Understanding "Swimmer's Ear"

Known to medical professionals as otitis externa, swimmer's ear is an inflammation of the ear canal. Its common name comes from the fact that it often occurs in children and young adults who swim frequently. However, any cause of dampness in the canal can lead to the irritation and chafing of swimmer’s ear – it’s actually very similar to diaper rash in babies.

The moisture can cause the skin inside the ear canal to become chafed, dry and cracked. A break in the skin may allow bacteria or (more rarely) a fungus to invade the tissue of the ear canal and cause an infection. Swimming in dirty or polluted water, therefore, is a common cause of swimmer's ear; the bacteria in the water find a hospitable home in the moist environment of an inflamed ear canal.

Skin conditions, such as seborrheic dermatitis and psoriasis, and excessive or improper cleaning of wax from the ears can also lead to swimmer's ear. Not only does wax protect the ear canal from excess moisture, but it also harbors friendly bacteria. Removing this protective barrier -- particularly with hairpins, fingernails, or other objects that can scratch the skin -- makes it easier for an infection to take hold. Hair spray or hair coloring, which can irritate the ear canal, may also lead to an outer ear infection.

Symptoms are isolated to the ear and include:

• Itching
• Watery discharge
• Severe pain and tenderness
• A foul-smelling, yellowish discharge
• Muffled hearing

Fortunately for those suffering from it, swimmer’s ear typically clears up quickly once treatment begins. The key is going to the doctor before the condition has the chance to get more complicated and painful. Basic treatment usually includes gentle cleansing of the ear and use of antibiotic drops. Oral antibiotics may also be prescribed by your physician. 

Are you in need of a primary care physician for your family? Visit www.gbmc.org/mydoctor for physicians in your area who are accepting new patients.

Total Knee Replacement Gets Patient Back in Motion

After two total knee replacements,
patient Kathleen Speca is on her feet again.

When Kathleen Speca, in her fifties, was diagnosed with early osteoarthritis in her late twenties, she recognized that her knee pain would increase over the years. However, after being diagnosed and treated successfully for breast cancer through radiation treatments and long-term medication, her discomfort worsened more quickly than expected. 

In the hopes of alleviating her pain, Mrs. Speca turned to Lee M. Schmidt, MD, Director of GBMC’s Joint Center. “We first tried a conservative approach of cortisone shots and physical therapy to strengthen the muscles surrounding my knee,” Mrs. Speca explains. When the pain persisted despite the treatment, she and Dr. Schmidt discussed and agreed upon the surgical option of a total knee replacement. 

“I had the first total knee replacement surgery on my right knee on March 6, 2012, and then on my left knee on October 23, 2012. Although I was prepared for a tough recovery, I bounced back like a teenager!” she says. “There was certainly pain and discomfort, but nothing I couldn’t handle. Plus, with Dr. Schmidt’s excellent surgical technique and by strictly following my physical therapy guidelines, I was off to a speedy recovery.”

According to Dr. Schmidt, “Every component of the joint replacement process is done at the Joint Center. Patients are evaluated by a surgeon and are given a guidebook that explains what happens each day in the hospital, how to prepare for surgery and plan for their recovery.” He adds that patients are invited to attend a class to meet the Joint Care Coordinator and become better educated about the process.

Post-operative care is provided on Unit 58, which is tailored specifically for joint replacement patients. The team includes orthopedic nurses, nurse practitioners, physician assistants, physical and occupational therapists and discharge planning specialists, all supervised by the Joint Care Coordinator. Each patient also has a designated coach to help them prepare for surgery and assist in recovery. In addition to total joint replacement, the Center offers a full array of surgical services, including  minimally invasive options and partial joint replacement surgery, in which only the arthritic portions of the joints are replaced, resulting in faster recovery.

“The nurses and techs on the unit were all fabulous. The care I received from the beginning to my discharge was superb,” says Mrs. Speca. “Dr. Schmidt and the entire staff treated me like family every step of the way.” 

Whether dancing, cooking or relaxing
at home, Mrs. Speca is thankful to be
pain-free.

Mrs. Speca enjoys dancing and cooking, which always played havoc on her knees. Even going up and down steps was extremely painful. “Now, I am better able to be on my feet for hours preparing meals for guests, and no matter what, I’ll never stop dancing,” she says. “It’s so nice not to have your knees hurt as you climb the stairs. I can keep enjoying my life as a productive person in society, continuing my career in the non-profit sector, volunteering and helping others.”

For more information on GBMC’s Joint Center, call 443-849-GBMC (4262) or visit www.gbmc.org/jointandspine.

Grilled Cilantro Lime Shrimp Kebabs

Ingredients:

• 32 jumbo raw shrimp, peeled & deveined
• 3 cloves garlic, crushed
• 24 round lime slices (optional)
• Olive oil cooking spray
• 1 tsp kosher salt (optional)
• 1 1/2 tsp ground cumin
• 1/4 cup chopped fresh cilantro, divided
• 16 bamboo skewers soaked in water 1 hr.
• 1 lime cut into 8 wedges

Instructions:

Heat the grill on medium heat and spray the grates with oil. Season the shrimp with garlic, cumin, salt and half of the cilantro in a medium bowl.

Beginning and ending with shrimp, thread the shrimp and folded lime slices onto 8 pairs of parallel skewers to make 8 kebabs total.

Grill the shrimp, turning occasionally, until shrimp is opaque throughout, about 1 to 2 minutes on each side. Top with remaining cilantro and fresh squeezed lime juice before serving.

Nutrition:

Servings: 8
Serving size: 1 kebab
Calories: 74
Fat: 1g
Protein: 13g
Carbohydrate: 3g
Fiber: 1g
Cholesterol: 94 mg
Sodium: 384 mg (with salt)

Recipe by Skinnytaste.com

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).