Thursday, April 20, 2017

Planning for the Unthinkable

Take Time to Make Your Wishes Known

It’s difficult to imagine, but try to picture yourself near the end of your life. An assortment of beeping devices and medications are the only things keeping you alive and doctors have told your family it’s not likely you’ll recover. Understandably distraught, your son and daughter have differing ideas of how to care for you. Your son is hopeful that something will change over the next few weeks – perhaps a different combination of medicines will bring back his mom. But your daughter feels that, even if your life could be prolonged, it wouldn’t be a quality one. You’d be confined to a hospital bed, connected to tubes, unable to care for yourself or communicate, and she believes you wouldn’t want to exist that way. The two of them disagree so strongly that they’re unable to be in the same room together. If you were awake, you would hate to see them divided like this. They used to be so close! If you had known how bitter they would become about your care, about the rift it would cause in your family, you would have made time years ago to tell them what you wanted your death to be like.

Scenarios like this play out in hospitals across the country more often than you might think. Discussing death is uncomfortable, both for the person contemplating his or her own mortality and the family members who don’t want to consider a life without their loved one. It’s no surprise that families tend to avoid talking about end-of-life care, but not discussing it might prove to be just as difficult.

In honor of National Healthcare Decisions Day, which took place on April 16, GBMC HealthCare wants to encourage all members of the community (regardless of age or health) to put the discomfort aside, complete an advance care directive, and name a healthcare agent.

Advance care directives are legal forms that ensure patients’ wishes for healthcare are followed in the event they are unable to speak for themselves due to illness or injury. Although these forms are not wills, they provide peace of mind to patients and relieve their loved ones from the burden of having to make difficult decisions during a health crisis. They also ensure that patients will have the right mix of treatments and support available at each stage of their illness.

A healthcare agent is a person, typically a trusted friend or family member, who will speak for you and make decisions based on what you would want done or your best interests if you cannot. He or she has a copy of your advanced directive, or knows where to find it. You decide who your agent is and how much power your agent will have to make these decisions.

A primary care physician is a great person to speak with about completing an advance directive and naming a healthcare agent. He or she will answer any questions you may have, direct you to appropriate resources that will help guide you through the process and ultimately, add your completed directive to your medical record.

If you already have an advance directive form, it’s very important to share it with your primary care team and any specialty physicians who may be treating you. Please remember to bring a copy to your next appointment. If you don’t have a primary care physician, visit www.mygbmcdoctor.com to find one who is right for you.

We Have Baltimore’s Best

Sarah Whiteford, MD

Better health and better care for our community. Our commitment to the neighborhoods we serve is echoed through the work our primary care teams do each day. Providing health education, guidance and patient-centered, evidence-based care to individuals and families across the region, we are here to help our patients take charge of their health and serve them throughout their lifetimes.

GBMC is honored to have Baltimore put their trust in us and we congratulate Dr. Sarah Whiteford for being named Best Family Physician in The Baltimore Sun’s Best of Baltimore Readers’ Choice poll.

Pan Seared Tuna with Sautéed Red Swiss Chard

In late March, GBMC held its first Facebook Live cooking demonstration featuring this healthy recipe from The Sleeved Chef, Michael Salamon. Michael graduated from the Culinary Institute of America and is passionate about “teaching cooking techniques and recipes to pre- and post-operative bariatric patients.” He had a type of bariatric surgery known as a sleeve gastrectomy in September 2016 and enjoys sharing his knowledge of cooking with fellow weight loss patients. Co-hosting the demonstration with him is Jana Wolff, RD, LDN, Director of Nutrition for GBMC’s Comprehensive Obesity Management Program, where Michael was treated.

The recipe is appropriate for bariatric patients, but it’s a great high-protein meal for anyone! Swiss chard is a leafy, nutrient-dense vegetable that contains antioxidants important for eye health, as well as others that act to reduce the body’s inflammatory response. Ginger contains gingerol, which is also known for its antioxidant and anti-inflammatory effects.

Please tune in to GBMC’s Facebook page on Tuesday, April 25 at 6pm for another live cooking demonstration with Michael and Jana!

Ingredients
4 oz. Ahi tuna
2-3 ea red Swiss chard
4 cloves garlic
½ in. ginger, fresh
1 tbsp extra virgin olive oil
1 lime, juiced
Kosher salt*
Black pepper*

*Recipe analysis assumes ¼ tsp salt and black pepper

Directions
  1. Remove tuna from refrigerator 15 minutes before cooking and place it on a clean plate. Season both sides with extra virgin olive oil, kosher salt and black pepper. Remove Swiss chard stems from leaves.
  2. Small dice the Swiss chard stems and julienne the leaves.
  3. Peel and mince ginger and garlic.
  4. Place cast iron pan on high heat; Place another pan on low to medium heat.
  5. Add olive oil to the pan on low to medium heat.
  6. When oil starts to perfume, add ginger and garlic to the pan.
  7. Sauté ginger and garlic for 1-2 minutes and add Swiss chard stems.
  8. Sauté Swiss chard stems for 2 minutes; Add Swiss chard leaves to pan.
  9. Wilt Swiss chard leaves and season with salt and pepper.
  10. When cast iron pan starts to smoke, gently place tuna in pan.
  11. Sear tuna for 1 minute per side for rare.
  12. Place sautéed red Swiss chard on a plate and place the tuna on top of it; Squeeze fresh lime juice over entire plate.
  13. Serve immediately.
Nutrition Information
Recipe yields 1 serving

Calories: 405
Total Fat: 19g
Saturated Fat: 0g
Cholesterol: 58mg
Sodium: 663mg
Protein: 26g
Carbohydrate: 17g


Recipe courtesy of Michael Salamon, The Sleeved Chef.

Wednesday, April 19, 2017

GBMC Nurse is Finalist in The Doctors and Prevention Most Amazing Nurse Contest!

Vote for GBMC's own Laura Clary, BSN, RN, FNE-A/P, SANE-A, CFN, CPEN, as the "fan favorite" in The Doctors TV show and Prevention magazine's America's Most Amazing Nurse contest. Laura is one of five finalists from a nationwide search. She is the clinical program manager of the Sexual Assault Forensic Examination (SAFE) program and cares for victims of sexual assault, child abuse, rape, human trafficking, intimate partner violence, and domestic violence. We encourage everyone to learn more about each of the five finalists. It truly is an amazing group! After you’ve reviewed the list, please vote for Laura as the "fan favorite" in the online poll.

Thursday, March 16, 2017

The New Face of Colorectal Cancer Could Be Yours

Too young for cancer? Think again. It’s true that most new colorectal cancer diagnoses occur in people 50 or older, which is why organizations like the CDC and American Cancer Society recommend routine colonoscopies to screen for it beginning at that age. But, as you may have seen in the headlines recently, cases are increasing in young adults.

A Journal of the National Cancer Institute (JNCI) study found that colon cancer rates among people age 20-39 are increasing 1-2.4% per year. The incidence of colon cancer in people 40-49 is increasing more rapidly than for any other age group. Some physicians and researchers believe this alarming trend could be the result of poor diet, inactive lifestyle and simply not knowing the risk factors for or symptoms of colorectal cancer. Watch Robert Donegan, MD, medical oncologist at GBMC, discuss this topic on ABC2 News.

You are at a higher risk for colorectal cancer if you:
  • have a family history of colorectal cancer
  • have a history of colorectal cancer, polyps or inflammatory bowel disease yourself
  • are African American or Jewish of Eastern European descent (Ashkenazi)
  • have type 2 diabetes
  • smoke
  • drink alcohol heavily
  • are overweight or obese
  • are physically inactive
  • consume a diet high in red meat and processed meat
  • have a certain genetic condition (such as Lynch syndrome, Turcot syndrome, Peutz-Jeghers syndrome)

Physicians want you to know that, regardless of your age,
  • there are no early warning symptoms of colon cancer or polyps. Screening before symptoms begin gives the best opportunity to prevent cancer by detecting and removing the pre-cancerous polyps. Detecting cancer during screening tests greatly increases the chance that the cancer is in a curable stage. 
  • once symptoms occur, if there is a cancer, it is more likely to be a more advanced cancer, and is less likely to be curable
  • symptoms that should warrant an investigation at any age include:
    • Persistent, significant change in bowel function (diarrhea or constipation)
    • Rectal bleeding
    • Persistent abdominal pain
    • Rapid, unexplained weight loss and new onset fatigue (It’s important to note that these may be features of advanced cancer from any source and are not specific to colorectal cancer.)
If any of the risk factors apply to you, or if you experience one or more of the symptoms listed above, take action! Talk to your primary care physician about the different types of colorectal cancer screenings and find out which one is best for you. When colorectal cancer is detected early, surgery, radiation and/or chemotherapy can provide effective treatment!

We also encourage you to join us for a Facebook Live on Thursday, March 23 at 10 a.m. GBMC Gastroenterologist Dr. Niraj Jani and ABC2's Ashley James will take questions on digestive disorders. You can click here to submit a question in advance.

Take a Little Time for You!

GBMC invites the men and women of our community to focus on their own health and wellbeing by attending Time for Me!, a FREE health lecture series taking place in April. Connect with our GBMC physicians and medical experts as they offer practical information and advice on the prevention, treatment and management of the most common health issues.

Topics will include genetic health risks, shoulder pain prevention and treatment, caring for your voice as you age and solutions for dizziness, imbalance and falls.

All events are held at GBMC in the Civiletti Conference Center from 6:30 p.m. until approximately 8 p.m. There is no cost to participate and all attendees will receive a special gift and a complimentary parking pass. We also encourage you to bring along family and friends!

For more information, call 443-849-GBMC (4262) or visit www.gbmc.org/timeforme.

Wear Red Day

If you visit GBMC on March 22, you may find yourself seeing red – from the lights in our main corridors and cafeteria to our decked-out employees. Wear Red Day serves as the official kickoff for our second annual Walk a Mile in Her Shoes®. Please join us in sporting red, a power color that represents energy and determination, to take a stand against rape, sexual assault, and gender violence.

Walk a Mile in Her Shoes is a one-mile walk on GBMC's campus on Saturday, April 22. The event raises money for our Sexual Assault Forensic Examination (SAFE) and Domestic Violence programs, while shifting perspectives about these often-stigmatized issues. Our SAFE and DV programs provide free confidential services that are available to everyone, 24 hours a day, 365 days a year. Nurses and advocates perform detailed medical-forensic examinations, collect evidence, and testify in court, but most importantly, they treat survivors with compassion and respect.

Get involved by posting pictures of yourself decked out in red to social media using #GBMCWalkaMile and register for Walk a Mile in Her Shoes by clicking here. If you fundraise $200 by March 21, you'll earn a choice of either red high heels or red Converse sneakers to walk in.