<p class="article-body"> It is commonly known that being overweight is related to health issues like diabetes and high blood pressure, but did you know that it can also put you at a higher risk for cancer, arthritis, sleep disorders, vascular disease, and more? Dr. Kevin Ferentz, primary care provider at GBMC Health Partners, explained that once patients reach medical obesity, or the “O-line,” as he calls it, their all-cause morbidity increases. “Once they reach the O-line, patients are more likely to die from <em>everything</em>,” he said. <br> <br> Dr. Ferentz stressed how important it is for patients to understand the implications of being obese. In his practice, he sees many patients with a BMI greater than 30 who do not believe they are obese because they see others who are much larger than they are. While it is often true that there are bigger people out there, Dr. Ferentz explained “we are so surrounded by morbid obesity that Americans have forgotten what normal looks like.” Approximately 35% of Americans are obese, and, according to a <a href="https://www.nejm.org/doi/full/10.1056/NEJMsa1909301?query=featured_home" target="_blank">study published in the New England Medical Journal</a> in 2019, that number could increase to 50% by 2030. “The data is truly alarming,” Dr. Ferentz stated. <br> </p> <figure class="image-full"> <img src="/sites/default/files/hg_features/hg_post/c4efa3a7fbb9894a8a8ca63dbb8ff9fb.gif" alt="Obesity Map"> <figcaption> Source: <a href="https://www.cdc.gov/obesity/data/prevalence-maps.html" target="_blank">www.cdc.gov/obesity/data/prevalence-maps.html</a> </figcaption> </figure> Whether his patients feel they are obese or not, Dr. Ferentz said that it’s imperative to use the correct terminology. Simply saying that someone is overweight doesn’t convey the severity of the situation. Obesity contributes to the death of 300,000 Americans every year, and sugarcoating the message is not going to change that. While Dr. Ferentz is committed to being honest with his patients, he emphasized that he never tries to shame them. “This is not an issue of shame,” he expressed. “This is a health issue like any other diagnosis.” <br> <br> As with other diseases, medication is a viable treatment option for many patients. Dr. Ferentz explained that weight-loss medication works as an appetite suppressant to help patients consume less food. “Ultimately, weight loss is about calories,” he said. “If you don’t take in fewer calories, you will not lose weight.” One pound of fat translates to about 3,500 calories, so to lose one pound per week, a person would have to consume 500 fewer calories per day. <br> <br> 500 calories is a significant amount to cut for what seems like a relatively small gain, which is why weight-loss medication is so helpful. When combined with lifestyle changes like exercising, eating well, and maintaining healthy sleep habits, medication can be the kick starter to losing weight and better overall health. Many patients see a 10-to-30-pound loss within a few months. <br> <br> Dr. Ferentz acknowledged there is a negative association with weight-loss medication that doesn’t exist for many other drugs. This is likely due to one of the earliest medications being recalled and the fact that, for many years, patients had to see specialized doctors who overcharged for prescriptions. “Frankly, it was a rip off,” Dr. Ferentz said. The situation has changed since then, and patients can now work with their primary care provider to be prescribed weight-loss medication. <br> <br> For patients needing to lose more weight than medication can manage, Dr. Ferentz recommends bariatric surgery. To some, surgery may seem extreme, but for those who need it, it can literally save their lives. “I hear the same two things from my patients that I refer for bariatric surgery: ‘this is the best thing I’ve ever done’ and ‘I wish I had done it sooner,’” he expressed. “I suggest that anyone looking to lose weight have an honest conversation with their primary care provider to see what options are available to them.” <div class="end-of-story"> </div>
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<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/dVrQYorQdu4" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> It's no surprise that children across the country are experiencing increased anxiety and depression caused by the pandemic. Isolation from friends and family members coupled with virtual schooling has taken a toll on both adults and children. Dr. Anthony Chico, Director of Emergency Psychiatry at GBMC, explains if you've noticed a change in your child's behavior, it's best to have an open and honest conversation with them to help get on the same page and deal with the problem. It's also important to help prepare your children for the next steps - as more vaccines roll out and restrictions are rolled back, there may be a new level of anxiety about getting back to "normal" life. </p>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/YKTnpNmoj5M" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> The signs and symptoms of colorectal cancers – abdominal pain, rectal bleeding, and changes in bowel movements – are things most people would rather not discuss. Joseph D. DiRocco, MD, MBA, FACS, eliminates this anxiety for his patients and helps them feel at ease at a vulnerable time. Together with his colleagues in the Sandra & Malcolm Berman Cancer Institute at GBMC, he creates a plan to treat each patient’s individual disease, whether that includes surgery, chemotherapy, or radiation, to achieve the best outcomes. With training from the renowned Memorial Sloan-Kettering Cancer Center, Dr. DiRocco expertly performs the latest endoscopic, laparoscopic, and robotic surgeries to make life better for his patients. </p>
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<p class="article-body"> Diabetes. Obstructive sleep apnea. Hypertension. Hypercholesterolemia. Depression. Anxiety. <br> <br> These are just some of the dangerous medical complications of obesity, according to Dr. Elizabeth A. Dovec, MD, FACS, FASMBS, a bariatric surgeon, bariatrician and medical director at Greater Baltimore Medical Center’s Comprehensive Obesity Management Program, or COMP. <br> <br> “Obesity is an epidemic with sobering statistics and terrifying upward trends,” she says. “Obesity has a negative impact on every aspect of our lives — health, lifespan and quality. It’s currently the number two cause of preventable death — and it’s trending to become the first.” <br> <br> </p> <h3> What is the treatment for obesity? </h3> Obesity, which is defined by a body mass index of 30 or higher, affects thousands of Maryland residents, many of whom choose GBMC for their surgical weight-loss solutions. For GBMC’s COMP, morbidly obese patients may qualify for some form of bariatric surgery: <ul> <li> With a BMI between 35 and 39.9 and suffering from one or more comorbid conditions such as heart disease, diabetes, hypercholesterolemia, osteoarthritis, hypertension, or obstructive sleep apnea </li> <li> With a BMI greater than 40. </li> </ul> However, weight-loss surgery often has a stigma attached, explains Dr. Dovec. <br> <br> “Think about your own thoughts about weight loss surgery. You may think these people are just lazy, lack willpower or are taking the easy way out. Obesity is associated with embarrassment and shame. Having to have surgery is perceived as the ultimate level of humiliation. We need to change that,” she says. “Weight loss surgery is effective; however, it requires commitment, dedication, hard work, and grit to achieve sustainable results.” <br> <br> <h3> So, what are the surgical options? </h3> The most common surgeries are gastric bypass (when your stomach decreases in size from a football to a thumb via a surgical procedure that divides your stomach into two sections) and a sleeve gastrectomy (when a surgeon removes approximately 75% of the stomach). At GBMC, both surgeries are performed through minimally invasive techniques, also known as laparoscopic surgery. <br> <br> “These are minimally invasive procedures done through tiny incisions,” Dr. Dovec explains. She says laparoscopic surgery results in a shorter length of stay and fewer post-operative complications and pain. <br> <br> “My mission in life is to normalize bariatric surgery,” she says. “Bariatric surgery is the fastest growing surgical specialty, and approximately 250,000 morbidly obese Americans have surgery.” <br> <br> Dr. Dovec explains that weight loss surgery can decrease or eliminate many of the medical issues a patient is facing. “Bariatric surgery should be highlighted as the most effective and durable treatment for morbid obesity,” she says. “Around 85% of patients will succeed in staying healthy and keeping their weight off. Surgery results in significant weight loss and helps prevent, improve, or resolve more than 40 obesity-related diseases or conditions including type 2 diabetes, heart disease, obstructive sleep apnea, and certain cancers.” <br> <br> In addition, Dr. Dovec points out that both quality and quantity of life are affected by a person’s weight. Surgery can help improve both. <br> <br> “It's time to feature the facts about bariatric surgery,” Dr. Dovec says. “None of us are immune to this terrible disease. Remember, by doing your homework, you could save a life, and it might be your own.” <div class="end-of-story"> </div>
<p class="article-body"> Chronic pelvic pain is a common ailment that may be hard to pinpoint in women of reproductive age. Christine M. Helou, M.D., a board-certified gynecologist with GBMC Health Partners, says there are several types of pelvic pain, ranging from acute, sharp spasms to heaviness or fullness that is felt more at the end of the day. <br> <br> Pelvic pain can be caused by several different ailments or illnesses. Dr. Helou explains, "It's not an easy fix." </p> <blockquote> The number of women that only have one cause of pelvic pain is minimal, and there's usually more than one diagnosis that goes into treating pelvic pain </blockquote> <br> <br> Some of the more common causes of pelvic pain include endometriosis, cysts, bowel disease, and pelvic inflammatory disease. Because of the variety of illnesses, Dr. Helou says she performs a thorough health history on every patient. <br> <br> "We ask them about timing and patterns of the pain and any past trauma to the area, including sports injuries, car accidents, even horseback riding," she says. "We check for abdominal wall tenderness and do a pelvic exam to check for any signs that suggest infection or excess scar tissue from prior surgeries." <br> <br> She notes that sometimes when pain continues for a long time, your brain starts to perceive the pain differently. Even after the original problem resolves, the pain can remain. When that happens, Dr. Helou explains, "We need to work to turn the pain signal down in the brain. All pain is experienced in the brain, and sometimes treatment efforts need to be directed there." <br> <br> Pelvic pain can be caused by so many factors, which means treatments can vary greatly, and improvements are often gradual over time. <br> <br> "Treatments can include medication, surgery, physical therapy, and complementary therapies like acupuncture, counseling, and even Botox injections," Dr. Helou says. "Often the best outcomes are found when we use a variety of treatments." <br> <br> Similar to the development of chronic pain, it can take time to find and address the underlying problems causing the pain, Dr. Helou says. <br> <br> Chronic pelvic pain isn't something you have to live with, according to Dr. Helou. She wants women to know that if something feels off, you shouldn't hesitate to reach out to your doctor. Whether it's pain during a period, discomfort when you urinate, or just a feeling of heaviness or tenderness in your pelvic area or lower back, finding the cause quickly will help put you on the road to recovery. <br> <br> "The multidisciplinary team at GBMC is committed to working with patients to navigate the complexities of chronic pelvic pain," Dr. Helou says. "We're here to provide support and present the best options available for each individual." <div class="end-of-story"> </div>
<p class="article-body"> The COVID-19 vaccine has been a major conversation topic this year as the pandemic drones on. However, health officials want to remind the general public to also stay up to date on non-coronavirus vaccinations — vaccines that help avoid preventable diseases. <br> <br> The viruses and bacteria that cause disease can be passed along by anyone who is not vaccinated. Preventable diseases include the flu, pneumonia, shingles, HPV, and hepatitis B. The latter two are both leading causes of cancer, according to the National Foundation for Infectious Diseases. One million people suffer from a bout with shingles each year in the United States, yet if they had received the vaccine, it is more than 90% effective in preventing transmission. <br> <br> In addition, the last thing anyone needs is to get sick with the flu and coronavirus at the same time, which could happen and leave those afflicted quite vulnerable. Not everyone can afford to miss weeks of work if they get sick. <br> <br> “I think everybody's hyper focused on COVID, appropriately so, but that doesn't mean that the risk of other preventable diseases has gone away,” says Jon Hennessee, D.O., GBMC Health Partners Primary Care. <br> <br> Hennessee, who is a family medicine physician and a former intensive care nurse, advises people to follow the CDC’s vaccination schedule. <br> <br> Getting people to come in for routine visits and keep up on their vaccinations was, at times, a struggle pre-pandemic, Hennessee observed. He notes there has been a “loss of focus on prevention because it pales in comparison to what we're seeing now. But all these preventable illnesses have historically been devastating, and the reason they're not anymore is because we have vaccines.” <br> <br> In addition to vaccinations, the methods of preventive medicine that have the greatest impact are lifestyle changes: diet, exercise, spiritual and mental health, and cancer screenings. <br> <br> “If we could get people to stop smoking, eat more vegetables, exercise regularly, get their vaccines, and do their cancer screenings according to evidence-based medicine, a lot of our primary care provider jobs would go away,” Dr. Hennessee says. “And I think most primary care providers would be OK with that.” <br> <br> One crucial vaccination, especially for teens, is the human papillomavirus vaccine. The HPV vaccine is recommended for both boys and girls at age 11 or 12, though it can be given as early as age 9 and up to age 26. HPV infections and cervical precancers have dropped significantly since the vaccine has been in use in the United States. <br> <br> “It has the most gravity and most effect if you've never had sex, which is why it's controversial,” says Hennessee. While parents may have concerns about vaccinating their children for a sexually transmitted disease, not doing so can have consequences later in life. “HPV can cause, in later years, cervical cancer and throat cancer.” <br> <br> HPV causes 27,000 cancers in women each year in the U.S., according to the CDC. <br> <br> “If we vaccinated everybody against HPV, we would eradicate cervical cancer,” Hennessee says. <br> <br> While COVID-19 is the first thing on everyone's minds right now, don't forget to keep up to date on other vaccinations. Health providers suggest checking your status on the following vaccinations: </p> <ul> <li> Haemophilus influenza </li> <li> Tetanus </li> <li> Pneumococcal </li> <li> Measles </li> <li> Mumps </li> <li> Rubella </li> <li> Varicella </li> <li> Influenza </li> </ul> GBMC Health Partners Primary Care practices offer all these vaccinations. <div class="end-of-story"> </div>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/LOHXiYnnFQc" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> More than 50 million Americans have some form of hearing loss, and mask-wearing has increased isolation and anxiety about communicating. Regina Presley, Au.D., FAAA, CCC/A, Senior Cochlear Implant Audiologist, explains if you are communicating with someone who has hearing loss in-person while wearing a mask, it's important to speak slowly, clearly, and loudly to ensure you are understood. On a virtual platform, ask for mics to be muted unless speaking. Many virtual meeting platforms have captioning available, and there are apps that offer real-time captioning as well. If you believe you may be suffering from hearing loss The Presbyterian Board of Governors Cochlear Implant Center of Excellence at GBMC may be able to help. </p>
<p class="article-body"> With everyone at home all day, it can be difficult to establish routines, especially when it comes to children and meals. With food readily accessible, mealtimes slide into snacks and vice versa. According to Lisa Davis, RDN, LDN, CDE, a registered and licensed dietitian with the GBMC Geckle Diabetes & Nutrition Center, it’s important to maintain a sense of normalcy with a meal schedule. <br> <br> “Having some semblance to the day, a routine or schedule, helps kids develop healthy eating habits from the get-go,” Lisa said. “Typically, adults get hungry every 3-4 hours, but kids get hungry more frequently. In between meals, you want a snack that’s half the calories of a meal because you don’t want them to fill up completely.” <br> <br> When choosing snacks, Lisa reinforces balance. She suggests wholesome foods such as fresh fruit, edamame or nuts, if children aren’t allergic, as well as classics such as peanut butter on celery with dried fruit or on whole grain bread with banana. Greek yogurt is also a versatile snack option because it can be made sweet with a little honey, cinnamon, fresh berries and granola or savory with garlic powder, onion powder, parsley or lemon juice as a dip with fresh vegetables. <br> <br> In the midst of a global pandemic, it’s also good to keep the immune-boosting properties from certain foods in mind. <br> <br> Vitamins C, D, and E are important for the immune system. Vitamin C is most widely known to be found in citrus fruits. However, red bell pepper and broccoli also contain a large amount of Vitamin C, which can be used to dip in Greek yogurt or hummus as a wholesome snack. Other great alternatives include spinach and garlic. <br> <br> Vitamin D is found primarily in dairy products, again Greek yogurt, but also many cheeses. Vitamin E is not water soluble like Vitamins C and D, so daily intake is not required. Almonds and sunflower seeds are a good source of Vitamin E. <br> <br> Preparation is just as important as the content of the snacks. Lisa encourages kids to build their own snacks to cultivate a sense of autonomy in the choice as well as independence. She also suggests including kids in the building of meals, such as helping to select which vegetable to eat for dinner. When safe to do so, taking kids to a farmer’s market to choose new fruits or vegetables to try, or to a farm or garden to pick their own, can help them to learn more about food itself and appreciate what it does for their body. <br> <br> Common high-fat snack foods such as corn chips and potato chips don’t do much for the body, but Lisa doesn’t recommend cutting them out completely. <br> <br> “You shouldn’t forbid candies or chips. You just don’t want them to be an everyday food,” Lisa said. “Making sure you include some of those foods helps kids realize it’s just part of the selection. Give them permission to have some of those foods, but also encourage them to eat some foods they can make themselves.” <br> <br> According to the American Heart Association, the recommended amount of daily added sugar intake for children ages 2 to 18 is less than 25 grams, or 6 tsp of added sugar daily, including no more than 8 ounces of sugar-sweetened drinks. For reference, a can of soda has about 9 teaspoons of sugar. <br> <br> “It has to do with balance,” Lisa said. “Snacks are designed to be a little more fun. While meals can be fun too, they really need to reflect a balanced plate and there is a reason for that. <br> <br> “Protein takes longer to digest, which keeps you full longer. Carbohydrates give you energy for at least a few hours. But if kids eat mostly carbohydrates, especially refined, low-fiber carbs, at meals, the result can be a rapid rise in blood sugar, followed by a blood sugar drop. That's when cravings for more carbs can kick in. The balance of proteins and carbs is always important for blood sugar stability. Meals, along with smart snacks like fresh fruit, nuts and cheese, will provide “consistent” energy through the day.” <br> <br> Each day won’t be perfect but maintaining balance and routine when it comes to our meals can keep us all physically healthy during this stressful time. </p> <div class="end-of-story"> </div>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/bKZaWhxlG74" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> The Centers for Disease Control and Prevention (CDC) is strongly recommending that children return to school with proper safety measures in place. Despite this, there remains skepticism that this is the best thing to do for the community. Timothy Doran, MD, Chairman of the Department of Pediatrics at GBMC, joined WBAL Radio’s Coronavirus Townhall to talk about the pandemic’s effect on children’s mental health and the importance of in-person learning. <br> <br> The most common concern is that children returning to school will increase the spread of COVID-19. While returning to school isn’t free of risk, Dr. Doran asserted that the benefits to children far outweigh the risk to the community. “We know that children are rarely seriously impacted by COVID-19. They have an innate resistance to it, and they clear the virus very quickly,” he explained. “There isn’t any evidence that community spread is worse when children are in school.” <br> <br> Children have been disproportionally affected by the pandemic, especially those with challenging home environments. “For many children, this affects food security and access to social services that they would normally receive in school,” he described. Dr. Doran also reported seeing increased social isolation and depression in children due to their inability to go to school and socialize with their friends. <br> <br> He encouraged parents to regularly check in with their children and to make sure they stay active. Even though the weather is cold, it is critical that children move their bodies and play. “Exercise is really important as well as maintaining social interactions as much as possible through the internet,” said Dr. Doran. He also suggested that children participate in activities with other children in lower risk environments. Outdoor games of tag or baseball allow physical distancing and are safer than activities that are indoors and involve close contact. <br> <br> Dr. Doran was asked whether schools should wait to return to in-person learning until children are vaccinated. He replied by saying that that was unrealistic. There is currently no data on how COVID-19 vaccines affect children, and clinical trials on children under the age of 16 are only just beginning. “It could be years before we know whether these vaccines are safe for children or not,” he explained. Dr. Doran did say that children should be vaccinated eventually, but only after the COVID-19 vaccine has been approved for that age group. <br> <br> He also acknowledged that children are not the only people impacted by virtual learning. Many parents have had the difficult task of working from home and managing their children’s education for almost a year. This is draining and can negatively affect parents’ mental health and productivity at work. Dr. Doran believes that in-person learning will help the entire family. He encouraged parents to communicate their frustrations and concerns to their local school system and PTA. “I think it’s time for people to come together and make recommendations to their school boards,” he said. <a href="https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/parental-resource-kit/index.html" target="_blank">Click here</a> for resources to help maintain the social, emotional, and mental well-being of your child during COVID-19. </p>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/y1rFDvwbKaw" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> Kimberly Levinson, MD, MPH, Director of Johns Hopkins Gynecologic Oncology at GBMC, discusses the HPV vaccine and its importance in preventing cervical cancer. She also discussed the importance of women having conversations with their gynecologist about screening. </p>
<p class="article-body"> Hemorrhoids are swollen veins in the anus and lower rectum. When inflamed, they can have an impact on routine activities. For many, a flare-up of “piles,” which hemorrhoids also are called, can be embarrassing to talk about — even with a doctor. <br> <br> But while getting them is common — an estimated 75% of adults get them according to the National Institute of Diabetes and Digestive and Kidney Diseases — it’s important to not neglect them and understand when medical attention is necessary. <br> <br> “Now that everybody has devices, they're spending a lot more time on the toilet,” says Joseph DiRocco, M.D., MBA, FACS, medical director of gastrointestinal oncology at the Greater Baltimore Medical Center. <br> <br> “I know my kids think that's the place to hide when they want to watch videos on the internet,” Dr. DiRocco says. “Some people have magazines or a library in the bathroom, but the longer you spend on the toilet, the more likely you’ll get hemorrhoids.” <br> <br> </p> <h3> So what is considered too long to sit on the toilet? </h3> Sitting in the bathroom beyond the time it takes to do a bowel movement is too long. Sitting in this position can cause pressure that leads to swelling and blood clotting in veins of the anus and buttocks. <br> <br> The old expression “crap or get off the pot” — that was probably originated by a colorectal surgeon, says Dr. DiRocco, who is a practicing colorectal surgeon. <br> <br> In addition, chronically straining is a cause and should be avoided, he says. Straining, constipation and frequent diarrhea can increase the likelihood of developing hemorrhoids. For those who already have hemorrhoids, all three can exacerbate your symptoms. <br> <br> <h3> Internal and external hemorrhoids: What's the difference? </h3> There are internal hemorrhoids and external hemorrhoids. <br> <br> “We're born with them, and we die with them,” Dr. DiRocco says. “They can cause symptoms and cause difficulty for people. Sometimes people can have enlarged hemorrhoids and have no symptoms whatsoever.” <br> <br> The symptoms of internal hemorrhoids and external hemorrhoids are different. <br> <br> External hemorrhoids, located around the anus, can swell and protrude, causing discomfort and pain. In addition, they can cause moisture leading to burning and itching. Painless bleeding can be a symptom, too. <br> <br> Internal hemorrhoids are deep inside the rectum where there are fewer nerves, so the pain is less severe. A main indication is finding blood in the stool and on toilet paper. <br> <br> <h3> What are the causes? </h3> When increased pressure occurs in the abdomen and pelvic region, hemorrhoids can flare up. <br> <br> Pregnancy can lead to increased blood flow in the pelvic area and can lead to large hemorrhoids. Obesity or excess weight causes extra pressure on blood vessels and constricts veins surrounding the anus and colon, which can lead to hemorrhoids. <ul> <li> Exercises such as squatting and heavy weight lifting can be culprits. </li> <li> Frequent loose stools, constipation, eating a low-fiber diet, and the aforementioned straining and sitting on the toilet for too long can cause hemorrhoids. </li> <li> Aging weakens the connective tissue between the anus and rectum making older people more susceptible to hemorrhoids. Though hemorrhoids are most common in adults aged 45 to 65, they can appear at any age, even in children. </li> <li> A strong family history is another factor. </li> <li> Sometimes the causes are unknown. </li> </ul> <br> <h3> When to see a doctor </h3> Bleeding, recurrent or persistent pain or itching in the area needs to be addressed, says Dr. DiRocco. If you’ve tried over-the-counter remedies for a week without relief, call your doctor. If stool is maroon-colored or black, which could indicate bleeding, call your doctor. If rectal bleeding will not stop and you feel faint or dizzy, call 911, as you might need a trip to the emergency room. <br> <br> <h3> Prevention and healing </h3> Listen to the body. Increasing dietary fiber and fluids is essential in combating this condition. <br> <br> Fiber bulks up the stool and makes it easier to pass through the intestines, so there's less effort required to have a bowel movement. Fluids prevent stool from drying out and becoming more difficult to pass. <br> <br> Additionally, make sure you are moving around throughout the day. Sedentary living exacerbates hemorrhoids. Boost your activity level. Even walking can make a difference. <br> <br> <h3> Comprehensive hemorrhoid treatment </h3> At Greater Baltimore Medical Center, physicians customize treatment plans to the individual patient. There are simple nonsurgical options such as creams, and surgeries are performed on site. Urgent appointments are available for painful conditions. <br> <br> Rubber band ligation, also called banding, is an effective and quick procedure for internal hemorrhoids. It takes less than a minute and typically does not require any pain medicine or time off of work. <br> <br> External hemorrhoid surgery can be done safely in the office with local anesthesia. A numbing medicine is applied at the time of surgery, which can numb the area for up to three days. “And that's been a real blessing for a lot of patients, because the initial day or two after having surgery certainly is the most sensitive time,” Dr. DiRocco says, “and being able to have the area numb until you have your first bowel movement makes a big difference.” <br> <br> For information about hemorrhoid diagnostic tests and treatments, visit gbmc.org/colon. <div class="end-of-story"> </div>
<p class="article-body"> The holiday season can trigger depression for a number of reasons. Financial stress, family obligations and loss of a loved one can cause grief. Memories of loved ones who have passed away can be triggered at this time. The days are shorter and darker, which can result in seasonal affective disorder. <br> <br> And this year, there’s the added stress of coping with the coronavirus pandemic. How do we celebrate the holidays while practicing social distancing? Well, there’s video chat, but that’s not nearly the same. <br> <br> “Depression feeds on isolation,” says Karin Mirkin, MD, a board-certified family medicine physician at GBMC Health Partners Primary Care – Perry Hall. COVID-19 and social distancing have caused a significant spike in depression symptoms and anxiety found in patients coming into the primary care practice at Greater Baltimore Medical Center, she adds. <br> <br> “People who weren’t depressed before, now are being diagnosed, so we help get those people into therapy,” says Dr. Mirkin. <br> <br> The uptick is widespread. Earlier this year, the Centers for Disease Control and Prevention (CDC) conducted a survey assessing the impact of coronavirus on mental health. The findings estimated that the prevalence of depression in June 2020 was approximately four times more than reported in the second quarter of 2019 (24.3% versus 6.5%). This is a significant rise, and can partially be attributed to the impact of COVID-19. <br> <br> </p> <h3> A common illness with a stigma </h3> Major or clinical depression is the most common mental health condition in the U.S., and it’s also the most common mental health condition among people who come into the primary care offices at GBMC, says Dr. Mirkin. <br> <br> Primary care physicians (PCPs) can treat mild to moderate depression and anxiety. If there’s anything more severe, the PCP will refer patients to a psychiatrist and/or a therapist. <br> <br> In 2017, 7.1% of all U.S. adults had at least one depressive episode — that's roughly 17.3 million adults, reports the National Institute of Mental Health. <br> <br> Yet the stigma remains. <br> <br> “We have to remember that the brain is part of the body,” Dr. Mirkin says. “It’s an organ, so the same way that your liver can dysfunction or your skin can have an outbreak, your brain can dysfunction when something’s out of balance, too.” <br> <br> <h3> How to recognize depression symptoms in yourself and others </h3> The two telltale signs to look out for are having depressed moods more days of the week than not and losing interest in doing things that previously were deemed enjoyable, says Dr. Mirkin. <br> <br> Other signs and symptoms include changes in appetite and sleep, feelings of worthlessness, lack of energy and fatigue, difficulty concentrating, as well as withdrawing from friends and loved ones.“Irritability can be a presenting symptom of depression or anxiety,” she says. <br> <br> Depression can cause suicidal thoughts — the brain’s way of asking for help and signaling it’s time to see a doctor. <br> <br> How can you encourage someone to get help? Reassure the person (or yourself), letting them know they are cared for and they don’t have to live in melancholy and sadness. With the right treatment, people can feel better and live a happier life, but taking the first step to healing can be the hardest part. <br> <br> <h3> How GBMC can help </h3> Around June of this year, GBMC implemented the Collaborative Care Model for treating mental health more holistically with a coordinated team. The model is part of the primary care offices and uses a collaborative approach, meaning GBMC counselors and psychiatrists work together on patients’ treatment plans and overall progress. In some cases, the psychiatrist will advise on medication. <br> <br> Depression can sometimes be caused by physiologic disorders, so those need to be ruled out before recommending a treatment solely based on behavioral health. <br> <br> Typically, patients meet with a therapist weekly or every other week for therapy sessions. But under the Collaborative Care Model, patients receive counseling in shorter, more frequent sessions, depending on their level of need. Patients pay a monthly co-pay rather than paying per session, making therapy more affordable and accessible. <br> <br> “It's like having a behavioral health coach who might give you homework to do. It's more goal-oriented, and the studies show that this type of approach is more effective to treat depression and help people get better faster,” Dr. Mirkin says. <br> <br> <h3> Coping tips and techniques </h3> If you feel sudden sadness or feelings of grief, experts recommend these coping strategies: <br> <ul> <li> Reach out to others. </li> <li> Do activities that you like to do, within the realm of COVID-19 safety precautions. </li> <li> Get moving. Exercise releases feel-good hormones, called endorphins, which can help stave off depression. </li> <li> Eat a healthy and well-balanced diet. </li> <li> Speak with your PCP about your symptoms so they can recommend a treatment plan. </li> </ul> For more information about family medicine, mental health or to schedule an appointment, visit <a href="/node/2531">www.gbmc.org/mydoctor</a>. <div class="end-of-story"> </div>
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