Youth Sports: Staying Active and Injury-Free

Friday, September 13, 2013 3:53 PM comments (0)

youth sportsPracticing multiple days during the week. Competing in tournaments on the weekend. Participating in rigorous training camps and leagues in the off-season. Playing the same or multiple sports year round. Does this resemble your child’s sports schedule?

Youth sports are becoming more competitive at younger ages, often requiring participation beyond the normal season to make the cut and see more starting time during games. As the pressure to participate increases and youth sports become more “professional,” your child’s risk for injury increases too. Sports are a great way to keep your child involved and active, but year-round practices for the same sport can lead to some health concerns as well, including stress fractures, ligament tears and musculoskeletal issues.  

Eric Chehab, MD, a NorthShore affiliated orthopaedic surgeon, offers some tips to help keep your kids active and injury-free:

  • Encourage participation in multiple sports. Not only will this prevent your child from overexerting the same muscle groups, it will also help develop different skills. A young athlete’s agility on the tennis court could be the key to helping him block the winning shot in the soccer net.  If your child does participate in multiple sports, try to ensure that he or she isn’t overlapping them in a season or throughout the week.
  • Limit your child to one committed sport per season. With more sports vying for year-round commitment, your child may be participating in multiple sports or leagues simultaneously.  If sport requires a great deal of practice time, this puts your child at increased risk for serious injury.  Here’s a useful rule of thumb to help prevent injury: “One sport per season and one league per sport.” 
  • Take one day off every week. Between all of the practices and games, it’s important for your child to have at least one day of rest each week.  A day off gives the body a chance to heal and recover.  You should also encourage your child to take one month off from sports and practices each year, especially if he or she is deeply involved in one or more sports. 
  • Ensure there is proper equipment and field conditions. Though this may appear obvious, much of the equipment used in recreational sports and travel leagues had been used previously and could be worn or defective.  This could expose your child to unnecessary risk. Field conditions are also important because a compromised field puts your child at risk for significant lower and upper extremity injuries.
  • Check in with the coach. The ability to teach safe technique is critical, particularly in contact sports like football and hockey.  Get to know your child’s coach and make sure he or she knows the rules of the game and how to play safety and prevent serious injury.

For additional information about sports injuries, including sports-specific tip sheets, visit the Stop Sports Injuries website: http://www.stopsportsinjuries.org 

What do you to keep your kids active?  How do you make sure they aren’t overdoing it?

Suicide Prevention: Identifying Risk Factors and Noticing the Warning Signs

Thursday, September 12, 2013 1:39 PM comments (0)

suicideAccording to the Centers for Disease Control, suicide was the 10th leading cause of the death in the U.S. in 2009. That year there were 37,000 suicides, with one million reported attempted suicides. In the same year, suicide was the third leading cause of death for young people between the ages of 15 and 24.

Suicide is a major health issue but it’s also a potentially preventable one. While there are several risk factors for suicide, any person who expresses suicidal thoughts or the intent to commit suicide should be taken seriously.  Risk factors for suicide include:

  1. Prior suicide attempts
  2. History and family history of mental disorders
  3. History and family history of substance abuse
  4. History of physical violence and sexual abuse
  5. Chronic illness and/or chronic pain
  6. Exposure to the suicidal behavior of family and friends

Knowing and acting on the signs of suicide exhibited by others could save thousands of lives each year. If someone appears depressed and/or expresses suicidal thoughts, it's important to listen closely and take that person seriously. It's especially important to be concerned if someone exhibits any of these signs and has also attempted suicide in the past, as most successful suicides were preceded by one or more attempts. 

Benjamin Shain, MD, PhD, Psychiatry at NorthShore, shares some of the warning signs of suicide and discusses what you can do to help a person who might be contemplating suicide:

  • Risk-taking behavior. Those who are contemplating suicide might “tempt fate” by taking risks that could lead to death, such as driving at dangerous speeds. 
  • Losing interest in previously important activities and friends. Unexplained loss of interest in things like sports, work and volunteer activities might also be combined with a withdrawal from interactions with friends and self-imposed isolation.
  • Researching methods of suicide. Searching suicide online or buying anything that could be used to commit suicide is an important sign to watch for.
  • Talking about death and hopelessness. Conversations and discussions might center on death and wanting to die or on feelings of hopelessness and lacking reasons to live. Potentially suicidal people might also talk about being a burden to family and friends or experiencing unendurable pain.
  • Extreme shifts in mood. Periods of deep depression could be punctuated by feelings of elation, happiness or rage.
  • Increased substance abuse. A history of substance abuse is a risk factor for suicide but increased use could be a warning sign of suicidal thoughts.
  • Noticeable changes in sleep patterns. This could either be exhibited as sleeping too much or suffering from insomnia. 
  • Giving away possessions. Suddenly giving away multiple items that seemed important to the person in the past.

What should you do if you notice these behaviors in a friend or family member?

First, discuss your observations or concerns with the person and/or other friends or family members. Make sure to listen to the person’s concerns and what might be stressful for them. It's essential to urge the person to speak to their primary care physician and/or a mental health professional. If you believe they are an immediate risk to themselves, call 911. 

How to Make the Most of Your Annual Visit

Friday, September 06, 2013 2:22 PM comments (0)

annual visit“How are you feeling?” is probably one of the first questions your doctor will ask during your annual visit. If you haven’t needed to see your doctor between physicals, your answer will most likely be, “Fine.” It won't be until later that you remember all the miscellaneous symptoms, heath issues, and aches and pains from the last year. 

Don’t miss another opportunity to maximize your time with your doctor. By planning and preparing beforehand, you ensure that you’ll remember to ask the correct questions during the limited time you have with your primary care physician.  

Curtis Mann, MD, Family Medicine at NorthShore, offers some tips on how to make the most of your time with your doctor:

  • Make a list of symptoms. Prepare a list of the aches, pains, symptoms and changes in your health that might have caused concern at some point between your annual visits. Prioritize your list of symptoms so that you can be sure to address those that are the most concerning. You might not be able to go over everything at your annual visit but you’ll be able to touch on everything during future visits. 
  • Have a list of important questions prepared. When pressed for time, questions that were high priority might get lost in the shuffle. Prepare a list of questions you want answered in advance and use it to jog your memory during your appointment.
  • Make another list of prescriptions and medications. Your list should include everything, from prescriptions to vitamins and supplements. You want to ensure you are giving your doctor your full health story. 
  • Come prepared to answer your doctor’s questions. This isn’t your first visit to a doctor, so come prepared to answer the basic topics: family health history, health concerns, etc. This will leave you more time to ask any specific questions you might have. 
  • Dress for the occasion. You might not have much face-to-face time with your doctor, so don’t wear clothing that requires lots of time to get on and off. To save even more time, ask to change into a gown before your doctor enters the room.
  • Write down what your doctor tells you. You’ll probably cover a lot of ground in very little time. Your doctor will write your prescriptions but lifestyle recommendations might be told to you. Write down recommendations your doctor makes so you can remember to follow them in the year between visits. 
  • Ask about a follow-up visit. If there are issues you have not addressed during your annual exam, ask your doctor about a follow-up visit before leaving the office.
  • Review printed materials after your visit. Don’t wait to read the materials your doctor provides, whether they are printed for you or provided through NorthShoreConnect. Are the medications listed correctly? Are your listed health issues up to date? This is where the teamwork between physician and patient can maximize healthcare outcomes.

Do you have a yearly physical? How do you make the most of your annual visit?

Kidney Stones: Risk, Treatment and Prevention

Wednesday, September 04, 2013 2:30 PM comments (0)

Kidney stones can cause pain that ranges from mild to excruciating; however, stones typically do not cause symptoms until they move from the kidney into the ureter (the tube that connects the kidney to the bladder). So how do they form? Kidney stones develop when urine consists of more crystal-forming substances than the urine can dilute. Often there is no single definitive cause of kidney stones but there are factors that increase one’s risk for developing them. Determining the type of kidney stone can be helpful in determining its cause and preventing recurrence.
kidney stones
Main kidney stone types:

  1. Calcium stones. The majority of kidney stones are calcium stones, most often calcium oxalate. Oxalate is found in food, including nuts, some fruits and vegetables, and chocolate.
  2. Struvite stones. This type of stone is associated with urinary tract infections (UTIs). They are composed of magnesium and phosphate.
  3. Uric acid stones. These are the second most common type of stones. Risk factors include diabetes, obesity, hypertension, gout and a high-protein diet.
  4. Cystine stones. These stones form in patients with a rare hereditary disorder called cystinuria.

Amanda Macejko, MD, Urologist at NorthShore’s Jon and Carol Water Center for Urological Health, answered several questions about kidney stones, including hereditary risk factors, and how best to treat and prevent recurrence:

If there is a family history of kidney stones, are you at an increased risk for developing them at some point?
Stones can certainly have a hereditary component. So, yes, if there is a family history one could be prone to developing stones. One of the best things you can do to decrease your risk is to make sure you drink plenty of water (2.5-3 liters of water daily).

Is there a particular group of people who are at higher risk of developing kidney stones?
Peak incidences of stones occur in people between the ages of 30-60. Caucasians and people who live in warm, dry climates are at higher risk of developing stones. Additionally, people with higher body mass index (BMI) are also at increased risk.

Aside from drinking a lot of water, what other preventative measures can be taken to avoid recurrence of kidney stones?
The stone prevention diet includes: limiting salt intake, avoiding foods high in oxalates and limiting consumption of animal protein. Salt intake increases calcium in the urine so we recommend avoiding canned, processed and fast foods which contain a lot of sodium.

For people with calcium oxalate stones, foods high in oxalate should be avoided, which includes tea, spinach, nuts, and, I’m sorry to say, chocolate. Animal protein, including red meat, chicken, fish, should also be limited. It is important to note that calcium restriction is not recommended.

I've had multiple stones over the years, do I need further tests?
For someone with multiple stones or a strong family history of stones , I highly recommend a metabolic work up. This involves blood work and a 24-hour urine collection (48 hours the first time). This helps your physician figure out what your specific risk factors are for stone formation, as well as look for possible underlying medical conditions. We perform this service in the Stone Clinic which is staffed by myself, Dr. Park (urology) and Dr. Sprague (nephrology).

Can kidney stones cause renal failure?
Nonobstructing stones in general should not cause renal (kidney) failure; however, untreated obstructing stones may eventually cause renal impairment.

Should you always go to the hospital for kidney stones?
This is really important. If your pain is tolerable with pain medication, whether over the counter or prescription, then you can probably follow up with your primary care doctor or urologist in the office to work out a plan. However, if your pain is not well controlled or you have significant nausea/vomiting, you will need to go to the emergency room. Typically they will be able to control your pain and/or nausea and you can return home. Most importantly, if you have fever (higher than 100.5˚ F.) or shaking chills, you need to go to the emergency room immediately. An obstructing stone associated with an infection is very serious and can be life-threatening.

If someone has a kidney stone but would rather attempt to pass it at home, what can he or she do to ease the pain from home?
Most patients take some form of pain medication whether it be over the counter or a prescribed narcotic while they are passing a stone. Additionally, we often prescribe an alpha-blocker. These are the same medications used to increase the flow of urine through an enlarged prostate. These medications have been shown to help relax the ureters and increase the rate of stone passage.

What can be done for larger stones that cannot be passed on their own?
Kidney and ureteral stones that are too large to pass often require treatment. Common outpatient treatments include shock wave lithotripsy or ureteroscopy. Shock wave lithotripsy is a procedure performed under anesthesia in which we break the stone using sound waves. After the procedure you then pass the fragments. In ureteroscopy, a small scope is passed through the urethra and bladder and into the ureter. The stone is broken up with a laser fiber and the fragments are subsequently removed with a tiny basket.

Have you ever had a kidney stone? What do you do to prevent them?

 

The Skinny on Food Portion Sizes: Portion Control Tips to Prevent Weight Gain [Infographic]

Thursday, August 29, 2013 9:00 AM comments (0)

Over the last 40 years, food portion sizes have grown substantially in the U.S. And since larger portions mean higher calorie counts, Americans have been steadily increasing in size as well. With obesity rates at an all time high, portion control should become a primary consideration when attempting to lose weight in a healthy way.

The experts at NorthShore University HealthSystem have created an infographic that puts food portion sizes into perspective. How much have portion sizes increased over the years? What does a real serving size look like? How can you avoid overeating at mealtimes?  Let our latest infographic with portion control tips help you avoid weight gain and maintain a properly portioned diet! Click on the image below for the full infographic

To embed this infographic on your website, find the embed code here.

What’s Wrong with Gluten? Celiac Disease Signs and Symptoms

Tuesday, August 27, 2013 4:32 PM comments (0)

celiac diseaseWhat’s wrong with gluten? There’s nothing wrong with it—unless you happen to be one of the two million men and women in the U.S. who suffer from celiac disease.

Gluten is a protein found in wheat, barley and rye.  People who suffer from celiac disease are unable to eat gluten because it causes an inflammatory reaction in their small intestines. This inflammation can cause damage to the lining of the small intestine and prevent the body’s absorption of nutrients and vitamins. If left unchecked, this intestinal damage can cause weight loss, bloating and diarrhea. The body is then deprived of important nutrients, which can damage organs including the heart, bones, kidney and brain. 

There is no cure for celiac disease but eliminating gluten from your diet can reduce symptoms and give your intestines an opportunity to heal. Signs and symptoms of celiac disease vary from patient to patient. They range from more typical symptoms like diarrhea, weight loss and bloating to essentially no symptoms at all. It’s important to discuss any of the following signs, symptoms or issues with your doctor because 70% of patients who have celiac disease go undiagnosed.

How do you know if you have celiac disease? David Labowitz, DO, MPH, Gastroenterology at NorthShore, shares some of the signs and symptoms of celiac disease: 

  • Diarrhea, abdominal bloating and weight loss. These are the most common symptoms of celiac disease.
  • Constipation and obesity. While somewhat counterintuitive, it’s important to know that not all patients will exhibit the typical symptoms. Some with celiac disease might suffer diarrhea and weight loss while others have the opposite. 
  • Anemia. Damage to the small intestines might inhibit the absorption of iron, a major component of the body’s red blood cells.
  • Headaches and numbness/tingling of extremities (neuropathy). Some patients exhibit these neurological symptoms.  
  • Acid reflux and heartburn. Celiac disease patients have significantly higher rates of gastroesophageal reflux disease (GERD). Up to 30% of celiac patient have reflux symptoms. 
  • Dermatitis herpetiformis. This is an itchy, blistering rash that appears most frequently on the arms, knees, trunk and head.  
  • Joint pain/arthritis. The most common locations for joint pain seem to be the knees, back, hips, wrists and shoulders.
  • Dental enamel defects and bone disorders (i.e. osteoporosis). Due to the poor absorption of calcium and vitamin D, patients might develop issues with their dental enamel and thinning of the bones. 
  • Elevated liver enzymes. This can be a common finding for celiac patients. An improvement is often noted in the in the abnormal liver numbers when patients are on a gluten-free diet. 
  • Infertility. In research studies, approximately 4-8% of patients with unexplained infertility have been found to have undiagnosed cases of celiac disease.

Do you have celiac disease? If so, what were your symptoms? How difficult was it for you to remove gluten from your diet?

What’s Triggering Your Headaches?

Friday, August 23, 2013 12:00 PM comments (0)

headachesHeadaches can be more than just a pain, interrupting your day-to-day life and making it difficult to concentrate on even the simplest tasks. The key to finding your way through the pain could be determining its type and trigger. 

There are many types of headaches and they vary in severity from person to person and type to type:

  1. Tension. Sometimes referred to as an “everyday” headache, they are the most common type and usually manifest as a constant ache around the head, at the temples or the back of the neck.
  2. Cluster. These are recurring headaches that come in cycles. They begin suddenly, and can be severe and often debilitating.
  3. Migraine. Migraines are severe headaches that can last between 4 and 72 hours. The pain is often exhibited on one side of the head. Migraine sufferers report sensitivity to light and sound, and often nausea and/or vomiting. 

What could be triggering your headaches? Steven Meyers, MD, Neurologist and Head of the Headache Program at NorthShore, discusses some common headache triggers:

  • Hormone level fluctuations. This most often occurs for women during menstruation. During menstruation, hormone levels can increase and drop dramatically, causing headache and migraine.
  • Sleep. When and how long you sleep can be very important. Disruption to your sleep pattern, irregular hours, too little or too much sleep can all cause headaches. Avoid changes in your sleep pattern when possible, and this includes oversleeping on the weekends.
  • Diet. Common foods, drinks and additives can cause headache pain. To determine your food sensitivities, keep a diary of your headaches and what you eat. By eliminating the food, you could decrease the frequency and severity of your headaches. If you suffer migraines, keep alcohol consumption to a minimum.
  • Caffeine. Small amounts of caffeine can help when you have a headache but frequent and excessive consumption can cause and even worsen headaches.
  • Stress. Stress levels can make a big impact on your health. Reducing stress levels can reduce the frequency and severity of headaches. Try exercise, stretching and relaxation techniques like meditation. 
  • Weather. Headaches can be triggered by changes in weather patterns in some particularly sensitive people. There is not much that can be done when it comes to weather but anticipating these changes and taking preventative measures could help.

Do you suffer from headaches? Do you know your headache triggers?

Short on Time? Tips to Get the Most Out of Your Workouts

Tuesday, August 20, 2013 5:01 PM comments (0)

exerciseSchedules fill up quickly, days are busy and sometimes it feels like there are just not enough hours in the day to accomplish everything on our to-do lists. And, unfortunately, it’s often our exercise regimens that are the first to fall by the wayside. But don’t give up! Regular exercise is one of the most important things you can do for your health and well-being. 

Thomas Hudgins, MD, Physical Medicine & Rehabilitation at NorthShore, shares some effective ways to maximize the time you have for exercise: 

  • Incorporate interval training into your cardio workout. Shift between periods of high intensity to low intensity to rev up your workout. The frequent change in resting heart rate will boost your metabolism and the toggling between intensities will increase your endurance.
  • Include exercise throughout the day. The American College of Sports Medicine recommends 20-30 minutes of aerobic exercise a day. You can work this into your daily routine by taking the stairs or parking at the farthest point from your destination in a parking lot.
  • Divide your workout equally between cardio and strength training. You’ll burn lots of calories but also improve your strength. Building muscle helps boost stamina for endurance sports and revs up your metabolism. Strength training also improves bone density, range of motion, and stability and balance. It’s a great exercise to explore now and as you age. 
  • Do full body exercises. If you are short on time focus on exercises that target your largest muscle groups, like squats, plank rows and lunges. Lunges can be conducted in all planes, meaning forward, backward, sideways and diagonal. Include weights with these exercises to get even more bang for your minutes. These exercises also work multiple muscle groups and are a safe, efficient way to build more muscle. 
  • Stretch thoroughly. Stretching after a workout, and sometimes even the next morning, will help reduce soreness and risk of injury. Don’t put your exercise at risk; injury could derail the healthy routine you’ve worked so hard to develop.
  • Work your core. Core stability and strength is important for any activity or sport. Planks will contract your abdominal, back and buttock muscles at the same time. It's easy to pull double duty too because core exercises can be conducted while you're watching TV or reading a book.

What is your go-to workout plan when you’re short on time?

Get Your Head in the Game: Concussion Fact vs. Fiction

Thursday, August 15, 2013 4:29 PM comments (0)

concussionPlaying a sport, whether contact or not, puts you at increased risk for injury. This includes many of the activities and sports kids and teens participate in during or after school. With any injury, especially head injuries, it’s important to know the difference between fact and fiction.   

Elizabeth Pieroth, PsyD, ABPP, the Associate Director of NorthShore University HealthSystem’s Sports Concussion Program, helps distinguish the facts from the fictions when it comes to concussion:

  • Fiction: You need to be “knocked out” to have a concussion.
    Fact: The majority of concussion episodes do not leave someone unconscious. In fact, only about one in every 10 concussions result in loss of consciousness.  
  • Fiction: Men suffer from concussions more than women.
    Fact: Women are just as prone to concussion as men. Some of the highest rates of concussions occur in women who play soccer, basketball or do cheerleading.  
  • Fiction: If you’re feeling fine, you probably don’t have a concussion and can continue to play.
    Fact: If you suspect that you or someone on your team has suffered a concussion, it’s important to stop play immediately. Symptoms don’t always surface right away, and it’s best to get examined by a trainer or team/family physician before going back to the game.
  • Fiction: The use of helmets and mouth guards can prevent and reduce your risk of concussion.
    Fact: While wearing a helmet can protect the head from fracture, it doesn’t guarantee reduced instances of concussion. As for mouth guards, there isn’t sufficient evidence to support the claim that head injuries can be reduced. Safety equipment in any sport is important, even if it doesn’t always protect from concussions.
  • Fiction: If someone has a concussion, they must avoid any and all stimulation until they are symptom-free.
    Fact: Most newly concussed patients will feel better if they avoid loud noises, bright lights and busy environments. However, there is no scientific evidence to support prolonged avoidance of stimulation. In fact, it may be counterproductive. It is more important to examine what triggers a person’s symptoms to better manage their environment.  
  • Fiction: It takes months to recover from a concussion.
    Fact: Most people who suffer a concussion recover in 1-2 weeks, although some have symptoms that persist. There are, however, treatments to treat lingering symptoms.

Have you ever suffered a concussion? 

Am I Allergic? Common Food Allergies

Friday, August 09, 2013 10:00 AM comments (0)

food allergies

Food allergy is a reaction by the immune system that occurs quickly after eating a food. Symptoms occur with ingestion of even a tiny amount of a food and can range from rash or mild itching of the mouth and tongue to life-threatening and life-ending reactions. Many people who think they have a food allergy actually have food intolerance. Food allergy is estimated to affect six to eight percent of children under five, and three to four percent of adults. 

Intolerances to food will affect most people at some point in their lives. For example, lactose intolerance occurs when your body can’t break down milk sugar leading to bloating, cramping and diarrhea. While food intolerances can be uncomfortable they are less serious than food allergy and are not life-threatening. 

Common food allergies for adults:

  • Shellfish--shrimp, crab, lobster
  • Peanuts and tree nuts--walnuts, pecans, cashews, pistachios, almonds

Common food allergies in children:

  • Eggs
  • Milk
  • Peanuts and tree nuts
  • Wheat
  • Soy
  • Fish and shellfish

How do you determine if you have a food allergy to a specific food? Understanding the symptoms of an allergic reaction is important. In allergic reactions, symptoms develop within seconds to a few hours of ingesting the food. Symptoms occur each time you ingest the food allergen. In fact, 85% of food allergic reactions occur have ingesting the same eight foods: milk, egg, wheat, soy, peanut/tree nuts, fish and shellfish. Symptoms can range from mild to severe—itching in the mouth; hives or eczema; swelling lips, face or tongue; trouble breathing; diarrhea, vomiting and abdominal pain; dizziness and fainting are all symptoms of allergic reactions. Anaphylaxis is a severe, life-threatening allergic reaction to foods. 

Rachel Story, MD, Allergist at NorthShore, highlights some approaches your physician might take to determine if you suffer from a more mild food allergy and what might be triggering your reactions:

  • History. A thorough history of reactions and the foods ingested in 2-3 hours prior to the reaction is important in diagnosis of food allergy.
  • Food diary. Your physician might ask you to start keeping a food diary for a period of time. Your diary will track what you eat, when you eat it and how you feel after eating certain foods.
  • Skin test. In a skin test, purified extracts of the suspected food will be placed on your back or arm and then the skin will be pricked with a skin-testing device to allow a small amount of the food to penetrate your skin. If you react with a raised bump you may have an allergy to that food. 
  • Blood tests. Blood tests can be performed to see if you have allergic antibodies to specific foods in your blood. These are often used with a skin test to identify food allergies.  

Food allergy can cause a severe reaction called anaphylaxis.  Symptoms of anaphylaxis include swelling of the airways with throat closing or difficulty breathing, a drop in blood pressure, rapid pulse and fainting. This type of reaction must be treated immediately as it could result in death. All people with suspected food allergy should be evaluated by a physician as they may need to carry medications to treat accidental ingestions of food allergens. Over-the-counter antihistamines such as diphenhydramine (Benadryl) and cetrizine (Zyrtec) are used to treat mild reactions. Severe reactions are treated with an injection of epinephrine that can be administered using an epinephrine autoinjector (EpiPen, AuviQ).

There are currently no FDA-approved treatments for food allergy. However, much promising research is ongoing and there is hope for a treatment for food allergy in the next 5 to 10 years. 

Are you allergic to a food? How did you discover your food allergy?

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