<p class="article-body"> Determining a true measure of health goes way beyond doctor appointments, annual checkups and how you happen to feel on any given day. Economic status, income level, environmental conditions, lifestyle behaviors — these and other variables all factor in to paint the complete picture, both for individuals and for communities as a whole. <br> <br> “Social determinants of health are all the conditions in which a person lives, works and plays,” says Melanie Miller, manager of Population Health Coordination at the Greater Baltimore Medical Center. <br> <br> According to National Association of Counties research, social and economic factors account for 40% of a person’s overall health makeup, with lifestyle behaviors making up another 40%. <br> <br> Here are some of the most significant social health determinants, and how GBMC is working to bridge the gaps. </p> <h3> Strains on Financial Resources </h3> “This is the biggest hurdle our patients are experiencing,” Miller says. In the event patients can’t afford to pay for their medications, housing, insurance and other cost-of-living expenses, GBMC care coordinators and managers look for ways to help find lower-cost alternatives and connect them to social services and agencies that may be able to provide assistance. <h3> Food Insecurity </h3> GBMC screenings reveal that a significant number of patients don't have access to — or can’t afford — healthy food. In these cases, care coordinators can put patients in touch with food pantries, Meals on Wheels and Hungry Harvest. GBMC also partners with SNAP to sell fresh local produce at discounted prices at an on-campus community market the first and third Friday afternoons of each month. <h3> Transportation </h3> Patients may have trouble getting to and from doctor appointments because they can’t drive or have lost their licenses and are dependent on family members, friends or public transportation. GBMC has teamed up with CountyRide and other ridesharing programs for medical transportation and assists patients with completing the paperwork needed to sign up. <h3> Social Isolation </h3> Care coordinators can recommend senior centers, agencies, affordable outlets and activities for elderly patients and others who feel lonely or disconnected from the community. <h3> Health Behaviors </h3> GBMC primary care providers work closely with their patients to screen for potentially unhealthy behaviors with a focus on preventive care, solutions and results. <h3> Domestic Violence </h3> “If a patient screens positive for intimate partner violence, we try not to let them leave the office without an intervention,” Miller says. GBMC’s Sexual Assault Forensic Examination and Domestic Violence (SAFE and DV) team provides confidential assistance to help patients in need locate resources and navigate appropriate next steps. <div class="end-of-story"> </div>
<p class="article-body"> <em>An ounce of prevention is worth a pound of cure.</em> <br> <br> Benjamin Franklin said it in 1736. Nearly three centuries later, we still struggle to incorporate this axiom into our lives — in particular, when it comes to healthcare. <br> <br> The annual exam. Cancer screenings. Immunizations. These small to-dos can make a big difference when it comes to catching (and preventing) chronic disease and illness — or even just bad habits — early on, when they are most treatable. <br> <br> Dr. Samantha Ober, who practices internal medicine at GBMC Health Partners Primary Care – Hunt Valley, is passionate about preventive care. A relative newcomer to the practice, Ober spends about half her time in the office doing annual physicals — either getting to know new patients or guiding her older population of patients through Medicare wellness exams. “Preventing illness is a priority,” she says. </p> <h3> MIND THE SCHEDULE </h3> Healthy adults don’t need much in terms of cancer screenings. Here are a few to keep in mind. <br> <br> <strong>CERVICAL CANCER SCREENING (I.E. PAP SMEARS).</strong> “Regular pap smears —every three to five years — begin around age 21 and usually finish around age 65, as long as a woman’s last three paps are normal,” says Ober. <br> <br> <strong>BREAST CANCER SCREENING (I.E. MAMMOGRAMS).</strong> “There are different recommendations, but we start the conversation at age 40,” says Ober. Mammograms are typically every one to two years. <br> <br> <strong>COLON CANCER SCREENING (I.E. COLONOSCOPY).</strong> This is for men and women starting at age 50 — or earlier if there is a family history. If your colonoscopy is clear, you can wait another 10 years before getting another. <br> <br> <strong>PROSTATE CANCER SCREENING (E.G. PSA TEST).</strong> Ober is sure to talk to her male patients about the risks and benefits of the PSA blood test, which is somewhat controversial. She says, “We do what we call ‘shared decision making’ with each patient.” <br> <br> <strong>LUNG CANCER SCREENING.</strong> “This is indicated for a very select population that meets a number of criteria,” says Ober. <br> <br> In addition to cancer screenings, annual exams are the ideal time to stay on top of conditions like osteoporosis, as well as the recommended vaccine schedule for adults. That includes: <br> <br> AN ANNUAL FLU SHOT. “We ask all of our patients if they’ve gotten a flu shot and it’s exciting when someone says yes,” says Ober. There are so many misconceptions about the flu shot, Ober finds herself doing a lot of patient education. “This flu season, we’ve already seen a number of flu-positive people — young, healthy people, 20- and 30-somethings — who are completely knocked out because they didn't get their flu shot.” <br> <br> <strong>TETANUS SHOT.</strong> Adults need a tetanus booster every 10 years. <br> <br> <strong>PNEUMONIA SHOTS.</strong> “Once you get to a later stage in life, something like a pneumonia can really take someone out,” says Ober. Vaccine schedules may vary between patients based on their given medical conditions, but everyone should receive a pneumonia shot at age 65. <br> <br> <strong>SHINGLES SHOT.</strong> Anyone who's had chicken pox is at risk for shingles as an adult. “I really do stress getting a shingles shot,” says Ober. The latest shingles vaccine is given at age 50 and is made up of two doses, given two to six months apart. <h3> SEEING THE WHOLE PATIENT </h3> The annual visit can feel like an additional to-do item for otherwise healthy adults. For those managing chronic conditions, it means yet another appointment. But it is so much more than that. <br> <br> Beyond the checklist of shots and screenings, the annual exam is a time to connect that isn’t about a chronic condition or crisis. For Ober, it’s an opportunity to talk about diet and lifestyle, mental health, substance use, physical activity or, for an older population, about memory issues or fall risks. Says Ober, “It’s all the stuff we don't talk about if they’re coming in for a cold or UTI or back pain.” <br> <br> Ober’s goal is always to see the whole patient at every visit, but one 30-minute appointment can fly by when a patient is, for instance, managing diabetes. “When I need to look at their blood sugar and adjust their insulin, it’s hard to pause to say, How is your mood today? How are you doing?” But that one extra visit every year gives both doctor and patient an opportunity to do just that — to start a conversation that may very result in a longer, healthier life. <div class="end-of-story"> </div>
<h3> What is Dysphagia? </h3> In and of itself, dysphagia is not a diagnosis but a symptom that refers to the sensation of food or liquid getting stuck in the throat or chest when swallowing. During the normal swallowing process, chewed or sipped material passes from the mouth through the esophagus and down to the stomach. Dysphagia occurs when there is resistance at any point due to functional issues or a physical problem, such as blockage or obstruction. <br> <br> According to the National Foundation of Swallowing Disorders, dysphagia is believed to affect up to 22% of the U.S. population over age 50, with 10 million Americans being evaluated for swallowing difficulties on an annual basis. Patients can experience dysphagia in different ways, most commonly by having to exert extra effort to swallow, hearing and feeling a gurgle in the throat when swallowing or coughing while eating or drinking. <br> <br> “Dysphagia can be categorized in one of two ways: by evaluating what part of the swallow is being affected or by the type of material that the patient is finding hard to swallow — food, liquid or pills,” explains Dr. Shumon Dhar, a laryngologist with the Johns Hopkins Voice Center at the Greater Baltimore Medical Center. <br> <br> If food and liquids are aspirated into the lungs due to dysphagia, it can lead to pneumonia and other serious complications. <h3> Who's At Risk? </h3> Anyone can develop dysphagia, but Dr. Dhar says it’s more likely to affect the elderly and patients who have gastroesophageal (acid) reflux, commonly called GERD. <br> <br> “Some genetic conditions may also predispose people to it,” he adds. “Dysphagia can affect patients who have a history of head cancer, neck cancer or hiatal hernia, and those with neurological or neuromuscular disorders.” <br> <br> Lifestyle can be a contributing factor as well. <br> <br> “Poor diet and obesity can lead to acid reflux, which is the number one cause of solid-food dysphagia,” Dr. Dhar mentions. “Whatever the cause, dysphagia isn’t normal and should always be investigated.” <h3> How is Dysphagia Evaluated </h3> The first things a doctor will do when evaluating a patient with dysphagia is obtain a complete medical history and perform an exam to try to determine what kind of material is getting stuck and where. The initial work-up may include a swallowing fluoroscopy or a modified barium swallow study performed by a radiologist, sometimes in conjunction with a speech language pathologist. <br> <br> “Fluoroscopy focuses on the anatomy of the esophagus to diagnose motility problems, strictures and hiatal hernias,” Dr. Dhar explains. “The barium swallow study looks at the dynamic function of the entire swallowing mechanism.” <br> <br> Dr. Dhar advises patients who are experiencing solid-food dysphagia to undergo an endoscopy procedure either transnasally while awake or under sedation to look for esophageal strictures, acid reflux damage, inflammation, infections and cancer. <br> <br> Other diagnostic modalities may include high-resolution manometry, a procedure in which a catheter is inserted into the esophagus to measure pressure generated during the swallowing process, and two kinds of 24-hour pH tests that measure acid reflux levels. One test uses a hardwired probe to transnasally test for acid reflux. <br> <br> The other, more advanced test is called a BRAVO. Here, a wireless pH capsule is attached to the esophagus during an esophagoscopy where it transmits reflux data for 48-72 hours. The capsule detaches on its own and passes normally through the digestive tract after the test is completed. <h3> Dysphagia Treatment Options </h3> Swallowing disorders are treated through patient-specific medical or surgical interventions. <br> <br> Speech pathologists employ different techniques and maneuvers to help the patient swallow more efficiently. Gastrointestinal reflux can be addressed with diet and lifestyle modifications, weight loss, natural anti-reflux medications called alginates or the use of proton pump inhibitors and H2 blockers. <br> <br> In some cases, esophageal dilation, Botox injections or surgery are used to correct the problem. <div class="end-of-story"> </div>
<p class="article-body"> There’s no shortage of options for women when it comes to birth control. But among all the pills, rings and shots, there is one type that is known for lasting several years without a replacement: an intrauterine device (IUD). <br> <br> “The copper IUD (brand name Paragard) is FDA-approved for up to 12 years. Hormonal IUDs are effective between three and seven years depending on the brand,” explains Elissa Nagy, D.O., an OB/GYN at Perinatal Associates for GBMC Health Partners. <br> <br> IUDs work by stopping sperm from entering the uterus to avoid fertilization. Both types of IUDs are incredibly successful at preventing pregnancy, with an efficiency rate of 99%. But even though IUDs are effective and easy to use, there are still many misconceptions about them. </p> <h3> Misconception 1: The IUD is painful. </h3> An IUD is a small T-shaped piece of plastic or copper that’s inserted in the uterus by a nurse or doctor. Dr. Nagy says once an IUD is in place, you shouldn’t be able to feel it at all, but the insertion process can be a bit uncomfortable. <br> <br> “It’s an in-office procedure, and I usually tell people to take Tylenol or ibuprofen beforehand because insertion can make you a little crampy, similar to having period cramps, but it should resolve in a few hours,” Nagy explains. <br> <br> Once the initial cramps have passed, usually within a day, there should be no pain associated with the IUD. <h3> Misconception 2: It’s only for women who don’t want children or who have already given birth. </h3> While one of the benefits of the IUD is how long it can stay in the body without being replaced, the idea that it has to stay in that long is simply not true, Dr. Nagy says. <br> <br> “The IUD is great because it lasts as long as you want it to, and you can take it out at any time. If you decide after six months you’re interested in having children or you want a different contraceptive option, it’s very easy to remove the IUD,” Dr. Nagy says. <br> <br> Fertility returns to normal right after the IUD is removed, making it a viable birth control option for women hoping to get pregnant in the future. <h3> Misconception 3: There’s a risk of infertility or miscarriage after removal. </h3> If an IUD is inserted correctly, it will not cause any difficulty for future pregnancies, Dr. Nagy says. <br> <br> “Within a month or two after removal, your pregnancy rate should be similar to what it was before inserting an IUD,” says Dr. Nagy. “[Women who had IUDs removed and became pregnant] have not shown an increase in miscarriage rates.” <br> <br> Dr. Nagy explains the only risk of miscarriage comes on the very rare occasion that someone gets pregnant while the IUD is in place. <br> <br> She emphasizes if this happens, you should call your doctor and have the IUD removed as soon as possible to decrease that risk. <h3> Misconception 4: The IUD will make your period heavier and more painful. </h3> There are two types of IUDs available in the US: copper (Paragard) and hormonal. Paragard doesn’t have any hormones and is wrapped in a tiny bit of copper. Hormonal IUDs are made of plastic and use the hormone progestin to prevent pregnancy. If you choose to have Paragard inserted, Dr. Nagy says you can expect to have a similar experience with your monthly cycle as before insertion, and some women do report a slight increase in bleeding and cramping. She explains if your periods are regularly painful and heavy, the copper IUD may not be the best choice of contraception. But if you go the hormonal IUD route, a decrease in bleeding is more likely. <br> <br> “10 to 20% of women don’t even have a period while on the IUD, which some women really enjoy not having to worry about, and that’s completely healthy and normal,” Dr. Nagy says. <h3> Misconception 5: An IUD can fall out, making it ineffective. </h3> To be fair, this is not actually a misconception because it can happen, but Dr. Nagy assures it’s a small risk. <br> <br> “Between 2 and 10% of IUDs can fall out, particularly in the first year after placement during a heavy period.” <br> <br> Dr. Nagy says if you believe your IUD has fallen out, you can either check for the strings yourself or make an appointment with your doctor to ensure proper placement. If your IUD has been misplaced, Dr. Nagy recommends making an appointment with your doctor to either get a new one inserted or to choose a different form of contraceptive. She also suggests using a backup form of birth control until that time. <br> <br> All things considered, Dr. Nagy highly recommends the IUD for the majority of women who are weighing their birth control options. <br> <br> “It’s greater than 99% effective, which is the same as tubal litigation, but it’s reversible, which is what makes it so great for women of all ages,” Dr. Nagy says. <div class="end-of-story"> </div>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/Vb4XvqCVBtE" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> The Eye Center at GBMC offers a full range of comprehensive services for eye health, including the treatment of Thyroid Eye Disease. Dr. Lawson Grumbine explains what Thyroid Eye Disease is and what new treatments are available. </p>
The benefits of taking birth control are well documented. It prevents unwanted pregnancy and can help regulate female hormones. However, the risks regarding the use of birth control and its correlation to cervical cancer are a little less clear, says Dr. Kimberly Levinson, MD, MPH, who is the director of the John Hopkins Gynecologic Oncology department at GBMC HealthCare. "There's a lot of mixed data about it [the use of birth control associated with an increased risk of cervical cancer]," she explains. "There are some studies that show an increased risk over time. There are others that show no increased risk over time." Dr. Levinson says there is one common factor in every cervical cancer diagnosis: the presence of human papillomavirus (HPV). Kimberly L. Levinson, MD, MPH "You need to have the HPV virus to develop cervical cancer. Patients without HPV do not have the risk," she says. She says the studies that have been done on birth control and its correlation to cervical cancer are retrospective in nature. This kind of backward analysis makes it impossible to define if birth control is the specific thing that causes the cancer or decreases the risk. "There's some data that suggests that certain intrauterine devices (IUDs) can lower the risk of cervical cancer, but we just don't have enough evidence to say yes, this is the reason," Dr. Levinson says. Dr. Levinson explains that women who want to prevent cervical cancer should focus less on the potential risks involved with their birth control and more on factors that will actually influence their chances of contracting the illness. "We do know what decreases the risk of cervical cancer," she explains. "Two things: HPV vaccination and screening. We want to prevent HPV from being contracted or catch these changes before they become something bad. Whether someone is on birth control or not, if we can identify the changes early and do something about them, we have the ability to prevent this disease." Screening protocols for HPV and cervical cancer vary based on age. For women under the age of 30, Pap smear screening is the standard, mostly because HPV is so prevalent in that population, says Dr. Levinson. "We know that HPV takes a really long time to make changes that lead to cancer, usually over the course of ten years." She adds that most women under 30 clear the disease with no issue, but it's important to stay on top of suggested guidelines for screening with your gynecologist, in case any discrepancies appear. "There are really not any symptoms for cervical cancer until the disease is late stage. That is why screening is so important," Dr. Levinson explains. Dr. Levinson says the risk of HPV isn't reserved for the female population; men are also at risk. "Herd immunity is an important thing, and the more people that we can vaccinate and get rid of this virus then we will affect populations," she says. Dr. Levinson tries as often as she can to stress the importance of getting the HPV vaccine to prevent cervical cancer. "Please think about the HPV vaccine as a cure for cancer. When people get the HPV vaccine, it prevents people from getting HPV disease, which prevents cervical cancer and any cancer caused by the HPV virus. This is the way to prevent those cancers, simply with this vaccine."
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/kBoEgt7WPOk" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> The nutrition labels of large food companies got a new design this year. Jana Wolff, RD, LDN, Director of Nutrition for GBMC's Comprehensive Obesity Management Program, discusses how to interpret the new labels on Greater Living with Don Scott. </p>
<p class="article-body"> Statistics indicate that approximately 48 million Americans — nearly 20% of the U.S. population — currently have some degree of hearing loss. Yet only a small percentage of people who could benefit from wearing a hearing aid actually do. </p> <h3> Types of hearing loss </h3> Hearing loss is classified into two main categories — sensorineural hearing loss, in which the nerve that transmits sound from the ear to the brain isn’t working effectively, and conductive hearing loss, caused by a physical blockage in the ear. A combination of the two is called mixed hearing loss. <br> <br> “Aging and noise exposure are the main contributing factors to sensorineural hearing loss; conductive hearing loss can result from wax buildup, fluid behind the eardrum and disruption in the ear bones,” explains Brian Kaplan, M.D., Chairman of the Department of Otolaryngology at the Greater Baltimore Medical Center (GBMC). <br> <br> Working in professions that involve prolonged exposure to loud noise increases the likelihood of eventual hearing loss; other causes can be linked to genetics, chemotherapy and the use of some medications. <h3> Diagnosis and treatment options </h3> Hearing loss is diagnosed through a physical exam that looks for any obstruction in conjunction with an audiogram to test sensorineural and conductive function as well as eardrum mobility. Approach to treatment depends on what kind of hearing loss the patient is experiencing. <br> <br> “For sensorineural loss, the standard treatment is hearing aids, until they no longer offer adequate benefit, then we consider cochlear implants,” Dr. Kaplan says. “Conductive hearing loss can usually be corrected through in-office procedures or surgery.” <h3> Latest developments in devices </h3> Like cell phones and computers, hearing aids continue to evolve, shrinking in size thanks to improving technologies. The latest iterations range from basic models to top-of-the-line products that offer sophisticated functions like connectivity to streaming media, phones and smart home systems. Prices can vary from a few hundred to a few thousand dollars depending on the model and features. <br> <br> “In about 18 months, hearing aids for mild to moderate hearing loss are going to become available over the counter with Apple, Samsung, Bose and other major players entering the market,” Dr. Kaplan adds. “The hope is to raise awareness around the importance of addressing hearing loss, and to make hearing aids more accessible and affordable.” <br> <br> Although hearing aids aren’t usually covered by Medicare or private insurance policies, financial assistance may be available through the VA and some charitable organizations. <h3> Other ear conditions </h3> Tinnitus, one of the most common health conditions in the U.S. — the sensation of hearing high-pitched ringing, chirping or other noises — affects more than 45 million Americans, according to the American Tinnitus Association. <br> <br> Often remedied with hearing aids, subjective tinnitus is caused by sensorineural hearing loss and can be exacerbated by anxiety, depression, sleep deprivation and caffeine. More rarely, objective tinnitus is a result of blood-flow abnormalities. <br> <br> “There’s a constant level of background noise around us all the time; think about how much quieter it gets when your power goes out,” Dr. Kaplan explains. “With hearing loss, you lose the background noise that can sometimes mask tinnitus, and that’s when it often becomes noticeable.” <br> <br> Eustachian tube dysfunction can also affect ear health, although hearing loss isn’t often a primary symptom. Allergies, sinusitis, nasal swelling and other conditions can make it difficult for the tube to function properly, creating a feeling of fullness, fluid or clogging behind the eardrum. <h3> Tips to prevent hearing loss </h3> Doctors are diagnosing hearing loss in increasingly younger patients, making early prevention efforts more important now than ever before. <br> <br> “Protect your hearing anytime you’ll be around loud noises — at concerts, mowing the lawn, using power tools — and start as early as you can,” Dr. Kaplan urges. “Once your hearing is gone, you can’t get it back.” <div class="end-of-story"> </div>
<p class="article-body"> Clinical trials are a valuable but often misunderstood part of healthcare. At the Sandra and Malcolm Berman Cancer Institute at GBMC, a multidisciplinary team uses clinical trials to bring progressive treatments and state-of-the-art care to cancer diagnoses. <br> <br> Clinical Research Nurse Manager Judy Bosley, RN, BSN, CCRP, says a stigma still surrounds clinical trials. <br> <br> "Sometimes, people are just a little leery of clinical trials. They're skeptical," Bosley says. <br> <br> To shed some light on what really happens during a clinical trial, here are the top five frequently asked questions. </p> <h3> Who is qualified for a clinical trial? </h3> Bosley says a common misnomer about clinical trials is that they're a "last-ditch" effort for patients. <br> <br> "We have clinical trials that span across all different phases of treatment, from patients who have early-stage cancers all the way to advanced stages," Bosley says. <br> <br> She adds that GBMC HealthCare offers trials for many different types of cancers and stages, including but not limited to breast, lung, colorectal, gynecologic, head and neck, blood-related, skin, prostate, and pancreatic cancers. But with 50 to 60 trials going on at any given time, she encourages patients to explore the options for their specific situation. <br> <br> Clinical trials may not be right for patients who are short on time or who have trouble fitting their current treatment into their schedules, according to Bosley. <br> <br> "There's a little bit more of a time commitment (with participation in a clinical trial). There are certain visits they have to make and stringent timelines," Bosley says. <br> <br> She says researchers try to minimize the time commitment as much as possible, but it's important to take an honest look at your schedule before committing to a clinical trial. <h3> What are the risks involved? </h3> Bosley says patients often ask whether they're just a guinea pig in the clinical trial process. She responds with a resounding, "no." Bosley adds that potential trial participants are often concerned about receiving a placebo instead of proper care for their cancer. She emphasizes that would never happen. GBMC trials typically compare drugs or analyze combinations of therapies to find what works best. Others are aimed at determining optimal dosage or protocols. Regardless, every patient receives quality treatment. <br> <br> "The only time there's a placebo added to a study is if it's in addition to what we know is the best care available," Bosley says. <br> <br> There is always a risk of side effects when the trial involves a drug treatment, but each patient is monitored closely to help mitigate potential risks. Bosley says one of the biggest risks is that the patient may not benefit from the trial. <br> <br> "Just like we can't guarantee they're going to benefit when we start any treatment, we can't guarantee that a patient is going to benefit from the clinical trial," Bosley says. <h3> How much will it cost to participate in a clinical trial? </h3> Patients generally don't have to pay any extra out-of-pocket costs for treatments received as part of a trial. Usually, the trial sponsor pays for research-related costs and any special testing. Any standard care costs (routine tests, treatments, or procedures) would be covered by the patient, and any insurance the patient has. Bosley says federal law requires most health insurance plans to cover routine care costs in clinical trials. A health insurance provider cannot prohibit a patient from entering a clinical trial or limit a patient's benefits. Before joining a clinical trial, you will receive an informed consent document that spells out the payments you'll need to make. <h3> How long will the trial take? </h3> The length of the study varies significantly based on the trial. Bosley explains it's not just the treatment time that goes into consideration for each trial. The short- and long-term follow-up are important as well. <br> <br> "We can be following patients up to 10-20 years, but the follow-up is usually an annual check-in that coincides with a visit to the physician," she says. <br> <br> For patients with late-stage cancers, the treatments can continue for a longer period of time, especially if they're effective. <br> <br> "We usually don't end treatments on the study if it's working and the patient is benefitting," Bosley says. "The number of cycles can be unlimited." <h3> How will I benefit from participating in a clinical trial? </h3> The short answer is that you'll get personalized care during your treatment, along with access to potentially cutting-edge therapies that could benefit your health. But it's the contribution to the greater good that Bosley thinks drives most patients to participate. <br> <br> Current treatments are available because of those who participated in previous trials. The bottom line is that taking part in a clinical trial is a valuable contribution to cancer research. <br> <br> "They're in this awful situation with this awful disease, but they're able to contribute and give back to somebody, whether it helps them or not," she says. <div class="end-of-story"> </div>
Samantha Ober, MD, board-certified physician at GBMC Health Partners Primary Care — Hunt Valley, explains why getting your flu shot is so important, and dispels myths about the vaccine. Online Form - 5 questions about the flu
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/X9l-yoe96Uw" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> Bimal Rami, MD, director of Neurosurgery at GBMC, can discuss the potential causes of severe back pain and address the question of when a surgery consult is recommended </p>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/MxlGg3KZiX8" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> More people than ever are living with diabetes. In the U.S., 3.3 million adults have diabetes and 1 in 4 of them aren’t even aware they have the disease. Dr. Hira Shakeel and WMAR News’ Christian Schaffer talked about the factors that increase your risk of developing type 2 diabetes, what you can do to lower the risk of you and your children developing diabetes, and the difference between type 1 and type 2 diabetes. <br> <br> </p> <blockquote> You can live the life you want with diabetes...it doesn't have to restrict you. </blockquote> <br> <br> “Type 1 diabetes is an autoimmune disorder,” Dr. Shakeel explained. “The body’s immune system attacks and destroys the cells in the pancreas that make insulin. In type 2 diabetes, the body’s cells don’t respond as well as they should to insulin, a condition called insulin resistance. The body then produces too much insulin, which accumulates in your blood, producing high blood glucose levels. Both forms of diabetes, if not well controlled, can cause a range of health problems including kidney damage, eye problems, and an increased risk of heart disease and stroke.” <br> <br> In addition to taking the medications your doctor recommends to manage your blood sugar levels, Dr. Shakeel recommends working with a nutrition specialist to create a personalized eating plan based on your age, height, weight, gender, and activity level. She notes that you don’t have to give up all your favorite foods, you simply need to manage portions and make them part of a balanced diet. <br> <br> To help make managing diabetes easier, Dr. Shakeel said it’s important to educate yourself about the nutritional content of your food and choose non-starchy vegetables, lean protein, and healthy fats. There are a number of apps that can simplify making wise nutritional choices by telling you how many calories, carbs, and other nutrients each food contains. “You can live the life you want with diabetes,” she added. “It doesn’t have to restrict you.”
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/x3XQ_5iG_fg" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> Dr. Hira Shakeel Discusses how to eat healthy during the holiday season when you have diabetes. </p>
<p class="article-body"> Giving birth is a significant moment in a woman's life, and for roughly one-third of women in the U.S., the arrival of their child comes hand in hand with a major surgery. Cesarean delivery (C-section) can happen for various reasons, but the end result is the same: a 4-to-6-inch wound in the mother's lower abdomen. <br> <br> Jennifer Heller, M.D., Medical Director of The Wound Center at GBMC HealthCare, knows it can be challenging for a mother to care for herself in addition to a newborn. However, ensuring the incision heals properly is important to the health of both mother and child. Here are five ways to help your C-section recovery go as smoothly as possible. </p> <h3> 1. Stay healthy during your pregnancy. </h3> Obesity and excessive prenatal weight gain not only increase your chances of having a C-section but it can also make it harder for the body to recover from a major trauma like surgery. <br> <br> Dr. Heller explains, "People who are obese have a higher chance of developing a seroma, or collection of fluid under the skin, and if a collection of blood forms under the c-section wound, that can increase the chance that the wound will open up." <br> <br> Smoking and diabetes can also affect how the wound heals. Pregnant women should continue to stay active, consume whole foods, and follow any directions given by their OB/GYN to maintain their health when they're expecting. <h3> 2. Keep an eye on the incision. </h3> The area around the incision will be sore for a few weeks following surgery, but with the help of prescribed or over-the-counter pain relievers, the discomfort should be manageable. Numbness and itchiness are normal, but there are several other signs that indicate the wound may not be healing correctly. <br> <br> Dr. Heller shares, "If you notice fluid draining out of a small site, red streaks on your belly, or the area around the wound is warm or tender to the touch, these can be signs of infection." <br> <br> She adds that a fever, shakes or chills, and a general unwell feeling could also be indicators that the wound isn't healing properly, and you should call your doctor. <h3> 3. Take it easy. </h3> This may be easier said than done with a new baby, but mothers really need to give themselves a break during the healing process. Avoid stairs, keep baby supplies close at hand, and accept any help that friends and family offer. Slow, gentle walks can help prevent constipation and blood clots, but strenuous exercise should be avoided until the doctor gives the green light. A perfectly healthy incision can take up to six weeks to heal properly, and Dr. Heller says an infected wound is usually healed in less than two months if the mother is in good health. <h3> 4. Maintain a healthy lifestyle post-pregnancy. </h3> Dr. Heller stresses maintaining healthy habits is just as important post-pregnancy as it was while carrying the baby. <br> <br> "The best way to prevent an infection after a C-section is by adhering to the same principles your OB/GYN recommended at the beginning of your pregnancy," she says. <br> <br> This includes eating the right foods, taking your prenatal vitamins, exercising regularly, and maintaining a healthy weight. <h3> 5. Don't be afraid to call if you have concerns. </h3> If something seems off with your incision, let your doctor know. <br> <br> "Although it's not an emergency requiring you to call 911, at first sign of infection call your OB immediately. Don't sit on it," says Dr. Heller. <br> <br> Your doctor will check for signs of infection and either make a recommendation for treatment or refer you to a specialist for additional care. <div class="end-of-story"> </div>
<figure class="image-right"> <img src="/sites/default/files/hg_features/hg_post/1166925754454ef3a8aa645f273e8026.jpg" alt="Brandon Costantino, Oncology Support Program Manager"> <figcaption> Brandon Costantino, Oncology Support Program Manager </figcaption> </figure> Written by Megan Doherty for <a target="_blank" alt="Jemma Everyday" href="https://jemmaeveryday.com/">Jemma Everyday</a> <br> <br> Cancer can be a scary word that conjures up many emotions. Fear, anxiety, sadness, anger and helplessness are all valid feelings that may follow a patient’s diagnosis. We recently sat down with Brandon Costantino, the Oncology Support Program Manager at GBMC, to discuss how patients can prevent, prepare, and cope with a cancer diagnosis. <h3> Prevention </h3> “It is very important for people to be proactive about their health,” Costantino emphasized when talking about cancer prevention. “Get your screenings, get checked, and maintain regular visits with your doctor. Ignoring a problem is not going to make it go away.” <br> <br> Prevention starts at home with regular exercise, a balanced diet, and healthy habits. Specifically, not using tobacco products and avoiding risky behaviors, such as drug use, is important in potentially reducing the risk of a cancer diagnosis. Be sure to advocate for yourself if something doesn’t seem right and set up regular screenings with your healthcare providers. <h3> Understanding Your Insurance </h3> Understanding what is included in your insurance coverage is critical when receiving a diagnosis that involves long-term care or expensive treatments. For example, many people often do not understand the differences between co-pays and co-insurance. Both are cost sharing for health services between the insurance companies and the insured. However, while co-pays are a flat fee, co-insurance is a percentage of the cost paid by the insured after their deductible is paid. <br> <br> “Unfortunately, a lot of unexpected health issues arise as we age,” says Costantino. According to Cancer.gov, the average age for a cancer diagnosis is 66 with 25% of new cancer diagnoses occurring with patients ages 65-75.1 Therefore, it is likely that a large percentage of cancer patients are also dealing with changes to their insurance plans. Understanding how your overall insurance plan works can help set expectations regarding the amount of your medical bills given various scenarios. Talk to your health insurance provider to gain more clarity about your specific situation. <h3> After Diagnosis: Know Your Options </h3> As Costantino points out, “Unless you are hyper-wealthy, you will probably need assistance to pay for cancer treatments.” Fortunately, there are several options available to those who have been diagnosed. <br> <br> Costantino discussed that one of the more frequent issues with cancer patients is their possible inability to continue working and receiving a regular paycheck. Regular bills, of course, do not stop and, when coupled with medical expenses, the total can seem overwhelming. Start by talking to your benefits expert or human resources department to find out what your disability insurance options are and if your income would be supplemented in the event you are unable to work. “Early in the process, ask who is designated to help you within your treatment facility,” says Costantino. “It’s key to get in contact sooner rather than later.” These experts know how to navigate the system to ensure that proper paperwork is filed with the appropriate companies to help ease the financial burden a cancer patient might find themselves under. He states, “Make sure to ask for help early. We cannot put the fire out after the house burns down.” <div class="end-of-story"> </div>
