Written by Rebecca Budde, SIU School of Medicine
Imagine having to ask someone to tie your shoes because bending over means you can’t breathe. Not being able to “catch your breath” means that you can’t take a long, hot shower or do simple chores like vacuuming without supplemental oxygen. Those with chronic obstructive pulmonary disease (COPD) live with these scenarios each day.
COPD is a common lung disease that causes difficulty breathing. The two main forms of COPD include chronic bronchitis and emphysema. COPD is expected to become the third leading cause of death worldwide by the 2030s, according to a 2013 report from the World Health Organization. Emphysema progressively destroys the lungs. Most patients with end-stage emphysema are very limited in their daily activities: their breathing is labor intensive, and they rely on supplemental oxygen.
Help for patients with end-stage emphysema
SIU School of Medicine has one of five programs in the United States offering the only known surgery to help those with end-stage emphysema. Dr. Stephen Hazelrigg, SIU cardiothoracic surgeon, performs lung volume reductions surgery (LVRS) at Springfield’s Memorial Medical Center (MMC). Dr. Hazelrigg has performed more than 500 lung volume reduction surgeries on patients from 13 different states since 1993.
How the surgery works
To relieve the stress on the diaphragm and help the patient breathe more easily, the surgeon makes three small incisions and removes the most damaged part of the upper lobe of the lung. Removing the damaged areas allows the remaining healthy tissue and surrounding muscles to work more efficiently. Without the damaged area, the lung shrinks down, and the diaphragm can relax and move up and down more easily.  “It doesn’t seem to make sense, but it works,” Dr. Hazelrigg says. “Many of these people are out of options; no other medications can help them.”
Relief and breathing improvement varies from person to person. Some patients may feel like they are breathing better during the hospital stay, but it usually takes a few months. Patients report after a month that they are able to do things such as shower more easily or walk through the house without supplemental oxygen. LVRS typically improves breathing by 40-50 percent. “This is a dramatic improvement in the lives of these patients,” Dr. Hazelrigg says.
There’s nothing like a good, deep breath and now even some who suffer from COPD will be able to breathe easier thanks to this life-saving surgery.
Learn more about Dr. Hazelrigg and watch a video about how LVRS changed one woman’s life. Read more about this surgery in SIU’s Aspects magazine.
Copytight © SIU School of Medicine, Springfield, Illinois

Written by Laura Bottom, SIU Center for Family Medicine
Pies, cookies, cakes, candies and fancy drinks make up a delicious holiday season.  According to Anne Daly, SIU Center for Family Medicine registered dietitian and certified diabetes educator, people with diabetes do NOT need to choose between delicious and healthy.  Healthy foods can look and taste great.
Here are some alternative healthy recipes you can make this holiday season. This low-calorie pumpkin pies is one of Anne’s facorites:

Low-Calorie Pumpkin Pie
Ingredients:

• 1-16oz cab solid-pack pumpkin
• 13oz can evaporated skim milk
• 1 egg
• 2 egg whites
• ½ cup biscuit mix (Bisquick type)
• 2 tablespoons sugar
• 8 packets sugar substitute
• 2 tsp pumpkin pie spice (mix of cinnamon, nutmeg, ginger and cloves)
• 2 tsp vanilla

Preparation:
Heat oven to 350 degrees. Lightly grease or spray 9-inch pie pan with vegetable pan spray. Place all ingredients in blender, food processor or mixing bowl. Blend 1 minute or beat 2 minutes with mixer. Pour into pie pan and bake for 50 minutes or until center is puffed up.

Splenda Gingerbread Cake
Ingredients:

• 2 cups unsweetened applesauce
• ¾ cups molasses
• 1/3 cup vegetable oil
• 3 eggs
• 3 cups all-purpose flour
• 1 1/3 cups Splenda No Calorie Sweetener, Granulated
• 2 teaspoons baking soda
• 1 teaspoon baking powder
• ½ teaspoon salt
• 2 teaspoons ground ginger
• 1 ½ teaspoons cinnamon
• ½ teaspoon ground cloves

Preparation:
Preheat oven to 350 degrees F. Spray bundt pan with butter-flavored cooking spray. Set aside. Pour applesauce, molasses and vegetable oil into a large mixing bowl. Add eggs. Stir well. Blend remaining dry ingredients in a separate bowl, mix well. Add dry ingredients to the applesauce mixture, stir well. Pour cake batter into prepared pan. Bake in preheated 350 degrees F oven 50-60 minutes, or until a toothpick inserted in the center comes out clean. Remove from oven. Cook cake in pan on a wire rack approximately 20 minutes. Invert cake onto serving plate. Serve warm or cool.

Sugar-Free Russian Tea
Ingredients:

• 4 ½ teaspoons sugar-free orange drink mix
• 3 ½ teaspoons sugar-free lemonade mix
• Artificial sweetener equivalent to 16 teaspoons sugar
• 1 tsp ground cinnamon
• ½ teaspoon ground cloves

Preparation:
Combine all ingredients and mix well. Store in an airtight container. To prepare one serving, add ¼ teaspoon of mix to ¾ cup (6oz) of hot water and stir well.
Copyright © SIU School of Medicine, Springfield, Illinois

Written by Laura Bottom, SIU Center for Family Medicine
Summer is over, but you can still enjoy the health benefits of an indoor pool. Whether you are trying to avoid cabin fever or want to change your exercise routine, water aerobics could be for you.
Running and jumping is less strenuous in water versus on land, so water aerobics produces less impact on joints and muscles. Most find that they can exercise longer in water because the joint and muscle pain that typically accompanies land exercise isn’t present. This makes it an ideal exercise for those with arthritis, back problems, foot or leg injuries, knee conditions, pregnant women, obese individuals or those just beginning a new exercise regimen.
But don’t be fooled by the low impact: These exercises are great at improving strength and cardiovascular health and building lean muscle. Moderate aerobic activity increases your heart rate and breathing, which benefits your heart. Exercising in water gives you 12 times the resistance of air. Just standing in water engages your core muscles, while kicking and cupping water helps build lean muscle development. Muscle development increases metabolism and creates an overall healthier body.
Need another reason to dive in? One hour of water aerobics can burn up to 500 calories. The calorie burn depends on the intensity of your movements, your size, water temperature and depth. The faster your movements and the use of your upper and lower body in deeper water produce the greatest calorie burn.
If you don’t want to take the plunge alone, bring a friend: water aerobics is a great form of group exercise. Because the majority of the moves are performed in water, you’re probably the only one who will know if you miss a step.
If you are interested in trying water aerobics, check with your local health and fitness centers. Some centers offer memberships for pool access only or discounted rates through senior programs, employment or special times of the year. Some centers also provide daycare services while exercising.
As with any new exercise, speak with your doctor first. In need of a primary care physician? SIU Center for Family Medicine cares for the whole family. Call 545-8000 to make an appointment. A new year is right around the corner; start it off on a healthy note!
Copyright © SIU School of Medicine, Springfield, Illinois

Written by Karen Carlson, SIU School of Medicine
If you’ve ever had jet lag, you know how hard it can be to function until you’ve caught up on sleep.
A recently published study shows that long-term disruptions of the sleep/wake cycle causes chemical changes in the brain’s centers for learning and memory that may accelerate memory loss in Alzheimer’s disease. The study, published this month in the Journal of Alzheimer’s Disease, is a collaboration between the University of California-Irvine and SIU School of Medicine.
The study, performed at SIU School of Medicine and funded by the National Institutes of Health* and the SIU Center for Alzheimer’s Disease and Related Disorders (CADRD) provides the first evidence that altered circadian rhythms, similar to what might be experienced during jet-lag or shift work, accelerates memory problems in mice that develop Alzheimer’s-like symptoms.
The research team is a collaboration between the laboratories of Gregory Brewer, PhD, of the University of California-Irvine, and co-authors Shelley Tischkau, PhD, associate professor of pharmacology at SIU School of Medicine and Kelsey LeVault, a former SIU clinical research specialist. Brewer was a professor of Medical Microbiology, Immunology and Cell Biology at SIU School of Medicine for 34 years.
People with Alzheimer’s disease often experience changes in their sleep/wake habits and have trouble sleeping. The underlying cause of these disturbances has been unclear. The researchers tackled this question by changing the time of lights-on so that it occurred eight hours earlier than expected every three days for two weeks in a mouse model of Alzheimer’s disease (AD).
“What the study found was that it’s the timing of sleep is important,” Tischkau said. “Sleeping during the day is proving to be harmful to our body’s metabolism.”
The study design approximates what people would experience if they flew to Europe every three days. Jet-lagged animals in both groups of mice had decreases in overall activity and performed worse on memory tests compared to animals that did not experience changes in their light/dark cycles. The performance of the AD mice was, however, much worse than the jet-lagged normal mice. Follow-up studies indicated that the jet-lagged mice all had decreased levels of glutathione in the brain, and the AD mice were affected more than normal mice. Glutathione is an antioxidant that can protect brain cells from damage due to oxidative stress.
Glutathione deficiencies are associated with harmful changes in energy metabolism within brain cells, creating an environment of oxidative stress. Accelerated oxidative stress is known to contribute to memory loss in Alzheimer’s disease. Therefore, this study shows that circadian disruption decreases the ability of brain cells to protect themselves from oxidative stress. The study identifies these oxidative stress pathways as novel drug targets for treatment of Alzheimer’s disease.
When we turn back the clocks for daylight savings time, we experience how small changes in sleep/wake schedules affect our lives. The take home message for patients, clinicians and caregivers is that good sleep habits, particularly a regular sleep/wake schedule, help maintain good memory.
Copyright © SIU School of Medicine, Springfield, Illinois

http://www.j-alz.com/content/uci-study-finds-jet-lag-sleep-disruptions-spur-alzheimer’s-memory-learning-loss

*grant R01 AG032431

Written by Lindsey Wright, RN, CDE
Diabetes: The diagnosis can be devastating, the management stressful and the information overwhelming. The reality is diabetes stinks, but with the proper education, tools and support, this chronic disease can be controlled.
Many who are newly diagnosed will turn to their friends, family, coworkers or the Internet. As a result, they’re left filtering through an excessive amount of information that isn’t always true. While friends, family and coworkers can be great support, a diabetes health care team will provide the safest and most reliable information.
Here are four common misconceptions about diabetes:

MYTH 1: Eating too much sugar causes diabetes.
FACT: While studies show that sweetened foods can increase the chances of developing diabetes, excess sugar alone is not enough to cause diabetes. Type 1 diabetes is caused by genetics and unknown elements.  Type 2 diabetes is caused by genetics and lifestyle factors.

MYTH 2: Type 2 diabetes isn’t as serious as type 1 diabetes.
FACT: Type 1 and Type 2 diabetes are serious diseases that can lead to the same complications, which include high blood pressure, heart disease, nerve damage, limb loss, kidney failure and blindness if not managed appropriately. Both types of diabetes should be taken very seriously.

MYTH 3: People with diabetes can eat as many sugar-free foods as they want and it will not raise their blood sugars.
FACT:  “Sugar-free” doesn’t always mean carbohydrate- or calorie-free. Carbohydrates make the largest impact on blood sugars. This doesn’t mean carbohydrates should be eliminated from the diet, but those with diabetes should pay particular attention to labels.

MYTH 4: When people with diabetes are placed on insulin, it means they have failed to properly care for themselves.
FACT: Even with the best effort, sometimes diet, exercise and medications fail to keep blood sugar levels in a suitable range in people with type 2 diabetes. Insulin injections give the control they need to enjoy a healthy life.

Lindsey Wright is a certified diabetes educator in the Department of Internal Medicine at SIU School of Medicine. To make an appointment with a member of the diabetes education team, call 545-8000.