Health Quarterly April 2021
Special Supplement to the
April 2021 HEALTH QUARTERLY
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UNDERSTANDING ERECTILE DYSFUNCTION, A LEADING MEN’S HEALTH CONCERN
Article Submitted By SIU Medicine
Among the many different health issues affecting men, erectile dysfunction is one of the most reported problems, and is something easy to discuss during June - Men’s Health Month. Unfortunately, men may feel embarrassed to talk about sexual dysfunction concerns with doctors. At SIU Medicine, the team encourages men to break the stigma and help raise awareness about this common condition that is thought to affect 30 million men.
What is erectile dysfunction? Many men experience occasional difficulty with achieving or sustaining an erection suitable for physical intimacy. But when it becomes a frequent and recurring issue, a man can be said to have erectile dysfunction (ED).
Common causes and risk factors for erectile dysfunction Erectile dysfunction can be caused by a variety of underlying reasons, including impaired blood flow to the penis, damage to nerves
in the penis, stress or another underlying medical condition. It’s most common in men older than 50, but it can affect men of all ages. In addition to advancing age, specific risk factors include: • High blood sugar (diabetes) • High blood pressure (hypertension) • Cardiovascular disease • High cholesterol • Alcohol and tobacco use • Overweight and obesity • Physical inactivity A majority of these risk factors are within a person’s control. With the help of a doctor, a person with erectile dysfunction can adopt healthy lifestyle changes to manage his ED more effectively—or avoid it altogether.
Treatment and management techniques for erectile dysfunction If you or a male loved one is having signs and symptoms of erectile
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dysfunction, treatment by an experienced physician is critical. Understanding the root cause can help you find an effective solution. Additionally, erectile dysfunction is often an early warning sign for heart disease. Seeking treatment for ED may alert you or your loved one to another underlying problem requiring medical intervention. Depending on individual health needs, a person’s erectile dysfunction treatment may include: • Medications to make it easier to get and sustain an erection, such as phosphodiesterase type-5 inhibitors (Viagra, Cialis, or Levitra) • Testosterone therapy (low testosterone, which is common with advancing age, can lead to worsening erections)Penile injections • Penile prosthesis implants or vacuum erection devices • Lifestyle modifications Understandably, many men who experience erectile dysfunction also deal with emotional and mental challenges including stress, shame, depression and anxiety. Psychotherapy and other avenues may be indicated to complement the medical treatment and optimize outcomes.
Do you know someone affected by erectile dysfunction? Healthy men can expect to enjoy healthy sex lives well into their 60s, 70s and 80s. If you or someone you know has concerns about erectile dysfunction, or have any other concerns regarding their health, connect with the SIU Medicine Men’s Health Team. Call 217.545.8000 to schedule an appointment or speak with a medical team member with your questions. With us, your privacy is always prioritized.
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3 HEALTH QUARTERLY
April 2021
NOISE MANAGEMENT IN DIGITAL HEARING AIDS Article Submitted By: Central IL Hearing Noise presents a particular challenge to individuals with hearing loss. Their most common complaint is “difficulty hearing in noise”. One cause is that most people with hearing loss have better hearing for noise than for speech. Noise is a common problem for people with normal hearing. Zagat Restaurant Guides and Consumer Reports list noise as one of the top complaints about restaurants.
The digital age Older hearing aids were very limited in their ability to control noise. Digital hearing aids are much more effective at improving hearing and comfort in noise. Techniques to manage noise include noise reduction, directional amplification and sound compression.
Noise reduction programs use the sound characteristics of noise to control the amplification. The chief benefit is improved comfort rather than improved speech understanding. Directional amplification uses multiple microphones to separate speech from noise and can provide a significant benefit. Adaptive and automatic directional processing adjust the directionality based on the characteristics and source a speech. A third technique controls the loudness of all the sounds. Compression automatically reduces amplification as the input signal increases. At high intensity levels, loud sounds are not amplified at all. The goal is to allow the user to hear soft sounds while being protected by loud sounds.
Impowering the hearing aid user As audiologists, we cannot program hearing aids to match everyone’s specific listening needs, Bluetooth technology which
connects your hearing aids to your smartphones, the user now has control to adjust their hearing aids response to maximize user comfort and speech clarity. They can adjust frequency bandwidth, noise reduction, speech clarity, volume, microphone directionality, steaming phone calls and music through their aids. By allowing patients greater control of their devices significantly increases user satisfaction. Today’s hearing aids have to be heard to be believed While these hearing aid technologies provide improve comfort and significantly better hearing in noise, hearing in noise will always be a challenge to someone with hearing loss and even those with normal hearing. Ironically, hearing aids can also provide the greatest help in these conditions.
RISK FACTORS FOR MELANOMA Skin protection takes center stage each spring and summer. Though it’s important to protect skin whenever spending time outdoors, including in winter, many people get the bulk of their outdoors time in when the weather is at its warmest, making sunscreen a must-have accessory in spring and summer. Melanoma is a form of skin cancer that can spread rapidly to other organs if it is not treated at an early stage. The Skin Cancer Foundation notes that between 70 and 80 percent of melanomas arise on normal-looking skin. When skin is exposed to ultraviolet radiation, that exposure can contribute to skin damage. Ultimately, melanoma can occur when damage from sunburn or tanning due to UV radiation triggers mutations that lead to uncontrolled cellular growth. Because melanoma is inextricably linked to exposure to UV radiation, it’s understandable if people assume that it’s always preventable. However, the American Cancer Society notes that there is no way for people to completely prevent melanoma. That’s because some of the risk factors are beyond individuals’ control. However, other risk factors are within people’s control, and recognizing those factors can help people lower their risk for melanoma. Uncontrollable risk factors Genetics and skin type are two significant risk factors for melanoma that are beyond individuals’ control. The SCF notes that one in every 10 melanoma patients has a family member who had the disease. In addition, melanoma is found more frequently in people with fair skin than in people with darker skin. Mela-
noma also is found more in people with light eyes, light-colored hair and red hair. People with these physical characteristics and family histories must be especially vigilant when spending time outdoors. Applying sunscreen with a minimum sun protection factor (SPF) of 30 and wearing protective clothing and hats that protect the skin from UV radiation are two ways that people with fair skin and family histories can protect themselves from melanoma. Controllable risk factors Unprotected or excessive UV exposure is a significant risk factor for melanoma. Anyone, regardless of their family history or skin type, should prioritize protecting their skin when spending time outdoors. The American Skin Association advises all people to avoid the sun between 10 a.m. and 4 p.m., when the sun’s rays are at their strongest. Tanning beds also pose a threat in relation to melanoma. The ACS notes that the idea that the UV rays of tanning beds are harmless is a misconception. Tanning lamps give off UV rays that can cause long-term skin damage and the ACS reports that tanning bed use has been linked to an increased risk of melanoma, especially among people who use such beds prior to turning 30. Checking the skin routinely is another way to combat melanoma. The ACS notes that certain types of moles are more likely to develop into melanoma than others. Routine self-examinations of skin can help people spot new or abnormal moles or other growths. Recognizing these abnormalities and reporting them to a physician immediately can help doctors treat them before they
turn into skin cancer. Melanoma is a potentially deadly form of skin cancer. Recognizing the various risk factors for melanoma is an important first step in combatting the disease.
April 2021 HEALTH QUARTERLY
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7 SENSATIONAL TIPS FOR SUMMER SKIN SAFETY
Article Submitted By SIU Medicine
As the temperature warms up, the days are long and the sun shines bright, more time is spent outdoors. During this favorite season for many, going to the beach, hosting backyard barbecues and playing sports outdoors might be some of your favorite activities. But spending in the summer sun without taking appropriate precautions could increase your risk for skin cancer. According to the National Foundation for Cancer Research, skin cancer is the most common type of cancer in the United States. Fortunately, it’s also the most treatable form. Skin cancer prevention is still much easier than skin cancer treatment. To increase your odds of having a safe summer in the sun, the experts at SIU Medicine recommend the following tips:
Slather on the sunscreen When enjoying the summer sun, sunscreen is your best friend. The National Foundation for Cancer Research recommends using a product with a sun protection factor (SPF) of at least 30. Because the sunscreen product breaks down, you should reapply sunscreen every 2 hours to maintain the same level of SPF protection, and after doing anything that removes the product from your skin, like swimming or excessive sweating. An ounce (a shot glass worth) is how much you need to cover your whole body, and about a teaspoon’s worth is needed for your face. Ensure that your sunscreen is “broad-spectrum,” meaning it protects you against UVA and UVB rays, both of which can contribute to skin cancer, as well as the aging effects of ultraviolet exposure. You can
check if a sunscreen is broad-spectrum by looking at the label on the front of the bottle. Additionally, a sunscreen will list if it is “water-resistant” for 40 or 80 minutes. This means that you should reapply if you have been in the water for any length of time greater than the number listed on the label. If you are concerned about a sunscreen allergy, the best products to use are ones that are “physical blockers,” meaning they are sunscreens that don’t use chemicals to absorb and break down ultraviolet rays; rather, zinc oxide or titanium dioxide reflects the sun’s rays off of you so your skin doesn’t absorb them. These sunscreens are the safest options for children and infants over 6 months of age. For infants under 6 months of age, dermatologists recommend keeping them out of the sun, and when this is not feasible, protecting them with clothing.
Seek shade and use maximum protection during peak hours The sun’s ultraviolet (UV) rays are the strongest between 10 a.m. and 4 p.m., so try to plan outdoor events earlier or later in the day if possible, but if this is not possible, try to seek shade and use protective clothing, in addition to your sunscreen. And don’t forget about reapplication every 2 hours and after excessive sweating and extended water exposure!
Stay out of tanning beds Like the sun, tanning beds expose you to harmful UV rays. Besides causing skin cancer, UV rays can also lead to premature skin aging. If having tanned skin color is important to you, opt for a sunless tanning product. But remember, the tanned color does not give you any additional sun protection.
Be careful at the beach Are you a beach bum during the summer months? Water and sand
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can actually reflect and intensify the sun’s rays. Be extra cautious while surfing the waves or building sand castles at the beach.
Wear protective clothing When it’s hot outside, your first instinct might be to wear as little clothing as possible. However, to prevent skin cancer, putting on protective clothing is key. When spending time in the sun, strive to wear long sleeves, a wide-brimmed hat and UV blocking sunglasses. During clothes shopping trips, look for items labeled with an Ultraviolet Protection Factor (UPF).
Stay safe in the car Being safe in a car doesn’t stop with fastening your seat belt. You need to protect yourself from the UV rays filtering in through your car’s windows. Window glass can prevent UVB rays, but not UVA rays, from getting to your skin. Always keep some sunscreen in your vehicle. Reapply it during long drives. Another option is installing a transparent window film. This type of film is available in all 50 states. According to the Skin Cancer Foundation, some window films can block out almost 100 percent of UV rays.
Get screened Getting screened regularly by an experienced doctor is an essential skin cancer prevention step. SIU Medicine’s board-certified dermatologists provide collaborative care based on the latest research. Do you have a family history of melanoma, a personal history of skin cancer, or a history of blistering sunburns and/or tanning? If so, you should get a full-body exam once each year. Do a monthly skin self-exam to look for new and unusual or changing moles. Summer can be a magical time of year--ideal for making fond memories with friends and family members. By following these simple tips, you can enjoy the summer sun without increasing your risk for skin cancer.
5 HEALTH QUARTERLY
VACCINATION ONE TOOL IN FIGHT AGAINST COVID-19 PANDEMIC
Article Submitted By: Passavant Hospital
Being vaccinated is one weapon against COVID-19, but it’s still important to continue mask usage, handwashing and social distance. “Vaccination teaches your immune system to recognize the virus and fight it off if you are exposed,” said Raj Govindaiah, MD, chief medical officer for Memorial Health System. “However, we are still learning how well vaccines prevent you from spreading the virus if you are exposed. We are also learning how long vaccines protect people from COVID-19. Until we know more, it is essential to wear masks, wash your hands and follow social distancing guidelines.” A third vaccine - developed and manufactured by the pharmaceutical division of Johnson & Johnson – is now available to the public alongside the Pfizer and Moderna vaccines. The Johnson & Johnson vaccine requires only a single dose. “Our goal needs to be getting as many shots in arms as possible, as quickly as possible,” said Govindaiah. “If you have the opportunity to be vaccinated, please do so. All three of these vaccines offer very significant protection against COVID-19 illnesses and will help us put an end to the pandemic.” Experts continue to learn more about natural immunity and vaccine-induced immunity related to COVID-19. Memorial Health System remains committed to sharing COVID-19 information with the community throughout the pandemic. Visit ChooseMemorial.org/ Article & Photos Submitted By: Passavant Hospital COVID19.
April 2021
April 2021 HEALTH QUARTERLY
REOPENING – BRINGING FAMILIES AND RESIDENTS BACK TOGETHER
Article Submitted By: White Hall Nursing
Since the Covid-19 pandemic hit, pictures, Face Time chats and window visits have taken the place of in-house visits which has weighed heavily on families, residents, and facility staff. The March 2020 restrictions were placed on nursing homes and assisted livings prohibiting residents from seeing their loved ones, traveling freely outside the facility and in the most extreme circumstances even leaving their rooms to socialize with other residents. “As much as caregivers build relationships with the elders and get to know them, there’s nothing like family,” said Bobbi Pratt, Regional Director of Admissions for White Hall Nursing & Rehabilitation, LLC. Recently CMS announced guidance on expanding indoor visitation and personal touch between families. Since late December, when vaccinations began, covid cases in nursing home residents have plunged 83%. “Vaccines have changed everything and nursing homes are now among the safest places you can be in your community in terms of covid.” stated Jill Spurgeon, Executive Director of White Hall Nursing & Rehab. Visitation is conducted through various means based on a facility’s structure and residents’ needs, including resident rooms, visitation spaces, and outdoors. Given the ongoing risk of Covid-19 transmission facilities still have to adhere to the core principles of Covid-19 infection control, including maintaining physical distancing and conducting visits outdoors whenever possible. Each long term care facility can reopen and reduce restrictions by moving gradually through three phases, which are in accordance with the CMS Nursing Home Reopening Recommendations. Phases are determined by: 1) Facility-onset cases, and 2) County incidence rates and 3) Facility readiness and resources. Changes in any of these parameters may require facilities move between phases, causing changes in visitation policies and other allowable activities. “We cannot express enough the importance of everyone getting vaccinated. One person who chooses not to vaccinate can affect ALL the other residents and families. We are stressing to staff the importance of being vaccinated so they can allow residents and families to continue to enjoy visits and being back together. ” stressed Jill Spurgeon Below are the key points of the CMS guidance issued 3/10/2021. State and Local guidance may differ, so facilities have to take into consideration the guidance of their local health departments in relation to percentage of their county positivity rates. • Outdoor visitation remains the preferred method of
visitation • If a facility has less than 70% of the residents vaccinated and a county positivity rate greater than 10%, visitation should be limited to compassionate only. (Hospice) Indoor Visitation: • Visitors must be screened. • Visitors must have no sign or symptoms of Covid-19 or any close contat with anyone suspected of or positive for Covid-19 in the last 14 days. • Screening must include the following: Ø Hand sanitizing upon entrance & frequently throughout visit Ø Properly fitting mask to be worn at all times Ø Visitors must proceed directly to the resident visitation area and cannot be allowed to proceed throughout the entirety of the facility. Ø Proper social distancing practices must be maintained throughout the visit Ø If the resident being visited is a least 2 wks post second vaccine, and desires direct contact the resident should wear a well-fitting face mask. (They can hug each
other) Long Term Care Facilities, Assisted Living Facilities, Supportive Living and Shelter Cares are currently advancing through Phases set forth by CMS although county positivity rates must also be taken into consideration as greater than 10% positivity rate begins to affect the reopening phases. Facilities have to successfully operate in each phase for 14 days before progressing to the next phase. “I feel I can speak on behalf of all long term care facilities and assisted livings that we are so happy to see residents reunited with their families. The isolation they have endured over the last year has taken a toll on them and has seemed so unfair. Protecting them was a top priority but many have said they wished they had been given a choice. Happier times are now here for them and we continue to look towards the future of completely getting back to normal.” stated Bobbi Pratt. If you have a loved one in the variety of long term settings available please get vaccinated and encourage those around you. Be the solution to keeping residents and families together! Their lifestyle is directly affected by their county positivity rates.
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7 HEALTH QUARTERLY
April 2021
5 TIPS TO MINIMIZE SPRINGTIME ALLERGIES—BEFORE THE SPRING SEASON EVEN ARRIVES Article Submitted By: SIU Medicine For those who suffer from seasonal allergies, changing of seasons causes a lot of headache. Runny noses, watery and itchy eyes, sneezing and congestion are common for people allergic to pollen, mold, ragweed and other springtime allergens. Disease prevention is just as important for your well-being as disease treatment. That’s why the team at SIU Medicine recommends preparing for springtime allergies before the season begins. Even if you can’t fully eliminate your allergy symptoms, you likely can reduce their severity and improve comfort by following a few simple steps.
5 Tips to Prepare for Springtime Allergies See an ENT-Allergy Specialist Before Symptoms Start An ENT-allergy specialist is a type of medical professional who specializes in diagnosing and treating allergies. Consulting with an ENT-allergy specialist gives you a better idea of what’s actually causing your allergic reaction, allowing you to effectively avoid the allergen once springtime comes around. ENT-allergy specialists can diagnose what is causing your symptoms by conducting a skin test. During a skin test, your doctor will prick the skin on the inside of your arm or your back with a tool that exposes you to a small amount of an allergen. If you develop signs and symptoms of an allergy,
such as redness, swelling or itchiness, then the test may be considered positive. An ENT-allergy specialist will also perform a physical examination and take a medical history to personalize your diagnosis and treatment. Additionally, an ENT-allergy specialist can recommend the best medications for your specific allergies. This cost-effective approach helps you avoid wasting money on over-the-counter remedies that may not work well for you. Tidy Up Your Home Spending more time indoors during the colder winter months can lead to a pile up of airborne particles that may exacerbate your allergies once springtime comes. Eliminate those potential allergens with regular cleaning: • Dust and vacuum (if possible, use a vacuum with high-efficiency particulate air filters) • Change air filters in your home and car • Keep up with routine heating, ventilation and air conditioning maintenance Track Local Allergen/Pollen Levels You can check daily how saturated your area is by allergens by checking various local and national pollen count websites. If your community has a high pollen count, you can take steps to minimize your exposure by: • Closing your windows
•
Minimizing time spent outside, especially in the morning or on windy days (the best times to go out during allergy season is after it has rained) • Wearing a face mask when doing yard work • Removing and washing clothes that you’ve worn outside, and showering after coming inside Irrigate Your Nose Nasal irrigation is a simple at-home way to clean out your nose. You’ll need a squeeze bottle or neti pot and simple saline solution. When using nasal irrigation it is important that boiled or distilled water is used. An ENT-allergy specialist or pharmacist can teach you how to use and set one up. Mold-Proof Your Home If you haven’t had your home tested for mold recently, now is a good time to do it. Consult with a local professional who can assess your entire home, get rid of mold and educate you about how to prevent more mold from growing. For instance, cleaning out your gutters and ensuring proper ventilation in moist areas like the bathroom are helpful. At SIU Medicine, our experienced ENT-allergy specialists, pharmacists, and other clinicians can help manage your springtime allergies. To request a consultation or learn more about how you protect yourself and your family from allergies this coming spring, visit siumed.org.
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April 2021 HEALTH QUARTERLY
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SYMPTOMS OF TESTICULAR CANCER AND HOW MEN CAN LOOK FOR THEM The best time for men to self-examine themselves for testicular cancer is right after taking a warm bath or shower. Men can do many things to maintain their overall health over the long haul. Eating right and exercising regularly can help men live long and reduce their risk for various diseases, including heart disease and diabetes. Learning about their bodies and how to
detect abnormalities is another step men can take to stay healthy, potentially helping them catch certain diseases, including testicular cancer, before they reach advanced stages. Men under 50 may not pay much mind to cancer, but the American Cancer Society notes that young and middle-aged men are more likely than men over 55 to be diagnosed with testicular cancer.
In fact, the ACS reports that the average age at which men are diagnosed with testicular cancer is 33. Learning the symptoms of testicular cancer and how to detect them may not prevent men from getting the disease. However, such knowledge can increase the chances that men detect symptoms when the disease is in its earliest, most treatable stages.
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What are the symptoms of testicular cancer? The American Urological Association notes that testicular tumors may produce various symptoms. A painless lump in the testicle is the most common sign of testicular cancer, but men also may experience swelling of the testicle or a feeling of weight in the scrotum, a pain or dull ache in the testicle, scrotum or groin, or tenderness or changes in the male breast tissue. Are symptoms always accompanied by pain? The AUA notes that swelling in the testicle may or may not include pain, so men should not ignore swelling simply because it’s not accompanied by pain. In fact, the AUA reports that very few men who develop testicular cancer feel
pain at first. However, men may eventually experience pain. In fact, pain may indicate that the tumor is growing. The experts at Johns Hopkins Medicine note that serious, acute pain is associated with rapidly growing tumors. Feelings of dull scrotal discomfort or heaviness are often described by patients experiencing pain. The importance of reporting symptoms Unfortunately, the symptoms of testicular cancer are not always reported quickly. According to the AUA, men wait an average of five months before reporting any symptoms or abnormalities to their physicians. That’s a mistake, as tumors can spread in that time. Any symptoms, however innocuous they may seem, should be reported
to a physician. That’s especially true for any symptoms that have lasted for more than two weeks. How to conduct a self-exam Self-exams can help men discover any abnormalities that may be symptomatic of testicular cancer. The AUA recommends that men conduct self-exams after a warm bath or shower, while standing, and when the scrotum is relaxed. The AUA recommends this fourstep self-examination, which is simple and only takes a few minutes. 1. Check each testicle. Gently but firmly roll each testicle between the thumb and forefingers. Feel the whole surface. The firmness of the testis should be the same all around. Men should know that it’s normal for one testicle to be slightly larger than the other. 2. Find the epididymis and vas deferens. These are soft, tube-like structures above and behind the testicle. These tubes collect and carry sperm. Young men can familiarize themselves with how these cords feel so they can more capably recognize any abnormalities that may appear. 3. Look for lumps, swelling or anything that does not seem right. Lumps or bumps are not normal, even if they cause no pain. Pain also is not normal, even if it’s only mild. 4. Check yourself at least once per month. Always look for any changes in size, shape or texture. Testicular cancer is not common. However, men must recognize the threat the disease can pose and include measures to look for and identify its symptoms in their health care routines.
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April 2021
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April 2021 HEALTH QUARTERLY
HOW TO MANAGE YOUR ASTHMA IN THE SPRING
Article Submitted By: Sarah D. Culbertson Memorial Hospital
environmental triggers and make springtime more bearable.
For many, springtime signals a long-awaited period of relief after being stuck indoors during the frigid winter months… a time to finally get outside and get a breath of fresh air. But as the world around us springs back to life and flowers begin to bloom, for many people just being outside can be irritating with allergens floating through the air. For people with asthma, this time of year can be particularly hazardous.
Although the warmer weather is certainly inviting, spending more time outside than necessary can only make things worse for your asthma. On days when environmental triggers are at high levels, keep your time outside at a minimum. This doesn’t mean you shouldn’t go outside at all — just don’t be outside more than you absolutely need to be.
Why is spring so hard for asthma patients? Because the airways in the lungs of asthma patients are often inflamed or swollen, they’re especially susceptible to certain triggers. According to the American Lung Association, some of these asthma triggers can include springtime pollen, smoke, air pollution, pet dander and even cold air. When allergens such as pollen are inhaled, they cause the airways to tighten even more, making it very difficult to breathe and triggering an asthma attack. Thankfully, asthma patients can take certain measures to reduce
Limit your time outdoors.
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will let you know what the air quality will be like for the day as soon as you wake up.
Be proactive.
Of course, you should also take proactive measures to minimize environmental triggers that may make their way in otherwise safe areas. Use air conditioners or air purifiers in your home, office or car to ensure you’re breathing clean air. Remove any potential triggers from your home such as plants or flowers. Finally, whenever you come into your home, be sure to wash Take your medication. your clothes and your hair as they may have picked up some This may sound like a no-brainer but taking your asthma medica- allergens from the air and could potentially trigger your asthma tion as prescribed by your doctor is the first step in minimizing even while indoors. You may also consider clearing your nasal the effects of allergens. Recently diagnosed patients should passages with a Neti pot or a similar nasal irrigation tool. become familiar with their inhalers and how they work. Also, Need further consultation? Dr. Elie Chbeir specializes in pulmcheck with your doctor before using any allergy medication and onology and sees patients from 9 a.m. to 5 p.m. at the Rushville ask if any other medicines may be effective. Outpatient Specialty Clinic, 238 S. Congress St. To schedule an appointment with him, call (217) 357-8500. If you have other Set up alerts. medical concerns and need to see a provider, your Sarah D. Many weather apps for your smartphone also include inforCulbertson Memorial Hospital team is here to help. mation about allergen triggers such as pollen count and ozone levels. Install a weather app and set up alerts on your phone that
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April 2021
VITAMINS AND SUPPLEMENTS WOMEN NEED
A balanced diet does more than provide sustenance and fuel for daily life. Eating an array of healthy foods gives people the best opportunity to naturally obtain the vitamins and minerals needed for optimal health. But certain nutrients may be lacking even when a diet includes an assortment of colorful produce and a careful mix of proteins, carbohydrates and fats. The right supplements can help overcome such deficits, and women often need different supplementation than their male counterparts. Vitamins geared toward women are not just a marketing ploy; most contain formulations that cater to women’s unique needs at various stages in life. The Office on Women’s Health and WebMD recommends these vitamins for women to maintain good health. Vitamin D The Cleveland Clinic reports that 42 percent of Americans are vitamin D deficient. Vitamin D comes from diet but also is produced in the skin when the body is exposed to sunlight. Vitamin D helps the body absorb and maintain adequate levels of calcium and phosphate, which are
essential to bone health. Rush University Medical Center says recent research suggests vitamin D may help guard against severe COVID-19 infections. Some populations have higher levels of vitamin D deficiency, particularly people of color, those with inflammatory bowel diseases and postmenopausal women. Folic acid Folic acid or folate (also known as vitamin B9) helps the body make blood cells and the DNA for new cells. This B vitamin also is key to preventing birth defects like spina bifida. According to the March of Dimes, one in two pregnancies are unplanned, and adequate folic acid is required at the early stages of gestation to help the fetus develop healthfully. All women who are sexually active are advised to take a multivitamin that contains folic acid in concentrations of 400-800 mcg. In addition, folate can be found in dark, green, leafy vegetables, nuts, beans, and cereals with added folic acid. Vitamin B12 Vitamin B12 comes mostly from animal products. Therefore, anyone who follows a vegetarian or vegan diet may need supplementation to ensure
they are getting enough B12. Pregnant women will find B12 is important for baby’s development. Without it, the infant may have low birth weight or other health problems, advises the OWH. Vitamin B12 also helps produce healthy red blood cells, may support bone health, could reduce risk of macular degeneration, and may reduce symptoms of depression. After age 50, women’s bodies cannot absorb vitamin B12 as readily, so supplementing or eating fortified foods can help. Calcium Growing girls need 1,300 mg of calcium each day to develop strong bones for adulthood. After menopause, women may need nearly the same dosage (1,200 mg) to help slow the bone loss that comes with aging. Calcium is found in low-fat dairy products and foods with calcium added. Healthy eating may be a goal, but the U.S. Food and Drug Administration notes that 99 out of 100 Americans don’t meet even minimum standards of a balanced diet. Supplementation can help meet those standards and ensure a long, healthy life.
April 2021 HEALTH QUARTERLY
WHY SHOULD I GET A COVID-19 VACCINATION?
Article Submitted By: Passavant Hospital
system to create antibodies that recognize and fight the virus that causes COVID-19. With COVID-19 vaccination in “The reality is that everyone the news, you may be wonderwill eventually develop ing whether it’s worthwhile antibodies to COVID-19 one for you to get the shot. Experts way or the other: either by say yes. getting vaccinated or by “Even if you’re not in a getting the illness,” said Dr. high-risk group, you can Griffin. “Vaccination is very help protect yourself and the safe – much safer than getting people you love by getting COVID-19 and risking serious vaccinated,” said Anthony Grifcomplications or a long-term fin, MD, chief medical officer, recovery.” Passavant Area Hospital. “We What about people who estimate that around 70 to 80 have already recovered from percent of the U.S. population COVID-19? While getting sick will need to be have some does provide short-term imlevel of immunity to COVID-19 munity, reinfection can occur. to end the pandemic. You In fact, cases of people getting can do your part to help life COVID-19 again within as little return to normal by choosing as three months have occurred vaccination.” worldwide and here in central The types of vaccine currently Illinois. available have all received “We advise that people who Emergency Use Authorizahave already gotten COVID-19 tion from the Food and Drug get vaccinated,” said Dr. Griffin. Administration, and while “While you shouldn’t risk they work in different ways, exposing others at a vaccinathey all have the same goal: tion clinic while you are still ill, “teaching” the body’s immune you can safety get vaccinated
when you have recovered.” While initial vaccination efforts have focused on older people, young people shouldn’t assume they’re safe from COVID-19. While rare, long-term side effects of COVID-19 infection in young people include severe lung damage that can lead to hospitalization and even death. “Unfortunately, we don’t always know which individuals are at the highest risk,” said Dr. Griffin. “That’s one of the reasons vaccination is so important. It’s the best way you can protect yourself and others.”
Article & Photos Submitted By: Passavant Hospital
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HOW TO REDUCE RISK FOR LYME DISEASE When the weather warms up and hours of daylight increase, few people can resist the allure of the great outdoors. Nature beckons each spring, and those answering that call must do so safely. Lyme disease is a potential threat for people who live in certain regions. The Centers for Disease Control and Prevention reports that Lyme disease cases have been reported in nearly every state, though residents in certain states are more vulnerable than others. For example, CDC data indicates that incidence rates were highest in several states in New England, including Maine, New Hampshire and Rhode Island, while rates in Oklahoma, Missouri and Wyoming were especially low. Lyme disease is spread by the bite of an infected tick. Playing, hiking, camping, or working in wooded or grassy places where instances of Lyme disease are high increases a person’s risk of being bitten. But that doesn’t mean those in areas like New England, the mid-Atlantic or the upper-midwest must avoid such activities. However, they should take steps to prevent tick bites when going out into the great outdoors. · Recognize where ticks live. The CDC reports that blacklegged ticks cause Lyme disease and that such ticks live in moist and humid environments. In addition, the Lyme Disease Association notes that ticks are most likely to be in certain areas, including woods, areas where woods meet lawns and where lawns meet fields. Ticks also may be living in tall brush/grass, under leaves, under
ground cover, near stone walls or wood piles, or in shady areas. Ticks also may be drawn to areas around bird feeders or outdoor areas designated for pets. · Wear insect repellent. The CDC recommends wearing insect repellents registered with the Environmental Protection Agency. Repellents should contain DEET, picaridin, IR3535, oil of lemon eucalyptus, para-menthane-diol, or 2-undecanone. The EPA even has a tool on its website that can help people choose the right repellent products for them. That tool can be found at https://www.epa. gov/insect-repellents/find-repellent-right-you. The CDC advises people to treat clothing and gear, including socks and tents, with
April 2021
products containing 0.5 percent permethrin, which can remain protective even after several washings. Pre-treated clothing may be protective even longer. · Check for ticks every day. Ticks can be found anywhere on the body, and the CDC recommends checking for ticks every day. Pay particular attention to underarms, in and around the ears, inside the belly button, the back of the knees, in and around all head and body hair, between the legs, and around the waist. Ticks pose a threat when spending time in the great outdoors. Various preventive measures can help people reduce their risk for Lyme disease
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April 2021 HEALTH QUARTERLY
ANKLE SPRAINS THAT WON’T HEAL
Article Submitted By: O.B. Idusuyi, M.D. Board Certified Orthopedic Surgeon Introduction
A sprained ankle is one of the most common orthopedic injuries. In the United States more than 25,000 such injuries occur every day. Although most of these resolve completely, chronic residual ankle symptoms still persist in about 20% to 40% of treated patients. We will outline potential causes of persistent pain after an ankle sprain
What is an Ankle Sprain? A sprain is actually an injury to the ligaments of the ankle joint, which are elastic, band-like structures that hold the bones of the ankle joint together and prevent excess turning and twisting of the joint (fig 1). In normal movement, the ligaments can stretch slightly and then retract back to their normal shape and size. Sprained ankles often result from a fall, sudden twist, or a blow that forces the ankle joint out of its normal position. Ankle sprains commonly occur while participating in sports, wearing inappropriate shoes, or walking or running on an uneven surface. The anterior talofibular ligament is one of the most commonly involved ligaments in this type of sprain. Approximately 90% of ankle sprains are inversion injuries.
Diagnosis of Ankle Sprain Patients who sustain ankle sprains present with pain or soreness over the injured ligaments, loss of function, swelling, bruising, difficulty walking, and or stiffness in the joint. These symptoms may vary in intensity, depending on the severity of the sprain. A severe sprain may be diagnosed in patients who report hearing or feeling a popping sensation, followed by immediate swelling and the inability to walk or finish
Article & Photos Submitted By: O.B. Idusuyi, M.D. Board Certified Orthopedic Surgeon
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15 HEALTH QUARTERLY their athletic endeavor after an inversion injury. In evaluating your injury, the orthopedic surgeon will obtain a thorough history of your symptoms followed by a lower extremity examination. X-rays or other advanced imaging studies may be ordered to help determine the severity of the injury.
Management The goal of treating ankle sprain is to prevent chronic pain, instability and disability. The first phase of routine ankle sprain treatment consists of rest, ice, compression, elevation, and usually the use of anti-inflammatory medications. We recommend an air cast for a low-grade ankle sprain while a severe sprain will require longer immobilization utilizing a walking boot or a short leg cast for three weeks. The amount of therapy that a person can handle will depend on their level of pain and the grade of sprain they experienced. It is not recommended to return to sports or extreme physical activities until hopping on the ankle is achieved without pain. Wearing high-top tennis shoes may also help prevent ankle sprains if the shoes used are laced snug and if the ankle is taped with a wide, nonelastic adhesive tape.
Residual Pain after Ankle Sprains Ankle pain not responding to treatment, stiffness, locking and catching swelling, giving way and numbness may persist several months following an ankle sprain. A careful patient history and physical examination is needed to assess the presenting complaint, mechanism of injury, level of activity, and exact location is paramount in delineating potential etiology. The orthopedic surgeon must rule out missed diagnosis and associated injuries at the time of initial ankle sprain (table 1). A partially treated or untreated ankle sprain may lead to chronic ankle instability, a condition marked by persistent discomfort and a “giving way” of the ankle. Weakness in the leg may also develop. Improper or insufficient rehabilitation may lead to impaired neuromuscular control, impaired propioception and postural control. Persistent pain with catching or locking in the ankle joint could be related to damage to the cartilage with intraarticular loose bodies within the ankle joint or an osteochondral defect (fig 2). Pain on direct palpation of bony prominences in the leg ankle and foot may indicate missed fractures at the time of initial injury (See table 1). Palpating for the area of maximal tenderness along the tendons and directly over the syndesmosis can rule out peroneal tears and chronic high ankle sprains. In teenagers with persistent ankle pain and recurrent ankle sprains the foot should be examined for stiffness of the joint below the ankle to rule out “tarsal coalition” – a condition characterized by abnormal fusion of foot bones.
Burning or shooting pain, numbness and tingling may indicate stretch injury on the cutaneous nerves surrounding ankle either from significant twisting at the time of initial sprain or from chronic swelling of the ankle. This condition in my experience leads to prolong recovery requiring 9 to 12 months for complete resolution of symptoms. Magnetic resonance imaging (MRI) evaluation is particularly useful in demonstrating chondral injury, bone bruising, radiographically occult fractures, sinus tarsi injury, tendon tears, degeneration, and impingement syndrome. The initial management of chronic ankle instability is a robust structured program of functional and prophylactic rehabilitation. Failed rehabilitation is an indication for surgical repair
Summary
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Table 1: Differential diagnosis of “Ankle Sprains that Won’t Heal” 1. Chronic lateral ankle instability 2. Osteochondral injury 3. High ankle sprains 4. Anterolateral ankle impingement 5. Sinus tarsi syndrome 6. Unrecognized fractures • Anterior process of calcaneus • Lateral process of talus • 5th Metatarsal base 7. Traction injuries of the superficial peroneal nerve 8. Peroneal tendon pathology
While ankle sprains are very common injuries seen by orthopedists and general practitioners alike, appropriate three-phase functional rehabilitation can provide excellent results with a minimum of co-morbidities and adverse. When symptoms persist after several months the examining physician must assess for potential missed diagnosis, inadequate ankle rehabilitation and associated injuries.
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