- Behavioral HealthGeneral Page Tier 3BlogIt’s officially law. After approval from voters, Maryland becomes the latest state to allow the adult use of recreational marijuana. Starting July 1, 2023 anyone in Maryland aged 21 and older can legally purchase marijuana—also known as cannabis—for recreational use from licensed medical cannabis dispensaries. Before visiting one, it’s important to know the facts, especially the possible impacts of marijuana use. Unregulated Potency First, read the label. Because the potency of legal marijuana is not yet regulated, you must read a product’s label to know how much tetrahydrocannabinol (THC) is in a marijuana product. THC is one of the main substances—called cannabinoids—in marijuana that makes people feel “high.” By law, marijuana product labels must list the concentration of cannabinoid compounds they contain. The higher the percentage of cannabinoids, the more potent the product is and the stronger its effects. You may be surprised to hear the concentration or strength of THC in marijuana products is increasing. A study of marijuana samples from 1995 to 2014 found that its potency had almost tripled. This is important to know, as the more potent a drug is, the more likely a person is to develop a substance use disorder from it. Responsible Use If someone aged 21 or older uses recreational marijuana, it is important to buy only from licensed dispensaries. This helps avoid unknown contaminants that can be dangerous or life-threatening, especially fentanyl. These factors are also crucial: Don’t drive while under the influence of any substance, including marijuana. It’s unsafe and illegal. Don’t combine cannabis with other drugs, including alcohol. The effects may be unpredictable. Inform your doctor about your marijuana use so they can tell you about any possible interactions with your prescribed medications. Keep marijuana out of the reach of anyone under the age of 21. Don’t use marijuana if your job doesn’t allow it or if you are on-call for a job, caring for someone who is sick or taking care of children. Don’t use marijuana while pregnant or nursing. Potential Risks Marijuana use—especially if it is frequent and in high doses—can sometimes cause people to be disoriented and have unpleasant thoughts or feelings of anxiety and paranoia. People who use marijuana are more likely to develop temporary psychosis, which means they don’t know what is real, hallucinate and can be paranoid, in addition to other symptoms. Marijuana users are also more likely to develop long-lasting mental disorders, including schizophrenia (a type of mental illness where people might have delusions and hallucinations, among other things). A just released study from the National Institutes of Health reveals young men are at highest risk of schizophrenia linked with cannabis addiction. Smoked marijuana can harm lung tissue and cause scarring and damage to small blood vessels, regardless of how it is smoked. Cannabis smoke has many of the same toxins, irritants and cancer-causing chemicals as tobacco smoke. Adolescent Use The human brain stops developing at around age 25. Use of cannabis by adolescents and young adults may cause harm to the growing brain, including serious problems with learning and feelings. Cannabis Use Disorder You also run the risk of developing marijuana use disorder, which means you are unable to stop using marijuana even though it’s causing health and relationship problems. Signs of marijuana addiction include: Using more marijuana than intended Trying but failing to quit using marijuana Giving up important activities with friends and family in favor of using marijuana Using marijuana in high-risk situations, such as while driving Continuing to use marijuana despite physical or psychological problems Needing to use more marijuana to get the same high Experiencing withdrawal symptoms when stopping marijuana use You should refrain from using marijuana recreationally if you already have a diagnosed mental health condition or are in recovery from a substance use disorder, as the risk increases for developing cannabis use disorder or returning to the substance you were previously addicted to. In Conclusion Remember, just because it will be legal for those over the age of 21 to use recreational marijuana does not mean that it’s always safe. Do it in moderation, avoid daily use or large amounts.Treat marijuana use the same way that you treat alcohol use—if you would not drink in certain situations, you also should not smoke or consume cannabis in similar situations. If you are using marijuana for the first time, start at lower potencies and increase slowly until you know how it will affect you. And it bears repeating: Purchase your marijuana legally, so you know exactly what you are consuming and eliminate the risk of accidental overdose by exposure to fentanyl. Author Aliya Jones, MD, is the Executive Medical Director of Behavioral Health for Luminis Health.0
- Cancer Care, Men's HealthGeneral Page Tier 3BlogSeptember is Prostate Cancer Awareness Month and there’s good reason to take note. According to the American Cancer Society (ACS), prostate cancer is the second most common cancer in American men. And, about one in eight men will be diagnosed with the disease in his lifetime. This year alone, nearly a quarter-million American men will get it and, sadly, more than 34,000 will die from it. These are scary numbers — and they underscore the importance of screening and finding prostate cancer early when successful treatment is more likely. About Screening Tests Prostate screening involves looking for prostate cancer before symptoms are present. We use two main screening tests: Digital rectal exam: In this test, a doctor feels the prostate gland for bumps or suspicious areas by inserting a gloved, lubricated finger into the rectum. Prostate-specific antigen (PSA) test: A PSA test is a blood test that measures levels of a particular protein produced by normal and cancerous prostate cells. The higher a man’s PSA level, the more likely prostate cancer is present. The problem with prostate cancer screening tests is they aren’t entirely accurate. Results might suggest you have cancer even when you don’t. On the other hand, a screening test could appear normal when cancer does exist. When there’s concern about prostate cancer, doctors do a biopsy, which involves removing cells from the gland and looking at them under a microscope to see if they appear abnormal. Unfortunately, biopsies can cause pain, bleeding and infection. They also sometimes lead to: Overdiagnosis: There are times when a man might never know he had cancer if he hadn’t had a screening test. Many prostate cancers grow slowly and don’t cause symptoms or threaten a man’s life. Rather than dying of cancer, he’s more likely to die with it. However, once he gets a cancer diagnosis, it can cause stress, anxiety and possibly, overtreatment. Overtreatment: When a man knows he has prostate cancer, he wants it treated, even if it’s likely the cancer would never cause problems. Unfortunately, treatment can cause bowel and bladder toxicity and erectile dysfunction, which can negatively — and unnecessarily — affect his quality of life. Prostate cancer screening recommendations Different medical organizations, including the U.S. Preventive Services Task Force, the American Urological Association and the American Cancer Society, make recommendations regarding who should be screened and when. And while their recommendations vary slightly, they all generally suggest that men take these steps to safeguard their prostate health: Regardless of your age, medical history or risk factors, you should talk with your doctor about the benefits and risks of screening and treatment before deciding. From roughly the age of 50 to 69, you should make a personal decision about getting screened with a PSA test. If you’re younger than 50 with increased risk factors — such as being African American or having a strong family history of prostate cancer — you should start conversations with your physician, and screenings, sooner. It’s okay to stop routine prostate cancer screenings at age 70. In general, most experts also agree that your PSA value can help support your decisions about screening frequency, and that your overall health and life expectancy should be considered as well. Making your decision So where does this leave you? Possibly, uncertain. But when in doubt, always speak to a medical expert. Your doctor can help you learn more about your risk for prostate cancer and weigh what’s most important to you when making screening decisions. In the meantime, it’s helpful to know the signs and symptoms of prostate cancer and to tell your doctor if you have them. When signs and symptoms, such as these, are present, looking for cancer may become more important: Blood in urine or semen Erectile dysfunction Pain the hips, back, or chest or other areas Urination difficulties, including a weak stream or frequent urination, especially at night Loss of bowel or bladder control Numbness or weakness in your legs or feet While all of these symptoms can be related to problems other than cancer, it’s crucial you get them evaluated to be sure. The team at Luminis Health is here to help. Schedule your consultation or screening appointment today. Authors Amar Rewari, MD, MBA is the Chief of Radiation Oncology for Luminis Health. Dr. Rewari is a board-certified radiation oncologist trained to treat all types of cancer with the latest radiation therapy techniques.0
- Cancer Care, Men's Health, Women's Health, Patient StoriesGeneral Page Tier 3BlogIt was finally time to celebrate. Earl Shellner had just received an honorary certificate for completing a long course of chemotherapy. This was the last big hurdle in his cancer treatment. Earl had already been through surgery and radiation to treat an aggressive form of rectal carcinoma. Now he was cancer free. Earl sat down to write thank-you notes to friends and family who’d supported him during his struggle. It was then that he realized something new was seriously wrong. He seemed to have forgotten how to write basic letters. ‘”I was starting on the notes and couldn’t remember how to make a cursive S and a J,” he recalls. “I had to look it up on the internet, how to make the lines and curves for those letters.” Friends and Family May Be the First to Notice Signs Earl didn’t understand what was happening. He spoke to his mother, who’d been staying with him during his cancer treatment. She had even more bad news. She told him it wasn’t just the alphabet he was forgetting. “She told me I’d been telling the same stories over and over again. I’d tell a story and then 15 minutes later I’d tell it again.” And there were other lapses. He couldn’t remember the name of a neighbor’s son who he’d known for years. When he went to brush his teeth, he couldn’t remember how to use the toothbrush. It turns out many of Earl’s friends also noticed his brain seemed muddled. No one wanted to tell him because he’d already been through so much. He was devastated. Before his cancer diagnosis, he’d been a high-energy, multitasking restaurant manager. “Now I didn’t want to leave the house. I didn’t want to socialize, and my mom had to take over my banking. I just couldn’t handle any of my stuff anymore,” he says. AAMC Nurse Identifies Chemo Brain Earl shared his concerns with his radiation oncologist, and a nurse on the team recognized the symptoms. She told him he had what’s known as cancer-related cognitive impairment or “chemo brain.” Estimates vary but studies suggest a significant number of cancer patients who’ve undergone chemo may experience some degree of cognitive impairment. Until recently, however, many doctors tended to dismiss the memory loss as a given side effect of treatment. Their advice was for patients to wait it out and hope the problems diminished over time. “There is a real knowledge gap,” says Matt LeBlanc, the nurse navigator for Anne Arundel Medical Center’s Cancer Rehabilitation Center. “Chemo brain exists but it is under recognized and undertreated.” A little over a year ago, AAMC decided to address the need directly by launching the cancer rehab program. Among other things, it offers cognitive therapy to cancer patients using techniques developed for those who’ve suffered traumatic brain injuries. Speech Therapy Helps Rebecca Gondak is a speech language pathologist at the center. She says many of her cancer patients arrive with significant cognitive impairments, including short-term recall and language retrieval. “Intelligence is not affected, the problem is a patient’s ability to access intelligence,” says Gondak. The good news is that with help, even a brain damaged by chemotherapy can form new pathways to compensate for what’s been lost says Gondak. Earl is a perfect example. When Shellner arrived at the Cancer Rehab Center, he tested far below average for memory and word recall. Gondak began a vigorous course of treatment using a combination of exercises, strategies and tricks to teach the brain new ways to access information. “Since people with chemo brain often have trouble with short-term memory one thing I do is teach them how to connect new information to something they are already familiar with,” says Gondak. Gondak says many effective strategies for recall are quite simple “Let’s say a patient parks on level 3A. How will they remember if they’re having short-term memory loss? Well, I’ll have them think of connections to the level. Maybe they have 3 children and want an A in school. That’s 3A.” Gondak also uses repetition and problem-solving exercises to help jump-start the brain. Rehab Gave Earl His Life Back After twelve sessions, Earl was thrilled with his progress. He’d jumped from the 13th percentile in cognitive function to the 79th percentile. Other patients have seen similar results. Gondak says one of the things she finds most moving is that many of her patients are making huge leaps in memory skills even as they endure cancer treatment. “We get a lot of patients in pain or who aren’t sleeping and still we see improvement, ” Gondak says. Earl says rehab has given him his life back. He’s no longer afraid to go outside or talk in public. He also continues to heed Gondak’s advice. He uses lists so he doesn’t overload his brain with too much information, he takes brain breaks and he puts essentials, like his keys and phone, in a designated place so he doesn’t lose them. The bottom line, says Earl, is the skills he’s acquired in rehab have allowed him to function again. “Rehab has made a tremendous difference in my life,” Earl says. “I can feel it everyday.” Read Earl’s first-person account of his journey on the Huffington Post.0
- Super Specialty ParentExpert Care for Your Bones and Joints When moving hurts, it's hard to do the things you need to do — or the activities you love. We can relieve your pain and get you back in action so you can live life to the fullest. With one of the largest orthopedic programs in the state, we have the know-how to treat a full range of bone and joint problems. ACS Recognized for Quality Care In 2018, Luminis Health Orthopedics received the American College of Surgeons' Exemplary designation for several quality measures. This is given to hospitals whose rates of complications, such as infections, are among the lowest in the country.0
- Behavioral Health, Senior CareGeneral Page Tier 3BlogAs a prevention education coordinator at Pathways, Anne Arundel Medical Center’s substance use and mental health treatment center, Mandy Larkins is in the community daily. She works to prevent anyone from having to deal with the devastating disease of addiction. “It can affect anyone, any age, any socioeconomic group, any gender and any race,” she says. Senior citizens are at greater risk for addiction if they take multiple medications and take prescription pain medications. According to the National Clearinghouse for Alcohol and Drug Information, up to 17 percent of adults age 60 and over abuse prescription drugs. Common medications of abuse include narcotic pain killers, sleeping pills and tranquilizers. To help prevent prescription addiction, Mandy reminds seniors to ask questions when talking to their doctors about certain medications. Questions to ask include: Does this medication have an addictive tendency? What are the side effects and will it interact with my current medications? What is the least amount of time I will need to take this medicine? Are there other options for this medication? Social drinking while taking medications can also cause a negative reaction, especially if someone is taking several prescriptions. “Social drinking could mean one glass of wine a night or it could mean five beers on a weekend, and these can certainly interact differently with medications,” says Mandy. “Have a conversation with your doctor about social drinking and what the problems would be with drinking and taking new medication.” The warning signs of addiction are sometimes hard to separate from the side effects experienced from the medications. Mandy notes that a drug side effect will show up soon after the patient starts taking the new medication. In contrast, addiction might take some time to display its symptoms. You might not see symptoms until the patient stops taking the drug. Signs of addiction include: Differences in sleep Changes in appetite Fluctuations in mood or unusual behavior Taking more than the prescribed dose of medication Taking medication for reasons other than what it is prescribed “It’s important to talk to your doctor if you have been treated for any addiction earlier in life,” says Mandy. “Certain medications could be trigger points for some people.” If you believe an elderly loved one may have an addiction problem, alert his or her physician. The right type of treatment will vary depending on the individual and the situation. AAMC’s Pathways Treatment Center offers individualized substance abuse and mental health treatment. Call 410-573-5449 for more information. Contributor Mandy Larkins is a prevention education coordinator at Pathways and can be reached at 410-573-5428.0
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