Thursday, June 16, 2016

Is it Time for Your Child’s Annual Check-up?

It’s easy to get caught up in summer fun when report cards, homework and exams seem so far away, but now is the time to schedule an appointment for your child’s back-to-school physical.

Nearly all schools require that children between the ages of four and 17 undergo annual physicals or “well-checks” that include immunizations and vision/hearing tests. These appointments are especially important if you have a young athlete who may encounter sports-specific issues and needs to learn about proper nutrition, exercise and rest.

Having annual physicals can also help your son or daughter establish a happy and healthy relationship with his or her primary care physician, should there be another reason to visit in the future. You can expect the care provider to do the following during the exam:

  • Discuss nutritional and sleep needs
  • Order tests depending on risk factors for conditions like anemia or high cholesterol
  • Perform age- and gender-specific height and weight checks
  • Conduct a physical examination
  • Review and update immunizations

In addition to the exam’s requirements, you can take this opportunity to ask your child’s physician to address any concerns you may have about health, weight, safety, and even attitude, peer pressure and feelings.

If it’s time for you to schedule your child’s next check-up, or if you’d like to select a new primary care physician for you or your child, call 443-849-GBMC (4262) or visit A GBMC team member will call you back within one business day to schedule an appointment.

Getting out of the Prediabetes Danger Zone

More than 29 million people in the United States have diabetes, but many more are at risk and are living with a condition called prediabetes. Patients whose blood glucose is too high to be considered normal but are not diabetic are considered to be in the danger zone. "The criteria for prediabetes is a fasting blood sugar between 100-125 and the results of another test called a hemoglobin A1C, which checks what blood sugar has been over the last three months," says Dr. Ruth S. Horowitz, Chief of the Division of Endocrinology at GBMC. "If the A1C is between 5.7 and 6.4, the blood sugar is moderately elevated and indicates prediabetes.”

Luckily, if you've been diagnosed with prediabetes, the progression to type 2 diabetes is not inevitable. There are lifestyle changes you can make to take control of your blood sugar. Focus on cutting high-carbohydrate foods, which easily break down into glucose and raise blood sugar levels faster than the body can produce sufficient insulin. By limiting the amount of carbohydrates you consume, the body can dispose of the glucose more effectively and maintain a normal blood sugar level. Dr. Horowitz recommends the following:

  • Limit highly-concentrated sweets, such as sugared drinks, juices, candy and cookies. 
  • Replace starchy dishes like potatoes, rice, pasta, peas and corn with complex carbohydrates such as broccoli, asparagus and spinach. 
  • Watch your fruit portion sizes. One serving of fruit is 1 small apple, orange or pear, half a banana or a ½ cup of chopped, cooked or canned fruit. Space out your servings of fruits throughout the day, rather than consuming them all at once. 

Working out is another effective way to stop diabetes in its tracks. Muscle is the largest consumer of glucose. By exercising, you increase the movement of glucose into the muscle, where it is broken down into energy and lowers blood glucose levels. Try to get 30 minutes of moderate exercise that raises your heart rate at least five times a week.

If you want to learn more about prediabetes or diabetes, visit for information. Some GBMC primary care practice locations offer free educational classes and one-on-one sessions for people with type 2 diabetes. Learn about controlling your diabetes, meal planning, regulating medication and more. Visit to find a primary care provider who can help you develop a healthy action plan and connect you with a Registered Dietitian and Certified Diabetes Educator.

Celebrating Survivors in a Big Way at Legacy Chase

Surviving cancer is a tremendous accomplishment, and at this year's 16th annual Legacy Chase at Shawan Downs, GBMC is celebrating survivors by going big: a mile and a half long to be exact! With help from survivors and their families and friends, we will attempt to break the Guinness World Record for the longest awareness ribbon, as a demonstration of GBMC's commitment to the fight against all cancers.

Join us on Saturday, September 24, 2016 as we "chase the record" and mark this momentous occasion by spending a day enjoying family-friendly activities, steeplechase horse racing, food trucks, a vendor village and most importantly, a homecoming of the GBMC survivors community.

Statistics show that one in three people has been touched by cancer in some way. Whether you have personally been diagnosed, or you've experienced the difficulty of watching a loved one battle cancer, the unfortunate reality is that cancer has affected us all. This June, GBMC has observed Cancer Survivors Day and hosted Oncology's 25th Annual Cancer Survivor Celebration. Now, we need your support to drive the message home by helping to make our world record attempt a success.

Here's how you can get involved:

  • Start a fundraising page. By raising $250, you can earn your own piece of the record-breaking lavender cancer awareness ribbon for friends and loved ones to sign and personalize. 
  • Volunteer at the event. We will need lots of people to hold the ribbon in the infield. Get involved! 

Cancer survivors and their supporters are invited to visit the survivorship tent to celebrate together with refreshments. To RSVP to this gathering, purchase tickets to the event or learn more about fundraising and volunteering, visit for all the details.

Listen Up: Earbud Safety

Hearing loss is often associated with seniors, but because of the omnipresent little white earbuds in schools, offices, busses and on children in the car or at home, it's becoming a serious issue for young people as well. "It's bad, and we aren't even going to see how bad the damage is for decades, which is part of the problem," says Brian Kaplan, MD, a GBMC Otolaryngologist. "Once you lose it, you can't get it back."

When listening through earbuds, the sound is directed straight into the ear canal, which makes the noise more damaging than with regular headphones. Using cheaply-made earbuds, like the ones that may come free with your device is especially harmful. Because of the poor earbud quality, you might find yourself cranking up the volume in order to try to block out external sounds.

So, how can you safely listen to your favorite music, podcasts and games without bothering those around you? Here are some practical tips from Dr. Kaplan, who calls hearing loss "the next public health crisis."

  • Use the 60/60 rule. Listen at no more than 60 percent of the volume capacity for no more than 60 minutes per day. This is a good, easy-to-enforce rule for kids. 
  • If the person next to you can hear your music, it is too loud and likely leading to permanent hearing loss. Turn it down. 
  • Use over-the-ear headphones, which are safer than in-ear earbuds because the sound is not funneled as directly into the ear canal. 
  • If you prefer earbuds, as many people who exercise to music do, buy better-quality earbuds that are designed to put high-fidelity sound closer to your eardrum. The sound isolation will prevent you from having to increase the volume. Higher quality earbuds will be more expensive, have rubber or foam tips and contour better to the ears. 

If you or your children are experiencing a ringing in the ears or are noticing progressive hearing loss, talk to your primary care physician about your symptoms immediately.  If necessary, he or she will refer you to a specialist. Visit for more information.

Pita Pizzas


1 cup tomato sauce
1 cup grilled, boneless, skinless chicken breast, diced (about 2 small breasts)
1 cup broccoli, rinsed, chopped and cooked
2 tbsp grated parmesan cheese
1 tbsp fresh basil, rinsed, dried and chopped
4 (6 ½-inch) whole-wheat pitas


Preheat oven or toaster oven to 450°F.

For each pizza, spread ¼ cup tomato sauce on a pita and top with ¼ cup chicken, ¼ cup broccoli, ½ tablespoon parmesan cheese and ¼ tablespoon chopped basil.

Place pitas on a nonstick baking sheet and bake for about 5-8 minutes until golden brown and chicken is heated through. Serve immediately

Recipe retrieved from Keep the BeatTM Recipes: Deliciously Healthy Family Meals provided by the U.S. Department of Health and Human Services. December 2010

Friday, May 20, 2016

Caring for a Stroke Survivor

If a loved one has survived a stroke, you are likely filled with relief, as stroke is the fourth leading cause of death in the United States. But despite the stroke not being fatal, recovery can often feel like the start of an uphill battle. Depending on the severity of the stroke and how long blood was blocked from the brain, it may take months or even years to regain functions. Because the brain was deprived of oxygen, and brain cells may be severely damaged or lost, it is very common for stroke survivors to lose cognitive and physical abilities.

The severity of complications from stroke vary widely from person to person. Each survivor's ability to recover is completely different, depending on the damage to the central nervous system, state of mental health and willingness to practice regained skills. If you plan to play an active role in a stroke survivor's recovery, it's important to maintain compassion and patience; progress can be slow and is not easily predictable. As May is National Stroke Awareness Month, here are some tips for caregivers and family members who want to aid in a loved one's stroke recovery:

  • Establish a fun regimen. A physical therapist will likely assign the stroke survivor repetitive tasks to practice. Repetition is key to improving motor skills, but variety is also important to keep the brain engaged and increase retention. Try inventing games, for example, flipping a coin. Heads could mean rotating the arms in wide circles; tails could mean holding a stretch for 60 seconds.
  • Let them sleep. Not only is it very normal for stroke survivors to sleep a lot, but it is vital to recovery. During REM sleep, the brain gets a chance to turn short-term memories about muscle movement into permanent memories. It's wonderful for survivors to sleep directly after practicing rehabilitation exercises as a way of "downloading" the skills.
  • Monitor moods. Post-stroke depression is very common. Remastering basic tasks, especially those that are essential to physical independence, can be emotionally difficult. Relearning skills is frustrating and can feel hopeless. If your loved one seems to be having trouble controlling his or her emotions or seems increasingly despondent, seek out a mental health professional.
  • Take care of yourself. You can't successfully help others unless you're mindful of your own health. Eat a nutritious diet, exercise regularly and stay on top of your regular doctors' appointments. If you don't have a primary care physician, find one at

GBMC offers a number of resources for stroke survivors, including the Center for Neurology, the Gilchrist Services Support Our Elders Program, Yoga for Stroke Survivors, and The Center for Rehabilitation Medicine. In addition, you may be interested in referring your loved one to a stroke support group. A brief list is included below for your reference. Remember progress, not perfection!

  • Bayview Medical Center
    Third Wednesday of the month
    6:00 - 7:30 pm
    Burton Pavilion Conference Room: 1st floor

  • Upper Chesapeake Medical Center
    Stroke Club
    Third Wednesday of every month
    10:30 - 12:00 noon
    443-643-1000 (main hospital number)

  • Medstar Franklin Square
    First Thursday of every month
    1:00 - 2:30pm

  • Saint Agnes Hospital
    Fourth Thursday of every month, January - October
    MMI Conference Room

Sunscreen 101

May's warming weather gets us thinking of sunny outdoor gatherings, beach trips and pool days — it's the perfect time to observe Melanoma/Skin Cancer Detection and Prevention Month. To get you geared up for safe fun in the sun, GBMC Family Medicine Physician Kevin P. Carter, MD, answers some common questions about sunscreen:

How should I choose an SPF level?
Any SPF between 15-50 is recommended. A sunscreen with at least SPF 15 will block 90% of the sun's harmful rays. With SPF 50, almost all of the dangerous rays will be blocked, but SPFs of 50+ are no more powerful than 50.

Is using makeup that contains an SPF sufficient?
It will be effective, but you can't expect it to work for you all day for the purpose of sun protection, even if it is still working as makeup. When out of the sun, reapply a sunscreen every two hours and allow at least 30 minutes for it to fully absorb into your skin.

What is the difference between physical and chemical sunscreen?
Physical sunscreens put a reflective UV barrier on the skin. The most common physical barriers are zinc oxide and titanium oxide. These can often leave a white-ish cast on the skin. Chemical sunscreens are absorbed into the skin and use chemicals to absorb the UV light, rather than block it. Both are effective; it's a matter of personal preference.

Is it better to use a spray or lotion sunscreen?
Though it may be easier and more convenient to use a spray sunscreen on squirming kids, it is not recommended for small children who can't hold their breath during application. It can irritate their airways if inhaled. Additionally, it can be difficult to tell if you've missed an area. Lotion sunscreen is a good choice because it's easier to tell where you've applied it, and the act of rubbing it in may mean you're being more thorough.

Should I choose a natural/organic sunscreen, or is store brand ok?
The most important thing is to protect your skin from UV rays, so any type of sunscreen is better than none at all. Make sure your sunscreen is labeled "broad spectrum" to ensure it protects against UVA and UVB rays. There has been concern based on animal studies that some of the chemicals used in sunscreens could have harmful effects. More research is still needed to determine if any of the concerns are applicable in humans.

When is it safe to start using sunscreen on babies?
Sunscreen is not recommended for infants under 6 months of age. The best sun protection for babies is a complete lack of sun. If your baby must be outdoors, stay in the shade and make sure he or she is wearing full-coverage clothing made of tightly-wound fibers. Hold the item of clothing up to the sun; if you can see through it, it is not sufficient for sun protection.

What should people with darker skin tones know about sun protection?
Regardless of how dark your skin tone is, you need to safeguard yourself from the sun's dangerous UV rays because of the cancer-causing and aging effects. Use sunscreen and sun-protecting clothing every time you're outside.

Talk to your primary care provider if you have questions about sun safety and preventing skin cancer. If you have a concern about melanoma or possible sun damage, your doctor can refer you to a dermatologist if needed. If you don't already have a primary care physician, visit to find one near you.