- Patient StoriesGeneral Page Tier 3BlogBy the time Joan MacLean met AAMC neurosurgeon Gary Dix, MD, she had been relying on a wheel chair for two years. The 74-year-old Annapolis resident has severe degenerative disc disease of the spine. She had already gone through a number of spinal fusions to stabilize her back, but as the disease progressed, her condition became debilitating. “The pain and weakness in my back and legs got so bad I couldn’t walk,” she says. “More than a block, and I just couldn’t do it.” Joan had developed sacroiliitis, an instability of the sacroiliac joint in the pelvis where the sacrum and the iliac bones meet. This joint is supposed be immobile, but Joan’s had been moving ever so slightly causing inflammation and severe pain. In the past, her only option for relief would have been another major back surgery. Doctors would have had to make a large incision, remove bone and tissue from the joint space. Then, after filling the space with graft material they would have had to install metal screws to immobilize the bones. Fortunately for Joan, Dr. Dix was able to offer her a minimally invasive, cutting edge procedure that very few hospitals in the country offer. The iFuse implant system relies on small titanium dowels inserted into the joint space to prevent the bones from moving. There is no need to cut into the bone, and there are no screws. “Once the joint is immobilized,” Dr. Dix says, “bone grows across the joint space which helps to further stabilize it and prevent painful motion.” The entire procedure is done through a small incision in the back. Last April, Joan had the iFuse procedure on her left side and it turned her life around. “It was the best thing I could have done,” she says. “We went on a cruise in January, and I walked ten miles around the ship.” This February, she repeated the procedure on the other side. “I couldn’t wait to get this done.” She says. “I’m so glad they do this here.” AAMC remains one of only a handful of hospitals in the area with the technology and experienced medical staff to offer this innovative procedure.0
- Behavioral Health, Infectious DiseaseGeneral Page Tier 3BlogFrom the start of the COVID-19 pandemic, we knew to be concerned about our physical health. But what we didn’t think as much about — especially since we couldn’t have foreseen the true impact it would have on our lives or the length of time it would last — is how it could affect our mental health. And today, we’re still learning. In general, we know the disruption we’ve all faced — from fear of the virus and drastic changes to our daily routines to complete isolation — isn’t good for us. And while some effects were already known, others reveal themselves every day. For example, we’re just now beginning to understand the connections between the pandemic and mental health issues that often plague teenagers, including eating disorders. Check out these recent observations: According to the National Eating Disorders Association, calls, texts and online chats to their helpline increased 58% from March 2020 to October 2021. A recent study shows a 25% jump in eating disorder-related hospitalizations for 12-18-year-olds overall. Girls 12-18 years old were hospitalized for eating disorders 30% more during the pandemic. The numbers are clear. And that means parents have a reason to be concerned. Learn more, so you can be ready if your teen needs help. What are eating disorders? Eating disorders are serious but treatable illness that affects people mentally and physically — and there are many types. People are most familiar with anorexia nervosa (self-starvation by severely reducing calories to lose weight) and bulimia (purging after eating an excessive amount of food). But other eating disorders can involve binge eating, obsessing over healthy eating, abusing laxatives and compulsive exercising. What’s behind the jump in eating disorders in teenagers? The pandemic pummeled teens’ daily routine and structure: Schools closed their doors and extracurricular activities, including beloved sports, came to a halt. But what hit them the hardest? Hanging with friends — a teen’s lifeblood — wasn’t an option (or was limited at best). Eating disorders are often related to control, so it makes sense that the uncertainty and stress of the pandemic could be a powerful trigger. When life feels turned upside down, someone with a tendency toward disordered eating could easily turn to controlling food — how much, what or when they eat — to feel like they’re in control of something. For example, stuck at home with less structure and more access to food, teens may binge-eat to deal with anxiety and stress. Then, if weight gain hits, they may go to the other extreme, restricting food and becoming overly focused on exercise. It’s no surprise: Social media fuels the fire. With school and activities limited, teens turned to their phones to feel connected to someone. They spent more time than ever scrolling through sites such as Instagram and TikTok. And although teens may feel less alone when they’re online, excess screen time exposes them to negative messages. What are signs of an eating disorder? Even today, with most schools and activities up and running again, stress and uncertainty still linger. Teens, like everyone else, are trying to live with the reality that COVID-19 is here to stay. Unfortunately, eating disorders continue to be how many teens try to cope. Changes in your teen’s regular eating and exercise habits are signs your teen may be struggling. Keep an eye out for these signs and take action if you notice: Defensiveness about food Obsessive workouts Preoccupation with counting calories Refusal to eat specific categories of food Skipped meals Sudden weight loss Also pay attention to what your teen’s saying. For example, comments about food — feeling guilt or anxiety about what they’re eating or not eating — or unhappiness about their body are red flags of a brewing eating disorder. Know how to help your teen Talking with teens can be tricky, but it’s the place to start if you suspect they’re using food or eating in an unhealthy way. Be direct and ask what’s going on without launching into a lecture. They’ll be more receptive to discussions in small doses. Focus on your concerns for their health, not body shape or size. Stumped for what those conversations should cover? Start with: Emotional eating. Help your teen understand how food can be a way people deal with emotions. Explain how talking through problems with friends, family or a counselor is a more effective (and healthy) way to cope with a problem. Healthy eating habits. Talk about eating when hungry and how to fuel their body to be healthy and strong. Make regular meals together a habit. Media messages. Help your teen understand that social media, television shows and movies portray unrealistic (and often “doctored”) body types as normal. Positive body image. Ask your teen how they feel about how they look, and explain how healthy bodies come in all shapes and sizes. Remember, as a parent, you’re setting an example. Practice the attitudes about food, eating and body image you want them to have. Reaching for ice cream for comfort after a tough day at work or bashing your “thunder thighs” every time you put on shorts is a message you’re sending that eventually sticks. You may think your teen isn’t listening or watching, but they are. Finally, don’t assume eating issues are “just a phase” your teen will grow out of. Research shows dealing with concerns about an eating disorder early and getting professional help are key to successfully treating it. Start by scheduling an appointment with your teen’s primary care provider. Sometimes it takes hearing something from someone other than mom and dad for a message to get through. But it may take more. If so, your doctor can offer the appropriate support or referral your teen needs. This article originally ran in the Enquirer Gazette. Authors Lauren Fitzpatrick, MD, medical director, Luminis Health Pediatric Emergency Department.0
- Infectious DiseaseGeneral Page Tier 3BlogHolding a red marker, Teri Boss writes ‘thank you’ on the inside label of each newly sewn gown. She sketches a tiny red heart beside every ‘thank you’ she writes. These gowns do not have an ordinary purpose. They adorn the backs of nurses at Anne Arundel Medical Center (AAMC) who are working every minute to save the lives of COVID-19 patients. Boss is one of nearly 40 community volunteers who have sewn almost 900 isolation gowns for the nurses of AAMC. In April, during our patient surge, the sewers produced 50-80 gowns a day. “I wanted to give back and take care of my country during this difficult time,” said Boss, a first-generation Polish American, who came to the U.S. in the early 2000s. “The love I’ve received from people in this country inspired me to help.” Teri Boss is one of nearly 40 community volunteers who have sewn almost 900 isolation gowns for the nurses of AAMC. Despite great efforts to conserve gowns during the pandemic, the supply was running low and more were needed for nurses caring for COVID-19 patients. “None of us were sleeping. We were worried about running out of isolation gowns,” said Joan Twigg, RN, who coordinated the gown conversions. “We have to protect our health care workers during this pandemic and back then we were seeing a lot more COVID-19 patients than we are now.” Sewing Angels Twigg said AAMC obtained 800-1,000 lab jackets to help with the shortage. They were not an easy replacement to isolation gowns because they opened in the front. Isolation gowns open in the back to prevent contamination. Twigg took some of the lab jackets home to see if she could make them work. Despite creating a prototype isolation gown, which sealed up the front and opened in the back, she still had a problem. “I brought them into the hospital and said ‘If we could just get a room full of sewers for two days we can do this,’” Twigg said. This was not an easy fix due to social distancing and visitor restrictions enacted by the hospital to protect patients and staff. Twigg contacted a friend who is a family and consumer sciences (FACS) education teacher to see if she could help or knew anyone who could. The friend connected her to FACS teacher, Lenore Martin, who reached out to her sewing network. Martin, who has sewn for years, reached out to fellow sewers and created a video to show them how to put the gowns together. With that, the volunteer COVID-19 sewing gown operation was born. Volunteer Lenore Martin sews gowns for AAMC nurses. “I think all of us feel great about being able to help,” Martin said. “It’s not a lot that people who aren’t qualified in the medical field can really do right now. I’m just really thankful that our sewing abilities are able to be beneficial to the hospital and to the nurses.” The gowns are made out of tent-like material and are washable for reuse. The reuse factor solved the gown shortage problem. Volunteer Julie Bays Julie Bays is a FACS teacher and a lifelong sewer. She learned from her grandmother at the age of 10. She calls sewing her “happy place” and was glad to join the team of sewers. Helping was personal for her. “I have a daughter who works in the emergency room,” Bays said. “I admire how she gets up and goes to work every day with such a willing spirit. It was really nice that I could do a little bit to help the people on the front lines.” The volunteers’ work has not gone unnoticed. They have received notes of thanks from nurses and photos with them wearing their gowns. Some AAMC nurses refer to the network of sewers as angels. They have sent pictures holding up signs that say, “Thank you, sewing angels.” Making a Difference Bays and other volunteers have also sewn masks and scrub caps for AAMC during the pandemic. Volunteer Monette Callahan Like Bays, Monette Callahan also has a personal connection to health care. Her son is an ICU nurse who is currently caring for COVID-19 patients in Baltimore. Regularly he tells her of the challenges that front line workers are facing. “My son says, ‘This is for real mom. This is scary. It’s not like what you see on social media,” Callahan said. Ultimately, Callahan wants to do her part to support her son as well as others working on the front lines of the COVID-19 pandemic. “I enjoy sewing the gowns because I know I’m helping and making a difference in my own way,” she said. “I have the skills, I have the machine and I have the time. Why not go ahead and help?” Learn ways you can help our community.0
- Weight Loss, Women's HealthGeneral Page Tier 3BlogSeason three of the popular television drama This is Us recently premiered on NBC. During the first episode, one of the main characters, Kate, is diagnosed with Polycystic Ovary Syndrome. Commonly referred to as PCOS, this hormonal condition affects nearly 1 in 10 women of childbearing age. Timing of the health discovery is particularly important since Kate and her husband are trying to get pregnant. The show has also documented the character’s struggle with her weight since puberty as fans look on with empathy. Kate’s diagnosis now helps to explain her infertility struggles and obesity, as it does for many Americans. What is Polycystic Ovary Syndrome (PCOS)? The exact cause of PCOS is not clear, but it is a set of symptoms caused by a problem with a woman’s hormones. It mainly affects the small organs that store a woman’s eggs, her ovaries. It can also affect the rest of the body. “Symptoms include irregular menstrual cycles, abnormal hair growth, acne and weight gain,” says Dr. Chason. “An evaluation may find higher levels of androgen hormones, glucose intolerance, and enlarged ovaries with a high number of small follicles (cysts). It can be difficult to diagnose because PCOS has a wide range of symptoms. Even professional societies debate the most accurate standards for diagnosis.” Understanding PCOS and fertility The hormonal imbalance contributes to the high levels of androgens, one type being testosterone. Higher than normal androgen levels can prevent ovulation. Ovulation happens when a mature egg is released from an ovary. This happens so it can be fertilized by a male sperm. “Most women with PCOS are not ovulating regularly or at all,” Dr. Chason says. An increase in testosterone causes eggs in the ovaries to never fully mature. The immature eggs then cause irregular ovulation, making it difficult to get pregnant. In most women, eggs that do not mature break down. In those with PCOS, the eggs stay trapped in the ovaries and begin to pile up. In addition, many women with PCOS have insulin resistance. The disorder can increase the risk of miscarriage as well as the risk of diabetes before or during pregnancy. The connection between excess weight and infertility Women with PCOS often have difficulties with metabolism. Though gaining weight does not happen to everyone, it is a common symptom. Excess weight interferes with ovulation. It’s also a risk factor for infertility and miscarriage apart from PCOS. This is because obesity changes the release of a key hormone called LH (luteinizing hormone) and also increases testosterone levels. Both contribute to hormone imbalance and immature eggs within the ovary. Dr. Doyle sees many women with PCOS come through her door. “Many of our female patients in the AAMC Metabolic and Weight Loss Surgery program suffer from PCOS as they begin their journey,” she says. “Almost 60 percent of women who suffer are obese. Similarly, half of sufferers have metabolic syndrome, a condition that increases the possibility of other health risks like diabetes and high blood pressure.” PCOS treatment and the odds of getting pregnant Lifestyle changes are the first line of therapy since exercise and weight loss can alter endocrine changes. This can’t cure PCOS, but it helps reduce symptoms and prevent some health problems. Often, losing weight decreases testosterone levels and regulates menstrual cycles. It also decreases a woman’s risk of diabetes and cardiovascular disease. A full set of treatment for PCOS depends on many things: age, how bad it is, general wellbeing, etc. Dr. Chason says that for women with PCOS who are not trying to get pregnant, birth control pills can normalize periods and decrease abnormal hair growth. The pill regulates testosterone. For women who would like to be pregnant, oral medications are available to induce ovulation. There is also in vitro fertilization (IVF), as Kate tries on the show. “Even with fertility treatment, a healthy weight is key to having a healthy pregnancy and delivery,” says Dr. Chason. “If a woman has irregular periods, a couple should find a specialist right away for an evaluation rather than keep trying on their own. Maintaining a healthy lifestyle and seeking expert help can make a world of difference.” READ MORE: 7 tips for successful weight loss Weight loss surgery Another option to help PCOS sufferers become pregnant is weight loss surgery. “I’ve had many patients who had weight loss surgery,” Dr. Chason says. “All of them saw an improvement in their overall health, often stopping their blood pressure or diabetes medications. In addition, their periods became more regular. Some of them then got pregnant on their own. Others still needed help, but they responded more quickly and easily to fertility treatment.” Dr. Doyle says her team has helped hundreds of patients find a path to a healthier life. The nutrition planning and weight loss surgery relieves many of the symptoms related to PCOS. In fact, the rate of PCOS in weight loss surgery patients falls nearly 60 percent before surgery and another 7 percent after surgery. This success stems from patients both losing weight and maintaining their weight loss. “Almost 90 percent of PCOS patients resume normal menstrual cycles after surgery. Nearly 60 percent also report improvement in other PCOS symptoms, like less abnormal hair growth and better control of hormones.” Authors Have you recently been diagnosed with PCOS or are struggling to get pregnant? Find help today. Dr. Courtney Doyle has offices in Annapolis and Easton. To learn more and meet Dr. Doyle, register to attend a free weight loss surgery seminar as the first step. Call her office at 443-481-6699 or visit our website to sign up online. You can visit Dr. Rebecca Chason at the Shady Grove Fertility Center in Annapolis. To schedule a consultation, call 410-224-5500 today.0
- WellnessGeneral Page Tier 3BlogMillions of us suffer from back pain. In fact, it’s one of the most common health problems in the United States. From a steady, dull throbbing to a sharp, sudden pain that radiates down your leg, there’s a wide range of ways you might experience it — and an even wider range of ways it can happen. Whether your pain developed suddenly after a fall or progressed slowly from age-related changes, the result is the same: symptoms that interfere with your daily life. That’s why it’s important to let a specialist take a closer look, so you can better understand your options and work together to build a treatment plan. Causes of back pain symptoms Almost everyone will experience back pain at some time in their life. Several factors can contribute to back pain, including your: Age Diet Family history Fitness level Job-related risk Stress level Weight When to see a doctor about your back pain symptoms Plan to see your doctor right away if you have pain that doesn’t improve after a few weeks, or if you have these symptoms: Back pain after a fall or injury Fever, which can be a sign of discitis or an epidural abscess Numbness and tingling Severe back pain that medicine doesn’t help Trouble urinating Unplanned weight loss Weakness Treatment for back pain The right treatment depends on the cause of your pain. Your doctor will do a full exam, which may include X-rays and scans, to better pinpoint what’s causing your pain and how best to treat it. An accurate diagnosis is essential as many different structural problems can give similar and often overlapping symptoms. In some cases, you can improve back pain with lifestyle changes, such as staying active to increase strength and balance. You could also work to maintain a healthy body weight to lower stress on your back. Traditional and complementary treatments Your doctor may suggest traditional treatments such as muscle relaxers or numbing injections. Your provider may also suggest complementary approaches such as acupuncture, spinal manipulation, Tai chi or yoga. When you may need surgery for back pain Conservative therapy, including physical therapy, is effective in nearly 80 percent of cases. If physical therapy and other traditional or complementary treatments are not providing relief, surgery may be an option to help alleviate your back pain. Surgical approaches range from minimally invasive procedures to more complex open operations, and an experienced surgeon can partner with you to develop a personalized treatment plan aligned with your overall health and wellness goals. In about 20 percent of cases, sacroiliac, or SI, fusion may be the most effective way to relieve back pain and restore stability. What is SI fusion? The SI joint is where the spine and pelvis meet. SI fusion makes the SI joint more stable since it, like any joint, can break down over time or because of an injury. The result is often a painful lower back. Your neurosurgeon will make a small incision and use an implant system to stabilize and fuse the SI joint to prevent ongoing pain. The procedure is designed to help you recover faster with fewer complications and better outcomes. SI fusion is a minimally invasive surgery that has a very high success rate. After surgery, patients typically recover in about three weeks using a walker or crutch. Most don’t need physical therapy during this time. Expert care for your back pain is within reach If you haven’t been able to find relief from back pain, ask your doctor if the pain could be related to your SI joints. If you are diagnosed with an SI joint condition, please contact Christopher Taleghani, MD at 443-451-4994. Authors Christopher Taleghani, MD, has performed more than 500 sacroiliac joint fusion procedures, making him one of the most experienced minimally invasive spine surgeons in the world. He is an invited lecturer, educator, and innovator in the development and advancement of minimally invasive surgical techniques.0
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