Thursday, December 31, 2009

Levindale Looks to the Future

As 2009 winds down, LifeBridge Health is taking a look at some of the major events of the past year. Today, we visit the change in leadership at Levindale Hebrew Geriatric Center and Hospital and Courtland Gardens Nursing & Rehabilitation Center.

by Helene King


As 2009 ends, a stroll down memory lane for Levindale Hebrew Geriatric Center and Hospital and Courtland Gardens Nursing & Rehabilitation Center reminded me of many interesting things, but the one that stands out is the change at the top.


Ron Rothstein resigned as president and COO of Levindale and Courtland Gardens and Vice President of Operations of Post Acute Services at LifeBridge Health to concentrate on his passions for his family and for sailing. His innovations are a wonderful legacy at both centers.


To continue Ron’s legacy and to create an exciting new future for Levindale and Courtland Gardens, Administrator Aric Spitulnik stepped up and took the leadership reins. He was chosen as the president of both centers and the vice president of Operations of Post Acute Services at LifeBridge Health.


In addition to overseeing operations at the nursing homes and the Levindale Specialty Hospital, Aric is spearheading phase one of a new resident complex and town hall center at Levindale on the Belvedere campus. If all goes as planned, construction should begin in January.


Aric’s work to expand and renovate Levindale’s physical structures are just part of his vision. Through culture change, he has worked to empower residents and patients at both centers.


“Levindale has been serving the community for more than 100 years, bringing our residents the wonderful medical care, a home-like atmosphere and innovative programs, and I am proud to lead the organization into the next generation,” says Aric. “I work with an amazing team of employees who puts the quality of care first.”

Wednesday, December 30, 2009

the year in medical media

As we say farewell to 2009, LifeBridge Health is taking a look at some of the major events of the past year. Today, we look at a few of the medical stories that received media attention in 2009.

It is the waning hours of the year, and as such it is customary for many to make "Top xxxx Lists!" as a way of making 2009 into an artificial entity that we will shortly wave a fond farewell to, for better or worse, and leave behind in favor of the uncertain newness of 2010. Trying to craft any such a list for the year in medicine is a mad folly, given the sheer amount of news and discoveries that happened every week of these past 12 months. That noted, what follows is my completely subjective shortlist of medical stories that received media attention in 2009.

The dominant story of the year was clearly the new strain of H1N1 influenza virus. From it's discovery at the end of March, through its spread throughout the world and official classification as a pandemic by the World Health Organization, no other issue came close to the "swine flu's" saturation of the media. Unfortunately, much popular news coverage of the outbreak has ranged from barely adequate to frankly horrible (ABC2's H1N1 Day of Answers was an excellent event, and a notable exception to this). Often focused on fearful hype or dismissive ignorance, many media reports chose to sensationalize and misrepresent certain aspects of the pandemic (vaccines side effects, for one) while not actually doing their job - objectively reporting facts in an informed way. Coupled with some poor choices in government communication to the general public, and a failure of manufacturers to deliver vaccine on the promised timetable, the end result was unnecessary public fear, confusion, and public health inadequacy where there should have been a smooth, strong response. In this, we are fortunate that the 2009 H1N1 strain is less virulent than it might have been. I'll be taking a much closer look at the pandemic to date, and future prospects, next week.

If there is one thing that rivaled influenza in terms of media coverage this year, it was the process to craft legislation for United States health care reform. As I type this, both the US House of Representatives and the Senate have passed separate reform bills after months of deliberation, and now face the difficult prospect of merging them together. To call what has led up to this point a "debate" would be particularly generous - the amazing variety of agenda-driven nonsense that has spewed out from various political factions and interest groups is staggering, and has often threatened to drown out the basic facts involved. Add to this that said basic facts are rather complex, and that there is no "right answer", and you end up with a media message that just cannot report the issues involved adequately. The process, and the conversations it has generated, say alot about we as a people, and both the strengths and weaknesses of our political process. Our current health system (cue cutting glare at most insurance companies here) is quite deficient in some ways, and the proposed legislation is an imperfect tool to bring about needed change, but it is a start.

In the midst of this incendiary health care mess, the US Preventative Services Task Force released a long-prepared update to their mammography screening guidelines in November. Based on solid science and cost-benefit analyses, they changed their recommendations to be that women at low risk of breast cancer should start discussing mammograms with their physicians at age 40 and get them routinely starting at age 50 (as opposed to just starting at age 40), and once started, getting them every two years instead of annually. What was done in order to reduce the costs and harms (due to false positive results leading to unnecessary surgery, among other things) to a population of women in whom mammography as a screening tool doesn't work as well to detect breast cancer was then portrayed by some elements of the media as a womens' rights issue or an example of healthcare rationing (neither being true). The fundamental point that many seemed to miss is that guidelines such as these for certain populations of people are not mandates for individual patients or physicians. At the end of the day, it is unlikely that many physicians will change their breast cancer screening practices based on these recommendations alone, and hopefully more women will have informed discussions with their physicians about mammography. I'll also be going into more detail on these and other screening recommendations in future weeks.

The last two medical media-related stories on my hit list have to do with interesting research that was reported to be far more significant than it actually was. October saw headlines about a study from Thailand that finally demonstrated an "effective" and "promising" HIV vaccination strategy using a combination of vaccines. Upon examining the study however, the results were that 31% less of the patients that had the vaccine combination acquired HIV when compared with those who did not, and after correction for leaving out some who were already HIV infected, this dropped to a 26% difference. This is a potentially interesting result, but given the variables and statistics involved, hardly qualifies for language like "promising" or "effective." October also brought reporting on another paper that described a virus called XMRV that was reported to be associated with chronic fatigue syndrome. The study described finding this pathogen in 3.7% of healthy patients, but in 67% of people diagnosed with CFS. While the paper itself was appropriately conservative in suggesting the association, several news outlets and at least one of the paper's authors were outspoken on this being a clear infectious link to a rather unclear syndrome. The problem with such bold statements here is that this study, while interesting, is certainly not definitive; patients labeled as having chronic fatigue syndrome may comprise multiple groups of people with different underlying disorders; XMRV is a poorly understood virus; and as with life in general, in medicine it is vastly important not to confuse correlation (saying that the virus is there in many of the patients that have the syndrome) equals causation (saying that the virus is the cause of the syndrome). Both of these stories do have merit behind them, and I look forward to further progress here in the coming year.

2009 has been a whirlwind of new medical information, hampered by frequently poor media dissemination of that information. Just as it is incumbent on various news outlets to embark on informed, non-sensationalistic science reporting, it is equally critical for the medical community and the lay public to seek out rational facts about medical issues, and evaluate media reports with a skeptical eye. May 2010 see better medicine reporting, for the more knowledgeable health of us all.

Northwest Hospital's Accomplishments of 2009

As we say farewell to 2009, LifeBridge Health is taking a look at some of the major events of the past year. Today, we remember the opening of the new breast care center at Northwest Hospital.

Of all the changes at Northwest Hospital in 2009, a highlight was the opening of the newly renovated Herman & Walter Samuelson Breast Care Center.

The center has some of the most advanced cancer detection technologies and treatment approaches – such as digital mammography, breast MRI, breast biopsy and multi-D cancer conferences, all in a comfortable and warm environment. It opened in June and is now located next to the main entrance of Northwest. The center is shepherded by breast surgeon and medical director Dawn Leonard, M.D., pictured at right with Northwest Hospital president Erik Wexler.

The center was made possible through a $100 million expansion and renovation project that ended in June. This multi-year fundraising effort, called the Renaissance Campaign, netted over $7 million in community support and grant funding. Other upgrades debuting in 2009 included the opening of the Sara and David S. Brown Outpatient Lobby, unique with its use of aromatherapy and calming music to soothe visitors, plus renovation of the main lobby and a new main entrance canopy.

The main lobby was renamed in honor of the Northwest Hospital Auxiliary in August.

Other construction at Northwest includes a pedestrian bridge that crosses Carlson Lane, connecting the hospital to a new professional building. By mid-2010, this building will house Northwest administrative offices, a pharmacy and the ambulatory surgery suite with four new operating rooms.



Tuesday, December 29, 2009

Courtland Gardens Celebrates New Chapter

As 2009 winds down, LifeBridge Health is taking a look at some of the major events of the past year. Today, we remember the historic name change of Jewish Convalescnet & Nursing Home to Courtland Gardens Nursing & Rehabilitation Center.

by Helene King

“A rose by any other name is still a rose”…and so is a nursing home with a compassionate, caring staff.

In 2009, Jewish Convalescent & Nursing Home changed its name to Courtland Gardens Nursing & Rehabilitation Center, but its excellent quality of care remains the same.

“The name better reflects the expanded resident enrollment that was instituted in 2007, when the center opened to people of all faiths,” says Aric Spitulnik, vice-president of post acute services for LifeBridge Health. “Analysis showed the demand for long-term care services within the Baltimore-area Jewish community was insufficient to maintain Jewish Convalescent’s Jewish-only census.”

The transition was seamless. Jewish residents continue to share in the traditions of living a Jewish lifestyle, and Christian observances have been added to the spiritual fabric of the long-term care center.

In 2009, a new state-of-the-art rehabilitation gym was built inside Courtland Gardens. Additionally, the center is one of the few nursing homes that has a physician and nurse practitioners as permanent members of its medical staff.

Courtland Gardens is part of LifeBridge Health, one of the largest, most comprehensive providers of health services in the Northwest Baltimore area, which also includes Sinai Hospital, Northwest Hospital and Levindale Hebrew Geriatric Center and Hospital.

Monday, December 28, 2009

A Banner Year for Sinai Hospital

As 2009 winds down, LifeBridge Health is taking a look at some of the major events of the past year. Today, we remember the expansion efforts at Sinai Hospital.

By Betsy Haley

Sinai Hospital continued to grow and expand patient care services throughout 2009.

In July, Sinai officially opened a 87,000-square foot, four-story addition that included an atrium, new Intensive Care Unit (ICU) and new Intermediate Care Unit (IMC). This expansion featured a green roof and other environmentally-friendly measures.

“In an effort to support our community and reduce our environmental footprint, Sinai Hospital strives to be a corporate leader in green development,” said Neil Meltzer, president and COO of Sinai Hospital. “This building expansion is a wonderful example of how hospitals can achieve a high level of patient care and incorporate environmental responsibility.”

The expansion features two new patient care areas, a 29-bed ICU located on the fourth floor, and a 36-bed IMC unit, located on the sixth floor. Both new units incorporate enhanced ergonomics for the patient care staff. Improvements include patient beds designed to reduce the need for lifting, raised outlets to decrease the need for bending and stretching, special flooring to support long periods of standing, and a pod-like setting with all medical supplies in close proximity. Also, each of the private patient rooms has sleeping space for families and computers at every bedside.

The new building also boasts the area’s first hospital roof garden. A helipad is also located on the rooftop which allows for transport of patients to the emergency department, operating rooms and the cardiac catheterization labs.

In December, The Herman & Walter Samuelson's Children's Hospital broke ground on the new wing. In addition to the new wing, the Children's Hospital will have associated upgrades and changes that will enhance the quality and efficiency of care, including all private rooms and family sleeping areas. These additions support the very heart of a family centered care program where the family is recognized as the constant in a child’s life. For this reason, family centered care is built on partnerships between families and health professionals during and after a child is treated for a diagnosed illness. Most importantly, family centered care improves and enhances clinical outcomes for children with special needs and provides more support for their families as they deal with the challenges and joys of raising a chronically ill child.

The construction will take place from now until mid-2012. To read more, click here.

Friday, December 25, 2009

LifeBridge Health Adopts Families for the Holidays

During this season of giving, LifeBridge Health is doing its part to help families have a happy holiday season.

Sinai Hospital and Northwest Hospital both have "adopt a family" programs, where departments or individuals provide gifts and food to a specific family in need. Participants also wrapped up the presents for the children and adults.

At Sinai, 52 families were adopted this year, with a total number of 187 people helped. There were 42 departments or private adopters who participated.

At Northwest, 23 departments or groups came together to adopt 17 families with 50 children, plus adopting a local homeless shelter.

The Sinai Hospital Employee Activities Committee also sponsored a new glove, hat and scarves drive for its pediatric and adult patients in honor of Sinai Hospital's "50 Acts of Kindness."

Thank you to Robbin Alexander and Erin Johnson in Women and Children's Services at Sinai, Tina Stokes of the Northwest Hospital Domestic Violence (DOVE) program, and the Sinai EAC! Many families and individuals will have a happier holiday and winter season because of you.

Thursday, December 24, 2009

Holiday Eating Tips from LifeBridge Health

By Jamie Strauss, R.D, L.D.N.
Clinical Dietitian, Food and Nutrition Services
Sinai Hospital

Will I survive the holiday eating? We often ask ourselves this question. In the back of our mind, we know that between Halloween and New Year's Day the average person gains 1 to 2 pounds. With busier schedules during the holidays, we often give in to comfort food cravings and to pressures from loved ones saying, “C’mon, eat some more!”

But just because we are surrounded by comfort foods and family does not mean that we have to give in to the cravings and pressures to overeat. All we should do is be mindful of what and how much we are eating. And enjoy the holiday season!

Here are 10 healthy eating tips that can help with the holidays:
  • Do not go to a gathering hungry. Eat as usual throughout the day so that you will be satisfied with smaller portions without overeating.
  • Offer to bring a low-calorie dish to an event. You will know there will be at least one “safe” item available.
  • When you are at a gathering, stand far away from the buffet so you are not tempted to nibble continuously.
  • Wherever you are, indulge in conversation. Conversation is calorie-free!
  • Eat something before going to an event with alcohol. The effects of alcohol are often felt more quickly on an empty stomach and may lead to overeating.
  • Try drinking one glass of water before each glass of an alcoholic beverage.
  • Eat slowly! It takes 20 minutes for the brain to signal to the stomach that it is satisfied.
  • Begin the meal with a salad and use a low-calorie dressing on the side.
  • Prepare side dishes with fresh herbs and sodium-free seasoning.
  • Use all fruit and light spreads rather than butter, cream, and gravy.
  • Choose to bake meats rather than fry.

Wednesday, December 23, 2009

Health Care for All Stops at Northwest Hospital

Maryland Health Care For All joined Baltimore County leaders yesterday at Northwest Hospital to celebrate close to 7,000 newly insured Baltimore County residents.

Those residents became insured through a health care expansion of the Medical Assistance for Families Program, created by the Governor's Working Families and Small Business Health Care Coverage Act of 2007.

Over 52,000 Maryland residents are enrolled in the Health Care for All program, and receiving medical care.

"We at the Maryland Health Care for All Coalition commend Governor Martin O'Malley and the Maryland General Assembly for enacting this health care expansion,” said Vincent DeMarco, president of the Maryland Citizens' Health Initiative. “They can be proud that because of their work Maryland has gone from 44th in the country in health care coverage for adults to 16th."

DeMarco joined Northwest Hospital president Erik Wexler and Del. Dan Morhaim, who is also an emergency medicine physician.

Those with questions about eligibility for the program should call 800-456-8900. City residents can inquire at 311 and Baltimore County residents can call 211. To read more from the Baltimore Sun, click here.

Tuesday, December 22, 2009

LiveWell@LifeBridge Helps Employees Get Healthy

At LifeBridge Health, we want our employees to be healthy, for their family, friends, co-workers and most of all, for themselves.

LiveWell@LifeBridge is a wellness program to help employees get healthy and stay healthy. There are business reasons why it make sense to offer this program, but there are also lots of reasons why we all should eat right, exercise regularly and take care of ourselves. Sometimes, it's difficult to do the right thing, not because we don't want to, but because life gets in the way.

The path to health begins with awareness. The first steps of LiveWell@LifeBridge starts with our non-union employees enrolled in the LifeBridge Health medical plans, with hopes that we can eventually extend it to union employees. Eligible employees can take the online health risk assessment and schedule a biometric screening for January. These two simple steps will give them a baseline for your wellness status--what's okay and what needs some attention. And participants will get a $25 gift card!

If you are a eligible employee, stop by Employee Information Booth between 11:30 a.m. and 1:30 p.m. tomorrow, and also be eligible for the Innovative Wellness Solutions drawings, which include a $250 Best Buy Gift Card.

Monday, December 21, 2009

Cellular Disconnect

by Zeena Dorai, M.D., FACS
Chief, Neurosurgery, Northwest Hospital; Director, Neuro-oncology, Sinai Hospital
Sandra and Malcolm Berman Brain & Spine Institute

Results of a 30-year Scandinavian study bring hopeful news for avid cellphone users. Researchers found no increase in certain types of brain cancer (gliomas and meningiomas) among nearly 6 million men and women in Denmark, Finland, Norway, and Sweden between 1974 and 2003.

Reported in a brief communication to the Journal of the National Cancer Institute , these results seem to dampen the speculation that a link exists between cellphone use and brain tumors.

Although the study notes a gradual increase in the incidence of brain tumors over time, the authors speculate that the cause likely has multiple factors, and may simply reflect an increase in diagnoses due to advances in technology. The study further reports no change in incidence of brain tumors during the sharp increase in cellphone usage during the 1990s.

However, the authors do note that the results of a second study “leave open the possibility of a small to moderate increased risk for glioma among the heaviest users of mobile phones." Preliminary unpublished data from the INTERPHONE study, a 10-year case–control study of brain tumors conducted internationally by the World Health Organization, suggest that those who engage in extensive cellphone use do face a higher risk of developing brain tumors later in life. The lead investigator stated that the study report would include a “public health message.”

It is clear that these results are not without controversy, and the bottom line is that the long-term effects of radiation from cellphone use are not certain. Nevertheless, some simple steps and common-sense practices can be taken to minimize the risks of radiation from cellphones:

1. Limit cellphone use and use land lines whenever possible.

2. Limit use of Bluetooth devices, which emit low-level radiation even when not in use.

3. Use a wired hands-free device.

4. Avoid carrying cell phones on your body.

5. Do not keep mobile phones close to you while you are sleeping.

6. Limit children’s use of cellular phones.

Saturday, December 19, 2009

stealth sensation and idle speculation

In skimming the medical news in preparation to comment on the now slightly less insane coverage of both influenza and the new USPSTF mammography guidelines, I was distracted by this headline from Science Daily: "Hidden Sensory System Discovered in the Skin." Hidden sensory systems, eh? Casting a dubious eye, I proceeded to read onward to see what anatomists might have been missing over the last several hundred years:
The human sensory experience is far more complex and nuanced than previously thought, according to a groundbreaking new study published in the December 15 issue of the journal Pain. In the article, researchers at Albany Medical College, the University of Liverpool and Cambridge University report that the human body has an entirely unique and separate sensory system aside from the nerves that give most of us the ability to touch and feel. Surprisingly, this sensory network is located throughout our blood vessels and sweat glands, and is for most people, largely imperceptible. (full story at ScienceDaily.com)

So far, so good, if a bit sensationally described. The existence of nerves that wire our glands to secrete the substances they produce, and blood vessels expand or contract in response to certain signals, is certainly not news. The interesting thing here is the idea that they may be somehow involved in detecting sensation from the skin, which is something that's never been considered before - after all, we already have an extensive set of nerves in place that do just that.

This particular research came about when two unrelated patients were evaluated by the paper's authors due to their similar, and previously unsubscribed, constellation of symptoms. Both had a congenital inability to feel pain, as manifested by the patients being unaware of significant injuries, such as broken bones, exposure to severe cold, and burns. In addition to other symptoms, both patients did have some degree of sensation to non-painful stimuli, which allowed them to accomplish their daily tasks and employment without any difficulties. The subjects underwent a detailed clinical neurological exam, as well as nerve biopsies and DNA analysis. The results show that there was an almost total absence of normal sensory nerves to the skin, but with no genetic mutations present that have been associated with other "congenital absence of pain" syndromes. The journal authors concluded:
...Our findings suggest three hypotheses: (1) that development or maintenance of sensory innervation to cutaneous vasculature and sweat glands may be under separate genetic control from that of all other cutaneous sensory innervation, (2) the latter innervation is preferentially vulnerable to some environmental factor, and (3) vascular and sweat gland afferents may contribute to conscious cutaneous perception. (abstract from Pain, 2009; 147 (1-3): 287; full article requires subscription)

Translation: (1) the genes that control different nerve systems are more complex and separate than previously thought, (2) the nerves that directly wire for sensation in the skin may be affected specifically by things in the environment that might not effect other nerve systems, and (3) the nerves that control blood vessel dilation and gland function may have a role in skin sensation as well. These are very interesting, as well as appropriately conservative, conclusions - based on two patients with extremely rare conditions, we have some new ideas about how the nervous system works. This will likely spur on more research to investigate how these different nerves intersect in terms of sensory input, and the potential genes involved.

Of course, the very preliminary nature of these observations doesn't prevent the authors from speculating to the media on what these findings might mean for specific diseases. From the Science Daily report:
"Problems with these nerve endings may contribute to mysterious pain conditions such as migraine headaches and fibromyalgia, the sources of which are still unknown, making them very difficult to treat." (full story at ScienceDaily.com)

The implications of this discovery for migraine headaches in particular is, admittedly, tantalizing. What causes the pain in migraines is not fully understood, and several theories involve the abnormal responses of blood vessels in the brain and surrounding tissues. Certainly, the idea that nerves connected to said blood vessels could themselves be generating pain signals might have significant importance for managing and treating such headaches.

All that said, any speculation at this point as to how this discovery may relate to specific diseases is just that - idle speculation. Much like the recent poorly reported and overblown "association" of XMRV with chronic fatigue syndrome, it is inappropriate to draw any clinical conclusions about poorly understood syndromes like fibromyalgia based on the actual content of this study. What is important is that through the description of these two rare patients, we have made a fascinating discovery at a very basic level about how our nervous system may work normally, or at least attempt to compensate when a genetic change has happened. How this plays out in the future in terms of pain disorders remains to be seen.

[Journal reference: Bowsher et al. Absence of pain with hyperhidrosis: A new syndrome where vascular afferents may mediate cutaneous sensation. Pain, 2009; 147 (1-3): 287 DOI: 10.1016/j.pain.2009.09.007]

Friday, December 18, 2009

Northwest Hospital Leaders Complete Hospital Evacuation Drill

by Holly Hosler


The best way to handle an emergency is to be prepared, which is why some leaders at Northwest Hospital spent Monday morning taking the DQE® Hospital Evacuation Course. Training on how to be prepared for a hospital evacuation is still a relatively new concept, and Northwest was one of the first hospitals in the area to offer this course to members of its Emergency Management team.


Though evacuations are rare, a number of situations – including fire, flooding or hazardous material event – could lead to the need to evacuate patients and visitors from part or all of the hospital.


When coordinating an evacuation, the safety of patients, visitors and hospital staff is paramount. Life safety and restoring stability to the situation are higher priorities than preserving property, though that is also important. In preparation for their exit, patients would be grouped by those who can walk, those who need wheelchairs and those who must be transported by bed, and a different evacuation plan would be created for each group. Patients able to be discharged immediately would be sent home, and transportation and care at other facilities would be arranged for the remainder of the evacuees.


After learning how to best evacuate a hospital, the class participated in a drill of a mock scenario and developed a specific plan to ensure a safe, swift and seamless evacuation.

The evacuation course compliments the other Hospital Incident Command System (HICS) training that Northwest Hospital managers, directors and vice presidents have already received. HICS is part of the National Incident Management System (NIMS) that was created by the federal government in response to the 9/11 terrorist attacks. NIMS gives first responders, EMS, police, fire and hospitals a common vocabulary for use in emergencies and disasters. This common lingo greatly improves coordination among the various agencies and organizations, leading to a more successful resolution of the situation.

Thursday, December 17, 2009

Blood Donors to Receive Gift Card to Starbucks

Don't let a few flurries deter you from giving blood at the blood drive Saturday in Fallston, from 8 a.m. to 2 p.m. In addition to the T-shirt and donation to Susan G. Komen for the Cure, the American Red Cross is also tossing in a $5 gift card to Starbucks for participants.

The drive is at Fallston Volunteer Fire Hall, 2201 Carrs Mill Road. To schedule your life-saving donation, e-mail Andy at johneisner65 (at) yahoo.com or call Lonnie at 410-671-7574.

Use Caution When Buying Toys

One of the speakers at the recent Maryland Public Interest Research Group press conference on toys at Sinai Hospital was U.S. Rep John Sarbanes, a father of three who spoke about the need for increased awareness. The 2009 "Trouble in Toyland" from the U.S. PIRG states that in 2007, there were 45 million toys and other children’s products recalled in 2007.

"We have to make sure the products that are sold are going to be safe," Sarbanes said. "You find often after the fact that toys you thought were safe are not."

To see the full video of Sarbanes, click below.




video

Wednesday, December 16, 2009

Breast Cancer is a Global Issue

By Deb Kirkland, RN, BSN, MPH
Nurse Navigator, Herman & Walter Samuelson Breast Center at Northwest Hospital

Breast cancer is the most common cancer in women around the globe. In 2002, there were 1.2 million cases globally, and over 400,000 deaths. The number of cases is projected to increase to 1.5 million each year. During the month of October, I had the unique opportunity to participate as a U.S. Delegate with Susan G. Komen for the Cure Global Mission in Cairo, Egypt.

Cairo, which has a population of 20 million people, has a visibly disturbing poverty level. After visiting the city's hospitals, National Cancer Institute, and Breast Cancer Foundations, it was an eye-opening experience to see and hear first hand about how the disease has impacted women there. Our latest cutting-edge tools to treat breast cancer would not translate well into such a setting; rather the goal is to apply methods that are appropriate, effective, and applicable.

But, sadly, problems with breast cancer awareness, early diagnosis, treatment and survivor rates are universal. In addition to those challenges, there are cultural stigmas that create major barriers to overcome. Lighting the pyramids pink at night for breast cancer awareness and holding the first Race for the Cure around the Great Pyramids, with over 10,000 participants and 300 survivors, was an initial effort to make it more acceptable to discuss this disease. To see survivors proudly wear their pink T-shirts in that culture was more impressive than seeing the pyramids themselves. You can see a picture here.

In the U.S., we survivors are proud and wear the pink as a badge of honor in surviving; in other cultures it is still taboo and many myths exist regarding the disease. Overall, it made me proud to be an American, proud to have the access and health care we expect. We have many treatment options and resources available that many countries do not.

Tuesday, December 15, 2009

LifeBridge Employees Open Hearts and Homes

This is the time of year where we think a lot about helping those in need. For some LifeBridge Health employees, that means welcoming a child into their home.

In July, David Grant, a physical therapist in the Sinai Rehabilitation Center, and his wife Jane completed foster parent training through the Foster/Adoptive Resource Program sponsored by the Baltimore City Department of Social Services (BCDSS). David’s motivation to foster children stemmed from wanting to "give back" because he says so many people have made a difference in his life.

“The things that made the biggest impact on me and my wife were small things,” says David. “But those small things had an impact on our lives.

“So far, we’ve fostered two brothers, ages 7 and 8. Their visit only lasted for one day but it was a roller coaster of anticipation, salt-stained little faces, open-armed care and even laughter as we played games and entertained them,” explains David. “When they left with the social worker and the lunches we packed for them, we knew we’d done the right thing.”

In Maryland, there are approximately 8,000 children in out-of-home placement, and 5,000 of those children are from the city of Baltimore. The goal of the BCDSS is to help provide safe, nurturing homes while the children are in out-of-home placement. Because recent studies indicate outcomes for children placed in family settings are better than those placed in group homes, BCDSS operates under the motto that “nothing matters more to a child than to have a place to call home.” Most of the children in foster placement are African American, and the ages range from infancy to 18 years old. The greatest need is homes for teens.

Employees interested in becoming a foster parent must first attend an information meeting with BCDSS, which addresses every aspect of the Foster/Adoptive Resource program. There are eight pre-service training classes, which occur twice a week. After attending the second class, applicants are assigned to a caseworker who guides the potential foster parents through the home study process, which can take roughly three months.

The BCDSS Foster/Adoptive Recruitment team visits LifeBridge Health one to two times per month to provide information, answer questions and recruit employees to become foster parents.

Doug Jackson, a biomedical technician at Northwest Hospital, and his wife Pat have been foster parents for more than 20 years.

“We have always taken in teenagers because of the ages of our own children," Doug says. "Even after our youngest son graduated from high school, we continued to welcome teens into our home because we felt called to do so. So many other foster families that we knew seemed to want younger children,” says Doug.

Doug and his wife have helped over 40 children, and still hear from several of them from time to time.

“I can't say the entire fostering process is all 'wine and roses,' but we feel we have been blessed to able to share our home and lifestyle with kids who were being taken out of their homes for whatever reason. We are glad we were able to help so many,” Doug says. “Fostering is one of the most satisfying and rewarding things you can do to help someone else. I encourage other LifeBridge employees to considering fostering. If you have an open heart and home, this is a great way to share love and help a child.”

Judith Mulloney, R.N., Pediatric Intensive Care Unit at Sinai, echoes Doug’s feelings.

“Many years ago my husband and I became foster parents to a little 22-month-old boy who had never been out of the hospital. He had many medical needs and was a challenge. Seventeen years later, he is a healthy young man with well-managed health issues. We ended up adopting him and he is a much loved member of our family. We would be lost without him,” says Judith.

For more information about the Foster/Adoptive Resource Program, contact Janet Allen at the Baltimore City Department of Social Services.

Monday, December 14, 2009

Blood Drive Saturday in Fallston

Giving blood is a great way to say "thank you" to a loved one. Philanthropist Andy Eisner went one step further - he created a blood drive to honor his mother, Sharon Miller.

Watching his mother undergo cancer treatment at Sinai Hospital left Eisner with a desire to help other patients. He worked with Garrett Caring for Kids to create a blood drive to benefit Sinai.

"Giving blood takes a little bit of your time, but it has a huge impact," Eisner says. "We know that money is tight for some people this time of year, and this is a way to give back that only requires your presence."

The blood drive will be this Saturday, December 19, from 8 a.m. to 2 p.m. at the Fallston Volunteer Fire Hall, 2201 Carrs Mill Road. Participants will receive a T-shirt and a donation in their honor will be made to the Susan G. Komen for the Cure.

To schedule your life-saving donation, e-mail Andy at johneisner65 (at) yahoo.com or call Lonnie at 410-671-7574.

Donors must be over age 17, healthy and at least 110 pounds. To review other donor eligibility requirements, click here.

Friday, December 11, 2009

Exercising Your Brain

Physical exercise does more than help your heart - it also helps your brain.

The reduction of cholesterol and avoiding plaque buildup in blood vessels, as well as maintaining a reasonable weight, may help keep your memory sharp. In an Owings Mills Times article published yesterday, Levindale geriatric psychiatrist Jeffrey Lafferman, M.D., says vascular or blood flow issues can impair a person's memory.

"Years of fatty foods and high blood pressure and being overweight lead to clots in the vessels that interfere with blood flow," explains Lafferman. "This can lead to problems with short-term memory."

Working out, whether it's with a brisk walk or group sport, can get that blood flowing to the brain and stimulate the memory. If you want a quick way to test your memory health, you can take Center for Memory and Brain Health director Majid Fotuhi's sample test, adapted from his book The Memory Cure.

For more information on the Center for Memory and Brain Health at the Sandra and Malcolm Berman Brain & Spine Institute, click here or call 1-888-747-8899.

Thursday, December 10, 2009

LifeBridge Health Helps Employees Further Education

If you are a nurse and working for LifeBridge Health, there are great opportunities to further your education.

The University of Maryland School of Nursing dropped by Sinai and Northwest hospitals today to discuss master’s degree programs, and Stevenson University visits regularly to discuss nursing programs. An “education night” was held by Stevenson at Sinai on Tuesday, and another one will be held at Northwest from 5 p.m. to 8 p.m. on Wednesday, December 17.

Meanwhile, registered nurses enrolled in graduate level, degree-granting colleges and universities in selected regions of the US may be eligible to apply for a Promise of Nursing Regional Faculty Fellowship (PON Fellowship). The PON Fellowship is designed to assist registered nurses who are preparing for the nurse educator role to achieve their degrees.

And of course LifeBridge Health offers tuition reimbursement options for both nursing and non-nursing students who are seeking degrees. Approximately 530 LifeBridge Health employees benefit from the tuition reimbursement program each year.

In general, an employee is eligible for tuition reimbursement if he or she has been employed for one month or longer. He or she can receive up to $5,000 per school year. Students must receive a grade of “C” or better to qualify, and the rate is prorated based on part-time verses full-time status. Courses must directly relate to an employee's current position, or for one which the employee can be promoted to within LifeBridge Health.

One example of how this works is Jennifer Skeete, a nurse in the Ambulatory Surgery department at Sinai, who has been using the tuition benefit since 2003. She says it's an incentive to advance her career while also relieving some of the financial burden. Jennifer is enrolled at Stevenson University and completed her bachelor of science degree in nursing.

“Now, I’m enrolled at the University of Maryland School of Nursing to earn an M.S.N. in Nursing Informatics," Jennifer says. "My ultimate goal is to stay within Sinai in the Information Systems department. The tuition reimbursement benefit gives me an incentive me to advance my career at a cost that I can afford."

The reimbursement also reflects Sinai's commitment to its Magnet hospital status, a designation showing excellence in nursing.

To learn more about the benefits of working for LifeBridge Health, visit LifeJobs. If you are a current employee and need additional information, contact Employee Services at 2-8000.

Wednesday, December 9, 2009

Some Women May Not Need Annual Pap Smears

by Holly Hosler

In case you missed it in the big news about the recent USPSTF mammography recommendations, the American College of Obstetricians and Gynecologists (ACOG) has also revised guidelines, specific to when women should get Pap smears.

The ACOG now recommends that women have their first Pap smear (test for the early detection of cervical cancer) at age 21 (rather than 18), regardless of their sexual histories. Also, most women no longer need Pap smears on an annual basis, and most can stop having them after age 65 or 70 if they have had no abnormal results in the past 10 years.

According to the ACOG, Pap smears conducted prior to age 21 have resulted in too many false positives, with women undergoing unnecessary procedures to eliminate abnormal growths in cervical tissue. The ACOG argues that by treating these cervical abnormalities, young women are put at risk for too much treatment, anxiety and infertility. Cancer of the cervix in women under age 21 is rare; odds of contracting it stand at about 1 in a million.

The new guidelines also say that women aged 21 to 29 should have a Pap smear once every two years, and women in their 30s and older should have one every 3 years provided that their last three tests were negative.

“ACOG has developed its guidelines based upon significant evidence based clinical data,” says David L. Zisow, M.D., F.A.C.O.G., gynecologist and associate chief of minimally invasive surgery at Northwest Hospital.

However, before you think you can skip your annual Pap smear this year, talk with your doctor about what is the best course of action for you. Regular Pap smears save lives, and the new guidelines should not be taken as a pass to start being lax about your gynecological health.

“Guidelines are just that - a starting point from which to think about what may be best for the individual patient and should never be substituted for clinical judgment,” explains Dr. Zisow. “Doctors will still need to exercise good clinical judgment in selecting appropriate patients to screen - or not to screen - in light of each individual’s history and medical circumstances.”

Tuesday, December 8, 2009

Handle Toys Before Buying

It's understandable if the Internet is your best friend this holiday season. But when it comes to toys for children, looking at at the item in a store may make the most sense.

Sinai Hospital pediatrician Oscar Taube says he encourages parents to try to handle the toy before buying it. One of the reasons is to make sure the parts are too big to be swallowed. Maryland Public Interest Research Group recommends using a toilet paper roll, which is slightly bigger than a child's windpipe, to check if it can be swallowed.

"There really is nothing like taking a toy in your hand," he said at the Maryland PIRG press conference on toy safety. "I do encourage my parents to try not to buy based on a picture, but to handle the toy and make sure it's safe."

You should also notice the noise level of the toy, Dr. Taube says. To hear more tips from Dr. Taube, click on the video below.


video

Monday, December 7, 2009

Sinai's Diabetes Resource Center Earns Recognition

Diabetes causes more deaths a year than breast cancer and AIDS combined, a sobering fact from the American Diabetes Association (ADA), which stresses the importance of living a healthy lifestyle and educating patients with diabetes and their families.

Consistent with national standards to provide high quality self-management education to people with diabetes, the Diabetes Resource Center at Sinai Hospital of Baltimore recently received the ADA’s prestigious Education Recognition Certificate.

The ADA awards certification only to programs that meet the strict criteria developed through its National Standards for Diabetes Self-Management Programs, which assure people that they are getting the best care.

In order to merit this distinction, programs must cover a wide range of topics, including everything from the disease process, nutritional management, goal setting, problem solving and psychological adjustments to preventing diabetic complications, detecting changes, monitoring levels and participating in physical activities.

“Participants in our program are taught self-care skills that promote better management of their diabetes treatment regimen,” says Sally Pinkstaff, M.D., Ph.D., director of the Diabetes Resource Center. “Having the knowledge and skills to understand and take action against this disease are essential components of diabetes treatment.”

The Education Recognition status is voluntary and is awarded for three years. The Diabetes Resource Center opened earlier this year. To learn more about the center, call 410-601-WELL (9355).

Friday, December 4, 2009

Children's Hospital Breaks Ground on New Wing

If you missed yesterday's Baltimore Sun story, the groundbreaking of the wing of the Herman & Walter Samuelson's Children's Hospital yesterday evening.

In addition to the new wing, the Children's Hospital will have associated upgrades and changes that will enhance the quality and efficiency of care, including all private rooms and family sleeping areas. These additions support the very heart of a family centered care program where the family is recognized as the constant in a child’s life. For this reason, family centered care is built on partnerships between families and health professionals during and after a child is treated for a diagnosed illness. Most importantly, family centered care improves and enhances clinical outcomes for children with special needs and provides more support for their families as they deal with the challenges and joys of raising a chronically ill child. The construction will take place from now until mid-2012. The following changes and upgrades are planned:

Pediatric Inpatient Capacity: An increase to a total of 26 pediatric inpatient medical and post-surgical single occupant patient rooms (including an isolation unit for oncology/high risk patients), with nurse stations and support areas as well as an in-room capacity to accommodate parents/family members.

Children’s Diagnostic Center (CDC): An increase to a total of three pre-operative beds, two procedure rooms with sedation/anesthesia capacity, and three recovery/post-anesthesia bays (including one isolation bay), with nurse station, support areas, and family waiting areas.

Pediatric Intensive Care Unit (PICU): six PICU beds (including 2 private single occupant isolation rooms for high risk patients and four semi-private rooms), with nurse station and support areas.

Pediatric Hematology and Oncology Unit: An increase to a total of six exam rooms and six infusion bays, with nurse station, support areas, and family waiting area.

Thursday, December 3, 2009

Most Women in Their 40s Will Continue to get Mammograms

Now that the U.S. Preventive Services Task Force (USPSTF) says that most women do not need mammograms until they are 50, will American women heed the USPSTF’s advice? A recent survey indicates that over two-thirds of women aged 40 to 49 say they will continue an annual mammography regimen, and some will do so even if they have to pay for the tests themselves.

In an online poll conducted between November 19 and 23 by Harris Interactive on behalf of LifeBridge Health, 69 percent of U.S. women aged 40 to 49 say they will get an annual mammogram despite the new USPSTF recommendations. Of these women, 48 percent will get mammograms if their insurance plans pay for them, and 21 percent say they will get them even if they have to pay out-of-pocket for the test. Only 5 percent said that they would not be getting mammograms in their 40s because of the USPSTF’s recommendations, and 16 percent said that they would not get mammograms regardless of the new recommendations. Fewer than 1 percent declined to answer the question, and about 1 out of every 10 women was unsure what she would do. Experts are concerned that the new USPSTF mammography recommendations may give women an excuse not to get regular screening mammograms.

“Practice guidelines that postpone mammographic screening and eradicate self and clinical examinations will have detrimental impacts on early diagnosis and cancer survival,” says Dawn Leonard, M.D., breast surgeon and medical director of the Herman & Walter Samuelson Breast Care Center at Northwest Hospital. Dr. Leonard sees many younger women who have breast cancer, particularly African American women who have a higher risk of getting breast cancer at an earlier age than is often expected by the medical community. While overall, the incidence of breast cancer in African American populations is slightly lower than in Caucasian populations, African Americans have a higher breast cancer mortality rate than other racial groups. When detected at Stage 1 or earlier, breast cancer survival rates are quite high – up to 98 percent, explains Dr. Leonard. She adds that mammography has the potential to detect breast cancers long before they are large enough to be palpable or felt by the woman through self breast exam.

“The medical community and the advocacy community have worked tirelessly since the ’70s to empower women to be more aware of their breast health needs and to make choices that improve breast cancer survival,” Dr. Leonard says. “The recent USPSTF recommendations appear to be a step in the wrong direction.”

The survey, which was conducted between November 19 and 23, 2009, very soon after the USPSTF’s November 16 announcement, polled 261 women between the ages of 40 and 49.

Survey Methodology
Harris Interactive® fielded the study on behalf of LifeBridge Health on November 19 and 20, 2009, via its QuickQuerySM online omnibus service, interviewing a nationwide sample of 261 U.S. women between the ages of 40 and 49. Data were weighted using propensity score weighting to be representative of the total U.S. adult population on the basis of region, age within gender, education, household income, race/ethnicity and propensity to be online. No estimates of theoretical sampling error can be calculated; a full methodology is available.

Wednesday, December 2, 2009

Many toys are still toxic, hazardous

If you're like many of us, you are shopping for toys this holiday season for a child in your life. But beware - many toys are still not safe.

Sinai Hospital hosted a press conference last week in partnership with Maryland Public Interest Research Group to address the dangerousness of toxic toys found on American store shelves. MPRIG announced its 24th annual Trouble in Toyland report, along with a new interactive tool accessible via smart phone or computer will help parents and other toy-buyers avoid some common hazards.


video

Click above to watch this video of Jenny Lavin from MPIRG discussing the report.

The interactive tool may be accessed here: http://toysafety.mobi or http://www.toysafety.net. And if toy buyers discover they have bought a dangerous toy, they can report it to Maryland PIRG using the new interactive website. Consumers should also report dangerous products to the Consumer Product Safety Commission (CPSC).

We'll be posting additional updates on unsafe toys throughout the month of December.

Tuesday, December 1, 2009

Sinai Hospital Offers HIV Services

While today is World AIDS Day, every day is a chance for staff at LifeBridge Health to provide education and awareness about HIV and AIDS.

One example: the Women, Children and Youth HIV Program at Sinai Hospital reached 300 people in 2007 through presentations at schools and organizations, and more than 2,500 people at health fairs. In addition to these presentations, HIV outreach coordinator Robbin Alexander and program coordinator Sarah Raihl, L.C.S.W.-C., run the bimonthly Women’s HIV Support Group, which helps a core group of six women talk about issues ranging from dating to nutrition.The WCYP gives attention to the psychosocial aspects of this chronic disease.

WCYP services include ongoing support services, referrals to community, HIV services and other social support services, care coordination with medical providers, illness counseling, in- home outreach services, crisis intervention for those newly diagnosed or experiencing a crisis, and a twice-monthly Women's Support Group for HIV positive women.

Baltimore will join cities across the nation today and deck a signature landmark in red lights to observe World AIDS Day. The Washington Monument in Mount Vernon will become red at 7 p.m. There will be a service at 6 p.m. at Mount Vernon United Methodist Church.

For more information about HIV services at Sinai Hospital, call 410-601-WELL (9355).