<p class="article-body"> Imagine a disease that can strike any joint or organ at any time, with no known cause or cure. Sarcoidosis is just that — an elusive disease that is seldom fatal, sometimes painful, sometimes not. It may plague an individual throughout his or her lifetime, or strike once and never return. Treatment might be effective, or it might not. <br> <br> “We call it ‘The Great Mimicker’ because it is often misdiagnosed,” says Elisabeth Carr, M.D., a sarcoidosis specialist who works in pulmonary and critical care medicine at Greater Baltimore Medical Center. <br> <br> Sarcoids are tiny, grain-like clusters of inflamed cells called granulomas that form in various organs throughout the body. Over time, they can grow into masses that damage organs. They are most commonly found in the lungs and lymph nodes, but can also show up in the brain, eyes, kidneys, liver, nervous system and skin, and elsewhere. They are thought to develop as an immune system response. <br> <br> According to the National Institutes of Health’s National Heart, Lung, and Blood Institute, African-American women ages 20-40 seem to be most at risk, but anyone is vulnerable. Some studies link sarcoidosis to chemical exposure, but the cause is uncertain. <br> <br> “I use the analogy of the pearl and the grain of sand, but we don’t know what the grain of sand is,” Dr. Carr says. <br> <br> If you’ve never heard of sarcoidosis, you’re not alone. Researchers don’t really know how widespread it is because some people might be unaware they have it. The disease can be difficult to diagnose since not all physicians are well educated about it. For example, if a patient complains of ankle pain, sarcoidosis is probably not the first thing a physician considers. The only way to diagnose it for sure is to examine a tissue sample under a microscope. <br> <br> The Life and Breath Foundation aims to empower newly diagnosed sarcoidosis patients to get the coordinated care they need and learn more about their complex condition. Sean Hull, who lost his mother to complications from sarcoidosis when she was only 59, started the foundation. <br> <br> Dr. Mark Lamos, past president and medical director of Greater Baltimore Medical Associates (GBMA), has been working with the foundation to build awareness in the medical community of how to combat the disease and help doctors coordinate and provide patient-centered evidence-based care. <br> <br> “Patients often receive non-comprehensive care because the records are not kept in one system — information is not shared well among caregivers,” Dr. Lamos says. “For example, you could have sarcoid of the lungs, and you may get sent to a pulmonary specialist, but if somebody forgot to send you to an eye doctor, you could have undiagnosed iritis, which is inflammation of the eye.” <br> <br> Lamos has seen hundreds of sarcoidosis patients over three decades of medical practice, so he knows how important it is for doctors to ask a lot of questions to diagnose and determine the extent of the disease. <br> <br> Patients are encouraged to seek an experienced medical center, such as GBMC, with doctors who specialize in sarcoidosis. <br> <br> Dr. Carr says there are treatments for sarcoidosis, but what works for one person might not work for another. <br> <br> “Steroids are the first-line treatment if the sarcoid is in a high-value location like the lung, brain, eye, or heart,” she says. “There are a couple of other options for cardiac sarcoid. After steroids, we have immunomodulators like methotrexate. They can be added to the steroids or used afterward. Injections of immunosuppressors such as TNF inhibitors would be the next treatment.” <br> <br> “All these medications have risks and side effects,” Dr. Carr adds. “I engage my patients in the decision-making process. Every sarcoidosis patient is different.” <br> <br> Though scientists are researching sarcoidosis, there is still much to learn, doctors say. For example, there is still a question about whether sarcoidosis is hereditary. <br> <br> “There are ‘flavors’ that are genetic, but it is not 100 percent across the board,” Dr. Carr says. “There is definitely a genetic component. It is an area of great interest in the scientific community.” <br> <br> “I think what will happen over time is that we will find different phenotypes of it, just like we know that you can have three different types of lung cancer,” Dr. Carr says. <br> <br> That will be one step closer to a cure. <br> <br> <em>- Lisa Jevens for Greater Baltimore Medical Center</em> </p> <div class="end-of-story"> </div>
"I'm so depressed." People are quick to throw this phrase around when their favorite show gets cancelled or after a bad day. But people who suffer from clinical depression, also known as major depression, are dealing with much more than sadness. They may experience a deep feeling of hopelessness that persists for weeks. It is all-consuming and often starts to have a negative effect on their normal activities and relationships. Other symptoms can include fatigue, feelings of worthlessness, impaired concentration, insomnia, and recurring thoughts of death or suicide. Depression can also manifest itself in physical ways: significant weight loss or gain, headaches, digestive disorders, and chronic pain. There is even mounting evidence that depression can take a more serious toll on physical health, in the form of stroke or coronary artery disease. People who are suffering from untreated clinical depression may feel unmotivated to take care of their health, follow doctors' orders, or attend healthcare appointments. If you know someone who is struggling with depression and may not be caring for themselves mentally or physically, it's important to choose your words wisely. Don't Say: "Pull yourself together." "Snap out of it." "You should be grateful for what you have." This type of advice is not beneficial and could possibly cause harm, leaving your friend to feel even more misunderstood or stigmatized. What may seem irrational to you is reality to someone who is depressed. They do not have a choice to "just feel better" because they may have a chemical imbalance in their brain which they cannot control. Do Say: "I'm here for you." "What can I do for you?" "Would you like me to go with you to an appointment?" Depression is so disorienting that it can make even the most commonplace daily tasks seem insurmountable. Just letting someone know that you're there to listen (without prying) or take a chore off their hands (without judgment) might mean the world to them. Encouraging a friend or family member to seek treatment can be awkward, but offering to accompany them to an appointment, whether a therapist, primary care physician, or even just the pharmacy, shows that you care about their wellbeing. It illustrates that you're being supportive and acknowledges that they're suffering from a medical condition, which isn't something one can easily shake off. Most primary care physicians can assess the physical symptoms of depression and make referrals for mental health care. In the Baltimore County area, there are several resources available to help residents treat depression. Call the Baltimore County Department of Health at 410-887-3828 or email behavioralhealth@baltimorecountymd.gov. The National Hopeline Network is a 24/7 national phone hotline specifically for people suffering from depression.
<p class="article-body"> Want to make your digestive tract happy and the rest of your body strong and healthy? Get busy tending your garden — the one in your gut. <br> <br> Yes, there’s a massive garden filled with beneficial bacteria and other microorganisms from top to bottom in your gastrointestinal system. Maintaining this flora is not only essential for proper digestion and elimination, experts say a healthy “gut garden” fights off disease and maintains overall vitality. <br> <br> “Your gut contains billions of bacteria and it forms a large percentage of your immune system,” says Niraj Jani, M.D., chief of gastroenterology at Greater Baltimore Medical Center (GBMC). “It’s like a roadmap that goes from your mouth to your anus. When it’s unbalanced with a lack of good bacteria, it blocks absorption of nutrients from food, which can adversely affect the liver, pancreas and kidneys.” <br> <br> The gut is actually a series of organs leading from the mouth and esophagus all the way to the colon. It transforms the food you eat into the nutrients your body needs to live and thrive. If it fails to do that properly, it leads to upset stomach, irregular elimination and often aggravates conditions like irritable bowel syndrome. <br> <br> A lack of good bacteria is a leading cause of diarrhea, which depletes electrolytes and is bad for your kidneys. Acid reflux, another common result of an imbalanced digestive tract, can cause trouble swallowing and even esophageal cancer over time, Dr. Jani says. <br> <br> “Our microbes are intimately involved in every aspect of our health, from ensuring our digestive well-being to influencing our likelihood of being obese and our risk of developing cancer or diabetes,” says Robynne Chutkan, M.D., author of “The Microbiome Solution: A Radical New Way to Heal Your Body from the Inside Out” (Penguin, 2015). “They even play a role in our brain chemistry and mental health, affecting our moods, our emotions and our personalities.” <br> <br> It helps to think of your body as composed of multiple living, breathing parts — a massive microscopic community whose health is directly connected to your own. <br> <br> “(It’s) essential that we learn more about where our microbes come from, what they do and why we literally can’t live without them,” Dr. Chutkan says. <br> <br> </p> <h2> Tending your garden </h2> Today’s busy lifestyles make it all too easy to compromise our guts. Stress and junk diets can be devastating to digestive health. But there are a number of steps you can take to correct depleted gut flora. <br> <br> “Some gastrointestinal problems are caused by infections, but a lot of them are self-induced,” Dr. Jani says. “The best way to correct them is to maintain a nutritious diet with lots of fruits and veggies, along with a healthy amount of fiber. Eating in moderation and avoiding excess is also important.” <br> <br> And while antibiotics are essential for fighting infection and eliminating bad bacteria, most are indiscriminate and wipe out good bacteria, as well. That’s when it’s time to regrow the garden, Dr. Jani says. <br> <br> “Probiotic supplements are especially effective after taking a course of antibiotics,” he says. “And yogurt is good to include in your daily diet, to get as much good bacteria in your system as possible.” He especially recommends yogurt that contains the B. infantis probiotic culture. <h2> A gut feeling </h2> Everyone knows that awful feeling, often striking at the worst possible time: a churning, uncomfortable sensation that demands immediate attention. Many people allow these symptoms to persist over weeks, even years, without seeking a doctor’s advice or treatment. <br> <br> They simply find it embarrassing to talk about things like diarrhea and constipation. And while it’s probably not the best topic for cocktail parties, it’s important to discuss persistent and severe symptoms with your doctor. <br> <br> Everyone experiences occasional bouts of indigestion, irregularity and diarrhea. But make an appointment with your physician if there’s a sudden change in bowel habits or unexplained weight loss, Dr. Jani says. <br> <br> “Also see a doctor if there’s persistent pain or difficulty tolerating food — and, of course, blood in your stool,” he added. “And if you’re 50 or over, get a colonoscopy.” <br> <br> When symptoms begin to appear, it’s smart to start a food journal and bring it to your doctor’s appointment. It can be very helpful in determining the root cause. <br> <br> “Use the journal to keep track of when the symptoms started and what you were eating at the time,” Dr. Jani says. “It’s important to write down any new medications you’ve taken, and let the doctor know if you’ve been traveling recently.” <br> <br> Don’t be shy about going into detail about your symptoms. Rest assured, your doctor has seen and heard it all, he says. Seeking prompt treatment can prevent a host of serious problems and steer you toward a lush and healthy gut garden for life. <br> <br> <em>— Bob Young for Greater Baltimore Medical Center</em> <div class="end-of-story"> </div>
<p class="article-body"> Influenza, more generally known as "the flu" is a viral infection that might feel like a common cold at first. The sneezing, coughing, sore throat and runny nose will likely seem familiar, but if you start experiencing a high fever (over 100 degrees Fahrenheit), chills and/or sweats and aching muscles, it may be the flu. One of the most effective ways to prevent influenza is to get an injectable flu vaccine. Though the flu tends to target young children and older adults, the Centers for Disease Control and Prevention recommends that everyone six months and older get an annual flu vaccination, with rare exception. Here are answers to some common questions about the flu: <br> <br> <strong>Q: Why is a flu vaccine important? </strong> <br> <br> A: Influenza is a serious disease that even healthy people can get very sick from and spread to others, often unknowingly. An untreated flu can lead to hospitalization or even death. When more people get vaccinated against the flu, it has less chance of spreading throughout our community. <br> <br> <strong>Q: When is "flu season"?</strong> <br> <br> A: Flu season in the United States can begin as early as October and last as late as May. This is when flu viruses are circulating at higher levels than other months. <br> <br> <strong>Q: How does the flu spread?</strong> <br> <br> A: Mainly, flu viruses are spread when people with the flu cough, sneeze or talk. This produces droplets that can land in others' mouths or noses. Less often, the flu virus can be transmitted by a surface or object that someone with flu has touched. <br> <br> <strong>Q: What are the best ways to avoid the flu? </strong> <br> <br> A: Get a flu shot! Wash your hands often with soap and water. Do not share linens, eating utensils or dishes with those who are sick. Disinfect frequently-touched surfaces often, especially if someone around you has been ill. Avoid touching your own mouth or nose if you haven't washed your hands first. <br> <br> <strong>Q: When is the flu considered contagious? </strong> <br> <br> A: It's possible for healthy adults to be contagious and infect other people beginning one day before symptoms develop and for up to five to seven days after becoming sick. Children may be able to infect others for longer than seven days. It is possible to "feel fine" but still spread the flu virus to others. If you or your child is sick, stay home until your doctor tells you it is OK to return to work or school. <br> <br> <strong>Q: How quickly will a flu vaccine be effective?</strong> <br> <br> A: It doesn't work right away. It takes about two weeks after vaccination for antibodies to develop in the body to protect against influenza. This is why it is best to get vaccinated early in the fall, before flu season is in full swing. <br> <br> Talk to your primary care physician about getting seasonal flu vaccinations for you and everyone in your family who is older than six months of age. If you do not have a primary care physician, visit <a href="http://www.mygbmcdoctor.com/" target="_blank">mygbmcdoctor.com</a> to find one who is right for you. </p> <div class="end-of-story"> </div>
<p class="article-body"> No ifs, ands or buts about it — nobody wants to get a colonoscopy. Some people don’t understand what it is or why it is important, or their doctors simply don’t mention it, so they think it’s unnecessary. And then there are those who just put it off. <br> <br> “People are usually worried it’s going to be painful, or think it’s embarrassing or dirty,” says Niraj Jani, M.D., chief of gastroenterology at Greater Baltimore Medical Center. <br> <br> The truth is, colonoscopy, which involves sending a camera into the colon to examine its lining, is none of those things. What it actually is: A truly lifesaving test that’s now easier, safer and more effective than ever. It detects not only cancer but also precancerous growths called polyps, allowing doctors to remove them on the spot before they become dangerous. No other cancer-screening test can do that, Dr. Jani says. <br> <br> The prognosis for colorectal cancer caught early is very good: The five-year survival rate is upward of 90 percent, according to the American Cancer Society (ACS). Found at later stages, however, survival rates drop. </p> <h2> Do you need a colonoscopy? </h2> The current ACS recommendation says most people should have their first test at age 50. Those at higher risk for cancer, because of family history, for example, should be screened sooner. Some experts also advise African-American men to be tested at age 45 since statistics suggest that population is developing colon cancer sooner, Dr. Jani says. Other doctors might recommend earlier screenings no matter what. <br> <br> “The incidence of colon and rectal cancer has been rising among people ages 25 to 45,” he says. “We’re not sure why — it could be linked to processed foods in our diet or obesity — but it’s a scary phenomenon.” <h2> So, you think because you feel fine you don’t need a colonoscopy? </h2> Consider this: “The Number One thing to realize is that rarely do you have symptoms with colon cancer until the cancer is very advanced,” Dr. Jani says. “That’s the whole point of doing colonoscopy — to find something early and remove it to eliminate the risk.” <br> <br> It can take 10 to 15 years for colorectal cancer to develop from a precancerous polyp, according to the ACS, so chances are regular screenings will help keep you healthy. And in one study reported in the New England Journal of Medicine, the death rate from colorectal cancer dropped by 53 percent in patients whose doctors found and removed precancerous polyps. <br> <br> But the odds aren’t with you if you put off the test. Colorectal cancer is the third most commonly diagnosed type of cancer and the third leading cause of cancer deaths, according to the ACS. <h2> Relieving the fear and stigma </h2> Advances in the procedure address many of the concerns keeping would-be patients away. “The biggest thing patients complain about is the prep,” Dr. Jani says, referring to the solution patients must drink to clean out the colon prior to the procedure. “You used to have to drink 4 gallons of the stuff, and it tasted terrible. Now we’ve evolved to preps that are much less in volume.” Think two doses of prep at only 16 ounces each — or about 6 percent of what you previously had to swallow. <br> <br> In addition, technology has improved in the form of high-definition, magnifying scopes that can see greater detail, allowing doctors to detect smaller polyps. Complications such as bleeding or colon perforation are rare, and often doctors can manage and correct those things immediately. <br> <br> “That’s a huge change,” Dr. Jani says. “In the past, you’d have to go to surgery, but now we can control most bleeding and repair perforations.” <br> <br> As far as controlling patients’ fears or embarrassment, doctors do all they can for that, too. “We’re sensitive to their feelings, so we explain what to expect, why it’s important and that our staff is highly trained and does colonoscopies day in and day out, which allays a lot of fears,” he says. “We also reassure patients that there really is minimal discomfort during and after.” <br> <br> Minimal discomfort is also thanks to another advancement: The use of carbon dioxide to gently inflate the colon (to make room for the scope) instead of oxygen, causing less pressure, gas and bloating, Dr. Jani says. <br> <br> So, while you may be a bit groggy afterward (from sedation) — and need someone to drive you home — most people feel good, he says. “Many patients even go out for lunch afterward.” <br> <br> Colonoscopy remains the gold standard screening for a reason: It can detect and correct potential problems early on. “It’s really the greatest screening tool available,” Dr. Jani says. <br> <br> <em>- Beth Janes for Greater Baltimore Medical Center</em> <div class="end-of-story"> </div>
<p class="article-body"> To get you geared up for safe fun in the sun, GBMC Family Medicine Physician <a href="http://mygbmcdoctor.com/owingsmills">Kevin P. Carter, MD</a>, answers some common questions about sunscreen: <br> <br> <strong>How should I choose an SPF level? </strong> <br> Any SPF between 15-50 is recommended. A sunscreen with at least SPF 15 will block 90% of the sun's harmful rays. With SPF 50, almost all of the dangerous rays will be blocked, but SPFs of 50+ are no more powerful than 50. <br> <br> <strong>Is using makeup that contains an SPF sufficient? </strong> <br> It will be effective, but you can't expect it to work for you all day for the purpose of sun protection, even if it is still working as makeup. When out of the sun, reapply a sunscreen every two hours and allow at least 30 minutes for it to fully absorb into your skin. <br> <br> <strong>What is the difference between physical and chemical sunscreen?</strong> <br> Physical sunscreens put a reflective UV barrier on the skin. The most common physical barriers are zinc oxide and titanium oxide. These can often leave a white-ish cast on the skin. Chemical sunscreens are absorbed into the skin and use chemicals to absorb the UV light, rather than block it. Both are effective; it's a matter of personal preference. <br> <br> <strong>Is it better to use a spray or lotion sunscreen? </strong> <br> Though it may be easier and more convenient to use a spray sunscreen on squirming kids, it is not recommended for small children who can't hold their breath during application. It can irritate their airways if inhaled. Additionally, it can be difficult to tell if you've missed an area. Lotion sunscreen is a good choice because it's easier to tell where you've applied it, and the act of rubbing it in may mean you're being more thorough. <br> <br> <strong>Should I choose a natural/organic sunscreen, or is store brand ok? </strong> <br> The most important thing is to protect your skin from UV rays, so any type of sunscreen is better than none at all. Make sure your sunscreen is labeled "broad spectrum" to ensure it protects against UVA and UVB rays. There has been concern based on animal studies that some of the chemicals used in sunscreens could have harmful effects. More research is still needed to determine if any of the concerns are applicable in humans. <br> <br> <strong>When is it safe to start using sunscreen on babies? </strong> <br> Sunscreen is not recommended for infants under 6 months of age. The best sun protection for babies is a complete lack of sun. If your baby must be outdoors, stay in the shade and make sure he or she is wearing full-coverage clothing made of tightly-wound fibers. Hold the item of clothing up to the sun; if you can see through it, it is not sufficient for sun protection. <br> <br> <strong>What should people with darker skin tones know about sun protection?</strong> <br> Regardless of how dark your skin tone is, you need to safeguard yourself from the sun's dangerous UV rays because of the cancer-causing and aging effects. Use sunscreen and sun-protecting clothing every time you're outside. <br> <br> Talk to your primary care provider if you have questions about sun safety and preventing skin cancer. If you have a concern about melanoma or possible sun damage, your doctor can refer you to a dermatologist if needed. If you don't already have a primary care physician, visit <a href="http://mygbmcdoctor.com/" target="_blank">mygbmcdoctor.com</a> to find one near you. </p> <div class="end-of-story"> </div>
<p class="article-body"> The warm spring weather has finally arrived, yet some of us are still coughing and sneezing. But are those coughs and sneezes allergies or signs of a common cold? One way to differentiate between the two is how long the symptoms persist: Colds last only about 3-14 days. If your symptoms last longer and happen around the same time each year, your primary care physician can help you determine if they are allergy related. <br> <br> When allergens such as dust and pollen enter your body, your immune system attacks them the same way it would attack a cold virus. The body creates chemicals like histamine to fight off the allergens, which causes symptoms to develop. Depending on the allergy, these symptoms may include sneezing, runny nose, hives or rashes and itchy, watery eyes. <br> <br> The good news is that allergens aren't contagious like colds, and there are a number of treatments and over-the-counter drugs that can help reduce the symptoms. Adopting some of the following daily habits may further ease the discomfort caused by allergies: </p> <ul> <li> Avoid exercising outdoors at dawn and dusk. These are the times pollen levels are at their highest. </li> <li> Prevent pollen from entering your home by keeping the windows closed and taking your shoes off before coming into the house. </li> <li> Wear a mask or handkerchief when doing yardwork to reduce the amount of allergens that you can potentially breathe in. </li> <li> Wash your hair before bed. This can prevent allergens from making their way to your pillow. </li> </ul> As for preventing colds, hand washing cannot be emphasized enough. Avoid touching your face, especially around your eyes, nose and throat as they are the main entryways for a cold virus to get into your system. Be sure to frequently clean and disinfect commonly-touched household surfaces such as light switches, door knobs and TV remotes. <br> <br> Talk to your primary care physician if you need help determining whether you have allergies or a cold. If you are diagnosed with seasonal allergies, he or she can also help you decide how to treat them so you can enjoy spring, rather than suffer through it. If you do not already have a primary care physician, visit <a href="http://www.mygbmcdoctor.com/" target="_blank">mygbmcdoctor.com</a> to find one today! <div class="end-of-story"> </div>
<p class="article-body"> More than 29 million people in the United States have diabetes, but many more are at risk and are living with a condition called prediabetes. Patients whose blood glucose is too high to be considered normal but are not diabetic are considered to be in the danger zone. "The criteria for prediabetes is a fasting blood sugar between 100-125 and the results of another test called a hemoglobin A1C, which checks what blood sugar has been over the last three months," says <strong>Dr. Ruth S. Horowitz,</strong>Chief of the Division of Endocrinology at GBMC. "If the A1C is between 5.7 and 6.4, the blood sugar is moderately elevated and indicates prediabetes.” Luckily, if you've been diagnosed with prediabetes, the progression to type 2 diabetes is not inevitable. There are lifestyle changes you can make to take control of your blood sugar. Focus on cutting high-carbohydrate foods, which easily break down into glucose and raise blood sugar levels faster than the body can produce sufficient insulin. By limiting the amount of carbohydrates you consume, the body can dispose of the glucose more effectively and maintain a normal blood sugar level. Dr. Horowitz recommends the following: <br> <br> </p> <ul> <li> <strong>Limit highly-concentrated sweets</strong>, such as sugared drinks, juices, candy and cookies. </li> <li> <strong>Replace starchy dishes</strong> like potatoes, rice, pasta, peas and corn with complex carbohydrates such as broccoli, asparagus and spinach. </li> <li> <strong>Watch your fruit portion sizes</strong>. One serving of fruit is 1 small apple, orange or pear, half a banana or a ½ cup of chopped, cooked or canned fruit. Space out your servings of fruits throughout the day, rather than consuming them all at once. </li> </ul> Working out is another effective way to stop diabetes in its tracks. Muscle is the largest consumer of glucose. By exercising, you increase the movement of glucose into the muscle, where it is broken down into energy and lowers blood glucose levels. Try to get 30 minutes of moderate exercise that raises your heart rate at least five times a week. <br> <br> The Geckle Diabetes and Nutrition Center offers individual <a href="/sites/default/files/hg_features/hg_post/3802067dbd0f20bcd3705b0d96d81740.pdf" target="_blank">diabetes self-management education and medical nutrition therapy</a> for patients with diabetes at several GBMC Health Partners practices. Visit <a href="/node/2531" target="_blank">www.gbmc.org/mydoctor</a> to find a primary care provider who can help you develop a healthy action plan and connect you with a Registered Dietitian and Certified Diabetes Educator. <div class="end-of-story"> </div>
<p class="article-body"> The Centers for Disease Control and Prevention (CDC) reports an alarming increase in Lyme disease, a bacterial infection transmitted by the bite of an infected tick, a blood-sucking parasite that resembles a poppy seed when it first attaches. Lyme disease infects more than 300,000 people a year — 10 times more than it ever has. <br> <br> Scientists think climate change may be to blame because it’s now the fastest-growing vector-borne infectious disease in the U.S. Increased temperatures are believed to accelerate tick reproduction, causing a population explosion in the tiny arachnids. And it’s spreading to new places and causing new problems. <br> <br> CDC research reveals that blacklegged ticks, responsible for spreading Lyme disease, are not only growing in number but have migrated west to new areas of the country. They’re now in nearly 50 percent of all U.S. counties, up from 30 percent in 1998. <br> <br> “The Northeast and Upper Midwest are, and have been, the regions from which the majority of Lyme diseases cases in the United States are reported,” says Maneesha Ahluwalia, M.D., an infectious disease specialist at the Greater Baltimore Medical Center. Yet, everyone living or traveling in tick-infested areas needs to pay attention, she warns. </p> <h2> Inadequate testing </h2> Despite the spread of the tick population, what might be of greater concern is the lack of appropriate testing available to those who might have contracted the disease. <br> <br> According to the International Lyme and Associated Diseases Society, nearly 40 percent of Lyme patients end up with long-term health problems — chronic infections, joint and muscle pain, fatigue, decreased short-term memory or ability to concentrate and speech problems — because there isn’t a reliable way to screen for the disease. <br> <br> The ELISA test, which most patients receive, misses 35 percent or more cases. Because of this, the average patient sees about five doctors over about two years before being properly diagnosed — making early detection difficult. <br> <br> “Early detection and treatment is key,” Dr. Ahluwalia stresses. <h2> The “bull’s-eye” rash </h2> Approximately 70 to 80 percent of Lyme disease cases are associated with a classic bull’s-eye rash, according to the CDC. <br> <br> <figure class="image-right"> <img src="/sites/default/files/hg_features/hg_post/4f6f7b5a0d4a254df8d4d7ed212aa1a0.jpg" alt="Lyme Disease bull's-eye rash"> </figure> Other early signs and symptoms include fever, chills, headache, muscle and joint aches and swollen lymph nodes. <br> <br> Later signs and symptoms, possibly a month or more after a bite, include severe headaches, additional rashes, arthritis, palsy, heart palpitations, dizziness, shooting pains, numbness and short-term memory problems. <br> <br> Once the rash is detected, get to a doctor as soon as possible. The most effective treatment is oral antibiotics twice a day for 14 to 21 days, says Dr. Ahluwalia. <h2> Prevention </h2> There are many things everyone can do to stay safe, says Dr. Ahluwalia. Other than covering exposed skin and using repellants with DEET (on skin or clothing) or permethrin (on clothing and gear), everyone who works or plays outside should inspect their skin. <br> <br> “Skin checks for ticks should take place after every potential tick exposure,” she says. “One should also check pets for ticks, as ticks can jump over to the human owner and cause infection in humans.” <br> <br> Once ticks are detected, they should be removed safely. “Use fine-toothed tweezers to pinch the tick at the point closest to the skin and pull straight out without twisting or turning. Wash the skin with soap and water immediately after. Then proceed to your primary care physician’s office,” advises Dr. Ahluwalia. <br> <br> Some experts recommend saving the tick in a sealed, labeled plastic bag in case you want to later have it tested for Lyme. <br> <br> An additional warning: Experts say it’s important to always listen to your body. If after a tick bite something feels off, tell your doctor. <h2> Other problem ticks </h2> Lyme disease isn’t the only problem caused by tick bites. The CDC lists at least 15 other types of diseases caused by various species of ticks, such as Rocky Mountain spotted fever, tickborne relapsing fever and Powassan disease. <br> <br> Additionally, the American College of Allergy, Asthma and Immunology reports that the Lone Star tick is being linked to the development of an allergy to red meat. The tick bite releases a sugar called alpha-gal into the blood stream. The person’s immune system responds by producing antibodies. The next time the person eats red meat, the body responds with an allergic reaction, such as hives or stomach cramps — or even anaphylaxis, a severe whole-body reaction that may include difficulty breathing. <br> <br> <em>- Julie Sammarco for Greater Baltimore Medical Center</em> <div class="end-of-story"> </div>
<p class="article-body"> <span>Cheering for the O's at Camden Yards is a time-honored Maryland tradition, but when did peanuts and Cracker Jack become funnel cakes, loaded nachos and fried mac 'n cheese? Indulging in special foods can be part of the fun of a day at the yard, so don't worry — you don't have to choose between bacon on a stick and carrot sticks. The stadium offers a variety of lighter options for people who want less caloric, more nutritional food at the game. </span> <br> <br> <span style="color: #00ff00;"><strong><i>If you're watching your weight...</i></strong> </span> <br> <br> <strong><img src="/sites/default/files/hg_features/hg_post/fc9eebcc0cec5743ad39275b6136980c.jpg" alt="Dempsey's Pub" class="image-left">Dempsey's Brew Pub & Restaurant (Eutaw Street – in the Warehouse)</strong><span>serves plenty of fried favorites, but their menu includes items for waistline-watchers, too. Choose a greens-based salad, like the Bistro Salad, Baby Arugula Salad or The Dempsey. Skip fatty add-ons like bacon, cheese and croutons; they can ruin the point of ordering a salad! Instead, request extra veggies such as cherry tomatoes, shredded carrots and avocado. For an added dose of low-fat protein, order your salad topped with chicken breast, tuna, shrimp, hard-boiled egg or black beans. Request a vinaigrette (not cheesy or creamy) dressing on the side. </span> <br> <br> <span style="color: #00ff00;"><strong><i>If you're craving a burger...</i></strong> </span> <br> <br> <strong>Baseline Burgers (Sections 27, 47, 348, 370)</strong><span> offers turkey burgers and veggie burgers, both of which are lower in fat and overall calories than traditional beef burgers, while still serving up a filling dose of protein. </span> <br> <br> <span style="color: #00ff00;"><strong><i>If want a taste of Maryland...</i></strong> </span> <br> <br> <span>Sometimes you just need a taste of Old Bay! Skip the loaded crab waffle fries and fried softshell crab sandwich and opt for a cup of Maryland Crab Soup from </span><strong>Old Bay Seafood (Section 43)</strong><span>. Though the sodium will still be high, at least you'll get a serving of veggies in the form of lima beans, corn, carrots and tomatoes while hitting the crabby craving. </span> <br> <br> <span style="color: #00ff00;"><strong><i>If you need a snack...</i></strong> </span> <br> <br> <span>Fries, chips and pretzels are all easy-to-grab snacks, but they are loaded with empty calories, offering little-to-no nutritional value. There are fresh snacks available if you know where to look: </span><strong>Eutaw Street Grill (Eutaw Street)</strong><span> has roasted corn on the cob; </span><strong>TAKO-Asian (section 49)</strong><span> serves edamame and veggie chips and </span><strong>Eutaw Market (Eutaw Street by the Orioles Team Store)</strong><span>sells fresh fruit cups. </span> <br> <br> <span style="color: #00ff00;"><strong><i>If you want a sweet treat...</i></strong> </span> <br> <br> <span>When you've had your meal but your dessert compartment remains empty, do your best to steer clear of the ever-present funnel cakes. </span><strong>Flying Fruit Fantasy (section 24)</strong><span> makes fruit shakes, smoothies and yogurt. They are still sugary but not as huge of a calorie bomb as other tempting options, such as the battered and deep fried Berger Cookie ice cream sundae. </span> <br> <br> <span style="color: #00ff00;"><strong><i>If you're gluten-free...</i></strong></span> <br> <br> <span><img src="/sites/default/files/hg_features/hg_post/4d8318a84022917a1061415db7ff01f2.jpg" alt="Oriole Park at Camden Yards" width="400" height="225" class="image-right">Avoiding gluten can add an additional challenge to eating out and making healthy choices. Though several of the classic burger and dog stands at Oriole Park are now offering gluten-free buns, try these lower-cal options: Gluten Free Veggie Wrap from </span><strong>Eutaw Market (Eutaw Street)</strong><span>, baked beans at</span><strong>Boog's BBQ (Eutaw Street)</strong><span> and the Pad Thai Cold Noodle Salad from </span><strong>TAKO Asian Bistro (section 49)</strong><span>. </span> <br> <br> <span style="color: #00ff00;"><strong><i>If you're in the suites...</i></strong> </span> <br> <br> <span>If you're lucky enough to be in a suite, eating healthy has never been easier. Choose from the following hearty whole-grain selections: Roasted Vegetable Panini, Cucumber Greek Salad, Heirloom Beet and Quinoa Salad, Whole Wheat Avocado Wrap and Sunflower Powerhouse Sandwich.</span> </p> <div class="end-of-story"> </div>
<p class="article-body"> If you’re at risk for diabetes or are living with the disease, there’s one more item you should add to your health to-do list — getting regular eye exams. “Poorly controlled blood sugar can lead to a number of eye problems, so it’s important to work with your primary care physician to make sure your A1C level, which reflects your average blood sugar level over several months, is in the appropriate target range,” explains Tanvi M. Shah, MD, a board-certified ophthalmologist at GBMC. <br> <br> Poor blood sugar control can cause several vision problems, including: </p> <ul> <li> Swelling of the eye’s lens, which causes blurry vision </li> <li> Diabetic retinopathy, a condition in which the blood vessels in the retina leak fluid or abnormal blood vessels grow on the surface of the retina causing gradual loss of vision </li> <li> Cataracts, which cause the lens of the eye to become cloudy, diminishing vision </li> <li> Glaucoma, a condition that increases pressure in the eye and causes fluid build-up, which damages the retina and optic nerve </li> </ul> While cataracts and glaucoma also affect people who don’t have diabetes, if you’re living with this disease, you’re 60 percent more likely to develop cataracts and they may develop at a younger age. Patients who have diabetes are also 40 percent more likely to develop glaucoma. <br> <br> <blockquote> “If you have fluctuating vision — sometimes it’s blurry, sometimes it’s not — or if you simply can’t see as well as you feel you should, you should make an appointment for an exam with an ophthalmologist,” says Dr. Shah. “The sooner the problem is diagnosed, the sooner we can start treatment to slow its progress and preserve your vision.” </blockquote> <br> <strong>Symptoms you should know</strong> <br> <br> Often, the earliest stages of eye problems caused by diabetes, including diabetic retinopathy, do not cause symptoms. GBMC offers a number of effective treatments for eye problems caused by diabetes, such as: <ul> <li> Focused laser treatment to stop the overgrowth of blood vessels and seal leaking blood vessels in the retina </li> <li> Injections of medications into the eye that slow the overgrowth of blood vessels and reduce fluid leakage </li> <li> Surgery to remove scar tissue and fluid build-up in the eye </li> </ul> “The best strategy is to take preventive steps to protect the health of your eyes. Work with your primary care physician to get good, consistent control of your blood sugar, blood pressure and cholesterol levels,” adds Dr. Shah. “One of the biggest problems is that there are more than 8 million people in the U.S. who have diabetes that is undiagnosed. Since they’re not receiving treatment to control their A1C, the disease can silently damage their eyes for years, so being proactive is important. If you’re at risk for diabetes but have not been diagnosed with the disease, see your primary care physician for regular blood tests to monitor changes in your blood sugar level.” <br> <br> To learn more about ophthalmology services and primary care at GBMC, visit <a href="/node/2492" target="_blank">gbmc.org/ophthalmology</a> and <a href="http://www.mygbmcdoctor.com/" target="_blank">mygbmcdoctor.com</a> or call 443-849-GBMC (4262). <div class="end-of-story"> </div>
<p class="article-body"> If stiff and sore joints make getting out of bed in the morning a chore, and climbing stairs feels like a battle, you may be suffering from osteoarthritis. The most common form of arthritis and the leading cause of disability today, osteoarthritis led to 992,100 hospitalizations in 2015. It is found in the majority of people who are over 65-years-old and 80 percent of people over 75; if you are obese or put prolonged stress on your joints, you are even more at risk. <br> <br> Osteoarthritis is caused when a joint progressively degenerates, whether knee, hip, ankle, spine or toe. This causes the breakdown of the cartilage cushioning around the joint. As a result, the bones rub together, causing achiness, instability, buckling or loss of function. You may also notice increased boniness, enlargement and/or deformity of your affected joints. These symptoms can develop gradually, be intermittent or slowly fade as you get more active throughout the other day. However, even though your discomfort might not progress past the mild-moderate level or may not seem permanent, you should still address your joint pain with your primary care physician. <br> <br> Eventually, osteoarthritis could cause you to limit or refrain from exercise, which can put you at risk for a host of other obesity-related complications. Osteoarthritis limits peoples' activity levels more than heart disease, cancer or diabetes. It's a common myth that you should not use or "wear out" a joint. Not only will regular low-impact exercise not increase the development of osteoarthritis, it will help you maintain a range of motion, muscle strength and a healthy BMI. <br> <br> Avoiding weight gain, or losing weight if you are already overweight, is the single most important factor in preventing and treating osteoarthritis. You may be surprised at the small amount of weight you'll need to lose to take a great amount of stress off your knees: losing just one pound can alleviate between 30-60 pounds of pressure. <br> <br> Here are some low-impact exercises that are useful for getting (or keeping) your joints moving: </p> <ul> <li> Swimming </li> <li> Yoga </li> <li> Zumba/dancing </li> <li> Walking </li> <li> Recumbent cycling </li> <li> Elliptical machine </li> <li> Kettle ball class </li> <li> Rowing machine </li> </ul> Depending on which joints are bothering you, your doctor may also be able to recommend assistive devices to help you stay active, such as shoes with good shock-absorbing properties or a cane. There are also some supplements that are proven to be effective in the treatment of osteoarthritis, including glucosamine sulfate, chondroitin sulfate, Vitamin D and S-adenosylmethionine.<a href="https://gbmc.formstack.com/forms/primary_care_appointment_request_2" target="_blank">Make an appointment with your primary care provider</a> if you have chronic joint pain or think you may need a referral to an orthopedist. If you don't already have a primary care provider, visit <a href="http://mygbmcdoctor.com/" target="_blank">mygbmcdoctor.com</a> to find one who is the right fit for you. Addressing osteoarthritis or other forms of joint pain and inflammation now is a great step to take in preventing weight-related diseases and injuries in the future. <div class="end-of-story"> </div>
<p class="article-body"> According to 2014 data from the American Cancer Society, an estimated 95,000 new cases of gynecologic cancer are diagnosed each year and approximately 29,000 deaths occur. Gynecologic cancers are defined as cancers that affect organs within the female reproductive system, including the cervix, fallopian tubes, ovaries, uterus, vagina and vulva. Awareness of the symptoms is often the best defense for women. <br> <br> Like many other forms of the disease, symptoms of gynecologic cancers are location-specific. “Endometrial cancer is the most common type of gynecologic cancer in the United States, and our ability to catch it early depends on women responding to symptoms of bleeding,” says Kimberly Levinson, MD, a gynecologic oncologist at GBMC’s Sandra & Malcolm Berman Cancer Institute. “Any episode of post-menopausal bleeding is abnormal and is a symptom that should be examined by a gynecologist.” Though not every episode of post-menopausal bleeding indicates a pre-cancerous or cancerous lesion, the bleeding is often an opportunity to catch atypical cell growth early. <br> <br> </p> <blockquote> The important thing is that women are aware of the symptoms, aware of the screenings available and aware of how gynecologic cancers can be treated if they do occur. </blockquote> Ovarian cancer is the most difficult to detect early, as there is no good screening mechanism for it. It spreads quickly and might not cause symptoms until its advanced stages. Patients tend to report persistent symptoms of abdominal bloating, changes in bowel or bladder habits and feeling full quickly. Conversely, cervical cancer is easily detected through screening and is slow-growing with a long pre-malignant state, meaning physicians can often stop the disease before it spreads. However, in order to do so, patients must keep up with regular screening practices so that the pre-malignant stages can be detected. <br> <br> Pap smears and human papillomavirus (HPV) testing can help identify women at risk for developing cervical cancer so that abnormal cells can be removed before they become invasive. HPV is a known cause of cervical cancer and a vaccine is available. “HPV-associated cervical cancer can largely be prevented via screening and vaccination,” says Dr. Levinson. “It is critical to vaccinate our daughters and sons prior to exposure to the virus so we can keep them from contracting it in the first place.” <br> <br> Vulvar and vaginal cancers are the rarest gynecologic cancers, often presenting with symptoms such as itching, irritation or pain, or simply a raised or visible lesion. It can be difficult to distinguish benign lesions from malignant ones, so all lesions should be examined and biopsies may be necessary. <br> <br> Treatments for gynecologic cancers include minimally invasive surgeries such as robotic surgery, laparoscopic surgery and single-incision surgery as well as more extensive open abdominal procedures, which are offered at GBMC’s Women’s Surgical Center. Minimally invasive procedures have drastically changed treatment for gynecologic cancer patients. According to Dr. Levinson, the development of minimally invasive techniques has yielded tremendous improvements in patient outcomes. “Recovery times are quicker and infection rates, pain scores and other surgical complications are significantly decreased.” <br> <br> <div class="end-of-story"> </div>
<p class="article-body"> About 117 million Americans have some form of chronic illness or disease, according to the Centers for Disease Control and Prevention (CDC). The National Sleep Foundation also reports that 37 million American adults suffer from sleep apnea, which occurs when a person’s breathing is disrupted during sleep. These statistics are noteworthy because sleep deprivation and sleep disorders such as sleep apnea can increase the risk for some chronic illnesses. Additionally, sleep disorders can worsen the outcome of a chronic illness. <br> <br> </p> <figure class="image-right"> <img src="/sites/default/files/hg_features/hg_post/a6e0a8ff774bb6fa431d107f84c80663.jpg"> <figcaption> Dr. Raya Wehbeh </figcaption> </figure> Raya Wehbeh, MD, a physician with GBMC’s Sleep Medicine practice and Sleep Center, specializes in the diagnosis and treatment of patients who suffer from sleep disorders. “Research has linked insufficient sleep to an increased risk for developing chronic illnesses like diabetes, high blood pressure, heart disease and obesity,” says Dr. Wehbeh, who is board-certified in Neurology and Sleep Medicine. “Controlling a sleep disorder like sleep apnea may help to prevent a person from developing a more serious chronic illness later in life,” she explains. Patients who have already been diagnosed with a chronic illness and are also experiencing symptoms of poor sleep should speak with their primary care physicians as well. “Improving a patient’s quality of sleep often has a positive impact on his or her chronic illness,” notes Dr. Wehbeh. <br> <br> Fortunately, primary care physicians can refer patients with sleep problems to specialists like Dr. Wehbeh, who perform sleep studies to monitor a patient’s brain waves, breathing patterns, limb movements and snoring. Sleep studies are painless tests that require an overnight stay at GBMC. A technician attaches wires with electrodes to the patient and monitors the resulting activity as the patient sleeps. After interpreting the results, the physician will make a diagnosis and recommend a course of treatment. <br> <br> <blockquote> People who frequently have trouble falling asleep, staying asleep, or who are excessively tired throughout the day should speak with a primary care physician about those symptoms instead of ignoring them. </blockquote> “In addition to speaking with a primary care physician about their symptoms, there are several things that patients can do at home if they’re having difficulty sleeping,” says Dr. Wehbeh. “Try to maintain a regular sleep schedule with a standard bedtime routine, avoid looking at television, computer or phone screens about a half hour before going to bed and allow yourself enough time to get seven or eight hours of sleep each night, which is the recommended amount for most adults.” <br> <br> Speak with a primary care physician about whether a sleep study or consultation could be beneficial for you or a loved one. If you do not have a primary care physician, visit <a href="http://www.mygbmcdoctor.com" target="_blank">www.mygbmcdoctor.com</a> or call 443-849-GBMC (4262) to find one who is right for you. <div class="end-of-story"> </div>
<h4> GBMC combines leading-edge technology with programs tailored to suit each patient's mobility needs </h4> With the growing number of aging baby boomers facing mobility issues, it should come as no surprise that demand is increasing for rehabilitation medicine. <br> <br> Around 15 percent of the world’s population — an estimated 1 billion people — live with disabilities. Nearly 7 percent of Americans report some degree of walking disabilities, according to Cornell University’s latest Disability Status Report. <br> <br> Greater Baltimore Medical Center has responded with a large staff of highly qualified physical therapists, the latest leading-edge technology and equipment, and programs tailored to meet each patient’s needs. It’s all about restoring and enhancing the functional ability of patients with physical impairments, many related to rising rates of obesity and diabetes. <br> <br> <figure class="image-right"> <img src="/sites/default/files/hg_features/hg_post/de06e3f1c925aa7af5beefa298213b9f.jpg" alt="Patient receiving physical therapy at GBMC's rehabilitation unit"> <figcaption> Patient receiving physical therapy at GBMC's rehabilitation unit </figcaption> </figure> “Traditionally, physical therapy is linked more with helping injured or ill [patients] regain flexibility and strength, and occupational therapy is [linked] to recovery of activities of daily living,” said Virginia A. Moratz, OTR, CHT, CLT, administrator and clinical director of the Center for Rehabilitation Medicine at GBMC. “Both professions work toward patient quality of life. We work to empower the patient.” <br> <br> Currently comprised of 17 providers plus support staff, GBMC’s Center for Rehabilitation Medicine is a state-of-the-art facility that provides a single source for comprehensive rehabilitation services including lymphedema diagnosis and management, oncology rehabilitation, vestibular therapy, pelvic floor and women’s health therapy, sports physical therapy and hand therapy. <br> <br> Giving Back: An army of volunteers helps give GBMC a family feel Lymphedema is a persistent swelling, usually of the arms or legs, though it can occur anywhere in the body. It often results from damage to or removal of lymph nodes as a part of the treatment for cancer. <br> <br> “There are patients who have suffered for years not knowing there was help,” Moratz said. “Our center is unique in that it has a comprehensive medical team, led by our medical director, Dr. Alan Kimmel, who is both a lymphologist and internal medicine physician. <br> <br> Moratz, a certified lymphedema, occupational and hand therapist, recalled a patient who had been repeatedly hospitalized with leg infections, placed on oxygen, and was unable to walk or work. Following a lymphedema diagnosis and daily outpatient therapy at the Center for Rehabilitation Medicine, his swelling was controlled, allowing him to walk again, forgo oxygen and return to work. <br> <br> Becky Stover, MS, RN, a nurse clinical system project manager at GBMC and an active athlete, was referred to the Center for Rehabilitation Medicine after suffering a debilitating broomball injury in 2013. <br> <br> “My pain intensified to the point of being unable to play broomball,” Stover recalled. “I began having difficulties with small tasks, such as walking up stairs or getting out of the car. I could barely lift a gallon of milk without having back pain.” <br> <br> Stover assumed she had a back injury, but her GBMC physical therapist, Emily Wood, diagnosed her with a rotated pelvis. Wood assisted Stover through stretches, weightlifting and balancing activities that gradually rebuilt her strength and realigned her pelvis. <br> <br> “My therapist set specific, realistic goals that aligned with my personal expectations,” Stover said. “Slowly, the pain lessened and I could go up and down steps without having a death grip on the railing.” <br> <br> Prior to her six weeks of treatment, Stover worried that she might never be able to resume playing sports. Six months later, having continued to build her strength at the gym, she has returned to broomball, and completed a 5K fundraising run last year. <br> <br> “The Center for Rehabilitation Medicine really made me feel like I mattered. The therapist worked directly with me, not with three to four other patients at the same time,” Stover said. “The people [are] what made the difference for me: from the front desk staff, the interns helping with my warm-up exercises, to my actual therapist. They were the reasons that I came back.” <br> <br> <em>- Paul Rogers with Greater Baltimore Medical Center</em> <div class="end-of-story"> </div>
