Health & Awareness Articles

Save Your Vision

Your vision is priceless. When it comes to eye health, sometimes our concerns start with visual acuity problems and end with contacts or glasses. It can be easy to forget that the eyes are related to the health of Read more

March is Colorectal Cancer Awareness Month

  Since 2000, March has been the month to promote awareness of colorectal cancer. Many individuals raise awareness on March 2nd by showing off their blues to call attention to the prevalence of this cancer. Jennifer Giebel, APNP at Sheboygan Cancer Read more

February is Heart Health Awareness Month

  In February heart-shaped decorations, cards, balloons, and chocolates appear everywhere. This is a great reminder that since 1964 February has been American Heart Month. Heart disease is the leading cause of death for men and, through the efforts of Read more

February: Go Red for Women!

You may know that heart disease is the leading cause of death for men. But did you know that heart disease is also the leading cause of death for women? In fact, in the US, 44 million women are Read more

January is Thyroid Awareness Month

  January is Thyroid Awareness Month. The thyroid gland is a butterfly-shaped endocrine gland found in the front of the neck. When functioning properly the thyroid often gets little attention. However, a malfunction can have a profound impact on health and wellness. Read more

March is Colorectal Cancer Awareness Month

Physicians Health Network Health & Awareness Articles


Since 2000, March has been the month to promote awareness of colorectal cancer. Many individuals raise awareness on March 2nd by showing off their blues to call attention to the prevalence of this cancer.

Jennifer Giebel, APNP at Sheboygan Cancer & Blood Specialists says, “Colorectal cancer is highly treatable which makes spreading awareness truly a potential lifesaver.” At the end of the large intestine are the colon and the rectum. When cancer occurs in these areas it is known as colorectal cancer. When it becomes metastatic, this type of cancer most commonly spreads to the liver. Colorectal cancer is the second leading cause of cancer death in the US and it affects women and men equally. The incidence for African-Americans is 20 percent greater than it is for Caucasians. Individuals with a first-degree relative with colorectal cancer, meaning a child, sibling, or parent have two to three times greater risk. “Colorectal cancer can occur in individuals of all ages but is most common in people over 50 years of age. However, it’s important for younger individuals to be aware of the risk factors for this disease to avoid mistakenly ignoring early symptoms,”

Screening for colorectal cancer is very important. This is because the earlier colorectal cancer is found the greater the chance of successful treatment. According to Giebel, “Men and women should have regular screening starting at age 50. Regular screening enables us to find precancerous polyps or colorectal cancer early when they are most easily treated.” In fact, when colorectal cancer is found in early stages, the 5-year survival rate can be 90 percent.
Symptoms can include:
• A change in bowel habits or the shape of the stool.
• Persistent abdominal discomfort – Including cramps, gas, feeling full, bloated or pain.
• Rectal bleeding – Finding blood in your stool or in the toilet after bowel movement.
• Weakness, fatigue or unintentional weight loss.
• The urge to have a bowel movement when the bowel is empty.
• Dark or black stools

In addition to regular screening, you can reduce your risk of colorectal cancer by making some positive lifestyle changes. These include:
• Avoid excess alcohol consumption
• Maintain a healthy bodyweight
• Avoid (or quit) smoking
• Be physically active

Treatment options vary, and Jennifer says, “The course of treatment depends on the size, location, and stage at which the cancer is found. Some smaller, local, early-stage tumors can be treated with surgery alone”. Some of the common treatment strategies for colorectal cancer include:
• Surgery
• Chemotherapy
• Biological Therapy
• Liver-Directed Therapy
• Radiation Therapy

“Symptoms can also be associated with many other health conditions and early colorectal cancer often does not cause pain. Contact your physician if you have symptoms and need to determine the cause,” said Giebel. Consider proudly wearing your blue on March 2nd and help spread to word that early detection of colorectal cancer can be a lifesaver.


February is Heart Health Awareness Month

Physicians Health Network Health & Awareness Articles


In February heart-shaped decorations, cards, balloons, and chocolates appear everywhere. This is a great reminder that since 1964 February has been American Heart Month. Heart disease is the leading cause of death for men and, through the efforts of groups like the American Heart Association, there is growing awareness that it is the leading cause of death for women as well.

Dr. Louie Coulis, MD, FACC, Coulis Cardiology says, “When dealing with heart disease risk it can be helpful for those concerned to look at their risk factors in two categories. Those they can change or modify and those they cannot.” Your age, sex, family history, and racial background cannot be changed. However, those factors that can be modified with lifestyle changes are:

• Blood pressure
• Body weight
• Cholesterol
• Exercise
• Smoking
• Type II diabetes.

“Targeting the modifiable risk factors means that doctors and patients can work together to make dramatic reductions in heart disease risk,” said Dr. Coulis. For example, diabetes is strongly linked to heart disease. In fact, the most common cause of death among type II diabetics is heart or blood vessel disease and their risk of death due to a cardiovascular event is as much as six times greater than non-diabetics. Unregulated blood sugar worsens the risk of heart disease but as Dr. Coulis notes, “even with controlled blood sugar a diabetic’s risk of heart disease is elevated.”

Likewise, smoking is a powerful heart disease risk factor. Smoking doubles one’s risk of heart attack and, according to Dr. Coulis, “smokers who quit can see a four-fold reduction in their risk of heart disease. Quitting also reduces the secondhand smoke exposure for others, which is also a heart disease risk factor.”

Most people survive their first heart attack and make a functional recovery. Dr. Coulis says, “The improvements in emergency cardiology mean that, if caught in time, those who suffer a heart attack can be treated. Still, it is a good idea for individuals at risk of heart disease and their loved ones to be acquainted with the symptoms of a heart attack.”
The symptoms of heart attack include:
• Chest pain, shortness of breath or fatigue. It is important to note that approximately 1/3
of people who have a heart attack do not feel any chest pain. Many of these are women,
non-Caucasian, or older than 75.
• Pain in the middle of the chest which can spread to the back, neck, jaw or arms.
• Nausea & vomiting which are sometimes mistaken for food poisoning or the stomach flu.
• Gas-like pain or pressure in the stomach area which is may be mistaken for indigestion.
• Lightheadedness or dizziness.
• Feelings of restlessness, sweating, or anxiety.
• Bluish lips, hands, or feet.
• Heavy pounding of the heart or abnormal heart rhythm.
• Loss of consciousness.

The word is spreading. There is greater awareness of heart disease, its risk factors, and the symptoms of a heart attack. If you are interested in assessing and lowering your risk of heart disease see your doctor.

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January is Thyroid Awareness Month

Physicians Health Network Health & Awareness Articles


January is Thyroid Awareness Month. The thyroid gland is a butterfly-shaped endocrine gland
found in the front of the neck. When functioning properly the thyroid often gets little
attention. However, a malfunction can have a profound impact on health and wellness. The
thyroid gland regulates the human body and its metabolic processes much like a thermostat
regulates a furnace or a gas pedal regulates an automobile engine. In other words, the thyroid
gland, by producing thyroid hormones, affects how our cells use energy. Like the gas pedal,
thyroid hormones increase the body’s metabolic rate. In fact, most of your cells have receptors
for the thyroid hormones which means that the thyroid has an enormous effect on our body.
The thyroid regulates body temperature, it influences brain health, heart function, muscle
strength, bone density, and much, much more.

The thyroid hormones have powerful effects and so the thyroid must be carefully
controlled by the body. Too little thyroid hormone and key processes around the body slow to a
crawl. Too much thyroid hormone and the same processes rev dangerously high. Dr. Liz Zurich,
D.O. from Sheboygan Internal Medicine Associates explains, “While the thyroid gland controls
many processes in the body, it is itself controlled by other glands.” That control comes down
from the pituitary gland in the brain in the form of thyroid stimulating hormone (TSH) As the
name implies, TSH signals the thyroid gland to release two hormones. One is triiodothyronine,
also known as T3, and the other is thyroxine, also known as T4. Just as the thermostat in a
house signals the furnace to shut off when the house is getting too warm, the release of T3 and
T4 into the bloodstream signals the pituitary gland to stop producing TSH. This type of control
forms an elegant loop known as a feedback loop.

Imagine a malfunctioning thermostat leading to either an overworked furnace or a furnace that
will not kick on when needed. Dr. Zurich says, “The thyroid gland can malfunction in a similar
way, becoming either underactive or overactive. We call these disease states hypothyroidism
and hyperthyroidism.” When normal thyroid function is disrupted many essential metabolic
processes can also become either underactive or overactive and lead to profound negative
health effects.

Dr. Zurich says, “There are several causes of hyperthyroidism, such as inflammation, viral
infection, or cancer, but most cases are caused by Graves’ disease. Graves’ disease is an
autoimmune disorder in which immune antibodies overstimulate the cells of the thyroid.” This
results in an enlarged and hyperactive thyroid that is producing too much T3 and T4. This
condition is most common between the ages of 30 and 50 and afflicts women more than men.
Because the thyroid influences so much that goes on in the body it is no surprise that almost
every organ can be affected by hyperthyroidism. It is also no surprise that the list of
hyperthyroid symptoms are diverse:

● Increased appetite
● Weight loss
● Nervousness or anxiety
● Irritability
● Increased perspiration
● Racing or irregular heartbeat
● Hand tremors
● Difficulty sleeping
● Muscle weakness
● Osteoporosis
● Diarrhea
● Goiter
● Bulging eyes or vision issues

The numerous and diverse symptoms associated with thyroid dysfunction means that,
sometimes, other health issues can resemble thyroid dysfunction. The thyroid may unfairly take
the blame. Your physician is best equipped to help you determine if you have a health issue
related to the thyroid gland. Dr. Zurich says, “When we want to test for thyroid dysfunction we
can check the levels of TSH, T3, and T4. These levels can tell us if the thyroid is overactive or
underactive. We may also test for the relevant antibodies in cases where Graves’ disease is

The best course of treatment for hyperthyroidism is determined by the patient and his/her
physician. In some cases, it is necessary for the patient to have their thyroid gland ablated, or removed. Thyroid hormone replacements are then taken to maintain normal levels. “Treatment for Grave’s disease, or other cases of hyperthyroidism, include anti-thyroid medications, surgery, or radioactive iodine,” said Dr. Zurich.

Observe thyroid awareness month with an appreciation of the important role the thyroid gland
plays in our health and wellness.

Smith, T. J., & Hegedüs, L. (2016). Graves’ Disease. New England Journal of Medicine, 375(16),
1552–1565. doi:10.1056/nejmra1510030

December Health Awareness: SAD

Physicians Health Network Health & Awareness Articles


Beating Seasonal Affective Disorder

Winter is cold, long, and dark. This lack of light can have a profound impact on our health. We often use the expression “winter blues” to refer to the familiar dip in mood and energy that comes with these cold, long nights. Mental Health Counselor Karla Willis is familiar with the profound changes in health some of us experience when the seasons change. She says, “When the winter season depresses our mood, energy, and enjoyment with life we call it Seasonal Affective Disorder, or SAD for short.”
Approximately four to six percent of the population experience SAD and the incidence varies with latitude. For example, about one percent of residents in Florida are diagnosed with SAD compared to nine percent in Alaska. Women are at a greater risk than men and teens and young adults are at greater risk than older adults. SAD starts in the fall as the days shorten, and symptoms peak in the winter. “It’s important to remember that Seasonal Affective Disorder is a type of depression. In fact, individuals with a history of depression are at greater risk for SAD,” said Willis.
Behind the scenes, our eyes do more than just provide us with vision. They send messages on special tracts of nerves to various structures in the brain regarding the time of day and the time of year. These messages are based on the type and amount of light stimulating the eyes. Some of these brain structures, such as the hypothalamus, the pituitary gland, and the pineal gland, govern neurotransmitters and hormones that control hunger, energy levels, sleep, and other important functions. The lack of abundant, full-spectrum sunlight in the winter results in less stimulation to these key brain structures and can impair the natural rhythms of hunger, energy, mood, and much more.
Levels of serotonin, a neurotransmitter that influences mood and appetite, are lowered in the brains of SAD sufferers. According to Willis, “A decrease in serotonin levels is shared by SAD sufferers and those individuals with other types of depression.” Melatonin, which influences, among other things, sleep, your body’s clock, and immunity, is produced excessively during SAD. These alternations in brain chemistry result in the characteristic symptoms of SAD which are:

● Decreased energy levels
● Increased sleep
● Increased appetite often with carbohydrate cravings
● Decreased ability to concentrate
● Social Withdrawal

A diagnosis of SAD is made by matching symptoms with the changing seasons; especially if the symptoms repeat for two years consecutively. “Multiple treatments can be effective for relieving the symptoms of SAD. A mental health professional can help patients decide which treatment or combination of treatments will benefit them,” said Willis.
Light therapy is a common and effective treatment for SAD. This treatment is based on the recognition that a lack of full-spectrum light stimulating the eyes leads to the symptoms of SAD. Light therapy involves looking towards, but not directly at, a special light-box for about 30 minutes every morning. These light boxes are very bright but not as bright a sunny day. Measured in lux, a unit of brightness, a typical light-box used to treat SAD produces 10,000 lux. Outdoors on a sunny day may be around 100,000 lux. Medications, often the same drugs used for other forms of depression, are also used to treat SAD. Particularly drugs known as selective serotonin uptake inhibitors which boost those diminished serotonin levels. Cognitive behavioral therapy, which involves identifying negative thoughts and cultivating positive thoughts and healthful behaviors, can be as effective as light therapy in the treatment of SAD. In fact, there is some evidence that cognitive behavioral therapy can help, not only with the current winter symptoms but with future winters as well. Willis says, “Cognitive behavioral therapy can give SAD sufferers tools that will help them minimize the impact of SAD year after year.” Other treatments that may be beneficial for SAD are vitamin D supplementation, herbal supplements, and exercise. It’s important to note that some of these treatments can take three to four weeks before symptoms begin to improve.
“Mental health professionals recognize SAD as a type of depression and we want to spread the word that it should be taken just as seriously,” said Willis. If you feel you are suffering from SAD contact your mental health provider or primary care physician.


Rohan, K. J., Mahon, J. N., Evans, M., Ho, S.-Y., Meyerhoff, J., Postolache, T. T., & Vacek, P. M. (2015). Randomized Trial of Cognitive-Behavioral Therapy Versus Light Therapy for Seasonal Affective Disorder: Acute Outcomes. American Journal of Psychiatry, 172(9), 862–869. doi:10.1176/appi.ajp.2015.14101293

Rohan, K. J., Meyerhoff, J., Ho, S.-Y., Evans, M., Postolache, T. T., & Vacek, P. M. (2016). Outcomes One and Two Winters Following Cognitive-Behavioral Therapy or Light Therapy for Seasonal Affective Disorder. American Journal of Psychiatry, 173(3), 244–251. doi:10.1176/appi.ajp.2015.15060773

November is National Diabetes Month

Physicians Health Network Health & Awareness Articles


November is national diabetes month; a time to promote awareness of the challenges faced by those with diabetes. In 1958 there were just over 1.5 million cases of diabetes in the US. In recent decades that number has steadily, and dramatically, climbed. In 2015 there were 23 million American adults with diabetes. this is a combined total of both type 1 and type 2 diabetes. Of the combined totals, only about 5 percent is attributed to type 1 diabetes. And the rest are type 2. Read more

October is Sudden Infant Death Syndrome (SIDS) Awareness Month

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Sudden Infant Death Syndrome, or SIDS, is the sudden and unexplained death of an infant under 12 months old. SIDS is the most common cause of death between the ages of 1 month and 12 months and it most commonly occurs between 2 to 4 months.
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September: Prostate Cancer Awareness Month

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September is prostate cancer awareness month. For men, prostate cancer is the second most common cancer after skin cancer and the second leading cause of cancer death after lung cancer. In fact, one in seven men will be diagnosed with prostate cancer and most cases occur in men over the age of 65.

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August is National Immunization Awareness Month

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Immunizations have had a dramatic effect in improving the health of children in the United States.
Most parents today have never seen the devastating consequences that vaccine-preventable diseases have on a child, a family or community.
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Summer Increases Our Need for Water Safety

Physicians Health Network Health & Awareness Articles


What better way to escape the summer heat than to take to the water? Backyard pools and lakes are refreshing, fun and great exercise. But, making a splash can come with some unique dangers. Many of activities in water will be done without trained lifeguards on duty. That means when you get ready to go to the beach, water safety is just as important as your towel, bathing suit, sun block and sunglasses.
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Protect Your Eyes from The Rays of Summer

Physicians Health Network Health & Awareness Articles


Summer is just around the corner!

That means it’s time to enjoy picnics and parades; beaches and ballgames; festivals and fireworks. Most of all summer means sunshine. Like most things we need to take the good with the bad when it comes to the rays of the summer sun.

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