Keeping Diabetes Patients Well

For diabetes patients, managing the condition can mean the difference between living a healthy life and one that’s full of medical complications and hospital stays. Since uncontrolled diabetes can cause a number of co-morbid conditions, from foot wounds that won’t heal to vision loss, keeping blood glucose under control plays a major role in improving diabetes patients’ quality of life.

“The evolution of our population is making it necessary to focus more on managing diabetes,” explains James Mersey, MD, Chief of Endocrinology at GBMC and Medical Director of the Geckle Diabetes and Nutrition Center. “Our aging population is growing as well as our population of overweight patients, both of which are more at-risk for developing diabetes.”

Dr. Mersey and Neal Friedlander, MD, FACP, Chairman of GBMC’s Department of Medicine, are spearheading an initiative committed to improving overall management for diabetes patients across GBMC, from the hospital’s inpatients to outpatients at its primary care and specialty practices.

One major improvement that has been developed as part of the initiative has been changes made to GBMC’s Geckle Diabetes and Nutrition Center. In addition to offering outpatient services such as support groups and nutrition counseling, the Geckle Center will add physician services three days a week so that patients can have their regular endocrinology visit at the same time they come in for their nutrition consult. “The goal is to improve accessibility and convenience for the patient, making it easier to take control of their diabetes,” says Dr. Mersey. “Eventually, we would like to consider getting ophthalmology and podiatry involved so that the Center can be a one-stop resource for our patients.”

Another major focus of the initiative is better education and transitioning of patients from the hospital to home. “Staff may be able to get a patient’s blood glucose under control during their hospital stay, but it’s paramount that patients be able to sustain that control once they are discharged to prevent recurring illness and readmission,” says Dr. Mersey. “We’re emphasizing treatment throughout the continuum of care while also empowering patients to take charge of their own lifestyles.”

To learn more about GBMC’s diabetes services, visit www.gbmc.org/diabetes.

Summertime Food Safety

Long days and warm weather make summer the perfect time of year for picnics and cookouts. Before you dig in, be aware that unwashed or undercooked food, as well as improperly cleaned dishware and utensils, can harbor bacteria, viruses and other toxins that cause gastrointestinal illness.

According to Niraj Jani, MD, GBMC’s Division Head of Gastroenterology and Gastrointestinal (GI) Oncology, the symptoms of what is commonly referred to as “food poisoning” may begin within two to six hours of eating contaminated food and include diarrhea, abdominal cramping, nausea, headaches or fever.  Do yourself, your family and friends a favor by taking these simple steps to keep gastrointestinal upset from ruining a good time. 

• Cook all meats fully! Beef should be cooked to 160 degrees or until the center is no longer pink. Poultry should be cooked to 165-180 degrees. Use a meat thermometer to take the guesswork out of cooking times.

• Wash hands, dishes, cooking utensils and meat thermometers thoroughly.

• Refrigerate leftovers promptly, especially those that contain egg or dairy products.

• Wash vegetables and fruits, even if they are organic and even if the fruit has thick skin or a rind. Organic produce can become contaminated during handling between farm and store, and a knife can carry bacteria from the skin or rind through the fruit’s flesh.

“Most food borne illnesses will resolve themselves within 48 – 72 hours,” says Dr. Jani. “But, if your symptoms are severe or do not improve after 72 hours, then it’s time to contact your physician.”


To find a doctor at GBMC, visit http://www.gbmc.org/.

Stopping Lung Cancer In Its Tracks

In October 2011, when Erin Morrissey coughed up a scant amount of blood, she didn’t think much about it. Then it happened again.

“The second trace of blood sent me to the doctor, who ran a gamut of tests,” says Ms. Morrissey. “What they initially thought was pneumonia ended up being a large, malignant mass on my right lung.”


Ms. Morrissey, who lives in Frederick, Maryland, was originally sent to a local physician who gave her a grim outlook – a diagnosis of stage IIIA lung cancer. He claimed her tumor was inoperable in its current state and would need many rounds of chemotherapy and radiation before it could be removed. “The thing about cancer is, once you have it, you want it out immediately,” she says. “Waiting to be operated on was hugely upsetting for me.”

She decided to seek a second opinion with Neri Cohen, MD, PhD, Chief of Thoracic Surgery at GBMC, who immediately gave her hope. “Dr. Cohen was a breath of fresh air,” says Ms. Morrissey. “He gave me the encouragement that I needed and, for the first time, I felt like I had a fighting chance.”


After reviewing her tests, Dr. Cohen decided that there was a very good chance the tumor could be removed without her receiving systemic treatment first. He explained that, for patients who need trimodality (surgery, chemotherapy & radiation) therapy, the data showed the same survival rate no matter what order the therapy was given.  Ms. Morrissey was quickly scheduled for surgery. Though 40 percent of her lung needed to be removed, the tumor was fully resected.

“We performed minimally invasive video assisted thoracic surgery (VATS) to remove Ms. Morrissey’s tumor,” says Dr. Cohen. “Using VATS was the most effective way to assess the extent of the disease and decide whether the tumor could be removed. With the help of the video camera, I get an excellent visualization of the surgical field and, in Erin’s case, was able to completely remove the tumor without complications. In general, this procedure is successful and boasts excellent results with a faster recovery time, fewer complications and less pain.”

Dr. Cohen notes that Ms. Morrissey’s cancer had already spread to some of the lymph nodes in her chest at the time of her surgery. Based on evidence from several clinical trials, he recommended a course of chemotherapy and radiation therapy following surgery to give her the best chance for a cure. After a two-day stay at GBMC to recover from the operation, Ms. Morrissey decided to undergo the treatments at a hospital closer to her home.  She credits her good results to Dr. Cohen’s expertise.


Today, Ms. Morrissey is stronger than ever. In fact, she didn’t even have to give up participating in the annual Hooly Plunge in her hometown of Cumberland, Maryland. She raised more than $10,000 for the Alleghany County Special Olympics by jumping into the icy waters of Lake Habeeb. “I’m certainly feeling like my old self again, thanks to the care I received at GBMC,” she says.

Learn More

Get additional information about the various treatments and procedures offered by GBMC’s Division of Thoracic Surgery by visiting www.gbmc.org/thoracic.

Oh My Aging Eyes! Vision Concerns As We Age

Much like the rest of the body as it ages, people’s eyes aren’t always what they used to be. “Oftentimes, subtle vision changes are just a normal part of the aging process and many can be effectively managed when caught early,” says C.P. Wilkinson, MD, Chair of GBMC’s Department of Ophthalmology. Vision concerns people commonly experience as they age include the following:

• Difficulty seeing items up close (presbyopia). This normal part of aging occurs when the lens is unable to bend well enough to focus images upon the retina. Reading glasses are a common solution to this problem. Some patients use progressive bifocals or special contact lenses.

• Sensitivity to glare, cloudy/fuzzy vision, double vision and difficulty with oncoming car lights in dim light. All of these symptoms can be related to cataracts, which are lens opacities. Wearing optimal eyeglasses can be helpful if cataracts aren’t bothersome. If a patient’s quality of life is believed to be impacted, surgery is an option. 
 
• Pain in or around the eye, seeing colored halos around lights, and sudden, severe blurring are symptoms of acute glaucoma, the relatively uncommon form of glaucoma. A loss of peripheral vision may indicate the late stages of chronic glaucoma, a more common form of glaucoma related to excess fluid pressure within the eyes that causes optic nerve damage. Older patients, those with a family history and African Americans are most at risk. One of the major challenges related to glaucoma is its lack of symptoms until very late in the course of disease.  Drops, lasers, and/or surgery are potential treatments to reduce the pressure in the eyes. Early detection of optic nerve damage before any visual field changes is key.

• Mild vision changes associated with pigment changes in the eye or the presence of small, yellowish deposits known as drusen. Signs like these may point to early stages of age-related macular degeneration (AMD), the most common cause of legal blindness in senior patients. The disorder affects the macula, or the central point in the retina that is responsible for vision needed for reading, driving and recognizing faces. Caucasians, the elderly and those with a family history are more at risk of developing AMD. Smoking and poor diet can also increase one’s risk. For less severe AMD, treatment may include taking vitamins, antioxidants and zinc. In AMD cases in which leakage and/or hemorrhage in the macula causes more severe vision loss, injections in the eye can help delay the progression of the disease and even improve vision in many instances.

According to Dr. Wilkinson, routine vision screenings can help to identify eye problems early, before permanent vision loss occurs. He advises people to take note of any changes to their visual abilities and discuss them with an ophthalmologist, especially if the changes are sudden and/or accompanied by discomfort or cause a disruption to daily life.

Learn More

GBMC has a number of board-certified ophthalmologists with a range of specialties, from pediatric ophthalmology to age-related vision disorders and low vision. To get additional information or to make an appointment, visit www.gbmc.org/ophthalmology or call 443-849-GBMC (4262).

Balsamic and Rosemary Grilled Salmon

Serve this heart-healthy fish with steamed green beans and a slice of whole-grain bread for a nutritious meal.


Ingredients

• 4 (4 ounce) salmon fillets
• Sea salt to taste
• 1 tablespoon balsamic vinegar
• 3 tablespoons olive oil
• 1/4 cup lemon juice
• 1 clove garlic, minced
• 1 sprig fresh rosemary, minced

Directions

1. Season salmon fillets to taste with sea salt and place into a shallow glass dish. Whisk together vinegar, olive oil, lemon juice, garlic and rosemary; pour over salmon fillets. Cover and refrigerate at least 30 minutes.

2. Preheat an outdoor grill for medium-high heat and lightly oil grate.

3. Remove salmon from marinade and shake off excess. Discard remaining marinade. Cook on preheated grill until fish is opaque in the center and flakes easily with a fork, about 4 minutes per side.

Serves four.

Nutritional information (per serving): 280 calories, 21 g fat, 160 mg sodium, 2.2 g carbohydrates, 19.7 g protein.


Source: http://www.allrecipes.com/