- Infectious DiseaseGeneral Page Tier 3BlogYou can’t turn on the news or scroll through social media today without hearing about the COVID-19 vaccine. And while we know you’re anxious to put the pandemic behind you, we also know you may have lingering questions about the vaccine. You aren’t alone. Many of your coworkers, family members and neighbors are wrestling with the same questions. We’ve never experienced a pandemic of this magnitude in our lifetimes, and we’ve never seen a vaccine developed this quickly. But investigating the details and unpacking what we know about the vaccine can go a long way in helping you feel more at ease. It’s important to know that multiple COVID-19 vaccines are under development. At this time, Pfizer and Moderna are the only vaccines available in the United States. They are the only COVID-19 vaccines that have received an Emergency Use Authorization (EUA) from the Food and Drug Administration (FDA). Fast doesn’t mean careless. It’s true; this vaccine is one of the fastest developed in modern history. But researchers were not starting from scratch when they learned about SARS-CoV-2, the virus that causes COVID-19. Both the Pfizer and Moderna vaccines are messenger RNA (mRNA) vaccines. Technology associated with the mRNA vaccine dates back to the 1990s. According to the Centers for Disease Control (CDC), researchers performed early stage clinical trials using mRNA vaccines for HIV, influenza, Zika, rabies, and others. Unfortunately, it has taken a pandemic to get the needed funding to push this technology forward to develop this type of vaccine. It’s also important to note the process has been able to move so quickly because: The clinical trials were centrally coordinated by the government rather than various pharmaceutical agencies. The clinical trials combined the first two phases to assess safety, dosing, and the immune responses. The FDA granted the Pfizer and Moderna vaccines an EUA to allow for quick approval and distribution. Under an EUA, approval is pushed ahead of less critical projects. In order to issue an EUA, FDA must determine the known and potential benefits of the vaccine outweigh its known and potential risks. CDC continues assessing the effectiveness of vaccines approved for an EUA. None of the factors that allowed the accelerated development of a COVID-19 vaccine have compromised safety, scientific or ethical integrity. No short-cuts have been made. The FDA recommends a vaccine have an effectiveness rate of at least 50 percent. Both the Pfizer and Moderna vaccines far exceed this standard. Both report about 95 percent effectiveness at preventing symptoms of COVID-19, including severe disease. This efficacy rate is extraordinary. You won’t get COVID from the vaccine, but you may experience mild flu-like symptoms. It’s not possible to get COVID-19 from the vaccine. Pfizer and Moderna vaccines only produce the spike protein from the virus, not the whole virus. However, when you get the vaccine you may experience some side effects, including chills, fatigue, headache, joint and muscle pain and injection site pain. But these side effects are typically mild and will go away on their own within one or two days. They represent immune activation and are seen with other vaccinations. It takes a few weeks for the body to build immunity after vaccination. That means it’s possible you could be infected with the virus that causes COVID-19 just before or just after vaccination and get sick. It takes about two weeks after your second dose for full immunity. Two doses of the vaccine are necessary. Both the Pfizer and Moderna vaccines require two doses to be effective. Pfizer’s second shot occurs three weeks after the first dose, and Moderna’s is four weeks. Health experts recommend you resist the urge to skip the second dose and make time for the second shot. Vaccines for all will take several months. Vaccine distribution will take a while to make it into your neighborhood. That’s because the Maryland Department of Health created a phased approach to vaccine distribution based on initial limited supplies. First available doses will go to those at highest risk of exposure to or developing complications from COVID-19, including hospital health care workers and nursing home residents and staff. Next up will be first responders and those at significant risk of severe COVID-19 symptoms. Phase 2 targets essential non-health care and transportation workers, and people at moderately higher risk of severe COVID-19 illness. Phase 3 focuses on vaccinations for the general public. According to the CDC, vaccines should be available to the general public by the spring of 2021 and distributed throughout the year. Now is not the time to let your guard down. Just because a vaccine is making its way into your area, it still isn’t time to let your guard down. It will take a while for everyone to get both doses of the vaccine. For a highly contagious disease like COVID-19, much of the population must be vaccinated to achieve herd immunity. Herd immunity occurs when enough people become immune to COVID-19 to make its spread unlikely. And, while Pfizer and Moderna vaccines show they’re about 95 percent effective at protecting you from the disease, they aren’t 100 percent effective. That means there’s a small chance you can still get COVID-19 after being vaccinated if you’re exposed. Experts recommend continuing all of the safety measures we know are working to keep the virus at bay, including the 3Ws: Wash your hands. Wear a mask. Watch your distance. For your health and safety, stay up to date. Information about the pandemic and the vaccine changes daily. For the latest recommendations for you and your family, listen to your local public health officials and bookmark the CDC’s vaccination page for the most up to date information.0
- Cancer Care, Women's HealthGeneral Page Tier 3BlogIn 2015, Rebecca Blizzard was about to begin a new chapter of her life in more than just one way. The year she turned 40 was the same year she chose to follow the cancer screening guidelines for detecting cancer early. After scheduling a visit with her doctor for her first-ever mammogram, results showed something wasn’t right. She went for a biopsy. It was breast cancer. In June 2016, she had a lumpectomy at Anne Arundel Medical Center (AAMC) followed by six weeks of radiation therapy to lower the risk of her cancer coming back. It wasn’t until a few months later that she would find out she tested positive for BRCA2, sometimes referred to as the “breast cancer gene.” Rebecca proceeded with the removal of her breasts. “At this point I didn’t want to take any chances, so I decided to have a double mastectomy,” she says. Her doctor referred her to Anne Arundel Medical Group (AAMG) Plastic Surgery for options regarding breast reconstruction. “After hearing all of my options, I chose a DIEP flap reconstruction,” Rebecca says. “That’s where I learned about the nipple tattooing procedure since my nipples could not be saved.” A new option AAMC’s Chief and Medical Director of Plastic Surgery Devinder Singh, MD, and Virginia “Ginny” Lobach, M.S., PA-C, informed Rebecca about breast reconstruction options, including nipple tattooing. As an alternative to nipple areolar reconstruction, which requires surgery, this caught her attention. “I was nervous about how another surgery would impact me,” she says. “I’m young and in my head, I didn’t want to not have anything. Ginny told me she recently trained to do 3D nipple tattooing, so I was all in for it.” Whatever your age, relationship status or orientation, it’s hard to predict how you will react to losing a part of your breast. According to breastcancer.org, there are many feelings an individual can experience when giving up a part of the body that is a hallmark of becoming a woman – including anxiety, uncertainty and sadness. This is the reason Dr. Singh and Lobach wanted to bring 3D nipple tattooing to AAMG Plastic Surgery. AAMG Plastic Surgery is unique in that it offers patients several innovative breast reconstruction options, including tissue expansion with Aeroform AirXpanders, pre pectoral implants, and microvascular deep inferior epigastric perforator flap (DIEP) procedures. 3D nipple tattooing is part of this comprehensive list. “It gives normalcy back to a patient,” says Lobach, who started the clinic after taking a course to learn the 3D technique of nipple tattooing. “I think nipple tattooing is for the woman who says, ‘I don’t want to look at my breasts,’ and doesn’t feel comfortable in her own skin. I want to give back that comfort. I want to create a full breast.” What is it? 3D nipple tattooing is done at the end of breast reconstruction after the nipple is removed during the mastectomy. It’s a noninvasive approach that Lobach performs in the office using a needle and pigmentation to create a 3D-looking nipple and areola. This approach creates an image of a nipple that feels flat to the touch but looks real. “Tattooing is the least invasive, low-risk way of providing a patient with a complete breast,” Lobach says. “Nipple reconstruction has been around for a long time as part of breast reconstruction. Unfortunately, reconstruction means another operation taking skin from somewhere else to create an areolar and nipple, leaving additional scars. The nipple usually loses projection after a year.” According to Lobach, the aesthetic results of nipple reconstruction are not as pleasing as a 3D nipple tattoo. “Working with the Rebecca Fortney Breast Center, we get to see many breast reconstructions that do not have the end result of an areola and nipple,” she says. “I saw that patients were not finished. And many were just OK with that result. They didn’t want to go through another operation. With 3D nipple tattooing, we are able to offer a completed breast reconstruction without another operation.” Is it safe? “Nipple tattooing is a safe technique and it’s always my patients’ choice,” Lobach says. “I want it to be an option so the patient can make their decision either way.” Despite a lingering negative connotation attached to tattoos by some, a 3D nipple tattoo is a safe alternative to regaining a full-looking breast after a patient has been diagnosed with breast cancer. There is a difference between the tattoo pigmentation Lobach uses and that of the one used at a tattoo shop. “I use an organic pigmentation made from lake salts,” she says. “I only like to use very safe products with very low risk of infection. It’s the same type of pigments that are used for cosmetic and facial tattooing. The pigment is a very soft and beautiful color. The patient also has a choice in the color we choose for tattooing.” Tattoo artists, on the other hand, often use metal-based pigments containing titanium, led or chromium. 3D tattoos are permanent but like any tattoo, will fade over time. Usually only one session is needed to create the tattoo, but an additional touchup session may be required over time. When a person is diagnosed with breast cancer, it is one of the scariest times of their lives. It can change them completely, particularly physically. Once a person has beaten cancer, they can focus on rebuilding themselves emotionally and physically. “I feel like the tattoo gave me my confidence back, which I needed after everything that happened,” Rebecca says. “It made me feel more comfortable looking at myself in the mirror.” Nipple reconstruction is often the last step in breast reconstruction. Find out more about our different options and schedule an appointment with AAMG Plastic Surgery today.0
- Women's Health, Pediatrics, Patient StoriesGeneral Page Tier 3BlogKristen DeBoy Caminiti has a photo she loves. Actually it’s more than that. “It’s my favorite picture, ever,” she insists. In the photo, taken by her husband, Matt Caminiti, Kristen cradles her son just seconds after his birth. She has her cheek against his, their eyes are closed and Kristen looks wrapped in grace. It’s a beautiful photo. Yet for many mothers it might not seem that unusual. That’s because when a healthy baby is delivered vaginally, he or she is usually put right on the mother’s chest. Early skin-to-skin contact is good for both mom and baby, and, as an added benefit, it makes for a great picture. But for generations now, immediate skin-to-skin contact hasn’t been an option for women giving birth by cesarean section. In a traditional C-section, after the baby arrives, he or she is briefly held up for mom to see, then whisked off by the neonatal team while the obstetrician finishes surgery. It can take close to half an hour before mother and child are reunited. Kristen and Matt know the routine well. Their first two boys arrived this way. While they still remember the births fondly, Kristen says she never got the birth experience she’d dreamed about. “You know, I’d always imagined that moment of my baby being born and being put on my chest and getting to hold and kiss and love him,” Kristen says. Then, a couple of weeks into her third pregnancy, a friend posted a video that caught Kristen’s attention. It was about family-centered cesarean techniques catching on in Britain. The techniques were relatively easy, and the goals simple— including letting mom see the birth and getting the baby onto mom’s chest as soon as possible. After viewing the video, Kristen was elated. “I thought, ‘Wow, this is cool.’ I decided I’d do everything I could to make it happen for me.” AAMC adapts AAMC is committed to patient- and family-centered care. So when Kristen asked her OB-GYN, Marcus Penn, MD, whether he’d be open to a family-centered cesarean, the answer was yes. While the techniques had never been tried before at the hospital, that didn’t bother Dr. Penn. “I knew it would be different than the norm, but I didn’t think it would be that hard to do,” says Dr. Penn. “So I met with the hospital’s clinical team, and we started setting it up.” Kristen was an ideal test case. Since she was having a scheduled cesarean, there was plenty of time to plan. Also, she’d done her research. If all went well, Kristen had this wish list: She wanted her head lifted and the drape lowered so she could see the birth. She wanted the baby placed immediately on her chest. She hoped her husband might be able to cut the umbilical cord. That was it. Of course, this list meant changes to cesarean routines that hospitals and doctors have honed to perfection over the decades. EKG leads would have to be on Kristen’s side instead of her chest and the pulse oximeter on a toe instead of a finger. She’d need the IV in her non-dominant hand so she could hold her baby, and everyone needed to be careful not to break the sterile operating field. Because it would be a first for all involved, the Caminitis and hospital staff crafted a written birth plan together. “It was super-positive,” Kristen says. “Everybody was on board.” Still, there were concerns. Anesthesiologist John McAllister, MD, says he fully supported the effort but wanted to be sure caregivers could still do their jobs and that the mother was aware plans might have to change. “Our primary goal is always patient safety,” he says. Success story On Oct. 1, 2014, Kristen’s son Connor was born. The birth went exactly as planned. “When Dr. Penn pulled Connor’s head out, it was so amazing,” Kristen remembers. “He had dark hair!” After delivery, the baby was passed straight to Kristen. Matt was at her side. “It was magical,” she says. And Connor stayed there, on Kristen’s chest, for the rest of surgery. “It was so great to be able to share the experience of meeting our baby together rather than me going with the baby to a separate room,” says Matt. “They were sewing me up and there were all those people there, and yet it was the most peaceful experience I’ve ever had. It was just me and my baby and my husband. That is all that mattered.” First change in years Betsey Snow, RN, the senior director of Women and Children’s Services for AAMC, says the birth represents the first big change to cesarean procedures in years. The last big change, she says, “was in the 80s, when dads were finally allowed in the operating room.” Besides the advantages of early skin-to-skin contact, Betsey says a family-centered C-section may be particularly helpful to women who’d hoped for a vaginal delivery but couldn’t have one. “A lot of women feel like they failed because they couldn’t have a vaginal delivery,” says Betsey. “This is a way to give them another option.” Having your baby at AAMC If you meet the following criteria, you will have a family-centered c-section: 1) Medically necessary, scheduled C-section AND 2) Healthy mother and baby. Your first step in the process is having a conversation and agreement with your doctor. We want to ensure your experience is the best for you and your family. Please know our very first priority is safety for you and your baby. C-section deliveries can be life-saving procedures when medically necessary; they carry a higher risk of negative outcomes for mothers and babies when not medically indicated. AAMC still recommends vaginal delivery as the standard. The Caminitis’ story was featured on NPR’s Morning Edition. Click here to read the story and listen to the broadcast. Expecting? Get ready for your big day with birth and parenting classes at AAMCevents.0
- Women's Health, PediatricsGeneral Page Tier 3BlogMotherhood is one of the most beautiful and exciting experiences in the world. It can also be downright difficult! Especially in the beginning, moms need the love and support of their partner, family and friends. Here are six ways you can help support a new mom. Drop off a meal. There is one thing all moms have to do—eat! She may not want you to do her laundry. She may not ask you to do her grocery shopping. But, she will eat your food—especially if it’s her favorite. A pre-made dinner is the best gift on those days when mom’s exhausted, has been tending to a newborn all day and can’t find the time to prepare a meal. Help her reach her “mom goals”— like breastfeeding! Many moms want to breastfeed. It becomes an important goal for her. But once the baby arrives she may run into challenges. If you know it’s important to her, encourage her not to give up and to consult help from a lactation consultant. Helping her find her strength and confidence as a mom is probably the most important and powerful way you can support her. (See below for a full list of resources.) Remind her she’s more than her new role. Many moms feel they lose their identity as they transition into motherhood. Moms give their babies a ton of love and they may not leave enough for themselves. Remind her that SHE is just as important as her new baby. Encourage her to spare some moments for herself to do something she loves, something that makes her feel like herself! Offer to tag along with her and help her find her confidence. Getting out of the house can feel like an overwhelming task with a new baby. Offer to go with her as she ventures out. Having a buddy with her as she learns to boldly nurse in public or change a diaper almost anywhere can help boost her confidence and set the right tone for her future solo trips. Just listen. A new mom may want to gush about all the adorable things her new baby is doing, or may need to vent about her difficulties as she discovers motherhood. If she needs to get some things off her chest, just listen. An open ear, a kind smile and an understanding hug will go a long way. Remind mom she’s doing a great job. Being a mom is not as easy as she may make it look. While holding it together, she might feel like it’s all about to fall apart. She may feel like her efforts are being shadowed by the challenges of breastfeeding. She may still be getting used to the responsibility of a new child. Tell her she’s doing a great job! It will mean so much to her that her efforts are noticed and that she’s somehow figuring out this motherhood thing. Being a mother is one of the hardest yet most rewarding jobs in the world. Sometimes it’s hard for a new mom to recognize the rewards because of the many hurdles she faces every day. All new moms have to find out what works for them and their new family but she shouldn’t feel alone in that journey. Be there to offer support, encouragement, a break or just to listen. She deserves it and everyone wins when mom is happy! Author Lindsay Bittinger is a local mom, living in southern Anne Arundel County with her husband, two daughters and one crazy puppy. Breastfeeding Resources Breastfeeding Basics Class: Learn how to prepare for breastfeeding, how to hold your baby, how often and how long to feed, how to avoid common problems and much more. Breastfeeding Warm Line: Anne Arundel Medical Center’s lactation staff is available to answer any questions you might have about breastfeeding. You can reach our consultants seven days a week via our Warm Line at 443-481-6977. Simply leave a message and they’ll return your call between 9 am and 4 pm the same day. You can also e-mail our lactation staff anytime at [email protected]. Breastfeeding Support Group: Breastfeeding mothers are welcome to this gathering on the second and fourth Thursday of each month. The group is led by Kim Knight, a board-certified lactation consultant. The group is very informal and welcoming to breastfeeding mothers regardless of experience or degree of commitment. Bring your baby! Find a Lactation Consultant: A board-certified lactation consultant can help address your breastfeeding concerns or challenges. You can find one in your area through the United States Lactation Consultant Association directory. Back to Work and Breastfeeding Support Group: Discuss questions and concerns common to nursing moms who returned to work. Share your experiences and hear new ideas on how to continue to work and breastfeed successfully. This group meets the first Friday of every month at the Big Vanilla in Pasadena. AAMC Smart Parents: Join our Facebook community focused on the journey of parenthood. This is a safe, non-judgmental group to ask questions and get answers from local moms and dads, and AAMC experts. Originally published April 14, 2016. Last updated May 2, 2019.0
- Patient StoriesGeneral Page Tier 3BlogIt was a typical evening as Amanda Brady chatted with her 16-year-old and eldest of three children, Lee. As the two sat in Lee’s room talking and sharing laughs, Amanda spotted a Post-It note stuck to the wall. Small, handwritten scribbles outlined some of the goals Lee wanted to accomplish that year. One goal in particular stood out to Amanda. It read, “Come out as pansexual by the end of the school year.” “I was totally confused because I had no idea what pansexual meant,” Amanda recalls. According to the Human Rights Campaign (HRC), pansexual describes someone who has the potential for emotional, romantic or sexual attraction of people of any gender though not necessarily simultaneously, in the same way or to the same degree. Soon after this, Lee asked his family to refer to him by the gender-neutral pronoun “they” while also noticeably becoming more isolated and depressed. The turning point It was during senior year of high school when Lee started self-harming and was eventually hospitalized because of suicidal ideation. “The hospitalization was rock bottom for our family, but it was also a blessing in disguise,” says Amanda. In talking with a counselor at the hospital, Lee opened up about identifying as transgender. While there, Lee, who was born female, also firmly stated that he wanted to be referred to as “he” or “they” and changed his name from Liana to Lee. “My husband and I were willing to support him in whatever he wanted to do,” says Amanda. “We told him that we loved him whether they were ‘her’ or ‘him.’” Amanda, who works as a clinical director of nursing at Anne Arundel Medical Center (AAMC), was determined to support her son and help him get through this dark time. Amanda says her family sought therapy, got Lee treatment for depression and anxiety and found an endocrinologist to start him on testosterone. “It hurt my feelings when I found out,” Amanda says admittedly, “but I never said I didn’t want him to be a boy. I always said I wanted him to be happy and that I would help the best way I could.” Amanda also joined AAMC’s Lesbian Gay Bisexual Transgender, Queer, Intersex or Asexual (LGBTQIA) Business Resource Group, a group of employees who joined together based on shared characteristics or life experiences. She wanted to glean from others ways she could better support her son. “The easiest part for me was when he cut his hair and started wearing male clothes because growing up I was a tomboy,” Amanda laughs as she reflects. “The hardest part was not knowing how to help him through the emotional state. He didn’t want to open up at all because he thought we wouldn’t understand.” Acceptance, communication and support Danny Watkins grew up in a small community in Allegany County and was raised in a traditional Catholic family. He told his parents he was gay when he was 15. To his dismay, he was faced with unacceptance and was unwillingly ‘outed’ to the rest of his family members. Traumatized, Danny tried not to be gay for the next two years to cope with pressure at home. At age 17, his family found out he was dating a boy and the family discord from years before resumed. “I felt very isolated and lonely,” he recalls. “It’s as if I were a giant air balloon that couldn’t fit in any situation. I was just barely functioning and trying to get through the day. I didn’t have the support I needed at home so I relied heavily on my friends. They became my support system I needed to survive until the relationship with my family started to slowly get better over the next couple years.” Danny pursued a career in nursing, moved out at 19 and worked at an inpatient psychiatric unit. He is now the director of clinical operations at Pathways, AAMC’s substance abuse and mental health treatment facility. “Working in mental health has really opened my eyes to suicidality in the LGBTQ community.” Four in 10 LGBT youth say the community in which they live is not accepting of LGBT people, according to the HRC which surveyed more than 10,000 LGBT-identified youth ages 13-17. An estimated 26 percent of LGBT youth say problems they face include not feeling accepted by their family, having trouble at school or with bullying, and coming out or being open. Danny advises parents with an LGBTQ child to work on acceptance first. “You should always support your child and try to approach them from a non-judgmental place,” he says. He also recommends keeping the lines of communication open and meeting your child’s friends as important steps to take. “Reassure your child that you love them and that you support them, no matter who they are inside.” Danny also advises parents to find a good support system by joining local support groups and finding a counselor in the school or community who can provide support and resources. Silver lining Amanda and her husband have fully accepted their son’s decision to come out as transgender. Amanda is also observing Lee becoming more comfortable with himself. Lee is currently a freshman in college. She says he is growing facial hair for the first time. “He has really blossomed,” she adds. Even as someone who has an LGBT child, Amanda admits she still doesn’t know all there is to know about the community but is committed to furthering her understanding so she can continue to support her son. “If you isolate your child because you don’t see eye to eye, that’s a very boring and lonely existence to live,” she says. “Love your child for who they are, that’s the bottom line.” Anne Arundel Medical Group (AAMG) Mental Health Specialists offers care for diverse mental health needs for adults and children ages six years and older. For more information, visit myAAMG.org/mental-health-specialists.0
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