Cycling can be an enjoyable physical activity, but improper bike fit can lead to discomfort, injuries, and time off the bike. A professional bike fit performed by a physical therapist ensures optimal alignment tailored to your body. These adjustments can reduce pain and improve power and efficiency. Beyond basic sizing, a thorough assessment considers factors like joint angles and weight distribution, which can be affected by handlebar and seat adjustments as well as foot positioning. As an expert in anatomy and body mechanics, a physical therapist can provide specialized insights that will allow you to fully enjoy cycling without limitations. Schedule a professional bike fit today and unlock the full potential of your riding experience.Visit www.activelifesports.com for more information.
Menopause inevitably happens for every woman, yet the information surrounding the topic can be sparse. The information available is often confusing or contradictory, especially around hormone replacement therapy (HRT) and its necessity. Deciding whether HRT is right for you starts with an understanding of how hormones work in the body, (refer to Part 1 for a more in-depth description of hormone fluctuation during menopause.) and then analyzing the risk/benefit ratio for you personally. Women approaching menopause should first consider whether to continue using hormonal birth control. Hormones & Birth Control Many women are on birth control, which can make identifying perimenopausal symptoms and the onset of menopause difficult. It is also a good idea to talk with your doctor about the risk/benefit ratio of being on the pill because there are a number of factors to consider. “When women turn 40, I try to encourage a longer-term and lower hormone birth control method like an IUD, or even encourage their partner to get a vasectomy,” Kimberly Kesler O’Rourke, MD, board-certified OB-GYN with GBMC Health Partners Perinatal Associates, said. “But some people need the pill. We try to at least get them on the lowest dose pill if they need to be on something.” Guidelines generally suggest if a woman aged 50 has not already gone through menopause, she should go off birth control pills for one to two months. If there is no period, an OB-GYN will check the Follicle-Stimulated Hormones (FSH) in the estradiol. With an FSH level above 50, there is almost no risk of pregnancy, which may indicate menopause is present or at least on the horizon. For women who are over 40 with a BMI of 35 and/or a history of breast cancer in their family, it is considered less safe for them to stay on the pill. “The risk/benefit ratio in that example would indicate it’s safer to look into other options rather than stay on birth control pills until 50,” Dr. Kesler O’Rourke said. “But I also see healthy women with low-risk families who will stay on low-dose pills until they're 50, if that’s what works for them and that’s what they prefer.” Once off birth control, is it necessary to replace those hormones with something else? History of Hormone Replacement Therapy Hormone replacement therapy (HRT) was the mainstay of treatment in the eighties, but treatment stopped abruptly when results from a Women's Health Initiative study were released early and out of context. The purpose of the study was to evaluate whether putting women on estrogen decreased their risk of heart disease. There were two arms of the study: an estrogen/progesterone arm and an estrogen-only arm. Women who had had a hysterectomy were put on estrogen only because they didn’t need progesterone. Women who had a uterus were put on both. The average age of women in the study was 60. The estrogen and progesterone arm saw increased heart disease and they stopped it before it was finished due to the possible dangers. The estrogen-only arm with no progesterone did not see the same increase. The flaw in the study was testing it on women who were 60, often 10 years out from menopause, who likely already had heart disease or precursors for it. Word got out, however, that HRT caused heart disease and women everywhere who were on HRT immediately called their doctors to stop treatment. Hormone Replacement Therapy Today HRT pills can still present a problem because of the nature of hormone levels in the body. “Say we take a blood sample of your hormone level, and your estrogen comes back at 10 and the bottom normal is 25,” Dr. Kesler O’Rourke said. “Theoretically, you would be prescribed 15 to make up the difference. But you can't really do that because hormones change all day, every day. At 8 a.m., you might need 10, but at 10 p.m., you need 40.” HRT has developed since the 80s, and is available in pill form as well as patches, vaginal suppositories, creams, and sprays. The latter forms all have less risk of clots and strokes than the pill, and they distribute hormones throughout the body more consistently, rather than up and down dosing or an oral pill. Dr. Kesler O’Rourke recommends HRT as a temporary management option in women who are experiencing symptoms across the board. But if they describe isolated symptoms, such as just hot flashes or just vaginal dryness, those can be treated with easier, specific and less risky methods. The hormones given in HRT are intended to stabilize the body while ovaries undergo the transition. While some women stay on HRT forever, there are risks and benefits to consider. “At some point in time, your body is through menopausal transition and the risk/benefit ratio changes,” Dr. Kesler O’Rourke said. “When you stop HRT, you're going to get a little bit of withdrawal from the hormone replacement, but your levels aren't changing as much anymore. You're in a new, steady state and the steady state doesn't bother people as much as the fluctuations.” Bodies are constantly changing, and the onset and persistence of symptoms can be heavily influenced by outside factors such as lifestyle, family history and preexisting conditions. Every treatment plan is going to be different and is subject to change as the body changes. The important takeaway is menopause is normal and manageable and OB-GYNs can help. Part 1: The Truth About Menopause
Menopause. It’s such a defining period in an adult woman’s life, yet little is communicated or discussed about it outside of the doctor’s office. Even the definition of menopause is often misconstrued. “Menopause means the cessation of menstruation for 12 months with no other identifiable cause,” Kimberly Kesler O’Rourke, MD, board-certified OB-GYN with GBMC Health Partners Perinatal Associates, said. “A lot of the problems or symptoms you hear about are actually perimenopause—getting irregular periods, hot flashes, mood swings—but menstruation hasn’t technically ceased yet. There are some people who go 12 months with no period and it's not technically menopause for other various medical reasons.” Menopause is one day, 12 months following your last period. On average in the United States, women are 51 when this occurs, but it can happen anywhere between 45-60 years of age, and the symptoms, such as the ones Dr. Kesler O’Rourke described, can begin much earlier. If menstruation ceases prior to 45 years of age, it would be considered premature ovarian failure. “At that point, we would definitely want to look for a root cause and potentially treat with hormones as there are increased risks of low estrogen when starting that young,” Dr. Kesler O’Rourke said. (More on hormones in Part 2) In the first 12 months to two years after menstruation stops, ovaries are still producing some hormones, just not enough to release an egg. This stage—when hormones are still present, just not as much as usual—is when women begin to feel most symptomatic. When the brain senses less estrogen, it increases the Follicle-Stimulating Hormone (FSH) to stimulate the ovaries to make more. The ovaries respond by making more estrogen and then the FSH decreases. But the ovaries don’t have much left, so it goes back down quickly. This rapid back and forth between the ovaries and FSH is what causes symptoms. Dr. Kesler O’Rourke compares it to a fireworks show. “When you first get your period in puberty, your hormones are very high. It's the very beginning and you're very symptomatic. You get PMS, bad periods, and then you even out,” she said. “Fireworks are going off steadily until toward the end of the show when they start to bang out really quickly—‘pow, pow, pow, pow, pow.’ And then you hear the last couple slowly pop off before it's over. That's sort of what your ovaries are doing because there are fewer eggs left, making less hormone. Once you get through that menopausal transition and the hormones are just low and stable, most people feel okay.” Hormonal levels can vary significantly within just an hour, making it challenging to rely on them as indicators for diagnosing menopause or determining the appropriate hormone replacement dosage. However, OB-GYNs can test for FSH and estradiol levels to identify unusual cases, such as women who experience perimenopausal symptoms before the age of 45. Dr. Kesler O’Rourke recommends preparing your body as early as possible for this change, including a healthy lifestyle of eating clean and exercising regularly, specifically lifting weights to maintain muscle mass that can often be lost along with estrogen levels. “Without resistance training, women begin to lose muscle mass in our 30s, and the metabolism goes with it. This really hits hard when menopause occurs,” she said. “When you’re in your forties, take advantage of those hormones still being around and stimulate your muscle mass so your body is ready for the change in hormone levels. The earlier, the better!” Menopause may seem like something women deal with in the dark, but as more women become gynecologists and experience these symptoms themselves, they can be better advocates and stewards of navigating this journey with women. “We're in a place now where women are the ones hearing this and treating it, and so we're experiencing it ourselves,” Dr. Kesler O’Rourke said. Talk to your doctor about your unique history and get help navigating symptoms today. Part 2: The Truth About Hormones During Menopause
Having a baby can be an exciting but stressful time that is full of unknowns. During pregnancy, there are many doctors’ appointments and tests performed to ensure the baby is growing and developing at a normal rate. Parents-to-be have the option of undergoing genetic testing to make them aware of any possible complications with their baby’s development. “We usually talk about genetic testing during the very first prenatal appointment,” says Aneesha Varrey, MD, an obstetrician-gynecologist with GBMC Health Partners Perinatal Associates, who specializes in maternal and fetal medicine. “It’s offered to women who want to make sure their baby doesn’t have a genetic abnormality that could affect his or her quality of life.” The genetic tests are done through a blood test of the mother, who has the baby’s DNA in her bloodstream. Dr. Varrey explains, “Every cell has 46 chromosomes, which are like small packages of genes, and all of us have a map as to how those genes are supposed to align. When they’re not aligned in a certain way, or if there’s an extra chromosome, it’s considered an abnormality.” The most common abnormality is having an extra copy of chromosome 21, which can lead to Down Syndrome. The risk of this abnormality varies with the mother’s age and not family history, says Dr. Varrey. “After age 35, women produce eggs with more chromosomal abnormalities. Before that age the risk of abnormality is 1- in-110, but after age 40, it jumps up to 1-in-40.” She says blood test results are more of a warning signal, not a diagnosis. “No life-altering decisions are made immediately after the screening test. We’ll schedule a diagnostic test to examine some placenta cells or amniotic fluid, then test those cells to see if the pregnancy is affected.” The hardest part for the parents, Dr. Varrey explains, is the waiting period from when the diagnostic test is performed to when they receive the results. “It usually takes 10 to 14 days to get results back, and it can be hard for the parents to bond with the unborn baby during that time.” She says once the results come in, if the baby does have an abnormality, the staff at GBMC is there to help parents with their decision to either continue the pregnancy or terminate it and to talk about if the same situation could be prevented in future pregnancies. “Having an extra chromosome is usually just a random occurrence,” she says. “One of the parents could have a rearrangement of chromosomes that doesn’t affect their life in any way, but it can cause mutations in a baby’s development. If this is the case, there are options like IVF that parents can explore.” She adds that, with medical and technological advances, quality of life and outcomes for babies born with Down Syndrome are much better than in the past. “There are so many more groups and resources available to parents,” she explains. “50% of babies born with Down Syndrome don’t see any structural abnormalities or heart defects.” Dr. Varrey emphasizes that, regardless of the genetic test outcome, the staff at GBMC is there to walk parents through their next steps. “We’re very available and accessible. Parents don’t have to spend a long time worrying because we’ll get back to them in a few hours. Our top priority is communicating with our patients.”
Colorectal cancers are highly preventable with regular screenings. If it does become cancerous, GBMC is here to help.The expert clinicians on the GI Oncology Team at GBMC treat patients with respect and compassion throughout the surgical process. Using innovative surgical techniques and interventions to manage pain, they can improve patient safety, enhance quality of care, and reduce complications and length of stay."Our experts offer fully integrated treatment plans for patients with complex colon and rectal conditions," Joseph DiRocco, MD, MBA, FACS, Director of Gastrointestinal Oncology for the Sandra & Malcolm Berman Cancer Institute at GBMC, said. "If you do need surgery, we can get you back to doing what you love quickly and successfully.""I was grateful I got screened early and could benefit from interventions. Dr. DiRocco and the team made me feel like the treatment plan was designed just for me," Lenny Brossoit, one of Dr. DiRocco's patients, said.We're more than just healthcare providers. We're your team. At GBMC, we face cancer, together.
The specialty pharmacy at GBMC has one goal: improve quality of life for patients. By supporting patients undergoing complex treatments for conditions such as cancer, rheumatoid arthritis, and multiple sclerosis, our pharmacists walk patients hand in hand through the process. We review lab results, medication history, provide counseling, request refills and even deliver medications to your home. These medications can be difficult to find and expensive. Our team operates alongside the financial advocacy program to ensure patients receive their medications promptly with reduced financial burden.
As people age, the risk for certain diseases and injuries increases. Sometimes, risk of injury is directly related to a disease, such as the loss of bone density and increased risk of bone fractures due to osteoporosis. James C. Johnston, MD, an orthopaedic surgeon at GBMC Health Partners Orthopaedics, explains postmenopausal women over the age of 50 are especially at risk of breaking a hip. “As women age, they don’t produce as much estrogen, which weakens their bones. That, combined with weakening vision and balance, makes for an increased risk of hip fractures,” he says. While postmenopausal women are at a higher risk, everyone over 50 should be aware that their bones may not be as strong as they used to be. Osteoporosis is a silent disease, says Dr. Johnston, so you wouldn’t know you have it until you break a bone. “There isn’t a way to stress test your bones like you can with your heart on a treadmill. So, a low-energy fracture, like breaking your wrist by tripping over a rug, may be the only indicator that your bone density could be improved,” Dr. Johnston says. “You can also get a DEXA scan to measure bone density and use the FRAX Score (Fracture Risk Assessment Tool) online can help assess your risk for osteoporosis.” If you are diagnosed with osteoporosis or osteopenia (pre-osteoporosis), there are some things you can do to increase your bone density. “Resistance training (weight-bearing exercise), avoiding alcohol and smoking, eating a balanced diet, and making sure you are getting enough vitamin D3 to build up your bones are all ways to treat and even reverse osteoporosis,” Dr. Johnston says. “Preventing falls is also incredibly important. If you don’t fall, you don’t fracture.” Increasing core strength, working on improving your balance, and having confidence as you walk can all help prevent falls, and in turn, prevent fractures. There are several types of hip fractures and various ways of treating them, usually requiring surgery. Dr. Johnston says the methods of treatment will vary from patient to patient, and that’s where having a dedicated team of specialists, like the ones at GBMC, comes into play. Another cause of hip pain as we age, not osteoporosis-related, is arthritis and this often occurs because of the way the hip is formed at birth. Trauma, genetics, family history, and even birth order can play a role in how your hip socket is formed, Dr. Johnston says, and some impingements can lead to hip problems later in life. He says keeping your weight in a healthy range is the best way to avoid hip issues due to arthritis as you get older. “If you have mild hip arthritis, carrying excess weight will only make that problem bigger, and hip problems are tough to treat because everything you do requires your hips,” he says. He also suggests low-impact exercises and avoiding deep squats and lunges to reduce the chances of further aggravating the stress on the joint. While weight loss is the single best way to treat arthritis, other treatments range from therapy to anti-inflammatories, cortisone shots and hip replacement surgery. “When you have hip arthritis and need a joint replacement there is more than one choice of hospital. We want patients and their families to know GBMC has an incredible joint replacement center,” Dr. Johnston says. “We have great surgeons and dedicated anesthesia teams. We’ve received the Joint Commission Certification for hip and knee replacement, and our team goes through the whole process with you. We have social workers for pre-op, great staff in the operating room, and an entire therapy team in the hospital and in your community that works together to bring a holistic approach to your care.”
Many individuals avoid seeking treatment for pelvic floor conditions because they are embarrassed, or they believe these issues are a normal part of aging. But 50-70% of our patients would attest that physical therapy is a good, noninvasive treatment option for pelvic floor disorders. Pelvic exercises can be done on your own, but working one on one with a pelvic physical therapist gives you the best result. Therapists can walk through exercises to strengthen, relax and retrain pelvic floor muscles and the core to improve functioning and reduce discomfort.
When it comes to car seat safety, it's crucial to understand the difference between rear facing, forward facing and booster settings. Always ensure the car is on level ground during installation and take the time to read both your car seat and vehicle manuals. When harnessing your baby, position shoulder straps correctly, secure the chest clip at armpit level, and perform a pinch test to ensure a snug fit. In Maryland, the law mandates rear facing for children 2 and under, but it's recommended to continue until the child outgrows height and weight limits. These best practices ensure safe transportation no matter your child’s age.
Welcoming a new baby into your family is an exciting time full of change and new routines. But for many new parents, postpartum depression is a complication they weren’t prepared to experience. An estimated seven out of 10 new moms in the U.S. suffer from some sort of depression after having a baby, ranging from a milder form of depression known as the “baby blues” to postpartum psychosis. “The baby blues usually occur pretty quickly after birth,” says Deborah Johnston, a clinical social worker at GBMC HealthCare. “It’s usually characterized by intense mood swings and feelings of overwhelm or anxiousness, but it tends to go away a couple of weeks after the baby is born. Postpartum depression can happen up to a year after giving birth and presents differently for everyone.” After childbirth, a mother can experience varied emotions ranging from joy and pleasure to sadness and bouts of crying. These feelings of sadness and tearfulness are called "baby blues," and they tend to decrease over the first two weeks after delivery. Baby blues are extremely common and estimated to occur in more than half of women within the first few weeks after delivery. Postpartum depression tends to last longer and severely affects women's ability to return to normal function. Occurring in approximately 6 to 20% of women, PPD affects the mother as well as her relationship with the infant. And it isn’t limited just to the person who gave birth. Adoptive mothers, women who have miscarried, and even men are at risk, according to Johnston. “We estimate about one in 10 new dads experience postpartum depression,” she says. “They’re expected to go back to work right away, to be the doers and the fixers and the support person for the mom, but not as many people are asking him how he’s doing.” Pregnancy raises estrogen and progesterone levels in women, but once the baby is born those hormones quickly fall to pre-pregnancy levels. These hormonal changes, coupled with lack of sleep and increased amounts of stress and anxiousness over a new baby, are all possible causes of postpartum depression. “Having a history of depression or anxiety will put you at higher risk, but the baseline for every person is different,” Johnston explains. “There’s a spectrum of symptoms and severity when it comes to postpartum depression, which makes it very beneficial to catch it early.” It's difficult to pinpoint who will be affected by postpartum depression, Johnston says, but the staff at GBMC makes it a priority to evaluate the mental health of both parents after the birth. “They’re asked 10 questions to rate how they’re doing on a scale. Then they’re given a score between zero and 30. If they score a 10 or above, a social worker will meet with them to give them resources, find out more about their history, and most importantly, give them permission to take care of themselves.” Having a hard time coping with the change a new baby can bring, trouble sleeping, and withdrawing from family and friends are all signs someone might be suffering from depression, but it can be hard to recognize it in yourself at first. “Partners are often the first to notice that something is off,” Johnston says. She encourages everyone to not hesitate in asking for help. “Talk to your doctor and share your concerns with family and significant people in your life. Don’t be afraid to ask for and receive help during this time.” Much like the oxygen mask safety recommendations on an airplane, Johnston says, it is imperative new parents protect their mental health first before worrying about everyone else. “Self care is your oxygen during this time,” she emphasizes. “Give yourself permission to recover, limit visitors, and set boundaries. Ask for help and say thank you when it’s offered.” Her biggest piece of advice to new parents? Get sleep whenever you can. “Lack of sleep takes away all your defenses!” Johnston says. “Taking a nap is taking care of the baby, just get some sleep!” Johnston says Postpartum Support International is a fantastic resource for finding support groups (both in person and via Zoom) and talking with experts.
Respiratory syncytial virus (RSV) is a virus that is most prominent in the U.S. during the fall and winter months. It causes cold-like symptoms, which are typically mild, but the illness can become more severe and lead to hospitalization, especially in young children. The 2022/23 RSV season was particularly bad, says Victor A. Khouzami, MD, Chair of Obstetrics at GBMC HealthCare. “Last year the RSV season was extremely severe, and we saw many more children than normal in the Neonatal Intensive Care Unit and Pediatric Emergency Department.” In fact, during the 2022/23 season, children were hospitalized with RSV-related illness at a rate of 605.5 per 100,000, more than 10 times the rate of the general population. Infants younger than six months are at the greatest risk for severe illness from RSV. This surge of RSV-related illness prompted the FDA to announce the approval of new immunizations and vaccinations for this year, and Dr. Khouzami is encouraging pregnant women between 32 weeks and 36 weeks to get the vaccine to protect their unborn babies. “When the mother gets the vaccine during that time frame [and at least 14 days prior to giving birth], the antibodies are passed through the placenta to the baby. The goal is to provide passive protection against RSV during the first few months of life,” he says. Beyond preemptive protection for the newborn, having the mother receive the RSV vaccine also increases immunization supply for other infants, Dr. Khouzami explains. “The vaccine for pregnant women and immunization for infants are two completely different products,” he adds. “There is already a backlog of infants and babies who are having a hard time getting access to Nirsevimab, the immunization which contains lab-made antibodies that protect against RSV, because of demand. If more pregnant women get vaccinated this season, their babies will already be protected, which frees up more immunizations for infants who haven’t received it.” Dr. Khouzami says opinions vary about the RSV vaccine, but many pregnant women elect to get the shot because of its impact on the health of their baby. “There is a small percentage of women who have reservations about vaccines as a whole, but when they learn that the alternative is their newborn will have to get a shot during his or her first week of life, most of them choose to get the vaccine themselves.” He explains that while both shots are equally protective and safe, it may be harder to get Nirsevimab to protect your baby after they’re born. Most private health insurance policies and Medicaid will cover the RSV vaccine at no cost to the patient, but everyone is encouraged to contact their provider to confirm coverage.
The term “robotic surgery” can conjure up a lot of images of futuristic medicine, but Emily Watters, MD, a bariatric and general surgeon at GBMC HealthCare, wants to make one thing clear: Robots aren’t performing the surgeries. “I put in the ports, connect the robot, and make the incisions. I’m controlling the arms of the robot. The robot simply gives me more control and precision during surgery to direct the instruments. I’m still the captain of the ship,” Dr. Watters said. Robotic surgery has been around for more than 20 years and was initially used for prostate surgery, Dr. Watters said. Now, several disciplines utilize robotic surgery, including urology, gynecology, colorectal, and Dr. Watters’ specialties of bariatrics and general surgery. She explains both patients and surgeons benefit from robotic surgery for several reasons. “One example is an abdominal hernia. The robot allows me to perform that surgery with only three or four small incisions, and the patient’s length of stay in the hospital is much shorter than with traditional surgery,” Dr. Watters said. She added that, as a surgeon, robotics provide her with better visualization and an ability to manipulate the instruments 360 degrees. The surgeon is also able to sit during surgery instead of standing hunched over, so surgeons can operate for many more years because the work takes a lesser toll on the body. Dr. Watters was first introduced to robotic surgery during her residency and quickly realized its advantage over traditional surgical methods. Dr. Watters recently took over as the Robotics Chair at GBMC, and she says they’re hoping to acquire another robot soon, as the one currently in use is in high demand. “The technology is just getting better, and we’re starting to train all staff so we can do 24-hour robotic cases, which is important for patients who need emergency surgery for diverticulitis and hernias.” Patient response to the robot has been incredible, said Dr. Watters, with many looking forward to the day they get to “meet the robot” in the operating room prior to their surgery. She encourages all patients needing surgery to ask their surgeon if they use robotics and to ask a lot of questions about the procedure. “Our patients are getting cutting-edge care here with the robot,” she emphasized. “We’re well equipped to treat all our patients at GBMC."
Let's be honest, cancer is scary, daunting, uncertain, and complicated. But at the Sandra and Malcolm Berman Cancer Institute at GBMC, the compassionate and dedicated team of experts makes sure no cancer patient ever feels they are alone. They accompany patients on every step of their journey from diagnosis to recovery. "Each patient's journey is very important and very different. At the Sandra and Malcolm Berman Cancer Institute, we consider each patient’s medical, emotional, and personal needs," Paul Celano, MD, FACP, FASCO, Herman and Walter Samuelson Medical Director of the Berman Cancer Institute, said. "We use a team approach to create the best possible treatment plan for you." Cancer is nuanced and complicated, so GBMC brings together multiple perspectives to ensure each patient benefits from the combined expertise of the entire treatment team. These weekly meetings bring together nurses and therapists who treat patients every day, the social workers and counselors who provide emotional and practical support, and the oncologists and specialists who bring their focused clinical expertise to each challenge. Doctors also gain insights and knowledge of the full team on how to approach problems in new ways, with new techniques. The result is targeted solutions that take into account both the physical and emotional health of a patient as well as potential risks from specific therapy options. GBMC’s experts are always in action to assess your progress, potential challenges, latest treatment methods, and your eligibility for clinical trials. We provide patients with a wide variety of cancer services: clinical trials, oncology support, radiology, a specialty pharmacy, and more. "As a cancer patient, GBMC was my lifeline, transforming not just my health, but my entire lifestyle. GBMC saved my life and gave me a second chance," Beth Nardone said. At GBMC we're more than just healthcare providers. We're your team. At GBMC we face cancer, together.
In the fall, marathon training gains momentum, but beware of stress fractures due to sudden mileage increases. GBMC Health Partners orthopedic surgeon Dr. James Johnston delves into the importance of gradual distance progression and proper stretching techniques. With kids returning to school sports, he emphasizes the need for early endurance building to prevent common sprains, strains, and even ACL injuries. For those considering high-impact activities, Dr. Johnston cautions against tendon ruptures and advocates for recognizing early symptoms to avoid complete tearing. Combatting joint issues like meniscal tears and arthritis while running can be tackled through low impact exercises such as swimming and biking, accompanied by joint swelling reduction techniques. Watch the video segment for an indepth exploration of these valuable insights to stay injury free and maintain optimal fitness this fall.
When dealing with an illness or a disease, medications are often necessary to help the body return to its healthiest state. “Many people are aware of routine medications—things that control blood pressure, high cholesterol, or antibiotics,” says Yuliya Klopouh, M.H., Pharm.D, Executive Director of Pharmacy Services at GBMC HealthCare. “You can get those from any local pharmacy and they’re readily available.” But there’s a unique category of medications, called specialty drugs, that are used to treat complex, chronic conditions like cancer, rheumatoid arthritis, and multiple sclerosis. “These types of medications require specific handling, special instructions, and/or may need to be administered by a medical professional,” explains Dr. Klopouh. “There is also often an exorbitantly high cost associated with these medications, which can make accessibility and affordability a struggle for some patients.” GBMC is taking a novel approach to specialty pharmacy in a hospital setting. “Most hospitals have a retail pharmacy within the building and then add a specialty pharmacy within the retail setting. We have set up a specialty pharmacy within GBMC that’s sole purpose is to serve our patients who need help accessing these types of medications.” Dr. Klopouh says the specialty pharmacy program was set up in parallel with the financial advocacy program, which allows patients to get medications much faster and spend less time worrying about the associated costs. “As soon as a prescription is given, the specialty pharmacy starts working on all the financial pieces that are required. Most patients can get their medications within hours, days at the most, whereas others using a retail pharmacy might have to wait weeks. And if they can’t afford it, they won’t take it.” Easing the emotional and financial burden from patients is at the forefront of the specialty pharmacy program. Dr. Klopouh says oncology patients make up the majority of the population utilizing the specialty pharmacy program but adds that it’s available to anyone who needs it. “They won’t have to worry about where they’re going to get it, or how they’re going to get it, or how will they afford it, which is the biggest thing.” Patient advocacy is the primary focus of every program at GBMC, and Dr. Klopouh want patients to know there are people working for them throughout every step of their journey. But she stresses it’s up to the patient to communicate any questions or concerns they have. “Don’t be quiet about what you need. We always attempt to be proactive and advocate for patients, but if you need assistance, ask, and it will be provided for you.”
