- Cancer CareGeneral Page Tier 3BlogBeginning this month – National Cancer Survivor’s Month – we will share a series of blog posts from our own cancer survivors. Each cancer journey is unique. At Luminis Health, we want to shine a light on these journeys from the perspective of our own patients. That’s why we’ve started this new series – bringing hope and comfort to those who have been touched by cancer. Here’s Maureen Disharoon’s story: Last summer, my husband, Larry, noticed that he had a blister between his toes. We didn’t think much of it, but a few weeks later, it looked a little angry, so we saw a dermatologist—the biopsy came back as melanoma. The dermatologist helped us get an appointment at Luminis Health Anne Arundel Medical Center (LHAAMC) the very next day, which was really kind of amazing. Going through this process during the year of COVID-19 added a challenging layer to this scary scenario. Over the next few months, Larry had surgery to remove his cancerous toe and a lymph node from his groin. A genetic test recommended by Dr. Adam Riker determined he had a version of the BRAF gene that makes melanoma worse, so he recommended immunotherapy following the surgery. It was a lot, but everything seemed to be going fine until December, when Larry started to have some behavioral and cognitive changes—we learned that the cancer spread to his brain, as well as his lung, his abdomen, and leg. This required an entirely new game plan on very short notice: whole brain radiation and full-blown chemotherapy. Throughout this process, Larry’s team of doctors at LHAAMC—Drs. Julie Oda, Mary Young, and Adam Riker —were amazing. They were right there at every new development. Dr. Riker always has a “we gotta go after this!” energy, while Dr. Oda has a gentle, caring approach—and both are brilliant. Dr. Young, the radiology oncologist, laid out an aggressive plan the first day she met Larry and moved heaven and earth to set up his whole brain radiation that started hours later…during Christmas week. This was not an insignificant feat. The whole team, including the nutritionist and other staff, gave us whatever we needed; not only did they design a treatment plan for him literally in hours, but everything was so personalized. When he went in for radiation, Dr. Young would occasionally walk Larry out herself and hand him over to me, adding a personal touch to this treatment phase. The staff has just been incredible, compassionate, and accommodating. From my perspective, as the spouse and advocate, I did a lot of notetaking, scheduling, and orchestrating. I’ve been a NASA consultant supporting many NASA missions for 40 years and this became my newest mission. Most people have seen how quiet and calm mission control is, but in reality, the rooms that surround Mission Control can be frantic. I tried to harness the frenzy, keep out the noise, and focus on the “mission.” We feel very grateful for the care Larry has received. Larry’s brother died of melanoma at 43, before immunotherapy and other targeted treatments existed. As long as the medicine is working, Larry will stay on it. We know it won’t cure it, but as his doctors say, we can put the cancer to sleep for as long as it will stay asleep. The cancer is asleep now, but if it wakes up—if the gene finds a backdoor, as it’s been known to—then maybe something else will be needed. Larry is still under the care of Drs. Oda, Riker, and Young, and they’re making sure we don’t let our foot off the gas. But things are hopeful right now: Larry celebrated his 65th birthday in April, and he’s looking and feeling good, he’s gained weight, mows the lawn, and has even gone golfing! If you told me this in February, I don’t know if I’d have believed it. So that’s where we are. We’re enjoying life. Every day we have like this is a win.
- Behavioral Health, PediatricsGeneral Page Tier 3BlogFor a lot of us, the pandemic has taken its toll on our mental health and wellbeing. That’s especially true for teenagers. At Luminis Health Anne Arundel Medical Center, we have seen an increase in mental health visits to the pediatric emergency room. That’s why we have created a new space for young patients to relax and chill out. Over the past few months, a planning team has transformed the hospital’s old playroom into a Zen Den, an area specifically designed to meet the mental health needs of teens. “Before a teen is admitted, there is a fair amount of wait time anxiety,” said Melanie Lee, clinical nursing director of Pediatrics for Luminis Health Anne Arundel Medical Center. “The Zen Den is a safe and supportive space that came at just the right time. During this pandemic, we saw an increase in teenagers needing mental health services.” The moment you walk in the room, you are surrounded by peace and calm – the lighting is dim, the walls are painted blue, and soft music is playing in the background. Teens can relax in a beanbag chair, write their feelings on a white board, or enjoy the Vector Jr. sensory station, complete with a bubble and jellyfish tower. “You feel like you are not in the hospital,” said Meghan Siegel, a certified child-life specialist at Luminis Health Anne Arundel Medical Center, “and it’s already making a difference. Patients are relieved, peaceful, and less stressed. It’s really a simple space.” The Zen Den was made possible thanks to donations from the community. When Rob Rex died in November 2020, his family asked loved ones and friends to donate money for a new playroom at the hospital. Nearly $14,000 were raised through the Luminis Health Anne Arundel Medical Center Foundation, which helped create this innovative addition to the Pediatric Emergency Unit. “We are happy to be able to give back to the community that has been so incredibly supportive of us,” said Jenn Rex. “There is not much more important than the mental health of our children and we are proud to have the Zen Den named in my husband’s memory and as a lasting reminder of the impact his life had on so many. Rob was the most positive person I have ever known and we look forward to doing as many positive things as we can in his honor.”
- Community, Infectious DiseaseGeneral Page Tier 3BlogIf you’re finally traveling to see friends or family this summer — or just hitting the road for some R&R — it’s still important to weigh the COVID-19 risks. But with careful planning (and some mask wearing, social distancing and handwashing) it might be OK to now book that long-awaited trip. First, Check Travel Restrictions Before you finalize your plans, check online for travel restrictions. Some places aren’t yet open to travelers or could require you to get a COVID test before arrival. And, even if travel is allowed, it’s smart to check infection rates where you’re going to make sure there isn’t a local spike in cases. If You’re Not Vaccinated The Centers for Disease Control and Prevention (CDC) say it’s safe to travel within the U.S. if you’re fully vaccinated and follow safety precautions. If you’re not vaccinated, they recommend you delay your trip. However, if you have to travel before then, you should: Get tested one to three days before you leave Quarantine for 10 days after you return home (or seven days with another negative test after your trip) Protect Yourself in Transit If you’re headed through a public transit hub such an airport, keep in mind it might be crowded. Even with signs reminding everyone to stay six feet apart, that might not always happen in lines, at busy gates and on shuttles. Take the following safety measures: Consider eye protection. You might want to wear protective glasses or a face shield in addition to your mask. Keep distance. Leave seats open between you and other travelers when possible. Mask up. Wear a mask in airports and transit stations, and on shared transportation like planes, trains, buses and taxis. Wash your hands often. Don’t forget to scrub up after touching common surfaces like turnstiles, touchscreens and handrails. Stay Safe at Your Destination Unfortunately, COVID isn’t taking a vacation just yet, and new variants are circulating. Keep taking the safety measures you take at home while on your trip. You might want to pick a destination with plenty of fun outdoor activities so you can enjoy yourself with a lower risk of virus transmission. If you’re headed to a beach or swimming pool, keep in mind that while the CDC hasn’t noted any reports of the virus spreading through water itself, the virus can still be passed through the air in a crowd of people. Prepare for the Unexpected When you’re packing your bags, think ahead. You might want to bring a few extra items to ease your mind and reduce your risk while you’re on the go. That could include: Extra masks in case yours get wet or dirty Harder-to-find safety gear like protective eyewear Sanitizing wipes to use on tables or counters And don’t forget the snacks. In some areas, transit food courts might be overcrowded or not yet fully open. If you’re traveling by car, bringing your own food can also cut down the need to go into busy markets or restaurants near hot vacation spots. Finally, Aim for Flexibility Travel advice continues to change as we learn new information about COVID. If you’re heading out for a trip soon, stay up to date on the news and ready to adjust your trip if needed. And remember, with so many people eager to travel, you may hit delays on the road or at rental car locations. But getting the chance to safely venture out, hug family and friends, and recharge a bit after the year we’ve had is well worth it. Authors Dr. Michael Glickman practices family medicine on Kent Island.
- Women's HealthGeneral Page Tier 3BlogIf you’ve ever dreaded laughing at a good joke or sneezing for fear of an “oops” moment, then you know what it’s like to live with urinary incontinence. You may be hanging back from doing things you love, worried you can’t get to a bathroom and embarrassed about leakage you can’t control. Here’s a start to learning more about the condition — its causes and treatments — so you can see that it’s possible to get back to living your best life. Incontinence is more common than you think. An estimated 15 to 25 million Americans deal with incontinence. But it’s hard to put a firm number on it because so many people are too embarrassed to talk about it. We do know women are two times more likely than men to develop urinary incontinence — and that physiology plays a part. The structure of a woman’s internal organs, pregnancy, childbirth and menopause all have an effect. Aging does too because pelvic floor muscles that support the urinary tract muscles weaken as you age, making it harder to hold in urine — though it’s not necessarily a normal part of getting older. There are different types of incontinence. The most common types of incontinence in women are stress incontinence, urge incontinence, and a mix of the two. Stress Incontinence Stress incontinence makes having fun unpredictable. Things like laughing, dancing and exercise put pressure on your bladder, causing uncontrollable leakage. You don’t feel an urge to urinate; it just happens. Weak pelvic floor muscles or the bladder out of its normal position are usually the culprits. Urge Incontinence A “gotta go” feeling you can’t ignore is urge incontinence, or overactive bladder (OAB). OAB can happen when certain nerves and bladder muscles don’t work together. Your brain tells your body you need to go to the bathroom, even if your bladder isn’t full. That signals the bladder muscle to contract, and the sphincter — the muscle that controls urine flow — relaxes. The urge comes on suddenly, even if you’ve recently emptied your bladder, and you may not make it to the bathroom. Some people have a frequent urge to go — up to eight times a day — and then barely go when they get to the bathroom. Mixed Incontinence Having more than one type of incontinence isn’t uncommon. If you do, stress and urge incontinence are usually the two that combine and lead to leakage. You don’t have to live with it Too many people stay silent about incontinence, assuming events like pregnancy, childbirth and aging make it an inevitable part of life you have to get used to. Not true. It’s very treatable, and often with self-help methods you can do it yourself. Lifestyle Changes For some people, reducing the risk of leakage is as simple as making lifestyle changes, such as: Avoiding lifting heavy objects Avoiding liquids in the evening Limiting caffeine and alcohol, which make you produce more urine Losing weight to relieve pressure on the bladder Kegel Exercises Weak pelvic floor muscles — those that support the bladder — are often at the root of leakage problems. Kegel exercises involve strengthening the muscles that control urine flow by tightening and relaxing them. Doctors often recommend women do Kegels during pregnancy to prevent incontinency problems. You can work with a physical therapist to learn how to do Kegels effectively. Bladder Retraining Timing is everything when it comes to staying dry. Finding the sweet spot takes practice. It may involve making sure your bladder is empty to prevent the urge to go. Make a pit stop every two hours if you know the urge to go hits every 2 ½. But you may have to retrain your bladder if the urge to go too often is a problem. That involves gradually extending the time between bathroom visits. For instance, if you go to the bathroom every hour, stretch it to an hour and 15 minutes, increasing the time over a few weeks. Medications, Devices or Medical Procedures If self-help approaches don’t help, your provider may suggest other options, such as: Medications that can help relax bladder muscles or block nerve signals that cause an urge to go Vaginal inserts available over the counter can be used to reduce stress incontinence A pessary, a ring-like device your doctor fits you for to support pelvic floor muscles and reduce stress incontinence Injections of a bulking agent in tissues around the bladder to help keep the opening closed and prevent leaks Pelvic floor stimulation to nerves and muscles to strengthen them and to reduce the urge to go A sling is a small piece of synthetic material surgically placed to support the urethra to improve leaking from stress incontinence Incontinence doesn’t have to control your life. Yes, it can feel awkward to talk with your doctor about bathroom habits. But incontinence is a very treatable condition. A full evaluation with a pelvic medicine and reconstructive surgeon can help you determine the best treatment for you. Asking for help can get you back to a life free of worries about leakage. Authors Aparna Ramaseshan, MD, is a Female Pelvic Medicine and Reconstructive Surgeon (FPMRS), at the Women’s Center for Pelvic Health. To make an appointment, call 443-481-1199.
- UncategorizedGeneral Page Tier 3BlogMay is Lupus Awareness Month. Lupus (also called Systemic Lupus Erythematosus) is a disease that effects 1.5 million people in the U.S., according to the Lupus Foundation of America. A 2019 survey found that 63% of Americans have never heard of lupus or have little information about the chronic illness. Here is what you need to know: Lupus is an autoimmune disease Lupus causes your immune system to attack healthy tissues and organs in the body. The body creates antibodies which attack your own cells. The chronic disease most commonly attacks your kidneys, skin, joints, blood cells, brain, heart and lungs. Lupus may not affect all of these in each patient. Lupus symptoms Lupus is often tough to identify because its symptoms are similar to other illnesses. Here are the most common signs and symptoms from the Mayo Clinic: Fatigue Fever Joint pain, stiffness and swelling Butterfly-shaped rash on the face that covers the cheeks and bridge of the nose or rashes elsewhere on the body Skin lesions that appear or worsen with sun exposure Fingers and toes that turn white or blue when exposed to cold or during stressful periods Dry eyes Headaches, confusion and memory loss It is important to remember that these symptoms may also occur with other illnesses. A doctor can perform an examination and tests to see whether a patient has lupus or a different condition. Risks for developing lupus Lupus is more common in women. A lupus diagnosis usually occurs between the ages of 15-45 years old. African Americans, Hispanics and Asian Americans account for the majority of lupus diagnoses. If fact, lupus diagnoses are two to three times more likely in African Americans compared to whites. You may also be at a greater risk if you have a family member with lupus. The disease may become more active during pregnancy, and require close monitoring. Causes of lupus In most cases, the cause of lupus is unknown. Experts believe it is possible to trigger lupus if you have a genetic predisposition for the disease, by hormonal changes, or by environmental factors. Treatment options There is currently no cure for lupus. You can manage lupus symptoms through a proper treatment plan created by your doctor. Treatment includes monitoring regularly. It may also include medications to help with symptoms, prevent worsening, and block the disease process. Health providers choose medicines very carefully. Medication selection depends on what other conditions a patient has, how severe the lupus is, and which features of lupus are the most active. Medications might include plaquenil, prednisone, imuran or benlysta. Author Susan Berger, MD, is a rheumatologist with Luminis Health Anne Arundel Medical Center.
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