Thursday, February 19, 2015

A Healthy Family: The Wingerds

Our “journey” with GBMC actually started during our infertility treatment as patients of Drs. Katz and Yazigi at the Shady Grove office in GBMC. My supervisor at the time suggested Drs. Katz and Yazigi as she had been a patient of theirs in years prior.

In our nearly six months of care at Shady Grove, we had a total of two retrievals and three transfers performed at the GBMC Women’s Surgical Center before we found out we were expecting. We had great experiences each time.

Close friends of ours had a baby at GBMC in 2009. When we visited them in Labor & Delivery afterwards, we were very impressed with the nurses, room, services and their obstetrician, Dr. Dominique Allen. When we found out we were expecting, we immediately decided to use the same obstetrician as our friends because we were set on having our baby at GBMC.

When I was 30 weeks pregnant, my water broke. I was not in active labor, so I was admitted to the high-risk OB unit for the duration of my pregnancy. I was an inpatient in this unit from December 11, 2012, until I delivered on December 20.  The nurse, Jeanie, and nursing assistant, Yvette, were absolutely amazing to me and my family.

Though I was happy to be in such great care, I was extremely depressed because I thought I would be spending the holidays on hospital bed rest. Jeanie and Yvette went out of their way to make things easier on me. They kept me company if they had down time, made sure both my husband and I were comfortable and did everything in their power to accommodate us while providing the most outstanding care I could have ever asked for.

When I went into active labor on December 20, Jeanie and Yvette both happened to be on duty. I was at the hospital alone at the time, so Yvette stayed with me as long as she could in Labor & Delivery and Jeanie even came over to check on me. They both made sure I was able to contact my husband and, because of their help contacting him, he was able to make it to the hospital before my emergency C-section.

Prior to the day our son was born, we did not know much about the NICU. Some doctors had come in to speak to us, but everything was a blur at that point so we honestly didn’t know what to expect. Our son was admitted to the NICU on December 20, 2012, and stayed there until being discharged on January 9, 2013. We spent our Christmas and New Years in the NICU, but all of the nurses and doctors treated us like family and truly made us feel like we were at home.

I specifically remember two nurses that did a tremendous job assisting us with caring for our preemie, Lauren and Kim. Lauren was so great when I went up to visit, no matter what time of day or night it was. After I was discharged home, I would call constantly and she never hesitated to take my call, provide updates and answer questions. Lauren was so patient, really helped ease our fears and shared in the celebration of small milestones. We were so thankful for her.

Kim was also a Godsend. She always helped with any questions we had and was instrumental in teaching us about the monitors, various procedures and tests and the NICU terms thrown at us day in and day out. There were many days where Kim felt like a part of our family because she would spend almost her entire shift with us. Drs. Helou, Pane and Birenbaum were wonderful as well.

The next stage of our GBMC journey included weight loss surgery. It was something we began discussing during our infertility journey. I was diagnosed with polycystic ovary syndrome (PCOS) at 18, and that is what caused our fertility issues. We were both significantly overweight and had been our entire lives. While researching PCOS and IVF, I came across information about bariatric surgery and mentioned it to my husband. After going through so much to get pregnant and then again with the pre-term labor and NICU stay, we both decided that we needed to do whatever we had to so we could be healthy and enjoy the time with our precious child. We both grew up in families that have significant weight-related health issues, and those issues caused close family members to die at early ages. We did not want our son to experience that because of us.

Having the surgery at GBMC was really a no-brainer. We had such amazing care in every department previously, so we had no question that the doctors in the Comprehensive Obesity Management Program (COMP) program would be just as great.

Since I had just had a baby, we decided my husband would go to the info session first and I would wait a few months. Unfortunately, while my husband was in the COMP program, he discovered one of our worst fears – he was diagnosed with severely uncontrolled diabetes. His blood test results actually came in not long after Dr. Dovec started with GBMC, and our first interaction with her was her calling my husband on a Sunday morning to discuss his blood tests because she was so worried about him. We were stunned, not only at the results, but that a doctor cared enough to call on a Sunday morning.

That call was reassurance to us that we had chosen the best doctors/practice for this step of our lives. Because of his diabetes, my husband’s surgery was essentially put on hold. We agreed that I would start the program at that point since we didn’t know how long it would take to get his diabetes under control.

I was ultimately able to have my surgery first and had it done the end of January 2014. Of course, as soon as I scheduled my surgery, his blood tests came back good enough to proceed with surgery and his was scheduled also. Although it was offered to have our surgeries on the same day, we decided against it solely because of having our one-year-old to care for. My husband ended up having his surgery about six weeks after me in the beginning of March 2014.

Our entire lives are different now that we have had weight loss surgery. We are not embarrassed to take family photos, we are looking forward to taking our son to his first amusement park next summer (we have never been as a couple because we both were worried about not fitting in most of the rides) and overall, we just have more energy and the ability to play with our son and chase him around. I have also become a runner which is something I always wanted to do, but I was never able to run more than a half mile before stopping (3-4 miles is a normal distance for me to run now). My husband has always been active in sports but has faced constant embarrassment because he was always the “big guy.” He is now able to play in games and no one singles him out. We are both able to shop in “normal” stores now instead of plus size/big & tall stores.  

My health has been severely impacted. I am off all of my blood pressure medicine, I no longer have high cholesterol, I am no longer pre-diabetic and, within a month of my surgery, I began menstruating on my own -- something that has never occurred in my life. We are not prepared to have another child yet, so we actually had to go as far as having an intrauterine device (IUD) implanted because my gynecologist believes I am no longer infertile.

My husband’s health has also been impacted. He is no longer on insulin, his diabetes is under control and on its way to remission, he no longer has high cholesterol and he has less joint pain from playing sports.

Our lives in general have been impacted because we just feel better overall. We have better attitudes about ourselves and aren’t depressed. Being happier with ourselves has made us happier in our marriage.

The most influential thing about our care at GBMC is how personable, knowledgeable and overall amazing everyone has been. It wasn’t just one doctor or one nurse that touched us enough to remember, it has been several. Since we were so impressed with the various dealings we have had with GBMC, we also decided to switch our primary care physician and our son’s pediatrician to a GBMC physician. All of the specialists that we choose (obstetrician, endocrinologist and ear, nose and throat) are at GBMC, and our son had minor surgery there (for tubes in his ears) in January 2015.

We couldn’t be happier with all that GBMC has given us.

To read more "Because of GBMC" stories, visit www.gbmc50.com/ourstories. To submit your own story, visit www.gbmc50.com/mystory.

Call Us First

With so many different options available when it comes to healthcare settings, knowing where to go when you need care can be confusing. This is especially true after normal business hours, on weekends or when you are experiencing symptoms that aren’t normal for your body.

Although not every ache or pain is an emergency, many people rely on the emergency room or an urgent care facility for care despite the fact that emergency room wait times are often long and visits can become expensive due to higher co-payments. It is time to break the habit of turning to the emergency room or urgent care for minor ailments. Instead, call your primary care physician first to see what the office recommends based on your symptoms. Calling your primary care physician before heading for the ER provides you with a number of benefits:

  • You receive care from a practice that knows you. Your primary care office has access to your medical records, meaning its staff knows which medications you take, what conditions you have and what care you have previously received. Staff can take a look at your medical history to help you make an informed decision about your current symptoms.
  • You get medical advice from a professional who knows your history. While you may not always talk to your specific primary care provider when you call his or her office, you will always talk to a physician, advanced practitioner or nurse. 
  • You avoid having repeat medical tests performed. Hospitals and urgent care centers can only treat you for the symptoms you have at the moment using the information they have. If you don’t have your medical records with you, they may have to rerun tests you’ve already had.
  • You avoid unnecessary extra expenses. While not every appointment is completely covered by your health insurance, visiting your primary care physician instead of going to the nearest emergency room could save you a lot of money. Emergency care is often billed at two to three times the rate of a primary care office.

GBMC understands that people are not always able to visit a doctor’s office during the normal business day, and that sometimes symptoms occur after hours or on weekends. In order to help prevent unnecessary emergency room visits, GBMC primary care offices have extended their daily hours and expanded into weekend hours, as well. Family Care Associates and the GBMC at Hunt Valley practice are even open on Sundays.

There are some conditions that require emergency treatment, however, and for those times, please do not waste precious seconds calling your primary care physician for assistance. Conditions that fall into the category of calling 911 or going to the emergency room include:

  • Trouble breathing
  • Severe chest pain
  • Difficulty speaking
  • Not acting like oneself
  • Uncontrollable bleeding
  • Serious injury

Know before you go. To find a GBMC physician, visit www.mygbmcdoctor.com.

Easy Tips to Avoid Falls

The season of snow and ice is well underway here in Maryland, so it’s wise to practice good safety habits to prevent injury from slipping and falling! According to the National Association of State Departments of Agriculture (NASDA), about 300,000 people slip and fall year-round with serious injuries, and 20,000 deaths occur each year because of it. In fact, the Centers for Disease Control and Prevention (CDC) estimated that more than $30 billion was spent in direct medical costs because of falls in 2012.

Some general fall prevention tips when snow or ice is forecast include:

  • Wear proper footwear like non-slip boots that will give you traction and keep your feet warm. 
  • Watch where you’re walking at night by using a flashlight or avoiding potentially icy areas completely.
  • Take smaller steps and use handrails when available. 
  • Help elderly friends or relatives by providing balance for them. 
  • Try not to carry large loads like bags or groceries across icy surfaces.

Improving your balance is another way to help protect yourself from slips and falls. Some good things to start with could be balancing on one leg for as long as you can, performing planks to strengthen your core, or squats without weights are good, too! Practicing yoga is also known to improve your balance and health.

If you do slip, fall and sustain a minor injury, GBMC’s primary care offices are here for you with extended hours on weekdays, Saturdays and Sundays at certain practices. Visit www.mygbmcdoctor.com to find a primary care physician who is right for you and your family.

The Pros of Probiotics

When you’re grocery shopping for your favorite brand of yogurt and it reads “Live and active cultures” on the label, are you fully aware of what that means? Believe it or not, there are actual living bacteria inside the yogurt. But have no fear, they are good, “friendly” bacteria that can help benefit you and your health!

There are different types of probiotic bacteria found naturally throughout the body, but there is an exceptionally high concentration within the intestines to promote easier digestion of food and to keep quantities of harmful bacteria in check.

Low levels of probiotic bacteria may contribute to unwanted problems like urinary tract infections (UTI), digestive problems, inflammatory bowel disease (IBD) and vaginal yeast infections.

In order to potentially increase probiotic bacteria, people can take probiotic supplements in the form of a pill or adjust their diets to include foods like yogurt, milk, soy drinks and fermented items like kombucha tea, tempeh or miso.

Consuming probiotic bacteria, under the guidance of a physician, may help alleviate symptoms caused by irritable bowel syndrome, stomach ulcers, colitis, acne and eczema in children, but it is not guaranteed. Other benefits may include:

  • Prevention of diarrhea as a result of taking antibiotics
  • Prevention of vaginal yeast infections, urinary tract infections and bacterial vaginosis, a mild infection 
  • Reduction of instances of colds and the flu

In 2009, a study at Stanford University Medical Center also found that people using probiotics were able to lose and maintain weight more easily following gastric bypass surgery compared to those who consumed fewer probiotics after surgery.*

So, the next time you’re in a grocery store, or looking for a change in your yogurt, look for one that has “live and active cultures,” is labeled with low, natural sugar and doesn’t have extra added ingredients! Consider trying out some fermented foods, as well! If you have any questions, contact your gastroenterologist.

For more information about care for Gastrointestinal Disorders at GBMC, visit http://www.gbmc.org/gi.

*Source - http://sm.stanford.edu/archive/stanmed/2009fall/upfront.html

Skinny Overnight Oats in a Jar

Ingredients

¼ cup oats
½ unsweetened almond, skim or soy milk
¼ medium banana, sliced
½ tbsp chia seeds
½ cup blueberries
Sprinkle of your favorite sweetener (optional)
Pinch of cinnamon

For Topping

1 tbsp chopped pecans or other nuts (optional)

Directions

Place all of the ingredients in a jar, shake or stir it up. Cover and refrigerate overnight. Before you eat it the next morning, add your favorite crunchy toppings such as nuts, granola, fruit, etc.

Nutrition

Serving Size: 1 jar
Calories: 243
Fat: 10.6 g
Carbs: 35.4 g
Fiber: 8.5 g
Protein: 6 g
Sugar: 12 g
Sodium: 94.7 mg


Recipe courtesy of www.skinnytaste.com.

Thursday, January 22, 2015

Exercises for a Fitter New Year

Boredom is one of the sneakiest sabotages to people’s goals of getting fitter or healthier in the New Year. It creeps in slowly, undermining their hard work and keeping them from progressing to their optimal health, leading to negative self-talk and decreased motivation. Don’t let this happen to you!

Instead of throwing in the towel when you decide you just can’t spend another day doing the same exact routine as usual, or giving up when you aren’t seeing the results you want, try mixing up your schedule with these fun and fitness-boosting activities and classes.

Walking — This low-impact, heart-rate increasing activity is good for just about any fitness level because of its ability to provide something for everyone. For the novice exerciser, walking is a good way to get muscles moving, burn extra calories, strengthen and tone the lower body and build stamina for other exercises.  As a bonus, walkers can tone their upper bodies and increase their exercise gains by carrying hand weights or donning lightly weighted backpacks.

Running — The ultimate full-body workout, running moves muscles that many people don’t even know they have.  With plenty of plans available online to take beginners off the couch or advanced runners into ultra-marathons, running can be customized to every ability level and every goal.  Not sure you could run for more than a few minutes?  That’s okay, too!  Many running plans start with Walk-Running or Run-Walking, allowing beginners to alternate running and walking in order to build up to distance running.

Kickboxing — Incorporating many forms of martial arts, this empowering type of exercise trains your muscles to move in new ways, building new muscle, toning old muscle, increasing flexibility and giving you a great cardio workout.

Dance/Zumba — A craze that has swept the world, cardio dance classes like Zumba are creating fun ways for people of all ages and ability levels to come together in the name of cardio workouts and fitness.  Dance to fun and upbeat songs, memorize dance routines filled with fitness-blasting moves and get to know some new friends in the process.

Pilates — A centuries-old tradition, Pilates incorporates low-impact muscle building and flexibility improving moves that tone the body and still the mind. Think of it as a slightly more intense yoga workout, in which slow movements are repeated in order to help build muscle and raise the heart rate.

Yoga — While not nearly as cardiovascular-focused as other workouts, yoga has been proven to be the ideal “workout sidekick.” Most fitness classes build muscle through repetitive movements, causing those working muscles to shorten and tighten. Yoga works to lengthen those muscles, working out the kinks and helping to release unnecessary tension wherever possible.  While it may seem like that would counteract the work from other fitness classes and activities, yoga actually aids in overall fitness as it helps the muscles to build in long, toned ways instead of short, stocky, bulky ways.

Swimming — The perfect activity for those with mobility issues such as joint pain, lower body injuries or recent surgeries, swimming provides a stress-free alternative to exercises like running, weight lifting and walking.  With many variations from which to choose, including lap swimming, treading exercises, kicking with a kickboard, water aerobics, water polo and many more, swimming provides a workout for all ability and skill levels.

Tai Chi/Chi Gong — Like yoga, tai chi and chi gong provide a very low impact complement to exercise.  Through deep breathing and long, slow muscle movements, exercisers the world over see their muscles elongate, their stress levels go down and their overall health and well being rise.

Weight Lifting — You can’t lose fat without building muscle and weight lifting is a great way to do just that.  Through repetitions of movements with a variety of shapes and sizes of weights, you can build up your muscles, toning them, creating greater strength and making yourself healthier in the process.  Weight lifting can be geared toward any ability level, beginning with 1 or 2 pound hand weights and going up to extremely advanced movements with barbells.

Boot Camp — A cardio extravaganza, boot camp-style classes do exactly what they seem like they should do: put you through an intense workout filled with body weight, weighted and cardio movements designed to work every single muscle in your body.  While most classes generally offer beginner level modifications for boot camp moves, it is important to make sure that the class you are attending caters to all skill levels.

Spinning — If you enjoy biking or riding a stationary bike, then spinning is for you!  Perched atop a spinning bike, instructors lead the class through a series of intensity intervals, treating the class as if the whole group were going up and down hills, racing as fast as they can and then treating their muscles to much deserved lower intensity “rests.”

Barre — A very low intensity workout, barre, or barre Pilates, utilizes props and small muscle movements to train specific muscle groups.  Props like exercise rings, exercise balls, weights and more are utilized as aids to resistance training, most while holding onto a dance barre, working different muscles to create changes throughout the body.

Interval Training — Interval training combines cardio with weight lifting, creating a mash up of exercises that raises the heart rate, builds muscle, burns fat and helps to transform the body.  Intervals of activity (with or without weights) are mixed with intervals of rest to help people gradually build themselves and achieve their fitness goals.

Harvey Institute Offers Non-invasive Prenatal Testing

The Prenatal Diagnostic Center at the Harvey Institute for Human Genetics at GBMC offers non-invasive testing that can determine fetal abnormalities in early pregnancy. Through the use of detailed fetal ultrasound and innovative blood tests, the Center is equipped to help educate pregnant women about genetic conditions, coordinate prenatal screenings, provide insights into test results and offer resources to help facilitate the best possible health outcome.

Physicians Natalie Blagowidow, MD, and Shama Jari, MD, work closely with a staff of genetic counselors to help guide patients through the process of prenatal testing in the Center. Patients who might consider such testing include women of advanced maternal age (those who will be 35 or older when they give birth), women with high-risk pregnancies, women with a history of fetal abnormalities in prior pregnancies and women with family histories of genetic conditions. Patients are referred by their obstetricians for prenatal testing. Couples interested in preconception counseling may be referred by their physician or can make appointments themselves.

There are two options for non-invasive screening a pregnant woman can obtain during the first trimester. The first is a detailed fetal ultrasound performed between 11-13 weeks of pregnancy. The ultrasound can identify markers that may indicate a higher chance of the presence of trisomy 13, also known as Patau syndrome, trisomy 18, also known as Edwards syndrome, and trisomy 21, Down syndrome — all of which can lead to major health complications for the mother and fetus. This ultrasound can be combined with bloodwork to determine a risk estimate for chromosomal abnormalities.

The second option is a cell-free fetal DNA screening. “The screening is performed by taking a blood sample from the mother,” says Dr. Blagowidow. The test also provides a high detection rate for abnormalities such as trisomy 18 and certain sex chromosome abnormalities. “The test is currently considered the best non-invasive tool for detecting Down syndrome prenatally,” Dr. Blagowidow adds. She recommends that women who choose the fetal DNA screening also have the detailed first trimester ultrasound.

While the benefits of the blood test are significant — a less than one percent false positive rate for Down syndrome and no increased risk of miscarriage — there are facts to consider before undergoing the screening. “It’s important for patients to know that cell-free fetal DNA testing is not ‘diagnostic,’ like an amniocentesis or chorionic villus sampling,” says Dr. Blagowidow, referring to definitive genetic tests. Cost can also be a drawback, as insurance companies have varying levels of coverage for this new genetic screening.

If a patient undergoes the prenatal screening and the results are positive, genetic counselors will help to facilitate next steps and review the pros and cons of further testing with the patient. “Our goal is to give parents-to-be as much information as possible, while preserving the health of both mother and fetus,” says Dr. Blagowidow.

For additional information about the services offered by the Prenatal Diagnostic Center at the Harvey Institute for Human Genetics at GBMC, visit www.gbmc.org/prenatalgenetics or call 443-849-GBMC (4262).