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 expected to become the third leading cause of death worldwide by the 2030s, according to a 2013 report from the World Health Organization.

COPD is a common lung disease that causes difficulty breathing. The two main forms of COPD include chronic bronchitis and emphysema. 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 [LM1] programs in the United States offering the only known surgery to help those with end-stage emphysema. Drs. Stephen Hazelrigg and Traves Crabtree are SIU cardiothoracic surgeons who perform lung volume reduction surgery (LVRS). 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. 

Copyright © SIU School of Medicine, Springfield, Illinois

SIU’s Center for Family and Community Medicine has grown into a powerhouse of care across the region. Learn more in this article.

Written by Rebecca Budde, SIU School of Medicine

This Turkey Day, give thanks for gluten-free alternatives and a little creative thinking. Just because you have celiac disease or non-celiac gluten intolerance doesn’t mean you should have to sacrifice your favorite traditional Thanksgiving meals. SIU School of Medicine’s Sibyl Cox, a registered dietician specializing in pediatric gastroenterology and nutrition, offers her favorite tips for keeping your tummy content this holiday season:

Tip #1: Pass on the stuffed turkeys.
Some turkey brines or marinades as well as injections can contain gluten, so making sure the bird is gluten-free is important. Butterball reports its fresh and frozen turkeys are gluten-free. Look for free-range or organic turkeys as an option.

Tip #2: Use gluten-free flour to thicken gravy.
Use an alternative to wheat flour, such as the gluten-free flours or cornstarch that you already use in baking.

Tip #3: Use gluten-free bread and broth to make stuffing.
Replace gluten-containing bread with your favorite gluten-free bread. Be sure any broth used to make the stuffing is also gluten-free. Or, try a gluten-free cornbread mix like Bob’s Red Mill and make a cornbread stuffing.

Tip #4: Whip up casseroles & vegetable dishes with gluten-free, cream soups.
Your gluten-free cornbread mix can be used to make corn casserole. Del Monte advertises its creamed corn is gluten-free, but always read labels. Gluten-free, cream soups can be used to make green bean casserole.  Also, casseroles can be topped with crushed up potato chips for crunch instead of bread crumbs. Opt for an easy veggie dish by roasting your vegetables with olive oil, salt and pepper, and then you don’t have to worry about gluten at all.

Tip #5: Choose frozen, gluten-free crusts for dessert.
Gluten-free flour blends can be used to make a pie, or you can purchase a frozen gluten-free pie crust. Another option is using gluten-free graham crackers for a graham cracker crust. Or simply go crustless; pumpkin pie is delicious this way as well.

Tip #6: Avoid cross-contamination.
To avoid confusion, separate and label gluten-free options. Use separate utensils for these foods and explain that a utensil used in gluten-free food cannot be used in another food, including things like crackers. Even placing a gluten-containing roll on a plate can result in cross-contamination for those who need to eat gluten-free.

Tip #7: Make family aware.
Consider hosting Thanksgiving, and let your guests bring flowers, drinks, table settings or other needed items. Or, offer to help whoever is cooking so that they’ll feel more comfortable with making gluten-free foods, and you’ll feel more comfortable eating them. Let friends and family know that many foods they may not be aware, including cheeses, soups, soy sauce, gravies, seasoning packets and broths, can contain gluten.

Also, take a moment to inform them about cross contamination and ask that if they are going to make a gluten-free food to be sure to do this before making other foods. Offer to bring your favorite gluten-free food so you know you will have something to eat. This is a great time to educate people about celiac disease and gluten.

Copyright ©SIU School of Medicine, Springfield, Illinois

Know the signs:

Written by Rebecca Budde, SIU School of Medicine

Spring forward – fall back.  This Sunday marks the day when we get to turn back the hands of time an extra hour. While it’s tempting to use the extra time to catch up on sleep, consider using your extra time getting yourself and your family prepared for the cold months ahead.

Appetize
Food for thought: Pumpkin pie and Christmas cookies are right around the corner, but you can plan some healthy options to help keep the winter weight away. Use your extra hour to plan out some healthy menus for the year. Get the slow cooker ready and freeze portions to help save cooking time during busy nights.

Winterize
It’s not too early to check the safety supplies in your car. Be sure you have a box with an ice scraper, tow rope, blankets, water, non-perishable food, gloves, hats, flashlight and batteries, candle and matches, first aid kit, shovel and any needed medications.

Organize
If you have a fireplace, be sure your chimney has been professionally cleaned. Have your gas lines checked if you have a gas fireplace. If you have a wood burning fireplace, it’s a good time to stock up on wood. Change your furnace filter and grab a couple extra to have on hand. Check your outdoor surroundings for areas that might be safety hazards when the snow and ice arrive.

Moisturize
Dry winter air is hard on the skin and makes breathing more difficult for some. Sanitize your humidifiers with vinegar and hot water so they’re ready to go when the cold hits.
Exercise
Take a brisk Sunday morning walk, rake the leaves or go for a bike ride. Getting up, moving and enjoying the daylight will help your body reset its natural clock.

Surprise
Opportunities abound to help others in the community. Make an effort to help neighbors clean their yard or serve dinner at the breadline.

Analyze
Enrich your mind: Plan a visit to a local museum, library or historical site or just take an hour to read that book you keep putting off. 

Copyright ©SIU School of Medicine, Springfield, Illinois

Think you know all there is to know about diabetes? Check out our myth busters below.

Written by Rebecca Budde, SIU School of Medicine

On average, someone in the United States has a stroke every 40 seconds; every 4 minutes, someone dies from one.

While some risk factors are out of your hands, you do have control over several of them. “Taking the risk factors you can control out of your life, can reduce the risk of stroke and other health problems significantly,” says SIU family medicine physician Dr. Rachel Rahmen. “Many of these preventable risk factors are related to each other, and taking control of one often leads to better results in other areas.”

Here are the risk factors you can control to help reduce your stroke risk:

High Blood Pressure (Hypertension)
This is a major risk, according to the American Stroke Association. Hypertension is roughly defined as blood pressures over 140/90 (normal is 120/80). Adopting healthy lifestyle habits to lower blood pressure can go a long way to prevent a stroke.

Smoking
After high blood pressure, smoking is the single greatest contributor to stroke. The nicotine and carbon monoxide in cigarette smoke damage the cardiovascular system in many ways. The use of oral birth control combined with cigarette smoking greatly increases stroke risk in women.

Physical Inactivity and/or Obesity
You’ve heard it before, but being a couch potato or being overweight/obese contributes to numerous preventable illnesses, including stroke. Since 1980, the prevalence of obesity in adults has doubled. In children, it’s tripled. With obesity comes higher blood pressure (remember, it’s the number one risk factor for stroke). Managing your weight will help lower your risk of stroke (along with diabetes, heart disease, and many others).

Diet
You’ve heard this one, too. A diet rich in fruits and vegetables is good for your waistline and reduces your risk of stroke. Lowering sodium intake and increasing potassium intake can lower blood pressure. Eating saturated fat, trans fat and cholesterol can raise blood cholesterol levels and your risk of stroke.

Type 2 Diabetes
Diabetes increases your risk of vascular diseases (atherosclerosis). People living with diabetes also may have difficulty keeping their blood pressure stable, have high blood cholesterol, suffer from peripheral artery disease and be overweight.  While diabetes is treatable, the presence of the disease still increases your risk of stroke.

Peripheral artery disease is the narrowing of blood vessels carrying blood to leg and arm muscles. It’s caused by fatty buildups of plaque in artery walls. This leads to a higher risk of carotid artery disease, which also raises the risk of stroke.­

Atrial Fibrillation
An estimated 2.3 million Americans have chronic atrial fibrillation —when a heart beats irregularly, quivering instead of beating. This affects the atria or upper chambers of the heart where blood can pool and clot. If a clot breaks off, enters the bloodstream and lodges in an artery leading to the brain, it can cause a stroke. Atrial fibrillation can often be controlled with medication.

Other Heart Diseases
Those with coronary heart disease or heart failure have a higher risk that those with hearts that work normally.

Asymptomatic Carotid Stenosis
The carotid artery is the large artery you can feel on the side of your neck. Atherosclerosis, the build up of plaque, narrows the carotid artery causing carotid artery stenosis.

Drug Abuse
Studies have shown that recreational street drugs such as cocaine, amphetamines and others are associated with increased risk of stroke and heart attacks.

Alcohol Abuse
Like smoking, alcohol abuse can lead to multiple medical complications, including stroke.

Resources are available to help you take charge of your health. Talk with your doctor about how you can lower your risk of stroke. SIU School of Medicine has numerous programs in place for patients interested in quitting smoking, better diabetes management and weight loss programs. People of any age can have a stroke. Stop a stroke before it starts.

To make an appointment with a primary care provider who can help you reduce your risk, call SIU’s Center for Family and Community Medicine at 217-545-8000.

Copyright © SIU School of Medicine, Springfield, Illinois

Written by Rebecca Budde, SIU School of Medicine

Each year about 795,000 Americans have a stroke and every four minutes someone dies of stroke, according to the Centers for Disease Control and Prevention.

So, what exactly is a stroke?

A stroke is damage to the brain, caused by a blood clot blocking the blood supply to the brain or when a blood vessel in the brain bursts, says Dr. Jatin Patel, a family medicine physician at the SIU School of Medicine’s Center for Family Medicine.

How do I know if someone is having a stroke and what do I do?

If someone you know has symptoms of stroke, get them to the emergency room immediately.

Look for the FAST warning signs of a stroke.

• Face drooping – One side of the face may droop or go numb. Ask the person to smile, then check to see if the smile is uneven.
• Arm weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
• Speech difficulty – Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence like “I like chicken soup.” Ask the person to stick out his tongue, if the tongue is crooked, does it go to one side or the other?
• Time – to call 9-11!

If the person has difficulty doing any of these simple tasks, call 9-1-1 immediately and describe the symptoms to the dispatcher, or take the person to the emergency room quickly. The sooner the person is treated, the better the outcome.

How are strokes treated?

According to Dr. Patel, a stroke caused by a blood clot can be treated with a strong blood thinner, tPA or tissue plasminogen activator. If the stroke is treated within the first three hours after it happens, it can help improve the outcomes of patients fairly well.

Next up: steps you can take to prevent a stroke.

Copyright © SIU School of Medicine, Springfield, Illinois

Women take heed, here are six checkups you need:

Written by Laura Bottom, SIU School of Medicine, Center for Family Medicine

Warm, summer nights are coming to an end, kids are back in school and the flu vaccine is one poke away. The Center for Disease Control and Prevention (CDC) and SIU Center for Family and Community Medicine recommend anyone 6 months and older to get a seasonal flu vaccine.

Myth 1: The flu vaccine can give you the flu.

Flu vaccines are currently engineered in two ways. One way uses an inactivate virus, resulting in a non-infectious vaccine.  The second way is with no flu virus at all, which is the case for recombinant influenza vaccine. Common side effects of the vaccines include low-grade fever, headache and muscle aches. Side effects at the injection spot can include soreness, redness, tenderness or swelling.

Myth 2: It is better to get the flu instead of the flu vaccine.

The flu virus can lead to very serious complications resulting in hospitalization or even death. “The flu can be extremely harmful especially in young children, older adults, pregnant women and people with certain chronic health conditions including asthma, heart disease and diabetes,” says Family and Community Medicine Chief Resident Dr. Safiya McNeese. “This vaccine helps to protect your body against the flu virus. Getting the flu vaccine is a much safer choice than risking serious illness.”

Myth 3: It is not necessary to get a flu vaccine every year.

“It is recommended that those who are 6 months and older get a flu vaccine every year,” Dr. McNeese says.Over time, the vaccination becomes less effective, leaving you less protected. Annual vaccination is important for the best protection from the flu virus.

Myth 4: I should wait to get vaccinated so immunity lasts throughout the flu season.

The CDC recommends people get vaccinated as soon as it becomes available. After being vaccinated, it can take about two weeks for antibodies that help protect your body against the flu virus to develop. It is best to get vaccinated BEFORE the flu virus is spread throughout your community, but it is never too late to get vaccinated.

Call you doctor’s office today to schedule a flu vaccination. Or call 545-8000 and ask for SIU Center for Family Medicine. Our team of doctors will care for your whole family through flu season and beyond.

Copyright ©SIU School of Medicine, Springfield, Illinois