- Men's Health, Weight Loss, Women's Health, UncategorizedGeneral Page Tier 3BlogMore than 29 million Americans have diabetes, and the Centers for Disease Control and Prevention (CDC) estimates that 8 million of those people do not yet know they have it. While these statistics are staggering, Barbara Mensah Onumah, MD, medical director of Luminis Health Diabetes & Endocrinology Annapolis, is even more concerned about another alarming fact: 86 million American adults—more than one out of three—have prediabetes, a precursor to type 2 diabetes. And, nine out of 10 people with prediabetes don’t know they have it. People with prediabetes have higher-than-normal blood-sugar levels but do not yet meet the criteria for a diabetes diagnosis. “Without lifestyle changes to reverse risk factors, 15 to 30 percent of those with prediabetes will develop type 2 diabetes within five years. If you take action, studies tell us that you can prevent or delay type 2 diabetes and, in some cases, return blood glucose levels to within the normal range,” Dr. Onumah stresses. Luminis Health Diabetes & Endocrinology Annapolis offers comprehensive management, treatment and education for patients with diabetes. The program was created to complement care given by patients’ primary care providers and other specialists. Luminis Health’s diabetes care resources include: group education classes and access to support groups highly individualized counseling one-on-one nutrition counseling instruction on insulin pump usage and continuous glucose monitoring The program can be reached at 443-481-4600. Because so many Americans do not know they are at risk for developing type 2 diabetes, Dr. Onumah says that education coupled with physician-recommended screening tests are essential. Education begins with learning the risk factors for type 2 diabetes. The two most significant risk factors, both modifiable, are obesity and inactivity. Non-modifiable risks include a family history of type 2 diabetes; African-American, Latino or Native American heritage; age of 45 or older; and for women, a diagnosis of gestational diabetes when pregnant. Knowing and discussing your risk factors with your physician helps pinpoint the right diabetes screening schedule for you. “A groundbreaking study showed us that education alone is not enough,” Dr. Onumah cautions. “There must also be motivational counseling.” The study she cites placed 3,234 overweight participants—all with increased risk for developing type 2 diabetes—into three distinct groups and followed them for three years. Compared to the placebo (those who did not receive individualized counseling or medication), those who received individualized counseling and were able to lose about 7 percent of their body weight through diet and exercise reduced their risk of developing diabetes by approximately 60 percent. The group that received medication alone reduced their risk of diabetes by about 30 percent. “It’s essential we understand the importance of increased risk of diabetes,” Dr. Onumah says. “Lifestyle interventions, addressed quickly and consistently, can change lives.” Author Barbara Mensah Onumah, MD, is medical director of Luminis Health Diabetes & Endocrinology Annapolis and can be reached at 443-481-4600. Originally published Nov. 17, 2015. Last updated Aug. 28, 2023.0
- Men's Health, Women's HealthGeneral Page Tier 3BlogThe holidays are here and so are all the get-togethers, parties and delicious meals. If you suffer from heartburn, then you know indulging in holiday fatty foods and alcohol can be a trigger, even if you take over-the-counter medications for temporary relief. However, if you notice that you are experiencing indigestion-like symptoms more than twice a week, you might have something more serious. Heartburn is the most common symptom of gastroesophageal reflux disease, or GERD. GERD is a digestive disorder that affects up to one in five U.S. adults. It happens when the muscle in the esophagus called the lower esophageal sphincter (LES) opens or relaxes too often or for too long. This causes stomach contents to back up into the food pipe, causing heartburn and acid indigestion. Other symptoms of GERD include shortness of breath, difficulty swallowing, chest pain, chronic cough, sore throat, hoarseness and bad breath. Although there isn’t a specific cure for the disease, you can make some lifestyle and diet changes to help you manage your symptoms: Maintain a healthy weight. The risk and severity of GERD tend to intensify for those who have higher body weights. Losing a few pounds could make you feel better. Avoid tight-fitting clothing. Tight clothes could exert pressure on the stomach, causing stomach acid to move up towards the esophagus and resulting in acid reflux. Try wearing looser clothes that don’t compress the stomach area. Avoid trigger foods and drinks. These include fatty or fried foods, tomato sauce, alcohol, chocolate, garlic, onion and caffeine. Eat smaller meals and slow down. Smaller meals can help you reduce pressure in your stomach while eating slowly can help you identify when you’re full more quickly. By slowing down, you’re also less likely to irritate your esophagus. Wait at least three hours after eating before lying down or going to bed. Staying up a few hours before going to bed will reduce your risk of reflux. Elevate the head of your bed. This will reduce the contact of the lining of the food tube with acidic contents and help you get a good night’s sleep. Quit smoking. Do not smoke or chew tobacco. Choose water over soda. Carbonation bubbles can expand in the stomach, causing increased pressure that contributes to reflux. Avoid creamed or cheesy foods and soups. All high-fat foods can cause reflux, so skipping the dairy items can help. If untreated, GERD can lead to more serious health problems over time, including esophageal cancer. It’s important that you talk to your primary care doctor about your symptoms and find a solution that works best for you. There is not yet a cure for the disease but with lifestyle modifications and/or medications, you can manage your symptoms to improve your quality of life. If lifestyle changes and medication don’t help manage your GERD symptoms, your doctor may refer you to a surgeon. Surgery may also be a reasonable alternative to a lifetime of drugs and discomfort. Author Adrian Park, MD, is chair of Anne Arundel Medical Center’s Department of Surgery and an internationally recognized specialist in minimally invasive surgery. To schedule an appointment with him, call 443-481-6699. Originally published Nov. 26, 2018. Last updated Nov. 14, 2019.0
- Community, Infectious DiseaseGeneral Page Tier 3BlogCharlotte Wallace makes her way inside Morris H. Blum Senior Apartments. She knocks three times on one of the wooden doors. ‘I’m a nurse with Anne Arundel Medical Center,’ she identifies herself. The lock slowly turns. Before Wallace knows it, a hand quickly grabs the bag she’s holding and then disappears with the sound of the door shutting. ‘Thank you,’ they shout from inside. She smiles, grabs another bag and repeats the process. She does this with more than 150 tenants in that building alone. “Some of the seniors we visit are scared and close the door immediately,” she said. “Others give us Halloween candy in exchange as a thank you and some are just excited to see new faces.” Wallace explained a few of the residents are not as in tune with the news or updates. As a result, they’re confused as to why Wallace and her team are there. “We answer their questions and give them as much education as we can,” she added. Wallace is a community health nurse at Anne Arundel Medical Center (AAMC). Her main role is to bridge the hospital and the community. When news about coronavirus (COVID-19) broke, she knew she had a lot of work to do. She started by contacting community partners to look at ways to slow down the spread of the virus. This meant looking at the ‘wrong trends,’ misconceptions and ways to close the gap. To do this, she launched the COVID-19 Community Outreach program. The primary goal of the program is to decrease the spread and hospitalization of COVID-19 patients. This is achieved through increased education and improved access to support and health services. “We quickly discovered there was a gap in some of our housing units,” Wallace explained. This was primarily the case where subsidized seniors, disabled adults and homeless shelter residents lived. Wallace had already built relationships of trust and understood the systemic problems in the community. As a result, her approach included passing out educational fliers and kits to meet basic needs. On April 14, she started to knock on doors to personally distribute the kits. To date, she has visited 18 different locations around Anne Arundel County – conducting visits in 14 of those locations by herself. Just a couple of weeks later, another team at Doctors Community Hospital (DCH) did the same in Prince George’s County. This team covered 10 additional locations. “We used the same program in Prince George’s County,” said Leslie Strimel, director of Case Management, Social Work and Transition for Care at DCH. “We sent out a nurse practitioner to the communities that the county identified as being in need of this program.” Just like in Anne Arundel County, Strimel said low-income seniors in residential facilities formed these communities. Each COVID-19 Community Outreach kit has two cloth masks per resident, two laundry detergent pods and a bar of soap per apartment, along with educational resources. The printed resources are Centers for Disease Control and Prevention (CDC) guidelines simplified by Wallace to help residents understand how to best protect themselves. Each kit also includes fliers that explain how to wear a mask, how to protect yourself and others, how to wash your clothes during the pandemic and much more. In Prince George’s County, the educational material includes the 211 number, which is also a crisis number for behavioral health. According to Wallace, the identified gaps already existed. However, the outbreak made these and the need to close them more obvious. “Some people told me that they just wash their clothes in hot water and don’t use any soap,” she said. “With the pandemic, a lot of our most vulnerable residents are taking a bigger burden. ‘Just doing telehealth’ is not possible without a phone or an email address. Some of these residents don’t even have a landline.” Wallace goes out at least twice every week and visits several sites to distribute kits. Additionally, she gives out kits with instructions. These are specifically for management at the sites and include best practices to protect their residents. Wallace also uses visits as an opportunity to conduct screenings. These include screenings for mental health and nutrition. According to her, many seniors she visits are scared, isolated, already limited and depressed. “We came across a senior who was very depressed,” she said. “I went through a basic screening and I gave the person the crisis response number in case they needed to reach someone. I was giving out that number at least once per building, which is common.” To date, the program’s teams conducted over 2,900 visits in Anne Arundel County and over 2,250 visits in Prince George’s County. And while it is hard to measure the true impact of the outreach, Wallace is confident the team is helping many during this difficult time. “One day, a team entered a floor to find a gentleman, with rotted nubs for teeth, standing in the hallway,” she said, adding that he started to cry. “He said he thought we missed him with our ‘masks and laundry soap’ after his sister, who lives in the same building, called him to tell him that the nurses came by her apartment.” After a short screening, they noted that he had major food insecurities and connected him to the Senior Nutrition Program. Another resident received her kit and couldn’t stop hugging it. “She was so excited to receive two laundry detergent pods,” Wallace said. Similarly, Ursula Friton, manager of Transitional Care at DCH, said residents in Prince George’s County have been very welcoming of the program. According to her, it’s been very new but a great experience both for the DCH team and the seniors. “There was a big need for this program in our county,” she said, explaining that the program is on its third week. “Seniors are happy to see us and very grateful to get their kits.” The outreach teams in both counties plan to continue working with managers at the various facilities. They plan to support the most vulnerable communities, even after the pandemic subsides. Wallace and Strimel are working with both counties and the Maryland Health Department to reach other communities that are in need of resources and information.0
- Cancer CareGeneral Page Tier 3BlogWhen cancer begins inside the mouth, throat or nose, it is considered a head and neck cancer. According to the National Cancer Institute (NCI), head and neck cancers account for nearly 4 percent of all cancers in the United States. That may sound low, but more than 70,000 new cases are diagnosed in the U.S. annually. Our experts review the symptoms associated with this disease. The signs of head and neck cancer include: Lumps and sores that do not heal Persistent sore throat Difficulty swallowing Harshness/change in voice Red or white patches in the mouth Trouble breathing or speaking If you experience these changes, talk to your primary care doctor. These could be symptoms of cancer in the oral cavity, throat, voice box, sinuses or salivary glands. Depending on your symptoms, age and medical history, your provider can recommend a diagnostic test for you. Options including imaging, biopsies and speech and swallowing tests. If you are diagnosed with a head and neck cancer, treatment may include: Surgery Radiation Chemotherapy There is potential to use these treatments alone or combined, depending on the subtype and extent of cancer. Treatment requires expert team work among multiple doctors, such as ear-nose-throat (ENT) doctors, surgeons, radiation oncologists and dentists. These providers work together to create a treatment plan. Risk factors for head and neck cancer include heavy tobacco use, heavy alcohol intake and human papilloma virus (HPV). In fact, according to the Head and Neck Cancer Alliance, at least 75 percent of head and neck cancers are caused by alcohol and tobacco use. To reduce your risk of this disease, our experts recommend: Avoiding alcohol – it is best to not drink alcohol. If you choose to drink, drink moderately, limiting intake to no more than two drinks per day for men and one drink per day for women (definition per the Centers for Disease Control). Avoiding tobacco – it is never too late to quit smoking. Call Luminis Health at 443-481-5388 for free resources to help you quit. Vaccination for HPV – most providers routinely recommend it for preteens ages 11-12. For adults up to 45 years, have a thorough discussion with your provider. If you or a loved one has been diagnosed with a head and neck cancer, our cancer team is here to help. Read about our cancer care services to learn more. Authors Antony Koroulakis, MD is a radiation oncologist with experience treating a wide range of cancers.0
- NutritionGeneral Page Tier 3BlogFood recommendations to eat more fiber, fruits and vegetables haven’t changed. These guidelines are not lost on the food industry either. In efforts to sell their products they use buzzwords on labels such as “equals one serving of vegetables,” or “a good source of fiber” to sell veggie chips, chewy bars and even cookies. It appears to have become about marketing, not healthy eating. This is not the only place in the grocery store that takes the opportunity to try and shape your choices and tell you what you should be eating. Let’s answer a few questions to set the record straight. Are brownies rich in fiber a good choice to increase our fiber? No, the fiber in these products is a white powder called inulin, polydextrose and modified starches. This processed fiber does not provide the bulk or fullness feeling as advertised to promote weight loss. The best sources of fiber are fresh fruits, vegetables and high fiber grains with more than three grams per serving. Is gluten bad for everyone? If you have celiac disease, then you shouldn’t eat gluten. There is also a group of people that have gluten intolerance, which does not cause the autoimmune response that individuals with celiac disease experience, yet improves digestion. Gluten intolerance research is ongoing since there aren’t diagnostic criteria to diagnose. Some people believe gluten-free eating is healthier — this is false. It is usually void of fiber; is higher in either fat or sugar, or both; and has more calories. Is organic healthier? There is not enough evidence to show that organic food is always healthier than conventionally grown food. While there are some differences in the nutrient contents, the flexible nature of food production and handling makes it difficult to generalize results. The term organic refers to foods that meet a set of standards that restrict the use of certain pesticides and fertilizers in farming. They are usually not processed using irradiation, industrial solvents or synthetic food additives. Does everyone need probiotics to be healthy? Not necessarily. Probiotics are a type of good bacteria. These microorganisms can help with digestion and offer protection from harmful bacteria, just as the existing good bacteria already do. You can find probiotics in foods like yogurts, sauerkraut and kimchi. Although more research is needed, there is evidence that probiotics might help treat diarrhea, especially after antibiotic use; irritable bowel syndrome; and ease allergic disorders, such as eczema and hay fever. If you take a supplement, make sure to check with your doctor first. Do detox teas and drinks clean our system? Our digestion system includes the liver and kidneys, which naturally cleanse our bodies of harmful substances. Usually, detox products are weight loss gimmicks designed to give people short-term gratification, with no regard for their long-term health, physique or lifestyle habits. If you want to lose weight, eat less and exercise more! The size of our grocery stores with 24 lanes is a good example of the difference of foods available today, compared with years ago when we had six lanes. The foods we look for to provide vital nutrients do not come in packages, bags or processed foods — they grow naturally and are found on the perimeter of the store. 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 May 7, 2018. Last updated Dec. 17, 2019.0
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