- Cancer Care, Women's HealthGeneral Page Tier 3BlogIn 2015, Rebecca Blizzard was about to begin a new chapter of her life in more than just one way. The year she turned 40 was the same year she chose to follow the cancer screening guidelines for detecting cancer early. After scheduling a visit with her doctor for her first-ever mammogram, results showed something wasn’t right. She went for a biopsy. It was breast cancer. In June 2016, she had a lumpectomy at Anne Arundel Medical Center (AAMC) followed by six weeks of radiation therapy to lower the risk of her cancer coming back. It wasn’t until a few months later that she would find out she tested positive for BRCA2, sometimes referred to as the “breast cancer gene.” Rebecca proceeded with the removal of her breasts. “At this point I didn’t want to take any chances, so I decided to have a double mastectomy,” she says. Her doctor referred her to Anne Arundel Medical Group (AAMG) Plastic Surgery for options regarding breast reconstruction. “After hearing all of my options, I chose a DIEP flap reconstruction,” Rebecca says. “That’s where I learned about the nipple tattooing procedure since my nipples could not be saved.” A new option AAMC’s Chief and Medical Director of Plastic Surgery Devinder Singh, MD, and Virginia “Ginny” Lobach, M.S., PA-C, informed Rebecca about breast reconstruction options, including nipple tattooing. As an alternative to nipple areolar reconstruction, which requires surgery, this caught her attention. “I was nervous about how another surgery would impact me,” she says. “I’m young and in my head, I didn’t want to not have anything. Ginny told me she recently trained to do 3D nipple tattooing, so I was all in for it.” Whatever your age, relationship status or orientation, it’s hard to predict how you will react to losing a part of your breast. According to breastcancer.org, there are many feelings an individual can experience when giving up a part of the body that is a hallmark of becoming a woman – including anxiety, uncertainty and sadness. This is the reason Dr. Singh and Lobach wanted to bring 3D nipple tattooing to AAMG Plastic Surgery. AAMG Plastic Surgery is unique in that it offers patients several innovative breast reconstruction options, including tissue expansion with Aeroform AirXpanders, pre pectoral implants, and microvascular deep inferior epigastric perforator flap (DIEP) procedures. 3D nipple tattooing is part of this comprehensive list. “It gives normalcy back to a patient,” says Lobach, who started the clinic after taking a course to learn the 3D technique of nipple tattooing. “I think nipple tattooing is for the woman who says, ‘I don’t want to look at my breasts,’ and doesn’t feel comfortable in her own skin. I want to give back that comfort. I want to create a full breast.” What is it? 3D nipple tattooing is done at the end of breast reconstruction after the nipple is removed during the mastectomy. It’s a noninvasive approach that Lobach performs in the office using a needle and pigmentation to create a 3D-looking nipple and areola. This approach creates an image of a nipple that feels flat to the touch but looks real. “Tattooing is the least invasive, low-risk way of providing a patient with a complete breast,” Lobach says. “Nipple reconstruction has been around for a long time as part of breast reconstruction. Unfortunately, reconstruction means another operation taking skin from somewhere else to create an areolar and nipple, leaving additional scars. The nipple usually loses projection after a year.” According to Lobach, the aesthetic results of nipple reconstruction are not as pleasing as a 3D nipple tattoo. “Working with the Rebecca Fortney Breast Center, we get to see many breast reconstructions that do not have the end result of an areola and nipple,” she says. “I saw that patients were not finished. And many were just OK with that result. They didn’t want to go through another operation. With 3D nipple tattooing, we are able to offer a completed breast reconstruction without another operation.” Is it safe? “Nipple tattooing is a safe technique and it’s always my patients’ choice,” Lobach says. “I want it to be an option so the patient can make their decision either way.” Despite a lingering negative connotation attached to tattoos by some, a 3D nipple tattoo is a safe alternative to regaining a full-looking breast after a patient has been diagnosed with breast cancer. There is a difference between the tattoo pigmentation Lobach uses and that of the one used at a tattoo shop. “I use an organic pigmentation made from lake salts,” she says. “I only like to use very safe products with very low risk of infection. It’s the same type of pigments that are used for cosmetic and facial tattooing. The pigment is a very soft and beautiful color. The patient also has a choice in the color we choose for tattooing.” Tattoo artists, on the other hand, often use metal-based pigments containing titanium, led or chromium. 3D tattoos are permanent but like any tattoo, will fade over time. Usually only one session is needed to create the tattoo, but an additional touchup session may be required over time. When a person is diagnosed with breast cancer, it is one of the scariest times of their lives. It can change them completely, particularly physically. Once a person has beaten cancer, they can focus on rebuilding themselves emotionally and physically. “I feel like the tattoo gave me my confidence back, which I needed after everything that happened,” Rebecca says. “It made me feel more comfortable looking at myself in the mirror.” Nipple reconstruction is often the last step in breast reconstruction. Find out more about our different options and schedule an appointment with AAMG Plastic Surgery today.0
- News & Press Releases, Infectious DiseaseGeneral Page Tier 3BlogLast updated at 12:45 pm Friday, May 15, 2020. In order to provide our patients and community members with helpful information about the 2019 Novel Coronavirus (COVID-19), we’ve created this post to share general information as well as details specific to those seeking care at a Luminis Health facility. For the safety of our patients, visitors and staff, the following visitor restrictions are in effect: To best protect our patients and team members, no visitors, with few exceptions, will be allowed until further notice. This is a proactive measure to reduce the spread of COVID-19. In the few cases where visitation is allowed, it is limited to one visitor per day. Exceptions include: Critical or end-of-life care situations Laboring mother support person Caregiver of a patient 21 years of age or under Surgical patient support person Outpatient test/procedure companion Person serving as surrogate decision maker Person performing official governmental function Person serving as support person for patients with disabilities To support this safety measure, all visitors will be screened upon arrival, and must pass a health screening to enter the facility. No visitors under the age of 18 unless they are parents of hospitalized children. This policy includes infants and siblings. AAMC NICU visitors are restricted to parents only, one at a time. People experiencing cold or flu-like symptoms should not visit. Patients coming to any Luminis Health facility with respiratory symptoms must request a mask upon arrival. Visitors returning from international travel may not visit until they have been in the United States, symptom free, for 14 days. We are suspending non-essential large (10 or more people) gatherings scheduled to take place on our campuses. If you have questions about an event you are scheduled to attend, please check with your event coordinator. Because the situation is rapidly evolving, we often reference Centers for Disease Control and Prevention (CDC) or Maryland State Department of Health websites below for the latest information. We encourage you to visit those sites for breaking information. If I am feeling sick, should I still keep my appointment? As you know, the world is experiencing notable person-to-person transmission of the novel coronavirus (COVID-19). Experts estimate that the majority of people who get this virus may have mild symptoms. But it can be quite severe for members of our community with underlying health conditions. For this reason, we ask that if you have any respiratory symptoms – such as a cough, runny nose, nasal congestion, sneezing, or fever – that you please cancel or postpone your specialist appointment unless it is absolutely essential. We know that you may have waited or planned for this visit, so we will make it a priority to reschedule your appointment when you are feeling better. Staying home while sick is one of the most important things you can do to help during this time. All of us have to work together to reduce the chance of transmission of this (or other) respiratory viruses. If you have respiratory symptoms, please call your primary care provider’s office to be evaluated. If you have traveled recently to China, Italy, Japan, Iran or South Korea, or think you may have been exposed to someone who tested positive for the novel coronavirus, please call your county health department. We appreciate your patience and consideration. Thank you for helping us keep your family, friends and neighbors healthy. What is 2019 Novel Coronavirus/COVID-19 and what are the symptoms? COVID-19 is a respiratory illness that can spread from person-to-person. The virus that causes COVID-19 is a novel coronavirus that was first identified during an investigation into an outbreak in Wuhan, China, in late 2019 and has now been detected in more than 170 countries. COVID-19 has similar symptoms to the flu, which include coughing, fever, sore throat and difficulty breathing. This is an emerging and evolving situation. For the most updated guidance, symptoms and information, visit the CDC website. How is COVID-19 spread? COVID-19 spreads between people who are in close contact with each other (within six feet) through respiratory droplets from coughs or sneezes. According to the CDC, there have not been documented cases of transmission of COVID-19 from surfaces contaminated with the virus. However, the CDC recommends cleaning visibly dirty surfaces followed by disinfection to help prevent COVID-19 and other viruses in homes and community settings. Are symptoms of COVID-19 different in children than in adults? The symptoms of COVID-19 are similar in children and adults, though children who have tested positive have generally exhibited milder symptoms. The CDC says it’s unknown whether children with underlying medical conditions and special health care needs might be at higher risk, however. What are the policies for visiting family and friends in the hospital who are being treated for COVID-19? To further minimize community spread of COVID-19, we are not permitting visitors for patients who have tested positive for COVID-19. For those patients, we can set up other means of communication for loved ones – FaceTime, phone calls, etc. I am scheduled for a surgery or procedure at a Luminis Health hospital – should I reschedule my appointment? As of March 18, 2020, we started limiting surgeries and procedures to emergencies or urgent cases only. This measure is now in effect until further notice. We are contacting patients directly. I have an appointment scheduled with my primary care provider or specialist – should I reschedule my appointment? In line with other measures taken to protect our staff and patients, and limit the transmission of COVID-19, starting March 24, 2020 until further notice, we will limit all outpatient in-office appointments to urgent patients requiring a physical exam only. We’ll shift all other routine visits to telemedicine visits or we’ll reschedule. Offices will remain open to staff, but not the public. This way we can continue to receive calls, triage the needs of patients and providers, and answer all requests and messages from patient portals. Our staff is already hard at work putting these measures in place. Is my Energize fitness class still scheduled? For the health and safety of all of our fitness fanatics, we are cancelling our Energize fitness classes for now. We encourage safe, outdoor exercise as the weather gets warmer. For our moms-to-be, check out our guide to safe exercise during pregnancy. I am currently in the cardiac rehabilitation program – should I still go in? For the health and safety of our patients, staff, and community, AAMC’s Outpatient Cardiac and Pulmonary Rehabilitation program will be cancelled for the time being. For updates, please call 443-481-1929. What if I think I have symptoms of COVID-19 and want testing? If you have symptoms of COVID-19 – with or without recent travel to China, South Korea, Japan, Italy or Iran – please call your health care provider to see if further screening is necessary before you arrive at one of our locations. By calling in advance, your provider can take your health history over the phone and, if needed, work with the appropriate state officials to determine if you require testing. In most cases, outpatient management with self-isolation at home is the best way to manage COVID-19 symptoms. When should I go to the Emergency Department? Only patients with fever, cough or shortness of breath and symptoms such as rapid heart rate, low blood pressure, high or very low temperatures, confusion, trouble breathing or severe dehydration should seek medical care in the ED. Call ahead to tell the ED that you are coming so we can be prepared for your arrival. If I am a high-risk individual, how should I protect myself? In order to reduce your risk of exposure to COVID-19, we recommend taking several precautions. You can learn more here. How does COVID-19 impact your pregnancy and baby? As with many other things, your immune system changes during pregnancy. This is normal, but it can increase your risk for contracting viruses and developing complications. Unfortunately, little is known about COVID-19’s effect on pregnant women and infants. Based on experiences from other coronaviruses, pregnant women may be at higher risk of severe respiratory illness, morbidity, or death as compared with the general population. It is important to understand that, so far, COVID-19 has not been detected in either amniotic fluid or breast milk. However, it is too early to determine long-term effects on infants born to women who had COVID-19 during their pregnancy. Is it safe for me to deliver my baby at Anne Arundel Medical Center? Yes, our visitor restrictions are in place for the safety of patients, visitors and staff, including parents-to-be. We continue to follow the recommendations of the CDC and the Department of Health. Check out these frequently asked questions about giving birth during this pandemic, and our answers. Can COVID-19 be passed from a pregnant woman to the fetus or newborn? It is unknown if a pregnant woman with COVID-19 can pass the virus to her baby through pregnancy and delivery. According to the CDC, no infants born to mothers with COVID-19 have tested positive for the virus. How is Luminis Health prepared for COVID-19 in our community? We are prepared and ready to care for patients with suspected or confirmed cases of COVID-19. Our clinical teams have been trained on how to identify, isolate and care for patients with this and other contagious illnesses. We have protocols and systems in place to keep patients, visitors and health care workers safe, and we work closely with the CDC and local and state departments of health to implement their guidance into our established protocols. Are there any people with COVID-19 in our community? Yes, there are confirmed COVID-19 cases in Maryland. Please check with the Maryland State Department of Health and your local department of health for the latest information and alerts. How do I keep myself and my family safe? The CDC released a step-by-step guide about how households should handle a potential outbreak of coronavirus in their community. The CDC also recommends the below everyday preventive actions to help prevent the spread of respiratory diseases, including: Wash your hands often with soap and water or use an alcohol-based hand sanitizer with at least 60% alcohol. Avoid close contact with people who are sick. Avoid touching your eyes, nose and mouth. Stay home when you are sick. Cover your cough or sneeze with a tissue, then throw the tissue in the trash. Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe. Note: These tips were adapted from CDC prevention tips. Learn more about how and when to use medical masks from the Journal of the American Medical Association:0
- Community, Men's Health, Women's HealthGeneral Page Tier 3BlogEvery May we honor a special holiday to celebrate motherhood, maternal bonds and the influence of women in society. To celebrate all the wonderful women in our community and beyond, we asked some AAMC employees to share the biggest lessons they still carry from the women who have inspired them. Here’s what they had to say: Chad M. Patton, MD, orthopedic surgeon: “My mother taught me that kindness, patience and listening to others goes a long way. My brothers and I are all physicians, and these lessons undoubtedly influence our approach to patient care.” Jennifer Brady, MD, cardiologist: “I learned from my mom at an early age that while receiving a gift gives instant gratification, the euphoria is short-lived. On the other hand, giving a gift provides a sense of satisfaction that remains for a long time and shapes how we feel about ourselves. My mom needed to draw upon her strengths when at the age of 45 she was diagnosed with a large tumor, which required extensive surgery. The courageous way she endured the arduous process gave me a perspective that has been extremely helpful as a clinician. I am grateful every day to my mom for being such an incredible role-model.” Kwasi Sharif, MD, pain management physician: “As a registered dietitian nutritionist, my mom has instilled in me the values of healthy eating and exercise. My habits today include exercising at least three times a week and obtaining at least seven hours of sleep each day.” Joseph Morris, MD, OB-GYN hospitalist: “I lost my dad when I was 12. My mom raised three boys, ages 12, 15 and 17, by herself. All of us went on to become physicians in large part from the lessons we learned from her. One lesson in particular that I remember is that if you want a good friend, be 75 percent of the friend.” Lauren Fitzpatrick, MD, pediatrician: “The piece of advice that I learned from my mother is always stand up for what is right, even if it is not the popular opinion. Growing up, my mother regularly reminded me to do the right things and not to worry about whether I was liked by others because of it. Those who respected me for doing the right thing were the ones I would want to surround myself with. As a pediatrician, taking care of children can be difficult some days, but doing the right thing for them is always worth it.” Jo Deaton, senior director, behavioral health: “One of the most influential people in my life has been my friend of 45 years, Donna. We met our first year of college, where I was an unhappy psychology major. Donna was pre-nursing and told me all about nursing. I had never considered that as a career but as I began to investigate, becoming a psychiatric nurse seemed like a good fit. I was 18 years old and Donna was a 26-year-old newly divorced, single mom of three young children. Donna has shown me that if you have a clear goal, you can achieve it regardless of your external circumstances.” Kay Hoskey, MD, urogynecologist: “As a retired nurse, my mother taught me the value of human connection, the magic of a smile and the importance of understanding a person’s story. It is not always easy to walk in some else’s shoes. Still, these lessons have helped me to connect with friends, patients and strangers alike.” Lil Banchero, RN, senior director, Institute for Healthy Aging: “I had the wonderful privilege of having two very strong loving females in my life, my dearest gram and my mom. Both smart and brave. I come from a family of four girls, so these two women really were strong advocates for our ability as women to do whatever we wanted. Over the years, they taught me many things. Be yourself. Do your best. Say please and thank you. Keep your word. Treat others the way you would like to be treated. Be independent. Be kind, compassionate and loyal. Do not hold hate in your heart. These are just a few of the many other lessons they taught me that have shaped me as a mother and nurse leader.” Heather Keats, OTR/L, occupational therapist: “Watching my mother as I was growing up, I learned to work hard and take full advantage of opportunities given to me. As a result, I am able to see the value in putting in the hard work now for the future pay off. This lesson carries over to all aspects of my life including relationships, health and career.” READ MORE: 6 ways to support a new mom0
- Our Team Is Here for YouAt Luminis Health, we take your concerns about fertility as seriously as you. We take the time to discuss your desire to have biological children and your options following your cancer diagnosis.Your treatment will include cancer and fertility specialists, nurses, clinical social workers, and more. We hold your hand and guide you through each step of your journey — toward health and your exciting future.TreatmentConditions/Services/Treatments PagePreserving Fertility When Treating CancerMany women confronting cancer face anxiety beyond what their diagnosis means for their own health. If a woman plans to start or grow her family, she worries about what her cancer means for that big, important life plan.Depending on the type of cancer and where it's located, cancer treatments can impact long-term fertility. These include radiation, chemotherapy, and surgeries. But there are many ways to adjust cancer treatments in ways that preserve fertility and support women's family goals.0
- Infectious DiseaseGeneral Page Tier 3BlogMost people who fall ill from COVID-19 don’t need advanced medical attention. Some benefit from a caretaker, a person committed to help manage recovery. Caring for someone else is a big responsibility. You want to fully understand how to properly care for your loved one, and for yourself, when dealing with a contagious illness like COVID-19. We can help you prepare. What makes a good caretaker COVID-19 caretakers put themselves in potentially harmful situations. Caretakers should be compassionate, flexible and in good health. Those who are fully vaccinated are much less likely to contract COVID-19 than those who are not vaccinated. The Centers for Disease Control and Prevention (CDC) discourages caregiving for those who have a compromised immune system or a chronic condition like heart disease or diabetes. Caretaker duties Many people who contract COVID-19 become physically unable to keep up with their daily activities. They may need help with basic needs, like shopping for groceries and caring for pets. As a caretaker, you may need to coordinate visits to the doctor that could be in-person or virtual. Your loved one will probably be asked to stay home. Picking up their medication and helping them follow their doctor’s orders, like resting and drinking fluids, are essential duties. Cleaning Maintaining cleanliness and personal hygiene stops COVID-19 from spreading. Identify frequently touched objects and surface areas and clean them often, in some cases, after each use. Household soap and detergent kill virus particles that collect on doorknobs, tables, light switches, canes, walkers and countertops. Wearing a mask Masks keep droplets from passing to others. You and your loved one should wear a mask any time you are in the same area. Your loved one should mask any time they are around others, even outdoors. Masks are most effective when worn properly, covering the nose and mouth. Keeping contact minimal Limiting contact is hard, but it’s the most effective way to avoid spreading the virus. Keep personal items separated, like utensils, plates and towels. Stay in separate rooms, including bedrooms and bathrooms. If you’re unable to maintain physical distance, make sure your surroundings have good air circulation. You can open windows or run fans. Keeping your loved one socially active Isolation is taxing. Make sure your loved one can still communicate with others throughout their recovery. Your loved one can stay connected, even at a distance, by greeting the mailperson from the window or receiving mail from family. Video calls through smartphones and laptops bring friends, family members and care team members right to your loved one without risking anyone’s safety. Knowing your signs As a caretaker, you can observe and monitor your loved one’s condition. COVID-19 symptoms include fever, cough and shortness of breath. If these symptoms begin to worsen, you may want to consider taking your loved one to the emergency room. Emergency warning signs include: Chest pain or pressure Confusion Labored breathing Skin that has turned pale, gray or blue Unconsciousness Preparing for the unexpected If your loved one’s condition worsens, seek emergency care immediately. Prepare a medical “go bag” ahead of time. In case of emergency, you can grab the bag in a hurry. You won’t waste critical time pulling items together, and you’ll reduce the likelihood that you’ll forget to bring something important to the hospital. Also, make sure you have a plan in case you, the caretaker, get sick. Designate an emergency contact with your loved one who can fulfill your duties if you are not able. Make sure your loved one has plenty of food, water, medication and other essentials. Many businesses offer delivery now. You may want to research the options ahead of time to help avoid panic. Helpful items for a caretaker Eye protection (face shield or goggles) Dish soap, hand soap and laundry soap Hand sanitizer with at least 60 percent alcohol Medical masks Over the counter medication to reduce fever (ibuprofen, acetaminophen) A thermometer Tissues and disposable paper towels Caring for yourself Caregiving can take its toll. Don’t feel discouraged if you face challenges. Watch for symptoms of burnout, like poor eating habits, difficulty sleeping and feeling of hopelessness. You need to meet your needs to be able to help your loved one. You can help care for yourself through: Breaking a big task into small, achievable steps Eating a healthy diet Limiting news intake Exercising regularly Taking a break from caregiving to recharge Author Stefanie Osterloh, CRNP, is a family nurse practitioner with Luminis Health Primary Care in Crofton, Md.0
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