- Behavioral HealthGeneral Page Tier 3BlogLife can be tough. There are the daily stresses, unexpected events and relentless responsibilities that can all be challenging. At times, we can feel overwhelmed and may need a little extra support. It may surprise you to hear one in five experience a diagnosed mental health condition each year. How can you help a loved one, friend, co-worker or family member who may be going through a hard time? Since May is Mental Health Awareness Month, let’s give you a mental health first-aid kit of sorts. Recognizing the Signs One way to provide support is to acknowledge when someone is going through a difficult time. Here are some common signs of mental health challenges: Excessive worrying or fear Feeling extremely sad or low Confused thinking or problems concentrating and learning Severe mood changes, including uncontrollable “highs” Persistent or strong feelings of irritability or anger Avoiding friends and social activities Changes in sleeping habits or feeling tired and low energy Changes in eating habits such as increased hunger or lack of appetite Overuse of alcohol or drugs Vague and ongoing “aches and pains” without an obvious cause Inability to carry out daily activities or handle daily problems and stress How to Approach Difficult Conversations If you suspect that a friend or loved one might be going through a rough patch, trust your gut. Speak to them one-on-one. Start by saying how much you care, followed by your observations. You might say, “I care about you, and I’ve noticed you haven’t been yourself lately. You seem more frustrated than you’ve been in a while and I’m wondering how you’re doing.” Tell the person you understand and it’s normal to ask for help. If it’s a child or teenager, ask them who you should talk to because you should never handle someone else’s mental health crisis on your own. If granted permission, enlist help from someone they trust, such as a parent, caregivers, older siblings, other relatives or a teacher, even a coach. Is Your Loved One in Danger? Some behaviors may indicate that a person is at immediate risk for suicide. Here are some warning signs: Talking about wanting to die or to kill oneself Looking for a way to kill oneself, such as searching online or getting a gun Talking about feeling hopeless or having no reason to live If someone you care about shows these behaviors, you should call or text 988 right away or call a mental health professional. The 988 Suicide and Crisis Lifeline provides free, confidential, 24/7 support for anyone who is thinking about suicide, concerned about a loved one or needing emotional support. Helpful Resources The National Alliance of Mental Illness is a nationwide grassroots organization that offers support for those with mental illness and for their friends and loved ones. They have a number of helpful support groups, including some in Prince George’s County. Maryland Coalition of Families supports families who have loved ones with behavioral health conditions. In addition, Luminis Health offers Pathways Family Wellness Workshop, a program that brings together family members (such as parents, siblings, aunts, uncles, or anyone else who is considered family) for an educational session, group therapy and personal growth. The program equips family members with communication skills, relapse prevention strategies and coping mechanisms for ongoing recovery. To register for an upcoming workshop, call 443-481-5449. Take Care of Yourself, Too If someone you are close to is working through mental health challenges, both you and the person in crisis are not alone. Reach out for support for yourself if you need it. Remember that it’s important to maintain boundaries between someone else’s experience and your own. You can empathize with what someone else is going through without owning responsibility for their experience.0
- PediatricsGeneral Page Tier 3BlogWhen school is out for the summer, your whole family may be on a more relaxed schedule. That may include kids’ bed times. But with the new school year beginning, it’s time to get your children back on track so they are getting enough sleep to focus on their school work. A lack of sleep can lead to an array of problems for children and teenagers. The American Academy of Sleep Medicine (AASM) says lack of sleep is linked to behavior and learning problems, and an increased risk of accidents and injuries. Some evidence also suggests a lack of sleep could lead to conditions including diabetes, obesity, hypertension and depression. Yet a 2016 study by the Centers for Disease Control and Prevention found that more than two-thirds of high school students are sleeping less than eight hours every night. This could be because there is a shift in the body’s circadian clock during puberty, causing teens to naturally prefer a later bed time. Are you confused about how much shut-eye your children should be getting each night? It varies depending on how old they are, but the AASM says babies, children and teens need much more sleep than adults. Here are its sleep recommendations: 4-12 months: 12-16 hours 1-2 years: 11-14 hours 3-5 years: 10-13 hours 6-12 years: 9-12 hours 13-18 years: 8-10 hours It can be hard to tell when young children are tired. While adults slow down when they’re exhausted, children speed up, the National Sleep Foundation says. For that reason, it can be easy to confuse signs of sleepiness with signs of attention deficit-hyperactivity disorder (ADHD). Back-to-school sleep tips The National Sleep Foundation offers the following tips for helping your child develop good back-to-school sleep habits: Two weeks before school starts, start to help your child get on a school sleep schedule gradually. Every night, set a slightly earlier bedtime, and every morning, a slightly earlier wake-up time. Don’t use the weekend to catch up on sleep. Before bedtime, start a relaxing routine, such as bath and story time for younger children or reading time for older children. Limit screens, including TV and electronic devices, before bed time. Avoid big meals close to bed time, and caffeine six hours before bed time. A dark room, comfortable bed, and room temperature that is not too hot or cold make for the best sleeping environment for your child. Most importantly, follow these rules yourself so you can set a good example for your children. If you suspect your child isn’t sleeping enough, talk to your pediatrician. Author Rebecca Duncan, MD, is a primary care physician with AAMG Kent Island Primary Care. To reach her practice, call 410-604-6560. Originally published Aug. 22, 2017. Last updated Aug. 16, 2019.0
- Orthopedics, UncategorizedGeneral Page Tier 3BlogAfter nearly 20 years managing pain for my patients as an orthopedic surgeon, I recently found myself on the other side of the medical system. I was the patient in need of a major surgical procedure. It was an eye-opening experience to say the least, and I gained a new appreciation for how vulnerable a patient feels when it comes to pain management. Opioids, such as Percocet and hydrocodone, are strong medications that play an important role in managing pain before and after surgery. Over the past 15 years, many factors have led to a dramatic increase in opiate prescriptions. Orthopedic surgeons rank third after pain specialists and primary care doctors in the number of opioid prescriptions they issue. The increase in prescriptions has led to more patients who become dependent or addicted to these drugs. This crisis has affected every social and economic class. Nearly one out of every three people in Maryland knows someone who is, or was, addicted. The rate of opioid-related deaths due to accidental overdose has more than doubled. These drugs cause more deaths than motor vehicle crashes or suicide. They’re also responsible for more patient deaths than cocaine and heroin overdose combined. The United States uses more than 92 percent of the world’s opiates, and we consume 99 percent of the hydrocodone manufactured. Yet, studies haven’t shown any increase in patient-reported pain to warrant this use. We should address the societal acceptance for these medications. Unfortunately, there’s not an easy solution to this problem. Doctors must do a better job of teaching patients about the risks of using opiates. Patients trust and rely on their doctors to guide them in managing their pain. Most patients do not willingly start abusing or misusing their pain medications. Many believe they are only following their doctor’s instructions. Opioid alternatives For most conditions that don’t involve surgery, doctors can manage patients’ pain without opiates. Medications like acetaminophen (Tylenol), certain anti-inflammatories (NSAIDs, like Motrin, Advil or Aleve), and Tramadol (Ultram) are all alternatives to opiate medications. Doctors can help manage pain before and after surgery by carefully using opiates. However, more opiates don’t always lead to better pain control. In some cases, they can lead to opiate-induced hyperalgesia. This means the more opiate the body’s pain receptors see, the more they want. For chronic conditions, a pain specialist is the best person to help manage pain. Role of patients and families Patients and family members also play an important role in preventing misuse or abuse of opiates. It can be difficult to identify people at risk of addiction, but those with opioid dependency tend to have psychological distress and poor coping skills. Behaviors like losing prescriptions or getting early refills are clear indicators. If a doctor expresses concern about possible addiction to a patient, the patient may be more open to their doctor’s concerns if family members also voice concern. At this point, it may be helpful to get the assistance of a pain management specialist or even going to a drug rehabilitation program. During my recent surgery, I realized that if it was difficult for me to navigate the system of pain management, it must be terrifying for non-medical professionals. Fortunately, I came through with a great result and a new focus on making sure my patients are well informed about their pain management plan. While the opioid epidemic is a complex problem, it’s important for patients and doctors to have open conversations about pain management to help stop opioid addiction. Author Alessandro Speciale, MD, is an orthopedic surgeon at The Spine Center at Anne Arundel Medical Center. To reach his practice, call 410-268-8862.0
- Infectious DiseaseGeneral Page Tier 3BlogIf you plan to prepare a Thanksgiving meal this year, make your grocery store trip well in advance of the holiday. The CDC advises against going shopping in crowded stores just before, on, or after Thanksgiving. This recommendation is to prevent the spread of coronavirus (COVID-19) among large crowds in grocery stores. Here are some helpful tips to keep you safe when shopping for the big day. Make a shopping list. Efficiency is key. Prepare a shopping list before your trip to the grocery store and get out as quickly as possible. This limits your exposure to others in the store. We know the positivity rate continues to increase in the community. This means there is a higher risk of encountering someone who has COVID-19, whether they are symptomatic or asymptomatic. Wear a mask and practice good hand hygiene. Use hand sanitizer frequently during your grocery store trip. This is important because multiple people are touching the same items in the store. Wear a mask and avoid touching the front of it while shopping. When you leave the store, use hand sanitizer before and after removing your mask. Consider curbside pickup or grocery delivery options. Checkout lines in the grocery store may be long the closer you get to Thanksgiving. There are other ways to avoid the holiday crowd. Curbside pickup and grocery store delivery are safer options. Avoiding large crowds is especially important if you have a pre-existing medical condition or a medical condition that puts you at greater risk of infection. Leave the kids at home. If possible, leave kids at home or use a delivery option. Many younger children don’t think about hand hygiene. Others may not be able to wear a mask because they are under two years old. Young children often touch items during the shopping trip and then put their fingers in their mouths. This puts them at risk for exposure. Consider grandparents’ risk. After you’ve cooked your hearty Thanksgiving meal with all the fixings, package some for grandparents and deliver it to their home. This is a safer option instead of inviting them inside your home for dinner. A multiple generation gathering makes grandparents more vulnerable to infection. Authors Jean Murray is the director of Infection Control at Luminis Health Anne Arundel Medical Center. Rajesh Shah is the director of Quality/Regulatory Affairs and Infection Prevention at Luminis Health Doctors Community Medical Center. Thanksgiving Recipe: Roast Turkey and Orange Spice Rub Start to finish: 1 hour and 45 minutes Servings: 11 1 tablespoon grated orange zest ½ teaspoon ground cinnamon ½ teaspoon ground cumin ½ teaspoon paprika ¼ teaspoon ground allspice or ground nutmeg ¼ teaspoon salt ¼ teaspoon black pepper 1/8 teaspoon cayenne pepper 5 pounds turkey breast with bone and skin 1 can of nonstick cooking spray Preheat the oven to 325° F. Lightly spray a roasting pan and baking rack with cooking spray. In a small bowl, stir together all of the ingredients except the turkey. Put the turkey on a cutting board or flat work surface. Carefully loosen the skin from the turkey breast by gently inserting your fingers between the skin and the meat, making a pocket for the orange zest mixture. Don’t break the skin. Discard any fat beneath the skin. Still working carefully, spread the orange zest mixture under the loosened skin as evenly as possible. Transfer the turkey to the rack in the pan. Roast the turkey for 1 hour and 45 minutes, or until it reaches an internal temperature of at least 170° F. Be sure the thermometer doesn’t touch the bone. Remove the turkey from the oven and let stand for 15 minutes. Discard the skin and all visible fat. Slice the turkey and serve. Recipe from Diabetes Food Hub.0
- Men's Health, Primary Care, Women's Health, WellnessGeneral Page Tier 3BlogChoosing a health care provider is a big decision. After all, you are placing your health in another person’s hands, depending on them to help keep you healthy and get you well when you are sick. You need expertise and experience. Compassion and strong communication skills. You want the whole package — and you might be surprised to learn that doctors aren’t the only people you can turn to for this high-level of medical care. Advanced practice providers (APPs) offer it too, and they’re playing a growing role in today’s health care system. What is an advanced practice provider? APPs are highly educated medical professionals. They include advanced practice nurses — such as nurse practitioners, clinical nurse specialists, nurse midwives and nurse anesthetists — and physician assistants. All have six or more years of college education and typically hold at least a master’s degree. During their training, they also get a minimum of 1,000 (and in many cases, significantly more) hours of supervised clinical experience. APPs are required to show proficiency in their practice area to become certified. And all must be licensed to practice. APPs typically also receive continuing education throughout their career. Expertise that meets your needs Often, APPs serve as primary care providers. And in Maryland, nurse practitioners can provide care independently. Depending on their area of expertise, APPs may: Administer anesthesia Advise patients on preventive care Assist in surgery Conduct physical exams Deliver babies Diagnose and treat medical conditions Educate patients Make referrals to other specialists Manage patient care Order medical tests and imaging studies Perform procedures Prescribe medications Take patient histories The benefits of advanced practice providers The benefits of seeing an AAP may be considerable. For instance, years of studies show that: APPs provide quality care. Research has shown that care provided by nurse practitioners is equivalent to care provided by doctors. Working with an APP is cost-effective. Care provided by nurse practitioners can be less expensive than care provided by a physician in many settings, including primary care, acute care and long-term care. Similarly, there are proven benefits associated with physician assistants (PAs). For example, a survey of people who’ve visited a physician assistant or had a family member who has, found that PAs: Gain patient trust. About 93% of respondents considered PAs trusted health care providers. Increase access to care. About 92% of respondents said having a PA made getting a medical appointment easier. Improve the healthcare experience. About 91% of respondents believed PAs improved the quality of healthcare. A team of experts ready to help You can count on advanced practice providers to give you the best possible care. They’ll be at your side, ready to offer the latest treatment and lend a friendly ear or hand to hold, as well. And if you require additional expertise, they’ll make sure you get that, too. With the strength of the entire Luminis Health team behind them, they’re ready to meet you wherever you are on your health journey, ensuring you have access to all the care you need to live your best life. Author Dr. Tormeika S. Sanford, DNP, MSN, CRNP is an internal medicine provider with Luminis Health Primary Care. Make an appointment by calling 240-241-7474..0
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