Back Pain Caused by Arthritis [Credit: Robert Kneschke]/[Dreamstime.com]

Back Pain Caused by Arthritis
[Credit: Robert Kneschke]/[Dreamstime.com]

Many forms of arthritis that affect the joints, muscles and/or bones can cause problems like pain, stiffness and swelling in the back. While any part of the back can be affected, the lower back is the most common site of arthritis back pain.

To help you better understand back pain caused by arthritis, we sat down with Steven Levin, M.D., a Johns Hopkins Pain Management specialist on staff at HCGH, for a Q&A session.

Q: What is spinal arthritis?
Spinal arthritis is the breakdown of cartilage in the facet joints—the joints that connect the vertebrae together and enable the spine to move. As the joints deteriorate, the vertebrae impact each other, creating friction during movement. This can result in mild to severe pain and potentially lead to the development of other degenerative spine conditions including osteoarthritis—an abnormal bone formation in the joints.

Q: What causes spinal arthritis?
It is most commonly caused by the natural aging process, but other factors, such as lifestyle, obesity, gender, heredity and injury, can increase a person’s risk.

Q: How do I know if my back pain is from arthritis?
If you are experiencing recurring pain that does not subside with conservative treatment after two to three weeks, visit your family doctor for an evaluation. Sometimes arthritis can be seen on an X-ray and often is strongly inferred by palpating your spine during a physical exam. While any part of the back can be affected, the lower back is the most common site of arthritis back pain. Typically we see back pain caused by arthritis in patients over the age of 50.

Q: How can spinal arthritis be prevented?
While spinal arthritis is not always avoidable, it might be possible to delay its development by avoiding some of the controllable risk factors. Good posture and body mechanics as well as maintaining a healthy weight and diet, having strong core muscles, and being flexible are important to back health. Exercise is in many ways like medicine— you should do the right exercise in the right amounts at the right time.

Q: How is spinal arthritis treated?
Many patients find relief through conservative, nonsurgical treatment that lengthens the spine and removes pressure from the compressed nerve that is causing pain. Physical therapy can improve motion and teach you proper body mechanics which will lessen the strain on your spine. Other conservative treatments include heat, over-the-counter pain medication, exercises and stretching.

Q: What if spinal arthritis does not respond to conservative treatment?
When conservative treatment doesn’t work, many patients benefit from specialized interventional techniques such as facet nerve blocks which involves the injection of an anesthetic to the area surrounding a nerve to help identify the pain and possibly to treat it and, sometimes, minimally invasive procedures such as radiofrequency ablation – a specialized technique that decreases pain signals from a specific area of nerve tissue and can reduce the severity of pain that arthritis can cause.

Q: Is there a cure?
While there is no cure for arthritis, a comprehensive treatment plan can be very helpful at managing symptoms and maintaining function. Effective treatments are available to enable a healthy quality of life.

Steven Levin, M.D., is a pain management specialist with Johns Hopkins Pain Medicine Center at Howard County General Hospital. For an appointment, call 410-955-7246.

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Child Getting a Flu Shot

Child Getting a Flu Shot
[Credit: Monkey Business Images, Ltd.]/[iStock]/Thinkstock

The flu vaccine is the first and best way to prevent getting the flu, which causes approximately 250,000 illnesses and 36,000 deaths each year.

We contacted Maura J. Rossman, M.D., health officer at the Howard County Health Department, to provide you with the latest changes in vaccine options and tips for making your child comfortable when getting a flu shot.

Read what she shared with us.

The Nasal Spray and Shot 

Recent studies found from 2013 until 2016 the nasal spray showed “poor or relatively lower effectiveness” at only three percent, according to Centers for Disease Control and Prevention (CDC). Based on these findings, the CDC voted that the live attenuated influenza vaccine (LAIV) nasal spray should not be used during the 2016 – 2017 flu season.

Generally, vaccines containing a live virus cause a stronger immune response in our bodies. The nasal spray was thought to be comparable or better than the flu shot; it was not. To date, there is no explanation for its poor performance.

The flu shot performed well during last year’s flu season, at 65% effectiveness, indicating that millions were protected from the flu. “Based on manufacturer projections, health officials expect that the supply of the vaccine for the 2016 – 2017 season should be sufficient to meet any increase in demand,” according to a written statement from the CDC in June 2016. The flu shot is available in good supply and safe for most people ages six months and up.

Tips for Getting Your Child Vaccinated

Parents who are having a young child vaccinated should consider following the CDC’s tips for making the experience less traumatic:

• Distract and comfort the child by cuddling, singing or talking softly.
• Smile and make eye contact with the child. Let him/her know everything is OK.
• Comfort the child with a favorite toy or book. A blanket that smells familiar helps him/her feel more comfortable.
• Firmly hold the child when he/she is sitting on their lap, whenever possible.

For older children:

• Take deep breaths with the child to help “blow out” the pain.
• Point out interesting things in the room to help create distractions.
• Tell or read stories.
• Support the child if he/she cries. Never scold the child for not “being brave.”

Parents can help keep their child healthy this flu season by having them vaccinated, and getting themselves vaccinated as well.

Maura J. Rossman, M.D. is the health officer at Howard County Department of Health.

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bipolar disorderSeveral weeks ago I was hospitalized for severe depression. I’d been dealing with a stressful project at work, my father’s terminal illness, and just getting over a painful breakup. For weeks it felt like I was drowning in my own head. I constantly felt exhausted. Simple tasks, like showering and getting something to eat, felt like climbing Mt. Kilimanjaro without oxygen. Crying for no reason became the new norm. I went through my normal routine, numb and almost robot-like and could not find it within me to feel any pleasure in what I did. My range of emotion was limited to sad, hopeless, and angry. I’d suffered from depression and anxiety most of my adult life, but I realized how bad it was getting when I started to have recurring suicidal ideations.

These ideations were what scared me the most. I had no control over my mind. It didn’t matter what I was doing, thoughts of ending my life became persistent. In a sick way, the thought of dying provided comfort in finally putting an end to my misery.

One morning, I had an extremely difficult time getting out of bed. I slowly showered, dressed for work, drove to the office, and told my boss that I was afraid I was going hurt myself. He knew about my struggle with depression and I explained my life was so unbearable that I wanted to end it. I cannot remember much, but I do know I was brought to the psych unit of the ER. I cried hysterically several times, begging the hospital staff not to admit me to the psych ward.

I was admitted to another hospital for short-term hospitalization where I was stabilized with medication and group therapy. I am currently in outpatient therapy to learn coping skills, stress management, and recognize behaviors that I need to work on.

living with bipolarHIGH FUNCTIONING
According to the National Institute of Mental Health (NIMH), Bipolar Disorder, also known as manic-depressive illness, is a chronic brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks.

I am Bipolar II which means I have patterns of depressive episodes and hypomanic episodes, but not the full-blown manic episodes, which involve elevated, high-energy moods. When I am hypomanic, I feel extremely energetic, talkative, and overly confident. For example, I’ll take on dozens of tasks at work and insist I do them on my own. Most of the time, I’m unable to complete the unrealistic goal I’d set for myself.

My psychiatrist said I am a high functioning bipolar. I’d been misdiagnosed with major depressive disorder all these years. Everyone that knows me thinks I’m a workaholic overachiever with a sweet, bubbly, outgoing personality. They think I have this tank of never-ending energy when I am up until 3:00 a.m. baking batches upon batches of cookies for no reason. Or when I can take care of a sick family member at the hospital all day and then answer work emails until 4:00 a.m. night after night for a week and not feel exhausted. I learned that this was also my hypomania.

No one ever saw the depression because I have mastered the art of hiding it from everyone, including most of my family and exes (even the last guy, who also had bipolar). When I am agitated or what I now know is an unstable mood, I always make a deliberate effort to be kind to those I interact with because I’m a firm believer that you never know what kind of day they’re having. It was only when I was alone that I allowed the dark depression to devour me and keeping up this act of normalcy took its toll.

show me all your scarsMANAGING MY DISORDER IS MY RESPONSIBILITY.
The key to leading a happy, functional life is managing my disorder to the best of my abilities. Thanks to my ex boyfriend (also bipolar), I have a huge head start in educating myself about the disorder. I am fortunate to have a strong support system to help me cope and finally adjust to my new reality.

I am doggedly determined to maintain my stability and health not just for myself, but the people in my life. I am working out a plan with my doctor and therapist to make sure I stay on track. I am learning to manage my stress and look out for triggers. And most of all, I am holding myself accountable for how I manage my disorder moving forward.

NEGATIVE LABELS
I’ve seen so many negative things in the media about people struggling with bipolar. Not one bipolar person is the same -and to negatively label all of us is ignorant and requires more education about the disorder. We, with bipolar, also ask for empathy and understanding. I know good people who struggle with this disorder; who work incredibly hard every day to maintain their stability for themselves and their families.

I did not choose to be bipolar. No one with this disorder did.

[Editor’s Note: This post is a personal account of one of our contributors who asked their name be kept private. If you or someone you know is suffering with depression and feels unsafe, please go to your nearest emergency room or call 9-1-1.]


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After learning you’re pregnant you’ll likely find yourself feeling excited and joyful while at the same time feeling overwhelmed with learning how to have a healthy pregnancy and the changes that are occurring in your body.

Watch Francisco Rojas, M.D., gynecology and obstetrics physician at Howard County General Hospital, briefly describe what you can expect during pregnancy including doctor visits, ultrasounds and health screenings.

Changes to Your Body
During pregnancy, your body experiences many changes that help nourish and protect your baby. In the first trimester, you can expect the following changes and symptoms.

  • Breasts swell and become tender as the mammary glands enlarge, in preparation for breast feeding. A supportive bra should be worn.
  • Areolas enlarge and darken, and veins on the surface of your breasts become more noticeable.
  • As the uterus grows and it presses on the bladder, causing frequent urination, and rectum and intestines, causing constipation.
  • Mood swings, similar to premenstrual syndrome, are partly due to surges in hormones.
  • Morning sickness, nausea and vomiting, occurs from increased levels of hormones to sustain the pregnancy. Though, nausea and vomiting do not only happen in the morning and rarely interfere with proper nutrition.
  • Heartburn, indigestion, constipation and gas may be experienced as muscular contractions in the intestines, which help to move food through the digestive tract, are slowed due to high levels of progesterone.
  • Clothes may feel tighter around the breasts and waist, as the size of the stomach begins to increase to accommodate the growing fetus.
  • Extreme tiredness is likely to be felt because of the physical and emotional demands of pregnancy.
  • An increased pulse rate occurs because cardiac volume increases by about 40 to 50 percent from the beginning to the end of the pregnancy. The increase in blood volume is needed for extra blood flow to the uterus.

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Did you know teens read nonfiction too? And, no, we don’t just mean Wikipedia or sources for research papers. A lot of questions come up during adolescence, and sometimes when you’re a teen, you want to find a reliable answer without having to consult another person (or swim in the sea of too many conflicting answers known as the Internet). This little video highlights some of the Teen Nonfiction Collection at HCLS.


Joanne Sobieck-Lingg is glad to blog about her many, disparate interests (though expert in none, except maybe parenthetical asides). In past lives, she was a writer, proofreader, editor, project manager, teacher, and even co-coordinator of a certain health blog. She has been happily ensconced among the fiction and teen books at the Central Branch of HCLS since 2003.


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Eliminating Gluten, Nuts and Dairy Photo

Brad Calkins | Dreamstime.com |Eliminating Foods Diet

With school starting soon, you’re probably busy with back-to-school activities, like buying clothes and school supplies, but is preparing your child’s school for his/her food allergies on the to-do list?

With a little organization, preparation and education, you can help keep your child safe from experiencing a food allergy reaction at school. We’ve created this list of tips to get you started.

Make an appointment with the allergist.
Discuss and update your child’s food allergy emergency plan for school, making sure the plan includes a photo of your child and your and the doctor’s contact information. Also, ask for any prescriptions that may need to be filled for the school.

Order a medical alert bracelet.
Along with your child’s name and allergy types, consider including that epinephrine should be given for a severe reaction.

Gather your child’s medical supplies.
Make sure all of your child’s medications are packed and ready to go to school. If it’s possible, provide the school with medications that will not expire; otherwise, make a note of the expiration date(s) on a calendar, so you’ll be ready to replace them before the expiration date.

If your child won’t have an epinephrine auto-injector on him/her at all times, provide one to the school nurse, your child’s teacher and any other school staff who will spend time with your child. The epinephrine container should be labeled with your child’s name, photo and emergency contact information.

Develop emergency plans with the school.
Speak with the school’s staff and make emergency plans for different scenarios, like snack time, lunchtime, classroom parties and field trips. Remind school staff they should give epinephrine immediately, then call 911 in the event of a severe allergic reaction.

Attend the school meeting.
Ask questions related to your child’s food allergy, including:

  • Where is the food kept, and where will your child eat?
  • Are tables cleaned with disposable disinfecting wipes? Sponges can spread allergens.
  • Which staff oversees snack and lunchtime, and do they discourage food sharing?
  • Can teachers give you several days’ notice of food-related events, including birthday parties?
  • Is food used as a reward in the classroom, and if so, can alternative rewards be given?
  • Are kids urged to wash their hands, instead of using hand sanitizer, before and after eating? Hand sanitizer gels do not remove allergens.
  • Is training provided to teachers on how kids describe allergic reactions (e.g. kids may say their food tastes spicy, tongue feels hot, mouth feels itchy or funny, or lips feel tight)?

Write a letter to other parents.
Your letter should include the allergies your child has, what can cause a reaction and the serious effects of a reaction. Explain cross contamination and how preventative measures can keep your child safe.

For year-long tips, read “Going to School With Food Allergies” at Johns Hopkins All Children’s Hospital website.


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crafting calm

Sharpen those colored pencils, clear some space at your desk, and begin your creation meditation. The adult coloring craze is well underway and there are designs for everyone. Many of the bestselling books on Amazon are adult coloring books and an abundance of beautiful designs are available free on the web. Even Crayola now has a product line for adults. You may experience many added social and emotional benefits if you start coloring.

Popular designs include mandalas, landscapes, plants, flowers, animals, and patterns. The mandala is a circular pattern with recurrent kaleidoscopic shapes. A Sanskrit term for circle, mandala has importance in both the Buddhist and Hindu traditions. The patterns may be interpreted as views of the universe and visual aids in meditation. The act of creating a mandala in sand symbolizes the life cycle in that there is birth, brief enjoyment of the image and then death. An episode of the television series House of Cards included a group of Tibetan monks painstakingly creating a large vibrantly-colored sand mandala. It took many days to create and then was swept away in a ritual ceremony. The fictional White House staff and visitors were reminded to appreciate the beauty and the value of the act of creation. We can be so busy that we forget to enjoy the people, work and art surrounding us.

Spending time coloring forces us to slow down and redirect our attention. We have to be creative and select the colors we will use to fill in the image. Let us practice true focus, ignore distractions, and enjoy the coloring motion. We must put aside competing tasks in order to complete the picture.

The repetitive motion of coloring is relaxing. Selecting the colors gives a sense of freedom without imposing the stress of making potentially risky decisions. The focus of filling in the coloring sheet promotes mindfulness and can help alleviate anxiety. Solo coloring may be the downtime an introvert craves, while group coloring might be an extrovert’s preference. Psychologists and neurologists have noted that tasks with predictable results are calming. Concentrating on positive tasks has the potential to dislodge negative thoughts and disrupt unhealthy emotional patterns. True art therapy usually includes the guidance of a mental health professional, but it’s clear coloring (itself) can be therapeutic. Artistic pursuits can to improve mood, focus, and attention. Concentrating on coloring can decrease feelings of fear and worry.

On it’s most basic level, coloring is fun, so if you’re a fan, it will brighten your day. If you’re interested in going beyond coloring in the lines, HCLS has wonderful instructional books on drawing, painting and crafts for children, teens and adults. The HCLS Lynda courses database offers free classes in software such as CorelDRAW and Photoshop.  Simply go to hclibrary.org, click on HCLS Now and select LEARN Online Classes.

Cherise Tasker is an Instructor & Research Specialist at the Central Branch and has a background in health information. Most evenings, Cherise can be found reading a book, attending a book club meeting, or coordinating a book group.

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