- Weight Loss, NutritionGeneral Page Tier 3BlogDietary Approaches to Stop Hypertension (DASH) is a diet plan to lower or control high blood pressure. Your blood pressure rises and falls throughout the day. High blood pressure is when stays elevated over time. The more your blood pressure rises above normal – which for the average healthy person is below 120/80 mmHg – the greater your health risk. There are no warning signs or symptoms that indicate you have high blood pressure. When you suffer from high blood pressure, your heart has to work harder. This can be dangerous. That combined with the high force of the blood flow, can harm arteries and organs such as the heart, kidneys, brain and eyes. The DASH diet follows heart-healthy guidelines to limit saturated fat and cholesterol. It emphasizes food rich in protein, fiber, potassium, magnesium and calcium, such as fruits, vegetables, beans, nuts, whole grains, and low fat dairy products. Research suggests it can also be effective in reducing inflammation, lowering the risk of developing kidney disease and decreasing levels of low-density lipoproteins (better known as bad cholesterol), along with several types of cancer. The DASH diet hasn’t gained much popularity because it has not been advertised as a weight loss diet. It is a dietary lifestyle designed for disease prevention and improved health. However, most people would likely lose weight given the recommended diet changes, which include limited portions of red meats, sweets and sugary beverages. With the DASH diet you fill up on delicious fruits and vegetables, paired with protein-rich foods. The following are recommendations on how to implement this plan into your life: Eat more fruits. Eat an apple or pear instead of cookies or muffins. Try a few dried apricots instead of pork rinds or chips. Increase your veggie consumption. Add extra vegetables to stews, soups and casseroles. Make one or two weekdays per week vegetarian days and experiment with a new recipe, where vegetables are the highlight. Turn to fat-free or low-fat milk products. Substitute sugary yogurt with plain, low-fat yogurt and add your favorite fruit. You can also use yogurt instead of sour cream, cream and salad dressings in recipes. Other calorie saving tips: Eat smaller portions by cutting back gradually. Try to be mindful of not just what you eat, but the speed, level of hunger or fullness and how your emotions dictate your choices. Snack on fruit, vegetables, boiled eggs, small pre-portioned cheese sticks and nuts. Don’t forget to hydrate with at least 64 ounces of water per day. It’s easy to mistake hunger for thirst. Eat in, not out, and plan healthy meals. Healthy eating takes effort and requires planning but the payback is a lifetime of health. The bottom line to lowering blood pressure is to follow a heart-healthy eating plan, maintain a healthy weight, limit alcohol and increase physical activity. Authors Ann Caldwell and Maureen Shackelford are nutritionists and registered dietitians at Anne Arundel Medical Center. To reach them, call 443-481-5555.0
- Physical TherapyGeneral Page Tier 3BlogThe way we breathe can either induce stress or encourage healing and calmness. Inhaling and exhaling properly affects us mentally and physically. What’s in a breath? Breathing is not only taking in oxygen. It’s also about managing the levels of carbon dioxide, a gas released when exhaling, that contributes to our respiratory function. The longer you practice exhaling through your nose, the more relaxed your body will feel as it releases more carbon dioxide. Carbon dioxide is a potentially toxic gas when it builds up in the body. What impacts my breathing? Seasonal allergies, along with irritants such as smoke, dust, pollen and fragrances effect the efficiency of breathing. These pollutants cause internal swelling, excessive mucous, coughing and a host of other health issues. What can I do to breathe better? Deep breathing lowers blood pressure and promotes the body’s balance. Diaphragmatic breathing is a form of deep breathing. Also known as “abdominal breathing or belly breathing,” it encourages full oxygen exchange as you inhale air into the deepest parts of the lungs while engaging your abdominal muscles. Practice deep breathing by lying on your back with a pillow under your head with your knees bent. Place one hand on your stomach and one hand on your chest. Inhale or breathe through your nose, allow your belly and chest to rise and then exhale out of your mouth. This technique is most effective when the stomach rises higher than the chest. How will intentional breathing and wearing a mask improve my health? Walking and taking deep breathes on a regular basis helps keep you healthy. The American Heart Association recommends 30 to 50 minutes of exercise daily to promote respiratory strength. Wearing a mask reduces the risk of transmitting COVID-19, the flu and other contagious diseases. Some ways to minimize the discomfort and anxiety of wearing a mask include: Using essential oils (placing a drop of lavender oil in your mask), chewing gum or wearing lip balm. Ultimately, wearing a mask is a form of self-care and shows respect for others. Luminis Health Physical Therapy is opening a new location in Upper Marlboro on Nov. 12. Authors Rhonda Fowler PT, MS, CLT, CWS, is a physical therapist at Luminis Health Doctors Community Medical Center. Clarissa M. Ocampo, MM MA CCC-SLP, CLSVT LOUD, is a speech language pathologist at Luminis Health Anne Arundel Medical Center.0
- OrthopedicsGeneral Page Tier 3BlogYou may not realize it, but your bones are in a constant state of regeneration. Your body naturally replaces old bone with new. But by the time you reach your mid-30s, you begin to lose more bone than your body can replace and then menopause speeds this process up. Over time this leads to thinner, weaker bones and the potential for developing osteoporosis. One in two women over age 50 will have an osteoporosis-related fracture in her lifetime. It’s important that you go for bone scans to measure bone loss, as well as incorporate lifestyle habits that can slow down the weakening of bones. Ultimately, this helps reduce your risk of fractures. A bone density test called DEXA (dual-energy x-ray absorptiometry) can diagnose osteoporosis. A DEXA scan uses very little radiation and produces detailed information about your bone density by comparing data from two X-rays operating at different frequencies. Information is collected and compared to a reference group to determine your bone mineral density. “The bone density from the DEXA scan helps your radiologist determine your T-score, which we use to diagnose osteoporosis,” says John Park, MD, a radiologist with Anne Arundel Diagnostics Imaging. “A T-score of -2.5 or lower indicates you have osteoporosis.” You should talk to your doctor if you’ve gone through menopause or if you have any of the following risk factors: Low physical activity Low body weight Smoke Drink too much alcohol Heavy caffeine use Have a diet low in calcium and vitamin D Previous fracture, especially after age 50 Menopause before age 45 Take certain medicines, for example long-term use of corticosteroids Family history of osteoporosis. There’s also a Fracture Risk Assessment Tool (FRAX®) for evaluating fracture risk. Using the results of the DEXA scan, a FRAX score can be given to estimate the risk of a fracture within 10 years. Unfortunately, many women don’t get screened. Even if they have a fragility fracture, many don’t realize that’s a sign they may have osteoporosis. “A bone fracture is not unlike a heart attack — they are both a sign that something is wrong. In the case of a fracture, it could mean you have osteoporosis or a weaker form of bone loss called osteopenia,” says Christina Morganti, MD, orthopedic surgeon and medical director of the Osteoporosis Program at Anne Arundel Medical Center Orthopedics. Bones shouldn’t break with low-energy falls such as from standing height or less. When they do, your doctor may want to run blood and bone density tests to determine if you have osteoporosis. If diagnosed, you should learn about weight-bearing exercise, fall prevention, nutrition and medication options for healthy bones. You can improve your bone health and reduce your risk of fragility fractures by doing the following: Pay attention to your calcium intake. Try to get 1,200 mg of calcium a day, preferably from food. If you don’t get enough from food, add a 500-600 mg calcium pill. Get enough vitamin D. Many people benefit from a supplement of 800-1,000 iu per day. Incorporate weight-bearing exercise into your lifestyle. Try walking 30 minutes a day. Plus, lift weights two or three days per week when cleared by your doctor. Evaluate your home. Throw rugs, slippery surfaces and poorly lit hallways can lead to falls and then fractures. Get your eyes checked. If your sight is impaired, your chance of falling is higher. Eliminate vices. Alcohol and tobacco are two common vices that are detrimental to your bone health. Educate yourself. There are many good resources on the web, including the National Osteoporosis Foundation: nof.org. Authors Christina Morganti, MD, is an orthopedic surgeon and former medical director of the Osteoporosis Program at Anne Arundel Medical Center Orthopedics. John S. Park, MD, is a radiologist at Anne Arundel Medical Center.0
- Cancer Care, Men's Health, Women's HealthGeneral Page Tier 3BlogColon cancer is the third most commonly diagnosed cancer in both men and women in the United States. It is also one of the leading causes of cancer deaths each year. The colon makes up most of your large intestine and is part of your digestive system. In the colon, salt and water get absorbed from food you eat in one of the final steps of digestion, before the remaining undigestible matter gets excreted from your body. Colon cancer usually begins with growths – called polyps – which form within the colon. These growths may become cancerous and, over time, can spread throughout the colon and into other areas of the body. Although there is no surefire way to prevent colon cancer, there are steps you can take to lower your risk: Get screened regularly. Regular screening for colon cancer is critical in order to find and remove polyps before they become cancerous. In general, it is recommended that all adults get screened annually, beginning at age 45. Speak with your doctor for more details on the type and frequency of screening that is right for you. Stay within a healthy weight. Being overweight or obese is a major risk factor for colon cancer, particularly if you carry excess weight around the midsection or belly. If you need to lose weight, keep these quick tips in mind: don’t drink your calories; eat slowly; and pay close attention to hunger cues. Eat only when you are truly hungry and stop when you feel full. Avoid red or processed meats. High intake of beef, pork and lamb is linked with increased rates of colon cancer. The same is true for processed meats, such as deli meat, bacon, sausage, hot dogs, ham and others. Keep these foods as occasional treats and choose poultry, seafood, legumes and nuts for your daily protein needs. Eat more fiber. The bacteria in your gut houses 80 percent of your immune system and, therefore, plays an important role in immune function, inflammation and metabolism. A healthy balance of gut bacteria has been linked with a decreased risk of colon and other cancers. Studies show that not only does eating a high-fiber diet lead to a favorable balance of “good” bacteria in your gut, but it is also associated with a reduced risk of colon cancer. Aim for 25-30 grams of fiber per day by eating vegetables, fruits, oatmeal, legumes, nuts, whole-wheat pasta, brown rice, whole grain bread and other grains. Add color to your plate. A diet rich in fruits and vegetables can reduce the risk of colon cancer. Plus, the phytochemicals found in these foods not only give them their vibrant colors, but they also act as cancer-fighting antioxidants in the body. Lycopene—found in tomatoes, watermelon and mangoes—is a great example. Eat a rainbow of different colored fruits and vegetables every day to make sure you’re getting as many different antioxidants as possible. Move your body. Physical inactivity is another risk factor for colon cancer, so be sure to move your body as much as possible every day. Take the stairs, park further from your destination, go for a walk, find a fun fitness class, or throw a dance party with your kids or grandkids. Have fun and make daily movement a habit. Avoid smoking and drinking alcohol. Both smoking and high alcohol intake are linked with an increased risk of colon cancer (and other diseases). It’s best to quit smoking altogether and limit your consumption of alcohol to no more than one drink a day for women and two drinks per day for men. All of these recommendations can help lower your risk factors for colon cancer. As an extra bonus, nearly all of them can also reduce your risk of other cancers and major diseases. That’s a win-win for your health! Authors Ann Caldwell and Maureen Shackelford are nutritionists and registered dietitians at Anne Arundel Medical Center. To reach them, call 443-481-5555. Originally published March 4, 2019. Last updated March 2, 2020.0
- 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
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