Aerobics offered at Sinai Hospital of Baltimore

You've been stalling for a month. Are you ready to finally make good on that New Year's resolution to get in shape?

The Sinai Hospital Employee Activities Committee is sponsoring an eight-week session of aerobics beginning Tuesday, Feb. 3, and ending on Thursday, March 26. Classes will be held at Sinai Hospital every Tuesday and Thursday evening from 5:30 p.m. to 6:30 p.m. The cost is only $20 for the entire session.

You do not need to be a LifeBridge Health employee to enroll. Family members and friends are welcome to join!

If you are interested in enrolling or have any other questions please contact Robin Krug at 410-601-8443.

Hope to see you in class!

The Frozen Pea Club

While researching other health care blogs, I recently came across the inspiring tale of the Frozen Pea Club. In case you haven't heard, a Virginia woman thought she had a good idea when she applied a bag of frozen peas to her breast following a needle biopsy to alleviate the swelling and pain. "Ice packs are hard and heavy," Susan Reynolds wrote on her blog. "As much as I try to be a good sport I'm not into having a brick sitting on my chest. That bag of peas added a touch of lightness to what could have been a sad and serious tale."

It turned out to be a great idea.

Reynolds shared her idea on her blog and included a photo of the bag of frozen peas peeking out from underneath her camisole. Word quickly spread and others who had found out about her diagnosis through the Internet began creating pea-themed photos in a show of sympathy.

According to the Washington Post article:

The frozen peas not only have sparked messages of support for Reynolds, 59, but have become the emblem of an online community of people sharing their experiences with cancer.

One online friend came up with the idea of donating the equivalent of the cost of two bags of frozen peas, about $5, to cancer research. That led Connie Reece, another online friend, to establish the The Frozen Pea Fund. As of early this week, the fund had raised more than $30,000.

It's a wonderful story. And a great example of how technology and social networking is transforming charitable giving. But what really intrigued me was how Reynolds says connecting with her online support group has helped bring "lightness" to her treatment.

Having worked with the braVo! art bra project here at LifeBridge Health, I saw first hand how a creative idea can unite a community of people from all walks of life behind a deserving cause. braVo! is a unique display and sale of handcrafted artwork using a woman's bra as the canvas. All proceeds from the sale of braVo! materials go to benefit the braVo! Financial Assistance Fund. This fund helps patients at the Herman & Walter Samuelson Breast Care Center at Northwest Hospital and the Alvin & Lois Lapidus Cancer Institute at Sinai Hospital obtain supplemental services not covered by insurance, such as breast prosthesis, wigs, massage therapy, certain medications, and transportation to and from treatment.

So ... has social networking helped you or someone you know cope with a cancer diagnosis and treatment? What pitfalls should cancer patients be careful to avoid in posting private health information online?

New Research Suggests Platelet 'Stickiness' May be the Single Most Important Risk Factor in Patients Treated with Coronary Stents

BALTIMORE, Jan. 27 /PRNewswire/ -- Most Americans know their cholesterol level, but do they know how "sticky" their platelets are? Research findings from Dr. Paul A. Gurbel, an interventional cardiologist and Director of the Sinai Center for Thrombosis Research based at Sinai Hospital of Baltimore, indicate that platelet aggregation or "stickiness" may be the single largest factor in determining the likelihood of developing serious complications, including heart attack, in patients treated with coronary artery stents.

"We currently measure the cholesterol level in everyone with vascular disease, yet the pivotal event that kills the patient - platelet aggregation isn't being assessed in any way," said Dr. Gurbel.

Dr. Gurbel's findings may explain why someone with no cardiac history could die suddenly of a massive heart attack, while an individual with high blood pressure, high cholesterol and plaque-filled arteries may never have a cardiac event because they had low platelet aggregation.

Along with his team at Sinai, Dr. Gurbel demonstrated that patients with platelets most prone to aggregate had the highest prevalence of complications, including heart attack, after coronary artery stenting.

Their work is helping to revolutionize the testing and treatment of patients with coronary artery disease, offering further evidence that a more personalized approach to anti-platelet therapy needs to be established.

Dr. Gurbel was one of the first researchers in the world to discover that up to 30 percent of patients taking clopidogrel, a drug designed to decrease platelet aggregation, do not respond to treatment.

"Of the millions of cardiac patients treated with clopidogrel, a significant percentage are non-responsive and remain at high risk for a major cardiac event," said Dr. Gurbel. "The platelet aggregation of each patient needs to be precisely measured to determine how well the drug is working. The blind administration of anti-platelet drugs without confirming a good response, in our opinion, will soon be reaching an end."

Click here for a recent story on Dr. Gurbel's research - http://www.wbaltv.com/video/17929792/index.html

Diabetes Resource Center Debuts at Sinai Hospital

Diabetes may be a manageable disease, but patients often develop complications stemming from a lack of education and too little communication with their physician. This is why experts say it’s time for a new approach to diabetes care that focuses as much on the patient’s psyche as it does on the physical ramifications of the disease.

“One-third of patients have a fear of injections, and physicians have not acknowledged that fact,” says Sally Pinkstaff., M.D., Ph.D., the medical director of the Diabetes Resource Center at Sinai Hospital of Baltimore.

In addition to addressing the fear about regular injections, staff members at the center acknowledge the constant maintenance required in controlling diabetes. By taking into consideration a patient’s feelings and daily lifestyle, the center is re-inventing diabetes management.

Dr. Pinkstaff recalled a recent visit from a 60-year-old patient who was diagnosed with diabetes 16 years ago and had stopped taking her insulin.

“The first words out of her mouth were ‘I’m here because I’m noncompliant,’” Dr. Pinkstaff says. Dr. Pinkstaff went on to suggest that she and the patient start over and develop a new plan that would help the patient get back on track. By taking the time to talk with the patient, Dr. Pinkstaff was able to convince her of the importance of not only taking her insulin, but also learning more about her disease.

“I said, ‘Here is a window of opportunity. Let’s see if we can do something,’” Dr. Pinkstaff says.

Education is key to helping people with diabetes manage their disease, so group classes are offered for ongoing education and support. The center’s components also include glucose monitoring, medication and/or insulin instruction, nutritional counseling, and a focus on prevention of complications. Other staff members at the center include diabetes nurse educators, pharmacists and registered dieticians.

There is a close relationship with patients. Physicians and staff can facilitate care with other specialists in the LifeBridge Health system, including the Krieger Eye Institute, the Sleep Center at Sinai and the Heart Center at Sinai. Plus, new technology at the Diabetes Resource Center includes real-time glucose monitoring, insulin pump therapy and intensive insulin treatment.

Diabetes is defined as having high blood sugars, but there are additional health problems associated with diabetes. They include blindness, heart or kidney disease, or atherosclerosis (hardening of the arteries). An estimated 17.9 million people in the United States have diabetes and most of them lead full and healthy lives.

In Maryland, the rate of diabetes has grown over the past 10 years, from 6 percent of adults in 1998 to 7.9 percent of adults in 2006. By the end of 2007, there were 358,000 adults with the disease in the state, according to the state Department of Health and Mental Hygiene. In Maryland it is estimated there is another undiagnosed group of 143,000 adults.

The Diabetes Resource Center staff makes it their mission to educate people on the risk factors for diabetes, including obesity. It is no coincidence that the obesity rates are tied to the rise of type 2 diabetes. There are 21.4 million men and 22.9 million women in the United States are obese.

“There’s a rising epidemic of obesity,” says Sigrid Anderson, R.N., M.S.N., C.D.E., B.C.-A.D.M., a consultant with the Diabetes Resource Center. “That is directly correlated to the rate of type 2 diabetes, which is at epic proportions.”

But the experts at the center always stress that diabetes can be controlled with a commitment on the part of the patient, family members and physicians.

“These programs treat the patient but really impact the whole family. Sinai is raising the standard of care,” Dr. Pinkstaff says.

PHOTO CAPITON: Sally Pinkstaff., M.D., Ph.D., earned her medical degree from the Medical College of Virginia and was an intern and resident at the University of Chicago hospitals, where she also completed her endocrinology fellowship. Dr. Pinkstaff also received a Ph.D. in physiology from Northwestern University and is currently an Assistant Professor of Medicine at Johns Hopkins School of Medicine.

Paging "Dr. Sponge Bob"

When Aaron Zuckerberg, M.D., was a young child, he faced one of the most unnerving procedures that anyone – much less a kid – could endure: a spinal tap. The memory stays with him to this day.

For all the wrong reasons.

“I remember thinking, ‘This needle is bigger than a baseball bat,’ and it hurt a whole lot,” Dr. Zuckerberg says.

The experience was so powerful, in fact, that Dr. Zuckerberg suspects it may be the reason why he’s doing what he does today: making the hospital experience a less scary one, and a less painful one, for children.

As an anesthesiologist at Sinai Hospital of Baltimore and a specialist in pediatric care, Dr. Zuckerberg is on the cutting edge of a movement to deliver anesthesiology in a whole new way, outside of the operating room and in a calm, warm, caring environment.

The idea of providing these services outside the operating room is called remote anesthesiology, and its use – especially the unique ways it’s practiced by Dr. Zuckerberg – could help make the hospital a happier place for kids in years to come.

“Our goal is to be kid-friendly, parent-friendly and, for the surgeons, very user-friendly,” Dr. Zuckerberg says.

Patients who come to Dr. Zuckerberg face any number of health problems. Some are young children who need spinal taps on a frequent basis, while others are developmentally disabled adults who need dental work or gynecological exams. Other common procedures that may involve remote anesthesia are radiotherapy, endoscopies and lithotripsy.

Dr. Zuckerberg’s team will go to any length to ease a patient’s worries – even if it means getting some help from an outsider, and even if that outsider doesn’t actually exist.

Like, for example, SpongeBob SquarePants.

The popular cartoon hero is everywhere in the remote anesthesiology department, from the television to the walls to the lanyard that Dr. Zuckerberg wears around his neck; and the sight of their lovable spongy friend is enough to put many nervous children at ease.

When it comes time for the anesthesia to be delivered, these young patients can relax, sit with their parents and watch cartoons.

“We create a place that is similar to what they would have at home. And because of that, we’re able to ease the anxiety for not only the children but the parents as well,” Dr. Zuckerberg says.

Although many university hospitals around the country now have pediatric remote anesthesiology programs, and the practices Sinai is putting to use are increasingly common, Dr. Zuckerberg says the team approach taken by the doctors and nurses in his office makes Sinai a uniquely comforting atmosphere.

Some patients become so comfortable with the staff, in fact, that they begin to treat their doctors and nurses like friends – or even family.

“One of the best rewards is when we see a child leaving, and they don’t want to leave,” Dr. Zuckerberg admits. “They came to us, and they were hesitant about coming, scared of the potential for a painful procedure, and then they actually don’t want to leave us. That tells us we did a good job.”

And it's not just his patients Dr. Zuckerberg worries about. In November, he traveled to Israel to take part in Wheels of Love, a 300 mile, five day bike ride to raise money for the Alyn Hospital in Israel. Dr. Zuckerberg raised $11,000.

So parents: What experiences have you had with pediatric anesthesiologists? Were hospital staff able to meet your expectations?

Beating the senior blues

We all deserve our golden years. After decades navigating life’s twists and turns, overcoming adversity, and working diligently to achieve success for ourselves and our families, we all should be afforded the opportunity in our late 60s, throughout our 70s and 80s, and well beyond, to relax and enjoy life to its fullest.

Unfortunately, the illness of depression robs many senior citizens of that ideal. Due in large part to the challenges seniors must face as they journey through the aging process, older Americans are particularly susceptible to clinical depression.

A National Institute of Mental Health study found that 2 to 3 percent of elderly people living in the general community – not in hospitals or nursing homes – may be clinically depressed. However, 8 to 10 percent of seniors who visit primary care physicians may fit the diagnosis for clinical depression, and between 20 and 25 percent of older people in hospitals have depression. One in three senior citizens living in nursing homes may be depressed, the study found.

Despite those troubling statistics, Sherry Myers, a registered nurse at Levindale Hebrew Geriatric Center and Hospital in Baltimore, says it’s vitally important to remember one underlying fact: Depression is not a normal part of the aging process.

“Sometimes seniors can get into a bad rut that can bring on depression,” Myers says. “It’s definitely curable. We see success stories every day.”

Depression is caused by a change in brain chemistry, usually triggered by circumstances in the environment, says Susan Levy, M.D., Levindale’s vice president of Medical Affairs.

“It’s a sadness, a loss of interest in activities, a change in sleeping or eating patterns,” Levy says. “Anything over two weeks is persistent. Just having a bad day doesn’t cut it.”

So how best to ensure that seniors who are suffering from depression get the care they need? The key, Levy says, is trying to diagnose it as early as possible. “It’s important to incorporate screening for depression as part of ongoing health care maintenance.”

In many cases, senior citizens do not realize they are clinically depressed. Common symptoms to look for can include insomnia; decreased appetite; increased lethargy; irritability; talk of suicide; dramatic weight fluctuations; paranoia; and memory loss or confusion.

Levindale takes a number of approaches to treating seniors with depression. “In the outpatient program, really throughout Levindale, we do group therapy,” Myers says. “When people are in a group of their peers and they can talk about their issues and find out that they’re not alone, it’s very helpful. We also do individual and family therapy.”

Before seniors in Levindale’s outpatient program are discharged, a detailed plan is created to help them avoid slipping back into depression. “We want to ensure they don’t go back to the same exact thing that they were doing,” Myers says.

Battling depression often can be an exhausting and discouraging endeavor. But Levy says the outcome usually is a positive one. “Like many diseases, it is a disease that will cycle,” she says. Ninety-five percent of the time, people can live happy, healthy lives.”

For more information about outpatient psychiatric services at Levindale, call 410-601-WELL (9355).

Health care coders in high demand

This week, the Baltimore Sun ran a feature story on Sandra Baker, a diagnostic coder at Northwest Hospital in Randallstown, just outside Baltimore. Asked what it takes to work in a hospital environment, Baker said teamwork, caring and respect are important values to keep. She added, "I love people, and I love helping people. So it makes it easy to do those things."

On a recurring basis, one of the hottest jobs in the Baltimore health care industry is health information coder. “Coders,” as they are called, verify information in patients’ records and code the information for various purposes. It’s a demanding job that attracts detail-oriented and meticulous personality types.

“This position is extremely hard to fill because there are not a lot of candidates in the field,” says Janice Lynn, Sinai Hospital business partner. “Since experienced coders are hard to find, hospitals work to retain these valuable employees when they have a good one. Hospitals such as ours specifically look for experience since there is a long learning curve.”

Health information coders check patient records for documentation of diagnoses and procedures. Coders must rely on their knowledge of medical terminology, disease processes and pharmacology. Another challenge is deciphering the handwriting of physicians and clinical staff. These technicians assign a code to each diagnosis and procedure. They consult bulky classification manuals and also rely on their medical knowledge to make sense of the patients’ treatment history. It can be monotonous and very meticulous work.

“One of the challenging issues we encounter when recruiting for coders is that many only have experience coding for physician’s offices,” says Joanie Montgomery, Northwest Human Resources Business Partner. “Since Northwest and Sinai are acute care hospitals, we both require hospital coding experience”.

“Hospitals and medical providers report coded data to insurance companies or the government [Medicare and Medicaid] for reimbursement of their expenses,” says Mary Lou Bond, Health Information manager at Sinai. “Internally, planners use coded data to identify patient needs, develop new services and evaluate quality of care. Researchers and public health officials use coded medical data to monitor patterns and explore new interventions. More and more Internet health care rating sites are using coded data to rate health care quality. Coding accuracy is highly important to health care organizations because of its impact on revenues and describing health outcomes.”

To perform this task, coders must possess expertise in the ICD-9-CM coding system and the surgery section within the CPT coding system. “But at heart, a coder is an investigator, a paper-pushing medical sleuth happy to scour every word in a medical record looking for documentation that can be coded,” says Mary Lou. “Illegible handwriting provides a challenge for us!”

To qualify as a health information coder, an applicant must complete coursework in medical terminology, anatomy and physiology, legal aspects of health information, coding and abstraction of data, statistics, database management, quality improvement methods, and computer science. The following schools in our region offer the program: Baltimore City and Baltimore County Community College and Howard County Community College. All inpatient coders are certified by the American Health Information Management Association. Those who pass the certification examination are awarded the CCS, CCS-P and CCA credentials.

If you'd like more information about becoming a coder, or to see available job listings for LifeBridge Health, visit lifejobs.org.

Are you a health information coder? What are the pluses and minuses of your job?

Photo of Sandra Baker courtesy of the Baltimore Sun.

The Great White Death Commeth: How to Safely Shovel Snow

Most portions of the U.S. are expected to experience a snowier-than-usual winter, according to the 2009 Farmer’s Almanac. Unfortunately, this means we will all be shoveling our driveways and sidewalks more often. Shoveling snow is a moderate-intensity exercise that could result in injury if done incorrectly.

Follow these tips to stay snow-safe this winter season. It will take some preparation, but your legs, back and heart will thank you:
• Before shoveling, warm up your muscles in your legs, arms, shoulders and back by stretching.
• If you must stand on ice, put down salt or sand to give your feet some traction. To maintain the best balance, stand with feet apart at hip-width.
• Use an ergonomic shovel with a bend in the handle – it will save your back by permitting you to bend less. When you do need to bend, bend at your knees.
• Spray the dish of the shovel with olive oil before you start. The oil will help the snow easily slide on and off.
• To give yourself the best leverage, space your hands apart on the shovel handle.
• Don’t put too much snow on the shovel at once. Shovel only truly manageable amounts of 1 to 2 inches at a time.
• Protect your back by tightening your stomach muscles while you lift.
• That said, if you can, push the snow instead of lifting it.
• Walk to drop the snow rather than throwing it, but if you must throw it, do not bend at the waist, but instead rotate your entire body to face the direction of the throw.
• Slow down. Most injuries occur when people try to shovel too quickly.
• Take a break every 5 to 10 minutes to regain your breath. Shoveling snow is like weightlifting, and if you don’t take breaks, you put could yourself at risk for heart attack.
• If you are overweight, elderly, or have a history of heart or back problems, you should forego shoveling snow altogether and use a snow blower or else have someone else shovel your snow.

Orthopedic experts at LifeBridge Health are available to talk about winter-related joint injuries and pain. For more information, call 410-601-WELL (9355).

LifeBridge Health & Fitness featured on WJZ-TV

On last night's evening news, WJZ Channel 13 reporter Kellye Lynn profiled CrossFit Baltimore, a new exercise program for serious athletes offered at LifeBridge Health & Fitness.

CrossFit offers members a grueling, high intensity workout guaranteed to raise their fitness level in half the time as a traditional workout.

With certified trainers playing the part of drill instructors, CrossFit utilizes many traditional exercises such as squats, push-ups, and pull-ups in a completely scalable exercise routine. Scalable exercises are those that can be adjusted to accommodate each individual’s level of physical fitness or strength. There are no high-tech exercise devices in a CrossFit routine. Participants use hanging ropes, kettlebells and even car tires to accomplish all of their strength and conditioning goals.

First developed for use by law enforcement and the military, the program has been retooled for anyone interested in physical fitness. However, CrossFit still maintains its intense nature. With names like “Fight Gone Bad,” the spirit of this workout routine is crystal clear.

CrossFit warm-ups and exercises focus on short bursts of continuous activity rather than long stretches on one machine. CrossFit is also unique in that exercises vary from day to day so participants never get bored with the same old routine. One routine might be running and doing sit-ups while the next is focused on doing pull-ups and squats. Mixing exercises helps keep the workout routine fresh and has led it to become one of largest exercises trends.

CrossFit is one of the fastest growing fitness movements in the country with over 300 official affiliates nationwide. LBH&F is the first official CrossFit affiliate in the Baltimore area.

Have you tried CrossFit? What CrossFit exercises are fixtures in your exercise routine?

January is Glaucoma Awareness Month

More than 3 million Americans have glaucoma, a group of eye diseases often caused by increased pressure inside the eye, according to the Glaucoma Research Foundation.

The best way to protect yourself is to be aware of your risk and to make sure you have a comprehensive screening regularly. People with higher risk for glaucoma include:

* Those with family history of glaucoma
* African-Americans over the age of 40
* Anyone with elevated eye pressure
* Anyone over the age of 60 (the older you are, the more you are at risk)

While glaucoma can not be cured, it can often be treated. The Krieger Eye Institute at Sinai Hospital offers a variety of treatment options -- from screening to surgical procedures. Log on to www.lifebridgehealth.org to find out more about the Krieger Eye Institute.

Give Blood!

Every two seconds, someone needs blood. Each day, patients across the country receive approximately 39,000 units of this lifesaving resource. This year alone, as many as five million patients will require blood transfusions, as accident victims, people undergoing surgery, and patients receiving treatment for leukemia, cancer and other diseases.

January is National Blood Donor Month. Maryland Governor Martin O'Malley recently issued a statement encouraging Marylanders to give blood.

“Particularly following the holiday season, when donations typically decline, it is important to make blood donation a habit,” states Governor O’Malley. “It is our civic responsibility to ensure that our friends, neighbors and even ourselves and members of our own families can rely on a stable blood supply should they require a transfusion. There is no such thing as a spare Marylanders and therefore all Marylanders are encouraged to learn more about giving blood and schedule a donation appointment by calling 1-800-GIVE LIFE.”

Sinai Hospital will host its first blood drive of the new year in Zamoiski Auditorium on Thursday, Jan. 8, from 1:30 to 6:30 p.m., and Friday, Jan. 9, from 7 a.m. to 12:30 p.m. Schedule an appointment online with the American Red Cross, or call the Sinai Blood Bank at ext. 410-601-5112. Walk-ins are also accepted.

Do you give blood regularly? What advice do you have for a first-time donor?

Winter Blues: How to Handle Seasonal Affective Disorder (SAD)

Winter Blues: How to Handle Seasonal Affective Disorder (SAD)
Nearly everyone gets the winter blues at some time or another, but for some, they are actually a serious medical disorder. It is estimated that over 6 percent of Americans suffer from Seasonal Affective Disorder (SAD) and over 14 percent get the milder form called Subsyndromal Seasonal Affective Disorder (SSAD). Both disorders are more prevalent in the parts of the world closest to the poles, leading researchers to think that down feelings in the wintertime are related to the lack of daylight. Your doctor can help determine whether or not your depression is season-related, but how do you know when your depression is severe enough to warrant a trip to the doctor?

Symptoms of depression include:
• Feelings of sadness, hopelessness and helplessness
• Lack of energy
• Feeling slowed down
• Trouble falling – or staying – asleep
• Changes in appetite and/or weight
• Inability to concentrate or make decisions
• Thoughts of death or suicide
• Loss of interest in people and activities
• Restlessness

If you don’t have severe symptoms of depression but are simply feeling blue this season, there are things you can do to lift your spirits, such as:
• Make it a priority to get exercise. On the rare sunny winter days, go outside and take a brisk walk so you get the mood benefits of sunlight as well as exercise.
• Take a daily vitamin.
• Stay well-hydrated by drinking water whenever you are thirsty.
• When the sun is out, do your work by a window.

Psychiatrists from Sinai Hospital of Baltimore and Northwest Hospitals are available to talk about dealing with the winter blues and when see a doctor about depression. Call 410-601-WELL for more information.

How do you use to cope with the winter blues?

Stay healthy this winter

WINTER: The bitter weather. The short days. The fattening food. Winter brings some of its own health challenges, but you can stay healthy as we head into the springtime.

New Year’s Resolution One: Keep the Weight Off this Winter

The winter just wouldn’t be the same without cookies, bread and anything laden with butter, cream and cheese. Studies show that, on average, Americans gain one net pound per year because of winter eating of so-called comfort foods. There are ways to avoid this weighty dilemma by serving highly nutritious, tasty food even when the temperatures plunge below freezing. Helpful tips from the experts at Sinai Hospital of Baltimore and Northwest Hospital include:
• Eat more fiber, especially in the form of fruits and vegetables.
• Serve fruits and vegetables that are currently in-season; they will taste much better than out-of-season produce.
• Substitute high-fiber sweet potatoes for high-carbohydrate potatoes.
• Use low-fat dairy products in recipes.
• Use applesauce in place of butter or oil in cakes.
• Rely on seasonings and herbs rather than fat for making food tasty.

What are some healthy eating tips you rely on to get through the winter months?