Vitamin D basics

Maddy Draper, APRN, a health care provider at OSF OnCall, says vitamin D is a nutrient our body needs to produce calcium. Calcium helps create strong teeth and bones. So logically, not having enough vitamin D leads to brittle bones (a risk for greater injury after a fall), plus muscle aches and pains. Others with a vitamin D deficiency may not show symptoms. Either way, a provider may order a blood test to confirm the issue and then may advise you to take a supplement. This is usually in pill form and can be prescribed or bought over the counter by itself or as part of a multivitamin.

“Or the provider may just talk about vitamin D-rich foods first before starting a supplement,” Draper says. “High fat fishes, egg yolks, some cheeses and mushrooms.”

Draper adds that pregnant women, babies (especially babies who are breastfed), the elderly and people with darker skin often lack vitamin D.

On the flip side, Draper says it’s rare, but a person can get too much vitamin D. Symptoms include nausea, vomiting and heart palpitations (feeling like your heartbeat is fast, pounding or otherwise irregular). You may also suffer kidney damage.

Summer sun

Here’s advice to commit to memory: Draper says research shows 10 to 15 minutes of sun exposure three times a day can get you a healthy amount of vitamin D.

“You want to protect your skin while doing that,” Draper adds. “Sunscreen and protective clothing like a hat and sunglasses. There’s not any research showing that sunscreen or clothes will prevent you from getting the vitamin D you need.”

Experts say your sunscreen should have a sun protection factor (SPF) of 30 or higher, and you should reapply every two hours. Clothing should be lightweight and light colored (Dark colors absorb more sunlight, leading to quicker heat illness.) Stay hydrated, and watch for redness and blisters from sunburns and suspicious moles that may be skin cancer. See a provider right away if you have issues from getting too much sun.

Another thing to note: Experts say a specialized lamp can help with seasonal affective disorder, a mental health condition often seen in the winter due to decreased daylight. The same logic does not apply for vitamin D. You need natural, not artificial light to get the vitamin D you need.

The bottom line

Draper says most people don’t have to worry about getting too much or too little vitamin D.

“The average person will get it through the sun,” Draper says. “If you live in a cold and dark environment, you’re at higher risk for vitamin D deficiency. People farther away from the equator are higher risk.”

If you have symptoms of too much or too little vitamin D or just have a concern, talk to your primary care provider.

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Author's note: This is part one of a four part story on infant nutrition misconceptions. Read part two here, part three here and part four here.
 

Bringing a new baby home raises the focus on their and mom’s well-being. Toward the top of the list: what and how the child is being fed.

Whether you choose to breastfeed or use formula, misconceptions about infant nutrition are everywhere. Xandra Anderson, an international board-certified lactation consultant at OSF HealthCare, cuts through the noise.

• My baby needs water in addition to milk or formula.
  
  It’s a common thought, Anderson says. One, adults need water, so people assume infants do, too. And two, formula can involve mixing in water, so mothers think they need to do the same with breast milk.
  
  “Really, breast milk is about 80% water,” Anderson says. “It’s there. It’s complete nutrition. You’re not missing anything.”
  
  Anderson adds it’s actually dangerous to give water to babies under six months. They can overhydrate, leading to possible kidney damage. After six months, Anderson says to talk to a health care provider about introducing water. She says one to two ounces of water per day to help wash down solid food is common.
   
• Breastfeeding will make my breasts sag.
  
  Anderson says breast changes begin during pregnancy and are not solely a result of breastfeeding. Some women will notice their breasts are larger once they are full of milk, but there are more factors at play.
  
  “[During pregnancy], your hormones are changing a lot. Your ligaments are stretching. We’re getting ready for a baby,” Anderson explains. “Then you have your baby, and your milk starts to come in. Regardless of whether you breastfeed or formula feed, you’ll see some breast changes. It was those hormonal changes in pregnancy.

“[Breast changes] can also be related to your lifestyle,” she adds. “Smoking affects your skin health, and you can see that affect the breasts. It can be related to age or a family history [of health issues such as lupus and other autoimmune diseases].”

Anderson also says research has found breastfeeding can actually promote breast health. For example, it can reduce your breast cancer risk.

• I have small breasts, so I won’t have enough breast milk to keep my child nourished.
  
  Anderson retorts with an affirmation we’ve heard since childhood: It’s what’s on the inside that counts.
  
  “Size of the breast is not a factor in being able to breastfeed. What is a factor is the amount of milk glands in your body. We all have those milk glands. Size just relates to fatty tissue,” Anderson says.
  
  The only time size may come into play, Anderson says, is if a woman gets a breast reduction where milk glands are removed. In that case, talk to a health care provider about your options.

Learn more

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

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Author's note: this is part one of a two part story on outdoor water safety. Click here for part two.


Warmer weather means people flocking to lakes and rivers in droves to enjoy some fishing or time on the boat. But something as simple as the wrong type of footwear can lead to an injury that ruins your day and maybe even your life.

In 2023, the United States Coast Guard reported 3,844 instances of something going wrong on a boat and 564 boating deaths. The numbers were down from 2022 and don’t capture what’s happening on every waterway in America. But they’re still worth paying attention to.

Bethany Huelskoetter, APRN, a family medicine provider at OSF HealthCare, knows a thing or two in this area of medicine, having treated patients for outdoor injuries for years, plus spending leisure time on the water.

• Entanglements in boat engines: Contacting the parts under the boat can lead to traumatic injuries and even limb loss. Huelskoetter has heard of instances where a boat driver unknowingly backs up into a swimmer’s midsection.
  
  “Make people aware of where the motor is, and tell them not to swim there,” Huelskoetter says. “Don’t put your feet on the boat’s propellor. It can be sharp and injure you. And if the driver is going to move the boat, they should know where everyone is.”
   
• Head injuries: Diving into water where you don’t know the depth is a big no. There can also be objects like logs, Huelskoetter says.
  
  “People can go down and not come back up,” Huelskoetter warns. “They hit their head, and it knocks them unconscious. And maybe there’s a current underwater that they’re unable to fight.”
   
• Slip and falls: Wet surfaces, like a dock or the back of a boat, make you prone to falls. First, Huelskoetter says to enter the boat in the right spot. That’s usually the back or the side. Don’t try to hop over a tall railing, for example. Second, find a good non-slip footwear that works for you. That could be a sandal or a specialized boat shoe. Huelskoetter says going barefoot can be OK, too, if you watch where you walk. Look for sharp objects, and avoid long contact with hot surfaces.

• The buddy system: Try to boat or fish with someone. They can help you if you have an emergency. If you’re alone, let people know your plans. Then if you’re not back when you planned to be, they can alert law enforcement to look for you.
   
• Fish hook impalements: It’s a tiny object. How bad can it be?
  
  Bad, Huelskoetter says. The hooks are dirty, so infections are possible.
  
  “If you can cut the [fishing line] string and come to an urgent care or your primary care provider, that’s fantastic,” Huelskoetter says. “But if you’re unable, push the hook the rest of the way through [the wound]. Then cut the barb on the end of the hook off. If you go fishing, have wire cutters with you in case this happens. Then you can slide the hook out.
  
  “Wash with soap and water, then keep the wound dry and covered. Antibiotic ointment is good to use,” Huelskoetter adds. “Follow up with your primary care provider in the following few days if it develops redness, soreness or anything else irregular. We expect it to be tender, but if you have redness, swelling, drainage or if you’re just unsure, contact your primary care provider.”
  
  Huelskoetter points out that you can usually send a photo to your provider via your online patient portal. Then the provider can advise what to do.

Getting help

If someone suffers a minor injury on the water, you can treat it with a first aid kit until you return home. If it’s a major injury like a concussion, gently move the person out of the water and onto a flat surface. Gentle movements are critical to prevent further injury like paralysis. Call 9-1-1 and meet first responders on land. A charged phone is crucial for a day outdoors, but signal can lack in rural areas. So it never hurts to have a global positioning system (GPS) device, too.

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Consequences

Some people may see skin care as purely cosmetic. If I’m not a model or television news anchor, I’ll just do the bare minimum.

That’s not the right approach, Oberheim says. Poor skin care, especially in older adults, can lead to persistent bruises and skin tears leading to wounds.

“Sometimes it doesn’t take much. I’ll see patients who have small dogs that jump on them. Even just the clawing from the dog will put a tear in the skin because the skin is so thin and fragile,” Oberheim recalls. “When that happens, we have to make sure to keep the skin clean and dry. If we end up with an infection, that can lead to cellulitis. Cellulitis can lead to other things, including sepsis [a possibly deadly condition where your body responds improperly to an infection]. So we’d need to take precautions and fix the infection with maybe some antibiotics.”

The bottom line, Oberheim says, is if your skin problem isn’t responding to at-home treatment after a few days, see your primary care provider or a dermatologist.

Other conditions

Other skin conditions to be aware of:

• Eczema (also called atopic dermatitis): This causes dry, itchy scaly skin patches. Experts don’t know exactly what causes it. But Oberheim says allergies, asthma and even stress can play a role, and it’s often worse in the winter. She says eczema can affect all ages and appear anywhere on your body.
   
• Rosacea: This causes redness, pimples, broken blood vessels and, in severe cases, a misshapen nose. It most often affects the face and eyes.
   
• Age spots (also called liver spots): Oberheim says these look like “big freckles.” They’re often flat and dark-colored. They’re associated with sun exposure, and so they’re often seen on the head and face.
  
  “They’re usually not super problematic, but they’re not cosmetically appealing,” Oberheim says.
   
• Psoriasis: This causes inflamed, red raised areas of skin that can itch and be painful. This is often seen on the scalp, elbows, knees and lower back.
   
• Poison ivy and oak: Oberheim says she sees these issues often in her clinic. When someone rubs up against the plant or an object that’s touched the plant, they can get a red, bumpy itchy rash with fluid-filled blisters.

Prevention

So, what should your daily skin care routine be? Should you be getting facials at the spa regularly? That’s probably not necessary, Oberheim says. But daily washing and moisturizing is. Look from certain things on skin care product labels: retinol (helps with skin firmness and reducing wrinkles), vitamin C (helps brighten age spots), hyaluronic acid (helps with moisturizing), niacinamide (helps reduce redness), collagen and peptides.

Other things to consider:

• Wear sunscreen of 30 SPF [sun protection factor] or higher when outside, and reapply it every few hours.
   
• Wear protective clothing like a wide brimmed hat, long sleeves and long pants when outside. Wash clothes right away when you get home. Also, know which plants are in your area to avoid the pesky ones.
   
• Don’t smoke.
   
• Drink plenty of water all the time, not just during outdoor activities.
   
• Don’t bathe or shower in very hot water. This can dry the skin.
   
• Try not to itch any skin lesion. You don’t want a wound to open and risk an infection.
   
• Know your body. Watch for suspicious moles or lesions that might be a sign of skin cancer. Experts say you can remember the ABCDEs: if the mole is asymmetric, has an irregular border, has an odd color, has a big diameter or is evolving, see a provider.

Learn more

Read more about how to keep your skin healthy on the OSF HealthCare website.

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• Maintain a healthy lifestyle through diet, exercise and keeping up with doctor appointments. Brim says this reduces your risk of a stroke, which can lead to a voice disorder. It can also prevent everyday illness and coughing.
  
  “If someone has had the flu or COVID and they’ve had a consistent cough, it can cause trauma to the vocal cords,” Brim explains. “The vocal cords are closing so rapidly with each cough.”
  
  Using a humidifier and taking lozenges without menthol can help with that pesky cough, Brim adds.
   
• Aim for 40 to 60 ounces of water per day.
  
  “That’s very helpful in maintaining a healthy environment for your vocal cords. It makes sure they’re not getting too strained,” Brim says.
   
• Watch your caffeine. High amounts can strain your vocal cords, Brim says.
  
  “Do you really need that second latte at noon?” she asks with a smirk.
   
• Don’t yell all the time. Obvious, right? But it’s tricky if you use your voice for a living.

“Maybe you have a job like an auctioneer or a teacher trying to yell over a group of students. You have to make your voice louder [for your job],” Brim says.

“Try to focus on more projection. And take vocal rests,” she adds. “Take 10 minutes to let your vocal cords reset. Drink water. Try to decrease the trauma to the vocal cords as much as possible.”

Learn more

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

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Is your toe sore to the touch? Is the skin around the nail puffy or red? An ingrown toenail may be to blame.

Marc Leonard, DPM, an OSF HealthCare podiatrist, says it’s an issue he sees frequently, but it’s one that’s easily preventable.

Dr. Leonard says an ingrown toenail is when the nail grows into the skin on the nail’s side. Some people get ingrown toenails due to a family history of the problem. They may just have wide toenails, in other words.

For others, it’s a product of how you take care of your feet.

“Bicyclists wear very tight shoes. They clip onto the bike. The shoes are very unforgiving.” Dr. Leonard says as an example. “The person is getting extra pressure on the side of the toes. It can definitely contribute to ingrown nails.”

Dance shoes sometimes have the same effect, he says.

Another culprit: clipping your toenails too low toward the side of the toe. Instead, trim straight across using clippers with a straight, not curved, blade.

Avoiding these risk factors is crucial for people with diabetes, Dr. Leonard warns. While that group is not more prone to ingrown toenails, an occurrence may mean serious complications.

“If their blood sugar is not under control, the infections from ingrown nails can get severe quickly,” Dr. Leonard says. “Sometimes there can also be circulation problems with diabetics.”

Dr. Leonard says some ingrown toenails will resolve on their own. But if a person has to come to a podiatrist’s office, it usually means the site is infected.

“We might trim out the side of the nail. That’s the easiest way to treat it,” Dr. Leonard says. “In other situations, we have to numb the toe and take out the side of the nail.”

If the toe is really inflamed and irritated, he says, a doctor will remove a larger portion of the nail, plus some excess skin and tissue. The person may also be sent home with antibiotic medication to keep the infection down.

For people with frequent ingrown toenails, there’s a permanent solution.

“We’ll actually kill the side of the nail,” Dr. Leonard says. “We’ll put a chemical in the base of the toe to kill the root. That eliminates growth of the nail on the side.”

That’s an outpatient procedure done at a podiatrist’s office. And in the days and months ahead, you would trim the nail normally, Dr. Leonard says. The nail would just be narrower.

Regardless of what happens to your toe, recovery from ingrown nail treatment involves rest and soaking the toe in warm water. You should be back to normal activities “fairly quickly,” Dr. Leonard says.

One more burning question to answer: how often should I trim my toenails?

“For most people, probably once a month or once every couple weeks,” Dr. Leonard suggests. But if you have a history of ingrown toenails or other toe issues, talk to your primary care provider or podiatrist about proper toe care.

Learn more about foot and toe care on the OSF HealthCare website.

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Author's note: this is part one of a two part story on supporting new moms. Click here for part two.


Bringing a baby home from the hospital is one of the most stressful, but exciting things a couple can experience. Rightfully so, much of the focus in the first few weeks and months is on the child. Are they eating properly? Is their onesie comfortable? How much crying is too much?

But Xandra Anderson, BS, IBCLC, an international board-certified lactation consultant at OSF HealthCare, says: Don’t forget about mom’s needs, as this is a delicate time for her too. Anderson has some tips that partners, friends and family members can take note of.

• Have a conversation before the baby arrives about what mom’s needs are. Your idea of support might not line up with hers, it might be outdated or mom might need something you’re not able to do.
  
  “The conversation needs to be very mom-focused and validating,” Anderson says. “This is a new experience. You’re going from a family of two to a family of three. Ask: What are your expectations? How do you feel like we can support you?”
  
  For example, Anderson says a new mom might complain of cramping and just want to be heard, rather than be given a solution or hard truth (like, take a pill or use a heating pad) right away.
   
• Set realistic, simple goals. As much as mom might want her postpartum headache or stomachache to go away entirely, it might not be possible, leaving mom feeling disheartened.
  
  Instead, try: “I want to feed the baby before they get fussy. I want to make sure I get a 20-minute nap when baby naps,” Anderson suggests. “Be realistic. For example, babies are not going to sleep through the night. So your goal cannot be to get a restful night’s sleep. That’s just not reality.”
  
  Other common, achievable goals: I want to drink three bottles of water per day. I know I’m busy in the morning, but I want to commit to eating something for breakfast. I want 15 minutes per day to enjoy a hobby. Or, dad can set a goal to always be the one to fold the laundry so mom gets a break from one task.
  
  For infant feeding: “Make the goal simply: I want to feed my baby,” Anderson implores. “It doesn’t have to be ‘I need to feed my baby, pump breastmilk, sleep and wash all the bottles.’ Feeding is your only job, and your baby’s only job is to eat.”
   
• Stay well fed, well hydrated and well rested. This goes without saying, but it can get lost in the never-ending task of child care. Keep a drink and a snack bag within arm’s reach as often as possible. Those snacks can be a sweet or salty treat in moderation, Anderson says. Or, look for one-handed foods like wraps that you can eat while feeding your baby. Try making this one of the simple tasks for a friend or mother-in-law. Put them in charge of the “snack station” in several rooms of your home.
  
  For sleep, Anderson simply says with a smile, “Do your best.
  
  “Everyone says to sleep when the baby sleeps, but there are some parents that have anxiety that stops them from doing that,” Anderson says. “If you can’t sleep, just rest. Turn devices off. Turn noises down.”
  
  This is another time you can tap into your support system, Anderson says. While you rest, see if someone can wash the dishes or put away the laundry.

The bottom line: Give yourself grace

Above all else, Anderson wants new parents to remember: Parenting is tough. Cut yourself some slack when things aren’t perfect.

Learn more

Read more about having a successful pregnancy and birth on the OSF HealthCare website. Pregnancy care at OSF includes new parent classes taught by people like Anderson on the local level.

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It’s the dead of winter, and you need to run to the mailbox or let your dog out. It’s just a minute, you think. A sweater and sandals will be fine.

Not so fast, says Maddy Draper, APRN, a health care provider at OSF OnCall who sees cold weather injuries often. She says exposure to frigid temperatures can have serious consequences.

Types of cold weather injuries

• Frostnip: Draper says this is a mild form of frostbite where exposure to cold temperatures turns the skin pink or red. Your skin may feel burning or numb.

“The numbness typically goes away with rewarming,” Draper says.

• Frostbite: This is a more severe case of cold exposure. Your skin may be numb and appear yellow, white, gray or black. It may feel waxy and have blisters.
   
• Hypothermia: This is when the body’s temperature drops below 95 degrees.

“There are different stages,” Draper explains. “The first is our natural response of shivering. It gets more severe. The person may get confused and have lethargy, memory loss and slurred speech. It can lead to a coma and death.”

Inside, too?

Yes, there’s a risk for these injuries inside, too, Draper says. Notably, there have been cases of infants getting hypothermia.

“The room may be too cold, and they’re not dressed appropriately,” Draper says. “If they’re in a bassinet or crib with just a onesie and it’s cold, that can lead to hypothermia.”

Signs of infant hypothermia are bright red skin and decreased energy. Sleep experts use a thermal overall grade scale (TOG) to suggest how much clothing a baby should wear to sleep depending on the temperature of the room.

Treatment

Draper says she usually sees cases of frostbite and hypothermia sent to the emergency department. Providers will rewarm you with warm water or blankets and may provide warm liquids to drink, warmed oxygen through a mask and nasal tube or heated fluids through an intravenous line (IV) or other methods. Medication can also help with pain and blood flow.

“The hospital has more imaging resources to see the impact of the tissue damage,” compared to urgent care, Draper says.

For frostnip, you can take steps to warm up at home.

“It’s not as fast as possible. It’s not as hot as possible. It’s just that gradual warming,” Draper says. “Get off your cool or wet clothes immediately. You don’t want to stick your hands or feet into hot, steaming water. Just warm water.”

That’s because hot water can burn your skin. And if your skin is numb, you may not feel the burn before the damage is done. If water is not available, you can place your hands in your armpits. And handle the sensitive skin gently. Don’t rub or massage it. If your feet are affected, get off your feet.

Prevention

Draper says older adults, people who work or do activities outside (like hunters or hikers), unhoused people and people with medical conditions (like peripheral artery disease, diabetes and Raynaud’s disease) are at a higher risk of cold weather injuries. Getting stranded in a vehicle without proper protection is also common in the winter. Drinking alcohol or using drugs may lead to you losing consciousness outside. And smoking impacts blood circulation, putting you at a higher risk, Draper says.

Some ways to beat the cold:

• Dress in layers. You can always take a layer off, but you can’t put one on if you leave it at home. Make a hat, scarf, gloves and winter boots part of your wardrobe. Make sure the clothes aren’t too tight to allow for blood circulation. And look for water-resistant garments when buying clothes.
   
• Have winter weather supplies, like blankets, flares, a first aid kit and food, in your vehicle.
   
• Be well fed and hydrated. Body fat, though unhealthy in excess, helps us stay warm. For drinks, avoid alcohol and caffeinated beverages.
   
• During outdoor activities, take breaks and go with a buddy. Keep a close eye on kids who may not realize how cold they are. Come inside to change from wet to dry clothes. Let others know your plans and when you’ll be back. If you’re not back in time, that’s a sign you may have fallen victim to the cold, and help should be sent.

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Emily Isom has a resolution for kids and their parents: pledge to keep your hands clean and away from your face to prevent the spread of illness.

Isom, a certified medical assistant in pediatrics at OSF HealthCare, often sees young people biting dirty fingernails and not washing their hands properly. Here’s a primer:

Nail hygiene

Isom says people of all ages should trim their nails regularly. Once a week for fingernails and once or twice a month for toenails is a good rule of thumb. In between trimmings, watch for dirt and other filthy matter caught under the tip of the nail. Some nail clippers come with a scraper tool to remove that debris. But don’t use your mouth to clean your nails.

“Our nails carry so many germs and bacteria. That’s how people keep getting sick and spreading illness,” Isom warns, referring to putting fingernails in your mouth or on your face. You can also chip teeth and get facial warts and pimples from putting nails on your face, she says.

Some people have long nails, either real or artificial. In these cases, use a nail brush to regularly wipe the nails clean. If you’re at work or school and don’t have a brush, wash the nails thoroughly. Lather warm water and soap on the palms of your hands. Take your fingertips and scratch against the palm of the other hand to get the soap in the fingernail. Do that for 20 seconds. Then, pull down the fingertips to the palm of the same hand and massage the soap in further. Put your hands upside down under hot running water to rinse.

Hand washing

Isom says most people concentrate on their palms when hand washing.

“You need to get in between the fingers, underneath the nails, on the back of the hands, rub your knuckles together and scrub your wrists,” Isom says.

After wetting your hands, scrub all those areas in soap for 20 seconds. Find a song that has a 20-second chorus and hum it while you scrub. Then, rinse under warm water, and dry your hands with a clean, dry towel. Isom also suggests wrapping a paper towel around your hand when touching dirty surfaces on your way out of the bathroom. Use the towel to shut off the faucet and open the door, then throw the towel away after you exit.

If a hand dryer is what’s available, run your hands under the warm air until they are completely dry. Resist the urge to dry halfway and walk out. Isom says that may do more harm than good and attract bacteria faster.

“Bacteria want to live on wet surfaces. They’re attracted to moistness,” she points out.

If a soap and sink aren’t available, Isom says to use sanitizer or wipes that are at least 60% alcohol based. The same process applies – lather or wipe all parts of your hand and wrist thoroughly.

If you have a cut or wound on your hand, like a paper cut, wash with care.

“Get a washcloth wet with warm water. Put soap on it. Then, clean around the cut or wound,” Isom says. “Don’t put [soap] directly into the cut. That could really irritate it.”

Convincing kids

Isom is a pediatrics provider and a mother. So, she knows getting kids to wash their hands and mind their nails is easier said than done. Her advice: make it fun.

“When handwashing, sing the ABCs for 20 seconds. Or have them sing to you.” Isom suggests. “Make a chart. Every time they wash their hands, have them put a sticker on the chart. They are going to fall in love with it and want to wash their hands over and over again.”

And remember Simon Says? Isom says it works with her daughter.

“Simon says don’t touch your face,” Isom says with a smirk.

Learn more

Read more about how to keep your hands clean and prevent the spread of illnesses on the OSF HealthCare and the United States Centers for Disease Control and Prevention websites.

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Holiday meals bring candy, cookies and other sweets in bountiful amounts. Most of us will chow down with a promise to return to healthy eating tomorrow. But people with diabetes must closely monitor their intake of sugar and carbohydrates at every meal.

What is diabetes? 

Aminat Ogun, MD, is a family medicine physician at OSF HealthCare. She says diabetes is a disorder that affects how your body uses blood sugar. Type 1 diabetes is when an autoimmune reaction stops your body from making insulin. Type 2 is when the body can’t recognize insulin and use it well. Gestational diabetes occurs in pregnant women.

Dr. Ogun says a sedentary lifestyle can be a big risk factor for developing diabetes, so regular exercise is important. Treatment typically involves medication and lifestyle changes.

Moderation is key 

Dr. Ogun says there’s no magic number of cookies you can eat on Christmas and walk away with no diabetes complications. Your nutrition depends on your age, sex, height, weight and more. Plus, she says the brain needs some sugar to function.

Dr. Ogun recommends small portions. Put just a couple of cookies or chocolates on your plate after the holiday meal. Don’t keep going back for more.

Mix in healthier snacks, like fruits, vegetables, nuts and legumes. Look for “whole grain” or “whole wheat” on the label. If you’re craving sugar, try yogurt with berries or an apple with peanut butter. Artificial sweeteners are another option to satisfy the sweet tooth, as Dr. Ogun says they do not raise your blood sugar level. For example, mix a sweetener powder into your water.

Dr. Ogun says if you rely on insulin, check your blood sugar level as often as your doctor advises.

“You would have discussed with your doctor the amount of carbohydrates you can take,” Dr. Ogun says. “Try to keep to that level.”

Dr. Ogun admits it may be more difficult for children not to gorge on holiday sweets. So, parents need to keep a close eye and provide motivation to eat healthy.

“If they eat a certain amount of vegetables of fruits in a day, maybe reward with a cookie or snack,” Dr. Ogun suggests.

Learn more 

Symptoms of diabetes include increased urination, increased thirst and blurred vision. More serious cases could bring nausea, vomiting and eye, heart and kidney issues. Nerve damage leading to numbness and tingling in your hands and feet known as diabetic neuropathy is also possible.

“We lose sensation in those areas. People may step on a nail and might not feel it,” Dr. Ogun says. “The issue grows and grows and leads to an ulcer, which makes wound healing harder for diabetic patients.

“That’s when we have to consider amputation,” of a foot, for example, she adds.

Diabetes can also be fatal, Dr. Ogun says.

Read about diabetes care on the OSF HealthCare website. If you have questions about this disorder or have symptoms, talk to your primary care provider.

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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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With temperatures cooling, Awad Alyami, MD, an OSF HealthCare pediatrician, says we’re approaching the peak season for sore throats. Many cases have time-tested treatments, but some can have serious complications.

Dr. Alyami says a sore throat is an infection that causes inflammation in your throat. They’re annoying and painful, bringing symptoms like difficulty swallowing or talking and swelling of glands and tonsils. Causes can include tonsil stones, heartburn and allergies. But most commonly, causes break down into two groups: viral and bacterial.

Viral infections

Dr. Alyami says many viruses can cause sore throats – the common cold, influenza, coronavirus and others. Dr. Alyami says if your sore throat comes with coughing or a runny nose, that’s a sign it’s a viral infection. You can start treatment at home with over-the-counter medicine like Tylenol and ibuprofen. You can also gargle salt water and, generally, stay hydrated. Water is good for all ages, and Pedialyte can help hydrate kids.

If your symptoms include fever and neck swelling, it’s a more serious situation. You should see a health care provider.

Bacterial infections

The main bacterial infection that causes sore throats is group A streptococcus (commonly known as strep or strep throat). Strep throat may bring the hallmark sore throat symptoms, but you should also watch for fever and white patches toward the back of your mouth.

“This is a bacterial infection that’s common in kids,” Dr. Alyami says of strep throat.  “About 30% of sore throats are strep, and about 70% are viral. It’s a big deal. We need to treat to prevent complications.”

The most common complication is dehydration, Dr. Alyami says.

“The sore throat is so bad, the child doesn’t want to eat or drink,” he explains.

Other times, untreated strep throat can lead to abscesses, or pus pockets.

“If that abscess gets big enough, it can go toward other structures in the body that are very important. That infection can spread and progress very quickly,” Dr. Alyami says. Life-threatening conditions like difficulty breathing can result.

Dr. Alyami says providers can diagnose strep throat with a throat swab. They treat strep throat with 10 days of antibiotic medication, either injected or taken orally. He says most kids will take the medicine orally unless that’s troublesome. For example, some kids have a tough time swallowing pills due to throat pain.

Prevention

It’s advice you’ve heard before, but it’s worth repeating. Dr. Alyami says good hand hygiene goes a long way to preventing sore throats. Wash your hands thoroughly, and keep them away from your face.

Early detection is also key.

“If the child is sick, especially with symptoms that could be strep, it’s better to get them to a health care professional early,” Dr. Alyami implores. “They can get checked and isolated for 12 to 24 hours before they start antibiotics.

“If you’re sure about what they have, it’s better to just bring them in and get them checked,” he adds. Or, a virtual visit is an option.

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Growing up on a farm a couple miles from the clinic where she works, Bethany Huelskoetter, APRN, knows the importance of playing it safe in a rural setting, whether you’re young or old. With National Farm Health and Safety Week coming up, Huelskoetter, a nurse practitioner at OSF HealthCare, says now is the time to review the basics of farm safety.

• Heavy machinery: For big equipment like a tractor or auger, know how to use it before you get in the driver’s seat. Know how to shut the machine off quickly in an emergency. When behind the wheel, know your surroundings. Go slowly and be very cautious in places like driveways where kids run around. Wear fitted, not loose, clothing.

“Machines have shafts and moving parts,” Huelskoetter explains. “You don’t want to have loose sleeves or something that can get caught in that mechanism and cause a catastrophic injury.”

• Driving smaller vehicles: Children and young adults are often found whizzing around a rural property on an all-terrain vehicle or motorbike. That can go south quickly, Huelskoetter warns. A passenger could be flung from the vehicle and get injured or killed.

              Wear a helmet and buckle the seatbelt. Don’t drive too fast, and don’t make sharp turns, especially on loose gravel. Sit in the vehicles the way they are intended. Don’t hang off the back or side. And never operate after drinking alcohol.

• Toxic materials: Farmers and homeowners often handle chemicals like pesticides. Huelskoetter advises reading the label so you know what you’re touching. The label should also tell you what protective equipment to wear and whether the product is toxic to pets.

The American Association of Poison Control Centers website has a national hotline and state-by-state resources for exposure to or ingestion of toxic materials. Huelskoetter says to have that phone number in your cell phone. When you call, someone will ask you basic questions about what happened and tell you what to do. You may be able to treat the issue at home, or the hotline may advise you to go to the nearest emergency department.

• Animal bites: Kids playing in nature may encounter “all kinds of crazy things,” Huelskoetter says. Bites from spiders, snakes and raccoons can happen. The first step, she says: clean the bite thoroughly with soap and water. Then, cover it with a band aid or clean cloth and go to the hospital.

“You never want to mess around with an animal bite,” Huelskoetter says. “Animals’ mouths are very dirty. So you want to start the bitten person on antibiotics quickly.”

Huelskoetter adds that while we view dogs and cats as domesticated, you never know if they have not been vaccinated and are carrying diseases like rabies.

• Heat: Two common heat illnesses are heat exhaustion and heat stroke. Huelskoetter says heat exhaustion generally describes when you overheat. Experts advise to move to a cool place, sip water and put cool, wet cloths on your body. If symptoms don’t improve or you start vomiting, call 9-1-1. Symptoms of the more serious heat stroke include hot, red, dry or damp skin, a fast, strong pulse, headache, dizziness, nausea and confusion. Call 9-1-1 right away. Untreated cases of heat stroke can cause permanent damage to organs or death.

                Some tips to avoid heat illness: Avoid being outside in the middle of the day. Take breaks in a cool area during the day. Keep a cooler full of water and drinks with electrolytes, like Gatorade. Sugar-free sports drinks are a healthier choice                     than the regular ones. Have some healthy snacks, too, like popcorn, pretzels or nuts.

“Whenever your body is sweating, it’s depleting its calories and energy,” Huelskoetter says. “So your body doesn’t just need water. It also needs nutrients to help you keep going throughout the day.”

• Be prepared: Work or play with a buddy. That way, someone is there if you get hurt. If you must go alone, let people know your plans before you leave for the day. Where on the property will you be? When are you expected back? If you don’t return at the right time, that’s a sign for your loved ones to look for you. Keep your phone charged in case you need to make an emergency call. Take a mobile charger with you. And if an emergency happens, call 9-1-1 and take an ambulance to the hospital. Don’t drive yourself or have someone drive you.

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“Mom! I have to go!”

“Hold it!”

It's an exchange you probably had as a kid on long car rides. But Uwais Zaid, MD, says it’s not just a funny vacation story. A person of any age or profession can find themselves holding their urine for a long time.

“In the medical field, we see this all the time,” says Dr. Zaid, a urologist who sees patients at OSF HealthCare. “When you’re rushing from patient to patient, doctors, nurses and technicians might not go to the bathroom as much as they should. They hold their urine the whole day.”

Dr. Zaid is sharing his playbook: why this phenomenon happens, how to fix it and what can happen if you don’t.

Why do we hold our pee?

Dr. Zaid says some people hold their urine simply based on the situation. They’re on a long car ride, and stopping will make them late. Or they might be at a dinner party and don’t want to seem rude by leaving the table.

“Then there’s another subset of people who just don’t have the desire to urinate. There’s something medically wrong,” Dr. Zaid explains. “As we get older, we can get dementia and be forgetful. So sometimes people just forget they need to urinate. Sometimes, you can have lack of bladder sensation from neurological conditions like multiple sclerosis. Or they might have had their bladder stretched for so long due to things like an enlarged prostate or scar tissue in the urethra.”

The consequences

In the short term, holding your pee will make you feel uncomfortable and antsy. We all know the feeling. Dr. Zaid has even heard from patients, “The feeling doesn’t bother me that much. What’s the problem?”

A few problems, the doctor says.

“It does increase your risk of urinary tract infections [UTIs]. Your bladder is almost like a swamp instead of flowing like a river. You have stagnation of urine,” Dr. Zaid says. “It can increase the risk of bladder stones. Also, the bladder is connected to the kidneys. It’s one fluid column. So if your bladder gets really distended, it can back up and hurt your kidneys. You can get kidney swelling.

“And when the bladder is chronically distended, you can get pouches called bladder diverticuli. Those pockets can hold on to urine and be sources for infection,” Dr. Zaid adds. Over time, these pouches can also lead to worse urinary control and even the inability to pass urine.

If holding your urine and not getting treatment for it lead to, for example, the kidney issues Dr. Zaid outlined, serious health problems and, rarely, even death are possible. Dr. Zaid says that shouldn’t scare people into drastically altering their bathroom habits. But it is something to be aware of.

Prevention and treatment

So what should be the best practices when we start thinking about the toilet?

• Before you even head for the bathroom, Dr. Zaid urges you to take care of your bladder and kidneys by staying hydrated. The U.S. Centers for Disease Control and Prevention (CDC) says daily water intake recommendations vary by person. So it’s a conversation you should have with your primary care provider. But, the CDC has general tips about staying hydrated and the dangers of drinking sugary or caffeinated drinks often.
   
• Plan ahead. For example, if you have a long commute, leave early to make time for rest stop breaks, and avoid drinks like soda. If you have a busy day at work, make a promise to yourself that you’ll take breaks to use the restroom. You can set a reminder alarm on your phone to nudge you.
   
• Try the “double void.”
  
  “You get to the toilet. You get done peeing. Wait 30 seconds, and then try to get a little more out,” Dr. Zaid suggests. “But don’t bear down and push because that creates trauma for your pelvic floor.”
   
• For older adults who might simply forget to use the bathroom, make sure they have someone checking in on them. Make sure they are empowered to speak up about their health. Setting an alarm reminder and having a clear path to the toilet can also help.

If someone consistently avoids or forgets to urinate or experiences symptoms like frequent UTIs, discomfort or difficulty emptying the bladder, it’s time to see a doctor.

Dr. Zaid says the first thing a urologist would do is look for anything blocking the urine. For men, this could be an enlarged prostate, scar tissue in the urethra, a bladder stone or tumor or trauma to the bladder area. For women, it could be a prolapse, when the bladder falls through the vagina.

“We can look inside the bladder with a camera. We can do a urodynamic study, which tells us about bladder function,” Dr. Zaid says.

Doctors would then form a treatment plan depending on what’s found. For example, bladder stones could be a “wait and see” situation. Or, a doctor could perform a procedure to remove the stones or break them apart and allow them to pass. Dr. Zaid says this is sometimes done with a laser in a minimally invasive procedure.

Dr. Zaid says in some more serious cases, the bladder stops working entirely.

“It’s something we can’t often fix. It’s really frustrating,” Dr. Zaid says.

Those people, he says, would need a catheter. It could be a short-term one to help drain the bladder or a long-term one to help correct the problem for a while.

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Sore throats: they’re pesky. They’re not just a winter thing (hello, spring allergies). And they can turn serious, such as strep throat.

Do a web search for at-home remedies, and you’ll get a lot of results. Which ones work? Which ones might feel good in the moment but don’t get the job done? Isha McConkey, DO, a family medicine physician at OSF HealthCare, has your checklist:

• Ice cream: Dr. McConkey doesn’t recommend it.
  
  “I know it feels good. But it will increase mucus production in most people. That’s going to exacerbate the [throat] irritation,” she explains. “We also don’t want a lot of sugar,” which could lead to cavities.
  
  In fact, Dr. McConkey says this logic applies to dairy foods overall. Skip them come sore throat time.
   
• Popsicles: These are OK, Dr. McConkey says. Just go for a sugar free or fruit juice-infused option.
   
• Cough drops: Choose cough drops with xylitol, a sugar alternative, Dr. McConkey says.
   
• Honey: “It’s excellent,” Dr. McConkey says. You’re still getting sugar, though, so don’t guzzle it. Try making a drink with hot water, honey and lemon. Or incorporate honey into your tea.
  
  “You can even add a little cayenne pepper. In some types of sore throats, it may make it worse. But most people find it can be very soothing. It has some numbing properties,” Dr. McConkey adds. But don’t take that as a license to eat spicy food. The acidity in tacos, for example, might cause throat irritation.
   
• Soups: Pop that chicken noodle soup in the microwave, Dr. McConkey says. She says research has found that some soups have antibacterial properties that can help with any illness. Opt for a low sodium can.
   
• Salt water: You’ve probably seen online videos or heard the tactic passed down by family members. Yes, it can help, Dr. McConkey says. Gargling salt water can decrease swelling, she says. Try it before you drink your tea or before you go to bed to help get a restful night.

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Author's note: this is part two of a two part story on staying healthy during summer vacations. Click here for part one.


Summer means getaways to de-stress and make memories. But the last thing you want is to catch a cold or worse, especially if you’re halfway across the world where health care resources might be different or scarce.

It's not too late to make some quick preparations, says Jennifer Whitfill, APRN, a family nurse practitioner at OSF HealthCare.

• Know your destination and what to do if something goes wrong.
  
  “If you have a medical condition, have your medications with dosages on a list. Have your health care provider’s information on that same page. That way in case something happens, they know how to get ahold of the provider to ask questions,” Whitfill says. “Investigate where is the closest health care facility, whether that’s a hospital or an urgent care, in case you need care quickly.”

This is especially important, for example, for people with heart conditions who might require a complex level of care at a moment’s notice.

• Consider travel insurance: It might not be needed for every trip, but it can give you some peace of mind.
   
• Crowded areas: Train stations and airports are full of people from all walks of life, and it’s a safe bet that some of them are under the weather.
  
  “Good hand hygiene is huge,” Whitfill says, especially after contacting high-touch areas like an escalator railing. “If you are immunocompromised or worried about catching something, you can always mask. Boost your immune system [prior to travel], and keep your distance [from others] as much as possible.”
   
• Sleep: If you’re crossing multiple time zones, adjust your sleep a few days in advance to avoid exhaustion. Whitfill says if you’re traveling east, go to bed and wake up a few hours earlier each day. If you’re traveling west, go to bed and wake up a few hours later.
  
  “Book a flight that lands early in the evening. After landing, try to remain awake until 10 p.m. local time. That helps adjust the body’s sleep cycle,” Whitfill explains. “Also practice good sleep hygiene. Drink plenty of fluids. When you’re flying, get up multiple times to keep blood flowing. Stay away from alcohol and caffeinated beverages.”
   
• Food and drink: You might have heard claims from friends and family that the water in [insert location here] is dirty and unsafe. That might be a bit exaggerated, but when in doubt Whitfill says to use bottled water, even when brushing your teeth. And pack some medicine in case you get diarrhea (Imodium or Pepto Bismol) or constipation (probiotic or laxative).

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

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

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

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

Bob’s outlook

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

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

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

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

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

Learn more

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

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It’s no surprise that kids love sugary drinks. It’s also no shock that a group of health organizations including the American Academy of Pediatrics, the Academy of Nutrition and Dietetics and the American Heart Association, have released new recommendations encouraging healthier hydration options for children.

The bottom line, according to experts, is kids and teenagers should drink water and cow’s milk and stay clear of drinks that contain added sugar, artificial sweeteners and caffeine.

Mohammad Soud, MD, a pediatrician with OSF HealthCare, says while the recommendations aren’t new revelations, it’s an important message to drive home.

“Our markets are infiltrated with a lot of drinks that seem to be popular and harmless,” says Dr. Soud. “However, these drinks carry a lot of issues when it comes to kids’ health. They are overloaded with caffeine and other stimulants, and caffeine can have a lot of adverse effects on both the cardiovascular and nervous system.”

Dr. Soud says caffeine drinks can cause high blood pressure, heart palpitations, anxiety, depression and interrupted sleep – all of which can affect academic performance. Sugar can also severely impact children’s health, contributing to Type 2 diabetes and obesity.

“There is mounting evidence that these artificial sweeteners are linked to certain types of cancers, like breast cancer,” adds Dr. Soud. “Artificial sweeteners  can also alter the gut bacteria.”

Perhaps the biggest surprise from the new recommendations might be that cow’s milk is the choice over plant-based milk.

“We get lots of questions from parents about plant-based milk, almond milk, oat milk, soy milk and rice milk,” says Dr. Soud. “Those are missing a lot of nutrients compared to cow's milk.”

Cow’s milk contains high-quality protein, essential amino acids and plenty of vitamin D, calcium, phosphorus and iodine, which are important for bone growth and brain development in children. But soy milk has been approved by the American Academy of Pediatrics as an alternative to cow's milk for children who have dairy allergies.

Water should be the go-to drink every day, says Dr. Soud. How much water, however, depends on the age, activities they participate in and the climate they live in.

·         40 fl oz per day for 5—8-year-olds

·         61 fl oz per day for 9—13-year-olds

·         88 fl oz per day for 14—18-year-olds

But it’s unrealistic to think kids won’t reach for something unhealthy from time to time. Dr. Soud’s message to his patients and parents is simple –- stick with water and cow’s milk first. But on occasions like weekends or special events, it’s OK to opt for a smoothie, fruit punch or a sports drink. Being flexible, he says, is the key.

“I encourage parents to read labels with their kids,” says Dr. Soud. “Any drink that has high sugar, this is what I call a sometimes drink. This is not an everyday drink. I tell parents to be role models for their kids. So when they are drinking water over soda, often kids mimic that behavior.”

Dr. Soud says establishing good hydrating habits will serve children and teens well into adulthood.

“We all want our kids to grow up with healthy habits, and hydration is an important part of a balanced diet,” he says. “You’ve probably heard the saying that you are what you eat. That applies to what you drink too. The rule is sip smart, water first, milk next and skip the rest.”

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Author's note: this is part two of a story on outdoor water safety. Click here for part one.


More sun and rising mercury mean people will head outdoors to lakes and forests. But something as simple as drinking river water can lead to an illness that derails your spring.

Bethany Huelskoetter, APRN, a family medicine provider at OSF HealthCare, hits the major safety points about leisure time on the water.

• Bug bites: Coat yourself with bug spray to start the day, and avoid hanging out in tall grass where pests can hide. If your bug bite comes with skin tissue damage, chest pain, muscle cramps, sweating or nausea, see a provider right away. Also, watch for a rash in the shape of a bullseye, which is common with tick bites. To remove a tick, use tweezers to get close to the skin, and gently pull the insect out. Avoid twisting and yanking.
   
• Life jackets: Illinois and Michigan outline their life jacket laws. And some additional suggestions from Huelskoetter: for young kids, use a life jacket that straps on like a diaper. Life jackets that go over the chest could come up over the child’s head, and they could slip out or have trouble breathing. And read the life jacket label to make sure it’s right for you based on your chest size and weight.
  
  Huelskoetter also says a life jacket or any wet object has a risk of mold. So, dry the life jackets by hanging them in the sun.
   
• Fire extinguishers: Like life jackets, Illinois and Michigan laws require a United States Coast Guard-approved fire extinguisher on board most watercraft. Boat fires do happen, Huelskoetter says, and a fire extinguisher can mean the difference between a small fire and an explosion.
   
• Dirty water: It’s tough for kids who want to explore, but Huelskoetter says you should keep lake water out of your eyes and mouth. For kids, that could mean wearing goggles.
  
  “There are bacteria, parasites and other microorganisms that can get in your eyes. Also, don’t open your mouth underwater. You don’t want to drink that water,” Huelskoetter says. “If you swim in a lake and your eyes get red or itchy, that’s a sign you might have an infection from an organism in the water. So we want to put you on the proper antibiotic or whatever medication we feel is best.
  
  If you drink the water, gastrointestinal upset can occur. If you have nausea, vomiting or diarrhea, you definitely want to be seen by a provider. We’ll do testing to determine what bacteria or parasite you came in contact with so we can treat appropriately,” Huelskoetter adds.
   
• Alcohol: Drinking responsibly can be a part of your day on the water. But Huelskoetter says the rules are just like on land: A blood alcohol concentration (BAC) of .08% is the legal limit, so be aware if you’re the boat captain.
   
• Fumes: My group is in the open air. How much should we worry about boat exhaust?
  
  Huelskoetter says you should be fine, but make sure your watercraft has good ventilation. You can also buy carbon monoxide detectors made to clip on boats or life jackets. This can be extra helpful if your boat has an enclosed cabin, Huelskoetter points out.
   
• Spoiled food: Of course, you’ll want to eat on your boating or fishing trip. That could include perishable items like a sandwich.
  
  Putting the food and drink in an ice-filled cooler isn’t enough, Huelskoetter says.
  
  “Keeping your cooler covered and out of the sun is going to do wonders. It’ll keep that ice nice and cool,” she says.
  
  “Never eat anything that’s been sitting out, and now it’s hot,” Huelskoetter adds. “Once food reaches room temperature, you want to be careful. You can go by smell, too. If it doesn’t smell right, don’t eat it.”

Getting help

Have a first aid kit for minor injuries. For major injuries like a head or limb wound, gently move the person to land and call 9-1-1. The word “gently” is important to avoid further injury like paralysis.

Experts also point out that cell phone service can be spotty in the wilderness. So you should also have a global positioning system (GPS) device.

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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.

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Author's note: This is part two of a four part story on infant nutrition misconceptions. Read part one here, part three here and part four here.



Bringing a new baby home raises the focus on their and mom’s well-being. Toward the top of the list: what and how the child is being fed.

Whether you choose to breastfeed or use formula, misconceptions about infant nutrition are everywhere. Xandra Anderson, a certified lactation consultant at OSF HealthCare, cuts through the noise.

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

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

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

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

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

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

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

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

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

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

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

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

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

Learn more

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

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Food deserts – neighborhoods that don’t have quick access to a grocery store with healthy options – are, sadly, nothing new. They lead to quick stops at the fast-food place or gas station, where healthy food may be at a premium.

But have you ever taken a deep dive into how food deserts can significantly impact a person’s health? And more importantly, what can be done about the problem?

Clare Spires, an exercise physiologist at OSF HealthCare, has some things to keep in mind. Spires also knows about food insecurity firsthand through her support of two OSF programs: Peace Meal, which provides meals in-home or at a central site to people 60 and older, and Smart Meals, which provides a meal kit for a family of four and teaches them to cook.

“We want diets high in fruits, vegetables and fiber and low in saturated fat. Gas stations and fast-food restaurants provide the flip side. They often provide no fruits and vegetables, food high in saturated fat and no good fiber food,” Spires says.

How to navigate food deserts

• Planning meals for the week is key, Spires says. Estimate how much food you’ll need and how much you have to spend.
   
• If you can’t help but go to the eatery or gas station often, choose healthier options.
  
  “I’ve found gas stations are very similar to grocery stores. As long as you stay on the outside perimeter, you’ll stay away from candy and chips that will be down an aisle,” Spires says. “When you walk in, there’s usually some sort of fresh fruit or vegetable right there. Pretzels are really great filling snacks. Nuts are good for you. You have granola bars too.”
  
  One caveat: Spires says to check labels of packaged salads at the gas station. She says they are often heavy on unhealthy preservatives.
  
  At restaurants, opt for a grilled chicken sandwich and water rather than a cheeseburger and soda. Spires also says healthy choices are sometimes hidden on the kid’s menu. Look there for things like apple slices, and make that your side instead of fries.
   
• When you can get to the grocery store, make wise choices. Spires suggests canned fruits and vegetables that have a long shelf life. For vegetables, look for options with low salt. You can also rinse the veggies at home to remove some of the salt. For fruit, look for options that are canned in 100% juice or water, not syrup.
   
• Consider creating a garden at home or advocating for a community garden in your neighborhood. Spires says this allows you to bank up healthy food for the winter. It’s also likely going to be cheaper, she says, given the rising cost of groceries. And working outside provides benefits to your physical and mental health, too.
  
  “It’s a little extra work, but it pays off in the long run,” Spires says.
   
• Talk with a dietitian, nutritionist or wellness expert about making diet changes.

How to help people who are struggling

Spires says everyone can help in the fight against food insecurity. Get to know your community so you know which groups are struggling, such as parents struggling to afford school lunches for their kids. Then, talk to health care groups, social service groups and government groups about changes. For example, it’s not uncommon for residents to encourage their city council to recruit a grocery store to town.

The consequences

Frequent meals from the gas station or drive through can lead to obesity, heart disease, diabetes, high blood pressure and high cholesterol.

“Fast food is notorious for being high in salt. Those foods retain water in our body and can lead to heart and lung problems,” Spires says.

Childhood obesity, Spires adds, is a big problem in the United States and can set kids up for a lifetime of health problems and doctor visits.

Learn more

If you have concerns about food insecurity, contact the OSF hospital near you to see if it offers a program like Peace Meal or Smart Meals. The OSF HealthCare website has healthy recipes.

Social service agencies or schools in your area can also help. Spires says food pantries typically are open to accommodate adults who work different shifts.

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This is part two of a two part story on hygiene myths. Click here for part one.

From health care providers to websites to advice passed down through generations, there are a lot of ways to get health care information, especially tips for minor ailments you can treat at home.

Awad Alyami, MD, a pediatrician at OSF HealthCare, breaks down some common myths.

• Myth: When I shower, bathe or wash my hands, really hot water is best to kill germs.

Fact: Really hot showers can feel good, but they may burn your skin. Dr. Alyami recommends setting your home’s water heater at 120 degrees or less. Then, when you use the shower or sink, warm, but not hot water is best.

Dr. Alyami adds that a cold shower after a sweaty summer activity is OK because it can reduce the chance of heat rash. But frequent cold showers can irritate your skin.

• Myth: Q-tips are meant for cleaning your ear.

Fact: “The ear is a self-cleaning oven. Most everything inside the ear will come out on its own,” Dr. Alyami says. “When we put anything inside the ear, we are pushing everything from the outside to the inside, especially earwax. It makes it harder for the ear to clean itself.”

Using Q-tips and similar devices can lead to injuries to the ear canal or eardrum, Dr. Alyami adds. Instead, during your shower or bath, gently clean and dry the outside of your ears. If your ears look or feel off (pain or itchiness, for example), see a provider.

“We can clean you safely in the office,” Dr. Alyami says.

• Myth: For cuts and scrapes, apply antibiotic ointment like Neosporin until it heals.

Fact: You can apply the ointment once after cleaning the wound and then again after the wound is healed. But doing so often can lead to contact dermatitis, a bad skin reaction.

• Myth: The “five second rule” is OK for eating food that’s fallen on the floor.

Fact: Dr. Alyami puts this one to rest once and for all: Don’t do it. Always eat off a sanitary surface.

He even says that research has shown that bacteria from the floor can attach to food in as little as less than one second. Eating dirty food can lead to vomiting and stomach illnesses.

Interview clips

Summer may be winding down, but health care providers want you to know that heat rash can happen year-round. Luckily, most cases resolve on their own with simple steps.

Maddy Draper, APRN, a provider at OSF OnCall, says heat rash (also called sweat rash or prickly heat) usually occurs in a hot or humid setting. This could be the summer heat or a year-round activity like the sauna or gym. Or, Draper says, using certain things on your skin – like bandages, medicine patches or thick lotion – can contribute. Either way, the result is clogged ducts trapping sweat under the skin, leading to a rash.

“It’s either raised, red bumps or blisters filled with clear fluid or pus,” Draper explains.

Draper adds that heat rash is more common in infants and young kids, but it can affect all ages. She says providers typically see the rash on a person’s midsection – front and back. It can also crop up on your arms and legs, especially where patches of skin come together, like your armpit. Sometimes the rash will be itchy.

“There’s no cure for it. It’s just getting back into a normal, less hot environment. Wear less clothing. Get the sweat off your body,” Draper says.

Don’t pop the blisters, as that can lead to a bacterial infection. Don’t use rubbing alcohol or peroxide on the rash, and don’t scratch the itch.

In other words: “Just leave it alone,” Draper says, and most cases will resolve in a few hours.

When to see a health care provider? If you develop a fever, if the rash persists for a couple days or if it looks different (such as red streaks up your arm), visit your local urgent care. In rare cases, blocked ducts can cause sweat glands to stop working. That makes it harder for the body to cool itself, and you can be prone to overheating.

Heat rash prevention involves many of the “hot environment” safety tips you’ve heard before.

“Stay in cooler environments,” Draper advises. “Everyone likes to be outside in the warmth, but try not to prolong those exposures. If you feel symptoms [of heat illness], come inside and cool off.”

During those breaks, drink water or a sports drink, wipe off sweat and change out of damp clothes. Also, remove bandages or patches when doing something that makes you sweat.

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How much water is too much?

But don't let lake life wash away your safety habits or good judgment. 

In 2023, the U.S. Coast Guard counted over 3,800 recreational boating accidents, resulting in 564 deaths. The Centers for Disease Control and Prevention (CDC) reports drowning deaths are on the rise for the first time in decades, with over 4,500 people drowning each year from 2020 to 2022. 

Jon Gehlbach, MD, is the medical director for the Pediatric Critical Care Unit at the OSF Children's Hospital of Illinois. He says there are many unknown factors in natural bodies of water like lakes and rivers that make them more dangerous than pools.

“They tend to be darker, so it’s harder to see what’s going on below the surface. They could have hidden obstacles," Dr. Gehlbach says.  "Currents play a factor as well. Kids might be great swimmers in the pool, but currents make it a lot more challenging to swim safely.”

Another harmful thing to keep in mind is the spread of waterborne pathogens and bacteria like E. Coli. 

The Illinois Environmental Protection Agency (IEPA) says to not transport water, animals, fish or plants from one body of water to another. 

Also, wash yourself, your boats and equipment with hot water as soon as possible once you're out of the water.

Health Highlights Video Version With Chyrons

Health Highlights Video Version Without Chyrons

When it comes to oral health in kids, Emily Isom has seen it all.

Cavities, gum disease and infections, improper tooth alignment and tooth loss come to mind quickly. Not to mention all the missed school time dealing with these issues.

But she’s also seen plenty of young people who are the picture of good oral health. And she’s on a mission to make more of the latter.

“The mouth is the gateway to the body,” says Isom, a certified medical assistant in pediatrics at OSF HealthCare and a former dental assistant.

“A lot of people don’t think about what our oral health can do to us if it’s not being taken care of,” she adds. “It can cause heart disease, diabetes and respiratory infections.”

Everyday prevention

Isom says kids and their parents should commit to daily habits that will improve their oral health.

For infants without teeth, Isom says parents should use a soft, cool washcloth to wipe the child’s gums twice a day. This helps clear bits of food and milk that can lead to bad breath, irritation and cavities.

“Touching their gums will help when they are older. They’ll be okay with brushing their teeth. They won’t fight the parents about it,” Isom says. “So, it’s good to start [oral health care] early."

Older kids should brush their teeth for two minutes, twice a day. Floss once a day. When a child has two teeth that touch, it’s time to start flossing. That could happen from ages two to six.

Before you rinse out your mouth with water, don’t forget about the tongue, Isom says.

“If we do not brush our tongue, bacteria can sit on it. It can get what I call ‘tongue sick,’” Isom says. “Bad breath can also happen.”

Outside of the bathroom, Isom reminds us that sugary and starchy food and drinks are prime suspects in oral health issues like cavities. So, parents should offer those foods in moderation. Isom calls out sticky candy as an example. She says the sugar tends to sit on your teeth for a while. Isom also says starchy food like bread, potatoes, rice, pasta and cereal can sit between your teeth unless you floss right away.

Another must-know for parents with babies: don’t put your baby to bed with a bottle. Aside from a choking hazard, Isom says the constant stream of milk or formula can lead to cavities and corrosion. She also says this can cause infants to be fussy and demand a bottle more often.

It takes some convincing

A mother of a six-year-old, Isom knows that some kids won’t brush and floss willingly. They see it as a chore.

Her response: make oral health fun.

“Make a dental chart. Add stickers to it, morning and night,” Isom suggests. “Give them rewards like a little toy. After each cleaning, they can get a reward. Turn on music or a timer for two minutes [of brushing.] Get toothbrushes with their favorite characters on them.”

Dentist visits

Isom says children usually have regular visits with a dentist twice a year. Others with known mouth issues may go every three to four months. But see a dentist right away if you notice red flags: pain in the mouth, persistent bad breath, discolored gums or teeth, bleeding gums or trouble swallowing.

A regular dental visit usually includes a thorough cleaning of the teeth and gums followed by fluoride treatment.

“[Fluoride] protects the enamel of the teeth,” Isom explains. “It protects your teeth from cavities. It just makes your enamel really strong so you can eat the things you want.”

A dental professional may also perform X-rays on your teeth regularly.

Something else for parents to make sure the dentist has in mind: oral cancer screening.

“Those are huge,” for oral health, Isom says.

A dentist may use their hands to examine your mouth and neck. They could use a light or have you rinse your mouth with a blue dye. Each method looks for abnormal, possibly cancerous tissue.

At the end of a dental visit, you may be sent home with a prescription or just instructions to keep your mouth happy. For example, you may get a prescription mouthwash to help with gum disease.

Learn more

Read more about how to keep kids’ mouths in good health on the OSF HealthCare and U.S. Centers for Disease Control and Prevention websites. If you don’t have a family dentist, talk to your primary care provider about finding one. OSF HealthCare Children’s Hospital of Illinois in Peoria offers dental care for children with special needs.

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After decades of decline, drowning deaths are on the rise in the United States, according to the Centers for Disease Control and Prevention (CDC).

Over 4,500 people died each year from drowning from 2020-2022, reported in the CDC’s Vital Signs study. The study shows drowning to be the number one cause of death for children ages 1-4. The research points out that 55% of American adults have never taken a swimming lesson, and that drowning death rates for Black people were 28% higher in 2021 than 2019.

Jon Gehlbach, MD, is the medical director of the Pediatric Critical Care Unit at OSF HealthCare Children’s Hospital of Illinois. He says swim lessons and adult supervision are two of the most important things for kids getting in the water.

“The best thing we can do to keep kids safe around the water is getting them comfortable with swim lessons. A common misconception among young, pre-swim lesson kids is that some type of flotation device is replacement for either swim lessons or adult supervision. Unfortunately, those devices aren’t really designed to keep kids safe in the water without those two other elements,” Dr. Gehlbach says.

Know CPR

In the unfortunate event your child loses consciousness underwater, Dr. Gehlbach says knowing cardiopulmonary resuscitation (CPR) is of the utmost importance.

“The first thing is to make sure you’re safe getting in the water. If you can’t swim, don’t turn a single-person drowning into a 2-person drowning by trying to be a hero. Instead, get help as soon as possible. If the drowning was unwitnessed, a quick glimpse around the pool will make sure there’s not an accident like a downed powerline that provides a route for electrocution. Ensure your own safety first,” Dr. Gehlbach says. “If you can exclude that, get the child out. I strongly feel that anyone who is going to be in a scenario where there are children swimming and there’s no lifeguard present, someone needs to be CPR certified. The best chance for a drowned child to recover is fast, effective CPR.”

Time is brain

“Time is of the essence. There’s a statement in critical care that ‘time is brain.’ The longer that brain is going without oxygen, the lower chance of a meaningful neurologic recovery,” Dr. Gehlbach says. “Ten seconds is far better than thirty seconds, which is far better than a minute.”

One of the most common reasons for child drowning, Dr. Gehlbach says, is when a child enters the pool without adults even knowing.

“A lot of those are family home pools where the kid gets outside and the family is not aware, they go to look for the child, and they’re at the bottom of the pool and who knows how long they’ve been down there,” Dr. Gehlbach adds.

Drowning isn’t what it looks like on TV

“I think many people are under the false impression that when a child begins to drown that it’s a noisy event with a lot of splashing, that’s how it looks on TV,” Dr. Gehlbach says. “Unfortunately, the realistic picture is that it’s a much more quiet and non-chaotic event. They slip below the surface, they inhale a lung full of water, and there’s no splashing just a quiet sinking to the bottom.”

Dr. Gehlbach recommends swimming lessons for anyone, especially young kids. If you have a pool at home, he recommends having a four-sided fence around the pool, and having an alarm system on your door which is closest to the pool in case a child gets outside.

Video Interview Clips

When it’s hot outside, people tend to reach for the water. But too much of a good thing can be a problem.

It’s called water intoxication and it’s making news. Recently, a young woman died from drinking too much water in a short amount of time, and a young boy was hospitalized after doing the same thing.

“Water intoxication comes from drinking too much water," says Elizabeth Clay, a nurse practitioner with OSF HealthCare. "And it can lead to some severe symptoms. You can get a headache, disorientation, confusion, nausea, vomiting – it can even be fatal.”

Other serious symptoms include muscle weakness, increased blood pressure and double vision. 

“The amount of water that a person should consume is going to be individualized," says Clay. "But overall, your kidneys can only handle so much. And that's between 0.8 and one liter. So, you really don't want to be taking in more than that per hour in water.”

Water intoxication can affect anyone. But it’s a problem that is especially common in people who participate in sporting events, military training or working outside.

“Dehydration can play a major role in water intoxication because when a person feels that they're getting dehydrated, they may try to overcompensate and may drink too much water at one time, and your body can't handle that," says Clay. "So, you'll start to get these symptoms whether it's nausea, vomiting, confusion – just disruption of your brain activity – and that comes from that depletion of sodium. And so, your cells inside your brain are holding on to that water and it causes swelling inside your brain and that can lead to some serious complications.”

Clay suggests taking frequent swallows throughout the day rather than chugging a bottle of water at once. Also, eat a healthy diet to get the needed electrolytes. And don’t drink just water. Sports drinks like Powerade and Gatorade, as well as coconut water and cow's milk are full of electrolytes.

There are no guidelines as to how much water a person needs each day. Some people still follow the 8x8 rule, which recommends drinking eight 8-ounce glasses of water a day. Still, it depends on certain factors like body weight, the amount of physical activity you get and the climate where you live.

"So, if you can, stay indoors and out of the sun during this hot weather," says Clay. "But if you must be outside – if you've got training or some sort of physical activity that maybe your job or work requires – just want to make sure that you're getting those electrolytes and that water that you need. Just don't overdo it.”

 If you begin to experience symptoms after drinking too much water, call 9-1-1 immediately. 


 

Interview Clips 

B-Roll

The Fourth of July holiday usually brings plenty of opportunities for the 3 Fs: fun, food and fireworks. That’s why it’s even more important to remember your ABCs: always be careful.

According to the Consumer Product Safety Commission, on average, 250 people go to the emergency room every day with fireworks-related injuries around the July 4th holiday. Most fireworks are illegal in the state of Illinois, but even the legal ones are risky.

“About a quarter of all ER visits are due to legal fireworks in the state of Illinois,” said Dr. Ben Kemp, OSF HealthCare emergency room physician. “Sparklers, for instance, can be relatively dangerous if used inappropriately: given to children who are too young to handle them, or lit in a way that they shouldn’t be, which we see occasionally where people wrap a lot of fireworks together or light them in a way where they cause a larger fire and can be potentially harmful.”

Dr. Kemp continued, “Never light a firework in your hand, obviously that can explode unexpectedly, quickly and you can get blast injuries to the hand or burn injuries to the hand and be very harmful. And also burns to clothing – clothing lights on fire and you can get burns to other areas. Facial injuries too – so a firework goes off in somebody’s face and you get injuries to the eye, the face and can be rather harmful and something we have to deal with.”

Dr. Kemp reminds everyone when using sparklers or other legal fireworks to always have a hose or bucket of water nearby, do so in a wide, open area and to make sure young children are kept at a safe distance. He also says be careful when it comes to alcohol use during festivities.

“Anytime somebody is drinking too much in the heat there is the risk of heat illness,” he warned. “Obviously drinking and driving is a terrible thing that we don’t want to see on a holiday, something us and law enforcement are very concerned about. And certainly mixing alcohol is a recipe for injury as well.”

The July 4th holiday is also a time for picnics. The Illinois Department of Public Health says each year about 1 in 6 Americans get sick from food poisoning, so you want to make sure you prepare, cook and store any food properly.

“You want to make sure things are cooked appropriately. Food sitting out for hours at a time, so something that’s got mayonnaise on it that’s sitting out for 2 or 3 hours, those sort of things can be at risk to cause gastroenteritis or food borne illness,” said Dr. Kemp.

And what would a summer holiday be without water activities, whether in a pool, lake or river? Again, safety is key. Drowning is the third leading cause of unintentional injury death, with children most at risk. Water-related injuries are something emergency department physicians don’t like to see come through the door, because an ounce of prevention can go a long way.

“Always ensure that you’re in a safe environment to dive into the water or jump into the water. Making sure little ones are well supervised when they are swimming or have appropriate floatation gear on,” advised Dr. Kemp. “The tragic things are when a little one is unsupervised and gets into a pool or a young, healthy person dives into a shallow pool of water and injures their neck. Those are things we don’t want to see.”

Check out more tips on fireworks safety, water safety and food safety for a safe and happy 4^th of July.

Interview Clips
 

B-Roll

In 2022, we saw a number of video trends that went viral on the popular social media app TikTok that were being portrayed as health “hacks” to try at home. Some of these included Nyquil-soaked chicken, at-home mole removals, storing avocados in a container of water, and mouth taping. Another health “hack” continues to go viral on the app: cold plunging. Everyday folks and celebrities like Hailey Beiber, Lizzo, David Beckham and Lada Gaga are trying it.

Cold plunging is not new. It involves submersion into freezing cold water and dates back to early ancient Egyptian and Greek practices. You have probably even seen professional athletes use ice baths for muscle recovery.

In the popular videos on TikTok, people are filling large tubs with water outside and, if they live somewhere that experiences cold winters, they are letting the surface of the water freeze overnight. The following day, they crack the ice and plunge themselves into the cold water. The individuals in the videos claim the cold plunging helps with many things, from improving sleep to supporting a healthy immune system. 

Anne Orzechowski, an OSF HealthCare family medicine advanced practice nurse, says to take these claims with a grain of salt.

“There are some benefits of cold plunging if it is done safely, if you are used to it,” says Orzechowski. “Some studies from the colder climates show that there might be an increase in white blood cells, so there are thoughts that you might not get as sick. There is a decrease in triglycerides, an increase in endorphins – so some people say they feel better.”

The American Heart Association says while there are some studies that suggest people who adapt to cold water immersion reduce inflammation and other cardiovascular risks, there are other studies that have found prolonged cold water immersion to cause heart muscle damage. 

So how does something that can potentially be beneficial and seem harmless to most people also pose such serious risk? First, it’s important to understand what exactly happens to our body when plunging into freezing cold water.

“The initial thing that happens when you jump into a cold body of water is that initial shock reflex – that gasp,” Orzechowski warns. “Your body hyperventilates. It tries to get your blood flowing a little faster, tries to get your heart rate moving a little faster, and get that blood moving a little bit. Then as you are in there greater than three minutes your body starts to kind of calm down and relax. But there is a real risk of hypothermia after that, so you have to be really careful with this.”

According to the Centers for Disease Control and Prevention (CDC), cold water immersion creates a specific condition known as immersion hypothermia that develops much more quickly than standard hypothermia, because water conducts heat away from the body 25 times faster than air.

“I would especially not recommend it for somebody with any sort of peripheral vascular disease, Raynaud’s, or any vascular issues associated with diabetes. You are not going to be able to feel your extremities very well and are not going to know when it is time to really get out,” says Orzechowski.

Orzechowski adds while some people claim that cold plunging helps to calm them and relieve stress, this calm feeling could actually be an effect of the constricting blood vessels. Furthermore, the National Center for Cold Water Safety warns that because blood vessels constrict in response to sudden cooling, cold water immersion causes an instant and massive increase in heart rate and blood pressure which increases the danger of heart failure and stroke.

Overall, the bottom line is that the risks of cold plunging tend to far outweigh the benefits. Orzechowski advises people who are intrigued by these videos to avoid trying it themselves.

“If you look up the TikTok ice plunge, you see a lot of people with hats on breaking into buckets of ice and jumping in. I really don’t recommend that. There is a risk of shock and there is a risk of arrhythmia,” cautions Orzechowski. “If you really want to do this, the takeaway point is just take a shower and turn the water to cold at the end, give yourself 10 to 15 seconds. That still has a benefit and has been shown to be beneficial as opposed to jumping into a bucket of ice outside.”

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A veteran urologist, Uwais Zaid, MD, has heard the comparisons.

Pain from a kidney stone is like giving birth.

“It’s true,” says the man who provides care at OSF HealthCare in Alton, Illinois.

“It’s horrible. They just can’t get comfortable. They’re writhing around in pain,” Dr. Zaid says of people suffering from a calcification-turned-blockage in the urinary tract.

“When the kidney gets obstructed, everything gets swollen upstream. That causes everything to get stretched out,” Dr. Zaid explains. “And it hurts a lot. Your body responds with severe pain in the flank area. It’s a sharp, stabbing pain.”

Other signs: you suddenly start feeling an urgency to urinate or your urine is anything but clear or yellow.

All those unpleasant symptoms are why prevention of kidney stones is key. It starts with what you put in your body.

Drink plenty of water, Dr. Zaid says. Doctors even recognize a “kidney stone belt” in the southern United States where people deal with sweltering weather and dehydration.

Avoid excess salt and sugar in your diet. That means cut back on soda and sweet tea. Too much meat, nuts and leafy vegetables can also cause problems.

“Other risk factors include a family history of kidney stones. Chronic diarrhea can cause dehydration and a loss of electrolytes,” Dr. Zaid says.

For small kidney stones – less than five millimeters across, or about the size of an eraser on the end of a pencil – a provider may see if the stones can pass out of your body through the urethra on their own. Medication can help with that.

But for trickier stones, there are several ways doctors can intervene. Dr. Zaid says providers can blast sound waves at the kidney stone from outside the body to break the stone apart. A doctor can send a camera through the urinary system, find the stone, use a laser to fragment it and remove the pieces. For larger stones – two to four centimeters – surgery involves an incision through your back to reach the stone, break it apart and remove it.

If you have symptoms of a kidney stone, don’t try to tough it out. Your symptoms may subside, but there may still be issues that could turn serious. Instead, see a doctor right away. They will perform a CT scan or ultrasound to find the cause of the pain, then develop a treatment plan.

“If the kidney remains obstructed for several weeks, that can lead to kidney damage,” Dr. Zaid warns. “If the kidney stone causes urine to get infected upstream, that can lead to sepsis, which is a life-threatening infection.”

Learn more about kidney stones on the OSF HealthCare health library and the OSF HealthCare blog.

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Andrew Zasada, MD, can’t help but chuckle when asked about the “latest and greatest” body cleansing fads.

But the internal medicine physician at OSF HealthCare says these whims can turn into anything but a laughing matter.

“When you put stuff that’s not really regulated in your body, you don’t know what’s going in,” Dr. Zasada says. “And if you mix in your regular medicine, too, you’re not doing yourself a favor.”

Dr. Zasada is reminding you to talk to your primary care provider before starting any significant treatment. Don’t believe everything you read online or on a label.

Diatomaceous earth as a cleanse

Dr. Zasada says diatomaceous earth has several legitimate uses in industry. But it’s also seen in powder form as a dietary supplement.

The product comes from ground-up and processed skeletons of algae. It contains silica, one of the main components of sand. There are two types of diatomaceous earth: edible, which contains 2% to 4% silica, and industrial with 60% or more silica.

Dr. Zasada says ingesting silica in small amounts – for example, mixing it in water – is harmless because it does not absorb into your body. But you should never inhale it.

“It causes irritation of the lungs which can be permanent and cause scarring. It can cause you to be short of breath. It’s called silicosis,” Dr. Zasada explains. “It’s similar to what coal miners get when they inhale coal dust. People die from silicosis every year.”

Dr. Zasada says some people claim diatomaceous earth cleanses your digestive tract and improves cholesterol. But he says scientific evidence for and against these claims is “scant at best.”

“There have been a few studies that showed that it lowers cholesterol. But at the same time, we don’t know what else that patient may have eaten because it was a poorly designed study,” Dr. Zasada says. “Was the silica responsible? Was it dietary? We simply don’t know.”

Dewormers and other cleanses

Dr. Zasada says dewormers do what the name suggests – remove intestinal parasites from your insides. He says they serve a purpose in livestock but not humans.

“Some people believe we all carry some type of parasite, and we need to deworm ourselves,” Dr. Zasada says with a sigh.

“If you really think you have an intestinal parasite, see your doctor. The test is simple. If you do, in fact, have a parasite, it can be eliminated.”

Dr. Zasada adds that there’s no evidence that our bodies are loaded with toxins that must be removed. He says that removal happens naturally through our liver, kidneys and bowel movements.

“We’ve been around as a species for hundreds of thousands of years without colon cleanses, and we’ve done pretty well,” he quips.

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

Urinary incontinence is when a person leaks urine by accident.

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

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

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

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

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

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

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

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

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

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

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

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

Interview clips

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