For the estimated 30% of Americans who suffer from seasonal allergies, increased levels of pollen and mold common in spring can bring on symptoms like sneezing, congestion, runny nose and itchy, watery eyes. In other words, spring is in the air—literally.
But, don’t let that keep you inside this season.
The experts at NorthShore University HealthSystem compiled some top tips and simple allergy remedies into our seasonal allergies infographic. This year don’t just brave the great outdoors
Miriam “Mia” Boelen, Physical Therapist at NorthShore
and author of “How to Live Well with Parkinson’s: Advice from a Physical Therapist” and “Health Professionals Guide to Physical Management of Parkinson’s Disease,” discovered her passion straight out of high school. After
visiting an uncle who had been diagnosed with Parkinson’s disease 10 years earlier, she knew that helping people in similar situations was what she wanted to do with her life.
Mia tells us why physical therapy is such an important part
of Parkinson’s disease treatment and shares stories of success that she attributes fully to the strength and determination of her patients:
How long have you been working as a physical therapist? I have been a physical
therapist since 1978 and have been working with people with Parkinson’s disease (PD) since 1990.
What attracted you to the field of physical therapy, in particular specializing in the treatment of those with Parkinson’s disease?
I became interested in physical therapy when I traveled to the Netherlands after high school to visit my uncle. He had been diagnosed with Parkinson’s a decade earlier. It was the first time I assisted an individual with walking and realized I
wanted to help other people who had similar physical challenges.
In 1988, I started working at Glenbrook Hospital. Later, I volunteered to help a movement disorder neurologist who was searching for a physical therapist to treat his patients with
Parkinson’s disease. I quickly developed a passion for treating people with Parkinson’s and similar movement disorders.
Why is physical therapy for the treatment of Parkinson’s disease so important?Physical
therapy is important for people with Parkinson’s from the time the individual is initially diagnosed and functioning well through all the stages of PD. In the early stages, we teach prevention—it is less work to prevent muscles from getting weak/tight
than it is to “catch up” later. Exercise is critical to controlling the motor symptoms of Parkinson’s. The physical therapist helps to create the optimal exercise program for patients, which often requires an individualized approach since
PD affects everyone differently.
Parkinson’s affects the part of the brain that controls movement so it requires individuals to pay more attention to their movements, even walking and getting in and out of chairs and bed. Movements are
typically smaller and can require more effort to normalize. In therapy, we teach people how to effectively use their attention to improve all aspects of moving, which results in reduced difficulties with walking and transfers. Some people with Parkinson’s
may need more assistance and in such cases the therapist can teach both the individual and his or her caregiver/spouse how to assist so there is less strain.
What would you say is the biggest challenge you often have to work with your patients
to overcome in terms of physical therapy for Parkinson’s disease?The biggest challenge is often helping individuals understand the benefits of using an assistive walking device such as a cane or walker/rollator. There are some individuals
who opt to become sedentary to avoid falling or feeling very unsteady. Or, worse, they fall and become injured. Becoming more sedentary to avoid falls is not necessarily done deliberately but this situation results in a progressive loss of strength and further
decline of balance. All of this can be avoided by using a walking aid that allows an individual to become more active in a safe way. This is important because remaining active has a multitude of functional and health benefits.
What do you find
most rewarding about your job?I frequently see individuals who are stressed about how Parkinson’s affects them and the lack of control or knowledge they have about PD. My ability to see my patients for consecutive appointments, one-on-one,
addressing all of their questions, allows me to see much of their uncertainty and stress dissolve to a more manageable level for them. I simply guide these individuals. After that, I pass the baton to them so they can self manage. It’s very rewarding
to see them improve physically and emotionally, to impart a greater sense of control over a situation they previously thought they couldn’t control.
Do you have a favorite story of success that you could share?Over the years,
I have accumulated many success stories and every one of them is due to the hard work and perseverance of my patients. I have the easy job; my patients do the hard work.
Here are just a few moments of success:
Patients who questioned
their ability to travel to their country of origin to visit relatives and were able to make the trip after treatment.
Find out more about Mia Boelen and her work with Parkinson's disease on her blog here and more information on the treatment options for Parkinson's disease at the
NorthShore Neurological Institute here.
April is National Parkinson’s Disease Awareness Month. All this month, we will feature a series of posts addressing Parkinson’s disease symptoms, genetics, treatment options and more from NorthShore neurologists—Demetrius Maraganore,
MD, Aikaterini Markopoulou, MD, and Ashvini Premkumar, MD— to raise awareness about this common and often disabling neurological disorder.
Demetrius Maraganore, MD:
Are the children of a parent with Parkinson’s disease
likely to inherit the disease? Is there a greater risk if the father or the mother has the disease?My research team conducted family studies that defined the risk of inheriting Parkinson’s disease. The children of Parkinson’s disease
patients carry a two-fold risk for Parkinson’s disease. They are twice as likely to get Parkinson’s disease compared to the children of persons without Parkinson’s disease. However, one needs to consider that the lifetime risk for Parkinson’s
disease in the general population is 2%, so the risk of Parkinson’s disease for the children of a patient is 4%, or twice the baseline risk for the general population. That’s a pretty low risk and I wouldn't recommend any specific lifestyle
changes or preventive therapies for the children of patients with Parkinson’s disease. That said, about 5% of Parkinson’s disease cases are due to an inherited gene abnormality (mutation). In families where multiple members have
Parkinson’s disease, the risk may be as great as 50% to the children of an affected person. When there are multiple family members with Parkinson’s disease, I refer patients for genetic counseling and in some instances we also perform genetic testing.
What are the most important genetic risk factors for Parkinson’s disease?There are two types of genetic factors that are important to Parkinson’s disease: 1) genes that rarely cause familial Parkinson’s
disease (multiple affected members in the same kindred), and 2) genes that are not causal but that slightly increase the risk for Parkinson’s disease in populations worldwide (susceptibility genes). About a dozen genes have been identified as rare causes
of familial Parkinson’s disease, and about a dozen genes have been identified as common risk factors in populations worldwide. The causal gene mutations are rare, accounting for less than 5% of all Parkinson’s disease cases. The susceptibility
gene variants are common—e.g., occurring in 25% of persons in the general population—but they have small effects (no more than doubling the risk for Parkinson’s disease). Of all of the Parkinson’s disease genes,
the most important is alpha-synuclein because it is both a causal gene in some families and also a susceptibility gene in populations worldwide. In other words, rare variants (mutations) cause Parkinson’s disease in rare families, while common variations
(polymorphisms) increase the risk for Parkinson’s disease worldwide. The alpha-synuclein gene holds the code for making the protein alpha-synuclein. The protein alpha-synuclein accumulates abnormally in the brain cells of every patient with
Parkinson’s disease regardless of the causes. Many scientists believe that it holds the key to understanding and curing Parkinson’s disease. Our research team at NorthShore has led many of the most important studies of alpha-synuclein and Parkinson’s
disease, including studies in families and in populations worldwide. We were also amongst the first to study the interaction of alpha-synuclein with other genes or environmental factors, or to study the association of the alpha-synuclein gene with motor and
cognitive outcomes in Parkinson’s disease. Are there genetic research studies of Parkinson’s disease at NorthShore? How can I participate? At NorthShore we are conducting a genetic study called the DodoNA
Project. We aim to discover genetic factors that predict how neurological diseases progress in severity and that predict disease outcomes. We aim to use this information to individualize the care of our patients and to halt the progression of neurological
diseases. One of the diseases we are studying is Parkinson’s disease. We will enroll at least 1,000 Parkinson’s disease patients into the study, and follow them at least annually for several years. To be eligible for the study
you need to be new to our Movement Disorders practice within the past year, a resident of Cook or Lake County and willing to provide a blood sample for DNA extraction and storage. We also require your permission to compare your genetic code with the information
that we collect in your medical record. If you wish to participate, the best thing to do is to request an appointment to be seen as a patient in the Department of Neurology at NorthShore. We can then enroll you into the study after your office
Oral cancers, which include cancers of the lips, cheeks, tongue, hard and soft palates, sinuses and throat,
or pharynx (also known as oropharyngeal cancer), often appear first as growths or sores in the mouth that do not go away. In addition to these lumps, bumps and sores of the mouth, potential symptoms include:
As with any cancer, early detection and treatment is paramount. Your dentist can conduct oral cancer screenings during your regular dental exam. NorthShore University HealthSystem is also offering a free oral cancer screening on
Sunday, April 27th from 9 to 11:30 a.m. at the John and Carol Walter Ambulatory Care Center at Glenbrook Hospital. Scroll through and register for an available time here.
Though everyone should be examined for oral cancer, Nicholas Campbell, MD, Medical Oncology, shares some of the
risk factors that can increase your chances of developing the disease:
Smoking. Lung cancer isn’t the only cancer smokers need to worry about. Smokers of cigarettes, cigars and pipes are far more likely to develop oral cancer
than those who have never smoked.
Use of smokeless tobaccos. Smokeless tobacco is also hazardous to your health. The use of chewing tobacco and snuff greatly increases a user’s risk of developing cancer of the lips, gums
Consumption of alcohol. The excessive consumption of alcohol has been linked with an increased risk of oral cancers.
Family history. A history of cancer in the family increases one’s risk
of developing many types of cancer, including oral and oropharyngeal.
Sun exposure. Multiple severe childhood sunburns not only increase one’s risk for certain types of skin cancer but can increase one’s risk for cancer
of the lips as well.
Men over the age of 50. Studies by the American Cancer Society say that men are twice as likely as women to develop oral cancer in their lifetime. Men over age 50 are at the greatest risk for the disease.
HPV exposure. A particular virus, the human papillomavirus (HPV), is the most common sexually transmitted infection in the United States. This virus also increases risk for oropharyngeal cancers.
HealthSystem with the Head and Neck Cancer Alliance is hosting a ree oral cancer screening event at Evanston Hospital on Sunday, April 12th starting at 9 a.m. Find out more and register here.
Karen Kaul, MD, PhD, Chair of the Department of Pathology and Laboratory Medicine at NorthShore, loves science and the science behind the practice of medicine. She specializes in molecular medicine and has devoted her career to developing
the field of molecular pathology. She also leads the Molecular Diagnostics Laboratory within the NorthShore Center for Personalized Medicine.
While most patients will never meet their pathologist or the many professionals working in laboratory medicine,
Dr. Kaul leads a remarkable team that works behind the scenes for their patients every single day. Here, she describes that groundbreaking work and the impact it will have the on the next generation of medicine:
often interact directly with patients but what do they do behind the scenes for their patients? Virtually all patients benefit from the work of professionals in pathology and laboratory medicine. These physicians and lab directors
interpret biopsies and complex laboratory tests, as well as oversee the operations and quality of the labs.
At NorthShore, we perform nearly five million clinical tests each year, as well as 100,000 microscopic examinations of samples removed
via biopsy or surgery. The information these tests generate determines much of the clinical treatment for each patient; we serve a critical role in healthcare delivery.
What does the NorthShore Molecular Diagnostics Laboratory do now?
What do you think it will be capable of accomplishing in the future for patients and treatment outcomes?The lab does testing for cancer, certain genetic diseases and also many infectious diseases for which we can detect the DNA of the microbe
more quickly than traditional methods. We can also use DNA-based techniques to identify antimicrobial resistance (or antibiotic resistance) and thus tailor treatment when traditional options might not be as effective.
The NorthShore Molecular
Diagnostics Laboratory also recently implemented Next Generation Sequencing and will soon set up testing for pharmacogenomics, which is the study of how a person’s DNA affects their reaction to certain medications. The goal of pharmacogenomics is to
ensure that each patient gets the right dose of the right drug the first time.
Our pathology department also includes the NorthShore Biorepository, which procures research samples of tumors, blood, and also procures the genomic samples for the Genomic
Health Initiative; these samples will be critical in the research that will advance our knowledge and the future of medicine.
And part of the future of medicine is personalized, or precision, medicine. What is your role in the NorthShore Center
for Personalized Medicine?I have been working in molecular pathology, the lab that performs DNA-based diagnostic testing, since the mid-1980s, and established the first molecular diagnostics lab at NorthShore in 1992. With the dramatic
advances in our knowledge of the genetics of disease, and the technological advances in our ability to more rapidly analyze DNA, the capabilities of molecular diagnostics are the starting point for personalized medicine.
By helping to determine
the best treatment for many types of cancer, our pathology medical staff do remarkable work every day to determine the gene mutations in tumor samples. While I am less involved in the daily operation of the lab, I am deeply involved in the Center for Personalized
Medicine here at NorthShore and am pleased to see the ongoing teamwork and progress on the clinical and research aspects of the program, and the use of electronic medical records and our strength in healthcare information technology, that will all be a part
of creating novel capabilities to care for our patients.
What impact do you think personalized, or precision, medicine will have on healthcare? I expect that in time these novel capabilities will be routine in how we practice
medicine, leading to better diagnoses, more effective treatment and better outcomes for patients. As we learn more, we may be able to more broadly predict disease risk and prevent diseases from developing.
What led you to medicine?
What led you to this field in particular? I always loved science, and especially enjoyed being able to use science to make people’s lives better. While a desire to help people leads many of us to medicine, and I enjoyed patient care,
I found that the ability to combine science, research, and caring for patients together was what suited me best and that led me to pathology. This field was certainly not on my career list when I began medical school, but I’m very fortunate to have discovered
it, particularly during this era of such rapid advances.
What do you find most rewarding about the work that you do? I love seeing the tremendous advances in medicine. Pathology and laboratory medicine has a tremendous impact
on patients, which is incredibly rewarding even though we generally do not meet the patients directly. I also enjoy working with the wonderful and dedicated team we have working in the labs. We also have training programs at NorthShore for both
medical technologists and pathology residents—our mission includes training the next generation of laboratory professionals, and I have very much enjoyed my involvement in these programs over the years.
What has been the biggest challenge
of your career so far? Time! There is a never-ending list of things to be done.
This Doctors' Day, recognize a doctor by sharing your stories of exceptional care or making a contribution in his or her honor by clicking
Gestational diabetes develops during pregnancy, typically between the 24th
and 28th weeks. Most women will experience some change in glucose levels during pregnancy due to fluctuating hormone levels. Gestational diabetes develops when glucose levels rise but a woman’s pancreas is unable to produce enough insulin to regulate
blood sugar levels. Developing gestational diabetes does not mean a woman was diabetic prior to her pregnancy, however approximately 20% of women with gestational diabetes will go on to develop type 2 diabetes later in life. Women with gestational diabetes
must make lifestyle changes to ensure their health as well as their baby’s.
Jacobson, MD, Obstetrics/Gynecology, discusses when women should be screened and what changes an expectant mother should make after diagnosis:
Women are screened for gestational diabetes approximately 24-28 weeks into pregnancy. However, women who
are at a higher risk for developing gestational diabetes—risk factors such as obesity, previous instance of gestational diabetes, family history of diabetes—will likely require earlier screening.
It’s important to keep gestational
diabetes in check to prevent complications that could affect your baby, such as excessive birth weight, increased risk of cesarean section, increased risk of birth trauma, premature birth, low infant blood sugar at birth, and an increased risk for type 2 diabetes
and obesity later in life. Left untreated, gestational diabetes can also result in a baby’s death.
Have questions about gestational
diabetes or advice to offer other women newly diagnosed with gestational diabetes? Join our new online community The Parent 'Hood to start a conversation today. Click here to
find out more.
Ready to hit the roads, trails and sidewalks this spring and summer? Before you lace up your running shoes and head out the door, check out these top running tips for all fitness levels from the experts at NorthShore University HealthSystem.
Scroll below for our full running tips infographic, from improving endurance and when and how to stretch to running-friendly snacks and injury-prevention:
This year, spring clean your diet, too. "Clean" eating means to create a balanced diet of fresh, unprocessed foods with the central focus on fruits and vegetables. The health benefits of clean eating are many, such as possible weight loss and the reduction
of one's risk for diabetes and some types of cancer, including colon cancer.
The experts at NorthShore University HealthSystem have created an infographic that illustrates the benefits of clean eating and breaks down the most important clean eating
guidelines. Click on the image below to view the full infographic.
Henry “Mark” Dunnenberger, PharmD, Senior Clinical Specialist Pharmacogenomics,
NorthShore Center for Personalized Medicine, believes that personalized or precision medicine is the “next generation” of medicine, an approach that will not only treat disease but also predict and potentially prevent many diseases too. His
field within personalized medicine, pharmacogenomics, stands to make a revolutionary impact on patient treatment and outcomes.
Here, Dr. Dunnenberger defines pharmacogenomics, describes its impact now and in the future, and tells
us why working in this revolutionary field is so rewarding:
What is pharmacogenomics? Pharmacogenomics is the study of how your DNA affects your response to medications. It’s because of small differences in DNA
that two patients can receive the same medication at the same dose for the same indication and still have different responses. The medication may work well for one patient, while the other patient may receive no benefit or experience side effects. By
analyzing genetic variation, we can predict who is more likely to experience these undesirable outcomes.
How can it help patients? How does it change treatment for diseases like cancer?If we know a patient’s genotype when
a medication is prescribed to them, we are able to make a more informed decision to treat patients with the conventional dose, alter the dose or chose a different medication all together altogether. These actions will reduce the risk that a patient will
experience a negative drug-related outcome. This all leads to safer, more effective treatment for each individual. It can be paraphrased as: The right drug, at the right dose, for the right patient, the first time.
What is the role of
pharmacogenomics in the NorthShore Center for Personalized Medicine?Personalized medicine is the next step in the evolution of medicine. It can be thought of as the tailoring of medical treatment to the individual characteristics, needs
and preferences of a patient during all stages of care, from prevention and diagnosis, to treatment and follow-up. NorthShore is instituting personalized medicine through the Center for Personalized Medicine. This center brings together clinical,
research and bioinformatics genomics experts from across the health system. Pharmacogenomics is a piece of the Center and one of the first to launch. (NorthShore’s pharmacogenomics clinic launched March 2015.)
What’s next for
pharmacogenomics? What developments do you see in the near future?Pharmacogenomics is advancing in numerous ways. First, we are learning more about differences in DNA, known as variants, which have an effect on drug therapy. This
will increase the number of drug/gene pairs we can implement in clinical care. Second, we are figuring out which patient populations will benefit the most from pharmacogenomics-based interventions. Third, we are discovering the best ways to deliver
pharmacogenomics data to all practitioners. Soon we will be increasing the number of genes we preemptively screen from 14 to 231.
What do you hope you’ll be able to do in the future?Travel to space … but really,
in the future, I hope every patient at NorthShore will have their individual pharmacogenomics data in their health record before they even need it. I hope we will have developed a system that can make the data actionable to improve their care when they need
What brought you to this field?I am drawn to this field because of the challenges it presents and potential rewards when those challenges are conquered. By working in the field of pharmacogenomics, I can help build a
system that could impact the care of every patient that walks through the doors of NorthShore. I cannot think of a more rewarding job.
What do you find most rewarding about your work at the NorthShore Center for Personalized Medicine? It’s a tie between working with some of the most intelligent people I’ve ever met and having them broaden my horizons every day, and helping improve the care of the patients at NorthShore.
Find out more about the NorthShore Center
for Personalized Medicine by clicking here.
There are many risk factors for colon cancer that are beyond your control—being over the
age of 50, family history of colorectal cancer, personal history of polyps, inflammatory intestinal conditions like Crohn’s disease or ulcerative colitis. There are, however, risk factors you can mitigate by making some simple and some not-so-simple
changes to your lifestyle.
Susannah Spiess, MD, Gastroenterologist at NorthShore, encourages everyone to make these healthy
lifestyle changes to help lower the risk for colon cancer:
Eat a high-fiber, low-fat diet. Studies have shown that diets high in fat and lower in fiber may increase your risk for developing colon cancer. These same studies also
indicate an increased risk for those who consume large quantities of red meat regularly. Shift the focus of your diet away from meat, particularly red meat, and give fresh fruits, vegetables and whole grains top billing on your plate.
and move. This doesn’t just mean 30 minutes of exercise a day. Get up and move throughout the day. An inactive, sedentary lifestyle can increase your risk of developing colon cancer. If you spend most of your day sitting behind a desk, stand
up and move every 20 minutes or whenever possible.
Lose weight. Changing your diet and increasing your activity level will work wonders on your waistline as well. Obesity significantly increases one’s risk for not only developing
colon cancer but also dying from the disease if diagnosed.
Break the habit. It’s a terribly unhealthy habit. Smoking increases your risk for a number of serious health issues, from lung cancer and heart disease to stroke and,
you guessed it, colon cancer. The time to break the habit is now.
Cut back. The excessive consumption of alcohol raises your risk for several types of cancers, including cancer of the colon and rectum. Monitor your daily and weekly
consumption of alcohol and ensure that it is no more than 14 units of alcohol per week and no more than three in any single day.
Get a colonoscopy. While adopting these lifestyle changes could reduce one’s risk for colon
cancer, screening colonoscopy is the only proven method of preventing the disease.
Have you made an appointment to get your first colonoscopy? Find out more