- Men's Health, Women's Health, Wellness, UncategorizedGeneral Page Tier 3BlogWhile many patients have success with safe, long-term weight loss after bariatric surgery, there are instances when revision of the surgery may be required. For those who are experiencing recurring complications, such as nausea, vomiting, abdominal pain, severe gastric reflux, or malnutrition, a qualified bariatric surgeon with expertise in revisional procedures can determine if corrective surgery is the right course of action. Candidates for revisional bariatric surgery may no longer be comfortable socializing or exercising, and they may be in pain or malnourished. In the case of severe gastric reflux, they may also be at high risk of esophageal cancer. The goal of revisional bariatric surgery is to correct the underlying problem by adjusting or removing an original bariatric device, such as a lap-band, and in some cases performing a new bariatric procedure that is more appropriate for the patient’s body and current condition. These include sleeve gastrectomy or gastric bypass. Patients should expect revisional surgery to be more complex than their original bariatric surgery, which may include a longer recovery time; however, the revision should enhance their overall quality of life. Read the inspiring story of a patient who underwent revisional bariatric surgery. Author By Alex Gandsas, MD, a bariatric surgeon and director of AAMC’s Weight Loss and Metabolic Surgery Program. To reach him, call 443-924-2900.0
- News & Press Releases, Infectious DiseaseGeneral Page Tier 3BlogDue to a significant increase in COVID-19 hospitalizations, Luminis Health is taking the unprecedented step of declaring a crisis at both its hospitals – Luminis Health Anne Arundel Medical Center and Luminis Health Doctors Community Medical Center. Since November 1, the healthcare system has seen a 320 percent increase in admitted patients with COVID-19, with more than 205 COVID-19 patients in its hospitals as of this date. This rise in hospitalizations, combined with ongoing staffing shortages, has made it necessary for the health system to implement crisis standards of care in order to continue providing safe and effective care to its patients. “The decision to declare crisis standards of care was made following careful consideration and discussion,” said Tori Bayless, CEO Luminis Health. “We are following our emergency operations plans. Decisions will be guided by a focus on maximizing our resources to care for our patients. These crisis protocols allow us to quickly pivot to help meet the overwhelming demand for hospital services. We are all in this together and never more have we needed the support of our communities as we fight through this most challenging time.” The health care crisis in Maryland is impacting many other Maryland hospitals, who have already implemented crisis standards of care protocols. At the same time we are escalating to crisis status, Maryland Gov. Larry Hogan has declared Maryland is in a catastrophic healthcare emergency. Crisis standards of care are used only in times of emergency, when the demand for healthcare exceeds the ability of the health system to provide it through normal means. The modified protocols allow healthcare leaders to change staffing, adjust or delay surgeries, and when necessary, deploy non-clinical staff to assist with patient care. Though rarely used, these protocols have been prepared and approved in advance for just this type of situation and are based on best practices and guided by ethical principles. “More than 70% of our hospitalized patients are not vaccinated,” said Dr. Stephen Selinger, chief medical officer for Luminis Health Anne Arundel Medical Center. “With Omicron spreading rapidly, it is critical our community get the vaccine and the booster as soon as possible and continue masking in public to help minimize COVID-19 symptoms and severity. This has an important impact on reducing hospitalizations and emergency room overcrowding.” The crisis caused by the increase in COVID-19 infections is also leading to increased wait times in the health system’s emergency departments. Adding to the crowding are people inappropriately seeking tests for COVID-19 at the emergency department, rather than going to one of the many test sites around the region, including one led by the Maryland Department of Health at Luminis Health Anne Arundel Medical Center. “While we are always here for serious illness and injuries, we are asking the community to avoid the Emergency Department for non-life-threatening issues,” said Dr. Sunil Madan, chief medical officer at Luminis Health Doctors Community Medical Center. “For COVID-19 tests and less severe illnesses and injuries, patients should visit their primary care provider or go to an urgent care center.” There are a number of ways the community can help, including: In addition to getting vaccinated and boosted, practice the 3W’s to stop the spread. Wear your mask, watch your distance, and wash your hands. Use the emergency room for true medical emergencies, not for minor injuries or COVID testing. If you have COVID-19 and are experiencing minor symptoms, please stay at home and contact your primary care physician if you have questions. Frequently Asked Questions What does crisis standards of care mean? Crisis standards of care protocols are put into place when there is a need to extend the availability of key resources, while also minimizing the impact of shortages on clinical care. These protocols have been prepared and approved in advance so that we can quickly implement them in times of crisis. This is the first time in the history of Luminis Health that we have implemented these plans. What changes for patients? It’s important to note that patients with serious illness and injury should continue to access needed care at Luminis Health. Our focus will be on care for the sickest patients who truly require inpatient hospital treatment. Those with less serious conditions should avoid the emergency departments and seek care from their primary care provider or an urgent care center. Patients can expect longer wait times for all services and increased limitations on visitors and communication with loved ones. We plan to increase the use of telemedicine to triage the need for in-person clinic appointments. What does it mean for staff? During this period, staff may be redeployed or asked to change regular protocols in order to better care for the sickest patients. These changes may include the frequency of imaging studies, expedited transfer and discharge processing, streamlined documentation, and the use of telemedicine to triage patients before scheduling inpatient clinic appointments. Surgeries will be limited to urgent cases that cannot otherwise be managed with more conservative measures, and the emergency department will be reserved for those with life-threatening illnesses and injuries. Can someone still go to Luminis Health when they need care? We are always here for those with serious illnesses and injuries. During this time, we ask those with less serious needs to go to their primary care doctor or an urgent care center. Because we are caring for so many with COVID-19, we have fewer staff and fewer beds available for those with other needs, so surgeries may be postponed. We are working diligently to get back to normal care protocols as soon as possible. How long will the crisis protocols be in place? It is difficult to know when the need for crisis standards of care will abate. Gov. Hogan has stated that the next four to six weeks could be a very difficult time for the state of Maryland, and the pandemic models we are seeing form the CDC and other trusted sources support this. The Incident Command teams at Luminis Health are closely monitoring the evolving situation and making decisions accordingly. What can the community do to help? The most important things the community can do is to take care of themselves. Get vaccinated and boosted. Practice the 3Ws – wear a mask, watch your distance and wash your hands. During this crisis, we ask those with less serious needs to go to their primary care doctor or an urgent care center rather than the emergency departments. Patients within the emergency department should understand that our staff is working at peak capacity, and there may be longer wait times or differences in care experience. All Luminis Health care teams are focused on being able to provide the highest quality, safe care to those who need it the most.0
- Plastic Surgery & Skin CareGeneral Page Tier 3BlogLaugh lines, crow’s feet and wrinkles around the forehead are signs of a life well lived – and a natural part of the aging process. But take heart: While wrinkles are a fact of life, there are safe and effective ways to minimize their appearance and, in some cases, slow their progression. Botox® and fillers are two of the most common noninvasive procedures to address wrinkles today and have grown in popularity over the last five to ten years. However, many patients still have questions and, sometimes, misconceptions about these approaches. We often see patients wanting to learn more about how injections and fillers can reduce the appearance of wrinkles and help them look younger. The first thing we do is talk about the difference between these procedures and the benefits of each. Then, together, we can determine which may be the best for you. Myth #1: Botox and fillers are the same thing While many confuse Botox and fillers, it’s important to understand they aren’t the same thing. Botox paralyzes muscles temporarily, which can help prevent the overlying skin from developing wrinkles. Fillers, on the other hand, can soften and fill lines and areas of volume loss like the cheeks or lips. With Botox injections, small amounts of Botox are injected into these areas to block signals from nerves to the muscles. The muscles are then no longer able to contract so the face doesn’t wrinkle. The most common areas for Botox include forehead lines and crow’s feet. Fillers, like Juvéderm® and Voluma® XC, use an injectable gel to fill a wrinkle that is already apparent. Juvéderm can be used to target wrinkles around the eyes and lips. Voluma XC can lift and smooth the cheeks. Another key difference between fillers and Botox is that Botox is a very effective measure to prevent or delay the appearance of wrinkles. The best time to start Botox is actually in your late 20s or early 30s, before wrinkles become obvious. The less you use the muscles in your face, the slower wrinkles will form. Of course, Botox and fillers need to be part of a comprehensive strategy that includes no smoking, sun protection and other skincare routines. READ MORE: Understanding your winter skincare routine Myth 2: My Botox won’t last The effects of Botox are not permanent but you and your provider can work together on a timeline that works to keep wrinkles at bay. Typically, we recommend about six months between injections, but that can vary based on your age and preference. The first sign it’s time to come back to the office is when the muscle begins to loosen up and start to move again, which is an indication the paralysis is wearing off. Fillers, on the other hand, can last up to two years. Your provider can help you decide what approach is best for you. You can experiment with fillers and Botox, but you need an experienced provider to guide you through the options that are best for you to ensure that injections are effectively administered. Just because you can get Botox at a spa or the dentist doesn’t mean you should. You need to see a knowledgeable provider who will create a strategy that addresses your concerns. Myth #3: My results won’t look natural One of the biggest misconceptions about Botox is that, because the muscles are paralyzed, you won’t be able to express emotion. But the areas targeted with Botox aren’t really needed to share your thoughts and feelings. For example, you don’t need to express anything with the muscles on your forehead, not being able to squint your eyes isn’t going to keep your family and friends from knowing how you feel and you can still certainly smile, frown and laugh. Fillers are also a natural, subtle way to reduce the appearance of wrinkles. Myth #4: Once I start, I can’t stop Botox and fillers are elective procedures that you can stop at any time, but it’s always best to discuss your plans with your provider to create a schedule that’s right for you. Your provider can also address any concerns you may have about the procedure or recommend a different approach to better meet your goals. AAMG Plastic Surgery offers nonsurgical and surgical cosmetic procedures to women and men. Choosing cosmetic plastic surgery is a deeply personal choice. To learn more about what’s the best fit for you, check out aahs.org/cosmetic. Authors Tripp Holton, MD is a plastic surgeon at AAMG Plastic Surgery. Kathryn Sidrow is a certified physician assistant at Anne Arundel Medical Group (AAMG) Plastic Surgery.0
- Plastic Surgery & Skin Care, Pediatrics, Patient StoriesGeneral Page Tier 3BlogImagine you’re able to use your gifts to offer life-altering surgeries to children in developing countries. Anne Arundel Medical Center plastic surgeon Devinder Singh, MD, has done this through his work with the international charitable group Changing Children’s Lives. Doctors volunteering with Changing Children’s Lives have performed free reconstructive surgeries on more than 1,000 children in countries including Thailand, Vietnam, Colombia, Guatemala, Dominican Republic, Honduras and Uganda. Dr. Singh, AAMC’s chief of plastic surgery and medical director of AAMG Plastic Surgery, says a typical mission includes upward of 25 people and takes a year or more of coordination to pull together. “But the return on investment is just amazing,” Dr. Singh says. “We can help as many as 50 kids with cleft lip or palate in just one week.” Surgical procedures include cleft lip and palate repairs, as well as treatment of congenital and traumatic facial deformities, burn scars and congenital hand deformities. “We also teach the hosting country’s plastic surgeons, so our work can continue after we leave,” he adds. Dr. Singh thanks AAMC for its unwavering support. “This is a hospital with a heart,” he says. “I appreciate that AAMC allows me to donate my time to help others.” Dr. Singh says his goal is to give back, whether it’s repairing a child’s cleft lip or advancing the field of medicine. He’s the former chair of the Maryland Board of Physicians and was recently elected into the exclusive American Association of Plastic Surgeons. He’s published 65 peer-reviewed scientific articles. Plus, he’s received invitations to deliver more than 100 academic lectures throughout the world. Dr. Singh looks forward to his next trip with Changing Children’s Lives, scheduled for Thailand early next year. ”My mission is to serve people who can benefit most from what I’ve learned during my many years as a plastic and reconstructive surgeon,” he says. “I love what I do for a living!” Like AAMG Plastic Surgery on Facebook for the latest updates from the practice’s medical team.0
- Community, Pediatrics, Patient StoriesGeneral Page Tier 3BlogWhen local pediatrician, Dr. Steve Brown, was young, he dreamed of being a doctor working on a boat. The first part of his dream defined his career as a pediatrician, and last year, he realized the second part while he served as a volunteer at The Lake Clinic, Cambodia. The clinic brings doctors, medical supplies and other services to seven floating villages on the Tonle Sap Lake in Cambodia. Many of the houses in these villages are either floating structures or built on stilts over the water, and the area is so remote that the only way to bring a clinic to the people is by boat. Dr. Brown had been consulting with clinics (including one in Cuba) over the internet for a year or so, helping them to assess more difficult illnesses or conditions. “I’ll get pictures of dermatological conditions, or something that transmits in a photograph,” he says, “and it’s easy for me to get a specialist to take a look at it.” After helping patients online, Dr. Brown had an opportunity to spend a month at the clinic where he experienced first-hand the extreme needs of people in such a remote location. “We traveled three to four hours to reach people who couldn’t even seek medical care if they wanted to,” he says. “Families are living off of $2 per day and it cost $40 to $50 worth of fuel just to get us there.” He says the most rewarding aspect of the work is the appreciation shown by the people they were helping. “The people are just so grateful that you’re there helping them and it gives you a warm feeling inside to be able to do that.” Dr. Brown also volunteers for Project Angkor, a humanitarian mission that sets up free temporary clinics in remote areas to treat patients and help train Cambodian medical students. Cambodia has a special draw for Dr. Brown, but volunteerism has characterized his career both near and far. As a member of the Maryland Physician Emergency Volunteer Corps, he worked with the Red Cross after hurricane Katrina to see people in Maryland who had been displaced from homes and needed medical care. “This kind of work is definitely what I went into medicine for,” he says. “I wanted to be able to help people who need the help.”0
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