Bariatric Surgery: Is It Right for You?

Wednesday, May 01, 2013 2:38 PM comments (0)

weight lossObesity is a condition that affects nearly one third of men and women in the United States, and its risk factors can cause severe and often life-threatening illnesses, such as diabetes, heart disease, stroke and an increased risk for developing breast, prostate and colon cancers.  While a healthy diet and consistent exercise routine are the best ways to stay fit, that combination might not be enough for everyone to maintain a healthy weight.

For those who struggle with severe weight loss problems, bariatric surgery, or weight loss surgery, can offer life-changing solutions. The procedures that fall under the category of bariatric surgery reduce the size of the stomach in various ways, restricting the amount of food patients can eat and increasing their ability to lose weight rapidly.

These procedures include:

  • Gastric Bypass—the most common bariatric procedure where the smaller, upper portion of the stomach is stapled, separating it from the rest of the stomach.
  • Gastric Banding, or Lap-Band—a silicone rubber band is used to separate the top of the stomach from the bottom of the stomach.
  • Gastric Sleeve, or Vertical Sleeve Gastrectomy —85% of the stomach is laparoscopically removed, leaving a smaller, sleeve-shaped portion.

Woody Denham, MD, bariatric surgeon at NorthShore, shares some of the basic criteria one must meet for weight loss surgery:

  1. Your BMI (body mass index) is higher than 40. A BMI of over 40 is the equivalent of being 100 pounds overweight for men and 80 pounds overweight for women. Those with BMIs between 35 and 39 might also be good candidates.
  2. You have an obesity-related illness. Obesity-related illnesses and health problems include: diabetes, high blood pressure, high cholesterol and sleep apnea.  Almost 90% of those newly diagnosed with diabetes are also overweight or obese. Patients who underwent bariatric surgery for their diabetes have often achieved complete remission of the disease.
  3. Your attempts to lose weight have been repeatedly unsuccessful. Your physician will review your weight losses and gains, and eating and exercise habits, to determine if you have exhausted more traditional weight loss strategies. This will also help your physician determine if there is another medical condition preventing weight loss.

As with any surgery, it is important to discuss what treatment options would be best for you with your physician. The weight loss journey doesn’t end with surgery. Losing weight will still require basic lifestyle changes, including diet and exercise.

To learn more about bariatric surgery and to determine if you’d be a good candidate, attend one of NorthShore’s Bariatric Information Sessions. This free session is offered the 3rd Tuesday of every month from 6-7p.m. at 501 Skokie Blvd. in Northbrook.

What do you do control your weight? Have you had weight loss surgery?

Parkinson's Disease: Symptoms and Progression

Thursday, April 25, 2013 11:32 AM comments (0)

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.

by Demetrius Maraganore, MD, and Ashvini Premkumar, MD

symptomsIs it possible to detect PD before symptoms begin?

There is no established method of detecting Parkinson’s disease before symptoms begin.  Because patients with Parkinson’s disease may lose their sense of smell decades before the onset of their movement disorder, some investigators have explored the use of smell testing as a method of detecting Parkinson’s disease in at-risk subjects (e.g., persons who carry a rare gene mutation known to cause Parkinson’s disease). Persons can lose their sense of smell for many unrelated reasons though (e.g., following an upper respiratory infection, head trauma, or if they smoke). Loss of smell can precede other brain degenerations such as Alzheimer’s disease, so smell testing lacks the specificity needed for a predictive test.

A more promising approach is brain imaging using a radiopharmaceutical called DATSCAN. This is a compound that is injected into a vein and that binds to the endings of dopamine nerve cells in the brain. In Parkinson’s disease, dopamine nerve cells degenerate; hence, there is less binding of DATSCAN. The uptake and binding of DATSCAN can be measured using a single photon emission computerized tomogram or “SPECT” camera.  We are currently conducting a study at NorthShore to determine if persons with mild to moderate traumatic brain injury, who are at an 11-fold increased risk for Parkinson’s disease, have lower DATSCAN binding than persons without a history of brain injury. This study would demonstrate that it’s possible to detect Parkinson’s disease in at-risk subjects before symptoms begin. 

DATSCAN could prove useful as a method to develop asymptomatic Parkinson’s disease in at-risk subjects who could then be prescribed treatments or lifestyle changes that might delay or possibly even prevent the onset of Parkinson’s disease symptoms.  My research associate Dr. Ying Wu is also exploring the use of automated MRI brain measurements in the same brain injury population to see whether MRI may prove effective in detecting preclinical Parkinson’s disease changes in at-risk subjects.

Are PD symptoms or outcomes different between men and women? Between races?

My research collaborators and I have conducted several studies of gender differences in Parkinson’s disease. At every age men are 1.5 times more likely to develop Parkinson’s disease than women. We observed no convincing difference in survival for men and women with Parkinson’s disease. While there was no difference in motor outcomes, we observed that the risk for dementia was greater in men than in women with Parkinson’s disease. It's possible that estrogen protects against dementia in women.

My collaborators and I observed no important differences in the rates of Parkinson’s disease worldwide, and I’m not aware of any convincing data to suggest that symptoms of Parkinson’s disease or its outcomes differ according to race or ethnicity.

What are some of the later complications of Parkinson’s disease?

Typically we associate Parkinson’s disease with movement disorders. As the disease progresses, patients may develop balance difficulties that result in falls. As a result, patients become increasingly dependent on assistance in walking. For example, they may need a cane or a walker or someone to walk with them.  As the movement disorder progresses more, patients may be entirely unable to stand or walk even with assistance

Parkinson’s disease is not just a movement disorder though. About one in three patients develop a significant decline in memory and mental faculties, or what we call dementia.  Both falls and dementia are dreaded late complications of Parkinson’s disease because they are resistant to medical or surgical treatments and because they carry an increased risk for nursing home placement and even death. Predicting falls and dementia as late complications of Parkinson’s disease is a research priority of the Department of Neurology at NorthShore and a current focus of my research.

Is there a way to slow or halt the progression of PD?

There is no proven method of slowing or halting the progression of Parkinson's disease. Treatments that have been studied and that failed to provide evidence of neuroprotection are: selegiline, vitamins E and C, pramipexole, ropinerole, and COQ10.  There is some statistical evidence that carbidopa/levodopa therapy may slow motor progression in Parkinson's disease, but the benefits are trivial.

Azilect is being promoted as a neuroprotective agent, but it’s dubious because the beneficial effects were observed at smaller and not higher doses. The drug is also very expensive and prone to multiple drug-diet and drug-drug interactions. At best, the benefits are nominal. A recent medical advisory panel to the FDA voted 17 to 0 that Azilect should not be approved as a neuroprotective therapy in Parkinson's disease.

Inosine dietary supplementation, to increase blood uric acid levels, may be neuroprotective; however, it may also increase the risk for heart disease, stroke or dementia. There is some evidence that vitamin D deficiency is a risk factor for Parkinson's disease; however, there are no clinical trials to suggest that vitamin D therapy slows the progression of Parkinson's disease. Similarly, observational studies have suggested that non-steroidal anti-inflammatory drugs (NSAIDs) or cholesterol lowering medications (statins) are associated with a reduced risk for Parkinson’s disease, but clinical trials evidence of neuroprotection is lacking. There are some early clinical trials of the calcium channel blocker isradipine, which may have neuroprotective effects in animal models of Parkinson's disease. Though, the animal models of Parkinson's disease are not always informative, and some calcium channel blockers can actually cause reversible parkinsonism.

One big hope on the near horizon is therapies targeting the alpha-synuclein protein in Parkinson's disease, including a vaccine that is in early phase clinical trials.  However, while genetic studies have indicated that alpha-synuclein is neurotoxic prior to the onset of Parkinson’s disease symptoms, my research team recently provided genetic evidence that alpha-synuclein may be neuroprotective late in the disease process. So it’s unclear if therapies targeting alpha-synuclein in Parkinson’s disease will be effective and safe. 

Recent studies have suggested that exercise might slow the progression of Parkinson’s disease. Apart from exercise, I have no recommendations regarding neuroprotection at this time.

Once dementia starts is there anything that can be done to reduce the loss of memory?

There are certain “cognitive enhancing” medications that may be useful in improving cognitive symptoms and slowing the progression of dementia in patients with Parkinson’s disease. These include a class of drugs entitled cholinesterase inhibitors (rivastigmine, galantamine, donepezil). The Exelon patch in particular was specifically studied in Parkinson’s patients and obtained FDA approval for treatment of Parkinson’s related dementia. Memantine, an NMDA receptor antagonist, has been FDA approved for treatment of Alzheimer’s dementia; however, in clinical practice, it has also been found to be helpful in certain patients with Parkinson’s disease related dementia. In addition, nonpharmacological interventions including exercise, social stimulation, and cognitive rehabilitation can be helpful in the treatment of dementia in Parkinson’s disease.

Apart from genes, are there any environmental risk factors for PD? 

My research team was funded by the National Institute for Environmental Health Sciences for more than ten years to study both genetic and environmental risk factors for Parkinson’s disease. We found that pesticide exposure, both occupational and gardening-related, was associated with a two-fold increased risk for Parkinson’s disease. In particular, exposure to herbicides carried an increased risk. Of the herbicides recalled by our study subjects, the one most significantly associated with Parkinson’s disease was 2,4-Dichlorophenoxyacetic acid, a major component of Agent Orange. There have been reports that Vietnam War veterans are at an increased risk for Parkinson’s disease. Pesticides may contribute to an increased risk for Parkinson’s disease by causing the alpha-synuclein protein to misfold and form toxic accumulations within vulnerable nerve cell regions.

My research team also observed that head trauma may be a risk factor for Parkinson’s disease. A closed head injury that produced loss of consciousness or that required hospitalization was associated with an 11-fold increased risk for Parkinson’s disease.  Head trauma may contribute to an increased risk for Parkinson’s disease by causing an acute spike in alpha-synuclein levels.

While my research team observed no evidence for an interaction of pesticide exposures and alpha-synuclein gene variants, a research team from California recently reported an interaction of head trauma and alpha-synuclein gene variants in Parkinson’s disease. Currently, my research team at NorthShore is conducting a brain imaging study of mild traumatic brain injury to determine if there are Parkinson’s disease-like abnormalities in the brain scans of persons exposed to head trauma, even in the absence of symptoms of Parkinson’s disease. We will also consider the interaction of traumatic brain injury and alpha-synuclein gene variations in that study.

Small Changes in Snacks Make for Big Changes in Kids’ Health

Friday, April 19, 2013 2:31 PM comments (0)

healthy snacksOver the last 30 years, childhood obesity rates have tripled in the United States, with nearly 1 in 3 children considered overweight or obese. Left unchecked, childhood obesity can lead to serious health issues in children, including diabetes, high blood pressure, high cholesterol, asthma and sleep apnea.

The good news is that small changes in snacks, like swapping those high in fat, sodium and calories for healthier, more filling options, can make a big impact. Felissa Kreindler, MD, pediatrician at NorthShore, shares some healthy snack options that won’t send the kids running … unless, that is, they always follow a healthy snack with some equally healthy exercise.

  • Vegetables. Bell peppers, broccoli, carrots, and sweet potatoes are high in vitamin C and also fiber, which both help kids feel fuller faster and longer. Make veggies more palatable to the younger set with a high-protein dip like hummus. Or, give them the ranch dressing they want but without the fat by serving a low fat yogurt-based version [recipe provided].
  • Cheese. It might be a surprise to see cheese on a list of healthy, kid-friendly snacks.  Yet in moderation, cheese is a great way to fill kids up and keep them from snacking later in the day. High in calories, yes, but cheese is also high in protein and calcium. When paired with vegetables and fruit, it can round out a well-balanced snack.
  • Fruit. It’s an obvious choice but not all fruits are created equal. Consider fruit high in fiber, like apples, avocado, bananas and berries. Dried figs, apricots and dates are a sweet replacement for the empty calories in candy. Transform avocados into guacamole and replace high-fat tortilla chips with whole grain crackers.
  • Peanut, sunflower, and almond butters and nuts. Great with fruit or on whole grain crackers, these nut butters are high in protein and heart-healthy fat. You can get the same benefits from whole nuts as well. When it comes to nut butters and nuts, stick with the natural options that limit added oils and sugar.

 What healthy snacks do your kids love?

Try this low fat, kid-friendly recipe for ranch dressing:

8 teaspoons dried minced onion

1 tablespoon dried parsley

½ teaspoon paprika

2 teaspoons salt

2 teaspoons pepper

1 ½ teaspoons garlic powder

1 cup nonfat yogurt

1 cup fat-free sour cream

 

Parkinson's Disease: Treatment

Tuesday, April 16, 2013 4:36 PM comments (0)

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.

by Ashvini Premkumar, MD

treatmentWhat are the most effective medications for the treament of Parkinson’s disease?
The most effective medications for the treatment of Parkinson’s disease are the dopaminergic medications. Carbdiopa/levodopa is by far the most effective, followed by dopamine agonists and lastly mao-b inhibitors.  Non-dopaminergic medications include anticholinergics, which are sometimes useful for treatment of tremor but have to be used with caution because of the side effect profile, particularly in elderly patients.

What are the most common side effects of carbidopa/levodopa? 
The most common side effects for carbidopa/levodopa that we see clinically include: nausea/vomiting, lightheadedness, sleepiness, hallucinations, and dyskinesias.

Do you recommend the early use of carbidopa/levodopa? Delay its use?  
The early vs. delayed use of carbidopa/levodopa has been debated for many years.  The crux of the debate rests on the concern that early use of carbidopa/levodopa may increase one’s risk for motor complications, namely fluctuations (“on” and “off” periods) and dyskinesias. The risk is approximately 40 percent within four to six years, particularly among young patients. Whether or not to start carbidopa/levodopa has to be highly individualized decision, which will be based on many factors, including disease severity, age, co-existing symptoms (i.e. cognitive impairment) and occupational concerns.

Please discuss Neupro transdermal therapy
Neupro transdermal therapy, or the rotigotine patch, is dopamine agonist that is FDA approved for the treatment of Parkinson’s disease. It can be used in early Parkinson’s disease. It also can be used as an adjunctive medication in advanced Parkinson’s disease as it was shown in studies to reduce “off” time by roughly one hour a day. It has also been approved in the treatment of moderate to severe restless legs. The side effects include: nausea/vomiting, somnolence (sleep attacks), reactions at application site, dizziness, anorexia and compulsive behavior. The specific benefit of Neupro, like other extended-release dopamine agonists, is that it maintains as constant a level of drug as possible throughout the day.

Some say that exercise eases Parkinson's diease symptoms. What exercises or physical activities are recommended for people with Parkinson’s disease?
We recommend an exercise program that combines aerobic activity and core muscle strengthening. And this should preferably be complemented by exercises aimed at balance and stretching (i.e. yoga and Tai Chi). 

Is it safe to ride a bicycle with PD? 
This question needs to be routinely addressed by the patient’s treating neurologist. In general, in the early stages of PD, where balance is not significantly affected, it’s considered safe. However, once postural instability becomes noted, either by reported falls or upon routine examination, then it would be advisable to ride only stationary bicycles.

How can I prevent falls if I have PD? 
Prevention of falls should be emphasized at each clinic visit with one’s treating neurologist. The best way to prevent falls is to be educated as to what causes falls in Parkinson’s disease and then to take every precaution to avoid those “missteps.” 

 

Dining on a Dime: Healthy Eating on a Budget

Thursday, April 11, 2013 1:54 PM comments (0)

budgeteatingWe often think that eating healthy means spending more money. You don’t necessarily have to sacrifice on flavor and the foods you love when trying to eat on a budget. Saving some green in your pocket book can be as easy as becoming a better planner both at the grocery store and in the kitchen.

When you think about stretching your dollars with your food, remember that making smart choices is a small price to pay when it comes to your overall health and wellness.

Kimberly Hammon, registered dietitian at NorthShore, shares the following recommendations for maximizing nutritional value and minimizing costs:

  • Shop seasonally. When produce is in season it tends to be less expensive. Another way to enjoy your seasonal favorites all year round is to can or freeze them for later use.
  • Plan your meals and make a list. Think about how often you have to throw items out in your refrigerator because they go bad. Planning out your menus and sticking to your shopping list will help reduce waste. It also is a good idea to shop on a full stomach. This way you’ll resist the urge to splurge.
  • Purchase items in bulk. Rice, beans and other items can be much more cost effective when purchased in larger quantities. You don’t have to worry about these items going bad, so there’s nothing wrong with buying in bulk. Just make sure you have proper storage space.
  • Buy frozen and canned vegetables. The nutritional value is often the same as fresh vegetables and the shelf life is much longer.
  • Start a garden of your own. A great way to reduce the cost of buying food is to grow it yourself. You can start growing many fruits and vegetables from seeds or seedlings inside, and then transfer them outdoors once the threat of frost is over.
  • Shop when you are not in a hurry. Take time to compare prices.  
  • Try to shop without your children. Unwanted items can creep into the cart with too many “helping hands.” Take turns with a friend for child care.
  • Limit your shopping to only once a week. The more trips to the store, the more money you spend. It is hard to purchase only a few items on any trip to the grocery store.

What do you do to reduce your grocery bill? What cost-saving tips do you have?

Parkinson's Disease: Deep Brain Stimulation

Tuesday, April 09, 2013 10:50 AM comments (0)

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.

by Aikaterini Markopoulou, MD

What is DBS?
Deep brain stimulation is a type of surgical treatment for Parkinson’s disease. It involves the insertion of electrodes into specific areas of the brain that control movement. The electrodes are connected to a battery that is placed under the skin in the upper part of the chest. Electrical current that passes through the electrode stimulates these brain areas on one side of the brain. This stimulation results in improvement of tremor and slowness or stiffness on the other side of the body.

Who is a good candidate for DBS?
To be a candidate for DBS surgery a number of conditions have to be met:

  • A diagnosis of typical Parkinson’s disease that involves a combination of symptoms such as tremor, stiffness, slowness of movement or balance problems
  • Duration of disease symptoms for more than five years
  • Symptoms that respond well to treatment with levodopa
  • Presence of complications of levodopa therapy
  • Absence of dementia
  • No other diseases or conditions that significantly affect overall health (e.g., conditions that affect blood clotting, heart and lung disease, moderate to severe depression, pregnancy)

Is DBS covered by Medicare?
Yes, DBS is covered by Medicare.

When a patient has bilateral DBS is it necessary to have two stimulators, or will one suffice?
In the majority of Parkinson’s cases, symptoms affect both sides of the body; therefore, electrodes are inserted in both sides of the brain. In some cases where the symptoms affect mostly one side, the electrode can be inserted only in the opposite site of the brain.

If you have DBS, how does it affect your ability to get through airport checks, metal detectors, etc.?
Each patient is provided with an identification card that includes information about the implanted stimulator. The TSA agent should offer a private screening or screening with a manual wand instead of the patient walking through a metal detector.

What percentage of DBS surgeries result in complications? What complications might a patient encounter?
The DBS surgery may result in complications both during the implantation and after surgery, which include bleeding at the electrode insertion site that can be fatal, hardware malfunctioning, and infection and symptom worsening. In a large multicenter clinical trial, 7.5% of patients developed intracranial hemorrhage, 10.6% device-related infection and 8.1% one-sided weakness.

How long is DBS effective?
Studies that have followed patients for ten years have been published and the DBS remained effective throughout the ten-year interval.

Are there any long term risks associated with DBS?
DBS therapy remains a safe treatment option for Parkinson’s patients for at least ten years.

 

Parkinson's Disease: Genetic Risk Factors, Family History and Research

Thursday, April 04, 2013 11:47 AM comments (0)

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.

by Demetrius Maraganore, MD:


laboratoryAre 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 visit. You can also support the DodoNA project by joining forces with NorthShore’s Auxiliary and by supporting the Hospitals’ Gala

Hepatitis C – Transmission and Screening

Tuesday, April 02, 2013 10:48 AM comments (0)

hepatitisHepatitis C, a virus which can lead to chronic liver disease, is spread through contact of already infected blood.  Many individuals who are infected with the hepatitis C virus do not experience symptoms and are not aware of having the virus. 

Dhiren Shah, MD, a gastroenterologist at NorthShore University HealthSystem, shares some important information on transmission of hepatitis C and tips on minimizing your risk:

  • Do not come into contact with any non-sterile equipment where blood is involved. If you are getting a tattoo or body piercing, be sure to do so in a licensed facility. Additionally, DO NOT share toothbrushes or razors with anyone who has hepatitis C. Sexual transmission is an uncommon way of transmission; however, the risk increases in patients who have a history of a sexually transmitted disease, multiple sexual partners or men who have sex with men. 
  • Do not participate in the use of illegal intravenous drugs. The most common way that hepatitis C is passed to others is through sharing illegal drugs with used, contaminated needles. If you are a user, you should go to a facility where you can receive clean needles and DO NOT share needles with anyone.

Who should be screened for hepatitis C?

  1. Any person born between 1945 to 1965
  2. Anyone with elevated liver enzymes
  3. Any person who has ever used illegal intravenous drugs and/or any history of snorting cocaine
  4. HIV patients
  5. Children born to women who have hepatitis C
  6. Dialysis patients
  7. Anyone who had an organ transplant before 1992
  8. Anyone who received a blood transfusion before 1992

Is there a vaccine for hepatitis C?  To date, there is no vaccine for hepatitis C; however, you should be screened for hepatitis A and B, and get vaccinated if you have not been previously exposed.  

What other questions do you have about hepatitis C?

 

Discovering a New Normal: Living with Multiple Sclerosis

Thursday, March 28, 2013 9:45 AM comments (0)

MSThe diagnosis can be hard and may leave you wondering if you’ll ever be able to return to your regular activities. Not everyone with multiple sclerosis (MS) experiences the same symptoms—ranging from fatigue, numbness, loss of balance and coordination, to speech or muscle problems—and most people with this disease do not suffer paralysis or become severely disabled.

According to the National Multiple Sclerosis Society, more than 2.1 million people in the world are affected by MS. Given that in many cases the signs of MS can be difficult to detect, it’s hard to know exactly how many in the United States are impacted by the condition.

We do know that for those who do have MS, the journey through the disease can be very debilitating. Zulma Hernandez-Peraza, MD, neurologist at NorthShore, shares her advice on how to cope with the diagnosis and adapt your life accordingly:

  • Don’t lose hope and stay stress free. As hard as it may be, it’s best to take each day at a time. Try not to dwell on the unknown and uncertainity. Unnecessary stress can aggravate some of your MS symptoms, so be sure to take time to relax and unwind.
  • Get moving. Staying active and engaging in moderate activities and stretching can be very helpful. Be sure to discuss the best workout regimen with your physician.
  • Eat right. It’s important to keep your body healthy, as this will help prevent other illnesses and keep up your strength. You’ll want to eat plenty of fruits, vegetables and foods rich in fiber.
  • Be yourself. Don’t let your condition get you down. As best as you can, try to stay involved and social. Keep up with your hobbies, family and friends. Not only will this keep your support network in place but it will also help keep your spirits up.

Do you know someone living with MS?

Colorectal Cancer – Early Screening Can Save Lives

Tuesday, March 26, 2013 9:30 AM comments (0)

colon cancerColorectal cancer is one of the leading causes of cancer deaths in both men and women in the United States. However, if everyone over the age of 50 were regularly screened, it might be possible to reduce deaths associated with colorectal cancer by as much as 60 percent.

Many women believe that colorectal cancer is a disease that affects more men than women, so they might not be aware of or believe they need to follow current screening recommendations. National Colorectal Cancer Awareness Month this March is the right time to spread the word that colorectal cancer affects men and women equally and that screening saves lives.

Joel Retsky, MD, Gastroenterologist, shares some important information about colorectal cancer everyone should know, men and women:

  • Your risk increases with age. More than 90% of colorectal cancer cases occur in those who are 50 or older. Everyone over the age of 50 should follow national screening guidelines and continue screening at regular intervals at least until 75 years of age.
  • You should not wait for symptoms. Colorectal cancer rarely causes noticeable symptoms in the early stages. Symptoms of colorectal cancer—bleeding from the rectum, change in bowel habits, noticeable weight loss—often do not appear until the cancer is advanced and more difficult to treat. Most colorectal cancers come from polyps, or abnormal masses, that grow in the inner lining of the large intestine. With screening, polyps can be removed before they even become cancerous.
  • Family history is important. If you have a family history of colorectal cancer, you may need to begin screening earlier, perhaps at 40 or even younger. You will also need to be screened more frequently than currently recommended by the national guidelines. 
  • Personal history is important. Some studies have shown that women who have had ovarian, uterine or breast cancer have a higher-than-average chance of developing colorectal cancer. Crohn’s disease and ulcerative colitis are also risk factors. Talk to your physician about how these risk factors might affect the frequency of your screenings.
  • There are several screening options. There are many tests for colorectal cancer, including fecal occult blood test (FOBT), sigmoidoscopy, colonoscopy, virtual colonoscopy and barium enema. Colonoscopy is the most effective test for colon cancer screening. Talk to your physician about which screening option is best for you.


If you’re 50 or over and have never been screened for colorectal cancer, make National Colorectal Cancer Awareness Month the month you schedule your first appointment.


Have you been screened for colorectal cancer?

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