- Infectious DiseaseGeneral Page Tier 3BlogTelehealth visits (also referred to as virtual visits, virtual consultations or telemedicine) are a great way to stay connected with your doctors from just about anywhere via a screen — like a computer, tablet or cell phone — instead of trekking to a medical office. Many chronic conditions and minor illnesses can be handled through a telehealth visit, including: Chronic disease guidance Dermatology care Medication management Mental health counseling Nutrition counseling Prescription refills Urgent care (sinusitis, back pain, urinary tract infections, common rashes, etc.) Wellness and general health information With the coronavirus pandemic in full swing, millions of people have found virtual visits to be a very convenient and effective way to stay in touch with their healthcare providers. Planning a telehealth visit? Download this handy checklist to help you prepare. A little prep goes a long way Know what you’ll need for your conversation with the doctor Taking the time to gather a few important items before your visit will help your virtual visit run smoothly and will allow you make the most of your time with your physician: Medication bottles: Those medication names can be real tongue-twisters. So, it’s best to let your doctor see the bottles and labels for each medication you take. That will ensure there are no mix-ups and clarify all medication names and dosage. Paperwork: Just like any medical visit, your insurance, medical history and other forms must be completed. Your doctor’s office can tell you if any forms on file need updating. Pen and paper: You’ll want to take notes while you talk to your doctor. Also, jot down your questions beforehand; it’s only natural to forget a question or two. Test results: If you’ve had any screening tests recently, make sure your doctor has the results prior to your visit. If you’ve done any home monitoring tests (like glucometer or blood pressure readings), it’s important to have those numbers on hand. Set up and test your equipment ahead of time If you’re new to virtual meetings, it’s essential to make time to get your device set up and ready to go. You might try a test with a friend, a quick check to make sure your doctor will get a clear picture and hear you well. Here are a few important reminders: Charge your device: Making sure your device is fully charged will help ensure your time with the doctor isn’t interrupted. Check your internet connection: If you’re using Wi-Fi, get the best signal you can. You may need to position yourself close to your internet router and/or close down other devices to improve your connection. Check your laptop, phone or tablet: Make sure video/camera and audio access has been enabled — and check the volume. Consider your lighting: Is your space private, quiet and well-lit? If you’re in front of a window, the bright light might shadow your face. Make sure your face is centered and your webcam is at eye level. Log on a few minutes early: This can help check for (and fix) any technological problems beforehand so you don’t delay your appointment. Why patients (and doctors) like telehealth visits During the pandemic, virtual visits went from being an item on our lists of things to try someday to becoming a necessity. And the benefits became clear, quickly: These visits helped us reduce exposure to COVID-19 while still getting the ongoing medical care we need. Even after we have coronavirus well under control, it’s likely doctors and patients alike will continue to enjoy the benefits of telehealth. After all, we’re much more comfortable with it now. Telehealth allows you to: Access medical specialists easily Address health issues without leaving home Save time off of work See your doctor quickly, possibly the same day We’re here, whenever and wherever you need us Telehealth visits are intended to help you get the medical attention you need without driving to see your doctor, risking exposure to contagious illnesses or spending time in a waiting room — especially if you aren’t feeling well. If you’re not sure about using your computer or cell phone for a telehealth visit, feel free to reach out to your provider’s office. They’ll be happy to walk you through the process, step by step, over the phone. Just remember: You aren’t the first to ask questions about telehealth visits. Our experts can explain it to you clearly, so you’ll feel comfortable. Authors Andrew McGlone, MD, is a physician with Anne Arundel Medical Group Annapolis Primary Care. You can reach him at 443-481-1150. Sufia Syed, MD, is an internal medicine physician at Doctors Community Practices at Laurel.0
- Infectious DiseaseGeneral Page Tier 3BlogWearing a mask is becoming optional for students in many parts of the country. Recently, Maryland lifted its statewide mask mandate for schools. This comes on the heels of the Centers for Disease Control and Prevention (CDC) easing mask recommendations under a new protocol to monitor COVID-19 and parents may be looking for ways to talk to their child or teen to help manage masking expectations. The new guidelines classify the country into low, medium and high levels of disease to provide individuals with an understanding of what precautions they should consider based on the level of disease in their community, their underlying risk, and their own risk tolerance. With most children ages 5 and older now able to get COVID vaccines, students have more protection from the virus than they had when the school year began. And because new COVID-19 cases and virus-related hospitalizations have fallen significantly following the Omicron surge, school districts are providing new guidance for masking that may leave some kids and teenagers uncomfortable, while others may be jumping for joy. Still, the risks COVID poses haven’t been eliminated. And for some people those risks are higher than others. When it comes to masking, it’s up to you to decide what’s best for your family based on your circumstances. Help your children understand the reasons behind your decision and emphasize the importance of respecting each family’s decision. It’s an important conversation — and that’s why we are weighing in with some helpful tips. When You Want Your Child or Teen to Continue Masking Up In general, COVID-19 is milder in children and teens than adults. However, certain medical issues, including diabetes, obesity and cancer may put kids at risk for more severe COVID disease. If your child has any of these conditions — or if someone in your household is at risk and your child could bring COVID home to them — you may, understandably, want your child to continue to wear a mask. Some parents have expressed concerns about how their children may be treated if they continue masking when most students go mask-free. And let’s be honest: Children can be cruel. It’s not unusual for kids to bully those who make different choices. And many times, kids feel pressured to conform. It’s important to remember that the COVID pandemic has been traumatic to everyone, and kindness is necessary for all of our healing. A heartfelt conversation with your child or teen may make things easier. Here are some tips: In an age-appropriate way, explain why wearing a mask is important and how it can help protect them and others. But try not to cause them to worry. Just help them understand why masking up is the right thing to do. Invite your child or teen to talk with you about their concerns or fears about continuing to wear a mask. Try to be understanding and to offer guidance on how to respond if your kids feel peer pressure. Make it clear that you’re trying to do what’s best for everyone in your family, just as other parents are trying to do what’s best for theirs — even if their choices are different. Remind your child or teen to tell someone if they feel bullied. And don’t hesitate to take concerns about bullying to school officials. It’s their goal to create an environment where everyone feels comfortable and safe. Set a good example. Wear your own mask when you’re in public or around other people. When you’re with your child or teen, avoid being critical of others who go without masks. When You Allow Your Child to Go Mask-Free If you decide it’s OK for your child or high schooler to attend school without a mask, all the same principles should apply to the conversation, including: Advising your child to be respectful of others who continue to wear masks. Explain that while you may feel it’s best for your child to go mask-free, other children have good reasons for masking — and no one should make them feel bad about it. Encouraging your child to stand up for kids if others are bullying them. Tell your child they can help by alerting a trusted adult. Remind your child that no one should judge another person because they’re different. Keep COVID Safety In Mind Of course, it’s also important to remember that while masks are now optional, COVID isn’t over. Everyone must continue to be cautious. Along with following CDC guidelines concerning vaccinating your child, it’s important to: Avoid letting your child be around others who are sick. Be on the lookout for COVID symptoms for at least 10 days if your child has close contact with someone who has COVID-19. If they’re up to date on their vaccine, there’s no need for them to quarantine. But if they’re not, they should stay home for at least five days. They should get tested for COVID at least five days after their contact even if they don’t have symptoms. Keep your child home from school and away from others if they develop COVID symptoms. Try to get them tested right way. And make sure they wear a mask around others in your home. Make sure to follow CDC guidelines for caring for someone with COVID if your child is diagnosed with the disease. By taking precautions, you’ll help keep your child and others safe. Authors Betina Franceschini, MD, is a pediatric hospitalist at Luminis Health Anne Arundel Medical Center’s Pediatric Emergency Department.0
- PediatricsGeneral Page Tier 3BlogAnother school year is here, and parents may ask, “Does my child need immunizations this year?” Immunizations are important because they keep our children safe, protecting them from certain infections and their complications by limiting the spread of illness. Kids usually receive immunizations when they see their pediatrician for an annual back-to-school wellness check-up. It’s a great time for your doctor to check your child’s progress and development and detect any potential problems. A child receives their very first vaccination at birth, an initial dose to protect against hepatitis B. For a complete guide on what ages children should receive vaccines, the CDC’s 2022 update of the “Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger,” is an excellent resource. Keep in mind that teenagers need immunizations, too. Each state decides which vaccines are required for your child’s enrollment and attendance at a childcare facility or school in that state. Polio Returns to the United States In July, the CDC reported a case of polio in an unvaccinated person in Rockland County, New York—the first case in nearly a decade in the United States—and the virus has been detected in that county’s wastewater. Polio is very contagious and can cause paralysis and even death. The CDC recommends children get four doses of polio vaccine, starting at two months. Keep track of your children’s vaccine record since the school where your child enrolls may require proof of vaccination. You can do this through your pediatrician’s office. Most electronic health records (EHRs) feature a patient portal to easily access or download this information. At Luminis Health, that portal is called MyChart. COVID-19 Is Here to Stay The recent appearance of polio in the U.S. has not reduced the importance of the COVID-19 vaccination for children. More than 1 million Americans have died from the virus, and almost 93 million cases have been reported. “We know that COVID-19 is here to stay,” a CDC epidemiologist said at a mid-August news briefing. The CDC recommends the COVID-19 vaccine for everyone six months or older, and boosters for everyone years and older, if eligible. COVID-19 vaccinations for children are safe. The known risks of COVID-19 and possible severe complications outweigh the potential risks of having a rare, harmful reaction to the vaccination. “The vaccines meet the Food and Drug Administration’s rigorous scientific standards for safety, effectiveness, and manufacturing quality,” says the CDC. They also undergo the most intense safety monitoring efforts in our country’s history. Children 6 months to 4 years need a three-dose primary series—initial doses—of Pfizer-BioNTech, or two doses of Moderna. For kids 5 – 17 years, it’s two doses of both Pfizer-BioNTech and Moderna. The CDC says moderately or severely immunocompromised children ages five through 17 years will need a third dose to complete their primary series, then boosters if they’re eligible. Children and teens with a weakened immune system should get one booster for ages five through 11 years and two boosters for ages 12 years and older. Remember that the COVID-19 vaccine can cause short-term side effects such as headache, low fever, or flu-like symptoms.0
- Cancer Care, Women's HealthGeneral Page Tier 3BlogOver the past 15 years, rates of new breast cancer have remained stable. However, breast cancer deaths have steadily declined, driven by improvements in many aspects of breast cancer care. The good news is that better treatment doesn’t necessarily mean treatment that is more aggressive. In fact, during the same time period many breast cancer treatments have scaled back, and specialists are working hard to find even more ways to treat less while delivering better results. Here are just a few ways breast cancer treatment has scaled back over the past decade: Fewer lymph nodes removed. Most women with breast cancer need surgery to check the lymph nodes in the underarm for cancer cells. Usually, the surgeons will remove the first lymph nodes in a larger ‘web’ of lymph nodes under the arm. In the past, if any of the first lymph nodes had cancer, surgeons would remove all of the remaining lymph nodes as well. Unfortunately, the more lymph nodes that are removed, the higher the risk of side effects, such as swelling of the arm from backed up fluid. A few years ago, researchers proved that many women with cancer in the first lymph nodes do not need the remaining lymph nodes removed. As a result, surgeons are performing far fewer extensive lymph node surgeries, which has led to fewer complications for women with breast cancer. Less radiation. In the past, women who had a lumpectomy needed six or seven weeks of radiation afterward to treat the rest of the breast. More recently, however, many women have options for less radiation treatment, sometimes taking as little as one week. Targeted medical therapy. Medications particularly targeted at a more aggressive form of breast cancer, known as HER2 positive cancer, have dramatically improved survival. At the same time, women who receive these targeted treatments do not need as many chemotherapy drugs, so they experience fewer serious side effects. These and other improvements in breast cancer treatment are possible because of scientific research studies. Locally, specialists at the Rebecca Fortney Breast Center at Anne Arundel Medical Center (AAMC) are also engaged in research to find ways to provide better care, while at the same time decreasing the side effects of treatment. Here are some of the exciting ways that research studies are moving breast cancer treatment forward today: Exploring the possibility of doing no surgery for some breast cancers that have shown excellent response to chemotherapy. Some women with breast cancer benefit from receiving chemotherapy before surgery. Sometimes, chemotherapy can shrink a tumor so that the patient requires less surgery. On occasion, the final microscopic analysis of the breast tissue removed after chemotherapy will even show that no cancer cells are detectable. If doctors could accurately predict which tumors would have no remaining cancer after chemotherapy, some breast cancers that show excellent response to chemotherapy might not need surgery at all. These women might be treated with chemotherapy and radiation alone. Although the approach of not having surgery would not be safe today, research studies are underway to determine if and when an approach of no surgery might be appropriate. Ultrasound to do less extensive lymph node surgery. Ultrasound, or sonogram, is a technique used to diagnose breast cancer in the lymph nodes before surgery. AAMC breast surgeons are studying information from ultrasound exams to tailor a patient’s treatment. Ultrasound may help to identify which patients with cancer in their lymph nodes should go to surgery, and which patients should start with chemotherapy prior to operation. For some patients, receiving chemotherapy prior to surgery may clear cancer from the lymph nodes, allowing the surgeon to remove fewer lymph nodes at the time of surgery. AAMC breast surgeons recently published research in the Annals of Surgical Oncology journal in this area in order to help specialists across the country improve their patient care. With rapid changes in the field of breast cancer care, medical decisions are complex. Talk to your doctor about which treatment option is best for you. We’ve seen amazing advances in breast cancer care in just a short time. I wonder what the next 15 years will bring? Author Rubie Sue Jackson, MD, is a breast surgeon at Anne Arundel Medical Center (AAMC). To learn more about the Rebecca Fortney Breast Center at AAMC, visit askAAMC.org/Breast. Originally published Oct. 2, 2017. Last updated Oct. 21, 2019.0
- General Page Tier 3BlogBy now, you’ve probably heard about GMOs (genetically modified organisms). But with all the talk about these harmful organisms in our food, how can you separate fact from fiction? Let’s start at the beginning. All food begins as an organism, a plant or animal with many traits. Since the dawn of agriculture, farmers have modified these traits using methods like selective breeding, cross pollination and hybridization to improve their crops. But GMOs go beyond these methods. To make a genetically modified organism, scientists select a desired trait from one living thing, copy that trait and place it in to another living thing. This process would not occur naturally. The most common GMO crops are soybeans, corn, cotton and sugar beets. Most GMO crops eventually end up on the dinner table as ingredients in the foods we eat, including everything from cereal to dessert. GMO crops are processed to become oil, sugar, starch, syrup, fiber and protein ingredients, as well as vitamins in foods and dietary supplements. Most meats, poultry, eggs, dairy products and farmed seafood contain GMOs because field corn and soybeans are used as feed for livestock. Beyond grains, most of the yeast and enzymes used to make everything from bread to cheese come from GMOs. Is non-GMO the same as organic? No. Non-GMO crops are still treated with herbicides and pesticides. Therefore, they are not organic. And the U.S. Food and Drug Administration hasn’t set any standards to regulate the use of the non-GMO label. On the other hand, certified organic products cannot include GMOs. This means farmers aren’t allowed to grow produce from GMO seeds, their animals can’t eat GMO feed and food producers can’t use any GMO ingredients. What does the organic certification mean? When you see the USDA organic seal on a food or beverage product, you’ll know it’s organic. This certification bans chemical fertilizers, synthetic substances, irradiation, sewage sludge and GMOs in the production of these products. Antibiotics and synthetic hormones are also banned in organic meat and poultry. How can you eat less GMO foods? In short, eat less processed foods. Replace processed snacks with foods that are naturally non-GMO. These include fresh fruit, vegetables, potatoes, dried beans, nuts and seeds. Consider buying only organic. Choose foods that are verified non-GMO by a third party, like The Non-GMO Project. Avoid dining out, as most restaurants don’t use non-GMO ingredients. Want to make a simple switch? The most important foods to buy non-GMO are meat, eggs, yogurt and milk. These foods are all affected by animal feed, which is often genetically modified. Are GMO foods harmful? To date, there is no solid research that shows people have been harmed by GMO foods. However, just because there’s no evidence of harm does not mean GMO foods have been proven safe. Most research hasn’t existed long enough to determine the effects of GMO foods throughout a person’s lifetime. Non-GMO and organic products are a good place to start, but if you really want a healthier diet eat more foods that don’t need a label. Fresh fruits and vegetables are the hallmark of a healthy, nutritious diet. Sources: New England Journal of Medicine: GMOs, Herbicides, and Public Health Consumer Reports: GMO foods: What You Need to Know Tufts University: Questioning GMOs To learn more about nutrition services at Anne Arundel Medical Center, visit AskAAMC.org/nutrition. Authors By Ann Caldwell and Maureen Shackelford, nutritionists and registered dietitians at Anne Arundel Medical Center. To reach them call 443-481-5555.0
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