Thursday, July 17, 2014

Got Milk? An Overview

Flavored? Unflavored? Sweetened? Unsweetened? With many types of milk now available in the grocery store, the options can be overwhelming! Different people have different needs, so it's smart to educate yourself and find the type that’s just right for you. Several nutrition factors to consider in selecting a type of milk are calorie, fat, calcium and protein content. We’ve broken down five popular types of milk to present the essential nutrition information to help guide you as you make a decision.

8oz. serving of Calories   Fat      Calcium   Protein  Vitamin D
Cow's milk (whole) 150 8g 25% DV 8g 25% DV
Cow's milk (skim) 80 0g 30% DV 8g 25% DV
Soy milk 110 4.5g   45% DV 8g 30% DV
Almond milk
(unsweet, unflavored) 
40 2.5g 45% DV 1g 25% DV
Coconut milk
(unsweet)
45 4.5g 45% DV 0g 25% DV











DV = Daily Value

Nutritional Needs
The National Institutes of Health (NIH) recommend that adults consume a minimum of 1,000 mg of calcium per day, although that increases to 1,300 mg per day for teenagers and 1,200 for women over 50. Just one eight-ounce glass of milk provides a significant source of calcium (cow’s milk has about 300 mg of calcium per 8 oz. serving). Almond and coconut milk provide as much Vitamin D and calcium as cow’s milk, but if you’re looking for a rich source of protein, almond and coconut milk might not be the best choice.

Cooking Uses
Using the different flavors and consistencies in milk can help you make even more delicious meals. Many Indian and Thai dishes call for coconut milk, as the sweet flavor and creamy consistency help bolster the exotic flavors in the recipes. Soy milk can be used as you would use cow’s milk in most recipes. Since it is a great source of protein, try it in energy-boosting foods, like baked oatmeal or homemade protein bars. Almond and soy milk are available in flavors like vanilla, which can be great in dessert recipes.

Dietary Preferences
If you are lactose intolerant but still want to consume recipes that involve milk or eat cereal, the use of almond or soy milk is a great substitute for cow’s milk. If you are dieting or simply trying to cut extra calories, the use of almond milk is a great substitute for cow’s milk. If you don’t like drinking it out of a glass at first, try it mixed in a smoothie or over cereal. 

Introducing the Expanded Johns Hopkins Voice Center

Imagine suddenly experiencing voice issues that affected your ability to communicate with your family and friends. Though conditions causing voice problems often affect those who use their voices professionally, such as singers and actors, they can happen to anyone.

To better treat its voice patients, the Milton J. Dance, Jr. Head & Neck Center recently expanded the Johns Hopkins Voice Center located on GBMC’s main campus in Physicians Pavilion West. In addition to a larger and completely renovated space, the Voice Center also houses the brand new Fender Music & Voice Studio, furnished with nearly $20,000 in music equipment generously donated by Fender. The expansion was made possible through a $1.6 million donation from the Milton J. Dance, Jr. Endowment Fund. “When someone is diagnosed with a vocal disorder issue, it is life-altering,” says Lee Akst, MD, director of the Voice Center. “This new addition is essential in assisting vocal disorder patients in the healing for their problems by offering them enhanced treatment options and specialized voice therapy by a team of highly trained voice clinicians.”

L to R: John R. Saunders, Jr., MD;
Barbara Messing, MA, CCC-SLP, BCS-S;
Deetzie Walker; Joseph Califano, MD;
Gail Cooper, Esq.; Lee Akst, MD
Not pictured: Kenneth Fletcher, MD
From speech pathologists to otolaryngologists, the Voice Center is comprised of a variety of specialists that work collaboratively to diagnose and treat voice conditions. Individuals who seek treatment at the Voice Center typically have diagnoses ranging from vocal cord paralysis to head and neck cancers, but individuals seeking education on how to protect their vocal cords will find the help they need as well.

For more information about voice or head and neck services, visit www.gbmc.org/voice or www.gbmc.org/mjdancehome. Additional information on the Voice Center expansion can be found in by clicking here to review the press release.

Make Your Wishes Known

Complete an Advance Directive


It may be difficult to think about completing an advance directive, but it doesn’t have to be. This is an important step patients can take to ensure their wishes about care are followed should they no longer be able to speak for themselves. In addition to providing patients with peace of mind, it also offers some relief to loved ones, lifting the burden of making difficult decisions if the patient is unable to do so.

Advance directives are legal documents that let others know an individual’s wishes about the type of care they want. The documents allow patients to name a healthcare agent and provide general guidance on his or her wishes. They are only used if the patient becomes unconscious or too ill to communicate. 

Directives can include the following components:

  • Living Will: This set of instructions explains the type of life-prolonging medical care a patient may or may not want, such as receiving CPR, being placed on a ventilator or using a feeding tube or IVs if a patient cannot eat or drink. 
  • Durable Power of Attorney: This is a legal document that names a “healthcare proxy,” which is someone who can make medical decisions for a patient if he or she is unable to do so. This person will represent a patient’s wishes on emergency care and on other medical issues like potential treatment options, blood transfusions, kidney dialysis, etc. Patients also have the right to appoint someone or the same person to help manage finances if they cannot.

Patients are encouraged to submit advance directives each time they go to the hospital to ensure the most current information and wishes are on file. It is not necessary to have a lawyer to fill out these documents. 

For more information on advance directives and advance care planning, talk to your healthcare provider or join Gilchrist Hospice Care for its Advance Care Planning Series. Click here to view upcoming dates and topics. If you’re ready to take the leap and fill out your advance directive now, click here.

Sensitive to Women’s Needs

GBMC Offers Comprehensive Pelvic Floor Care


Pelvic health may not be the most comfortable topic to broach with a physician, but women who are experiencing symptoms should know they are not alone. In fact, by the age of 60, about one in three women will have experienced some type of pelvic health issue. “Pelvic floor problems are more common than people realize and can lead to uncomfortable symptoms, from urinary and fecal incontinence to pelvic pain,” explains Joan Blomquist, MD, Division Head of Urogynecology at GBMC and fellowship trained urogynecologist. “Consulting with a doctor can result in an individualized treatment plan to help alleviate symptoms.”

Understanding the Pelvic Floor
The pelvic floor supports the urogynecologic tract, which includes the female reproductive organs and bladder, as well as the rectum. These areas can be injured by pregnancy, childbirth or surgeries such as hysterectomy. Muscle and nerve damage or lumbosacral disease can also spur pelvic floor issues. When the pelvic floor is weakened, the muscles and nerves may not work together properly, resulting in leakage, constipation, or the inability to hold the pelvic organs in place.

Offering a Variety of Individualized Treatment Options
GBMC takes a multidisciplinary approach to treating pelvic floor disorders. Its comprehensive services include a team of expert providers including urogynecologists, colorectal surgeons, physical therapists and a gastroenterology (GI) physician. “To include gastroenterology in a collaborative approach to treating pelvic floor disorder patients is unique in the community hospital setting,” explains Kisha Weiser, MD, one of the only GI physicians in Maryland with a special clinical interest in pelvic floor dysfunction. “But, urinary and fecal incontinence often go hand-in-hand because the same nerves control the anal sphincter and neck of the bladder.”

Because the specialists in each discipline collaborate so closely, their patients can seamlessly address all components of their pelvic health issues. In addition, the team offers a wide variety of approaches, from conservative treatments to surgical interventions. Conservative options include dietary changes, physical therapy, medication, botox injections and insertion of pessaries, devices that provide structural support to the pelvic organs. Surgical alternatives include implantation of a neurostimulator, to offer better bladder and bowel control, placement of slings to treat incontinence and pelvic reconstructive surgery to treat prolapse.

An added convenience for GBMC patients is the availability of an on-campus pelvic floor physical therapist at the Greater Baltimore Center for Rehabilitation Medicine. Claudette Cole, PT, DPT, CLT, teaches patients functional movement and body mechanics as well as exercises to do at home to strengthen the pelvic floor and alleviate pain.

"If you're experiencing any symptoms of a pelvic floor disorder, speak with your primary care physician first. He or she will direct you to the appropriate specialist,” explains Dr. Blomquist. “GBMC’s team of experts will work together to develop a treatment plan tailored for your individual goals, needs and comfort level.”

For additional information about GBMC’s services relating to pelvic floor disorders, visit www.gbmc.org/urogyn, www.gbmc.org/colorectal, www.gbmc.org/KrohCenter, www.gbmc.org/rehabmedicine or call 443-849-GBMC (4262).

Crust-less Summer Zucchini Pie

Ingredients
  • 10 oz shredded zucchini, all liquid squeezed out
  • 1/2 cup shallots, chopped
  • 1/4 chopped fresh chives
  • 1/2 cup part skim mozzarella
  • 2 tbsp grated parmesan cheese
  • 1/2 cup white whole wheat flour
  • 1 tsp baking powder
  • 2/3 cup fat free milk
  • 1 tsp olive oil
  • 2 large eggs, beaten
  • 1/2 tsp kosher salt
  • fresh cracked pepper to taste
  • cooking spray 

Instructions
  1. Preheat oven to 400°F and lightly spray a pie dish with cooking spray. 
  2. Combine zucchini, shallots, chives and mozzarella cheese in a bowl.
  3. Sift flour and baking powder in a medium bowl, then add remaining ingredients and blend well. 
  4. Combine flour mixture with zucchini mixture and pour it into the pie dish.
  5. Top with parmesan cheese and bake 30-35 minutes or until knife comes out clean from the center. Let stand at least five minutes before serving.
Makes six servings


Nutrition
Serving size: 1/6 of the pie
Calories: 125.3 
Fat: 4.8 g 
Protein: 8.1 g 
Carb: 13.1 g 
Fiber: 2.0 g 
Sugar: 2.5 g
Sodium: 420.1 mg 

Recipe courtesy of Skinnytaste.com

Thursday, June 19, 2014

Cause for Celebration

One Woman’s Triumph over Breast Cancer



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

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

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


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

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


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

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

June is Men's Health Month

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

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

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

Preventive Health
Many diseases in men develop slowly over long periods of time and may not be identified without regular screenings. 
  • It is important for men to have an annual physical exam. This should include a prostate and reproductive health exam, which can identify certain types of cancers specific to men.
  • The American Heart Association recommends that men age 20 and over should have their cholesterol checked every five years to ensure normal range.
  • The annual physical exam is also a good time to bring up any concerns with your primary care physician. Keeping a list of any questions you may have is one way to make the most out of your appointment.  
A primary care physician is a great resource for men. If you do not have a primary care physician, please visit www.gbmc.org/mydoctor for a list of GBMC physicians who are currently accepting new patients.