- Women's HealthGeneral Page Tier 3BlogLet’s face it, urinary incontinence—the loss of bladder control—is not a sexy subject. But it’s a common problem that women of all ages often find too embarrassing to even talk about. For women affected by this, everyday life things—like going to the gym, sitting in a meeting or a night out with friends—can be extremely difficult, not to mention downright depressing. Think this is an “old person” issue? Not so. Surprisingly, one in four women under the age of 40 experience some form of incontinence. Women tend to suffer two types of incontinence: urge incontinence, the sudden and strong desire to urinate with only a few moments’ warning, OR stress incontinence, the involuntary loss of urine during physical exertion—such as lifting heavy objects and exercise, or even coughing, laughing and sneezing—that puts pressure on the bladder. Carrying and having a baby is not always the cause of urinary incontinence. Sometimes there are anatomical problems in the pelvis or in the back that can contribute. Also, certain medications, medical conditions and lifestyle habits can cause leakage issues. There is a bright side to this; while urinary incontinence isn’t always preventable, you can decrease your risk: Maintain a healthy weight Practice pelvic floor exercises, especially during pregnancy Avoid bladder irritants, such as caffeine and acidic foods Eat more fiber, which can prevent constipation, a cause of urinary incontinence So when do you need to see a doctor? When the leaks become problematic and impact normal everyday living. Make sure to bring up incontinence problems with your primary care doctor or gynecologist so they can refer you to a specialist. To learn more about treating urinary incontinence, visit askAAMC.org/PelvicHealth. Author By Kay Hoskey, MD, urogynecologist at Anne Arundel Medical Center’s Women’s Center for Pelvic Health. She can be reached at 443-481-1199.0
- OrthopedicsGeneral Page Tier 3BlogIf you’re a long-distance runner, you know the importance of fueling up before you hit the streets or your favorite running trail. What you should eat and drink to maximize your performance, though, is a mystery for many runners. Should you load up on carbohydrates? Go heavy on the protein? Down sports drinks? Here’s what runners should consider as they train. Carbohydrates and running The National Academy of Sports Medicine (ASCM) says athletes may have up to 40 percent greater energy needs than non-athletes. That means if you’re not eating the right foods, your performance could suffer. Carbohydrates are an important part of any runner’s nutrition plan. Carbs are stored in your muscles as glycogen, which serves as long-term energy storage. Your body relies on glycogen when you exercise, and it’s important to keep your glycogen stores full so you don’t crash during a tough workout. Eat before you work out, even if you don’t feel hungry, says The American College of Sports Medicine. About three to four hours before your workout, eat a meal of 300-600 calories that contains mostly carbohydrates, a moderate amount of protein, and a low amount of fat. Examples include toast with peanut butter, or a turkey sandwich with fruit. The ACSM says endurance athletes, such as distance runners, should refuel every 45 to 60 minutes during a long workout, taking in 30 to 60 grams of carbohydrates (or 120-240 calories) each hour. For shorter races or runs, it is not necessary to consume food during the race, but post-run replenishment is most efficient immediately after exercise. Good foods to eat during a long exercise session include energy gels or beans, honey, bananas or oranges. Eat your protein Remember the importance of protein. It is the building block of your cells, and it’s especially important during the recovery process. Running and training breaks down cells. As you recover, those cells are repaired to make you better, faster and stronger — as long as the right ingredients, including protein, are available. The ACSM recommends eating a post-workout snack of 300 to 400 calories containing a mix of carbs and protein. The carb-to-protein ratio should be 2:1 in short, low- to medium-intensity workouts, or 3:1 in long, high-intensity workouts. Opt for low-fat, high-protein sources, such as beans, fish and poultry. Milk-based protein, like chocolate milk, is thought to be one of the best sources of protein post-workout. Fats aren’t all bad Fats, like carbs, provide energy. Healthy fats, such as polyunsaturated fats and monounsaturated fats, are part of a balanced diet. They should be at least 20 percent of your total fat intake, according to the ACSM. Avocados are a good source, as well as nuts, olive oil, and salmon. Steer clear of saturated and trans fats, which can raise your cholesterol and lead to heart disease. A few special micronutrients: Iron, vitamin D, and calcium Long-distance runners are at high risk of iron-deficiency anemia. Low iron can result in decreased performance and a general feeling of tiredness. Your level of ferritin, a protein that stores iron, can determine if you need to take supplements. There is some debate over what is considered low, though 35 nanograms per millileter is often used as a minimum benchmark. You should talk to your doctor about the appropriate screenings for this. Adding iron-rich foods, like beef, can help. Turkey, chicken and some fish also have lesser amounts of iron, which your body can best absorb alongside foods rich in vitamin C. Vitamin D is crucial for bone health. Research has connected it to muscle strength, inflammation, and many other functions. Unfortunately, it is hard to get enough vitamin D, especially if you are wearing your sunscreen to protect your skin from the sun’s harmful rays. You can get your vitamin D level tested with a blood draw to determine if you need a supplement. Many doctors recommend taking 1,000 international units (IU) of vitamin D as a general rule. Calcium is also an important ingredient for not only strong bones, but also muscle and nerve health. Getting 1,000 to 1,500 milligrams of calcium from food each day is best. Hydration is important Making sure you are drinking enough water is important for everyone, but it’s especially important for runners. Research shows that dehydration, even if it’s mild to moderate, can decrease performance. There is some debate about whether you should use thirst as an indicator to drink, or if you should drink water before thirst sets in. Current recommendations are to bring water along with you on runs that are longer than an hour, or longer than a 10K. The ACSM suggests drinking two to four ounces every 15 to 20 minutes. It is possible to drink too much water during a long race, such as a marathon. In serious cases, you could develop hyponatremia, when your body has too much water and the level of sodium in the blood is too low. For long runs, consider a sports drink. Not only do they give you an extra boost of carbohydrates, they also replace sodium that you lose while sweating. They are also a good choice for hydrating after a run longer than 60-90 minutes. One last bit of advice: Don’t try any new foods or drinks on race day. You never know how your body might react, and that could be the difference between a great race and a bad one. By choosing the right foods and making sure you are staying properly hydrated — both during training and on race day — you can have your best race ever. Author Christina Morganti, MD, is an orthopedic surgeon at Anne Arundel Medical Center and avid long-distance runner. Dr. Morganti ran cross country and track at Brown University, and continues to compete in road races herself and run around cheering on her kids in their races. She has run numerous marathons, including New York, Boston, and the Marine Corps Marathon. You can reach her practice, AAMC Orthopedics, at 410-268-8862. Originally published Nov. 14, 2017. Last updated May 31, 2019.0
- Infectious DiseaseGeneral Page Tier 3BlogThere are now three COVID-19 vaccines authorized for use in the U.S. – Pfizer, Moderna and Johnson & Johnson. It’s natural that many are seeking out which is the “best” vaccine. The best vaccine truly is the one that you can receive first. If you have the opportunity to receive a COVID-19 vaccine, take it. Here’s why: All Prevent Severe Illness, Hospitalization and Death All three of these vaccines were 100% effective in clinical trials at preventing death. All are highly effective at preventing severe illness and hospitalization. Ultimately, these are the most important features of any vaccine. Waiting for a specific vaccine keeps you from protecting yourself against getting severely ill or dying of COVID-19. All Have Similar Side Effects The most common side effects are injection site pain, fatigue, headache and muscle pain. Some report fevers. It’s reported that younger adults are more likely to experience these. What we know as side effects are actually expected immune responses. They’re a sign your immune system is kicking into gear. They do not signal that the vaccine is unsafe. All Offer a Better Path to Protection Than Getting Infected COVID-19 can have serious, life-threatening complications. There’s no way to know how COVID-19 will affect you. Vaccination provides you protection without having to experience the illness. Every day you wait to get vaccinated puts you at higher risk of getting infected and seriously ill. Waiting for what you think may be the “best” vaccine isn’t worth the risk you take while waiting. The best vaccine is the one you can get the soonest.0
- Women's HealthGeneral Page Tier 3BlogLena Dunham. Whoopi Goldberg. Susan Sarandon. These are just a few of the high-profile women who have publicly discussed their experience living with endometriosis. Endometriosis is a gynecologic condition that occurs when tissue that normally lines the inside of the uterus grows elsewhere in the abdomen. Endometriosis is very common, affecting as many as 10 percent of American women of childbearing age, or more than 6.5 million women in the United States. While the cause of endometriosis is not clear and there is not a defined gene, there may be a familial link. According to a 2008 study out of Yale University School of Medicine, women with an affected mother or sister have as high as a 10-fold increased risk of developing endometriosis. Although some women don’t experience symptoms with endometriosis, many report intensely painful menstrual cramps and pain during sex. Over time, untreated endometriosis can lead to chronic inflammation and scarring in the abdominal cavity, resulting in debilitating pain beyond the menstrual cycle. Severe endometriosis can involve other organs such as the bowel and bladder, causing non-gynecologic symptoms such as pain with bowel movements and urination. Endometriosis is traditionally diagnosed by confirmation of implants seen in surgery. However, it can often be diagnosed on symptoms and physical exam alone. Endometriosis before and during pregnancy One of the biggest concerns women with endometriosis have is whether they can get pregnant. There is a strong link between endometriosis and infertility. As many as 40 percent of women struggling with infertility are diagnosed with endometriosis. If you know you have endometriosis, it is important to meet with an infertility specialist prior to getting pregnant because you may require treatment of endometriosis before any fertility treatments. Treatment must be a multi-pronged approach It is important to understand that there is no “silver bullet” cure for endometriosis. For women who receive a diagnosis of endometriosis later in life, they often develop a hypersensitivity to pain, which is not easily treated with medication or surgery alone. Successful treatment of endometriosis requires a team of specialists in both surgical and nonsurgical fields. Drug treatments: Medicine for endometriosis should tackle one of two issues: ovulation and inflammation. Supplemental hormones, most commonly in the form of birth control pills, suppress ovulation, which suppresses the endometriosis flare during menstrual cycles. There are also safe hormonal alternatives, such as Depo-Provera injections or the hormonal IUD. Over-the-counter medications such as ibuprofen suppresses inflammation and provides pain relief. For patients with more severe pain, certain medications can damper the pain signals in the brain. It is important to note that opioids often do not help endometriosis pain and should be avoided. Surgical treatments: I often do not recommend surgery as the first-line treatment for endometriosis. However, if the pain is severe and medication is not working, surgery may be the next option. There are many surgical options with endometriosis, like removing ovarian cysts (cystectomy), removing endometriosis implants, removing one or both ovaries (oophorectomy), and removing the uterus (hysterectomy). What kind of surgery you need will depend on your age, health status, whether you intend to get pregnant in the future and many other factors. Pelvic Floor Physical Therapy (PFPT). Many patients with chronic pelvic pain due to endometriosis are excellent candidates for pelvic floor physical therapy. With chronic pain, the muscles in the vagina often tense up, resulting in significant pain during sex or with movement. Pelvic floor physical therapy is a safe and effective co-treatment for pelvic pain and should be offered to women who exhibit signs of vaginal muscle tightening or tenderness on exam. Be your own advocate Although there is no specific way of preventing endometriosis, there are ways you can impact the condition and manage your symptoms. The first thing I always tell women is not to ignore the pain. Pain that starts only during menstrual cycles can eventually become worsened or become constant due to amplification of your brain’s interpretation of pain. This can be very difficult to treat. Second, don’t be afraid or embarrassed to seek help from an expert. If surgery is recommended for you, always get a second opinion before proceeding. Be an advocate for yourself, your body and your life. Finally, get support and talk with other women who also live with endometriosis. The more women who speak up about endometriosis, the more attention this condition will get and the more we can advocate for better resources for women and healthcare providers. Author Jessica Ton, MD, is a specialist in minimally invasive gynecologic surgery with Anne Arundel Medical Group (AAMG) Gynecologic Specialty Surgeons. To schedule an appointment with her, call 443-481-3493.0
- Men's Health, Senior Care, Women's Health, UncategorizedGeneral Page Tier 3BlogThe American Lung Association reports chronic obstructive pulmonary disease (COPD) claims nearly 135,000 American lives annually, making it the third deadliest disease after heart disease and cancer. COPD, characterized by shortness of breath, chronic cough, and chronic mucus production, is not curable, nor can you reverse lung damage linked to COPD. You can, however, treat and maintain the disease with these proactive steps. Medication Adherence “In the short term, medications help decrease COPD exacerbations. But there are long-term benefits, too,” explains Keith Goulet, DO, a critical care medicine and pulmonary disease specialist at Anne Arundel Medical Center. “Exacerbations increase lung damage. So every flare-up you prevent today slows down future disease progression.” Consult a Pulmonologist Typically, your primary care physician is the first doctor to assess symptoms associated with COPD. The next step is to consult a pulmonologist, a physician with advanced knowledge and skill in the diagnosis and treatment of lung conditions and diseases. “You need to make sure your COPD diagnosis is accurate and you’re on the right medications,” says Dr. Goulet. “Ask your doctor questions if you have them. COPD can be a scary disease because it’s not curable. But it is treatable. Learning everything you can about the disease often calms those fears, and ultimately improves your quality of life.” Be Your Own Advocate Anne Arundel Medical Center offers free classes and support groups to help people with COPD better understand disease symptoms, drug administration, lifestyle adjustments, and coping strategies. COPD 101 is a 90-minute class held monthly in the fall, winter and spring. The Better Breathers Club, a support group held every other month, emphasizes lifestyle changes, such as how to travel with COPD and how nutrition plays into COPD management. Visit AAMCevents.org or call 443-481-5555 for more information or to register. Quit Smoking Smoking is not the sole cause of COPD, but it is estimated that 80 percent of those diagnosed with COPD are either current or past smokers. Specific to COPD, cigarette smoke contains toxins that irritate the lungs and trigger symptoms. Take our pledge to love your lungs, and be entered to win a $50 Visa gift card! Stay Active For COPD patients, every breath taxes the breathing muscles. To keep these muscles in good shape, it’s essential that you stay active to the best of your ability and always follow your doctor’s recommendations. Author By Keith Goulet, DO, a critical care medicine and pulmonary disease specialist at Anne Arundel Medical Center. He can be reached at 410-266-1644. Originally published Sept. 24, 2015. Last updated Nov. 11, 2019.0
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