AAMC Livi ng Healthier SUMMER 2016

AAMC Living Healthier

SUMMER 2016

IN HIGH GEAR

Keeping a lifelong athlete's knees in the race

?Managing Heart Failure ?S ummer Health Tips ?Advances in Spine Surgery

LEADING THE WAY

It's Academic

At Anne Arundel Medical Center (AAMC), research and education play a key role in how we provide high-quality care each day. They are also part of our commitment to advance medicine for a healthier tomorrow. In this orthopedics-focused issue of AAMC Living Healthier Together, it's worth noting that our extensive outcomes research on joint replacement has helped us improve patient care, and AAMC celebrates five consecutive years as the busiest joint program in Maryland. Similarly, our James and Sylvia Earl Simulation to Advance Innovation and Learning (SAIL) Center improves the practice of medicine through research and innovation -- like Dr. Adrian Park's ergonomics research featured in this issue. AAMC has a long history of hosting medical students, residents, fellows and allied health students because we believe research and education allow us to provide better care to you. In July 2017, we are taking the next step forward by becoming a teaching hospital, when we welcome our first class of surgery residents. These physicians will have an opportunity to gain hands-on experience and training with AAMC's surgeons, some of whom are featured in the pages of this magazine. We look forward to training the region's next generation of physicians and surgeons. In good health,

Victoria W. Bayless, President and CEO Anne Arundel Medical Center

WEB EXTRAS

Watch videos, see photos and read more about stories in this issue of AAMC LIVING HEALTHIER TOGETHER at Living.

Anne Arundel Medical Center (AAMC), a regional health system headquartered in Annapolis, Maryland, serves an area of more than 1 million people. In addition to a 57-acre Annapolis campus, AAMC has outpatient pavilions in Bowie, Kent Island, Odenton, Pasadena and Waugh Chapel.

The Power of Flowers

Florists donate bouquets to patients

Mark and Cindy Cheben have owned and managed The Gateway Florist in Annapolis for the past seven years, pouring time and energy into their thriving flower shop. But each Tuesday afternoon, you'll find Mark at AAMC. He's there to donate bouquets of flowers to welldeserving patients.

"We were just looking for a simple way to give back to the community," says Mark. "We've been very blessed and want to care for other people."

Thanks to the generosity of Mark and Cindy, for the past seven months AAMC Patient Advocacy has delivered bouquets of flowers to patients in need each week. Recipients include a mom

on bed rest waiting to deliver her baby, a man spending his 91st birthday in the Emergency Room, a fianc?e whose soon-to-be wife passed away during his hospital stay and many more.

While Mark and Cindy can't solve patients' health issues, they can brighten their day and make them feel cared for and loved. We appreciate their support.

Summer 2016

AAMC Living Healthier

IN THIS ISSUE

2 Leading the Way ? Flower power ? Stretching research ? Watson comes to AAMC

4 Better Together ? Keeping joints healthy ? Spine surgery

8 Healthier U ? Beating the heat ? Sun safety ? Sandal-ready feet

10 AAMC All Around You ? Signs of thyroid disease ? A llergy forecasts ? Healthy travel

12 Calendar ? Classes, events, support groups, and other ways to interact with AAMC

15 Chronic Conditions ? Managing heart failure

16 Make a Difference ? Lung screenings grant ? Rebecca Fortney ? Heart of Gold Gala

18 Living Well ? Avoiding sports injuries ? Farmers market tips

20 Motivate ? Breast cancer survivor helps others

was created by AAMC to give you and your family information to live healthier. This publication is intended to provide health information to our readers and should not be considered a substitute for consulting with a physician. For copies, call 443-481-5555 or email aamcpr@. If you prefer not to receive future mailings, please visit Mailings or call 443-481-5555.

2 SUMME R 2016 | LIVING HEALTHIER TOGETHER

Stretch Goals

Study finds stretching helps surgeons work more safely

Wouldn't you want your surgeon to have greater stamina and focus and less pain? Research by Adrian Park, MD, chair of AAMC's Department of Surgery, may prevent surgeons from suffering workrelated pain, potentially making surgery safer for patients.

As the surgeon's tools and incisions become smaller, surgeries are easier on the patient but oftentimes harder on the doctor. Minimally invasive surgeries require surgeons to remain still for long periods of time. This has led surgeons to experience more frequent pain in the neck, shoulder and back areas during and after performing an operation.

In Dr. Park's study, surgeons performed a 90-second series of targeted exercises every 20?40 minutes during surgery. Surgeons who took the breaks reported less discomfort and an improvement in physical performance and mental focus. Most of the surgeons who took part in the study said they wanted to incorporate targeted stretching micro breaks into their operating rooms in the future.

"It seems obvious that stretching would help relieve any discomfort while performing surgery. But the act

of pausing during surgery is not a widely accepted practice -- we are trained to work until we finish the job," says Dr. Park.

Dr. Park, an expert in the ergonomics of the surgical suite, says a cultural shift is needed in the way surgeons are trained. Otherwise, he warns, we could face an epidemic of occupational injuries to surgeons.

Adrian Park, MD, is an international expert on ergonomics in the surgical suite.

Paging Dr.Watson

AAMC partners with IBM to bring Siri-like technology to medicine

AAMC is among a select group of organizations to join with IBM's supercomputer "Watson" to bring cognitive imaging or "brain mapping" into healthcare. You may remember Watson won against its human opponents in a game of Jeopardy in 2011.

While the vast amount of medical data gathered is often too great for humans to analyze and interpret,

Watson can process 40 million documents in 15 seconds.

AAMC will work with IBM Watson Health experts to train Watson on various health conditions, improving its ability to help physicians deliver care in the future.

"Our early adoption of Watson's cutting-edge technology has the potential to revolutionize the way we deliver care to our patients by creating greater efficiencies and providing deeper insight to our physicians," says David Todd, MD, medical staff vice president and medical director of Anne Arundel Diagnostic Imaging.

For more information on IBM Watson Health, visit WatsonHealth.

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BETTER TOGETHER

In High Gear

Keeping a lifelong athlete's knees in the race

Highs and Lows

High-impact exercises should

be done in moderation, and include activities with sustained

periods of running, jumping

or lifting heavy weights.

Low-impact exercises include walking, swimming, biking, light resistance work with exercise bands, some forms of dance, yoga and Pilates.

Injuries and a lifetime of high-impact sports have left Doug Herman, 58, with significant knee damage and arthritis. Yet this competitive athlete maintains peak performance by varying his exercise routine and working closely with the orthopedic specialists at Anne Arundel Medical Center to help protect and preserve his knees. "I've been exercising my entire life. I've got to stay in motion," he says.

Whether you're an older weekend warrior or a young competitive athlete, the earlier you take steps to protect your joint health, the longer you can continue to participate in the activities you love, says Mark Chaput, a physical therapist and executive director of Anne Arundel Medical Group's Orthopedic and Sports Medicine Specialists.

"Doug and I are baby boomers, the first generation to exercise purely for enjoyment and fitness," says Mark, a competitive cyclist who trains with Doug. "We've learned the hard way that starting cross-training early will help preserve your joints. And if you already have an injury or arthritis, there are ways to lessen the impact and the symptoms. However, some younger athletes still make the same mistakes we made."

Doug was a young surfer and water skier in the 1970s when he faced his first knee surgery to repair a torn ACL, leaving him vulnerable to arthritis. When doctors suggested that he pursue a less risky activity, he chose competitive running. But 15 years of continuous training and many marathons later, he was in trouble. "My orthopedist advised me to stop running to save my knees," he says.

That's when Doug switched to competitive cycling, a low-impact sport that puts much less pressure on lower body joints than running. That's also when he learned the benefits of cross-training, a strategy that alternates high- and low-impact activities.

MIX IT UP

"Regular exercise protects joints by strengthening the surrounding muscles and keeping bones strong, but sustained, high-impact exercise can place extreme impact on joints over the long term," says Daniel Redziniak, MD,

an AAMC board-certified orthopedist who specializes in sports medicine. "For example, when one leg hits the ground during a run, five times your body weight is translated across the knee joint, leading to wear."

Cross-training can protect joint health in people of all ages and all activity levels by allowing time for the joints to recover from this stress, he says. It should include low-impact activities; exercises that strengthen the "core" area, which includes abdominal and back

A Lifetime of Healthy Bones and Joints

Kids and teens Don't go straight from zero to 100. Avoid fractures by stretching and strengthening well before returning to seasonal sports.

Teens Strengthen muscles and increase muscle mass with weight training to protect bones and joints in contact

and high-impact sports.

Go Bayhawks! ? AAMC is the official hospital for the Chesapeake Bayhawks and Anne Arundel Medical Group (AAMG) Orthopedic

and Sports Medicine Specialists provides the official orthopedic surgeons for the team. Learn more at OSMS.

4 SUMME R 2016 | LIVING HEALTHIER TOGETHER

Doug Herman and Mark Chaput were running buddies who, after running many races together, made the switch to competitive cycling to preserve their knees. They recently competed in a two-hour cycling climb up Whiteface Mountain in New York.

my weightlifting routine, using proper posture and limiting my time," says Doug. "I feel stronger all the way around."

muscles; and a regular regimen of stretching to help joint-supporting tendons, ligaments and muscles stay limber, says Dr. Redziniak. This whole-body approach can help prevent not only common knee and hip problems, but also lower back pain, rotator cuff injuries of the shoulder, and a multitude of other bone and joint injuries, he adds.

"I now alternate my cycling sessions with swimming and core strengthening. And, I'm more careful with

ARTHRITIS OPTIONS

Doug has also benefitted from orthopedic intervention to manage his arthritis symptoms. According to Dr. Redziniak, people with arthritis can help prolong the life of their joints and remain active by:

? Maintaining a healthy weight. ? Using ice and anti-inflammatory medication. ? Bracing joints for strenuous activities. Those who need additional relief may benefit from therapies, including: ? Cortisone shots directly into the affected joints for

extended pain relief. ? Viscosupplementation shots, which may help

lubricate the affected joint for periods of up to six months. Doug currently uses anti-inflammatory medications and viscosupplementation injections. Due to his careful arthritis management and the switch to cross-training, his doctors say he'll likely avoid joint replacement surgery for up to a decade longer. Doug doesn't plan to let the inevitable surgery stop him. In fact, many people with artificial knee and hip joints can continue high-performance, competitive activities as long as they protect the new joints, says Dr. Redziniak. Doug's got an advantage: He now knows exactly how to do that.

"Every pound

you gain or lose translates to roughly five

pounds of pressure on or off

your knees." ?Orthopedist Daniel Redziniak, MD

Teen girls Replace the calories burned during high-intensity cardiovascular sports to avoid excessive fat loss that can lead to reduced bone density.

Adults Use stretching and light resistance strength training to keep stiff joints limber and reduce arthritis symptoms. Maintain a healthy weight to take pressure off the joints.

Women Get enough vitamin D and calcium, and participate in loadbearing activities such as walking, running, dancing or resistance training to keep bones strong. Ask your doctor about a bone density scan after menopause.

High volume ? Did you know The Joint Center at AAMC performs more joint replacements

than any other hospital in Maryland? Learn more at Joint.

Daniel Redziniak, MD

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BETTER TOGETHER

Hope (center) was the third generation to be treated by Dr. Roy Bands. He treated both her mother Karyn and Karyn's father Dave for spine issues.

Back at It Spine surgerybrightensfuture for student Hope Lomvardias

Roy Bands, MD

After numerous setbacks, Hope Lomvardias thought she was out of options.

In the spring of 2015, Hope was a 17-year-old Archbishop Spalding junior who was excitedly touring colleges around the Northeast in preparation for applying in the fall. However, during the long car trips, she started experiencing intense low back pain, as well as leg pain and numbness. Her mother, Karyn, an infusion nurse at Anne Arundel Medical Center, became increasingly concerned.

"When we would stop the car, Hope could hardly stand up because she was in terrible pain," explains Karyn. "And, it just worsened. I knew something was wrong, because I've had my own cervical spine issues, and I recognized nerve pain."

Because of Hope's young age, her healthcare providers were reluctant to diagnose a spinal disc problem. Eventually, Hope had an MRI that confirmed a large herniation in the disc in the lowest

part of her spine, between L5 and S1 -- an unusual diagnosis at her age. She began conservative treatment options that included medication and physical therapy.

"During all of this, Hope started her senior year of high school," recalls Karyn. "It really created problems because she was in excruciating pain."

Hope was able to make arrangements with the school to use the elevator and a rolling backpack, although she hated having to do things differently than her classmates. When Hope was younger, she wore a brace to treat her scoliosis, and she didn't like feeling different again. However, she had little choice.

NEXT STEPS

The medication and physical therapy did not offer Hope the relief she needed, and school was getting more difficult.

Her parents gave her the option of taking placement tests and going straight into college. But Hope did not

Need relief? ? See what factors may play a role in back and neck pain and receive recommendations

for follow-up steps with our free back and neck pain profiler at SpineHealth.

6 SUMME R 2016 | LIVING HEALTHIER TOGETHER

want to give up her high school experience, including

graduating with her class and going to prom. She

continued on with physical therapy, while searching

for other treatment options.

" Hope then met with Roy Bands, MD, an orthopedic

surgeon at The Spine Center at AAMC. Dr. Bands had

Immediately

treated both Karyn and Karyn's father for spine issues, and now Hope would be the third generation to see him.

"Hope had a degenerative herniated lumbar disc,

after the surgery, I felt so much

which in someone her age, we believe is primarily genetic," says Dr. Bands. "She has a strong family history of this, including her mother and grandfather."

better. It was amazing. I was

At first, Dr. Bands recommended Hope continue physical therapy so he could monitor for any improvement. "Unfortunately physical therapy did

basically pain free. I'm so glad

not improve her condition, so we then discussed her surgical options."

According to Chad Patton, MD, medical director of

that I decided to

have surgery."

The Spine Center at AAMC, "Our philosophy of care

-- Hope Lomvardias

is patient-centric from beginning to end. It's important

to exhaust conservative treatment options before

surgery is considered."

A SURGICAL SOLUTION

Although Hope was hesitant to have back surgery, she also recalls how badly she was hurting. "One time it got so bad right before surgery that I even thought `if only I can have my leg amputated' because I couldn't stand the pain," she remembers. "The pain was that bad." By that point, Hope was ready for surgery.

"The surgery to repair a herniated disc involves opening the spinal canal and shaving off the herniated portions of the disc. It's called a laminectomy and discectomy," explains Dr. Bands.

Hope had surgery over the Christmas break to minimize her time away from school, and she emerged in a much better place both physically and mentally.

"Immediately after the surgery, I felt so much better," says Hope. "It was amazing. I felt like I had my old leg back. I was basically pain free. I'm so glad I decided to have surgery."

Now, Hope has returned to her life as an active teenager. Dr. Bands cleared her to play sports again if she'd like. Plus, Hope was accepted to Johns Hopkins, where she plans to study history in the fall.

"Hope is a perfect example of how back surgery can make significant improvement in your life," says Dr. Bands.

Better Images, Better Outcomes

The Spine Center at AAMC recently added the O-arm

3-D imaging system, which can improve patient safety

and outcomes during complex spinal procedures.

"The O-arm captures full 360-degree 3-D images of

a patient's spine, giving us precise anatomical views,"

explains Chad Patton, MD, orthopedic surgeon and

medical director of The Spine Center at AAMC. "In real

time, navigational software can show us where our

instruments and implants are in relation to the patient's

anatomy without having to take additional x-rays during

the surgery. Not only does this dramatically decrease

the radiation exposure to the surgical team, but it

also improves patient safety and ultimately allows

us to tackle more complex

surgery here at AAMC." According to Dr. Patton,

AAMC's investment in O-arm technology is one additional way the hospital provides the highest quality care possible.

Chad Patton, MD, medical director of The Spine Center at AAMC, is shown in front of the new O-arm 3-D imaging system.

Lower Back Pain 101 ? This free class features a spine doctor along with a physical therapist in a small group setting. Learn easy

back injury prevention exercises and common back treatments. Register at .

7

HEALTHIER U

Sunny Days Are Here

2HOW TO REDUCE YOUR RISK OF SKIN DAMAGE Go ahead -- get outdoors and enjoy some fun in the sun. But don't forget to protect your skin. Whenever your skin is exposed to UV rays, you're at risk of

3 ways to enjoy a happy, healthy summer short-term and long-term skin damage, including skin cancer, wrinkles and sun spots.

Summer is here! With many long, warm, sunny days ahead, Anne Arundel

Glen R. Gibson, MD, surgical oncologist at Anne

Medical Center experts offer tips for a happy, healthy summer.

Arundel Medical Center's DeCesaris Cancer Institute,

offers four recommendations to help you keep your

1HOW TO EXERCISE IN THE SUMMER HEAT Exercise is crucial to maintaining heart health, but with summer in full swing, it's important to factor in outdoor temperatures when you're planning your activities for the day. Interventional cardiologist Jerome Segal, MD, medical director of the

skin youthful-looking and healthy:

Wear SPF & cover-ups. Whenever you're outside, apply UV-blocking sunscreen with an SPF of 30 or greater to all exposed skin. Reapply every two hours

Heart Institute at Anne Arundel Medical Center, shares some tips.

or sooner, especially after swimming or excessive

sweating. Wear clothing that covers skin, particularly

Adapt. Dr. Segal suggests scheduling outdoor workouts for early morning or late

if you plan to be outside for prolonged periods of time.

evening hours when the sun is less intense and the temperatures tend to be cooler.

A hat is a great choice for protecting your face and

Another option is to exercise indoors or consider adding swimming to your workout neck. Also, remember to seek shade whenever possible.

regimen. "Also, take regular breaks," says Dr. Segal. "Find a cool place to stop for a

few minutes, hydrate yourself, and then continue with your workout."

Don't believe in the "base tan." While it's true that

gradually getting a tan may reduce the risk of severe

Hydrate. If you're exercising or having a very active day, add

sunburn, the risk of skin cancer rises with total sun

one or two glasses of water to the recommended eight per

exposure. Therefore, going to a tanning booth before

day. If you've been diagnosed with heart disease, Dr. Segal

the beach is a never a good idea because it only increases

stresses the importance of talking to your doctor about the

your risk of long-term skin damage and skin cancer.

appropriate guidelines for your specific needs. If vigorous

physical activity lasts over an hour, consider sports drinks

Start good habits NOW. Skin cancer takes years to

to replace electrolytes. You'll also want to avoid caffeinated

develop, and we can't reverse the damage that's already

or alcoholic beverages, as they can dehydrate you quickly.

done to our skin. However, good sun protection

habits, such as wearing sunscreen and limiting

Partner up. If you can, exercise with a friend. Not only will

exposure to UV rays, will reduce the risk of cancers in

a workout partner keep you motivated and accountable, but

your future. Get your children started with sun safety

it's also safer. If anything goes wrong, a friend can call for help.

from an early age to develop good lifelong habits.

"A workout partner may also help you recognize boundaries

for safe exercise and make sure you aren't experiencing any

Don't ignore the signs. Everyone needs to take any

signs of heat exhaustion, or worse, heat stroke," says Dr. Segal.

new or changing non-healing scabs, moles or sores

seriously. Don't ignore these,

Dress for success. If you're

as they could be signs of skin

staying outside, dress for the heat

cancer. Check your skin on a

by choosing lightweight, light-

regular basis for irregularities

colored clothing and breathable

and go see a dermatologist as

fabrics, or fabrics that wick away

soon as possible if you find

moisture from the skin. A hat or

something. All forms of skin

sunglasses and sunscreen with SPF

30+ are also a must.

Jerome Segal, MD

cancer, including melanoma,

are curable if caught early.

Glen R. Gibson, MD

Blog ? Learn how to make your own sports drinks with

our recipe at Living/SportsDrink.

8 SUMME R 2016 | LIVING HEALTHIER TOGETHER

Blog ? Know the ABCD and E's of moles to track

skin cancer by reading Living/MoleID.

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