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PERSPECTIVE A quarterly journal with the latest news, stories and updates

Spring 2017

Breathe Easier — Get Relief from Spring Allergies

Lose the Salt, Keep the Flavor Know Your Diabetes Risk

TAKING ON ALZHEIMER’S


PALOS HEALTH WELCOMES NEW PHYSICIANS Surekha Boddipalli, M.D.

Michael Frank, M.D.

Jayesh Madhani, M.D.

Board certified in Internal Medicine and specializing in Hematology and Oncology, completed her residency at Lenox Hill Hospital in New York and fellowship at Lankenau Medical Center in Wynnewood, PA. She received her medical degree from State University of New York, Buffalo, NY. Dr. Boddipalli is affiliated with DuPage Medical Group, 17495 LaGrange Rd., Tinley Park, IL.

Board certified and specializing in Cardiothoracic Surgery, completed his residency at McGaw Medical Center of Northwestern University and fellowships at Northwestern University, Chicago. He received his medical degree from Indiana University School of Medicine in Bloomington, IN. Dr. Frank is affiliated with Cardiothoracic and Vascular Surgical Associates S.C., 4400 W. 95th St., Suite 205, Oak Lawn, IL.

Board certified and specializing in Internal Medicine. Completed his residency at Hahnemann University, Philadelphia and fellowships at Albert Einstein Medical Center, Philadelphia and University of Oklahoma College of Medicine. He received his medical degree from B.J. Medical College, Ahmedabad, India. Dr. Madhani’s office is located at 14544 John Humphrey Dr., Orland Park, IL.

Jose Garcia-Gonzalez, M.D.

Hanh Mai, D.O.

Board certified and specializing in Ophthalmology, completed his residency at the University of Puerto Rico, Rio Piedras, Puerto Rico and fellowship at the University of Illinois, Chicago. He received his medical degree from the Ponce School of Medicine in Ponce, Puerto Rico. Dr. GarciaGonzalez is affiliated with Retina Consultants Ltd., 7667 W. 95th Street, Suite 103, Hickory Hills, IL.

Board certified and specializing in Hematology and Oncology, completed her residency and fellowship at Loyola University Medical Center, Maywood, IL. She received her medical degree from Des Moines University, Des Moines, IA. Dr. Mai is affiliated with the Loyola Center for Cancer Care & Research at Palos Health South Campus, 15300 West Ave., Suite 108, Orland Park.

Sandeep Chandra, M.D. Board certified and specializing in Internal Medicine, completed his residency at UIC/Advocate Christ Medical Center in Oak Lawn, IL. He received his medical degree from Maulana Azad Medical College, Delhi, India. Dr. Chandra’s office is located at 5331 W. 79th St., Burbank, IL.

Paul Danielsky, M.D. Specializing in Orthopaedics, completed his residency at Western Michigan University School of Medicine in Kalamazoo, MI and fellowship at Southern Illinois University School of Medicine in Springfield, IL. He received his medical degree from the University of Michigan School of Medicine in Ann Arbor, MI. Dr. Danielsky is affiliated with Advanced Orthopedic & Spine Care, 6701 W. 95th St., Oak Lawn, IL.

Luay Rifai, M.D. Alexander Green, M.D. Board certified and specializing in Cardiac Electrophysiology, completed his residency and fellowship at Loyola University Medical Center, Maywood, IL. He received his medical degree from the Indiana University School of Medicine, Bloomington, IN. Dr. Green is affiliated with Loyola University Medical Center, 2160 S. First Ave., Maywood, IL.

Board certified and specializing in Cardiology, completed his residency at University of Illinois/Advocate Christ Medical Center. He received his medical degree from the University of Jordan, Amman, Jordan. Dr. Rifai is affiliated with Consultants in Cardiology & Electrophysiology, LLC, 5151 W. 95th St., Oak Lawn, IL.

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PALOS HEALTH PERSPECTIVE


Madulika Saxena, M.D.

Salman Waheed, M.D.

Board certified and specializing in Internal Medicine, completed her residency at Kampur University, Kampur, India. She received her medical degree from Kampur University, Kampur India. Dr. Saxena’s office is located at 5331 W. 79th St., Burbank, IL.

Board certified and specializing in Hematology/Oncology, completed his residency and fellowship at Rush University Medical Center, Chicago. He received his medical degree from Rush University Medical Center. Dr. Waheed is affiliated with DuPage Medical Center, 17494 S. LaGrange Rd., Tinley Park, IL.

Michal Szczodry, M.D. Specializing in Orthopaedics, completed his residency at University of Illinois at Chicago and fellowship at Johns Hopkins University, Baltimore. He received his medical degree from the Medical School of Warsaw, Warsaw, Poland. Dr. Szczodry is affiliated with Midwest Orthopaedic Consultants, 10719 W. 160th St. Orland Park, IL.

William Walsh, M.D. Board certified and specializing in Emergency Medicine, completed his residency at University of Illinois College of Medicine Peoria, IL. He received his medical degree from Finch University School of Health Sciences Chicago Medical School.

Dr. Walsh is affiliated with Palos Health 12251 S. 80th Avenue, Palos Heights.

Johnathan Watson, M.D. Specializing in Orthopaedics, completed his residency at Rush University Medical Center and fellowship at the University of Pittsburgh Medical Center. He received his medical degree from the University of Chicago College of Medicine. Dr. Watson is affiliated with Advanced Orthopaedics and Spine Care, 6701 W 95th Street, Oak Lawn, IL.

The physicians listed or quoted, while having privileges, are not employees or agents of Palos Health unless they are specifically identified as such.

Discrimination is Against the Law Palos Health complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Palos Health does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Perspective is a publication of Palos Health 12251 South 80th Avenue Palos Heights, IL 60463 708.923.4000 paloshealth.com Terrence Moisan, M.D. President and CEO Heather Mascarello Editor, Perspective Osborn & DeLong Graphic Design

Palos Health focuses on … n n n

Creating a better everyday life for our community Supporting healthy living while calming the anxiety of serious illness Providing compassionate health care

Español (Spanish): ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de Español (Spanish): ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-708-923-4840 (TTY: 1-708-923-4601). asistencia lingüística. Llame al 1-708-923-4840 (TTY: 1-708-923-4601). Polski (Polish): UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy Polski (Polish): Jeżeli mówisz po polsku, skorzystać z bezpłatnej pomocy językowej. ZadzwońUWAGA: pod numer 1-708-923-4840 (TTY:możesz 1-708-923-4601). Zadzwoń pod numer 1-708-923-4840 (TTY: 1-708-923-4601). językowej. 繁體中文 (Chinese): 注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 1繁體中文 (Chinese): 注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 708-923-4840 (TTY:1-708-923-4601). 1-708-923-4840 (TTY:1-708-923-4601). 한국어 (Korean): 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 한국어 주의: 한국어를 사용하시는 경우, 언어 전화해 지원 서비스를 무료로 이용하실 수 있습 있습니다. (Korean): 1-708-923-4840 (TTY: 1-708-923-4601) 번으로 주십시오. 니다. 1-708-923-4840 (TTY: 1-708-923-4601) 번으로 전화해 주십시오. Tagalog (Tagalog – Filipino): PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang Tagalog – Filipino): PAUNAWA: Kungwalang nagsasalita kaTumawag ng Tagalog, kang gumamit ng(Tagalog mga serbisyo ng tulong sa wika nang bayad. samaaari 1-708-923-4840 gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-708-923-4840 (TTY: 1-708-923-4601). (TTY: 1-708-923-4601). : (Arabic) ‫العربية‬ ‫ (هاتف الصم‬1-708-923-4840 ‫ اتصل برقم‬.‫ فإن خدمات المساعدة اللغوية تتوافر لديك بالمجان‬،‫ إذا كنت تتحدث اللغة العربية‬:‫تنبيه‬ .)1-708-923-4601 :‫والبكم‬ Русский (Russian): ВНИМАНИЕ: Если вывы говорите на на русском языке, то то вамвам доступны Русский (Russian): ВНИМАНИЕ: Если говорите русском языке, доступны бесплатные услуги перевода. Звоните 1-708-923-4840 (телетайп: 1-708-923-4601). 1-708-923-4601). 1-708-923-4840 (телетайп: бесплатные услуги перевода. Звоните જરાતી(Gujarati): (Gujarati):સુસુ ના: જો જો તમે તમે ગુગુ જજરાતી બોલતા હો, તો લ્ક ભાષા સહાય સે વાઓ સે તમારા માટેતમારા ઉપલબ્માટે ધ છે. ફોન ગુજગુરાતી ચચના: રાતી બોલતા હો,નિ:શુ તો નન:શુ લ્ક ભાષા સહાય વાઓ કરો 1-708-923-4840 (TTY: 1-708-923-4601). ઉપલબ્ધ છે . ફોન કરો 1-708-923-4840 (TTY: 1-708-923-4601). ‫( وُدرُا‬Urdu): ‫رادربخ‬: ‫ںیہ ےتلوب ودرا پآ رگا‬، ‫۔ ںیہ بایتسد ںیم تفم تامدخ یک ددم یک نابز وک پآ وت‬ ‫لاکوُدرُا‬ (Urdu): ‫خ‬: ‫(اردو آپ اگ ر‬TTY: ‫ول تے‬1-708-923-4601). ‫ ب‬،‫۔ ہ یں د س ت یاب م یں م فت خدمات ک ی مدد ک ی زب ان ک و آپ ت و ہ یں‬ ‫بردار ںیرک‬ 1-708-923-4840 ‫ ک ری ں ک ال‬1-708-923-4840 (TTY: 1-708-923-4601). Tiếng Việt (Vietnamese): CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn Tiếng Việt (Vietnamese): CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành bạn. 1-708-923-4840 (TTY: 1-708-923-4601). phí dành chocho bạn. GọiGọi sốsố 1-708-923-4840 (TTY: 1-708-923-4601). ATTENZIONE: In caso la lingua parlata l'italiano, sono disponibili servizi Italiano (Italian): Italiano (Italian): ATTENZIONE: In caso la lingua parlata siasia l'italiano, sono disponibili servizi di di assistenza linguistica gratuiti. Chiamare il numero 1-708-923-4840 (TTY: 1-708-923-4601). assistenza linguistica gratuiti. Chiamare il numero 1-708-923-4840 (TTY: 1-708-923-4601). ी (Hindi): ध्यानदेंदे:ं: यदद यदि आप हिंददी बोलते हैं तो आपके मुफे ्तललए में भाषा सेवाएं उपलब् ध हैं। से 1-708-923-4840 ह द िं हिंी द(Hindi): ध्यान आप द िं ी बोलते ैं तो लिए आपक मफ् त में भाषा स ायता वाएिं उपलब्ध ैं। 1ु सहायता (TTY: 1-708-923-4601) पर कॉल करें।. 708-923-4840 (TTY: 1-708-923-4601) पर कॉल करें । . Français (French): ATTENTION: Si vous parlez français, des services d'aide linguistique vous Français (French): ATTENTION: Si vous parlez français, (TTY: des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-708-923-4840 1-708-923-4601). sont proposés gratuitement. Appelez le 1-708-923-4840 (TTY: 1-708-923-4601). λληνικά (Greek): ΠΡΟΣΟΧΗ: Αν μιλάτε ελληνικά, στη διάθεσή σας βρίσκονται υπηρεσίες λληνικά (Greek): ΠΡΟΣΟΧΗ: Αν μιλάτε ελληνικά, στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης, οι οποίες παρέχονται δωρεάν. Καλέστε 1-708-923-4840 γλωσσικής υποστήριξης, οι οποίες παρέχονται δωρεάν. Καλέστε 1-708-923-4840 (TTY: 1-708(TTY: 1-708-923-4601). 923-4601). Deutsch (German): ACHTUNG: Wenn Deutsch sprechen, stehenIhnen Ihnenkostenlos kostenlos sprachDeutsch (German): ACHTUNG: Wenn SieSie Deutsch sprechen, stehen liche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-708-923-4840 (TTY: 1-708-923-4601). sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-708-923-4840 (TTY: 1-708-9234601).

SPRING 2017

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UNTANGLING ALZHEIMER’S: Palos Health Joins National Study

Hearing a diagnosis of Alzheimer’s disease can be devastating for patients and their family members. Unfortunately, more people will be receiving this news in the coming years as the incidence of Alzheimer's continues to rise. The Centers for Disease Control and Prevention (CDC) estimates that 5.4 million Americans suffer from this kind of dementia with that number expected to triple by 2050 as the baby boom generation ages. Recently, Palos Health joined a national study that hopes to provide scientists with a better understanding of how Alzheimer’s affects the brain while improving treatment options for patients. SPRING 2017

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Understanding Alzheimer’s Alzheimer’s is a specific type of dementia that most often affects people over 60 years of age. The symptoms of Alzheimer’s are similar to other forms of dementia, with both including a decline in the ability to think, memory loss and difficulty communicating. However, Alzheimer’s patients also have difficulty remembering recent events or conversations, and may experience impaired judgement, disorientation, depression, confusion and behavioral changes. In later stages of the disease, symptoms may also interfere with daily tasks like tooth brushing and getting dressed. Symptoms may develop gradually, getting worse as time goes on, although the speed of the progression appears to be variable. “The hallmark of Alzheimer’s is memory loss, especially for recent events. You may notice that people aren’t paying bills on time, are forgetting birthdays and anniversaries, or are not remembering places, names, etc.,” says Mark Sinibaldi, M.D., a board-certified psychiatrist who regularly sees Alzheimer’s patients at Palos Hospital. “Interestingly, there are now some studies suggesting a loss of balance and/or abnormal gait — for example, slowness — may be a clue that a person is developing Alzheimer’s.” While the symptoms of Alzheimer’s are well

documented, the actual cause of the disease is not understood. Some cell loss in human brains is normal as they age, however in Alzheimer’s patients the degradation of the nerve cells in the brain appears to be caused by the presence of two abnormal proteins: amyloid plaques and neurofibrillary tangles. Amyloid plaques are sticky buildup which accumulates between nerve cells, while neurofibrillary tangles (NFTs) are insoluble twisted fibers inside the brain’s cells. The formation of these proteins is thought to contribute to the symptoms of this puzzling condition. Dr. Sinibaldi explains, “Alzheimer’s is a clinical diagnosis. There is no blood test or radiology test at this time that can diagnose Alzheimer’s with 100 percent accuracy. A brain magnetic resonance imaging (MRI) or computerized tomography (CT) scan may show that the brain has shrunk but would not show the presence of plaques.”

The IDEAS Study In February of 2016, the American College of Radiology Imaging Network, in collaboration with the Alzheimer’s Association, began a study that they anticipate will lead to a more accurate diagnosis and improved outcomes for Alzheimer’s patients. The Imaging Dementia—Evidence for Amyloid Scanning (IDEAS) Study uses positron emission tomography

Psychiatrist Mark Sinibaldi, M.D. (left), discusses patient scans with radiologist Daniel Frankel, M.D.

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(PET) scans to help determine whether or not amyloid plaques are present in the brain. The goal is to enroll over 18,000 people in the study from throughout the United States.

and emergent care, Medicare may begin to consider reimbursement for all qualifying patients,” said Dr. Sinibaldi.

How to Participate in IDEAS

Radiologist Daniel Frankel, M.D., brought the IDEAS study to the attention of Palos Health. Currently Palos Imaging & Diagnostics uses a unique PET scan that provides optimal brain imaging ideal for diagnosing patients as well as collecting data for the study.

Criteria are in place for individuals looking to participate in the study. Patients must be at least 65 years of age and have Medicare. They must be under the care of a doctor currently enrolled in the study (several doctors with admitting privileges at Palos are currently enrolled). Patients must be suspected of having Alzheimer’s and have at least minimal cognitive impairment.

“A PET scan that shows amyloid plaques can support an Alzheimer’s diagnosis, but it does not necessarily confirm it,” explains Dr. Frankel. “The presence of amyloid could be related to other diseases of the brain. However, a negative test rules out Alzheimer’s with the expectation that the patient will not develop the disease in at least the next ten years.”

“This is an important study, and Palos Health is excited to be a part of it. Our hope is that Alzheimer’s patients can get a faster diagnosis that will result in better overall care and quality of life,” said Dr. Sinibaldi.

The study will provide information to help doctors narrow down the type of dementia a person is experiencing so they can begin the appropriate treatment. Knowing what type of cognitive impairment they are dealing with can help patients by decreasing uncertainty and increasing confidence as they move forward with medical care.

Reducing Your Risk While research is ongoing as to how Alzheimer’s can be prevented, it seems that a healthy lifestyle may play a role in delaying the mental and physical decline associated with the disease. ”Being physically active and getting a good night’s sleep is believed to reduce the risk of Alzheimer’s,” says Dr. Frankel. While scientists do not yet know if healthy habits including a healthy diet, maintaining an appropriate weight and not smoking can directly prevent or delay Alzheimer’s disease or age-related cognitive decline, the National Institute of Health notes that they do help lower the risk of certain chronic diseases while maintaining and improving overall health.

For example, if the PET scan uncovers the presence of amyloid, and the doctor believes the patient meets clinical criteria for Alzheimer’s, the treatment may include approved Alzheimer’s drugs including donepezil and memantine, which have been shown to slow the progression of the disease. Alzheimer’s patients can also begin counseling and other interventions to achieve a better quality of life, including exercise and recreation, nutritious eating and social interactions.

To learn if you or a loved one may be a candidate for the IDEAS study, visit ideas-study.org.

Currently Medicare pays for amyloid scans if they are performed as part of the IDEAS study. “If the study shows that the use of the PET scan along with corresponding treatments results in improved outcomes, such as reducing hospital admissions

To find out about participating in the IDEAS study at Palos Hospital, call Behavioral Health at 708.923.7878.

Stay Healthy You can take steps to lower the risk of chronic disease and boost your overall health and well-being. Health experts encourage all adults to: n n n n

n

exercise regularly eat a healthy diet rich in fruits and vegetables engage in social and intellectually stimulating activities control type 2 diabetes

n n n n

lower high blood pressure levels lower high blood cholesterol levels maintain a healthy weight stop smoking get treatment for depression

Source: U.S. Department of Health and Human Services

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Emergency Room or Immediate Care? Palos Hospital

Palos Health South Campus

Emergency Department 12255 S. 80th Avenue Palos Heights

Immediate Care Center — South Building 15300 West Avenue Orland Park

(please use the hospital’s south main driveway and follow the signs)

ER Conditions Treated

Immediate Care Conditions Treated radiates to your arm or jaw or is accompanied by sweating, vomiting or shortness of breath

䡲 Severe abdominal pain 䡲 Fainting 䡲 Difficulty breathing

䡲 Sudden difficulty speaking, or trouble

䡲 Severe or persistent vomiting

understanding speech 䡲 Altered mental status or confusion,

䡲 Head trauma

including suicidal thoughts

䡲 Medication overdose

䡲 Sudden weakness or paralysis,

䡲 Serious extremity injuries

especially on one side of the face or body

䡲 Sudden, severe pain anywhere

䡲 General medical and injury care 䡲 Occupational medicine 䡲 EKG (electrocardiogram)

(not for acute chest pain) 䡲 School and sports physicals 䡲 Accidents and falls 䡲 Sprains and strains 䡲 Moderate back problems 䡲 Breathing difficulties (i.e. mild to moderate asthma)

䡲 Severe heart palpitations

in the body

䡲 Bleeding/cuts (not bleeding a lot but requiring

䡲 Coughing or vomiting blood

䡲 Sudden, severe headache

䡲 Suspected poisoning

䡲 Sudden testicular pain and swelling

䡲 Compound fracture (bone protrudes

䡲 Newborn baby with a fever (babies

stitches) 䡲 Diagnostic services, including X-rays and

laboratory tests through skin) 䡲 Convulsions, seizures or loss of

less than three months old with a temperature of 100.4 degrees or higher need to be seen right away)

consciousness 䡲 Falls that cause injury or occur while 䡲 Moderate to severe burns 䡲 Serious head, neck or back injury 䡲 Pregnancy-related problems 䡲 (Signs of) Stroke (e.g. loss of vision,

sudden numbness, weakness, slurred speech, or confusion) 䡲 Persistent chest pain, especially if it

taking blood thinning medications 䡲 Deep cuts that require stitches or

a large open wound that won’t stop bleeding

䡲 Eye irritation and redness 䡲 Fever or flu 䡲 Vomiting, diarrhea or dehydration 䡲 Severe sore throat or cough 䡲 Minor broken bones and fractures

(i.e. fingers, toes) 䡲 Skin rashes and infections

䡲 Eye injuries

䡲 Urinary tract infections

䡲 Severe flu or cold symptoms

䡲 Ear pain

䡲 High fevers or fevers with rash

䡲 Painful urination

Hours of Operation: Open 24 hours a day, 7 days a week, including holidays.

Hours of Operation: 7 a.m. – 8 p.m., Monday through Friday 8 a.m. – 8 p.m. Saturday and Sunday

Dial 911 immediately for any medical problem that appears to be life-threatening


ACH

!

A mild winter and an early spring in the Midwest allows more time to enjoy the blooms of flowers, trees and plants. However, it also means an especially brutal allergy season. A high concentration of tree pollen has been reported for Illinois, and looking forward to summer it shows no signs of slowing. With so many overthe-counter allergy medication options, it is helpful to consult with a board certified allergy specialist and be tested before self-medicating. Informed allergy sufferers are less likely to overmedicate and can tailor medication use to specific seasons and Amee pollens. Perspective Majmundar, M.D. spoke with Amee Majmundar, M.D., an allergy & immunology specialist at Palos Health South Campus in Orland Park, to discuss how patients can get relief from symptoms and what new treatments are currently available to allergy sufferers.

during the spring and summer months, where the pollen counts are unseasonably high. Humidity and heavy rains can bring about heavy mold counts, too.

Perspective: What are some common allergy issues you see at this time of year?

adults suffering from eye symptoms called "vernal" or spring conjunctivitis. They can have severe itching that can lead to infection and a stringy discharge from the eyes. Over-the-counter eye allergy preparations can help, but can also result in rebound symptoms and permanent redness of the eyes if overused. Consulting with an allergist to get an appropriate therapy is strongly advised.

The common symptoms include: allergic rhinitis, sinusitis or inflammation of the nasal and sinus passages, ocular conjunctivitis or itching, tearing and redness of the eyes and asthma. I am seeing more patients frustrated with allergy symptoms that are not controlled by standard treatment options. They are seeking more permanent solutions instead of just blocking symptoms with nasal sprays and allergy pills. Allergy sufferers can inquire about newer therapies that recently have been FDA approved, making them a realistic option.

Perspective: Itchy, red eyes seem to be a problem for many people, as well as trouble breathing. AM: This time of year, I see a lot of children and

AM: During the spring and summer months, allergy sufferers experience nasal, ocular and sinus symptoms related to tree and grass pollen. Heavy precipitation during the preceding fall and winter can contribute to a pollen tsunami, or pollen vortex, SPRING 2017

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I also see asthma flares in children and adults. Asthma is often labeled as "exercise" induced, and people feel that physical activity is their only trigger. However, almost 80 percent of pediatric asthma is allergy triggered/related. While exercise can trigger the symptoms, the root cause is most often allergies to airborne elements like tree, grass, ragweed, dust mites and pets.

Board certified allergists are available at Palos Health to help ease the symptoms of allergy sufferers. Find a doctor near you today at paloshealth.com.

Health Conditions That May Be Allergies According to Dr. Majmundar, some recurring health problems ay actually be allergies.

Perspective: What are some of the new therapies for allergy issues?

䡲 Chronic cough — a prolonged cough that has not responded to standard cold regimens or decongestants, antibiotics or cough suppressants.

AM: Newer treatments for allergies include immunotherapies which involve systematic desensitization to airborne allergens. Therapies can involve administering shots or tablets of allergen extracts to restore tolerance. This can be achieved over months to years and can result in a permanent cure to allergies as opposed to the Band-Aid approach that over-the-counter allergy medications offer.

䡲 Colds — recurrent colds or a cold that lasts more than two weeks. 䡲 Sinus infections 䡲 Ear infections 䡲 Asthma — new onset symptoms or childhood asthma that recurs in adulthood can be due to allergies. Often, a childhood history of food allergies and eczema can manifest in adulthood as rhinitis and asthma. There is a stepwise progression of allergic disease during life. Eczema, food allergies, asthma and allergic rhinitis can occur all at once or present themselves at different ages depending on genetics and environment.

Perspective: Who is a good candidate for these new treatments? AM: Immunotherapy can be helpful in patients who have tried over-the-counter or prescription allergy medications, including nasal steroid sprays. If the patient's symptoms do not respond to standard medications or if they are having side effects to these meds, allergen immunotherapy is indicated. Another important fact is that up to 40 percent of allergy sufferers can go on to develop asthma. Allergen immunotherapy or desensitization shots are the only treatment proven to preserve lung function and prevent the development of asthma. It can also reduce asthma symptoms and the need for inhalers in patients who already have asthma. This is true for both pediatric and adult patients.

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䡲 Skin rashes such as hives or eczema — severe pollen seasons or food sensitivities can cause a person to develop immediate or delayed (up to 48 hours after exposure) skin rashes that are generally itchy. They can be localized to one area of the body or all over.

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The Low Down on Low Sodium: Lose the Salt, Keep the Flavor Living with a heart condition can mean a lot of lifestyle changes, one of which is limiting daily sodium intake. Unfortunately, this is easier said than done. Salt is present in much of the food we eat, including prepared foods from the grocery store, home cooked dishes and restaurant meals. Limiting salt in these areas can seem like a huge hassle, made even worse by the fear that mealtimes will now be bland and unexciting. But that doesn’t need to be the case. Many people have learned to incorporate low-sodium strategies into their daily life, discovering effective approaches to grocery buying and new, healthy ways to prepare food. Most find that their taste buds adjust to the decrease of salt in their diet and that meals are still be satisfying while overall health has improved.

Sodium Facts: The good, the bad and the ugly Sodium (the most common form of which is table salt) is an essential mineral for the human body. Not only does it help to maintain fluid balance, it’s also critical for the transmission of nerve impulses and for muscle contraction. However, you can have too much of a good thing. Excess sodium can result in abnormally high blood pressure and damage to the kidneys, and in some cases can lead to a heart attack or other forms of cardiovascular disease.

1,500 to 2,000 mg A low-sodium diet usually means limiting your daily intake to 1,500 to 2,000 milligrams (1.5 to 2 grams) per day. That may sound like a lot, but keep in mind that one teaspoon of salt is equal to 2,300 mgs of sodium. According to the Centers for Disease Control (CDC), the average American gets more than twice the recommended daily dose of sodium: 3,466 milligrams to be exact. Much of the food we eat contains sodium, even those that may otherwise seem healthy. For example, processed foods like cottage cheese or lunch meat contain added sodium. Raw chicken and pork sold in stores are injected with a sodium solution. Even foods with low-sodium per serving — like bread or milk — can add up to a significant amount when eaten several times a day.

cut back on daily sodium intake. Obvious tactics like limiting the salt shaker at meals and reducing the amount of salt when cooking will help. Substituting spices like pepper, red pepper flakes and cayenne pepper for salt when cooking add a flavorful zip to dishes and contribute to their nutritional value too. Dry or fresh herbs can give standard recipes a new taste. Palos dietitians recommend experimenting by adding herbs like basil, bay leaves, dill, rosemary, parsley, sage, dry mustard, nutmeg, thyme and paprika to recipes. A squeeze of fresh lemon or lime juice or a splash of vinegar can also brighten the flavors of a dish.

Shake Off the Salt

Salt-free seasonings are another way to add flavor; you can use an already prepared product or create your own customized blends. Search the Internet for recipes, or get creative and invent something new! But always check with your doctor first before using a salt substitute.

There are some easy yet effective strategies you can implement to

Avoid processed foods by shopping the perimeter of the grocery

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store, where fresh fruits and vegetables typically are on display. Choose fresh poultry, fish, pork and lean meats rather than canned or processed meats, and limit your intake of sauces, mixes and “instant” products, including flavored rice and ready-made pastas. When buying frozen vegetables check to see that no sauces or salt have been added.

Figuring Out Labels Canned and packaged foods are required to list the amount of sodium in each serving on the Nutrition Facts label. The goal for those on a low-sodium diet is to select foods with 140 mg or less of sodium or per serving. Look for labels marked “low sodium” (140 mg per serving), “reduced sodium” or “less sodium” (25 percent less sodium than regular versions) or “lite” or “light sodium” ( 50 percent less sodium than regular versions).

Low Sodium Restaurant Dining

“Choose fresh poultry, fish, pork and lean meats, and limit your intake of sauces, mixes and ‘instant’ products.”

While restaurant meals can be very high in sodium, you don’t need to avoid them completely. Have a dining out strategy in place so you can enjoy the experience without elevating your sodium levels. If possible, make meal choices beforehand by visiting the restaurant’s website. You can find out specific information on the sodium content of a variety of foods by visiting ChooseMyPlate.gov. The SuperTracker feature on the site offers a tool called Food-A-Pedia that allows you to find the sodium content of over 8000 foods. Once you arrive at the restaurant, servers should be able to answer any menu questions and suggest low-sodium options. If you’re unsure of a meal’s sodium content you can ask to see the restaurant’s nutritional information. Eating establishments in Illinois

Hidden Sodium Sources More than 40 percent of daily sodium intake comes from the following foods: 䡲 Breads and rolls

Other foods high in sodium: 䡲 Bouillon cubes, broth 䡲 Condiments (ketchup, mustard)

䡲 Cold cuts and cured meats such as deli or packaged ham or turkey (luncheon meats)

䡲 Frozen entrees 䡲 Frozen pancakes, waffles

䡲 Pizza

䡲 Instant oatmeal

䡲 Fresh and processed poultry

䡲 Packaged rice and noodle dinners

䡲 Soups 䡲 Sandwiches such as cheeseburgers

䡲 Packaged sauces and soups 䡲 Prepared salad dressings

䡲 Cheese

䡲 Tomato juice and sauce

䡲 Pasta dishes

䡲 Sauces, soy sauce

䡲 Meat-mixed dishes such as meat loaf with tomato sauce

䡲 Seasoning mixes 䡲

䡲 Chips, pretzels, popcorn

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Smoked, processed and cured meats like hot dogs and sausage

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(as well as many other cities and states) are required by law to have this information available. When ordering, safe choices are: broiled, grilled or roasted meat, poultry, fish or shellfish accompanied by plain potatoes, vegetables or noodles. Request that your meal be cooked without salt or monosodium glutamate (MSG). Avoid casseroles, mixed dishes, gravies and sauces as

well as garnishes like olives and pickles. Ask for salad dressings and sauces to come on the side so you can limit their intake. Go easy on condiments and skip the bread basket. If possible, avoid restaurants that do not allow for special food preparation (like buffets or diners). Switching to a low-sodium diet does involve some effort, but

Low Sodium RECIPES THAT Keep the Flavor Citrus Marinated Chicken Ingredients

Yield = 6 pieces

1/2 cup light brown sugar 6 Tbsp olive oil 1/4 cup apple cider vinegar Juice from ½ fresh squeezed lemon Juice from 1 fresh lime 3 Tbsp spicy brown mustard 1 1/2 tsp minced garlic 1/4 tsp black ground pepper 6 boneless, skinless chicken breasts Directions 1. Combine brown sugar, oil, vinegar, juice from lemon and lime, mustard, garlic and pepper in large Ziplock bag. Mix well. 2. Place chicken in bag. Refrigerate at least six hours and up to 24 hours. 3. Place chicken on grill top or skillet to sear each side with grill marks. Bake approximately 20 minutes until done. Cook chicken until internal temperature 165 degrees. Each serving contains: 224 calories, 30 gm Protein, 7 gm Fat, 8 gm Carbohydrate, 117 mg Sodium

Homemade Spaghetti Sauce Ingredients

Yield = 8 1/2 cup servings

2 Tbsp chopped fresh basil 1 tsp chopped fresh oregano 2 Tbsp unsalted, solid butter 1/4 cup diced onions 1/4 tsp kosher salt 1 Tbsp minced garlic 2 cups diced canned tomatoes, no added salt 2 cups canned tomato puree, no added salt 1/4 tsp granulated sugar 1 Tbsp extra virgin olive oil 1/4 tsp black pepper Directions 1. Wash basil and oregano under cold water. Chop just before serving. 2. Heat butter in medium saucepan over medium heat until melted. Stir in onion and salt. Cook, stirring occasionally until liquid has evaporated and onion is golden brown, about five minutes. 3. Stir in garlic and cook 30 seconds. Stir in tomatoes, puree and sugar. Bring to a medium-low simmer until thickened slightly, about 10 minutes. 4. Turn off heat. Stir in chopped basil, oregano, oil and pepper. 5. Serve over cooked pasta. Each 1/2 cup serving contains: 87 calories, 2 gm Protein, 5 gm Fat, 7 gm Carbohydrate, 3 gm Fiber, 155 mg Sodium

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the results are more than worth it. Many people are inspired to meet the challenge of healthy eating and find they enjoy coming up with creative ways to prepare the foods they love. Keep track of your salt intake and adjust as needed — your heart will thank you!

DASH DIET

.. . . . .. . ... . ..

Many people have found the DASH diet helpful when trying to limit sodium intake. DASH (Dietary Approaches to Stop Hypertension) is a dietary pattern promoted by the U.S. based National Heart, Lung, and Blood Institute to prevent and control hypertension.

The low sodium DASH plan has been proven to lower blood pressure and provide additional health benefits like reducing the risks of stroke and heart disease and lowering cholesterol. The plan encourages eating a diet full or fruits and vegetables, and low-fat or nonfat dairy, with whole grains. It is a high fiber, low to moderate fat diet, rich in potassium, calcium, and magnesium. The DASH Diet Action Plan and The Everyday DASH Diet Cookbook are two options that give more information about incorporating this diet into you daily life. For additional help with low sodium living, contact Nutrition Counseling Services at 708.923.4330 to set up an appointment with a registered dietitian.

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Helping Patients Heal through

N U T R I T I O N Good nutrition is important for all, but it’s especially critical for hospital patients. Patients who consistently eat a healthy diet in essential nutrients tend to have shorter hospital stays, helping them to avoid complications such as infection and bed sores.

Getting Patients Back to Where They Want to Be — Home

advise them on which ones are safe and appropriate for their individual needs.”

How Nutrition Helps

Patients who consistently eat a healthy diet in essential nutrients may experience the following:

According to the National Institutes of Health, proper nutrition is essential for wound healing, while a lack of protein in the Dietitians at Palos Health agree diet has been shown to conon the benefits of adequate percent decrease tribute to poor healing rates. nutrition throughout a patient’s in length of Those with serious or chronic hospital stay. With support hospital stay wounds can often heal more from the Academy of Nutrition quickly and completely when and Dietetics, they developed percent decrease protein is incorporated into their a Malnutrition Quality Improvein unwanted daily diet. Since protein is necesment Initiative (MQII) to address hospital visits sary for building and repairing issues of malnourishment tissue, it is especially important among patients and improve Reduced complicato receive adequate amounts duroverall health. By partnering tions after surgery ing the healing process. It also with doctors, nurses and other aids in immunity, helping patients health care providers, they are to avoid or minimize the effects of critical illnesses. working to integrate and optimize nutrition care for all patients. Palos believes in keeping the patient, his or her

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Taking Action Malnutrition can be diagnosed in a variety of ways, but is most often associated with unexplained weight loss and loss of muscle mass. It commonly occurs with many medical conditions and in the elderly. All patients admitted at Palos Hospital are now screened for malnutrition using a simple tool that identifies weight loss and eating habits. If a patient is determined to be at risk, proactive measures are set in motion, including informing his or her doctor, and arranging a consult with a registered dietitian to address specific nutrition needs.

family and caregivers informed as to the importance of proper nutrition to recovery. Education materials including how to select and prepare healthy foods and nutrition supplements are provided during the patient stay and upon discharge. Among malnourished patients, maintaining weight after leaving the hospital is an important factor in helping patients avoid further hospital visits. Additionally, nutrition intervention can improve surgical outcomes by reducing complications, making it easier to fight infections and heal.

Registered dietitian Gary Linhart, nutrition manager at Palos Hospital, explains how the patient nutrition consult works, “The first step is to provide the patient with a variety of healthy foods, especially high protein foods that can help to promote healthy weight gain. Patients who have a poor appetite or who have difficulty eating can be given oral supplements to increase their nutritional intake. Dietitians work with patients to sort through the many nutritional supplements available and

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CLASSES EVENTS & GROUPS

WELLNESS Take Better Care of Your Back Learn how posture, body mechanics and other forms of physical therapy can be used to prevent or manage back pain. This workshop is led by a Palos physical therapist. Registration is required. TIME/DATE: 6 to 7 p.m., Wednesday, May 10 (Additional dates available.) LOCATION: Palos Hospital, 12251 South 80th Avenue, Palos Heights

Eat healthy for your heart’s sake! Understand how to control fat and saturated fat intake, avoid trans fats, cholesterol and sodium, increase fiber and read food labels. Taught by a Palos registered dietitian. INFORMATION: For additional information, including meeting times, call 708. 226.2330. LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights COST: $10; $5 for each additional person

REGISTRATION: 708.226.2300

Courage to Quit

COST: Free

This eight-week program is designed for adults who are ready to quit smoking. Offered by the Respiratory Health Association.

Matter of Balance Maintain your independence and reduce your fall risk. Led by physical and occupational therapists at Palos, this program emphasizes practical strategies to manage falls. TIME/DATE: 10 a.m. to noon, Tuesdays, May 2 to June 20 TIME/DATE: 10 a.m. to noon, Wednesdays, May 3 to June 21 LOCATION: Palos Hospital 12251 S. 80th Ave., Palos Heights REGISTRATION: 708. 226.2300

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Nutrition for Your Heart

COST: $80

2017

TIME/DATE: 9 to 10 a.m. Tuesdays, beginning May 2 LOCATION: Palos Hospital 12251 S. 80th Ave., Palos Heights COST: Free REGISTRATION: 708.226.2300

Gentle Yoga Cancer patients and their loved ones can learn how to reduce stress and anxiety, regain strength and flexibility and minimize treatment side effects. Poses can be done on the floor or on a chair (your choice). TIME/DATE: 4:30 to 5:30 p.m., second and fourth Thursdays

To register for any of these FREE events, go to paloshealth.com/classes or call 708.226.2300.

LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708.226.2300 COST: Free

Diabetes and Daily Life

On the Move: Recent Developments in Joint Replacement Surgery

Get practical information of about how to live with and manage diabetes. Endocrinology specialist Avni Vora, M.D., reviews the importance of diabetes control and shares realistic tips on managing blood glucose levels and reducing complications.

Learn about the most recent advances in orthopaedic surgery from experienced health care practitioners. Board-certified orthopaedic surgeon David Butler, M.D., and nurse practitioner Brian Johnson discuss advances in pain management and blood conservation in joint replacement surgery. The benefits of Direct Anterior Approach hip surgery and Reverse Shoulder Arthroplasty for deficient rotator cuff will be explained and current techniques in knee replacement surgery including less invasive options will also be discussed.

TIME/DATE: 6:30 – 8 p.m., Tuesday, April 25 LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708.226.2300 COST: Free

FAMILY-CENTERED Family-Centered Care Programs CARE

Birth, Babies and Beyond Get the most out of your birthing experience. In a relaxed setting, expectant mothers and their support person learn about labor, birth, medical interventions, physical and emotional changes after birth, infant care and more. TIMES: Classes available in two formats: a four-week session, one evening/week on Wednesdays from 7 to 9 p.m. beginning April 26 and June 7 ($85/couple), or a weekend Express program from 8 a.m. to 4 p.m. on Saturdays, May 20 or June 24 ($85/couple, meals provided). Call for available dates. LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708. 226.2300

Baby Basics This three-hour class offers up-todate information on caring for a newborn. Topics include: feeding, diapering, bathing, growth and development, infant stimulation, newborn characteristics and behavior, infant-soothing techniques, signs of illness, immunizations, choosing baby equipment, car seat safety and general safety. TIME/DATE: 6:30 to 9:30 p.m. Wednesday April 12, Wednesday, May 17, Wednesday, June 28 Meets on the fourth week of the Birth, Babies & Beyond class. Call for additional times and dates. LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708.226.2300 COST: $20/couple

Take Charge of Your Thyroid Do you suffer from fatigue, unexplained weight gain, mood issues or muscle and joint pain? The problem could be related to your thyroid. Board certified surgeon Samer Rajjoub, M.D., explains common symptoms of thyroid conditions and offers treatment options, including less invasive measures. TIME/DATE: 6:30 – 7:30 p.m. Tuesday, April 18 LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708.226.2300 COST: Free

TIME/DATE: 6:30 – 7:30 p.m., Wednesday, May 24 LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708.226.2300 COST: Free

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Breastfeeding Basics

Joy of Grandparenting

A Palos lactation consultant provides the basics for successfully nursing your baby. This class covers breastfeeding advantages, practical techniques, pumping, storing, returning to work, dad’s role and family support.

Are you welcoming a grandchild? Explore the many facets of the grandparent role and learn about family adjustment as well as ways you can support the new parents. An update on childbirth practices, the latest in baby care and a tour of the Birthing Center are included.

TIME/DATE: 6:30 to 9 p.m. Thursday, April 13, Thursday, May 18, Thursday, June 8. Call for additional dates. LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708.226.2300 COST: $20/couple

TIME/DATE: 7 to 9:30 p.m. Thursday, May 11. Call for additional dates. LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708. 226.2300 COST: FREE

Infant/Child/Adult CPR

Nursing Moms Network

Be prepared to act in an emergency. This American Heart Association class is intended for anyone 11 years and older interested in learning cardiopulmonary resuscitation techniques to assist infants, children and adults in distress. Note: This is not a class for CPR certification.

Get the support you need when it comes to breastfeeding. Meet and share experiences with other mothers and receive ongoing guidance and support from an experienced lactation consultant.

TIME/DATE: 6 to 9 p.m. Thursdays, April 6 and 20, Thursdays, May 4 and 25, Thursdays, June 1 and 15. LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708. 226.2300 COST: $30/person

Birthing Center Tour One of the most important decisions to make when expecting a baby is where to deliver your child. Learn how Palos is different from other hospitals through our single-room maternity care, where labor, delivery, recovery and postpartum all take place in newly remodeled private rooms. TIME/DATE: 6 to 6:45 p.m., select Wednesdays or Thursdays; 11 to 11:45 a.m., select Saturdays. Call for dates. LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708.226.2300 COST: Free

TIME/DATE: 11 to 12:30a.m., Tuesdays LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTATION: 708.226.2300 COST: Free

SUPPORT Support Groups

GROUPS

Look Good … Feel Better Look your best during cancer-fighting treatments with training from cosmetic industry professionals. Learn makeup, skin and nail care techniques as well as how to wear wigs, hats and scarves to enhance your appearance. This non-medical program is offered in partnership with the American Cancer Society. TIME/DATE: 3 to 5 p.m., Tuesday, May 9 and Tuesday, August 8 LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708. 226.2300 COST: Free

Lymphedema Support Group Network with others experiencing lymphedema while receiving updates on products, community resources and management strategies. TIME/DATE: 5:30 to 6:30 p.m., Wednesday, May 10. Call for additional dates. LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708.226.2300 COST: Free

Caregiver Support Group Offered by professionals from Palos Home Health Care, this group provides emotional and practical support for family members and friends caring for a loved one in the last years of life. REGISTRATION: Call for details, 630.257.1111. COST: Free

Cancer Survivors Discussion Group All cancer survivors are welcome to attend this group focusing on both supportive and educational care. Participants can network with other survivors facing similar struggles. This discussion group is brought to you by The Cancer Support Center. TIME/DATE: 6 to 7:30 p.m., second Wednesdays LOCATION: Palos Hospital, 12251 S. 80th Ave., Palos Heights REGISTRATION: 708.226.2300 COST: Free

TIME/DATE: 10 to 11 a.m., first Thursday of each month (no group in July or December – February) LOCATION: Palos Hospital 12251 S. 80th Ave., Palos Heights REGISTRATION: 708. 226.2300 COST: Free

WEIGHT Weight Management MANAGEMENT PROGRAMS WeightWise Discover a healthy approach to weight management for adults who prefer individual attention. Appointments scheduled at your convenience. LOCATION: Palos Hospital REGISTRATION: 708.923.4330

Shapedown (6 to 17 years) This ten session program is designed for overweight children and teens or as a preventative program for those at risk of obesity. The individualized format works to mold positive eating and exercise habits while addressing self-esteem. Education, family support and behavior modification also are addressed as keys to success. LOCATION: Palos Hospital REGISTRATION: 708.923.4330

Fall Prevention Support Group Open to anyone concerned about falling. Each month a different fall prevention topic is discussed, followed by Tai Chi exercises led by a Palos physical therapist.

WAGS Volunteers Share the unconditional love your dog brings with patients at Palos Hospital. Dedicated owners with naturally confident, calm and gentle dogs may be good volunteer candidates for Palos Hospital’s WAGS Animal Assisted Therapy Program. Owners, as volunteers, visit patients twice a month with their obedient and docile dogs.

TO LEARN MORE OR APPLY: Call 708.923.5593 or visit paloshealth.com/WAGS. Applicants will be contacted for pre-screening and those who meet qualification requirements will be scheduled for temperament testing on Wednesday, May 17.

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PALOS HEALTH

Non-profit Organization U.S. Postage

12251 South 80th Avenue Palos Heights, IL 60463

PAID Palos Health

Palos Hospital 12251 South 80th Avenue Palos Heights, IL 60463 708.923.4000

Palos Health South Campus 15300 West Avenue Orland Park, IL 60462 708.460.5550

Palos Women’s Center 17333 South LaGrange Road Tinley Park, IL 60487 708.590.5500

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Unravelling the Mystery of Alzheimer’s

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Diabetes: Know the Warning Signs

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G R E E N

Alleviating Spring Allergies

Cut the Salt, Keep the Flavor

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H E A LT H

May 4 Container Garden Salad

June 1 Healthy Barbecue

Looking for an easier way to garden this spring? Master Gardener Margaret Burns-Westmeyer returns to Palos to discuss how pots and planters can be used to grow herbs and vegetables on your deck or patio.

Make healthy choices at your get togethers this summer! Palos registered dietitian nutritionist Loretta Wojtan shares innovative and nutritious recipes perfect for summer gatherings. Also get up-to-date summer food health and safety tips.

Palos Registered Dietitian Nutritionist Jennifer Koman will share healthy and easy recipes to inspire your menu planning. TIME/DATE: 6:30 – 7:30 p.m., Thursday, May 4 LOCATION: Palos Hospital, 12251 South 80th Avenue, Palos Heights

More classes inside!

TIME/DATE: 6:30 – 7:30 p.m., Thursday, June 1 LOCATION: Palos Hospital, 12251 South 80th Avenue, Palos Heights

Sign up for our free presentations online at paloshealth.com/classes-events

Profile for Palos Health

Spring 2017 perspective  

The quarterly magazine of Palos Health.

Spring 2017 perspective  

The quarterly magazine of Palos Health.

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