<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>
<figure class="image-full"> <img src="/sites/default/files/hg_features/hg_post/953b12be9f0d8162ac038275196a9d4f.jpg" alt="Ophthalmology, eye care graphic"> </figure> <div class="end-of-story"> </div>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/32qgK70S3-I" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> Stuffing, gravy, pie, cake, cookies, and candy. It can be a challenge to eat healthy during the holidays, but Jana Wolff, RDN, LDN, Director of Nutrition at GBMC’s Bariatric Surgery and Comprehensive Obesity Management Program, has some great advice to help you enjoy the holidays (even the cookies!) while making healthier eating choices. She talked with Ashley James, anchor of WMAR-2 Good Morning Maryland, about healthy swaps for holiday favorites, where to find healthy recipes, and why she doesn’t believe in “forbidden foods.” <br> <br> “While many people do gain weight during the holidays, making goals that focus on losing a certain number of pounds often just end up with people frustrated and hungry,” Jana said. “This holiday season, instead of making number-based goals, try setting action-based goals. Work to increase the amount of exercise you get, eat more fruits and vegetables, and try mindful eating. Then the numbers in terms of lost pounds will follow.” <br> <br> Mindful eating can be especially helpful when you’re faced with lots of holiday treats. Rather than just popping food in your mouth without thinking, mindful eating focuses on slowing down and listening to your body’s hunger and fullness signals. It’s also important not to skip meals so you can eat more later in the day. What usually happens is that by dinner time, you’re starving and overeat. <br> <br> “I don’t think there’s value in denying yourself certain foods,” Jana explained. “There really are no ‘forbidden foods.’ It’s about moderation. Anything can fit into your eating plan; you just need to moderate the amount of that food that you eat.” <br> <br> For people who are looking for healthy recipe options, she recommends <a href="https://www.skinnytaste.com/" target="_blank">Skinny Taste</a>, <em>New York Times</em>, and <a href="https://www.eatright.org/food/planning-and-prep/recipes" target="_blank">Eatright.org</a>. And if you want to lose weight, Jana says to remember that change takes times. A good first step is to keep a food log so you know what you’re eating, then talk with a dietitian who can help you make an eating plan that you can stick with for life. “Diets are a short-term solution,” she said. “What you want to do is to make changes you can live with for the long term. It’s those consistent changes that make the difference.” </p>
<p class="article-body"> Lung cancer is the <a href="https://www.cdc.gov/cancer/lung/statistics/" target="_blank">second-most common cancer</a> and the leading cause of cancer death in the United States. November is Lung Cancer Awareness Month, and Jennifer L. Sullivan, MD, FACS, says the number one risk factor for lung cancer hasn't changed in years. <br> <br> "Smoking cigarettes is still considered the most significant risk factor," Dr. Sullivan says. "After that, it becomes harder to pinpoint the cause, but it's usually environmental exposure like secondhand smoke and chemical exposures, such as radon and asbestos." <br> <br> <a href="https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm" target="_blank">The CDC reports</a> that people who smoke cigarettes are 15 to 30 times more likely to get lung cancer or die from lung cancer than people who do not smoke. <br> <br> Like other cancers, the earlier lung cancer is detected, the better chances are for survival and recovery. Dr. Sullivan says the problem is that lung cancer is hard to detect early. <br> <br> "You don't really know you have lung cancer until it's far advanced and you get symptoms," she says. "It's rare to have an early-stage lung cancer showing symptoms because of where it's located in your lungs. Most lung cancers are picked up by a screening for something else." <br> <br> Lung cancer-specific screening has only been widely available since 2010 for certain patients based on their age and smoking history. New recommendations from the U.S. Preventative Services Task Force (USPSTF) could broaden the recommendations and save thousands of lives. <br> <br> "The recommended revision that's in progress would lead to 2 million more people becoming eligible for screening and could result in 3,000 more people catching and treating their lung cancer early," Dr. Sullivan says. <br> <br> The new guidelines would lower the screening age from 55 to 50 and the smoking history threshold from a 30-pack year (the equivalent of a pack a day for 30 years) to a 20-pack year. The American Cancer Society is currently reviewing the recommendations and is expected to update their lung cancer screening guidelines by the end of 2020. <br> <br> Dr. Sullivan is thrilled about the update but adds it's still up to the patient to schedule their screening – a potentially life-saving move. <br> <br> "There are a lot of people eligible for screening who don't take advantage, and the earlier we treat lung cancer, the better. Catching cancers early works," she says. <br> <br> Dr. Sullivan encourages anyone who is eligible for screening to make an appointment. While she understands some people may be nervous about being screened or treated at a hospital with COVID-19 still prevalent, she notes GBMC is following every protocol and standard to keep patients safe. This includes proper PPE use, testing and screening before any procedure. <br> <br> "I performed surgery at the height of the pandemic because a patient wanted their cancer out, and we're now scheduling surgeries regularly. GBMC has great control and planning to get patients through their screening or surgical process without exposure," Dr. Sullivan says. <br> <br> Learn more about lung cancer screening and treatment options available at GBMC at <a href="/node/5822">www.gbmc.org/lung</a>. </p> <div class="end-of-story"> </div>
<p class="article-body"> Pancreatic cancer has come to the forefront of many people’s minds since several high-profile celebrities succumbed to the illness, most recently “Jeopardy!” host, Alex Trebek, and Supreme Court Justice, Ruth Bader Ginsburg. It has gained a reputation for being one of the most dangerous cancers because it is so difficult to detect and treat. <br> <br> Unfortunately, pancreatic cancer rarely shows symptoms until it is very advanced or has spread to other parts of the body. While the disease presents itself differently in every patient, there are several common risk factors for pancreatic cancer to look for: </p> <ul> <li> Tobacco use </li> <li> Chronic pancreatitis </li> <li> Obesity </li> <li> Exposure to certain chemicals </li> <li> Age </li> <li> Family history of pancreatic cancer </li> <li> Inherited genetic syndromes </li> </ul> Unlike breast or colon cancer, pancreatic cancer has no standard screening for people of average risk. Researchers have not been able to find a test that reliably identifies pancreatic cancer and doesn’t flag other non-related and potentially benign issues. This is why it is critical to address any symptoms with your doctor. Symptoms of pancreatic cancer include, but are not limited to: <ul> <li> Abdominal pain </li> <li> Fatigue </li> <li> Loss of appetite or unintended weight loss </li> <li> Jaundice (yellowing of your skin and the whites of your eyes) </li> <li> Diarrhea </li> <li> Dark-colored urine </li> <li> New diagnosis of diabetes or existing diabetes that's becoming more difficult to control </li> </ul> If pancreatic cancer is found, it is important to seek treatment from an experienced team of experts. “It’s not one of the more common cancers that we see,” explained Kruti Patel, MD, radiation oncologist at the Sandra and Malcolm Berman Cancer Institute at GBMC. “Pancreatic cancer is complex, and it is paramount that each patient’s case is evaluated by a multi-disciplinary oncology team that has experience in treating this disease.” <br> <br> The pancreas is positioned deep within the body and is next to other critical organs like the liver and bowel. This can make surgery and recovery difficult for patients. In addition to surgery, other available treatments include radiation, chemotherapy, and immunotherapy. Gang Chen, MD, PhD, medical oncologist and hematologist at the Berman Cancer Institute, described how the team develops a treatment plan that is tailored to each patient. “We look at each person’s tolerance to different kinds of treatment and the extent of their disease. Some patients are not good candidates for surgery, but advances in chemoradiation have allowed us to deliver the treatment that is less difficult on the body.” The same cancer may be managed differently in different patients based on what is best for the individual as a whole. <br> <br> While there is still much to learn about screening and treatment, recent progress in next generation sequencing giving doctors hope that there will come a time when a pancreatic cancer diagnosis is not so devastating. To learn more about resources available to cancer patients and their families at The Sandra and Malcolm Berman Cancer Institute, visit <a href="/node/2190">www.gbmc.org/cancer</a>. <div class="end-of-story"> </div>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/DTZSrqvNGew" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> At the beginning of the COVID-19 pandemic, many people delayed medical care out of fear of being exposed to the virus. Unfortunately, this led to patients not receiving the care that they needed. In this episode of Greater Living Live, Mark Fisher, MSN, RN, CEN, TCRN, Senior Nurse Manager of Emergency and Pediatric Services at GBMC, spoke with Mary Beth Marsden to explain the current situation in the Emergency Department (ED) and provide advice for when people should seek emergency care. <br> <br> “When the pandemic began, everyone was fearful of the unknown, but as we’ve gone through this, we’ve learned much more about the virus,” said Mark. “The additional information has given people some comfort and we are seeing people return to receive typical emergency care.” He recommended coming to the ED if you develop sudden or unexplained new symptoms. Mark explained that if you begin experiencing symptoms that you’ve never had before, it is important to seek care immediately because it could be a sign of a serious health event. Other symptoms that call for emergency care include: </p> <ul> </ul> <li> Shortness of breath </li> <li> Chest or upper abdominal pain or pressure </li> <li> Fainting or sudden dizziness </li> <li> Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body </li> <li> Sudden changes in vision </li> <li> Confusion or changes in mental status </li> <li> Any sudden or severe pain </li> <li> Uncontrolled bleeding </li> <li> Severe or persistent vomiting or diarrhea </li> <li> Coughing or vomiting blood </li> <li> Suicidal thoughts </li> <br> While patients are once again seeking care, some are still hesitant to call 911 and would prefer to drive themselves to the ED in order to reduce potential exposure to COVID-19. When asked whether it is better to come to the ED in an ambulance or to drive yourself, Mark responded “We want people to use their own judgment, but emergency medical personnel can begin care sooner than you would receive it if you came to the hospital yourself. If you’re having symptoms that could be signs stroke or cardiac issues, I would strongly recommend calling 911 because they can start interventions sooner and time is of the essence.” <br> <br> If you choose to drive yourself to the ED, <a href="/node/2209" target="_blank">MyChart</a>, GBMC’s patient portal, has a new feature called “On My Way” that will notify the ED that you are coming. This allows staff to begin processing patient information and streamline your care when you arrive. “We’re very excited about the innovation that is happening in emergency care,” Mark expressed. “The app can also recommend that you call 911 if your symptoms require immediate care.” <br> <br> The GBMC ED was recently renovated to better serve patients and improve efficiency. “The frontline ED staff, the infection prevention team, and GBMC’s safety team were able to provide input and make this renovation as effective as possible,” explained Mark. GBMC also continues to follow public health guidelines to keep patients safe. In addition to frequent cleaning and mask wearing, the ED has put in place visual cues, like signage and floor stickers, to aid with physical distancing and educate patients on safety best practices. “Please don’t put off getting care if you need it. If you feel like you’re having an emergency, call 911 or come to the ED right away,” said Mark. “We are still here for you.”
<figure class="image-full"> <img src="/sites/default/files/hg_features/hg_post/43846e54edc4e15959990412b64ce047.jpg" alt="Pediatric Vaccination graphic"> </figure> <div class="end-of-story"> </div>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/LZpgY1maY8k" allowfullscreen="allowfullscreen"></iframe>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/DxycLSFHSGU" allowfullscreen="allowfullscreen"></iframe>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/rjqwIOyCWEI" allowfullscreen="allowfullscreen"></iframe>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/cfHsvkNdosA" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> You know how tired you feel when you don’t get a good night’s sleep, but did you know that sleep problems can have a big impact on your overall health? Stephanie Wappel, MD, a sleep and pulmonary medicine physician at GBMC Health Partners Pulmonary & Sleep Medicine, talked with Good Morning Maryland’s Ashley James about the importance of sleep and what steps you can take if you have sleep issues like insomnia or sleep apnea. <br> <br> “Sleep is not an on/off switch,” explained Dr. Wappel. “Sleep is an extension of our waking lives. It impacts our health in many ways, affecting our immune system, memory, emotions, ability to learn and retain information, gastrointestinal health, and even our hearts and lungs. That’s why getting an adequate amount of good quality sleep is so important.” <br> <br> Dr. Wappel shared her advice on how to fall asleep and stay asleep. The most important thing you can do is to keep a consistent bedtime and wake up time, even on the weekends. Other tips include waiting until you’re sleepy to get in bed, developing a calming bedtime routine that starts about a half hour before you head to bed, and avoiding activities that make you more alert like eating, socializing, and screen time right before bedtime. <br> <br> Most adults need between seven and nine hours of sleep per night. Studies have found that getting less or more sleep than that recommended amount can harm your heart. Asked about natural remedies for sleep problems like melatonin, chamomile, and valerian, Dr. Wappel said that before you try supplements, you should shape up your sleep hygiene and bedtime habits. <br> <br> “Make sure you’re sleeping in a quiet, dark, cool room,” she said. “No television should be on. If you need background noise to fall asleep, there are white noise machines and apps you can try. The blue light from the television is the same blue light produced by the sun, so it tricks our brains into believing it’s daytime and promotes wakefulness.” <br> <br> If you’re having sleep problems like ongoing insomnia or loud snoring that could be caused by sleep apnea, talk with your primary care physician who can start the process of figuring out the underlying cause of your issues and refer you to a sleep specialist if necessary. “We live in a 24/7 culture,” added Dr. Wappel. “There’s always something to watch or do, and we don’t always respect our bodies’ need for sleep, but sleep is an essential part of a healthy life.” </p>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/6UnfVNs3zy8" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> Christine M. Helou, MD, a board-certified gynecologist at GBMC, explains uterine fibroids and when to seek help for this potentially painful condition. </p>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/q-AoeRMSCio" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> With attention understandably focused on the COVID-19 pandemic, there might be an important thing you haven’t gotten around to yet — getting your annual flu vaccine. Mary Beth Marsden talked with Sahayini Kumar, MD, an internal medicine specialist with GBMC Health Partners, about why it’s especially important to get your flu vaccine this year, what chronic health conditions increase your risk of getting seriously ill from the flu, and how GBMC is making it easier than ever to get your flu shot. <br> <br> “October is the best month to get your flu shot, but it’s not too late to still get tremendous benefit from getting vaccinated,” explained Dr. Kumar. “Last year there were 38 million cases of the flu in the U.S. with 400,000 people hospitalized. But data showed that 7.5 million flu cases were prevented by people getting the flu shot.” <br> <br> Flu can be especially dangerous for people with chronic health conditions including heart disease, diabetes, asthma, and COPD. Dr. Kumar also said that with the ongoing COVID-19 pandemic, getting a flu shot can help keep serious flu cases at a lower level so hospitals dealing with an increasing number of COVID-19 patients won’t be overwhelmed. <br> <br> There are different types of flu vaccine, including a higher dose vaccine for older people whose immune systems are not as strong and a nasal mist that may be easier for young children who are anxious about injections. All versions of the vaccine, however, contain the same four strains of the virus, which is killed or weakened. Because the flu virus mutates every year, the vaccine is updated annually to include the strains of the flu that are most likely to be prevalent, which is why you need to get the vaccine every year. <br> <br> To make getting your flu shot as easy as possible, GBMC is offering <a href="/node/3491" target="_blank">drive-in flu shots</a> through November 14. No need to go to the doctor’s office or pharmacy or even get out of your car! Ask your primary care physician how to make a drive-in flu shot appointment or make your appointment on the MyChart app. “You’re not just doing this for yourself. Even if you’re young and healthy, get the shot to protect others in your family and community who are at greater risk of complications from the flu,” advised Dr. Kumar. </p>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/qRkvPRfca64" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> Most people are familiar with the flu vaccine, but did you know there’s also a vaccine that protects against pneumonia? Jerrica Mueller, MD, an internal medicine resident at GBMC, talked with Mary Beth Marsden about why people with certain health problems are at greater risk from pneumonia and who should get the pneumonia vaccine. <br> <br> “While most cases of pneumonia are treated on an outpatient basis, some people get sicker and require treatment in the hospital,” Dr. Mueller explained. “Your age and whether you have other chronic health problems affect your risk of experiencing complications from pneumonia. Children under the age of 5 and adults over 65, for example, have less robust immune systems, so they’re at an increased risk. And people with conditions that weaken the immune system or the lungs, such as diabetes, COPD, and asthma, are also at a greater risk as well as people who smoke.” <br> <br> The pneumonia vaccine can help lower that risk. It’s recommended for everyone 65 or older as well as younger people with one of the chronic conditions, Dr. Mueller mentioned. Unlike the flu shot, you only need to get the pneumonia vaccine once if you get it when you’re 65 or older. <br> <br> Side effects from the vaccine are usually mild and may include tenderness and swelling at the injection site, low grade fever, and fatigue that only last a day or two. “Talk to your primary care physician to find out if you should get a pneumonia vaccine,” said Dr. Mueller. “The good news is that the cost is 100% covered by Medicare and most commercial insurance plans.” </p>
<iframe class="embed-responsive-item" src="https://www.youtube.com/embed/R8Q3LwVL6ko" allowfullscreen="allowfullscreen"></iframe> <p class="article-body"> As companies around the world work to develop a safe, effective vaccine to protect people from the COVID-19 virus, it’s important not skip other essential vaccines that help protect your family from serious, preventable illnesses including the flu, pneumonia, shingles, measles, and more. Joseph Fuscaldo, MD, Medical Director of Clinical Quality at GBMC, talked with Mary Beth Marsden about why now, more than ever, it’s important for people to make sure they’ve received the recommended vaccines, how vaccines work, and when a COVID-19 vaccine may be available. <br> <br> “Vaccines help the body mount a stronger immune response to certain viruses and bacteria, protecting people from what can be life-threatening illnesses,” Dr. Fuscaldo explained. “They can be especially important for people whose immune systems are not as strong as a healthy person’s, like older people. People often forget that just 150 years ago, our life spans were shorter due to infectious diseases that we have now essentially eradicated with vaccines, including smallpox and polio.” <br> <br> He talked about the reasons people give for not wanting to get a vaccine, from worry that it will be painful to concern about contracting the disease from the vaccine. “There is no way to get infected with the disease from the vaccination,” he said. “Some people experience minor symptoms like a low-grade fever, but that is in fact the body’s immune response to the vaccine. All FDA-approved vaccines are carefully evaluated for safety and effectiveness through clinical trials. I am a staunch believer in vaccines and only recommend to others what I recommend for my own family.” As for a vaccine to prevent COVID-19, Dr. Fuscaldo said the current plan once a vaccine is approved by the FDA is for frontline employees to receive it first, since they are more at risk of exposure to the virus. “I’m confident that neither safety nor quality will be comprised during the approval process. When Dr. Fauci says a safe, effective vaccine is available, I’ll roll up my sleeve,” he added. </p>
