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

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

What are migraines?

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

The list of triggers is, unfortunately, long.

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

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

You can prepare

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

How can you prepare?

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

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

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

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

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

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

Interview clips

Previous coverage

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Three steps to help with severe or frequent headaches
When should you see a specialist for your headaches?
Weather changes can be a pain for migraine sufferers

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

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

PMAD basics

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

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

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

Screening and treatment

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

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

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

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

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

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

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

Why it’s important

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

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

Learn more

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

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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.

Interview clips

Previous coverage

Hernias: More common than you think

You’ve likely heard of bronchitis, an illness that impacts the larger lung airways and leaves you feeling short of breath and just generally yucky.

This fall and winter, here’s another respiratory illness with “bronch” in the name to be aware of, especially if you have young kids: bronchiolitis. It’s an ailment that Awad Alyami, MD, an OSF HealthCare pediatrician, sees often this time of year.

The basics

Dr. Alyami says bronchiolitis is an infection of the bronchioles, or the small airways that branch out in the lungs.

“When they become infected, there is a lot of mucus. It makes it harder to breathe,” Dr. Alyami explains.

Other symptoms include fever, runny nose, cough and dehydration. Bronchiolitis is “easily spread,” Dr. Alyami says, through respiratory droplets, like when you cough. The illness is most common in children, especially kids under two. Other high-risk groups include babies born prematurely, with chronic lung disease, with heart disease present at birth and with immune system deficiencies.

“There are also environmental risk factors, like babies who are exposed to smoke and babies who attend day care,” Dr. Alyami adds. Attending day care, he explains, will expose a child to illnesses, no matter how clean the place is.

Cause, diagnosis and treatment

Dr. Alyami says other viruses like influenza and COVID-19 can cause bronchiolitis, but respiratory syncytial virus (RSV) is the most common cause.

“You need to see a doctor if your baby has trouble breathing at any time,” Dr. Alyami advises. “Or if your baby is younger than three months and they have a fever. Or if they are older than three months and they have a fever for more than three days. Or if the child has signs of dehydration, like if they are making fewer wet diapers than normal.”

Unlike the flu and COVID-19, there is no test for bronchiolitis. But, a health care provider may swab your nose anyway to see if you have another virus. Other tests like a chest x-ray may be done. And the provider will also examine you and ask about your health history to come up with a diagnosis.

Treatment involves making you feel comfortable until symptoms resolve.

“One of the most important things is nose suction as needed,” Dr. Alyami says. “When we suction the nose and keep it clean, it’s easier to breathe.”

A bulb suction is the most common device to do this. When you’re really stuffed up, you can use nasal spray or drops to make the secretion thinner. Then, use the suction. You can also use a humidifier if your home’s air is dry. Dr. Alyami says these devices and medicines are widely available in retail stores.

You can treat the fever with over-the-counter medication. Drink fluids to stay hydrated.

“Typically, day three to day five are the peak of symptoms,” Dr. Alyami says. “After five days, they start to improve. Symptoms can last seven to 14 days. And typically, the cough lingers for a little longer.”

In serious cases, your child may have low oxygen and need to be admitted to the hospital. There, doctors will use an oxygen tube inserted into the nostrils to help breathing. In rare cases, a doctor will put a breathing tube down the child’s throat.

Prevention

Want your child to avoid all this? Preach healthy habits, especially in fall and winter when respiratory illnesses peak. Wash your hands thoroughly. Cough and sneeze into your elbow or a tissue. If you’re sick, stay away from others.

Dr. Alyami adds that since RSV is the main cause of bronchiolitis, you should look into the RSV vaccine. This cold weather season, the vaccine is available for certain groups, like older adults, infants and pregnant women. Talk to your primary care provider if you have questions.

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Advice for when the holidays spread more than Christmas cheer

Runny noses, sore throats and coughs are back in season.

For parents, it’s a yearly dance with kids at school and family gatherings that help spread germs, colds and viruses. Since it’s impossible for every person to avoid this, how can we minimize the severity of your symptoms? That’s where Kimberly Walker, MD, a family medicine physician at OSF HealthCare, comes in with some helpful advice.

Over-the counter options

Not every symptom calls for a doctor’s visit, and if you address your signs early enough, Dr. Walker says the length of your cold can decrease drastically.

“Within the first 24 hours, you can take Zinc lozenges,” Dr. Walker says. “That helps inhibit the amount of the virus that’s getting into your cells and body. But it’s only working within that first 24 hours.”

For children and adults alike, Dr. Walker offers another easy to find alternative that can provide relief.

“We’ve used this for many years, the Vick’s VapoRub. Luckily, it doesn’t sting or burn as much anymore. They have the creams and rubs which are a great source to use for your children to breathe easier and to sleep easier.”

Another option that has some health benefits? Celery.

“It has properties where it will numb the back of the throat and helps with sore throats. So, you can give them celery and peanut butter, ants on a log, right? It’s a good treat and helps with their sore throat,” Dr. Walker adds.

How to treat children with a cold

First and foremost, hand hygiene is key. Turn it into a fun game with your children at home. Remind them to cough into their sleeve and not out into thin air, spreading viral particles around.

“In children we want to make sure they’re well hydrated. Make sure they’re drinking plenty of fluids, particularly water and not sugar beverages. For any body aches or fevers they may have, given them Tylenol,” Dr. Walker says. “You can also do children’s Motrin, and cycle that with the Tylenol. Usually those are weight-based dosing, so make sure you know how much your child weighs and pay attention to the directions on the medication boxes.”

For babies, medicine isn’t always an option. Dr. Walker offers some advice for caregivers to provide comfort to infants with a cold.

“The biggest thing is going to be nasal irrigation with saline and making sure their airways are clear of mucus,” Dr. Walker says. “Really suctioning and getting those airways clear is very important for them.”

How can decongestants help?

“This is going to be a self-limited illness. Decongestants are going to help you breathe better,” Dr. Walker says. “You can also use an antihistamine with the decongestant, something like Claritin-D. It is something that will help you breathe better and rest better.”

But when you’re walking the pharmacy aisle seeing a bunch of different options, how can you choose? Dr. Walker has some tips.

“Afrin is a good decongestant to use, but you can only use Afrin for three days. Flonase is an intranasal steroid, but Flonase has been proven in studies not to help in the common cold. It is helpful with allergies, though,” Dr. Walker adds.

Colds and viruses tend to last one to two weeks. If your symptoms are more serious or linger on much longer than that, reach out to your primary care team and schedule an appointment. You can also consider an in-person or virtual visit to OSF OnCall Urgent Care. A virtual visit is available 24/7.

Video Interview Clips

Diabetes: a recap

Aminat Ogun, MD, a family medicine physician at OSF HealthCare, recaps Types 1 and 2 diabetes and where Type 1.5 fits in:

• Type 1: Dr. Ogun says the body’s immune system attacks insulin-producing cells in the pancreas.
  
  “Insulin is a hormone that brings glucose from food from the blood to the body’s cells for energy. So in Type 1 diabetes, the pancreas isn’t producing insulin,” Dr. Ogun explains. “This type of diabetes is usually seen in childhood and adolescence. It’s sudden onset. Symptoms are increased urination, increased thirst, weight loss and blurry vision. A lot of these people are dependent on insulin shots.”
   
• Type 2: The pancreas is producing insulin, but the body doesn’t recognize it. Dr. Ogun says these patients are typically age 40 and up, and the disease has a gradual onset.
  
  “Management is lifestyle modifications, like a healthy diet and physical activity,” Dr. Ogun says. “And there are medications to help control blood sugar like Metformin and Jardiance®, plus insulin shots.”
   
• Type 1.5: This is also called latent autoimmune diabetes in adults (LADA).
  
  “It’s a slow progressing form of Type 1 diabetes. It’s autoimmune like Type 1, but it’s usually seen in adults,” Dr. Ogun says. Symptoms are similar to Type 2 diabetes: fatigue, nausea and vomiting. Or, Dr. Ogun says some people may have little to no symptoms.

More on Type 1.5

So, if Type 1.5 diabetes can mimic Types 1 and 2, how do providers pin down a diagnosis?

Dr. Ogun says it’s something providers are learning more about and getting better at. She says providers will take a blood sample to look at your blood glucose and antibodies. Providers can also sample your blood or urine to look at your C-peptide level. C-peptide is a byproduct of insulin production, and if it’s low it’s cause for concern.

Treatment is similar to Type 2 diabetes: oral medication or an injectable GLP-1 medication like Ozempic®.

“But eventually once the autoimmune destruction happens, the person will need regular insulin,” Dr. Ogun says. “One good thing is that if you are aware the person might have Type 1.5, starting insulin earlier is a little bit better. Maybe that can preserve some of the cells in the pancreas and preserve some pancreas function.”

Shoring up your diet and exercise can also help.

Prevention

Dr. Ogun says since Type 1.5 diabetes is an autoimmune disease, there’s no bonafide way to prevent it. She adds there is a genetic component, meaning a child of someone with Type 1.5 is at a higher risk to get in themselves.

But, Dr. Ogun says sometimes education can be the best prevention. She says she’s happy Lance Bass has spoken out. Bass is active, fit and has diabetes – a sign that it can happen to anyone, and you should be aware of the disease.

Learn more

Read more about preventing and managing diabetes on the OSF HealthCare website.

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Tim Scott, 70, is the first patient to receive the treatment at OSF. Scott traveled from Princeton, Illinois, after receiving a prostate cancer diagnosis. He says he searched for the best cancer care nearby as soon as he was given the news about his diagnosis on Valentine's Day 2024. The OSF Cancer Institute was recommended to him by his care team.

Scott knew he wanted to get treatment quickly, knowing his family history with prostate cancer.

“It had taken my father away and my great-uncle,” Scott says. “I felt fortunate that the proton therapy was in the immediate area.”

On Monday, April 1, Scott began the first of 28 treatments in his cancer journey. He says the appointment was quick, and he felt comfortable with the medical team.

“Your staff had me laughing, which I like,” Scott says. “We had a good time this morning. Everybody walked out and said ‘you’re the man! You’re the first guy!’ Everything went really well and it’s an amazing treatment.”

Scott will receive treatments Monday through Friday until he reaches 28 treatments.

“The treatment itself, by the time they took the different angles of the radiation, it was probably no more than 10 minutes in there. I was very pleased, and the staff made me feel comfortable. It went well today,” Scott says.

The OSF Cancer Institute is the only center outside of Chicago and St. Louis offering proton therapy in the region. James McGee, MD, founding director of the OSF Cancer Institute, says this treatment is less invasive than current treatments being offered.

“It's where a packet of energy with positively charged proton particles is used to go to one spot of the tumor and treat that spot of the tumor,” Dr. McGee says. “We're able to go anywhere in the tumor. Very little dose on the entry side, and no dose on the exit side. Using all of that, we can corral the radiation into the tumor and reduce the dose of radiation to the normal and healthy tissues that we don't want to get incidental radiation, like the lymph nodes and things where the immune response is being mounted to that cancer."

The therapy is powered by a Varian ProBeam® 360° System cyclotron. Dr. McGee says the ability to rotate the system 360 degrees allows the technology to target cancer from any angle.

 "We know the biological effect of protons is often felt to be at least 10% higher than with X-ray therapy. That gets factored into treatment planning. We also know the ability to give these treatments in a way that doesn't affect the immune system, allows the actual radiation treatment to be more effective,” Dr. McGee says. “We're seeing more and more evidence that there is better tumor control in certain situations. People are not failing that would've failed at those doses with X-ray therapy. Also, we're not generating secondary cancers from the radiation."

It is estimated the OSF Cancer Institute will treat upwards of 3,700 cancer patients annually with an estimated economic impact on the Peoria-area of $1-billion over the next decade.

Proton therapy is used most frequently for head and neck, prostate, spine, breast, sarcoma, brain, and esophagus cancers. It can also be a re-treatment after prior radiation.

To learn more about cancer services at the OSF Cancer Institute, please call 1-844-OSF-4-HOPE or 1-844-673-4467. 

Other key features for patients include:

- Brachytherapy: Also known as implant radiation, brachytherapy is a treatment that is delivered from inside the tumor and can deliver more intense doses of radiation at the tumor site. It is most commonly used to treat cancers of the female pelvis, prostate, breast, eye and skin. Currently, patients are transported all over the hospital in order to receive these procedures. When the HDR Brachytherapy suite in the OSF Cancer Institute opens, everything will happen here. This state-of-the-art surgical suite is outfitted with a GE CT on rails, specially designed for the space. This will make for a much better patient experience. 

- Teaching Kitchen: The CEFCU Teaching Kitchen will offer a healthy lifestyle educational environment by focusing on prevention and wellness efforts to lower the risk for cancer and cancer recurrence. Patients and families affected by cancer will benefit from classes where they learn how to prepare foods that address specialized needs while going through cancer treatment. Prevention of other diseases and chronic health conditions are also addressed, with advanced IT technology, remote access can be offered for live-streaming classes.  

- Healing Garden: Located on the east side of the campus, this area has a number of features including statues of the Welcoming Virgin Mary, St. Peregrine, the patron saint of cancer, and St. Francis of Assisi. There is a water feature along the path, and the space will host the Gilmore Foundation Teaching Garden. The fresh food grown here will be used in the teaching kitchen, which is right next to the healing garden.

- Cancer Support Services: The main focus is assisting patients and their families from diagnosis through survivorship, as well as prevention for those at a higher risk of developing cancer. These services include nurse navigation, dietitians, financial navigation, counseling, cancer specific clinics and survivorship. 

Video Interview Clips

When talking about the opioid crisis in America, you don’t have to explain much to Howard Marsh.

A first responder for nearly a half century, Marsh has gone on numerous ambulance calls for a suspected overdose.

“It breaks my heart,” says the Advanced Medical Transport paramedic. “I just can’t believe people do this to their bodies.”

New federal data show nearly 108,000 people died of an overdose in 2022. That's up slightly from 2021. It’s a time to know the facts and misconceptions about overdoses, their causes and ways to reverse the deadly effects. One such way is naloxone, known under the brand name Narcan, a medication that has become more available in recent years to both first responders and everyday citizens.

“It’s really a good drug to have around,” Marsh says.

Narcan basics

Les Mennenga is lead educator for East Central Illinois Emergency Medical Services (EMS), an OSF HealthCare organization that trains ambulance workers. He describes Narcan as an opioid antagonist that helps reverse the effects of dangerous drugs like fentanyl, morphine, heroin and Tramadol.

“If we get too much of those medications in our system, they’ll bind with receptor sites in our brain. They’ll slow our breathing and pulse rate down,” Mennenga says. “They can actually stop the signal to our diaphragm and make us stop breathing.”

Conversely, he says, “Narcan gets to those receptor sites, competes with the opioid and will knock it off. It will help the person restore their breathing.”

Mennenga says Narcan does not work with methamphetamine, cocaine and other non-opioids.

At the scene of a suspected overdose, typically the first bits of information come from friends or family of the ailing person. Those people likely know if the person has a history with a certain drug, for example. First responders will also look for drug paraphernalia like needles. Mennenga says if the person is still alert and breathing, they would not qualify for Narcan.

“The only time we should be administering Narcan is if they’re having difficulty breathing,” Mennenga says. “They’ll be unresponsive, snoring-like respirations or not breathing at all.”

Blue lips are another sign, Marsh says.

There are three ways to give Narcan: through a shot into the muscle; intravenous therapy, commonly known as an IV; and the most common and simple way, Mennenga says, is a nasal spray. Mennenga adds that Narcan may be combined with cardiopulmonary resuscitation (CPR) or a bag valve mask to help restore breathing.

Mennenga says once the person comes to, they might experience withdrawal symptoms like nausea, vomiting or, in rare cases, a seizure or heart issues. First responders will provide more care as needed.

“Go to the hospital and get checked out,” Marsh advises. “We prefer we take you in case something happens in route.”

What you should know

East Central Illinois EMS has rolled out a Narcan leave behind program. The agency provides kits for first responders to leave with friends, family and others after responding to an overdose. The program serves as a reminder that this is an important issue. Experts say survivors are at high risk for repeated overdoses, and Narcan may be the only chance to save their life.

“Overdoses are quite common, unfortunately,” Mennenga says. “Nobody’s immune to the opioid crisis.”

He says if you want a supply of Narcan at home, contact your local health department for options.

Mennenga also says Narcan, shockingly, has some detractors. He says some people think opioid users need to learn the consequences the hard way. But Mennenga, a veteran of the EMS world, says many people who suffer overdoses aren’t your stereotypical drug user. Their use might have started with an injury, leading to pain medication. Or older adults often mix up pills and take too many.

“If they really want to get some help, we can give them resources like their public health department or the state public health department,” Mennenga says.

Learn more

Websites for the U.S. Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration, the Illinois Department of Public Health and the Michigan Department of Health and Human Services all have information on opioid addiction, treatment and recovery. If you are in crisis, the national Suicide and Crisis Lifeline is 9-8-8.

Interview clips - Les Mennenga

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Mental health care starts with a first step

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

Feeling bloated today? You’re not alone.

It’s not uncommon to get the sensation caused by gas, air or fluid retention in the stomach or small intestine. But what’s important to know: bloating has many causes, says Aminat Ogun, MD, an OSF HealthCare family medicine physician. So don’t let it linger and hope it will go away. If symptoms persist, see a health care provider so they can rule out something more serious and give proper treatment.

“It might feel like your stomach is full, swollen or sometimes tender. It can cause some discomfort,” Dr. Ogun says.

Causes for bloating include:

• The body makes too much gas.
   
• An overgrowth of intestinal bacteria. H. pylori is a common type. Dr. Ogun says it causes chronic inflammation in the stomach lining, and it can lead to peptic ulcers or even stomach cancer if untreated.
   
• Diet issues, like intolerance of certain carbohydrates or a gluten intolerance.
   
• Hormone changes during a woman’s menstrual cycle.
   
• Abnormal gastrointestinal motility. Simply put, this is when your gut is not working properly. Dr. Ogun says one example is gastroparesis.

              “The body takes its time before its able to pass food from the stomach to the small intestine,” she explains.

• Stress, anxiety and depression.

Dr. Ogun points out that we can’t control some of those causes, but others we can. She says a typical first step for a person with bloating is to change their diet. She says doctors may recommend a diet with a long name: fermentable oligosaccharides, disaccharides, monosaccharides and polyols. But just remember the abbreviation: FODMAP. It describes carbohydrates that are difficult for the body to break down.

Foods to avoid on the FODMAP diet: pasta, cereal, bread, yogurt, ice cream, apples, cherries and peaches. Alternatives include quinoa, brown rice, eggs, cheese, grapes, strawberries, chamomile tea, peppermint tea and ginger tea.

“Have a food diary,” Dr. Ogun suggests. “See what triggers your bloating symptoms and see if you can eliminate those foods.”

People with bloating may also take medicine like Gas-X. If you have intestinal bacteria, you’ll be on antibiotic medication.

Dr. Ogun adds for people age 55 and up, bloating is less common, and other health issues are, simply due to older age. So, if you are of that age and have sudden bloating symptoms, see a provider to find out if your symptoms are bloating or something more serious. And for all ages, if you have severe diarrhea, nausea, vomiting or unintentional weight loss, stop by a doctor’s office.

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

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

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

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

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

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

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

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

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

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

How things can change

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

“It’s all individualized,” she says.

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

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

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

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Recent reports from the United States Centers for Disease Control and Prevention (CDC) are again raising awareness of hepatitis C.

A 2022 report found “too few people diagnosed with hepatitis C are being treated, despite availability of medications capable of curing this viral infection.” Specifically, the agency estimates fewer than one in three people with health insurance are getting direct-acting antiviral treatment for the infection within a year of diagnosis. A June 2023 study published by the CDC also examined gaps in access to treatment, building on the 2022 findings.

The statistics resonate with Marcie Lindstrom, a gastroenterology advanced practice provider at OSF HealthCare.

“If we go back 10 or 15 years, hepatitis C treatment was really difficult,” Lindstrom notes as a possible reason for the hesitancy. “Treatment lasted a year or a year and a half. It required an injection. People really felt bad during treatment.”

Conversely: “Treatment today is so easy. It’s completed in as little as eight weeks. It’s a pill. No more injections,” Lindstrom says.

The basics

Lindstrom says hepatitis – whether A, B, C, D or E – describes inflammation of the liver. She says hepatitis C is a blood-borne virus, and doctors over the years have settled on some common ways it spreads:

• A blood transfusion prior to 1992. Prior to that time, screening blood donors for diseases was not reliable.
• A tattoo or piercing at a place that’s not regulated
• Men who have unprotected sexual relations with men
• People who use illegal drugs, either through a needle injection or snorting through the nose

“Often people are at parties and sharing a straw or dollar bill to ingest. There are a lot of blood capillaries inside the nose. Those can break open,” and blood can spread, Lindstrom says.

Lindstrom calls hepatitis C a silent ailment due to a lack of symptoms.

“Many people can have hepatitis C for decades before they become aware of it,” she says.

Even worse, when a person does have symptoms, they may be vague and tough to distinguish from everyday problems. Fatigue and body aches are common complaints.

Often, Lindstrom says a provider discovers hepatitis C after a person comes in for some routine bloodwork. The bloodwork may come back showing elevated liver enzymes, and a test specifically for hepatitis – also a simple blood test – would then be done.

But if you have any hepatitis C risk factors, you should talk to your health care provider about when you need to be screened. A provider may recommend a screening once a year. And generally, federal guidelines say all adults should be screened for hepatitis C once in their life, and all pregnant women should be tested during each pregnancy. Ask your provider about it when you’re younger rather than older, Lindstrom pleads.

Why it’s important

Untreated hepatitis C can lead to liver scarring known as cirrhosis. That means fewer cells doing their daily functions, which, in turn, can lead to liver failure, liver cancer and even death.

“That’s why treatment is important. We don’t want people to progress to getting cirrhosis,” Lindstrom says. “If they take their eight to 12 weeks of treatment and don’t have a lot of scarring, we have a high success rate in clearing the virus – 98 to 100%.”

Learn more

Read more about gastroenterology care on the OSF HealthCare website.

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Nearly 800,000 Americans suffer a stroke each year.

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

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

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

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

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

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

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

Why it’s important

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

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

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

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

Prevention

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

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

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

Learn more

Read about stroke care on the OSF HealthCare website.

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One in 1,000 Americans are affected by secondary lymphedema. It’s a chronic disease when there’s an increased collection of lymphatic fluid in the body that causes swelling. Those with cancer are known to develop lymphedema, which can lead to skin and tissue changes, according to the National Institutes of Health.

Sometimes those with lymphedema can inherit the disease, known as primary lymphedema, which is much rarer. You can be born with lymphedema, develop it during puberty, or later.

There’s no cure for lymphedema. It’s a disease, and one like diabetes that you have to manage through treatment. Treva Haney, a supervisor in Rehabilitation Services at OSF HealthCare, says her team works through different treatment plans with patients to meet their specific needs.

“Usually the plan of attack for treating lymphedema is complete congestive therapy,” Treva says. “This involves compression bandaging and a special, lymphatic massage.”

Along with the massage and bandaging, the plan can include manual lymph drainage, which – like it sounds – is a specialized form of manual therapy used to stimulate the lymph system and promote drainage.

Haney says exercise is a great way to get lymph fluid moving from the part of the body where it has collected.

“We have therapists who will use some of the equipment to get people moving and exercising. We teach the patients how to do the self-massage and how to do the bandages. As we get that limb better under control, we can recommend compression garments that they can wear,” Treva says.

Haney says some patients her clinic works with are former cancer patients.

“Our lymph system just builds up and you can get a big arm. We see that a lot with ladies who get breast cancer treatments,” Haney says. “They have axillary nodes or armpit nodes removed as part of their treatment and then their arm will swell. We occasionally see it in the legs from other pelvic cancers.”

“Stay active, stay mobile!” Is the advice Haney has for those looking to prevent lymphedema.

“If you can maintain a healthy and active lifestyle, that can decrease your risk for lymphedema,” Haney says.

People should see an occupational therapist or physical therapist if they’ve been diagnosed with lymphedema or have swelling due to a post-surgery or post-traumatic injury. You’ll need a referral from your physician to set up an initial evaluation.

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Roughly 20,000 Americans are diagnosed with esophageal cancer each year. It’s a form of cancer more commonly seen in men, with around 1 in every 100 men or 1 in every 400 women being diagnosed over their lifetime.

While other forms of cancer have specific screenings to find the disease, esophageal cancer treatment relies greatly on the presence of symptoms.

“The most common symptoms are patients who have trouble swallowing,” says Kyle Stang, MD, a radiation oncologist with OSF HealthCare. “We call it dysphagia. Whether it’s trouble getting food down when you’re swallowing or pain when you swallow, that’s the most concerning symptom. You can also have reflux or heartburn that don’t get better with medications. Other times, folks can present with weight loss, coughing, shortness of breath or even chest pain.”

The esophagus is the tube that connects your mouth and stomach. It helps deliver food between the two. According to Dr. Stang, esophageal cancer is a more aggressive form of cancer. He emphasizes the importance of seeing your doctor as soon as possible when symptoms are present.

“The way we treat esophageal cancer really depends on the stage and scenario. For some types of very early stage esophageal cancer, we can treat that with surgery alone,” Dr. Stang says. “For most patients, we’re talking about chemotherapy and radiation therapy for about five and a half weeks. Following that, we’ll typically re-evaluate someone to see if they’re a good candidate for surgery to take out the tumor in the esophagus or the upper part of the stomach.”

Dr. Stang says some common risk factors for esophageal cancer include alcohol, smoking, obesity, and a pre-existing history of gastroesophageal reflux disease (GERD), as well as Barrett’s Esophagus, which is a condition related to chronic inflammation of the esophagus where some of the cells begin to turn dysplastic (showing abnormal development. 

"We consider that to be a pre-invasive condition,” Dr. Stang adds.

While there’s a lot of work to do in the medical community regarding the treatment of esophageal cancer, Dr. Stang says one new treatment is showing promise.

“The ongoing clinical trials have been looking at a new form of treatment called immunotherapy,” Dr. Stang says. “Newer trials are looking at this therapy to see if we can bring in that new agent after chemotherapy and radiation therapy to see if we can improve outcomes.”

While the immunotherapy trials may not provide results for years, Dr. Stang reminds patients to see their health care provider if you experience any symptoms.

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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.

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