Best Genetic Test = Knowing Your Family History

Thursday, March 15, 2012 8:31 AM comments (0)

Family-HistoryThe field of Medical Genetics has seen tremendous advancements over the years and is greatly impacting the way healthcare is delivered. Despite this, one of the best “genetic tests” for guiding your personalized care and estimating risk is to know your family medical history.

By analyzing your family history, you can be alerted to an increased health risk whether it’s heart disease, cancer or another condition.  If the risk is high enough, changes in medical management or further testing may be indicated to help personalize one’s care.

Peter Hulick, MD, Medical Geneticist offers his advice on how to track your family history to personalize your healthcare:

  • Use a Family history tool—such as MyGenerations—to personalize medical care and simplify the recording process.
  • Provide complete, accurate information. Be sure to record the health condition and the age it occurred.
  • Complete your family history to span at least 3 generations (including siblings, aunts/uncles, parents and grandparents from both your maternal and paternal side).
  • Update information periodically to include new health conditions.
  • Review information with your healthcare provider. Determine with your physician if further follow-up is necessary.

Do you have a family history of health conditions? How many generations of health information do you know?

Drowsy Driving – Importance of Driving When Alert

Tuesday, March 13, 2012 8:31 AM comments (0)

Drowsy-DrivingYou are getting sleepy, very sleepy. All hypnosis aside, hopefully when your eyelids get heavy, you yawn uncontrollably and your head begins to nod up and down, you are not behind the wheel of a car.

According to the National Sleep Foundation’s Sleep in America poll, a surprising 60 percent of Americans have felt sleepy and drowsy when driving. The reasons are many: you’ve had a long day at work, you’re powering through exits on a road trip to make it to your final destination faster or you’re driving in the evening. No matter what the reason, drowsy driving can be just as dangerous as driving under the influence,and puts both you and others at serious risk.

Neil Freedman, MD, Sleep Medicine specialist at NorthShore, offers his insights on how to stay alert at the wheel and avoid injury:

  • Know the risks for drowsy driving. While everyone is at risk for driving while sleepy due to sleep deprivation, there are certain risk factors and groups of individuals who are at increased risk for sleep-related accidents. Accidents related to drowsy driving are more common in younger individuals (teens and early 20’s); those with untreated sleep disorders such as obstructive sleep apnea; individuals with medical disorders that result in sleep disruption such as chronic pain syndromes, congestive heart failure and COPD; those taking medications that may result in, or enhance the effects of, sleepiness (antihistamines, certain types of pain medications and some classes of antidepressants); and those employed in certain occupations that lead to sleep loss such as shift workers.

    Individuals should also avoid driving in the late evening and in the early morning hours, as this is the time period when our circadian clocks increase our drive for sleep.

  • Know the signs of sleepiness. All individuals who get into automobile accidents due to sleep loss or excessive sleepiness have symptoms long before their accident occurs. It is important to recognize the signs of excessive sleepiness and take action to avoid sleep-related accidents. Common symptoms that are associated with drowsy driving include:
       -   Yawning
       -   Difficulty keeping your eyes open
       -   Difficulty remembering where you have been driving for the last several
           minutes
       -   Ending up too close to the car in front of you
       -   Missing road signs and driving past your turn or exit
       -   Any drifting such as into other lanes, onto the rumble strip or shoulder
           on the side of the road

If you exhibit any of these symptoms while driving or know that you are too tired to drive prior to getting into the car, you should either not get behind the wheel, or pull over to the side of the road or to a rest stop.

  • Prevent sleep-related accidents prior to driving. In addition to pulling over and not driving when you are obviously tired, recommendations to prevent sleepiness-related accidents include:
       -   Get a full night of sleep prior to driving.
       -   Avoid driving late at night or in the early morning hours.
       -   Share the driving with someone else on a long trip.
       -   Avoid sedating medications prior to and while driving.
       -   Pull over and take a nap when you are too tired.
       -   Use caffeine for short-term improvement in alertness. (Importantly,
           caffeine only improves alertness temporarily and is not a substitute for
           adequate amounts of sleep.)

Have you ever been too sleepy to be driving? What do you do to stay alert behind the wheel?

Focus on Nutrition: Get Your Plate in Shape

Friday, March 09, 2012 8:11 AM comments (0)

Healthy-EatingGetting in shape and thinking about your daily nutrition is now a little easier. The food pyramid has been replaced by the new MyPlate visual, which is based on the most recent revision of the Dietary Guidelines for Americans.

There are three main focus areas for the new Dietary Guidelines. Melissa Joy Dobbins, a registered dietitian at NorthShore, provides tips on how to put these strategies into action:

Balancing Calories:

  • Enjoy your food, but eat less – Try using smaller plates, bowls and cups.
  • Avoid oversized portions – Watch your portion sizes to help decrease your intake of excess calories. Follow the MyPlate visual to balance your plate for optimal nutrition. 

Foods to Increase:

  • Make half your plate fruits and vegetables – Many people don’t realize that fruits and vegetables don’t have to be fresh or organic to be healthy.  Produce that is frozen, canned and dried is a nutrient-rich and budget-friendly option.
  • Make at least half your grains whole grains – Add a little variety to your meals by experimenting with different whole grains in place of more processed and refined starches.  Try brown rice instead of white, or snack on popcorn instead of chips.
  • Switch to fat-free or low-fat (1%) milk – Gradually switching from whole or 2% milk to lower-fat milk cuts the fat and calories, but doesn’t reduce the calcium or other essential nutrients.

Foods to Reduce:

  • Compare sodium in foods like soup, bread, and frozen meals – and choose the foods with lower numbers.  A food that contains 140 mg of sodium or less is considered “low sodium” and if it contains 35 mg or less, it is considered “very low sodium.”
  • Drink water instead of sugary drinks – Make it a point to carry a bottle of water with you during the day.  Try diluting fruit juice with water to cut the sugar and calories, while still providing flavor and fluids.

For more helpful ideas to get your plate in shape, check out the “Ten Tips” series.

What nutrition tips do you have? How balanced is your plate?

High-Risk Pregnancy: Healthy Baby, Healthy Mother

Wednesday, March 07, 2012 8:11 AM comments (0)

High-risk pregnancy

Pregnancy brings about many changes—both for the mother and baby.  While most women have normal, healthy pregnancies, everyone is at some risk for problems.

Issues during a pregnancy can range in severity—from poor nutrition, nausea or fatigue to gestational diabetes, preeclampsia, infectious diseases or premature birth. With the proper planning, education and physician involvement, many risks can be greatly reduced or avoided.

Scott MacGregor, D.O., gives his recommendations about what women can do both before and during their pregnancy to ensure a healthy self and baby:

  • Prior to pregnancy begin prenatal vitamins or folate to reduce the risk of birth defects.
  • Exercise and eat a balanced diet.
  • Consult with your physician or midwife before pregnancy if you have medical problems, such as diabetes or hypertension.
  • Consider genetic screening or testing if you are concerned about problems, such as Down syndrome.
  • Optimize maternal and fetal surveillance for medical problems, such as maternal heart disease, diabetes and hypertension.
  • Optimize obstetric management and fetal surveillance for obstetric problems, such as multiple gestation and prior preterm delivery.
  • Consider fetal testing and surveillance during pregnancy to improve outcome.

What are some things you’ve done to prepare for a healthy pregnancy? What have you done during your pregnancy?

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Have high-risk pregnancy questions? Join Dr. MacGregor for a live medical chat on Friday, March 16 at 1:30 p.m. He’ll answer your questions about risk factors, treatments and signs of high-risk pregnancy. Save the date and submit your early questions today.

Surviving Cancer – Learning How to Live Again

Monday, March 05, 2012 8:44 AM comments (0)

Cancer is hard on everyone—families, friends and especially on the individual—even if the outcome is successful. As advances in cancer treatments have led to more cancer survivors, the necessity for supporting and nurturing survivors through the end of treatment and their cancer experience is necessary.Surviving-Cancer

Carol Rosenberg, MD, Director of NorthShore’s Preventive Health Initiatives and Living in the Future (LIFE) Cancer Survivorship Program, provides the following tips to help cancer survivors and their loved ones navigate the end of their battle with cancer. These help to ensure quality of life and long-term health:

  • Learn how to transition from being a cancer patient to a cancer survivor.
    The transition from an intense oncology treatment environment back to your community, family and primary care environment can be difficult. It is important to recognize that you need to develop a new “normal.” 
  • Develop a survivorship care plan.
    After treatment, it’s smart to compile a portable detail of medical records, resources and information that can be shared with your other healthcare providers. As part of the Living in the Future (LIFE) Cancer Survivorship Program at NorthShore, a survivorship care plan is documented in the electronic medical record. This includes a summary of the survivor’s cancer history and treatment, a personalized risk assessment, preventive practice recommendations and more.
  • Prepare for concerns and struggles upon exiting treatment.
    Depending on the type of cancer, concerns post-treatment may vary. The most common concerns for all cancer survivors are fear of recurrence, fatigue, anxiety and weight gain (especially for breast cancer survivors). In the case of breast cancer, lymphedema (swelling of the affected arm) is a major concern.
  • Know how often you should be checked for cancer recurrence.
    The frequency for monitoring recurrence will depend on the type of cancer, the National Comprehensive Cancer Network (NCCN) guidelines, and your oncologist’s familiarity with your particular cancer. Most people who are finished with an active treatment protocol are monitored by their oncologist in three- to six-month intervals for the first five years. Some cancers are monitored more frequently.

Are you or someone you know a cancer survivor? What changes to your or their lifestyle have been made? What words of wisdom do you have for others?

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Additional resources and useful information for survivors are offered on a monthly basis at the MRW Survivorship 101 seminars offered through NorthShore’s Living in the Future (LIFE) Cancer Survivorship Program. These monthly educational workshops address major topics such as a lifestyle, psychosocial issues, genetics, and insurance and employability.

Colon Cancer Prevention: Screening is Key

Thursday, March 01, 2012 8:41 AM comments (0)

Colon Cancer ScreeningColon cancer is one of the most preventable cancers in the United States—nearly 90% preventable with colonoscopy. Despite this, it is the second leading cause of cancer death, affecting more than 29,000 men and women in this country each year.

NorthShore Gastroenterologist, Monica Borkar, MD,  provides a list of risk factors that affect the development of colon polyps—and thereby, colon cancer—including:

Colon cancer starts as a polyp, or growth, in the colon.  These polyps grow slowly over many years, and larger ones are more likely to be dangerous.

In most cases people do not have symptoms, although common symptoms of colon cancer include:

  • Change in bowel habits
  • Unintentional weight loss
  • Weakness
  • Abdominal pain
  • Blood in the stool
  • Age  - Most people who develop colon cancer and colon polyps are over 50 years old.
  • Genetics - A family history of colon cancer imparts a greater risk of developing polyps and cancer; people are usually screened earlier than 50 and are advised to return at shorter intervals if colon cancer has affected someone in their immediate family.
  • Diet - A diet high in red meat and low in dietary fiber may lead to colon cancer development.
  • Exercise - A sedentary lifestyle may be associated with colon cancer so exercise at least one hour three times per week.
  • Personal history of colon polyps - Individuals who have a history of colon polyps are more likely to develop them in the future.
  • Personal history of colon, endometrial, breast or uterine cancer.
  • Certain genetic conditions - Specific types of colitis or inherited diseases can make colon cancer more likely.

National guidelines recommend that individuals with a lack of the risk factors listed above undergo colonoscopy at age 50. Colonoscopy for colon cancer screening—a 20-minute procedure—is the most important test to check for polyps and cancer, even before symptoms arise, and leads to prompt diagnosis and treatment with an excellent survival rate.

Are you surprised by any of the risk factors listed above?

Home and Herbal Remedies to Help with Common Problems

Tuesday, February 28, 2012 8:34 AM comments (0)

Home Remedies

We don’t always have time in our busy lives to go to the doctor or pharmacy for common ailments (such as a cold, flu or upset stomach). In many cases you can help relieve symptoms with herbal remedies and treatment methods at home.

Leslie Mendoza Temple, MD, a NorthShore Integrative Medicine physician offers some at-home tips to help cure common illnesses:

  • Common cold/congestion/sinusitis:
    Place a few drops of eucalyptus essential oil on a warm, wet washcloth. Fold the washcloth over and breathe in the vapors. Dropping some of the oil in the shower or bath creates a steambath that can soothe irritated airways. Avoid this if you’re sensitive to eucalyptus or dislike the scent.
  • Sore throat and spastic cough:
    Ingest a teaspoon of raw, locally sourced honey during a coughing fit or dilute it in hot water and drink frequently to soothe inflamed tissues in the throat. (Not recommended for children under the age of one year.)
  • Upset stomach:
    Place a warm water bottle on belly and perform a “Hara” abdominal massage. Start at the bottom right of your belly, move hands gently up under the right rib cage. Then move hands across to the left under the rib cage, and move them down the left abdomen to the lower middle of the belly. Drinking fennel, chamomile or licorice tea liberally will help soothe the stomach and aid hydration.
  • Cold sores
    Soak a Q-tip with licorice root extract (in glycerin base, not alcohol base) and apply the Q-tip directly to the lesion at the first tingling sensation. Do not touch the dropper to a used Q-tip. Dab liberally and often until resolved. This may also be used in the genital area during herpes outbreaks.
  • Mild, first-degree burns (skin is intact)
    Apply the juice and gel from an aloe vera leaf directly on the burn. To soothe the skin, alternate with calendula cream or ointment.
  • Diaper rash or irritated genital tissues
    Mix an A & D ointment or thick diaper cream with equal parts of calendula cream or an over-the-counter hydrocortisone cream into the palm of your hand and apply to irritated tissues twice daily. Do not use the hydrocortisone cream for longer than two weeks at a time. The A&D and calendula creams may be used long-term.

What home remedies do you use? Have you ever tried any of these home remedies?

Eating Disorders: Importance of Support from Family Members and Friends

Thursday, February 23, 2012 4:54 PM comments (0)

Eating DisordersEating disorders can be easy to miss in our busy, health-conscious and appearance-focused culture. However, they are a serious problem affecting an estimated 7-11 million women and men in the United States. When left untreated, eating disorders may develop into a chronic, destructive, emotional illness with many physical complications. Friends and family members can help combat this illness by offering support and being aware of early warning signs. Suellyn Alexander, Clinical Program Manager at NorthShore Center for Eating Disorders offers some tips for friends and family members of someone struggling with an eating disorder:

Early warning signs may include:

  • Making excuses for not joining the family for meals
  • An excessive interest in wanting to eat healthy, food preparation, calorie counting, personal appearance and compulsive exercising
  • Unusual food rituals
  • Mood and behavior changes including depression, irritability, social isolation and sleep disturbances
  • Don’t ignore the issue. Express your concern openly, honestly and with compassion.
  • Denial of any possible problem when confronted with symptoms does not mean there is not a problem. Don’t be deterred by a strong, negative reaction.
  • Suggest an evaluation with a professional who has experience treating eating disorders.
  • Continue to provide support and avoid getting into a power struggle.
  • Be a good role model in terms of nutrition, exercise and body image issues. Seek professional advice and support for yourself.

Do you know anyone who struggles with an eating disorder? What have you done to help? What advice would you give to others? -- For additional online education and support resources, visit:

Further questions or concerns? Call NorthShore Center for Eating Disorders at 847.480.2617.

 

Guest Post: Wes Fisher, MD - Listen to your Heart

Tuesday, February 21, 2012 12:34 PM comments (0)

The middle aged man sat cheering his favorite football team.  Just after the game while sitting in front of his TV, he felt strange: lightheaded, sweaty, somewhat short of breath.  He tried to stand, but felt worse. So he sat and re-gained his composure.  He noted a slight bead of sweat on his brow and felt like he just couldn’t take a full breath in.   Other than that, he didn’t feel too bad at first.
Heart Health
So he waited a bit.  “Maybe going outside will help,” he thought.  He managed to walk outside and did feel a bit better for a while, but when he returned inside, he felt the same.  Slowly, nausea overcame him and he had to go to the bathroom and get sick.  Again after that, he felt improved but never felt back to normal.

He waited a bit more and called his wife.  He described to her what he was noticing as she googled his symptoms: some 399,478 search results appeared.  She read the list to him: heart trouble, stomach trouble, neurological trouble – the possibilities seemed endless.  Uncertain what to do, they finally decided to call their family doctor.

“Do you have any aspirin in the house?” he asked.

They scoured their cabinets.  “I can’t believe it!” she said. “No, we can’t find any.”

“Then why don’t you take him over to the Emergency Room right now to get checked out,” the doctor suggested. They thought about it a bit and because his symptoms had not resolved for over an hour and a half, they agreed.

Upon arrival to the emergency room, he was found to have a sustained heart rate of 206 beats per minute at rest – far outside the normal 50-100 beats per minute he should have had.    The process to determine the cause and treatment were started immediately and, gratefully, he left the hospital several days later with his treatment regimen in place.

So why should you care?

Because sometimes, despite all of the information available to all of us these days thanks to news agencies, public service announcements, smartphones, and instant search engines, heart disease can present in unpredictable, unimaginable ways.  When it does: denial is our worst enemy in providing effective treatment.

So if you’re not sure if your symptoms could be caused by your heart, don’t wait.  Get it checked out.  

More often than not, you’ll be glad you did.

-Wes Fisher, MD

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Have questions about heart disease? Join Dr. Brian Shortal, cardiologist for a live online chat on Thursday, February 23 from 12-1p.m. Submit your questions in advance.

Watch Your Step – Avoid Foot and Ankle Injuries this Season

Friday, February 17, 2012 7:46 AM comments (0)

Foot-Ankle_InjuryWhat do you do to avoid slipping? Do have a preferred method for staying injury-free?

Our feet and ankles get a workout every day – even if it’s just from walking around the house or to and from the car running errands. According to the American Academy of Orthopaedic Surgeons, one hour of strenuous exercise puts up to one million pounds of pressure on your feet. Now imagine how much additional stress your feet and ankles can be subjected to when roads and sidewalks are icy and snowy.

Lan Chen, MD, an orthopaedic physician at NorthShore offers her insight on how to avoid a foot or ankle injury this season:

  • Wear the right shoes for the right weather.  High-heeled boots may be fashionable, but flat or low-heeled boots with good traction soles are best for the snow.  Avoid wearing long flowing dresses or coats as they can get tangled with your feet and cause you to lose your balance.
  • Use caution and check for slick walkways or roads when exiting your car or home.  Keep doorways clutter-free and watch out for slippery areas. Most importantly, keep your hands free for better balance and support in case you begin to fall.
  • Don’t ignore an injury.  If you have pain, swelling and inability to put weight on your foot or ankle, or just feel as if something isn’t right, seek medical attention.  Some seemingly minor sprains can lead to significant ligament and cartilage damage resulting in long-term pain, instability and, ultimately, arthritic changes if they are not treated.
  • If you aren’t able to immediately see your doctor, use the R.I.C.E method:
    o    R: Rest your foot or ankle.  Staying off it will minimize pain.
    o    I: Ice your injury to help reduce swelling.  Never put an ice pack directly  
         onto bare skin; use a thin towel to cover the ice pack and ice for 20
         minutes at a time.
    o    C: Compress the area of swelling with an ACE wrap or an elastic brace.
    o    E: Elevate the foot above the level of the heart. 
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