- Cancer Care, Men's Health, Women's Health, Patient StoriesGeneral Page Tier 3BlogIt was finally time to celebrate. Earl Shellner had just received an honorary certificate for completing a long course of chemotherapy. This was the last big hurdle in his cancer treatment. Earl had already been through surgery and radiation to treat an aggressive form of rectal carcinoma. Now he was cancer free. Earl sat down to write thank-you notes to friends and family who’d supported him during his struggle. It was then that he realized something new was seriously wrong. He seemed to have forgotten how to write basic letters. ‘”I was starting on the notes and couldn’t remember how to make a cursive S and a J,” he recalls. “I had to look it up on the internet, how to make the lines and curves for those letters.” Friends and Family May Be the First to Notice Signs Earl didn’t understand what was happening. He spoke to his mother, who’d been staying with him during his cancer treatment. She had even more bad news. She told him it wasn’t just the alphabet he was forgetting. “She told me I’d been telling the same stories over and over again. I’d tell a story and then 15 minutes later I’d tell it again.” And there were other lapses. He couldn’t remember the name of a neighbor’s son who he’d known for years. When he went to brush his teeth, he couldn’t remember how to use the toothbrush. It turns out many of Earl’s friends also noticed his brain seemed muddled. No one wanted to tell him because he’d already been through so much. He was devastated. Before his cancer diagnosis, he’d been a high-energy, multitasking restaurant manager. “Now I didn’t want to leave the house. I didn’t want to socialize, and my mom had to take over my banking. I just couldn’t handle any of my stuff anymore,” he says. AAMC Nurse Identifies Chemo Brain Earl shared his concerns with his radiation oncologist, and a nurse on the team recognized the symptoms. She told him he had what’s known as cancer-related cognitive impairment or “chemo brain.” Estimates vary but studies suggest a significant number of cancer patients who’ve undergone chemo may experience some degree of cognitive impairment. Until recently, however, many doctors tended to dismiss the memory loss as a given side effect of treatment. Their advice was for patients to wait it out and hope the problems diminished over time. “There is a real knowledge gap,” says Matt LeBlanc, the nurse navigator for Anne Arundel Medical Center’s Cancer Rehabilitation Center. “Chemo brain exists but it is under recognized and undertreated.” A little over a year ago, AAMC decided to address the need directly by launching the cancer rehab program. Among other things, it offers cognitive therapy to cancer patients using techniques developed for those who’ve suffered traumatic brain injuries. Speech Therapy Helps Rebecca Gondak is a speech language pathologist at the center. She says many of her cancer patients arrive with significant cognitive impairments, including short-term recall and language retrieval. “Intelligence is not affected, the problem is a patient’s ability to access intelligence,” says Gondak. The good news is that with help, even a brain damaged by chemotherapy can form new pathways to compensate for what’s been lost says Gondak. Earl is a perfect example. When Shellner arrived at the Cancer Rehab Center, he tested far below average for memory and word recall. Gondak began a vigorous course of treatment using a combination of exercises, strategies and tricks to teach the brain new ways to access information. “Since people with chemo brain often have trouble with short-term memory one thing I do is teach them how to connect new information to something they are already familiar with,” says Gondak. Gondak says many effective strategies for recall are quite simple “Let’s say a patient parks on level 3A. How will they remember if they’re having short-term memory loss? Well, I’ll have them think of connections to the level. Maybe they have 3 children and want an A in school. That’s 3A.” Gondak also uses repetition and problem-solving exercises to help jump-start the brain. Rehab Gave Earl His Life Back After twelve sessions, Earl was thrilled with his progress. He’d jumped from the 13th percentile in cognitive function to the 79th percentile. Other patients have seen similar results. Gondak says one of the things she finds most moving is that many of her patients are making huge leaps in memory skills even as they endure cancer treatment. “We get a lot of patients in pain or who aren’t sleeping and still we see improvement, ” Gondak says. Earl says rehab has given him his life back. He’s no longer afraid to go outside or talk in public. He also continues to heed Gondak’s advice. He uses lists so he doesn’t overload his brain with too much information, he takes brain breaks and he puts essentials, like his keys and phone, in a designated place so he doesn’t lose them. The bottom line, says Earl, is the skills he’s acquired in rehab have allowed him to function again. “Rehab has made a tremendous difference in my life,” Earl says. “I can feel it everyday.” Read Earl’s first-person account of his journey on the Huffington Post.0
- Women's Health, Heart CareGeneral Page Tier 3BlogYears ago, doctors recommended rest and limited activity to expecting moms as they progressed through each stage of pregnancy. While you should always check with your health care provider on what would be best for you and your baby, staying active during your pregnancy has shown to ease back pain, improve your mood, and prevent the risk of gestational diabetes and pregnancy-induced high blood pressure. Exercise will also help you maintain a healthy weight during pregnancy and may reduce your risk for a Cesarean section. Physical activity will not increase your risk of miscarriage, low birth weight or early delivery. But there are some safety tips you should keep in mind: If you’re new to exercise, your heart rate should stay below 150 bpm. Stay well hydrated before, during and after exercise. Eat a snack or drink juice 15-30 minutes before you exercise. Stop if you become dizzy, short of breath or experience any bleeding. Do not exercise outside when it is very hot or humid. As your body makes room for your growing baby, you may wonder which exercises are safe during each trimester. Learn your risk for heart disease with our free online heart health profiler and take the first step toward having a healthy heart for life. First Trimester I wouldn’t start training for a marathon just yet, but if you are able to work through the first-trimester morning sickness and fatigue, going for a brisk walk is a great exercise during this stage. But if you’re just getting started, walk 10-15 minutes a day and gradually increase to a 30-minute walk 3-5 times a week. For women without pre-existing health conditions, moderate activity does not have heart rate limitations. This is especially true for women who were exercising prior to pregnancy. If you were highly active before getting pregnant and remain healthy, you can continue. Second Trimester Has your morning sickness and fatigue decreased? You may find you have more energy in your second trimester. However, as your joints begin to loosen, you are at a greater risk for injury (like sprains and strains). At 14 weeks, we recommend avoiding activities like skiing, contact sports, karate and other activities that increase your risk of falling. You may continue with walking, swimming and pre-pregnancy exercise as long as it isn’t high-impact or lifting weight over 25 pounds. Prenatal yoga and stretching can also be very beneficial and help increase your strength and flexibility as you prepare for childbirth. Third Trimester The best workouts for your third trimester are swimming, walking and biking in a reclined exercise bike. Prenatal yoga is still a good option for this stage as you get ready to deliver your baby. If you’re continuing with weight resistance exercises, it’s okay to lighten the load. Modifying bicep curls to about 3-5 pounds will still help keep your arms toned. Some women work out through the end of their pregnancy, but some may stop. Either way, it’s important to listen to your body and talk with your doctor. Patients with the following conditions should especially ask their provider before starting exercise: heart and lung conditions, cervical problems, low-lying placenta, high blood pressure later in pregnancy, and vaginal bleeding and cramping. As always, it is best to discuss any questions or concerns with your obstetric provider. Need a reminder? Download your Safe Exercise During Pregnancy infographic now. Author Frederick Guckes, MD, is an OB-GYN at Luminis Health Ob-Gyn Annapolis. You can schedule an appointment with him by calling 410-573-9530. Originally published Jan. 28, 2019. Last updated Oct 21, 2024.0
- Cancer CareGeneral Page Tier 3BlogThis year, National Cancer Survivors Day is celebrated on June 2. This is a day that recognizes cancer survivors and their loved ones. A day in which people share their journeys and experiences with others to give hope and inspire. But most importantly, it’s a day that raises awareness of a disease that has a major impact on society in the United States and across the world. A person is considered a cancer survivor from the day of diagnosis throughout the rest of their life. Cancer survivors face challenges during and after treatment. As a nurse navigator for cancer patients who has been working in the field for over 15 years, I am sure most of you know someone touched by the diagnosis of cancer. READ MORE: Conquering cancer: What’s next? Throughout my career, I’ve seen many people desperately wanting to help when a loved one is touched by cancer. It’s a challenging time. Drawing from my experiences, here are a few tips to keep in mind along the journey of cancer: Treat your friend or family member the same as you would normally. They are the same person they have always been. Try not to let the new diagnosis alter your relationship. Try to explore your own feelings and emotions ahead of time. It is very difficult to hear that a loved one has cancer. By processing your own feelings, you can better focus on your friend or family member. Listen to their thoughts and concerns. A cancer diagnosis is life changing. Your loved one will be trying to establish a “new normal”. Educate yourself. Take time to learn about and prepare for the cancer type that your friend or family member has experienced. Side effects and treatment results vary. Cancer treatments are not all the same. For example, a person treated for breast or prostate cancer will experience completely different side effects than someone with head and neck cancer. Learn about the diagnosis. What is predicted to be a significant side effect of the cancer or treatment? Head and neck cancer treatments result in significant swallowing difficulties and severe dry mouth. It can take quite some time for a person treated for head and neck cancer to complete a meal, if they are able to eat at all. Consider other ways of support rather than bringing them food, like spending time with them or helping with chores. Do not be afraid to ask how you can help them. Be patient. Keep in mind that long after treatment is complete, side effects can continue. Head and neck cancer can cause some patients to dread going out to dinner or participating in a shared meal. Often their tastes have changed and they no longer enjoy the foods they used to. Or as mentioned, a meal can take a long time to get through and friends and family have completed their meal long before they have. Sharing a meal is such a big part of our culture. Consider alternative ways to bond and connect. Be supportive. Often, the most difficult time for some survivors is after treatment is over. The routine of actively treating the cancer is complete. Waiting for the tests and imaging to determine if the cancer is gone is quite scary. When treatment is completed, survivors are no longer surrounded by their treatment team and can sometimes feel abandoned. There is often a perception from friends and family that treatment is over and life should go back to normal. Recovery from treatment can take up to a year or more. It is at this time when patients feel like “nothing is being done” that they may need you the most. READ MORE: Patient advisor helps fellow cancer survivors and patients Life does go on and survivors have the beautiful gift of being here to live it – probably with more intensity and appreciation for the little things in life. If you’re a survivor, be kind to yourself and give yourself, your family, and those around you time. Facing your feelings and learning how to cope with them is important. It took time to adjust to cancer, you should also give yourself time to adjust to life after cancer. But don’t forget, you’re a survivor and are now stronger than you were before. You will get through this. Author Jacqueline Shanahan is a nurse navigator at the DeCesaris Cancer Institute at Anne Arundel Medical Center. She can be reached at 443-481-5801. Originally published June 4, 2018. Last updated May 22, 2019.0
- Men's Health, Women's Health, Heart CareGeneral Page Tier 3BlogHigh blood pressure, or hypertension, is the leading cause of heart attack, stroke, heart failure and kidney disease. It’s called the “silent killer” because it often has no warning signs or symptoms, and many people don’t know they have it. So with one in three adults in the United States having high blood pressure, it’s natural for you to question if you should worry about it. My answer is yes, but with some qualification. It’s not necessary, and sometimes unhelpful, for people to take their blood pressure multiple times a day. The benefits of blood pressure control occur after many years of treatment and it’s the rare circumstance where normalizing one’s pressure requires a sense of urgency. Also, one or two elevated readings at home, at the drug store, or a doctor’s office does not mean you have high blood pressure—it is a diagnosis that generally requires weeks or months to establish. I personally don’t believe that patients should monitor their blood pressure at home unless specifically instructed to by their doctor. But that doesn’t mean you’re off the hook. It’s important to know your blood pressure numbers and understand what they mean. This helps keep the lines of communication open between you and your doctor, so you can work in partnership toward the healthiest you. Understanding the Numbers Your blood pressure reading is made up of two numbers, but do you know what they are telling you? The top number is called your systolic blood pressure. This represents the force of blood through your blood vessels during your heartbeat. Normal: 119 or below is normal systolic blood pressure Prehypertension: 120-139 High blood pressure: 140 or greater High blood pressure in those over 60: 150 or greater The bottom number is called your diastolic blood pressure, representing the force of blood through your blood vessels when your heart is resting. Normal: 79 or below is normal diastolic blood pressure Prehypertension: 80-89 Hypertension: 90 and greater The good news is that it is possible to prevent and control high blood pressure through some simple lifestyle changes: Maintain a healthy weight Get physically active Follow a healthy eating plan Limit salt and sodium Limit alcohol consumption Lifestyle changes aren’t always enough depending on where you fall on the spectrum, in which case your doctor will work with you to incorporate blood pressure medication into your healthy lifestyle routine. We live in the age of fitness trackers and electronic health self-monitoring devices, so I understand the desire may still be there to check your blood pressure regularly on your own. If you can’t resist the temptation, or simply find peace of mind in more regular monitoring, I recommend taking your blood pressure once a week, at the same time of day, such as in the morning or evening, unless your doctor has instructed you otherwise. Listen to more about the numbers you should know for heart health from Dr. Jonathan Altschuler at AAMC’s docsTALK: Spring Screenings. Author By Jonathan Altschuler, MD, interventional cardiologist and medical director of the Cardiac Catheterization Lab at Anne Arundel Medical Center.0
- Wellness, Heart CareGeneral Page Tier 3BlogDo you have high cholesterol? You’re not alone — millions of adults in the United States face this common but serious issue. High cholesterol increases the risk of heart disease, stroke and other chronic health conditions. In Prince George’s County, heart disease is the leading cause of death, underscoring the urgency of managing cholesterol levels. But how can you take control? At Luminis Health, we understand it’s not always easy. That’s why we’re here to explore the difference between “good,” “bad” and even “stealthy” cholesterol, review lifestyle changes that can help, and weigh the pros and cons of statin medications. Good vs. bad cholesterol Believe it or not, cholesterol isn’t all bad. Cholesterol helps build cells, create hormones and vitamin D, and aid in digestion. Problems can develop, however, when you have too much bad cholesterol or not enough good cholesterol in your bloodstream. In your body, cholesterol and triglycerides (fats from food, such as butter) combine with proteins to form lipoproteins, which travel to cells through your bloodstream. It’s likely you’ve heard of these, although perhaps by nickname: High-density lipoprotein (HDL) is often referred to as “good cholesterol” because its job is to move the bad cholesterol out of your arteries and into your liver, where it breaks down. Good cholesterol can be found in foods like nuts, fruits and vegetables, avocados, olive oil, oatmeal, beans and whole grains. Low-density lipoprotein (LDL), also known as “bad cholesterol,” causes fat to build up in your arteries, either restricting or blocking blood flow. Bad cholesterol is common in foods like red meats, processed meats and fried foods. Stealthy cholesterol is the common name for lipoprotein(a) or Lp(a). It’s often called “stealthy cholesterol” because high Lp(a) levels usually don’t cause symptoms and diet, exercise and cholesterol medication don’t affect it. It’s a genetic condition detected by a special blood test. You can have high cholesterol if you have too much LDL, too little HDL or a combination of both. Stealthy cholesterol is also quite common. According to the American Heart Association, one in five people worldwide has high levels of Lp(a). Whether you have high or stealthy cholesterol, you’re at an increased risk of experiencing heart pain (angina), a heart attack or a stroke. How to combat high cholesterol Certain lifestyle changes can help you keep your cholesterol in check, including: Eating a healthy diet that includes heart-healthy foods like vegetables, fruits, whole grains, fat-free or low-fat dairy, and protein-rich foods such as fish and lean meats. Exercising regularly — aim for 150 minutes each week. Limiting your alcohol intake. Maintaining a healthy weight. Quitting smoking. If high cholesterol is an issue for you, your doctor may also prescribe medications to decrease your levels of bad cholesterol, increase your levels of good cholesterol and/or reduce your levels of triglycerides. One type of medication, called statins, can do all three. The pros and cons of statins Unfortunately, you can still have high cholesterol, even if you maintain a healthier lifestyle or have recently made some positive changes. Many of us now take a statin, which is a class of medication that helps lower cholesterol. Statins work by blocking a substance your body uses to produce cholesterol, helping to slow the buildup of plaque in the arteries. Statins are especially beneficial for people who have already had a heart attack or are at high risk due to conditions like diabetes or high blood pressure. In addition to lowering cholesterol, statins may also have anti-inflammatory effects that further protect the heart and blood vessels. However, it’s important to be aware that statins can come with potential side effects, such as: Constipation Diarrhea Fatigue or sleep issues Headache Increased blood sugar Liver damage Muscle or stomach pain Nausea or vomiting Rash You’re more likely to experience side effects from statins if you’re female, take other cholesterol-lowering medications, drink excessive alcohol or have conditions like hypothyroidism, kidney disease or liver disease. Certain medications and even foods (such as grapefruit juice) can also interact with statins. Your doctor can help you weigh the risks and benefits to decide if statins are right for you. The support you need, close to home If you suspect you have high cholesterol or are experiencing concerning symptoms, it’s important to seek expert medical screening and treatment. The faster you get a diagnosis, the sooner we can take steps to help you lower your risk for serious health complications. Find a primary care provider at Luminis.Health/PrimaryCare or call 301-927-0088 to schedule an appointment at our Greenbelt location. The Luminis Health Community Health team also offers free community clinics with essential screenings, including A1C testing, cholesterol and blood pressure screenings. For details about upcoming clinics, visit Luminis.Health/CommunityClinics. Authors Sufia Syed, MD is an internal medicine physician at Luminis Health.0
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