Parkinson's Disease Research at NorthShore Strives to Lead to Better Patient Outcomes

Friday, April 11, 2014 1:11 PM comments (0)

parkinsons

As part of National Parkinson’s Disease Awareness Month, Demetrius Maraganore, MD, Chairman of Neurology at NorthShore, shared some of the findings of his ongoing research into the genetic factors that influence Parkinson’s disease progression and outcomes. He also tells us why research like this is so important for Parkinson’s disease patients and their families: 

Why is funding for and research into Parkinson’s disease so important? 
It’s important because the treatments that we have available don’t prevent Parkinson’s disease (PD) or slow or halt its progression.  PD is characterized by progressive motor and cognitive impairment.  PD patients have a seven-fold increased risk of nursing home placement and a two-fold increased risk of death.  The annual cost of PD in the U.S. exceeds $23 billion. Presently 2% of people will develop PD during their lifetime, and the prevalence of PD is expected to double by 2030. The cumulative burden of PD to society is and will be staggering.  Our patients and their families deserve methods to predict, prevent and halt PD and those will only come through research.

How long have you been conducting research into Parkinson’s disease?  
My research in Parkinson’s disease (PD) started in 1989, when I was an honorary clinical and research fellow to the late Professor C. David Marsden at the National Hospital for Neurology and Neurosurgery in London, England.  Dr. Marsden was the founder of the international Movement Disorders Society and its official journal, Movement Disorders.  His associate, Professor Anita Harding, was a pioneer in the field of neurogenetics.  Together, we launched the first genetic studies of Parkinson’s disease.  

That has remained the focus of my research, including for 20 years on the faculty of the Mayo Clinic in Rochester, MN, and in the four years that I have been Chairman of Neurology at NorthShore. While my research at Mayo focused on identifying genetic factors that contribute to the cause of PD, my research at NorthShore has focused on understanding how those genetic factors influence disease progression and outcomes.  Our research aims to develop methods to predict outcomes in PD, and to use that information to improve neurological health.

Why have you focused the bulk of your career on the study and treatment of Parkinson’s?  
As a clinician, it’s very gratifying that there are many treatments that we can employ in the first many years to reduce the burden of the disease on patients and families.  However, I recognize that the benefits of the existing treatments wane with time, and I’m driven by the sense of urgency to identify the factors that contribute to the progression of Parkinson's disease. Our goal is to target those factors so that every individual patient can have the best possible outcome. 

For more information on the NorthShore Neurological Institute and the research being done at NorthShore, click here. 

Fresh Recipe: Healthy Spring Rolls Three Ways

Monday, April 07, 2014 8:00 AM comments (0)

Spring rollsFresh spring rolls are a quick way to boost your intake of nutrient-dense foods. Simply purchase the pre-made rice papers (spring roll wrappers), fill with your favorite vegetables, roll, and enjoy.  You can add lean protein like shrimp, chicken breast or tofu to make spring rolls a more filling snack or a meal.  Low sodium soy sauce is a perfect accompaniment to these healthy treats. 

Katrina Herrejon, Certified Diabetes Educator at NorthShore, shares her recipe for healthy spring rolls three ways:

Ingredients:
Spicy: Serrano pepper, radish, lettuce and green onion
American: Avocado, carrots, zucchini, red pepper and basil
Shrimp: Shrimp, cucumber, bean sprouts and cilantro 

Reasons to Love Spring Rolls:

  1. Portable. Sometimes there is just no time for a knife and fork.  Springs rolls are a great way to take your vegetables on the go. And, they can be eaten with one hand.
  2. Raw. Uncooked vegetables are packed with fiber, vitamins and minerals.  They are also particularly filling, which helps to make these low-calorie wraps satisfying.
  3. Quick. You don’t need to perfectly julienne your vegetables to make a delicious spring roll.  Just finely chop whatever vegetables you have on hand and roll it up!  

Nutrition Information Spicy: 

Calories 48
Total Fat 1g
Total Carbohydrate 9g
Fiber 1g
Protein 1g

Nutrition Information American:
Calories 62
Total Fat 3g
Total Carbohydrate 10g
Fiber 2g
Protein 1g

Nutrition Information Shrimp:
Calories 59
Total Fat 1.5 g
Total Carbohydrate 9g
Fiber 1g
Protein 3.5g

*Nutrition information may vary based on brand of spring roll wrapper used. 

Survive the Season: How to Combat Seasonal Allergies in Your Home [Infographic]

Wednesday, April 02, 2014 6:35 AM comments (0)

April showers bring May flowers, and May flowers just might bring seasonal allergies. Don’t suffer the sniffles, sneezes, and itchy, watery eyes of seasonal allergies without fighting back. Our springtime infographic highlights some allergy basics and provides tips to help you combat seasonal allergy symptoms in your home. 

Click on our infographic for more information and useful tips.

Reduce the Pain, Choose the Right Medication

Tuesday, April 01, 2014 8:00 AM comments (0)

aspirinIt can be challenging to choose the right over-the-counter pain medication. While the choices are many, it’s very important to make a decision based on your symptoms and other medical issues. Not all pain relievers are created equal, and knowing the difference between various types can be very helpful.

Before taking any medication, you should consult with your physician and/or pharmacist. Additionally, you should carefully read labels for warnings and other information. This is especially true for combination products used for treating pain and other conditions, such as colds, allergies, arthritis and muscle aches.

Acetaminophen and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are the most commonly used over-the-counter pain medications. The main difference between the two is that NSAIDs help reduce pain, fever and inflammation. Acetaminophen only reduces pain and fever.

George Carro, Pharmacist at NorthShore Evanston Hospital, helps clarify the differences between these common over-the-counter pain relievers to help you make a better, more-informed decision:

Acetaminophen (Tylenol®) tends to be milder on the stomach. Keep in mind that acetaminophen will not help with inflammation. Acetaminophen is an active ingredient in many other medications, including cold and flu preparations. Be sure to read all labels carefully so you do not exceed the recommended maximum daily dose of acetaminophen.
Safe for Children? Acetaminophen is generally considered safe for use in children. Always be sure to confirm proper usage and dosing information with your pediatrician.
Side Effects? Liver toxicity, including liver damage and failure, can be associated with improper use of this drug.  Alcohol consumption in combination with acetaminophen use may increase this risk.

NSAIDs—Aspirin (Bayer®), Ibuprofen (Advil ®or Motrin®), Naproxen (Aleve®) and others—can help relieve pain and reduce inflammation.
Safe for Children? As with any drug for children, it is recommended to discuss proper usage and dosing information with your pediatrician. Please consider the following for use in children:

  • Aspirin should not be used in children under the age of 16 years. It has been associated with Reyes’s syndrome, a potentially fatal disease in children.
  • Ibuprofen is not recommended for use in children under the age of 6 months.
  • Naproxen is not recommended for use in children under the age of 12 years.

Side Effects? The most common side effects include stomach and kidney problems. It is recommended to take all NSAIDs with food to help minimize stomach irritation. If you have heart conditions, stomach ulcers or blood disorders, please consult with your physician before taking these medications.

No drug—prescription or over-the-counter—is without risks. Always consult with your physician if you have any questions or concerns about your medications. Our NorthShore pharmacists can also answer questions and help you make informed, over-the-counter pain reliever selections.

Honor Your Doctor on Doctors’ Day

Sunday, March 30, 2014 9:00 AM comments (0)

Dr. TalamontiNational Doctors’ Day was established to honor physicians and the profound impact their work has on patients and the larger community. There are too many doctors at NorthShore worthy of recognition to honor each individually, so we extend our thanks and congratulations to each and every one for their individual achievements and the excellent care they always strive to provide.

We regularly hear from grateful patients, like Paul Upchurch, who want to find a way to honor their doctors. Paul developed a pancreatic tumor that required a highly complex surgery. After meeting with several doctors, he eventually found his way to Mark Talamonti, MD, Surgical Oncologist at NorthShore.

Today, Paul is doing well. This year, he honored Dr. Talamonti and the exceptional care he received with a donation to support the groundbreaking research being done at NorthShore. He shared his NorthShore patient story with us:

“Nearly two years ago, I discovered that I had a tumor on my pancreas that required a highly complex surgery and long recovery period. I knew I needed to get better to be able to take care of my family. I met with several doctors, but I knew Dr. Talamonti would be my surgeon during our very first meeting."

“Dr. Talamonti’s approach was to treat me as a whole person, not just a disease. Through his research, he was able to develop an individualized treatment plan based on my health history and the makeup of my tumor. The surgery was every bit as tough as Dr. Talamonti had said it would be. But my story ended happily. Today, I feel better than ever. I’m extremely grateful to Dr. Talamonti for his work and research in individualized medicine. I thank him for saving my life. I look forward to celebrating Dr. Talamonti for many Doctors’ Days to come.”

It’s patients like Paul who make the work of healers such as Dr. Talamonti possible. If you would like to make a gift of your own on Doctors' Day please click here. Your gift can support research or programs in a clinical area of your choice. If you have a NorthShore patient story to tell, email philanthropy@northshore.org.

Colon Cancer: Reducing Your Risk

Tuesday, March 25, 2014 12:46 PM comments (0)

Reducing riskThere 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.

Get up 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 here

Dispelling the Myths of the Colonoscopy

Thursday, March 20, 2014 3:24 PM comments (0)

colonoscopyColon cancer is the second leading cause of cancer death in the United States, claiming nearly 29,000 men and women each year. It is surpassed only by lung cancer. Colon cancer also happens to be one of the most preventable cancers. Studies have shown that a colonoscopy can reduce the risk of developing and dying from colorectal cancer by 90%. A colonscopy can enable a physician to identify and remove polyps before they even become malignant. 

David Labowitz, DO, MPH, Gastroenterology at NorthShore, addresses some of the damaging myths about colonoscopy that discourage many from getting this lifesaving procedure when they should:

Myth #1: The “prep work” is terrible.
You do have to empty your colon before a colonoscopy. This is the hardest part of the exam, but the most important.  I always tell patients that without a good prep, it’s like driving through fog—you cannot see where you are going.  However, the prep does not have to be a terrible experience. The day before the procedure, you should stop eating solid food and consume only clear liquids; however, you can have more than just water. Incorporating variety—tea, Jell-O, sports drinks and broth—into your 24-hour clear liquid diet will help make it more bearable.

The most common complaint is the volume of colonoscopy prep electrolyte solution that must be consumed to clear the bowels. To make this easier, we actually split the drinking of the prep into two different time periods (the evening before and a couple of hours before the procedure).  This not only is an easier way for patients to accomplish the prep, but has been shown in national studies to be a better way to prep for the procedure.  Think about the prep this way: the cleaner your colon, the faster and easier the procedure the next day. Unfortunately, if your colon isn’t clear because you have failed to drink the solution, polyps and lesions could go undetected or the results could be inconclusive. Further, the procedure may need to be repeated. It’s all about doing it right the first time.

Expert Tips! Make the Prep a Little Easier 

  • Drink it all at once, as quickly as possible through a straw
  • Refrigerate it so it's nearly ice cold
  • Suck on a piece of hard candy or chew a piece of gum immediately after drinking the solution
  • Mix the solution with something like Crystal Light

Myth #2: The procedure is painful.
A colonoscopy is a very tolerable procedure. Further, it does not take very long and most of the time is completed within 20-30 minutes. Before the procedure begins, you will be given a sedative to help you relax. In fact, most patients will sleep through the entire procedure and wake up not remembering any of it. Those who remain awake during the procedure report nothing more than slight cramping or pressure in the abdomen, similar to the feeling of having a bowel movement. 

Myth #3: It’s embarrassing.
Our NorthShore gastroenterologists perform over 35,000 GI procedures each year—the majority being colonoscopies—so they have a lot of experience making sure patients are as comfortable with the process as possible. Patients can also make an appointment with their gastroenterologist before the procedure to meet face to face and ask any questions that will help them feel more comfortable. 

Myth #4: There is a high risk of complications.
Complications during or after a colonoscopy are very rare. The bottom line is your risk of developing colon cancer is far higher than your risk of suffering a complication due to a colonoscopy. It is, however, important to schedule your colonoscopy with a physician who is certified to perform this procedure. 

Myth #5: Colonoscopies aren’t necessary for women.
Colorectal cancer affects men and women in nearly equal numbers. It’s not a man’s disease; therefore, screening colonoscopies are for everyone. Women need to schedule their first screening colonoscopy starting at age 50, just like men. More than 90% of colorectal cancer is diagnosed in people who are 50 or older. Those with a family history of the disease and other risk factors—a history of inflammatory bowel disease (IBD), history of polyps, type 2 diabetes, obesity and smoking—might need to start screening early and undergo screening more often. Ask your doctor when you should begin screening.

For more information on colonoscopies and to make an appointment, click here

Spring "Clean" Your Diet: Clean Eating Guidelines and Benefits [Infographic]

Thursday, March 20, 2014 9:14 AM comments (0)

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.

infographic image

Spring into Training with Fewer Injuries

Friday, March 14, 2014 11:44 AM comments (0)

runningSpring is on its way, which means athletes everywhere are emerging from hibernation and throwing on their running shoes. Before you join their ranks, follow along as Adam Bennett, MD, Sports Medicine at NorthShore, answers our sports-injury prevention questions, from what changes you should make to your diet if you’re in training, to what you should do if training starts to hurt:

If you experience pain while in training for an athletic event, what are your options?
The main issue is to determine the cause of the pain. If the cause is muscle soreness, then more rest between runs or training may help. Additionally, some strength training via yoga, Pilates or basic weight lifting may diminish soreness after a workout. If pain persists, seek medical care, which could include X-rays depending on the site and severity of the pain.

What causes shin splints and what is the best way to deal with them and still be able to exercise?
First order of business is to make sure that your shin splints are in fact, shin splints. Other causes of shin pain include muscle strains, stress fractures and tendinitis. "Shin splints" is a painful condition that occurs when the muscle attachments pull on the periosteum (a membrane that covers bones) of the tibia, which leads to inflammation and pain. If you do have shin splints, anti-inflammatory over-the-counter pain relievers, intense stretching, deep tissue massage, gait analysis, modifying the type of shoe you wear and rest days in your training program all may help diminish your symptoms. Formal physical therapy is an effective way to implement all of these strategies.

Are sports and recovery drinks after a workout or training better than simply drinking water? Do they aid recovery?Sports drinks contain glucose and electrolytes, which need to be replenished after sweating during training or exercise. Sports drinks are probably not essential for exercise lasting 20 minutes or less. For exercise lasting longer than 20 minutes, research shows improved performance when utilizing fluids that contain glucose and electrolytes. Research also indicates that ingesting carbohydrates and protein within 10 minutes of an intense workout improves recovery. I don’t have brand recommendations but I believe it’s a good idea to replenish with a drink that uses natural flavors and sweeteners and avoids ingredients like high fructose corn syrup. Certainly anything with caffeine, which might dehydrate the athlete, is a bad idea. Please tell your kids not to drink soda pop after exercise.

Is it better to consume protein drinks or food sources of protein after a workout for muscle recovery?
I would guess they are about equivalent. The advantage of a drink is that you replenish fluids as well.

If you have an injury in your arms or wrists, such as tendonitis, what exercises could you do to increase strength without causing further injury? 
This is a tough scenario but there are things you can do. Specifically putting resistance in your mid-forearm and keeping your hands and wrists relaxed can allow you to work out the major muscles of your upper body without irritating the tendons in your wrists. If you’re having trouble figuring out how to pull this off try working with a personal trainer a couple of times and have him or her show you.

For those training for a marathon, half marathon or triathlon, do you have any diet and training recommendations?
My first recommendation is to consider implementing rest days as part of your training. I often suggest athletes work longer and more intensely one day and then allow for complete rest the next day. If that is too much rest, consider a two-days-on, one-day-off schedule. Rest days allow for replenishment of glycogen stores in the muscle cells and fluid losses to be replaced adequately. As a result, athletes typically feel better on workout days and can push themselves even harder, which ultimately leads to a better performance on race day.

In terms of a daily diet, avoiding fried foods, caffeine and alcohol is likely to bring benefit. If you sweat a lot, you may need to add salty foods to your diet. This is especially important if you cramp easily.

For those not in training but who still want a great workout, what would you recommend?
High-intensity interval training is likely the most effective way to improve overall fitness. For my patients who are frustrated with their ability to lose weight, I often suggest they incorporate high-intensity interval training into their workout routine. Crossfit is a popular example, which works for some, but there are many ways to do this type of training. 

If you are concerned about the risk of injury during strength training as an older athlete, what should you do? Are lighter weights with more reps better? Or, should you increase weight and reduce reps?
Most people don't realize the importance of resistance training to overall health. My only concern about injury is if you had arthritis in any of your upper extremity joints (shoulder, elbow, wrists). If you do have arthritis in these joints, then lighter weights would be preferred. If you continue to lift to the point your muscles become sore the next day, it is unlikely you will lose significant muscle mass. My only suggestion is to vary the weight, repetition or motion of your regimen so your body won’t adapt as easily. This will ensure maximum benefit from every session. 

For more information on keeping your young athletes healthy, join us on Thursday, March 20th from 7:00-8:30 p.m. for a Sports Medicine Symposium at Highland Park High School. We invite you to join us for a discussion on how to keep young athletes in optimum health and prevent injuries. For more information, call Matt Castle at 224-765-2090. 

 

It’s Nap Time

Friday, March 07, 2014 11:22 AM comments (0)

nappingA lack of sleep can leave you feeling groggy and foggy all day, impairing your ability to focus on work and even retain information. That’s not all; lack of sleep also decreases libido, ages skin and can inhibit your ability to lose weight. Chronic sleep deprivation—regularly forgoing the recommended 7 to 8 hours or due to other sleep disorders—can have serious consequences on your health, including increased risk for heart disease, heart attack, stroke, high blood pressure, diabetes and depression. In other words, maintaining good sleep habits is an essential part of a healthy lifestyle. And, unfortunately, most of us aren't doing that. 

If done correctly, there is great power in a well-timed nap. While you should not rely on naps to repair the damage done by inadequate sleep or chronic sleep deprivation, naps can recharge your energy levels and improve your mood. The key is to time them just right. Short naps are preferable. Longer naps may be taken on occasion to make up for an occasional lapse in sleep schedule.

Thomas Freedom, MD, Neurologist and Program Director of Sleep Medicine at NorthShore, breaks down nap time to help you achieve maximum benefits from a little daytime shuteye:

10 to 20 minutes. Often called the “power nap,” this short rest period is a great way to recharge your personal energy battery, boosting alertness and increasing your midday focus. Keep your power naps to 10 to 20 minutes because you’ll stay in lighter stages of non-rapid eye movement (NREM), which means you won’t wake up feeling groggy and can get right back to work feeling refreshed. Also try to take the nap early in the afternoon.

30 minutes or more. Word of warning: Naps longer than 20 minutes could leave you with sleep inertia, or grogginess that can last up to 30 minutes after waking. If you need to be back on your feet right away, keep your nap to less than 20 minutes. Otherwise, after the fog wears off, you’ll enjoy the same restorative benefits of the power nap.

60 minutes. If you find yourself forgetting information halfway through your day, 60 minutes of shuteye might be able to help. A nap between 30 and 60 minutes will get you to slow-wave sleep, which can help improve your decision-making skills and recollection of information. You’ll need to give yourself a little recovery time after an hour nap, as the effects of sleep inertia could be more pronounced. There is a possibility that a nap of this length could also disrupt your sleep at night.

90 minutes. A 90-minute nap gives you a full sleep cycle—from the lighter stages of sleep all the way to REM (rapid eye movement). A nap of 60 to 90 minutes can improve decision-making skills and even enhance creativity. At this length, make sure to nap with care. You don’t want to disrupt your regular sleep schedule or keep yourself up at night by napping too long during the day. Sleep inertia may also be more of an issue.

Do you take day-time naps to boost your energy levels?

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