Give Your Brain a Work Out

Your brain might not be the first thing that comes to mind when you hear the word “exercise.” However, the truth is that it can benefit from a good workout too. Studies have indicated that various brain exercises can boost brain health as you get older and also help prevent memory loss. Different activities that encourage mental stimulation may improve the areas of memory, reasoning and ability to process information more quickly.

How does it work? According to some animal studies, the mental stimulation supports new nerve cell growth and prompts communication between nerve cells. It can even decrease some of the hallmarks of Alzheimer’s disease, such as proteins and plaques seen with the disease.

There are many ways to challenge your brain, ranging from simple to complex.

• Eat with your nondominant hand: Switching things up while doing this typically easy task makes your brain work harder.
• Do puzzles: Puzzles, by definition, are designed to test the user’s ingenuity and knowledge.
• Play memory games or board and card games with friends or family: These can help keep your memory in tip-top shape. The socialization is an added bonus!
• Take up a new hobby: Challenging yourself to learn something new, perhaps how to speak a new language or play a musical instrument can be a tricky, yet fun and rewarding, way to boost brain health.
• Do research: Something as simple as perusing the Web or reading the paper helps you absorb new facts and can inspire curiosity.
• Read and write: These tasks require thought and concentration, which will help keep you sharp in the long run.
• Consider adopting a Mediterranean diet: this diet, which is also heart-healthy, consists of olive oil, vegetables, fruit and fish, and may have some positive impacts on brain health.
• Get your exercise: physically active adults may be less likely to develop Alzheimer’s disease than those who do not exercise. 

Want to know more about this topic? Register for the next Time for Me! women’s health lecture on Tuesday, October 1, 2013! Dr. Michael Sellman, Chief of the Division of Neurology at GBMC, will discuss brain health and share tips for keeping your brain fit. 

Time for Me! lectures are FREE to attend, but please register at www.gbmc.org/timeforme.

Beware the Bull’s Eye – Protect Yourself from Lyme Disease

The summer season may be over, but Marylanders should continue taking measures to avoid tick bites. Black-legged ticks (also known as deer ticks) are prevalent in the mid-Atlantic, even in September and October. Ticks infected with the Borrelia burgdorferi bacteria can transmit the bacteria to people, which can cause Lyme disease. Although it’s rarely fatal, Lyme disease is a serious illness. If left untreated, the infection can spread to a person’s joints, heart and nervous system. After several weeks to months, patients may also experience swelling of the membranes surrounding the brain, temporary paralysis of one side of the face and forgetfulness or confusion.

Lyme disease can be difficult to diagnose because the symptoms mimic other conditions and people may not recall having been bitten by a tick. But according to new information released by the Centers for Disease Control (CDC) in late August 2013, approximately 300,000 Americans are diagnosed each year – 10 times the number of cases reported to the CDC. The good news is that people who receive treatment early in the disease progression are likely to make a full recovery. Here are some steps you can take to keep yourself and your family safe.

Prevention is Key

• Wear insect repellent: the CDC recommends using one with at least a 20 percent DEET concentration.
• Avoid grassy or wooded areas: if you can’t avoid such areas, wear long sleeves, long pants, shoes and a hat, along with insect repellent.
• Check yourself, family members and pets daily: you may be able to remove ticks before they attach. Make sure to check in places where ticks are known to hide, such as under the arms, in and around the ears, inside the belly button, on the back of the knees, in and around all head and body hair, between the legs and around the waist. 
• Learn the correct way to remove an attached tick: removing a tick within 24 hours reduces your risk of developing Lyme disease. 
• Know the symptoms: they often (but not always) include a “bull’s eye” shaped rash accompanied by fever, headache and fatigue. If you experience these symptoms, talk to your primary care physician.

How to Safely Remove a Tick

• Use fine-tipped tweezers and grasp the part of the tick that's closest to your skin (the head, not the belly).
• Slowly pull the tick straight out, without twisting it.
• Wash the bite with soap and warm water. 
• Throw the dead tick into the trash. Do not use a lit match, nail polish, petroleum jelly or other topical agents to remove a tick.
• Contact your doctor.

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

September is Prostate Cancer Awareness Month

Prostate cancer is a prevalent disease in men. In fact, studies indicate that most men who are 70 or older have experienced or will experience some form of prostate cancer. Aside from skin cancer, it is the most common cancer that men face.

Symptoms of prostate cancer include:

• Frequent urination
• Trouble starting or stopping urination
• Weak/interrupted urinary stream
• Pain or burning during urination or ejaculation
• Blood in urine or semen

Although symptoms may be caused by a benign prostate enlargement, men should still see their doctor to rule out prostate cancer any time these signs are present. Fortunately, prostate cancer is often slow-growing and is typically caught early. When caught early, the prognosis is usually very good. Treatment options range from watchful waiting (in cases of low-risk cancers) to surgery, radiation therapy, chemotherapy, hormone therapy and/or use of a “prostate cancer vaccine” that spurs the body's immune system to attack prostate cancer cells.

The American Cancer Society gives the following guidelines regarding when men should consider talking with a doctor about the pros and cons of screenings, such as prostate-specific antigen (PSA) test and digital rectal exams (DRE): 

• Average risk: 50 years old 
• High risk (African Americans and men with a father, brother or son diagnosed before age 65): 45 years old
• Men with more than one first-degree relative diagnosed at an early age: 40 years old

While certain factors, like age and race, are outside of a person’s realm of control, other risks can be managed. The main controllable risk factor is diet. Men concerned about prostate cancer may be able to reduce their risk by limiting consumption of red meat and high-fat dairy products, as well as incorporating more fruits and vegetables into their diet.

GBMC offers low-cost prostate cancer screenings to members of the community. Learn more by visiting our Calendar of Events.

Crock Pot Three Bean Turkey Chili

Ingredients:

• 1.3 lb (20 oz) fat free ground turkey breast
• 1 small onion, chopped
• 1 (28 oz) can diced tomatoes
• 1 (16 oz) can tomato sauce
• 1 (4.5 oz) can chopped chilies, drained
• 1 (15 oz) can chickpeas, undrained
• 1 (15.5 oz) can black beans, undrained
• 1 (15.5 oz) can small red beans, undrained
• 2 tbsp chili powder

For the Topping

• 1/2 cup chopped red onion
• 1/2 cup chopped fresh cilantro
• low-fat shredded cheddar cheese (optional)

Directions:

1. Brown turkey and onion in a medium skillet over medium high heat until cooked through.
2. Drain any fat remaining and transfer to crock pot. 
3. Add the beans, chilies, chickpeas, tomatoes, tomato sauce and chili powder, mixing well.
4. Cook on high for 6-8 hours.
5. Garnish with onions, cilantro and cheese and enjoy!

Nutrition:

Servings: 12
Serving size: 10.8oz
Calories: 206.3
Fat: 1.4g
Protein: 16.8g
Carbohydrate: 31.8g
Fiber: 9g

Recipe by: Gina’s recipes, Skinnytaste.com

Living with Varicose Veins? New Treatments Mean You Don’t Have To

Dr. Carter Freiburg (left) and Dr. Peter Mackrell

Many people think varicose veins are a cosmetic problem, but if you’re living with them, you know that’s not true. They can cause pain, burning and achiness that make it hard to work, exercise, sit or stand. 

Varicose veins occur when the valves controlling blood flow through the veins don’t work properly. They leak and blood collects in the veins, putting them under pressure and causing them to become weak, enlarged and painful. 

“It’s a common misconception that varicose veins are a purely cosmetic concern,” says Carter B. Freiburg, MD, a vascular surgeon at Vascular Surgery Associates on the GBMC campus. “Not only can they cause serious discomfort that interferes with daily activities, they also have a psychological impact that can affect a patient’s quality of life.”

Treat the Cause, Relieve the Symptoms

Vascular Surgery Associates offers options that treat the root cause—the leaky valves in the veins. The first step is conservative treatment. An in-office ultrasound pinpoints leaky veins. Patients then wear compression stockings, elevate their legs and take non-steroidal anti-inflammatory medications for about three months. 

“If conservative treatment does not provide the level of relief patients want, there are a number of minimally invasive procedures we can perform in our office or the outpatient surgical setting to close the vein with leaky valves,” explains Peter J. Mackrell, MD, Chief of Vascular Surgery at GBMC and a vascular surgeon at Vascular Surgery Associates. “These procedures use local anesthetic or a light sedative, cause very little discomfort and take about 30 minutes. There are no sutures or staples, just gauze dressings and an ace bandage on the leg for a day. Patients are generally back at work in about two days.”

Minimally invasive treatments include: 

• Saphenous vein ablation: A laser heats and closes the vein. Blood drains into deeper veins, relieving pressure on the varicose veins, allowing them to shrink. 
• Sclerotherapy: After saphenous vein ablation, if the patient has spider veins that are too small for excision, the spider veins are injected with a tiny needle that delivers a fluid called a sclerosant. This fluid seals the spider veins shut and they are then no longer visible. 
• Vein excision: After ablation or sclerotherapy, removal of the varicose veins through tiny micro-incisions may be appropriate. Recovery takes only 2 ½ days and involves little post-operative discomfort. 
• Topical laser treatment: This option diminishes the appearance of spider veins and is used for certain spider veins that are not good candidates for sclerotherapy and spider veins in other areas, such as the face.

“If you want to explore treatment options for varicose veins, you’ll find full-service vascular care in our comfortable office setting at GBMC,” adds Dr. Freiburg.

To schedule an appointment with Dr. Freiburg or Dr. Mackrell at their office in Physicians Pavilion West on the GBMC campus, call Vascular Surgery Associates at 410-825-4928.

GBMC to Open Human Milk Bank to Care for Premature Infants

Premature babies face a number of challenges. In fact, 10 to 15 percent of those born at a weight of fewer than 1500 grams will develop a potentially fatal complication called necrotizing enterocolitis, a condition that causes damage to the lining of the intestines. Fortunately, studies have shown that this condition can often be avoided by using breast milk. For this reason, GBMC will soon add a Human Milk Bank to its Neonatal Intensive Care Unit (NICU).

According to Howard Birenbaum, MD, Director of Neonatology at GBMC, “Some new mothers experience insufficient milk production, are unable to breastfeed due to a medical condition or choose not to breastfeed. But, we want the most vulnerable babies to have the advantage of breast milk, as it contains live cells, antibodies and many more components that help decrease the likelihood of infection and gastrointestinal problems. Breast milk won’t prevent all cases of necrotizing enterocolitis, but it reduces the incidence by half and is a big step in the right direction.”

Dr. Howard Birenbaum

GBMC’s goal is to provide all babies younger than 30 weeks gestation or weighing less than 1,250 grams with an exclusive human milk diet if the parents approve, even if the milk does not come from the biological mother. As the infant grows, the breast milk will require fortification to ensure they are getting additional nutrients and more calories to continue to grow at the appropriate rate. GBMC will utilize human milk derived fortifiers, as well. Once babies reach about 1,800 grams, they can transition to premature formula if the mother does not intend to continue providing breast milk. .

The milk will be supplied by licensed milk banking organizations in San Jose, California and Wake, North Carolina, which follow strict regulations put in place by the Human Milk Banking Association of America. All milk will be processed and tested to ensure product safety before it will be sent frozen to GBMC. “Maryland has stringent requirements regarding donating human tissue, and breast milk is considered a tissue. Parents can rest assured that the milk their babies receive is safe and healthy,” explains Dr. Birenbaum.

Dr. Victor Khouzami

According to Victor Khouzami, MD, Chairman of Obstetrics and Director of Women’s Services at GBMC, costs associated with having a Human Milk Bank are high, but the benefit to babies is worth it. “In the long term, very premature babies who have had the advantage of human milk are less likely to deal with future gastrointestinal issues and expensive, complex surgeries,” he says. Dr. Khouzami adds that milk bank services are not yet covered by insurance in Maryland, but thanks to generous support from the Women’s Hospital Foundation, donations will cover the cost of breast milk for babies in need at GBMC. “We express our sincerest gratitude to the Women’s Board for making our Human Milk Bank possible. Having this service available here is the right thing to do for our most fragile babies,” says Dr. Khouzami.

Additional funding is needed in order to support the Human Milk Bank. To make a donation, visit http://foundation.gbmc.org or call 443-849-2773. Please note: GBMC is not able to accept donations of breast milk itself.

A Life Saved Twice - Gastric Bypass Patient Wins Colon Cancer Battle

Me today, in training for my next
half- and full-Ironman races.

Fifty-five-year-old Brian Lewis was just learning his “new normal” after undergoing a successful gastric bypass. He was embracing his healthy lifestyle when, two weeks after completing a grueling physical competition, he received a shocking colon cancer diagnosis. This is his story, in his own words.

When my first granddaughter was born in 2007, I remember holding her and realizing that I had a lot to live for. She was, in a way, an inspiration for me to get back in control of my life. I was very overweight and, basically, my family physician told me that I needed to lose weight or I would die. I had a heart attack at age 45 and suffered with several other medical issues, from sleep apnea to asthma. It was time to make a change.

The Marine Corps Marathon in
2009 was the first marathon I ran
after having gastric bypass
surgery at GBMC.

I found out about GBMC’s Comprehensive Obesity Management Program (COMP) through my insurance company and decided to check out the program. Living hours away on the Eastern Shore, I knew I wouldn’t be able to utilize all of the program’s helpful resources (such as the support groups), but the entire team impressed me, from the surgeons and dietitians to the patient services assistants. They seemed to have thought of everything to help their patients succeed. I chose to go through with gastric bypass surgery — a decision that changed my life. My surgeon, Babak Moeinolmolki, MD, performed successful laparoscopic surgery on July 2, 2008, and by the following March, I had trained for and completed a half-marathon! My asthma and sleep apnea were gone. I no longer needed many of the medications I used to depend on. Best of all, I was confident that I was going to be around for my grandchildren. GBMC’s COMP team saved my life, and they continue to support me and troubleshoot any weight or diet challenges I face.

Nation's Triathlon in 2010. This was
the first triathlon I completed. The
money I raised was donated to finding
a cure for cancer.

A few years later, in July 2011, a new diagnosis changed my world. Two weeks after competing in a half-Ironman race, which consisted of 70.3 miles of swimming, biking and running, I was diagnosed with colon cancer. Having had no obvious symptoms, I was caught off-guard. Polyps had been found during a routine colonoscopy screening and tested positive for cancer. Unsure of what to do, I talked to Dr. Moeinolmolki, who suggested I make an appointment with his colleague George Apostolides, MD, FACS, FASCRS, GBMC’s Chief of Colorectal Surgery. Dr. Apostolides saw me right away, and we soon realized that my cancer was aggressive. During the initial diagnosis and CT scan, it appeared that the cancer was stage 1, with no apparent lymph node involvement. After a sonogram about 10 days later, Dr. Apostolides recognized that the cancer actually had reached my lymph nodes and was stage 3. I underwent surgery on August 2 and began a six-month course of chemotherapy on September 15. I’m happy to say that I’ve been cancer-free ever since.

Although I have nerve damage from my chemotherapy that causes discomfort in my feet and still feel a little tired sometimes, I’m working hard to get back into the good physical condition I was in before cancer. Determined to keep pushing toward that “new normal” I enjoyed after my weight loss surgery, I’m training to do a full-Ironman in November. I continue to live the healthy lifestyle that I began after my bariatric surgery, focusing on nutrition and fitness. My GBMC physicians remain a powerful resource for me in my endeavors, and everyone who cared for me did a wonderful job explaining what to expect each step of the way. When I had my bariatric surgery, I was thankful to know I’d be here for my grandkids. Now, thanks to both Dr. Moeinolmolki and Dr. Apostolides, I’m hopeful that I’ll be here for my great-grandkids, too.

Visit www.gbmc.org/weightloss, www.gbmc.org/colorectaloncology or call 443-849 GBMC (4262) to get additional information about the services offered by GBMC’s Comprehensive Obesity Management Program and Colorectal Oncology Department.