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.

Eric Aldrich, M.D., is the medical director of the Stroke Center and director of Inpatient Neurological Services at Howard County General Hospital. For an appointment, call 410-740-7890.

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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]/[]

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

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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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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