- Pregnancy & Birth, Women's HealthGeneral Page Tier 3BlogAs you start your pregnancy journey, you may have different options for prenatal care. While many women still seek traditional one-on-one appointments with their OB-GYN or midwife, more women are taking advantage of group health care like CenteringPregnancy®. The cornerstone of CenteringPregnancy® is the group discussion that takes place for the majority of each visit. During this time the group of moms — who are all due around the same time — have a chance to talk with their providers and fellow moms about important topics including labor and delivery, breastfeeding and infant care. Each CenteringPregnancy® visit also includes self-led health assessments and one-on-one belly checks with your OB-GYN or midwife. Benefits for mom and baby As group prenatal care has grown in popularity over the years, research has shown this type of healthcare can have a positive effect on both mothers and babies. A Yale School of Public Health study showed women who participated in group prenatal care were more likely to have healthy babies and go the full term of their pregnancy. According to the research, women in group prenatal care are: 33 percent less likely to have undersized infants Less likely to have a preterm delivery or an infant with low birth weight More likely to have babies that spend less time in the neonatal intensive care unit (NICU) Less likely to get pregnant again soon after giving birth, which can increase risk of preterm delivery According to research done by the National Institutes of Health (NIH), women attending group prenatal care are also more likely to: Feel ready for labor and delivery Have better prenatal knowledge Feel more satisfied with their care Start breastfeeding Balancing private time with group sessions While much of the CenteringPregnancy® visit will consist of group discussion time, it’s important to note that CenteringPregnancy® does not eliminate the one-on-one interaction you get with your provider. Every visit will include private belly time where your doctor or midwife will take measurements and check your baby’s health. You can use this time to ask questions that you may not be comfortable sharing with the group. Your care team will also take part in the group sessions and help lead many of the discussions. As most CenteringPregnancy® visits last between 90 minutes and two hours, this means you actually get 10 times the amount of time with your provider compared to a typical office visit. Finding friendship and support One of the main goals of the CenteringPregnancy® visits is for women to connect with fellow moms who are facing the same questions about giving birth and infant care. You may feel more relaxed and confident after talking through some of your concerns with the women in your group. You may also find unique solutions and points of view that can help you approach a problem in a different way. The group sessions are also a great time for partners, spouses and care people to connect with others who will be helping with delivery and infant care. These individuals can participate in all aspects of the CenteringPregnancy® visit. Remember you don’t have to share during the group session if you’re not comfortable doing so. But you may find you feel more comfortable sharing information as time goes on. Keep in mind that all women and their care persons in the CenteringPregnancy® group are told to maintain discretion with any information shared during the visits, and in some cases, participants are asked to sign a confidentiality form during the first visit. Empowering women to lead healthy lives Another goal of the CenteringPregnancy® visits is to help women better understand their health and empower them to take charge of their lifestyle and risk factors. Sessions include education about healthy choices and preventive steps you can take to avoid health problems during or after pregnancy, such as diabetes or heart conditions. Each visit starts with a self-led health assessment, which means you learn how to take your own health data, including weight and blood pressure. You track this data throughout the CenteringPregnancy® visits and record it in your own medical records. You will also have the opportunity to set health and lifestyle goals. The goals may focus on weight, diet, hydration, stress management, relationships or any other challenges you may be facing during pregnancy. Ultimately, the CenteringPregnancy® program aims to help women stay healthy and confident throughout their pregnancy and into motherhood. For more information about the program, visit CenteringPregnancy®0
- Orthopedics, Physical Therapy, PediatricsGeneral Page Tier 3BlogAs we approach the start of school sports seasons, it’s important for parents to understand concussion and how physical therapy can help. A concussion is a mild brain injury from direct or indirect trauma to the head. Concussion is known as an “invisible injury,” since it’s often not seen on an MRI or CT scan. Concussions can range in severity, and symptoms can include: Emotional/mood disturbances Light and noise sensitivity Cognitive impairment/memory loss Sleep disturbances Headaches and migraines Dizziness Motion sensitivity Visual impairment Neck disorders Pain You might assume that a concussion involves passing out or losing consciousness, but that’s not always the case. In many cases, a person with a concussion never loses consciousness. If your child suspects they’ve suffered a concussion while playing a sport, they should stop play immediately. Continuing to play or practice with a concussion is dangerous and can lead to longer recovery. It is important to allow the brain to heal after a concussion. But, this doesn’t mean you should do nothing. Staying still can make your brain more sensitive to movement. New research shows returning to a normal routine can aid in recovery. Modify your activities, but don’t avoid activity completely. Here are some things you can do to help with recovery: Do 30 minutes of daily low-impact aerobic exercise Get adequate hydration and nutrition Try to get at least eight hours of sleep a night Limit screen time Alternate short amounts of activity with rest periods, and use your symptoms as a guide. If symptoms get worse, decrease your activity level. Just as you would not run a marathon the day after knee surgery, you should not do too much too soon following a concussion. Physical therapy can also optimize recovery. Vestibular physical therapy, for instance, includes various head and eye exercises designed to improve your balance and reduce dizziness. A physical therapist can also prescribe other exercises to improve your coordination, endurance and tolerance for physical exertion. The first few sessions of physical therapy may make you feel worse but, over time, you will begin to feel better as your tolerance for activity improves. The time it takes to recover from a concussion varies. Different factors can include the severity of your injury, whether or not you’ve had a concussion before and your family history of migraine. Before returning to sports, get the okay from your doctor. Authors Emily Olsen, DPT, NCS is a physical therapist at Anne Arundel Medical Group (AAMG) Physical Therapy. For more information on vestibular physical therapy for treatment of concussion, or to schedule an appointment, call 443-481-1140. Originally published July 24, 2017. Last updated July 30, 2019.0
- OrthopedicsGeneral Page Tier 3BlogMike Upton, 75, is an avid spinner. It was during a class he noticed numbness in his left leg. “I felt like my leg was going to give out when getting on my bike,” Mike said. He would occasionally have this sensation for nearly a year before it got progressively worse. He began experiencing balance issues and muscle weakness in his thigh. “I lacked strength in my leg to go up and down stairs and I became increasingly worried about this.” Concerned these were symptoms of complication from a previous hip replacement, Mike saw his hip surgeon who referred him for an MRI scan of his lower back. The results were negative. Still concerned, Mike went to his primary care doctor who suggested spinal steroid injections. The injections did not help and Mike continued to experience numbness. His doctor then referred him to Alessandro Speciale, MD, an orthopedic surgeon specializing in the spine and spine disorders at Anne Arundel Medical Center (AAMC). Dr. Speciale ordered an MRI of Mike’s neck and thoracic spine, the longest region of the spine running from the base of the neck down to the abdomen. The images showed that Mike had a dangerous herniated disk in the middle of his back. Working as a team “We describe to patients that spinal disks look like jelly doughnuts and, when a disk herniates, it’s like the jelly squirting out of the doughnut and hitting a nerve,” Dr. Speciale explained. “By the time of Mike’s surgery, the herniated disk had become calcified. So, in this case, you had what looked like a piece of bone poking into the spinal canal, blocking spinal fluid from getting through. This was damaging Mike’s spinal cord.” Mike’s surgery would be high risk, with a 75 percent likelihood of success. Dr. Speciale knew he had to bring together a multidisciplinary team. He requested the help of AAMC Thoracic Surgeon Stephen Cattaneo, MD, and Neurosurgeon Timothy Burke. “This case was special in its complexity and inherent risk of paralysis or worsening of other neurologic symptoms,” explained Dr. Cattaneo. “Dr. Speciale was very concerned that removing the disk could compromise the spinal cord, so he involved Dr. Burke and me for expertise in our respective areas.” Each doctor sat down with Mike and explained what their roles would be during the surgery. “My wife and I felt confident with what they told us and how they explained the procedure step by step, so we decided to get it done,” Mike said. Just two weeks after his diagnosis, Mike was in the operating room. Looking back, he describes the ordeal as a flash. “I went from being a candidate that didn’t require surgery to needing to get in there quickly,” he said. “I was very impressed with the speed at which all the doctors saw me and the time each took to walk me through the procedure and their respective roles…this was all very impressive.” Preventing paralysis Mike’s surgery took nearly 10 hours. When waking up in intensive care, Mike said the first thought that crossed his mind was his ability to move. “I wiggled my toes first and made sure my legs could move,” he said. Once he came into consciousness, Dr. Speciale, Dr. Cattaneo and Dr. Burke each congratulated him on a successful surgery. The doctors explained to Mike they had removed part of his rib to turn it in to a substitute disk out of his own bone. They explained that there was no damage to the spinal cord. “This was a really rare disk herniation and probably one of the highest-risk procedures,” said Dr. Burke. “Dr. Speciale, Dr. Cattaneo and I worked side by side to remove bone from the spinal cord without damaging it. The procedure goes to show the importance of teamwork to do cases like these successfully. At AAMC, we have a unique advantage of having great teams available for our patients.” READ MORE: 5 tips to prepare for home life after joint replacement or spine surgery Regaining strength After his surgery on Monday, Mike was discharged from the hospital Friday afternoon. He walked out with the help of a cane. From the very beginning, he noticed renewed strength and balance. To further improve, he completed six weeks of physical therapy. Now, he is slowly getting back into his spinning routine. “I know this could have been more serious, so I’m very grateful to the doctors and the team at AAMC,” Mike said. Authors Alessandro Speciale, MD, is an orthopedic surgeon specializing in the spine and spine disorders at Anne Arundel Medical Center (AAMC). Stephen Cattaneo, MD, is a thoracic surgeon and medical director of Thoracic Oncology at AAMC. Timothy Burke, MD, is a neurosurgeon at AAMC.0
- Pregnancy & Birth, Women's HealthGeneral Page Tier 3BlogIf you’re new to CenteringPregnancy®, you may have a lot of questions about your first visit, especially if you’re only familiar with one-on-one appointments with your OB/GYN or midwife. Don’t worry — having questions about this new experience is normal. Each CenteringPregnancy® visit includes self-led health assessments, a belly check with your healthcare provider and group discussion time. Meetings generally start at 16 weeks of pregnancy and continue through your due date month. The group will include eight to 12 expecting moms who are all due around the same time. It’s important to bring up any concerns with your prenatal care team prior to your first CenteringPregnancy® visit, as they will be able to provide more detailed information about the experience and what to expect. In the meantime, here are answers to some of the common questions around CenteringPregnancy® visits. What does the health assessment entail? For most women, each CenteringPregnancy® visit starts with a health assessment. During the health assessment, your care team will show you how to take your own blood pressure, weight and health data, which you will record in your medical chart. You will check this data each week and track your progress throughout your pregnancy. Some women may not be able to complete the health assessment before the group discussion starts. If that is the case, the health assessments may continue to take place during a break time halfway through the visit. Will I be able to meet with my provider privately? Every CenteringPregnancy® visit includes one-on-one time with your doctor or midwife for a private belly check. Your care team will use this time to take measurements and potentially do ultrasounds to assess your baby’s health and growth. Belly checks my take place at the beginning of the visit or during the break time. During your belly check you can bring up any personal questions or concerns that you may not feel comfortable bringing up with the group. We will ensure each woman gets the privacy she needs with her provider to ensure sensitive information is kept confidential. What will we talk about during group discussion? Most of your CenteringPregnancy® visit will be made up of group discussion time with the moms and members of your care team. During this time, your care team will lead discussions and interactive activities that aim to answer some of the major questions and concerns many expecting moms face. We will talk about topics including: Nutrition Stress management Pain management and common discomforts Labor and delivery Breastfeeding Infant care In addition to the planned topics, we will also be sure to leave time for the moms to ask questions and talk about any topics that may be on their mind. With these group discussions, we hope to help women feel more confident about motherhood and provide them with an environment where they can find support and friendship from other moms. How much am I required to share during the CenteringPregnancy® group discussion? While we encourage participation from everyone in the group, it’s important to remember that no one is required to share during the CenteringPregnancy® meetings. If you feel hesitant sharing your thoughts early on, don’t worry — many moms feel more comfortable as time goes on. Am I allowed to bring someone with me? Every participant is allowed to bring a spouse, partner or support person to the CenteringPregnancy® visits. This person can help you with your health assessments, sit with you during the belly check and participate in the group discussion. How long will the CenteringPregnancy® visit last? Each CenteringPregnancy® visit lasts between 90 minutes and two hours. This gives you 10 times the average time as a typical office visit with your healthcare provider. If you have more questions about CenteringPregnancy® please view our program website.0
- Women's HealthGeneral Page Tier 3BlogFor most pregnant women, prenatal appointments are typically a one-on-one experience with an OB/GYN or midwife. But a growing trend in prenatal care called CenteringPregnancy® is shifting the way women receive care during pregnancy. CenteringPregnancy® combines the one-on-one provider experience with group prenatal care. Over the course of 10 prenatal visits, women receive routine prenatal care and spend time discussing pregnancy health topics with a group of 8 to 12 expecting moms who are all due at the same time. With this group-based program, moms not only receive personalized prenatal health care, they also have an opportunity to build friendships and community that can support them throughout pregnancy and motherhood. What does a CenteringPregnancy® visit include? CenteringPregnancy® visits include health assessments, a belly check with your provider and discussion time with the group of moms. Meetings start at 16 weeks of pregnancy and continue through the moms’ due date month. Unlike typical one-on-one visits, CenteringPregnancy® visits last between 90 minutes and two hours. This means moms get 10 times the average time spent with a provider during a prenatal check-up. Health assessment Every CenteringPregnancy® meeting starts with a health assessment, which is a time to check and record your basic health data. What’s unique about the CenteringPregnancy program is that you’ll learn how to take your own weight and blood pressure and document the information in your own chart. Belly check Each meeting also includes one-on-one time with your provider for a private belly check. You can also use this time to ask private questions that you may not feel comfortable sharing with the rest of the group. Group discussion In addition to the health check-ups, most of the CenteringPregnancy® visit includes ample group time with fellow moms and their partners or support people. During the group discussion, your care team will lead conversations and interactive activities that cover important topics like nutrition, stress management, common discomforts, labor and delivery, breastfeeding and infant care. The group discussion period always includes time for moms to discuss and ask questions about topics that are important to them. What are the benefits of CenteringPregnancy®? CenteringPregnancy® has been shown to improve the lives and outcomes of pregnant women. While the program may not be for everyone, it can bring many benefits for expecting moms and their families, including: Empowering moms to take charge of their own health Helping moms create friendships that can support them throughout pregnancy and motherhood Encouraging positive health behaviors and better health outcomes Helping ease anxiety and feelings of isolation that many new moms face Research has also shown that CenteringPregnancy can improve birth outcomes, such as: Lowering your risk of preterm births Reducing low birth weight Increasing breastfeeding rates In fact, a 2015 study done by the Yale School of Public Health found that group prenatal care can help the health of mother and baby. The study showed that women who participated in group prenatal care were 33 percent less likely to have babies with a low birth weight. The moms who had group care also had babies who spent less time in the neonatal intensive care unit. Is CenteringPregnancy® covered under my insurance? Group prenatal care like CenteringPregnancy® is usually billed to your insurance plan as a prenatal visit, so there shouldn’t be extra out-of-pocket costs for participating. Because CenteringPregnancy is your prenatal visit, it isn’t considered to be an added service, such as a childbirth education class. However, it’s important to talk with your insurance provider first to check your coverage. To learn more about CenteringPregnancy® and whether it’s right for you, talk to your provider or care team. Contributor: Ginny Bowers, Certified Nurse Midwife and International Board Certified Lactation Consultant (IBCLC).0
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