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.
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!
Posted by hcgh_md on Jul 19, 2016 in Health | 0 comments
Patient Meeting with Geriatrician.
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.
Summer is not half way done and many of us are involved in the back to school process. Educators, parents and students will all experience that half-excitement, half-dread, pit-of-the-stomach feeling that unfamiliar experiences and change generate. And of course, there is a picture book for that. Lots of them. Reminding us that we can do this.
A little girl in a humongous blue-striped helmet chooses a bike, practices a lot, and (aided by a patient guy in a green tie) learns to ride. The gentle text offers pithy encouragement. “Let’s go! . . . Watch everyone ride . . . They all learned how . . . Come on, let’s give it a try . . . Training wheels are helpful . . . They keep you from tipping over.” Raschka’s well-chosen words, spread over several pages, admonish: “Find the courage to try it again, again, and again until… by luck, grace, and determination you are riding a bicycle!” Raschka deconstructs what’s needed to acquire this skill (which may be unique for its lessons on the physics of motion and the rewards of self-reliance), but also suggests the complexity of achieving balance and independence in any of life’s transitions.
From those wobbly first steps to those wobbly last steps, it’s all about the balance. And if you have a cheerleader and someone to catch you that’s an extra bonus.
Kevin Henkes’ wonderfully appealing child-mouse has a stubborn habit: worrying. Wemberly, a shy white mouse with gray spots, always feels nervous. “At the playground, Wemberly worried about/ the chains on the swings,/ and the bolts on the slide,/ and the bars on the jungle gym.” She tells her father, “Too rusty. Too loose. Too high,” while sitting on a park bench watching the other mice play. Her security, a rabbit doll named Petal (rarely leaves her grip. Henkes lists Wemberly’s worries, “Big things” heads the list, paired with a vignette of the heroine checking on her parents in the middle of the night with a flashlight, “I wanted to make sure you were still here.” He shows how Wemberly’s anxieties peak at the start of nursery school with huge text that dwarfs illustrations. At school Wemberly meets another girl mouse, Jewel, who turns out to be a kindred spirit (she even carries her own worn doll). Henkes offers no solutions, handling the subject with realistic gentleness; while playing with Jewel, “Wemberly worried. But no more than usual. And sometimes even less.”
Sometimes you just want to know that you are not the only one. A perfect book for those with anxiety and for those who ‘don’t understand what all the fuss is about’.
Sometimes you need to be your own cheerleader and this girl has it covered. No matter what she does, wherever she goes, or what others think of her, she likes herself because, as she says, “I’m ME!”. Evoking Dr. Seuss’s work with quirky absurdity, she is so full of joy that readers will love her. Even with “-stinky toes/or horns protruding from my nose”. The rhymes are goofy, the illustrations are zany (for the “I like me on the inside” verse, he shows the narrator and her horrified dog in X-ray mode).
Whatever new experiences await you, you can do this! And we have a book, DVD, or e-resource that might help. See you at the library.
Posted by hcgh_md on Jul 5, 2016 in Health | 0 comments
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.
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.
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.
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.
I rejoice when the weather is warm enough to swim! Swimming is one of the most healthful ways to exercise, and is broadly enjoyed by people of all ages, from babies to the aged. People can get into the pool and enjoy themselves so much that they don’t even know how much beneficial aerobic (heart-pumping) exercise they’re getting.
Aerobic exercise itself has important health benefits: it reduces harmful inflammation linked to many diseases; lowers stress; lowers blood pressure; strengthens muscles (including the heart), and can even help smokers to quit. In fact, swimming is one of the most highly-recommended types of aerobic exercises, according to Johns Hopkins exercise physiologist Kerry J. Stewart, Ed. D. In addition, it’s one of the best exercises for older adults, as it’s easy on the joints.
Most swimmers in Howard County don’t have access to natural bodies of water, such as lakes or the ocean, so we swim in the neighborhood pool, kindly supplied by Columbia Association, one of the neighborhoods in other towns, or by a private owner. The water in these pools needs to be carefully maintained for cleanliness, because the people splashing around bring bacteria into the standing water of the pool. The operators of these pools add chemicals to the water. Without chlorination, health risks would prevent our swimming in a pool.
Most pool operators maintain water cleanliness with chlorine-based chemicals, then test the water for the correct balance of pH (acid-alkaline balance) and chemicals several times throughout the day. Although several alternatives to chlorine exist, each has a disadvantage, including a substantial differential in price. So additions of chlorine seem to be the default choice for water cleanliness.
But chlorine use has its side affects: it’s drying to skin and hair, and may make swimmers’ eyes redden and burn. Some some people are undeniably allergic to chlorine; some people suspect chlorine of causing serious diseases of the respiratory tract or even cancer; but research on these serious side effects is not conclusive.
But (sniff) what’s that sharp smell? Smells like too much chlorine!
Actually, that smell is the result of inadequate amounts of chlorine. Here’s the science: molecules of chlorine combines with molecules of nitrogen or ammonia being thrown off our bodies (organic matter). This is what smells bad. Whenthere is more chlorine in the water, the chlorine can do its job and the odor should be minimal. It’s inadequately-chlorinated water that is most irritating to the skin and eyes, and may be implicated in swimmer’s ear, a common ear infection due to constantly-wet ear canals and bacteria in the water.
And why is the water so cloudy? It’s due to any combination of these events: particles forced out of the water by imbalanced water, poor filtration or sanitation, or heat. Hot days can contribute to cloudy water.
Unless there are other health-related risks, the health benefits, fun, and social value of swimming far outweighs the disadvantages posed by chlorine. One of the rites of summer is swimming, especially out of doors on a hot Maryland day.
The Center for Disease Control’s Triple A’s of Healthy Swimming go into depth on ways to keep everyone healthy when in the water. The most important and easiest of these include:
- Staying out of the water if you are ill, especially illness of your digestive tract. Also stay out of the water if you have a cut or other break in your skin. Being aware of potential water-borne problems.
- Showering before you swim to rinse off the organic materials on your skin. This way, you won’t be contributing to what the chlorine as to break down.
- Regular bathroom breaks for children and adults are crucial. Urine, after all, in another organic material.
- Protecting yourself with eye goggles, an after-swim shower, shampoo, and body moisturizer.
- Questions to ask the pool operator: “Are chemical levels checked at least twice per day, or more often when the pool is heavily used?”, “What is the latest pool inspection score?”, and “Has the pool operator completed specialized training in pool operation?”Have a great swim!
Posted by hcgh_md on Jun 21, 2016 in Health | 0 comments
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.
- 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.”
- 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.
To find a primary care physician, visit Howard County General Hospital’s Find a Doctor webpage.
With the pressure of the beach and pool season upon us, many people start looking for stomach exercises to look better in their bathing suits. Visions of 6 pack abs, or any pack abs for that matter, from magazine photos and TV ads often drive these requests. It takes months and months to build muscle tissue and developing visible abs requires a great amount of work with both nutrition and exercise as well as the right genetics. Additionally, any sort of 1, 2, or 6 pack does not necessarily equate to great posture and daily function just as the absence of a “pack” does not indicate weak muscles.
So, where’s the motivation to exercise if the visible benefit comes with so much work and little promise of actually seeing those abdominals? Ever experience back pain or stiffness? Or neck/shoulder “stress”? Going beyond what we look like in our swimsuit and on to exercises that impact our posture takes a generic workout and extends it into specific and appropriate movements for each individual person to help minimize some of these annoying, painful issues.
Posture! Such an exciting word, right? At some point, we’ve all had to address our posture either because of a constant nagging to “stand up straight” or our bodies screaming at us in pain. Let’s take a deeper look and investigate what this means. Throughout this article, you will learn how posture influences breathing, muscular tightness and balance and some tips to help make improvements and feel better overall.
A normal spine consists of a curvature in the neck or cervical area, the mid back or thoracic area and the lower back or lumbar area. Over time, abnormal curvatures develop in one or more of these areas contributing to various aches and pains. The terms kyphosis, lordosis and scoliosis define these curvatures. Kyphosis means a curve in the upper part of the back1, often appearing with slouched, rounded shoulders and a forward head. Lordosis appears as a strong curve in the lower part of the back, like a sway back. With scoliosis2, the spine curves in a C or S shape and the shoulders and/or hips appear higher on one side.
In the average person, these postural issues signal how our bodies develop over time and can come from sitting for hours, carrying a purse or backpack, and in most cases can be positively impacted through the right exercises. Finding the balance of appropriate strength training, range of motion exercises, and cardiovascular exercise can help improve these muscular imbalances.
For example, for someone with rounded shoulders doing exercises to open up the chest, strengthen the upper back and mid-section will bring the head and chest back up into better alignment. Doing lengthening exercises on the hamstrings may help as well. This will also help open up the lungs for better breathing. The person with a sway back will benefit from exercises loosening up the lower back, strengthening the muscles that extend the hip and opening up the hip flexors. Look at how you stand in the mirror. While it may not seem extreme, pay attention to how your shoulders, hips, and head sit in relation to each other.
Spend time working on incorporating exercises that strengthen the entire body and develop a well-rounded program with all components. With exercise, take time to be intentional with your movements. Make sure to use appropriate progressions with the right intensity for your fitness level, at that point in time. Learn proper form and the benefit of movement for a lifetime, not a moment in time.
[Editors note: As always, please speak with your family physician before starting a new exercise program.]