Cancer Care
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Ready to quit smoking? 7 medications that can help
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Deciding to make a major lifestyle change — like quitting smoking — can be a challenging task. Nicotine is the real culprit in making it difficult to quit. Nicotine is present in all tobacco products, and is the substance that causes dependence on tobacco. Having the right tools to help you quit can lead you to success. Medication is one tool some people use to help quit smoking.
As a certified tobacco treatment specialist (TTS), people trying to quit often ask me, “Which medication works the best?” My answer is always, “The best medication is the one that works for you!” Here are the seven FDA-approved medications available to help people quit their smoking habit.
But remember, medication isn’t always the answer; in fact, some people are able to successfully quit smoking without using these aids. Before trying any new medication, you should talk with your healthcare provider to make sure the fit is right for you.
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Chantix (Varenicline) This is the newest medication to treat tobacco dependence. It targets the nicotinic receptors in your brain, which are the source of nicotine addiction. The medication works by gradually lowering a person’s desire to smoke. As with any medication, Chantix affects each individual differently and there may be side effects. Before getting a prescription, talk with your healthcare provider to determine if it’s right for you.
Zyban (Wellbutrin, Bupropion) This prescription has been available for several years. Originally prescribed to treat depression, Wellbutrin was found to reduce a person’s desire to smoke. It is often used in combination with nicotine replacement medications.
There are five different types of nicotine replacement therapies (NRTs). These medications provide nicotine to the body of someone who is nicotine dependent. Using NRTs allows for a gradual withdrawal from nicotine and helps avoid or reduce nicotine withdrawal symptoms. Withdrawal symptoms can include, irritability, intense cravings or urges to smoke, headaches, restlessness and others.
The Nicotrol® inhaler This prescription medication isn’t really an inhaler, but more like a “puffer.” The liquid nicotine gets absorbed through the lining of the mouth. It is not inhaled into the lungs. The inhaler is fast-acting, giving quick relief from nicotine cravings. While they may look similar, they inhaler should not be confused with electronic cigarettes or vape cigarettes. Electronic cigarette devices are not yet fully regulated and are not FDA approved for quitting smoking.
Nicotine nasal spray This is the fastest working of all the NRTs. The nicotine from the nasal spray is absorbed through the lining of the nasal passages. It should be avoided for anyone who has sinus troubles.
These three nicotine replacement medications are over-the-counter.
Nicotine patches The patch is the only long-acting nicotine replacement medication. This means it enters the system slowly and stays there longer. Most people tolerate this well with few side effects.
Nicotine gums This fast-acting option isn’t chewed like regular gum, but rather chewed until nicotine is released (a tingling or peppery taste on the tongue). Users then keep the gum between the cheek and gum. This process is repeated as needed.
Nicotine lozenges These are also fast-acting and dissolve gradually. For both lozenges and gum, the amount used is based on each individual’s level of nicotine dependence. The more severe the dependence is, the higher amount of medication is needed to ease withdrawal symptoms.
Nicotine dependence is considered a disease. Just like other diseases, medication can be a solution. Make sure you have all the tools you need to regain control over your health. Talk to your healthcare provider so you have what you need to quit tobacco for good.
Ready to quit smoking? Visit askAAMC.org/QuitSmoking or call 443-481-5366 to learn how AAMC can help you.
Author
By Joanne Ebner, a cancer prevention program supervisor at Anne Arundel Medical Center.
Originally published Sept. 20, 2016. Last updated Dec. 13, 2018.
Orthopedics, Pediatrics, Wellness
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6 tips for sledding safety
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When winter brings us snow, there’s one place you’ll likely find the neighborhood children—the local sledding hill. Where you don’t want to find them, however, is at the doctor’s office or hospital due to a sledding injury. Yet according to the Journal of the American Academy of Pediatrics each year more than 20,000 kids end up in emergency rooms with sledding injuries.
Keep your children safe on the local sledding slopes by following these tips:
Wear protective gear.
Your children may protest, but they should always wear a helmet. Wearing layered clothing, such as gloves, hats and boots can help protect against cuts, bruises and frostbite. If they get wet, encourage them to come in for dry clothing.
Choose the right sled.
The best sleds are those with runners and a steering mechanism. Inflatable tubes, snow discs, and random objects like plastic sheets or cafeteria trays are not good choices because children can’t properly steer them.
Select the best sledding spot.
Avoid sledding in areas that end near a creek, pond or road. Wide, clear spaces with a gradual incline work best. Be careful to avoid obstacles such as rocks, trees, poles and benches.
Use the safest sledding position.
While daredevils love to go head first down the hill, make sure your children are in a seated position with their feet first to avoid a head injury.
Teach your children how to avoid collisions.
Make sure children get off the sled and out of the way as soon as they get to the bottom of the hill. As they return back up the hill, they should walk on the outer edges rather than directly through the sledding path. Teach your children how to steer to avoid hitting anything that gets in their path. Also, show your children how to safely roll off the sled if they lose control.
Watch out for dangerous conditions.
It’s important that your children can see where they’re going. They should avoid sledding during a heavy snowstorm or at night in poorly lit areas. Also, it’s best to not sled into a snowbank unless they built it. Snowbanks can mask a tree stump, fence or some other hidden danger that can cause injury.
Skiing or snowboarding? Don’t miss these safety tips before heading to the slopes.
Originally published Jan. 21, 2016. Last updated Dec. 6, 2018.
News & Press Releases
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Anne Arundel Medical Center named among Baltimore metro area Top Workplaces
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Anne Arundel Medical Center has been awarded a 2018 Top Workplaces honor by The Baltimore Sun Media Group.
The list is based solely on employee feedback gathered through a third-party survey administered by research partner Energage, LLC (formerly WorkplaceDynamics). The anonymous survey measures several aspects of workplace culture, including alignment, execution and connection.
“It is an honor to be named a Top Workplace by The Baltimore Sun Media Group,” said Julie McGovern, vice president and chief human resources officer. “We pride ourselves on being a diverse, friendly and collaborative team of professionals who work together to innovate the future of health care. We also believe in caring for our caregivers, which means providing our team members opportunities to experience new challenges within a supportive environment where they can grow, learn and make a difference.”
“Top Workplaces is more than just recognition,” said Doug Claffey, CEO of Energage. “Our research shows organizations that earn the award attract better talent, experience lower turnover, and are better equipped to deliver bottom-line results. Their leaders prioritize and carefully craft a healthy workplace culture that supports employee engagement.”
“Becoming a Top Workplace isn’t something organizations can buy,” said Claffey. “It’s an achievement organizations have worked for and a distinction that gives them a competitive advantage. It’s a big deal.”
For more information about career opportunities at AAMC, visit www.aamccareers.org.
Weight Loss
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Guidelines recommend weight loss surgery for diabetes
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If you live with type 2 diabetes, especially if you are obese, updated guidelines came out in 2016 calling for weight loss surgery to become a more routine treatment option for your diabetes.
This is the first time bariatric surgery is recommended specifically as a diabetes treatment. Before, people considered bariatric surgery as an obesity treatment that only had the extra benefit of helping control diabetes.
The recommendations were endorsed by the American Diabetes Association and more than 40 other health groups.
And, it makes sense. Type 2 diabetes and obesity can be a deadly combination, and many studies have shown weight loss surgery can drastically improve diabetes.
These studies show that most obese diabetics who undergo weight loss surgery see their blood sugar levels dramatically improve. This is something I’ve seen with my patients, too. Some even no longer require medication to maintain normal blood sugar levels.
People can control diabetes with diet, exercise, medication or insulin. But those who struggle to control the disease could face heart disease, kidney disease or stroke. Some may risk limb amputation or sight loss.
The updated guidelines conclude the surgery should be a regularly considered option for certain patients with diabetes. It’s about better blood sugar control instead of pounds lost.
Instead of bariatric surgery, the procedure is called metabolic surgery when performed for diabetes. If you have a body mass index, or BMI, of 40 or greater, weight loss surgery is recommended regardless of your blood sugar level. If you have a BMI of at least 35 and have tried lifestyle changes and medication to control your diabetes with no success, the surgery is also recommended.
Weight loss surgery may also offer other benefits for diabetics. The surgery affects hormones, gut bacteria and other substances that may change how the body handles insulin and blood sugar.
Medicare often pays for certain types of weight loss surgery for people who are obese with an illness, like diabetes. Although rules vary, some insurance companies cover the surgery, too. Perhaps with these updated guidelines, insurance companies will expand coverage.
The surgery is not a cure for diabetes, since some people relapse. However, many people do remain in remission for years. It’s important for those struggling with obesity and diabetes to know weight loss surgery is an important treatment option.
To learn more about weight loss surgery, attend a free seminar at Anne Arundel Medical Center. To learn more or register, visit askAAMC.org/WeightLoss.
Author
By Alex Gandsas, MD, a bariatric surgeon and director of AAMC’s Weight Loss and Metabolic Surgery Program. To reach his practice, call 443-924-2900.
Originally published Jan. 30, 2017. Last updated Nov. 28, 2018.
News & Press Releases
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AAMC names vice president of Population Health and Clinical Improvement
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Anne Arundel Medical Center (AAMC) announces Deneen Richmond, MHA, RN, as its new vice president of Population Health and Clinical Improvement.
Richmond comes to AAMC from Inova Health System, where she served as vice president of Performance Improvement and Outcomes. Prior to this, she held leadership positions at Holy Cross Hospital, the Delmarva Foundation and the National Committee for Quality Assurance.
Richmond assumed the role of vice president of Population Health and Clinical Improvement in November. In this position, she will provide oversight and direction for designing, implementing and supporting a robust population health, care management program and promoting a quality improvement culture consistent with AAMC’s mission.
“We are thrilled to welcome Deneen to Anne Arundel Medical Center,” said Mitchell Schwartz, MD, chief medical officer and president of Physician Enterprise at AAMC. “Her role is a unique position that will help us continue to shape the future of health care delivery both at AAMC and in Maryland.”
“This role reflects our vision of living healthier together and building population health-based care models to improve the health of our whole community,” said Barbara Jacobs, chief nursing officer at AAMC. “Deneen brings tremendous experience to this role and we look forward to her leadership.”
Richmond received her bachelor’s degree in nursing from the University of the District of Columbia and her master’s degree in healthcare administration from The George Washington University. She holds an adjunct faculty position at The George Washington University and received the Milken Institute School of Public Health’s Excellence in Teaching Masters Level Online award this past spring. Richmond is a resident of Bowie, Md.