- Orthopedics, Pediatrics, WellnessGeneral Page Tier 3BlogElbow injuries in young baseball players are an increasingly common problem seen by orthopedic surgeons because the act of throwing creates substantial stress on the elbow. The elbow is protected by a combination of ligaments and muscle that help to dissipate this stress. Repetitive throwing, however, can cause significant injuries including ligament tears, cartilage loss, bone spurs, and even fractures. These injuries, whether treated conservatively or with surgery, lead to a significant amount of time spent on the sidelines. Coaches and parents must understand how to reduce the frequency of these injuries. Prevention starts with limiting the amount of throwing and allowing for proper rest. To reduce injuries, the Academy of Orthopaedic Surgeons recommends the following: Players should not throw for three consecutive months during the year. Player should not compete on more than one team during the same season. Players and coaches should follow pitch counts to prevent stress on the elbow (see chart) Players should not throw breaking balls until age 14. Resist the urge to play the same player as pitcher and catcher during the season as this can create stress on his/her elbows. Despite appropriate limits and rest, injuries can still occur. Pain, stiffness, decreased velocity, and decreased accuracy are all potential indicators of a developing elbow injury. Players should not throw through pain. Initial treatment should consist of rest, ice, and anti-inflammatory medication. If the symptoms do not resolve within seven days, consultation with an orthopedic specialist is recommended. Author By Cyrus Lashgari, MD, orthopedic surgeon at AAMG Orthopedic and Sports Medicine Specialists, a practice of Anne Arundel Medical Center. To reach him, call 410-268-8862.
- Community, News & Press Releases, UncategorizedGeneral Page Tier 3BlogRecently, AAMC pharmacists Adrienne Belton and Lucretia Jones used their professional expertise to help a patient on the oncology unit understand how and when to take her medications. They talked with her at length, providing guidance on when to take them, how often, which medications should be taken with food, and possible side effects to look out for. Then they went a step further and assisted the patient in obtaining her medications at the lowest available cost so she could afford them. The patient left the hospital feeling confident in her ability to follow her new medication regimen. These pharmacists embody an emerging role of the pharmacist in the hospital, directly interacting with patients, families and care teams to provide needed medication reconciliation and medication education. Previously, pharmacists spent the majority of their time in the centrally-located inpatient pharmacy performing tasks including dispensing medication, monitoring drug therapy, preparing IV medication, and sterile product preparation. They consulted with physicians and nurses via phone about patients’ therapy, but they almost never visited the units or talked directly with patients and families. Besides the obvious benefits of having a pharmacist do face-to-face consults with patients, families and providers, other potential benefits include decreasing drug costs, reducing hospital re-admissions and increased patient safety and satisfaction. But workflow inefficiencies weren’t providing pharmacists time to talk with patients. Their responsibilities were too broad, leaving them little time for face-to-face patient interactions. So, a team made up of pharmacy leaders, physicians, a nurse, a performance improvement specialist, and an IT specialist, worked together to redesign the pharmacist’s workflow to prioritize work and allow for greater patient interaction. Some of the improvements they made are: They worked with physicians and nurses to increase awareness of pharmacists as an available resource for medication utilization review, medication reconciliation and patient education. They enhanced Epic, the electronic medical record system, to make it easier to prioritize high-risk patients for medication review and education. They collaborated with the charge nurses to improve communication around patient discharges so that the pharmacists could prioritize educating patients who are ready for discharged about their medications. The goal is to free up a total of six hours per day for up to 30 patients to be seen on the units by pharmacists. This will help to ensure these patients receive the appropriate medications while they are here and understand their medications before they go home. They are also spending more time reviewing drug utilization with physicians, educating them on newly available drugs, risks and interactions. This has helped improve medication safety, lower drug costs and increase physician and patient satisfaction.
- Men's Health, Women's HealthGeneral Page Tier 3BlogWith the recent measles outbreak there’s a lot of information being shared about vaccinating children. But, how do adults know if they’re protected, or if they could benefit from a booster shot? It’s common protocol for children to have two doses of the combination measles-mumps-rubella (MMR) vaccine: one dose between 12 and 15 months and a second booster between four and six years old. However, most adults have only had one or no vaccine. One dose of the MMR vaccine is considered about 93 percent effective at preventing measles, while two doses raises effectiveness to 97 percent. The 3 percent of the population that is fully vaccinated but still vulnerable to catching measles would still have a milder version of measles, if exposed. How do I know if I’m protected from measles? The vast majority of Americans are considered immune to measles, either because they were vaccinated or they had measles before. You’re considered covered if you: have immunization records documenting that you have received two doses of the MMR vaccine at any point in your life; had a blood test confirming immunity against measles at any point in your life; had a blood test confirming you had measles at some time in your life; or were born before 1957. You do not need to receive an MMR booster vaccine if any of the above is true. If you can’t find any immunization or blood test records, talk to your doctor about getting a booster or a blood test to check your immunity. Do I need a booster shot? If you have documentation of only one dose of the MMR vaccine, you can ask your doctor whether you should have a booster vaccination. For adults, the Centers for Disease Control recommends a second dose of the MMR vaccine if: you’re a student at a higher education institution; you work in at a healthcare institution, like a hospital; or you travel internationally. The second dose of the vaccine should be administered no earlier than 28 days past the first dose. Measles is a highly contagious, yet easily preventable, disease if we all take the proper precautions. Traveling internationally? Check with your doctor to see if you should get a measles booster. Author By Lauren Parmer, DO, a family medicine practitioner at Pasadena Primary Care within Anne Arundel Medical Center’s Pasadena Pavilion. To reach her office, call 443-270-8600.
- 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.
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