Osteoporosis: How to Prevent a Silent Killer By Deborah Collins, PA-C

Every year more than 200 million people will suffer from Osteoporosis, and 3 million new US cases will be diagnosed. In fact, half of all adults 50 years and older, are at risk of breaking a bone and should be screened before they require medication. The reason Osteoporosis is often overlooked is because there are usually no symptoms. “You cannot feel your bones becoming weaker.” It is for this reason that it is often called “a silent disease” until a fracture occurs.  What is especially alarming is that 80% of the people who suffer a fracture over the age of 50, will not be advised to be tested or treated for Osteoporosis.  If you knew that your risk of a fracture was equal to the combined risk of breast, uterine, and ovarian cancer, would that change your mind about the importance of early screening?

At the Couri Center, our providers recognize the importance of your bone health. It is just as important to us as your breast and cervical cancer screenings.  We want to help PREVENT you from this disease before a fracture occurs. In fact, we have customized Couri girl MedPax supplements for this very purpose!  Couri girl Osteopenia is for women diagnosed or at high risk of developing osteopenia and Couri girl Osteoporosis, is for women diagnosed with osteoporosis.

Unfortunately, 24% of hip fracture patients, over the age of 50, will die in the first year following a hip fracture. Osteoporosis is not only costly, but it can be deadly. However, with early intervention, it is not only preventable but treatable.  If you have any one of the following risk factors, please have a conversation with your provider and consider a simple test for screening.

  • All women age 60 and over, independent of risk factors
  • Menopausal females under the age of 60 who have risk factors such as:
  • Low body weight< 130 pounds
  • Prior fracture- non-traumatic or low trauma as in falling from standing height or spine compression fractures. Basically, a break over the age of 50
  • High-Risk medication use – steroids, chemotherapy agents, Tamoxifen, Depo-Provera >5 years, anti-seizure medication
  • Chronic disease associated with bone loss (Hyperparathyroidism, Malabsorption, Malnutrition (Bulimia/anorexia), Premature Menopause, Hyperthyroidism, Chronic Liver Disease, Rheumatoid Arthritis, Diabetes
  • Regular alcohol use, more than 3 drinks a day
  • Cigarette smokers

Here are a few tips to prevent Osteoporosis

  • Eat a healthy diet and exercise regularly, which can help slow or stop the loss of bone mass and help prevent fractures.
  • Talk to our registered dietitian to make sure you are getting enough calcium and Vitamin D in your diet.
  • Get a screening bone density test, which is the best way to diagnose low bone mass before it becomes Osteoporosis.
  • Let us help you determine a treatment plan. If your screening test indicates that you may have Osteoporosis, or have other significant risk factors for breaking a bone, call the Couri Center to schedule today:  309 692-6838.



The Couri Center Welcomes Deborah Collins, M.S., PA-C

Training/Education: Deborah Collins, M.S., PA-C

Meet Deborah Collins, M.S., PA-C.  Dr. Michele Couri, and the Couri Center team proudly welcomes Deborah to our practice, May 2019.  Deborah received her Physician Assistant training at the University of Southern California, Los Angeles in 1997. She completed her Women’s Health and Internal Medicine training at the West Los Angeles Veterans Administration, UCLA in 1999. She subsequently worked in Community Health Clinics specializing in Family Planning, Obstetrics and Family Medicine for nearly 15 years. Read more on training/education

Deborah is excited to join the Couri Gynecology Center, where she can incorporate her family medicine background, while expanding her knowledge of Integrative and Functional Medicine. We hope you enjoy learning more about her in the following interview.

Interview Q & A with Deborah Collins, M.S., PA-C:

What is one word you would use to describe yourself? Adventurous.

What are you most proud of?  My three wonderful children.

 How do you recharge?  By having coffee with a friend or going for a walk.

Do you like to cook? What is a favorite recipe? I love to cook!  Homemade Chicken Enchiladas is my favorite.

Which sports teams do you root for? I used to be a Padres fan, but now I am a cubbies fan!

If you were to tell one person “Thank You” for helping me become the person I am today, who would it be and what did they do?  Probably my mom! She always worked hard and was a great example to me. She was a Chief in the United States Navy who served 20 years of Active Duty.

 What movie or novel character do you most identify with?  “Patch Adams.” Developing compassionate connections with my patients is what brings me joy. I also have a pretty humorous side and can be quite silly at times. I sincerely feel that laughter is an essential part of healing, and simply good for the soul.

 When are you the happiest? When I am spending quality time with my family.

 If you really knew me, you’d know…. that I love adventures and traveling.

 What would you most regret not having done by the end of your life? I have no regrets, and I am blessed beyond measure – anything else is a gift!

 What characteristic do you most admire in others? Integrity and honesty.

What are you most passionate about?  Helping others pursue their dreams, and watching them succeed.

 What one memory do you most treasure?  Holding my father’s hand while he passed away.

 What would a “perfect” day look like for you?  Breakfast with my children, going for a beautiful hike or a walk as a family, followed by a short nap. After that, I would prepare dinner for some good friends, coupled with a nice bottle of wine and a delicious dessert to end the evening.

 What’s the most important lesson you’ve learned in the last year?  Since I had a house fire in 2018, I learned that “things” don’t mean much to me. Everything is replaceable, except your family and pets. I don’t put as much value into objects anymore. Life is so much simpler!

 If you could volunteer your time, what would you do? I would serve Veterans in some capacity.

 What is your favorite season?  Why?

I love the summer because I love to be outside, barbecuing, swimming, gathering with friends/family.

 If you had just one box for all your stuff, what would you put in it?  Funny, I have actually had to do this. I put all my family pictures, important papers, Military medals/coins, grandmother’s jewelry all in one box.

 What type of music do you enjoy? I love all genres, but probably Hip-Hop above all.

What is your least favorite exercise? Probably running.  What’s your go-to workout?  I like the Arc Trainer or Elliptical

 Favorite book(s)?  Any Biography, I love to learn about people!” Self-Help books, “Letting Go,” “The Secrets of Forgiveness,” “The Grief Handbook,” “Lean In.”  Nonfiction: “Educated” by Tara Westover, “This is Going to Hurt” by Adam Kay, and of course, The Bible by God.

We have so many incredible female patients here at the Couri Center.  What would you most like to share with them?  I would like them to know that I am a relatable woman who has endured heartbreaks and joys over my lifetime, as they may have. I am probably the most open-minded person they will ever encounter. I consider it an honor to get to know them individually, and feel their healthcare journey begins with a partnership between the two of us, to help them achieve their goals.


Deborah is accepting new and existing patients. Schedule today at 309-692-6838 or visit www.couricenter.com.

Meet harmonié . Bio-identical hormone replacement therapy

Anti-Aging at the Couri Center:

The proper balance of hormones is vital to a woman’s health. Recent studies show that women are experiencing menopause at much earlier ages. By age 40, most women are totally depleted of normal levels of estrogen and have lost nearly all their progesterone and more than half of their testosterone. While a normal part of aging, these changes can greatly affect the way we feel. Untreated, imbalanced hormones cause a variety of undesirable symptoms.

Symptoms of hormone imbalance:

  • Anxiety/Depression
  • Fatigue/Loss of energy
  • Weight gain
  • Decreased libido/Sex drive
  • Hot flashes/Night sweats
  • Hair loss
  • Insomnia
  • Loss of muscle tone
  • Brain Fog/Loss of memory
  • Irritability
  • And more…

Dr. Michele Couri, MD, FACOG, ABIHM has specialized in gynecology and women’s health for over 18 years.  Passionate about treating changing hormones & symptoms of menopause, the Couri Center is the leader in women’s bio-identical hormone replacement therapy pellets.  Trust the experts.

If you suspect fluctuating hormones are causing undesirable changes in your body, it’s easy to get your hormone levels checked:  Schedule here: info@couricenter.com or call 309 692-6838.







Combating Estrogen Dominance By Hope Placher, MMS, PA-C, IFMCP

One of the most frequent concerns that I hear from my patients is suspicion of a hormonal imbalance.  It’s easy to have a love / hate relationship with our hormones; can’t live with ‘em – can’t live without them! Ask a woman in menopause what it’s like to have too little estrogen, or hear from a friend who has PCOS how too much testosterone can negatively affect her body.

Today, I am focusing all of my attention on estrogen.  A short list of it’s duties include: building up endometrial tissue in the uterus, protecting our mood, brain and heart, and keeping our vaginal tissue moisturized and pH balanced. Estrogen is so important to the female body – but we need to keep it in check! Trust me, you can have too much of a good thing. Symptoms of estrogen dominance are: irregular or heavy menstrual cycles, water retention, fibrocystic / tender breasts, mood swings, hair loss, thyroid dysfunction, foggy thinking, fatigue, PMS – just to name a few.

It’s important to understand that our hormone levels are not static. When a woman’s menstrual cycle is normal, estrogen is the dominant hormone for the first two weeks leading up to ovulation. Estrogen then becomes balanced by a surge of progesterone during the last two weeks of the cycle. Unfortunately, this hormonal symphony can be disrupted if the ratio between estrogen and progesterone is out of tune. To understand if this hormonal imbalance is taking place, a simple blood or saliva test can be performed on a specific day of your cycle. Your provider will determine which method of hormonal testing is right for you.

Here are some practical ideas to keep your hormones in sync:

  1. Eat lots of fiber. Estrogen is excreted by your bowel; if stool is not properly and frequently excreted, estrogen will be re-absorbed.
  2. Detoxify your liver. Sweat. Utilize an infrared sauna or ask your provider if you are a candidate for a focused 7-21 day liver detox.
  3. Eat the highest quality food your budget allows. Factory farmed animals are high in estrogen containing growth hormones. Look for grass fed meats and organic dairy.
  4. Learn to love your veggies. Studies show indole-3-carbinol (I3C) – prevalent in the cruciferous veggie family have been found to alter estrogen metabolism – thus protecting against hormone-dependent cancers.  Need help managing your nutrition? Contact our Registered Dietitian for a consultation.
  5. Decrease stress.
  6. Assess the quality and ingredient list of personal care products to avoid xenoestrogens.


Hope Placher, MMS, PA-C, IFMCP

Dense Breast Tissue & Mammograms By Renee Alwan Percell, PA-C

Breast cancer is the most commonly diagnosed cancer in women and second leading cause of cancer death in American women, according to The American College of Obstetricians and Gynecologists. Mammogram screenings should begin for the general population at age 40. Regular mammograms can find breast changes that could be cancer years before physical symptoms develop. Women should become familiar with how their breasts normally look and feel and report any changes to their health care provider.

After your mammogram is complete the radiologist will look at the images and describe it on the final report. Breast tissue will look different depending on what type of tissue you typically have. Women can have almost entirely fatty tissue, scattered fibroglandular densities or heterogeneously dense tissue. Forty percent of women ages 40 and older have dense breasts. You are more likely to have dense breasts if you are younger/ premenopausal.

Dense breast tissue is common and is not abnormal. Dense breast tissue can affect you in two ways. It increases the chance that breast cancer may go undetected. Dense breast tissue and cancer both appear white on a mammogram. It also increases your risk of breast cancer. The reason why it increases your risks is unclear. At this time, experts do not agree with what tests should be performed to further evaluate the dense tissue. However, women with heterogeneously dense tissue should consider breast a sonogram or MRI, especially if they have other risk factors for breast cancer such as the BRCA 1 or BRCA2 gene mutation, first-degree relative with breast cancer, and/or radiation therapy to chest between ages of 10 and 30 years.

In the United States, law requires health care providers in some states to inform women when mammograms show they have dense breasts. Illinois is one of the few states that currently mandate insurance reimbursement for supplemental screening exams for women with dense breasts. At the Couri Center, we are committed to your health and providing you with the information you need to make the best decision for you. When we receive your mammogram report, if the radiologist notes “dense breast tissue”, we will notify you. We recommend you join our portal system so we can send you information via email. It takes only minutes to register!


Be Well,

Renee Alwan Percell, MMS PA-C



Top Questions Answered: HPV Vaccination By Renee Alwan Percell, MMS, PA-C


In 2006, a vaccination was made available that prevents cancer. It’s remarkable when you think about it like that. Wouldn’t you want to prevent cancer? This vaccination was the Quadraivalent HPV Vaccination that protects young adults against HPV Types 6, 11, 16, and 18. In 2014 the vaccination was updated to the 9-Valent HPV Vaccination that protects against 9 genotypes of the virus.

So what is HPV? HPV is a virus that is transmitted through sexual contact. Most HPV infections go away by themselves within 2 years. But sometimes the HPV infection will last longer and can cause certain cancers and other diseases. HPV is a virus that can cause cancer of the cervix, vagina, vulva, penis, throat and tongue. It is also a cause of genital warts. One in four people have HPV but it often doesn’t have any symptoms. Since there are no obvious signs of infection, it is easily spread and may only take one sexual encounter to become infected.

Does this vaccine really work? According to the CDC, clinical trials show that the vaccine provides close to 100% protection against cervical pre-cancers and genital warts. There has been a 64% reduction in HPV type infections among teen girls since the vaccine came out in 2006. The 9-Valent Vaccine has been shown to reduce cervical, vulvar, and vaginal cancer as well as penile cancers and warts at a greater than 99% rate.

Is the HPV vaccination safe? The United Sates currently has the safest, most effective vaccine supply in history. The CDC and FDA closely monitor any associated side effects/adverse events through the Vaccine Adverse Event Reporting System. All of the HPV vaccinations went through safety testing and clinical trials. There have been more than 60 million doses of HPV vaccine distributed since 2006 and there is no data to suggest that there are any severe adverse reactions linked to the vaccination. There are potential side effects but they are minimal and the same as many other vaccinations. The most common side effects are redness, swelling around the area and soreness that is temporary and will pass on their own without any treatment. Brief fainting can happen after any medical procedure including vaccinations. Your provider administering the vaccine may recommend staying 15 minutes after administration to prevent fainting.

Who should get the HPV vaccination? The recommendation is for girls and boys at the age of 11-12 as part of the adolescent immunization platform to help reduce the incidences of HPV infection. This group is more likely to complete the vaccination series versus an older teen thereby giving the child full protection against HPV. The vaccination is most effective in those who have not been sexually active, although the vaccination is recommended regardless of prior exposure to HPV. It can be started at age 9 and through age 26. It is recommended to have two doses at least six months apart.

What are you going to do? I’ve been asked by many fellow mothers about this vaccination. My children are younger so I hadn’t thought about it from a mother’s perspective until now. When I see statics like: 50% of new HPV infections occur in 15-24 year olds, my conclusion is that I will vaccinate my boys and daughter at the recommended age. The evidence based medicine is solid and supports the recommendation.


Renee Alwan Percell, MMS, PA-C



Creative Healing By Hope Placher, MMS, PA-C, IFMCP

When was the last time you did something creative for the pure joy of expressing yourself? One of my functional medicine mentors, Deanna Minich, posed that question a while back. She was researching how our health is affected by creativity.  I had to think – am I creative? Yes! Yes, I used to be very creative as a vocalist. I still love to sing, but have not been intentional to express that component of who I am. As many of you know, I am a first time mother of twins and most, if not all if my time in the past seven months has been consumed (and enjoyably so) with caring for my family. I was disappointed in myself when I reflected on my lack of intention with my creative side.  It’s not uncommon for creative endeavors to be pushed aside when time is sparse.

If you, like myself, have not been indulging in the enjoyment of creative energy, you may be missing out on a vital piece of your overall health and well-being. In the past few months I’ve had a string of patients who have been extremely motivated to make major changes in their health. Diet, lifestyle, hormone balance, exercise-you name it. They do it and they do it well. And although they feel ’95% better,’ they have expressed frustration that they were ‘missing a piece of the puzzle to total wellness.’ I didn’t have the answer and that weighs on me. I now wonder if the absence of creativity could be hindering people from complete healing.

So what do I mean by creativity? Singing, dancing around your house, looking at a piece of art, doodling, scribbling down your hopes and dreams, taking a painting class, watching clouds float by, enjoying a novel – to name a few. It’s hard to objectify creativity because the options are endless. Don’t be scared of judgment or the potential to fail! Even just listening to music or looking at art has healing benefits. A systematic review of the health benefits of music found that it has the power to positively influence inflammatory cytokines (any of various proteins, secreted by cells, that carry signals to neighboring cells) and cortisol, as well as reduce stress, and thereby provide health benefits for stress-related illnesses. Another study found that listening to music during childbirth reduced the level of postpartum anxiety and pain, and it also reduced the rate of early postpartum depression.

One hypothesis for why creativity is so beneficial to health is that it facilitates deep relaxation. Many of the studies above included patients who felt more relaxation or had reduced stress after creating or enjoying art. Studies have found that stimulating the relaxation response, which is the opposite of the stress response, is correlated with improved health. In one study that compared long-term practitioners of activities that stimulated the relaxation response, such as meditation, led to a decrease in ACTH (a polypeptide hormone, that stimulates the cortex of adrenal glands), which stimulates the stress hormones.

Just recently, Drexel University published an article demonstrating that coloring, doodling, and drawing all showed significant blood flow to the prefrontal cortex of the brain. This is the portion of the brain related to regulating our thoughts, feelings and actions. It is also related to emotional and motivational systems and part of the wiring for our brains reward circuit. And there was no significant difference between artists and non-artists! Creativity is mind-body medicine.  I don’t know what medium will work for you, but I hope you find joy in connecting to your creative spirit and letting it flow out of you.


Hope Placher, PA-C, IFMCP


Finding Joy in Everyday Movement By By Hope Placher, PA-C, MMS, IFMCP

tiny girl twirling gabby-orcutt-98868

To begin with, I’d like to take a moment and thank you for your prayers, support and well wishes while I was gone on maternity leave. It should come as no surprise that after a major life event, we might see the world through a different lens. I know this was true for me after the loss of my sister four years ago, and it certainly has happened again over the past four months. I have had the opportunity to reflect on the changes that occur from a twin pregnancy and becoming a new mother. I can confidently say that my life has been turned upside down in the most wonderful sort of way.  One of the most beautiful observations I’ve witnessed has been watching my babies learn to move their bodies.  When I untuck them from their swaddles every morning, their little arms immediately shoot up and stretch toward the ceiling. Their toes curl down with focused intention. Their eyes sparkle with excitement as their hands make their way toward their faces and gummy grins follow. The excitement of simple movement and learning the joy of their body is apparent all day long. The wonderment they express is contagious!

I think it has become part of our culture to associate or even interchange movement with exercise. Exercise can carry the connotation of a punishment for poor life decisions. You’re forced to go through the motions of exercise to burn ‘x’ amount of calories and fat.  I began to appreciate the difference between exercise and movement as I attended my first post-delivery ‘exercise’ class about six weeks after my C-section. I was completely discouraged with my immobility and lack of strength. I struggled to bend over to touch my toes or even successfully complete one assisted push up. My chest was so large and engorged from breast-feeding that even lying on my stomach in defeated exhaustion was painful and embarrassingly unsuccessful. I felt defeated at how much stamina I had lost. ‘Exercise’ was awful to me! My body had lost its sense of pleasure for exercise, so long as I kept my focus on what my evolving body could not do. Even though I could not lift as heavy a weight or run as fast a pace, I could still move! I started to focus less on comparing my pre-pregnancy fitness level to my post-pregnancy self. I began thinking about the movements of my body not only when I exercise, but throughout the day. I began focusing on what my body can do – reminding myself to be kind to my body, the same gentle way I’d want to treat my son and daughter. We need to become conscious of the gift of movement that we are capable of. Our bodies were made to move! Completing a workout to achieve an external goal at the expense of not enjoying the process is shortsighted and not sustainable.  Focusing on the intentional movement of my body when I swim, walk or pick up my babies has given me a greater appreciation of the gift of my body – regardless of size, shape or weight. What a blessing it has been to be reminded of the simple joy of movement from my babies. I hope you are kind to your body and find joy in the every day movements.

To Your Health,


Hope Placher, PA-C, MMS, IFMCP