Cause for Celebration

One Woman’s Triumph over Breast Cancer

Cancer survivor Jeannine Moriconi
with one of her physicians,
oncologist Robert Donegan, MD.

Jeannine Moriconi, mother of three and married to her high school sweetheart, had her annual mammogram in 2012, but the journey that followed was anything but routine. Her rigorous course of treatment for breast cancer was concluded with a celebration of life and love. This is her story, in her own words.

I wasn’t completely surprised when I received a call following my annual mammogram in April 2012 requesting that I come back for additional films. I’d had questionable results on previous mammograms that required biopsies, though they all had been benign. I didn’t become anxious until the radiologist explained that the films showed calcifications, which can indicate cancerous cells, and said he wanted to take multiple biopsies. Having lost three friends to breast cancer, including my best friend just a year prior, I had a bad feeling as I nervously awaited the results. 

General surgeon Frank Rotolo, MD, told me that the biopsies showed I had ductal carcinoma in situ (DCIS), a noninvasive form of breast cancer. He explained that DCIS is considered Stage 0 breast cancer and is highly treatable without chemotherapy. Lumpectomy and radiation are commonly used to treat DCIS, but given my history of abnormal mammograms, I opted for a mastectomy. I wanted to decrease the chance of the cancer spreading or coming back. I had a bilateral mastectomy and reconstruction in August 2012, and I was feeling good about my decision and my future.

Mrs. Moriconi ringing the
bell to signify the end of her
cancer treatments.

One week after the surgery, my husband Jim took me to my post-operative appointment, which went much differently than expected. Dr. Rotolo sat down and looked at us with a pained expression. “I don’t know how to tell you this, but it’s worse than we thought,” he said. I was shocked to learn that additional testing on the tissue that they removed indicated I had a more invasive Stage 2-A cancer, which had traveled to my lymph nodes. I thought that by electing to have the mastectomy I was going to be fine, but it turned out that was only the beginning. 

Armed with the knowledge of my new diagnosis, I met with oncologist Robert Donegan, MD, who outlined a treatment plan of chemotherapy and radiation. The new diagnosis was frightening, but I felt comforted by all the doctors and nurses at GBMC. Having my complete care team under the same roof was both convenient and reassuring. When I was hospitalized for five days with an intestinal reaction and colitis following my first chemotherapy treatment, nurses were by my side through it all, and I could tell they truly cared about me. After Dr. Donegan changed my medication to prevent those complications, I had four chemotherapy sessions — once every three weeks — followed by 12 consecutive weekly treatments. The positive support around me kept me going. I took the drug Herceptin every three weeks for a year and concluded with six weeks of radiation under radiation oncologist Albert Blumberg, MD. Through the course of my treatment, I never felt alone when I was at GBMC.

Mrs. Moriconi celebrates with her
husband and children following her
last treatment.

The support of my family and friends through this journey has been incredible. On my last day of treatment, October 10, 2013, my husband orchestrated a surprise for me at GBMC. I had planned to do the ritual bell-ringing outside the Sandra & Malcolm Berman Cancer Institute to signify I had completed my last treatment, but I wasn't expecting a massive celebration! When I walked outside, I saw the faces of more than 100 friends and family crowded into the vestibule to celebrate with me. There were yellow balloons everywhere — the color of celebration — and every row had people from all different parts of my life. There was my entire family, my childhood friends, our friends from Rhode Island, my son’s rugby coach and of course GBMC staff. I looked at Dr. Donegan and said, “This is why I have been able to get through all of this.” The physical and emotional recovery process has been a challenge, but I am focusing on enjoying life and the people around me. I’m fortunate to be where I am, and thankful to have had such outstanding care. 

For additional information on GBMC’s extensive services for cancer patients, visit www.gbmc.org/cancer or call 443-849-GBMC (4262).

June is Men's Health Month

June is a time to create awareness about health issues affecting men and to encourage early detection of disease. It's important for men to take steps to improve their health and be informed about the screenings they should receive on a regular basis. 

The two leading causes of death in males are heart disease and cancer. Combined, these factors make up 50 percent of male deaths. The National Institute of Health indicates that, in addition to genetic factors, heart disease can be brought on by unhealthy lifestyle factors, such as smoking and being overweight, which can also lead to high blood pressure and diabetes. 

Healthy Behaviors 
According to the United States Centers for Disease Control and Prevention, there are many things men can do each day to improve their health. Small daily changes, over time, can make a big impact on overall health.

• Sleep. Adults need a minimum of seven to eight hours of sleep per night. Getting enough sleep helps to balance the hormones that control hunger, resulting not only in increased energy, but the ability to make better food choices the next day. 
• Diet. Studies show that increasing daily intake of fruits and vegetables can help fight off certain types of cancer. Protein is an important component of a healthy diet for men. Try to select lean protein from chicken, fish and eggs. 
• Exercise. The CDC recommends that men exercise for at least two and a half hours per week. Adding just a small amount of exercise helps to reduce risk of heart disease!
• Quit Smoking. The benefits to your health from quitting smoking are immeasurable, with perhaps the most significant being the reduced risk of lung cancer and heart disease.  

Preventive Health
Many diseases in men develop slowly over long periods of time and may not be identified without regular screenings. 

• It is important for men to have an annual physical exam. This should include a prostate and reproductive health exam, which can identify certain types of cancers specific to men.
• The American Heart Association recommends that men age 20 and over should have their cholesterol checked every five years to ensure normal range.
• The annual physical exam is also a good time to bring up any concerns with your primary care physician. Keeping a list of any questions you may have is one way to make the most out of your appointment.  

A primary care physician is a great resource for men. If you do not have a primary care physician, please visit www.gbmc.org/mydoctor for a list of GBMC physicians who are currently accepting new patients.

Health Physicals Aren’t Just for Grown Ups

Keeping up with annual physicals is important not only for adults but also for children. In many cases, annual physicals are actually required by schools or summer athletic programs before kids can even attend or participate. With summer camp season and the next school year approaching in a few months, parents are encouraged to schedule physicals or well checks with their child’s primary care provider.

There are several compelling reasons to make sure your child gets a physical or “well check” every year, or as often as directed by your doctor. During this examination, the care provider will:

• Update immunizations
• Discuss your child’s nutritional and sleep needs to ensure proper growth and development
• Ensure that current growth and development is on track for their age
• Perform a physical exam, which entails checking the heart and lungs, and other age and gender-specific checks (observing for curvature of the spine, checking blood pressure, performing breast or testicular exam, etc.)
• Order any tests, depending on your child’s risk factors for conditions such as anemia or high cholesterol

What to expect during the office visit may be different for boys and girls and typically varies depending on age, as needs change over time.

Because physicals are often required well in advance of participation in sports and other activities, parents sometimes find themselves in a time crunch and feel rushed to get their kids’ physicals completed by a given deadline. Although some clinics can schedule physicals in a pinch, with a little bit of advanced planning, parents can get their child in to see their regular pediatrician or family medicine physician for these services. “If possible, it’s better for children to be seen by their regular doctor for the sake of consistency, familiarity and record keeping,” says Robin Motter-Mast, DO, GBMC Chair of Family Medicine. “To alleviate stress, we recommend that parents call and get these appointments on the calendar so that results will be available well before any program’s or school’s cut-off point.”

Is your child in need of a physical? Are you? Visit www.gbmc.org/mydoctor to find a primary care physician who is right for your family. To learn more about GBMC’s pediatric services, visit www.gbmc.org/peds. 

Rare Hernia is No Match for Skilled Surgeon

Dr. Timothee Friesen of GBMC's
Finney Trimble Surgical Associates

Mary Frank, a 49-year-old substitute teacher from Baltimore, suffered from heartburn for years, frequently experiencing the burning sensation of acid reflux in her chest after eating. She learned that a hernia was the likely culprit behind her discomfort. Until recently, her symptoms were well-controlled with prescription medication and over-the-counter antacids when she needed extra relief. 

One afternoon last summer, Ms. Frank’s symptoms took a frightening turn; she was having lunch at a restaurant and suddenly began having severe chest pain and shortness of breath. She called 911 and was taken by ambulance to the emergency room of a local hospital. “I had horrible pain in my chest that extended into my shoulders. I knew it had to be related to the hernia,” Ms. Frank notes, adding that this was the worst her symptoms had ever been. 

Ms. Frank was admitted to the hospital, where a battery of tests revealed that her hernia was so advanced, it would require surgery to repair it. After being discharged, she was referred to Dr. Timothee Friesen, a general surgeon at GBMC’s Finney Trimble Surgical Associates office, in early October 2013. 

“I loved Dr. Friesen right away,” she says. “He drew pictures to show me exactly what would happen during the surgery, explained everything and answered all of my questions.”

“Mary was suffering from the effects of a paraesophegeal hernia” says Dr. Friesen. “This is the least common type of hernia. It occurs when the opening in the diaphragm through which the esophagus passes is larger than usual, allowing the stomach to push up into the esophagus. It’s dangerous because the stomach’s blood supply could get cut off, causing the tissue to die.” To fix the problem, the surgeon performs a laparoscopic procedure to wrap the herniated portion of the stomach around the esophagus, closing the hole. 

Dr. Friesen states that hernias like Ms. Frank’s are rare. “It’s more likely for women to experience ventral or incisional hernias, which are caused by a weakened abdominal wall.” These hernias commonly show up as a bulging mass below the skin’s surface and can develop at the site of an incision from a previous surgery. Symptoms of hernias frequently include pain in the abdomen and acid reflux, but some go undetected.

“If acid reflux is a problem and it is not responding to medication after a year, consult with a physician. It could be a symptom of a more serious condition,” adds Dr. Friesen.

Following Ms. Frank’s surgery in December 2013, she was placed on a post-operative liquid diet for two weeks. After that, she was able to resume a normal diet with no problems. “Before the surgery, I was afraid to eat. Every day I had stomach pain, chest pains and difficulty breathing. Thanks to Dr. Friesen, all of the heartburn and reflux completely disappeared,” says Ms. Frank. “I couldn’t be happier with the results!” 

For additional information on the general surgery services offered at GBMC and the surgeons of Finney Trimble Surgical Associates, visit www.gbmc.org/generalsurgery or call 443-849-GBMC (4262).

Berry Yogurt Popsicles

Ingredients

• 8 oz plain Greek yogurt
• 1 cup fat-free milk
• ½ cup mixed fresh berries
• 3 tbsp honey

Instructions

1. Combine yogurt, milk, mixed berries and honey in blender and puree until smooth. (If desired, add 1 scoop natural whey protein powder to double your protein.) 
2. Divide among six 3-4 oz ice pop molds, adding a food-safe stick if necessary
3. Freeze at least 6 hours.

Nutrition (per popsicle)
97 cal
8 g protein 
14 g carb
1 g fiber 
13 g sugars
1 g fat
0.5 g sat fat, 
43 mg sodium

Recipe courtesy of Prevention.com

Know the Risk Factors for Stroke

May is an enjoyable month, with flowers in full bloom and the promise of warmer weather on the way. May is also National Stroke Awareness Month, and a great time to educate yourself on how to manage stroke risk factors and reduce your risk of stroke. 

While some risk factors for stroke are unavoidable, such as age, gender, race and family history, many are controllable. According to the National Stroke Association, up to 80 percent of strokes can be prevented by working closely with a healthcare professional to manage, reduce or eliminate risk factors. Controllable risk factors for stroke include high blood pressure, diabetes, high cholesterol, obesity and smoking. Experts at GBMC’s Primary Stroke Center state that the risk of stroke is significantly decreased when these risk factors are addressed. 

Simple lifestyle changes can help you drastically reduce your risk. Since high blood pressure is the leading cause of strokes, be sure that your primary care physician is regularly monitoring your blood pressure and that you take any blood pressure medications exactly as prescribed. If you have diabetes, be sure to eat a healthy diet, exercise regularly and take all medication as prescribed. If you are obese, consider a weight loss program; the risk of stroke increases even if you are only 20 pounds overweight. Quitting smoking will significantly reduce your risk—smokers are twice as likely to have a stroke as non-smokers. Other healthy lifestyle changes, such as becoming more physically active, help reduce your risk of stroke. 

If you think someone is having stroke symptoms, you should always call 911, even if the symptoms go away. The warning signs of a stroke can be explained using the acronym FAST, which stands for Face, Arms, Speech and Time. If you suspect someone is having a stroke, ask them to smile. If one side of the face is drooping, this is a clear indication for stroke. Next, ask the person to raise both arms. If one arm is drifting downward, this is another clear indication of stroke. To check if the person’s speech is slurring, a possible sign of stroke, ask them to say a sentence. Mumbled, slurred speech is a common occurrence during a stroke. Lastly, time is of the essence: if you observe any of these signs, call 911 immediately.

May is Skin Cancer Detection and Prevention Month

Skin cancer is a prevalent problem in the United States – in fact, it is the most common form of cancer in the country. Fortunately, there are a number of actions people can take to protect themselves from the ultraviolet rays that are often at the root of skin cancers, including:

• stay in the shade during the midday, when UV rays are most hazardous 
• wear a hat, sunglasses, sunscreen with sun protective factor (SPF) 15 or higher that protects against UVA and UVB rays 
• wear clothing that covers arms and legs
• avoid indoor tanning 

Don’t forget to protect your skin, even during the winter and on overcast days.

Know Your Risk
Certain characteristics can increase an individual’s risk for skin cancer. These risk factors include having fair skin, a family or personal history of skin cancer, history of sunburns and/or indoor tanning, having skin that burns, freckles or reddens easily, having blue or green eyes or blond or red hair and having certain types and a large number of moles. Luckily, anyone can perform a self head-to-toe examination to keep track of skin changes that could indicate cancer. It’s easy to do - just note the appearance of spots on your body, paying close attention for asymmetry, jagged or uneven borders, uneven color and diameter larger than a pea. If you notice anything different, such as a new growth, a sore that won’t heal or a change in a mole, consult your physician or dermatologist. 

For individuals at increased risk of developing skin cancer, an annual skin exam might help put their minds at ease. For a patient who has never had an atypical mole or very few atypical moles, the examination is quite brief – about 10 minutes. Those with more suspicious spots or growths may require longer appointments. In some cases, your dermatologist might biopsy, or remove a sample of skin, from a suspicious area for further testing. If you’ve noticed any specific changes or areas of concern during your self exams, don’t be shy – point them out to your doctor and ask questions.

GBMC periodically hosts $15 skin cancer screenings. The next skin cancer screening is taking place in GBMC’s Radiation Oncology department on June 10. Click here for details. To schedule an appointment, call 443-849-3080 or register online.