostate cancer will not show symptoms.

“It is something we certainly do take seriously in urology,” Dr. Zaid says.

What is the prostate?

The prostate is a male gland about the size and shape of a walnut. It surrounds the upper part of the urethra, or the tube that carries urine from the bladder. The prostate makes some of the fluid that’s part of semen.

Risk factors

Dr. Zaid says the risk for prostate cancer increases with age.

Other risks: “African American men are at a higher risk,” Dr. Zaid says. “Certain dietary things like too much red meat and greasy, fatty food. And certain type of exposures such as Agent Orange for some of our veterans.”

And like most other ailments, a family history of prostate cancer should put you on higher alert.

Screening: how and when

Dr. Zaid says prostate cancer screening involves two simple tests. One is a blood test that measures the amount of a hormone produced by your prostate called prostate-specific antigen (PSA). An abnormally high reading might warrant further examination by your health care provider.

The other test is a digital rectal exam, where your provider will feel for lumps on the prostate.

Don’t get that confused with a colonoscopy, the more invasive screening that looks for colon cancer, Dr. Zaid says.

“It doesn’t require any special or horrible bowel prep,” Dr. Zaid says of the prostate exam. “It’s about a 20 second thing we do in the clinic that can save your life.”

You should always see your health care provider anytime something seems off with your body. But the American Urological Association has guidelines for when to get a prostate cancer screening.

“For most men, we want them to start screening with an annual PSA [test] at age 54 to 69,” Dr. Zaid explains. “For certain men, you want to start earlier if you have a risk factor.”

After age 69, Dr. Zaid says you should talk to your primary care provider about what screenings are right for you.

What should you not do?

Don’t think this type of cancer is so common that you should just let it run its course. Dr. Zaid says there are aggressive types of prostate cancer that can be deadly.

Also, Dr. Zaid warns of herbal remedies for cancer in general. He says your best bet is to see a doctor.

Treatment

Dr. Zaid says treatment for prostate cancer depends, in part, on how much the cancer has spread.

If it’s contained to the prostate gland, he says radiation (sending radiation waves to destroy the cancer cells) or surgery to partially or fully remove the gland are options.

“If the prostate cancer has escaped the prostate gland, there are a lot of treatment options,” Dr. Zaid explains. “This is actually a very active area [in medicine] with all sorts of research and new medications.”

Hormone therapy may be an option here, the doctor says.

“It’s very manageable,” Dr. Zaid says on treatment of the disease.

Interview clips

Previous coverage

OSF HealthCare library: Prostate cancer

OSF HealthCare Newsroom: Urinary incontinence and the link to prostate cancer

“That’s going to change the way we do a lot of major urologic procedures. Instead of using multiple incisions, we use one or two incisions and get the job done that way,” says James Sylora, MD, urologist at OSF Little Company of Mary. “That should increase patient comfort and get them home earlier and back to work sooner.”

According to Dr. Sylora, the single-port robot will now be used for 90% of urologic procedures, such as surgeries to remove all (nephrectomy) or part of a kidney (partial nephrectomy). This is done primarily to treat kidney cancer. This can also be used for benign and reconstructive procedures.

The SP Robot allows the surgical team to access target organs in patients who have previously undergone surgery. Beforehand, scar tissue would have made it more difficult, Dr. Sylora says.

Most patients being treated with this technology have localized prostate cancer or small renal masses. In cases of renal cancer, the single-port robot helps preserve kidney function.

Thanks to this new approach, most patients can return home the same day as their procedure - a major improvement from previous procedures that required multiple days of hospital recovery. The need for pain medication has also dropped significantly.

“Several of the patients take a few Tylenol #3 or extra strength Tylenol as their post-operation pain medication. It’s quite remarkable,” Dr. Sylora says. “I wouldn’t have believed it until I started doing it. And sure enough, it’s true.”

The OSF Little Company of Mary team began using the single-port robot earlier this year and has already treated roughly a dozen patients with promising results.

“OSF has invested in having this new technology. They’re one of the only private hospitals across the country to have invested in this type of technology,” Dr. Sylora says. “They’re staying at the cutting-edge and we’re happy to provide this service.”

The Da Vinci SP system enables robotic-assisted surgery through a single incision, offering a streamlined and less invasive alternative for patients. Its specialized design, flexible instruments and enhanced vision support a new generation of surgical precision and recovery.

A pinched nerve can also be a culprit.

“The most common cause [of a pinched nerve] is arthritis. Over time, a disc [in your spine] dries out and starts to bulge. Arthritis builds up in the joints of the neck. That can start squeezing on the nerve,” Dr. Syed explains.

“Certain activities can increase the risk for all that,” he adds. “You do something that requires moving your neck a lot. You do a lot of strenuous work. That can cause things to happen a little bit faster. It can also happen if you’re sitting at a desk at an uncomfortable angle for prolonged periods.”

Pain from a pinched nerve can travel down your body and into your hand, for example.

Treatment

Regardless of the cause of your neck pain, Dr. Syed says a good physical therapy program – both in the doctor’s office and continued at home – can take care of many cases before surgery is discussed. He estimates only around 10% of his patients need surgery.

If it does get to surgery: “A lot depends on which nerves are pinched and where,” Dr. Syed says. “For some people, we go in from the back of the neck to free up the nerve. For some, we go in through the front of the neck. Some surgeries are fusion surgeries. Some are what we call motion sparing. Rather than taking the individual bones of the neck and turning them into one bone, we’re able to keep them free. That preserves [the person’s] motion.”

Prevention

Here's an alert to put in your phone for morning, midday and evening: stretch. Stretching often can keep your neck limber. Five to 10 repetitions of up/down and side to side motions can go a long way, Dr. Syed says.

Practicing good posture goes hand-in-hand with stretching. Sit up straight at your work desk, and take breaks to walk around. Dr. Syed says research is still in progress on how much a standing desk or sitting on a big bouncy ball helps. But he says if those decrease your pain, go for it.

“If you work at a very physically involved job, make sure you have good ergonomics [good workplace behaviors]. If something is a two-person lift, grab someone. Don’t try to lift heavy things by yourself,” Dr. Syed implores.

A diet high in protein, vitamins and calcium is another must-do. Calcium helps prevent osteoporosis, a condition that weakens bones and makes them more prone to breaking.

And lastly, manage chronic illnesses, and drop the cigarettes.

“We know from a lot of studies that smoking damages bone metabolism. It accelerates arthritis. It’s bad for blood supply and nerves,” Dr. Syed warns.

Learn more

Read more about how to keep your body in top shape on the OSF HealthCare website.

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The Peoria, Illinois-based hospital system has brought surgical oncologist Tamara Floyd, MD, to the care team at OSF HealthCare Saint Francis Medical Center in Peoria. Dr. Floyd performs cytoreductive and HIPEC (hyperthermic intraperitoneal chemotherapy) surgeries in Peoria, while also seeing patients in Bloomington and Galesburg.

HIPEC procedures are mostly for patients who have tumors or cancer spread in the abdominal cavity. 

Cancerous tumors are removed through cytoreductive surgery where the surgeon initially attempts to remove as much of the cancer as possible. Surgery is then followed by HIPEC, which is when a heated chemotherapy – at just over 106 degrees Fahrenheit – is administered into the abdomen. The heated chemo is then circulated around the area inside the abdomen to treat any remaining microscopic tumor cells.

HIPEC can be beneficial for several types of cancer patients. The one it benefits the most is LAMN, or low-grade appendiceal mucinous neoplasm. HIPEC is considered a standard of care for patients who have seen their cancer spread into the space in the abdomen that contains the abdominal organs.

These can be appendix, colorectal, and now more data indicates stomach cancer patients may benefit from HIPEC, Dr. Floyd says.

"Additionally with more data, pancreatic cancer is being looked at as well. Even patients with breast cancer. Another cancer that benefits from HIPEC is peritoneal mesothelioma." 

HIPEC can be a viable treatment option at any stage, Dr. Floyd says. But as some people are diagnosed with later stage disease, it can feel like no options are possible. HIPEC changes that.

"It's beneficial to have the option of doing HIPEC, or cytoreductive surgeries, for patients who have peritoneal spread of disease, which for most cancers means it is a stage 4 disease," Dr. Floyd says. "In a lot of instances, if you're talking about stage 4 disease, there aren't a lot of other options."

While HIPEC is a viable option for low-grade cancers, it's also a helpful option for later stage, more aggressive cancers. Patients with signet ring or goblet cell features, which are more aggressive subtypes, can also be treated with HIPEC. 

"Signet ring is one of the subtypes of appendiceal, colon or rectal that can be treated. There are even some subtypes of gastric or stomach cancer that are considered a signet ring or have signet ring features," Dr. Floyd says. "Cytoreductive and HIPEC can be considered for those patients."

Throughout a cancer journey, combining traditional chemotherapy that is administered through IV with HIPEC provides a "synergistic effect" Dr. Floyd says. HIPEC allows the chemotherapy to be administered directly to the cancer cells and kill them that way. 

Dr. Floyd has done one HIPEC at OSF Saint Francis so far and has another planned soon. It's anticipated that within the next year, Dr. Floyd and her team will start to do three to four HIPEC surgeries a month as OSF HealthCare Cancer Institute continues to grow as a destination center.

Patient recovery times can be one to two weeks in the hospital after HIPEC surgery, which is why having this option for Central Illinois patients is so important. It allows the patient and their families to stay close to home, instead of having to travel hours away. Dr. Floyd says the longer travel times can turn patients and their families away from pursuing care. 

Heated chemotherapy can also be used in thoracic cavities. This would then be called HITEC or HITOC, Heated IntraThoracic Chemotherapy. This is for patients who have disease spreading in the pulmonary area. 

Types of cancers that can be treated by HIPEC: 

-          LAMN (Low-grade appendiceal mucinous neoplasm)

-          Appendiceal

-          Colon

-          Rectal

-          Gastric

-          Stomach

-          Pancreatic

-          Breast

-          Mesothelioma

-          Ovarian

For more information on cancer treatment options at OSF, visit the OSF HealthCare Cancer Institute website.

Video Interview Clips

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

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

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

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

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

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

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

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

There is hope

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

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

Learn more

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

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Shiny new toys will be lying under many Christmas trees this season, sure to bring joy to kids around the world. 

But inside these things also lie dangerous pieces parents and others need to keep an eye on. 

Things such as batteries and magnets, both small and shiny, are potentially life-threatening objects. 

Tinsley Anderson, MD, a pediatric surgeon with OSF Children's Hospital of Illinois, calls small, round batteries “particularly problematic.” Saying they can easily get stuck in the esophagus and cause a burn injury. 

When a child swallows a battery like this, surgery is needed.

"In buying gifts for your kids, I'd look for toys that don't have parts that come apart. If they have a battery component, make sure it's screwed in," Dr. Anderson says. "That way you're not changing the battery, and in a year from now, your kid probably won't want the toy anyway." 

Dr. Anderson says mucus and moisture inside the body completes the battery's circuit, activating the battery and causing an alkaline burn. 

She says warning warning signs to look out for if your kid swallowed a battery, is if they're drooling, unable to swallow or eat, have belly pain, or if an item is missing and you think your child might have eaten it. 

It's crucial to head straight to the emergency room to be checked.

Video Version With Chyrons

Video Version Without Chyrons

Parental instincts and quick reaction time led to two central Illinois parents saving their child’s life.

It started at home when the parents noticed something was extremely wrong with their 2-year-old son. They performed CPR and resuscitated him. He was transported to OSF HealthCare Children’s Hospital of Illinois in Peoria where it was determined he had suffered sudden cardiac arrest and had a malignant heart condition known as Brugada syndrome.

What is Brugada syndrome?

Brugada syndrome is a rare genetic disorder that causes heart arrhythmias and sudden cardiac death.

“Most kids that go through that, unfortunately, don’t survive,” says Harma Turbendian, MD, a pediatric cardiac surgeon with OSF Children’s Hospital of Illinois. “So, this was fast-acting parents who knew what they were doing, then EMS, followed by our team here in the ICU.”

Meet the team

The medical team at OSF Children’s Hospital who treated the toddler was led by Sunita Ferns, MD, the director of Pediatric and Adult Congenital Electrophysiology, Mark Plunkett, MD, the chief of Pediatric and Congenital Heart Surgery, and Dr. Turbendian, who was the primary surgeon in the procedure.

OSF HealthCare surgical teams have been using a device known as the EV-ICD, or extravascular implantable cardioverter-defibrillator, made by Medtronic, since spring 2024. But the new technology had only ever been used on adults or much older teenagers. The purpose of the device is that if or when a malignant heart arrhythmia occurs in the person, it will shock the heart back into rhythm.

By analyzing the 2-year-old’s response to a trial of antiarrhythmic medications in the ICU and incorporating insights from his preliminary genetic results, Dr. Ferns made the diagnosis of Brugada syndrome and brought together a team of specialists.

“We needed buy-in to trial a new device for the first time ever in a patient his size from the surgeons and good technical support. Medtronic was excellent. We called our field engineers and had a whole team here,” Dr. Ferns says.

Time to start the procedure

Sudden cardiac arrest is quite rare in kids, only happening in approximately one out of 100,000 children each year. However, the survival rate after one of these events is very low as well, with only 5% of pediatric patients surviving an out-of-hospital cardiac arrest.

Dr. Turbendian explains how the device is inserted.

"They're fairly small incisions that are required for implantation of the device. You actually don't have to access the heart in order to place this thing," Dr. Turbendian says. "You can make a small incision under the breastbone and one part of the device just slides through that small incision to sit under the sternum."

The possibility of implanting an EV-ICD takes away the need for open heart surgery to select patients.

Traditionally, a transvenous pacemaker has been used for older kids and adults. It was determined by Dr. Ferns and her team that the transvenous device was too large for the 2-year-old patient, and the EV-ICD was the better option. The EV-ICD incisions are much smaller, making this the more minimally invasive option.

"The lead was inserted, and the device was implanted outside of his rib cage," Dr. Ferns says. "Given that a 2-year-old is going to grow leaps and bounds over the next decade or two, it's an excellent choice for him. When we tried this, it was the first time in the world that someone trialed it on someone this small.”

Dr. Plunkett calls the device a game changer. One that will send shock waves across the globe in the world of medicine.

“Children in the past had to undergo much larger procedures, oftentimes a sternotomy or thoracotomy. The devices were often bigger, and we were sewing patches on the heart or implanting coils," Dr. Plunkett says. "And some of those devices were not as effective as this new technology." 

History-making procedure

"It’s the first of its kind. This implantation is the smallest and youngest child ever to have this device," Dr. Plunkett says. "So that has expanded its application and market in a huge way. Its design initially was for adults or adult-sized patients. The fact we've proven it to be effective and safely implantable in a child this size really expands its application immensely."

Dr. Ferns agrees, hoping the team’s work will get published soon, which helps medical centers across the world learn when and how to perform this procedure.

"It tells the world that we can now use (the EV-ICD) in a smaller child. That's how a lot of pediatric implants or newer technologies happen. It's one or two centers that do it and they publish their results," Dr. Ferns says. "We expect that to be published shortly. There are kids all around the world who sustain cardiac arrests, and they now have this option." 

EV-ICDs are just a “safety net”

“We don't want it to keep shocking a child, because that's no way to grow up. To keep worrying about when your next shock is going to happen," Dr. Ferns says. "So, we monitor these devices constantly. If we see any arrhythmias in the background, despite the medication he's on, we are able to offer him other technologies. Ablative technologies can help modify the substrate, which is the tissue that's responsible for the bad rhythm.” 

Dr. Ferns is in charge of the child’s post-surgery care moving forward. She says Quinidine, a drug that was initially made to treat malaria and now treats irregular heart arrhythmias, was the perfect match for the patient’s condition.

“He has responded exceptionally well to this treatment,” Dr. Ferns adds.

This decision was made after the child’s EV-ICD did its job and went off while at home. His parents had to bring him back to the team at OSF HealthCare, who then had to ensure everything was meshing correctly.

While Dr. Ferns says the patient will forever be “married” to cardiology, she’s confident in the techniques and technology the Electrophysiology (EP) Lab at OSF HealthCare Saint Francis Medical Center has to treat these patients. The EP Lab manages arrhythmias from unborn fetuses all the way to patients in their 70s with complex congenital heart disease. Technology like contact force sensing and high-density mapping are available, along with many other resources.

If the patient’s symptoms were to worsen as time goes on, Dr. Ferns and her team in the EP Lab have the ability to perform ablations which target any abnormal heart tissue causing the arrhythmia, suppressing the abnormal electrical focus.

The generator of the device is in the axillary region, or the armpit. So as the child gets older and bigger, the strain sometimes found on conventional epicardial leads as a child gets taller is eliminated. The battery of the ICD should last 10-12 years.

Saving the patient’s life started at home

All three doctors say they can’t overemphasize the importance of the parents’ actions at home.

“When we look at the magnitude of this, first we have to go back to the fact this child survived an arrest at home, was successfully resuscitated, was neurologically intact and presented to our hospital," Dr. Plunkett says. 

This leads Dr. Ferns to say learning CPR is one of the most important things someone can do. Especially as kids enter middle and high school age and are involved with high intensity sports.

Another benefit of an EV-ICD is that if/when a patient experiences an arrhythmia, it will notify the congenital heart team in the EP Device Clinic.

"Most arrhythmia syndromes tend to happen at higher levels of activity. Many abnormalities can be detected by a simple noninvasive test such as an electrocardiogram (ECG)," Dr. Ferns says. "Universal screening is not yet common in the United States, but it is a part of the health care system in many European countries." 

Strong family history is a sign to get checked out

Strong family history of sudden cardiac arrest or heart disease is a sign to get seen by a cardiologist. Dr. Ferns recommends starting off with an ECG which she advises doing before kids participate in high intensity athletics. 

To learn more about the Electrophysiology Lab at OSF Saint Francis Medical Center, visit the OSF HealthCare website.

Dr. Sunita Ferns Video Interview Clips

Dr. Mark Plunkett Video Interview Clips

Dr. Harma Turbendian Video Interview Clips

We’re in a time right now that Jason Bill, MD, an interventional gastroenterologist with OSF HealthCare calls an “obesity epidemic.”

Data from the Centers for Disease Control & Prevention (CDC) would back up that claim, stating that more than 100 million adults in the U.S. are obese. The prevalence of obesity increased over 11% when comparing statistics gathered from 1999-2000 to statistics from 2017-March 2020. In the earlier timeframe, obesity prevalence was 30.5%. The latest data showed obesity skyrocketed to 41.9%.

Tis the reason for countless “magical” weight loss drugs popping up on commercials, food-prep companies offering specials and zero-calorie drinks lining store shelves. But there’s no real sign of promise yet that America’s obesity problem is slowing down. This leaves many frustrated by the never-ending struggle of trying to eat healthily while working out, and not seeing any progress.

If you’re in that demographic, you’re not alone, and there may be a newer option to consider.

Introducing endoscopic bariatric procedures

In the last six to 12 months, Dr. Bill and his team at OSF HealthCare have started performing endoscopic bariatric procedures, a minimally invasive option to help patients lose weight. 

Dr. Bill says this option is perfect for those who either don’t qualify for bariatric surgery or for those who qualify but just do not want to undergo surgical intervention. His team is able to offer two different procedures:  Endoscopic Sleeve gastroplasty and trans-oral outlet reduction. 

"I think the patients that do the best are patients who have a body mass index (BMI) of 30-40 motivated and active, but just not getting to where they want to go with their standard diet and exercise,” Dr. Bill says. "We do everything through the mouth with our endoscopes. We take a camera to the stomach and use an endoscopic device that goes on the tip of the endoscope to run sutures and decrease the volume of the stomach. These are restrictive procedures, with the sleeve gastroplasty we are reducing the volume of the stomach by about 70 percent." 

Another option Dr. Bill’s team offers is called outlet reduction.

“It’s been really nice for patients who have had bariatric surgery and now are a few years out, but they start noticing they feel hungry or are gaining weight," Dr. Bill says. "We use that same suturing device and narrow down that prior opening that has stretched out over time." 

Minimally invasive means minimal recovery time. Patients go under general anesthesia, undergo the procedure, and then go home the same day. Dr. Bill says side effects are minimal as well. You might have some nausea and stomach discomfort for two to three days. However, the symptoms after the outlet reduction are even less severe, leaving patients energized and ready to get back on their weight loss journey.

How could endoscopic bariatrics and weight loss medicine connect?

"I think they should be used together. I think patients who will do best are those that undergo either surgical or endoscopic weight loss procedures initially.  Then, during their follow up consider starting a medication such as Mounjaro or Wegovy that can result in more robust weight loss,” Dr. Bill says. 

‘Take the lifestyle change head on’

The endoscopic weight loss procedure isn’t a get-out-of-jail free card to return to poor eating habits. It’s also not an excuse to cancel that gym membership or give up on daily exercise.

"The follow up after the procedure is probably as important, if not more important than the procedure itself. The procedure is likely to be successful, because your team is highly skilled, but the rest of the success is built on the patient’s motivation, diet, and exercise since it's a lifestyle change. They have to take that head on otherwise the procedure is not going to work,” Dr. Bill says.

These procedures are generally covered by Medicare and Medicaid. However, it’s hit or miss right now with other commercial payers. Dr. Bill’s team collaborates with the weight loss management team at the RiverPlex in downtown Peoria to get patients prepared for a procedure, and you’ll always know ahead of time whether insurance will cover your procedure.

If an endoscopic bariatric procedure sounds like something that would benefit you, you can call OSF Medical Group – Gastroenterology at 309-308-5900.

Video Interview Clips

Roughly 465,000 amputations take place in the United States each year, with 83% of them being lower limb amputations like toes and legs, according to the Amputee Coalition.

Eric Martin, DO, the chief of Vascular Surgery at OSF HealthCare Saint Francis Medical Center in Peoria, Illinois, has crafted a predictable and consistent method that provides reliable outcomes for heroic limb salvage. He does it through procedures referred to as regenerative reconstruction, a treatment currently reserved for the most serious of cases like severe bacterial infection, traumatic crushed limbs, and lower limb ulcers that have become infected and spread throughout the body. These procedures normally accompany a lower limb revascularization with either a bypass procedure or angioplasty and stenting.

“We're here to treat people who have a lot of disadvantaged anatomy and protoplasm (living part of cells) with many medical comorbidities, who otherwise would not be able to heal. Through regenerative reconstruction, we're able to accelerate wound healing and accelerate healing of other diseases processes much quicker,” Dr. Martin says. “In the past, amputation or death was the end point. Now we're able to save lives, have a much more robust limb salvage program here at OSF HealthCare which also makes a difference in terms of affecting mortality in certain patients."

OSF Saint Francis is the only location in Illinois performing advanced regenerative reconstruction procedures at this high of a level.

"We like to pride ourselves on being at the tip of the spear at regenerative reconstruction in the state of Illinois," Dr. Martin says. “We've built that up by having good relationships with companies and getting our hands on the latest and greatest products on the market. We’re always trying to optimize our arsenal of regenerative medicine to provide the best results for our patients. Not only to help with the regenerative reconstruction phase, but also to help address chronic biofilm (bacteria) in the inflammatory phase of wound healing.”

Fish skin, pig intestine, pig bladder and more!

Dr. Martin’s algorithm is built by a group of surprising products made up of animal tissue (xenografts) and human tissue (allografts). This includes fish skin, pig intestine, pig bladder, cow tendon and tissue from human umbilical cords that come from planned procedures with women who have planned, elective C-sections.

"The healing capabilities of the fish skin have been quite remarkable," Dr. Martin says. “One of the big reasons is that it's very homologous (same make up) to human skin. The characteristics and composition of the fish skin are nearly identical to what you'd see with human skin. If you'd take a slice of human skin and a slice of fish skin and put it under an electron microscope and look at it, it'd almost look identical.”

The fish skin manufactured by Kerecis, a company in Iceland, spurs on new blood vessel growth and collagen deposition, and eventually helps encourage growth of the outer layer of skin. The fish are caught from the northern Atlantic Ocean near Iceland, and are then skinned and manufactured in plants located in Ísafjörður, Iceland. Dr. Martin started using the fish skin products in August 2023.

Joe Smith, executive vice president of Research and Development and Product Life Cycle at Kerecis, traveled with other researchers to Peoria to learn more about Dr. Martin’s case studies. He says through these techniques, the world is going to see patients healed in ways we never have before.

“We harvest the fish skin right out of the ocean, take the scales off, and put it through a very gentle process,” Smith says. “What comes out is a medical device, homologous to human tissue, and totally absorbs in the body in seven days.”

Smith calls regenerative reconstruction “medical miracles,” and says with the combination of talented surgeons and top tier products these life-saving procedures can be done more and more.

"We also use pig bladder and pig intestine. One company (Organogenesis) has been able to take pig intestine and cross link it to increase its structural integrity and combine it with type 1 collagen. They then add PHMB (Polyhexamethylene biguanide) which is a very powerful antimicrobial agent. When this tissue is put into the human body, it's very good at killing recalcitrant bacteria that are resistant to antibiotics taken by mouth or through the veins," Dr. Martin says.

When Dr. Martin’s patients arrive at the hospital, their wound’s cross-sectional area can cover an entire lower leg or foot, depending on where the infection is. But the wounds don’t start that way. Even a quarter size ulcer on the bottom of someone’s foot, if left untreated, can grow substantially.

Pyoderma gangrenosum cure

A recent case is the first of its kind in the world of medicine. Dr. Martin and his team were able to cure a patient with a rare autoimmune disease called pyoderma gangrenosum. Traditionally, this disease did not have a cure and was treated with corticosteroids and immunosuppressive agents only. These medications had many unwanted side effects for patients.

“This is the first surgical cure in the history of medicine, where we were able to eradicate the ulcers that formed in his leg and were present for over a decade through the use of surgery and regenerative medicine," Dr. Martin says. "It was really the regenerative medicine that helped provide immunomodulation and benefit to him to help suppress his body's own immune system and allow him to heal and recover so nicely.”

Who could benefit from this treatment?

Dr. Martin says in the past, medication was offered to patients, but oftentimes the medicine would have side effects with it.

“So now by avoiding long-term use of medicine with many deleterious side effects, the surgery was curative for this patient, and he's done very, very well,” Dr. Martin says.

Most of his patients have diabetes and a history of compromised circulation or have peripheral artery disease. Most are people who smoke and have high levels of cholesterol and blood pressure as well. These people often go on to develop non-healing ulcers in their lower limbs that are arterial, venous or neuropathic in origin.

“Others are patients who have venous stasis disease where vein valves are not working properly, and they go on to develop a venous ulcer,” Dr. Martin adds. “You must first treat the reflux disease and ablate the incompetent vein, before going on to treat the ulcer. The treatment for this is either radio frequency ablation (RFA) or using glue, in the form of VenaSeal.

Many people get amputations because after undergoing treatment time and time again, their wounds just won’t heal. Dr. Martin calls these “chronic wounds.” He says they’re much more difficult to treat than acute wounds because the biofilm (bacteria) doesn’t respond to treatment like antibiotics.

The biofilm fixes in on one place, and something called quorum sensing takes place. Dr. Martin calls this a “bacterial forcefield,” which causes the medical team to be much more aggressive in treatment. Biofilm develops an extracellular polymeric substance (EPS) consisting of lipopolysaccharide (LPS). This substance made by biofilm, makes it much more resistant to degradation with standard antimicrobial therapy.

This calls for debridement to clear away the damaged tissue, normally from a saline jet system called VERSAJET, which aims to reduce the bacterial bioburden in wound beds. Then through a bottled wound lavage solution called Irrisept (chlorhexidine gluconate), Dr. Martin’s team can irrigate the area. In addition to sharp debridement with a scalpel, Dr. Martin’s team has other adjunctive means to address the biofilm.

Now it’s time to aggressively treat the area with human allograft tissue, fish skin and mammalian-based skin products.

Story straight from the operating room

While operating on a patient at OSF Saint Francis, Dr. Martin discussed his process. The patient’s Achilles’ heel was eroded because of the infection from her chronic wound that had grown for over a year. After debridement, Dr. Martin found a healthy part of the Achilles’ tendon sheet and was ready to treat the area.

“We’re going to be able to regenerate the tendon sheet by using an umbilical cord graft and a piece of fish skin called SurgiBind designed to help reconstruct tendon and cover bone,” Dr. Martin says. “This fish skin tends to be very homologous to human tissue, including similarities in the extracellular matrix (ECM) like laminin, fibronectin, glycosaminoglycan, hyaluronic acid, proteoglycans, collagen and elastin.” Dr. Martin remarks these characteristics are all important for the health of human tissue.

Jessica Collins, a medical device representative and surgical specialist with Kerecis has seen the success stories from regenerative reconstruction.

“The massive amount of technology and products that Dr. Martin has figured out how they all work together synergistically and uses on these patients to help them save body parts, is remarkable,” Collins says.

This patient was suffering from a rare, serious disease called calciphylaxis in both of her legs. She had gone on to develop end stage renal disease (ESRD) with stage 5 chronic kidney disease and was in dire need of a kidney transplant. However, the calciphylaxis in her legs kept her from being eligible for a kidney transplant. In addition, the patient presented in septic shock to the emergency room because the area of skin ulcerations in her lower legs had become secondarily infected with an aggressive fungal infection and polymicrobial bacterial organizations. Because of this, Dr. Martin was consulted to help treat the patient, and the course of action became regenerative reconstruction. Her other option was bilateral above knee amputations (AKAs).

“It’s easy to amputate, that would be the simple solution to this problem. This is the harder course and the road less traveled,” Dr. Martin said during the regenerative reconstruction procedure.

Dr. Martin calls the start of his procedure a “triple stack” of different tissue products.

“We’ve put down the amniotic membrane grafts, we’ve selectively placed umbilical cord grafts and then I’ve wrapped the leg with Kerecis fish skin,” Dr. Martin says. “Why I’m doing this is because the amniotic membrane grafts will incorporate (attach) within three to five days. They contain an abundance of growth factors that are involved in cell signaling and cellular recruitment. The umbilical cord grafts tend to incorporate within 10-14 days, and they contain the progenitor stem cells that help to signal other stem cells to migrate to the wound bed. The fish skin takes more like 14 to 18 days to incorporate, and it contains many components of the extracellular matrix and collagen. It’s a sequential absorption of these grafts into the tissue which helps to build up the granulation tissue from the bottom up and to make this wound more superficial.”

After wrapping the leg, Dr. Martin injects a porcine (pig-derived) bladder xenograft around the wound. He says it addresses the “zone of injury” and will recruit cells to improve cell signaling, pulling healthy cells from the area around the wound bed into it. This pig bladder contains four types of collagens that help with cellular recruitment. He says this maneuver will help skin regenerate within a month in that area, starting to close the wound from the outside in.

“I’ve been doing this for about 10 years in over 350 patients. I’ve never had an adverse reaction, complications, or side effects from doing this,” Dr. Martin says. “Every time, I get a fairly consistent result of helping wounds shrink in size.”

The next step is to cover the wound with a layer of collagen-based product stemming from bovine tendon made by Integra Lifesciences.

“The tendon has two layers. An outer silicon layer that serves as a protection from the environment, similar to what the epidermis would do,” Dr. Martin says. “On the inside, it contains type 1 collagen and chondroitin sulfate from shark cartilage. This helps to generate cell migration into the wound bed.” This process benefits the healing process for patients, Dr. Martin continues, adding that it also protects the grafts underneath.

The bovine layer will then be stapled to the outer skin surrounding the wound bed. Before finalizing the wrapping of the bovine tendon, Dr. Martin places additional powdered fish skin in between the fenestrations of the fish skin product already sewn in place. This helps to promote granulation tissue, which develops during the process of healing. The bovine layer will be left in place for about 22-25 days.

Goals of regenerative reconstruction

The hope of the regenerative reconstruction is to heal wounds from the outside in. In other words, “shrink the wound.” Some of Dr. Martin’s patients had wounds for over a decade before they came in, and by that time their wounds are exponentially worse off.

“I definitely think if patients are able to get to us at a much earlier stage, and not so late because now they're facing sepsis as a result from their wounds becoming infected, now they have a blood stream infection, their blood pressure is low, their heart rate is elevated, and certain organ systems are beginning to fail (kidneys, lungs, liver, heart). A lot more goes into having to resuscitate them and keeping them alive in addition to treating their wounds,” Dr. Martin says. “So definitely before they get to the end stage of full-blown septic shock, it would be nice if patients could get to us at an earlier stage of their clinical presentation so we could treat them more aggressively and get them healed much quicker.”

While the regenerative reconstruction is a very in-depth procedure, it actually decreases the amount of time someone is being treated and lessens long-term morbidity. Someone’s life expectancy after a major amputation is normally around five years, Smith says.

While the cost of surgery can be a lot up front, Dr. Martin says by healing the wound quicker, it will decrease the cost in the long run for both patients and the hospital system. He adds the products used at OSF are all covered by the major health insurances as well.

Dr. Martin was invited to Iceland this June by Kerecis and was the 2024 grand prize winner for the most outstanding regenerative reconstruction in the United States and Europe for one of his cases. He’s slowly becoming one of the country’s foremost leading authorities in regenerative reconstruction, speaking to many research scientists around the country about his work.

Now his goal is to train other doctors around the world, using his techniques in regenerative reconstruction and offer patients new hope and a promise for a better tomorrow.

Video Interview Clips

B-Roll (Not Graphic)

B-Roll (Very Graphic - viewer discretion advised)

In his year-long battle with cancer of the esophagus, Jim Corby encountered many nerve-wracking moments.

But when asked about it, one memory comes to mind for the retired construction worker from Alton, Illinois. One that happened far away from a doctor’s office.

On July 27, 2022, Corby was chosen to throw the ceremonial first pitch at the Alton River Dragons baseball game. Members of care team at OSF HealthCare Moeller Cancer Center in Alton, James Piephoff, MD, and Manpreet Sandhu, MD, were at his side. Also watching was a group of young women Corby coaches on the softball diamond.

“He knew if he didn’t throw a strike, he would never hear the end of it from the girls on his team,” Dr. Piephoff says.

No pressure, Jim.

Esophageal cancer: The basics

Dr. Piephoff, a radiation oncologist, says around 20,000 people in the United States are diagnosed with esophageal cancer each year. The cancer claims around 16,000 lives in the U.S. each year.

There are two types. The most common (around 70% of U.S. cases) is adenocarcinoma in the lower esophagus. The other type is squamous cell carcinoma, typically above where the airway separates into the lungs.

Both types are associated with excess smoking and drinking, something Corby found out the hard way.

“I smoked two-and-a-half to three packs of cigarettes a day,” Corby says. “The day I went in for surgery, I threw them out the window. I haven’t smoked since.”

Obesity is also a risk factor for adenocarcinoma.

“Obesity leads to increased risk of gastroesophageal reflux disease,” Dr. Piephoff explains. “It’s the acid churning up in the lower esophagus that leads to the risk of developing what’s called Barrett’s esophagus. That’s a precancerous condition.”

Screening isn’t common for cancer of the esophagus, so Dr. Piephoff says it’s important to watch for symptoms, which can mimic those of heartburn. See a doctor if symptoms won’t go away.

“Know your body. Don’t be afraid to talk to your doctors about it. Don’t try to minimize your symptoms,” Dr. Piephoff urges. “If there’s a change you notice, you need to convey that to your doctor.”

On treatment, Dr. Piephoff says he typically sees a person go through chemotherapy and radiation to shrink the cancer followed by surgery to remove the tumor. During surgery, instruments are sent down the throat and not through the chest, meaning an easier recovery for the person. Early detection could mean surgery only.

“There are some patients who are not able to have surgery because of medical conditions like a bad heart or bad lungs,” Dr. Piephoff says. “They get treated with radiation and chemotherapy without surgery.”

Immunotherapy is also a part of the treatment plan for some people. This involves changing how your immune system works so it can fight cancer, according to the American Cancer Society.

Jim’s journey

Corby says he started having pain in his midsection last year when he ate. Treatment for heartburn and acid reflux didn’t help. An ultrasound and CT scan didn’t get his doctors any closer to a solution. All the while, Corby says it hurt so much to eat, he started losing weight.

In September 2021, doctors examined Corby’s esophagus with a camera.

“The doctor came in and sat down, which I knew was not a good sign,” Corby recalls.

“That day was when my life changed,” he says.

The exam found a cancerous mass in Corby’s lower esophagus. The next few months were a whirlwind.

“It happened real fast,” Corby says.

“They got me here [to Moeller Cancer Center] to see Dr. Piephoff and Dr. Sandhu. They came up with a program to try to get me going,” Corby says. “I went through chemotherapy and radiation first. Then they sent me over to St. Louis, and in January I had surgery.”

The surgery to remove the cancer preceded a nine day stay in the hospital where Corby says he couldn’t eat or drink aside from the occasional ice cubes or water sopped from a sponge.

Sometime later – Corby can’t remember exactly when – he was back at OSF Moeller Cancer Center meeting with Dr. Sandhu.

“She said ‘Your scan came back. You’re cancer free.’” Corby says.

“I couldn’t believe it,” Corby adds. “How many times do you hear about people who have cancer who die? You hear more of that than you do cancer free.

“The odds were against me 100%, but I guess I beat the odds.”

The first pitch

Corby’s first pitch at the River Dragons game went – where else? – right down the middle of the plate, eliciting a cheer from his support system and all the fans learning his story for the first time. For Corby, it was a sigh of relief. No need to worry about razzing from his softball players.

“I got lucky,” Corby says, fighting back happy tears.

Learn more

Visit the OSF HealthCare website to learn about cancer treatment. This includes the new OSF Cancer Institute in Peoria, Illinois, which will serve the entire OSF service area will the latest treatment, education and more.

Interview clips - Dr. James Piephoff

Interview clips - Jim Corby

Terminology

David Rzepczynski, MD, an OSF HealthCare gastroenterologist, says it’s important to first lay out some similar sounding terminology.

• Diverticulum (singular) or diverticula (plural): These are the bulges that form when an inner part of the colon sticks out through a weak spot in the colon wall.
   
• Diverticulosis: This is the name of the condition when the bulges occur.
   
• Diverticulitis: This describes when the bulges become inflamed.

Causes, symptoms and diagnosis

Dr. Rzepczynski says diverticulosis occurs when your colon is trying to push stool forward, and the organ is not as bulky as it should be. The diverticula bulges then form.

The condition has been more common in people over 60, but Dr. Rzepczynski says health care providers are seeing a rise in cases in people in their 40s and 50s.

Diverticulosis can run in families. It’s also tied to your lifestyle.

“A diet that has more red meat, less grain and less fiber might put you at a higher risk,” Dr. Rzepczynski says.

Smoking, excess alcohol and obesity are also risk factors.

Symptoms of diverticulosis include abdominal pain or constipation. But it often comes with no symptoms and is found during a colonoscopy.

Treatment

Dr. Rzepczynski says in mild cases, a provider may tell you to change your lifestyle, such as getting more fiber in your diet. This makes bowel movements smoother.

“Often, people will look to use fiber supplements,” Dr. Rzepczynski says. “The amount of fiber intake from supplements pales in comparison to what you can get from your diet.”

Also, eat a healthier diet overall. Dr. Rzepczynski says there used to be a myth that nuts, popcorn and seeds would get lodged in the colon bulges. He says studies have shown those foods are not a risk factor.

Other lifestyle tips: exercise and cut out tobacco and alcohol.

Dr. Rzepczynski says more serious cases of diverticulosis can come with two complications. One is bleeding.

“You could have a blood vessel on the outside of the diverticulum. If it ruptures into the diverticulum, it could cause sudden bleeding from the rectum,” Dr. Rzepczynski says.

Dr. Rzepczynski says bleeding from diverticulosis is not common. He ballparks it at around one in 2,000 cases. People on blood thinning medication who develop diverticulosis have a higher risk of bleeding.

While unpleasant, Dr. Rzepczynski says most bleeding cases resolve on their own.

The second, more serious complication is diverticulitis, or when the diverticula bulges become inflamed. This happens when there is a tear in the diverticulum, and bacteria from stool leaks. And it can lead to a host of other problems: pockets of pus known as abscesses, issues passing stool and a urinary tract infection.

Symptoms of diverticulitis include pain in the lower left abdominal area, abnormal bowel movements, nausea and vomiting. If you have these symptoms, it’s important to been seen by a health care provider quickly. A doctor may order a computed tomography scan (commonly called a CT scan) to diagnose diverticulitis.

Dr. Rzepczynski says it’s not common for diverticulosis to progress to diverticulitis, and most cases of diverticulitis can be treated at home with oral medication. But, he says 12 to 15% of diverticulitis patients spend time at the hospital. Treatments there include antibiotic medication through intravenous therapy (IV) and surgery. If surgery is necessary, a doctor will drain any abscesses then remove the inflamed area of the colon.

“They’ll try to reconnect the colon at that time,” Dr. Rzepczynski explains. “But if the surgery is done on an emergency basis, sometimes the person may have a colostomy where part of the colon is coming out through the skin. That’s a temporary measure.”

A colostomy comes with a bag on the outside of your body that collects the waste that would normally leave your body via a bowel movement.

Dr. Rzepczynski warns that surgery isn’t a permanent fix. He says around 15% of diverticulitis patients who have surgery end up with another bout. It reinforces the importance of lifestyle changes. You should also get on a colonoscopy schedule as advised by your health care provider.

Learn more

Read more about how to avoid diverticulosis on the OSF HealthCare website.

Interview clips

Anal and rectal cancer occur in parts of the body near each other, and they both have prevention steps and time-tested treatments. But they are different types of cancer, says Raman Kumar, MD, a colorectal and general surgeon with OSF HealthCare.

Rectal cancer

Dr. Kumar says the rectum is the last part of the colon, where stool is stored.

Signs of rectal cancer include bleeding, irregular bowel movements (such as the shape of the stool changing and the inability to have a complete bowel movement), weight loss, fatigue and pain in the rectal area.

Rectal cancer impacts men and women roughly equally, and it’s seen “at almost any age,” Dr. Kumar says. If you smoke and eat a lot of red meat and processed food, your risk will go up.

Anal cancer

Dr. Kumar says the anus is where stool comes out. He says signs of anal cancer can be like those of rectal cancer. But often, he says an anal cancer diagnosis starts when a person believes they have hemorrhoids, or when the veins or blood vessels around the anus and lower rectum become swollen and irritated due to extra pressure.

“It turns out not to be a hemorrhoid. It could be a mass or a lesion. You could have some bleeding, especially when you’re wiping with toilet paper or wet wipes,” Dr. Kumar says.

Anal cancer’s prevalence in the United States is “very low,” Dr. Kumar says, with around 8,000 cases per year. Around two-thirds of the cases are women, and it’s more common in age 50 and up.

“The number one cause of anal cancer is HPV, the human papillomavirus,” Dr. Kumar says. “So, it is considered a sexually transmitted disease.”

But he says you don’t have to be sexually active to get anal cancer. Regardless, there are vaccines for the most common HPVs that cause cancer.

Prevention and treatment

Symptoms aside, Dr. Kumar says there’s a must-do for anal and rectal cancer prevention: get on a colonoscopy schedule as advised by your health care provider. A colonoscopy is when a provider inspects your colon and surrounding areas using a tiny camera on the end of a tube. Dr. Kumar says generally, colonoscopies start at age 45. But they could start earlier if you have a family history of cancer.

Other tips: Don’t smoke. Exercise regularly. Eat a healthy diet with plenty of fruits, vegetables and fiber. Thirty grams of fiber per day is a good goal, Dr. Kumar says.

If you do have symptoms of anal or rectal cancer, see a provider to get checked out.

Dr. Kumar says treatment for anal cancer is usually chemotherapy and radiation therapy. He says when treated properly, the typical five-year survival rate is around 80%.

“The only times we would operate on anal cancer are to get the original [cancerous] mass out and if the cancer comes back,” Dr. Kumar explains.

For rectal cancer, Dr. Kumar says around 40% of people can also be treated with chemotherapy and radiation. Others will need surgery to remove the cancer. But Dr. Kumar says medicine has progressed to where people can typically avoid a colostomy, or when a part of the colon is diverted outside the skin to bypass a damaged part of the colon. This is temporary and comes with a bag that collects the waste that would normally leave your body via a bowel movement.

Learn more

Read more about prevention and treatment of rectal and anal cancer on the OSF HealthCare website.

Interview clips

Eight years ago, two surgery nurses at OSF HealthCare Saint Francis Medical Center in Peoria were approached about a big problem that cost their hospital several million dollars a year in lost revenue – cancelled surgeries.  An anesthesiologist approached surgery nurses Jill Teubel, MSN, BSN, RN and Mary Marvin, APRN, MSN, RN to see if they had a way to prevent cancelling surgeries because of overlooked implanted medical devices.

Hundreds of surgeries each year at OSF Saint Francis were being cancelled or delayed because patients had implanted medical devices with electrical components, such as pacemakers to regulate the heart and spinal stimulators to suppress pain. Without the devices temporarily turned off during surgery, patients and the devices could be harmed.

Jill Teubel says nurses, surgeons and anesthesia providers need to know, in advance of the procedure or surgery, specific instructions for each device and how to keep the patient safe.

“With that comes some pretty specialized directions when you come in for a procedure. Those are usually hidden and so it’s very difficult to find those.”

Teubel and her colleague, Mary Marvin, set out to create a spreadsheet to list every implantable medical device on the market with model numbers, surgery instructions, even contact information for the device sales rep who - in some cases - would have to come on site prior to the planned surgery.

Teubel and Marvin often spent their personal time researching, documenting and regularly updating the information in a matrix they called Device Table.

Marvin says the effort was worth it because 4.5% or more than 1,900 patients coming to OSF Saint Francis Medical Center for surgery each year have an active medical device implant.  By addressing these patient devices in the pre-operative area, the hospital saved $1.9 million dollars annually in lost revenue due to cancellations which have since been reduced to nearly zero because of implants.

“Doing all his work upfront, we save the patient the misfortune of being cancelled. A lot of times the patient’s family will come in to be with them; to take care of them after the case,” Marvin explains.

Their Device Table document was laminated and attached to surgery carts. Over the years, it expanded from two pages to 80. Teubel and Marvin knew they needed something more manageable, so they pitched their idea to the OSF Innovation Studio, a part of OSF Innovation.

Kip McCoy, vice president, OSF Innovation Studio says his team initially built an Access database that could be more easily updated. But after learning there were no other solutions in the marketplace, the Studio team realized it needed additional expertise to more fully develop a scalable and potentially commercial product.

A Peoria-based company Enoch Collective worked with the Innovation Studio team to create, test and revise a web application that could be expanded and customized to meet the needs of the surgery team.

With an added ability to connect to Epic, one of the largest electronic medical records software systems in the country, Teubel expects to see the software commercially licensed.

“It was a solution we solved for our surgery area, and it’s been neat to work with the physicians and staff. For them to come back to us and say, ‘This really helps us. We use this all the time,’ that’s really satisfying because as a nurse, you go into the profession to help people.”

Lasting impact on patients and safety

Marvin relishes the idea of having a lasting impact by sharing their labor of love.

“The thought that someday someone in California or New York could be protecting their patients by utilizing our app is something that is very special to us because as nurses, taking care of the patient always comes first.”

The Innovation Studio team helped support a patent application. Approval can take between two to four years. In the meantime, the women are joining forces with a former member of the Innovation Studio team to form a new startup company, OpenSurg, to further develop, scale and eventually market the software and app that now includes information about 75 medical devices.

Senior Vice President for OSF Innovation, Becky Buchen says this spin-off company shows the benefit of leveraging the talents of frontline workers and then having a system in pace to help Mission Partners (employees) explore development, testing and possible commercializing of their idea.

“When you really start to leverage the ideas they have, because they’re at the frontline of care, they’re seeing the challenges being faced every day, whether it’s by our patients or their fellow Mission Partners (employees), and then bringing forward those ideas really starts to advance the transformation of health care.”

In preparation for the results of creating an innovative ecosystem, OSF developed an intellectual property policy in 2018. It provides the opportunity for revenue-sharing for intellectual property created by Mission Partners through the course of their employment. OSF HealthCare and OpenSurg recently signed a comprehensive licensing agreement.
 

Video clips with Jill Teubel and Mary Marvin

Video clip with Becky Buchen

B-roll for Device Table solution

Basketball season is in full swing, and with it comes the possibility of ankle injuries. You’ll hear doctors and television commentators rattle off different ways to describe an ankle injury. Sprain, strain, fracture and break are common ones. Marc Leonard, MD, an OSF HealthCare podiatrist, says it’s important to know what these conditions mean and how to treat and prevent them.

The good news: you don’t need to memorize four definitions.

Sprains and strains

Dr. Leonard says a sprain and a strain generally describe the same thing: when a ligament or tendon is torn or weakened.

“Maybe it’s a basketball player who twists their ankle,” Dr. Leonard suggests. “It gets a little swollen and bruised. We’re able to treat that conservatively with the acronym RICE. Rest, ice, compression and elevation.”

Fractures and breaks

Dr. Leonard says an ankle fracture and an ankle break also generally describe the same thing: a crack in a bone. He often sees this in older adults who have fallen down the stairs or on the ice.

“If there are breaks in multiple bones and we consider it an unstable ankle, then we would fix it surgically,” Dr. Leonard says. “The process is surgery, then maybe physical therapy and perhaps a brace.”

Dr. Leonard says surgery patients usually go home the same day. A doctor will use screws, staples or both to stabilize the ankle. The person then needs to rest and not put weight on the ankle for six to eight weeks.

Treatment and prevention

Amid basketball season, here’s the take-home advice for when someone suffers an ankle injury: get them off their feet.

“We would advise them to be non-weight bearing. They would use crutches until they can get an X-ray. Then we can decide whether protecting the ankle, physical therapy or surgery may be appropriate,” Dr. Leonard says.

Prevention, Dr. Leonard says, is tough, due to all the movement that comes with sports or just a jog around the block. He advises to just be sensible with your movements. If you know your body can’t handle a cutting motion that comes with running a basketball play, don’t do it. Or, when you’re walking, go slow and watch for ice. And when you do get hurt, get care quickly. Don’t play through the pain.

Dr. Leonard also says that some people with a history of ankle problems may wear a brace during any physical activity, not just when recovering from an injury. But for others, he says a brace isn’t necessary.

“Play with a purpose. Be intentional. And hope for the best,” Dr. Leonard says matter-of-factly.

Learn more

Read more about keeping your body in top shape this winter on the OSF HealthCare website.

Interview clips

Related stories

For ankle sprains, think RICE
Take it slow on the ice: Walk like a penguin

Fall sports are running at full speed, and with them come potentially career-changing injuries.

A tear or sprain of the anterior cruciate ligament, or ACL, is one of the more common knee injuries in high-demand sports like football and soccer.

Keith Corpus, MD, is an orthopedic sports medicine surgeon with OSF HealthCare and Great Plains Orthopaedics. He says while the outpatient visit to fix your ACL may only take a day, the recovery time is much longer.

“It’s at least a nine month recovery process to get you back to full sports,” Dr. Corpus says. “There’s protocol we progress through. We have to get your motion back then we have to get your strength back. Then we have to get you back running, which is normally around the four or five-month time point.”

After this, patients will use crutches and wear a brace to protect the knee. 

“As we progress you into higher-level athletics at the six-month time point, we transition you typically to a smaller brace that you can wear while you’re playing. Then full return to sports is, at earliest, 9 months,” Dr. Corpus says.

Dr. Corpus says ACL injuries normally happen in sports with sharp changes in direction.

“It’s really common in cutting and pivoting sports,” Dr. Corpus says. “You’ll put your foot in the ground and then turn, and your ACL can tear. It can obviously cause things like pain, but it can also cause prolonged instability and other damage to your knee.”

In the young athletic population, Dr. Corpus says the ACL almost always has to be fixed.

“There are certain populations as we age that we don’t fix them. But in our younger athletes playing contact sports, we fix them to try and prevent things from happening down the line if your knee becomes increasingly unstable,” Dr. Corpus says. “It’s certainly surgery. We basically try to make you a new ACL.”

While the circumstances of an ACL tear are often not avoidable, Dr. Corpus says there are some proactive steps you can take to protect your knee as a whole.

“Having proper mechanics when you’re cutting, pivoting or landing are important. There are strategies we can have to try and limit those,” Dr. Corpus says.

Another tip: Take your time and don’t rush into things.  

“Work up into things. If you’re transitioning from one sport to another, or if you’ve been inactive for the winter and now you’re ramping up into things, make sure you’re doing so in a slow and deliberate manner,” Dr. Corpus says.

Dr. Corpus says ACL injuries are very common during the summer months with a lot of kids playing football and soccer. OSF HealthCare has orthopedic surgeons and sports medicine doctors available to evaluate you after an injury, and work through a treatment plan to get you back in action. You can find providers and locations here.

B-Roll

Video Interview Clips

Kent Splaingard, DMD, recalls decades ago when he learned his mother had stage three gum disease. Her dental providers told her that dentures were likely in a few years.

But after thirty years of treating his mother, Dr. Splaingard says she lost just one tooth.

“I always point it out here,” Dr. Splaingard says, gesturing to where the tooth was. “I remember taking that tooth out thinking, ‘What a failure.’ But I really look back at it and say, ‘What a success.’ Mom had her teeth all her life.”

It’s a prime example of how therapeutic dental treatment can reverse the effects of gum disease. And it’s something he sees weekly with patients at OSF HealthCare in Alton, Illinois. Dr. Splaingard is a retired private practice dentist and an instructor at Lewis and Clark Community College in nearby Godfrey. He and his students regularly see OSF patients who need extra dental attention.

It’s important work, Dr. Splaingard says, because our body functions as a whole. Advanced gum disease will likely make other medical conditions worse.

“The mouth is like a picture window into the body’s health,” he says.

Gum disease basics

Dr. Splaingard says gum disease is a bacterial infection caused by poor oral hygiene. The bacteria embed into the gum tissue, and that typically results in a low-grade chronic infection (in other words, a problem over a longer period). Left untreated, your gums will constantly be red (not the normal pink), swollen and sore. Bleeding is possible, too.

“You see a lot of debris on the teeth. You may see a film of bacteria. You also see a white-ish coating on the soft tissue,” Dr. Splaingard adds.

“You also see the social and economic problems with the people who can’t chew properly. The poor nutrition they may be getting,” he adds.

Treatment for gum disease is a combination of thorough cleaning by a dental professional, treatments that stop bacteria from reproducing and antibiotic medication. In severe cases, a dental specialist may perform surgery. That could involve pulling some or all of a person’s teeth.

Prevention

Dr. Splaingard says gum disease can be passed down genetically, but general prevention goes back to what dentists have told you since you were a kid.

• Brush and floss regularly. The American Dental Association recommends brushing twice per day and flossing once per day. If you have questions about frequency, talk to your dentist.
• See a dentist regularly. Twice per year is a good starting point, but some people who need extra attention could go four times per year.
• In between those appointments, watch your teeth and gums and let your dentist know if something doesn’t seem right.

“It’s education, motivation and self-treatment,” Dr. Splaingard says.

Learn more

Read more about oral health on the OSF HealthCare website.

Interview clips

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

Christina Reifsteck knows the statistics all too well.

Law enforcement officers may not live as long as people in other professions. The job requires you to be in a constant state of hypervigilance for up to a 12-hour shift. The resulting stress may lead to serious heart issues.

But Reifsteck, a sergeant with the Rantoul, Illinois, police department, her colleagues and OSF HealthCare are trying to change that.

Rantoul police have partnered with OSF HealthCare Occupational Health and OSF HealthCare Cardiovascular Institute to have OSF provide heart screenings and the necessary follow-up appointments for officers.

“We wanted to make sure our officers have a better knowledge of what is going on inside their body,” Reifsteck says. “Sometimes you can’t see the problems.”

For Reifsteck, that need for knowledge played out on a gray February morning at OSF HealthCare Heart of Mary Medical Center in Urbana, Illinois. With monitors attached to her body, she walked, then ran on a treadmill while OSF Mission Partners (employees) observed her heart rate on a screen. It’s known as a stress test.

“The treadmill started out slow, and every couple minutes it got faster, and the incline raised higher,” Reifsteck recalls. “You did feel like at the end you were getting a workout. But it felt fine.”

“With the stress test, we try to identify someone’s functional capacity and if they demonstrate any evidence of impairment of blood flow to the heart,” says Alaa Ujayli, MD, an interventional cardiologist at OSF HealthCare Cardiovascular Institute in Urbana.

Down the hall, Reifsteck got pictures taken of her heart.

“We look at calcification of the coronary arteries, which is the beginning of plaque disease,” Dr. Ujayli says.

Reifsteck got reassuring news that her test results looked good. But a follow-up appointment with a cardiology provider was on her calendar for two days later.

“See where we are and if I need to make some lifestyle changes,” Reifsteck says. “First responders function better when they’re healthy.”

Dr. Ujayli agrees.

“Cardiovascular disease is a preventable illness,” he says. “If we establish preventive measures, we have a significant impact on the progression of the disease.”

Those measures include medication, talking with a dietitian to change eating habits, consistent exercise, better sleep habits and avoiding smoking and alcohol. Mental health care like meditation and visiting a counselor are also helpful for everyone, but especially first responders. More serious heart issues may require a procedure in the hospital.

Learn more about heart care on the OSF HealthCare website.

Interview clips - Sgt. Christina Reifsteck

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

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

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

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

But let’s get one thing straight.

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

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

Have the discussion

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

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

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

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

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

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

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

A major cause

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

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

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

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

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

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

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

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

Learn more

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

Interview clips

Previous coverage

TikTok trend deemed dangerous
Catch your ZZZs
Getting a wake-up call
Chronic fatigue is nothing to sleep on
Slumber hours slump
OSF HealthCare blog entries on sleep
 

At 94 years old, every day counts for Jim Bier.

The Champaign, Illinois, resident, U.S. Army veteran, and retired map-maker is able to manage things like visiting the store and strolling his backyard gardens – a space resembling the University of Illinois Japan House gardens, which Bier designed. It all comes with less chest pain and easier breathing thanks to a minimally-invasive heart procedure offered at OSF HealthCare.

“I’ve been at home, exercising, building up my legs, and I don't have the difficulties breathing like I did before all this happened back in the garden days,” Bier says. “And so I would say I'm in very good shape at this point.”

Bier pauses and adds with a chuckle, “From my waist up. I still have to work on my legs.”

Approved by the U.S. Food and Drug Administration in 2011, transcatheter aortic valve replacement, or TAVR for short, deals with a thickened aortic valve in the heart that can’t fully open. This reduces blood flow and could mean symptoms like chest pain, shortness of breath, fainting, and fatigue.

Tariq Enezate, MD, a cardiologist at OSF HealthCare Cardiovascular Institute in Urbana, Illinois, explains that the TAVR procedure begins with making a small cut near the patient’s groin. The doctor then inserts a small catheter – “smaller than my little finger,” Dr. Enezate notes – and guides it up to the heart to insert a new valve. This is opposed to the more invasive open-heart surgery, which can lead to a longer and more painful recovery for the patient. Minimally-invasive surgeries like TAVR also avoid the need to stop the patient’s heart.

“Those patients are old. They have a lot of diseases. So, many of them, they are not good candidate for surgery. And the surgery team might think they might not be in good shape and strong enough to handle the stress of open heart surgery,” says Dr. Enezate of potential TAVR patients. “In those situations, TAVR is actually lifesaving.”

For Bier, the lifesaving series of events began on Christmas Eve of 2021. By then, Bier had been dealing with heart problems for nearly a decade and had used a blood thinner after open heart surgery didn’t yield the best results. But a visit to the emergency department that day turned into a week-long stay and the question: What more needed to be done? Eventually, Bier says doctors told him about one last surgery that was needed – “the big one,” as Bier puts it. He needed a new heart valve.

An avid reader, Bier researched the TAVR procedure to allay his concerns.

“I’m a person who goes with the flow,” Bier says. “You talk to any of the nurses who've dealt with me at the hospital. They're saying all the time, ‘Go with the flow.’ That's what I kept telling them all the time. And in that way I'm pretty optimistic about it.”

Still, Dr. Enezate recognizes that even minimally-invasive heart surgery may cause stress. He says the patient’s care team – everyone from the cardiologist to the anesthesia team – meets with the patient and their family several times before the procedure.

After TAVR patients go home, Dr. Enezate explains, they eventually will enter cardiac rehabilitation to rebuild the strength needed to do the everyday activities they love. Other appointments with a provider and medications like a blood thinner are also typical.

“We have a big team of doctors, nurses, nurse practitioners, therapists, social workers, and so many people,” Dr. Enezate says. “Take care of the patient, take care of their family, answer their questions, get the tests, the procedures that they need. And after the procedure, we are on top of things.”

At OSF HealthCare Heart of Mary Medical Center in Urbana, where TAVR recently launched, that team includes Dr. Enezate, Ashraf Al-Dadah, MD, Alaa Ujayli, MD, and Kelli Lamaster, the cardiac program coordinator. Each of them undertook years of schooling and training to be able to successfully oversee operations like TAVR.

“If you asked a cardiologist 10, 20 years ago and you tell them a patient with valve replacement can go home next day, they would think that you're crazy,” says Dr. Enezate. “But now, it is reality.”

Visit the OSF HealthCare TAVR website for more information and to find a provider near you.

Interview clips - Jim Bier

B-Roll

Previous TAVR stories from the OSF HealthCare Newsroom

Mick Jagger Recovering After TAVR Procedure - April 5, 2019

Forging the Path – TAVR for Congenital Heart - December 10, 2021

New Innovations are the Heartbeat of TAVR - November 3, 2022

It can be an embarrassing ailment, but experts say it’s time to talk about it.

Urinary incontinence is when a person leaks urine by accident.

Uwais Zaid, MD, a urologist at OSF HealthCare in Alton, Illinois, says urinary incontinence can wreak havoc on a person’s social life and intimacy with partners. In other words, you can’t go out and have a good time with friends if you don’t know when you’re going to suddenly “go.”

“It can be associated with medications. It can be associated with aging,” Dr. Zaid says. “It can be associated with certain surgeries. A lot of our cancer survivors, whether they're from prostate cancer, cervical cancer, uterine cancer…they can have effects to their urinary control.

“Things as normal as having children,” Dr. Zaid adds as a cause.  “Over time [childbirths] can wreak havoc on the pelvic floor and on the urinary sphincter, and you can have urinary accidents as a result.”

While incontinence is often associated with older people, Dr. Zaid says all those precursors apply to any age.

Dr. Zaid says urinary incontinence breaks down into four groups.

• Stress: This is when the bladder sphincter does not work as well. Simple things like coughing, sneezing, laughing or bending over could provoke a release of urine.
• Urge: “When the bladder has a mind of its own,” Dr. Zaid remarks. This is when you have to go and you just can’t make it to the bathroom in time. Dr. Zaid adds that hearing or seeing certain triggers like running water or jingling of keys as you rush to enter your home might provoke urge incontinence.
• Overflow: This occurs when your bladder is full. This is the opposite of urge incontinence, Dr. Zaid says, and is associated with infections and kidney issues.
•  Functional: This applies to someone who may have normal bladder control but can’t get to the toilet in time due to physical limitations like arthritis.

A health care provider will ask you about your symptoms and health history to see which type of urinary incontinence is ailing you. Testing would typically follow. Each type of incontinence, generally, has its own treatment plan.

• Stress: A provider may recommend pelvic floor physical therapy as treatment. For women, a small device can be inserted to stop leaks. Surgery is also an option.
• Urge: You may be told to cut back on caffeinated food and drink, spicy food and alcohol. Medicine and surgery are also options.
• Overflow: “That's where we need to make sure we're not missing anything like a blockage - for women, a prolapse and for men, an enlarged prostate.” Dr. Zaid says.  “A stone in the bladder. A tumor in the bladder. And we also need to make sure the kidneys are functioning okay.”
• Functional: Since people with this type of incontinence may have a normal bladder, external solutions are necessary. For example, keeping your route to the bathroom clear of obstacles like chairs and doors. For older adults with physical limitations, have a walker handy for when the need to go arises.

Other tactics include urgency suppression, when you distract yourself from thinking about urinating. You could take long, relaxing breaths or sit completely still.

Timed voiding is when you schedule times to urinate. Dr. Zaid says this can work in both directions. If you are urinating too frequently, set a timer on your phone to go every hour. Then when you get comfortable, you can increase the time. If you are holding on to your urine too long, set a plan, get comfortable then decrease the time.

The bottom line: if something seems off about your bathroom visits or if friends or family remark “You’re sure in there a lot,” see a doctor.

“If you’re chronically wet down below, it increases your risk of fungal infections and skin breakdowns,” among other serious health issues, Dr. Zaid says.

Interview clips

Previous coverage

Gotta go? Try these six bladder tips

This collaboration will better serve patients in the community by bringing exceptional medical and surgical specialties closer to home. The affiliation combines a commitment to exceptional care and an expanded, comprehensive network of expert specialty and subspecialty physicians for patients in the area.

The latest collaboration will see Ameera Nauman, MD, a pediatrician at OSF Saint Anthony’s, move into the SSM Health network while continuing to see patients at the OSF Medical Group office in Godfrey. The Godfrey office offers primary care for adults as well as pediatric care. Dr. Nauman will have access to SSM Health Cardinal Glennon Children’s Hospital, a world-class facility in St. Louis, for emergency and specialty care, such as advanced pediatric diagnostic testing, surgical services and sports care.

“I’m excited to be part of this collaboration that will allow my patients greater access to timely and exceptional care from pediatric specialists who are at the top of their field,” said Dr. Nauman. “Parents can know all of their child’s medical needs are in the hands of well-equipped, premier health professionals.”

“Hospital and health care providers can no longer operate in silos and must be willing to embrace meaningful collaboration that will result in availability of high quality, sustainable health care across their communities,” said Jerry Rumph, president of OSF Saint Anthony’s. “Dr. Nauman will be supported by pediatric specialists in areas including cardiology, oncology, neurology and gastroenterology. This team will have access to the NICU [Neonatal Intensive Care Unit] and a Level I [One] Pediatric Trauma Center at Cardinal Glennon Hospital, where providers are equipped to handle the most complicated and complex cases.”

Jeremy Fotheringham, region president of SSM Health St. Louis and Academics, said, “This collaboration will allow us to better meet the needs of this community while providing value and convenience to our patients. By working together, we further our Mission and Vision to ensure all people have access to the high-quality, personalized care they need.”

OSF Saint Anthony’s and SSM Health are excited about the new affiliation and are currently developing additional opportunities to bring more medical specialties to the greater Riverbend community to enhance and improve the health and wellness of residents. In April, the health systems announced enhanced heart care close to home through the addition of Sridhar Kumar, MD, a cardiologist at SSM Health Saint Louis University Hospital, who became chief of Cardiology Services at OSF Saint Anthony’s.

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