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.
Summer 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.
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.
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.
With 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.
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:
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.
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.”
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.
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.
My son had his blood pressure checked at a recent doctor’s visit. He made a terrible face as the cuff squeezed his arm. I assured him he was going to live. After the nurse left the room he said to me, “what do the numbers mean?” I told him I was not sure, but your numbers must be good or the nurse would have said something. Not the best answer or the most reassuring, so I decided to educate myself. Blood pressure is commonly recorded as two numbers and written as a ratio. The top (or typically higher) number is your systolic pressure, and it measures the pressure in the arteries when the heart beats. The bottom (or typically lower) number is your diastolic blood pressure, and it measures the pressure in the arteries between beats.
What are normal numbers? If you are a person age 20 or older, a systolic blood pressure reading of 120 or lower and a diastolic blood pressure reading of 80 or lower puts you in the normal range. Your blood pressure changes throughout the day. It is lowest when you are sleeping and may go up when you are excited, nervous, or physically active. Systolic pressure readings of 140 or higher or diastolic pressure readings of 90 or higher are in the range for hypertension or high blood pressure. The range for high blood pressure does not change with age, and one reading in the range for hypertension does not automatically mean you have high blood pressure.
Even if your blood pressure is within the normal range there are things that you can do to minimize your risk for developing hypertension, especially because hypertension can take years to develop, and you may not experience any noticeable symptoms. Some of the risk factors for hypertension are advancing age, diabetes, family history, obesity, stress, or a sedentary lifestyle. Other risk factors include smoking, high intake of sodium, saturated fats, or alcohol. High blood pressure may increase your risk for further health complications, such as kidney failure, stroke, or heart attack. You can read more about hypertension/high blood pressure and the risks here.
It is vital (recommended that you) to get your blood pressure checked regularly, even if you are symptom free. The HCLS Savage Branch has free, walk-in blood pressure screening and monitoring offered by Howard County General Hospital: A Member of Johns Hopkins Medicine on the second Monday monthly during the summer from 10-12 pm. You can also measure your own blood pressure at home with a digital blood pressure device that can be purchased from your local pharmacy or store. It is a good idea to calibrate your reading with your reading at the doctor’s office. It is best to take the measurement when you are at rest and at the same time every day.
The good news is that if you have high blood pressure there are things that you can do to modify your lifestyle and lower your blood pressure and your risk for other cardiovascular diseases. The next time you visit the library check out one of the books on hypertension or DASH-type (Dietary Approaches to Stop Hypertension) diets.
I was just at the doctor’s last week, and I had my blood pressure checked. I immediately sent a text to my son with my readings—120/70. What are your numbers?
Nancy Targett is an Instructor & Research Specialist at the Miller Branch. She lives in Columbia and is the proud mom of three boys and a girl and a Siamese cat.