During pregnancy, there are a variety of tests performed to keep track of the health of both the mother and the unborn child. Prenatal genetic testing is optional but gives parents-to-be information about whether their baby is at risk for certain genetic disorders or birth defects. Genetic disorders are caused by variations in a person’s genes or chromosomes. As Natalie Blagowidow, MD, medical director of the Harvey Institute for Human Genetics and director of the Prenatal Diagnostic Center at GBMC HealthCare explains, the screening process has evolved as science has evolved. “We’ve been screening for sickle cell for more than 50 years. Over the years, other genetic disorders have been identified, like cystic fibrosis, and more recently spinal muscular atrophy (SMA). It’s really been in the last six to seven years that SMA has become more prevalently screened for.” Spinal muscular atrophy refers to a group of hereditary diseases, the most common of which affects the SMN1 gene. Dr. Blagowidow explains, “SMN1 is called the survival motor neuron gene. When it doesn’t function normally, it leads to weakness in the muscles that help you with posture and strength, as well as eating and breathing. When untreated, severe forms of the disease are fatal in childhood.” Dr. Blagowidow adds SMA is a recessive disorder, and most people don’t realize they have the gene for it. “This means each parent must carry the gene, and if both parents do, there is a one-in-four chance that your baby will be born with SMA,” she says. Testing for SMA (along with several other genetic diseases) is typically covered by insurance, when recommended by a doctor, Dr. Blagowidow says. “There are more than 500 conditions a person could be screened for, but the basic panel looks at far fewer genes.” If both parents are found to have abnormal SMN1 genes, there are options available to them. “Typically, parents will meet with a genetic counselor who lays all the information out,” Dr. Blagowidow says. “They can do a diagnostic test to figure out if the pregnancy is affected. If the fetal test is positive, we can arrange for the couple to speak with experts in treating the disease. We then can help and support them, whether they opt to continue the pregnancy or not.” Dr. Blagowidow mentions testing for SMA has been added to newborn screening in most states in recent years, but she says the earlier it can be identified, the greater the chances of treating it effectively. “None of the SMA treatments are perfect, but once the child has symptoms, the treatment isn’t as beneficial,” she says. “This is why carrier screening is so important, because the parents can look to have treatment lined up once the baby is born.” For parents who are on the fence about genetic testing, Dr. Blagowidow offers this perspective. “You can benefit your child by knowing this. It can help you anticipate what’s going to happen.” She adds that it’s not just unborn babies who may be affected by your choice to get screened. “We’ve had patients who have preschool-aged children get carrier screening, and they’re found to have the same recessive gene. So, their child, who’s 4 years old and has undiagnosed symptoms, turns out to have the disease and now they know what they’re dealing with and can move forward with a more effective treatment plan.” Dr. Blagowidow recommends talking to your doctor if you have any concerns about prenatal genetic testing.
Summer is a more relaxed time of year, with fewer appointments and more lenient schedules, but there are some things you shouldn’t put off until fall. Scheduling your child’s back-to-school physical is one of them. “Summer is a period of vacations for all of us. Everyone takes vacations, and schedules can be rather limited because everyone in the office is also trying to get away,” said Robin Motter-Mast, DO, FAAFP, CPE, Chief of Staff at GBMC HealthCare. “Physicians’ and providers’ schedules are almost full now, three months in advance of the start of the school year. If you think you can wait until the last minute to get in, it will be almost impossible.” She says the benefits of scheduling back-to-school physicals outweigh any inconvenience around making room for them in your summer schedule. One main reason for planning ahead is to make sure children are up to date on vaccinations. “Parents often think they’re done once kids are in school, but there a few [vaccinations) that trickle up to high school, and vaccination recommendations change all the time,” Dr. Motter-Mast explained. The larger emphasis of these regular physicals is on the relationship between the provider and the patient. “We want to continue to build on these relationships with the parents and children year after year, check in and reconnect, and see their development. We also complete screenings and testing to make sure they’re up to speed physically and mentally.” One of those screenings has become more necessary since 2020, Dr. Motter-Mast emphasized. “COVID-19 brought a significant rise in depression and anxiety in kids, so we’ll check in and see if they’re feeling okay,” Dr. Motter-Mast said. Physicians at GBMC use evidence-based screening tools to check for depression and anxiety in children. Treatment and follow-up depend on what the physician sees during those screenings. “It depends on the individual patient, but we often recommend counseling,” Dr. Motter-Mast explained. “We have behavioral health care managers at GBMC who are integrated in the primary care offices. We focus on team-based care, so physicians, social workers, and psychiatrists all work together using cognitive behavioral therapies and potentially medications to treat depression and anxiety.” GBMC physicians will also take note of the child’s height and weight and make sure they’re growing appropriately and staying in a healthy weight range. “Childhood obesity is occurring more frequently than in the past, so if a patient is over a BMI (Body Mass Index) we’re comfortable with, there may be more lab work needed so we can avoid childhood diabetes and hypertension,” Dr. Motter-Mast said. She said the conversations around development tend to shift as children get older, beginning with a focus on age-related milestones in younger children and moving to risk-taking behaviors as they reach school age. Physicians may ask questions about home safety, bullying, drugs and alcohol, or sexuality, among other topics. “Oftentimes we ask the parent to leave the room so the kids can have an open and privileged dialogue, without any penalties,” she explained. “Most parents are happy to leave the room and have another voice act as a parent. Sometimes when another adult says it, your child might listen more closely.” Dr Motter-Mast emphasized that, above all else, GBMC focuses on the wellbeing of each patient and encourages parents to not delay getting their back-to-school physicals scheduled as soon as possible. “The best part of our job is being able to foster that relationship every year with a patient, to build trust, and to know about them. It’s the best feeling to be able to see a child that you’ve known for years grow up and be able to catch up with them.”
Pelvic floor issues affect up to 30% of women. But Joan Blomquist, MD, chair of the Department of Gynecology at GBMC HealthCare, says that doesn’t mean women have to live with those symptoms. The two most common pelvic floor conditions are pelvic organ prolapse and urinary incontinence. Pelvic organ prolapse occurs when a person experiences a loss of support of their pelvic organs. This allows the organs (including the bladder, uterus, and rectum) to bulge into, or even outside of, the vagina. “Women with pelvic organ prolapse can often feel a bulge or see something protruding in the pelvic area,” Dr. Blomquist said. “Depending on the severity, it can have an impact on bladder and bowel function.” The biggest risk factor for pelvic organ prolapse is giving birth via vaginal delivery, Dr. Blomquist explained. Even though the initial injury may occur at the time of childbirth, most women don’t have symptoms for many years. The pelvic floor muscles may compensate for a while, but over time they may fail. Most women present with symptoms more than 20 years after their first delivery. There are several treatment options available for pelvic organ prolapse. Physical therapy and pelvic floor exercises are usually the first step, and Dr. Blomquist said patients often have great success with this. Some women opt to have a pessary – a vaginal support device – inserted to help hold the organs in place. Surgery is also an option and is individualized depending on the patient. “Surgery can be done through the vagina or laparoscopically, depending on the individual patient’s anatomy, age, and physical activity level,” Dr. Blomquist explained. GBMC recently started a postpartum perineal clinic for patients who experienced a more difficult vaginal delivery (for example, a large perineal tear or episiotomy). “They have the option of being automatically referred to us and being seen a few weeks after delivery. This allows us to assess the patients to be sure everything is healing well. We also get them started with physical therapy and hopefully set them up to have a decreased risk of pelvic organ prolapse and urinary incontinence later in life.” There are two types of urinary incontinence: stress incontinence and urge incontinence. Stress incontinence occurs when leakage happens because of something physical, like a cough, jump, or sneeze. “Stress incontinence is pretty common in the first couple years after childbirth, but it can develop later in life, too,” Dr. Blomquist said. Urge incontinence is also known as ‘overactive bladder’ and is more common as people age. Men can also have urge incontinence, but it happens more often in women. Dr. Blomquist emphasizes that treatment varies depending on the type of incontinence, with one exception “Physical therapy helps with both stress and urge incontinence,” she said. “A lot of times, it’s the first thing we recommend with either diagnosis.” Other treatment methods for stress incontinence include inserting a pessary or a procedure called ‘bulking,’ where the urethra is injected with a material (such as a water-based gel) that creates cushions in the urethra, making it harder for urine to leak. Surgery is also an option, with the most common type being a ‘sling procedure.’ “The sling procedure is a relatively minor outpatient surgery,” Dr. Blomquist explained. “A small incision is made in the vagina, and special needles direct the sling into position. It takes about a half hour to perform and has around a 90% success rate. Studies show it works for many years.” In addition to physical therapy, urge incontinence is usually treated with behavioral modifications, such as avoiding certain foods that irritate the bladder. Medications can also be prescribed for urgency, as well as additional treatments after physical therapy, like Botox injections and nerve stimulators. Regardless of what type of incontinence or prolapse you suffer from, Dr. Blomquist wants everyone to know there are a variety of treatment options available to patients. “Although pelvic floor issues aren’t necessarily dangerous to your health, they can impact your quality of life, and prevent you from doing the things you enjoy,” she said. “We offer very conservative to more involved therapies depending on your comfort level. You can call us and have a consultation without needing surgery or injections."
There is a screening test for cancer that not only pinpoints early signs of the disease but also gives doctors the ability to remove those signs from your body immediately. “Colonoscopies are the only cancer screening tests we have in medicine where we can actually prevent cancer because we can identify changes in the lining that might be precursors to cancer and remove those changes,” says Nina Ferraris, MD, colon and rectal surgeon at GBMC HealthCare. “Everyone should be screened!” The CDC recommends regular screening beginning at age 45 (lowered in 2018 from the age of 50). These screenings are an integral part of preventing colorectal cancer and finding it early. Recent headlines of celebrities with colon cancer, like Chadwick Boseman who passed away at the age of 43, have highlighted the importance of colorectal cancer screening. But Dr. Ferraris says more emphasis is needed. “Just because you’re young and look healthy doesn’t mean you shouldn’t be screened. Younger people are most resistant to colonoscopies, but they give us a chance to take polyps (small clumps of cells that form on the lining of the colon) out, see whatever’s going on in the colon, and stop it before it becomes cancer.” She mentions there are screening alternatives to colonoscopies, but they aren’t as effective at pinpointing any issues. “Cologuard tells you if there’s a suspicion of something wrong. It doesn’t have the actual ability to remove polyps [like a colonoscopy does]. It’s better than not getting screened at all, but I favor the colonoscopy for our younger patients. If you receive a positive Cologuard screening result, it needs to be followed by colonoscopy,” Dr. Ferraris says. Dr. Ferraris emphasizes that a lack of family history of colorectal cancer does not preclude you from risk. “We’re still not sure exactly why we’re seeing more cases of colorectal cancer in younger patients, but it’s multi-factorial. What you’re eating, your personal habits, your family history, all these things play a role,” Dr. Ferraris explains. She also says a change in bowel habits, blood in your stool, or unexplained bloating should send you to the doctor as soon as possible. There is still a stigma around colonoscopies, Dr. Ferraris acknowledges, but it’s one she’s hoping people will push aside in favor of their health. “Give us one day to clean things out and clear you of any signs. At most, you’ll get 10 years without seeing us, but if there’s anything there, you’ll know and can take steps to handle it.” She jokes there are some lesser-known benefits to having a colonoscopy, like taking a good nap and having the day off from work, but she is serious about the effectiveness of the screening. “This is really the most effective type of cancer screening there is, and everyone should be screened,” Dr. Ferraris says.
When you have a wound, your biggest concern is healing it. Having to drive across town to several different practices to get the best possible care should be the least of your worries. “The GBMC Wound Center prides itself on being multidisciplinary,” says Jennifer A. Heller, MD, RPVI, FACS, Medical Director of the Wound Center at GBMC. “We can address any kind of wound, and we do so at one site so patients can be evaluated in one setting.” Multidisciplinary means a team of experts in vascular surgery, podiatry, diagnostic testing, and infectious disease are all under one roof, which makes it easier for patients to be seen and get on track to heal as quickly as possible. The care team at the Wound Center at GBMC focuses on the whole body throughout the healing process, Dr. Heller says. “When we formulate a treatment plan for a patient, it doesn’t just address and identify the cause of their wound, but it also takes into account any factors that could be causing a delay in healing.” This multifaceted treatment plan may include nutritional assessment and counseling, diabetic education, pain management, and patient and caregiver counseling. Patients who may benefit from hyperbaric oxygen therapy will receive a comprehensive evaluation to assess whether this therapy is appropriate. In hyperbaric oxygen therapy, a patient spends time in a pressurized chamber. “Wounds need oxygen to heal properly. Exposing certain types of wounds to 100% oxygen may speed up healing, and we’re one of just a few centers in the area to offer this type of therapy,” Dr. Heller says. The Wound Center also offers treatment for lymphedema, a swelling due to a disruption of lymphatics. “Lymphedema can happen out of the blue,” Dr. Heller says. “But it’s more common to have swelling after surgery or cancer treatments. Our goal is to identify any issues before they get out of hand so we can treat the lymphedema appropriately and get our patients healthy.” Even with a comprehensive approach to patient care, GBMC recognized there were aspects of the Wound Center that could be improved to better meet patient needs. In fall 2023, the Wound Center will relocate to the ground level of the main hospital building. At its current location, on the fourth floor, some patients struggle to get to appointments on time. This reconfiguration and renovation of the center space with larger rooms and adjacent parking will result in improved service, outcomes, patient comfort, convenience, and satisfaction. “Now patients won’t have to navigate the entire hospital to get to the Wound Center. They’ll have dedicated parking and can walk right in,” Dr. Heller says. “A lot of people say they wish they’d come to GBMC sooner. We’ll expedite your treatment plan and provide a lot of education, so if it happens again in the future, you’ll know what to do.”
Advanced Care Planning is an important topic that everyone should consider, regardless of age or health status. It involves making decisions about the care you would want to receive if you became seriously ill or unable to make decisions for yourself. Whether you're a caregiver, a healthcare professional, or someone who wants to plan for their own future care, we are here to help give insight to advanced care planning and how it can help ensure that your wishes are respected and that your loved ones are better equipped to support you during challenging times.
Advanced Care Planning is an important topic that everyone should consider, regardless of age or health status. It involves making decisions about the care you would want to receive if you became seriously ill or unable to make decisions for yourself. Tracie Schwoyer-Morgan shares her story about how Advanced Care Planning helped her and Aunt with end-of-life care. For more information on Advanced Care Planning, visit these links: https://www.gbmc.org/advance-care-planning https://gilchristcares.org/services/elder-medical-care/advance-care-planning/ https://theconversationproject.org/
Folks looking to lead a healthier lifestyle are likely to focus first on diet and exercise, but the overlooked “middle child” in the journey to healthy living is sleep. Sleep is incredibly restorative and helps improve physical, mental, and emotional health. Experiencing disrupted sleep can elevate blood pressure and stress levels, slow metabolism processes, affect insulin levels and the body’s response to it, as well as impair mood, lead to excessive daytime sleepiness, or cause anger and irritability. Trouble falling asleep or staying asleep is a common problem and often exacerbated by lifestyle changes and stress. Behavior modifications to practice good sleep hygiene like establishing a manageable bedtime routine; avoiding alcohol, exercise, and caffeine close to bedtime; and keeping screens out of the bedroom are all helpful practices. But they may not be enough to conquer sleep, which could be indicative of a larger issue. Further problems can arise when people try alternative solutions on the market, rather than consult a physician first. Some of these interventions do not address the root of the problem. Relying on band-aid solutions rather than diving deeper into the larger message the body is trying to send may end up in frustration and, ultimately, continued sleepless nights. Raya Wehbeh, MD, Medical Director of Sleep Medicine at GBMC, offered her professional opinion about some of the trendy solutions to achieving better sleep: Melatonin Melatonin is a natural hormone secreted in the body to regulate the brain’s circadian clock. It is usually secreted at night and inhibited in the morning by natural sunlight. According to Dr. Wehbeh, melatonin can assist in regulating sleep for people with disorders such as circadian rhythm disorder or REM sleep behavior disorder. However, for a diagnosis like insomnia or for patients who have tried the sleep hygiene strategies above, it is often not her first course of action. “While it has some sedative properties, melatonin can work best as a supplement for people who have a delayed sleep phase, meaning their sleep schedules have shifted to be later at night, and melatonin works to correct that shift. It has to be administered at a certain hour in relation to the individual’s current sleep schedule, and if it is administered at the wrong time, it can have the opposite effect, which is why I think it should be used in consultation with a physician,” Dr. Wehbeh said. “In my opinion, it’s not often used the way it’s supposed to be by the general public. If someone feels like it’s working for them, I won’t challenge them, but it’s not something I normally recommend as a first-line treatment.” Learning your chronotype Chronotype is a body’s natural tendency to want to be asleep or awake at a certain time of day, what people might casually refer to as “night owls” or “early larks.” According to Dr. Wehbeh, even when you know your chronotype, unless you have the flexibility to arrange your life around when your body wants to be awake, you will need to make adjustments to get good sleep. “The good thing is, your chronotype is not the only thing that controls when you go to bed or wake up,” Dr. Wehbeh said. “The other strong factor is the circadian clock, which is the biological clock in our brain that is controlled more by outside factors like light, activity, exercising, and other daily habits—these tend to tell the clock when to send signals to be awake and to be asleep.” If given the opportunity, your body will likely return to its natural rhythm. For example, a night owl with a 9-to-5 job that means they have to be up in the morning might, upon retirement, revert to their night owl schedule. Knowing your chronotype might be helpful in guiding decision making and as a general awareness of your body’s natural rhythm to achieve better sleep/wake schedules, but it's not likely to be a solution to sleep challenges. Smart watches Some watches and other devices used to track sleep have been compared to formal sleep studies, but, according to Dr. Wehbeh, most do a better job of identifying wakefulness from sleep rather than particular sleep stages. “I like people to go more by how they are feeling rather than by what the watch is telling them and then worrying about it,” Dr. Wehbeh said. “We can use watches as a guide, not a diagnostic tool.” If a patient is referred to the Sleep Center at GBMC, Dr. Wehbeh and her team aim to get a full picture of a patient’s medical history and sleep experience to treat the root cause of the problem. Patients might be asked to keep a sleep diary, which can be used in conjunction with devices, to get a full view of the sleep experience. Sleeping pills Sleeping pills can be used as a short-term treatment for insomnia in certain situations, especially if there is no underlying sleep disorder; however, they should always be used with caution and under the guidance of a physician. They can have side effects, their effectiveness may wane over time, or you can become overly dependent on them for sleep. Treatments such as cognitive behavioral therapy for insomnia (CBTI), in conjunction with adopting healthy sleep habits, have been shown to be much more effective long term compared to sleeping pills. CBTI walks patients through habits and thoughts that might have fed into insomnia over time. Good sleep is important. Whether it is a mild annoyance or a persistent problem, reach out to a professional if you are experiencing sleep problems. “It comes down to prioritizing sleep,” Dr. Wehbeh said. “People focus on diet and exercise, and sleep should be one of the things they focus on as well. If you have trouble falling asleep or staying asleep, and the problem has persisted for more than three months, it could be a sleep disorder, and it’s possible we can make you feel better. It’s recommended you see a doctor, especially when it gets to the point where it’s affecting your quality of life.”
Dr. Emily Watters, MD, talks with Ericka Dixon on what robotic surgery is an how weight loss surgery may be beneficial for your health
There are more than just physical changes involved when a patient decides to undergo bariatric surgery. Emily Watters, MD, who works in the Bariatric and General Surgery departments at GBMC HealthCare, explains the importance of having emotional support once the decision has been made. "Not everyone is supportive because there's still a lot of stigma around weight loss surgery. People tend to think it's an easy way out, when really that's quite the opposite." The emotional aspect of the surgery is so crucial to a patient's success, Dr. Watters says, that everyone who decides to undergo surgery must be evaluated by a psychologist beforehand to make sure there are no underlying disorders that would make the surgery unsuccessful. Once the surgery is scheduled, patients are given six months of nutrition education to ensure they're ready for the changes that will take place after the operation. Dr. Watters explains, "Monthly nutrition meetings are held via Zoom in a group setting. If a patient has additional questions or needs extra help, they're able to set up a one-on-one session with a registered dietitian." In addition, to help prepare for and recover from their surgery. This includes meal ideas and grocery lists, exercise recommendations, and important habits to start building. While all this information is helpful, Dr. Watters says it's the support from others that can really make a difference in a patient's success. "You can't do this alone. The best way to be successful is if you have someone to encourage and support you along the way," Dr. Watters explains. The team at GBMC recognizes not everyone has the support of their friends and family, so they've created a community within the hospital to give support and encouragement to every patient. "We have a private Facebook group for folks who have gone through the program," Dr. Watters says. "There are people in there that are brand-new to the journey, and we have one patient who's 10 years post-surgery giving advice and sharing her story. Whatever point of the journey you're on, there's someone there with you." She says some of the topics discussed in the group include dealing with negativity from loved ones and how to navigate events centered around eating, such as birthday parties and holidays. In addition to the support group, patients are given suggestions by their care team on how to prepare for life post-surgery. This includes logistical planning, which could include selecting a protein (and a backup in case the patient gets tired of the first one) and having recipes on hand that are easy to make. But, Dr. Watters adds, it also includes suggestions for a new lifestyle. "Finding a new activity or hobby that doesn't revolve around food can really help a patient's success," Dr. Watters says. "Recognizing you might need to find a new group of people to be around if your current circle isn't supportive can also make a big difference." Patients meet with a dietitian post-surgery to answer questions and ensure they're adapting to their new lifestyle, as well as monthly support group meetings. Dr. Watters says, while bariatric surgery can be life-changing, it's important to remember we're all human and things don't always go perfectly. "My colleague, Dr. [Shauna] Costinett says, don't slip, don't slide.' Don't let one slip (an off meal or an off day) dictate the rest of your year or define your progress." She adds, whether a patient wants to share their surgery with friends and family is a decision that belongs to them. "It's okay to keep this to yourself. If you get a negative reaction from anyone, they do not have to be allowed on this journey with you." Dr. Watters says the bariatric team at GBMC prides itself on the emotional support they offer to patients before and after bariatric surgery and encourages anyone who has questions to reach out.
<p class="article-body"> GBMC Health Partners Primary Care is built on the idea that physician-led, personalized care coordination teams manage your health alongside you. There is no one-size-fits-all approach to healthcare and the journey is much easier to navigate with a support system. <br> <br> Here to give practical advice for taking control of your health in the new year and starting 2023 off right are GBMC leaders and 2022 <em>Baltimore</em> magazine Top Docs—Gregory Small, MD, Director of Primary Care Medicine at GBMC HealthCare and Internal Medicine Physician at GBMC Health Partners Primary Care, Texas Station, and Theresa Nguyen, MD, Interim Chair of Pediatrics and Pediatrician with GBMC Pediatric Group. <br> <br> <strong><em>Primary Care for Adults with Dr. Gregory Small</em></strong> <br> There are a host of things adults need to check off their health to-do lists. From vaccinations and screenings to labs and behavioral health evaluations, the list can get long and confusing. Working with a primary care provider (PCP) can help create a plan with age- and gender-specific recommendations that make sense for you. <br> <br> “For too long, too many patients have engaged in the act of healthcare as episodic: a symptom arises, we run to an urgent care or we run to an Emergency Department or we rush to a specialist,” Dr. Small said. “We are chasing a symptom, but we don’t have one person who’s looking at the big picture, tying everything together or who has been doing certain screenings up front to give us an awareness of what to expect in the future.” <br> <br> Even younger individuals or those without chronic illness can still benefit from having a PCP. <br> <br> “This is where primary care doesn’t need to be one size fits all. Maybe that healthy person doesn’t have to come in every year on the day. But a lot of times it becomes meaningful when you engage them in their history and family history and what to look out for,” Dr. Small said. <br> <br> Care plans include timely checks like vaccinations and screenings as well as long-term goal planning such as weight loss or nutrition improvement. Dr. Small views tackling these larger intentions with “prescriptions.” <br> <br> “What is your exercise prescription? How do you approach this?” Dr. Small said. “Too often it’s ‘I’m going to try and fit this in’ versus ‘I’m going to make this a priority.’” <br> <br> Mental health also needs to become a priority, especially for teens and young adults. According to the CDC’s Adolescent Behaviors and Experiences Survey (ABES), a third of high school students categorized their mental health as poor during the pandemic and nearly half felt persistently sad or hopeless. Having a PCP at GBMC gives these individuals the opportunity to take advantage of the Collaborative Care Model. <br> <br> The aim of the Collaborative Care Model is to provide brief and timely interventions for mild to moderate mental health issues, in the convenience of a PCP office, while referring out those with more serious illness. It is designed to efficiently use psychiatric expertise to help the maximum number of people without delaying treatment. <br> <br> Dr. Small and his team are there to help you make yourself a priority. <br> <br> <strong><em>General Pediatric Care with Dr. Theresa Nguyen</em></strong> <br> Parents today have enough to worry about. Dr. Nguyen takes the guesswork out of how to set your child up for success with her trifecta of health. Three simple focus points that will serve as the foundation for your child’s health are sleep, nutrition, and movement. <br> <br> Sleep—The recommended amount of sleep is 9 to 11 hours for elementary and middle school children and 7 to 9 hours for high schoolers. Dr. Nguyen said the way to determine the amount of sleep your child actually needs is by evaluating their sleep on the weekends. <br> <br> “I ask kids, ‘What time are you going to sleep and what time are you getting up on the weekend?’ Then, we get a better idea of how much sleep their body would like to have," Dr. Nguyen said. <br> <br> Consider good sleep hygiene to assist with bedtime resistance and establishing good habits. No screens at least one hour before bed and ideally not in the room at all. Reading or relaxation exercises can help the body calm down as well. For anxious kids or those with racing thoughts, Dr. Nguyen suggested journaling or drawing to mimic the act of “throwing away” thoughts as well as more tactical suggestions like finger tracing and deep breathing. <br> <br> Nutrition—When considering meals and snacks, choose as many foods that grow in the ground as possible. Whole, unprocessed foods are the most beneficial nutritionally, but Dr. Nguyen also recommended not limiting snacks and “treat” foods because heavy restrictions tend to breed unhealthy habits long term. Her rule of thumb is eating at least one plateful of vegetables daily, either divided across meals or at once, with as many colors of the rainbow as possible. <br> <br> Movement—Dr. Nguyen prefers the term movement to exercise. Movement expands the options. It could be running or playing soccer but could also be dance or yoga. A healthy amount of movement could include walking the dog as a family or hitting the trails. Also, aim to get as much of your movement outdoors as possible. <br> <br> Building confident, resilient kids requires routine and consistency with this trifecta, as well as a parent’s ability to model the behaviors. Everyone—parents, teens, and young kids—is experiencing extra stress right now, and parents can model the behaviors they want their children to pick up while maintaining their own health along the way. <br> <br> “If you want to grow something, you have to plant and nurture the seed for it to grow in you and your child,” Dr. Nguyen said. “Start with yourself because you can’t teach anything that you’re not embodying.” <br> <br> Perfectionism is not the aim. If stress causes you to have a less than ideal response in front of your kids, it’s OK to show them it happens, and then give them an opportunity to see what repair looks like by taking accountability and explaining how you will react differently next time. <br> <br> Raising resilient, confident kids requires building resilient and confident families. Participating in developing healthy habits together will help them last a lifetime. </p> <div class="end-of-story"> </div>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/HchrZ3KxuNw" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> David F. Gottlieb, MD, is a medical oncologist and hematologist at the Sandra and Malcolm Berman Cancer Institute at GBMC. He earned his medical degree from Albany Medical College and completed residency and fellowship training at the University of Maryland Medical Center where he was elected to the Gold Humanism Honor Society. Dr. Gottlieb believes in a patient-centered approach that prioritizes open communication and shared decision-making with the goal of providing evidence-based, compassionate care. <br> <br> On Wednesday, December 14, Dr. Gottlieb shared a wealth of knowledge on various blood cancers and disorders and how to treat them. Dr. Gottlieb is a recent addition to the Berman Cancer Institute and was drawn to our team because of the collaborative, community environment. <br> <br> Here are some key takeaways Dr. Gottlieb shared: <br> </p> <ul> <li> There are three ways to treat cancer: surgically removing the cancer, targeting the tumor with radiation, and medically treating the disease. For some patients, a combination of all three is the key; for others, especially those with blood cancers, targeted immunotherapy is the best treatment option. GBMC's Medical Oncology team works collaboratively to be sure each patient's care plan is individualized to their needs. </li> <li> There are a variety of different blood disorders that can be benign and not considered cancerous. However, there are blood cancers that are also considered blood disorders. Dr. Gottlieb and his team treat all types of blood cancers and disorders, the most common being leukemia. Dr. Gottlieb shared that while there is a genetic predisposition to some cancers (like breast) there is not for blood cancers or disorders. </li> <li> Multiple Myeloma is a cancer that forms in a type of white blood cell called a plasma cell. When your plasma cells are healthy, they help you to fight infections by making antibodies that attack viruses and germs. With Multiple Myeloma, those cancerous plasma cells accumulate in the bone marrow and crowd out healthy cells. So, instead of producing helpful antibodies, those cancerous cells produce proteins that can cause problems. At this time, there is no cure for Multiple Myeloma, but there are ways to manage the disease such as targeted chemotherapy and immunotherapy and/or bone marrow transplants. </li> </ul> Dr. Gottlieb finds feedback from patients and loved ones helpful for the medical teams. He also enjoys working with GBMC volunteers in the oncology department. If you wish to support the Sandra and Malcolm Berman Cancer Institute, Dr. Gottlieb said the best way is to donate. <a href="https://www.classy.org/give/288692/#!/donation/checkout">Please consider a donation to the Cancer Institute today.</a>
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