Monday, May 31, 2010

Skin cancer: Why it’s Important to Catch this Common Disease Early

This week, we've used the blog to talk about Vitamin D and Protecting Your Skin . Today we tackle skin cancer.

It's beautiful and sunny today in Baltimore, but remember to put on your sunscreen before heading outdoors. About one million cases of skin cancer are diagnosed in the U.S. every year, and one in 5 Americans will be diagnosed with skin cancer at some point in his or her lifetime. Some of the risk factors for skin cancer include having a fair complexion (especially with red or blond hair), a blistering sunburn as a child or teenager, exposure to radiation – including light from tanning beds, and certain medical conditions that weaken the immune system.

In a Lunch and Learn session at the Alvin & Lois Lapidus Cancer Institute last week, Sean T. Gunning, M.D., talked about the three forms of skin cancer: basal cell carcinoma, squamous cell carcinoma and malignant melanoma. Basal cell, which is the most common skin cancer, typically affects the head and neck and is primarily caused by sunburn. It can look like a spot that is shiny, with a rolled border that may turn into an ulcer or a red scaly spot. If you have a sore or pimple that doesn’t heal after 4 to 6 weeks, you should see your doctor as it could be basal cell skin cancer.

Squamous cell skin cancer forms after chronic sun exposure. Patients who have received a kidney transplant are especially at risk. This type of skin cancer can metastasize and spread to other parts of the body, making it very dangerous.

Finally, malignant melanoma is the least common form of skin cancer, making up only about 5 percent of cases. However, it is the most deadly. People with light complexions, with one or more blistering sunburns before age 18 and a large number of moles are particularly susceptible. Moles should be checked against the ABCDs:
  • Asymmetrical – Is the mole an odd shape with sides that don’t match the other?
  • Border – Does the mole lack a defined border?
  • Color – Is the color the same throughout the mole, or are there patches of brown, black, white, red or blue?
  • Diameter – Is the mole larger than ¼” in diameter (about the size of a pencil eraser)?
If the answer to one or more of these questions is “yes,” go see your doctor.

If skin cancer metastasizes (spreads to other organs), it can be life-threatening. Therefore, early detection is important. Skin cancer screenings will be held at Northwest Hospital on June 14 and on June 28 at Sinai Hospital. To sign up for one of these free screenings, call 410-601-9355.

-Holly Hosler

Friday, May 28, 2010

Magic of Life Gala Fundraser Features American Idol Jordin Sparks

If you love watching American Idol, now you have the chance to see the winner of season six live at the 2010 LifeBridge Health Magic of Life Gala.

Jordin Sparks will headline this one-night only concert at the Meyerhoff Symphony Hall on Saturday, June 5. Proceeds from the evening will benefit projects at Sinai Hospital, Northwest Hospital, Levindale Hebrew Geriatric Center and Hospital and Courtland Gardens Nursing & Rehabilitation Center (formerly Jewish Convalescent & Nursing Home). The 2008 gala raised $2.5 million.

Sparks captured the nation’s heart as the winner of American Idol in 2007. Since then, she’s been touring the country with her unique blend of R&B and pop. She is a Grammy nominee and an American Music Award winner, and soon to star in "In the Heights."

In addition to Sparks’ soothing sounds, gala goers will laugh at the comic talents of SARGE. There also will be cocktails, a light supper party and a dessert reception.

The gala kicks off at 6 p.m.

For more information or to purchase tickets, you can call 410-601-9328 or send an e-mail to jpolkow (at) LifeBridge Health employees are eligible for discounted tickets.

Thursday, May 27, 2010

Sinai Kicks Off Walking at Work on Wednesdays

If yesterday's weather was any indication, Mother Nature is sending a resounding "yes" to Sinai employees ready to exercise.

Under sunny skies, Sinai Hospital kicked off its annual Walking at Work on Wednesdays program at noon in the K lot. Roughly 125 employees turned out and one lucky winner received a $25 Target gift card. All Sinai employees are encouraged to wear walking or running shoes EVERY Wednesday through Labor Day. Levindale and Northwest are also promoting walking at work.

Walking is one of the least expensive but most beneficial way to get in exercise. According to the National Institute of Diabetes and Digestive and Kidney Diseases, walking improves stamina, tones muscles, burns calories, and relieves stress. Many health care providers may feel stress, work odd hours, or face other challenges when trying to squeeze in an exercise plan. But walking at work during a lunch hour or break can be a great way to keep your day on track. Aim for 10,000 steps a day!

The Walking at Work program is one of the reasons Sinai and Northwest hospitals were awarded the American Heart Association's Gold Start! Fit Friendly award. This honor is for hospitals that have a healthy environment and are "creating a culture of physical activity in the workplace," according to AHA Chief Executive Officer Nancy Brown.

To see more about the LifeBridge Health's Fit & Friendly goals, and the Walking at Work on Wednesdays program, watch our video below.

Tuesday, May 25, 2010

Vitamin D: Should you soak up the sun to get this vital nutrient?

Yesterday we discussed UVA sun rays and the aging effects they cause. Though UVA can also be responsible for skin cancer, UVB is the part of sunlight primarily responsible. (Think UVA, “A” for “aging”; UVB, “B” for “bad.”)

However, UVB light, which is the more dangerous of the two, is also the part of sunlight that causes the body to produce vitamin D – a necessary nutrient. Recent medical news has stressed that up to half of the U.S. population could be vitamin D deficient, and the FDA is considering increasing its daily recommendation of 400 International Units (IUs) of vitamin D to 800 IUs. Healthy levels of vitamin D have been linked to a decreased risk for osteoporosis, high blood pressure, cancer and certain autoimmune diseases.

While vitamin D occurs in foods such as fish and fortified dairy products, your body produces vitamin D naturally when you skin is exposed to sunlight. In fact, just 20 minutes of full body exposure will produce 10,000 International Units of vitamin D. (After about 20 minutes, your body creates a chemical response so you can’t produce too much vitamin D.) If you wear sunscreen (recommended to reduce your risk for skin cancer), the UVB rays will be blocked and your body will NOT produce vitamin D. So should you forego sunscreen so that you can get your vitamin D?

In a May 19th lunch and learn at the Alvin and Lois Lapidus Cancer Institute, Sean T. Gunning, M.D., said that he believes that the jury is still out on the health benefits of vitamin D. While there is a correlation of people who have higher levels of vitamin D in their systems and a lower risk for certain diseases, it doesn’t mean that their health is due to the vitamin D.

Healthy people tend to exercise outside, make better dietary choices and take vitamin supplements – all of which can lead to higher levels of vitamin D. Therefore these people may test higher for vitamin D simply because of their choices that make them healthy also give them more vitamin D; their health is a byproduct of their lifestyle, not necessarily because of their high levels of vitamin D.

As for getting the recommended daily amount of vitamin D, so far there’s no evidence that the vitamin D produced from being out in the sun is superior to the vitamin D we can get from vitamin supplements. The 400 (and even 800) IUs recommended by the FDA is an amount that can be easily obtained through a multi-vitamin, making it unnecessary to expose your skin to the sun.
-Holly Hosler

Monday, May 24, 2010

Protecting Your Skin

Dermatologist Sean T. Gunning, M.D., addressed a full house at Wednesday’s Lunch and Learn session at the Alvin & Lois Lapidus Cancer Institute. Thanks to the graphic images he shared of skin damage, either aging or skin cancer-related, it’s a safe bet that most members of the audience probably won’t be venturing outside again without first applying a hefty dose of sunscreen! Today’s blog entry will cover the aging effects of ultraviolet A (UVA) rays; tomorrow we'll address ultraviolet B (UVB) and vitamin D; and the next day we’ll talk about sunlight and skin cancer.

“Tanning is your body’s response to direct DNA damage by ultraviolet light,” says Dr. Gunning, noting that a peeling, blistering sunburn actually signifies dead cells. The sun depletes the collagen and elastin in your skin, so if you are concerned with keeping your youthful looks, your best bet is to stay out of the sun, use a sunscreen that blocks UVA as well as UVB rays, and cover your head, face and neck as much as possible.

For both anti-aging and anti-cancer measures, Dr. Gunning recommends that you apply sunscreen 2 to 3 hours before you go out, and then again every 2 to 3 hours you spend outside. If you’re swimming or participating in water sports, sunscreen should be reapplied every 40 minutes.

Skin protective factor, or SPF, only measures how well the sunscreen blocks UVB rays, the part of sunlight most responsible for causing skin cancer. Some more advanced products, however, also block UVA rays, the rays that are chiefly responsible for causing age spots and wrinkles. Dr. Gunning recommends that people use a product with a SPF 45 rating that also contains mexoryl, Ti02 or helioplex to block the UVA light.

How do you know if darker blotches on your skin are freckles or age spots? According to Dr. Gunning, freckles will fade with decreased sun exposure, while age spots are permanent.

Somewhat ironically, there’s evidence that the fear of aging is a greater motivator than the fear of cancer in causing women to protect their skin. Recently, a study conducted by a dermatology professor from the Northwestern University Feinberg School of Medicine found that college-age females reduced their visits to the tanning bed by 35 percent after being shown images of wrinkles caused by tanning. These same women had been previously unmoved by the dramatic risk of melanoma caused by tanning beds.

While you can’t reverse previous skin damage, you can take steps now to slow down the aging process by protecting yourself from UVA light. Windows, including those in cars, block UVB but not UVA rays. If you’re doing a lot of driving or riding in a car, use a sunscreen that protects against UVA. And when outside, a hat and long sleeves are your friends.

In what ways does your skin show sun damage? What are you doing to protect your skin from UVA rays?

-Holly Hosler

Friday, May 21, 2010

Is Your Child Being Bullied?

by Sharon B. Richter, D.O.
Behavioral and Developmental Pediatrics, The Herman & Walter Samuelson Children's Hospital at Sinai

Bullying has received a lot of attention lately, with many school districts revising their anti-bullying policies in the wake of cases like Massachusetts teenager Phoebe Prince.

Bullying is aggressive behavior that is intentional, repeated over time, and involves an imbalance of power or strength. A child who is being bullied has a hard time defending himself or herself.

Most people think of bullying in the form of physical aggression, such as hitting or pushing or in terms of teasing and verbal insults. But bullying also includes less observable behaviors such as social exclusion or isolation, stealing or damaging property, and threatening the victim, or forcing him to do things.

Cyberbullying is a relatively new form of bullying, where the victim is harassed through e-mail, cell phone, texts, instant messaging, chat room exchanges, or a website. On the Internet, the bully is allowed to be anonymous. If the target of the bully does not know who is bullying them, there is additional stress associated. The anonymity of the bully also leads bullies to engage in behaviors that they might not do face-to-face. Social media is accessible 24 hours per day, so victims may receive test or instant messages or read things about themselves when they are anywhere in addition to school, such as in their own home. Victims of cyberbullying are also less likely to report the bullying to adults for fear of having their parents remove their cell phone or computer from them.

There is an enormous impact from bullying on not only the victim, but also the bystanders, and school or community. Victims of bullying are more likely to have emotional health difficulties such as depression, suicidal thoughts and low self-esteem. They are also likely to have lower grades than their peers. Bystanders are affected as they may believe that they are in an unsafe environment, appear fearful, and feel powerless to act and guilty for not acting. When teachers and school administrators do not take action to stop the bullying, the school environment becomes one of fear and disrespect. Students feel insecure, have difficulty learning, and do not trust that the adults care about them or have control over the students. Bullying behaviors need to be taken seriously by all adults who interact with children.

There is a common perception regarding bullies that they are also more likely to have emotional health difficulties. Many bullies themselves also have poor grades, and are more likely to engage in high-risk behaviors such as getting into frequent fights. They are more likely to steal and vandalize property, drink alcohol, smoke, and carry a weapon.

However, there are also many bullies who are very popular among their peers and their teachers. This is more common among bullying girls but can be seen with the bullying boys as well. For this reason, it is often difficult for adults to believe that these students engage in bullying behavior.

Some children who are bullied may actually start the fight with the bully, and this behavior needs to be identified and stopped. For these children, called “bully-victims”, social skills may need to be directly taught. These children are at the highest risk for later mental health and emotional problems.

Although bullying has always occurred, it is now occurring with greater prevalence and increased lethality than it has in the past. Up to 25 percent of students have reported being victims of bullies.

There are warning signs that bullying is occurring to a child. In addition to the obvious bruise, torn clothing or missing and destroyed property, there are emotional signs. A child may be experiencing bullying if he or she appears sad or anxious, avoids school, withdraws from social activities, or has declining grades. Additional signs of cyberbullying are that the child appears sad or upset after using the computer or reading a cell phone message.

If you are a parent or educator, you can be a partner in anti-bullying interventions. Effective interventions for bullies need to come from adults in charge. These interventions must be implemented in schools and communities and alter the response towards bullying of teachers and other supervising adults. Changes within the upper reaches of administration are needed in the school and community system in order for the interventions to have a lasting effect. If you are a parent, you can also use these questions to start a conversation about bullying with your child.

While bullied children are at risk for later emotional and behavioral problems, there are some factors that promote resiliency in children who are victims of bullying. Maternal warmth, sibling warmth and a positive atmosphere at home are all particularly important in bullied children for promoting emotional and behavioral adjustment. Parents can help their children find friends, inside and outside of school, with whom to spend time. Children need to be taught to avoid isolation in school, as bullies are less likely to target people when they are alone than when in a group. Parents of children who are bullied need to be in contact with school personnel, encourage their child to report the bullying to the authorities, and expect that the bully will receive a consequence.

Thursday, May 20, 2010

Parking Notice

Sinai security will be blocking off handicapped and valet parking sections on Friday and Saturday to repaint. Drivers or passengers who remove the blockades and park their vehicles in the construction zone will be towed. Patients who need handicapped parking will be assisted by the valet attendants. We regret this inconvenience.

Bike to Work Tomorrow

If you're like many of us, finding time to exercise can seem impossible.

But one way to fit in exercise is to walk or bike to work. And what better day to try that than tomorrow, Baltimore's Bike-to-Work Day?

Biking is a low-impact activity that's especially great for anyone with bad knees. It's a way to burn off those calories: a 150-lb person can expect to burn 300 calories in a half hour by biking between 12-14 mph. Biking to work also saves you money on gas and car maintenance, plus saves you money on parking. By biking to work, you are also cutting back on pollution and being environmentally responsible.

Tomorrow is a great day to start a new commitment to biking to work. Remember to wear a helmet and layer your clothes. Morning celebrations for Bike-To-Work Day will be at:
  • Anne Arundel Co/Annapolis - City Dock, Annapolis
  • Baltimore City - War Memorial Plaza at City Hall (100 N. Holliday St.)
  • Baltimore County - Courthouse Square (400 Washington Ave, Towson)
  • Carroll County - Westminster
  • Harford County - Government Center (220 S. Main St, Bel Air)
  • Howard County - The Mall in Columbia (by Sears Service Center, 10300 Little Patuxent Parkway, Columbia
And once you're getting back into biking, remember that the Save-A-Limb Ride is October 17.

Wednesday, May 19, 2010

Celebrate Cancer Survivors with LifeBridge Health

Are you or a loved one a cancer survivor?

If so, then join us for LifeBridge Health's Cancer Survivors Day, an afternoon of fun, information, companionship and education. Light refreshments will be provided. There will be a survivors celebration activity and a keynote speaker, Kathy LaTour.

LaTour is a nationally renowned humorist, inspirational speaker and cancer survivor. Diagnosed with breast cancer in 1986, LaTour went on to write The Breast Cancer Companion. She is the creator of the one-woman show “One Mutant Cell” and has served on on the board of the National Coalition for Cancer Survivorship.

Cancer Survivors Day will be from 2 to 5 p.m. on Sunday, June 6 at the Pikesville Hilton. There is no charge, and the event is open to the public. However, pre-registration is encouraged. Call today at 410-601-9355.

Tuesday, May 18, 2010

Hot Topics in Women's Health

There’s still time to sign up for a ladies tea at Northwest Hospital this Sunday, May 23 at 3 p.m.

The highlight of the event will be two vibrant speakers who are women’s health experts: Women’s Wellness Center director and gynecologist Dee-Dee Shiller, D.O., and Herman & Walter Samuelson Breast Care Center medical director and breast surgeon Dawn Leonard, M.D.

These two doctors will be talking about some of the most pressing issues in women’s health today, answering questions such as when you should start getting mammograms and how often; should you have a genetic test to find out your risk for breast and ovarian cancers; and whether your daughter should receive the new vaccine for cervical cancer. Topics relating to menopause will also be discussed, including the pros and cons of hormone replacement therapy, as well as alternatives to HRT.

The event will help introduce the Women’s Wellness Center to the community. The center opened earlier this spring at Northwest Hospital, and is now accepting new patients for physicals and gynecologic care. Patients of the center will be able to take advantage of special amenities and services such as guidance from a health coach who helps patients develop a personalized comprehensive wellness plan. The health coach can also assist patients in scheduling appointments for tests or with specialists. Soon, the center will also be offering massage therapy, yoga and Pilates classes, and a free, community lecture series on women’s health topics.

At the event on Sunday, tea and light refreshments will be served, and all attendees will receive a free canvas tote bag - a great fit for use at the beach or gym.

To sign up for “Hot Topics in Women’s Health: A Ladies Tea,” call 410-601-WELL (9355).

Monday, May 17, 2010

Osteoporosis Drugs Offer New Hope

Osteoporosis or ‘porous bone,’ is characterized by low bone mass and structural deterioration of bone tissue. It leads to bone fragility and an increased risk of fractures of the hip, spine and wrist.

According to endocrinologist Esther Krug, M.D., the director of the Sinai Hospital Center for Bone Health, there are risk factors you can control - make sure that you are getting the recommended dose of calcium, stop smoking and avoid excessive alcohol use. However, factors like age, gender and body frame size - small thin-boned women are at higher risk for osteoporosis - are beyond your control. Luckily, new treatment options make it easier to find some relief.

“The treatment of osteoporosis is developing really fast,” Krug says.

The goal of physicians like Krug is to keep patients from fracturing their bones and ending up in the hospital. Caregivers of an elderly parent should consider adding a rubber bath mat in the shower or tub, make sure the house is free of clutter, and use plastic or carpet runners on slick floors to prevent slipping.

Why does grandma's body react so much worse to a fall than yours?

Krug explains that your body stops adding new bone after age 30, with rapid bone loss beginning around age 50. Women lose bone mass faster after menopause. Fractures are a key cause of disability in post-menopausal women, and it is estimated that there are 1.5 million fractures from osteoporosis each year costing America $18 billion annually.

Plus, a 2004 report by the U.S. Department of Health and Human Services Surgeon General estimates there are 800,000 trips to the emergency room and 500,000 hospitalizations stemming from osteoporosis.

While fall prevention is important, endocrinologists may recommend daily or monthly bone-building medications for severe cases of bone loss.

“If taken as prescribed, the medication lowers the rate of bone loss dramatically,” Krug says.

In 2007, the New England Journal of Medicine published an article detailing results of a three-year trial involving a once-yearly injection of zoledronic acid for treatment of postmenopausal osteoporosis. Those patients receiving the medication were nearly 8 percent less likely to develop a break in the lower back than those who were not receiving it. The FDA approved zoledronic acid for treatment of osteoporosis in 2007.

The injections of zoledronic acid, known as Reclast, allow some patients to bypass oral medication, which for some patients causes stomach upset. Nursing home residents who exhibit a low rate of compliance may benefit more from a yearly injection rather than taking another pill.

Krug, who tends to see the most extreme cases of osteoporosis, estimates roughly 25 percent of her patients are taking Reclast.

“It does liberate the patient,” she says. ‘So far, it’s performing well, and it is well tolerated by patients.”

Other injectable treatment options include Boniva, which is given four times a year. And another new drug on the market – Forteo - builds bones, cutting the risk of fracture in half.

At Northwest Hospital’s Outpatient Infusion and Cancer Therapy Center, nurses see an average of one to two patients a week for Reclast treatment, says Northwest's Mary DeClue, R.N.

“With Reclast, it’s one appointment and you are done for the year," DeClue says. "There is a lot of work done on our end to make sure all the lab work is in order, and then we call the patient to set up an appointment."

She says the nurses have not received any negative feedback about side effects, other than fatigue. But experts warn that these medications should not be prescribed unless proper indications are met – patients should talk with their doctor about the best treatment for them.

(Adapted from MdMD for Life, 2010)

Friday, May 14, 2010

Preparing for Surgery: A Testimony

Marketing's Sandra Crockett had successful eye surgery at the Krieger Eye Institute last week. This is an account of her preparation for eye surgery.

My eye surgery at Sinai Hospital is scheduled, and I am filled with trepidation and hope.

It has been more than a year since I’ve learned surgery was an option. I had uveitis (inflammation of the uvea; cause unknown in my case) which has given me both cataracts and glaucoma. The surgery can not be done if the uveitis is active, so I have had to wait.

Getting to surgery requires some necessary steps, which increase if you are over age 50.There is the pre-admission evaluation and testing, which must be done within thirty days of the surgery. This includes blood tests, a urinalysis and an electrocardiogram.

My primary care physician completed my outpatient history form, which states any sort of physical issues. And, I’ve been told to have a complete list of medications (for me that is three different eye drops and one twice-a-day pill, for eye pressure) to present to the nurse the day of surgery. I started on a heavy dose of steroids three days before surgery, but won’t take it on the day of surgery.

Those preparing for surgery are reminded not to eat, drink or smoke after midnight the day of the surgery. Aspirin is not allowed, but other medications are sometimes allowed - check with your physician. No make-up is to be worn the day of surgery and any jewelry is to be left at home.

It's important to plan who will be there with you after surgery. Obviously driving home after eye surgery is a non-starter. If there was no one available to take me home after surgery, it would be canceled.

Behind the scenes at Sinai, the PASS department is busy watching out for all the hospital’s preoperative patients. PASS stands for Pre-Anesthesia Screening Service.

“We review all of the paperwork,” says Tina Sewell, PASS nurse practitioner. If necessary, they also see patients.

PASS' ultimate goal to physically see all preoperative patients, regardless if the patients have a primary physician to provide screening. Only some patients see a PASS nurse.

“If a patient can’t get to their primary care doctor or if they have had anesthesia issues in the past, we will see them and discuss it,” says Patricia Valentino, a PASS nurse practitioner,

Some patients need guidance on which medications should be taken before surgery, says Patricia Drummond, PASS nurse practitioner. “We do a consult on what they need to take, whether it's blood pressure, psychiatric drugs, whatever," she says.

My best advice for people facing surgery is to put yourselves in the hands of good doctors and good hospitals. Ask questions and make sure you understand all of the answers.

That’s the medical part. There is also the rest of life after surgery. I will be out of action for about a month. Running is my exercise of choice but that will be out of the question for a couple of months. Ouch! Besides weight control, running provides stress relief. A long-time running buddy is already looking ahead. He is planning on running a November marathon in New Hampshire.

“And there’s a half marathon for you!” he says.

I know that November will be here before I know it. In the meantime, I’ll be a woman walking for the next few months.

Thursday, May 13, 2010

LifeBridge Health Facilities Win Environmental Awards

Sinai Hospital, Northwest Hospital, and Levindale Hebrew Geriatric Center and Hospital were award winners at the 2010 Environmental Excellence Awards ceremony at the CleanMed conference.

Sinai and Northwest won the Partner for Change with Distinction Award and the Making Medicine Mercury-Free Award. Levindale won the Partner for Change Award and the Making Medicine Mercury-Free award. The award winners are chosen by Practice Greenhealth, the nation’s leading organization for health care institutions dedicated to creating a healthier environment.

The Partner for Change with Distinction Award is a new recognition for health care facilities that have achieved improvements in mercury elimination, waste reduction and pollution prevention. These improvements include the installation of bi-fuel generators at Sinai and Northwest that are cutting emissions by 80 percent. Other successes include reducing medical waste across LifeBridge Health from 25 percent to 11 percent of the total waste stream; composting 236,070 pounds of food from the hospital cafeterias in 2009; reducing chemicals in cleaning and pesticide management; and increasing recycling systemwide from 8 percent in fiscal year 2008 to 16 percent in fiscal year 2010.

The Making Medicine Mercury-Free award is a testament to Sinai, Northwest and Levindale’s commitment to virtually eliminating mercury. This toxic metal is traditionally found in thermometers, batteries, feeding tubes and can cause harmful health effects in patients. By making medicine mercury-free, LifeBridge Health is ensuring healthier patients and reducing mercury from infiltrating our environment.

The Practice Greenhealth awards reflect LifeBridge Health’s continued commitment to environmental excellence. Previous honors have included the Baltimore Business Journal’s 2009 Award for Green Policy, a 2009 Environmental Protection Agency Trailblazer Award and a 2010 Communitas Award in the category of Green Initiatives.

To see a complete list of 2010 award winners at the CleanMed conference, click here.

Wednesday, May 12, 2010

Sinai President Speaks at CleanMed Conference

LifeBridge Health has several success stories around sustainability and environmental excellence. Even better, we like to share our best practices in the hopes that other hospitals will follow suit in reducing waster and finding innovative energy solutions.

At the CleanMed 2010 conference, held this year at the Baltimore Convention Center, Sinai President Neil Meltzer shared some of our accomplishments.

"To us, sustainability means being a good neighbor," he told the audience at the Hospital Leadership Plenary Panel. The other members of the panel were Barbara Sattler, RN, Ph.D., a University of Maryland Nursing Professor and Director of the Environmental Health Education Center; Knox Singleton, President and CEO, Inova Health System, and Jeffrey Rivest, President and CEO, University of Maryland Medical Center.

"Our waste costs have declined by half while the area of our square feet has increased," Meltzer said. In 2007, the total area was 1,810,906 square feet and the waste costs were $1,269, 158. In 2010, the total area was 2,520,043 square feet while the waste costs were $666,000.

Additionally, by using energy efficient equipment, conserving energy and using alternative and renewable technology when cost-effective, LifeBridge Health saved $825,000 from fiscal year 2010 to fiscal year 2011.

LifeBridge Health Vice President of Capital Improvements and Facilities Peter Arn, along with LifeBridge Health Director of Facilities Lewis Poe and Reduction in Motion President Bill Griffith, will be speaking more about success in waste reduction and energy efficiency at a CleanMed session Thursday called "Cooperation Not Competition: Achieving Success Across LifeBridge Health."

Monday, May 10, 2010

Donate Blood This Week

It's time for LifeBridge Health spring blood drives!

As always, the need is great. According to the American Red Cross, every two seconds in the United States, someone needs blood. A single car accident victim can require up to 100 pints of blood. One donation from someone like yourself can help save the lives of up to three people.

The theme for spring is "Hit a Home Run." Donors at Sinai Hospital or Northwest Hospital will receive a packet of "baseball cards" which contains a prize code. The prize code may reveal a single, double, triple or home run prize that may include gift cards or other prizes. All participants are also enrolled in a grand drawing for a "Grand Slam" package that includes baseball tickets, hotel and dinner.

The blood drive at Sinai will be tomorrow, May 11, from 1 p.m. to 6 p.m. and Wednesday, May 12 from 7 a.m. to 1 p.m. The location is IS Training Room #3.

The blood drive at Northwest will be from 8 a.m. to 2 p.m. on Friday, May 14 in the Pike and Owings Room.

Visitors or community members are welcome to walk in at Sinai or Northwest. Employees can register to donate through the LifeBridge Health intranet. You can also call the blood banks: Sinai at 410-601-5112 or Northwest at 410-521-5926.

Friday, May 7, 2010

Northwest Hospital Debuts New Pharmacy Device

Northwest Hospital recently purchased a new automated pharmacy device for its intravenous medication preparation, making it one of the few hospitals in the country to do so.

Last month, Northwest became one of a few dozen hospitals nationwide to use DoseEdge, which provides more features to ensure the safety of IV medications. Any medication that is given intravenously, rather than orally, works quickly and efficiently since it goes directly into a patient’s blood stream, says Northwest Hospital Director of Pharmacy Ken Mercer. But the disadvantage is the wrong dose of an IV medication can cause huge problems for a patient.

“The IV lab is where we produce our highest risk and highest cost medications,” says Mercer. “IV medications must be prepared in a sterile area similar to an operating room.”

DoseEdge offers a combination of bar code scanning and dose tracking to help keep patients safe. While bar code scanning is common when dealing with oral medications, DoseEdge marks the first time that this scanning is available for IV medications.

“All of the IV products that we carry for preparation of doses are built in a formulary,” says Mercer. “When IV medication orders that need to be prepared are sent to the DoseEdge system, the pharmacy preparer is prompted to complete a series of steps in the preparation.”

All products used in the preparation of the dose are barcode scanned to confirm they are correct. If the pharmacy preparer attempts to use an incorrect product, DoseEdge won’t allow them to proceed, thus preventing a medication error.

DoseEdge’s dose track ability feature is another new, added benefit.

“Before DoseEdge, all we could identify is that a dose was sent from the pharmacy system for preparation, but there was no way to know the progress of the dose or where the dose was,” Mercer says. This would create the occasional problem with the lab being able to see that the dose was requested for preparation, but could not see if the dose was made or where it was delivered.

Now, with DoseEdge, Mercer compares an individual dose of IV medication to being similar to ordering a package via FedEx or UPS: in the same way that you can see that your new Amazon book is headed to Kentucky, pharmacists can see that the important dose is ready and en route to a nurse.

The next step of the DoseEdge implementation is a “scan on delivery” feature, Mercer says. The pharmacy staff member making the IV dose delivery will scan the dose into the appropriate delivery place, such as a nurse server drawer or medication refrigerator.

“We will then be able to tell the nurse exactly where their dose is and when it was placed there,” Mercer says. “This will represent fewer lost and remade wasted doses, saving time and money on duplicate work and improving customer satisfaction.”

To see a video of DoseEdge at work, click here.

Thursday, May 6, 2010

Thank You for Being a Nurse

Join us in celebrating Nurses' Week! LifeBridge Health has scheduled a number of activities during Nurses' Week (May 6-12) to celebrate our dedicated nurses.

Sinai Hospital kicked off festivities yesterday with a Nursing Luncheon that featured keynote speaker Bertice Berry, Ph.D. The Sinai nurse of the year, Jean Becker, RN, was recognized and presented with an award. There will also be a social tomorrow in the Greenspring Cafe from 4 to 8 p.m.

Northwest Hospital has a theme of Northwest Nursing Team 2010: Caring for a Healthier Tomorrow. Their celebratory breakfast included raffles, prizes and trivia contests. The Northwest nursing winners were announced and are: Victoria Cardonigara, RN, Clinical Care Coordinator, GRCU Team/Nurse of the Year; Audrey Allen, CNA IMC Team/Nursing Technician of the Year; Sandra Lynch, Unit Clerk/Preceptor of the Year; and Karen Quarles, Unit Clerk of the Year.

Levindale began today with their festivities by hosting a breakfast. There also will be light appetizers available from 2 to 4 p.m. this afternoon; a distribution of gifts tomorrow, boxed lunch on Saturday, Ice Cream Day on Sunday and Monday, and awards presented on Monday.

Courtland Gardens celebrating by hosting a series of games, allowing weekend staff to wear jeans, hosting a staff/resident breakfast at 8:45 a.m. Monday, and hosting a potluck on Tuesday from 2 to 4 p.m.

Congratulations to the nursing winners and thank you to all of our nurses! Meanwhile, are you a patient who wants to recognize a nurse? Our Champions of Care program is a great way to do just that.

Wednesday, May 5, 2010

Help Available for Domestic Violence Victims

The tragic case of Yeardley Love, a UVA student killed this week during an altercation with her ex-boyfriend, is an unfortunate reminder that domestic violence can impact anyone.

"Anyone can find themselves caught in an abusive relationship," says Northwest Hospital Domestic Violence (DOVE) program coordinator Audrey Bergin. "Here were two young people who are well-educated and, by all accounts, successful athletes who found themselves in this terrible situation. It's a reminder that domestic violence does not discriminate."

Since the DOVE program began five years ago, Bergin and her staff have helped more than 800 victims, many of whom came in through Northwest ER-7. The program staff educates Northwest’s entire in-house medical staff about how to recognize signs of abuse, how to screen for it, and what victims’ rights and reporting laws are. Additionally, staff provide 24/7 crisis counseling for the people it helps, gives education to domestic violence victims about their legal options and will accompany victims to court.

The Family Violence Program at Sinai Hospital is also dedicated to breaking the cycle of abuse, providing individual and group counseling for women, ongoing support services, services coordination, legal information and court advocacy.

If you or someone you know is in an abusive relationship, you can call the National Domestic Violence Hotline at 1-800-799-SAFE (7233) 24 hours a day. You can find a complete list of services available in Maryland by clicking here.

Sadly, only 4 percent of domestic violence homicide victims had reached out to a domestic violence hotline at the time of their death, Bergin says. That's why first responders, including Baltimore County Police, are increasingly using a "lethality assessment", a series of 11 questions developed by the Maryland Network Against Domestic Violence that has been shown to improve victim safety. To learn more, you can watch this ABC News video or click here.

To learn more about violence prevention programs at LifeBridge Health, call 410-601-WELL (9355).

Tuesday, May 4, 2010

My First Mammogram, Part Two

Yesterday, a LifeBridge Health patient shared about her background and why she needed a diagnostic mammogram. In Part Two, she talks about her experience of getting a mammogram for the first time. To read Part One, click here.

While getting insurance coverage was easy for me, what was not so carefree was dealing my inherent fear of mammograms. I remember when my mom got her first mammogram at age 40 and the horror with which she relayed the experience to my dad. (She used the word “pancakes.”) Even my doctor told me to take two Tylenol beforehand, as getting a mammogram would be “excruciating.” On the other hand, two other women told me that mammograms did not hurt them. So along with my fear, I was also very curious about a procedure that could be described in such different terms.

I spent much of my time in the waiting room worried. Not worried about my lump, mind you; I was worried about the mammogram. I couldn’t even focus my mind well enough to read. All I could do is look at pictures in a fashion magazine.

Therefore it came as a shock when I had a very comfortable mammogram. Easy peasy. I think there were several reasons for this. For one, I chose the Herman & Walter Samuelson Breast Care Center at Northwest Hospital, where they have MammoPad® -- a warm, foam cushion that prevents one’s breast from being pressed against cold, hard metal during the x-rays. They use a new pad for each woman, so it’s completely sanitary. The pad doesn’t interfere with the images produced, so it’s also cleared by the FDA. (Having never had a mammogram with a MammoPad, my mom told me that she wishes she could get one, as she thinks it would make the mammogram a lot more comfortable.)

I also scheduled my mammogram for a time during the month shortly after my period, when my breasts would be less fibrous and not as tender. To prepare for the mammogram, I avoided caffeine (I postponed my daily cup of coffee until afterward), and I took two Tylenol as my doctor had advised.

The mammography tech was extremely nice, and she put me at ease as she was positioning me for the mammogram. The machine also didn’t compress my breasts as tightly as I expected it to. The process went so smoothly that I now know that my fears about mammograms were unfounded. While I think it definitely helps for pre-menopausal women to schedule their mammograms at the ideal part of their cycle, next time I will consider forgoing the Tylenol.

My mammogram didn’t find anything urgent, and because I’m very young, the breast ultrasound gave the radiologist better information about my particular situation. However, I no longer fear the test that may one day save my life.

If you’ve had a mammogram, what was your first one like? Have you used the MammoPad before? Sound off in the comments below.

Monday, May 3, 2010

My First Mammogram

One of our LifeBridge Health patients wrote the following account of her experience of finding a breast lump and having a diagnostic mammogram. Part One deals with finding a breast abnormality, specifically in a young woman. Part Two, which will be posted tomorrow, is about getting a mammogram for the first time.

I was watching TV one evening when a commercial for an area breast care center came on. It reminded me that I needed to do my monthly breast self-exam (BSE). As I approached my left nipple, I felt an unusual lump. Thinking it was monthly cycle-related, my first reaction was to check for a similar lump in my right breast. Nothing. Okay…, I thought, Maybe the lump will go away after my next period.

When it did not, I went to my doctor. She felt the lump too, and given my family history, she wanted me to get a mammogram even though I was only in my early 30s. My paternal grandmother had been diagnosed with breast cancer when she was 38. I had heard that women with a strong family history of breast cancer should have their first mammogram when they are 5 to 10 years younger than the earliest age at which their relatives were diagnosed with the disease.

Unfortunately, there are a few problems with having a mammogram at such an early age. First, young breasts tend to be very dense, so the X-rays can be hard to read, even if they are digital. (However, some studies suggest that digital mammography is better than traditional film-based mammography for detecting abnormalities in dense breasts. Digital mammography also delivers less harmful radiation than the old technology) My doctor also gave me a script for a breast ultrasound, which gave the radiologist better information in my particular case.

Additionally, health insurance providers may be reluctant to cover the cost of a mammogram before age 35. Women who need to be screened earlier because of certain risk factors will be required to produce a special order from their doctor. Even so, this order might be questioned by insurance. However, I had a palpable lump, so coverage was easy for me to obtain.

If you have found a lump in your breast, do you know what to do? Ideally, routine screening mammography catches breast cancer early, before a lump can be felt. That’s why the American Cancer Society recommends that women with low to average risk for breast cancer should have a baseline mammogram between the ages of 35 and 40 to provide a record of what’s normal for them, and then get a screening mammogram every year from ages 40 to 70.

If you want to know more about your personal risk for breast cancer, you can take a free health assessment here.