- News & Press Releases, Heart CareGeneral Page Tier 3BlogAnne Arundel Medical Center (AAMC) has received the American Heart Association/American Stroke Association’s Get With The Guidelines®-Stroke Gold Plus Quality Achievement Award. The award recognizes AAMC’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized evidence-based guidelines. AAMC earned the award by meeting specific quality measures for the diagnosis and treatment of stroke patients. These measures include the proper use of medications and other stroke treatments with the goal of speeding recovery, and reducing death and disability for stroke patients. READ MORE: Reducing stroke risks This year, AAMC also achieved the next level of Chest Pain Center with Primary PCI Accreditation by the American College of Cardiology (ACC). AAMC earned the higher-level accreditation for continuing to show exceptional competency in treating patients with heart attack symptoms, and for streamlined systems from admission to evaluation to diagnosis and treatment to appropriate post-discharge care. AAMC exceeded an array of stringent criteria. The ACC also acknowledged that the hospital’s team of doctors, nurses, clinicians, and other administrative staff support the efforts leading to better patient education and improved outcomes. READ MORE: The heart of the matter: Lowering your risk of heart disease “This recognition is testament to our culture of quality and the people behind our carefully designed systems of care to deliver the best possible outcomes for our patients,” said Jerome Segal, MD, medical director of Cardiovascular Services at AAMC. “We are proud to be recognized for our efforts by the industry’s most leading organizations.” To learn more about AAMC’s stroke services, visit www.askAAMC.org/stroke, and for more information about AAMC’s heart services, visit www.askAAMC.org/heart.
- Men's Health, Senior Care, Women's Health, UncategorizedGeneral Page Tier 3BlogWhile death is a natural part of life, many people find it hard to bring up end-of-life discussions with their loved ones and even their doctors. More than 90 percent of people think these conversations are important, yet fewer than 30 percent have actually had them with their families. It may seem impossible to plan for the end of life, but Patricia Czapp, MD, chair of clinical integration at Anne Arundel Medical Center, explains death isn’t a surprise for most people. “You need a general plan,” she says. “It should involve really good conversations about what’s important to you in your life and, more importantly, who will make decisions for you if you can’t speak for yourself.” Dr. Czapp says your spokesperson should be someone you trust, whether that’s a relative or close friend. It’s important to identify someone and have a conversation about your wishes, even though bringing it up can be uncomfortable. AAMC is proud to partner with The Conversation Project, a group that recognizes the difficulty and importance of these conversations. The Conversation Project offers resources like the Conversation Starter Kit that breaks down the discussion process into four easy steps: get ready, get set, go and keep going. “They guide you through the things you should be thinking about: What level of quality of life would you like? Are you willing to go to a nursing home if you might never come home? What would it be like if you couldn’t talk or you couldn’t recognize your family members anymore?,” says Dr. Czapp. “Those are things you’ve got to have a conversation about. If you wait until it’s too late and you’re in the emergency room it doesn’t always go very well. You don’t have time to process it all.” READ MORE: The Conversation Project: Sharing your wishes for end-of-life care Advance directives are also important. They are written instructions that explain your healthcare decisions if you are no longer able to speak for yourself. However, the decisions you make when preparing the advance directive may be different than the ones you would make when you become ill. This is why Dr. Czapp recommends having a spokesperson to make decisions for you. A spokesperson can talk to your doctor and help apply the decisions you made in your advance directive to your current health status. Just as you have end-of-life conversations with your loved ones, you should also have them with your doctor. It is important that your doctor understands your wishes and beliefs in order to help you. Medicare now pays for these face-to-face meetings about end-of-life care. “Eventually, everybody’s life comes to an end and if we can stop denying that then we can say, ‘How do I plan for the best ending?’” concludes Dr. Czapp. What is palliative care? Here are the top three things you need to know about palliative care from Dr. Czapp: Palliative medicine focuses on quality of life, symptom management, care planning and skillful decision-making that involve the body, mind and spirit. Palliative care is reserved for people who have a serious illness that can be life-threatening. Palliative care and hospice care share a similar whole-person, comprehensive approach. However, hospice is reserved for people who have a short life expectancy. Learn more about The Conversation Project, and how it can help you and your family. Contributor Patrica Czapp, MD, is the chair of clinical integration at Anne Arundel Medical Center. Originally published Dec. 23, 2015. Last updated June 7, 2018.
- Orthopedics, Physical Therapy, WellnessGeneral Page Tier 3BlogRunning: It’s a form of exercise that doesn’t require spending money on fancy gear, and can be done anywhere, alone or with friends. Some scientists say it can even make you feel happier and live longer. Best of all? You only need the right pair of shoes to get started. But, whether you’re a seasoned runner or just working up to your first mile, it may not be as simple as lacing up your running shoes. While research shows that runners’ joints and bones are actually healthier than the average person’s, some runners do get injured. A growing number of doctors and physical therapists (including myself) believe people can prevent running-related injuries by fixing how they run. Evaluating how you run can help identify the root cause of an injury or identify a bad habit that may lead to injury. For example: Runners with long strides tend to develop knee pain. Runners with a narrow gait are prone to shin splints and IT Band syndrome. Runners with an excessive bounce are prone to Achilles tendonitis and plantar fasciitis. Muscle weakness is another frequent cause of injury. For example, weakness in your hips may lead to pain in your knees. A physical therapist can perform a professional running assessment, which usually takes place at a hospital or sports center and lasts about an hour. During a running assessment your physical therapist will analyze your readiness to run, injury history, running goals and training and race schedule. The therapist can also assess your form by looking at balance, strength and flexibility as well as how your joints move. To do this, the therapist may take a look at how the small joints in your foot move while sitting and what changes when your foot bears weight as you stand, walk or run. Is your foot stiff, flexible, flat or high-arched? Do your toes have enough motion when pushing off? How does the ankle joint move when you squat? The physical therapist may also record your running with a high speed camera to collect information about your gait. The therapist slows the footage down to study your movement closely, looking at the runner from head to toe to make any necessary corrections. By slowing the video down, the therapist has a detailed view of the different running stages at various angles and can see what could be triggering injuries or affecting your running efficiency. A video evaluation can also help runners find the right shoe with the right support. The physical therapist can look at your current running shoe and wear pattern to see how they fit to give suggestions and a plan that works for you. If you experience pain while running or want to improve your form and efficiency, a professional running assessment can really help. Running shouldn’t lead to injuries. AAMG Physical Therapy’s Running Program offers running gait assessments at most outpatient rehab clinics. To schedule your exam with a physical therapist, call 443-481-1140. Author By Dat Quach, PT, a senior physical therapist at AAMG Physical Therapy and supervisor at the Bowie Pavilion clinic. Originally published June 22, 2016. Last updated June 4, 2018.
- Women's HealthGeneral Page Tier 3BlogWhen Roxanne Walsh’s son Van was born in October 2016, it could have been a difficult delivery. The Pasadena woman was more than a week overdue when she gave birth to the nearly 10-pound boy after 64 hours of labor. But there was someone by her side who helped make things much easier – her midwife Maria Mayzel, MSN, CNM, with Anne Arundel Medical Group (AAMG) Bay Area Midwifery. “I felt like she just had a gentle, guiding hand,” says Roxanne, 30, a hairstylist at Studio Salon in Annapolis. “I loved my experience. I wouldn’t change it for anything.” AAMG Bay Area Midwifery is a freestanding birth center located on Anne Arundel Medical Center’s (AAMC) Annapolis campus. Staffed by seven certified nurse-midwives, the midwifery team takes a holistic, individualized approach to pregnancy. “Just having a freestanding birth center in the state of Maryland is unique. We’re one of only two in the state,” says Maria, who has worked at AAMG Bay Area Midwifery for four years. While moms-to-be can opt for unmedicated births in the birthing center, AAMG Bay Area Midwifery is still an active part of the hospital. Clients, like those who want pain management such as an epidural, can choose between giving birth in the hospital or in the birth center. Clients who have high-risk pregnancies receive care from both the midwives and a team of specialists at AAMC. A seamless transfer system between the birth center and the hospital adds an extra layer of safety. “Safety is always our number one priority,” Maria says. READ MORE: The rising popularity of birth centers Roxanne learned about AAMG Bay Area Midwifery from her sister, who delivered three of her four children there. She liked the birth center’s attitude toward pregnancy, especially the close interactions all patients have with their midwives. Roxanne’s husband, Shane, also liked the idea of a natural birth for their first child. She remembers counting down the days until her first appointment, when she was eight weeks pregnant. But five weeks later, when she had her first sonogram, she learned some surprising news. Roxanne has a bicornuate, or heart-shaped, uterus, a condition that affects about 1 percent of women and frequently causes complications during childbirth. Risks can include a higher risk of miscarriage, improper attachment of the baby’s placenta, excessive bleeding and premature birth. Though Roxanne and Shane were concerned, the team at AAMG Bay Area Midwifery was reassuring. “Our plan was to just take it as it came,” Roxanne says. “I felt very confident.” As her pregnancy progressed, Roxanne held out hope that she would be able to have her baby in the birth center. But shortly after the 30-week mark, midwives told her she would be a better candidate for delivery in the hospital’s birth center, due to potential risks during labor. “At this point, we didn’t know how far my uterus could expand,” Roxanne says. Though she was disappointed, the partnership between the midwives and the hospital team comforted her. Plus, she would still be able to have one of the midwives by her side. Maria says the goal is always to honor the family’s wishes, which is why it is important to start talking about their birth plan early on. Those conversations include the entire family, Maria says. “The client’s family is the most important part of the birth team,” she says. Shane said his main concern was the safety of his wife and child, and was happy with the decision to deliver in the hospital. “It was just a change of scenery,” he says. The birth Roxanne went into labor at around 5 pm on a Saturday night, just as she and Shane were leaving a movie. At that point, she was more than 41 weeks pregnant. She called Maria, who told her to call back when the contractions were five minutes apart. A day later, the pain was intense and the contractions were holding steady. She made an appointment for Monday, when she had a stress test and learned her cervix was just four centimeters dilated. Maria says Roxanne was experiencing prodromal labor, which is when contractions happen for hours, even days, with no cervical change. After a day of therapeutic rest, Roxanne’s labor began to slowly progress. She returned to AAMC on Tuesday, and Maria — who happened to be on call that day — made a plan with Roxanne to proceed with labor induction. Roxanne was still in labor when Maria’s shift ended. “I was ready to lose it,” Roxanne says with a laugh. But Maria stayed an hour and a half past the end of her shift to help bring Van into the world — an example of the close relationship the midwives develop with their clients. “One of the biggest things we can offer our clients is more time,” Maria says. Roxanne says she had the experience she always envisioned, complete with essential oils, flameless candles and music — lots of Alice Coltrane in particular, she recalls. Shane, a musician who plays in several Annapolis-area bands, used special headphones to play Alice Coltrane for the baby when Roxanne was pregnant. Van came into the world happy and healthy, weighing nine pounds, 14 ounces. An ongoing relationship Today, Van is an active 18-month-old who loves to bang on his dad’s drums and play with blocks. And his parents couldn’t be happier with their family’s experience at AAMG Bay Area Midwifery. “She was a calm force of wonderful energy,” Roxanne says of Maria. “I feel like a lot of people would have talked me into doing other things, but I had a midwife who advocated for me.” Roxanne’s relationship with AAMG Bay Area Midwifery now continues through annual well woman visits. “At my six-week checkup, I was so sad I was leaving,” she said. “So I was thrilled to learn that I could still receive all my wellness care from the midwives.” AAMG Bay Area Midwifery midwives provide well woman and primary care for women throughout their life span, including family planning, Pap smears, screening and treatment for sexually transmitted infections, breast exams and referrals for mammograms, referrals for mental health services, and menopausal care. Roxanne says she will always remember the sense of community she felt throughout her pregnancy. She encourages any mom-to-be who wants a personalized birth experience to consider AAMG Bay Area Midwifery. “You couldn’t make a better choice,” she says.
- Men's Health, Orthopedics, Women's Health, UncategorizedGeneral Page Tier 3BlogTotal hip replacement is one of the most successful surgeries for relieving pain and increasing function if you suffer from osteoarthritis in your hip. Traditionally, hip replacements were performed through two approaches – posterior or anterolateral. Now, the anterior method is gaining popularity as the “hip” hip replacement. When you have osteoarthritis in your hip, we always begin with conservative treatments, including: anti-inflammatory medications maintaining a healthy weight physical therapy a cane in the opposite hand to off load the pressure on the joint injections But if your pain persists, it’s imperative to have a surgeon skilled in modern replacement strategies to get you back on your feet and active again. Although originally described in 1881, the direct anterior approach to hip replacement was only sporadically used until recently. Technology advances, coupled with patients’ increased desire for minimally invasive surgery and faster recovery, has the anterior hip replacement gaining in popularity. Anterior hip replacement patients are routinely walking with physical therapy within hours following the surgery. The anterior approach is a muscle-sparing procedure that exposes the hip joint with one small incision over the front of the hip. The muscles and tendons are spread apart temporarily, rather than detaching them from the hip or thigh bones, as done during the traditional hip replacement approaches. Anterior hip replacement leads to less trauma to the soft tissues and more stability following surgery. During the surgery the patient is placed on a special table, called the Hana® table, that has independent leg spars allowing us to maneuver the patient’s legs to perform the surgery through the small anterior incision. This table also allows us to use intra-operative x-rays to “fine tune” the alignment of the hip replacement components. This offers better wear properties and increased stability of the hip. We use standing x-rays taken prior to surgery and reproduce this with our intraoperative x-rays to appropriately position the hip replacement components specifically for each patient, as well as make leg lengths equal. One of the biggest differences between the anterior approach and traditional hip replacement is the freedom from “hip precautions” following the procedure. Anterior patients can position the hip anywhere they feel comfortable immediately after surgery. Muscles are not cut and the risk of dislocation is low, which enables patients to have more freedom of movement after surgery. Anterior hip replacement patients are routinely walking with physical therapy within hours following the surgery. Following a traditional hip replacement, the surgeon must give specific instructions on hip precautions to prevent dislocating the new joint. These include avoiding bending the hip and turning the foot, sleeping with a pillow between the legs for six weeks, avoiding crossing the legs and not sitting in low chairs. But, for anterior hip replacement patients these precautions are unnecessary. Many patients go home in less than 24 hours and complete outpatient physical therapy within four to six weeks. The incision is closed with absorbable sutures and skin glue, which enables you to shower immediately and not have to have sutures or staples removed. The direct anterior approach can be utilized for nearly all total hip replacements. Whether patients have osteoarthritis, rheumatoid arthritis, femoral neck fracture or advanced avascular necrosis, the anterior approach is a reliable and reproducible surgical approach. Anterior hip replacement can help you get back to the life you want to be living. Author By Justin Hoover, MD, orthopedic surgeon at AAMC Orthopedics. To reach his practice, call 410-268-8862. Originally published March 31, 2015. Last updated May 31, 2018.
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