- PediatricsGeneral Page Tier 3BlogQ: How can I make sure the time change doesn’t affect my kids’ sleep? Are they getting enough sleep? First, it’s important to keep kids on a schedule with a bedtime routine. For example, kids should bathe, brush their teeth, spend a little time reading, then get to bed at a specific time. It’s important to go to bed and wake up at the same time every day to keep on schedule. With daylight saving time, it may take a few days to adjust. But sticking to your overall routine is key. To help kids adjust sooner, move their bedtime routine up by 15 minutes each day for four days leading up to March 8, when the clocks spring forward. Let’s say your child’s bedtime is 8 pm: Begin at 7:45 pm on March 4 Begin at 7:30 pm on March 5 Begin at 7:15 pm on March 6 Begin at 7:00 pm on March 7 How much sleep do kids need? It depends on their age. Enough sleep is essential for kids to learn and stay focused at school. Infants: 12 to 18 hours a day Toddlers: 12 to 14 hours a day Ages 5 to 12: 10 to 12 hours a night Teenagers: 8 to 10 hours a night Find more health tips for your kids. Author Michael Clemmens, MD, is a pediatrician and the medical director of Pediatrics at AAMC. Originally published Feb. 15, 2017. Last updated March 2, 2020.
- Cancer CareGeneral Page Tier 3BlogLife after cancer can be a very exhilarating yet complicated time in someone’s life. From the time you get the diagnosis, you become extremely focused on the fight of your life. Everyone you know rallies around you and it’s an all-out war against this invader. At the end of your journey, God willing, you get the news and results everyone has been working toward and praying for — you’re cancer free. Then, it’s back to everyday life. I call it the “cancer hangover.” My wife compares it to the lead-up and excitement you feel during Christmas time and the feeling you have the day right after. She said the significant other also experiences this culmination of intense emotions, dedication and support. READ MORE about Brian’s story and how he learned that it’s never too early to take care of your health. Throughout my journey with colon cancer, I kept a journal of sorts with notes in my phone. I find it inspiring to go back and read what I thought in that moment. My notes read: Don’t wait until you are faced with your own mortality to be the son, husband, father, friend, neighbor and person you can be. Live life. Allow yourself to love, strive and achieve. Find patience and peace in life’s challenges. Accept your defeats and learn from your mistakes. Appreciate life’s victories, no matter how small, and be your own biggest fan and critic. Be patient and know that others are going through daily challenges as well. Don’t be afraid of self-analysis and to be critical of yourself. But make sure you also appreciate the positives and come up with a plan for improvement. Find what inspires you, absorb its strength and allow it to usher you forward. You can be a hero starting now. Your actions create the costume. Finding inspiration is easy. It’s remaining inspired that is the true test. Only coming from the lion’s mouth can we learn to roar. A day’s challenge is only as challenging as we make it. A worry will drag you down, confronting it will rise you up. Sometimes you have to ask yourself, in an honest first-hand opinion, what you can do to be the person you know you can be. We grow stronger in the face of adversity, wiser in the wake of mistakes and kinder with hearts open. The better ‘you’ is around the corner, the same one you have been around before. I am one of the lucky ones. After a shocking diagnosis, I was able to complete my cancer treatment plan and am happy to say I continue to be a cancer survivor. It took a lot of patience, a lot of faith, a lot of support and a comprehensive plan from the doctors to be where I am today. Listen to your body and seek help if something isn’t right. We all have our own challenges in life, it’s important to work your way through each battle in order to win the war. Take things one step at a time and prepare yourself to succeed. I’m grateful for the opportunity to share my story so others may be able to learn from my experiences and know that they can overcome what lies ahead. If you’re 50+ this year, pledge to have your colonoscopy. Learn more at askAAMC.org/Milestone50. Author Brian Page, from Annapolis, is a father of two and a 41-year-old colon cancer survivor. Originally published March 11, 2019. Last updated March 2, 2020.
- Men's Health, Women's HealthGeneral Page Tier 3BlogNutrition information seems to change daily. That can leave some of us a little confused and often wondering about the right diet to follow. Can sugar harm your heart? Are eggs in or out? Is caffeine good or bad? There are a few reasons why the outcomes of nutrition research can be misunderstood or flawed. We cannot isolate a nutrient’s effect. In the past, nutrition research focused on the role of a single nutrient acting as a magic bullet to prevent disease or as the only thing responsible for the development of a disease. We can get so stuck on the health benefits of a certain vitamin or phytochemical that we miss an important point: Different components in a single food can work together to benefit our health, and so can components in different foods eaten together. This is known as “food synergy.” One example of how different nutrients and components in food work together is the pairing of broccoli with tomatoes. In a study published in 2004 in the Journal of Nutrition, prostate tumors grew much less in rats fed tomatoes and broccoli than in rats who ate diets containing only broccoli or only tomatoes and in diets that contained cancer-fighting substances (like lycopene) that had been isolated from tomatoes or broccoli. The bottom line is that a lycopene supplement may not hurt, but the whole tomato will probably help more. And a tomato eaten with broccoli may be even better. Nutritional relationships are complex but the natural state is usually the best package. READ MORE: Nutrition myths: Hype or help? Data is flawed. Data collection for nutrition studies is flawed. We tend to underestimate what we eat, but even more importantly, we don’t remember what we ate to report it back. Additionally, when we eat out, we don’t know what ingredients are used or how our food is prepared. As nutritionist Marion Nestle says in her book, Food Politics, “The most intellectually demanding challenge in the field of nutrition is to determine food intake.” In studies comparing one diet to another, it is not always possible to control what people eat. For example, in a study comparing a group eating a low-fat diet to a group eating a higher-fat diet, those in the low-fat group cheated and ended up eating a higher-fat diet than the researchers recorded, while those in the control group (or normal diet) lowered their fat intake voluntary, perhaps because the study made them aware of it. Without the researchers knowing about this, the two groups were not far apart in the amount of fat they were eating. This is why it’s not surprising the “low-fat diet” group didn’t show any health benefits. Genetics play a role. Something else that’s confusing about nutritional research is the genetic difference among the participants studied. These differences can impact how individuals digest and use nutrients in food. Sometimes, when a study of a nutrient shows a difference only in a small number of people, it could be due to individual metabolic differences. We cannot separate the metabolism of a food from the genetic makeup of the person eating it. While individual studies may give different data about a particular nutrient, the value of a healthy diet is not in doubt. More often than not, studies show good food choices have a positive impact on health and poor diets have negative and long-term effects. Let food be your medicine to deliver the nutrients you need to perform, maintain function and fight disease. American diets that mimic the U.S. Department of Agriculture’s “My Plate” have a lower incidence of major chronic diseases. To look for nutrition information, visit www.nih.gov and www.eatright.org. Originally published June 3, 2019. Last updated March 2, 2020.
- Heart Care, Patient StoriesGeneral Page Tier 3BlogI vividly remember the day Kathy Brown, my mother in-law and a dedicated teacher, was diagnosed with amyloidosis. It’s a rare disease that causes proteins usually produced in your bone marrow to build up in your organs. At the time, I was a cardiology fellow at the University of Maryland. I understood the severity of the diagnosis. Less than a month later, the disease had taken over Kathy’s heart and she was in heart failure. Her advanced heart failure team breathed hope into a hopeless situation. Doctors put Kathy on the transplant list and she received a new heart within two months. I was in awe that a team of doctors, my mentors and teachers, could give someone a second chance at life. The doctors were instrumental in my training. But Kathy, true to her calling, also taught me important lessons. The doctors showed me how to treat heart failure. Kathy taught me how to care for heart failure patients. It was then that I chose to further my training in advanced heart failure. Heart failure occurs when your heart muscle doesn’t pump blood as well as it should, leaving your heart too weak or too stiff to pump efficiently. Nationally, it’s the number one reason people are admitted to the hospital. It’s also the number one reason why people return to the hospital within 30 days of leaving. Symptoms of Heart Failure Shortness of breath Swelling in your legs, ankles, feet or stomach Fatigue Rapid or irregular heartbeat Sudden weight gain from fluid retention You can help prevent heart failure by managing the conditions that cause it. These include high blood pressure, coronary artery disease, diabetes, obstructive sleep apnea and obesity. But not all conditions, like the one Kathy suffered from, can be prevented. Medical treatments and lifestyle changes can improve the symptoms of heart failure and increase quality of life. If you’re living with heart failure, your doctor may recommend a plan that includes: Losing weight Reducing and monitoring salt in your diet Exercising regularly Managing stress Limiting your daily fluid intake to 2 liters per day What is most important for patients with heart failure is a close relationship with your cardiologist. These patients require frequent office visits and medication adjustments in order to avoid hospitalization. Kathy’s experience taught me the importance of easy access to care. Kathy had to drive more than one hour every other week to see her heart failure specialist, which was difficult. Having a heart failure doctor close to her home in Annapolis would have made her life much easier. It was then that my professional vision became clear. I wanted to be the heart failure specialist in Annapolis. Doctors are constantly thinking about how we can improve the lives of heart failure patients. Although Kathy passed away due to complications from her disease, I carry with me the lessons I learned from her to improve the lives of patients with heart failure in this community. Author Jennifer Brown, MD, is a cardiologist and heart failure expert with Anne Arundel Medical Center. Originally published March 1, 2016. Last updated Feb. 24, 2020.
- Behavioral Health, PediatricsGeneral Page Tier 3BlogI sent the group chat a message literally 10 minutes ago. Why aren’t they responding, are they mad? I can see they read it. Did I do something wrong? Maybe I annoyed them. Are they busy? No, they’re mad. Do they think I’m pushy? I shouldn’t have sent it. But I’m just trying to make plans with them, why would that be wrong? Maybe I’m not funny enough? Is it because I don’t have that many friends? Social pressure can be best defined as the influence that society has on an individual – or for the purpose of this post, children and young adults. The scenario above is a representation of what can go through a child’s mind when they’re experiencing the pressure of wanting to fit in or being liked by others. This can also often lead to anxiety, which more children are experiencing today than just a few years ago. In fact, there was a 20 percent increase in diagnoses of anxiety in kids ages 6 to 17 from 2007 to 2012, according to a recent study published in the Journal of Developmental and Behavioral Pediatrics with data collected from the National Survey of Children’s Health. The data on anxiety among 18- and 19-year-olds is even more concerning. Since 1985, the Higher Education Research Institute at UCLA has been asking college freshmen if they “felt overwhelmed” by all the tasks they were assigned to do. The first year, 18 percent of students replied yes. By 2000, that increased to 28 percent. Six years later, this number was nearly 41 percent. But why? There are many reasons. There’s more data available today than there was before that allows us to examine these numbers more in depth. There’s also more emphasis on “success” and “not failing”, more demanding tasks, more focus on “happiness”, joining sports teams, participating in enough activities, and parents pressuring children to do more of these activities. And then there’s digital devices and social media. A lot of times children have access to a computer or internet and are constantly connected to everything that is going on outside of their world. It never shuts down. So from the time they wake up in the morning to the time they go to sleep, they’re being pressured by somebody or something. How many people have liked my picture? Are there any comments? Have I gained new followers? How does this impact my child? Continuous access to digital devices allows kids to escape emotions they deem as uncomfortable, like boredom, loneliness or sadness. Escaping to a cyber world lets them “do something” at all times, even when they’re away from situations or places that might make them feel pressured or anxious. Their electronics have substituted opportunities to develop mental strength, such as coping with discomfort, spending time with their very own thoughts or connecting with others. These are basic skills we all need in our everyday lives. Social media has created a culture of constant comparison and the need to portray a specific lifestyle. And this, in turn, adds to the social pressure of often feeling the need to “show” others what you’re doing and documenting everything. Is it “kids just being kids” or should I be concerned? Around age four to six, it’s normal for kids to want to play by themselves. However, once they get a little older and they refuse to talk to others because of their anxiety, that’s when you should start paying attention. If they don’t interact with other kids or don’t want to play, that’s when you want to reach out to them and check in. If they can’t feel like they can be themselves, struggle to adapt to their environment or start losing a sense of themselves because that hasn’t been developed yet, talk to them. For teenagers, you’ll see their anxiety expressed more outwardly. It’s normal for them to want their own space and start developing relationships with others. However, if they want to stay at home a lot, they’re not talking to anybody or start avoiding activities that involve interacting with others, that should be a red flag. They might have many friends on the internet, but it’s also important to have friends in real life so they can have meaningful conversations with others and develop basic social skills. Is anyone to blame? No! It’s not anything that anyone does wrong. It’s kids going through phases of life and learning how they cope with those phases. Most of the times, children want to be listened to without being judged. A good way to keep the pressure down is creating an environment where they can feel they can communicate with you without feeling judged. Don’t just dismiss certain behaviors because for children, events that might not seem like “a big deal” for parents can be a very big deal for them. Don’t judge them or their friends. Give them correct alternatives but don’t force them into behaving a specific way. All children are different. What can I do? A lot, actually! Here are a few tips you can follow: Pre-teens: Pay attention. Take some time with your child before bed or in the morning to talk. Encourage self-expression. Allow your child to express him or herself. Try things like art and music. Get them involved. Your child should engage in outside activities away from tablets and video games. They should also have interaction with their peers so they can learn appropriate social behaviors. At this age, you still have a lot of control over the activities your child does. Get them involved early on! Set family time. Without electronic devices! Playing a board game together, cooking together and building something together is always a good idea. Monitor access. Pay attention to their YouTube channels and the things they’re watching on TV. Be careful with the news, scary movies or shows that are not age appropriate. Teens: Know their social circles. Knowing their friend group and the kids they’re spending most of their time with is important. It’s OK to ask questions and want to be involved. Know their social media. It’s hard for parents to do this because very few kids, especially teens, want to be friends with their parents on social media. But this goes back to communication. If you can communicate with your child then you can know what’s going on and understand what pressure they have. Get them involved. Make sure they’re not spending all day in their rooms. Find some fun activities to do together, both in and out of the house. Make sure they have a schedule. Teens need structured time as much as possible to avoid any negative influences. You can’t sleep all day and stay up all night. Your child needs motivation and their body needs to be productive. It’s healthy to have proper sleeping hygiene and a routine. Open communication. Have family time without electronics. It’s crucial to have time set aside in your home where you can talk to each other and open conversations. Ask questions, find resources and learn more at askAAMC.org/HealthyMinds. Author Jennifer Williams (Walton), MA, LPC, LCPC, is a mental health professional at Anne Arundel Medical Group (AAMG) Mental Health Specialists, located in Annapolis. To reach her, call 410-573-9000. Originally published Aug. 27, 2018. Last updated Feb. 21, 2020.
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