I don’t know whether you’ve had any lab work done recently, but if you have, there’s a good chance your healthcare provider took a look at your vitamin D level. Why all the growing interest in vitamin D? Won’t a couple of glasses of milk per week and some sunlight take care of it?
Sufficient vitamin D promotes bone growth and repair and is required for our bodies to absorb calcium. Adequate calcium levels help assure bone strength. Conditions associated with low vitamin D levels include rickets, osteomalacia, and osteoporosis. Symptoms of decreased vitamin D include bone pain, muscle weakness, and fatigue. Older adults may experience symptoms of depression and cognitive impairment.
The NIH Dietary Supplements site notes that vitamin D is naturally present in very few foods. Fatty fishes such as mackerel, tuna, and salmon contain vitamin D. Tiny amounts of vitamin D are found in beef liver, cheese, and egg yolks. Some mushroom varieties are grown under ultraviolet light to boost their vitamin D content. Much of our vitamin D, however, is ingested from artificially fortified products such as milk, breakfast cereal, and yogurt. Ingestion of supplements and cod liver oil will also boost vitamin D levels. Patients with an abnormally low level of vitamin D may be advised to take vitamin supplements as it is difficult to obtain significant amounts of dietary vitamin D.
Sun exposure causes our skin to synthesize vitamin D. During cold winter days and in smoggy conditions, sun exposure is limited, thus decreasing the body’s vitamin D creation. People who have more pigment in their skin are able to block some UV radiation – helpful in preventing sunburn, but detrimental to generating vitamin D. As we age, our skin’s ability to synthesize vitamin D decreases. The use of sunscreen also blocks the initiation of vitamin D production. Patients with digestive disorders such as inflammatory bowel disease or celiac disease may have decreased ability to absorb ingested vitamin D. Obesity is also be associated with decreased vitamin D levels as fat cells absorb vitamin D from the blood.
Studies have shown that vitamin D deficiency can lead to an increased susceptibility to colds, especially for those who have asthma and lung conditions. Blood cells critical to immune function have vitamin D receptors. When enough vitamin D is not present, the risk of autoimmune disease and infection increases.
Researchers have also found an association between low vitamin D levels and stroke. When vitamin D levels are insufficient, patients are at higher risk for strokes. In patients who have had strokes, the stroke is likely to be more severe if the vitamin D level is decreased. Links have also been found between poor bone health, low vitamin D level and increased risk of cardiovascular disease. Much research is underway to improve our understanding of population studies indicating high rates of hypertension, obesity and glucose intolerance in patients with low vitamin D levels. Further studies are needed to increase our understanding of the significance of vitamin D levels.
[Editor’s Note: As always, please consult your physician before taking any kind of supplement. Your doctor(s) are your greatest resource for your health needs. The post above is for informational purposes only and should not be interpreted as medical advice.]
Posted by HCGH_CL on May 12, 2016 in News | 0 comments
Retiring nurse Judy Brown has spent 34 years in health care at Howard County General Hospital. Here, she poses in her first nursing uniform holding her nursing graduation photo. She shares her insights on nursing, health care and Howard County in this farewell blog.
In 1982, I found myself working at a hospital in the community I called “home.” I wanted the quality of care to be the best it could be, and for the past 34 years, I have committed to doing just that.
Medicine runs in my family. My son is an emergency department physician in Pittsburgh, and my husband is a professor and medical researcher at Johns Hopkins Bloomberg School of Public Health. My mother attended nursing school during World War II. She never finished school and that was her biggest regret. She was my inspiration and the reason I chose to become a nurse.
Data collected from an aptitude test Bryn Mawr Hospital School of Nursing gave me during the application process said that I had a strong data analysis trait—which is true, and that I should be an accountant—which I didn’t want to do. I knew I wanted to work with people. Instead of following the path the data directed, I pursued my diploma in nursing and followed my nursing degree with a bachelor’s in business administration. Management was for me–after all, I wanted my first boss’s job. For two years I was a full-time student by day and a full-time nurse at night.
My work at Howard County General Hospital (HCGH) started as a shift director. Over the years, I continued my education with a master’s degree in administrative science from Johns Hopkins University and worked my way up in nursing at HCGH. During my tenure as the chief nursing officer, I felt strongly that HCGH should be moving toward magnet status, and my degrees were in business. I didn’t want my education to keep the hospital from achieving magnet status, so I went back and got my master’s in nursing.
To nurses today – I encourage you to achieve your education—one course at a time if that is what it takes—to progress, even if you want to stay at the bedside. No one can ever take it away from you.
Over the course of my career in nursing operations, I spearheaded the implementation of numerous programs at the hospital including the Sexual Assault Forensic Examiner (SAFE) Program and, with my team, launched The Center for Wound Healing at HCGH.
Today, I am the senior vice president of Outcomes Management and I provide oversight of performance improvement and am responsible for risk management, patient safety, infection control and The Joint Commission and CMS regulatory compliance. It was not my choice to move to the quality and regulatory role. But I had the clinical background and excruciating attention to detail–so I guess the aptitude test was accurate after all.
When I think about life after retirement in July 2016, it’s the people that I will really miss.
Posted by HCGH_CL on May 6, 2016 in News | 0 comments
Howard County General Hospital Emergency Department nurse Emilia Alvarez-Negron, RN, (right) in 2010 with her mother, Vilma E. Grevi Rosario, at her nursing pinning ceremony.
Reflections for National Nurses Week 2016
You reach an age in life where you reminisce…where am I? What have I done with my life? Where am I going? Am I on track for what I set out to do? I was 31-years-old when I was reminded in an instant that I had not embarked on my lifelong dreams yet.
It was 9-11. The day the towers came down. I watched it happen. From 1993-2000 I worked in and around the World Trade Center. I knew the city that was underneath the towers and the intricacies of the offices above ground. I wanted to do something. I wanted to help but had no training. That day reminded me that I needed to find a way to end my career as an executive assistant and begin my journey to become a nurse. I wanted to take care of people—not corporate executives—anymore.
Ever since I was a little girl, my mom called me Joan of Arc. I was always taking up other people’s causes and helping people. I have always been empathetic and sympathetic, although coming from the Bronx, working in corporate America and running with the bulls, you wouldn’t believe so.
By the age of 27, I was married and had three children. My focus was on daily life and taking care of their needs and working hard to survive life in New York. I knew that sitting in a classroom was not an option for me, but the online education era was beginning to take hold.
At the age of 34, I began my nursing career journey. I took as many courses as I could online, in the evenings, on the weekends—all while working full-time and being a mom. I had ignited a fire and it just kept getting bigger and bigger with each class I tackled. I had discovered my passion. With my first patient encounter, I knew I had found my calling in life. It took me five years, but at the age of 39 I graduated nursing school at the top of my class with my husband, parents and children by my side and my first grandchild in my arms.
As a nurse, I knew it started with teaching. I discovered in nursing school the best way for me to learn was to teach others. My schoolmates helped me recognize the pure joy in helping others learn and watching them grow. I also knew I wanted to get my master’s in science of nursing and then continue to nurse practitioner. I wanted to go as far as I could. Along the way I discovered just how few Spanish- speaking health care providers there were and the needs that existed.
I moved to Maryland with my family six years ago and worked in the Emergency Departments of several Baltimore-area hospitals before I landed at Howard County General Hospital (HCGH). I chose to work at HCGH because, when I walked in the door, I was welcomed with open arms in such a way that I felt I was home. It was warm, it was welcoming, it was a Johns Hopkins-affiliated community hospital and it had a feel to it that said, “we are here for you.” If you knew me, you’d know I strive for excellence in everything that I do. I wanted to align myself with people who think the same way I do, and I have to say I made the right choice.
As I finish my master’s degree as a nurse practitioner this August with an emphasis on acute care for adolescents and gerontology and a post master’s in nursing education, I have an opportunity to not only teach the public about disease processes—as I have done as a nurse these six great years—but now I can also help to treat them by actually managing their disease processes and prescribing medications when they are acutely ill.
I believe things happen for a reason, and certainly everything that has occurred in my life has not been by accident. I believe God put me on this planet to become a nurse and everything that I have ever experienced has been so that I can be the bilingual Spanish nurse that I became.
When a patient comes into the Emergency Department, they may be experiencing their worst moment possible and you do something that changes their world. You have made an impact. They probably won’t remember you but when you go home at night, you know you made a difference. That is nursing.
I had a career as an executive assistant and, although I was good at what I did, I can’t say that I loved my job. I can say that I absolutely love what I do now as a nurse and I wouldn’t change it for the world.
Emilia Alvarez-Negron, RN
HCGH Emergency Department
Posted by HCGH_CL on Apr 26, 2016 in Health | 0 comments
[© Kjetil Kolbjornsrud | Dreamstime.com]
Do you use caffeine to help wake up in the morning or perk up in the evening? If the answer is yes, you are not alone. Millions of people use caffeine on a daily basis. According to Johns Hopkins Medicine, “caffeine is the most mood-altering drug in the world.”
On average, Americans consume about 280 milligrams of caffeine daily—about 30 milligrams alters mood and behavior and 100 milligrams can result in physical dependence. So how many cups of coffee a day is too much? The Food and Drug Administration (FDA) warns that four to seven cups of coffee is too much, however, everyone can be affected differently.
If you consume too much caffeine on a daily basis, side effects can include insomnia, nervousness, irritability, upset stomach, rapid heartbeat, muscle tremors and restlessness. Those who do not consume caffeine on a regular basis may be more sensitive and experience negative effects faster. Also, factors such as age, gender (females are more prone), medications and body mass can play a role in sensitivity.
The recent buzz
In recent years, caffeine use has been on the rise, and the industry is responding to Americans’ obsession with caffeine. While caffeine was typically consumed through coffee, tea, cola beverages and chocolate, more recently, caffeine can be found in all shapes and sizes—from energy drinks and pills, to powder you can mix into food and caffeinated gum. This addiction has become increasingly easier to form.
The addition of these products to the market has dramatically impacted public health, with thousands of caffeine overdoses, addiction and, in rare instances, death. The FDA has stepped in to warn people about the risks involved with consuming too much caffeine and has also banned various new, dangerous caffeinated products.
It’s not all perks
Caffeine can also be especially dangerous to those with existing health conditions. According to the FDA, “People with heart problems shouldn’t use caffeine because it makes their hearts work too hard.” Additionally, “People with anxiety problems or panic attacks may find that caffeine makes them feel worse.”
If you are one of the many caffeinated people out there, it is important that you monitor how much caffeine is in the food and drinks you consume and listen to your body if you think you could be experiencing a reaction or withdrawal. Speak with your primary care doctor about your caffeine intake to see what is right for you.
As you may already know, the Central Branch of HCLS closed its doors for an exciting three-month renovation (it’s going to be so cool when it reopens!). Central team members have been temporarily relocated to the East Columbia and Miller Branches during this time. Both East Columbia and Miller have been welcoming and accommodating beyond belief. Moving, however, is never without stress, confusion, and a bit of nerves. It occurred to me, as an adult woman, that if a temporary move into a more-than-friendly territory gives me the jitters, then a young person encountering his or her first move into a new home must be completely freaked out.
So if you’re getting ready to move and you’ve lost your mind (as well as your keys and match to every other sock) in a slew of boxes, and you haven’t accidentally packed the kids, then they may be just as stressed out, if not more so, than you. The first thing you can do is head to the library and pick up some books that might ameliorate your kids’ unease.
One of my favorites out of the gate is one from our Summer Reading 2015 picks, Peanut Butter & Cupcake by Terry Border. A simple tale about newly transplanted Peanut Butter who wanders around his new town with a soccer ball looking for a new friend to play with. Don’t be fooled by the simplicity and humor of this story; one of the biggest fears of a child who is moving is finding new friends.
Continuing with the theme of friendship, but also focusing on the anxiety caused by how “scary” a new place can be, is the charming Lenny & Lucy by Phillip C. Stead. This American Library Association Notable Books for Children pick and Publishers Weekly Best Book of the Year for 2015 will reassure your kids that their feelings are perfectly normal and that things will get easier.
Before I Leave by Jessixa Bagley takes a different tack. This sweetly sad picture book focuses on the fear of leaving behind a beloved friend with a new move. And the heartwarming Ice in the Jungle by Ariane Hofmann-Maniyar touches on the loss of the familiar and how alien a new place can seem. While Eve Bunting’s Yard Sale explores the theme of loss even more deeply as the main character must watch her family sell off some of their possessions to move from a house to an apartment. And if you want a book that that’s less of a story and more of an aid to help you start a conversation about the fears your child may be having about the move, then a nonfiction book such as Moving by Caitie McAneney might be what’s needed.
This is just a drop in the bucket of books covering this topic (a catalog search on moving, household will give you many more options). We even have some books for the older kids such as Seven Dead Pirates by Linda Bailey for middle grade readers (if you think moving is hard, try moving into a house occupied by the ghosts of seven pirates). There’s also Tell Me Three Things by Julie Buxbaum for teens (about a teen grappling with grief, navigating a new school and step-family, and corresponding online with a mysterious new “friend”). Or maybe a graphic novel such as Lost in NYC: A Subway Adventure by Nadja Speigelman will provide some comfort.
Moving, at any age, can be a trying experience. A book might bring a sense of peace (or at least help alleviate some of the loneliness and anxiety) for a kid. Even adults need support and comfort during a move. That being said, if you get a chance, I hope you’ll swing by the East Columbia Branch and say hi to me sometime during the next three months.
Posted by HCGH_CL on Apr 12, 2016 in Cardiac, Health | 0 comments
[© Skypixel | Dreamstime.com] Some common anemia symptoms include lack of color in the skin, increased heart rate, fatigue, headaches, and irregular or delayed menstruation. When anemia is left untreated or is severe, it can affect your whole body—especially your heart.
Many people suffer from anemia but do not realize how it can affect your heart’s function. Anemia can cause your heart to work harder to pump blood and result in a rapid or irregular heartbeat.
What is Anemia?
Anemia is a common blood disorder that occurs when there are fewer red blood cells than normal, or there is a low concentration of hemoglobin in the blood. “Anemia stems from a variety of conditions,” says Karl Kasamon, M.D., a hematologist on staff at Howard County General Hospital, “but the most common cause is iron deficiency.” Common symptoms include lack of color in the skin, eyes and lips, increased heart rate, fatigue, breathlessness, irritability, headaches, irregular or delayed menstruation and jaundice.
“Those at the highest risk for anemia are menstruating females and generally elderly patients who have gastrointestinal related blood loss or bleeding,” says Dr. Kasamon. When anemia is left untreated or is severe, it can affect your whole body—especially your heart.
“The connection between anemia and heart complications is clear,” says Dr. Kasamon. “Red blood cells carry oxygen from lungs to tissues. When your red blood cells are low (you are anemic), your heart has to pump and carry blood cells much faster to deliver the same amount of oxygen. This strains the heart to contract faster and more intensely than normal.”
If you already have a heart condition, the condition can worsen if you develop anemia. Other factors, such as demographics, can determine the risk of anemia linking to heart conditions. “For example, 20 year olds with severe anemia rarely have dangerous complications, whereas older adults are at a much higher risk even if they are just mildly anemic,” says Dr. Kasamon.
Anemia is a reversible disorder. To optimize heart health, seek treatment for anemia to correct the red-blood-cell level back to normal, which will take strain off and positively affect your heart. Treatment varies depending on the cause of anemia and can include iron supplements, changes in diet, vitamins, prescription medication, blood transfusions or bone marrow transplant.
Dr. Kasamon also encourages those with anemia symptoms to be screened by a physician. “Patients often assume their anemia is caused by iron deficiency and self-medicate with iron. In some cases, this can cause iron overload and ironically lead to a variety of complications, including heart failure.”
I love carbs! Technically, our bodies and brain NEED carbs. But the carbohydrates I’m referring to are the “bad” ones. The ones I grew up with: white rice, white potatoes, taro, and all kinds of breads. Frankly, I have a potato problem. I love potatoes in all their glorious forms! However, I am partial to a giant mountain of home made mashed potatoes. So, in order to keep an eye on my blood sugars, I trick myself with one of my favorite low-carb sides: garlic cauliflower mash. It’s a surprisingly delicious way to enjoy cauliflower while simultaneously satisfying those carb cravings for mashed potatoes.
Ingredients: cauliflower, minced garlic, salt, pepper, olive oil, butter, milk (optional: paprika, spinach, white beans, pesto)
Chop a head of cauliflower into florets. You can either blanch the florets in boiling water for 15 minutes, or stem the florets in the microwave or on the stove. You just need to get the cauliflower tender for “mashing.” While florets are cooking, get a small fry pan going with medium heat- then, drizzle a bit of olive oil, add a minced garlic clove. (At this point, you could add add a handful of spinach to lightly wilt in the pan or white beans or pesto or additional seasonings.) Whatever healthy, brave concoction you’ve created in your garlic pan, add to a food processor. Then, drain the water from your blanched cauliflower and add florets to the food processor as well. Blend in food processor with a little bit of salt/pepper, up to 1 Tbsp of butter, and splash of milk until its nearly smooth. Scrape down the sides occasionally. Keep an eye on its consistency so you don’t put it over the edge as a puree. You can also do this step manually with a fork or masher. Either way, it’ll be tasty. Dress up your mash with chives or other fresh herbs.
Another delicious and simple way to get more cauliflower into your diet: cauliflower rice!
My sister-in-love (as opposed to sister-in-law) bought some cauliflower rice from the store the other night. It was basically a head of cauliflower that was pulsed in a food processor and repackaged in a foam tray with a price tag and plastic wrap. Save yourself the extra cost and just get a head of cauliflower. Once your raw cauliflower is pulsed to the point of rice (or cous cous) texture, you should set a fry pan on medium heat with a drizzle of olive oil. You can then add a clove of garlic minced, along with a small white/yellow onion minced, maybe a handful of baby portobellas chopped. Saute until mushrooms are soft and onions are nearly translucent. At that point, add the cauliflower. This is a great base for any and all flavors you’re interested in creating. Simply season with salt and pepper or anything your heart desires! What’s great about cauliflower is that (like rice) it will absorb the seasoning beautifully. I’ve seen Indian cauliflower rice with cumin, turmeric, ginger, etc. The pellets of cauliflower will also absorb the colors of your herbs and spices! Try something fun like a Spanish style cauliflower rice or something Guam-style like achote red-rice (annatto seeds).
Cauliflower is pretty easy to work with, you just need to put in time. There’s all kinds of great recipes for cauliflower tots (like potato tots), cauliflower soup, cous cous like salad, cauliflower popcorn (deep fried cauliflower), “steaks”, tortillas- the only limit is your imagination! Try out our Paleo cookbooks for more ideas!