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