Checking In With 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, here about the first month of training from rider Randy Reisfeld!

Week 1: Well, my first spin class over with, and I survived! But wow…..I was really nervous the whole day in anticipation of the class. I’m usually not like that, but I guess it was the unfamiliarity of the equipment, and not knowing what to expect when I got there. It was 45 minutes of grueling riding, up and down in the seat, but my goal was to keep pedaling for the whole time, and I did it!. Even wearing padded bike shorts, the worst part was the soreness of sitting on the seat. They tell me that in about 2 weeks, it won’t be so bad. I guess I’ll find that out. Just proud of myself that I made it through the first class.

Week 2: As I continue to progress with my spin class, I am finding that I enjoy it, much to my surprise. It is a difficult work-out, but the nice part about it is that you can modify it to you’re abilities. My goal each class is to try to continue to increase the resistance and stay with the class through the whole 45 minutes or hour class. I even purchased spin shoes, 2 pairs of padded bike shorts, and just recently bought a padded seat cover that I can also use on my bicycle. Haven’t tried out the padded seat yet…..planning on that at tonight’s class.

Week 3: This week was not a good week for working out. Wasn’t feeling well, so I missed the whole week of spin class, though I got back in the saddle over the weekend. Tried out the padded seat cover, but didn’t like it, as I kept slipping off the seat. Was drained from the class Saturday morning, a combination of not feeling well over the week, and a week of missed classes. Got home, and didn’t move from the sofa for two hours!! Feeling much better now, so I will continue with my three times per week spinning. I’ve also been swimming, which I’ve been alternating with the cycling classes, and I’m feeling more in shape, though the pounds aren’t changing. But I will persevere!!

Week 4: Much better performance last night at class. Had a lot of energy, and was able to increase the resistance and push myself through the whole class. The time went much faster, and I wasn’t going to collapse, like I felt last week. Oh yeah, and my butt didn’t hurt at all!! My goal for the remainder of this week, besides a couple more spin classes, is to get out on my own bike, hopefully this weekend, and see how I feel doing the real thing.

There are 11 weeks to go till the ride!! I can do it!!!
-Randy Reisfeld

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.