Behavioral Health, Pediatrics
General Page Tier 3
Is it puberty or something else? Navigating your child’s changing behavior
Blog
As a parent of four, I understand how stressful it can be to carry that title. Being a parent means carrying a world of responsibilities. We have to watch out for all sorts of external triggers – think peer pressure, social media and school shootings – to help our children navigate through this world as best as possible. And we’re also needed to help them through their various developmental stages.
One of those stages is puberty and all the mood swings that come with it. If you’re a parent, you’ve probably experienced the eye-rolling, the snappy response out of nowhere, and the need to ask the same question multiple times before something gets done (asking them to look up from their phone during dinner!).
Sometimes those behaviors are normal, it’s your child navigating new emotions and developmental changes. But sometimes, it’s a result of something more than just puberty or “kids being kids.” I have been working in the mental health field for the past 30 years and a lot has changed. What used to be a slight increase in mental health problems reported over the years has turned into an ever-increasing peak.
But why? Think about everything that society has dumped on kids nowadays: Anxiety based on school safety, higher expectations, challenging curriculums and, of course, there’s social media. This is a lot of “weight” for a child to carry.
How do you know what’s normal and what’s not? Here are a few warning signs that can help you tell if your child needs another layer of support and/or professional help:
Elementary Age
Change in behavior or change in play (hitting, bullying, biting).
Intensity of emotions (anger or fear).
Increased physical complaints.
Change in sleep patterns (nightmares).
Difficulty concentrating.
Middle School Age
Prolonged or strong feelings of irritability or anger.
Difficulty relating to peers.
Thinking and/or talking about suicide.
Avoidance of friends and social activities.
Confused thinking or problems concentrating.
High School Age
Excessive worry or fear.
Feeling excessively sad or low.
Extreme mood changes.
Abuse of substances (alcohol and drugs).
Thinking and/or talking about suicide.
The best thing you can do as a parent is provide a safe, nurturing home and community with realistic limits on social media and screen time. Give them a sense of stability and a true balance of exercise, activities, nutrition, family meals and something I call the “gift of time” for optimal emotional health.
The gift of time is listening without interruption and giving one’s full attention if even for 15-30 minutes a day. Take the time to listen – really listen – to your child without interruption and judgement. Encourage them, foster their independence and above all, love them unconditionally! Providing stability among our world’s instability is one of the most critical components to supporting our children and teenagers.
Ask questions, find resources and learn more at askAAMC.org/HealthyMinds.
Author
Cindy Radovic, MA, BA, BSN Board Certified, is the manager of Mental Health Services at Anne Arundel Medical Center’s (AAMC) Emergency Department. To schedule an appointment with her, call 443-481-3519.
0
General Page Tier 3
Recipe: Stir-fry zucchini noodles
Blog
These vegetable-based zucchini noodles, also known as “zoodles,” are the perfect pasta substitute for a lighter option. Here’s a tip: it works best if you have a spiralizer or spiral cutter. These tools are available at most kitchen stores and often only require turning a handle after cutting off the ends of your zucchini.
Try this easy-to-follow recipe for a healthy dose of vegetables, most of which you can find at your local farmers market.
INGREDIENTS
1 tablespoon olive oil
2 yellow onions
4 small zucchini, spiral cut
½ cup sliced cherry tomatoes
½ cup sliced mushrooms
1 tablespoon low-sodium soy sauce
2 tablespoons low-sodium teriyaki sauce
1 tablespoon sesame seeds
¼ teaspoon fresh grated ginger
INSTRUCTIONS
Heat oil in a wok or medium-sized pan over medium heat. Add onions, and cook for 4-5 minutes, or until translucent and tender. Add other vegetables including the spiral cut zucchini and continue cooking for 2 minutes.
Add soy sauce, teriyaki sauce and sesame seeds; mix and continue to cook for 5 minutes or until zucchini is tender. Remove from heat and serve.
Yield: 4 servings
Originally published Aug. 1, 2016. Last updated Oct. 17, 2018.
0
Orthopedics, Senior Care, Women's Health, Uncategorized
General Page Tier 3
Treating osteoporosis: A fracture may be a wake-up call
Blog
For some people, having a heart attack can be life changing, spurring them on to healthier life choices, like regularly exercising, starting a heart-healthy diet and taking medication.
A bone fracture is not unlike a heart attack — they are both a sign that something is wrong. In the case of a fracture, it could mean you have osteoporosis or a weaker form of bone loss called osteopenia.
Bones shouldn’t break with low-energy falls such as from standing height or less. When they do, your doctor may want to run blood and bone density tests to determine if you have osteoporosis. If diagnosed, you should learn about weight-bearing exercise, fall prevention and nutrition for healthy bones. In addition, you may be a candidate for an osteoporosis medication.
There are several medications available to treat osteoporosis:
Bisphosphonates make up the largest class of drugs. This includes Fosamax (Alendronate), Actonel (Risendronate), Boniva (Ibandronic acid), and Atelvia, which are pill form, and Zometa and Reclast (Zoledronic acid), which are once-yearly injections. These drugs have been studied in large clinical trials for up to 10 years, and complications are rare. We typically recommend patients cycle on and off bisphosphonates in three- to five-year cycles. You can take a “drug holiday” with careful follow up and strict attention to weight-bearing exercise and good calcium and vitamin D intake.
Prolia (Denosumab) is a newer treatment option administered through a shot every six months. It is very effective in protecting bone mass and is well tolerated by patients. There is a slight risk for patients who are prone to infection or who are on immunosuppressive therapy, since it is an antibody therapy. It acts on the same cells as bisphosphonates, so it could have similar risks.
Hormone replacement therapy for women after menopause may help protect bones. Evista (Raloxifene), a pill taken daily, affects the estrogen receptors on breast and bone tissue and helps protect against both breast cancer and osteoporosis.
Forteo (Teriparatide) is the only medicine currently available that builds bone. It is an injection self-administered daily. It is limited to two years of use. Once the two years of therapy are complete, you switch to one of the other medicines to maintain the gains you made with Forteo.
Most of the medications reduce the risk of having a new fracture by about 50 percent. If you’ve had a fracture from a low-energy injury and you have osteopenia, you’re also a candidate for one of these medications.
Osteoporosis is one of the most undertreated diseases of modern times, despite the abundance of good treatments. Fractures from osteoporosis lessen your quality of life with each new fracture.
We must treat fractures as a life-altering event triggering treatment of osteoporosis, just like a heart attack triggers treatment of cardiac disease.
Author
Christina Morganti, MD, is an orthopedic surgeon at Anne Arundel Medical Center. She has opened a dedicated osteoporosis program at her practice, AAMC Orthopedics. To reach her office, call 410-268-8862.
Originally published Sept. 25, 2015. Last updated Aug. 26, 2025.
0
Cancer Care
General Page Tier 3
AeroForm expanders: Revolutionizing breast reconstruction
Blog
Getting breast implants after a mastectomy is an emotional process. Preparing your body for the implants can also be an arduous task. It can involve weekly doctor’s visits, needles, saline and an often uncomfortable process. However, new technology has changed the landscape for many women. There’s now an option that eases the stress for breast cancer survivors and gives them the opportunity to play an active role in the healing process.
With the AeroForm tissue expander system, patients use a remote-control device that communicates with expanders in their body through Bluetooth-like technology. This gives the patient the choice to expand their breast tissue anytime and anywhere with up to three puffs of air a day with a few hours in between. With one press of a remote control, the patient releases a dose of 10cc of carbon dioxide. This gradually expands the breasts over time.
READ MORE: Tips on supporting a loved one through cancer
This new technology is an alternative to the traditional method of tissue expansion still used at most hospitals, with patients having to visit their doctor frequently to have 50cc or more of saline injected. And, although the upfront cost is higher for this technology, in the end, we think that this novel technology lowers costs since there will be less visits to the doctor. The reward for patients is incalculable. Here are the top benefits of the expander system:
It is patient-controlled. Patients are in control and decide how often to dose and when to stop expanding their breasts.
You can do it anywhere. Patients can release the puffs of air anywhere and anytime they want without having to schedule a doctor’s visit, take off from work or even worry about daycare.
There are no needles involved. Therefore, there is no need to feel anxious! By using the remote-control device, patients can press a button to release a dose of air that expands their breasts steadily. Each small dose can barely be felt.
Less risky. No needles also means there is less risk for infection or rupture, which can happen occasionally with saline-filled expanders.
It’s more empowering. With an AeroForm expander, the patient has full control and releases her own doses instead of having to come in every one to two weeks to have a doctor inject fluid into the breast.
Patients enjoy playing an active role in their own recoveries. AeroForm is a game-changing technology that allows patients to be fully involved in the process — it decreases pain and complications and literally hands them control.
Author
Tripp Holton, MD, is a plastic surgeon at Anne Arundel Medical Group (AAMG) Plastic Surgery and specializes in breast reconstruction, including microvascular surgery as well as cosmetic surgery of the face and body at Anne Arundel Medical Center. You can reach his office at 443-481-3400 or AAMGPlasticSurgery.com.
0
Behavioral Health
General Page Tier 3
Former Pathways patient says treatment program changed her life
Blog
Abby Forbes was in drug rehabilitation for the second time when she had to overcome an unexpected hurdle.
By the time she was in her mid-twenties, Abby had been battling addiction for nearly a decade. She began consuming alcohol at 15, drinking to the point of blacking out. She later began experimenting with marijuana and ecstasy before moving on to heroin.
Her addiction led her to Pathways, Anne Arundel Medical Center’s drug and alcohol treatment facility, where she was determined to get clean for good.
But a new obstacle stood in her way. This time, it was in the form of adventure therapy, Pathways’ hands-on outdoor activities course designed to challenge patients’ problem-solving skills.
Abby remembers standing on a wooden platform with about 15 other people. Each person had to climb up a rope and swing to another platform several yards away.
As Abby struggled with the rope, the others tried to help. Still, she was determined to do it herself, insisting to the group that she could handle it despite falling twice.
Mark Sakraida, Pathways’ adventure therapy coordinator, walked over to her. His words remain clear in Abby’s mind, 16 years later.
“How is that like recovery?” he asked her.
It was as if a lightbulb went on in Abby’s mind.
“I learned to ask for help,” she says.
“I couldn’t do it alone”
Abby first came to Pathways in 2000, after her parents had kicked her out of their home.
“I was in a very child-like state,” she recalls. “I wanted what I wanted, when I wanted it.”
She briefly moved in with a boyfriend, living in his family’s basement in squalid conditions. After a few days, she called her parents. They told her she could come back home – as long as she went to rehab.
She remembers having a chip on her shoulder the first day at Pathways, though she felt better after receiving treatment for drug withdrawal symptoms.
Abby stayed at Pathways for 15 days. She loved the supportive community there, but didn’t know what to expect upon being discharged.
“I was scared,” she says. “I left with knowledge of coping skills. And then it somehow evaporated.”
Abby says she got back in touch with other users, and fell back into her old habits. Seven months later, she returned to Pathways.
This time, she was in a different place mentally.
“I wasn’t as nervous. I was excited about who I was going to meet and learn from,” she says.
Abby had been through adventure therapy when she was at Pathways the first time, when she learned the importance of teamwork.
Yet it wasn’t until she was back for a second round, standing on that platform and working hard to climb up the rope, that the lessons hit home.
“I couldn’t do it alone,” she says.
READ MORE: The benefits of play: Why the playground is essential to a child’s development
The benefits of adventure therapy
Now 42, Abby has been sober since 2001. She works as a peer support specialist with the Anne Arundel County Department of Health, connecting addicts with community resources such as Pathways.
Abby says Pathways gave her a strong foundation that has served as the basis for her successful recovery.
She regularly attends 12-step meetings, where she met her husband. And she’s still not afraid to ask for help when she needs it.
Mark, who has served as adventure therapy coordinator since 1994, cites an ancient Chinese proverb when explaining why adventure therapy works.
“Tell me, I’ll forget. Show me, I’ll remember. Involve me, I’ll understand,” he says. “I tell patients that my job is to take them out of their comfort zone – and I think I do a pretty good job of that.”
More than a decade and a half after leaving Pathways, Abby finally got the chance to thank Mark.
She was at a work meeting at Pathways this summer when she walked past him in the hallway. She stopped and told him how she still thinks about the lessons she learned so many years ago.
“He has a special place in my heart,” Abby says.
Mark says he relishes every chance he gets to give his patients a dose of Vitamin A – “pure adrenaline.”
“Every day I do this is a blessing,” he says.
Ask questions, find resources and learn more at askAAMC.org/HealthyMinds.
0