Wednesday, August 10, 2016

Chasing the Record at Legacy Chase!

The Greater Baltimore community has trusted GBMC HealthCare with providing the highest level of compassionate care for more than 50 years. With advanced treatment options available from some of the region’s leading physicians, the Sandra & Malcolm Berman Cancer Institute is no exception. Statistics show that one in three people has been touched by cancer in some way. Whether a loved one has battled cancer or you personally have been diagnosed, the reality is that cancer affects us all.

Join us Saturday, September 24, 2016 for the 16th annual Legacy Chase at Shawan Downs. Set in in Maryland’s picturesque horse country, Legacy Chase is GBMC’s signature event benefiting its oncology services and patient support programs. Fill up your car with family and friends, pack a cooler and picnic and spend a day in the warm September sun for this homecoming of the GBMC community. With family-friendly activities, steeplechase horse racing, food trucks and a Vendor Village, Legacy Chase offers something for everyone.

To add to the fun, this year, we’re attempting to break the Guinness World Record for the world’s longest awareness ribbon – right in the infield of Shawan Downs! Stretching a mile and a half long, the lavender ribbon is a symbol of GBMC’s commitment to the fight against all cancers. Join us for this momentous occasion as we “chase the record!”

Legacy Chase Lowdown

A Farmer’s Field parking pass starts as low as $35 per car load with additional premiere seating available. Find the best admission option for you at www.legacychase.org.

Gates open at 10:00am and Guinness World Record Judging begins at 11:30am.

The Kids’ Korner offers games and activities for children of all ages, including face painting, visits from your favorite princesses and superheroes, stick pony races and more!

Cancer survivors and their loved ones are welcome to join us at the Cancer Survivorship tent for refreshments. RSVP online at www.legacychase.org to receive a free parking pass.

Graduates of GBMC’s Neonatal Intensive Care Unit (NICU) and their families are welcome to participate in a reunion with other NICU families and members of the NICU team.

Volunteers are needed! Sign up at https://gbmc.formstack.com/forms/ribbonvolunteer.

GBMC at Hunt Manor: Community and Convenience

Convenience is key at GBMC at Hunt Manor. Patients who live in Phoenix and the surrounding sprawling neighborhoods don’t have to venture down the JFX for accessible care they can count on. Open seven days a week with walk-in appointments and extended hours on weekdays, Hunt Manor ensures patients receive immediate care when issues arise. According to Practice Manager Suzanne Auer, early morning appointments are especially appreciated. “It means a lot when people can fit in a doctor’s visit and then go about their day without disruption,” she says.

Hunt Manor clinicians strive to provide the care they would want for their loved ones, but for Tu Cao, DO, many patients have begun to actually feel like family. “I build relationships, get involved and have established care with patients’ children, parents or grandparents,” she says. “I love feeling included as part of the family and neighborhood.”

The established community presence is important to Registered Nurse Practitioner Kim West, too. “We live and work in this neighborhood. People love having this level of excellence right in their backyard,” she says. “It’s a pleasure and privilege to make our own community, from newborns to geriatrics, healthier.”

The Hunt Manor team includes six physicians, Tu Cao, DO; Lisa Carey, DO; Joseph Connelly, MD; Luisa Massari, MD; Robin Motter-Mast, DO; and Francis Sanzaro, MD, along with a certified nurse practitioner, Kim West, CRNP, and a physician’s assistant, Deanna Shapiro, PA-C. They coordinate and collaborate with the entire GBMC HealthCare System, functioning as a comprehensive patient-centered medical home, with specialists and tests readily available. A gynecologist and gastroenterologist visit the office each month so patients don’t need to travel as much. “Our resources are really top-notch,” Ms. West says. “Our patient care coordinator makes things happen quickly: transferring notes, scheduling appointments, following up and delivering lab results. We all hold each other accountable for getting patients to their goals.”

Education is another one of those goals. In addition to providing care swiftly and conveniently, the Hunt Manor practice is focused on keeping patients out of the hospital by providing as much preventive medicine as possible. “Educating patients helps them take health into their own hands,” Ms. Auer says. For example, patients with diabetes can attend in-house classes led by certified educators from GBMC’s Geckle Diabetes and Nutrition Center. “They learn how to manage their blood sugar, eat healthily, exercise and take their medicine so they don’t end up in the hospital,” she says.

Family Medicine physician Joseph Connelly, MD, prides himself on the fact that the practice has established itself as a community resource where people know problems will be treated with personalized attention to detail and a level of diligence they may not find elsewhere. “I always want to be the type of doctor who spends enough time,” Dr. Connelly says. “I like to evaluate each day at the finish and know that I was complete and thorough. It keeps the joy in the practice.”

GBMC at Hunt Manor is currently accepting new patients! For more information about this and other GBMC primary care physician practices, visit www.mygbmcdoctor.com or call 443-849-GBMC (4262).

Asian-Style Steamed Salmon

Ingredients

1 cup low-sodium chicken broth
½ cup shiitake mushroom caps, rinsed and sliced
2 tablespoons fresh ginger, minced (or 2 teaspoons ground)
¼ cup scallions (green onion), rinsed and chopped
1 tablespoon light soy sauce
1 tablespoon sesame oil (optional)
12 ounces salmon fillet, cut into 4 portions (3 ounces each)

Directions

Combine chicken broth, mushroom caps, ginger, scallions, soy sauce and sesame oil (optional) in a large, shallow sauté pan. Bring to a boil over high heat, then lower heat and simmer for 2-3 minutes.

Add salmon fillets and cover with a tight-fitting lid. Cook gently over low heat for 4-5 minutes or until the salmon flakes easily with a fork in the thickest part (to a minimum internal temperature of 145°F).

Serve one piece of salmon with ¼ cup of broth.

Nutrition Information

Servings: 4
Calories: 175
Fat: 9g
Saturated Fat: 2g
Cholesterol: 48mg
Sodium: 208mg
Protein: 19g
Carbohydrates: 4g

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

Thursday, July 21, 2016

The 411 on A1C: Diabetes Education Classes Can Help

When you eat, whether the food is sweet or not, your body breaks some of the nutrients down into a sugar known as glucose. Cells need glucose for energy, but if you already have enough, the remaining glucose is left floating in the blood. The level of sugar that builds up in the bloodstream can be measured with an A1C test, also known as a glycated hemoglobin test. Levels between 5.7% and 6.4% signify pre-diabetes and an increased risk of diabetes. Levels above 6.5% indicate diabetes.

If you have diabetes, managing your A1C level is vital to ensuring you don't develop complications such as eye, nerve, foot or kidney damage. Home blood sugar testing is an important and useful tool, but it only provides a snapshot of your blood sugar levels in the moment. An A1C test provides an average from the past three months, which can provide a more accurate sense of how well you're managing your type 2 diabetes. Patients with diabetes should get an A1C test every three to six months.

There are ways to improve your blood sugar management and contribute to lowering your A1C score:
  • Register for free diabetes education classes. GBMC offers a series of two 90-minute classes in its primary care offices: Diabetes Basics and Taking Charge of Your Diabetes. Both include education, support and resources. Learn how to manage your meals, understand target blood glucose numbers and become comfortable self-monitoring. To sign up, call your PCP's office and request to speak with the RN Care Manager.
  • Get moving. Find a workout you enjoy that will encourage you to get at least 30 minutes of exercise five times a week.
  • Stick to a schedule. When you overeat or skip meals, your blood sugar levels are rising and falling too much. Have regular well-balanced meals.
  • Balance your diet. You may be surprised what one serving size of fruit looks like. A diabetes educator can help you plan a proper diet that works for you.
For qualifying patients, GBMC also offers one-on-one sessions with a registered dietitian who is also a certified diabetes educator at these practices: Hunt Valley, Family Care Associates, Hunt Manor, Owings Mills, Joppa Road and Internal Medicine Residents. If you are interested in diabetes education, call the Nurse Care Manager at your primary care practice. Feel free to forward this e-mail to a friend or family member who might need help managing their A1C level, too. In need of a primary care provider? Find one near you.

Safe Summer Travels

No one likes to think about being sick on vacation, but with so many news stories about various epidemics circulating in popular summer destinations, we turned to two of GBMC’s infectious disease physicians Maneesha Ahluwalia, MD, and Alina A. Sanda, MD, for advice. Here are their tips for a safe and healthy vacation:

Q: What is the number one precaution I should take when traveling?

Maneesha Ahluwalia, MD
A: Hand washing cannot be emphasized enough; it’s like a do-it yourself vaccine! Lather with water for at least 20 seconds (about one Happy Birthday song) and dry with a clean towel. Wash before eating, before and after treating a cut or wound, after using the toilet, after touching an animal or garbage and after changing diapers. Avoid those who are coughing and sneezing, and if you must cough or sneeze, do so into your shirt sleeve or elbow, not hand.

Q: What are some good items to pack?

A: Pack full-sized bottles of sunscreen and insect repellent, especially if visiting a tropical location. Use products with 25 percent DEET; you don’t need more than that. Apply sunscreen first, and then insect repellent. Also bring hand sanitizer or dissolvable soap, which does not require water to rinse off. Oral rehydration salts can come in handy for people who become dehydrated due to traveler’s diarrhea or vomiting. Bring along 1% hydrocortisone cream; it is helpful for a variety of skin conditions from insect bites and poison ivy to allergies, rashes and overall itchiness.

Alina A. Sanda, MD
Keep your prescription medications in your carry-on luggage and bring extra just in case. If you have any chronic illnesses, carry a card that identifies, in the local language, your blood type, medical conditions, medicines you take, and any allergies you have. Wear a MedicAlert bracelet if you have serious medical conditions.

Q: Are there foods or drinks I should avoid?

A: If you are traveling abroad to places like Africa, Asia or South America, do not drink the tap water. Brush your teeth with bottled water. Avoid eating raw fruits or vegetables unless they have a thick peel, like a banana or orange. In all locations, be wary of food served at room temperature, raw or soft-cooked eggs, raw or undercooked meat or fish, unpasteurized dairy and wild game.

Q: Should my family be vaccinated before we travel abroad?

A: Visit a travel clinic 6-8 weeks prior to traveling and bring along your vaccination history, a detailed itinerary and your travel dates. They will be able to give you reliable advice on recommended vaccines. Some vaccines and malaria prevention tablets must be started weeks prior to travel, so be sure to plan in advance. For the most up-to-date, reliable travel alerts for every country, visit the Centers for Disease Control and Prevention website at http://www.cdc.gov/.

Q: What should I do if I think one of my family members has contracted a disease?

A: Seek medical attention immediately. Hydration is usually a good first step. Find a safe and reliable doctor who speaks your language by contacting the US embassy in your destination country (http://www.usembassy.gov). Upon returning home, make an appointment with a primary care physician, who will assess your symptoms and determine whether a referral to an infectious disease specialist is necessary.

To learn more about infectious diseases and primary care at GBMC, visit www.gbmc.org/infectiousdiseases and www.mygbmcdoctor.com or call 443-849-GBMC (4262).

Not Just a Headache: Managing Migraines

Migraines are often perceived as simply bad headaches but in actuality, more than 37 million Americans are suffering from a debilitating condition that can't always be handled with a dose of Tylenol. Though migraines are a type of headache, they are more severe and can be accompanied by nausea, vomiting, tingling, stroke-like symptoms and sensitivity to light and sound. Sometimes a migraine phenomenon can even occur without a headache.

According to GBMC neurologist Arash Taavoni, DO, identifying one's migraine triggers is the key to preventing them. He recommends that patients log their food, stress levels and sleep, along with other environmental factors, like weather conditions and barometric pressure, in an effort to find patterns. There are even mobile phone apps, such as MigraineBuddy, that can be useful in helping patients log their migraine symptoms, frequency, duration and intensity by automatically making data correlations to pinpoint a migraine's cause. Some of the most common food-related triggers are caffeine and MSG, which is often found in highly-processed and convenience foods, so establishing a healthy diet is the first step to addressing migraines. In addition to lifestyle and behavioral factors, genetics and hormones can make certain people more prone to migraines; they can run in families and are more common among women.

While identifying triggers as a means of trying to avoid migraines is ideal, sometimes this isn't enough and other treatments may be needed. There are two types of medications that can be prescribed – preventive and abortive. Other than pills, there are also intranasal and injectable medications for faster relief. There are even treatments without medications, such as headband-like devices patients can wear at home that use electrical impulses or magnets to reduce migraines by acting on the nerves associated with head/face pain. Dr. Taavoni notes that acupuncture may be helpful as a complementary treatment, as well.

Some patients with chronic migraines who have not had adequate success with medications and lifestyle modifications could be candidates for Botox® injections. "To prevent migraines, Botox® is injected into 31 specific spots on the head and shoulders, administered every three months by a trained physician," Dr. Taavoni says.

If you're suffering from migraine headaches, your primary care physician can likely help you find a solution. If migraines are frequent and refractory or if there are additional neurological symptoms, you should see a neurologist: http://www.gbmc.org/neurology.

Run Safely in the Sun

If you've exercised on a treadmill through the cold winter and rainy spring, an outdoor summer run can seem so appealing. Running outdoors is a great way to mix up your fitness routine while getting a boost of vitamin D; the varied terrain activates different muscles, but it's important to be aware of how the heat and humidity can affect your physical abilities. A relative humidity of 60% or more hampers sweat evaporation, which hinders your body's ability to cool itself. Heat-related illnesses, such as heat cramps, heat exhaustion and heat stroke are all real possibilities for children, the elderly and particularly for outdoor runners, according to Mark Lamos, MD, Medical Director of Greater Baltimore Health Alliance (GBHA) and Internal Medicine physician at GBMC.

Heat cramps: If you're sweating a lot, you're losing salt, water and electrolytes as you exercise; this can cause painful and involuntary muscle spasms in the arms, calves and abdomen. Hydrate immediately with water or electrolyte-infused sports drinks or tablets.

Heat exhaustion: Severe water and/or salt depletion can lead to weakness, excessive thirst, headache, loss of consciousness, nausea, vomiting and dizziness. Heat exhaustion can also involve heat cramps. Drink plenty of fluids (not caffeine or alcohol), remove tight clothing and take a cool shower or bath. If cooling measures fail to provide relief after 15 minutes, get medical help.

Heatstroke: The most severe of heat-related illnesses, heatstroke can be life-threatening if left untreated. It causes the body's internal temperature to climb beyond 104 degrees, and the body loses its natural ability to cool off. Someone suffering from heatstroke may also have an altered mental state, throbbing headache, high temperature, rapid pulse and lose consciousness. Seek medical attention immediately while simultaneously cooling the body as quickly as possible with water and ice packs.

Dr. Lamos suggests a proactive approach to summer safety to help families avoid an unwanted trip to the hospital. Follow these tips to exercise safely in the warmer months:
  • Stay hydrated. Run in public parks or on trails that have water fountains. If you'd rather go your own way, bring a bottle of water or wear a hydration pack, like a Camelbak.
  • Make a plan. Avoid exercising outside when the sun is at its most intense, between 10 a.m. and 2 p.m. Plan routes that are well-shaded or have cool areas where you can take a break if needed.
  • Be prepared. Wear loose-fitting, light-colored, breathable clothing (like cotton) and a hat. Apply sunscreen generously at least 30 minutes before sun exposure, even if it is an overcast day.
Before exercising in the heat, talk to your doctor about the medications you are taking and how they may affect your tolerance of heat. GBMC primary care offices have extended and weekend hours to accommodate busy schedules. If you don't have a primary care physician, find one today at www.mygbmcdoctor.com.