- Plastic Surgery & Skin CareGeneral Page Tier 3BlogWe all age, but you can take steps to keep your skin youthful. Transitioning your skin care regimen is only half the battle. As we age we lose volume in the skin around the upper lip and over the cheekbones and often gain volume around our neck, which can make us look older. Injectable remedies can help. Treatments should only be performed by licensed health care professionals. Here are some of the latest anti-aging trends: Injectable fillers can improve the appearance of nasolabial folds (lines that run down the sides of the nose to the corners of the mouth) and marionette lines (lines run from the corners of the lips downward towards the jawline). Today’s commonly used fillers use a natural substance to plump up sunken areas and make the shadows in deep lines disappear. Juvèderm is the world’s top-selling filler and is used to fill lines, cheeks, vertical lip lines and lips. For example, Juvèderm Voluma XC can help add volume to your cheeks to lift and contour the area, lasting as long as two years. The procedures are done in office, and results are instant. Botox remains the best treatment for crow’s feet and the frown lines that appear between the eyebrows. Many physicians also use this to relax the lines that run across the forehead. By relaxing the muscles just below the skin’s surface, the lines smooth out and give you a more youthful look. Remember, there are also lifestyle habits you can adjust for healthy skin: Drink lots of water. While we hear this often when it comes to healthy skin, it is not cliché. Drinking water is good for your skin and overall health. An adequate amount of water daily keeps your body’s systems running properly and that includes your skin. A lack of hydration can make your skin dry, tight and flaky. Dry skin has less resilience, which makes it more prone to wrinkling. Protect your skin from the sun. Even in winter when skies are overcast, UVA and UVB radiation can damage your skin. And a significant amount of sun exposure can occur even when you’re not outside. Up to 60 percent of UVA radiation linked to premature aging (UVA) can penetrate glass. Sitting by a window for extended periods of time throughout the day, whether it is in a car or a building, can increase harmful sun exposure. Apply broad spectrum sunscreen (SPF 50) every day. Avoid smoking. The nicotine in cigarettes and the smoke itself is very harmful. Smoking not only deprives the skin of oxygen but damages collagen, which is a protein that holds your skin together. Smoking speeds up the development of wrinkles and leaves skin dry and discolored. But the best way to ensure youthful-looking skin is to prevent skin damage when you’re young. Melanoma, one of the more worrisome skin cancers, has been linked to sunburns before the age of 18. And there seems to be a connection between severe sun exposure as a child and damage to the weathered-appearing skin as an adult. Patients who have the worst skin as adults in terms of aesthetics and possible development of skin cancer had their worst sunburn before age 18. Learn more about Luminis Health Plastic Surgery’s cosmetic services.0
- Physical Therapy, Women's HealthGeneral Page Tier 3BlogEver heard of pelvic physical therapy? Probably not. And if you have, a single word likely comes to mind: Kegels. But pelvic therapy involves much more than repeatedly contracting and relaxing your pelvic floor muscles (the muscles that control the flow of urine). In fact, many pelvic floor physical therapists are baffled that pelvic floor care for new moms is often summed up in one incomplete, oversimplified and often ineffective piece of advice: “Do your Kegels.” “Most women have never been assessed to see if they are doing Kegels properly,” says Yong Zheng, MD, urogynecologist with Anne Arundel Medical Center’s Women’s Center for Pelvic Health. Pelvic physical therapists are experts of the musculoskeletal system. “We completely examine our patients’ abdominal and pelvic muscles, and we help with bowel, bladder and sexual functioning. We use biofeedback and electric stimulation to teach the muscles to work properly.” Moving Beyond Kegels Pelvic physical therapy helps treat problems like incontinence, prolapse, pelvic pain, low libido, painful sex and constipation safely, and without medication or surgery. It can even help with that post-baby belly pooch called diastasis recti. So why isn’t it a standard treatment option for these postpartum issues? Well in some places, it is. In countries like France, Australia and the Netherlands, doctors actually prescribe pelvic physical therapy to new moms. Most women receive therapy sessions before they’re cleared to resume physically demanding activities (read: sex and exercise). “In Europe, new moms are taught, mainly by physical therapists and midwives, how to do Kegel exercises before they leave the hospital,” says Dr. Zheng. “After delivery, if a woman has a third or fourth degree tear, she’ll undergo physical therapy as a standard part of postpartum care.” But in the U.S., pelvic therapy still isn’t part of routine care for new moms. “In the United States many women, and even some doctors, are not familiar with pelvic physical therapy,” she says. Here’s why: At the six-week checkup after giving birth, doctors assess the uterus and cervix, but often ignore the pelvic floor muscles. And since most pelvic floor issues aren’t life-threatening, many women suffer in silence and wait for symptoms to go away. But symptoms don’t always go away and they can have lasting effects. “If these issues are not addressed, women can experience continued weakening of pelvic muscles, which leads to worsening of incontinence,” says Dr. Zheng. A Common Sense Solution Pelvic physical therapy after giving birth just makes sense. Think of it like this: Pushing a 5- to 9-pound child through a small canal in the body is arguably the most strenuous athletic event of a woman’s entire life. Just like triathletes and marathon runners ice, stretch and rest their legs after a big race, new moms should also heal their strained muscles. “While vaginal delivery is a natural process, it is truly very traumatic to the pelvic floor,” says Dr. Zheng. “It’s imperative to let the pelvic floor heal properly after delivery because those muscles can be your best friend but can also be your worst enemy.” Start The Conversation Until the U.S. catches up with Europe’s pelvic care standards, it’s up to women to talk to their doctor. “Talk to your health care provider about any symptoms that occur or are exacerbated after delivery,” says Dr. Zheng. “When in doubt, ask.” Asking your doctor for a referral for pelvic therapy could mean the difference between a full recovery and worsening pelvic floor issues. “Incontinence is common after birth, but not normal to extend past the six-week mark,” she says. “Although it is hard to manage a newborn, and a mother’s own needs are often put second, it is important to seek care as soon as possible.” Biofeedback: displays your pelvic muscle activity on a computer screen to better understand when you are squeezing or relaxing your pelvic muscles. This truly helps you know how to properly strengthen or relax your pelvic floor. Electric stimulation: also called e-stim. A physical therapist uses a device to deliver a weak electrical current to re-educate your muscles how to contract properly and improve sensation and awareness of the pelvic area “There is nothing better than helping a mom feel more like herself, get back to working out safely and feel more confident with her body,” says Dr. Zheng. Author Yong Zheng, MD, is a urogynecologist with AAMC’s Women’s Center for Pelvic Health. You can reach her office at 443-481-1199. Originally published Dec. 15, 2017. Last updated May 1, 2019.0
- Physical TherapyGeneral Page Tier 3BlogAs a speech-language pathologist, I’ve become sensitized to some of the challenges my patients’ families face after years of shuttling my kids to therapy appointments. Family schedules are busy and complicated. Finding balance for things most important is always worth it. Here are some tips to make the speech therapy process smoother. READ MORE: Understanding adult speech therapy Schedule appointments around your needs. When choosing therapy appointment times, schedule around your family’s needs. An appointment at seven o’clock in the morning may be appropriate for a five-year old but not a teenager. Also, consider focus and energy levels throughout the day. Some medications, such as stimulants for attention deficit-hyperactivity disorder (ADHD) have peak effectiveness periods. Caregivers can and should help find the best therapy appointment time for each patient. Come prepared. A pediatric speech evaluation is similar to a doctor’s appointment with more toys and no shots. Come early, as there will be paperwork. Bring a snack, a drink and a favorite toy. And bring any related medical or educational reports. Be supportive, not overbearing. Allow the patient to speak for his or her self. But advocate for them if they are unable to express their concerns. Don’t be afraid to ask for a break. Set realistic goals. Goals need to be easily achievable and simple to understand. Small, incremental, change is more sustainable. Personalize the experience. Patients are more likely to succeed when speech therapy reflects their interest. A speech articulation goal for a child might target the “r” sound when saying their friend Ryan’s name, for example, or when singing Baby Shark. Parents and caregivers can help identify personalized speech therapy targets. Tell the truth. Work with your therapist to modify goals that aren’t working. Tell your therapist if the patient did not follow recommendations or do their homework. I always encourage and appreciate honest feedback. Take homework seriously. Like any exercise program, consistency is the key to lasting change. Speech therapy homework helps to carry over learned strategies to real life. Make homework a part of your existing routine. An additional homework task may seem impossible, so try tucking speech therapy exercises into other activities. I hid my son’s flashcards next to his dinner plate, his car seat and his toothbrush. Add some fun and include the whole family. Homework can be on an iPad or part of a game or craft. Try exercises while watching a favorite TV show.Parents, siblings, grandparents, babysitters, teachers, and friends can all assist with speech therapy homework. Life is hectic. I hope these tips make your family’s speech therapy experience a little easier. After all, we are here to help. Author Chana Breuer is a speech-language pathologist at Anne Arundel Medical Group Physical Therapy in Crofton. To schedule an adult or pediatric speech therapy appointment, please call 443-481-1140.0
- Women's HealthGeneral Page Tier 3BlogMaintaining good health during pregnancy involves more than just watching your weight and taking your prenatal vitamins and folic acid. It also includes managing your blood pressure. Blood pressure is the force of the blood pushing against the artery walls. The force is created with each heartbeat as blood is pumped from the heart into the blood vessels. If the pressure in your arteries becomes too high, you have high blood pressure, also called hypertension. Sometimes high blood pressure is present before pregnancy. In other cases, high blood pressure develops during pregnancy. SEE MORE: Are you at risk for high blood pressure? Take this quiz! While there is no exact cause of hypertension during pregnancy, there are many factors that increase your risk of having it. Your risk may be higher if you’re: Pregnant for the first time Overweight or obese Over 40 years old African American Giving birth to multiples Have a history of hypertension Hypertension is known as the silent killer because those who have it often do not have symptoms. “This is why it’s so important to come to all of the prenatal care appointments,” says Laura Merkel, MD, a board-certified obstetrician and gynecologist at Annapolis OB-GYN. “Even if you’re feeling great, we want to see you, measure your blood pressure and check on your baby.” While many women with high blood pressure deliver healthy babies, hypertension can affect the kidneys and increase your risk of heart disease, kidney disease and stroke. Other complications include: Fetal growth restriction: High blood pressure can decrease the flow of nutrients to the baby through the placenta. The baby may have growth problems as a result. Preterm delivery: If the placenta is not providing enough nutrients and oxygen to your baby, your provider may decide that early delivery is better for your baby than allowing the pregnancy to continue. Placental abruption: This condition, in which the placenta prematurely detaches from the wall of the uterus, is a medical emergency that requires immediate treatment. Cesarean delivery: Women with hypertension are more likely to have a cesarean delivery than women with normal blood pressure. A cesarean delivery carries risks of infection, injury to internal organs, and bleeding. Your health care provider may also test your urine for protein because hypertension during pregnancy may lead to preeclampsia. This is the most serious form of hypertension during pregnancy. Along with high blood pressure, there are signs that some organs may not be working properly. Preeclampsia is a serious condition characterized by the following signs and symptoms: High blood pressure. Swelling of face/hands. Protein in urine. Changes in vision. Call your doctor if you are experiencing any of these symptoms. Preventing High Blood Pressure During Pregnancy There isn’t a magic pill or one single medication that prevents high blood pressure during pregnancy. The good news is there are some simple ways to keep your blood pressure down. You can: Reduce salt intake. Limit intake of caffeine. Avoid tobacco entirely. Get lots of rest. Drink at least 10 glasses of water every day. Do not drink alcohol. Reduce stress levels. Elevate your feet when possible. After the birth of your baby, your care team will closely monitor your blood pressure. Your gynecologist and nurses will watch for any symptoms of preeclampsia. Typically, blood pressure falls back into normal and safe levels within a few weeks of delivery. However, we encourage all new moms to continue monitoring themselves once they’ve arrived home, especially as it relates to high blood pressure. Signs your blood pressure may still be high are: A headache that won’t go away. Irregular vision (spots, blurry vision). Nausea or vomiting. Very little urine output. You just don’t feel well overall. “If you notice any of these symptoms, contact your health care provider right away,” says Dr. Merkel. “Don’t attribute a bad headache to being a normal pregnancy symptom, it could be something more serious.” Originally published April 4, 2018. Last updated April 26, 2019.0
- OrthopedicsGeneral Page Tier 3BlogAs the weather warms up, you may be packing up the little ones and heading to the playground more often for some outdoor fun. But it’s important to keep safety top of mind as your kids play. From 2002 through 2015, there were more than 350,000 playground slide injuries involving children younger than six years old, according to a 2017 University of Iowa study. The study looked at a national database of injuries treated in U.S. emergency rooms. You might think it’s safer to go down the slide with your child, but it actually puts them at risk for a leg fracture. “Unfortunately, we see too many of these fractures every year. We don’t see this happening in children who go down the playground slide alone,” says Dr. Edward Holt, an orthopedic surgeon with AAMC Orthopedics. More than a third of the children in the University of Iowa study broke a bone. Those breaks usually involved the child’s lower leg. Typically, these injuries occur in children between the ages of 8 months to two years, Dr. Holt says. “The weight of the parent behind the child twists the child’s leg if his toe touches the sliding board,” Dr. Holt explains. If you don’t want to let your toddler go down the slide alone, then make sure the child’s feet don’t touch the slide, Holt says. “In this case, it’s best to remove the child’s rubber-souled shoes before going down the slide,” he says. Beyond the playground Some backyard toys can be every bit as dangerous as those on your neighborhood playground. Trampolines, for example, cause thousands of injuries every year in the U.S. and the American Academy of Pediatrics even warns parents not to buy them. Dr. Holt says the most common injuries he sees are sprained ankles, wrist and leg fractures, arm and elbow injuries, and head and neck injuries, which tend to be the most serious. “Before you buy a trampoline, set up rules for the use of it. Then go over those rules with your kids and get their buy-in. You should also look at your homeowners’ insurance and liability policy to make sure that backyard trampolines aren’t excluded from your policy,” he says. Children under the age of six should not play on an adult-sized trampoline, Dr. Holt adds, though there are child-sized trampolines available for younger kids. If you do buy a trampoline, Dr. Holt says place a net around the trampoline so children can’t fall off. And make sure the trampoline has a ladder to prevent children from trying to jump off of it. You should also place the trampoline on a level surface with padding on the springs and frame. Dr. Holt also urges parents to avoid having the trampoline next to a tree or second-story deck. He says children could run into those things or worse, be tempted to jump off of them onto the trampoline. Author Edward Holt, MD is an orthopedic surgeon with AAMC Orthopedics who specializes in foot and ankle problems. Originally published May 24, 2018. Last updated April 26, 2019.0
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