- 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.0
- Heart CareGeneral Page Tier 3BlogWhat are healthy foods for your heart? The choices you make in your diet can have a powerful impact on your heart. Certain foods and beverages have nutrients and natural compounds that can lower cholesterol, maintain healthy blood vessels and protect your heart. Here are the top picks for heart-smart foods to eat often. Adding these foods to your diet can keep your heart healthy and reduce your risk of a heart attack or stroke. Leafy green vegetables All vegetables are nutritious, but dark leafy greens like spinach, kale, Swiss chard, and collard greens are especially rich in vitamins, minerals and antioxidants that promote healthy blood clotting, lower blood pressure, and protect your heart and blood vessels. Eat leafy green vegetables daily by adding them to salads, sautéeing them as a side dish, adding them to soups or stews, or blending them into a smoothie. Avocados This creamy, satisfying fruit is full of heart-healthy, unsaturated fats. Replacing foods like butter, margarine, cheese, or processed meat with avocado can reduce your risk of heart disease. Skip the tortilla chips, though. For healthier ways to eat avocado, add it to your salad or sandwich or dip fresh vegetables into your guacamole. Fresh or frozen berries Colorful blueberries, strawberries, raspberries and blackberries contain polyphenols, antioxidants that reduce inflammation, protect blood vessels and lower your risk of cardiovascular disease. Fresh or frozen berries can be added to overnight oats, yogurt and salads, or enjoyed on their own for dessert. Oats and barley These whole grains are full of soluble fiber, which helps reduce LDL (bad) cholesterol. Soluble fiber also slows digestion and keeps you feeling full for longer, which can promote weight loss. Add these grains to your weekly meal plan by eating oats for breakfast and trying barley as a side dish, in soups, or as a base for salads. Beans (legumes) Chickpeas, lentils, black, pinto, kidney, white beans, and all other dried beans or legumes are heart-smart superfoods. They’re full of plant protein, cholesterol-lowering soluble fiber, and many other nutrients that support your heart, blood vessels, and blood pressure. A 2023 analysis of studies published in Nutrition, Metabolism, and Cardiovascular Diseases found that eating about 3 cups of beans each week can reduce your risk of heart disease. To meet that goal, add beans to soups, stews, chili, tacos, and salads, and blend them with herbs to make dips and sandwich spreads. Fatty fish Oily fish, such as salmon, sardines, mackerel, and rainbow trout, are excellent sources of omega-3 fats (fish oil). These essential fatty acids can help reduce blood pressure and triglyceride levels. Research links a higher fish intake to a lower risk of heart attack and stroke. As such, the American Heart Association recommends eating at least two servings (a total of eight ounces) of fatty fish each week. If you don’t like oily fish, lean fish or seafood like tilapia, cod, or shrimp still provides some omega-3 fats. Any type of fish is better than none. Nuts and seeds All nuts and seeds are excellent sources of unsaturated, heart-healthy fats which can improve your cholesterol. They also contain significant antioxidants to reduce inflammation and protect your heart and blood vessels from oxidative damage. To get the most benefits from nuts and seeds, vary them in your diet: Snack on almonds, peanuts, and pistachios. Sprinkle chopped walnuts, pecans, pumpkin, or sunflower seeds on salads and roasted vegetables. Add a spoonful of chia or ground flaxseeds to a smoothie. Olive oil Olive oil is an essential ingredient in the Mediterranean diet, and extensive research supports its benefits for heart health. A 2022 study published in Frontiers in Nutrition found about 1 ½ tablespoons of olive oil each day is enough to reap the benefits. Use it to make salad dressings, in place of butter or other oil for baking, and when roasting fish, chicken, or vegetables. Tea According to a 2021 study published in the Annals of Medicine, drinking two cups of unsweetened brewed green or black tea each day can reduce the risk and progression of cardiovascular disease. Researchers believe antioxidant compounds in tea called flavonoids account for its benefits. If you prefer herbal tea without caffeine, try hibiscus tea. A 2022 review and analysis of 17 studies published in Nutrition Reviews determined it can reduce risk by lowering blood pressure and LDL cholesterol. The bottom line When it comes to heart health, food is medicine, so try to incorporate as many of these foods as possible into your regular diet. If you are taking blood thinners or other medications, talk to your physician before making substantial changes to your diet as some foods can change the effectiveness of those medications. Make sure you stay on top of your heart and overall health by getting regular wellness checks and notifying your doctor about any heart-related symptoms. Author Author: Luminis Health Chief of Cardiac Surgery, David J. Caparrelli, MD. Dr. Caparrelli has more than 20 years of experience in both cardiac and vascular surgery. To make an appointment with Dr. Caparrelli, please call 443-481-1358.0
- Cancer Care, Women's HealthGeneral Page Tier 3BlogOur bodies do a lot for us — carrying us through each day when we’re at work and at play. But we don’t always listen to the signals. When you notice something in your body isn’t quite right, it can be worth getting checked out without delay. Watch for early warning signs Most commonly found in women after menopause, endometrial cancer affects the inner layer of the uterus (endometrium), causing growing cancer cells to thicken the lining of the uterus or form a tumor. Usually, endometrial cancer causes symptoms early on that lead women to check with their doctor. And fortunately, taking early action often means catching it at a highly treatable stage. Here are the symptoms women most commonly notice. Unusual vaginal bleeding. About 90 percent of women with endometrial cancer have abnormal vaginal bleeding. If you haven’t gone through menopause yet, you might notice a change in your period or bleeding between periods. After menopause, if you have any vaginal bleeding, you should be checked out by a doctor. Other pelvic symptoms. Some women with endometrial cancer experience pelvic pain, pain during sexual intercourse and trouble urinating. It can also cause unusual vaginal discharge after menopause. Know if you’re at risk for endometrial cancer About three percent of women receive a diagnosis of endometrial cancer in their lives, most commonly around the age of 60. You might have a higher chance of developing it if you: Are obese Have a close family history of endometrial cancer, which can be passed to you from your mother OR father Have never been pregnant Started your period early (before the age of 12) or started menopause late Take estrogen without progesterone for menopausal hormone therapy Take tamoxifen for breast cancer If you’re worried about your risk for developing cancer, talk to your doctor about what you can do to help protect yourself. Generally, being physically active and eating a healthy diet can help reduce your overall risk. Act quickly if you have symptoms If you notice one of the symptoms listed above, schedule an appointment with your gynecologist. They’ll likely talk to you about your health history and do a physical exam. And if needed, may also recommend an ultrasound of the area to look for tumors or see if your endometrium is thicker than normal. These two common tests can help the doctor check the cells in your endometrium: Endometrial biopsy. The doctor will insert a thin, flexible tube into your uterus through your cervix to remove a small amount of tissue. They’ll examine the cells with a microscope to check for cancer. The doctor will use a tool with a light and lens to look for and biopsy any abnormal areas. Your care team might also order additional tests if needed. Sometimes unusual bleeding or other symptoms are flags for different conditions that are less serious than cancer. But it’s important you still get checked to understand what’s causing the change in your body. If it is endometrial cancer, doctors will likely recommend surgery and other therapies, such as radiation and chemotherapy, to treat it. Be your body’s best advocate Right now, there’s no standard screening test to check for endometrial cancer. The best way to catch it early is to listen to your body — and take note of any signs or signals. If you’ve noticed a change in your body recently or have questions, we’re here to support you. Authors Monica Jones, MD, MS, FACS, FACG is the chair of Luminis Health Anne Arundel Medical Center’s Women’s and Children’s services. To make an appointment with a Luminis Health gynecologic oncologist, please call 443-481-3493. Luminis Health was recently joined by Michael L. Hicks, MD, a board certified gynecologic oncologist. Dr. Hicks has a wealth of experience in gynecologic oncology.0
- Digestive Care, SurgeryGeneral Page Tier 3BlogWhile watching television one evening, Mark Bachteler of Gambrills, Maryland, suddenly didn’t feel well. He thought he might need to cut back on spicy foods, but the stomach pain and vomiting didn’t go away, even after a few weeks. At first, being unable to keep food down helped him meet his weight loss goals. He stopped eating out and only ate soft foods at home. But after losing more than 50 pounds, he and his wife agreed it was time to see a doctor. Mark was referred to Dr. Sanmeet Singh, Medical Director of Endoscopy at Luminis Health. Dr. Singh performed an endoscopy and diagnosed Mark with achalasia, a rare condition that occurs when food and liquid can’t move from the esophagus to the stomach. To fix it, Dr. Singh recommended a minimally invasive procedure called peroral endoscopic myotomy (POEM). The procedure gently cuts the tight muscle at the bottom of the esophagus, opening the passage so food can reach the stomach again. “Given the severity of Mark’s symptoms, POEM was the right choice for him,” Dr. Singh says. “It’s minimally invasive, allows for a faster recovery than traditional surgery, and delivers relief by cutting the tight muscle without large incisions. We’re proud to be one of the few centers in Maryland equipped to provide this advanced level of care close to home.” After just one night in the hospital, Mark went home to his wife and two sons, ages 11 and 8. “It has been life-changing,” Mark says of the experience. "I am now eating more solids than I have in the last 1.5 years. I no longer have to always worry about being near a bathroom or someplace where I can step away when eating with others. Dr. Singh truly changed my life." A few weeks later, Mark and his family went on a beach trip to Delaware with his in-laws. Everyone was glad to see him enjoying family meals again after so many missed mealtimes in the past. Next, Mark is looking forward to a golf trip and enjoying meals out with his golf buddies. If you or someone you know has a digestive disease, please call 443-569-4855 to make an appointment with our team.0
- Quit SmokingGeneral Page Tier 3BlogTobacco usage is the leading cause of preventable death in the United States. The Centers for Disease Control and Prevention (CDC) estimates that approximately 34 million adults currently smoke cigarettes, while an estimated 2.5 million middle and high school students use at least one tobacco product, including e-cigarettes and vapes. Beyond being harmful to users, tobacco products can also be fatal. According to The World Health Organization (WHO), the tobacco industry is responsible for the death of 8 million people worldwide each year, as well as widespread deforestation and overall environmental destruction. Steps to reduce tobacco usage in the U.S.: In recent years, there have been ongoing steps by the Food and Drug Administration (FDA), CDC and White House to curb tobacco usage, which accounts for $225 billion spent annually on medical care to treat smoking-related illness and disease in adults. Recently, the Biden administration announced it will be developing a rule that would set a maximum nicotine level in cigarettes and other tobacco products to help lower nicotine content so that people are more successful in their cessation efforts. Also, the FDA moved to ban the sale of Juul electronic vaping devices in the U.S., though the ban is temporarily on hold while it is reviewed by an appeals court. In addition to these efforts, work is underway to further reduce tobacco usage, including increasing the legal age to purchase tobacco products to 21, as well as a proposed rule by the FDA to ban the manufacturing and sale of menthol-flavored cigarettes and ban all flavored cigars. These initiatives are focused on continuing to reduce the number of people who use tobacco products, as well as support those who want to quit. The risk of smoking and using tobacco products Smoking and tobacco use harms every organ of the body, causing many diseases and reducing the health of smokers. There is no safe form of tobacco, including electronic cigarettes. The risks of smoking and tobacco usage include: Shortness of breath Increased risk of heart attacks and strokes Lung and other cancers (larynx, mouth, pharynx, esophagus, pancreas, bladder, breast, cervix) Chronic pulmonary diseases (chronic bronchitis and emphysema) Long-term disability All cigarettes are harmful, and any exposure to tobacco smoke can cause both immediate and long-term damage to the body. Scientists have identified more than 7,000 chemicals and chemical compounds in tobacco smoke. At least 70 of them are known to cause cancer. The benefits of quitting For people who quit smoking, there are immediate and long-term benefits in doing so. Within 20 minutes of quitting, the body begins to repair itself and some of the damage caused by smoking: Carbon monoxide levels in your blood drops back to normal Improved circulation Walking becomes easier Decrease in coughing, shortness of breath and infections Reduced risk of heart disease, stroke and cancer Support to help you quit Quitting tobacco will increase both longevity and quality of life. Quitting smoking is an important health decision, but how someone quits is also important. There are many safe, FDA-approved medications and strategies that can help people to quit. Consult your healthcare provider, a tobacco treatment specialist or contact the Maryland Tobacco Quitline at 1-800-QUIT-NOW for additional support. If you are ready to give up cigarettes and other tobacco products, Luminis Health is here to help you. There are a number of resources to help you successfully quit, including: Tobacco Treatment Specialists Individual or group counseling sessions Attend a “Be Free From Nicotine” Workshop For more information on our smoking cessation and nicotine dependence program, call 443-481-5366 or 443-481-5367. This article was originally published in the Enquirer Gazette. Authors Stephen M. Cattaneo, MD, is the Medical Director of Thoracic Oncology and the Division Director of Thoracic Surgery at Luminis Health Anne Arundel Medical Center (LHAAMC). Cherise Easton, BS, NCTTS, Health Educator & Nationally Certified Tobacco Treatment Specialist.0
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