- Orthopedics, Women's Health, UncategorizedGeneral Page Tier 3BlogA stress fracture is caused by micro-cracks in the bone that result from overuse and “fatigue failure of bone.” Every day, the body produces new bone to replace the bone that is broken down by daily wear and tear. This is typically a balanced process, but increased stress from physical training and repetitive overuse can lead to micro-fractures, also known as stress fractures. If not addressed early, these smaller stress fractures can lead to full fractures. Certain sports are more commonly associated with stress fractures: basketball, running, fitness class, racket sports, dance, and gymnastics. And, the most common lower leg stress fractures are tibia, tarsals, metatarsals and fibula. Female athletes have 3.5 times the fracture risk of males, especially female runners and gymnasts. This higher risk may be related to underlying menstrual irregularities and decreases in bone density or factors specific to the female anatomy and biochemistry. What A Stress Fracture Feels Like: Pain is worse after activity and relieved with rest. Short periods of rest may temporarily relieve the pain, but it starts to hurt as soon as you return to that activity. How We Treat It: Phase I: Pain control and rest, usually 10 to 14 days. Phase II: Reintroduction of activity; may last several weeks depending on location and type of stress fracture. Phase III: Preparation for return to competition. Increase sport-specific conditioning such as running drills, cutting drills, and selected skill work. Treatment lasts until the patient is symptom free, which can take several weeks. Even once you’re no longer in pain you may not heal for 3 to 6 months. Surgery is rarely necessary. Prevention: Correct training errors, such as forming and minimizing training frequency, duration and intensity. Take adequate rest periods during training. Stress fractures are increased in first two weeks after increased training intensity. Maintain a healthy diet/weight. Stress fractures are associated with lower fat intake, lower caloric intake, eating disorders, and weights less than 75 percent of ideal body weight. Remember, your doctor can be your partner in developing an exercise routine and diet to fit your needs. Dr. Semakula is a featured guest for our March docsTALK live show on Thursday, March 19th. Register today for this free event. Find out more tips and events for Living Well With Joint Pain by visiting www.LivingHealthierTogether.com. Author By Barbara Semakula, MD, specialist in sports medicine and non-operative care of fractures, osteoarthritis and joint pain at Anne Arundel Medical Center’s Pasadena Pavilion. To reach Dr. Semakula, call 410-280-4707.
- 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.
- Men's Health, Women's Health, Uncategorized, Heart CareGeneral Page Tier 3BlogJust because you know your risk for a heart attack, doesn’t mean you know your risk for heart failure. Oftentimes people use the terms heart attack and cardiac arrest interchangeably, even though they are two distinct conditions. Heart Attack = Plumbing Issue You can think of a heart attack as a plumbing issue—when your pipes get clogged it’s going to cause some big problems. A blockage of the coronary arteries causes a heart attack. The blockage prevents oxygen-rich blood from reaching a part of the heart muscle and, if not quickly resolved, can cause parts of the heart muscle to begin to die. With a heart attack your heart generally continues to beat, despite the blockage. Cardiac Arrest = Electrical Issue On the other hand, a cardiac arrest is an electrical problem. The electrical circuit to your heart goes out–it’s like a black out. It starts when the electrical signals that control the timing and the organization of the heartbeat become chaotic and then the heart suddenly stops pumping. Without blood pumping to the brain, loss of consciousness and death occurs. Sometimes cardiac arrest can be triggered by another traumatic event, like drowning, electrocution, drug abuse, and even a heart attack. You are at higher risk if you have coronary heart disease, weakened heart (cardiomyopathy), or if you or a family member have history of certain heart conditions like arrhythmias, cardiac genetic disorders, or thickened heart muscle. Warning Signs There are varying warning signs you may experience before a heart attack—including chest pain, shortness of breath, weakness, dizziness, palpitations, and nausea—but the warning signs for cardiac arrest are pretty clear: Loss of consciousness No breathing No pulse Death will occur if treatment is not provided in the first few minutes. What You Can Do So what should you do if you’re with someone who goes into cardiac arrest? First, you should dial 911 to get help on the way. You should immediately begin CPR. If an automated external defibrillator (AED) is nearby, use it. These are becoming more common in public places like malls, airports and community swimming pools. Prepare yourself now by signing up to learn CPR and how to use an AED through community classes, like Anne Arundel Medical Center’s Heartsavers Class. Nearly 400,000 out-of-hospital deaths occur from cardiac arrest each year. Acting fast and knowing what to do can save lives. Learn CPR and how to use an AED at one our upcoming Heartsavers classes. Plus, find out your “heart age” and risk of heart disease by taking our quick, free heart profiler at www.AAMCYoungAtHeart.org. Author By Baran Kilical, MD, a board-certified cardiologist and cardiac electrophysiologist with Anne Arundel Medical Center. To reach his office, call 410-897–0822.
- Community, News & Press Releases, Heart CareGeneral Page Tier 3BlogAt Anne Arundel Medical Center we know that small acts make a big difference in the lives of our employees…and especially our patients. So, this Heart Month we’ve asked our employees to take the lead on committing random acts of kindness (RAKs) throughout the hospital in order to show their Heart@Work. We’ve even equipped our employees with special Heart@Work cards they can hand out to fellow employees, visitors and patients when they’ve been “RAKed.” Plus, there are displays around the hospital where you can pick up cards. We hope you’ll get in on the action and share your story with us here on our blog, our Facebook page, or Twitter. A cup of tea, flowers out of the blue, an encouraging note – it’s amazing how a simple act of kindness can turn around someone’s day. Need some ideas to get started: Place an encouraging Post-It note on a co-worker’s computer. If you have long hair, cut it and donate it to a charity that provides wigs for those in need. Invite someone new over for dinner or prepare a meal for someone. Buy a coloring book and crayons. Keep a few sheets and crayons in your bag to help a parent with a restless child. Buy a cup of coffee for the person behind you in line. Leave a generous tip.
- Men's Health, Heart Care, Patient StoriesGeneral Page Tier 3BlogIt had been a good night. After celebrating Mass, Father Jim Kiesel, a pastor at St. Joseph Parish in Odenton, took a group of seminary students he was supervising out to dinner. “We had a ball,” Father Jim says.“I felt great.” But when he got home, Father Jim, 58, says he started having pains in his chest and a tingling down his arm. His chest felt heavy. So he phoned a parishioner, who is also a nurse, for advice. “She told me to call 911 immediately.” It was the best advice he could have received. When Father Jim arrived at the emergency room of AAMC, he was quickly diagnosed with what’s called ST-segment elevation myocardial infarction, or STEMI, the most severe and dangerous form of heart attack, in which the blood flow in a coronary artery is completely blocked. Elizabeth Reineck, MD, an interventional cardiologist at AAMC, says the situation was grave: “The artery to the back side of his heart was completely blocked. We worked rapidly to get him to the catheterization lab and open up his artery.” 1,000 Lives—and Counting Luckily, Father Jim had arrived at the right place. AAMC’s Emergency Heart Attack Program has saved more than 1,000 lives since its introduction in 2002. It’s a certified intervention center, and the response time is among the best in the country. “The goal is to open a patient’s artery within 90 minutes from the time they arrive at the hospital,” Dr. Reineck says. “But here at AAMC, the vast majority of our patients have their artery open within 60 minutes.” In the catheterization lab, Father Jim received an emergency angioplasty. During the procedure, a balloon-tipped tube is threaded into the blocked artery and then inflated. He also received a stent, a tiny wire-meshed tube that holds the artery open. Father Jim says he feels incredibly lucky. The intervention saved his life, and the care that followed as he recovered at AAMC was compassionate and professional. “Anything I needed, they were right there to help me,” he says. The Doctor-Patient Partnership Father Jim says what has really stuck with him is the way Dr. Reineck and fellow cardiologist Jerry Segal, MD, interacted with him, “as an equal.” “So often doctors are in and out, but Dr. Reineck and Dr. Segal really took time with me,” Father Jim says. “It wasn’t just business—it was genuine care.” For her part, Dr. Reineck says she works hard to create a partnership between doctor and patient. “If you respect patients, they are more likely to value the information you provide,” she says. “For instance, if you help patients understand why the medication is important, they are much more likely to take it.” It’s worked for Father Jim. Despite eating well and exercising regularly, he admits he had one serious vice before his heart attack—cigarettes. “I’d been a smoker since I was 17.” But no longer. “I’m a reformed smoker now,” he says. Father Jim is also participating in AAMC’s Cardiac Rehabilitation Program, which offers medically supervised exercise and counseling. Now, Father Jim is again at work at St. Joseph, easing back into normal life. He says perhaps his biggest challenge these days is learning to let people take care of him instead of always taking care of others. “I have a long life ahead,” he says. “I’m confident of that.” And he adds happily, “I also expect to have a long relationship with my cardiologist.” Are you at risk? Learn your heart age and risk for heart disease with our free online heart health profiler. Contributor Elizabeth Reineck, MD, is an interventional cardiologist at Anne Arundel Medical Center.
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