Blood Drive Today at LifeBridge Health & Fitness

It's the end of March, which means that American Red Cross Month is almost over. But there's still one more chance to show your support by providing blood to hospital patients.

The American Red Cross will be at LifeBridge Health & Fitness today from 1 to 6 p.m. Call 410-318-6817 to reserve a space.

According to the Red Cross, every two seconds someone needs blood, but only a small percentage of the eligible U.S. population donates blood in any given year.

Tips for a successful donation include:

• Maintain a healthy iron level in your diet
• Hydrate – drink an extra 16 oz of liquid before and after your donation
• Have a healthy meal before your donation – avoid foods high in fat just prior to donation
• Remember to bring your identification (such as a driver's license)

A Few Clicks to a New You

(The following is excerpted from Md.MD for Life 2010, available now.)

by Amy Novotney

It took a friend’s unhappy marriage for Lisa Cullen to stop making excuses for her high cholesterol and the excess weight she’d been carrying around for several years. While out powerwalking one morning last August, Cullen, who lives in Gaithersburg, Md., couldn’t help thinking that if she were having marital problems, she’d get revenge on her husband by losing weight and doing everything she could to look great.

“It hit me like a ton of bricks how ridiculous that sounded,” she recalls. “Why would I wait for an unfortunate circumstance to get healthy, fit and happy with myself?”

So Cullen took to the Web. That afternoon, she signed up for Weight Watchers Online and says the site's food and exercise tracker and recipe builder helped her lose nearly 30 pounds, without requiring attendance at the weekly weigh-ins and group meetings that are a key feature of the program's 46-year-old weight-loss plan.

“I am totally not a meetings person,” Cullen says. “I just didn't have the time to commit to being in a certain place at a certain time every week.”

For years, Internet-based weightloss sites such as Weight Watchers Online, SparkPeople and eDiets have touted dieter success from the comfort of home, and their numbers are
growing. SparkPeople, for instance, now has more than 5 million registered users.

The sites – which typically cost between $10 and $25 a month, though some are free – offer interactive Web tools such as food and exercise diaries, weight-loss trackers, online chats with dietitians and member message boards for posting your favorite low-cal recipes or requesting tips for sticking with your diet. There are even applications for your Blackberry, iPhone or other mobile devices to help you track eating on the go.

Sounds great, right? But do they work?

Research shows that they do.

To read more, click here.

The Volunteers are Coming!

Ahhhh spring: a time for new beginnings. Winter coats are stored away. Shoveling 50 inches of snow is a bad memory. Grocery store stampedes are over for now.

Here at LifeBridge Health, spring means eager bright young volunteers will be showing up. The Teen Volunteer Program is now accepting applications.

“For most of them, it will be the first time working in a hospital setting and they learn it is not like what they see on television,” says Gloria Duvall an administrative coordinator in Guest Relations and Volunteer Services at Sinai Hospital.

“Teens who are considering a career in health care, either as a doctor or nurse are interested,” says Gloria. “And they learn there are many different jobs in a hospital.”

At Sinai, teens must be at least 15 years old and in high school or college. At Northwest Hospital teens can be 15, but must have completed the ninth grade. Levindale Hebrew Geriatric Center and Hospital accepts teens between the ages of 14 to 18.

All the young volunteers must have certain things in common. “They must be mature and self-motivated,” says Janine Boulad, volunteer coordinator at Levindale.

The volunteers will be given consideration for what their interests are and most will experience working in more than one department. “We do ask them if they want a clinical or clerical setting and will try to honor that,” says Jennifer Terrell, director in the Volunteer and Business Outreach Department at Northwest.

According to all involved, young people who have volunteered in the past have gotten a lot out of the experience. “This is a real growing experience for them,” says Janine. They also learn skills, like being on time, being observant and being self-motivated they can transfer to any job.

“Some confirm that this is what they want to do, “ Gloria says. “Others learn that being in a hospital is not for them.”

For more information on volunteering, click here.

LifeBridge Health Receives Three Alfred Knight Awards

LifeBridge Health was honored by the Maryland Society for Health Care Strategy and Market Development this afternoon, taking home a total of three Alfred Knight Awards.

Certificates of Merit were given for LifeBridge Health "Wash Your Hands" campaign (Integrated Marketing Campaign); Northwest Hospital's Herman & Walter Samuelson Breast Care Center Brochure (Service Line Brochure); and the "No Soap" Harris Poll, a component of the hand washing campaign (Media Placement).

The Alfred Knight Awards, named in honor of for MSHMD president Alfred J. Knight, Jr., are given each year in recognition of outstanding work by Maryland/D.C. hospitals and health care marketing departments. Awards honor initiatives that have had a measurable impact on the organizations and people they serve.

LBH Yoga Instructor to Dance in "Memory Ball"

Lorinda Belzberg may be a longtime yoga instructor and former professional figure skater.

But with no formal dance training, the idea of a dance competition filled her with trepidation.

Luckily, the Alzheimer Association's Memory Ball and its "Dancing Stars" competition were a reason to strap on her ballroom shoes.

"The Alzheimer's Association is near and dear to my heart," Belzberg says. "I became involved because of a dear friend and family member who were diagnosed with this terrible disease. The association asked me to dance and I was delighted to say yes."

Belzberg is the yoga program co-coordinator at LifeBridge Health & Fitness, and has lived in Baltimore since 1990. A native of Canada, she was a Corps de Ballet skater for the Ice Capades.

Belzberg is practicing her dancing for the April 24 ball, and meeting weekly with international dancer Genya Bartashevich. But regardless of how the event goes, what's important is the money raised will benefit the Alzheimer's Association.

"We've broken all fund-raising records for this," Belzberg says. "Every dollar can equal a vote."

Belzberg is currently under $1,000 away from her goal. To contribute/vote, click here.

The Memory Ball "Dancing Stars," starts at 7 p.m. at the Baltimore Marriott Waterfront Hotel. There will be a cocktail reception, followed by dinner and entertainment provided by the "Dancing Stars," who will perform and compete for "votes." The Memory Ball is black-tie attire. Tickets are $300. For more information, click here.

Health Care Hero Winners Announced

Congratulations to our finalists and winners of the 2010 Maryland Daily Record's Health Care Hero Awards. Click on their name below to read their full nomination.

Volunteers
Ruth Leibowitz, Levindale Hebrew Geriatric Center and Hospital
Jerome Fineblum, Sinai and Northwest Hospitals

Physician
Harpal Khanuja, M.D., Sinai Hospital

Advancements in Health Care
Levindale Hebrew Geriatric Center and Hospital

Nurse
Linda Covert, R.N.

Health Care Hero Finalist: Jerome Fineblum

The Maryland Daily Record's Health Care Heroes awards ceremony honors special caregivers who exemplify extraordinary commitment to their profession. Stay tuned to the blog to hear details about our winners.

Jerome Fineblum is a champion of volunteer service. In the past five years, he has contributed more than 5,000 hours of service to Sinai Hospital. Jerry also volunteers at Northwest Hospital, giving 2,600 hours since 1993.

In addition to his work at Sinai and Northwest, Jerry has worked for 13 years with the Visiting Nurses Association doing home hospice visits. This work with hospice patients fills a need and offers perspective on what's important, he says.

The past-president of Beth El Seniors' Organization, Jerry's other volunteer commitments include the Jewish War Veterans Post #493, the Pikesville Senior Center Council, and the local AARP chapter. He is a Baltimore native.

He was named Veteran of the Year in 1988 by the Jewish War Veterans.

LifeBridge Health congratulates Jerry and the other Health Care Hero finalists!

My Experience in Haiti

by Heather Kline, P.A. - C, MMS
Sinai Hospital Department of Orthopedic Surgery

After I heard about the Haiti earthquake on January 12, I felt compelled to do whatever I could to help people there. I knew going in what needed to be done, but never realized the full impact of disaster relief, or how it would affect me.

I went down to Haiti with a group called Project Medishare. It is sponsored by the University of Miami and has done medical missions to Haiti since 1994.

We arrived on midnight, February 3. We stepped onto the tarmac and I was immediately met with U.S. Army soldiers with M-16s. At this point I'm thinking "what did I just get myself into?"

The airport was nothing but a broken-down abandoned building in the middle of the airfield. We quickly realized that we had to unload the plane of all the bags because we were the only people.

Once we arrived at the camp, it was mainly composed of four large tents. There was an adult tent, a pediatric tent with operating room (pictured at right), a sleeping tent for staff, and a big supply tent. A pediatric patient is pictured above left.

Overall, the camp was well equipped with supplies and equipment. We had several X-ray machines, central sterile, pharmacy, outpatient wound clinic, a functioning operating room, showers and porta-potties. The main problem we found was lack of organization, which was mainly due to the lack of staff.

While in Haiti, I worked most of the time in the operating room, scrubbing into cases and running the operating room board. I was fortunate enough to work with some of the best people I have ever met. We had a staff of about 75 people from all areas of the country; and it was the way health care should be, with no divisions and everyone working together to do what was right for the patient. It was health care in its truest form. We were able to complete many surgeries, including amputations, fracture care, skin grafting, debridement of wounds, external fixation and emergent injuries.

One of the best experiences of my trip came when they brought a young man into our ICU/OR. He had survived for three weeks under the rubble. He was walking to the market when the quake hit and was able to live by eating the groceries that he was carrying. The last several days he was under the rubble, barely alive, he said a “woman in a white gown brought him water and food” until they were able to dig him out. Despite his mental anguish, he was so appreciative and offered to pray for us. He truly is a remarkable man. I was also able to make a cot every night for his mother and told her she would never have to wake up without her son again.

I am truly blessed to have had the opportunity to help the Haitian community. I plan to go back during the summer, with several of the same staff. It is difficult to comprehend how truly fortunate we are until we visit Third World countries. On the left is a picture of people waiting in a long line to get rice following the earthquake.

We are lucky to born into one of the greatest countries in the world. We should be grateful and give to those who are less fortunate. Now is the time to get involved.

Know Your Risk Factors for Diabetes

Would you like to delay or prevent diabetes if you could? Would you like to prevent possible severe diabetes-related complications, including loss of sight or limbs?

Millions of Americans are at risk for developing type 2 diabetes, according to the American Diabetes Association (ADA). It's up to you to take action.

The ADA has designated tomorrow as “American Diabetes Association Alert Day.” That should be the day people stop putting off knowing their risk for type 2 diabetes and take the ADA’s easy online assessment.

Type 2 diabetes also is known as “adult onset diabetes” to distinguish it from type 1, or "juvenile" diabetes. However, the obesity rates for children have skyrocketed and type 2 diabetes is now being diagnosed in people at younger ages.

Sometimes you might hear people refer to diabetes as “sugar.” Type 2 diabetes is characterized by the body not being able to produce enough insulin or cells ignoring insulin. When we eat, our bodies extract glucose (sugar) and other nutrients needed for fuel. After a meal, the glucose level rises and causes the pancreas to make insulin. Without enough insulin, glucose can not get into the cells but remains in the blood. Too much glucose in the blood is what can cause diabetic-related health problems, including problems in the eyes, feet, skin and organs.

If you have already been diagnosed with diabetes, Sinai Hospital offers the Diabetes Resource Center.

"In our program, people learn how they can better handle their treatment regimen," says Sally Pinkstaff, M.D., Ph.D., director of the Diabetes Resource Center at Sinai. "Having the knowledge and skills to understand and take action against this disease are essential components to successfully living with diabetes."

Education is crucial when coping with diabetes. The specialized staff at the Diabetes Resource Center at Sinai spends quality one-on-one time with each participant, discussing his or her condition and creating an individualized action plan. There are also group sessions for ongoing instruction and support.

The center's services also include real-time glucose monitoring, medication and/or insulin training, nutritional counseling, and a focus on prevention of complications. The staff includes physicians, diabetes nurse educators, pharmacists and registered dietitians.

The ADA has awarded the Diabetes Self-Management Program at Sinai its Education Recognition Certificate for quality diabetes self-management education.

To make an appointment with a diabetes specialist, call 410-601-WELL (9355).

Celebrate National Social Work Month

In honor of Professional Social Work Month, we sat down with Jennifer Gandel Kachura Neonatal Intensive Care Unit social worker Erin Gillard, LCSW-C. Erin is one of the many dedicated social workers in the LifeBridge Health system, and spends her days helping families with pre-term infants.

Q: Why did you choose a career in social work?

I've always had an interest in helping people and being an advocate. Social work was a natural fit. You are empowering people to find their own inner resources.

Q: What's an average day for you like in the NICU?

I meet with the families of babies who are newly admitted. I talk to them about their support system, and can connect them to the proper people or groups. There can be a range of psychosocial issues for families, ranging from helping teen parents to someone with a mental health or substance abuse problem. I run a support group twice a month for families of babies in the NICU. I spend the afternoons connecting with family members that I may miss during the day. During the week I spend 30 hours in the NICU and 10 hours on obstetric coverage. I spend as much time with a family as necessary.

Q: How long do you work with families?

I have babies who are here for 24 hours and babies who are here for months. But even when the infants go home, we keep in touch with the families. That's one of the reasons for our NICU reunion next month - it gives people a chance to get together and reflect on what was a critical time in their lives.

Q: What's the biggest challenge of being a social worker?

It can be frustrating to help families navigate the red tape around issues like insurance.

Q: What's the best part?

It's a privilege that people allow you into their lives at such a difficult time. And every day is different. It's a good feeling when you can support someone. Having a baby is such a special time and people really rally. You often see people at their best.

To see job opportunities at LifeBridge Health, click here.

Health Care Hero Finalist: Harpal Khanuja, M.D.

The Maryland Daily Record's Health Care Heroes awards ceremony honors special caregivers who exemplify extraordinary commitment to their profession. The breakfast to honor the 2010 finalists is on Wednesday, March 24, but before the big day we wanted to use this space to profile the nominees.

Arthritis and other bone and joint conditions can often be debilitating, even with proper medical attention. Now imagine if you had no access to proper medical or surgical care. These conditions can quickly develop into a situation where common tasks become impossible.

Harpal Khanuja, M.D., orthopedic surgeon at the Rubin Institute for Advanced Orthopedics at Sinai Hospital, gives patients in the developing world hope. Since 2006, Dr. Khanuja and his Operation Walk Maryland teams have been traveling to developing countries to provide free surgical and orthopedic care.

A national organization, Operation Walk was founded in 1994 by Lawrence D. Dorr, M.D. Operation Walk surgeons, nurses and health professionals have operated on more than 3,000 patients in Russia, Cuba, Nepal, China, the Philippines, Nicaragua, Mexico, El Salvador and the United States.

Operation Walk Maryland was founded by Dr. Khanuja and his wife Maria to improve the quality of life for disadvantaged patients across the globe who suffer from joint disease. Operation Walk Maryland provides free joint replacement surgery and care to impoverished individuals in need; all the care is free to the country and the individual.

Operation Walk Maryland raises over $100,000 a year. It has arranged donations and provided free care and supplies. In addition, Operation Walk Maryland educates local orthopedic surgeons and their health care teams about the current treatment and technologies available to treat individuals with debilitating joint disease.

Dr. Khanuja views Operation Walk as the most rewarding aspect of his career. He points out that not only is the team composed of the best trained providers in the United States, but the team members are also true ambassadors from Maryland to many parts of the world.

Dr. Khanuja's daily work as a surgeon at the Center for Joint Preservation and Replacement at Sinai Hospital is also a source of great pride. The center is composed of health care professionals with specialized training and expertise in all aspects of orthopedics and joint reconstruction surgery. Dr. Khanuja is a part of an interdisciplinary treatment team that includes orthopedic surgeons, physiatrists, anesthesiologists and pain management specialists, physician assistants, nurses, nurse practitioners, physical and occupational therapists, social workers, case managers, surgical and orthopedic technologists, radiology technologists, administrators, secretaries, referral and financial coordinators, and other support staff.

Dr. Khanuja also is a researcher, developing and improving methods of joint preservation and replacement. Through the Center for Joint Preservation and Replacement and the internationally attended Hip Joint course, Dr. Khanuja provides education to orthopedic surgeons and health care professionals to observe and study hip resurfacing and reconstruction methods.

Health Care Hero Finalist: Ruth Leibowitz

The Maryland Daily Record's Health Care Heroes awards ceremony honors special caregivers who exemplify extraordinary commitment to their profession. The breakfast to honor the 2010 finalists is on Wednesday, March 24, but before the big day we wanted to use this space to profile the nominees.

Eighty-year-old Ruth Leibowitz has been volunteering at Levindale Hebrew Geriatric Center and Hospital since 2006. During that time, she has completed over 3,100 hours of service. In addition to her work at Levindale, Ruth is also a volunteer for both the Greater Chesapeake & Potomac Blood Region of the American Red Cross and the state chapter of the Red Cross.

At Levindale, Ruth provides all the administrative support for the volunteer department, often running the department when the coordinator is away. She tracks all the hours for approximately 150 volunteers.

Although the administrative work is very detailed and time consuming, the majority of Ruth’s time is spent organizing the volunteers who knit and crochet lap robes and blankets for the residents, as well as those who sew walker bags for our residents/patients and clients. She also knits and crochets herself.

Ruth started a one-woman campaign to have all the yarn and material donated so the volunteers could be given all the necessary supplies to make the much-needed items for the residents. She has written letters to area businesses so that there is a constant supply of material and yarn, which is donated. She will drive to the upholsterers to pick up large donated bolts of material.

Now every patient, resident, or client who needs a blanket or walker bag can have one. The volunteer department distributes between 10-20 blankets per month. In 2006 the knitters completed 392 hours, and in 2009 they completed an amazing 5,134 hours.

When it was brought to her attention that the women did not have proper head coverings to wear in the synagogue at Levindale, Ruth purchased the material and spent hours making head coverings so that all the women could have them for the high holidays.

These items that Ruth makes sure are always available really do make a difference to our residents, patients and clients. It’s the personal touch that makes Levindale seem a little more like home. It’s these unique gifts that brighten the day for the people when they receive them.

When Ruth isn’t busy getting materials making blankets or keeping the volunteer office running smoothly, she still finds time to visit with residents or help out with special functions when needed.

Health Care Hero Finalist: Linda Covert, R.N.

The Maryland Daily Record's Health Care Heroes awards ceremony honors special caregivers who exemplify extraordinary commitment to their profession. The breakfast to honor the 2010 finalists is on Wednesday, March 24, but before the big day we wanted to use this space to profile the nominees.

Linda Covert is a nursing clinical leader in the orthopedic and trauma unit at Sinai Hospital. She has been a Sinai nurse for 21 years.

Linda exemplifies the characteristics of a health care hero based on her knowledge in the field of nursing, advocacy for patients, and the community and leadership within the hospital.

As the only certified orthopedic nurse at Sinai Hospital, Linda is always willing to lend a helping hand to all staff members, regardless of the task. She is a mentor to the staff and a shining example of how to provide the best care to our patients.

“Linda is “my go to nurse” on the unit,” said Sue Pugh, R.N., Advanced Practice Nurse for the orthopedic, neuroscience and rehabilitation units. “Whenever I need to know what’s going on, and happening at the bedside of our critically ill patients, I ask Linda. She has excellent assessment skills and quickly identifies when a patient’s condition is deteriorating and needs immediate assistance.”

For the past two years, Linda has organized and ran the Orthopedic Nurse’s Day at Sinai, which includes hands-on education and “show and tell” events about orthopedics and orthopedic health care concerns. Linda also participates in the annual community education event related to orthopedic concerns at Pimlico Elementary/Middle School.

Linda is an exceptionally strong nurse leader and is well respected by her orthopedic surgeon colleagues. In addition to all of her leadership and patient care roles at Sinai, in 2008 Linda was the president of the Baltimore chapter of the National Association of Orthopedic Nurses.

“As a clinical leader, Linda never hesitates to get involved in situations that arise with patients and is able to quickly fix a problem when she see’s it,” said Sue. “She’s not afraid to speak up and advocate for the staff or patient when she knows it is in the best interest of either or both. Sue is an invaluable leader in our Sinai nurse community.”

Health Care Hero Finalist: Levindale Hebrew Geriatric Center and Hospital

The Maryland Daily Record's Health Care Heroes awards ceremony honors special caregivers who exemplify extraordinary commitment to their profession. The breakfast to honor the 2010 finalists is on Wednesday, March 24, but before the big day we wanted to use this space to profile the nominees.

Advancement in Health Care: Levindale Hebrew Geriatric Center and Hospital

A true neighborhood is more than people just living in the same area. It is also a feeling of closeness that those people share.

In 2005, Levindale Hebrew Geriatric Center and Hospital became the first long-term care center in Maryland to begin implementing the Neighborhood Model. We are constantly striving to improve the concepts created by William Thomas, M.D. The national concept of the Neighborhood Model turns the traditional structure of a nursing home upside down to become more resident-centered. This means that residents are given the ability to make more choices about their daily lives. Levindale employees are also empowered to hear those choices and to act on them.

Culture Change
In the business world, it is always a challenge to retrain people. However, it’s nothing new for Levindale to be a pioneer for the elders that it serves. Levindale’s culture change journey began when it became the first Eden Alternative center in Maryland in 2000. The Eden philosophy recognizes how important quality of life is for all residents.

So it only seemed natural that Levindale would embark on the inventive Neighborhood Model, the next step of culture change. This includes:

• Giving residents more control over their lives, by having staff schedules work around what residents want.
• Improving the one-on-one relationships between staff members and residents.
• Improving the staff’s commitment to patient care and the work environment.
• Showing employees that they are appreciated.
• Increasing family involvement and satisfaction.

Structural Changes
The Neighborhood Model not only requires cultural change but organizational restructuring. Levindale has gone from using a medical model to using a quality-of-life health model. It has also redesigned the way that it operates, switching from a traditional top-down management organization to self-governing teams.

Neighborhoods
Each unit is now a neighborhood. Neighborhoods are made up of the residents who live there and the employees who work there, from nurses to housekeepers to social workers to dietary employees. Neighborhoods incorporate families and visitors. Each neighborhood has a leader, who can be from any department.

Commitment
Levindale has made the commitment to spend the time and resources to train every employee in the Neighborhood Model philosophy. No matter what department, each employee is part of a neighborhood and taught the principles of homelessness, sensitivity, enhanced dining, plus encouraged to know residents for who they are.

Levindale continuously works to empower the staff and to build neighborhood teams to self schedule, problem solve and plan social events with more resident involvement.

Finally, Levindale is breaking ground this year to build new buildings and renovate existing ones to construct private rooms and kitchens on each floor.

We believe the Neighborhood Model is the future of nursing home care. The top priorities are to make sure the residents enjoy life and that employees think it is the best place to work. These are lofty goals, but ones that can be achieved.

Daylight Savings Time Starts Tomorrow

If you find yourself tired at work next Monday morning, it could be because this weekend will be the shortest one of the year. (Don’t forget to “spring” your clocks forward before bed tonight, as Daylight Savings Time begins at 2 a.m. Sunday.) Or, it could be because you suffer from one or more of 85 known sleep disorders.

This past week (March 7 – 13) was National Sleep Awareness Week. Doctors estimate that 60 million Americans suffer from one or more sleep disorders, and yet it is believed that 95 percent of sleep disorder cases remain undiagnosed.

This is unfortunate. Lack of quality sleep is often responsible for car crashes and mistakes and accidents in the workplace.

Plus some sleep disorders, like obstructive sleep apnea (OSA), exact a heavy toll on one’s health. OSA has been linked to high blood pressure, heart attack and stroke. OSA, in which the upper airway repeatedly becomes blocked during sleep, is a condition that affects 24 percent of men and 8 percent of women. Symptoms include loud, irregular snoring; restless sleep with frequent (and possibly unnoticed) awakening; and waking up with a headache, dry mouth and/or sore throat.

Other common sleep disorder symptoms include daytime sleepiness; frequent nighttime urination; irritability or moodiness; memory loss; and poor concentration.

If you haven’t been getting a good night’s sleep lately, you owe it to yourself – and to your long-term health – to talk with your doctor about having a sleep study and seeing a sleep specialist.

Sleep studies are covered by most insurance plans. If you have a referral from your physician for a sleep study and consultation, appointments for a sleep study are available seven days a week at the sleep centers at Northwest and Sinai Hospitals. To schedule a sleep study, call 410-601-9355.

Daylight Savings Fun Facts

Did you know that Benjamin Franklin was the first one to record the idea of daylight savings? He thought it could be an economical way to save energy if church bells would ring earlier than usual in the summer to wake up people shortly after sunrise. With the early waking time, people would be persuaded to go to bed sooner, thus saving on candles and oil for lamps to light time spent awake in the dark.

In the U.S., Daylight Savings Time (DST) began in 1918. At that time, each local jurisdiction passed its own rules about whether or not to go on DST and on what day, which occasionally led to confusion about what time it was and where. (Imagine what air travel must have been like in those days!) Not until 1966 did the United States pass the Uniform Time Act, which standardized the dates that states must observe DST. However, states are still free to not use DST, and Arizona and Hawaii are currently the only ones that skip the biannual ritual of changing clocks.

What do you think about DST? Does it affect your sleep?

If you have repeated sleep problems and want to schedule an appointment at a sleep center, call 410-601-WELL.

Grey Matter

by Robin Wilson, M.D., Ph.D.
Sandra and Malcolm Berman Brain & Spine Institute

Last night, we once again got to see Grey's Anatomy's Dr. Izzie Stevens at Seattle Grace Hospital (Season 6, episode 9, “New History”), pushing the wheelchair of her high school teacher, Dr. Singer (played by Joel Grey). Izzie returned not to reclaim her career, but to demand a medical workup to determine why her mentor went from teaching school to living in a nursing home in less than one year. After a lumbar puncture, Dr. Singer leapt from the exam table, his confusion cleared and his ability to walk restored. Izzie realized that Dr. Singer had a treatable disease - normal pressure hydrocephalus (NPH) - and set out to talk her friends into providing free shunt surgery for him.

Every week at the Adult Hydrocephalus Center of the Sandra and Malcolm Berman Brain & Spine Institute, we evaluate patients for possible NPH. Like Dr. Singer, most of our patients are older than 60 and have experienced a gradual decline in balance and ability to walk; some are wheelchair bound. Many also have mild dementia and loss of bladder control. We diagnose NPH by reviewing the patient’s medical history, signs and symptoms, physical exam, brain MRI, and response to removal of cerebrospinal fluid by lumbar puncture or extended drainage (while in the hospital). Because the symptoms associated with NPH have many other causes, we evaluate patients thoroughly to confirm that surgery is likely to help before we recommend it.

Though sometimes remarkable improvement is achieved with shunt surgery, the magnificent and instantaneous response demonstrated by Dr. Singer is not what we expect to see. Typically after shunt surgery, our patients experience gradual improvement over 6–9 months. As the shunt only treats hydrocephalus, if a patient has other disorders contributing to dementia, mobility impairment, or loss of bladder control, unfortunately, he or she will have only partial improvement with the shunt. We tell our patients, “We can make you better, but we can’t make you any younger.”

Izzie had the right idea, though - no Grey area about it. A patient who has a progressive course of gait or cognitive impairment deserves a complete medical workup to screen for a treatable disorder such as NPH.

To learn more about normal pressure hydrocephalus, visit the Adult Hydrocephalus Center or call 410-601-WELL.

The Evolution of Liver Transplantation

End-stage liver disease is best treated by a liver transplant, a renowned gastroenterologist said at yesterday's Sinai Hospital Department of Medicine Grand Rounds.

Paul Y. Kwo, M.D., is an associate professor of medicine and the medical director of liver transplantation in the Division of Gastroenterology and Hepatology at Indiana University. His talk at Sinai was made possible by the Ellen Wasserman Lectureship.

The good news, according to Dr. Kwo, is that the increased use of the Model for End-Stage Liver Disease (MELD) gives more weight to disease severity than the patient's time on the wait list. At Indiana University, the median wait time for a liver transplant is 1.6 months versus 11.3 months nationwide, and the adult survival rate for the organ recipients is at 90.04 percent. Physicians are "inching our way" toward transplants for HIV-positive patients, and there's increasing evidence that age doesn't impact the success of a liver transplant.

Plus, transplantation in patients with severe obesity is "feasible," Dr. Kwo said. "The one-year survival rate is no different," he said.

Now for the bad news.

The demand for livers, along with other critical organs, continue to exceed what's available. Liver cancer (hepatocellular carcinoma) is the most rapidly increasing cancer in the United States. Hepatitis C is the most common indicator for liver disease; between 3 to 4 million people are infected in the United States; and half a million people have Hepatitis C-related cirrhosis. Cirrhosis is the slow degeneration of the liver, and while it's most commonly associated with alcohol, it can also result from hepatitis B, C or D or other diseases. Finally, while the death rate from liver disease has fallen overall, it is still highest in the African-American population.

What does this mean for you? Protect your liver by avoiding excessive alcohol consumption and eschewing drugs. Maintain a healthy diet and weight, and stop smoking.

Finally, remember that National Donate Life Month is around the corner. Talk to your family members about becoming an organ donor and sign up with your state registry.

on holism

"If holistic-health advocates were content with encouraging sensible preventive medicine or with criticizing the economic organization of American medicine, we might be enthusiastic, but they are not. If the movement were without influence on American life, we would be indifferent, but it is not. Holistic medicine is a pablum of common sense and nonsense offered by cranks and quacks and failed pedants who share an attachment to magic and an animosity toward reason.

Too many people seem willing to swallow the rhetoric—even too many medical doctors—and the results will not be benign. At times, physicians may find themselves in sympathy with the holistic movement, because some fragment of the rhetoric rings true, because of certain practices and attitudes they encounter in their daily work with colleagues and patients, or because of dissatisfaction with the economic and social organization of medicine. One hopes they will speak bluntly, but it does no good to join forces with cranks and quacks, magicians and madmen."

-C. Glymour and D. Stalker from "Engineers, cranks, physicians, magicians"; N Engl J Med. 1983 Apr 21;308(16):960-4

Updated - 10:50pm: While I like letting quotes like this one stand on their own merit, I'll provide a bit of insight as to what got this on my mind. The word "holistic" is often used to describe philosophies or treatments that are being marketed as being somehow outside of, or different than, medicine - the implication is that they somehow address the "whole patient" while medical practice does not... which is patently untrue. Terms like holistic and "natural" don't mean anything beyond marketing, and the above quote from a seminal journal article from almost 30 years ago still holds true about that today.

Sinai Forms Health Equity Panel

Sinai Hospital has formed a Health Equity Community Advisory Panel to look at inequalities in health care and how they are affecting the health outcomes of the residents in the communities that Sinai serves.

"Sinai was founded over 143 years ago because of health inequalities that the Jewish community faced," said Neil Meltzer, president and COO of Sinai Hospital. "We have a history of responding to inequities in our society. It's important that we understand the different groups in our community and respond to their health care needs in a way that is most comfortable for them while still ensuring the best outcomes."

The panel is made of a diverse group of people from health care and non-health care backgrounds, including local political and community leaders, state health officials, and residents who are of Caribbean, Orthodox Jewish, Russian, Hispanic and African American descent. Two researchers, one from the University of Maryland and one from Morgan State University, also are part of the group.

"We want to partner with a broad-based group of people who can help us understand the changing demographics of our patient population and how it affects their health," said Pamela Young, Ph.D., director of Community Initiatives at Sinai and co-chair of the hospital's Health Equity Task Force. "We eventually hope to tap into this group's expertise to develop strategies and implement efforts to make a meaningful impact on the health of our communities."

Sinai's initiative began three years ago when state Delegate Shirley Nathan-Pulliam selected Sinai for a pilot project to look at whether training hospital staff to be culturally sensitive to patients could improve health outcomes. That initial project evolved into Sinai's decision to develop a Health Equity Task Force inside the hospital. This group is helping raise awareness of health inequities and educate staff with the goal of improving patient-provider communication to achieve better health outcomes. The development of the Community Advisory Panel is the next step in Sinai's health equity project.

The health equity project is being conducted with the guidance of the Adventist HealthCare Center on Health Disparities in Montgomery County, whose expertise will be used to design and implement strategies developed by the Health Equity Task Force and the Health Equity Community Advisory Panel.

Celebrate Registered Dietitican Day

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

Today health care and community organizations across the United States are celebrating the annual Registered Dietitian Day.

Registered Dietitian Day was created by the American Dietetic Association to increase the awareness of registered dietitians (RDs) as the critical providers of food and nutrition services. Today is the great day to reflect on how RDs, including those at LifeBridge Health, help people enjoy healthy lives.

Registered Dietitian Day and National Nutrition Month promote the ADA and registered dietitians. RDs educate the public and media as they provide valuable and credible information on food and nutrition.

Registered dietitians:

• are food and nutrition experts who provide a scientific basis for a health lifestyle.
  
• have degrees in nutrition, dietetics, public health or a related field from accredited colleges and universities. They have completed an internship and passed an examination.
• work in hospitals, schools, public health clinics, nursing homes, fitness centers, food management, food industry, universities, research, and private practice.
• use their nutrition expertise to help individuals make positive lifestyle changes and are advocates for advancing nutrition knowledge.
  

Don’t forget to wish the registered dietitians in your facility a Happy RD Day!

Guidelines for Prostate Cancer Screening Revised

by Sandra Crockett

When it comes to cancer screening, the process of early detection and treatment seem straightforward. But slightly revised guidelines from the American Cancer Society encourage physicians and patients to have a conversation about prostate cancer. The goal is to help men in their decision-making process regarding screening.

“We are now at the beginning of a very large conversation with the public over treatment of prostate cancer,” says S. Mark Redwood, M.D., Chief of Department of Urology at Sinai Hospital.

The guidelines focus on men with no symptoms of prostate cancer who can expect to live at least 10 more years. These men are encouraged to discuss the uncertainties, risks, and potential benefits associated with prostate cancer screening with their physician, with the talks starting at age 50. Men with no symptoms who are not expected to live more than 10 years (due to their age or health conditions) should not be offered prostate cancer screening.

The risks or side effects of treatment may outweigh the benefits of treatment, the ACS says.

“What is new is the direct statement that if a patient has many (serious) conditions such as diabetes, heart disease, or other illnesses that would shorten his life, less aggressive approaches should be taken with respect to screening for prostate cancer,” Dr. Redwood says.

However, this opens another dilemma. “The problem arises in the judgment of what constitutes a serious co-morbid condition and what is less life threatening,” he says.

What also hasn’t changed is the ACS recommendation that African-American men, and men who have a father, brother, or son diagnosed with prostate cancer before age 65 begin discussing screening options at age 45. Men with multiple family members affected by the disease before age 65 can start at age 40.

Prostate cancers are now being classified into low, intermediate and high risk, Dr. Redwood says. If the man is still undecided after talking with their doctor, ACS recommends the doctor make the call based on his or her knowledge of the patient's health preferences and values.

“We are fortunate to have multiple modalities for prostate cancer treatment, including Cyberknife, prostatic brachytherapy, da Vinci Robotic Prostatectomy and cryoablation of the prostate at the the Alvin & Lois Lapidus Cancer Institute at LifeBridge Health,” Dr. Redwood says.

It would benefit the patient and his family to have these conversations with a LifeBridge physician who is comfortable with presenting all aspects of management.

“We provide comprehensive care of prostate cancer,” Dr. Redwood says.

For patient education and availability of comprehensive services for prostate cancer management, LifeBridge Health invites patients and their families to participate in this new dialogue now encouraged by the ACS guidelines.

To make an appointment with a urologist, please call 410-601-WELL (9355).

VSP Helps Employees Learn New Computer Skills

by Holly Hosler

What if you could perform your job better all because you spent a scant six hours in front of a computer? Hundreds of LifeBridge Health employees have done just that by taking a computer course at VSP. VSP provides training, job assessment and business services to the Baltimore community.

“Our most popular class is Excel for Beginners,” says Tracy Piazza, a VSP technical skills trainer who teaches the computer courses. “It’s a very functional course as Excel does everything – it calculates budgets and inventories; it tracks data much like a database would; it allows users to create charts and tables; and it can be used to execute mathematical formulas that give managers good information.”

Morgan Green, patient care associate in the Intermediate Care Unit at Sinai Hospital, took classes in both Word and Excel. She had some experience with Word in high school, but the VSP classes reacquainted her with the program, which she was using extensively for her job in dietary. Now that she’s a nursing student, Morgan finds the skills she gained invaluable to her school work and even uses Excel to make charts for her assignments.

“The teacher made the classes fun,” Morgan says. “Tracy was very helpful and even gave us her e-mail and phone number so that we could ask her questions outside of class.” Upon completion of a workshop, each student receives a user-friendly manual for the software and a quick reference card.

Jonathan Karanja, clinical systems coordinator at Levindale, also took the Word and Excel classes at VSP. Jonathan’s newfound knowledge of Excel allows him to use pivot tables for audits, which are a large part of his job. The computer classes have also made him the computer “go-to guy” at Levindale and Courtland Gardens.

“I love the fact that I can help others with what I know,” he says.

VSP offers Word and Excel courses (at beginner, advanced and expert levels) and PowerPoint (beginner and advanced), so no matter your existing knowledge of these computer programs, chances are there’s a class for you. For those who consider themselves computer-illiterate, there’s a Computer Fundamentals class, which teaches students the Windows operating system and how to use a mouse through a series of “mousercises.” And if figuring out the LifeBridge Health e-mail system is a puzzle for you, there’s a class on using GroupWise. Each two-session course meets for three hours during a workday morning or afternoon; and if the course relates to your job, many departments will even cover the $72 class fee.

Linda Bailey, recreation therapist at Levindale, was motivated to take the two PowerPoint courses so she could prepare a formal presentation, but she now applies her expertise to better serve the residents.

“Learning how to use PowerPoint has opened up a whole new world of activities for my residents and me,” says Linda. “Some of my residents have problems with the spoken word and require visuals to know what we are talking about. … With PowerPoint, the entire group can view the pictures at one time.” She also uses the software to play Jeopardy! games with the residents, which helps keep their minds active and memories sharp.

“I cannot say enough about how happy I am that through my employer I was able to update my skills in such a practical way,” concludes Linda. “My new skills benefit the people I work with.”

To learn more about VSP, call 410-358-8200.

Celebrate National Nutrition Month

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

What is National Nutrition Month? How did it start? Is there a different theme every year? These questions may be floating around in your mind if you have wandered into your facility’s cafeteria and saw a banner hanging or dietitians at a booth advertising good health.

National Nutrition Month is a nutrition education and information campaign created by the American Dietetic Association. The campaign, held each year in March, focuses attention on making informed food choices and developing better eating and physical activity habits.

Initiated in March 1973 as a long-week event, “National Nutrition Week” became a month-long observance in 1980 in response to growing public interest in nutrition. The American Dietetic Association (ADA) sponsors National Nutrition Month as part of its mission to promote optimal nutrition and well being for all people by advocating for its members.

Each year National Nutrition Month has a different theme with key messages. The theme for March 2010 is “Nutrition from the Ground Up." These messages include making it clear that eating right doesn't have to be complicated. A healthy eating plan emphasizes fruit, vegetables, whole grains, low-fat or fat-free dairy and includes lean meats, poultry, fish, beans, and nuts and is low in saturated fats, trans fats, cholesterol, salt and added sugars.

Nutritional health includes being aware of portion sizes. Even low-calorie foods can add up when portions are larger than you need.

You should make the most of family meal times. Eating meals together provides the opportunity to help children develop a healthy attitude toward food and enables parents to serve as role models, introduce new foods, and establish a regular meal schedule.

Finally, balancing physical activity with healthy diet is best for managing weight and promoting overall health and fitness.

Women's Heart Group Offered at Northwest

Do you or someone you know have heart disease?

A partnership through Northwest Hospital and the National Coalition for Women with Heart Disease is now providing support for women living with heart disease. Heart disease can include coronary heart disease, congestive heart failure, and congenital heart disease. Each year, roughly 1.2 million Americans have a coronary attack, and about 452,000 will die.

Heart disease is the No.1 killer of women. The mission of WomenHeart is to improve the health and quality of women with heart disease and to be advocates.

A Baltimore County chapter of WomenHeart was recently formed. The first meeting will be Tuesday, March 9 at 11 a.m. in the Reisters Room on the Ground Floor of Northwest Hospital. Women who have heart disease or at risk for heart disease (for example, hypertension) are invited to attend. A heart-healthy brown bag lunch is encouraged.

For more information, call Cardiac Rehab's Lisa Gerberg at 410-701-4333.

Blog Subscription Winners

Congratulations to Shanika Jones, practice manager in the Sinai Division of Gastroenterology, and Barbara Church, director of long-term care at Levindale. Shanika was our 100th subscriber to the LifeBridge Health blog, and Barbara was chosen at random as one of our other faithful subscribers. Thank you to everyone who has subscribed!

The Question of Organic Food

By Sandra Crockett

So you want to eat healthy but are confused about all the different guidelines. It’s pretty clear to most people that trans fat is something to limit in your diet or stay away from altogether. The same is true of high fructose corn syrup (HFCS), although hard to do since it is in so much processed food products.

Perhaps going organic is the safer way to go. But what exactly makes any produce “organic?” And what if you have the choice of going to a grocery store and buying something labeled “organic” or going to a local farmers market and purchasing fresh produce without the “organic” label? It's clear that the road to good health, healthy eating, and being kind to the environment is not always easy.

A food label “organic” means the producer has been certified organic, says Laure L. Sullivan, resident district manager, Food and Nutrition Services for LifeBridge Health. The producer has to meet certain standards to gain certification, and it is not the same for all countries.
In the United States, a food labeled “organic” usually means only organic ingredients were used. Legally, if a food is 95 percent organic, it can be labeled organic.

That said, buying from a local farmer’s market whenever possible would be your best bet, Sullivan explains.

“Buy local at your local farmer’s market and support the farmers,” Sullivan says. Farmers at local markets can have organic produce without having the organic label. “Farmers’ produce can be chemical free but not all farmers can afford to get the certification,” she says.

“You can get organic strawberries from China. But then you have the whole carbon footprint question.”

LifeBridge Health buys as much seasonal produce from local farmers as possible, Sullivan says.

Like we said, living healthy and being environmentally aware is not always easy. However, if you love yourself and your planet, it is worth it.

If you want to learn more about how sustainable food practices, several hospitals in Maryland and D.C. are being recognized tomorrow night for improving nutrition, maximizing carbon footprint and purchasing sustainable-produced meat through the Balanced Menu Challenge.

The “Balance Meets Taste” event kicks off National Nutrition Month for March 2010. It is being organized by Maryland Hospitals for a Healthy Environment.

If You Go
What: Balance Meets Taste
When: Thursday, March 4
Where: Pier 5 Hotel, Baltimore Inner Harbor, 711 Eastern Avenue, Baltimore, MD
Time: 6:30 - 10 p.m.
Cost: $100 (hors d’oeuvres and cocktail hour, four-course meal including wine. Proceeds donated to Future Harvest – Chesapeake Alliance for Sustainable Agriculture.
For More Information: 410.706.1924 or click here. You can also e-mail Lmitc001 (at) son.umaryland.edu

LifeBridge Health Wins Social Responsibility Award

LifeBridge Health has won the 2010 Communitas Award for Green Initiatives, under the category of Excellence in Corporate Social Responsibility.

Communitas winners are recognized for specific programs involving volunteerism, philanthropy or ethical, sustainable business practices; and nominees are evaluated based on the extent and effectiveness of their programs. The size and potential scope of the nominee is also taken into consideration.

The green initiatives at LifeBridge Health include waste reduction, composting, non-toxic chemicals, green construction, and the reduction of energy use. By switching to compact fluorescent lighting in operating rooms, cafeterias, and parking garages, LifeBridge Health saved nearly $400,000 in fiscal year 2009. LifeBridge Health is the only Maryland-based health care system on the list of 2010 winners.

The Communitas awards are an outgrowth of the pro bono recognition program of the Association of Marketing and Communication Professionals, a group that honors creative achievement and fosters partnerships with charities and community organizations.

Colon Cancer Screenings Save Lives

by Sandra Crockett

Talking about colorectal cancer may make you wince. But discussing it with your physician is a key to good health. In fact, it may save your life.

March is National Colorectal Cancer Awareness Month, and a good opportunity to discuss colon cancer screenings, which are relatively painless. For African Americans, the recommended age for screening is now 45.

“For uncertain reasons, African-Americans often have more advanced cancers at the time of diagnosis, hence the modified guidelines,” says John C. Rabine, M.D. The recommended age to begin screenings for other ethnic groups remains 50.

Rabine, a gastroenterologist at Sinai Hospital, points out that colon cancer is the third most common cancer in this country.

“And – depending on which study is cited - a colonoscopy reduces that risk by 65-90 percent," he says.

Colonoscopies are powerful tools that only needs to be done every 8-10 years in patients who are considered "average-risk" for colon cancer. Cancer of the colon or rectum causes an estimated 55,000 deaths each year, according to the American Journal of Gastroenterology. More than 138,000 new cases of colorectal cancer are diagnosed annually, and men and women are equally susceptible to the disease.

Sudhir K. Dutta, M.D., head of Sinai’s Division of Gastroenterology, and Rabine’s preferred method of screening for cancer is the colonoscopy. A colonoscopy allows a doctor to look inside the entire large intestine. The procedure, which enables the physician to see things such as inflamed tissue, abnormal growths (polyps) and ulcers, is most often used to look for early signs of cancer in the colon and rectum.

“It is somewhat of a misnomer to call it a screening test, as it is really intended to remove polyps and be a preventative test,” Rabine says.

All colon cancers arise from polyps, which are benign growths that can occur in several locations in the gastrointestinal tract. They vary in size and look like small bumps growing from the lining of the bowel. If identified at a very early stage, they can be removed before they become cancerous, usually while the doctor is examining the large intestine during a colonoscopy.

“Polyps are very common in adults,” says Dutta, who explains that there is an increased chance of developing them as you age. He adds that with appropriate screening like the colonoscopy, “we should be seeing fewer cases of colon cancer.”

The Endoscopy Center at Sinai Hospital is the principal site of GI diagnostic work, providing endoscopic procedures of the gastrointestinal tract including the esophagus, stomach, duodenum and colon. Using state-of-the-art equipment, medical specialists can provide a quick and accurate diagnosis of a GI problem.

To schedule an appointment or learn more, call 410-601-WELL (9355).