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

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

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

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

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


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


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Eliminating Gluten, Nuts and Dairy Photo

Brad Calkins | Dreamstime.com |Eliminating Foods Diet

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

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

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

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

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

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

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

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

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

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

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


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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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Summer4827805659_9da7bd0ae7_b is all about having fun in the sun. We’ve all made plans to enjoy the beach, lake, and/or pool. Many of my friends are planning to lay on the beach and even out their tans for that perfect summer-kissed glow (due to all the up-coming weddings they are attending). Seems like no big deal, right? Well, it’s NBD until you have few moles removed from your back and your doctor is telling you that a sunburn you got 10-15 years ago is probably what made those moles a problem today. Listen, skin cancer is the most common type of cancer and accounts for about half of all cancers diagnosed. According to the American Academy of Dermatology nearly 145,000 Americans will be diagnosed with some form of melanoma this year. Moreover, 75% of skin cancer deaths are due to melanoma. It is a big deal.

My fiance just had a mole removed from his back two weeks ago. Today, he goes in to have the stitches removed. The doctor explained to us that on a scale of 1 – 5, where “1 is normal” and “5 is cancer” the previous biopsy of the mole was a “3” and that’s why the mole and the area around it needed to be excised. As a cancer survivor and liver transplant recipient, I understand the importance of protecting my skin because I am “100 times more likely than the general public to develop squamous cell carcinoma.” Despite the cautionary tales I’d shared and the “wear sunscreen” speech I’ve relayed from my doctors, friends, and fellow cancer survivors- it wasn’t until this happened to him that it “clicked.”

I don’t want you to have to end up with a cancer diagnosis to realize and practice the simple steps you can take to avoid getting sunburned. Sunburns today could be skin cancer in a year or 10 years. Trust me. Cancer is expensive and interrupts your life significantly. Below are some questions and answers to help make the case for protecting your skin this summer.

Q: If the sun is so scary, are you expecting me to stay inside all summer?

A: Please don’t hide in your closet all summer. Go outside, be active! It’s essential to your health in countless ways. I’m just asking that you be smart about it. Avoid going outside during the hottest part of the day when the sun is at its highest peak. If you can’t avoid being outside during that time, limit your time in the sun, find shade, wear broad spectrum protective clothing, hats, sunglasses, etc. Think about it this way, one hour of sun at 9 A.M. is nearly equivalent to 15 minutes of sun at 1 P.M. Your goal is to stay safe in the sun. As my fiance says regularly, “Fun ends when safety ends.”

Q: So, how much sunscreen do you really need? 

A: You need to apply at least one oz. of sunscreen every two hours in order for it to really be effective. Truly! If you’ve spent 4-5 hours at the beach and a quarter of your 8 0z. tube of sunscreen isn’t gone, you didn’t use enough. If you went with a group and you still have any sunscreen left- clearly, you all didn’t use enough. Rule of thumb: apply sunscreen 30 minutes prior to being out in the sun and reapply often. Even if your sunscreen is labeled as “water-resistant” or “water-proof” you still need to reapply. Efficacy of these kinds of sunscreens means about 40-80 minutes of SPF coverage when wet.

Q: Fine! I’ll wear sunscreen. What SPF (Sunburn Protection Factor) should I use? 

A: There is some debate over this. Many believe that the higher the SPF number is, the greater it is at protecting you from UVA/UVB rays. Actually, it’s pretty negligible; but for someone who has a history of or susceptibility for skin cancer, the marketing of SPF numbers could mean peace of mind. Truth is, no matter the SPF you put on, it’s ineffective after a couple hours. Which means, it’s not necessarily the SPF number that counts, it’s how often you reapply. Effectively, you should reapply after you do anything that could make the sunscreen slough off. Be sure to purchase a quality sunscreen with “broad spectrum” protection. An everyday SPF of 15 (blocks 93% of harmful rays) for your daily commute through life, in and out of buildings, etc. should be sufficient (reapply religiously). Thankfully, many lotions and make up products include SPF 15 already. However, if you’re playing in a sporting event, or near water (which is reflective) in directly sunlight, etc. you’re probably better off with a thicker, higher SPF of 30+ (blocks 97%+ harmful rays) which is the recommendation found on hopkinsmedicine.org.

Q: Sunscreen is gross. Couldn’t I just use a tanning bed?

A: If you want to jump from the frying pan and into the fire, that’s your decision as an adult. However, there’s a reason why Howard County, Maryland does not allow tanning for minors. If you read the report and its findings, I expect that you’ll see how important your skin is too. Perhaps you’ll decide tanning beds aren’t for you and that wearing sunscreen isn’t such a bad idea after all.

Clearly, I’m not a doctor or medical professional. Please consult with your primary care physician or your dermatologist for your skin health needs. Take these questions and answers as what they are: another way to hear the “wear sunscreen” speech.

Remember: use high quality, broad spectrum sunscreen, and reapply religiously!

JP is the HCLS Editor & Blog Coordinator for Well & Wise. She is also a Children’s Instructor & Research Specialist at the Savage Branch & STEM Education Center. She is a storyteller, wannabe triathlete, myriad hobbyist, cancer survivor, and liver transplant recipient.

 

 

 


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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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