- Heart Care, Patient StoriesGeneral Page Tier 3BlogI vividly remember the day Kathy Brown, my mother in-law and a dedicated teacher, was diagnosed with amyloidosis. It’s a rare disease that causes proteins usually produced in your bone marrow to build up in your organs. At the time, I was a cardiology fellow at the University of Maryland. I understood the severity of the diagnosis. Less than a month later, the disease had taken over Kathy’s heart and she was in heart failure. Her advanced heart failure team breathed hope into a hopeless situation. Doctors put Kathy on the transplant list and she received a new heart within two months. I was in awe that a team of doctors, my mentors and teachers, could give someone a second chance at life. The doctors were instrumental in my training. But Kathy, true to her calling, also taught me important lessons. The doctors showed me how to treat heart failure. Kathy taught me how to care for heart failure patients. It was then that I chose to further my training in advanced heart failure. Heart failure occurs when your heart muscle doesn’t pump blood as well as it should, leaving your heart too weak or too stiff to pump efficiently. Nationally, it’s the number one reason people are admitted to the hospital. It’s also the number one reason why people return to the hospital within 30 days of leaving. Symptoms of Heart Failure Shortness of breath Swelling in your legs, ankles, feet or stomach Fatigue Rapid or irregular heartbeat Sudden weight gain from fluid retention You can help prevent heart failure by managing the conditions that cause it. These include high blood pressure, coronary artery disease, diabetes, obstructive sleep apnea and obesity. But not all conditions, like the one Kathy suffered from, can be prevented. Medical treatments and lifestyle changes can improve the symptoms of heart failure and increase quality of life. If you’re living with heart failure, your doctor may recommend a plan that includes: Losing weight Reducing and monitoring salt in your diet Exercising regularly Managing stress Limiting your daily fluid intake to 2 liters per day What is most important for patients with heart failure is a close relationship with your cardiologist. These patients require frequent office visits and medication adjustments in order to avoid hospitalization. Kathy’s experience taught me the importance of easy access to care. Kathy had to drive more than one hour every other week to see her heart failure specialist, which was difficult. Having a heart failure doctor close to her home in Annapolis would have made her life much easier. It was then that my professional vision became clear. I wanted to be the heart failure specialist in Annapolis. Doctors are constantly thinking about how we can improve the lives of heart failure patients. Although Kathy passed away due to complications from her disease, I carry with me the lessons I learned from her to improve the lives of patients with heart failure in this community. Author Jennifer Brown, MD, is a cardiologist and heart failure expert with Anne Arundel Medical Center. Originally published March 1, 2016. Last updated Feb. 24, 2020.0
- Behavioral Health, PediatricsGeneral Page Tier 3BlogI sent the group chat a message literally 10 minutes ago. Why aren’t they responding, are they mad? I can see they read it. Did I do something wrong? Maybe I annoyed them. Are they busy? No, they’re mad. Do they think I’m pushy? I shouldn’t have sent it. But I’m just trying to make plans with them, why would that be wrong? Maybe I’m not funny enough? Is it because I don’t have that many friends? Social pressure can be best defined as the influence that society has on an individual – or for the purpose of this post, children and young adults. The scenario above is a representation of what can go through a child’s mind when they’re experiencing the pressure of wanting to fit in or being liked by others. This can also often lead to anxiety, which more children are experiencing today than just a few years ago. In fact, there was a 20 percent increase in diagnoses of anxiety in kids ages 6 to 17 from 2007 to 2012, according to a recent study published in the Journal of Developmental and Behavioral Pediatrics with data collected from the National Survey of Children’s Health. The data on anxiety among 18- and 19-year-olds is even more concerning. Since 1985, the Higher Education Research Institute at UCLA has been asking college freshmen if they “felt overwhelmed” by all the tasks they were assigned to do. The first year, 18 percent of students replied yes. By 2000, that increased to 28 percent. Six years later, this number was nearly 41 percent. But why? There are many reasons. There’s more data available today than there was before that allows us to examine these numbers more in depth. There’s also more emphasis on “success” and “not failing”, more demanding tasks, more focus on “happiness”, joining sports teams, participating in enough activities, and parents pressuring children to do more of these activities. And then there’s digital devices and social media. A lot of times children have access to a computer or internet and are constantly connected to everything that is going on outside of their world. It never shuts down. So from the time they wake up in the morning to the time they go to sleep, they’re being pressured by somebody or something. How many people have liked my picture? Are there any comments? Have I gained new followers? How does this impact my child? Continuous access to digital devices allows kids to escape emotions they deem as uncomfortable, like boredom, loneliness or sadness. Escaping to a cyber world lets them “do something” at all times, even when they’re away from situations or places that might make them feel pressured or anxious. Their electronics have substituted opportunities to develop mental strength, such as coping with discomfort, spending time with their very own thoughts or connecting with others. These are basic skills we all need in our everyday lives. Social media has created a culture of constant comparison and the need to portray a specific lifestyle. And this, in turn, adds to the social pressure of often feeling the need to “show” others what you’re doing and documenting everything. Is it “kids just being kids” or should I be concerned? Around age four to six, it’s normal for kids to want to play by themselves. However, once they get a little older and they refuse to talk to others because of their anxiety, that’s when you should start paying attention. If they don’t interact with other kids or don’t want to play, that’s when you want to reach out to them and check in. If they can’t feel like they can be themselves, struggle to adapt to their environment or start losing a sense of themselves because that hasn’t been developed yet, talk to them. For teenagers, you’ll see their anxiety expressed more outwardly. It’s normal for them to want their own space and start developing relationships with others. However, if they want to stay at home a lot, they’re not talking to anybody or start avoiding activities that involve interacting with others, that should be a red flag. They might have many friends on the internet, but it’s also important to have friends in real life so they can have meaningful conversations with others and develop basic social skills. Is anyone to blame? No! It’s not anything that anyone does wrong. It’s kids going through phases of life and learning how they cope with those phases. Most of the times, children want to be listened to without being judged. A good way to keep the pressure down is creating an environment where they can feel they can communicate with you without feeling judged. Don’t just dismiss certain behaviors because for children, events that might not seem like “a big deal” for parents can be a very big deal for them. Don’t judge them or their friends. Give them correct alternatives but don’t force them into behaving a specific way. All children are different. What can I do? A lot, actually! Here are a few tips you can follow: Pre-teens: Pay attention. Take some time with your child before bed or in the morning to talk. Encourage self-expression. Allow your child to express him or herself. Try things like art and music. Get them involved. Your child should engage in outside activities away from tablets and video games. They should also have interaction with their peers so they can learn appropriate social behaviors. At this age, you still have a lot of control over the activities your child does. Get them involved early on! Set family time. Without electronic devices! Playing a board game together, cooking together and building something together is always a good idea. Monitor access. Pay attention to their YouTube channels and the things they’re watching on TV. Be careful with the news, scary movies or shows that are not age appropriate. Teens: Know their social circles. Knowing their friend group and the kids they’re spending most of their time with is important. It’s OK to ask questions and want to be involved. Know their social media. It’s hard for parents to do this because very few kids, especially teens, want to be friends with their parents on social media. But this goes back to communication. If you can communicate with your child then you can know what’s going on and understand what pressure they have. Get them involved. Make sure they’re not spending all day in their rooms. Find some fun activities to do together, both in and out of the house. Make sure they have a schedule. Teens need structured time as much as possible to avoid any negative influences. You can’t sleep all day and stay up all night. Your child needs motivation and their body needs to be productive. It’s healthy to have proper sleeping hygiene and a routine. Open communication. Have family time without electronics. It’s crucial to have time set aside in your home where you can talk to each other and open conversations. Ask questions, find resources and learn more at askAAMC.org/HealthyMinds. Author Jennifer Williams (Walton), MA, LPC, LCPC, is a mental health professional at Anne Arundel Medical Group (AAMG) Mental Health Specialists, located in Annapolis. To reach her, call 410-573-9000. Originally published Aug. 27, 2018. Last updated Feb. 21, 2020.0
- Heart CareGeneral Page Tier 3BlogAugust 30, 2018, started like most other mornings. I woke, showered and got dressed. As I stood at the kitchen counter making my lunch, I began to feel just a little bit odd. There was a hint of what I thought was heartburn that I noticed in the upper back part of my throat. I took an antacid pill and pressed forward with my salad chopping. I then noticed my left jaw. It didn’t hurt, really – I just knew it was there. I also began to feel a very slight fluttery feeling in my chest. The sensation was just below my clavicle and I could feel it just in the upper part of my chest. Overall, I thought I felt a bit anxious. I sat down on a bench in the kitchen and then moved to the couch to try to relax. Within another few moments, I felt a flushed feeling from my head down to my feet. A symptom I remember having felt before during bouts with a stomach bug: nausea and a sense of pending diarrhea, so off the bathroom I headed. I remember passing the desk in the living room, but the next instant I opened my eyes to find myself lying on the floor. Still trying to make haste to the bathroom, I got to my feet only to open my eyes again and find myself face-down on kitchen floor. I had lost consciousness twice! I was now drenched in sweat. About that time, my husband came in from having mowed the lawn and he insisted on calling 911. Good move, Rob! My husband was not typically home during this time, but someone, somewhere, was surely watching over me that day. I knew things weren’t right, but I honestly thought I was experiencing a stomach issue — heart attack was so far removed from my realm of reality. Within five to eight minutes the EMTs arrived. I really had no idea of the severity of the situation – just that I wanted the odd bodily sensations I was feeling to cease. When I arrived at Anne Arundel Medical Center, a team of about 15 was waiting for me (never a good sign). The team took me to the catheterization laboratory – what organized, efficient, saviors they were! Led by Dr. Eric Ginsberg, I was “fixed” and in a recovery room before it even hit me what had actually happened. A bit later, it finally sank in: I had a heart attack. But, how could that be? I am not a picture of health, admittedly; I am very overweight, and I am diabetic, but for the six or so months prior to this, I had been really focusing on my health. I was working with my primary care provider to get my blood pressure under control, and I was working on my diet and A1C (blood sugar test for diabetics) as well. I’d sworn off sugar and lost nearly 30 pounds. I thought I was “on it.” But, I have a family history of heart disease – my dad died at the age of 41 after having had two major heart attacks – and until recently, I didn’t take my diabetes too seriously. August 30, 2018, could have turned out way worse, but it also never could have happened at all. While I am grateful for the amazing care I received, if I could go back, I would tell my 35-year-old self to take into account my family history of heart disease now. Because while I eventually tried to do the right thing, I was too late. Remember, six months of being healthy won’t reverse a lifetime of bad choices. Don’t let “too late” be today. You’re not immune to the “facts of life” just because you think you’re on top of things. It’s important to take all health issues seriously regardless of how bullet-proof you think you are. At the end of the day, it’s better to be seen by a health care professional than to be viewed by grieving friends and family. I completed cardiac rehabilitation at AAMC, yet another wonderful group of caring and effective health care professionals. I have regular appointments with my endocrinologist and dietitian. I’m at the gym three times a week, and I’m focusing on my health. The most devastating recollection of the entire event was the look on the faces of my husband and my two daughters when they walked into my room after the stent procedure. I’m doing whatever I can these days to try and ward off the pain I saw in their eyes and set myself up for a better future. Learn your risk for heart disease with our free online heart health profiler at askAAMC.org/HeartHealth and take the first step toward having a healthy heart for life. Author Karen is a 62-year-old heart attack survivor from Annapolis. Originally published Feb. 21, 2019. Last updated Feb. 13, 2020.0
- Behavioral Health, Pediatrics, UncategorizedGeneral Page Tier 3BlogThe heroin epidemic in Maryland continues to make headlines, with both Maryland Governor Larry Hogan and Anne Arundel County officials having declared it a “public health emergency.” But as any parent would tell you, it’s not just heroin they worry about but a whole host of temptations that seem to be impacting kids at even younger ages. Parents are still the primary influence on their teens. According to research done by the Substance Abuse and Mental Health Services Administration, approximately 93 percent of teens reported their parents would be disappointed if they used alcohol, cigarettes or other drugs. Education is definitely one of the biggest keys in the fight against adolescent drug use. The earlier we can teach them about the importance of decision making and what drugs and other substances can do to their body, the better chance we have of them not wanting to try them. Information changes every day. It will be hard to combat something you know very little about. Educate yourself and make sure that you are really listening to your child and talking to them without bias and judgement. Our children are informed of many things and it is our job to make sure that the information they get is valid. The Academy of Pediatrics calls it Purposeful Parenting. The National Institute on Drug Abuse cites the importance of family bonding saying it is the bedrock of the relationship between parents and children. Some tips to keep in mind: Be a parent to your child, not a friend. Educate yourself about what’s happening in your child’s school, in the community and about resources available to help. Be a positive role model and promote positive behaviors. Communicate effectively. Good communication helps reassure family members that they care about each other and appreciate each other’s efforts. Good everyday communication can also make it easier to bring up issues, make requests when needed and resolve conflict when it arises. Every family needs ongoing communication about shared interests and concerns, such as running the household, recreational activities and solving problems, to name just a few. Family members also need to be able to express feelings to each other and talk about motions such as happiness, anger, sadness, concern and anxiety. Learn more about the J. Kent McNew Family Medical Center, a 16-bed mental health hospital for adults opening in March. The Hazelden Betty Ford Foundation offers these tips on things to remember for effective communication with your child: Expressing Positive Feelings We all feel good when our efforts are acknowledged. Try deliberately expressing positive feelings using these steps: Look at the person. Tell the person what he or she did that pleased you. Tell him or her how it made you feel. Expressing Negative Feelings To air negative feelings in a way that will help resolve them, try these steps: Look at the person and talk with a serious tone of voice. Tell the person what he or she did that displeased you. Tell him or her how you feel as a result and be specific. Make a request for change, if possible. Express Feelings Clearly with “I” Statements Describe your own feelings and avoid putting others on the defensive. For example, instead of saying “you really ticked me off when you were late for dinner last night,” try saying “I was angry when you came home late for dinner last night. I’d appreciate it if you’d be on time or call if you’re going to be late.” You will be surprised how comfortable a child is about talking about drugs, especially if it is something that is so prominent in their environment. A parent’s knowledge of drugs, positive influence and productive conversations with children can carry their child a long way in having a healthy and productive drug-free life. Author Keshia Brooks, BSPH, MBA, is supervisor of Prevention Education and Family Wellness at Pathways, Anne Arundel Medical Center’s substance abuse and mental health treatment facility. You can reach her office at 410-573-5422. Originally published Jan. 15, 2016. Last updated Feb. 11, 2020.0
- Behavioral HealthGeneral Page Tier 3BlogMost of us wouldn’t think twice about seeing our doctor for stomach pain, a sports injury or the flu. But many people don’t get help for mental health concerns. Sometimes it’s the fear of a label, cultural stigma or worry over not getting the right treatment. Whatever the hesitation, it’s important to see a doctor who will treat both your physical and mental healthcare needs. According to Raymond Hoffman, MD, medical director of the Division of Mental Health and Substance Use, your first call for mental health concerns can be to your primary care provider. “A primary care doctor can prescribe medications for many common mental health issues,” says Dr. Hoffman. He or she may also act as the point person for additional care, such as referring you to a therapist. Regardless of who ultimately treats you, Dr. Hoffman notes that addressing mental health concerns involves entering into a trusting relationship with your healthcare provider, who supports healing and recovery. Many of us think of mental healthcare as treating psychiatric illnesses such as bipolar disorder, major depression and psychosis. But it’s just as important to give attention to everyday concerns such as stress, seasonal depression and anxiety. Medical conditions such as diabetes, multiple sclerosis, Parkinson’s and heart disease can worsen depression or anxiety — and vice versa. That’s why it’s so important to seek treatment that takes your whole health into consideration. Erasing the Mental Health Stigma MYTH: Mental health conditions are uncommon. FACT: Mental illness is more common than most think. According to the National Alliance on Mental Illness, one in five Americans will experience mental illness in their lifetime, and one in 25 will experience a serious mental illness that interferes with their life. MYTH: Mental health conditions are untreatable. FACT: Many mental health conditions are not lifelong challenges and might only require treatment for a short time. With advances in modern care, you can successfully manage even chronic mental health conditions. MYTH: Mental health conditions aren’t real medical conditions. FACT: Just like heart disease and diabetes, mental illnesses are medical conditions. Primary care doctors and specialists can effectively treat them. Where to start with mental health help You don’t need to suffer through a mental health condition alone. Unless you’re dealing with a severe mental health issue, a good place to start is your primary care doctor. Your doctor will review your medical records, talk with you about new symptoms or concerns, and work with you to create a treatment plan. If you already have a good relationship with your doctor, you may feel most comfortable talking to him or her. Your doctor may also better understand what stressors you’re dealing with at home and work, and how they affect your physical health. In many primary care offices, a medical assistant screens patients for depression as part of the yearly well visit using a standardized screening tool. This two-question tool can provide information for a doctor to follow up. Doctors can use a more in-depth tool if the initial screening points to depression. The good news for mental health The good news is that mental health conditions are treatable. If your doctor identifies a mental health condition, he or she may provide brief counseling in the office, prescribe medication or refer you to a specialist. Your doctor may also suggest individual or group therapy. According to Dr. Hoffman, “The evidence shows that if most people who are suffering because of symptoms from mental health problems or substance abuse get help, they can be in less distress and function better.” Mental Health and Substance Abuse Services at AAMC AAMC offers a range of services, such as: The J. Kent McNew Family Medical Center, a 16-bed mental health hospital for adults, is opening in March. Pathways, AAMC’s substance use and co-occurring mental health treatment facility Partnerships with the Department of Health and local mental health and substance use providers to connect patients to resources Anne Arundel Medical Group Mental Health Specialists, an outpatient mental health clinic for ages 3 and up AAMC Psychiatric Day Hospital, a partial hospitalization program The Recovery Navigator Program, which provides screenings and referrals in the primary care setting Introduction of mental health consultations in primary care offices Learn more about AAMC’s range of mental health and substance use services, from outpatient group therapy to partial hospitalization. Author Raymond Hoffman, MD, is the medical director of the Division of Mental Health and Substance Use. Originally published Dec. 5, 2016. Last updated Feb. 10, 2020.0
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