Enjoying the Sun? Remember to Protect Your Eyes!

July is designated as Ultraviolet (UV) Safety Month. When people think about protecting themselves against the sun’s harmful UV rays, they tend to focus on their skin. However, the same rays can also have damaging effects on unprotected eyes. In fact, studies have shown that long-term UV exposure may cause several conditions, including macular degeneration, which can lead to low vision, cataracts and even cancer.

Protection
Remember to put on a pair of shades while slathering on the sunscreen (even during cloudy days!). With so many sunglasses on the market, it may be difficult to determine which ones offer the best protection from the sun. When scoping out your options for sunglasses, look for some of the following features:

• Ability to block 99 percent or 100 percent of UVA and UVB rays
• Sunglasses that meet American National Standards Institute (ANSI) Z80.3 blocking requirements
• UV 400 protection

Wearing broad-brimmed hats can also offer some protection for the eyes.

Dealing with Low Vision Caused by Long-Term UV Exposure
For individuals who suffer from low vision due to long-term UV exposure (or for a variety of other reasons), daily activities such as reading, driving, recognizing faces, and interacting with others can prove to be physically and emotionally challenging. To help improve quality of life for those with low vision, GBMC offers the VIEW (Vision Information Education Wellness), its on-campus low vision retail store, which supplies many non-optical aids such as “talking” clocks, canes for mobility, magnifiers and computer software to assist patients with day-to-day living. It is also a showcase for new low vision technology.

The VIEW is located at 6569 North Charles Street, Physicians Pavilion West, Suite 504 and is open for walk-in customers between 8:30 a.m. and 4:00 p.m. Monday through Friday.

To complement the products available for sale at the VIEW, consider scheduling an appointment at GBMC’s Richard E. Hoover Rehabilitation Services for Low Vision and Blindness. Specialists at Hoover develop individualized plans to help patients of all ages achieve their goals. Additionally, patients have access to an on-site occupational therapist, who also makes in-home visits.

Learn more about Ophthalmology and Low Vision at GBMC – visit www.gbmc.org/ophthalmology or www.gbmc.org/lowvision. 

Not Everything’s the Same About Twins

Kimberly Williams holds fraternal twin
daughters Kellie and Charlie on the day
they were discharged from GBMC.

Nearly eleven years ago, Kimberly Williams’ twin daughters entered the world in a most unusual way—they were born nearly eight weeks apart from each other.

At 23 weeks pregnant, Ms. Williams, now 47, was admitted to GBMC’s Mangione High-Risk Obstetrics Unit. She was in labor, but only one of her babies was threatening to deliver. “This uncommon situation is possible when the babies do not share the same amniotic sac, which was the case with Ms. Williams’ fraternal, or non-identical, twins,” explains Hsiao-Hui Lin, MD, her obstetrician. “The baby’s odds of survival were not favorable, so we did everything possible to keep Ms. Williams from delivering.” For one week and one day, Ms. Williams was inverted in bed, with her head toward the floor and her feet toward the ceiling. Two short hours after returning to an upright position, Ms. Williams delivered baby Kellie at 24 weeks and one day old. Her premature lungs were so underdeveloped that she needed round-the-clock care in the neonatal intensive care unit (NICU) for 100 days.

Ms. Williams remained in the High-Risk OB Unit, which consolidates all prenatal services, inpatient care and antepartum testing into one location, through the rest of her pregnancy. In and out of labor for several weeks, she couldn’t risk leaving the hospital in case something went wrong with the second twin. “The nurses and staff of both the High-Risk unit and the NICU treated me like family. They did everything within their power to make me comfortable and reassure me that my girls were going to be okay.”

Ten years later: Charlie (far left),
Kellie (right) and their mom, Kimberly,
visit with Dr. Hsiao-Hui Lin.

Fifty-four days after Kellie’s birth, Charlie arrived. After a brief stay in the NICU with her sister, she was discharged, and two weeks later, Kellie was home too. Despite the obstacles they faced as infants, both girls have enjoyed happy and healthy childhoods so far. 

Ms. Williams and the twins visited with Dr. Lin near their tenth birthday, and stay in touch with many other members of the team that cared for them. “Thanks to all of the exceptional staff who cared for me and my fragile babies, I can testify that even the most unexpected and scary situations don’t always become sad stories,” she says.

Visit www.gbmc.org/highriskob, www.gbmc.org/nicu or call 443-849-GBMC (4262) to get additional information about the services provided by GBMC’s High-Risk OB Unit and NICU.

Shaved Summer Squash Salad with Prosciutto Crisps

Ingredients:

• 1 medium zucchini
• 2 medium yellow squash
• 1/4 teaspoon salt 
• 2 tablespoons thinly sliced fresh mint 
• 1 tablespoon extra-virgin olive oil 
• 1/2 teaspoon grated lemon rind  
• 1 teaspoon fresh lemon juice  
• 1/4 teaspoon freshly ground black pepper 
• 3 thin slices prosciutto (1 ounce), chopped 
• 1/4 cup (1 ounce) crumbled ricotta salata or feta cheese 

Instructions:

1. Shave the zucchini and squash into thin strips using a vegetable peeler. Discard seeds. 
2. Place zucchini and squash in a medium bowl, and toss with salt.
3. Combine mint and next 4 ingredients (through pepper) in a small bowl; stir with a whisk. Pour the mixture over zucchini and squash; toss.
4. Heat a small nonstick skillet over medium heat. Add prosciutto; saute for 2 minutes or until crisp.
5. Place 3/4 cup salad on each of 4 plates. Top each serving with 1 tablespoon cheese; sprinkle evenly with prosciutto.

Nutrition:
Calories: 68
Fat: 4.9g
Protein: 3.5g
Carbohydrate: 3.6g
Fiber: 1.1g
Cholesterol: 6mg
Sodium: 269mg
Calcium: 36mg

Recipe by Ivy Manning, Cooking Light

Thyroid Cancer is No Match for Determined Grad Student

Twenty-four-year-old Diandra Denier is a busy Towson University student, working on her master’s degree thesis. She was taken by surprise in the summer of 2012, when she was diagnosed with thyroid cancer. This is her story, in her own words.

Diandra Denier at a conference in
October 2012, two months after
surgery to treat her thyroid cancer.

I earned my undergraduate degree in cell and molecular biology, so I’ve been reading about cancer in textbooks for years. I’m familiar with the statistics—the National Cancer Institute estimates that one in three Americans will develop cancer. I certainly didn’t think I had immunity, but didn’t expect this to happen at such a young age. 

Two years ago, I went to my primary care physician due to swollen lymph nodes in the left side of my neck. I tested positive for mononucleosis. Satisfied with that answer, I went on with my life. I was a college student and didn’t have health insurance at the time. The lymph nodes didn’t seem to shrink to normal size, so when I got insurance a couple of years later, I went to see another doctor. Because the lymph nodes were so enlarged and the swelling hadn’t subsided over such a long period of time, my new doctor was concerned that the source of the swelling was something far worse than mono. Within a few days, I was referred to Patrick Ha, MD, FACS, who specializes in head and neck surgery for cancer patients at GBMC.

Dr. Ha performed a neck dissection to remove the lymph nodes in my neck and also removed my thyroid gland. He explained that, although only a portion of my thyroid was affected, the entire gland had to be removed as a preventive measure to avoid a recurrence. I underwent radioactive iodine therapy to destroy any cancer cells that may have been left behind after surgery. Fortunately, my first scan after treatment showed that the therapy had effectively targeted the right areas and the disease had not spread elsewhere in my body.

Diandra (center) on her first day home
following surgery with brother Noah
(left), sister Desiree (right) and
boyfriend Kenneth (back).

Being treated for cancer was terrifying, but I always felt like I was in excellent hands. GBMC’s staff helped me maintain an optimistic outlook through the whole experience, taking exceptional care of me and reassuring me that I could beat this disease. Dr. Ha even called me several times after my surgery to check in. Additionally, the staff at the Greater Baltimore Lymphedema and Rehabilitation Center became like family to me. Due to the location of my lymph nodes in relation to veins and tendons in my neck and shoulders, I needed physical therapy to rebuild the muscles in my left shoulder after surgery. I was often there two times a week, and they were very helpful in showing me specific exercises that I could do at home to ensure a speedy recovery.

Although fighting cancer is a scary experience for anyone, I was fortunate to have a less aggressive form that was caught before it had a chance to spread. Now, I’m vigilant about my follow-up appointments. Keeping up with annual exams for early detection is a task I take very seriously.

I decided on a career in cancer research or biotechnology because I lost an aunt to breast cancer. When I was diagnosed with cancer myself, I was afraid that everything I’d been working toward for the past six-and-a-half years was going to be taken away because of my illness. Thanks to the staff at GBMC, I have the opportunity to use my own cancer experience to help those diagnosed in the future. 

For more information about the Thyroid Center at GBMC, including a video featuring Brian Kaplan, MD, FACS, Surgical Director of the Center, visit www.gbmc.org/thyroid or call 443-THYROID (849-7643).

When a Doctor's Office Becomes a Home

Last year, the GBMC at Hunt Valley practice became GBMC HealthCare's first official Level 3 Physician Practice Connections-Patient-Centered Medical Home (PPC-PCMH) as noted by the National Committee for Quality Assurance (NCQA). This recognition was of great significance to the practice’s patients, as it meant the staff was equipped to provide more patient-centered and evidence-based care, focusing on prevention, wellness and the active management of chronic disease.

Now, GBMC has additional exciting news to share! Three more of its primary care practices have also attained this recognition: GBMC at Hunt Manor, GBMC at Texas Station and Family Care Associates (main campus, Physicians Pavilion East).

What is PPC-PCMH?
The goal of the PPC-PCMH program is to improve primary care by encouraging organization, coordination, tracking of care and implementing the various technologies to facilitate such changes. Ultimately, these steps help healthcare organizations to provide better health and better care to their patients at a lower cost. Level 3 is the highest PPC-PCMH recognition currently obtainable; achieving this recognition takes about two years and is a great accomplishment for each primary care practice.

How the Practices Have Changed
Perhaps one of the most critical components to achieving PPC-PCMH status is the implementation of an electronic health records (EHR) system. An EHR system facilitates better communication between primary care physicians and specialists so that each provider involved in a patient’s care remains in the loop. This improves safety by helping to avoid treatments that may counteract each other and ensuring that follow-up appointments are kept. If patients have difficulty taking the next steps recommended for their care, practices can connect them with a care coordinator to assist. Additionally, patients are encouraged to be active participants in their healthcare through tools such as the myGBMC patient portal, which allows them to access information about their medical history and communicate electronically with their caregivers. 

A strong emphasis is being placed on improving patients’ access to care. GBMC’s PPC-PCMH practices have made schedule adjustments to ensure they can take urgent appointments every day as well as get patients in for non-emergent issues more quickly. In fact, GBMC’s primary care practices offer extended weekday hours as well as Saturday hours.

According to Ben Beres, Chief Operating Officer for Greater Baltimore Medical Associates (GBMA), the PPC-PCMH recognitions directly correlate with GBMC’s vision of providing every patient, every time, with the care that we would want for our own loved ones. “The hard work and dedication it takes to become a Level 3 PPC-PCMH is well worth it when you look at the benefits it brings to our patients. It is certainly the right thing to do for our community,” he says.

To find a Primary Care Physician who is right for you, visit www.gbmc.org/mydoctor or call 443-849-GBMC (4262).

Vacation First Aid

Remember to Pack These Items!

The weather has warmed up and children are out of school (or are about to be), which means that summer vacation plans are on many people’s minds. While you’re excitedly packing your bag for a quick or extended stay out of town, take a few minutes to gather these first aid materials. Hopefully, they won’t be needed! But, if a minor health concern arises, they should help you to avoid spending valuable vacation time in the aisles of a drugstore or supermarket. 

Antihistamines 
An over-the-counter antihistamine can relieve the symptoms of different types of allergies (food, seasonal, indoor). It can also help to treat rashes caused by poisonous plants like poison ivy.

Aloe Vera Gel
This cooling gel, made from the leaves of the aloe vera plant, is useful for treating sunburn, blisters, bug bites and even blemishes. 

Saline Nasal Spray 
It’s not the most pleasant sensation, but using a saline nasal spray periodically to keep mucus membranes moist may help to lower your chances of getting sick when traveling. 

Adhesive Bandages 
In case of a skinned knee or stubbed toe, have a few adhesive bandage strips stashed in your travel first aid kit. Clean the abrasion with soap and water, and let it dry thoroughly, before applying the bandage. 

Elastic Bandage 
Twisted an ankle running after a Frisbee? A stretchy fabric bandage comes in handy to support sprains. It can also be used to maintain pressure on a bad cut and to hold an ice pack against a bump or bruise.

Pain Medication 
Taking ibuprofen tablets or capsules is another method for relieving inflammation and soreness. Always follow the indications on the product label, though.

Antacids 
Indulging in rich foods and eating more than normal can cause heartburn or upset the stomach. A variety of over-the-counter products can help alleviate many stomach symptoms.

Nail Clippers
Use these to rid yourself or your child of a bothersome hangnail instead of biting the skin or nail (yuck!). 

Prevent Fireworks Injuries this July 4th

Summer is just starting, but before you know it, Fourth of July celebrations will be in full force. Fireworks will accompany many of those celebrations and, unfortunately, some injuries will result. Even products considered to be safe, like sparklers and small firecrackers, can cause serious burns or damage to the eyes. According to the American Academy of Pediatrics (AAP), nearly half of those injured by fireworks each year are under the age of 15. It’s not too early to start thinking about ways to protect your children this July 4th, or how to care for them if an injury does occur.

Safety first!

• Use fireworks, firecrackers and sparklers outdoors only.
• Never leave children unattended with fireworks or sparklers.
• Always read and follow label directions on all fireworks carefully.
• Make sure children maintain a safe distance from the area where fireworks are being lit.
• Have water nearby (a garden hose and a bucket) to soak used sparklers and other fireworks to make sure they're extinguished.
• Never re-light a "dud" firework (wait 15 to 20 minutes, then soak it in a bucket of water).
• Never throw or point fireworks at other people.
• Never shoot fireworks in metal or glass containers.

How to care for a first-degree (top layer of skin) burn: 

• Hold the injured area under cool (not cold) running water or immerse in cool water until pain subsides. Use cool compresses if running water isn’t available.
• Protect the burn by covering it with a sterile, non-adhesive bandage or clean cloth. Do not apply butter or ointments, which can cause infection.
• Give an over-the-counter pain reliever such as ibuprofen (Advil, Motrin), acetaminophen (Tylenol), or naproxen (Aleve) according to the product’s label.
• Seek help from a doctor if pain and redness last more than a few hours or if signs of infection develop (worsening pain, redness, swelling, fever or oozing).

Call 911 if:

• The burn penetrates all layers of skin
• Skin looks leathery or charred, with patches of white, brown or black
• The burn blister oozes or is larger than two inches
• The person burned is an infant or elderly