Back to school season means youngsters spending time in locker rooms and college students doing the same in dormitory bathrooms. Despite everyone’s best efforts, the floors in those spaces have a reputation of not being the cleanest. Quickly doing your business while barefoot may seem like no problem. But lingering on the floor may be a virus that causes painful plantar warts.

“Plantar warts are one of the most common skin lesions we’ll see in our office,” says Marc Leonard, DPM, an OSF HealthCare podiatrist.

What are plantar warts?

Dr. Leonard says plantar warts (also called plantar verruca) are caused by a virus that gets into the bottom of your foot. The warts can spread easily.

“It looks like a callus. You see little growths. Sometimes they even satellite out, and we’ll get other little growths around that original lesion,” Dr. Leonard explains.

So, Dr. Leonard’s advice is to treat the issue early. If you see a wart, make an appointment with a podiatrist. Treatment is generally two steps. First, a provider will shave off the excess skin. Then, they will apply acid to the feet.

“It’s an acid that almost blows up that outer layer of tissue. Then we decompress it,” Dr. Leonard says. “Even with that, it still takes several treatments.”

Dr. Leonard says your feet will be sore for a couple weeks after treatment. So, you’ll want to stay off your feet if possible.

Left untreated, Dr. Leonard says plantar warts can cover the entire bottom of both feet and even your hands if you touch the warts. Walking will be painful, and so will treatment.

Prevention

If wart-covered feet and multiple acid treatments don’t sound like fun, there are easy prevention steps.

For dirty places like bathrooms and locker rooms, wear a slip on-type shoe like a shower shoe or flip flop. When you’re done, dry the shoes off or let them dry in front of a fan so they’re ready for the next use. Then, put on your sturdy, everyday shoes. In other words, don’t see this as an excuse to wear flip flops all day. Dr. Leonard and other podiatrists will tell you that your feet need more support.

Also, clean your feet, socks and shoes regularly. Don’t walk around in dirty or wet socks and shoes. If you sweat a lot, have extra pairs of socks to change into. And use a disinfectant wipe to clean your nail clippers.

Learn more

Learn more about keeping your feet healthy on the OSF HealthCare website.

Interview clips

Related articles

OSF HealthCare library: Warts
OSF HealthCare library: Warts in children
OSF HealthCare blog: Your feet deserve some love

With age comes physical limitations. But it’s important to stay active, says John Rinker, MD, an internal medicine physician who specializes in geriatrics at OSF HealthCare. When you keep moving, it helps reduce the risk of things like diabetes, high blood pressure, heart disease, obesity, cancer and neurocognitive diseases like Alzheimer's.

In other words, Dr. Rinker says, it’s not fun to live long if you’re not well. Your lifespan versus your health span, as he puts it.

“It really, really pays to maintain exercise and be in good physical shape as you age. It reaps huge dividends on how long you live,” Dr. Rinker stresses.

Guidelines

Each person should have a tailored plan as advised by a health care provider. But regardless of your age, the American Heart Association (AHA) generally recommends 150 minutes of moderate physical activity or 70 minutes of vigorous physical activity each week, spread out over several days. A brisk walk would qualify as moderate intensity (also called zone two training), while running, swimming or riding a bike would be vigorous. Vigorous exercise is associated with a term called VO2 max, referring to maximum use of oxygen. In layman’s terms, you’re breathing hard and conditioning the heart.

“Most of that type of [vigorous] training is at a higher interval. You’re going to get breathing really hard for three to five minutes while you sustain a pace that’s rather difficult. Then you’re going to rest and let that heart rate come back down. Then go back to the hard exercise,” Dr. Rinker explains. “That back and forth with the heart rate really helps to train how well your heart can pump blood to muscles. That’s a really good marker of how well conditioned you are.”

The AHA also recommends two days of strength training per week. That could be lifting weights, using resistance bands or calisthenics, where you use your body weight for resistance rather than equipment.

“I really like the strength training piece,” Dr. Rinker says.

“It doesn’t take a lot as you age to tension a muscle enough to maintain muscle mass. We really find that people who are able to maintain muscle more muscle mass as they age are going to do much better with those health span and lifespan issues,” he adds. “So, the goal isn’t to make everyone a huge bodybuilder. The goal is to decrease the rate of decline as we age.”

On the days you do strength training, aim for 30 minutes per day. Dr. Rinker says if you really want to lean into this area of fitness, consider getting a personal trainer.

Limitations

It’s important to work around your ability and not push through pain, Dr. Rinker says. If aging has brought back or leg pain, skip the treadmill and try swimming or a weightlifting session while seated.

“You want to make sure you’re not going to injure something further. That will create a bigger setback or other deficit that are not going to help you in the long run,” Dr. Rinker says.

The bottom line

From VO2 max to zone two to calisthenics, there are a lot of terms to keep straight. If you don’t want to overthink it, just remember to keep moving. Push yourself with some vigorous workouts if you can, but commit to some form of exercise regularly.

“Most of your day-to-day exercise [as an older adult] should be just basic activity,” Dr. Rinker says. “Think of a brisk walk. Walking at a pace for about 30 minutes where you could still hold a conversation with somebody, but it would be difficult to sing a song.

“If I can just get someone to walk every day, I think they’re going to be in good shape,” he adds.

Learn more

Read more about moving your body safely and aging well on the OSF HealthCare website.

Interview clips

Related stories

Get cozy: How to exercise at home
Gardening benefits more than your taste buds
Exercising your heart

• Backward walking: “It works different muscle groups than forward walking. You’re going to work different parts of your shin. It’s going to help a lot with ankle mobility,” Dr. Rinker says.
  
  Try walking backward for a couple minutes on your walk. Keep safety in mind by avoiding trip hazards. Look for an even, non-crowded surface, like a sidewalk or track. Dr. Rinker doesn’t recommend it on a treadmill.
   
• The number six: There are a few workout variations that incorporate the number six. One encourages you to walk for 60 minutes at either 6 a.m. or 6 p.m. Another suggests a six-minute warmup and six-minute cool down, while others say six refers to getting active six days a week.
  
  “The 6 a.m. or 6 p.m. – what I love about that is it schedules the walking,” Dr. Rinker points out. “For some, the barrier to exercise becomes their life schedule. Things get in the way. You meant to exercise, but you look back on your day and realize you never did. Then a week goes by [with no exercise].”
   
• Farmer’s walking: This is where you walk with a heavy object in each hand for a defined distance. Think of a farmer carrying seed bags back to the barn. Dr. Rinker says this can help with balance, muscle growth and grip strength – all things proven to increase longevity.
   
• Rucking: This is walking with a weighted vest or backpack. Dr. Rinker says this came into the mainstream after people saw military members walking with all their gear. Like farmer’s walking, rucking burns fat and builds strength, including in your heart, without increasing speed.
  
  Dr. Rinker says it can be as simple as loading up a backpack with books or other household objects. Just start with a small amount, and work your way up.
  
  “It doesn’t take a lot of weight for you to really feel it within the first 10 to 20 minutes. You don’t want to be stuck far out with a heavy backpack,” Dr. Rinker warns.
   
• Japanese walking: This involves alternating between slow and fast walking. Dr. Rinker says to think of it as high intensity training but in a walking format. If you set out for a 30-minute walk, try switching from a brisk pace to a slow pace every three minutes. Dr. Rinker says this can be especially beneficial for people who are not well-conditioned. He says it can strengthen your heart.
  
  “For people who have a fear of exercise, this is a nice way to ease in,” Dr. Rinker says.

The bottom line

Dr. Rinker says any of these exercise variations is OK to try. Just know your limits, and find a routine that works with your body and schedule.

“It can be boring to do the same thing every day,” Dr. Rinker says. “Finding different variations often leads you to feel challenged, wanting to do more and wanting to try new things.”

Why it matters

Are you doubting that walking is for you?

“Walking is a wonderful way to improve cardiovascular fitness, muscular strength, endurance and balance,” Dr. Rinker says. “In general, humans are meant to move. The more we’re moving our bodies, the healthier we’re going to be long term.

“Bed rest is good for no one. We need to be moving,” he adds with a smile. Walking is free and requires no equipment, Dr. Rinker adds.

The American Heart Association recommends adults get 150 minutes of moderate-intensity exercise per week. But Dr. Rinker says if your body can tolerate it, try for more.

Limitations

The ability to walk beyond daily tasks might be limited for some. A young person might have a chronic injury, or an older adult might simply have wear and tear on their body. 

Dr. Rinker stresses that if an exercise makes you hurt badly, stop it and seek guidance from a health care provider. But, there are ways you can still make walking a part of your routine.

“Change the timeframe or pace. Go for shorter distances,” Dr. Rinker suggests. “There are some people who, let’s say, have COPD and have trouble breathing. They feel short of breath, so they stop walking. We actually want them to walk and spend some time with some shortness of breath. They actually improve their exercise tolerance. Their breathing improves over time.”

Another approach: if you’re used to taking a 30 minute walk, break it up into five minute walks throughout the day.

Learn more

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

Interview clips

Related stories

Lifespan vs. health span
Get cozy: How to exercise at home
Cold, cold, go away: How to stay active in chilly weather
Walk this way
A shin-termission: Navigating lower leg pain
‘It shouldn’t be a barrier to play'
Keeping backs healthy in school

Humans are on their feet most of their life. So why wouldn’t you want a proper pair of shoes?

Specifically, look for footwear that’s wide enough to prevent two common toe issues: bunions and hammer toe.

Marc Leonard, DPM, an OSF HealthCare podiatrist, sees these ailments frequently but stresses they are treatable without surgery when caught early.

Bunion

A bunion is when bones move out of place to form a bump on the toe joint, drawing the toe inward. Bunions are mostly seen on big toe, but they can happen on the pinky toe, too. This is called a bunionette or tailor’s bunion. Dr. Leonard says bunions are often caused by joint hypermobility, and they can also be genetic.

If pain from a bunion is not impacting your daily life, getting wider shoes or using a splint may do the trick. When the discomfort becomes intolerable, a doctor will discuss surgery.

“We make a cut in that bone, bring it over back into alignment and put some screws in,” Dr. Leonard explains. “Then we protect the area during post-operative course.”

The surgery is outpatient, and you typically can walk out of the doctor’s office. But beyond daily household activities, you should be off your feet for a month.

“We find the more people rest and elevate the foot, the better they feel. There’s less swelling and less potential for complications,” Dr. Leonard says.

Six to eight weeks after surgery, the person can resume exercise.

Hammer toe

Hammer toe is when a toe (usually one other than the big toe) contracts up, resembling a hammer.

“They make very prominent knuckles that can rub in the shoe and get red, irritated and sore,” Dr. Leonard describes.

Like bunions, splints and wider shoes are a short-term treatment, and outpatient surgery is possible for more severe cases.

“We remove some of the bone which allows the toe to reduce the contracture. Then, typically, we stabilize it in that new position with a wire for four weeks,” Dr. Leonard says. “Then that wire comes out. The toe should be more stable, straighter and hopefully not rub and cause the same pain it did prior to surgery.”

Recovery time is like bunion surgery but may be a little quicker.

 Finding footwear

The common link between bunions and hammer toe? A big step toward prevention is picking the right footwear.

“Cheapest is not best,” is an understatement, Dr. Leonard says.

“Things I recommend avoiding: flip flops, lighter weight canvas shoes or shoes that just don’t give you a lot of support,” Dr. Leonard adds. “Instead, I recommend a good, sturdy walking shoe. If you have to do a sandal or flip flop, get something that’s well-made with good arch support.”

Avoid wearing high heels all the time, Dr. Leonard also advises. You can also try an orthotic device, or a shoe insert to give you more support. Over the counter orthotics are just fine, Dr. Leonard says, but a podiatrist might recommend taking a mold of your foot to make a custom insert.

Learn more

Learn more about foot care on the OSF HealthCare website.

Interview clips

Previous coverage

Stand up for your feet

Find the right foot for summer foot health

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.

Interview clips

It’s important to exercise year-round for your physical and mental health. Clare Spires, an exercise physiologist at OSF HealthCare, has some tips to stay active in the winter.

• Before you even pick up a weight or lace up the running shoes, set standards for yourself.

“Even if you can just make the goal to do something that day,” Spires says. “It doesn’t need to be an hour or hour-and-a-half workout. It can be 30 or 45 minutes. It can be at home, at a gym or outside. But just making those goals possible and achievable.”

• Workout in the daylight. This can give you a mood boost and, if you’re outside, ensure you have enough light to be safe. Try working out on your lunch break or just when you have 20 minutes to spare, Spires suggests.
   
• If the outdoors is not nasty (like a blizzard), a walk or run outside is doable, Spires says. Just keep your safety in mind.

“Check the weather forecast. Use shoes that have more traction for those slippery sidewalks. Stay hydrated. Dress appropriately,” Spires advises.

Proper attire includes layers of sweat-wicking fabrics, and gloves and hats to warm your hands and head. Also, have a safety plan that includes access to first aid and a phone. Workout with a buddy when you can.

Also, know your limits. Spires says if you wouldn’t go to the gym for two hours, don’t shovel snow for two hours. Do it in five-to-10-minute chunks.

“We also use something called the rate of perceived exertion (RPE) scale,” Spires explains. “It’s one to 10. Ten would be the hardest exercise you’ve ever done. One is just sitting on the couch. We ideally like people to stay in that four to six moderate intensity range. So, if you think shoveling snow is in the four to six range and not creeping up to an eight or nine, that would be appropriate for you to do.”

On the positive side, Spires adds that depending on your location, you can branch out and try workouts like snowshoeing, ice skating or sledding.

“It’s fun to try new hobbies that are going to get you more active,” Spires says.

• When snowed in and working out in your home, use your surroundings to your advantage. For example, Spires suggests going up and down the stairs a few times with breaks in between.

“You can do different body weight exercises like jumping jacks or squats,” Spires adds. “You can get creative and use soup cans, water bottles or even bottles of hairspray to add a little bit of weight or intensity to your workout.”

Just like working out outside, Spires says to be aware of your surroundings. Am I on carpet or hardwood, which may be slick? Is there a stray cord or a wandering child I could trip on? Is there a counter or dresser nearby for me to catch my balance?

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

Interview clips

Related stories

Get cozy: How to exercise at home
Hit your head? Don't just shake it off

Icy roads? Gym too far away? Or are you just not a people person? Cozy cardio may be right for you.

What is cozy cardio?

Clare Spires, an exercise physiologist at OSF HealthCare, says cozy cardio, in simple terms, is a way to make exercise comfortable in your home. It’s wise to talk to a health care provider about what workout is right for you. But generally, cozy cardio offers some freedom. For example, you can work up a sweat with an instructional video or app. Or you can just find a routine that works for you.

Equipment

Spires says you don’t have to rush out and buy equipment. But if you like having something to hold or press your feet to, there are options.

Walking pads have become popular. These are miniature treadmills with just the bottom structure. There are no rails and monitor at eye level like a traditional treadmill.

“Some can do inclines,” Spires says. “You can put it under a desk if you’re a remote worker. It’s just another way to get those steps in during the day without leaving your house.”

A small set of weights can be a welcome addition. Skip the 50 or 100-pound weights, Spires says. Two to five pounders are a good start.

“If you’re doing some bigger muscle groups like biceps and quads, you could add more weight,” Spires says. “But typically, those at-home workouts are made that you can lift weights with something like a soup can or a water bottle.”

Keep that water bottle handy for hydration, too. And a mat can help with balance.

Safety

Gyms typically have safety measures and employees watching out for injuries or emergencies. During cozy cardio, you could be alone in an environment that wasn’t meant for exercise. Think of a cluttered living room.

So, Spires says to do a safety check before each workout. Remove trip hazards like cords and rugs.

“If you could use a little extra stability, maybe work out next to a counter that you can hold onto. Avoid something that’s going to move on you quickly,” Spires advises.

Exercise with someone, if possible. Have a phone nearby in case you need to call 9-1-1. Start slow, and work up to your goals.

How much?

The American Heart Association recommends 150 minutes of moderate intensity exercise or 75 minutes of vigorous exercise per week, spread out over several days. For those with that goal in mind, many do 30 minutes of sweat-building for five days per week. Others do 50 minutes per day for three days. Spires says you can have some cardio days and some weightlifting days. She says it’s good to mix it up.

Spires says when defining “moderate intensity,” think about singing a song while working out. If the strain of the workout means you can’t sing without running out of breath, you’re at moderate intensity. “Vigorous” would be an activity above that, like running.

It’s a process, but Spires says the benefits are worth it. Regular exercise means lower blood pressure, cholesterol, chance of diabetes and chance of heart disease. You might also see improved mood and sleep.

Interview clips

Related stories

Weight doesn't have a calendar
Why gardening makes great exercise
Four exercise routines you can do at home
Exercise snacking: The quick and easy way to a healthier heart

She was about to become a statistic in a polio epidemic and battle a disease that still impacts her in 2024.

Though polio is nearly eradicated today thanks to childhood vaccinations, both the disease and the shots have garnered headlines lately. This month, Paul Alexander, who spent much of his life in an iron lung, passed away at age 78. And the state of Illinois is combating a measles outbreak, reminding us of the importance of vaccines.

Kemnetz’s story

Kemnetz says the week she got her headache that led to a polio diagnosis was a painful blur.

“All my senses were on high alert,” she says. “The littlest sound was like somebody stomping next to my ear. We had a little night light. I couldn’t even stand to have it on.”

On Sunday, the family doctor made a house call and immediately called for an ambulance. Kemnetz wound up at Mercy Hospital in Urbana, Illinois (now OSF HealthCare Heart of Mary Medical Center). That next month, she says, was also a blur. Among other things, doctors upon her arrival performed a spinal tap to examine Kemnetz’s spinal fluid. She also recalls waking up one day with doctors preparing to put her in an iron lung to help her breathe.

“I screamed at my parents not to put me in that. I was terrified,” Kemnetz says.

After leaving the hospital, Kemnetz got more treatment near her home before spending over a year at a hospital in New York. There, she reprogrammed her leg muscles to work through repetitious exercises. It’s what we know today as physical therapy. Eventually, she returned to a mostly normal life and a career in real estate.

Polio then vs. now

Albert England, MD, an infectious disease physician at OSF HealthCare, says polio has been around “for a long time.” There’s even evidence of ancient Egyptians having it, he says. The disease is caused by a virus that “invades the nervous system and can cause total paralysis in a matter of hours,” according to the World Health Organization (WHO). Other symptoms are flu-like, including fever, difficulty breathing, fatigue, headache, vomiting, a stiff neck and pain in the arms or legs.

Dr. England says today, doctors use ventilators to help sick people who can’t breathe. But back in 1952, the iron lung – which Kemnetz got acquainted with – was the help available for people with polio.

“It produced negative pressure around the patient, allowing the lungs to expand and contract regularly,” Dr. England explains.

“It was like having CPR 24/7,” Kemnetz says of lying in the tube. “So uncomfortable.”

Kemnetz also gave blood to help develop a polio vaccine, the number one way we have come to fight that disease and many others. It’s a topic she’s passionate about today.

“We have to save the children,” she says.

The United States Centers for Disease Control and Prevention (CDC) says children should get four doses of the polio vaccine as a part of routine childhood vaccinations. The CDC says while it’s rare, adults who know or suspect they did not get the shots as kids should get them as adults. Adults who are at an increased risk of getting the disease, such as working in a laboratory where the virus may be present, can get a booster shot.

“The vaccine prevents illness by developing antibodies,” Dr. England explains.

Kemnetz today

In 1985, Kemnetz developed post-polio syndrome, a disorder that weakens the nerves and muscles. She says her hands “look nice,” but everyday tasks like writing, eating or shuffling cards are tough.

“There are just not as many neurons providing the strength the people need,” Dr. England says of post-polio syndrome.

But, after being told in 1952 that walking, having children and living a long life was unlikely, Kemnetz is counting her blessings. Among them are the chances to recount her life story with her children and grandchildren.

“I think I thumbed my nose at them pretty good,” she quips about her prognosis back then. “The word ‘can’t’ isn’t in my vocabulary.”

Interview clips

B-roll

Related stories

The history of vaccines and how they're developed
Back-to-school season is the right time to check if your child is up-to-date on vaccines
Tips for your newborn's vaccine schedule
Vaccinations: They're for adults too
Importance of vaccinations
RSV's impact on your baby

Fast forward to June of 2023, and Sandford’s world is about to change again.

Three, two, one.

The door at OSF Moeller Cancer Center in Alton, Illinois, opens, and Dr. Manpreet Sandhu walks in. She tells Sanford he has cancer in his upper intestine, liver and lymph nodes. It’s in an advanced state and not curable. Devastating news for anyone.

But cancer wasn’t about to slow down the 67-year-old from Brighton, Illinois. He’s still bull riding on a senior tour during chemotherapy, making him a prime example of why staying active during cancer can help in the fight.

Jack’s journey

A Virginia native and Army veteran, Sandford came to southern Illinois around a decade ago to take a manufacturing job. He rode bulls off and on during that time, earning the nickname Sandman.

In late May of 2023, Sandford was at a rodeo and got sick.

“I was throwing up and couldn’t ride,” he recalls.

At first, he and his wife thought it was food poisoning.

“My wife cooks great food, though,” Sandford says, ruling idea one out.

Next stop: seeing a doctor.

Sandford went to OSF HealthCare Saint Anthony’s Health Center in Alton, Illinois. Providers quickly told him more advanced imaging was needed to get to the bottom of things. Then came the cancer diagnosis and a treatment plan.

“I’m here every other Monday getting chemo,” Sandford lays out matter-of-factly. “I get sick. I have my bad days and good days. It makes you irritable and hard to be around. But you just have to not really think about it that badly. You just need to keep moving forward.”

Why staying active is important

In her early visits with Sandford, Dr. Sandhu says it was clear that he wanted to stay active. It’s advice she would give anyone on a cancer journey.

“We have conversations with our patients to see where they are and what their goals are,” says Dr. Sandhu, a medical oncologist.

“Chemotherapy medicines are strong. They will make your muscles and bones weak,” she adds. “If we maintain our physical strength, we’re able to counteract those side effects better. In addition, staying active also improves immune health.”

Pursuing hobbies can also boost your mental health and bring a sense of achievement, Dr. Sandhu adds. It’s something critical during a difficult cancer fight.

“Start slow. Small steps,” Dr. Sandhu advises. “We tell our patients: one day at a time. We’re not going to look five years out. We’re going to look to tomorrow.”

For example, Dr. Sandhu sees people who are on chemotherapy and think they are too weak to exercise. She suggests starting on a pedal bike, then progressing to walking. And don’t make it a chore. Do it outside with family or friends. Find joy in the activities.

Sandford agrees, especially about having a support system. He’s lucky to have two: his family by blood and his bull riding family.

“We always take care of each other. We have a prayer service before rodeo,” Sandford says.

Ride on

Sandford is now the oldest bull rider on his senior tour. He’s had ups (placing high in competitions) and downs (a broken collarbone thanks to a mean old bull). But he’s not hanging up his jacket anytime soon.

“The man upstairs put a bump in the road for me. He didn’t tell me to quit,” he says.

Three, two, one. On to the next challenge.

Interview clips - Jack Sandford

Interview clips - Dr. Manpreet Sandhu

B-roll

Related content

OSF HealthCare Newsroom cancer stories
OSF HealthCare Blog cancer stories
Cancer care at OSF HealthCare

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

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

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

An annual physical exam is critical, too.

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

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

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

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

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

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

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

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

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

Learn more about heart care on the OSF HealthCare website.

Interview clips

B-roll

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

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

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

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

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

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

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

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

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

Learn more about stroke care on the OSF HealthCare website.

Related stories

Strokes are more common in older adults

It’s no secret that walking has many benefits to a variety of people. Study after study has shown that people who participate in a walking program find substantial improvements in blood pressure, slowing of resting heart rate, decrease of body fat and body weight, lower cholesterol, better quality of life and greater endurance, among other benefits.

“Walking affects you physically in a positive way, but it also affects you mentally in a positive way," says Matt Davidson, a physical therapist with OSF HealthCare. "You’re getting the cardiovascular component, you’re burning calories, and it’s also good for the legs and endurance. It helps with things we do on a daily basis – grocery shopping, walking around the neighborhood, yardwork – so it’s a very important aspect of everyday life.”

While walking may not be a better cardio workout than running, it may be the best choice for many people. Walking helps with increased flexibility, increased muscular strength and reduces the risk of diseases such as diabetes and hypertension. And you don’t have to be a world-class athlete to reap the benefits of incorporating a walking program into your daily routine.

“A walking program is a very good choice for people with different activity levels, but particularly those who are starting an exercise program," says Davidson. "You’re getting components of cardiovascular exercise, but you’re also getting those muscles to work through your legs; it doesn’t have to be long periods of time and it doesn’t have to be fast paced but just the activity level of going up from where you are now is a foundation to build on later or maybe with other exercise.”

The best part about walking is it can be done anywhere. Now is the perfect time to find a favorite nearby path, a city park or a walking trail. When the weather starts to turn, head inside to a shopping mall or invest in a treadmill with adjustable inclines, walking styles and speed, all of which will help with caloric burn and target a specific muscle group.

“I think walking is more convenient," says Davidson. "You don’t have to go to a gym to walk. You can walk around the neighborhood when the weather cooperates. You have treadmills sometimes at home that you can use. I’ve even had patients who walk laps repetitively around their basement. They listen to music and turn it into a fun activity that they enjoy and it doesn’t take driving across town to do it.”

Davidson offers other tips for beginning walkers. Find a walking buddy who will help with accountability. Purchase a good pair of comfortable, properly fitting shoes, the best financial investment you’ll have to make for your walking program. Remember to start any walk with a quick stretching routine or jog in place, and stretch after your walk to reduce soreness. Start your program slowly to avoid burnout, and keep track of your progress with a walking app or a journal. 

“I would recommend you start at what you feel is a three, four, five when it comes to intensity on a zero to 10 scale," says Davidson. "Work your way up and add maybe a quarter mile every time you walk, depending on your age and fitness level.”

Most importantly, Davidson adds that you should always check with a physician before starting any exercise program, especially if it’s something new for you.

Interview Clips 

B-Roll 

Warmer temperatures bring the return of pesky insects, especially at dusk.

Experts say while most bug bites are not serious, there are times when you need to see a health care provider immediately.

Most bites can be treated quickly

Andrew Zasada, MD, an internal medicine physician at OSF HealthCare, says treatment of most minor bug bites (think mosquito or bee) is down to a science.

First, move away from the area so the bugs don’t bite you again. If the insect left a stinger behind, gently remove it with tweezers.

“Put some ice on the bite site. Wash it gently. Put a little calamine or hydrocortisone on it. Keep it elevated,” Dr. Zasada says.

Don’t scratch the bite site. Leave it alone and let it heal. For children who may find it difficult not to itch, put a Band-Aid over the bite. You can take an antihistamine like Benadryl, Allegra or Zyrtec for itching and ibuprofen or acetaminophen for pain.

If you notice a rapid worsening of symptoms in the 30 to 45 minutes following the bite, or if the wound is not healing over several days, it may be a sign of a more serious problem. See a health care provider.

Serious insect bites

Dr. Zasada says in the Midwest, two types of spiders come with dangerous fangs: black widow and brown recluse.

“These bites can cause tissue destruction at the bite site,” Dr. Zasada explains. “The venom is very potent. It can cause cell death. It’s very irritating.”

If the venom gets into your bloodstream, then chest pain, muscle cramps, sweating and nausea could follow. Dr. Zasada says black widow and brown recluse bites are “very rarely” fatal, but the illness they bring is quite unpleasant.

If you think you’ve been bitten by a black widow or a brown recluse, see a health care provider right away. Your local urgent care is equipped to treat insect bites, but if your symptoms have worsened, the Emergency Department at your local hospital may be the best destination.

Another serious condition to keep an eye on after a bug bite is an allergic reaction known as anaphylaxis.

Symptoms of anaphylaxis include shortness of breath, wheezing and a drop in blood pressure. Dr. Zasada says some people with known allergies may have an EpiPen handy and can inject themselves to alleviate symptoms. Regardless, immediate attention from a medical professional is still needed.

 Leave the critters alone

It’s inevitable that a stroll through the neighborhood will bring an encounter with an insect like an ant or mosquito. But Dr. Zasada says spiders that pack a punch don’t want to mess with humans. They tend to come out at night and live in wooded areas or a dark space in the back of a garage.

In other words, don’t mess with them, and they won’t mess with you.

“When you take clothing out of storage, shake it to make sure there are no spiders,” Dr. Zasada suggests. “When you clean the garage, don’t sit on anything that’s been stored there for a while. Dust it off first.”

Interview clips

Previous coverage

Summer wound care

'Tis the (tick) season

Nearly 800,000 Americans suffer a stroke each year.

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

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

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

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

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

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

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

Why it’s important

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

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

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

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

Prevention

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

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

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

Learn more

Read about stroke care on the OSF HealthCare website.

Previous coverage

OSF HealthCare Newsroom stroke stories
OSF HealthCare stroke blogs

You visit a health care provider for a minor ailment, and you leave with a plan to get better. It could be medication or changing habits, combined with follow-up appointments.

But the issues in the background don’t go away. You might say to yourself:

•  I don’t have a car or childcare. How am I going to get back for the important follow-up?
   
•  A gas station is the only place around me to get food. I can’t go for walks because it’s unsafe. How am I going to start living healthier?
   
•  I can’t afford a new mattress. What will stop my back from hurting in the morning?

These outside, non-medical factors are called social determinants of health. Health care providers everywhere are trained to ask people about them and link them with resources.

Lucas Edwards, PA, is a primary care provider at OSF HealthCare in Godfrey, Illinois. He sees social determinants of health come into play frequently.

“[Some] patients don’t have a car or someone they can depend on for consistent rides,” Edwards says. “They might have something that’s going on that’s medically urgent, and they can’t get to where they need to go. And so they put things off until it gets to the point where things get a little bit out of control.”

In those cases, people usually end up in the emergency department – nobody’s idea of a pleasant day and a more costly way to receive care.

To keep social determinants of health in mind, Edwards says to speak up when you make first contact with your provider’s office – whether that’s on the phone, checking in on a tablet at the front desk or with a medical assistant in an exam room. Tell the person about your circumstances and be willing to answer when asked about the same.

The provider will see you for what brought you there, of course. But they might also direct you to programs within the health system or in the community to help. For example:

•  An upcoming visit may be changed to virtual, an option that became more common during the pandemic.
   
•  You might be able to get care at a reduced cost.
   
•  You could be referred to a social worker.

Edwards also says a simple conversation may enlighten.

“Some patients may not have had the same access to education. They don’t understand that they have this wound on their leg, and if they don’t keep it clean, it can get worse,” Edwards says.

“The provider and the patient need to be on the same wavelength. They need to understand why I want them to do something,” Edwards adds.

There’s one last player in the social determinants of health world: the people responsible for a community’s infrastructure and other daily things we often take for granted.

For example, your doctor can treat an infection. But if you go home and drink the same contaminated water, you’re back to square one.

Or, things cost more at the grocery store than they used to.

“We work with patients who have financial constraints. They have a fixed income, and they can only spend X amount on some object,” Edwards explains. “You need to go to the grocery store and get your bare necessities. So a lot of times, their health care dollars they have budgeted get dwindled.”

“It takes a village,” to keep everyone healthy, Edwards adds.

OSF HealthCare is proactive on social determinants of health. An ongoing effort aims to have people coming to medical offices fill out a social determinants of health screen at least once a year, either through their online patient portal or on a tablet at the office. Among patients screened so far, around two-thirds identified a social need.

Learn more about social determinants of health on the World Health Organization website.

Interview clips

Previous coverage

OSF Newsroom stories on social determinants of health

OSF HealthCare blog: Caring for patients beyond the health care setting