Medication and Heart Disease

Certain kinds of medications can have an adverse effect on your teeth.

Long ago, children exposed to tetracycline developed tooth problems, including discoloration, later in life. The medication fell out of use, however, and is not an issue today.

The best precaution is to ask your family physician if any medications he or she has prescribed can have a detrimental effect on your teeth or other oral structures.

A condition called dry mouth is commonly associated with certain medications, including antihistamines, diuretics, decongestants and pain killers. People with medical conditions, such as an eating disorder or diabetes, are often plagued by dry mouth. Other causes are related to aging (including rheumatoid arthritis), and compromised immune systems. Garlic and tobacco use are other known culprits.

Dry mouth occurs when saliva production drops. Saliva is one of your body’s natural defenses against plaque because it acts to rinse your mouth of cavity-causing bacteria and other harmful materials.

Some of the less alarming results of dry mouth include bad breath. But dry mouth can lead to more serious problems, including burning tongue syndrome, a painful condition caused by lack of moisture on the tongue.

If dry mouth isn’t readily apparent, you may experience other conditions that dry mouth can cause, including an overly sensitive tongue, chronic thirst or even difficulty in speaking.

Heart Disease

Poor dental hygiene can cause a host of problems outside your mouth—including your heart.

Medical research has uncovered a definitive link between heart disease and certain kinds of oral infections such as periodontal disease. Some have even suggested that gum disease may be as dangerous as or more dangerous than other factors such as tobacco use.

A condition called chronic periodontitis, or persistent gum disease, has been linked to cardiovascular problems by medical researchers.

In short, infections and harmful bacteria in your mouth can spread through the bloodstream to your liver, which produces harmful proteins that can lead to systemic cardiac problems. That’s why it’s critical to practice good oral hygiene to keep infections at bay—this includes a daily regimen of brushing, flossing and rinsing.

Antibiotic Prophylaxis

In some cases, patients with compromised immune systems or who fear an infection from a dental procedure may take antibiotics before visiting the dentist.

It is possible for bacteria from your mouth to enter your bloodstream during a dental procedure in which tissues are cut or bleeding occurs. A healthy immune system will normally fight such bacteria before they result in an infection.

However, certain cardiovascular conditions in patients with weakened hearts could be at risk for an infection or heart muscle inflammation (bacterial endocarditis) resulting from a dental procedure.

Patients with heart conditions (including weakened heart valves) are strongly advised to inform our office before undergoing any dental procedure. The proper antibiotic will prevent any unnecessary complications.

When is it right to add a protein supplement?

Joshua Steckler, owner of Push Fitness, a personal training studio located in Schaumburg specializing in weight loss, muscle toning, and nutrition recently shared in the Daily Herald’s Health and Fitness section that to ensure a variety of dietary nutrients, we recommend eating a combination of proteins, fats, and carbohydrates.

Many clients come to us eating too many carbohydrates and not enough protein. Not that protein is more important than carbohydrates, or fat for that matter, but if you lack quality protein, you’ll have a hard time maintaining healthy body composition.

Protein is essential for preserving and building muscle, and its consumption helps reduce hunger while stabilizing blood sugar levels — all of which help you burn fat while supporting overall health.

We always preach the importance of building your diet on a foundation of natural and wholesome foods, especially protein-dense foods such as beef, chicken, fish, and eggs. Additionally, having a whole food alternative like a protein powder is a great option for a pre- and post-workout shake or convenient snack options.

So how much protein do you really need? The American College of Sports Medicine suggests that those individuals who are strength training regularly need 0.5 — 0.8 grams of protein per pound of body weight. You may need more or less depending on your body composition and individual goals, but this is a good rule of thumb.

We recommend the following protein powder supplements if you aren’t getting enough protein from whole foods.

• Whey Protein Powder. Whey is a type of protein derived from dairy products. It contains all the essential amino acids our body must obtain from food, so it’s a top choice of many athletes or those wanting to maintain and build muscle. Whey should be avoided by those with lactose issues or those who may have an intolerance to dairy.

• Egg Protein Powder. Egg protein is generally a powdered version of egg whites. It contains all the essential amino acids and many vitamins and minerals, so it’s also a great source for muscle-building proteins. Egg protein is lactose-free, so it may be a good option for individuals who can’t do whey protein.

• Hydrolyzed Collagen Protein Powder. Collagen protein powder is made from the connective tissue, skin, and bones of animals. It might not sound appealing, but hydrolyzed collagen is similar to bone broth or gelatin used for cooking and it contains a substantial amount of protein. Collagen has a slightly different amino acid profile than whey or egg, but it can still help repair and build muscle, while supporting bones and connective tissue. A good-quality collagen supplement may be an option for someone with both dairy and egg allergies.

• Plant-based Protein Powders. Vegetarians as well as those wanting to get more plants in their diet may benefit from a plant-based protein supplement. A combination of rice, pea, and hemp protein will give you a dose of all the essential amino acids and adds the benefit of phytonutrients as well.

With any supplement, it’s important to understand that its safety and efficacy will be dependent on the ingredients. Is the source grass-fed or raised on factory farms? Are the animals treated with hormones or antibiotics? Were chemical pesticides or artificial sweeteners used? Was the protein powder heated during processing or chemically treated? These are all important questions that should be answered before you make your purchase.

So ensure a balanced diet by eating quality protein from whole foods often, and supplementing when needed.

Five Secrets for Steadier Workouts

Rachel Bachman wrote in the May 22, 2017 edition of the Wall Street Journal that many of us vow to get to the gym—then life intervenes. But 21% of U.S. adults do manage to get enough exercise, and these people have some common traits and habits. They are consistent but not rigid. They have open minds about what defines “exercise.” And they have different motivations than the weary conscripts who enroll at the gym on New Year’s Day.

Here are some habits of those who exercise frequently that just might help the rest of us:

They work out at the same time most days. – A study published in April in the British Journal of Health Psychology examined 181 people who exercised an average of 300 minutes a week—twice the federally recommended minimum.

Most of those people picked a regular time to work out and stuck with it.

“When things become predictable you don’t need to invest in much thought,” says the study’s lead author, Navin Kaushal, a postdoctoral fellow in preventive medicine at the Montreal Heart Institute, University of Montreal.

Being in a certain environment at a certain time of day “brings up a mental script of the behaviors and you go into autopilot.”

They have a streamlined pre-exercise routine with visual cues. In another study published in 2017 and led by Dr. Kaushal, new gym members were asked to create cues to prompt them to exercise. A cue might be running clothes, shoes and headphones laid out on a dresser. The plan is that when a runner wakes up, he sees the cues, dresses and dashes out the door.

After eight weeks, members of the study’s experimental group were 1.7 times more likely to meet physical-activity guidelines than those in a control group.


They’re more flexible than infrequent exercisers about how long or vigorously they exercise.  Active people are less likely to have all-or-nothing definitions of physical activity, according to a study soon to be published in BMC Public Health. The study looked at 40 women, 11 of whom said they exercised at least three times or two hours a week.

“The old-school belief was, you set a goal, it’s a bull’s-eye. You hit it or you miss it,” says the study’s lead author, Michelle Segar, director of the University of Michigan’s Sport, Health, and Activity Research and Policy Center. “But life is messy. When you’re more flexible, you’re able to shift your position, your stance, do something less. It removes the psychological punishment of ‘Oh, I failed.’ ”

If a frequent exerciser’s workday spills into her hourlong spin class, for instance, she might still hit the gym to pedal 20 minutes on her own.


An increasing number of active people are widening their definition of exercise.

Many people think exercise has to last at least 30 minutes and make you sweaty and exhausted. Dr. Segar’s ongoing research suggests that frequent exercisers increasingly view things like walking meetings and family bike rides as things that “count” as exercise.

Steve Rabinowitz, a 41-year-old government analyst in Greenbelt, Md., has been working out about five days a week since he turned 40. He mostly does high-intensity interval training workouts using a free site called Fitness Blender, but recently tried Pilates and ballet-inspired barre workouts and enjoys them.

“I push myself when I feel like I can, but when I can’t, that’s OK too,” he says. “I really try to listen to my body.”

During a recent work training he attended, Mr. Rabinowitz climbed five floors of stairs to a meeting room eight times over two days—sometimes sprinting, sometimes walking. He says he enjoys exercise more since he’s expanded his options.


They’re more likely to exercise for pleasure than for weight loss or other long-term health goals.

A study published in 2016 in the Journal of Consumer Research recruited 61 gymgoers at a University of Chicago weight room. Researchers randomly sorted them into two groups and gave each group six exercise options, such as biceps curls or dead lifts.

People in one group were told to choose the exercise they most enjoyed, while the people in the other group were told to choose the exercise most useful for their health goals. Both groups were instructed to do as many sets of their selected exercise as they could.

People who chose an exercise for enjoyment completed an average of 29 reps, compared with 19 reps for those who chose the exercise they thought would help them with health goals. That was true even though the two groups chose similar exercises with similar amounts of weight.

“If I really care about having a healthy heart, that’s what gets me to the gym,” says Kaitlin Woolley, the study’s lead author and a Ph.D. candidate at the Booth School of Business at the University of Chicago. “But that’s not what keeps me there.”

The best brain-boosting foods for final exam season

Compared with the rest of the body, the brain expends an enormous amount of energy and requires ample fuel for that energy, especially during heavy-hitter exam time. A healthy human brain can process information as fast as 268 mph, can make trillions of connections to other cells and can think nearly 60,000 thoughts a day. These thoughts are being generated by the brain’s 100 billion neurons. Boy, the brain is busy.

Despite being engrossed by these facts, my boys still questioned whether healthy foods could in fact support their brainpower for exams. It worked wonders to refer them to research studies by neuroscientist, distinguished fellow and New York Times best-selling author Daniel G. Amen, who has worked with 135 active and retired NFL players. Amen put professional athletes on a special diet that included increased lean proteins and vegetables, regular exercise and adequate sleep, as well as nutritional supplements such as fish oil and vitamins. Within six months, the players showed significant increases in cognitive scores, blood flow to the brain, self-reported better moods, memory and motivation. Many athletes had 50 percent boosts in attention, information processing speed and accuracy on tests. Seems worth a try, boys.

The most important brain food is probably the omega-3 fatty acids. Healthy brains are about 60 percent structural fat, with omega-3 fatty acids and specifically DHA the most prevalent. These fats help reduce brain inflammation, build and repair cell membranes, aid with stress management, and have been shown to be fundamental to brain development in children (the reason there is so much DHA in breast milk and infant formula). The best sources of omega-3s and DHA are wild salmon, sardines, mackerel and fish oil supplements.

Brain-friendly foods:

• Protein builds new and repairs damaged tissue in our bodies and brains. Amino acids (parts of proteins) ignite certain neurotransmitters in the brain. For instance, eating the amino acid tyrosine, found in salmon, eggs, turkey and red meat, helps the body produce norepinephrine and dopamine, which promote brain alertness and activity. Other brain-boosting proteins include avocados, chicken, beans, and raw nuts and seeds.

• Antioxidants found in fresh foods such as blueberries, carrots and leafy greens strengthen the blood vessel walls in the brain. There are 100,000 miles of blood vessels in the brain, so that is no small job. Vitamin C, found in citrus and green vegetables, is a powerful antioxidant that has been shown to reduce oxidative stress in the brain and helps control spikes in cortisol, leading to more stable energy levels.

• B vitamins are essential for blood and nerve health, which are important for the brain. These vitamins also provide long-lasting energy needed for exam time. Feed on spinach, avocados, beans and nuts.

• Water keeps the blood viscous and moving, bringing more oxygen and nutrients to the brain. Knowing that three soda cans’ worth of blood travels through the brain every minute, it seems right to keep it moving.


• The brain is vulnerable to oxidative damage from free radicals that are released in our modern-day world and also created when our body breaks down certain foods.

• Caffeine and sugar can make it harder for a child to focus and increases stress levels.

• Trans fats and hydrogenated oils have been shown to contribute to diminished cognitive function.

Oh, and let’s not forget breakfast. If you want to increase your chances of focusing during exams, don’t even think about skipping breakfast. Test scores of children who miss breakfast are generally worse than those who eat a well-balanced meal. Children who eat breakfast show better academic performance, longer attention spans and reduced hyperactivity in class.

Even though the secret to success and good grades is not as simple as baked salmon, it clearly can’t hurt to enter exam time with a well-fed brain. So our grocery cart this month will include plenty of that brain-boosting salmon, plus leafy greens, blueberries, eggs and avocados, and we will be putting a premium on healthy breakfasts. Perhaps I’ll start sounding a little smarter this month, too.

• Seidenberg is co-founder of Nourish Schools, a nutrition education company, and co-author of “Super Food Cards,” a collection of healthful recipes and advice.

Register Now for Flat Apple 2017

What Is Flat Apple?

Healthy Lombard’s Flat Apple Summer Program is designed to motivate kids (and their parents since adults are children’s role models) to start, or continue physical exercise,  participate in healthy group activities, and practicing healthy habits. The program is designed to encourage kids to keep their bodies moving when they are on summer break from school.

The summer activity is called Flat Apple because participants need to show the Healthy Lombard logo (a one-dimensional apple) to receive their participation raffle ticket and/or find the Flat Apple 2017 logo at weekly geocaching sites.

Children ages preschool through high school were eligible to participate.

DIRECTIONS (as easy as 1,2,3)


EITHER Click on the Facebook link at the top of this  website and then click “Sign Up”or use THIS LINK TO REGISTER.


Like us on our Facebook Healthy Lombard Selfies page (so that you can post your Selfies and Videos).

  1. Participate in any or all of the Flat Apple Activity. There are 4 ways to have fun:
    Go to a designated site BETWEEN June 1 and August 10. ( i.e. Guest Services Desk, Located Lower Level below The Eatery at Yorktown Mall, show the Flat Apple logo, participate in their activity, and then fill out a raffle ticket. SITES AND DATES OF ACTIVITIES ARE LISTED BELOW AND ON OUR HEALTHY LOMBARD CALENDAR.
  2. Find our Geocache sites. (The coordinates are listed below and will also be emailed out to participants.) Take a selfie with the Flat Apple Geo Sign, post it on our Facebook Healthy Lombard Selfies Page. (We will fill out one raffle ticket for you per site/per day.)
  3. Create a 1-minute or less video on a healthy topic using Facebook Live, Instagram, or similar app. (ideas are on the Healthy Lombard Flat Apple 2017 website). Post it to our Facebook Healthy Lombard Page (We will fill out one raffle ticket for you for each posting we approve.) Remember to add in your family password so we can find you!
  4. Take a selfie of YOU doing something healthy (swimming, playing ball, etc.) using Instagram or a similar app. Post it to our Facebook Healthy Lombard Page. DON’T FORGET to add in your family password so we can fill out a raffle ticket for you. Limit – 1 photo per day.)


The participant (preschool – high school age individual) MUST BE registered by a parent or guardian to win.

Although Flat Apple activities are open to children from preschool to high school, some events are age-specific so please check event information on the Flat Apple 2017 Page of the Healthy Lombard website.

Individuals participate in activities at their own risk.

Students may participate in more than 1 activity per day but cannot repeat an activity (i.e. student could do 1 geocache photo, 1 selfie photo, 1 video, and 1 site activity each day, but cannot do 2 or more of the same type of activity each day.)

Registering grants permission for photo of participation to be posted on the Healthy Lombard Internet sites.

Raffle drawing will be held at the August Healthy Lombard Partner Board Meeting. Winners’ will be notified by email or phone and their FIRST names will be posted on the Flat Apple 2017 page of the Healthy Lombard website.

Winners and their families will be invited to a prize reception in September.

Cut out sugar

Assurance shared that the average American sugar intake is about 32 teaspoons of sugar per day.

Since it is the #1 food additive in the foods we consume, it can often be overlooked. However, cutting down on sugar in your diet may be one of the biggest ways you can improve your health and manage your weight.

Here are steps you can take to cut down on the amount of sugar you intake:

1. Cut it out gradually: Research has shown that sugar is addictive. Use a step-by-step process so your body can adapt to the change.

2. Ask yourself: When do you consume sugar the most? Once you know what to cut down, make a plan. For example, if you normally put sugar in your coffee, gradually reduce the amount you usually add over the next couple weeks.

3. Try cooking: By cooking your own food, you will greatly reduce the amount of sugar you intake. Processed foods are full of hidden sugars and artificial sweeteners even if they are marked as “low-fat” or “no fat” foods.

4. Sleeping helps: Studies have found a relationship between sleep deprivation and junk food cravings. By getting enough sleep, you will set yourself up to avoid those sugar cravings and stay on track with your diet.

What’s in a dietitian’s fridge?

Dietitians are food and nutrition experts! So what would a dietitian eat for breakfast? What foods would she keep out of her kitchen?  Edwards-Elmhurst Hospital  asked Alanna Elliott, RD, LDN, an outpatient dietitian at Edward Hospital in Naperville, what she keeps in her fridge.

Q:  What are your go-to condiments?

A:  Depending on the meal, my go-to condiments include yogurt salad dressings (like Bolthouse), or coconut aminos. Coconut aminos is made from the nutrient-rich “sap” from the coconut tree, it has many amino acids, vitamins and minerals. I also make a lot of stir-fry meals, so using coconut aminos is how I get that soy sauce taste without all of the sodium!

I use several different types of yogurt salad dressings on anything from salads to wraps and even as a marinade.  They are much lower in sodium than other salad dressings and still taste great. If I’m having a sandwich, I will choose either mustard (Dijon, spicy or regular) or Miracle Whip made with olive oil—it’s much healthier than mayonnaise but still very tasty!

Q:  Is there meat in the fridge?

A:  Yes! The main staples in my fridge are chicken breasts, ground chicken breast and extra lean ground turkey. I also try to make salmon when I can.  These items are very lean and provide high quality protein without a lot of fat.

My family loves chicken enchiladas, chicken and veggie stir fry, and ground turkey/chicken “spaghetti” with zoodles (zucchini noodles).  If we are having the occasional red meat, I will choose extra lean ground beef (sirloin 96/4), or a lean steak such as top round or sirloin tip.

Q:  What do you have to drink?

A:  I drink mainly water throughout the day. I try to fill my 32 oz. water bottle at least three times a day. I know that sounds like a lot, but I am very active during the day and work out six days a week, so it is very important to maintain hydration. I also drink green tea in the morning for a little boost of caffeine and antioxidants.

If I’m having cereal, I will use skim milk (I use Fairlife milk) to make sure I’m getting enough protein and unsweetened vanilla almond milk if I’m baking or making oatmeal.

Q:  What takes up the most space in your fridge?

A:  Eggs! We (mostly me) go through so many eggs per week, our entire top shelf is filled with egg cartons. I eat egg whites to get lean protein (1 egg white has 17 calories, 0 grams fat, and 4 grams protein), but I occasionally will make an omelet with 4-5 egg whites and 1 whole egg.

The yolk isn’t bad, it’s actually full of healthy nutrients like fat soluble vitamins and essential fatty acids, but it also adds an additional 55 calories each. I don’t like to use the pre-separated egg white cartons either, buying whole eggs and separating them myself is cheaper.

Q:  What items are banned from your kitchen?

A:  Soda, juice, and pretty much anything pre-packaged and processed. I only like to buy whole, real foods and cook everything from scratch (not as hard as it sounds!). I don’t buy pre-packaged granola bars or muffins, I make all of my own. It’s cheaper, healthier and tastier! Basically the only things we have in our kitchen that are not in our fridge/freezer are oatmeal, quinoa, brown rice, cereal, almonds and popcorn.

I make my and my family’s health a priority and schedule time to cook healthy meals. It’s all about priorities.  If I know I’m going to have a busy week, I will take time on the weekend to whip up a big batch of a healthy casserole or soup and eat throughout the week. If I have time, I’ll make two different things to change it up a bit.

Q:  What’s stocked in your freezer?

A:  Frozen vegetables (my favorites are green beans and broccoli), frozen meat not used before the use-by date, 100 percent fruit bars, berries for smoothies and for topping cereal/oatmeal, and frozen bananas. I can never use all of the bananas we buy before they go bad, so I peel them and keep them in a freezer bag to use in baking or oatmeal.

Q:  What’s your favorite post-workout meal?

A:  I usually work out first thing in the morning, so I would eat breakfast right afterwards (see below). If I work out in the afternoon, I usually have a snack of non-fat plain Greek yogurt with berries, a mini omelet with toast or a homemade granola bar/muffin afterwards.

Q:  What do you whip up for breakfast?

A:  My go-to breakfast is five egg whites and one cup of cooked oatmeal with two tablespoons of chocolate PB2 (powdered peanut butter) and 1 teaspoon of Stevia. This provides a good balance of carbohydrates and protein, especially after my morning workout.

Sometimes I will make an omelet with one whole egg and five egg whites, low-fat mozzarella cheese and veggies with two pieces of whole wheat toast dry or with Earth balance olive oil spread.

Q:  What’s your biggest meal of the day (and what do you eat)?

A:  Truthfully, all three of my meals are about the same size. I usually eat six times per day, three smaller meals with healthy snacks in between to sustain my energy and hunger levels throughout the day. Eating smaller amounts more frequently has been shown to stabilize blood sugar levels for consistent energy, help you avoid overeating due to hunger, and have a positive effect on metabolism.

Q:  What do you eat for energy? How often?

A:  I usually eat a balanced snack with healthy fats, carbohydrates and protein. My favorite snacks are a homemade granola bar/muffin, a brown rice cake with one tablespoon of natural peanut butter, low-fat chocolate milk (try Fairlife, it has more protein and less sugar than regular), 10 almonds with two clementines, or half a turkey sandwich on whole wheat bread.

I make sure to eat every 2-3 hours, and I never go more than three hours without eating to ensure I have consistent energy throughout the day.  It’s important to avoid blood sugar spikes and crashes that can occur with large meals less frequently.

Relief from Raynaud’s Syndrome Symptoms

Jennifer McGrath, L.Ac., Dipl.OM shared in a recent newsletter that Raynaud’s syndrome, also known as Raynaud’s disease, causes a sudden constriction of the vessels supplying blood to the skin, largely affecting the fingers and toes. The symptoms, commonly known as an attack, may be triggered by cold temperatures or emotional stress. Most cases are mild and can be treated with lifestyle changes such as wearing warm gloves and socks, and avoiding rapid temperature changes. While not life-threatening, in rare cases, when left untreated, the affected tissue may become necrotic and gangrenous.

According to a small 1997 study published in the Journal of Internal Medicine, acupuncture is effective in treating primary Raynaud’s syndrome. The patients that received acupuncture experienced a statistically significant decrease in the frequency, severity and duration of their vasospastic attacks. The patients in the control group showed no improvements. Researchers concluded acupuncture was safe and effective for treating the symptoms of primary Raynaud’s syndrome.

As a cold environment or object is often responsible for triggering an attack, this may indicate a Yang deficiency. When Yang energy is low, blood circulation may slow down as a result. Symptoms of Yang deficiency include feelings of cold, lower back or knee pain and a weak pulse. Treatment in this case would focus on boosting Yang energy, circulation and the immune system.

Research studies effect of vitamin C on cancer cells

The Daily Herald reported recently that one of the most exciting areas of medicine today involves the use of stem cell therapy.

Stem cells may be beneficial for degenerative joint disease and chronic neurologic disorders and repairing damaged organs. It has been discovered that tumors also contain stem cell-like cells. These cells are responsible for tumors developing resistance to chemotherapy and radiation therapy as well the metastasis of cancer.

Some medical research has shown that cancer stem cells can be suppressed. Interestingly, vitamin C strongly suppresses cancer stem cell activity both in the test tube and probably in humans.

Cancer stem cells are believed to be most involved in the development of chemotherapy and radiation therapy resistance. These cells are ultimately responsible for treatment failure and metastasis in patients with advanced disease.

A successful anticancer therapy would not only address the normal cancer cells, but also try to inhibit the activity of cancer stem cells. There are a few experimental medications that do seem to suppress cancer stem cell activity, however vitamin C as well as an extract of milk thistle, silibinin, may be able to suppress cancer stem cell activity.

In a combined study done at the University of Manchester (England), University of Calabria (Italy) and the Albert Einstein College of Medicine demonstrated that cancer stem cell activity can be inhibited by both vitamin C and silibinin. Although the study was conducted in the test tube, it was discovered that these compounds interrupt an important metabolic pathway in cancer stem cells called the Krebs cycle.

The Krebs cycle is an important metabolic pathway for generating energy. Cancer stem cells seem to make more energy than normal cancer cells and so interrupting this important pathway significantly reduces cancer stem cell metabolic activity.

Several experimental drugs also affect the Krebs cycle in cancer stem cells, but these drugs can have significant side effects that would limit their use. In contrast, vitamin C and silibinin have very few side effects and in general are quite safe.

Although this individual study does not prove that select natural compounds are clinically effective in the treatment of cancer, it may help to explain some data involving vitamin C and cancer.

A large study published in Cancer Epidemiology, Biomarkers and Prevention demonstrated that taking vitamin C reduces the risk of mortality as well as recurrence (reducing cancer stem cell activity?) in patients diagnosed with breast cancer. In this study almost 5,000 women were followed for four years. Those women who began taking vitamin C within six months of their diagnosis had an 18 percent reduced mortality risk and a 22 percent reduced risk of recurrence.

Another study published in the European Journal of cancer involving over 17,000 women with breast cancer demonstrated a 19 percent reduced mortality risk. Interestingly, in this study vitamin C supplementation not only decreased the risk of dying from breast cancer but decreased the risk of overall mortality.

Although the studies are not definitive, they are highly suggestive that these alternative therapies may be “ready for prime time” in the war against cancer.

• Patrick B. Massey, MD, PH.D., is medical director for complementary and alternative medicine at Alexian Brothers Hospital Network and president of ALT-MED Medical and Physical Therapy, 1544 Nerge Road, Elk Grove Village. His website is

Put Some “Spring” in your Step

Gregory G. Caronis, M.D., a board-certified orthopedic surgeon with Advocate Medical Group Orthopedics, shared that with the long-awaited, warmer days of spring approaching, don’t let all of the activities you looked forward to all winter get spoiled by a problem that many people face — aching feet and ankles. It’s hard to be active and healthy when pain is a constant.

With a board-certified specialty in disorders of the foot and ankle, I see many patients who have lived with years of discomfort that plagues both recreational and daily activities. They become more sedentary, postponing important physical activities that have both physical and psychological benefit. Many of these conditions can be treated medically with simple, conservative measures. Others have surgical solutions that can ultimately yield an enhanced quality of life. Orthopedic surgeons like me who complete post-residency education and training through a fellowship in disorders of the foot and ankle can address both the medical and surgical causes of these painful conditions.

It Feels Like there’s an Icepick in my Heel: This common complaint presents to my office several times each week, if not daily. This patient complains of intense pain at the undersurface of the heel, usually associated with extreme stiffness in the morning and after extended period of sitting. We call this “start-up” pain, and it is a hallmark of a condition called plantar fasciitis. The plantar fascia is a tendon sheath that runs along the undersurface of the foot. It is commonly associated with inflexibility of the Achilles tendon and flat arches. Sometimes increased activity will bring on a flare — sometimes it occurs with no apparent reason. While this condition is quite painful and inconvenient, it usually resolves over time with a course of ice, rest, anti-inflammatory medications like ibuprofen and physical therapy. Stretching the heel cord, or Achilles, is the mainstay of treatment. Cushioned gel heel cups provide considerable relief and cortisone injections are sometimes utilized if the condition persists for several months, despite treatment. Sugery is reserved for refractory cases — in nearly 20 years of practice, I’ve operated on only a handful of patients.

My Achilles is so Tight — it Might Tear: The largest tendon in the body, the Achilles tendon is a common site of inflammation. It connects the muscles in your lower leg to the heel bone, and is commonly aggravated by athletic activity — sometimes the culprit is overuse, but degenerative changes can also play a role. Patients hobble into my office with pain and swelling in the base of their heel and a concern about rupturing the tendon due to pain and tightness. They point to the back of the heel as being the source of their trouble, and there is often a painful “bump.” Patients complain of pain in the back of the heel with physical activity and an overall tightness in the Achilles. Tightness in the heel cords or Achilles plays a significant role — tightness can be associated with flatter arches or the overall loss in flexibility that tends to occur naturally as we age. Conservative measures like ice, anti-inflammatory medications and, particularly, stretching can be helpful in alleviating symptoms. The condition can become chronic, and a period of immobilization in a walking boot can sometimes calm the tendon to the point that physical therapy is more effective. I sometimes operate for treatment of prolonged cases that fail to respond to these other treatments.

My Big Toe is Killing Me: Patients frequently come to see me when pain at the base of the great toe causes walking or athletic activity to be painful. Arthritis at the joint of great toe or first metatarsal phalangeal joint is the most common site of arthritis in the foot. The bones of the foot and great toe are generally covered with a smooth cartilaginous surface. Chronic stress on the joint from certain anatomy of the foot that places excessive force on the joint or injury from running or other sports can damage the cartilage — often with the development of painful, bony spurs at the top of the joint and roughening of the two articular surfaces. The toe becomes inflexible, and every step is associated with pain. I frequently recommend simple measures like avoiding high heels and purchasing shoes with a wider toe box can be helpful. Ice and anti-inflammatory medication can reduce symptoms. Patients tend to be more comfortable in a shoe with a rigid sole. If symptoms persist, surgery is an option. If the degeneration is not particularly severe, a more minimal surgery can be done to remove the offending bone spurs. In advanced cases, I perform a fusion to encourage the two surfaces to grow together. Patients usually have fairly limited ROM at that point, and they trade a minimal increase in stiffness with pain relief as the two rough, arthritic surfaces are no longer rubbing together.

Every Step Hurts: When standing, walking or running, the three bones that make up the ankle joint provide support, shock absorption and balance. The bones allow for the up and down movement of the ankle. There is another joint beneath the true ankle joint that provides for the side to side motion of the ankle that is essential in enabling us to adjust our gait on uneven surfaces. These joints are typically covered by a smooth, slippery articular cartilage surface that provides for easy, fluid motion. Sometimes from trauma but, more commonly, through wear and tear, the cartilaginous surface starts to wear or become roughened, and abrasive osteoarthritic surfaces are the result. Patients come to see me distressed as each step is associated with the pain of the two rough surfaces colliding.

Arthritis of the foot and ankle can present in a variety of ways. My patients often complain of tenderness at the ankle joint along with warmth or swelling. Early morning pain is often worse as is the aftermath of extended standing or walking. Nonsurgical therapy varies from anti-inflammatory medication — like ibuprofen – to bracing and inserts for shoes which support and help to minimize pain. Periodic cortisone injections can help keep pain under control.

If degenerative changes are severe enough and fail to respond to conservative therapies, my patients and I have a discussion about surgery. For arthritis of the ankle — or tibiotalar joint — two surgical options exist — a total ankle replacement or a fusion. The most appropriate surgery depends of a variety of factors which I review carefully with patients during a pre-operative consultation.

A fusion, or arthrodesis, fuses the bones of the joint completely, making one bone out of two. The goal is to decrease pain by eliminating motion in the arthritic joint. I remove the damaged cartilage in surgery and then use pins, plates and screws to fix the joint in a permanent position. This is usually a successful and durable solution to the problem. An important factor to consider is the extended period of non weightbearing required after surgery to facilitate successful fusing of the two bony surfaces. My staff and I work together to ensure that the patient has a post operative rehabilitation plan that will allow them to continue to take care of the business of life while ensuring optimal frecovery.

For some patients, a total ankle arthroplasty (TAA or ankle replacement) is a good surgical choice. With a TAA, the damaged cartilage is removed and the bone is prepped — a new metal and plastic joint is implanted — effectively replacing the joint. While TAA is an excellent solution for a painful, arthritic ankle joint, the life-span of the implant must be considered. Current implants last about 20 years, and the joint does not respond well to demands such as running or jumping — generally making TAA a poor choice for a younger patient. I typically perform ankle replacement surgery in older, less physically active arthritic patients with appropriate indications for surgery.

I’m Confused — Orthopedist or Podiatrist for Foot/Ankle Pain? With so many options available to treat common disorders and associated pain in the foot and ankle, don’t suffer with limitations to basic daily and recreational activities.

While podiatrists have a role to play in care of the foot and can manage a number of common conditions, orthopedic surgeons like me who specialize in foot and ankle conditions are medical doctors who have completed medical school, an orthopedic residency and an additional year of fellowship specific to disorders of the foot and ankle. We are well-trained and uniquely qualified to use medical, physical and surgical methods to restore function and to lead a team of other professionals including physician assistants, physical therapists and pedorthotists.

In Chicago, we eagerly await the return of longer, warmer days. Life is too short to struggle with nagging, chronic foot and ankle pain that makes each step a burden. Consider the options and take needed action to put some “spring” in your step.

Gregory G. Caronis, M.D. is a board-certified orthopedic surgeon with Advocate Medical Group Orthopedics. His practice specialties include disorders of the foot and ankle, fracture care and general orthopedics. Dr. Caronis is currently accepting new patients in his Lincolnshire and Libertyville offices. For more information or for orthopedic questions, he can be reached at or at AMG Orthopedics (847) 634-1766.