by Matt SheehanOSF Healthcare
We see depression leads to difficulty with concentration
ADHD in adults, online quizzes may spread misconceptions and mis-self-diagnosis
by Matt SheehanOSF Healthcare
Napping, how much sleep should infants and small children get
by Tim DitmanOSF Healthcare
DANVILLE - Decades ago, a day at school for a kindergartener would usually involve an afternoon nap. Today, some schools have phased that out, leaving parents to wonder what’s right. Luis Garcia, MD, an OSF HealthCare pediatrician, says daytime sleep plays an important role in a child’s development. He says parents should look at it in terms of daytime sleep and nighttime sleep added up to total sleep. He stresses that each child has unique needs, and you should get to know your child’s sleep habits. But there are guidelines. For young kids, Dr. Garcia says nighttime sleep stays mostly consistent at 10 hours. Daytime sleep varies by age.
“Usually, the need for naptime decreases when kids reach 4 to 6 years old,” Dr. Garcia says. “At that point, they only need to sleep the 10 hours at night.”
When and how long
Dr. Garcia says naps for kids should be 30 minutes to two hours. So, you can do some math. For example: your 2-year-old needs four hours of daytime sleep with naps no greater than two hours. So, aim for some two-hour slumbering mid to late morning and early afternoon.
“It’s not recommended to nap after 3 or 4 p.m. to avoid causing disruptions at bedtime,” Dr. Garcia warns. “We want to allow at least four hours between last nap and bedtime to avoid the kids being too tired at bedtime.”
Bad nighttime sleep leads to irritability and poor concentration the next day, he adds.
No more naps
Dr. Garcia suggests parents look for signs that their child is ready to stop napping.
“Is the kid refusing or having a hard time taking a nap? If they do take a nap, do they have a problem falling asleep at night?” Dr. Garcia asks.
You should also talk to your child’s school or day care. If they have daily nap time, let that continue until the child ages out of the facility. If the facility is flexible, inform them of your child’s sleep habits and come up with a plan.
When the time comes to stop naps, Dr. Garcia recommends a clean break. There will likely be some fussiness, but it will subside. Moving bedtime up by 20 to 30 minutes can help.
Sleep tips
Some general good sleep tips:
Sundowning; What happens when the sun goes down
by Tim DitmanOSF Healthcare
Courtney McFarlin, PA
Key takeaways:
Sundowning describes nighttime behavior in older adults, especially those with dementia, due to a disruption in the circadian rhythm. The person may be agitated, moody, not want to go to sleep or physically aggressive.
Ways to help include medicine like melatonin, eliminating long naps and practicing general good sleep hygiene. Homes should also be arranged so the elder does not fall or wander outside.
A caregiver may ultimately have to decide whether to move the person to an assisted living facility.
Many things can disrupt your circadian rhythm, like illness, stress, artificial light and genetic factors. But McFarlin says sundowning is most often seen in older adults with dementia and similar disorders like Parkinson’s disease and Huntington’s disease. Chronic alcohol use can also bring about sundowning.
What does sundowning look like? McFarlin says the person may be agitated, have mood changes and pace around. They may not want to go to sleep. And the person may even physically lash out at others.
“Reports and research have shown that it’s most common when people are in mild or moderate stages [of dementia],” McFarlin says. “You would think as one progresses with dementia, it would get worse. But it actually improves a little bit.”
How to help
McFarlin says caregivers of older adults often come to her with a plea: help us do something about my loved one’s nighttime behavior. The caregivers are sometimes awake through the night keeping an eye on things, leading to sluggishness, crankiness and other issues during their workday.
First, McFarlin reminds you that support groups exist – if not in-person in your community, then online – for caregivers of older adults. But for medicinal aids, McFarlin says melatonin is a good first option.
“It’s a natural hormone that our body produces that helps aid in sleep,” she says.
McFarlin adds that studies have found decreased levels of melatonin in older adults with or without dementia.
Serotonin-based medications, hypnotics and anti-anxiety medications can also help. Paxil, Prozac, Seroquel, Risperdal and Haldol are common brand names. Talk to your health care provider or a sleep specialist if you have questions about these medicines.
Something to strike from your loved one’s routine: long naps.
“It’s suggested that a less than three-hour naptime schedule is advised,” McFarlin says. “If I find my patients are napping quite a bit, I’ll encourage them to take less naps.”
Other sleep hygiene tips:
Ducking winter's toughest punch, avoiding potential health issues
by Paul ArcoOSF Healthcare
Every year, thousands of people end up in an emergency department due to things happening when they’re shoveling snow
Photo: Serkan Gönültaş/PEXELS
Key Takeaways:
“If you really should not be shoveling snow, or you’re at higher risk, I recommend trying to find someone else who can do it for you, whether that’s a neighbor or a family member. I highly recommend that," adds Henderson. "It’s not worth the broken hip or the hospital follow up. Another thing for people who are at higher risk is to bring a cellphone. If you do fall, you’re able to call somebody.”
Before you bundle up and head outside to shovel your driveway, make sure you follow proper safety measures to avoid injury. If you or a loved one experiences severe injury, heart attack, or other medical emergencies while shoveling snow, call 911.
- Every year, thousands of people visit the emergency department due to snow-related injuries or events.
- People at the greatest risk are the elderly, those with back issues or a history of heart problems.
- Wear appropriate clothing to stay warm and avoid frostbite.
- Other tips include lifting with your legs, push (don't) lift the snow, take breaks, and be aware of ice.
- If you experience a medical emergency, call 911.
Hospital recommends virtual visits due current Covid spike and rise of RSV
by Matt SheehanOSF Healthcare
As many viruses continue to make the rounds in our communities, it is paramount to monitor your symptoms and know when the right time is to seek medical care in person.
PEORIA - OSF HealthCare hospitals, clinics, and emergency departments across the state continue to see a big influx of people seeking care. The increase in patients in waiting rooms can lead to elevated exposure of germs and viruses, plus longer wait times.
As many viruses continue to make the rounds in our communities, it is paramount to monitor your symptoms and know when the right time is to seek medical care in person. Sarah Overton, the Chief Nursing Officer for OSF Medical Group, Home Care and Employee Health, stresses the importance of virtual care when your symptoms are mild.
“That way we’re not exposing you to anyone in the public and you’re not exposing the health care worker to illness,” Overton says. “Unfortunately, we are seeing an increase in health care worker illness where our nurses and doctors have to stay home because they are being exposed to illness.”
Photo: Andrea Piacquadio/Pexels
Hospitals across the state and in the OSF Ministry network have been seeing a spike in COVID-19 patients. If you suspect you have COVID-19 but your symptoms are mild, take an at-home COVID-19 test.
The federal government has another stockpile of at-home tests that are free to order on COVID.gov. Every household can receive four free rapid tests. Dr. Brian Curtis, Vice President of Clinical Specialty Services with OSF HealthCare, says taking tests at home will help free up space at medical facilities.
“Coming in just to get tested takes up spots for the people that are really sick or are high-risk,” Dr. Curtis says.
“The Emergency Room is reserved for those true emergencies,” Overton adds. “We have patients that have heart attacks and lung issues with their COPD. Additional patients overflowing the Emergency Room takes away precious time from assessing those patients who shouldn’t be exposed to those viruses while being in our waiting rooms.”
But COVID-19 isn’t the only virus making the rounds in our communities right now. Influenza, Respiratory Syncytial Virus (RSV) and others are being seen often as well. So how can we stop the spread of viruses?
· Stay home when you aren’t feeling well.
· Wash your hands and use hand sanitizer regularly.
· Cough or sneeze into your elbow.
· Wipe down high-touch surfaces with disinfectant wipes.
· Don’t share glasses or silverware with others.
· Receive the flu shot.
For treating mild symptoms at home, Dr. Curtis offers some guidance for using over-the-counter options.
“You can take Tylenol or Motrin for fevers and aches. Make sure to drink plenty of fluids and get plenty of rest,” Dr. Curtis says.
Overton says to make sure you read the labels on any over-the-counter medication you buy. If you have any questions, you can ask a retail pharmacist, or send a message through MyChart to your OSF care team.
When is the right time to be seen?
“If you have a super deep cough that’s hanging on for quite a while or have a fever that lasts for several days,” Overton says. “Or if you have high-risk factors and may benefit from some of our medications for COVID, like Paxlovid, which are readily available in our retail pharmacy locations. We also have COVID-19 boosters able to be administered in our primary care offices.”
“There is a medication for influenza, but if you have a mild case, you’ll have more side effects from the medication than you are having from influenza itself. As far as RSV goes, there’s really no treatment for it except for supportive care.”
If you are sick and plan to visit a medical facility, please cover your face with a mask to decrease exposure to the health care workers.
Colds and viruses tend to last one to two weeks. If your symptoms are more serious or linger on much longer than that, reach out to your primary care team and schedule an appointment. You can also consider an in-person or virtual visit to OSF OnCall Urgent Care. A virtual visit is available 24/7.
Pre-workout supplements not for teen and youth athletes, a healthy diet is safer
by Matt SheehanOSF Healthcare
The question is should middle- or high school-aged kids use these supplements? The answer: Probably not.
Photo: Aleksander Saks/Unsplash
Dirty nails and mouths don’t mix
by Tim DitmanOSF Healthcare
DANVILLE - Emily Isom has a new year’s resolution for kids and their parents: pledge to keep your hands clean and away from your face to prevent the spread of illness.
After wetting your hands, scrub all those areas in soap for 20 seconds. Find a song that has a 20-second chorus and hum it while you scrub. Then, rinse under warm water, and dry your hands with a clean, dry towel. Isom also suggests wrapping a paper towel around your hand when touching dirty surfaces on your way out of the bathroom. Use the towel to shut off the faucet and open the door, then throw the towel away after you exit.
If a hand dryer is what’s available, run your hands under the warm air until they are completely dry. Resist the urge to dry halfway and walk out. Isom says that may do more harm than good and attract bacteria faster.
“Bacteria want to live on wet surfaces. They’re attracted to moistness,” she points out.
If a soap and sink aren’t available, Isom says to use sanitizer or wipes that are at least 60% alcohol based. The same process applies – lather or wipe all parts of your hand and wrist thoroughly.
If you have a cut or wound on your hand, like a paper cut, wash with care.
“Get a washcloth wet with warm water. Put soap on it. Then, clean around the cut or wound,” Isom says. “Don’t put [soap] directly into the cut. That could really irritate it.”
Handwashing
Convincing kids
Isom is a pediatrics provider and a mother. So, she knows getting kids to wash their hands and mind their nails is easier said than done. Her advice: make it fun.
“When handwashing, sing the ABCs for 20 seconds. Or have them sing to you.” Isom suggests. “Make a chart. Every time they wash their hands, have them put a sticker on the chart. They are going to fall in love with it and want to wash their hands over and over again.”
And remember Simon Says? Isom says it works with her daughter.
“Simon says don’t touch your face,” Isom says with a smirk.
Key takeaways:
Dietitian says we don't need to fear aspartame
by Tim DitmanOSF Healthcare
URBANA - With the new year starting this week, your mind may wander back to conflicting summer news about aspartame, an artificial sweetener found in things like diet soda, gum, ice cream, yogurt and other sugar-free foods. The World Health Organization (WHO) cited “limited evidence” of aspartame being “possibly carcinogenic to humans.”
Not so fast, responded the United States Food and Drug Administration (FDA).
“Aspartame is one of the most studied food additives in the human food supply,” the agency said. “FDA scientists do not have safety concerns when aspartame is used under the approved conditions.”
Carly Zimmer, a registered dietitian-nutritionist at OSF HealthCare, explains how we got here.
Zimmer says the agency within WHO that researches cancer has four levels of certainty that a substance can cause the disease. Group one is labeled “carcinogenic to humans.” Things like tobacco, alcohol and solar radiation are here. Group 2A is “probably carcinogenic to humans.” Group 2B is “possibly carcinogenic to humans.” And group three is “not classifiable as to its carcinogenicity to humans.” Coffee and mercury are in this group.
WHO put aspartame in group 2B along with aloe vera plant extract and traditional Asian pickled vegetables.
“That group B classification means there is a possible risk for that substance to cause cancer, not that it’s necessarily linked to cancer,” Zimmer says.
The other thing to consider: Zimmer says the FDA sets an acceptable daily intake for the six sweeteners it has approved. For aspartame, the limit is 50 milligrams per kilogram of body weight. For example, someone who is 60 kilograms (or 132 pounds) would have to consume 75 packets of aspartame (think of brand names like Equal, NutraSweet and Sugar Twin) in a day to reach the limit.
“It would be pretty hard to reach those numbers,” Zimmer says.
That’s not a license to add a lot of sweeteners to your drinks or drink soda with every meal. Sugary foods are bad for your heart, among other things, and should be consumed in moderation. But cancer risk from diet soda? It’s not something to lose sleep over.
“Artificial sweeteners definitely have a place [in diets], but we don’t want to consume them in excess,” Zimmer says. For example, sweeteners can add sweetness to foods without raising blood sugar. That’s helpful for people with diabetes or heart disease.
Want to cut aspartame out greatly or all together? Try fruit-infused water, which you can make at home or get at the store. But check the label. Zimmer says drink mixes like Crystal Light often have aspartame. Hint Water is a better choice, she says. Also, look for high levels of added sugar on the food label.
And in general, talk to your health care provider or a dietitian if you have questions about what you should eat and drink.
What we eat is the biggest risk factor for heart disease
by Tim DitmanOSF Healthcare
URBANA - Philip Ovadia, MD, has a roadmap for the next time you go to the grocery store: stick to the outer sections. That’s where you’ll find fruits, vegetables, dairy and less processed meats.
The further in you go, the more likely you are to encounter sugary, processed foods that can harm your health when consumed en masse.
“What we eat on a daily basis is the biggest risk factor for developing heart disease,” says Dr. Ovadia, an OSF HealthCare cardiothoracic surgeon who, himself, changed his eating habits and went on a weight loss journey.
Moreover, he says, health care experts have moved away from high fat and high cholesterol foods driving heart disease risk. That’s not a license to eat those foods all the time. But it’s more important, experts say, to keep an eye on sugary and processed foods.
Some chief examples: candy, snack cakes, cereal, cookies, chips, crackers and packaged or canned food. Think boxes, bags and colorful labels. After all, the manufacturers want you to buy the products.
And here’s one you’ll hear many doctors say: don’t drink your calories. In other words, avoid excess sugary drinks like soda and juice.
“The problem with fruit juices, as opposed to eating the fruit, is that a lot of the fiber has been stripped out of the juice,” Dr. Ovadia warns. “You’re getting very concentrated levels of sugar.”
For example, Dr. Ovadia says a glass of orange juice may contain the juice of around eight oranges. You wouldn’t think twice about downing the orange juice, but would you eat eight oranges in one sitting?
Consequences
In the short term, Dr. Ovadia says eating a lot of sugary and processed foods will cause your blood sugar level to rise.
“Increased sugar in the bloodstream is directly damaging to our blood vessels,” Dr. Ovadia says. “This is one of the things that can start the process of plaque formation, or blockages, in the blood vessels.”
Long term, Dr. Ovadia says your body can become insulin-resistant. Insulin is the primary hormone your body uses to control blood sugar level. If you’re insulin-resistant, insulin can’t do its job. Dr. Ovadia says this is a precursor to diabetes and metabolic syndrome, a cluster of unhealthy conditions. Both are “major” risks for heart disease, he says.
Some tips:
Look for “added sugar” on the food or drink label, and consider skipping that food.
Find foods that are as close to naturally occurring as possible. As Dr. Ovadia puts it: things that grow in the ground or things that eat things that grow in the ground.
“You should be able to look at your food and know exactly what’s in it,” Dr. Ovadia says. “It should have simple ingredients. You can look at them and know what they are.”
Or ask yourself: would my great grandparents have this food available? Would they even recognize it as food?
For breakfast, try fresh fruit or a hard-boiled egg instead of a biscuit. For lunch, eat a salad with ingredients you mixed instead of a pre-packaged salad. And for dinner, get a lean protein like chicken or fish from the deli counter, not sliced meat in a package.
Pay attention to how you feel after eating.
“If you find yourself getting hungry very quickly after eating, that’s a sign that food is not providing your body with the nutrition it’s looking for,” Dr. Ovadia says.
That means you shouldn’t look at junk food as “in moderation,” Dr. Ovadia says, because you’ll most always be left hungry. He prefers the phrase: “the lower junk food, the better.”
Key takeaways:
- Sugary, processed foods are a big risk for heart disease.
- When shopping, stick to the outer aisles. Buy items with simple ingredients.
- If you feel hungry again soon after eating, the food you ate is likely not providing the body the nutrition it needs.
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