woman eating a high blood pressure friendly meal

Woman Eating a High Blood Pressure Friendly Meal

Everyone loves a delicious dish, including yourself, right? Though when you suffer from high blood pressure (hypertension) you’re likely to think you’ve got two choices when it comes to eating: eating incredibly tasteless bland food for the rest of your life or continue eating the way you typically do and see where it takes you, after all, there’s medication.

The problem with the latter is it can contribute to taking more medication or worse yet, lead to heart disease and stroke.

But, there’s good news, you can take care of your blood pressure and be a foodie at the same time, you just have to be a smart foodie. Start being a smart foodie with these six simple tips.

  1. Understand how to read food labels
    The nutrition facts label is a key tool when making healthier food choices. The most important number on food labels … serving sizes. According to Johns Hopkins Exercise Physiologist, Kerry J. Stewart, Ed.D., “a lot of people don’t pay attention to serving size when they read nutrition labels, so they wind up getting double, triple or even quadruple the amount of calories, carbs, fats and so on.” Once you know the serving size, you can better measure calories and choose your nutrients wisely – taking in more fiber, potassium and vitamins A and C and reducing cholesterol, sodium, sugars, saturated fats and trans fats, which can also be found in hydrogenated and partially hydrogenated oils.
  2. Stay hydrated
    It is important for the body to have adequate fluids, especially water. Water helps prevent dehydration, flushes out excess sodium, assists with weight loss, and helps with the digestion and absorption of key nutrients. Your water intake doesn’t always have to be straight out of the tap, try spring water or add a twist of lemon or lime for some added flavor. Unless you’re advised otherwise by your physician, you can still have your favorite beverages, though you’ll want to limit your intake of them because of their added sugars or salt. Make these an indulgence rather than an everyday occurrence.
  3. Reduce your sodium intake
    Too much salt or sodium can cause your body to retain fluid, which can increase blood pressure. To reduce your sodium intake eat fresh produce, use herbs and spices for flavor and choose low- sodium or no-added-salt “convenience” foods.
  4. Include a variety of colorful vegetables
    Vegetables add important heart-healthy nutrients and fiber that help you feel satisfied and full. If you’re a vegetable lover, try eating more vegetarian meals. Vegetarian diets tend to be higher in potassium, magnesium and calcium. You can find loads of vegetarian recipes online. Experiment, try new dishes and see what you like.
  5. Eat fresh, in-season fruit
    It’s healthier, more refreshing, and best of all, requires very little prep work from you. Though, if you like creating in the kitchen, try various fruit salad combinations and add it to other foods for extra pizazz. Either way, fruit is a good multi-purpose food; you can start or end your day with it or snack on it in the middle of the day and on the go. According to the United States Department of Agriculture, the following fruits are available during the following seasons:fruit by season
  6. Choose nuts and seeds for fun snacks
    Nuts and seeds make for great snack foods. They’re rich in sources of energy, magnesium, protein and fiber. But, if you’re going to snack on these, remember to choose salt-free. The National Institutes of Health’s (NIH) National Heart, Lung and Blood Institute recommends eating almonds, hazelnuts, mixed nuts, peanuts and sunflower seeds.

With these six tips, you now have a starting point for eating delicious dishes with a healthy twist.

For more help on managing high blood pressure, enroll in our Living Health with Hypertension class.

What are your favorite high blood pressure friendly foods? Share with us and our readers.


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Colon Cancer Screening Ten Second Assessment

Colon Cancer Screening Ten Second Assessment

Between hearing the dreaded prep stories and the thought of having a device inserted into your bottom, it’s no wonder you’re probably questioning … is colonoscopy screening really necessary?

Yes, it is! According to Johns Hopkins Medicine, colorectal cancer is the second leading cause of cancer deaths in the United States and the third most common cancer in men and women. Yet, it’s one of the most curable types of gastrointestinal cancer, if detected early.

It all starts with a small polyp that grows in the colon’s lining. If untreated, the polyp grows larger and larger, to the point of becoming cancerous. When it’s at that point, the cancer starts to spread.

Now knowing why it’s necessary, let’s get to the truth behind the myths.

The prep drink tastes awful and you have to drink a lot of it.
While it might not taste like your favorite beverage, the good news is bowel prep has become easier. Products have greatly improved, as recently as within the last few years, and many physicians are prescribing a split dose – half the night before and half the morning of the procedure.

Expect to live in the bathroom.
To say you will live in the bathroom during your prep is an exaggeration, but you will visit it often, so it’s best that you spend your time in a comfortable setting with a bathroom close by.

No food the day before your procedure.
Not exactly, though you can expect to be on a limited diet. Physicians will typically instruct you to only eat a light breakfast and lunch before noon. After noon, you can expect to be on a clear liquids diet, but don’t worry, it’s not just water. You can drink your favorite juices, tea, coffee (without cream), soda and indulge your sweet tooth with jello, popsicles and Italian ices, so long as they don’t include pieces of fruit.

The goal is to have a clean colon so the physician can easily detect any polyps.

Having a device inserted in your bottom must hurt.
The device is a colonoscope. It’s a flexible camera that can easily move through the colon, allowing the physician to examine your colon and detect and remove any polyps.

While this may sound uncomfortable, you’ll be given a sedative before the procedure, so that you’re in a comfortable, drowsy, twilight sleep while this is happening. You probably won’t even remember the procedure when you wake up or feel any discomfort – most don’t.

No symptoms, no family history means no need for screening.
Colon cancer typically starts as precancerous growths. Precancerous growths don’t usually display symptoms, so feeling fine doesn’t exempt you from getting screened. And, if you think you can escape colon cancer because it doesn’t run in your family, think again. Everyone is at risk.

Screening should start at age 50 and younger if you do have a family history of colon cancer or if you are African-American or Eastern European Jewish decent.

Don’t let myths or fears stop you from getting screened. If you have additional question and concerns, speak with your physician. But if you’re ready to get screened, make an appointment with our physicians.


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Heart disease is the leading cause of death in men and women in the United States, according to the Centers for Disease and Prevention (CDC). Unfortunately, you may not realize that you are at risk of having a heart attack until it’s too late.

While there is very little you can do to change your family medical history, you can make lifestyle changes to lower your risk. First, learn about the behaviors that increase the risk of heart disease, and then start taking preventive steps.

Behaviors that Increase Heart Disease Risk

Preventive Steps

Eat a heart-healthy diet

Add these following foods to your diet. They are considered to be the main ingredients of a heart-healthy diet.

  • Vegetables – greens (spinach, collard greens and kale), broccoli, cabbage and carrots
  • Fruits – apples, bananas, oranges, pears, grapes and prunes
  • Whole grains – plain oatmeal, brown rice and whole-grain bread or tortillas
  • Fat-free or low-fat dairy foods – milk, cheese or yogurt
  • Protein-rich foods – fish high in omega-3 fatty acids, lean meats, poultry, eggs, nuts, seeds, soy products and legumes (lentils and some bean types)
  • Oils, butters, nuts and seeds – canola, corn, olive, safflower, sesame, sunflower and soybean oils; nut and seed butters; walnuts, almonds and pine nuts; and sesame, sunflower, pumpkin and flax seeds

Aim for a healthy weight 

Body mass index (BMI), a measure of weight relative to height, is commonly used for determining weight category (underweight, healthy weight, overweight and obese). Adults are typically considered to be at a healthy weight when their BMI ranges from 18.5 to 24.9.

Use Johns Hopkins Medicine’s BMI calculator to help determine your BMI.

Lower stress

Improve your emotional and physical health by learning to manage stress and practice stress-reducing activities, including:

  • Seeing a mental health care provider
  • Joining a stress management program
  • Meditating
  • Being physically active
  • Practicing relaxation therapy
  • Speaking with friends, family and community or religious support systems

Increase physical activity

Routine physical activity can lower bad (LDL) cholesterol and increase good (HDL) cholesterol levels, control high blood pressure and help with losing excess weight.

The National Heart, Lung and Blood Institute recommends the following:

  • Moderate-intensity aerobic exercise – at least 2 hours and 30 minutes per week
  • Vigorous aerobic exercise – 1 hour and 15 minutes per week

Before starting a new exercise program, you should first ask your doctor how much and what physical activities are safe for you.

Quit smoking

Speak with your doctor about programs and products that can help you quit smoking, and try to avoid secondhand smoke. If you are having trouble with quitting on your own, consider joining a support group.

Visit your doctor

According to David Jackson, M.D., a cardiologist on staff at HCGH, one of the critical steps to keeping your heart healthy is seeing your doctor for a routine physical exam. Your doctor checks your blood pressure, cholesterol and blood sugar – the big three indicators for heart attack and stroke.

“If your numbers start to become abnormal, you may not feel different or experience symptoms, so it’s important to have them checked periodically and more frequently as you age,” says Dr. Jackson. “Having a primary care physician monitoring your care to identify trends in your numbers is important.”

Learn more about why primary care physicians are important to your health.

More Information

For more details on heart-healthy living, view the National Heart, Lung and Blood Institute’s Heart-healthy Lifestyle Changes.

Share Your Thoughts

Do you have any heart-healthy tips – recipe, exercise, stress reducing or other tips? We’d love to hear them, and our readers will appreciate them too. Share them in the comments area.

 


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Jeniah Simpson wearing a red hat from the American Heart Association's Little Hats, Big Hearts for heat disease awareness.

Jeniah Simpson wearing a red hat from the American Heart Association’s Little Hats, Big Hearts. Supporters knit and crochet red hats to give to thousands of babies at participating hospitals during American Heart Month.

Congenital heart defects are the most common type of birth defect. But despite great advances in screening and diagnosis, congenital heart disease can go unnoticed for a long period of time until heart damage has progressed enough to cause detectable symptoms.

While we celebrate Valentine’s Day this week, it also marks Congenital Heart Disease Awareness Week. The pediatric cardiologists at Johns Hopkins Children’s Center and elsewhere remind both parents and their pediatricians to watch for any subtle signs that could signal the presence of congenital heart disease.

What Is a Congenital Heart Defect?

When the heart or blood vessels around it do not develop properly or develop abnormally before birth, a condition called congenital heart defect occurs (congenital means “existing at birth”). Congenital heart defects occur in close to one percent of all babies born, affecting some 40 thousand infants annually in the U.S. That’s about eight babies for every one thousand children born in the U.S. Most young people with congenital heart defects live into adulthood now, but may require more than one intervention or surgery to treat their condition.

Types of Congenital Heart Defects

  • A hole between two chambers of the heart (common defect)
  •  The right or left side of the heart is not formed completely (hypoplastic)
  • Only one ventricle is present
  • Both the pulmonary artery and the aorta arise from the same ventricle
  • The pulmonary artery and the aorta arise from the “wrong” ventricles

Signs and Diagnosis of Congenital Heart Disease

In infants, the classic signs include the following:

  • Fatigue
  • Sweating around the baby’s head during feeding
  • Slow growth
  • Breathing fast while at rest and/or asleep
  • Irritability
  • Bluish or pale skin, a sign of abnormally low oxygen levels

In older children, typical signs of congenital heart defects include:

  • Complaints of heart palpitations
  • Feelings of dizziness
  • Getting tired very easily with physical exertion
  • Inability to keep up with other kids

Cause of Congenital Heart Defects

In most cases, the cause is unknown. Sometimes a viral infection in the mother causes the condition. The condition can be genetic (hereditary). Most heart defects either cause an abnormal blood flow through the heart, or obstruct blood flow in the heart or vessels.

Treatment for Congenital Heart Problems

As children grow, some minor heart defects such as small holes may repair themselves. But when a defect requires correction, there are both non-surgical and surgical treatments available today which are less invasive and involve cardiac catheterization, medical device insertion, and minimally invasive heart surgery. In rare cases, a heart transplant may be needed.

Learn more about congenital heart defects from Johns Hopkins Medicine’s Pediatric Cardiology.


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Primary care physicians (PCPs) hold the key to better health for you and your family. These physicians are on the front lines of health care and they get to know you, your family and medical history. It’s important to have a PCP that you like and have a good relationship with to get the best care possible.

Your PCP is like the quarterback on a football team calling the plays, or in this case, making the plans to address your health concerns and guiding your plan of care. Primary care can handle 85 percent of the problems that patients have, and can coordinate care needed for other problems as well.

It’s so important to get good primary care that many health care systems, including Johns Hopkins Medicine, are creating a new approach to primary care called “medical homes.”

Vice President of Population Health and Advancement at Howard County General Hospital, Elizabeth Edsall Kromm, Ph.D., offers some important insights on the benefits of primary care.

Broad Knowledge and Skills
While PCPs are not specialists, they have a special skill set, which allows them to be adept at spotting a broad, underlying condition responsible for a range of symptoms. Depression or a chronic inflammatory disorder, for example, can manifest in any number of ways: stomach discomfort, joint pain or problems with multiple organs.

There is a growing emphasis today on preventive medicine and maintaining overall wellness to ward off problems before they occur, if possible. Helping preserve and protect your health helps you save money on health care costs and also reduces costs for the health system overall.

For example, cardiovascular disease, diabetes and other chronic conditions are preventable. The effect of healthy habits on a person’s life can be enormous. Recent preliminary evidence shows a 5 percent reduction in weight in an overweight person can reduce their risk of diabetes by 65 percent.

Your Primary Care Team
To help ensure care is delivered most effectively and efficiently, health care systems are creating the “patient-centered medical home.” In short, the medical home transforms a primary care clinic or other facility into a home base, where most of what a person needs for better health is located and available.

Though the primary care physician remains at the center of providing care, emphasis on a team is paramount. These teams typically include nurse practitioners, physician assistants, health coaches, community health workers and more.

Technology Makes It More Personal
Electronic medical records are another component of the medical home that seamlessly weave together detailed notes from every care provider who sees the person, lab and imaging results, and the like. This way the primary care team can get reports on which patients are facing gaps in their care.

For more information about the benefits of primary care and selecting the best physician for you and your family, read Four Reasons Why You Should Have a Primary Care Physician.


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Measure your health scale.

Measure your health scale. [Credit: Iqoncept] / [Dreamstime]

A healthy weight is an important contributing factor in your overall health. It can help you prevent and control many diseases and conditions, including heart disease, high blood pressure, type 2 diabetes, gallstones, breathing problems and certain cancers.

Determining a Healthy Weight
How much you should weigh is not as simple as looking at a height-weight chart. You need to consider the amount of bone, muscle and fat in your body’s composition.

The amount of fat your body carries is a critical measurement, and can be measured using the Body Mass Index (BMI). Our Adult BMI Calculator helps you determine if you are at a healthy weight, overweight or obese.

If your results indicate you are overweight, having extra body weight from muscle, bone, fat and/or water; or obese, having a high amount of extra body fat; you should consider speaking to your health care provider. While BMI provides a fairly accurate assessment, it’s not a perfect measure.

You may also find it helpful to attend our Wellness Screening for Your Health, which provides a free weight risk assessment.

Achieving a Healthy Weight
Many factors can contribute to your weight, and while you may not be able to control factors like family history, the environment, genetics and metabolism, you can change your behaviors and habits.

The service providers of our Journey to Better Health program, a program that provides health monitoring and support services to Howard County residents and faith community members, recommend the following when trying to lose weight to achieve a healthy weight:

  • Set a goal
    Your weight loss goal should be a realistic goal that you can accomplish. You should start slow and change only one habit at a time.
  • Conduct a needs assessment
    Identify what you need to accomplish your goal. Make a checklist of supplies/tools and resources you need to support your goal. For example, identify the amount of healthy food options in your pantry. If you have little to none, you will need to stock up on your healthy food supply.
  • Start immediately
    In the words of Benjamin Franklin, “do not put off until tomorrow what you can do today.” Empower yourself to make small efforts that can be repeated to make your goal come to fruition. For example, take the stairs instead of the elevator or include a fruit or salad with your meal.
  • Track your progress
    Whether it be on paper or a mobile app, recording your activity informs you of how you are progressing towards completing your goal. You may find you are on target or need to make improvements. It may seem mundane, but tracking your progress is critical towards achieving success.
  • Celebrate your success
    Find healthy ways to reward your accomplishments. For example, schedule a massage or go line dancing with friends.

For more information on losing weight, read our Five Step Weight Loss Guide for the New Year.

Maintaining a Healthy Weight
Continuing the healthy lifestyle changes you adopt, including eating a healthy diet and engaging in 60 to 90 minutes of physical activity most days of the week, are key to maintaining a healthy weight.

Successful weight maintenance is considered to be regaining less than six to seven pounds in two years and sustaining a reduced waist circumference of at least two inches.

For long-term motivation, ask your friends, family and health care provider(s) for encouragement, consider joining a support group and attend health screenings that assess your weight. Our Journey to Better Health program offers such screenings in the community for free. For a schedule of dates and locations, call 410-720-8788 or send an email to hcgh-j2bh@jhmi.edu.

The longer you can maintain a healthy weight, the more likely you will achieve long-term success.

For more healthy weight information, view Aim for a Healthy Weight from the National Institutes of Health (NIH).


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Family caregiver serving food to loved one. [Credit: Katarzyna Bialasiewicz] / [Dreamstime]

Dementia touches most everyone, whether they have it or know someone who does.

Dementia is the gradual loss of cognitive functioning (thinking, remembering and reasoning), which eventually interferes with a person’s daily life. Dementia is a set of symptoms, not a disease. Memory loss is a common dementia symptom and Alzheimer’s disease is the most common form of dementia.

As dementia progresses, people cannot manage their lives on their own and depend more on others for help. Their caregivers are often family.

When caring for a loved one with dementia, caregivers should:

  1. Make decisions in advance. Have conversations about finances, health care, transportation and living arrangements, while it is still possible for the loved one to participate in the decision making process.
  2. Research resources. The Alzheimer’s Association is a great place to start—offering a 24-hour hotline and local support groups.
  3. Stay active. Encourage the loved one to remain socially active and continue to pursue activities he/she enjoys.
  4. Play music. Dementia patients often respond to music from an era when they were active, and music is a great way to involve a younger generation in caregiving and connecting with the loved one.
  5. Make safety a priority. Keeping the loved one safe becomes a big issue as dementia progresses. It may be necessary to schedule additional in-home help or move the loved one into a care facility.
  6. Manage medications. Keep a current medication list and seek medical assistance in eliminating drugs that might cause or add to your loved one’s confusion. Use pill boxes to manage medications and seek pharmacies that can prepackage medications in daily doses.
  7. Stay calm. Personality and behavior changes, especially agitation and depression, are all common symptoms of dementia. Try to be agreeable in your conversations and do not argue, unless there is imminent danger.
  8. Keep to a routine. Maintain regular routines in a calm, familiar environment to help reduce the stress and anxiety that often occurs in people with dementia.
  9. Take care of yourself. Caregiving can be extremely stressful and comes at great cost, often including a loss of the relationship with the loved one.

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Woman on scale happy about weight loss. [Credit: Edward J. Bock III] / [Dreamstime]

Woman on scale happy about her weight loss. [Credit: Edward J. Bock III] / [Dreamstime]

Weight loss is one of the top items that appear on New Year’s resolution lists. Unfortunately, only a small percentage of people succeed, while most see it as a reoccurring item for the next new year.

What most people do not realize is that is takes more than just desire to lose weight. It takes commitment and planning, beginning with our step-by-step guide.

Step 1: Make a Commitment
Rather than just committing to losing weight, commit to specifics. Commit yourself to the amount of weight you want to lose, the date by which you want to lose it, diet changes you will make to establish healthy eating habits and your plan for exercising regularly.

The best way to lose weight is to set a reasonable goal and lose it slowly and gradually. An initial weight loss goal of 5 to 7 percent of body weight is realistic for most individuals.

Step 2: Know Your Current State
Speak with your health care provider about the state of your health, specifically asking about weight-related risks. Healthy weight is especially important if you have or have had heart disease; type 2 diabetes; stroke; high blood pressure; high total cholesterol level; cancer of the uterus, gallbladder, kidney, stomach, breast or colon; and arthritis, especially osteoarthritis of the back, knees and hips.

Keep a food diary for a few days to realize what and when you are eating so you become aware of the types of food you eat most often and your mindless eating tendencies. If you find you eat a lot of processed foods, know that those foods tend to be high in trans fats, sugar and sodium or salt, which make it difficult to lose weight.

Also analyze your lifestyle. Identify obstacles that could be a challenge for your weight loss, and think of solutions to overcome those challenges. Recognize opportunities that can support your weight loss (e.g. living near a fitness center) and how to take advantage of those opportunities.

Step 3: Set Milestones
Establish short-term goals for yourself that will act as milestones to getting you to your long-term goal weight. These goals should be specific and realistic. For example, lose 1/2 to 1 pound a week. Achieving your milestones will motivate you to continue making progress.

Your milestones should also be forgiving when you experience occasional setbacks. Rather than criticize yourself and give up, forgive and get back on track as soon as possible. It’s realistic for you to sporadically have setbacks.

Step 4: Take Advantage of Resources and Support
Reach out to family, friends and co-workers who will support you. Perhaps they are trying to lose weight as well, in which case you can support and motivate each other. You are more likely to eat better and exercise more if your friends and family are doing the same.

Also look to local organizations for information and guidance. For example, Howard County General Hospital offers a free Looking to Lose Weight class where a certified nutritionist and registered dietitian discusses the physiology and health challenges that affect weight, and teaches meal plans that taste great, provide a balanced diet and promote health.

Learn to read food labels to make better food choices. Foods like gravy, mayonnaise, sauces and salad dressings often contain hidden fat and lots of calories, and some yogurts may be low in fat, but are high in carbohydrates and sugars. Or, eat foods in their natural state, and you will not have to read labels at all!

Step 5: Monitor Your Progress
Evaluate your progress of the milestones you set in Step 3. Identify areas of your plan that are working well and areas that need adjusting. It may be necessary to rewrite your short-term goals and plan accordingly.

As you are monitoring your progress, you may find you need to focus more on the fit of your clothes and less on reading the scale, especially if you have increased your exercise level. As you increase muscle mass and lose fat, the reading on your bathroom scale may not change much, but the fit of your clothes may be looser. Measure your waistline and compare the results.

Do not forget to reward yourself for your successes, but not with food. If achieving your milestones are coming too easily, consider adding a new, more challenging milestone that will get you to your long-term goal.

Using this step-by-step guide will get you on your way to achieving your New Year’s weight-loss resolution and having a healthier new year.


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Adult children caring for aging parents.

Adult children caring for aging parents. [Credit: Goldenkb] / [Dreamstime.com]

Caregiving for an aging parent can be challenging. Follow these tips to make the process easier.

Prepare for Doctor’s Visits

Older patients often have more health issues to discuss. Create an agenda and questions for the appointment. Attend appointments with your loved one, if you can, or send someone you trust, who can take notes and help remember and understand everything that was said.

Also bring all of their prescription bottles to their appointment. Elderly patients are more susceptible to side effects and interactions between medications and they often see many physicians—so bringing bottles is extremely helpful to the physician.

Organize Daily Medications

Use a pill dispenser with compartments for each day of the week or another reminder system to let your loved one know when to take medications. You can also keep a medication schedule and post it somewhere visible—the refrigerator or medicine cabinet.

Set an alarm on your loved one’s phone, watch or clock to help make taking medications a part of the daily routine.

Make a List of Medications

Maintain a list of medications—with the name of the drug, the dose, how often it is taken and why. Keep a copy somewhere immediately accessible, like your purse or car, in case there is an emergency. Schedule annual medication reviews with your loved one’s primary health care provider. Keep in mind, many common drugs can have interactions with food.

Fill Prescriptions at One Pharmacy

Using one pharmacy makes refilling prescriptions simpler and it helps your pharmacist protect against drug interactions and avoid potential problems. Some pharmacies even deliver.

Take Advantage of Technology

Many health care providers, pharmacies and insurance plans offer apps or websites to manage records. These online tools can help you retrieve and share health care information quickly. If you rely on electronic files, be sure to keep a back-up of logins and passwords. Johns Hopkins MyChart is one example—for more information, visit MyChart.

Discuss Advance Directives

Start the difficult but important conversations about end-of-life care early, when you are not in a crisis, and there is more time to think and make better decisions.

Advance directives identify who will make decisions regarding treatments, such as life support measures, when your loved one is too sick to do so themselves. The designee should have a full understanding of the patient’s wishes.

Know that you are not alone. There are many great resources for caregivers. To start, download a free copy of the Johns Hopkins guide “Take Care: A Guide for Family Caregivers.”

Anirudh Sridharan, M.D., is a board-certified geriatrician on staff at Howard County General Hospital.

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Lung cancer is the second most common cancer in the United States, though it is not often detected early. It usually has no noticeable symptoms until it is in an advanced stage, when a tumor grows so large that it starts pressing against other organs, causing pain and discomfort.

However, screenings offer hope for early detection, and avoiding risks can help prevent lung cancer from developing. Know what to expect from lung cancer screenings and what risks to avoid.

Lung Cancer Screenings

  • Why screen for lung cancer? More people die of lung cancer than any other cancer each year. A recent large study has shown that for certain individuals with a history of smoking, early screening helped reduce mortality rates. (© One Photo | Dreamstime.com)
  • Who should be screened for lung cancer? Individuals age 55-77 who are current smokers or have smoked the equivalent of 30 pack years (number of packs a day smoked x number of years smoked) are screening candidates. If you are at risk, please ask your doctor about getting screened. (© Simone Van Den Berg | Dreamstime.com)
  • Do I need a doctor’s order? A referral from your primary care physician or pulmonologist is needed. (© Thodonal | Dreamstime.com)
  • Does insurance cover the cost of screening? Most insurance plans cover the cost and, depending on your plan, there may be a co-pay. Medicare does cover the cost. (© Olivier Le Moal | Dreamstime.com)
  • How safe is screening? Johns Hopkins Medical Imaging in Columbia uses an ultra low-dose CT scanner which reduces CT radiation exposure up to 60 percent, compared to traditional scanners. [Credit: [Jupiterimages]/Thinkstock]

Lung Cancer Risks

  • Smoking
    Cigarette smoking is the most significant risk factor in developing lung cancer. Nearly 90 percent of lung cancer diagnoses can be prevented if cigarette smoking were eliminated.
  • Family history
    People who have a family member diagnosed with lung cancer are twice as likely to develop cancer as someone without a family history of lung cancer. That rate increases for those who have two or more first-degree relatives (brothers, sisters, parents or children) who developed lung cancer.
  • Secondhand smoke
    While the same cancer-causing agents are inhaled in smaller amounts, secondhand smoke does increase the risk of developing lung cancer.
  • Occupational exposure
    Exposure to asbestos, once common among specific construction and manufacturing jobs and firefighters, is known to cause mesothelioma. Other toxins, such as arsenic, nickel and chromium, as well as tar and soot, can also increase the risk of developing lung cancer, especially among those who smoke.
  • Environmental exposure
    Chemicals and other cancer causing substances may exist in homes and offices, increasing the risk of people who live and work in them. The most common culprit is radon. Thirty percent of deaths caused by lung cancer have been linked to radon exposure in people who have never smoked with the percentage increasing for those who have smoked.
  • Vitamin supplements
    Beta carotene was once believed to have aided in reducing the risk of lung cancer among heavy smokers. Substantial evidence now shows beta carotene supplements increases the risk of lung cancer, especially among people who smoke one or more packs a day.

Read more about lung cancer, screenings, smoking and e-cigarettes.


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Man and Woman Sleeping [Credit: Monkey Business Images] / [Dreamstime.com]

Most of us love the extra hour we gain when daylight savings time ends in the fall. However, feeling better rested may not result from simply sleeping in an extra hour. Rather, aligning your waking time more with daylight – a physical cue that makes all the difference – is the more likely explanation.

Your biological internal clock, known as circadian rhythm, responds to light and darkness. When your activity does not correspond with sunlight cues, it throws off your circadian rhythm, causing your sleep to be disturbed. The extra hour helps with resetting your body’s exposure to sunlight.

Getting a good night’s sleep is important. If you are wondering how important, consider the risks associated with poor sleep and the benefits of good-quality sleep.

Risks from Poor Sleep

  • Weight gain
  • Heart attack
  • Stroke
  • High blood pressure
  • Diabetes

Benefits from Good-quality Sleep

  • Feeling better
  • Looking younger
  • Experiencing improved memory and concentration
  • Feeling less moody and grouchy

While seven to nine hours is optimal for most adults, you can achieve big improvements in your sleep quality by practicing consistency, which is going to bed and waking up at the same time every day.

If you are not currently doing this, try testing it. Make a point of going to bed and waking up at the same time for a couple of weeks. I did this several years ago. For two weeks, I went to bed at 11 p.m. every night and woke up every morning at 7 a.m. After five days, I felt like the last time I had slept so well was in middle school.

However, if you think you are getting enough good-quality sleep, but are still very tired, that is a signal for getting evaluated. Start by contacting your primary care provider who may be able to treat your sleep condition or recommend someone who can. The good news is that common sleep disorders can be treated.

Rachel Salas, M.D. is the assistant medical director for the Johns Hopkins Center for Sleep at Howard County General Hospital.

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Stroke: What You Need to Know

You’ve most likely heard the term “stroke” and may even know people who suffered from a stroke, but how much do you really know about stroke? Do you know risk factors, warning signs and what to do in the event of a stroke?

Saturday, Oct. 29 is World Stroke Day, and to help you learn about stroke, we’ve included the basics to help you take preventive measures, and understand what to do if you or someone you know is experiencing a stroke.

About Stroke
Stroke occurs when blood flow to the brain is disrupted, either by a blood clot that blocks one of the vital blood vessels in the brain (ischemic stroke) or a blood vessel bursts spilling blood into surrounding tissues (hemorrhagic stroke). Even a brief interruption in blood supply can cause problems as brain cells begin to die after just a few minutes without blood or oxygen.

Risk Factors in Both Women and Men
While some risk factors cannot be changed, like age, others can be changed. Reduce your chances of stroke by improving the factors you can change.

  • Being inactive
  • Older age
  • Previous heart and blood vessel (cardiovascular) disease
  • Being overweight
  • Having an unhealthy diet (e.g. high in fat, cholesterol and sugar; low in fruits, vegetables, grains, nuts and olive oil)
  • Smoking
  • Metabolic syndrome – a group of findings and lab test results that increase the chance of stroke, heart attack and diabetes

Warning Signs and Course of Action
Learn from Eric Aldrich, M.D, medical director of the Stroke Center and director of Inpatient Neurological Services at Howard County General Hospital, on how to use F.A.S.T. to detect warning signs, and what to do if you think you or someone you know is experiencing a stroke.

 


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According to the Centers for Disease Control and Prevention (CDC), the flu is more dangerous than the common cold for children. Children younger than 5 years old typically need medical care, and severe cases are more common in children younger than 2 years old. Children with chronic health problems like asthma, diabetes and brain and nervous system disorders are especially at high risk of developing serious complications from the flu.

The CDC recommends flu vaccinations for children as being the single best way to protect them from the flu. Common vaccination methods have included the nasal mist and shot. However, recent research has found the nasal mist to be ineffective, and because of this the CDC is only recommending the shot as an effective vaccination method.

Convincing children to get the shot is likely to be a hurdle for parents, but parents can make the experience less stressful with these tips from Laura Hagan, Howard County General Hospital Pediatric Emergency Room nurse manager, and her little helpers.

Parents may also find it helpful to try these following tips:

  • Taking slow, deep breaths – Deep breathing can help children relax and concentrate on something other than the shot. For this reason, parents should ask their children to breathe all the way down to their belly.
  • Focusing on something in the room – Parents can distract their children by getting them to concentrate on the details of a poster, picture or sign in the room. For example, if there’s a picture, they can count the number of flowers, animals or other images in the picture. In the case of a sign, they can try to think of new words from the same letters that are in the sign.
  • Coughing – Encouraging children to cough as the needle goes in may help them feel less pain during the process.
  • Relaxing the arm – A tense arm can make a shot hurt more, so parents should try to get their children to relax their arm.

For more information, view Johns Hopkins All Children’s Hospital’s Five Tips for Surviving Shots.


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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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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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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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One of the first steps women, who are thinking of having a baby and want to make sure they have a healthy pregnancy, should take is to see a gynecology and obstetrics physician. The first visit to a gynecology and obstetrics physician doesn’t have to happen after becoming pregnant. Actually, it’s best to visit before becoming pregnant.

Proper health before becoming pregnant is almost as important as maintaining a healthy pregnancy. That’s where the pre-pregnancy exam can help.

Watch Francisco Rojas, M.D., gynecology and obstetrics physician at Howard County General Hospital, briefly describe the pre-pregnancy exam.

In addition to the pre-pregnancy exam, other steps can be taken to reduce the risk of complications and help prepare for a healthy pregnancy and delivery, including:

  • Ceasing smoking – Studies have shown that babies born to mothers who smoke tend to be born prematurely, be lower in birth weight and are more likely to die of sudden infant death syndrome (SIDS).
  • Eating healthy foods – A balanced diet before and during pregnancy is essential for nourishing the fetus.
  • Maintaining proper weight and exercise – Overweight women may experience medical problems, like high blood pressure and diabetes, and women who are underweight may have babies with low birth weight.
  • Taking folic acid and prenatal vitamins – Folic acid helps reduce the risk of brain and spinal cord birth defects. Prenatal vitamins, prescribed by your healthcare provider or a midwife, provides your body with the necessary nutrients that’s needed to nourish a healthy baby.
  • Avoiding harmful substances – Exposure to high levels of some types of radiation and some chemical and toxic substances may negatively affect the fetus.
  • Limiting exposure to possible infections – Pregnant women should avoid eating undercooked meat and raw eggs and coming into contact with cat litter and feces, which may contain the Toxoplasma gondii parasite that can cause a serious illness in or death of a fetus.

Look for the next post in our series, What to Expect Early in Your Pregnancy.

Francisco Rojas, M.D., practices obstetrics and gynecology at Johns Hopkins Community Physicians – Howard County and Odenton. For an appointment, call 443-367-4700.

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For an older adult, an ache or pain can have far-reaching effects, bringing additional concerns that are specific to their age. For example, a new knee pain can bring worry about reduced mobility and loss of independence or worsening existing illnesses.

If an older man has knee pain, he’s thinking about a lot more than just the pain. He’s thinking this might be the end of things as he knows them. He fears he’ll have to move, go into a nursing home or never see his dog again. That’s when a geriatrician can help.

Geriatricians are medical doctors who specialize in meeting the unique health care needs of older adults, including:

• Developing health care plans that are specific to older adults.

• Treating complicated conditions that are common with older adults, including heart disease, arthritis, diabetes, urinary problems, erectile disorder, cancer, depression and memory loss.

• Empathizing with older adult concerns, often anticipating what they think and feel when discussing how medical conditions will affect their lives.

• Providing a streamlined approach for working with specialists, a common need as older adults develop more health conditions as they age.

• Reducing the risk of adverse drug effects and drug interactions. Older adults typically take multiple medications. Aging bodies process and store medicine differently than younger bodies. Lack of proper understanding and monitoring could bring on complications.

While geriatrician’s help patients age gracefully, there are steps older adults can take towards living a healthy lifestyle. Learn more from our previous post, The Practice of Geriatrics – Six Steps to a Healthy Lifestyle.

Scott Maurer, M.D., is a geriatrician practicing in Glenwood. For an appointment, call 410-489-9550.

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Howard County General Hospital Emergency DepartmentWith so many medical care options these days, it’s confusing to know when you should go to the Emergency Room (ER) and when you should seek care at your physician’s office or urgent care center. When in doubt, trust your instincts. If you think you’re having a true medical emergency, always call 9-1-1.

This easy reference guide takes some of the guess work out of deciding.

Fever
First: Try acetaminophen or ibuprofen to control your fever. If your fever doesn’t go down, call your primary care physician or visit an urgent care facility.
Go to the ER: If you have a fever higher than 102 degrees that does not come down with acetaminophen or ibuprofen.

Flu Symptoms
First: Most physicians suggest you stay home and treat symptoms with over-the-counter medications and fluids. Your physician may prescribe medicine. After hours, your physician may have an answering service. Urgent care facilities are also a good option when your physician’s office is closed or unable to accommodate you for a visit that day.
Go to the ER: If you’re having difficulty breathing, a prolonged high fever, severe dehydration or relapse after getting better.

Broken Bone, Strain or Sprain
First: Typically a strain or sprain can be evaluated in a physician’s office or urgent care center. You may be referred for tests, physical therapy or to a specialist.
Go to the ER: If you think you have broken a bone.

Non-urgent Imaging Tests
First: Imaging studies such as an MRI, CT scan, ultrasound or X-ray, can be performed at many area imaging centers.
Go to the ER: If your physician specifically requests that you go the ER for a certain test.

Head Injury
Always go to the ER: If you hit your head, lose consciousness, experience a seizure and/or are vomiting.

Heart Attack or Stroke Symptoms
It’s especially important to call 9-1-1 if you are experiencing chest and/or arm pain, trouble breathing, excessive sweating and fatigue. These can all be symptoms of a heart attack. Howard County Fire and Rescue Services are specially trained to evaluate and stabilize heart attack patients while our team mobilizes at the hospital to prepare for your arrival. Do not drive yourself to the hospital.

Real Time Advice
Many physician practices now offer after-hours urgent care or an answering service, so check with your physician about these types of services. Also know that your primary care physician knows you and your medical history best and can often guide you to the appropriate treatment facility during office hours. Also, your insurance company may have a nurse hotline that can provide treatment and care setting advice. Again, none of these options should delay you from calling 9-1-1 if you feel you are having a true medical emergency.

Robert Linton II, M.D., is the director of the HCGH Emergency Department.

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Primary Care Physician Consulting Patient

[Credit: monkeybusinessimages]
[iStock]/Thinkstock

If you’re healthy and feeling good you’re probably wondering why you would need a primary care physician. According to William Saway, M.D., an internal medicine physician on staff at HCGH, “Even if you’re totally healthy, a primary care physician plays a very important role in keeping you healthy.”

Several benefits for having a primary care physician include:

  1. Gaining a Medical Home
    “Your primary care physician’s office is your medical home—they know you and your medical history to treat you best when you are feeling sick,” says Dr. Saway. They also ask you about your family’s medical history and use that information for preventative care and to determine any screening or testing you may need. “Patients who are otherwise healthy may have a family history of a condition that they in turn are susceptible to and they need to be monitored,” notes Dr. Saway. An emergency room visit can often be avoided by establishing a relationship with a primary care physician. Some local primary care practices also have extended hours or operate urgent care centers.
  2. Early Detection
    While you may feel perfectly fine, Dr. Saway warns, “You can have high blood pressure, diabetes and/or high cholesterol, which are silent killers. Pain brings you to the doctor and bleeding brings you to an emergency room but these conditions don’t give you a clue that you need to see the doctor. An annual visit to your doctor for screenings can provide insight before a condition can become serious.”
  3. Access to an Educational Resource
    A physician’s job is also to educate. For example, it is important to understand the consequences of high blood pressure or cholesterol or untreated diabetes. Your physician is your resource. Use your wellness visit to ask questions and get answers. If the need arises for you to seek the care of specialists, your physician can recommend specialists specific to your needs. Furthermore, they can provide collaboration between specialists and guide you to the appropriate resources. Specialists and patients should keep the primary care physician informed so care can be effectively managed.
  4. Electronic Tracking of Your Health Care
    Most physicians offer an electronic medical record that tracks test and screening results and generates reminders when you are due for a follow-up appointment, exam or test. This tool can be extremely helpful for managing a chronic illness. Your physician’s online website portal can provide education and an option for you to communicate with your doctor.

Internal medicine and family practice physicians serve as primary care physicians. Internal medicine physicians provide health care to adults and are skilled in preventing, diagnosing, treating and managing adult diseases as well as encouraging disease prevention and screening and promoting well-being. Family practice physicians provide ongoing, comprehensive health care for patients of all ages and genders. They also emphasize disease prevention and screening.

If your access to care is limited because of cost or insurance, Chase Brexton Health Care offers solutions as a Federally Qualified Health Center that serves underserved populations in the community as well as insured patients. “Our health care team is focused on helping patients stay healthy and providing care for urgent and chronic diseases. I enjoy working with my patients and their families to provide them with a comprehensive, team-oriented approach,” says Sarah Connor, D.O., a family medicine physician on staff at HCGH.

To find a primary care physician, visit Howard County General Hospital’s Find a Doctor webpage.

William Saway, M.D., specializes in internal medicine with Columbia Medical Practice in Columbia. For an appointment, call 410-964-5300. 
Sarah Connor, M.D., specializes in family medicine with Chase Brexton in Columbia. For an appointment, call 410-884-7831.

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