<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/iHVUqGebqEQ" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> Barbara Messing, MA, CCC-SLP, BCS-S, FASHA, Director of the Milton J Dance Jr. Head and Neck Center at GBMC, explains how to keep your voice healthy. </p>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/oMWrsZmThYQ" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> Watch Gilchrist's Chief Medical Officer, W. Anthony Riley, MD as he answers "What is Advance Care Planning?" in an interview with BMore Lifestyle. </p>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/9qEf4-DNqNI" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> April is Child Abuse and Sexual Assault Month. Laura Clary, BSN, RN, FNE-A/P, SANE-A, Clinical Program Manager of GBMC's SAFE and Domestic Violence Program, explains the support available at GBMC to help victims of sexual violence. </p>
<p class="article-body"> <style> .col-sm-3.blog-date { display:none; } </style> </p> <figure class="image-full"> <img src="/sites/default/files/hg_features/hg_post/2b18151a2aa8e90531cd3163e5ac0a5a.jpg" alt="Oral Head and Neck Cancer Infograph"> </figure> <div class="end-of-story"> </div>
<p class="article-body"> One morning, in just a matter of hours, the Greater Baltimore Medical Center emergency room ran out of naloxone — the drug that treats opioid overdose. So many overdoses came in simultaneously that the ER’s entire 40 milligram supply vanished, explains Dr. Jeffrey Sternlicht, GBMC’s chair of emergency department services. <br> <br> That’s just one way the opioid crisis has transformed emergency medicine. And Sternlicht isn’t alarmed just because he’s in the ER regularly. It goes much deeper than that. <br> <br> “I really feel like I was gamed by the system,” he explains. “Big Pharma and everyone else who has made so much money [off opioids] did it off the backs of well-intended people.” <br> <br> Sternlicht explains how physicians, nurses and even patients bought into the lie that opioids were not addictive — thanks, in no small part, to the Joint Commission’s 2001 pain standards, which stated as much. “We were taught to make pain a zero,” says Sternlicht — a lesson that led to prescription abuse, heroin addiction and the deadly overdoses that are the scourge of emergency rooms everywhere. <br> <br> Sternlicht’s personal passion, now, is to try to reverse course. </p> <h3> Treating addiction in the ER </h3> The ER is not a substance abuse treatment center, but it is on the frontlines of the opioid crisis. And new policies and procedures have transformed the services they provide. <br> <br> At GBMC, says Sternlicht, most patients in the ER are now screened for substance abuse, part of the Maryland Screening, Brief Intervention, Referral to Treatment (SBIRT) program. <br> <br> If someone screens positive, there are peer recovery coaches who do a brief intervention and, when appropriate, a warm handoff to an outside treatment center. Specifically for overdose patients, there’s a separate peer-based team that provides additional follow-up. <br> <br> And for certain patients, explains Sternlicht, the ER at GBMC is one of a few places to administer buprenorphine — part of a medication-assisted treatment plan to help people wean off opioids. <br> <br> Sternlicht was ambivalent at first, but the efficacy of buprenorphine was hard to ignore. “There are very few areas in medicine where I can decrease mortality by 60 percent,” he adds. “We’re doing that — and I’m proud of it. We’ve saved lives already.” <h3> New ways to manage pain </h3> Another way to reverse course is to reduce the amount of opioids in circulation. That starts with policies like not replacing lost or stolen medication, and prescribing the shortest course of opioids possible. Already, opioid prescriptions are down 15 percent in Maryland. Sternlicht estimates his own prescriptions are down by 60 percent. <br> <br> That doesn’t mean patient pain has gone away. Instead, the medical community has become more creative when it comes to managing it. <br> <br> Sternlicht and his colleagues are experimenting more with alternatives to opioids, called ALTOs, such as lidocaine patches, trigger point injections, ultrasound-guided nerve blocks, long-acting local anesthetics — even small doses of ketamine — as well as considering other alternative treatments like acupuncture. <br> <br> “Our toolkit used to contain [over-the-counter pain relievers] and opioids,” says Sternlicht. “I look at it now as multimodal analgesia.” <h3> Where we go from here </h3> Despite all the policy and procedural changes, and growing public awareness, the opioid crisis is far from over. In fact, says Sternlicht, even in the best-case scenario, opioid overdose deaths will rise for several more years. <br> <br> True change will require much more of the same — fewer opioid prescriptions and better treatment for addiction, as well as a new understanding of pain by patients and doctors alike. “We have pain for a reason,” says Sternlicht. “I hate to say it, but zero pain is not a reality.” <br> <br> Sternlicht admits the work ahead is humbling. “I don't see this crisis ending in my career,” he says. “We have to try to act now.” <div class="end-of-story"> </div>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/9t5Pixn5Ay0" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> Dr. Laura Scott, Director of the Pediatric Inpatient and Emergency Unit at GBMC, explains when children should go to the pediatrician and when they should go to the emergency department. </p>
<figure class="image-full"> <img src="/sites/default/files/hg_features/hg_post/589930a56736252c84005fcef9c9e3f7.jpg" alt="Sleep 101 Infographic"> </figure> <div class="end-of-story"> </div>
<p class="article-body"> March is Colorectal Cancer Awareness Month, bringing digestive issues front and center. Digestive disorders can affect the upper or lower gastrointestinal system, from the esophagus and stomach to the intestines and colon. <br> <br> A major point of focus in recent years due to media promotion of over-the-counter medications, gastroesophageal reflux disease, or GERD, is a common condition that occurs when excess stomach acid splashes back up into the esophagus. <br> <br> “We’re seeing increased incidence of GERD among younger patients due to the obesity epidemic and today’s stressful lifestyles,” says Dr. Niraj Jani, director of the Greater Baltimore Medical Center’s Division of Gastroenterology. “Acid reflux can manifest in a variety of symptoms including hoarseness, chronic cough, trouble swallowing, chest pain and generalized abdominal pain.” <br> <br> As a primary symptom of GERD, heartburn may not seem like a big deal, but it should merit a medical exam to rule out cardiac problems and other underlying conditions. <br> <br> “Occasional heartburn after you eat pizza probably isn’t a serious issue,” Dr. Jani says. “We’re talking about patients who suffer with symptoms to the point that it’s affecting their diet, their sleep habits and their tooth enamel.” <br> <br> What Dr. Jani calls “alarm symptoms” should be evaluated immediately — difficulty swallowing, vomiting blood or a sensation of food sticking in your throat. <br> <br> Comprehensive treatment for acid reflux factors in nutrition, behavioral counseling, medication and, if warranted, endoscopic or surgical intervention. OTC medications vary from mucosal protectants that coat and protect the stomach and esophagus from acid, to hydrogen blockers and proton pump inhibitors. However, Dr. Jani warns against long-term use of any over-the-counter medicines to treat heartburn or reflux. <br> <br> “If you have chronic symptoms, you should be seen by a gastroenterologist,” he explains. “There are patients who just self-medicate and never get any medical attention, and then they present later on with esophageal cancer or other advanced conditions.” <br> <br> Another common digestive concern, irritable bowel syndrome affects between 25 and 45 million people in the United States, according to the International Foundation for Gastrointestinal Disorders. IBS is defined by abdominal pain and changes in bowel habits lasting longer than three months in the absence of infection or other contributing factors. <br> <br> “Inflammatory bowel disease is a different condition, encompassing autoimmune diseases like Crohn’s and ulcerative colitis,” Dr. Jani adds. “These present mostly in younger populations with symptoms like bloody stools, diarrhea, urgent bowel movements and abdominal pain.” <br> <br> As with GERD, patients with irritable bowel syndrome or inflammatory bowel disease should insist on a thorough medical evaluation. <br> <br> “At GBMC’s Kroh Center for Digestive Disorders, we incorporate IBS and IBD experts, a GI cancer team, dedicated nurses, nutritionists, behavioral health and acupuncture,” Dr. Jani points out. <br> <br> Colonoscopy remains the gold-standard screening for colon cancer detection, with current guidelines recommending a baseline procedure at age 50 for healthy adults, although Dr. Jani says stool-based tests that can be performed at home may serve as an initial screening tool for some patients. <br> <br> “The bottom line is — don’t ignore or minimize any GI issues you may be experiencing,” he urges. “If there’s a problem, we can offer solutions to help, and early detection and diagnosis make a big difference.” <br> <br> For optimal digestive health, Dr. Jani suggests following a Mediterranean-style diet high in fruits, vegetables and healthy fats; eating smaller meals four or five times a day; and limiting triggers such as caffeine, chocolate and alcohol. </p> <div class="end-of-story"> </div>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/JED9leUdYNc" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> High blood pressure (hypertension) is known as a silent killer because there aren’t always visible symptoms. It harms the blood vessels in your brain, heart, kidneys, and other organs, causing them to function improperly and become permanently damaged. GBMC Health Partners nurse practitioner Jordyn Jersey stresses the importance of having your blood pressure checked regularly. </p>
<p class="article-body"> Whatever the motivation, one of the most common New Year's resolutions is to lose weight. Weight loss is a great way to gain self-confidence, but it has health benefits that go far beyond that. It can help reduce joint pain, manage diabetes, lower cholesterol, improve sleep, lower your risk of cancer, and much more. Even minor weight loss can have significant impacts on both your physical and mental health. For example, did you know that every pound you lose takes 4 pounds of force off your knees? <br> <br> There are endless products and programs that claim to help people reach their weight-loss goals. The instant gratification of fad diets can be very tempting, but remember that they aren't a sustainable way to lose weight. The safest and healthiest way to lose weight is gradually (around 1-2 pounds per week) over time. While this doesn’t have the same immediacy as many popular diets, it has a longevity that extreme diets do not. Here are some tips for getting started on a healthy weight-loss journey! </p> <ul> <li> <strong>Understand your motivation.</strong> Why are you trying to lose weight? Is it to manage diabetes or lower your cholesterol? Do you feel like you can’t keep up with your kids? Understanding the “why” behind your goal makes it easier to stay motivated. </li> <li> <strong>Reflect on your personal challenges.</strong> Are you a stress eater? Do you eat too much fast food? Once you pinpoint exactly what you’re struggling with, you can make goals to directly address those issues. </li> <li> <strong>Think small.</strong> Start with achievable goals. Instead of saying you’re going to lose 50 pounds, think in terms of incremental weight loss. When your goal is too big, it’s easy to become discouraged and go back to your old habits. </li> <li> <strong>Practice healthy habits.</strong> Stay hydrated, exercise, and eat healthy foods! Simple healthy lifestyle changes can make all the difference in the world. You’ll feel better and have a great baseline to kickstart your weight loss. </li> </ul> The best way to get started is to talk to your primary care physician (PCP) about making healthy and realistic goals. <a href="/node/2416" target="_blank">GBMC Health Partners Primary Care practices</a> focus on overall health and your PCP will help you determine what is healthy for your whole body. <a href="/node/3193" target="_blank">Check out this video</a> to see how GBMC supports patients throughout their weight-loss journey. Our team of physicians, nurse care managers, care coordinators, physician assistants, behavioral health consultants, medical assistants, and diabetes educators is dedicated to providing the best possible care to all of our patients. To make an appointment or find more information about GBMC’s primary care practices, visit <a href="/node/2531" target="_blank">www.gbmc.org/mydoctor</a>. <div class="end-of-story"> </div>
<figure class="image-full"> <img src="/sites/default/files/hg_features/hg_post/17adbec7460001ad161b1a18808a5c35.jpg" alt="The Easiest Ways to Meet Your New Year’s Resolutions - Infographic"> </figure> <div class="end-of-story"> </div>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/ufH4mtHwmZs" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> Greater Baltimore Neurosurgical Associates at GBMC can help alleviate pain with minimally invasive surgical and non surgical options. </p>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/QoduQZ8ZOCY" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> <strong>Breaking the grip of pain</strong> <br> <br> According to the CDC, 50 million people in the U.S. are living with chronic pain. For 20 million of those people the pain is severe enough that it limits daily life and work activities. Dr. Justin Slavin, GBMC neurosurgeon, and Dr. Inai Mkandawire, DO, FAAPMR, a physician at KureSmart Pain Management at GBMC, discussed the wide range of options for treating and managing pain effectively with Christian Schaffer, WMAR 2 News. <br> <br> “The first step is to figure out the source of the pain,” said Dr. Slavin. “For neck and back pain, unless the situation is an emergency, we work to first control the pain with non-surgical options that can range from physical therapy and modifying activities to medications. When surgery is the best treatment option, I’m an advocate for minimally invasive surgery. The goal is an easier recovery and less post-operative pain.” <br> <br> Adds Dr. Mkandawire, “We treat everything under the sun, including back and joint pain, headache pain, fibromyalgia, and pain from cancers and cancer treatment like nerve pain related to chemotherapy. The key is always to find the cause of the pain and make sure there’s no serious underlying cause for it.” <br> <br> With growing concern across the country about the risks of opioid pain medications, Dr. Slavin explained there is a time and place for their use. “Acute short-term pain relief, for example after someone has surgery, is when opiates can be effective,” he said. “But these medications are not the first line treatment for chronic pain.” <br> <br> “If you’re concerned about a pain medicine that your doctor has prescribed or if you have dealt with addiction, don’t be embarrassed to ask your doctor questions and express your concerns frankly. We’re here to help you, not judge you,” said Dr. Mkandawire. “And keep in mind, a pill doesn’t really treat the problem. It’s a temporary measure.” The goal of pain medicine specialists is to help patients get back to the activities they enjoy and that they need to perform on the job. “We see patients who go years living with pain and don’t see a doctor. Then once they come in and treatment is effective, they say, ‘I wish I’d done this years ago,’” added Dr. Slavin. “Pain in and of itself is not dangerous. You can live with pain, but it’s pretty miserable. If we can make your life better by getting your pain under better control, that’s a reasonable goal.” </p>
<p class="article-body"> Contrary to popular belief, time doesn’t necessarily heal all wounds. <br> <br> According to Jennifer Heller, M.D., medical director of GBMC’s Wound Center, the body usually goes through three basic stages of healing after suffering a wound. <br> <br> “During the inflammatory phase, the body sends white blood cells to fight the injury and launch the healing process,” Dr. Heller says. “Healing continues during the proliferative phase, which eventually leads to the remodeling phase where the scab has disappeared and new skin has formed over the wound site.” <br> <br> If you’ve got a wound that seems to be taking longer than normal to heal, here are a few possible reasons why: </p> <h3> You’re a smoker. </h3> Because smoking narrows blood vessels, it restricts oxygen delivery to the wound, slowing healing at the cellular level and increasing your chances of infection <h3> Underlying medical conditions. </h3> Health conditions like diabetes, arterial disease, lupus, renal failure and others can compromise your immune system and prolong the healing process. <h3> Medications. </h3> Medications that are required to treat some illnesses (steroids and blood thinners, for instance) may hinder your body’s ability to repair itself. <h3> Poor nutrition. </h3> “Good nutrition is a vastly underestimated factor in wound healing,” Dr. Heller says. “We stress this with our patients all the time. Protein is an especially important healing component.” She encourages patients to consider a liquid protein supplement. There are also supplements specialized for patients who are on diabetic diets. Multivitamins and other nutritional supplements are often recommended. <h3> Poor circulation. </h3> Normal blood circulation is very important for wound healing. “Anytime someone comes to us with a leg wound, we assess their circulation through a physical exam and ultrasound,” Dr. Heller says. “Depending on the characteristics, location and other factors, we can get a pretty good idea of whether the wound is due to poor blood supply, other factors or a combination. Sometimes we have to take measures to correct the arterial or venous circulation before treatment can proceed.” <h3> Overweight or obesity. </h3> Excess weight can cause chronic swelling in the legs that prevents wounds from healing effectively. “Sedentary patients, paraplegics and the elderly can develop pressure ulcers, particularly in the sacral area,” Dr. Heller says. “We take a proactive approach with people from assisted-living facilities to try to prevent these wounds before they occur.” Don’t hesitate to see your doctor if you have a wound that won’t heal. “With most wounds, you should start to see some improvement within a few days,” Dr. Heller says. “It never hurts to have it examined. If you come in right away, we can treat the wound before it turns into a major problem. At the very least, we can reassure you that it’s healing the way it should.” Over-the-counter ointments and triple-antibiotic creams may offer some benefit for minor injuries like skinned knees and superficial scrapes but shouldn't replace medical treatment in cases of serious or penetrating injuries. It’s always important to watch for signs of infection and seek treatment immediately if you notice fever, a foul odor, drainage, redness or soreness at the wound site. “How quickly your wound heals really depends on your overall health,” Dr. Heller says. “There are steps patients can take to minimize risk factors that prolong the healing process, such as smoking cessation, diabetes management, making sure you follow a healthy diet and exercising on a regular basis.” The Wound Center at GBMC is a multidisciplinary physician group that offers comprehensive wound care treatment including pain management, surgery, education and counseling. <div class="end-of-story"> </div>
<p class="article-body"> The holidays are often thought of as the happiest time of the year, but for many, this simply isn’t the case. With increasingly busy schedules and the pressures of gift giving, the holiday season doesn’t always live up to joyous expectations. This can be especially true if you’re experiencing the symptoms of depression or anxiety. Anxiety can be either chronic (ongoing and long-term) or seasonal. Seasonal anxiety often starts in the fall and continues throughout the winter. Reduced sunlight can cause a drop in your brain's serotonin and melatonin levels, which disrupts your mood and sleep patterns. Even though seasonal anxiety is temporary, it is no less serious than chronic anxiety, and if you see symptoms in yourself, you should schedule an appointment to talk with your primary care physician (PCP). <br> <br> It may be challenging to recognize whether your feelings are due to the heightened stress of the season or if they indicate more serious anxiety. Here are some common symptoms that could mean you are experiencing higher than normal levels of stress: </p> <ul> <li> Feelings of nervousness or restlessness </li> <li> Excessive worrying </li> <li> Trouble concentrating on everyday activities </li> <li> Insomnia and/or fatigue </li> <li> Muscle tension </li> <li> Gastrointestinal problems </li> </ul> Depression can also be seasonal and often accompanies anxiety. Common symptoms of depression include: <ul> <li> Loss of interest in activities you usually enjoy </li> <li> Social withdrawal </li> <li> Prolonged sadness </li> <li> Feelings of hopelessness </li> <li> Disrupted sleep patterns </li> </ul> If you aren't sure whether you're experiencing anxiety or depression, your PCP can help. The good news is that both conditions are treatable with a variety of options like practicing relaxation techniques, counseling or therapy sessions, increasing physical exercise, taking prescription medications, or a combination of all the above. GBMC Health Partners Primary Care has incorporated routine behavioral health screening tests to help identify potential anxiety, depression, and substance use disorders and ensure patients get the treatment and resources they need. <br> <br> To serve our patients better, GBMC and Sheppard Pratt Health System formed a collaborative partnership in November 2016. The joint initiative embeds full-time licensed clinical social workers (also called behavioral health consultants) in GBMC Health Partners Primary Care practices. They work alongside visiting Sheppard Pratt psychiatrists and substance use counselors (for prescribed and illegal substances) from Kolmac Outpatient Recovery Centers. Having these specialists available in primary care practices gives patients the care they need more quickly, and in a comfortable, familiar setting. It can also help to prevent unnecessary Emergency Room visits, where people go when they mistake symptoms of stress and anxiety for something like a heart attack. <a href="/node/2956" target="_blank" alt="An Emphasis on Behavioral Health at Our Advanced Primary Care Centers">Watch this short video to learn more</a>. <br> <br> If you suspect that someone you know is going through anxiety or depression, is using prescribed or illegal substances to cope, or is having the symptoms listed above, support them by being receptive and listening. Remind them that anxiety and depression are more common than they may think and there is no shame in seeking treatment. Encourage them to make an appointment with their doctor, and if they are hesitant or uncomfortable, offering to go with them can make all the difference in the world. <br> <br> For more information about GBMC Health Partners Primary Care practices, visit <a href="/node/2531" target="_blank" alt="My GBMC Doctor">https://www.gbmc.org/mydoctor</a>. <div class="end-of-story"> </div>
