<p class="article-body"> Coffee enemas, dry brushing, juicing, essential oils — these aren’t just new-age health trends. All have been touted for a common and serious condition of the lymphatic system called lymphedema. <br> <br> Never heard of it? Not even sure what the lymphatic system does? Here’s a crash course: Every cell in your body, as part of normal functioning, produces byproducts. “Syrupy lymphatic fluid is produced by every cell in the body. The lymph vessels suck up that ‘trash,’ carry it through the body and deposit it in lymph nodes, which are like recycling centers,” says Alan Kimmel, M.D., Medical Director of Rehabilitation Medicine at Greater Baltimore Medical Center. <br> <br> If lymph nodes or vessels are removed or damaged during cancer treatment including chemotherapy, radiation or surgery, it can disrupt the system. (Extreme obesity can, too, and some people are just genetically prone to lymphedema.) At some point — months, years or even decades after initial lymph damage — the fluid may build up in a limb, causing lymphedema, discomfort and mobility issues. One first notices swelling, then, the fluid can harden and the limb becomes heavy, stiff and susceptible to infection and wounds. </p> <h3> A common but not well-known condition </h3> Although lymphedema affects up to 10 million Americans, it’s understandable if you’ve never heard of it. Even many physicians, nurses and therapists aren’t familiar with current best treatments, Dr. Kimmel says. “It’s not as simple as wearing a compression stocking,” he says. “And, thanks to the internet, there are a lot of squirrely therapies out there.” <h2> What is effective: </h2> <h3> See a specialist early </h3> Prevention is the goal, so at GBMC, cancer patients visit the rehabilitation center before undergoing cancer treatment and their progress is tracked. “We do baseline testing to measure lymphatic flow,” he says, which helps the care team (physician, advanced practitioner, certified lymphedema therapists, and RNs) catch lymphedema early. “We also educate patients to come straight to us if they notice swelling, pain or mobility issues.” <h3> Complete decongestive therapy (CDT) </h3> If lymphedema develops, “we come up with a treatment plan that focuses not only on getting the swelling down, but also individual goals — do you want to go horseback riding again or swimming or wear certain shoes?” Dr. Kimmel says. It involves manual lymph drainage and massage, compression bandaging, help with exercises and more. Patients visit the center 3 to 5 days a week for lymphatic massage, during which a therapist breaks up dense tissue and manually redirects lymphatic fluid. In between appointments, limbs are wrapped. <h3> Elevation </h3> When lying down, place a 3 to 4-inch pillow under your arm or leg. While sitting at your desk, likewise rest your heel on a small step stool. “It’s an old wives’ tale that the limb has to be above your heart,” Dr. Kimmel says. <h3> Walking and range-of-motion exercises </h3> “When possible, walking is the best thing in the world,” Dr. Kimmel says. “If you’re not elevating, you should be moving.” When sitting or lying down, do what he calls ankle pumps: Raise and lower the front part of your foot keeping the heel planted. “It squeezes the lymphatic vessels, helping move the fluid up from the legs.” <h3> Restrict salt intake </h3> That doesn’t mean just avoiding the saltshaker. Most salt comes from processed and prepared foods, so cut back on those especially when dining out. <h3> Lose weight if needed </h3> Aim to drop 10 percent of your current weight if you’re significantly overweight. “Even modest amounts will make a big difference,” Dr. Kimmel says. “Without lifestyle changes, we can treat the lymphedema but it will just keep coming back.” <h3> Compression garments </h3> They aren’t a magic bullet but do help as part of a comprehensive treatment plan, Dr. Kimmel says. There are a lot of different kinds available, so work with your therapist to find those that feel comfortable and that are easy enough to put on and remove. <br> <br> There are a host of newer treatments — supplements, surgeries, etc. — but be wary, Dr. Kimmel says. Though there are number of cutting edge surgical procedures, they often come with great risk of complications and limited benefit. Even when surgery is considered, it is the lifestyle modifications that are ultimately the “secret sauce” for success. <br> <br> Instead, stick with a trained therapist’s program, Dr. Kimmel says. “For most folks, if they do what they’re supposed to, they don’t get into trouble again.” <div class="end-of-story"> </div>
<p class="article-body"> You probably don’t think much about your knees — unless they start to hurt. And, thanks to osteoarthritis, there’s a good chance that could happen as you get older. Osteoarthritis is the common wear-and-tear type of arthritis that occurs when the knee’s protective cartilage wears away and causes pain, stiffness and loss of motion. <br> <br> “Arthritis affects over 50 million adults and is the leading cause of disability,” says Lee M. Schmidt, M.D., chief of orthopedics and director of the Joint Center at Greater Baltimore Medical Center. <br> <br> The good news: Taking care of your body’s largest joints can help you avoid or reduce pain and prevent or put off knee replacement surgery. Here’s how: <br> <br> </p> <h3> Lose just a little weight </h3> “For every pound you lose, it takes 4 pounds of force off your knee,” Dr. Schmidt says. Start with a small, attainable goal. “Losing any weight is a big deal.” In fact, when a group of women lost an average of 15 pounds, they cut their knee pain in half, according to a study presented at a past American College of Rheumatology meeting. <h3> Exercise wisely </h3> Working out may be the last thing you want to do on aching knees, but research shows staying active helps. “Rather than jogging, go for low-impact activities and those that improve flexibility like cycling, the elliptical machine, swimming, yoga and Pilates,” Dr. Schmidt says. <h3> Strengthen muscles that support knees </h3> The most important: quadriceps, or thigh muscle. “When muscles become weak, the mechanics of the knee are disrupted,” Dr. Schmidt says. “People may favor the leg or strain the joint to compensate.” Multiple studies show a benefit to strengthening the quadriceps, so talk to your doctor about which exercises they recommend or see a physical therapist or certified trainer. Just avoid any exercise that involves deep knee bends, squats or lunges. <h3> Eat an anti-arthritis diet </h3> There’s no magic bullet; simply opt for more fruit, vegetables, whole grains, nuts and fish high in omega-3 fatty acids like salmon. “There’s a lot of support for a Mediterranean-style diet,” Dr. Schmidt says. “It’s thought to reduce inflammation which contributes to pain.” <br> <br> Preliminary research also suggests specific foods might help, including cruciferous veggies like broccoli, garlic, tart cherry juice, turmeric and vitamin C-rich produce. <h3> Choose supportive shoes </h3> Save the flip-flops for the beach and high heels for special occasions. “Excessive wear of heels can shorten the Achilles (tendon), which can put more strain on the knee,” Dr. Schmidt says. But also make sure your go-to comfy sneakers provide good arch support. <h3> Try acupuncture </h3> Studies have suggested that patients receiving acupuncture had less pain compared to no treatment, but the results weren’t statistically significant. Although more research needs to be done, this treatment may be worth a try, Dr. Schmidt says. <h3> Consider topical and oral medications </h3> You’ve got options: Anti-inflammatory creams and numbing patches, plus over-the-counter pain relievers like Tylenol, Aleve or Advil. “Different people respond well to some treatments and for others, they don’t help,” Dr. Schmidt says, adding that the goal is to relieve discomfort in the short-term, allowing you to exercise, build strength and lose weight — all of which help in the long-term. Prescription anti-inflammatory medications can provide greater relief, but as with all medications, check first with your primary care physician to avoid potential drug interactions. <h3> Talk to your doctor about injections </h3> If symptoms progress, injections of certain medications can likewise lessen or alleviate symptoms entirely. “Injections don’t cure arthritis, but while the knee is feeling better, this is your chance to build up strength that can prevent a reoccurrence of pain,” Dr. Schmidt says. <br> <br> Cortisone injections reduce inflammation and thus, pain. Another option: hyaluronic acid, which occurs naturally in joints as a lubricant and shock absorber. “One theory is that it stimulates the healing of damaged cartilage,” he says. “Another is that it tricks the body; it sends the brain a message that this is a normal healthy joint, so the brain doesn’t send out signals that cause inflammation and pain.” <br> <br> Patients could get as much as six to nine months or more of relief from one injection, and can have injections every six months as long as they continue to help, Dr. Schmidt says. <br> <br> Injections involving stem cells and platelet-rich plasma are two newer options, however. Stem cells can be obtained from bone marrow concentrate and are the body’s most powerful regenerative cells. While there are many websites and ads touting the use of stem cells for curing arthritis, Dr. Schmidt warns that stem cells are still considered experimental and are not covered by insurance plans. <br> <br> So, if you’ve tried every other treatment and are still feeling pain and stiffness that affect your daily activities, it may actually be best to consider surgery, he says. “The other concern is if people develop instability, they may fall and break a hip or something else; then it’s too late.” <div class="end-of-story"> </div>
<p class="article-body"> No one likes to think about being sick on vacation, but warm, humid weather and crowded summer destinations can be a recipe for illness. GBMC infectious disease physicians Theodore Bailey, MD, JD, MA, and Maneesha Ahluwalia, MD, offer some tips for a safe and healthy vacation: <br> <br> </p> <figure class="image-left"> <img src="/sites/default/files/hg_features/hg_post/4706e05f098aa854a17c42f1c49cc52d.jpg"> <figcaption> Maneesha Ahluwalia, MD </figcaption> </figure> <h3> Hand washing is the number one precaution to take when traveling </h3> Hand washing cannot be emphasized enough; it’s like a do-it yourself vaccine! Lather with water for at least 20 seconds (about one Happy Birthday song) and dry with a clean towel. Wash before eating, before and after treating a cut or wound, after using the toilet, after touching an animal or garbage, and after changing diapers. Avoid those who are coughing and sneezing, and if you must cough or sneeze, do so into your shirt sleeve or elbow, not into your hand. <br> <br> <br> <br> <h3> Pack wisely! </h3> Bring full-sized bottles of sunscreen and insect repellent, especially if visiting a tropical location (these need to be packed in your checked baggage if you’re flying to your destination). Use products with 25 percent DEET; you don’t need more than that. Apply sunscreen first, and then insect repellent. Also bring hand sanitizer or dissolvable soap, which does not require water to rinse off. Oral rehydration salts can come in handy for people who become dehydrated due to traveler’s diarrhea or vomiting. Bring along 1% hydrocortisone cream; it is helpful for a variety of skin conditions from insect bites and poison ivy to allergies, rashes and overall itchiness. Keep your prescription medications in your carry-on luggage and bring extra just in case. If you have any chronic illnesses, carry a card that identifies, in the local language, your blood type, medical conditions, medicines you take, and any allergies you have. Wear a MedicAlert bracelet if you have serious medical conditions. <br> <br> <figure class="image-right"> <img src="/sites/default/files/hg_features/hg_post/b7601bb09d0c4c33f35a9443d83a7c22.jpg"> <figcaption> Theodore Bailey, MD, JD, MA </figcaption> </figure> <h3> Avoid local foods or drinks in certain parts of the world </h3> If you are traveling abroad to places like Africa, Asia or South America, do not drink the tap water (includes ice in drinks, ice cream, or food washed in water, like salads). Brush your teeth with bottled water. Avoid eating raw fruits or vegetables unless they have a thick peel, like a banana or orange. In all locations, be wary of food served at room temperature, raw or soft-cooked eggs, raw or undercooked meat or fish, unpasteurized dairy and wild game. Eating only freshly cooked meals while piping hot is the safest approach to eating while traveling. <br> <br> <h3> Consult with a doctor about vaccinations before traveling abroad </h3> Visit your primary care physician or a travel clinic about 6-8 weeks prior to traveling and bring along your vaccination history, a detailed itinerary and your travel dates. They will be able to give you reliable advice on recommended vaccines. Some vaccines and malaria prevention tablets must be started weeks prior to travel, so be sure to plan ahead. For the most up-to-date, reliable travel alerts for every country, visit the Centers for Disease Control and Prevention website at <a target="_blank" alt="Center for Disease Control Website" href="https://www.cdc.gov/">http://www.cdc.gov/</a>. <br> <br> <h3> Seek medical attention immediately if you think you or a family member has contracted a disease </h3> Hydration is usually a good first step in treating an illness. Find a safe and reliable doctor who speaks your language by contacting the US embassy in your destination country (<a href="https://www.usembassy.gov/" target="_blank">http://www.usembassy.gov</a>). Consider travel insurance to protect against the costs of medical care and medical evacuation for travel related illnesses. Upon returning home, make an appointment with a primary care physician, who will assess your symptoms and determine whether a referral to an infectious disease specialist is necessary. To learn more about GBMC Health Partners primary care practices, visit <a href="http://www.mygbmcdoctor.com/" alt="mygbmcdoctor.com" target="_blank">www.mygbmcdoctor.com</a>. Even if your vacation ends without apparent illness, you may not be home free yet. If you were taking medicine to prevent malaria, you will need to keep taking it for up to four weeks (depending on the medication) after your return. Moreover, some infections take time to show themselves so if you become ill weeks to months or even longer after you travel. Symptoms that appear after a trip should prompt your primary care doctor to think about travel related infections. <div class="end-of-story"> </div>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/yu6BpttOlUo" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> A survivorship nurse takes us through the journey of helping patients handle a difficult time. </p>
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<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/AbgPggP2Dww" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> Memorial Day weekend is the official start of the summer, and thousands of people will be traveling to the beach for a summer vacation from now until September. The last thing you want are any kinks, such as foot and back pain, to inhibit your vacation. Flip flops are easy to love. They’re easy to wear and help to keep your feet cool. Dr. Jamie Johnston, an orthopedic surgeon at GBMC says flip flops are fine for the pool or beach, but extended daily wear can lead to foot or back pain. Additionally, look for sandals with a thicker sole and arch support. Thin, rubber soled flip flops don't offer the proper arch support or protection against rocks or other hazards on the ground like nails and broken glass. </p>
Oh say, can you see? If you experience eye pain, irritation, redness, itching or blurry vision, you’re not alone. From myopia (nearsightedness), hyperopia (farsightedness) and astigmatism to macular degeneration, glaucoma and cataracts, most people are likely to experience an eye problem or vision issue at some point, and the potential for problems increases with age. Here are five points to keep in mind for optimal ocular health: Get regular eye exams The best thing you can do to keep your eyes healthy is to maintain a routine exam schedule. The American Academy of Ophthalmology recommends having a baseline eye exam at age 40 (sooner if you have a family history of eye disease or are having any issues) performed by a medically trained physician, and follow-up exams on a regular schedule as determined by the doctor. A professional eye exam should include a vision screening, eye pressure check and possible dilation to examine the inside of the eye. Some medical diagnoses can affect your vision Diabetes, high blood pressure, auto-immune diseases and certain other diagnoses carry the potential to affect your vision, mainly depending on how well you control the disease and how long you’ve had it. “Many times, there are no symptoms until advanced stages,” says Tanvi M. Shah, MD, a Comprehensive Ophthalmologist and Cataract Surgeon at Greater Baltimore Medical Center (GBMC). “Sometimes, you might experience inflammation, dryness or blurred vision from retinal swelling or cataracts. Patients with any of these diagnoses should see an eye doctor regularly and follow up as instructed to prevent or control further damage.” Daily use of digital screens can affect your eyes In today’s electronic age, it’s nearly impossible to get through the day without using a laptop, tablet, phone or other digital device, but too much screen time can cause eye strain, increased risk of myopia and the potential for dry eyes. If you spend a lot of time in front of an electronic screen, take breaks at 20-minute intervals and focus on something in the distance for at least 20 seconds to give your eyes a quick rest. Don’t overuse over-the-counter drops It’s easy to squeeze in a few OTC drops when your eyes are feeling red and tired; just make sure to read the label and directions. “The OTC drops I recommend most for regular use are artificial tears for lubrication,” Dr. Shah says. “OTC medications for red eyes tend to contain chemicals that create a white appearance, but don’t address the cause of the redness. And the redness can actually increase after you stop using the eye drops.” For allergy-related eye redness and itching, Dr. Shah recommends looking for a product that includes an antihistamine and mast cell stabilizer. Some foods can help support eye health Eating carrots and other foods rich in vitamins C and E, zinc, lutein and omega-3 fatty acids may reduce your chances of adverse eye conditions as you age. An Age-Related Eye Diseases Study funded by the National Eye Institute indicates a link between these nutrients and lowered risks for macular degeneration, cataracts and dry eyes. For the healthiest eyes, try to work citrus fruits, nuts, whole grains, cold-water fish and leafy green vegetables into your daily diet.
<p class="article-body"> Sexual assault and domestic violence are far more common than we'd like to think. These crimes don't discriminate between age, race, gender identity, or economic status; they truly can happen to anyone. Every 98 seconds, an American is sexually assaulted. One in four women and one in seven men will be victims of domestic violence over the course of their lifetimes. Shame and fear often prevent people from reporting the crimes and from getting appropriate medical care for their injuries. <br> <br> GBMC’s <a target="_blank" alt="SAFE & DV Program at GBMC" href="/node/2551">Sexual Assault Forensic Examination (SAFE) and Domestic Violence (DV) Programs</a> provide unique services to the community. Their specialized clinicians and advocates attend to patients’ medical needs while creating an environment that re-empowers victims. The SAFE and DV Programs: </p> <ul> <li> respond to the Emergency Department 24/7 </li> <li> assess, document and treat injuries </li> <li> collect and package forensic evidence </li> <li> offer language translation services. A Language Line is always available, and a Spanish-speaking advocate may be available for immediate assistance or follow-up. </li> <li> provide follow-up contact and support </li> <li> advocate for victims through emotional support, education, safety planning, danger assessment, and referrals for counseling/shelter/legal assistance </li> </ul> To ask questions or make an appointment, call the SAFE/DV departments directly at 443-849-3323. If you need immediate, 24-hour assistance, call GBMC's Emergency Department at 443-849-2225. <strong>If you are currently in danger, call 911.</strong> <br> <br> Abuse may begin slowly and escalate over time. If you aren't sure whether you are experiencing abuse or are uncomfortable going to the Emergency Department, talk to your GBMC <a href="http://www.mygbmcdoctor.com/" target="_blank" alt="mygbmcdoctor.com">primary care provider</a> (PCP). The integrated care management teams are equipped to assess your situation and refer you to the help you need. Every person deserves to be safe and feel secure. <br> <br> To encourage dialogue about sexual assault and domestic violence, as well as show support for survivors, GBMC is hosting its 3rd annual <a href="http://gbmc.healthcare/walkamile/" target="_blank" alt="Walk A Mile in Her Shoes">Walk a Mile in Her Shoes</a>® on Saturday, April 21. All are invited to participate in the 1-mile walk and attend the pre-party with food and prizes. <a href="http://gbmc.healthcare/walkamile/" target="_blank" alt="Walk A Mile in Her Shoes">Click here</a> to register and start fundraising! <div class="end-of-story"> </div>
<p class="article-body"> <strong><a target="_blank" href="http://www.baltimoresun.com/paid-posts/?prx_t=rJEDAHpYeA2EQQA">To view the video content, click here</a></strong> <br> <br> It can hit when you least expect it. You bend over to pick something up or turn a certain way and — yeow! — you feel a pang in your lower back, and suddenly it hurts to stand up straight or even walk. Or, the pain may come on gradually, feeling more dull and uncomfortable. <br> <br> Either way, you’re likely to experience lower back pain at some point in your life — 80 percent of people do, according to the National Institute of Neurological Disorders and Stroke. What’s more, it doesn’t only target those who are on their feet all day. A survey by the American Physical Therapy Association (APTA) found that more than half of those with lower back pain sit much of their workday. It also found that pain interferes with the ability to do daily tasks for 39 percent of adults, while it disrupts the sleep and the exercise routines of more than a third. <br> <br> Whether you’ve experienced pain in the past, are currently nursing an aching back or are hoping to avoid it altogether, here are five key things to know or do: </p> <h3> It’s probably not serious </h3> While back pain can be, both literally and figuratively, a pain that interferes with your activities, most of the time it’s temporary, resulting from simple overuse, a strain or minor injury, according to the APTA. Back pain is also more common as you get older and intervertebral discs begin to naturally lose fluid and flexibility. Weak stomach and back muscles can also contribute. <h3> You can help prevent it </h3> Your mother was on to something if she scolded you for slouching. Your spine is responsible for supporting the heavy load that is your upper body, and is best equipped to manage it when straight and steady. So, try to keep your back straight and shoulders back; when standing, keep weight evenly balanced on feet and, when sitting, choose seats with good lumbar support. Other simple tricks: Wear comfortable shoes when walking, stretch before exercising, incorporate back and abdominal strengthening moves into your workout routine and always lift from the knees, avoiding twisting your back or body while lifting heavy objects. <h3> Be sure to keep moving </h3> Inactivity can contribute to and be a risk factor for lower back pain, says Mike Wah, PT, DPT, OCS, a physical therapist with Active Life & Sports Physical Therapy, which is affiliated with the Greater Baltimore Medical Center system. If you’re experiencing pain, resist the urge to stay in bed, which research shows may make things worse. Instead, try to keep as normal a routine as possible. “Walk, bike or do whatever cardio activity you prefer,” Wah says. <h3> Stretch — and not only your back </h3> Because hamstrings, hip flexors and other muscles connect to the lower back, tightness in those areas can put added stress on the back, Wah says. Check out the video above for a few easy ways to loosen up. <h3> Try physical therapy first </h3> Hot and cold packs, over-the-counter pain relievers and stretching shown in the video can help ease acute pain, but if things don’t improve after about 10 days (or pain radiates down your leg), consider seeing a physical therapist who can help with assessment, stretches, strengthening exercises and other helpful strategies, says Joe Palmer, PT, DPT, OMPT, CSCS, CMTPT, a physical therapist also with Active Life & Sports. “The trend now is to try to steer people away from prescription medication and injections as first choice solutions for back pain,” he says. (You can follow the movement through the #TryPTfirst.) <br> <br> Note: Always consult your doctor before starting a new exercise routine. <div class="end-of-story"> </div>
<p class="article-body"> A quick primer: A bunion is a bony bump on the joint at the base of your big toe. It develops when your big toe pushes against your next toe, forcing the joint of your big toe to enlarge and stick out — because of this, the bump (bunion) and the joint may be red and painful. Yes, bunions are incredibly painful, especially when walking. <br> <br> “Bunions are bony prominences on the inside (medial side) of the great toe metatarsal phalangeal joint,” explains Dr. Steven Kulik, an orthopedic foot and ankle surgeon at Greater Baltimore Medical Center (GBMC). “Because your shoe puts pressure on the area, the bunion hurts. The smaller the shoe, the more pressure on the bunion — and the more pain.” <br> <br> If you have a bunion, surgery could be the answer to your pain problems; it corrects the deformed area of the foot near your big toe. Also known as a bunionectomy or hallux valgus correction (hallux valgus means “foot deformity” in Latin), the outpatient surgery typically takes between one and two hours and eight to 12 weeks to recover, explains Kulik. <br> <br> “Bunion surgery, if done well, will relieve the pain in your foot and allow you to walk comfortably,” says Kulik. “It will also allow you to wear comfortable shoes. It’s a permanent solution that fixes your problem.” <br> <br> Before choosing surgery, many people get relief from bunion pain by wearing larger shoes with a wider toe area or cushioning bunions with protective pads. Ice and anti-inflammatory medication are also useful. If you can’t find a way to relieve the pain with these options, surgery just might be the answer. <br> <br> “Bunion surgery is a realignment surgery,” explains Kulik. “Since there are different types of misalignments, there are many different types of bunion surgery. It’s best to find a surgeon who can perform different types of bunion surgeries to accommodate your deformity, rather than a surgeon with a ‘one size fits all approach.’ A foot-and-ankle-trained orthopedic surgeon, who is a member of the American Orthopaedic Foot & Ankle Society, fits that description.” <br> <br> Signs you should get surgery: </p> <ul> <li> Your pain restricts or prohibits you from completing everyday routines or activities. </li> <li> You can’t walk more than a few blocks without severe foot pain. </li> <li> Your big toe remains swollen and painful even with rest and medication. </li> <li> You have pain bending or straightening your big toe. </li> </ul> Simply stated, the indications for bunion surgery are pain, deformity and an inability to find any shoes that are comfortable for everyday use. <br> <br> “The best candidates are people in pain, those who have trouble finding comfortable shoes to wear, and people who have failed with conservative treatment, which consists of wide shoes, ice, and occasionally anti-inflammatory medications,” Kulik says. “Though some leather shoes can be stretched over the bunion by a shoemaker, if these measures fail, then surgery needs to be considered.” <br> <br> Good news: Naturally being in good health with good blood flow in your feet will make you an excellent candidate, as well. And, after surgery, you should be able to live a normal life wearing many different shoes. <div class="end-of-story"> </div>
<p class="article-body"> We may not like to talk about it, but colon cancer remains a very common cancer, and it is a dangerous topic to ignore. According to the Centers for Disease Control and Prevention (CDC), colorectal cancer is the third most common cancer among men and women in the United States, and while it mostly affects people 50 years and older, the number of young patients has been rising in recent years. <br> <br> Screening for colon cancer is all about prevention. Unlike many other cancers, colorectal cancer can be stopped before it starts. Most of the time, the disease starts as pre-cancerous polyps, which your doctor may be able to remove during a colonoscopy, the gold standard testing procedure to screen for colorectal cancer. Finding and removing these polyps can save your life. <br> <br> Unfortunately, there are few early warning signs for this disease, so it is important to be screened regularly, especially if you have one or more factors putting you at a higher risk for colorectal cancer. These factors include: </p> <ul> <li> Being over the age of 50 </li> <li> Having an inflammatory bowel disease such as Crohn’s disease or ulcerative colitis </li> <li> Having a family history of colorectal cancer or other cancers </li> <li> Being of African American or Jewish Eastern European descent (Ashkenazi) </li> <li> Having certain genetic conditions, such as Familial Polyposis Syndrome, and Lynch Syndrome (HNPCC- Hereditary Non-Polyposis Colorectal Cancer) </li> </ul> The preparation to cleanse the colon and rectum for a colonoscopy has a reputation for being unpleasant, but there are new options available to make it easier for patients to tolerate. Rather than having to drink an entire gallon of solution, patients can choose half-gallon options — flavors have also been improved and made more palatable. Many doctors are now prescribing a “split dose,” which allows patients to drink half of the prep solution the night before and the other half on the morning of the procedure. Colonoscopies are not painful and 95 percent of people sleep through them with no memory afterwards. <br> <br> While most polyp growths and colon cancers do not present early with symptoms, and symptoms may be due to a variety of conditions other than cancer, if you are experiencing symptoms, it is possible that any cancer present is at a more advanced stage. Check with your <a alt="MyGBMCDoctor.com" href="http://www.mygbmcdoctor.com/" target="_blank">primary care provider</a> if you have any of the following symptoms: <ul> <li> Rectal bleeding </li> <li> Abdominal pain </li> <li> Change in bowel habits </li> <li> Unexplained weight loss </li> <li> Lack of appetite </li> <li> Unusual bloating </li> </ul> Joseph DiRocco, MD, Medical Director of Gastroenterology (GI) Oncology at GBMC, recently discussed symptoms and treatments for GI cancer during a <a href="/node/3331" target="_blank">Facebook Live</a> with Ashley James from WMAR-TV. They were also joined by one of his patients, who described his experience with colorectal cancer. <a target="_blank" href="/node/3331">Click here to watch the segment!</a> <div class="end-of-story"> </div>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/Fv1R57MfhhQ" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> Colorectal cancer is one of the most common cancers in the U.S. The American Cancer Society says lifetime risk is about 1 in 22 for men and 1 in 24 for women. What’s more, recent research found a sharp increase in rates among young and middle-aged people. <br> <br> For this video, Joseph DiRocco, M.D., a colorectal surgeon and medical director of GI Oncology, and Niraj Jani, M.D., chief of the Gastroenterology Division at Greater Baltimore Medical Center, team up to share key facts that can help you protect yourself. <br> <br> In the event that you need a specialist, the Gastrointestinal (GI) Oncology Multidisciplinary Program of the Sandra and Malcolm Berman Cancer Institute uses a team-based approach to delivering high-quality, comprehensive cancer care. Our GI Oncology team looks to current research to direct our program while providing the gold standard in care. <br> <br> The GI Oncology Multidisciplinary Tumor Board meets regularly to discuss patients. The team includes surgery, radiation oncology, medical oncology, radiology, pathology, gastroenterology, interventional radiology, genetics, research and oncology nursing. Individual patients are discussed with feedback shared by each discipline. Patients find this process reassuring and it serves as a great communication tool. <br> <br> In addition, our colorectal surgeons use “Early Recovery After Surgery” (ERAS) evidence-based pathways for our colorectal patients. These pathways employ best practices for patients before, during and after surgery. The surgeons, anesthesiologists, nurses, physical therapists and occupational therapists all partner together to optimize patient outcomes. These protocols have patients up and moving more quickly after surgery. Research shows that patients experience less pain and shorter hospital stays when these pathways are utilized across the different disciplines. <br> <br> The GI Oncology program is also equipped with a GI Oncology Nurse Navigator, Amy Nahley, RN, MS, OCN. The Nurse Navigator facilitates communication between the different specialty areas involved in the care of GI Oncology patients. Newly diagnosed GI cancer patients get necessary staging scans and definitive treatment in a timely manner. As an Oncology Certified Nurse (OCN), Nahley provides symptom management, care coordination and support to patients whether their treatment involves chemotherapy, radiation, surgery or a combination of modalities. GBMC also launched an Upper GI and Hepatobiliary Cancer Multidisciplinary Clinic. The clinic serves as a “one stop shop” for patients. Dr. Rina Patel, a medical oncologist with a focus on gastrointestinal cancers, and Dr. Arun Mavanur, a surgical oncologist and director of Surgical Oncology at GBMC, lead this clinic. When a patient arrives at the clinic, he/she can see both specialists in one afternoon and connect to other resources such as Oncology Support Services, research, nutrition and nursing, when appropriate. The clinic provides multidisciplinary and personalized care. </p>
<p class="article-body"> <em>Exploring the Benefits and Misconceptions of the HPV Vaccine</em> <br> <br> The number of human papillomavirus (HPV)-related cancer cases continues to rise in the United States, despite a vaccine that can prevent most cancers associated with the virus. The Centers for Disease Control and Prevention (CDC) estimates that more than 90 percent of sexually active men, and more than 80 percent of sexually active women, will be infected with at least one type of HPV at some point in their lives. About half of these infections are with a high-risk HPV type such as 16 and 18, which cause 63 percent of all HPV-associated cancers in the United States. <br> <br> HPV-related cancer, however, can be prevented with the HPV vaccine, which has been available for more than a decade. <br> <br> Because there is no cure for the virus itself, the best way to fight HPV is to be vaccinated before becoming sexually active. Theresa Nguyen, MD, Vice Chair of Pediatrics at GBMC, said that the HPV vaccine can be given between the ages of 9 to 26 years in females and males. “The American Academy of Pediatrics recommends that the HPV vaccine be administered at 11 or 12 years of age, when the immune response is the best.” <br> <br> The CDC estimates that the HPV vaccine can prevent an estimated 29,000 new cancers per year. Yet, some parents remain leery about the vaccine due in part to a lack of education and reliable information about its cancer prevention benefits. <br> <br> <strong>The Importance of the HPV Vaccine</strong> <br> <br> “There are about 15 oncogenic types of the HPV virus,” explained Kimberly Levinson, MD, Associate Director of Gynecologic Oncology at GBMC during a recent Facebook Live interview. “About 70 percent of cervical cancer is caused by just two types of HPV, and about seven types of HPV account for more than 90 percent of cervical cancers. The vaccine we have available today is a 9-valent vaccine, covering nine types of HPV. Realistically, we have the ability to eliminate HPV and its associated diseases with the preventive vaccine.” <br> <br> According to Paul Celano, MD, FACP, FASCO, Herman and Walter Samuelson Medical Director of the Sandra and Malcolm Berman Cancer Institute, the HPV vaccine is one of the few established vaccines known to prevent cancer. “It’s extremely important that people take advantage of this vaccine. Each year 13,000 people are diagnosed with cervical cancer and more than 4,000 women die from the disease annually. Virtually every cervical cancer case is associated with the HPV virus,” he said. <br> <br> “It’s not only about cervical cancer, but HPV is also associated with vulvar, vaginal, anal, penile, and oral pharyngeal cancers,” Dr. Celano added. <br> <br> <strong>Understanding Misconceptions and Benefits of the HPV Vaccine</strong> <br> <br> As effective as this vaccine is, Dr. Nguyen said that some parents are concerned about its long-term health effects and safety, sometimes declining to have their children vaccinated. <br> <br> “Some common misconceptions about the HPV vaccine are that it encourages sexual activity, can cause premature ovarian failure [and hence sterility], paralysis, and even death. None of these claims, however, have been confirmed through evidence-based science.” <br> <br> “The HPV vaccine is incredibly important,” she stressed. “The vaccine protects against HPV infections that are associated with cervical cancer, anal cancer, and throat cancer. It also protects against HPV infections that cause genital warts. Hence, it is most effective if given before sexual activity.” <br> <br> <strong>How Physicians Can Help Improve HPV Vaccination Rates</strong> <br> <br> “As physicians, we need to emphasize the long-term, proven health benefits of the HPV vaccine and help parents understand that they can potentially prevent cancer in their child with this vaccine,” Dr. Celano said. <br> <br> Dr. Nguyen agreed, adding, “We can improve our vaccination rates in adolescents by encouraging immunizations during sick visits as well as annual physicals. Physicians need to build strong rapport and trusting relationships with families to facilitate discussions of potentially controversial vaccines.” </p> <div class="end-of-story"> </div>
<p class="article-body"> It is never too early to pay attention to risks associated with heart disease and stroke. High levels of cholesterol, among other factors, increase the body’s risk for ischemic vascular disease (IVD). IVD is characterized by plaque buildup in the blood vessels. The buildup results in a condition called atherosclerosis that restricts normal blood flow and can affect any artery of the heart, brain, arms, legs, pelvis and kidneys. The term “ischemic vascular disease” includes any of the diseases caused by plaque buildup including: </p> <ul> <li> Coronary Heart Disease (CHD) – refers to atherosclerosis in the arteries of the heart </li> <li> Carotid Artery Disease (CAD) – refers to plaque buildup in the arteries on either side of the neck leading to the brain. </li> <li> Peripheral Arterial Disease (PAD) – refers to a buildup of plaque in the arteries that carry blood to the head, organs, and limbs </li> </ul> All types of IVD are caused by atherosclerosis, and there are many factors that can trigger plaque buildup in the arteries. These factors include: <ul> <li> Smoking </li> <li> High blood pressure </li> <li> High sugar levels due to insulin resistance or diabetes </li> <li> High amounts of fats and cholesterol in the blood </li> </ul> Cholesterol on its own is necessary for building new cells throughout the body, insulating nerves and producing hormones. The liver makes this necessary cholesterol, creating it in exactly the quantities that the body needs to remain healthy. When the body inappropriately makes too much cholesterol (often a genetic trait) or excess cholesterol is introduced into the body from overeating cholesterol rich foods, including milk, eggs, and meat, cholesterol begins to stockpile in the blood and builds up in the arteries. This can lead to a narrowing of the arteries, thereby reducing blood flow to vital organs and potentially leading to a heart attack, stroke, or severe peripheral vascular disease, which can make it difficult to walk. <br> <br> Waiting for signs or symptoms of plaque buildup to occur may be life threatening as IVD typically does not cause symptoms until the artery is severely narrowed or totally blocked. The best prevention of high cholesterol and IVD is to work with a primary care physician to have cholesterol and lipid (fat) levels checked through blood tests. This will allow the physician to detect possible plaque buildup in the arteries before blood flow is impacted. <br> <br> Treating IVD can be completed with medications that control blood pressure and high cholesterol to prevent blood clots from forming in the diseased blood vessels<em>, </em>or routine surgeries to remove plaque buildup. Other treatment options include smoking cessation, dietary changes, maintaining or achieving a healthy weight and incorporating more physical activity into your daily routine. It may not be easy to manage all these things on your own, but the care team at your primary care physician’s office is there to help. And technology can, too! <a alt="MyChart at GBMC" target="_blank" href="/node/2209">MyChart at GBMC</a> allows you to keep track of your most recent cholesterol and blood pressure levels, view lab results, communicate securely with your physician, make appointments, and request prescription refills, all from the convenience of your mobile phone or computer. <br> <br> Information on all of GBMC’s primary care practices is available at <a alt="www.mygbmcdoctor.com" target="_blank" href="http://www.mygbmcdoctor.com/">www.mygbmcdoctor.com</a>. <br> <br> <div class="end-of-story"> </div>
<p class="article-body"> So maybe getting your ex’s name tattooed across your shoulder wasn’t the best idea, in retrospect. (Or the skull and crossbones that followed after you broke up). Fortunately, these days, yesterday’s regrettable ink no longer has to be permanent. <br> <br> The Vein Center at Greater Baltimore Medical Center began offering tattoo-removal services in 2017 using state-of-the-art Q-Switched lasers, the best medical-grade product on the market for this purpose. <br> <br> “As a surgeon, I can appreciate that no intervention is without risk,” said the center’s director Jennifer Heller, MD. “Patient safety is the most important factor. We want to be able to offer a safe environment and resources for this service that include a comprehensive evaluation.” <br> <br> Vein Center patients receive a free consultation, a medical work-up, and an opportunity to discuss any conditions (such as allergies, pregnancy, or use of prescription acne medication) that might contra-indicate the procedure before the laser ever comes into play. During the procedure, a laser beam is moved across the tattoo to break up the semi-liquid ink particles in the skin. Then, the body’s lymphatic system can absorb the ink and carry it away. A cooling tool is used in conjunction with the laser to prevent thermal injuries and to help numb the treatment area. <br> <br> Getting rid of a tattoo isn’t quite as quick as getting one, and patients shouldn’t expect results after one treatment. Esther Kim, a nurse practitioner with the Vein Center at GBMC, says eight to 10 sessions are usually the norm to fully remove a tattoo. Results and the number of sessions required depend on the patient’s health, as well as the color, location, and age of the tattoo. <br> <br> “Red, yellow and green inks take longer to remove because they involve larger pigment particles close to the top surface of the skin where’s there less tissue and fluid protection,” she explained. “This requires us to use lower laser settings to avoid thermal damage. Also, removing a tattoo from an area of the body with greater blood flow goes more quickly than removing a tattoo on an extremity like a hand or a foot.” <br> <br> The laser sessions can last anywhere between five and 30 minutes each and must be spaced four to eight weeks apart to allow the lymphatic system to carry away the ink particles between treatments. Laser tattoo removal services aren’t covered by insurance, and pricing can vary by provider. For example, the Vein Center at GBMC charges by the square inch, with patients paying as they go for each treatment. <br> <br> Most people are pleasantly surprised to discover that the procedure is less painful than they anticipate. <br> <br> “Patients describe it as the feeling of being snapped with a hot rubber band,” she said. “There’s virtually no residual pain immediately after the treatment, whereas pain after tattoo application is more prolonged.” <br> <br> “The most telling sign that it’s not terribly painful is that our patients continue to come back for their follow-ups!” Heller added. </p> <div class="end-of-story"> </div>
