- Women's HealthGeneral Page Tier 3BlogIf you’ve ever dreaded laughing at a good joke or sneezing for fear of an “oops” moment, then you know what it’s like to live with urinary incontinence. You may be hanging back from doing things you love, worried you can’t get to a bathroom and embarrassed about leakage you can’t control. Here’s a start to learning more about the condition — its causes and treatments — so you can see that it’s possible to get back to living your best life. Incontinence is more common than you think. An estimated 15 to 25 million Americans deal with incontinence. But it’s hard to put a firm number on it because so many people are too embarrassed to talk about it. We do know women are two times more likely than men to develop urinary incontinence — and that physiology plays a part. The structure of a woman’s internal organs, pregnancy, childbirth and menopause all have an effect. Aging does too because pelvic floor muscles that support the urinary tract muscles weaken as you age, making it harder to hold in urine — though it’s not necessarily a normal part of getting older. There are different types of incontinence. The most common types of incontinence in women are stress incontinence, urge incontinence, and a mix of the two. Stress Incontinence Stress incontinence makes having fun unpredictable. Things like laughing, dancing and exercise put pressure on your bladder, causing uncontrollable leakage. You don’t feel an urge to urinate; it just happens. Weak pelvic floor muscles or the bladder out of its normal position are usually the culprits. Urge Incontinence A “gotta go” feeling you can’t ignore is urge incontinence, or overactive bladder (OAB). OAB can happen when certain nerves and bladder muscles don’t work together. Your brain tells your body you need to go to the bathroom, even if your bladder isn’t full. That signals the bladder muscle to contract, and the sphincter — the muscle that controls urine flow — relaxes. The urge comes on suddenly, even if you’ve recently emptied your bladder, and you may not make it to the bathroom. Some people have a frequent urge to go — up to eight times a day — and then barely go when they get to the bathroom. Mixed Incontinence Having more than one type of incontinence isn’t uncommon. If you do, stress and urge incontinence are usually the two that combine and lead to leakage. You don’t have to live with it Too many people stay silent about incontinence, assuming events like pregnancy, childbirth and aging make it an inevitable part of life you have to get used to. Not true. It’s very treatable, and often with self-help methods you can do it yourself. Lifestyle Changes For some people, reducing the risk of leakage is as simple as making lifestyle changes, such as: Avoiding lifting heavy objects Avoiding liquids in the evening Limiting caffeine and alcohol, which make you produce more urine Losing weight to relieve pressure on the bladder Kegel Exercises Weak pelvic floor muscles — those that support the bladder — are often at the root of leakage problems. Kegel exercises involve strengthening the muscles that control urine flow by tightening and relaxing them. Doctors often recommend women do Kegels during pregnancy to prevent incontinency problems. You can work with a physical therapist to learn how to do Kegels effectively. Bladder Retraining Timing is everything when it comes to staying dry. Finding the sweet spot takes practice. It may involve making sure your bladder is empty to prevent the urge to go. Make a pit stop every two hours if you know the urge to go hits every 2 ½. But you may have to retrain your bladder if the urge to go too often is a problem. That involves gradually extending the time between bathroom visits. For instance, if you go to the bathroom every hour, stretch it to an hour and 15 minutes, increasing the time over a few weeks. Medications, Devices or Medical Procedures If self-help approaches don’t help, your provider may suggest other options, such as: Medications that can help relax bladder muscles or block nerve signals that cause an urge to go Vaginal inserts available over the counter can be used to reduce stress incontinence A pessary, a ring-like device your doctor fits you for to support pelvic floor muscles and reduce stress incontinence Injections of a bulking agent in tissues around the bladder to help keep the opening closed and prevent leaks Pelvic floor stimulation to nerves and muscles to strengthen them and to reduce the urge to go A sling is a small piece of synthetic material surgically placed to support the urethra to improve leaking from stress incontinence Incontinence doesn’t have to control your life. Yes, it can feel awkward to talk with your doctor about bathroom habits. But incontinence is a very treatable condition. A full evaluation with a pelvic medicine and reconstructive surgeon can help you determine the best treatment for you. Asking for help can get you back to a life free of worries about leakage. Authors Aparna Ramaseshan, MD, is a Female Pelvic Medicine and Reconstructive Surgeon (FPMRS), at the Women’s Center for Pelvic Health. To make an appointment, call 443-481-1199.0
- Cancer CareGeneral Page Tier 3BlogAccording to the American Cancer Society, prostate cancer is the second most common cancer in American men, with about one in eight men diagnosed with it in his lifetime. It may be time to schedule a prostate cancer screening if you: Are 50 years old or older Are 45 years old or older, African-American, or have a family history of prostate cancer Screening may involve a blood test called a Prostate-Specific Antigen (PSA) and a digital rectal exam to feel the prostate for abnormalities. You and your health care provider should decide together if prostate screening is right for you. If you have received a prostate cancer diagnosis, the good news is that, now more than ever, there are multiple treatment approaches for prostate cancer. The National Comprehensive Cancer Network recommends a number of treatment approaches. These range from active surveillance for lower-risk prostate cancer, to a combination of surgery and/or radiation therapy and/or systemic therapy for higher risk prostate cancer. Large studies have shown equal cure rates between these different options, depending on the situation. Your prostate cancer providers will talk to you about the risks and benefits of each option. Here are some basics about the major approaches. Active Surveillance Active surveillance (AS) means getting PSA testing and physical exams with your urologist. It is a way of keeping a close eye on your prostate cancer without actually treating it. This can be an excellent option, especially for men with lower-risk prostate cancer. About half-of men who choose this option are able to avoid treatment down the line. Ask your prostate cancer providers if AS is a good option for you. Surgery Surgery is done by your urologist, and is an excellent option especially in younger, healthy men. It typically involves removing the entire prostate, and is the only way to see what the true extent of cancer is inside the prostate. Today, the robotic assisted prostatectomy allows surgeons enhanced vision, control and precision and translates to less pain, shorter hospital stays and faster recovery. Speak to your urologist about the possible side effects of surgery and recovery. Radiation Therapy Radiation therapy (RT) is another excellent treatment option. It is non-invasive, and typically uses high-energy X-rays targeting the prostate, and sometimes additional areas around it. It is typically given daily, Monday through Friday. There are many different RT regimens, ranging from just five treatments to 44 treatments, for a wide variety of different clinical situations. You meet with your doctor every week while you are on treatment to review any side effects and to help manage them. RT is extremely well-tolerated in the vast majority of men, and serious long term complications are rare. Speak to your radiation oncologist about the possible side effects of RT and recovery. Systemic Therapy Systemic therapy is treatment that goes throughout the whole body, and can be important to reduce the chances of prostate cancer spreading outside of the prostate, especially to the bones. It is often an option in men with higher risk prostate cancer. It is typically given in the form of androgen deprivation therapy (ADT), sometimes called “hormonal therapy”. This therapy comes in different forms, and decreases your testosterone levels, which actually helps prevent the prostate cancer from spreading. In recent years, certain types of ADT have shown newly-discovered benefits, especially in men with high-risk prostate cancer. It can be given over a period of 4 months, up to even three years, depending on the clinical situation. Ask your prostate cancer providers if ADT can benefit you. Making your decision So, what treatment might be the best for you? It can be a complicated decision. Your doctors will help you weigh the risks and benefits of these different approaches to prostate cancer to help you decide which is best for you. If you or a loved one have received a prostate cancer diagnosis, the cancer specialists at Luminis Health are available to meet with you to discuss treatment options. Call us at 443-481-5800 to schedule a consult. Authors Antony Koroulakis, MD, is a board-certified radiation oncologist at Luminis Health.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
- Patient StoriesGeneral Page Tier 3BlogThis week, Luminis Health Anne Arundel Medical Center (LHAAMC) welcomed our oldest surgical patient in the hospital’s history. Mary Saxe is 109 years old and recently moved to the Annapolis area to live closer to her son and daughter-in-law. After breakfast with friends, she suddenly lost balance and fell on her right side. She was quickly brought to LHAAMC for evaluation and medical staff determined her fractured hip would require surgery. Dr. Bigby performed a partial hip replacement on Mary’s right hip. “Everyone has been so kind,“ she said of her medical team. “They’re taking good care of me while I’m here.” “On behalf of the entire JSU team, it was an honor to care for Mary after her hip surgery,” said Eve Sage, Clinical Director, General Surgical Unit & Joint and Spine Unit. “Mary’s wit, words of wisdom and appreciation for life filled our hearts.” “We were so impressed with the level of care, professionalism and services that our mother received at LHAAMC,” said Charles Saxe, Mary’s son. “She was in good hands.” In the coming days, Mary will begin rehabilitation. “People always ask me to share my secret to aging well,” Mary said. “I have no secret at all. The only recommendation I have is to keep moving. Keep moving as much as you can, as long as you can.” Thank you to the entire LHAAMC team for their expert care as Mary recovers!0
- Plastic Surgery & Skin CareGeneral Page Tier 3BlogThe dog days of summer have arrived and, fittingly, August is Summer Sun Safety Month. For many, it is the peak season to be outside having fun in the sun. But along with the heat and late summer sunshine comes the importance of remembering to stay hydrated and remain diligent about sunscreen application. The Importance of Sunscreen Sunscreen helps prevent skin damage from the sun’s powerful ultraviolet (UV) rays, which can lead to skin cancer, discoloration and wrinkles over time. There are two types of UV rays: Ultraviolet A (UVA) has a longer wavelength. It is associated with skin aging. Ultraviolet B (UVB) has a shorter wavelength. It is associated with skin burning. While UVA and UVB rays differ in how they affect the skin, they both can harm you. Unprotected exposure to UVA and UVB damages the DNA in skin cells, producing genetic defects, or mutations, that can lead to skin cancer and premature aging. UV rays can also cause eye damage, including cataracts and eyelid cancers.Everyone should wear sunscreen daily, year-round. UV rays and sun damage do not discriminate and can cause harm to people of all races and colors, even in the winter when up to 80% of the sun’s UV rays can reflect off snow causing sun damage. It is important to apply sunscreen to your face daily, as you are exposed to the sun even when you don’t realize it, such as when driving. If you are going to be outside in full sun, sunscreen should be applied liberally to your entire body. Types of Sun Protection There are two major types of sunscreens: chemical sunscreen and sunblock. Chemical sunscreen—which is what we normally refer to as sunscreen—filters the sun’s UV rays, only allowing some to get in. In contrast, sunblock—also known as physical sunscreen—reflects the sun’s UV rays and blocks them from penetrating the skin. Sunscreens usually contain oxybenzone or avobenzone, while sunblock has titanium oxide or zinc oxide. Both are effective at protecting your skin from the sun’s UV rays. SPF (Sun Protection Factor) refers to the percent of UVB rays that are blocked. SPF 15 blocks about 15% of UVB radiation, while SPF 30 blocks about 97%. Any sun protection above SPF 30 offers negligible additional production from UVB rays. Sunscreen Recommendations Skin care experts recommend using a broad-spectrum sunscreen or sunblock that is at least SPF 30. Broad-spectrum sunscreen provides protection against both UVA and UVB rays. For optimal sun protection, use sunscreen or sunblock that contains titanium dioxide and zinc oxide. Wear waterproof sunscreen if you plan to spend time in the water or sweat and reapply at least every two hours, regardless of SPF coverage. It should be reapplied even more frequently if swimming or sweating. Make It a Habit Including sunscreen in your daily skin care regimen is a helpful way to make it a regular practice. A variety of skincare products contain sunscreen, including skin moisturizers, makeup primer and foundation. These are easy ways to incorporate sunscreen application into your daily routine so that you can enjoy outside activities safely, any time of the year. Stop by the Luminis Health booths at Bowie Baysox games on August 18 and 19 to pick up a travel-size sunscreen for UV protection on the go! This post was originally featured in the Enquirer-Gazette. Authors Lauren Eisenbeis, MS, PA-C, is the lead plastic surgery physician assistant at Luminis Health.0
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