The Vitamin D Advantage

Wherever one looks these days, vitamin D is labeled as practically the Holy Grail of good health. But the natural source of vitamin D is from the sun, which causes a dilemma for us all. Too much sun can mean courting skin cancer, but not enough may cause a vitamin D deficiency.

Vitamin D deficiency is widespread in dark-skinned African Americans and anyone with similar skin tones. The reason is that melanin limits the amount of sunlight exposure penetrating the skin.

And not having enough vitamin D could raise your risk of developing several conditions including cardiovascular disease or osteoporosis, says Asha Thomas, M.D, the director of the Sinai Hospital Division of Endocrinology.

Think swallowing a daily multi-vitamin means you are covered? Think again.

“Multi-vitamins typically have 400 units of vitamin D,” Dr. Thomas says. “That might be appropriate if you already have normal levels of vitamin D. But we are finding most people are deficient. So many people are way too low.”

Only relatively recently did people even know what their vitamin D level was. “Physicians just recently started checking people’s,” says Dr. Thomas.

According to the National Center for Health Statistics, 36 percent of Americans are vitamin D deficient. Researchers believe that number could be double for African Americans. In fact, vitamin D deficiency has been called “the hidden epidemic” for darker-skinned people.

“There is a higher incidence of vitamin D deficiency in African Americans starting in puberty and older,” Dr. Thomas says. Reasons could be because it is the time young people stop playing outdoors or other lifestyle reasons, she says.

Getting your vitamin D from the sun or supplements is a personal choice and both will work. But check with your doctor to find out where you stand with vitamin D and how much sun to get or supplements to take.
-Sandra Crockett

Alternatives to Knee Surgery

No one is eager to have knee surgery. Luckily, there are options that can relieve pain.

Recently three orthopedic doctors from the Rubin Institute for Advanced Orthopedics (RIAO) gave a free lecture at LifeBridge Health & Fitness on the management of hip and knee osteoarthritis. Drs. Michael A. Mont, Ronald E. Delanois, and Harpal (Paul) S. Khanuja all informed their listeners about safe options to surgery. Thanks to the interactive nature of the lecture, the audience was able to address any concerns they had about their own hip and knee pains.

Dr. Mont began the lecture with an informal question and answer period. He started off by asking the audience “how would you treat joint pain?” The crowd reacted by shouting answers like “Aleve!” “Tylenol!”

“How many people think narcotics are appropriate for pain?” Few people raised their hands. “Many doctors are anti-narcotic” continued Dr. Mont, “but I have patients that think that narcotics are their best option. They take their prescribed dosages and it works great, but when the patient starts to increase their dosage, they may begin to get addicted.”

Tylenol and Aspirin can work just as well as any other medication, says Dr. Mont, but it is important that if you are taking those medications frequently, you get checked regularly because of the possible side effects on the kidney and liver. It is also important to note that when your pain level decreases, you should get off the meds!

Another alternative to surgery is a shot of cortisone. Dr. Mont says that he has given around 100,000 shots, and he notes few disadvantages.

He also recommends mild exercise, with concentration on exercises such as cycling, swimming, or using an elliptical machine. Patients should stay away from anything like a step machine or treadmill. He explained that “a typical step is 2-3 times body weight, and running puts 7-10 times body weight on your knees, which could create major pain for someone who has knee or hip osteoarthritis.”

Suggestions also included exercises to strengthen frontal muscles, hamstrings and side muscles . The RIAO also offers a detailed exercise sheet. Dr. Mont advises that 20 minutes of exercise every-other-day produces excellent results.

When people are in pain, surgery should not be their immediate thought. The physicians at the RIAO offer a variety of different treatments for pain including non-surgical methods. Over time, if the non-surgical methods don’t work, the physician will discuss the possibility of knee surgery.

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

Arthritis and Aging

Contrary to popular belief, there is joy that comes with aging. There’s seeing your children bloom into responsible self-sustaining adults. There’s having the time to do what you want during the day. There are decades-long friendships that bring immense satisfaction.

But does suffering from arthritis have to be part of aging? Is arthritis inevitable, as you grow older?

“There are some who think it is unavoidable,” says Susan Levy, M.D. “And certainly, we see an increase in arthritis as people age “

But there’s a catch.

“Some people may not have any symptoms of arthritis although they may still show indications of arthritis,” says Dr. Levy, who is the medical director at Levindale Hebrew Geriatric Center and Hospital and Courtland Gardens Nursing & Rehabilitation Center.

In other words, you could have arthritis but have no, or very minimal, physical ailments of the disease. And that is very good news. Staying physically active, getting a handle on stress and remaining – or getting to – a healthy weight can make all the difference.

Over the counter medication can be all that is needed for moderate arthritic symptoms, Dr. Levy says. “And some people can see a benefit from chrondroitin and glucosamine, the dietary supplements are commonly used for arthritic joint pain. “There is clinical evidence that chrondroitin and glucosamine can benefit some people,” she says.

But you may want to save your money if looking into other herbal options. “There is not really good evidence about other herbal remedies.” Dr. Levy says.

Exercising muscles around the joint to build strength and flexibility can help. And listen to your body when it comes to how much exercise is too much, she says. “Your own discomfort will tell you.”

If you are suffering with severe problems that do not go away such as swollen joints, see your doctor immediately. You don’t have to suffer in silence. To make an appointment, call 410-601-WELL (9355).

-Sandra Crockett

Northwest Hospital Surgeon Performs First Da Vinci Robot Hand Surgery

Stacey Berner, M.D., medical director of the Hand Center at Northwest Hospital, has become the first surgeon in America to perform a revolutionary new robotic hand surgery.

Berner used the da Vinci Surgical System to perform an ultra precise surgery. Instead of traditional open surgery or conventional laparoscopy surgery, the da Vinci allows the surgeon to use high magnification and movements that eliminate human hand tremors.

“The new approach of using the da Vinci Surgical System significantly increases access to hard-to-reach structures and potentially offers better results for patients," Dr. Berner says.

Berner operated with two robotic arms, one with each hand and a third using a foot pedal. The da Vinci also allows the surgeon to view the entire operation with 3-D imaging.

By using this method, the surgeon can improve patient outcomes. Patients may experience less blood loss, less pain and shorter recovery times. While the a Vinci Surgical System has been used for other procedures such as gynecologic and prostate conditions, this is the first time it's been used for hand surgery.

To learn more about options for hand surgery, call 410-601-WELL (9355).

Levindale Goes United

How would you like to help people in need and have a really good time while you’re doing it? That’s the goal of the United Way Campaign at Levindale Hebrew Geriatric Center and Hospital.

The official campaign kicked off earlier this month and it will run through August 20. There are lots of ways for employees and visitors to participate that will satisfy their sweet tooth, win prizes for them and even allow staff members to wear denim on special days, normally not allowed.

“We want to raise money for people in the community who have fallen on hard times,” says Carol Carder, chairwoman for Levindale’s campaign this year. While this is her second time leading the effort, Carol has been donating her time and money to the United Way for more than 20 years.

Some of the many activities and raffles being offered throughout the month at Levindale are listed below, and they all have one thing in common. They’re designed to remind people about the importance of giving while being part of a team that has fun. How do donations help?

“One of the charities that I’m most involved with is My Sister’s Place. This shelter for women and children in Baltimore provides meals, shower and laundry facilities and life skills workshops,” adds Carol. “What’s really significant about My Sister’s Place is that it gives women the skills to become independent again.” This particular charity is also helped through the WINGS group at LifeBridge Health.

As a quick refresher about United Way, it is a worldwide network in 45 countries. Here in our own backyard, the United Way of Central Maryland gives funds to about 1,600 different organizations.

For more information on Levindale’s campaign to help the United Way, contact Carol Carder at 410-601-2276 or email her at ccarder (at) llifebridgehealth.org.

Levindale’s United Way Activities Include:

• Wednesday, July 28 Popcorn sale
• Friday, July 30 Donuts and coffee
• Monday, August 2 Parking space raffle
• Friday, August 6 Dessert wheel
• Wednesday, August 11 Fundraiser at Green Turtle in Towson
• Friday, August 20 Levindale’s Got Talent

-Helene King

Oncology on Canvas Arrives at Northwest Hospital

This week Eli Lilly and Company and the National Coalition for Cancer Survivorship (NCCS)'s traveling art exhibition, Oncology on Canvas: Expressions of a Cancer Journey, was installed at Northwest Hospital. It will be on display in Northwest's main lobby and in the Specialty Clinic through August 1.

The exhibition consists of 25 works of art created by an international body of cancer patients, their family and friends, cancer advocates and health care professionals to express on canvas and in narrative what gives their cancer journey meaning, according to materials on the exhibit produced by Lilly. Artworks are entered into a competition and prizes are awarded in the following categories: Overall Best of Exhibition Winner (1st - 3rd prizes); Best of Participant Category Winner (cancer patient; family, friend or caregiver; health care professional); and Best of Participant Category Winners in Each Medium (watercolor, oil, pastel, photography, acrylic and mixed medium).

Competition participants do not submit their work for recognition or monetary gain; entries are kept anonymous and prize winners receive donations ranging from $1,000 to 10,000 for the charity of their choice.

Lilly started the Oncology on Canvas competition in 2004 and has subsequently run biannual contests in 2006, 2008 and 2010. (The 2010 art is now being judged.) Each year, there are over 2,000 entries from about 40 countries, with about a quarter of them from the U.S.

For more information about this inspirational exhibition, visit www.lillyoncologyoncanvas.com.
-Holly Hosler

Governor O'Malley Discusses Health IT at Sinai

Governor Martin O'Malley, Lt. Governor Anthony Brown, state Secretary of Health and Mental Hygiene John Colmers, and a group of hospital leaders in Maryland came to Sinai Hospital yesterday to discuss the latest in health information technology.

The state's health IT vision has three major components: creating a statewide network of health information, encouraging the adoption of electronic health records, and maximizing federal funding.

"We are leading the nation in health records, advancing the vision for health IT as well as for hospitals, clinics and primary care physicians," O'Malley said.

Representatives from CRISP (Chesapeake Regional Information System for our Patients), the state's health information exchange and regional extension center, attended the forum. Their goal is to allow health information exchange (HIE) to be accessible by different health care providers, which makes for more efficient and safer patient care. The Electronic Health Information Exchange launches in September with five Montgomery County hospitals - Holy Cross Hospital of Silver Spring, Montgomery General Hospital, Shady Grove Adventist Hospital, Suburban Hospital, and Washington Adventist Hospital.

The way the exchange will work is like this: take a patient who is seen at Sinai and receives a diagnosis of diabetes and hypertension. That patient may arrive in another Baltimore hospital's emergency room months later, and that hospital's staff would not know of the patient's previous medical history. By sharing the patient information for items like current medications, tests and conditions through a safe and secure electronic system, the emergency room staff can best treat the patient.

"Over time this will also reduce the redundancy of care, such as tests that don't need to be done," O'Malley said. "It's about both the quality of care and the cost of care." To hear more from the governor, click on the video below.

Another goal of the administration is to establish universal adoption of electronic health records and to provide information on certified electronic health record vendors who can offer discounts.

Maryland is among the first three states to have a state Health IT plan approved by the U.S. Department of Health and Human Services national Coordinator for Health Information Technology.

Sinai Hospital Leads the Way In Buying Local Food

Sinai Hospital is the first hospital to receive food from Baltimore's Real Food Farm, a reflection of our commitment to healthy and local food options.

Farmer Tyler Brown (on left) delivered cucumbers and squash last week, which Sinai Food and Nutrition Services Director Laure Sullivan said would be used in the salad bar.

Pictured on right are Brown with Sinai Chef Matt Sercombe. The second delivery of vegetables from Real Food Farm was scheduled for today.

"There are so many health benefits of local food," Sullivan said. "Local food is good for the community and good for the body. There are also economic reasons, such as we are getting a better quality of food that lasts longer.

Real Food Farm, a project of Baltimore's Civic Works, is located in Clifton Park. It uses high tunnel greenhouses to produce organic fruits, vegetables, and herbs for Baltimore residents.

Sinai Hospital was the first hospital in the state to sign the Healthy Food in Healthcare Pledge, and LifeBridge Health is the only health care system in Maryland to sign the pledge, signifying a commitment in local, nutritious, sustainable food as well as modeling healthy food practices

Buying locally benefits both our patients, visitor and larger community by providing better tasting food with less pesticides, plus shows support of the local farmer.When you buy locally, you are also helping the environment because food doesn't need to be transported over as long a distance, thereby cutting down on the use of oil and gas.

This week is Buy Local Week in Baltimore, where residents are challenged to buy at least one thing from a local farm every day for a week. According to the Buy Local Challenge, a project of Southern Maryland Agricultural Development Commission, if every Maryland household purchased just $12 worth of farm products for eight weeks (basically the summer season), over $200 million would be put back into the pockets of our farmers.

New Scanning Technique May Lead the Way to Alzheimer Treatment

by Robin K. Wilson, M.D., Ph.D.
Associate Director, Adult Hydrocephalus Center, Sandra and Malcolm Berman Brain & Spine Institute

Ever forget where you put your keys and worried for a moment that you’ve started to develop Alzheimer disease? A study presented at last week’s Alzheimer’s Association International Conference suggests that a noninvasive imaging procedure using a PET scan and a new radioactive tracer called AV-45 (Avid Radiopharmaceutical, Inc.) may eventually allow your physician to check for the presence of amyloid - a protein that is associated with AD - before true symptoms of dementia develop.

Though the buildup of amyloid does not guarantee that a person will become cognitively impaired, this new technique may allow the detection and - eventually - treatment of cognitive changes before irreversible damage occurs.

AD is just one of many causes of dementia, and amyloid buildup is just one factor related to the progression of AD. Nevertheless, if some researchers design noninvasive procedures for finding early cognitive changes and other researchers develop medications that can reduce the speed of these changes, eventually it’s possible that your physician will be able to prescribe a medication that could slow the process of cognitive decline before you lose your car keys as well as your car.

Though most neurologists and geriatricians do not expect a “cure” for dementia in the near future, they recognize that slowing its progression and enabling patients to spend a few more years living independently can make a tremendous difference. The AV-45 tracer may help with this goal.

The Sandra and Malcolm Berman Brain & Spine Institute offers a full spectrum of specialty programs and provides comprehensive diagnostic and therapeutic care for those with cognitive impairment and other neurologic disorders. For more information or an appointment, call 410-601-WELL (410-601-9355).

LifeBridge Health Is United!

United Way of Central Maryland provides more than $10 million in community funding to various organizations and agencies serving in and around Baltimore, and 15 Baltimore County non-profits received $64,065 in grants this year. The United Way works with several partners, including Northwest Hospital, VSP, the American Heart Association (Mid-Atlantic) and the American Red Cross of Central Maryland.

Sinai Hospital kicked off its United Way campaign yesterday with members of the executive leadership team playing "Family Feud."

The men's team - vice presidents Lionel Weeks and Joel Suldan, CEO Warren Green, and Chief Medical Officer Daniel Silverman, M.D. - won the first game, while the women's team - vice presidents Taylor Foss, Lorrie Liang, Ev Amaral and Barbara Epke - won the "lightning round."

Sinai Volunteer Services manager Beth Markowitz and Human Resources benefits consultant Lori Turner were the official scorers, letting a team know when they would receive the dreaded "X" for an incorrect answer. Shannon Wollman, manager of development at Sinai, was the host of the game.

Events at Sinai that will raise money for United Way include a basket raffle until July 20 (the baskets are pictured on the left), a Pet Mascot Contest from Tuesday July 27 to Friday, July 30, a fundraiser at Mount Washington Tavern on Tuesday, August 3, a cookie sale on Thursday, August 12, and a PartyLight Sale on Wednesday, August 18.

LifeBridge Health employees who donate to United Way will be eligible for a variety of prizes. Yesterday's contest winner for the free day of Paid Time Off was Dotsy Selway in Surgical Oncology.

Northwest Hospital will kick off its United Way campaign on Thursday, July 22 at 2 p.m. in the cafeteria with an ice-cream social. (The night shift kick-off will be at 10 p.m.) Levindale and Courtland Gardens begin their campaigns today.

A New Strategy In Fighting HIV

Tuesday’s announcement of a new national policy of addressing HIV and AIDS has inspired optimism among many Baltimore health care workers.

The White House report, available here, announced several goals, including lowering the rate of new cases of HIV by 25 percent in the next five years, reducing the HIV transmission rate by 30 percent, and increasing the number of people who know their HIV status to 90 percent. The Baltimore-Towson area has a high rate of diagnosis of new HIV cases, and the fifth-highest report rate of AIDS cases in 2007.

The national report points out that “the urgency associated with combating the epidemic appears to be declining as people with HIV live longer and more productive lives” and that there need to be greater targeted efforts toward high risk populations, including men who have sex with men and black women. According to the report, roughly three-fourths of HIV/AIDS cases in the United States are among men, the majority of whom are gay and bisexual men. The HIV diagnosis rate for black women is more than 19 times the rate for white women

John Cmar, a Sinai Hospital internal medicine physician with a subspecialty in infectious diseases, says the 60-page report is a “call to arms” in that it asks government agencies, hospitals and non-profits to work together in lowering the number of new cases and making sure there are specific outreach efforts to key groups.

“The previous strategy for addressing HIV have been targeted toward the general population and targeted everyone, as opposed to saying that there are high-risk populations and we need to focus more intensively on those groups,” he says. “Also, the report addresses prior efforts, which have often been bulwarked on a single thing, such as finding a vaccine. Moving forward, we have to do a whole bunch of different things at the same time in order to reduce both the number of new cases and increasing the number of those with knowledge of the HIV status.”

For health care educators like Robbin Alexander, Sinai outreach worker for HIV/AIDS, there’s a balancing act between acknowledging that certain groups are at higher risk alongside making sure that everyone understands how HIV can be transmitted.

“Yes, there are certain populations impacted more than others, but we must certainly not overlook any one population, because all people can practice risky behaviors,” she says. “Let's not look the other direction anymore, and believe it is not happening, because it is here, and both the state and individual communities have the power to help ourselves and the people we care about.”

In addition to Sinai’s community outreach efforts, many physicians like Dr. Cmar work with HIV-positive patients to make sure they are receiving the proper medical care, a key recommendation in the White House report. Sinai also has an outpatient infectious disease program and rapid HIV testing available to patients treated in Sinai ER-7. Patients who are admitted to the hospital for another reason, but are diagnosed with HIV during their stay, are immediately plugged into the care services available at Sinai.

On Monday, several teams will be canvassing Baltimore to offer free rapid HIV tests. Participants are tested with a cotton swab on the inside of their check and receive results in 20 minutes. Sinai will be hosting a health fair and free HIV testing on Friday, July 30 in the Zamoiski Auditorium from 1 p.m. to 5 p.m. .

Why Donate Blood? One Woman's Story

When Nancy Smith’s husband developed a serious infection, he received five pints of blood and numerous platelets that saved his life.

That was the first time someone close to this licensed clinical professional counselor at Levindale’s Behavioral Health Day Program needed blood. However, it wasn’t the first time Nancy realized that blood donations could be the difference between life and death. After all, she began giving when she was 19 years old. That’s an amazing 47 years of rolling up her sleeve!

Nancy is among the many Levindale employees planning on donating at the Friday blood drive, held in Schwaber Multi-Purpose Room at Levindale from 9 a.m. to 3 p.m.

While she’s never met the people her donations have helped, Nancy knows that among the many groups in need of blood are those suffering from burns, accident victims, people with diseases and premature babies.

“I started donating at a young age because it was something I could do,” explains Nancy. “I’ve continued for nearly five decades because I’m glad to have the opportunity to serve those in need.”

Nancy says there’s no reason to be afraid of the process. “If you give at Levindale, from beginning to end, the whole thing only takes about 45 minutes. That includes giving your medical history, donating, and eating cookies and pretzels afterward.

The donation, itself, takes about ten minutes. Nancy says it doesn’t hurt her at all, but she urges anyone on the fence about giving to focus on what the person who needs the blood is going through instead of the quick stick you will experience. She also reminds you that it hurts much more to get shots to travel abroad.

Nancy doesn’t do anything special to prepare except eats foods rich in iron a week or two before she donates. Women especially can experience low iron levels, so it’s important to make sure they’re normal.

“If you are reluctant to give, search your conscience,” advises Nancy. “It really is a privilege. After all, one pint of blood can save as many as three lives.”

First-time donors can find more information here. If you would like to donate on Friday, call Janine Boulad at extension 410-601-2260 or Mel Lindenmuth, R.N., at 410-601-2312 to sign up. All LifeBridge Health employees and community members are welcome, and walk-ins are accepted.

Sinai Team Returns From Haiti

Yesterday marked the six-month anniversary of the Haiti earthquake. As you can read here and here, there is still much work to be done in recovery efforts, as 1.6 million Haitian citizens are homeless and a minuscule amount of the promised aid has been delivered.

Many Haitian citizens need medical care. That's why a health care team from Sinai Hospital, led by Drs. John Herzenberg and Aaron Zuckerberg, returned last month to Hopital Adventiste d'Haiti in Port au Prince. The focus of the trip was to provide reconstructive orthopedic surgery to the earthquake victims, as well as general support to HAH. The team members include three orthopedic surgeons, one podiatrist, one anesthesiologist, one family practitioner, five nurses, one physical therapist, one surgical instrument technician, and three volunteers. In the course of under a week, the team performed 54 surgeries.

"We were all very touched by this,” Dr. Zuckerberg told the Jewish Times. “We were all crying when we left. We all want to go back. The question isn’t if, it’s when.”

You can read more by visiting the Team Sinai blog or the Haiti bones blog.

Summer Eye Safety

Most of us tend to concentrate on protecting our skin during the warmer months of the year. But did you know that protecting your eyes is just as important as protecting your skin, especially while participating in certain activities at home?

Not only do your eyes need to be shielded from the sun, they also need to be protected from debris, household particles, and saltwater or chlorinated water.

According to the American Academy of Ophthalmology, 48 percent of reported eye injuries occur in the home, nearly a third of which were caused by play or sports, and more than one in five injuries were due to performing home repair or using power tools.

“Goggles or wraparound safety glasses are a smart idea for all safety concerns – in and out of the home,” says Gerami Seitzman, M.D., an ophthalmologist at the Krieger Eye Institute at Sinai Hospital. “So many injuries occur at home that are 100 percent preventable. Properly shielded eyes will be protected from flying debris while doing yard work or aerosolized sawdust from power tool use.

“Most of the eye injuries that I encounter are from work injuries in construction or welding,” says Seitzman. Eye injuries from sports such as basketball, lacrosse and tennis are also very common.

If you or your children are headed to the pool this summer, make sure to wear goggles. They will allow you to avoid eye damage when swimming in a chlorinated pool or in a large body of water such as the ocean. The chemicals in the chlorine can dry out the eyes resulting in irritation, and the high salt and dirt content in the ocean can have a similar effect.

Our eyes also need protection from other natural elements like sun rays and pollen. Sunglasses are crucial at all ages and during every season, Seitzman says. Wear sunglasses especially between the hours of 10 a.m. and 2 p.m. when the sun's rays are the strongest.

Other tips:
-Eyewear should completely cover your eyes and provide protection from UVA and UVB rays.
-Use a cool compress and artificial tears if you have red, irritated eyes.
-Wear goggles when doing a home repair project, including woodworking.

-Betsy Haley

NFL Players Visit Children's Hospital

Pediatric patients at the Herman & Walter Samuelson Children's Hospital at Sinai had their day brightened with the help of three NFL players.

Retired Atlanta Falcon Keion Carpenter, Buffalo Bill Aaron Maybin and New England Patriot Alge Crumpler visited the inpatient unit this afternoon. They are in town for the second Annual Commitment to Change (C4C) camp in Woodlawn, as both Carpenter's and Maybin's charities, The Carpenter House and Project Mayhem, are hosts of the camp. The 6-day camp is designed to teach young athletes both technical skills and healthy living skills, while incorporating the importance of education and college prep.

Carpenter, who was born at Sinai, said visiting the children at Sinai as a "humbling experience."

"We can't take the little things for granted," he says. (You can see more of Carpenter in the video below.)

The players, who signed hats, played games and talked with the patients, were a big hit with everyone from teenagers to young children.

"I'm glad they are taking time off to visit me and the other kids," 15-year-old Noah Dannis of Ellicott City said. "It makes me feel good. It was definitely cool to meet them."

Joseph Awunganyi, who escorted his 4-year-old Joerel to meet the players, says his son loves to watch football players on television. Joerel has been at Sinai for the past week with a strep infection, but his family hopes he'll be able to return home soon. In the meantime, his smile at Carpenter, Maybin and Crumpler said it all.

"They really lifted his spirits," his father said.

You can turn in tonight at 5, 6, 10 and 11 p.m. on Fox 45, WBAL, WJZ and WMAR to see more of the players' visit.

Staying Healthy on Vacation

Vacation days are here and the living is good. But while illness may be the last thing you want to think about, being prepared for a health emergency could make the difference between a great vacation or one you would rather forget.

So consider the following a handy checklist from LifeBridge Health.

• Insurance card: Don’t leave home without it.

Your insurance card is just as vital as your passport and any other identification. Check with your insurance provider before you leave to see how they handle any out-of-network charges. For example, generally Medicare does not cover health care outside the United States, but there are Medicare Advantage and Medigap policies that will give you coverage. To learn more, read Medicare Coverage Outside the United States.

• Pack enough maintenance medications for the duration of your trip – and then some.

Stuff happens that could delay your return. The volcano eruption in Iceland caused many vacationers throughout Europe to have their trips extended, whether they wanted to or not.

• Oh say can you see?

The prudent thing to do if you wear glasses or contact lenses is to bring an extra pair. Need a cheap back-up pair? Try an online store like Zenni Optical. It's also a good idea to consider taking a pair of prescription sunglasses. And don't forget the contact lens solution!

• Pack enough over-the-counter medications

Ever tried asking for sinus medication at an Italian pharmacy? Even if you are staying in the U.S., pack away a few over-the-counter medications for conditions such as colds, motion sickness, diarrhea and allergies. Depending on where you are going, also consider insect repellent, sunscreen, Band-Aids, and an anti-itch cream. Finally, those traveling with car sickness-prone children may want to consider packing a rehydration solution like Gatorade or Pedialyte, as well as a change of clothes, wipes, and hand sanitizer.

• You’ve arrived at your destination. Is the water safe?

And speaking of hydration, do your homework to see whether it's safe to drink tap water. Remember it’s not just the drinking water that you should be concerned about. Those freshly washed vegetables and fruit served at that colorful little street stand in a foreign country could come back to haunt you.

• Wash your hands thoroughly and often to help reduce any disease transmission.

• If you are camping or in a place where it may be hard to wash up, pack hand sanitizer. Always disinfect your hands when preparing food.

• Don’t forget to stay hydrated and try to sleep well.
  

Getting enough rest and drinking fluids will allow you the energy needed for sight-seeing and excursions. If you are a light sleeper, consider taking ear plugs or a sleep mask. If you are traveling in different time zones, check out this article on jet lag.

Here’s to a great vacation and to coming home healthy and happy.
-Sandra Crockett

Serenity Now!

Who doesn't need a chance to release stress and renew energy?

Participants at the Women's Wellness Center's Summer Serenity program on Monday, July 12, will learn mindfullness techniques from expert Amy Bloom Connolly, the founder of S.H.I.N.E. (Support, Honor, Inspire, Nurture and Evolve). The program runs from 6:30 - 8 p.m. at Northwest Hospital.

"We are thrilled to have Amy come into our space and offer this type of program," says Women's Wellness Center health coach Adrienne Bannon, M.S. "This is a taste of what we're hoping to bring into the women's wellness center. We can bring these mindfulness practices into all areas of our lives."

These techniques, such as deep breathing and relaxing the body, help us release stress and renew our energy levels. Mindfulness allows the brain and body to be open and aware.

"In this heat, it's a wonderful break. Everyone is sure to leave with a renewed sense of wellness. These are great techniques for staying healthy," Bannon says.

One article on the S.H.I.N.E. program is here. Recent studies have shown that mindfulness can help those with anxiety and depression, or increase relationship satisfaction.

Sign up today for the Summer Serenity program. Call 410-601-9355 to register.

Meet Our Save-A-Limb Riders

Editor's Note: We've asked two former LifeBridge Health orthopedic patients to do the Save-A-Limb ride in October. As they train, they'll be sharing their experiences here on the LifeBridge Health blog. Today, meet rider Justin Newman!

When I walked down the aisle at the Maryland Zoo in November 2008, little did I know it would result in this blog post two years later, discussing recovery from knee surgery.

Following a delightful wedding (complete with Tux and Tails), my wife and I flew to Barcelona and boarded Royal Caribbean's Navigator of the Seas to cruise across the North Atlantic back home. As the boat progressed across the ocean, my bride and I decided it would be a wonderful idea to avail ourselves of the on-board ice skating rink.

Ice skating while on a boat sailing across rough waters (30 and 40 foot waves were common) admittedly seems a bit foolish in hindsight, but at the time, perhaps it was the "newlywed glow" surrounding my head. Only a few minutes into skating, I fell, necessitating a visit to the ship's crude medical facilities and crutches for the remainder of the trip.

Upon our return to Baltimore, I sought out one of Baltimore's top orthopedic surgeons, Jon Koman. Koman, a sports medicine doctor who has specifically published articles on arthroscopic meniscal repair, seemed the right doctor to repair my left meniscus.

After the surgery and recovery in January 2009, Dr. Koman encouraged me to find a low impact physical activity to continue my recovery. While I biked to work daily in 2003 and 2004, I've hardly been on a bike since moving to Baltimore ... and promptly having my bicycle stolen. So, my wife and I found two bicycles on Craig's List for the sum total of $100, and we started doing a little riding.

Of course, without a goal, life intervenes and I haven't ridden nearly as much as I should. When given the opportunity to work with the trainers at LifeBridge Health & Fitness, I jumped at the opportunity to train for the sixty-mile Save-a-Limb Metric Century ride this fall.

When I'm not getting ready for Save-a-Limb, I'm the Chief Operating Officer of Capalon Communications, a Baltimore-based website development, hosting, and telecommunications firm, a consultant for Katz Associates, and the founder of Walter Rescue, an animal rescue group providing rescuers with access to emergency medical care for rescued dogs and cats. If I'm not on a bicycle, I'm likely to be accompanied by Joey, a 5 1/2 month-old Guide Dog Foundation service dog-in-training, as well as my lovely wife, whom I don't blame for suggesting ice skating in the North Atlantic.
-Justin Newman

Meet Our Save-A-Limb Riders!

Editor's Note: We've asked two former LifeBridge Health orthopedic patients to do the Save-A-Limb bike ride in October. As they train, they'll be sharing their experiences here on the LifeBridge Health blog. Today, meet rider Randy Reisfeld!

A 30- or 60-mile bike ride ... What, am I crazy? Well, as a divorced mom with three teenagers, I know crazy is in my vocabulary!

Hi. My name is Randy, and I am going to tell you a bit about myself, and why I want to train for the Save-A-Limb bike ride.

First, as an occupational therapist here at Sinai, I know the benefits of such a great cause as this. Though I spend most of my work time in the Jennifer Gandel Kachura Neonatal Intensive Care Unit, I know many of the therapists who work with pediatric and adult clients that have had orthopedic surgeries or therapy. Independence in daily living skills and optimizing functional skills are goals of occupational therapy. Even though I am working with tiny babies, I am helping them achieve the highest level of function possible so that they can continue to develop those skills needed for independence down the road. The Rubin Institute of Advanced Orthopedics provides a resource to clients that have disruption in their functional skills, and this event will raise money for those that are unable to access the care.

Secondly, on a more personal note, I have experienced the disruption in my own functional skills quite a few times over the past three years. In February 2008, I underwent a 3-level lumbar fusion here at Sinai. I spent six days in the hospital, and three months at home, recuperating.

One month after finally getting back to work full time, I had a crazy fall, and fractured my right arm, again requiring surgery, and rehabilitation. More recently, I have been dealing with daily migraine headaches.

All of these things impacted my ability to function, whether short or long-term. I turned 50 this year, and I want to be healthy, active and fit for my next 50 years. I know this can happen, and my goal is to complete the 30-mile bike ride to prove to myself, and to others that age is just a number.

I will be sharing my training experiences here, and maybe motivate others to attempt to do something that might seem out of your reach or comfort zone. It's all for a great cause!
-Randy Reisfeld

Staying Safe This Weekend

Fireworks are one of the highlights of the Fourth of July holiday. However in the blink of an eye, a mistake can tragically turn their beauty into permanent injury, eye damage or blindness.

According to the Centers for Disease Control and Prevention, in 2008, seven people died and an estimated 7,000 were treated in emergency departments for fireworks-related injuries in the United States. The CDC estimates that 60 percent of fireworks injuries occur this weekend.

Adults are not the only ones injured from these kinds of accidents. More than four out of every 10 people hurt is a child under 15. More boys than girls are injured.

Bottle rockets, roman candles and sparklers accounted for most of the burns, wounds and “shrapnel.” Most of the problems were to the hands, then eyes and finally the face. In many cases, permanent scarring occurred.

Of those injuries, nearly 1,500 were eye related in the same one-month time frame.

“Fireworks can cause painful eye injuries such as corneal burns or corneal abrasions,” explains Gerami D. Seitzman, M.D., an ophthalmologist at Sinai Hospital. “They can also cause blindness if an explosive particle were to travel into the eye and damage the delicate structures required for sight.”

The best thing you can do is let professionals set off the fireworks and watch the display from at least a quarter-of-a-mile away. Children should be closely supervised around fireworks. Parents should remember that sparklers can be more than 1,000 degrees AND can ignite clothing.

“If the worst happens and someone suffers an eye-related injury, do not attempt to remove a foreign body from the eye,” warns Dr. Seitzman. “It is best to simply cover the eye with a shield or sunglasses and immediately take the person to the emergency room.”

After Surgery, Things are Looking Up

Editor's Note: Marketing Department writer Sandra Crockett had eye surgery in May at the Krieger Eye Institute and is sharing her experience with our blog readers. You can read about her preparing for surgery here.

It was all worth it. The four separate surgeries in May, two weeks apart by two Sinai physicians, were all worth it. The six weeks at home on medical leave from work? Worth it. The "no exercising" and "no driving" directive, the “roller coaster” of a ride that meant terrific vision some days, not so great other days? Worth it.

I’m six weeks out from my last surgery and my vision is vastly improved. I will even say it’s great.

I had glaucoma surgery and cataract surgery on both eyes (May 5 for the right eye and May 19 for the left eye). These surgeries caused a reoccurring autoimmune disease - called uveitis - to flare up big time. I knew and accepted this going in. I was warned – having to sign a document that I understood this would most likely happen – before the surgeries.

In fact, it was my years-long struggle with treating uveitis that caused the cataracts and glaucoma to develop at a somewhat younger age than usual. The cataracts were causing seriously impaired vision, and the glaucoma meant my eye pressure was dangerously high. I had been treated at other health facilities, with no good outcome, before I came to Sinai two years ago.

The uveitis could be brought under better control once the cataracts were gone and the eye pressure dropped, said my primary ophthalmologist, Gerami Seitzman, M.D.

I asked her what I could do pre- and post-surgery to facilitate the best surgical outcome. She said the best thing I could do was “have a positive attitude.”

It was kind of crazy right after the procedures on May 5. The next day, the huge bandage came off my right eye. There was an eye chart on the wall and Dr. Seitzman asked if I could make out anything or if it was “all just one big blur.” Turns out, everything was crystal clear! Better out of that right eye than I had seen in, well, I can’t ever remember seeing anything that clearly.

Dr. Seitzman told me great vision right away was unusual. I was thinking, maybe that “positive attitude” paid off. She cautioned that it might be “a roller coaster” and the next day could be different.

Boy, was she right. The following day things were blurry. And so it went for the next few weeks. And let’s not forget the medication! I needed eye drops for the uveitis, plus an antibiotic and oral steroids. The eye drops were administered in different dosages at different times of the day. For instance, one medication in the right eye every two hours. Another medication in the right eye four times a day. A high dose of oral steroids that kept me up at night. And that was just for the first week.

Then my left eye was operated on. I had an entirely different medication schedule for that eye. Finally, this week, I am using one eye drop twice a day in both eyes. And the oral steroids, thank goodness, are gone.

So six weeks out from the last surgery and things are looking good. Make that things are looking great! It is exactly like Dr. Seitzman told me. It took time and patience. For someone who got her first pair of glasses in the third grade, imagine my shock at learning I was now cleared to drive without them. Everyone who has had cataract surgery knows the joy of having the “veil” lifted from one’s vision.

I am hoping that I am done once and for all with the uveitis as well. Only time will tell. Right now, I am maintaining that positive attitude.
-Sandra Crockett