Your Health Matters

Stroke: When Time is not on Your Side

noreply@blogger.com (Meritus Health) — Mon, 13 May 2013 20:38:00 +0000

Stephanie Dias was 57-years old when she suffered an ischemic stroke while at work. She knew something was wrong when she took a sip of water and it ran down her front—and when she couldn't push herself up in the chair with her leg. When a co-worker spotted Stephanie and saw her blank stare, she and other co-workers decided to call 911.

Each year, more than 600 patients arrive at Meritus Medical Center’s emergency department with signs and symptoms of stroke. Stephanie was one of the lucky patients. Her fast-thinking co-workers got her to the hospital’s emergency department quickly, and soon after, Stephanie was diagnosed with an ischemic stroke and given tissue plasminogen activator (tPA), a clot-busting drug.

Brain attack
Stroke occurs when a blockage or burst blood vessel interrupts blood flow to the brain. Minutes after, brain cells begin to die because they lack oxygen and nutrients. That’s why stroke victims need immediate medical evaluation, and when possible, the administration of tPA—but it must be given within three hours from the start of stroke symptoms.

“Sudden” is the telltale sign of stroke
On the positive side, stroke is largely a preventable, treatable and beatable disease. On the negative side, the American Stroke Association says that less than a third of people in the U.S. can name more than one warning sign of stroke. A lack of knowledge or misinterpretation of stroke signs can mean a delay in getting to the hospital, and a greater chance of serious brain damage.

“Sudden” is the telltale sign of stroke. People suffering a stroke suddenly have trouble walking (loss of balance), seeing (blurred or blackened vision in one or both eyes) or speaking (slurred speech, inability to speak or confusion). Other signs of stroke include weakness on one side of the body and an unexplained sudden and severe headache.

If you think someone is having a stroke, you simply need to act F.A.S.T.
Face. Ask the person to smile. Does one side of the face droop?
Arms. Ask the person to raise both arms. Does one arm drift downward?
Speech. Ask the person to repeat a simple sentence. Are the words slurred?
Time. If the person shows any of these symptoms, call 911. Make note of when the first symptoms appeared and tell EMS personnel once they arrive.

If you have a hard time committing F.A.S.T. to memory, you can download a free mobile application to your smart phone (iPhone or Android) by going to www.strokeassociation.org. Remember, even if symptoms seem to go away, doctors warn that you should go to the hospital not more than one hour from when your symptoms first appeared.

Lower your risk
Unfortunately, as we age, we begin to have risk factors for stroke, including high blood pressure and high cholesterol. An unhealthy lifestyle, particularly smoking, high blood pressure and poorly-controlled diabetes, speeds up blood vessel damage that contributes to stroke. For area residents, stroke risk is high. The 2012 Meritus Health Community Health Needs Assessment indicated that almost half of 55-64 year olds and almost two-thirds of people over the age of 65 were told they have high blood pressure, and half were told to reduce their cholesterol. If you have the following conditions, talk to your healthcare provider about how to effectively manage your risk factors.

High blood pressure
High cholesterol
Overweight/obesity
Sedentary lifestyle
Diabetes
Smoking/nicotine use
Alcohol abuse or illicit drug use
Heart disease
Atrial fibrillation (irregular heartbeat)
Estrogen or birth control pill use, especially when combined with smoking

May is Stroke Awareness Month. Raise awareness and fight stroke by making sure you know the signs. And remember, the combination of diet and exercise goes a long way in reducing your chance for stroke.

By: Anne Gill

Staying Healthy on Shift Work

noreply@blogger.com (Meritus Health) — Mon, 06 May 2013 19:56:00 +0000

While most of the world sleeps, nurses, doctors, police officers, firefighters, pilots, truck drivers, DJs and waiters, among others, work outside of the traditional “9 to 5” daytime schedule. New employees will often begin their careers on the night shift as a way to get their foot in the door. Additionally, shift work tends to pay more, and, for some parents, it allows them to spend more time with their children or avoid using childcare. “I get to eat breakfast and dinner with my kids—and when they’re at school, I sleep,” says Jim Recabo, RN, administrative nursing supervisor and team leader at Meritus Medical Center.

On the downside, the third shift can really do a number on the body. A weakened immune system, insomnia, indigestion, heart disease, weight gain and diabetes have all been linked to shift work. Going against the body’s internal clock, or circadian rhythms, can also lead to shift work disorder. Because the body’s clock is controlled by a part of the brain influenced by light, working by night and sleeping by day can throw your body out of whack.

Meritus Health nurses Jim Recabo and Jennifer Edwards stay healthy, fit and sane despite working the third shift. Here’s how they do it:

Eating

Pack a lunchbox full of protein such as turkey or tuna sandwiches, boiled eggs and string cheese. Although common, don’t associate the graveyard shift with meals from vending machines and fast food joints.
Don’t eat a huge meal just before your shift ends.
Eat complex carbs, as they release energy slowly.
Avoid caffeine before bedtime and drink it in moderation throughout your shift.
Fill up on water to reduce fatigue caused by dehydration.

“I really look at when and how much I eat. When my work day backs up to a day off, I limit my calories,” explains Jim. When Jim transitioned back to daytime hours, he found himself eating seven meals a day, or waking at 1 a.m. and snacking because that’s his usual lunch hour. At one time, he use to eat right before bedtime, but it’s a habit he has since broken. Jennifer Edwards grazes by eating six small meals throughout her waking hours.

Sleeping

Block out light in your bedroom.
Wear sunglasses while driving home from work to reduce your exposure to sunlight.
Take a short nap before your shift. According to the National Sleep Foundation, a short nap yields more brain benefit than a nap lasting 30-minutes or longer, which can cause grogginess.
Keep to the same bedtime ritual and schedule.
Use earplugs and eyeshades to block out noise and light.

Jennifer admits that she logs in four hours of sleep each day. With a 12 year-old son and 15 year-old daughter, Jennifer is always on the go. The 11 p.m. to 7 a.m. shift gives Jennifer time to help her son, who has ADHD, remain focused on his nightly homework. Her typical schedule is: sleep when she gets home, bring her daughter’s softball bag to school by 2:30, do after-school homework with her son, attend a softball game or practice, eat a family dinner, take a 20-minute nap and head to work. “I’m a big believer in 20-minute naps,” explains Jennifer. She’s been known to catnap in her car while her daughter is on the softball field.

To transition from a night to a day schedule, Jim grabs three hours of sleep after his night shift ends and wakes up to a planned agenda. At the end of the day, Jim goes to bed when his family does so that he switches to their schedule for his days off work.

Exercise

Get some exercise during work breaks to boost alertness. Take the stairs, squeeze in a power walk or perform jumping jacks in the break room.
Exercise before your shift to increase your energy level.
Schedule workouts on your days off.

While it may rev up some people, Jim heads to the gym right after work. “If I don’t exercise first thing, it won’t happen,” says Jim.

Family and social time
Don’t be a hermit. Jim tends to socialize with other health care workers and night shift workers who understand his lifestyle.

Get your family and friends on the same page. “You really have to adjust everyone’s expectations,” says Jim. His family and friends know not to call during the day. “They’re used to me disappearing and taking naps on my days off.”

Quality time with her family fuels Jennifer forward. “This shift allows me to spend weekends with my family, help my son with his homework and never miss my daughter’s softball games.”

Watching your schedule
Between commuting and family responsibilities, shift workers have very little opportunity to rest between shifts. That’s why it’s important to manage your schedule. “I keep a meticulous schedule,” admits Jim. He pays close attention to his four-weeks-in-advance schedule, making sure he has more than one day off in between night shifts. “Otherwise you’re either short-changing yourself on sleep or you’re not accomplishing basic things like seeing your kids, grocery shopping, housekeeping and paying bills.”

For Jim and Jennifer, shift work has helped them maintain a work-life balance and create lasting friendships along the way. “I couldn’t do what I do without the support of my co-workers,” admits Jennifer. “We pick each other up.”

By: Anne Gill

Organ Donation: And Life Goes On

noreply@blogger.com (Meritus Health) — Tue, 30 Apr 2013 21:03:00 +0000

Meritus Medical Center takes organ donation seriously. It’s the only Maryland hospital to receive the National Organ Donation Medal of Honor from the U.S. Department of Health and Human Services six years in a row. The award recognizes hospitals that achieve a 75-percent conversion rate of eligible patients donating organ and tissue.

Meritus Medical Center works with the Living Legacy Foundation, a nonprofit organ procurement system, to encourage family members to donate the organs of their loved ones. Organ donation includes kidneys, heart, lungs and liver, in addition to tissue donation, which includes skin, bone, cardiovascular tissue and corneas.

Jennifer Gelman, director of communications at Living Legacy, links Meritus Medical Center’s successful organ donation contribution to how the hospital educates the community and the way it treats organ donor families. Each time an organ consent is made, hospital staff raise a special flag outside of Meritus Medical Center. The hospital also participates in Flags Across Maryland, a campaign sponsored by Living Legacy and Donate Life Maryland to raise awareness of the 2,200 Marylanders who await an organ transplant—and to recognize those who have donated in the past.

At face value, facilitating the organ donation process appears clinical. Dig deeper, and you’ll find organ donation to be a brave and benevolent act by donors and their families. “The impact on the lives of the recipients and their families can be so much bigger than what you can imagine,” explains Cathy Duray-Baker, LCSWC, social worker and organ donation team member at Meritus Medical Center. “It’s really the selfless essence of the ‘pay it forward’ philosophy. As tragic as the loss of one life can be, that loss can have so many positive outcomes for so many people on donor waiting lists.”

Cathy, along with team members from Meritus Medical Center’s critical care, emergency department, spiritual care services, and other departments collaborate with Living Legacy to identify possible donors. The hospital’s goal is to gain organ donation consent from those who will not live through a fatal accident or cardiac arrest. In each of those consents, seven organs and variety of tissue can be considered for donation.

Often, patients decide on their own to be donors, registering their driver’s license through a donor registry, or on an advance directive or living will. If the patient is not a designated donor, a representative from Living Legacy discusses with the patient’s next of kin whether an organ can be considered for donation.

“Organ donation can bring a positive light for the patient’s family despite the grave situation,” explains Tamara Yeager, RN, critical care clinical educator for Meritus Medical Center.

Without a doubt, an end-of-life conversation is heart-wrenching, but according to Cathy, the discussion gets easier when the patient’s next of kin know they are carrying out the patient’s wishes. That’s why she encourages everyone to have a discussion about organ donation.

As a member of the organ donation team, hospital chaplain and pastoral educator Phil Pinckard’s passion for organ donation goes beyond the hospital walls. He traveled twice to the annual Transplant Games of America where living donors, recipients and donor families gather. Chaplain Pinckard says, “I’ve never met a family who has regrets about saying yes to organ donation.”

To learn more about organ donation, go to www.donatelifemaryland.org. By entering your Maryland driver’s license number, you can specify which organs and tissue you choose to donate. The website also lets you share your wishes with family and friends with a simple email.

Here are Meritus Health Employees wearing green in support of organ donation:

By: Anne Gill

Reassuring Your Frightened Child in Times of Crisis

noreply@blogger.com (Meritus Health) — Mon, 22 Apr 2013 20:10:00 +0000

The television images appear again and again: an explosion in Texas, people running from the finish line of a marathon or a school shooting. Even as adults we find ourselves seeking ways to cope with the violent events that occur in our world, and how to avoid seeing the disturbing images.

As parents, you want to protect the innocence of your children. Yet there is a careful balancing act that needs to be achieved when it comes to providing basic and realistic information to ground our kids when they hear about things at school, the playground or their day care provider’s.

“Parents need to be aware that children may react strongly to those events and should be prepared to discuss their child's thoughts and feelings,” said Julie Kugler-Bentley, coordinator of the Employee Assistance Program for Meritus Health’s Behavioral Health Services.

She says adults can help their children by knowing what media they are exposed to, providing calm, matter-of-fact explanations for things that are happening and equipping them with the confidence to know how to behave when confronted with a frightening situation.

Here are some guidelines from Julie:

Be honest about the situation. Give your children information at their own level and put it in context. Explain that even though frightening things happen every once in a while, most children go about their day with no harm. Don't describe unlikely scenarios that would unnecessarily frighten your children.
Make it your business to know what information your child is getting. Monitor their exposure to television, and be with them to explain what they are seeing and answer their questions. Ask them what they are hearing at school and give them factual information to dispel rumors they are hearing from others. Communicate with daycare providers, teachers, school counselors and administrators when necessary to share information about hos your child is coping and to get additional helpful information or direction.
Limit how much time they spend watching violent movies, videos, or computer games. The impact of violence for children is cumulative.
Know that behavioral impacts at different ages happen because children of varying ages react differently. Younger children may show more separation anxiety when their parents leave them at daycare or school. Older children may present a rough exterior or aggressive behavior.
Provide extra emotional support for your children. Review safety precautions and practice routines of going to and from school with them. Teach your children that they should go to an adult they trust if they feel threatened in any situation.
Avoid infecting your children's lives with your own anxiety. Feeling overwhelmed by anxiety caused by traumatic events? Take steps to deal with your own feelings by talking to a trusted friend or counselor, meditating, praying or other activity before your children are affected.
Some children have other factors in their lives that may make them especially fearful. Children who have experienced a traumatic incident in the past, children who are grieving a personal tragedy, and children who are ill are all more susceptible to anxiety.
Give your child personal reassurance. Tell them what you are doing to ensure their safety, what their daycare provider or teacher is doing to maintain safety, and what they can do to enhance their own safety.
Don't overdo it. Maintain normal routines for eating, sleeping, and play. Keep an eye open for any signs of anxiety.

By: Linda Norris

Child Abuse Prevention Month

noreply@blogger.com (Meritus Health) — Mon, 15 Apr 2013 20:26:00 +0000

Pinwheels at the entrance of
Meritus Medical Center

It’s a topic that hits the pit of your stomach. It’s tragic, horrifying and unthinkable. But we must think about child abuse and its presence in our community. “By raising awareness of the plight of child abuse and its effects, people will have the education to know how to respond to the signs of child abuse,” says Pam Holtzinger, coordinator for the forensic nursing program at Meritus Medical Center. Pam’s job is to evaluate child maltreatment patients at the hospital and train other healthcare providers to know the signs and report suspected child abuse cases.

Last week, staff at Meritus Medical Center placed nearly 1,600 pinwheels outside the hospital’s main entrance, each one symbolizing a reported case of child abuse in Washington County. While the actual number of child abuse victims is unknown, 700 more child abuse cases were reported in 2012. Pam says that number is encouraging because more people are reporting child abuse, which helps professionals intervene and prevent further abuse.

The abused and abusers
A child can be abused physically, emotionally, sexually or by neglect. According to the Centers for Disease Control and Prevention, or CDC, 81 percent of victims are maltreated by a parent. Men and women play a near-equal role in abusing children. “Child abuse isn’t limited to a neighborhood, gender or socio-economic class. It can run a broad spectrum,” emphasizes pediatrician and internist John Reed, M.D., Smithsburg Family Medical Center.

Most of the time, kids know their abuser and the abuse occurs at home. While child abuse and neglect can happen to a child of any age, infants and toddlers are the most vulnerable. According to the U.S. Department of Health and Human Services, approximately 80 percent of children who die from abuse are younger than age four.

The roots of child abuse
A family history of maltreatment, drug and alcohol use, lack of parenting skills, a merry-go-round of caregivers in the home and stress and/or a lack of support all contribute to a potentially abusive environment. Also at high risk are parents who are young, single, low income or who have many dependents, according to the CDC.

“Child abuse can often occur when adults are thin on resources, time and money,” says Dr. Reed.

Recognizing child abuse
According to Dr. Reed, sudden changes in a child’s behavior can signal child maltreatment. “Look for children who go from happy to sad, outgoing to withdrawn or the child who makes comments above and beyond what is expected at that age.”

Abused children can also act out, engage in risky behavior or have trouble developing and maintaining relationships. Kids with more frequent injuries (i.e. accident prone) should raise your antennae, says Dr. Reed. “If the story doesn’t seem to add up, that should tell you something.”

A neglected child may have poor hygiene, ill-fitting clothes and is often left alone without adult supervision or allowed to play in unsafe situations. A sexually abused child may have trouble sitting or walking, or show interest in sexual activity beyond his or her age.

What you can do
“Offering to help is the best form of prevention,” says Dr. Reed. “If you suspect a parent is stressed out or having difficulties coping with parenthood, offer to babysit, listen to the parent’s concerns or suggest resources in the community. Simply offer to help and establish a relationship.”

Contacting Child Protective Services is another way to intervene and remain anonymous. According to Pam, you only need a suspicion to report abuse. “Make the call and let the professionals evaluate it and help prevent any further abuse from happening.”

Hospitals are safe havens for abused children. At Meritus Medical Center, forensic nurses are trained to read the signs of child abuse, ask the right questions and work with law enforcement and social services to place the child in a safe environment. Other resources within Washington County include:

Washington County Child Protective Services, 240-420-2222 (24-hour phone line).

Safe Place, the Washington County Child Advocacy Center, provides all reported victims of child sexual abuse in Washington County and their non-offending caretakers with comprehensive forensic interviews, medical treatment and mental health treatment. Contact Safe Place at 240-420-4308 or go to www.safeplaceac.org.

Parent-Child Center helps parents become nurturing parents through a home-based parent aide program, mentoring opportunities, parenting classes, teen parenting support; and by providing clothing, home furnishings, diapers and formula. Contact the Parent-Child Center at 301-791-2224 or at www.hagerstownparent-childcenter.com.

Citizens Assisting and Sheltering the Abused, or CASA is a safe harbor for children, teenagers and adults in Washington County who have been affected by domestic violence, sexual assault or abuse and rape. CASA helps individuals survive abuse and establish a new and safe life by providing counseling, support groups, abuser intervention, legal services and workshops on parenting skills and other topics. Contact CASA at 301-739-4990 or at www.casainc.org.

The Washington County Board of County Commissioners proclaimed April 2013 as Child Abuse Prevention Month in Washington County. Their proclamation asks that all citizens become more aware of child abuse and its prevention within the community and support parents to raise their children in a safe, nurturing environment. From a person who is on the front lines of child and domestic abuse, Pam agrees. “It really does take a village to raise children, so we want everyone to be involved and to make a difference in the life of a child.”

Pictured from R to L: Commissioner Jeff Cline, Jesus Cepero, VP and CNO,
Commissioner Ruth Anne Callaham, and Pam Holtzinger

Meritus Health nurses in the Pinwheel Garden

Babies Born Too Soon

noreply@blogger.com (Meritus Health) — Mon, 08 Apr 2013 20:24:00 +0000

A routine pregnancy can become a high-risk pregnancy without notice. One out of every nine babies is born premature each year, yet the cause of pre-term labor is not fully understood. “There are many known factors related to preterm labor, but it’s sometimes difficult to identify the exact cause of it,” said obstetrician/gynecologist Gary Smith, MD of Women’s Health Center at Robinwood.

Babies are considered preterm when born at 37 weeks or earlier. The less time a baby spends in the mother’s womb, the greater the chances of the baby having severe health problems—like lung, liver, digestive, brain and immune system complications. While many women never dream they will have a baby born too early, preterm births can occur in women who have no known risk factors.

According to Dr. Smith, the best defense is to know your risk factors and get obstetrical care early in your pregnancy.

Factors for preterm labor include:

Having a previous preterm birth
Carrying more than one baby
Trauma to the cervix or previous procedures on the cervix such as second trimester abortions
Uterine abnormalities
Health conditions like high blood pressure and diabetes
Cigarette, drug and alcohol use
Poor diet
Significant physical or psychological stress and major depression
Infections
Uterine bleeding in the second or third trimester
Low prepregnancy weight and low weight gain during pregnancy
Less than 12 to 18 months between pregnancies

“I tell my patients to live a healthy lifestyle and know their risk factors and the signs for preterm labor,” says Dr. Smith.

Indicators for preterm labor can include:

Contractions every ten minutes or more often that don’t resolve with rest and fluids
Fluid or bleeding from the vagina
More than usual pelvic pressure
Middle, low back pain
Cramps similar to menstrual cramps

“Early access to health care is so important,” explains Dr. Smith. “If a woman is at high risk for a preterm delivery, we can begin progesterone injections to help the uterus grow and prevent contractions early in the pregnancy.” Physicians can also treat the cervix surgically to prevent it from opening too soon in the pregnancy. Dr. Smith suggests going to www.uptodate.com/patients for more information on risk factors and indicators of preterm labor.

Help for preemies
When a woman goes into preterm labor, physicians use medications to slow down contractions and inject the mother with steroids to mature the baby’s lung development. When babies are born prematurely, they need help breathing, eating and staying warm, and require the advanced care of a special care nursery or newborn intensive care unit (NICU). Meritus Medical Center’s Special Care Nursery cares for babies as early as 32 weeks gestation.

The March of Dimes promotes the health of babies by preventing premature births, birth defects, and infant mortality. On Saturday, April 27, the March of Dimes walk will be held at Fairgrounds Park in Hagerstown. Each year, Meritus Health and its employees participate by forming walking teams and raising money. Neonatal nurse Kelly Footen, RN has been a March of Dimes Walk team captain for the past four years. Since that time, Meritus Medical Center has tripled its fundraising efforts for the walk. “Whether it’s surfactant therapy for lung development or PKU screening to ensure a baby’s growth and development, I see the work of the March of Dimes first-hand,” says Footen. If you would like to contribute to the Meritus Health team go to www.marchforbabies.org.

By: Anne Gill

Performance Enhancing Drugs: What Parents Need to Know

noreply@blogger.com (Meritus Health) — Tue, 02 Apr 2013 13:57:00 +0000

Special guest post by Dr. Daniel Warner of Robinwood Orthopaedic Specialty Center.

Dr. Daniel Warner

In a frequently referenced 1997 Sports Illustrated article, aspiring Olympians were asked two questions; “If you were offered a banned performance-enhancing substance that guaranteed that you would win an Olympic medal and you could not be caught, would you take it?” Remarkably, 195 of 198 athletes said yes. The second question was: “Would you take banned performance-enhancing drugs with a guarantee that you will not be caught, you will win every competition for the next five years, but then will die from adverse effects of the substance?” More than 50 percent of the athletes said yes to this question as well.

Driven by the popularity of sports and athletes’ drive to succeed, the use of ergogenic (performance enhancing) drugs, or PEDs, is at all-time high in the United States today. Fifty-seven percent of high school students play on formal sports teams, and 1-3 million U.S. athletes nationally are taking some form of performance-enhancing drugs. Many of these athletes are youth who use these substances without knowledge of their risks and potential benefits.

Powerful dietary supplements and energy drinks have become part of the PED landscape for some athletes. These drinks and supplements can be found in vitamin and grocery stores and even gas stations. Young people are also using dietary supplements in combination with stimulant prescription medications, such as those used for attention-deficit hyperactivity disorder. Ritalin and other amphetamines are used at surprising rates by teenagers.

In addition to energy and dietary supplements, a growing number of non-elite athletes are using anabolic-androgenic steroids, or AAS, human growth hormones, or HGH, erythropoietin, or EPO and insulin.

A series in Sports Illustrated outlined the breadth of the problem, which encompasses not only players but also media personalities, police and paramilitary personnel and ordinary Americans who want to look, feel and live “at the top of their game.” Eighty percent of PED users are reported to be non-elite athletes.

The most common PEDs are anabolic steroids (eg. testosterone, androstanediol), creatine, stimulants (eg. amphetamine, ephedrine), Erythropoitetin, or EPO, and human growth hormone, or HGH. Although ephedra-based dietary supplements—which have also been used by athletes to reduce fatigue, lose weight and improve mental alertness—were banned by the U.S. Food and Drug Administration in 2004, their place is being taken by an increase in the use of drugs to treat ADHD among athletes.

What’s the appeal?
Athletes may have several reasons for using performance-enhancing drugs. An athlete may want to: build mass and strength of muscles and/or bones; decrease injury recovery time; increase delivery of oxygen to exercising tissues; mask pain; stimulate the body; relax; reduce weight or hide the use of other drugs.

Why are these drugs so appealing to athletes? Besides making muscles bigger, anabolic steroids may help athletes recover from a hard workout more quickly by reducing the muscle damage that occurs during the session. This enables athletes to work out harder and more frequently without overtraining. In addition, some athletes may like the aggressive feelings they get when they take the drugs.

Athletes face enormous pressure to excel in competition. They also know that winning can get them more than a gold medal. A star athlete can earn a lot of money and a lot of fame and athletes only have a short time to do their best work. Athletes know training is the best path to victory, but they also get the message that some drugs and other practices can boost their efforts and give them a shortcut, even as they risk their health and their athletic careers.

Are PEDs ever used for medical reasons?
Anabolic steroids are used therapeutically in medicine to induce bone growth, stimulate appetite, induce male puberty and treat chronic wasting conditions, such as cancer and HIV/AIDS.

EPO is used in treating anemia resulting from chronic kidney disease and myelodysplasia from the treatment of cancer.

In children, HGH injections are approved for treating short stature of unknown cause as well as poor growth due to a number of medical causes.

In adults, approved uses of HGH include:

Short bowel syndrome, a condition in which nutrients are not properly absorbed due to severe intestinal disease or the surgical removal of a large portion of the small intestine
HGH deficiency due to rare pituitary tumors or their treatment
Muscle-wasting disease associated with HIV/AIDS

What are the consequences of using PEDs improperly?

Men may develop:

Prominent breasts
Baldness
Shrunken testicles
Infertility
Impotence

Women may develop:

A deeper voice
An enlarged clitoris
Increased body hair
Baldness
Infrequent or absent periods

Both men and women might experience:

Severe acne
Increased risk of tendinitis and tendon rupture
Liver abnormalities and tumors
Increased low-density lipoprotein, LDL cholesterol (the "bad" cholesterol)
Decreased high-density lipoprotein, HDL cholesterol (the "good" cholesterol)
High blood pressure/hypertension
Heart and circulatory problems
Prostate gland enlargement
Aggressive behaviors, rage or violence
Psychiatric disorders such as depression
Drug dependence
Infections or diseases such as HIV or hepatitis if you're injecting the drugs
Inhibited growth and development and risk of future health problems in teenagers

What symptoms could help identify someone who is abusing PEDs?

Possible red flags include:

Behavioral, emotional or psychological changes — particularly increased aggressiveness ("roid rage")
Changes in body build, including muscle growth, rapid weight gain and development of the upper body
Increased acne and facial bloating
Needle marks in the buttocks or thighs
Enlarged breasts in boys or smaller breasts in girls
The bottom line… people who are abusing PEDs will not be themselves.

Is damage done from improper use of PEDs reversible?

In males, changes that can be reversed include reduced sperm production and shrinking of the testicles (testicular atrophy). Irreversible changes include male-pattern baldness and breast development (gynecomastia).

In the female body, anabolic steroids cause masculinization. Breast size and body fat decrease, the skin becomes coarse, the clitoris enlarges and the voice deepens. Women may experience excessive growth of body hair but lose scalp hair. With continued administration of steroids, some of these effects become irreversible.

Rising levels of testosterone and other sex hormones normally trigger the growth spurt that occurs during puberty and adolescence and provide the signals to stop growth as well. When a child or adolescent takes anabolic steroids, the resulting, artificially high, sex hormone levels can prematurely signal the bones to stop growing.

Steroid abuse has been associated with cardiovascular diseases, including heart attacks and strokes, even in athletes younger than 30.

Many abusers who inject anabolic steroids may use nonsterile injection techniques or share contaminated needles with other abusers. In addition, some steroid preparations are manufactured illegally under nonsterile conditions. These factors put abusers at risk for acquiring life-threatening viral infections, such as HIV and hepatitis B and C.

The most dangerous of the withdrawal symptoms from anabolic steroid use is depression because it sometimes leads to suicide attempts.

References:
http://www.resoundinghealth.com/casebook/show/206
http://www.dmos.com/articles/Honkamp_Youth_Athletes_Feb_08.pdf
http://www.mayoclinic.com/health/performance-enhancing-drugs/HQ01105
Hayashi, A, AAOS Now,” PED use: Legal, natural, and deadly”, Oct 2008
Schafer, M, Porucznik, M, AAOS Now, “If you’re not cheating, you’re not trying”, June 2008

Diabetes Alert Day

noreply@blogger.com (Meritus Health) — Mon, 25 Mar 2013 19:48:00 +0000

It’s not as festive as St. Patrick’s Day and it’s not a paid holiday, but many healthcare experts will argue that Diabetes Alert Day is one of the most important days of the year.

Diabetes affects 25.8 million people in the U.S. and is a major cause of heart disease and stroke. Experts predict that by 2050, one in three U.S. adults could develop diabetes.*

Type 2 diabetes develops over time. “You don’t wake up one day with a blood sugar level of 300,” says Laurie Sandberg, RN, B.S.N., certified diabetes educator. With type 2 diabetes, the body becomes resistant to insulin or the pancreas stops producing insulin. Yet very often people with type 2 diabetes have no symptoms. That’s why the American Diabetes Association promotes a one-day “wake up call” to help people understand their risk factors for prediabetes and type 2 diabetes.

Risk factors for type 2 diabetes
Your diabetes radar should be up if you have a family member with type 2 diabetes, are overweight (especially storing excess fat in your belly), lead an inactive lifestyle and are older. People more likely to develop type 2 diabetes also include African Americans, Hispanics, Native Americans, Asian Americans and women diagnosed with gestational diabetes during pregnancy.

Diabetes Alert Day is about prevention. “Type 2 diabetes can be prevented or delayed, but you need to discover it early,” says Sandberg. Left undetected or poorly managed, diabetes can cause nerve, liver, kidney and eye damage as well as heart and blood vessel disease. But often people are afraid or don’t want to know if they are diabetic.

The first thing you need to do is go to StopDiabetes.com and take the Diabetes Risk Test or go to the American Diabetes Association’s Facebook page. The test takes about one minute and asks you questions about your age, family medical history, exercise habits, weight and height and medical conditions. If you score a five or higher, you’re at risk for developing diabetes and should talk to your primary care physician.

Your doctor may order a fasting blood glucose test and a hemoglobin A1C test (a test that measures your blood sugar level over three months). A normal fasting blood sugar range is between 70-99. A reading of 126 or higher means you’re diabetic and any number in between 100 and 125 is considered prediabetic. Here’s the good news: people with prediabetes who lose weight and increase their physical activity can prevent or delay type 2 diabetes, and in some cases return their blood glucose levels to normal.

Having a diagnosis of diabetes or prediabetes doesn't mean a life of misery or future complications—you just need to manage it. With the help of your primary care physician and diabetes support, you can take control of the disease and not let it control you. Meritus Endocrine, Nutrition and Diabetes Education Center (MEND) supports diabetics by providing education and nutrition planning from a nurse certified diabetes educator and a registered dietitian. Medicare and most other insurers cover diabetes education and nutrition services.

Most of the time, diabetes can be controlled with diet, exercise, weight loss and oral medication. You just need to stay ahead of it, get diabetes support and don’t let it overwhelm you.

By: Anne Gill

* American Diabetes Association

Nurse Certification Promotes Excellence

noreply@blogger.com (Meritus Health) — Tue, 19 Mar 2013 16:52:00 +0000

Some of us may admire nurses for their ability to stand and move around for 12-hour shifts or their capacity to listen and assess a patient’s status. Others might appreciate how nurses can translate diagnoses, test results and life-style changes in a way that patients can understand.

Any way you slice it, nurses spend the most time with patients and have an enormous affect on patient care. That’s why more and more nurses are receiving nursing certification in specific clinical areas. “Certification is where the healthcare industry is going,” explains Jody Bishop, M.S.N., RN and Magnet Program Director. “Healthcare needs are becoming more complex, and as a result, require nurses to become more specialized.”

Nurses achieve certification credentials through specialized education, experience in a specialty area and a qualifying exam administered by a certifying agency, such as the American Nurses Credentialing Center (ANCC). The preparation and testing for nurse certification pays off. Nurses remain up-to-date with the latest developments in their specialties and are more prepared to care for chronic or critically ill patients.

“National certification in a specialty area such as emergency nursing, critical care or anesthesia recovery signifies that a nurse has achieved a higher level of knowledge,” says Jesus Cepero, Ph.D., RN, NEA-BC, Vice President and Chief Nursing Officer at Meritus Health. “This knowledge helps improve patient care and outcomes. Nurses who achieve national certification show a continued commitment toward education and excellence in nursing practice.” Jody Bishop agrees, stating, “Certification is really a validation of nurses’ experience, and it demonstrates nurses’ commitment to life-long learning.”

On March 19, we recognize the contributions of certified nurses as part of Certified Nurses’ Day. At Meritus Health, 160 nurses have attained nursing certification in emergency care, obstetrics, critical care, oncology, pediatrics and perioperative care as well as midwifery and advance practice nursing (nurse practitioner).

Not only does certification show the public that nurses have met high standards of practice, but it gives nurses a sense of pride and professional accomplishment for all they have achieved. “I am so proud of our certified nurses, and those who prepare to take on certification,” states Cepero.

By: Anne Gill

When a Knock to the Noggin is not Okay

noreply@blogger.com (Meritus Health) — Thu, 14 Mar 2013 20:25:00 +0000

A physician once said to me, “I can fix broken bones, but I cannot fix broken heads.” As parents, we do everything in our power to protect our children from harm. Yet despite our best efforts, last year Meritus Medical Center treated 217 patients under the age of 16 with concussions, and another 457 patients who were over the age of 16.

Concussions are not uncommon. The Centers for Disease Control and Prevention claim that 1.7 million people in the U.S. suffer from a traumatic brain injury (TBI). Traumatic brain injury happens when a bump, blow, jolt or other head injury causes damage to the brain. As the number of concussion cases and awareness continues to grow, a local group is making sure that high school athletes with concussions get the right assessment at the right time.

The Brain Injury Community Outreach Council, a volunteer group of medical professionals, teachers, trainers and parents, educate the community about protecting youth from head trauma. Last year, the council implemented concussion, or “impact,” testing at Smithsburg High School, and plan to expand the program to other Washington County high schools.

Here’s how “impact testing” works: after an injury occurs, athletes sit at a computer and respond to questions related to sustained attention, visual-motor processing speed, visual and verbal memory, selective attention and reaction time to name a few measures. The results can identify whether or not the student has suffered a brain injury and needs to see a doctor.

The test takes the guesswork out of determining the extent of the injury right after the event. For parents, physicians and coaches, the test helps decide when an injured athlete can return to play following a concussion. And when it comes to your head, the risk for more serious injury occurs when an athlete gets a concussion and continues to play, or returns to play before the brain has fully healed.

Help for parents
By next school year, the council plans to expand concussion testing to all Washington County schools and involve the Meritus Health school nurses. As a parent, there’s much you can do to prevent a serious head injury:

Protect your child’s head by requiring them to wear a helmet when biking, skiing and skateboarding.
Know the signs of a concussion and seek medical attention when necessary.
Give detailed information to your healthcare provider about your child’s head injury and behavior post-injury.
Closely monitor head injuries and tell coaches about any concussions your child experiences.
Explain the seriousness of a brain injury to your child. It’s not ok to shake off a head injury.
Let your child’s brain heal after a brain injury by prohibiting physical and mental activities (this includes video games, Facebooking and texting).

Serious brain injuries can lead to problems with thinking, memory, reasoning, communication and depression as well as personality changes. That’s why it’s important to know the signs and seek medical attention fast.

What to look for after a head injury

Loss of consciousness
Difficulty following directions
Slowed reaction time
Fatigue or insomnia
Headaches, nausea, blurry vision
Sensitivity to light or noise
Changes in behavior
Reduced tolerance to stress and/or busy environments
Disoriented/impaired memory/can’t recall events just prior to or after the injury

March is Brain Injury Awareness Month. If you’d like more information on brain injuries, please call 301-790-8618.

Heart Patients’ Reason to Celebrate

noreply@blogger.com (Meritus Health) — Mon, 11 Mar 2013 20:35:00 +0000

A Johns Hopkins cardiologist believed in something that many Meritus Medical Center cardiologists and cardiac nurses knew first hand: caring for heart attack patients in our community makes sense for patients and their families. The Hopkins cardiologist led a study that proved that regional hospitals, without on-site cardiac surgery, could provide care to heart attack patients instead of transferring patients to a specialty care hospital.

Five years ago, the Maryland Healthcare Commission confirmed Meritus Medical Center’s ability to perform emergency percutaneous cardiac intervention (PCI) on patients with ST segment elevation myocardial infarction (STEMI). That’s a mouthful, but STEMIs are heart attack patients and PCI is an intervention in which a tiny balloon is inflated to reopen a blocked artery and restore blood flow to the heart. The faster blood flow is re-established, the better the patient’s chances of a good recovery.

Before getting the green light to treat heart attack patients, Meritus Medical Center invested in technology and recruited cardiac professionals from metropolitan cardiac centers to help build the hospital’s STEMI program. Up until that point, heart attack patients traveled to Baltimore or the Washington, D.C., area for treatment.

“Before our STEMI program, caring for a heart attack patient almost always involved a helicopter ride to a Baltimore area hospital—and that was dependent on the availability of a helicopter and the weather,” says cardiologist Tarek El-Sherif, MD. “We weren’t always able to comply with best medical practice.”

Best practice is a 90-minute “door-to-balloon time,” established by the American College of Cardiology and the American Heart Association. The clock ticks from when the patient arrives in the emergency department to when a balloon is inflated to open the patient’s blocked arteries. Meritus Medical Center averages a 64-minute door-to-balloon time.

“There is a potential for complications when transferring a patient out of the hospital, in addition to the hardship placed on the family to travel to a tertiary care center,” says interventional cardiologist Robert Marshall, MD, a founding member of the program.

Today, Meritus Medical Center treats both heart attack patients and patients needing elective angioplasty to lessen the symptoms of coronary artery disease. The hospital performs the second highest number of cardiac interventions for non-surgical heart hospitals in the state of Maryland. “The population is clearly at risk,” adds Dr. Marshall.

When it comes to cardiac care, Meritus Medical Center keeps moving the ball forward. Since receiving the Maryland Health Care Commission’s approval, they’ve received the American Heart Association’s Mission Lifeline accreditation and become a Maryland Institute for Emergency Medical Services Systems (MIEMSS) designated Cardiac Interventional Center. The hospital’s cardiac catheterization lab research team is also participating with Yale University and Duke University on cardiac research studies.

More than five years ago, if you or a loved one had cardiac trouble, you were traveling to Charm City for a better chance at life. Today, expert care is right around the corner. Happy anniversary, Meritus Medical Center’s STEMI program!

The Cardiac Cath Lab Team at Meritus Medical Center

By: Anne Gill

Helping You Get Healthier During National Nutrition Month

noreply@blogger.com (Meritus Health) — Mon, 04 Mar 2013 17:27:00 +0000

March is National Nutrition Month! This month, there are a few changes happening in Meritus Health’s Robin’s Nest and Cove. The first change is the removal of all deep fryers. The fryers will be replaced with TurboChefs, which mimic the effect of deep frying without all of the extra calories. The second big change is the addition of the Go, Slow, Whoa program. Go, Slow, Whoa is a visual embodiment of the USDA Dietary Guidelines for Americans that educates and reminds us what foods we should be eating and how frequently.

Why has Meritus Health decided to implement these changes?

Meritus Health’s mission statement is “Meritus Health exists to improve the health status of our region by providing comprehensive health services to patients and families.”

Heart disease, diabetes and high blood pressure are just a few negative health troubles caused by the obesity problem affecting not only our nation, but our local Washington County community. If the rate of obesity continues as it has been, Trust of America’s Health, a non-profit organization dedicated to preventing epidemics, projects that more than 58% of people in Maryland will be obese by 2030.

It is our hope that by implementing these changes, we can help to improve the health of our employees and our community and combat the rising obesity rates in Washington County.

What exactly is the Go, Slow, Whoa program?
Meritus Health Executive Chef Joseph Fleischman described the Go, Slow, Whoa program as, “Like a stop light. Go is green, and includes food you can eat every day. Slow is yellow; be cautious eating these foods and only eat them occasionally. Whoa is similar to a red light; you can eat these foods every once in a while, but moderation is key.”

Go foods are high in nutrients, low in calories and minimally processed. The Go category includes natural foods such as fruits, vegetables and whole grain bread. Foods categorized as Slow have more sugar and fat and are more processed than Go foods, such as white flour bread, 100% fruit juice and pretzels. Foods in the Slow category should only be enjoyed a few times each week. Whoa foods pack lots of calories, but little to zero nutritional value. Because they contribute to weight gain, unhealthy cholesterol and high blood pressure, the intake of Whoa foods should be very limited. Examples of Whoa foods include ice cream, doughnuts and regular soda.

Visitors and employees who visit the Robin’s Cove, the Meritus Medical Center dining room the Robin’s Nest in Robinwood Professional Center will see green and yellow markers on the healthier options available.

By working together to educate and support healthy eating through the Go, Slow, Whoa program, everyone benefits.

Please let us know what you think about the healthy eating changes Meritus Health is making by sending an email to: kayla.murphy@meritushealth.com.

Pacemakers and the Pope

noreply@blogger.com (Meritus Health) — Mon, 25 Feb 2013 19:44:00 +0000

Sadly, the human body wears out over time. But, Pope Benedict XVI’s resignation at age 85 shocked many. After all, he was the first pontiff to do so in nearly 600 years. The exact reasons for the Pope’s resignation remain unclear, but he says his declining strength is holding him back.

Ten years ago, the Pope underwent a pacemaker implantation. Three months before calling it quits, he received a replacement. Could heart health be the cause of his early retirement? According to cardiologist Joseph Reilly, MD of Hagerstown Heart, a slow heartbeat is commonly related to age and one of the reasons for a pacemaker. “Bradycardia [slow heart rate] can be a progressive condition related to the heart’s aging electrical system,” explains Dr. Reilly.

With each heartbeat, an electrical signal generates from the top of your heart to the bottom. As the signal travels, it causes the heart to contract and pump blood. “Your heart has electrical wiring just like your house. If there’s a problem at one point of your electrical wiring, you may need a pacemaker,” says Dr. Reilly.

A slow heartbeat
Bradycardia occurs when your heart beats too slowly. Because there’s not enough cardiac output to do normal things, you can become winded, tired, dizzy, lightheaded, or even faint. In addition to the heart’s normal age-related changes, cardiovascular disease can also damage the heart’s electrical system and cause Bradycardia. Even medical conditions like an under active thyroid or too much potassium in the blood can slow a heart rate.

Treating Bradycardia
The average resting heart rate is somewhere between sixty and one-hundred beats per minute, but if your heart is beating under sixty beats per minute, chances are a pacemaker is for you. An electrocardiogram (EKG) helps a cardiologist determine how your heart is functioning.

Dr. Reilly most often sees people age 65 or older requiring a pacemaker, but his oldest patient was a 103-year-old woman. “She initially refused to get a pacemaker at age 98, but she came back asking for a pacemaker when she could no longer cook breakfast for her great, great grandchildren,” says Dr. Reilly.

Medical marvel
A pacemaker weighs about an ounce—the size of a half-dollar piece, or a pocket watch. Its battery and computer circuitry monitors the heart, sending tiny electrical signals to increase its rate if it detects a slow rhythm. Most pacemakers last six to eight years.

Dr. Reilly, a specialized electrophysiologist, performs pacemaker procedures in the hospital’s catheterization lab. The procedure is done under local anesthesia where the cardiologist makes a small incision under the collarbone to implant the pacemaker. Patients stay overnight in the hospital for monitoring and report back to their cardiologist for an evaluation several weeks later.

Life after a pacemaker
Once the pacemaker starts regulating the heart, patients don’t feel a thing—but they do feel better. “More than 80% of my pacemaker patients say they have more energy and more mobility,” says Dr. Reilly. Patients check back with their cardiologists several times a year to follow their pacemaker’s functioning.

Although it’s unlikely that a pacemaker would stop working because of electrical interference, it’s recommended that pacemaker patients seek an alternative to airport metal detectors, avoid MRI scans and place a cell phone on the ear opposite to the pacemaker.

Despite modern medical advances, only the Pope knows what’s best for him. His new pacemaker will carry him into his nineties, but the rest of his body needs to keep up too. He wouldn’t be the first to spend his golden years out of the public spotlight.

How Food Comes to Your Emotional Rescue

noreply@blogger.com (Meritus Health) — Tue, 19 Feb 2013 20:46:00 +0000

While surfing the internet or watching your favorite TV show, you munch on caramel popcorn, and soon you’ve consumed 250 calories with not much thought. “People eat on the go or mindlessly and sometimes eat when they are not physically hungry,” says Diane Sullivan, licensed certified social worker (LCSW-C) with Meritus Health’s Behavioral Health Services. Emotional eating is eating driven by an emotion or feelings rather than hunger.

Diane explains that people must tell the difference between emotional hunger and physical hunger. Here’s how you can separate the two:

Emotional hunger comes on fast; physical hunger gradually builds
Certain foods like French fries or ice cream help fill an emotional void, but people who eat to satisfy hunger are open to a variety of foods.
People who eat when they’re hungry stop when they’re full; emotional eaters tend to keep eating.
Emotional eating brings about feelings of guilt; physical hunger does not.

You can use your body, not your head to get an idea of how hunger and fullness feels like. From famished/starving to “Thanksgiving full,” a basic hunger/satiety scale rates your hunger level before you eat and again after you’ve finished eating.

Food as a mood regulator
People with a “calming problem” tend to eat emotionally according to Sara Smith, licensed graduate social worker (LGSW). “Food is often used as a mood regulator,’ says Diane. “If you feel restless, a cupcake makes you feel better. Start by asking yourself, ‘what am I looking for in food?’ Negative emotions like emptiness, stress, boredom, loneliness and anger trigger eating,” says Diane. “You have to replace the negative with positive counterparts.” If you’re stressed, find a peaceful activity like yoga. If you’re lonely, pick up the phone and call a friend. “You can use food some of the time, but not all of the time,” explains Diane.

Diane underscores the relationship between self-esteem and food. “You have to understand a person’s relationship with food in terms of their thinking, beliefs, feelings and behavior. But you must change your thinking before you change your behavior.” Emotional eating often suppresses people’s unpleasant thoughts and feelings. As awareness is heightened, people need to replace those feelings with healthy responses.

Getting help
Meritus Health’s Behavioral Health Services offers a three-session educational and support program called “Love Yourself Now, Don’t Weight” which focuses on building self-esteem and learning strategies for body acceptance while working to improve health through setting healthy lifestyle goals. “The course asks participants to look at themselves beyond their physical bodies and appreciate who they are today rather than waiting to reach a weight loss goal,” explains Sara. “We encourage people to accept where they are now and set personal health goals.” Exercise and healthy eating is promoted and weight loss can be a byproduct of the course. Another ten-week treatment group called “Life is More than Food” is available for those currently in individual therapy to help build self-respect and create healthy coping strategies. For more information on these programs, call Behavioral Health Services at 301-766-7600.

Research continues to link the experience of eating to tastes, smells and the memory of the food experience, but new studies indicate that the stomach may influence the brain by releasing hormones—a gut/brain connection for craving high-fat foods. If you’re worried about your emotional connection to food, talk to your primary care physician about counseling to help you better understand your triggers.

By: Anne Gill

Prescription Drugs: What You Eat, Drink and Pop Matters

noreply@blogger.com (Meritus Health) — Mon, 11 Feb 2013 21:43:00 +0000

Jennifer Reinke, Pharm.D., RPh.

My husband has an iron gut. Spicy chicken wings and a beer pose no problem for him. Me—I can’t handle a donut and a drive home in the back seat of a car. So, if anyone would experience a drug interaction, it would be me, right?

“Everyone has the potential to have an adverse drug reaction and no medicine is risk free,” warns Jennifer R. Reinke, Pharm.D., RPh., of Home Care Pharmacy. The National Institute of Health defines an adverse drug reaction as a harmful or unpleasant reaction related to the use of medicine.

According to Dr. Reinke, adverse reactions fall into two main categories: side effects like nausea or a reduction in the drug’s desired effect—like combining certain antibiotics with milk and diluting the drug’s wallop. Everyone should pay close attention to the prescriptions, beverages and herbal supplements they take.

Food and beverage
The “wake you up in the morning” glass of grapefruit juice shouldn't be taken with certain blood pressure-lowering drugs and cholesterol medications. “It’s best to avoid all citrus juices when taking your medications,” advises Dr. Reinke. She suggests drinking water to swallow your pills.

Alcohol can increase or decrease the effects of many drugs. “If the drug is metabolized by the liver, alcohol is not allowed,” warns Dr. Reinke. Taking Flagyl (an antibiotic used to treat a variety of infections) and drinking alcohol may result in an irregular heartbeat, low blood pressure, sweating and nausea. “Mixing alcohol and prescription drugs is the number one drug-food interaction question I get from my customers.”

Taking monoamine oxidase (MAO) inhibitors for depression and eating chocolate could cause a sharp rise in blood pressure. Dr. Reinke notes that the antibiotic Zyvox interacts with chocolate and smoked or dried meats. Dairy products can also be a bad companion for some medications.

Dietary supplements
According to Dr. Reinke, combining dietary supplements and medications has not been widely studied, but data from emergency departments and poison control points to supplement and drug combinations to avoid. Vitamins A, D, E and K are fat-soluble vitamins that can build up in your system. “Vitamins D and E are especially popular these days due to their link to bone and heart health,” explains Dr. Reinke. But taking vitamin E with a blood-thinning medication such as Coumadin can increase anti-clotting activity and put you at risk for a significant bleeding event. St. John’s Wort can reduce the concentration of medications in the blood. “Do not take an herbal supplement without first talking to your healthcare provider,” emphasizes Dr. Reinke.

Knowledge is power
If you’re in the habit of tossing the leaflet that accompanies your prescription into the trash, stop! The leaflet details medication side effects and precautions, so take the time to read it, advises Dr. Reinke. Here are some other suggestions on how you can be a well informed prescription drug consumer:

Keep your medications in their original containers.
Schedule time to talk to your Primary Care Physician or pharmacist about your medications and possible interactions.
Check with your PCP or pharmacist before taking an over-the-counter, or OTC medication or supplement if you’re on a prescription medication.
Tell your PCP and pharmacist about any new drugs prescribed by specialists
Use one pharmacy for all drug needs. Unless affiliated, pharmacies can’t exchange prescription information with one another.
Keep a record of your medications, OTC drugs and supplements

“Pharmacists are the most accessible healthcare providers out there,” says Dr. Reinke. She encourages people to call ahead and make an appointment with a pharmacist to discuss medications. By bringing your medications along, a pharmacist can help fill out a medication card for you to keep nearby. Pharmacies like Home Care Pharmacy take pride in getting to know customers and devoting time to their questions.

By: Anne Gill

“Growing Pains” – are they real?

noreply@blogger.com (Meritus Health) — Mon, 04 Feb 2013 21:52:00 +0000

“Mommy, my legs hurt.” It’s a common complaint in children, but why do spry, energy-filled kids experience leg pain? Inaccurately labeled as “growing pains,” leg pain can be attributed to your child’s physically strenuous day. “This type of pain isn’t related to growth, but rather to your child’s level of activity,” explains physician assistant Jennifer Nunnelee, PA-C at Smithsburg Family Medical Center.

Who gets them?
According to Jennifer, about 10-20% of children experience “growing pains.” Pain typically crops up between the ages of three to five, and reappears from age eight to twelve, with girls reporting more growing pains than boys.

Telltale signs
Commonly, a throbbing pain occurs in both legs, usually in the calf and upper thigh muscles and behind the knee. The pain tends to happen at night and can be severe enough to wake a child up, though the pain usually disappears in the morning. “Growing pains don’t occur at the joint: they usually occur in the leg muscles,” explains Jennifer. “You never have pain in the upper extremity without pain in the lower extremity, and pain occurs in both limbs.” If the pain occurs only in one leg, you should discuss the symptom with your pediatrician.

When to worry
Although most limb pain can be attributed to an athletic day, keep a close eye on several factors. A painful reaction to gentle touches, pain that interferes with your child’s activities and persistent pain should prompt a visit to the pediatrician. You should also be on the look out for pain early in the day, redness, tenderness and swelling in the joint area. Cautionary signs also include limping, overall weakness, fever and unusual tiredness. “‘Growing pains’ are intermittent. Most serious conditions typically cause persistent pain,” explains Jennifer.

Leg pain could be a sign of a stress fracture, juvenile rheumatoid arthritis, bone infection, bone cancer, Legg-Calve-Perthes Disease, sickle cell anemia, leukemia or rickets. So, if your child has persistent pain or the symptoms listed above, see your pediatrician right away.

Help for tired legs
If your child complains of “growing pains,” pour on the love. Usually a gentle massage to the affected area does the trick, though you can also offer acetaminophen (Tylenol) or ibuprofen and apply a heating pad.

So, are growing pains real?
Technically, no. But leg pain in growing children is real. If you are concerned about your child’s leg pains, don’t hesitate to call your pediatrician. If you don’t have a pediatrician, check out the listings in Healthline.

By: Anne Gill

Stuck on Zumba

noreply@blogger.com (Meritus Health) — Mon, 28 Jan 2013 21:00:00 +0000

Valerie Pensinger, RN

Dancing with the Stars fans know there’s nothing better than watching a couple tango through a competition. As the new year unfolds, wouldn’t it be nice to transition from dance observer to dance participant? I’m not suggesting a gig on Dancing with the Stars, but consider taking a Zumba class.

Cha-chaing to better health
Zumba is a Latin dance-inspired class that incorporates easy-to-follow dance steps such as the rumba, salsa, mambo and cumbia. For more than four years, Meritus Health’s care manager Valerie Pensinger, RN, has attended Zumba classes. When her instructor went on medical leave, Valerie didn’t want to miss taking classes, so she became certified to teach Zumba. “I’ve done step aerobics in the past, but this program really motivates me,” says Valerie. “It makes me feel young.”

Valerie doesn’t come from a dance background, but has participated in group exercise programs for years. She teaches or attends class twice a week, while juggling a full-time job and spending time with her husband and two children. “I bring intensity to a class—you definitely break a sweat,” says Valerie. Ever the nurse, Valerie cautions her students to be mindful of toe-knee alignment while dancing, wear proper footwear that cushions the body’s joints and sip water during class to stay hydrated.

Zumba’s appeal
Zumba attracts mainly women to fitness facilities, recreation centers and dance studios. “People come to cut loose and have fun,” explains Valerie. Don’t worry about what you look like while shaking your hips because novice dancers and those with rhythm have the same goal—to sweat. Whether it’s Latin dance, hip-hop, or belly dancing, Zumba requires no previous dance experience according to Valerie. “It’s a party-like atmosphere with a bunch of friends—and not a chore like some other workouts,” adds Valerie.

The basic Zumba class spans one hour and trained instructors have the flexibility to design classes to their own style, and some incorporate strength training. “It’s always fresh and the music makes it fun,” explains Valerie. She emphasizes that Zumba is a great workout for people who love to exercise in a group.

“I’m not an exercise guru, but this is something that has stuck with me,” says Valerie. Zumba is about the fun, camaraderie and exercise—not to dazzle the judges. This new year, find a form of exercise that interests you. It may be Zumba, spinning or walking the mall with a friend. Just get moving.

By: Anne Gill

Women: Wear Red and Take Note

noreply@blogger.com (Meritus Health) — Mon, 21 Jan 2013 21:25:00 +0000

Twinkies have an infinite shelf life. Mrs. O’Leary’s cow started the Great Chicago Fire. Old men have heart attacks. Misconceptions are everywhere. Every year, the American Heart Association designates a day in February to wear red and remind us that woman too get heart disease. In fact, it is the number one killer of women.

And here’s another misconception. Women’s heart attack symptoms are the same as men’s symptoms. Wrong. Women often don’t know they’re having a heart attack, so they don’t show up in the emergency department until well into the attack, and then the outlook doesn't look good.

This February, spread the word about women and heart disease. Know the signs and how to live a more heart-healthy life.

Know the signs. Instead of the crushing chest pain, women’s symptoms are more subtle, like shortness of breath; shoulder, arm, neck or jaw pain; unusual fatigue and even pain between the shoulder blades or abdomen. Women can break into a cold sweat or feel nauseous during a heart attack.
Stay on top of your cholesterol, blood pressure and blood sugar numbers. Ask your primary care physician how often you should get these numbers checked.
Keep or get moving. Consistent exercise burns calories while lowering your blood pressure, cholesterol and blood sugar levels. Aim for a brisk 30-minute walk most days of the week.
Eat to health. Dedicate half of your plate to fruits and vegetables: the brighter, the better.
Watch your waist-to-hip ratio. Abdominal fat increases your risk for heart disease and diabetes, so if your shape resembles an apple, not a pear, it’s time to lose that belly fat.
Heed menopause. Women’s estrogen levels drop after menopause, and so does the ratio of good and bad cholesterol—LDL increases and HDL decreases. Remember, you want LDL levels low and HDL levels high. Talk to your primary care physician about natural ways to boost estrogen levels.
Don’t smoke. If you tried quitting and have not had success, get professional help from Meritus Health’s Beat the Pack program (call 301-790-8907 for more information).

Socialization and smarts
It’s no secret. Women like to socialize—and it’s good for our hearts because it relieves life’s daily stressors. On Monday, Feb. 11, Meritus Health combines fun and education with an Evening of Red Wine and Dark Chocolate. You get the scoop on the health benefits of red wine from an expert at the University of Maryland and hear from cardiologist Joseph Reilly, M.D., of Hagerstown Heart, on coronary artery disease. The evening winds down with advice from a Johns Hopkins University psychologist on how to keep sexual desire alive. An evening of laughs and education is yours for only $30 and includes a delicious dinner. Round up your gal pals and call 301-790-8907 to register.

Heart disease isn’t an old man’s disease. To show support and understanding, wear red, take action and commit to fighting this deadly disease. See you on Feb. 11!

By: Anne Gill

Meet TG3

noreply@blogger.com (Meritus Health) — Fri, 18 Jan 2013 18:34:00 +0000

He completed 20 touchdowns and threw for 3,200 yards in his NFL debut season. The 2011 Heisman Trophy winner, Robert Griffin III, also known as RG3, reinvigorated the Washington Redskins and helped them post a 10-6 season record.

He’s board certified in emergency and undersea and hyperbaric medicine, and passed rigorous evaluations to be named a fellow in three American boards of medical specialties. The Wound Center’s medical director, Thomas Gilbert III, D.O., FACEP, FAPWCA, FACHM, also known as TG3, built Meritus Medical Center’s Wound Center and redefined wound care in the tri-state area.

Anne Gill (AG): How have you created a buzz in wound care?
Dr. Gilbert (TG3): It’s really about our strong patient outcomes and word of mouth. We have a wound care team that’s dedicated to exceptional patient care. Many of our patients come to us with multiple chronic wounds or wounds that won’t heal. We look at these situations as challenges.

AG: What types of wounds do you treat?
TG3: Post-surgical wounds, pressure ulcers, diabetic foot ulcers, wounds associated with bone infections, wounds as a result of soft tissue radiation injury from radiation therapy and any chronic wound which won’t heal.

AG: Tell me about your defensive game. How do you tackle chronic wounds?
TG3: First, we look at the patient’s vascular supply and its ability to heal a wound. We assess whether there’s bacteria in the wound, or if the wound is not improving after two to three weeks, we then re-evaluate as a team and look for other treatment options. One option is the use of hyperbaric oxygen therapy for certain wound types such as diabetic foot ulcers, bone infections, graft failures or radiation injury. Hyperbaric oxygen therapy places the patient in a 100% oxygen enriched environment under pressure. This environment enriches the tissues with oxygen and promotes the development of new blood vessels near the wound. It also enhances the effectiveness of certain antibiotics. Another treatment option is the use of bio-engineered skin substitutes to support wound closure. These skin substitutes contain fibroblasts, keratinocytes and growth factors stimulating new tissue growth.

AG: Talk about the Center’s journey into the big league. How did it all begin?
TG3: When we first started, we’d see only six patients on some days. We reached out to people in Washington County, Chambersburg and Martinsburg. Soon our results spoke for themselves. Today, patients come from as far as Winchester and Reston, Virginia, and Cumberland, Maryland. As our volume grows, we continue to add dynamic staff to our team.

AG: It sounds like you have a good record. Let’s talk stats.
TG3: We are tied into a wound expert program that compares our patient volumes, types of patients seen and best practices with 350 other wound care centers. The national average for limb amputation is 3%; we’re at less than 1%. Most chronic wounds heal in 16 weeks; we have it down to 12 weeks.

AG: In healthcare, stats talk volumes, but so does patient satisfaction. You appear to have some raving fans.
TG3: First, we do our best to bring new patients in within 24 hours—no waiting. And, we look at the patient holistically. How can we help the patient? We look at his/her nutritional status; how well-controlled is diabetes and blood pressure? We manage the IV antibiotics and the patient’s blood glucose and check renal function, particularly if we place him/her on antibiotics that may interfere with kidney function. Our nurses make sure patients have the answers to their questions before they leave. If a patient needs to be admitted to Meritus Medical Center, we fast track them in.

AG: Any thoughts on the competition?
TG3: Our patient outcomes speak volumes, but so do our team members. Our physicians are board certified in hyperbaric, emergency and internal medicine, so there’s not much that gets by us. Our Wound Center team includes hyperbaric certified nurses and respiratory therapists.

AG: What’s your Heisman Trophy?
TG3: We received accreditation as a clinical hyperbaric facility by the Undersea and Hyperbaric Medical Society (UHMS) last fall. The accreditation involves a thorough review of the Wound Center’s staffing, training, equipment and patient processes. UHMS patient care standards are closely aligned with nationally established Joint Commission standards so patients can come to us knowing they’re receiving expert care.

Baby, It’s Cold Outside

noreply@blogger.com (Meritus Health) — Mon, 14 Jan 2013 21:16:00 +0000

Old man winter hasn’t hit hard yet, but when the wind howls at 30 mph and the thermometer dips below 32 degrees Fahrenheit, frostbite can occur. Depending upon how long you’ve been outside, frostbite, or frozen body tissue, can cause a loss of feeling and color in the nose, ears, cheeks, chin, fingers or toes. Redness or pain in any skin area could be a sign that you have frostbite.

Hypothermia, another outdoor hazard, happens when your normal body temperature of 98.6 degrees falls below 95 degrees due to being outside for too long or becoming wet and cold. Signs of hypothermia include lots of shivering, feeling very tired, confused and sleepy. Both frostbite and hypothermia can happen before you know it, and the young and elderly are especially vulnerable. With both conditions, it’s important to seek medical help right away.

Braving the elements
As a rule, limit your outdoor exposure, dress in layers and stay dry. Layers of lightweight, moisture-wicking materials trap air in between each layer to keep you warm. If you have children, dress them in one more layer of clothing than you would wear. Don’t forget that more than 40 percent of body heat is lost from the head, so don’t forget to cover your noggin.

Did you know that your heart works extra hard to keep you warm when it’s cold? Add snow shoveling to the mix and you could be putting too much strain on your heart, especially if you have heart disease. Digging out is dangerous if you have problems with balance or osteoporosis too. Think of snow shoveling as weight lifting. Don’t take on more than you can handle and shovel early and often. If you must lift the snow (instead of pushing it), squat with your legs bent, feet apart and lift with your legs. Never bend at the waist.

Whether shoveling or shopping, wear rubber-soled boots when trekking on snowy and icy surfaces. Keep your hands out of your pockets (you need your arms for balance) and take short, shuffling steps on icy areas.

Prepare for cold weather driving by checking your vehicle’s antifreeze, tires and windshield wipers. Stock you car with a windshield scraper/brush, kitty litter, shovel, jumper cables, blanket, change of clothes, water and dried fruit or energy bars.

Preparing the homestead
There’s nothing cozier than a roaring fire. If you use your fireplace regularly, have your chimney inspected and cleaned every year and install a carbon monoxide detector in your home. Don’t forget to get your furnace inspected and cleaned before winter. If you must use space heaters, make sure they’re Underwriter's Laboratory (UL) certified, not too large for the space you’re heating and positioned away from foot traffic. While candles add ambiance to a cold winter’s night, they fall under the fire hazard category. According to the U.S. Fire Administration, more than 50 percent of candle fires start because a candle is placed too close to something that might burn, like a mattress, curtain, blanket or piece of furniture. Consider using battery operated candles or electric warmers with low-wattage light bulbs. If you must use a candle, place it in a metal, glass or ceramic holder and find a spot where it cannot be tipped or knocked over.

Be it old man winter, Jack Frost or Father Frost, the worst of our weather may be right around the corner, so be prepared.

By: Anne Gill

Meritus Health Flu Advisory

noreply@blogger.com (Meritus Health) — Fri, 11 Jan 2013 17:47:00 +0000

In response to the surge in active flu cases in our community, Meritus Health is encouraging all visitors to refrain from visiting Meritus Medical Center at this time, especially individuals who are most vulnerable to acquiring the flu. Those at a greater risk include, infants and children, senior citizens, and individuals with asthma, COPD, a history of heart failure or respiratory failure, or otherwise have a compromised immune system. Children 17 and under are restricted at this time from visiting patients at the hospital.

Anyone experiencing cold or flu-like symptoms should not come to the hospital as a visitor. Flu symptoms include fever, feeling feverish, chills, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, and fatigue/tiredness. Some individuals may also experience vomiting or diarrhea. It is important to note that individuals with the flu may not have a fever.

If you have mild flu-like symptoms you are encouraged to treat at home with rest, fluids, ibuprofen, and steam. You should also wash your hands regularly and avoid exposing others. Call your physician’s office if you have questions about your symptoms. If your symptoms worsen, it’s important to call your physician’s office as soon as possible.

Meritus Health’s medical practices are taking extra measures to accommodate sick patients. If you do not have a primary care physician, you may contact any of the following Meritus Health medical practices to make an appointment:

North Pointe Internal Medicine - 240-313-9850
White Oak Pediatric and Adult Medicine - 240-313-9890
Potomac Family Medicine - 301-791-7900
Smithsburg Family Medical Center - 301-824-3343
Robinwood Family Practice - 301-714-4400
Williamsport Family Practice - 301-582-1150
J. Correces, MD - 301-665-4593
Robinwood Internal Medicine - 301-665-4825
WillowWood Adult Medicine - 301-714-4175

For life-threatening symptoms, individuals should call 911 or go to the Meritus Medical Center emergency department. Urgent Care centers at Robinwood Professional Center and the Sylvania Centre are also available for non-life-threatening illnesses and injuries. Due to the large volume of flu cases, wait times are longer than usual in our Urgent Care centers and the emergency department.
Meritus Medical Center may also reschedule elective surgery cases for individuals who are more vulnerable to the flu and to reallocate those resources to the high number of inpatients with the flu.

The most effective ways to reduce your risk of acquiring the flu are to get vaccinated, to regularly wash your hands, and to avoid individuals with flu-like symptoms. The flu typically peaks in January and again in March. It is not too late to get a flu shot. The flu shot is recommended for people over six months of age. Individuals should call their primary care physician to see if the flu shot is available or stop by a Home Care Pharmacy location. All Home Care Pharmacy locations have the flu shot available. The flu shot helps prevent or lesson the severity of many strains of flu.

Safety on the Hills

noreply@blogger.com (Meritus Health) — Mon, 07 Jan 2013 21:41:00 +0000

Spring is a mere ten weeks away and January and February can be the snowiest months in the mid-Atlantic. You can either remain indoors for the long haul or embrace what nature offers. Downhill skiing and snowboarding let you take in the winter wonderland and get much-need winter exercise. But if you’re new to snow sports, you’ll want to take a lesson to learn how to put on the gear, move around, slide downhill and stop—all skills needed to avoid potential accidents.

Injury on the slopes
All sports involve a chance of injury. Area ski resorts prepare for occasional falls and accidents by equipping its slopes with ski patrollers and onsite first aid clinics. “Skiing, snowboarding and tubing enjoy excellent safety records,” says Mike Schuman, safety director at Whitetail Resort in Mercersburg, Pennsylvania. While most injuries require basic first aid like bandaging, splinting and applying ice, Whitetail establishes guidelines with hospitals such as Meritus Medical Center to provide important information about injured ski resort customers. “We have an understanding of what kind of information the hospital needs and how they want our care here to be consistent with what they’re going to follow up on,” explains Mike.

Orthopedic surgeon Ralph Salvagno, M.D. with the Center for Joint Surgery and Sports Medicine and trauma surgeon at Meritus Medical Center, is often called in for ski injuries. “Typically with skiers you tend to see long bone injuries such as the tibia, which is the lower bone beneath the knee and femur,” explains Dr. Salvagno. Snowboarders often fall backward, use their hands to brace the impact and find themselves with a wrist fracture or shoulder injury.

In both skiing and snowboarding, beginners suffer almost three times more injuries than the more experienced participants, according to the Wilderness Medical Society. A skier’s ability, speed and the improper adjustment of equipment are factors in snow sport injuries. Both Dr. Salvagno and Mike from Whitetail agree that prevention is key. “Everybody likes to see the tricks, but you really need to ski within your limits,” warns Dr. Salvagno. Before you take on the mountain, follow these snow sport guidelines.

Snow Sport Safety 101

Get professionally fitted for all ski gear and buy or rent skis that are appropriate for your skiing ability. According to the National Institute of Health, poorly adjusted bindings are directly related to injuries. Bindings are adjusted to your height and weight, so have your bindings and boots fitted at a ski shop. For ski poles, make sure your arms form right angles when the handles of the poles touch the ground and your hands grasp the tips.
Wear a ski-specific helmet, not a bike helmet
Take a lesson. Beginners and moderate skiers or boarders benefit from lessons that provide basic skills such as turning and stopping, operating your equipment and preventing injuries.
Avoid frostbite or hypothermia by dressing for warmth. Choose mittens over gloves, invest in snow/ski pants and dress in layers.
Ski with a friend and obey the skier safety code (printed on lift tickets and posted throughout the ski area). Stick to the posted runs and never ski into an “off limits” area.
Stop skiing when you feel tired. Snow sports can be physically demanding. Also, drink plenty of water as dehydration affects endurance.
Avoid drinking alcohol. First, your senses need to remain sharp hitting the hills and second, alcohol is a diuretic and may cause or worsen dehydration.
Know your skiing abilities. If you’re a beginner, stick to the “green” runs. According to the Wilderness Medical Society, most skiing fatalities occur in people who exhibit high-risk behavior.

Whitetail and other area ski resorts run programs that encourage helmet and ski safety. “We do everything we can to get information into the hands of people who are coming here so they can ski and snowboard defensively and really reduce their risk,” emphasizes Mike Schuman.

By: Anne Gill and Linda Norris

Hot Fitness Trends for 2013

noreply@blogger.com (Meritus Health) — Mon, 31 Dec 2012 19:31:00 +0000

The start of each New Year presents a chance to change it up. If you’re tired of running around the neighborhood or hitting the gym, Meritus Health physicians and healthcare providers offer insight on the latest fitness trends.

TRX Suspension Trainer is a portable piece of workout equipment developed by a Navy SEAL. The system uses nylon straps and handles that attach to a stationary object so you can do push-ups, lunges and pull-ups using your body weight. The TRX engages more muscles (especially core) than the same moves performed on the ground. “I like this workout because you can perform it anywhere—your home, office or while traveling,” says internist Jerry Correces, MD. “It’s a great program for those who want to step up their exercise and add more intensity.” But, he cautions to work various muscle groups (i.e. not just the back muscles) for a balanced workout.

High-Intensity Interval Training (HIIT) is a cardio workout that alternates bursts of all out energy with periods of more moderate exercise (i.e. running fast for one minute, followed by two minutes of walking). Whether you’re walking, running, swimming or using a stair climber or elliptical, the HIIT methodology compresses a workout. “For people who can’t spend hours at the gym, HIIT is a great way to burn a lot of calories in a short period of time,” says Alix Gilbert, PA-C of Robinwood Family Practice. “You can increase your endurance and metabolism, and strengthen your heart.” But doing too much at once increases your risk for injury explains Alix, so listen to your body.

CrossFit offers a boot camp-style workout that features constantly varied functional movements performed at a high intensity. Class format varies from day-to-day, but typically involves swinging kettlebells, flipping tractor tires, rope climbing and Olympic weight lifting. “You’re constantly challenging the body,” says Total Rehab Care‘s Angie Davis, physical therapy assistant and certified personal trainer. “It’s hardcore and fast, but you really work your endurance muscles.” Get help from a personal trainer on proper workout form before starting CrossFit. Timed workouts add an extra risk of injury because people rush through the regimens without properly positioning themselves.

Body-weight training incorporates movements such as push-ups, planks and pull-ups to create a routine that tones and increases fitness levels. Often packaged as an exercise program, gyms are now incorporating body weight as a form of resistance training. “Try combining body-weight training with high-intensity interval training to make an effective workout,” suggests Dr. Correces.

Spinning is an alternative to outdoor cycling where an instructor leads participants through a warm-up, peak effort period and cool down performed on stationary bikes—all set to music in a studio or gym setting. Spinning is adaptable to any fitness level and there are no complicated moves to learn. Participants are encouraged to listen to their bodies and adjust the bike’s resistance accordingly. Like any group exercise, classes can become monotonous and you have to push yourself for results.

Zumba incorporates Latin-inspired music with easy-to-follow dance steps for an aerobic workout. Classes run for one hour and typically involve dance steps such as the rumba, salsa, mambo and cumbia. “Zumba combines fresh moves with fun dance music and requires no previous dance experience,” says Valerie Pensinger, RN and Zumba instructor. This lively workout is ideal for people who love exercising in a group, but as Dr. Correces points out, you can test the waters by dancing to a Zumba DVD at home. Remember, your workout is only as good as your instructor so pick a class or DVD carefully.

Digital body monitors use ultrasensitive movement to track steps, distance, calories burned and time spent exercising. These “accountability devices” sync with a computer or smart phone and let you log in meals (calories in) and workouts (calories out).

Minimalist running shoes have evolved from lightweight running shoes with little cushioning to essentially gloves for the feet. Mimicking the feel of barefoot running, running enthusiasts believe the shoes help them build endurance and become faster, and minimize injury. “The shoes place emphasis on the mid- and fore-foot, reducing the breaking motion when the heels strike against the ground which can lead to less shock to the heels and joints. But for runners with mid- and fore-foot deformities, these shoes might not be a good match,” explains podiatrist and avid runner Stephen Bui, MD of Robinwood Orthopaedic Specialty Center. He advises runners with any type of foot pain to see a podiatrist for a biomechanical exam before trying minimalist shoes, and to take at least eight months to transition from regular running shoes to minimalist shoes.

Employee wellness programs seek out ways to motivate employees to improve their overall health. Over the years, Meritus Health has offered its employees biggest loser challenges, gym discounts, onsite yoga classes, stair climbing competitions, smoking cessation programs and healthy eating seminars. “When it comes to wellness, there are different strokes for different folks so we offer lots of options,” says Cindy Earle, RN, community health education and wellness manager at Meritus Health. “Our goal is to help employees feel better on and off the job.”

Before starting any new exercise program, get the thumbs up from your primary care physician. “The key for any type of workout is injury prevention,” explains Dr. Correces. “It’s okay to feel exhausted after a new program, but if you experience pain, that’s another issue. Pain means you’re either not ready to increase the intensity, or you’re developing an injury.”

By: Anne Gill

A Team for Hazmat Spills

noreply@blogger.com (Meritus Health) — Mon, 24 Dec 2012 18:00:00 +0000

A photo from a drill, showing the
Powered Air Purifying Respirators and
a decontamination tent.

You hear it from time to time: I-70 is shut down due to an overturned tractor-trailer and chemical spill. Most of us pay little attention to the incident unless it affects our commute. For first responders and Meritus Medical Center, a hazmat spill that involves contaminated victims triggers text messages and voicemails to members of its Hospital Emergency Response Team (HERT).

“Our hospital is well-prepared for hazmat incidents and goes well beyond national requirements for patient decontamination,” explains Josef Chlebowski, emergency response coordinator at Meritus Medical Center. “You get trauma services and an emergency response team under one roof at Meritus Medical Center.”

The U.S. Environmental Protection Agency defines hazardous waste as liquids, solids, gases or sludges that are potentially harmful to our health or the environment. According to Joe, some of the most common spill scenarios include gasoline, diesel fuel, propane, sulfuric acid and fertilizer. Joe, a paramedic and firefighter, leads the hospital’s HERT.

Hazmat know-how
The HERT includes hospital volunteers from the emergency department (ED), facilities engineering, environmental services, nutrition, information technology and corporate communications to name a few. As soon as the ED receives notification from Emergency Medical Services (EMS) of a hazmat incident, 30 members of the HERT assemble in the hospital’s ED. While patients are in transit, HERT creates a controlled environment by sealing off an ambulance bay and hanging tarps. Safety supplies like masks, Dawn dishwater detergent, baby shampoo and space suits known as Powered Air Purifying Respirators fly out of storage and into action. Because EMS identifies the type of hazardous material involved in the accident before coming to the ED, the HERT knows in advance of how to care for the incoming patients.

Once at Meritus Medical Center, contaminated patients are moved to a 10x10 shower room where clothing is removed and patients undergo a five to ten minute rapid shower using decontamination solution. The shower room is equipped with suction airway and oxygen ports for patients who are seriously injured. A final step involves a second shower in a separate area and a dressing room where patients are gowned.

Treating the masses
For mass casualties, like an overturned bus involving hazardous waste, the HERT sets up tents and trailers in the hospital’s parking lot equipped with electric generators, water and oxygen. This hazmat village is capable of handling 50 patients in one hour. Joe notes that the HERT runs “patient surge” drills two times a year to prepare for such an event.

Joe knows from experience that people can appear at the ED doors contaminated from hazardous waste. “They have no idea that they can sicken others around them,” explains Joe. “We’re here to contain and clean victims of hazmat incidents—and protect people within the hospital.”

The team’s expertise also includes preparing the hospital for an influx of influenza patients. “Between the training, drills and supplies, our hospital emergency response team is prepared for what comes at us.”

By: Anne Gill

A Kickin’ Life Lesson

noreply@blogger.com (Meritus Health) — Mon, 17 Dec 2012 21:21:00 +0000

A nurse, an emergency room doctor and three active kids. It’s a family that could easily be short on family time. But since January 2010, the Kotch family uses Tae Kwon Do, a form of martial arts, as a way to exercise and spend quality time together.

Stephen Kotch, MD, medical director of Meritus Medical Center’s emergency department practiced martial arts in college so a light bulb went off when he saw an advertisement for a parent’s night out at a martial arts studio shortly after his daughter wanted to try something other than dance. The Kotch’s twin 13-year-old boys and nine-year-old daughter participated in a night of kicks, pizza and anti-bullying discussions—and the kids, especially their daughter, were hooked.

“After that experience, Steve wanted us all to join, but I was the only holdout,” said Karen Buckwalter Kotch, RN. “He explained that our commitment to the practice would guide our kids.” The family went from practicing Tae Kwon Do two days a week to four days a week. The Kotch children watched their parents struggle to learn new moves, reinforcing that learning doesn’t come easy at any age.

Martial arts is practiced for self-defense, competition, physical health and mental development. Along the way, the Kotch family has learned many life lessons. When Karen couldn’t break a brick by using her hands, she opted for a swift kick to get the job done. “We all learned that you can’t let barriers get in the way of achieving a goal. You have to look past the problem.”

All five Kotch family members achieved black belt status—the highest belt color denoting a degree of competence. But getting to that level meant goal setting, like running a nine-minute mile and cranking out 100 push ups and 100 sit ups over four minutes. “When our daughter came down with a fever and couldn’t attempt her run during her pre-test, the four of us repeated the run with her to show our support,” said Karen.

As parents, Steve and Karen feel good knowing their grade school and adolescent kids can defend themselves if harm comes their way. The studio devotes time to anti-bullying discussions, but also teaches participants how to defend themselves when necessary.

Spinning kicks, sparring, striking and deflecting punches have improved the family’s flexibility, endurance and strength. Steve’s back problems are markedly better, and both husband and wife are in the best shape of their lives. Karen admits that 300-400 kick combinations in 40 minutes makes her typical run look easy.

But the real take away from Tae Kwon Do is holding adults and kids to higher standards according to Karen. “The kids see us being critiqued and watch how we accept constructive criticism,” explained Karen. At the core of martial arts is integrity, discipline and respect. “The kids have learned to love and take care of themselves. Self-confidence is a big part of it. They understand that doing their best is what counts in life,” said Karen.

“I never knew that martial arts could be more than just a sport—it’s a way of life.”

By: Anne Gill

Your Health Matters

Stroke: When Time is not on Your Side

Staying Healthy on Shift Work

Organ Donation: And Life Goes On

Reassuring Your Frightened Child in Times of Crisis

Child Abuse Prevention Month

Babies Born Too Soon

Performance Enhancing Drugs: What Parents Need to Know

Diabetes Alert Day

Nurse Certification Promotes Excellence

When a Knock to the Noggin is not Okay

Heart Patients’ Reason to Celebrate

Helping You Get Healthier During National Nutrition Month

Pacemakers and the Pope

How Food Comes to Your Emotional Rescue

Prescription Drugs: What You Eat, Drink and Pop Matters

“Growing Pains” ­­– are they real?

Stuck on Zumba

Women: Wear Red and Take Note

Meet TG3

Baby, It’s Cold Outside

Meritus Health Flu Advisory

Safety on the Hills

Hot Fitness Trends for 2013

A Team for Hazmat Spills

A Kickin’ Life Lesson

“Growing Pains” – are they real?