Mothers and Substance Use

By Christopher Welsh, MD

Women have some unique challenges when it comes to alcohol, tobacco and drug use and misuse. These differences are based on both biology and culturally defined expectations of women. Hormonal changes, the menstrual cycle, fertility issues, pregnancy, breastfeeding and menopause can all impact a woman’s use of substances. Women often use smaller amounts of a substance for shorter amounts of time before developing a problem. They also may have greater physical problems from their substance misuse.

Alcohol, tobacco and drug use during pregnancy can present significant problems for both the mother and the fetus/baby. Different substances can increase the chances of:

  • miscarriage,
  • stillbirth,
  • premature birth,
  • small head size,
  • low birth weight, and
  • delayed physical and brain development.

When a woman uses substances – especially opioid pain killers, sedatives and alcohol – during pregnancy, the baby may go through withdrawal after birth. This condition is often called neonatal abstinence syndrome (NAS).

Although it can be hard for anyone with a substance use disorder to stop, women, in particular, may be afraid to get help during or after pregnancy due to concerns over possible legal or social services involvement. Issues related to child care also make it harder for women to get treatment.

If you have a problem with substance misuse, it is important to get help. Counseling and medications can be very helpful, as FDA-approved medicines do exist to help with addiction to opioids, alcohol and tobacco.

Call the University of Maryland Medical Center’s Outpatient Addictions Treatment Services (OATS) at 410-328-6600. The program even has a play center where children are watched while you participate in counseling.

Dr. Welsh is the medical director of Substance Abuse Consultation Service and medical director of the Comprehensive Recovery Program at University of Maryland Medical Center, and an associate professor of psychiatry at University of Maryland School of Medicine.

Physical Fitness and Sports Month: Commonly Asked Questions About Sports Injuries with Dr. Packer

Dr. Jonathan Packer is an orthopaedic surgeon with the University of Maryland Department of Orthopaedics and an Assistant Professor of Orthopaedics at the University of Maryland School of Medicine.  Dr. Packer specializes in sports medicine and is a Team Physician with the University of Maryland Terrapins.  Below he answers common questions about sports injuries.

What are the most common sports-related injuries you see in your clinic?

The most common sports related injuries are ankle sprains and contusions.  The most common knee injuries that I see are meniscus tears and knee ligament injuries, such as the MCL (meniscus collateral ligament) and ACL (anterior cruciate ligament).

What can an athlete do after an injury to recover quicker?

The treatment depends on the specific injury and the severity of the injury.  The athlete should have the injury evaluated by the team Athletic Trainer, who can then determine whether the injury requires an evaluation by a physician.  Low grade injuries typically respond well to rest and different treatments to reduce the inflammation (elevation, ice, anti-inflammatory medications – i.e. Ibuprofen or Naproxen).

Why should an athlete use ice and not heat on an injury? 

The initial treatment goals after an acute injury (first 48 hours) are to reduce inflammation and swelling.  Cryotherapy, such as ice, is an effective method of reducing the swelling and bleeding into the tissues.  Heat is used for chronic injuries to relax and loosen tissues and to increase blood flow to the area, typically before participating in sports.

Can an athlete play with a cast or brace? 

It depends on the injury and the sport.  Athletes are frequently cleared to play with either a cast or a brace.  Your sports medicine physician will be able to make the decision whether or not it is safe to play with a cast / brace or not given your injury and sport.

When does an athlete need to see a physician? 

If the athlete’s team has an Athletic Trainer, s/he should evaluate the athlete and determine whether a referral to a physician is necessary.  In general, if the injury is accompanied with a “pop” or if a joint has a large amount of swelling, then it is concerning for a more serious injury that should be evaluated by a physician.  Other reasons to see a physician are joint instability and failure to improve with rest and anti-inflammatory treatments.

How can sports injuries be prevented?  

Sports injuries are best prevented by a dedicated prevention program that would ideally start at least 6 weeks before the start of the season. The prevention programs should focus on flexibility, muscle coordination and strengthening, neuromuscular control, plyometrics, body mechanics, and proper landing techniques.  The prevention programs are especially important for preventing ACL tears and have been shown to reduce non-contact ACL tears by up to 80%.  There are many different prevention programs that can be found online.  Two of the most well-known and established programs are the Prevent Injury and Enhance Performance (PEP) Program and the Knee Injury Prevention Program (KIPP).  Athletes and their coaches can find these programs online here and here.

Why should athletes choose University of Maryland Department of Orthopaedics to diagnose and treat their sports injuries?  

The University of Maryland has many physicians that specialize in Sports Medicine and treat all types of sports injuries. If at all possible, we will try to get you back to your sport without surgery. However, if surgery is necessary, we have the expertise to treat even the most complex injuries. The Sports Medicine team has extensive experience and are the team physicians for 12 high schools and for the University of Maryland Terrapins.

To make an appointment or to learn more about the University of Maryland Department of Orthopaedics sports medicine specialists, call 410-448-6400, or visit their website.

3 Things to Know about Mother-Child Relationships

By Sarah Edwards, DO

  1. Healthy moms = healthy children and families. Healthy moms are essential to building children’s healthy brains and helping everyone in the family grow well and love well. Maternal depression, anxiety and stress can affect how a mother interacts and develops a relationship with her baby. Babies need a safe and stable connection with a caregiver for social, emotional and cognitive development. If this attachment is not strong, it can have lasting effects on a child’s brain, and puts children at risk for behavior and emotional problems.
  2. Family bonding is key to a healthy family. The good news is that there are effective ways to help caregivers bond with their children and promote a healthy relationship for the whole family. Finding joy in themselves and each other helps everyone feel loved and part of something important: their family.
  3. Help is available. If you have concerns about your relationship with your young child, contact the University of Maryland Medical Center’s Secure Starts Clinic at 410-328-3522 to make an appointment.

Dr. Edwards is the medical director of child and adolescent psychiatry services at University of Maryland Medical Center and an assistant professor of psychiatry with the University of Maryland School of Medicine. For a consultation, call 410-328-3522.

The Love Blanket Project Spreads Love Around UMCH

Love comes in many shapes and sizes, but for Robin Chiddo it’s square, 44×44 and fuzzy.

Today, Robin from the Love Blanket Project dropped off 33 custom t-shirt blankets that will be given out to children staying at the University of Maryland Children’s Hospital.

The Love Blanket Project started in 2015 when Robin, who recently retired from her position as director of business development at the UMD Alumni Association at College Park, was looking for a heartfelt gift for her sister. In her research, Robin also wanted to find a company that had a clear, mission-driven purpose—then she came across Deaf Initiatives’ Keepsake Theme Quilts (KTQ).

Deaf Initiatives is an organization that employs deaf individuals and teaches employees how to run a small business in a deaf-friendly environment. Robin and her sister loved the first quilt they received, and she started the Love Blanket Project soon after.

Robin sends donated t-shirts to KTQ, and in 4-8 weeks, she receives beautifully crafted blankets. Each blanket is gift wrapped by Robin and the Love Blanket Project team, topped with a “have a comfy day” card and donated to hospitals across the state. The Love Blanket Project has donated to University of Maryland Children’s Hospital since the organization’s beginnings.

Myracle and her mom with a new Love Blanket

Robin has no trouble finding enough shirts—between the UMD bookstore, athletics department and generous donations from Corrigan Sports and Tough Mudder, the Love Blanket Project is swimming in shirts!

So, how can you help?

Robin is always looking for volunteers to help with fundraising. Each blanket costs $110 to produce, and all money to produce the blankets comes from fundraising and donations. If you want to get in touch with the Love Blanket Project, call 202-528-2208 or email loveblanketproject@gmail.com.

Shannon Joslin (left, Child Life Manager) and Robin Chiddo with one of past years’ blankets.

Going Above and Beyond to Ease the Stress of Blood & Marrow Transplant Patients

The facility where the stem cells are stored.

The Blood and Marrow Transplant unit at the University of Maryland Medical Center was presented with a challenge in housing recovering cancer patients at the beginning of March 2017. Usually, UMMC and the BMT unit use The American Cancer Society’s Hope Lodge to provide temporary housing for out-of-town BMT patients recovering from stem cell transplants. However, building construction began across the street from the Hope Lodge, making it unsafe for recovering BMT patients to stay there. Recovering from a stem cell transplant can be physically challenging, and construction debris and dirt could compromise patients’ recuperating immune systems, impeding the healing process.

This left Majbritt Jensen, a social worker at UMMC who oversees the psycho-social aspects of BMT treatment and recovery, concerned for her recovering cancer patients. Out-of-town patients must stay within an hour of UMMC to ensure that their recovery from their stem cell transplant was successful. Without discounted housing from the Hope Lodge, these patients would need to stay at a local hotel for at least 100 days. Not all insurance policies cover lodging expenses, meaning that many patients and their caretakers would be financially responsible. Jensen and her team knew that adding a financial burden to the patients and their families during this time could complicate and stress their recovery. So Jensen, along with Bob Mitchell, Associate Director for Administration, and Stan Whitbey, Vice President of Cancer Services, searched for a solution.

The solution they found was a generous grant from the Meizlesh Memorial Fund. This grant ensures that BMT patients can be housed at hotels in close proximity to UMMC. This will make it easier for the patients to be monitored during their recovery and visit the hospital if they experience any complications. Jensen attributes the success of receiving the grant money to the hard-working team surrounding her and the patients who inspire her.

“Everyone in our unit values life and treats everyone so kindly,” says Jensen. “And, I love being there for the patients and seeing them get well. Every day I am reminded of what really matters.”

Jensen also runs a support group that aims to connect current BMT patients with those who are in recovery.

For more information, visit the Bone and Marrow Transplant Service at UMGCCC.

Maternal Mental Health Matters

MAY 3, 2017 IS WORLD MATERNAL MENTAL HEALTH AWARENESS DAY
#maternalMHmatters

Today is World Maternal Mental Health Awareness Day, and we’re helping to bring attention to an important health issue and available treatment options.

Worldwide, as many as one in five women experience some type of perinatal mood and anxiety disorder (PMAD). PMADs include postpartum depression, postpartum anxiety, postpartum obsessive compulsive disorder and others.

“There is still this myth that pregnancy is blissful and if you don’t enjoy pregnancy and having your baby, there’s something wrong with you,” says Patricia Widra, MD, assistant professor of psychiatry with the University of Maryland School of Medicine and a psychiatrist at University of Maryland Medical Center.

“But fifteen to twenty percent of women have this experience, and there are ways to treat it.”

Because of the stigma that often surrounds mental health disorders, many women hide or downplay their symptoms. Not getting support or treatment can have a devastating impact on the woman affected as well as on her partner and family. It’s important to treat a PMAD like any other health problem so that families can thrive.

“Most people don’t realize it, but post-partum depression (PPD) is the most common serious complication after delivery,” says Dr. Widra.

Women whose pregnancies end in miscarriage or stillbirth often experience not only grief but also postpartum depression. In addition, giving birth to a premature child, or having a child spend extended time in a neonatal intensive care unit (NICU) can also take a toll on a mother’s mental health.

Why is PMAD so prevalent? “We don’t know,” says Dr. Widra. “Part of it is depression in women in this age group is already more prevalent than in men anyway, even without pregnancy. Pregnancy is a major change-of-life event. Sometimes a woman doesn’t have enough social or financial support or doesn’t have a partner. Hormonal changes also have an effect – this is where a lot of current research is focusing. Somehow these shifts seem to trigger PMADs. We don’t know specifically why it happens in some people and not others.”

Symptoms of PMAD can appear any time during pregnancy and the first 12 months after childbirth. The good news is there are effective and well-researched treatment options available to help women recover.

“It’s important that a woman is medically screened for a mood or anxiety disorder at least once during her pregnancy – preferably in the second or third trimester,” says Dr. Widra. “Just as we screen women for diabetes and thyroid disorders during pregnancy, it is just as critical to screen for mood and anxiety disorders. Currently this is not the standard of care. There is a lot of push federally and in Maryland to make it the standard.”

What you can do: If you are a new mom, be aware of how you’re feeling, and seek help if you’re experiencing symptoms of PMAD. If you know someone who is a new mom, ask her how she is really feeling and encourage her to seek help if she needs it.

“Some women think that because they’re discouraged from taking most medications during pregnancy that there isn’t anything their doctor can do to help with an anxiety or mood disorder,” says Dr. Widra. This is not the case. “We now have research to show that there are non-medical treatments that are evidence-based to help women with mental health problems during pregnancy. It’s also considered relatively safe to use some antidepressants during pregnancy.” The bottom line, says Dr. Widra, is there are effective medical and non-medical treatment options available to women even during pregnancy.

Life changes around pregnancy make women more vulnerable to mental illness. Mental healthcare provides the necessary support to empower women to identify resources and personal capabilities. This can enhance their resilience to difficult life circumstances and support them to nurture their children optimally. Caring for mothers is a positive intervention for long-term social development.

Here are some mental health tips for women during their reproductive years:

  • If you are feeling blue, anxious or depressed, don’t wait. Talk to your doctor or a mental health professional about it as soon as possible.
  • If you’re taking medications for a mood or anxiety disorder and you become pregnant, don’t stop taking them without talking to a mental health professional.
  • Eating well, regular exercise, and a good night’s sleep are important during this period of your life as they are at any time in your life.
  • Do things that are good for brain health such as meditation and yoga.
  • If you have a history of depression, be proactive and aware of any signs and symptoms.

For more information or to make an appointment with a doctor who specializes in women’s emotional health and reproductive psychiatry, call 410-328-6091.

Fertility: 12 things you didn’t know (and 1 to never ask)

By Katrina Mark, MD

1. Fertility naturally declines as we age

That alone doesn’t mean you should start to worry. The general advice I give a woman is if she has been trying to become pregnant for a full year with no luck, she might consider a fertility evaluation. For a woman over age 35, she might consider it after six months. If a woman is younger and has irregular periods, it’s likely she isn’t regularly ovulating, so she might want to be evaluated sooner.

2. Sometimes there’s a reason for infertility – and sometimes, there’s not

There are some things we know cause infertility. About 20 percent of the time, we find no reason for it. For a woman, infertility can be due to a condition that causes you to not ovulate regularly such as diabetes, thyroid disease and polycystic ovaries. It can also be caused by blocked fallopian tubes or a history of ectopic pregnancy. For men, it can be due to semen issues such as a low sperm count.

Early menopause in women under the age of 40 is rare, but it can run in families and cause infertility. Lifestyle factors such as smoking and obesity contribute to infertility in both women and men.

3. Taking birth control for long periods of time does not hurt fertility

No, taking birth control stops you from getting pregnant, but it doesn’t hurt fertility once you stop taking them.

4. If you are having trouble conceiving, consider these culprits:

  • Lifestyle factors: If you smoke, try to quit. If you are obese, try to lose weight. Vigorous exercise and low body weight can also cause ovary issues. Marathon runners and gymnasts have this issue frequently. Luckily, increasing body fat percentage or decreasing exercise a small amount can often correct it.
  • Chronic conditions: If you suffer from a chronic condition such as diabetes or hypertension, make sure you are managing it and keeping it under control.
  • Ovulation issues: For women who aren’t ovulating regularly, the first line is usually Clomid, a pill that makes a woman’s body produce eggs and ovulate each month. Many OB-GYNs will prescribe this, so you don’t necessarily need to see a fertility specialist.

If there’s no known reason trouble conceiving, your OB-GYN may refer you to a fertility specialist for treatment. Fertility specialists and even some OB-GYNs perform intrauterine insemination (IUI), where sperm are placed directly in the uterus around the time the ovary releases one or more eggs to be fertilized. In vitro fertilization (IVF) is when the sperm and egg fertilize outside the woman’s body and then the fertilized egg is implanted in the uterus.

5. Your OB-GYN can often provide some fertility assistance

If a woman is trying to conceive, she should share this with her OB-GYN. If she is having trouble, an OB-GYN can provide a general evaluation to look for causes, as well as provide education, which often is very helpful.

6. Don’t worry if it’s been a month or two and you’re not pregnant

Ninety percent of couples get pregnant within a year. Don’t worry if it’s only been a few months. This is normal and usually there’s nothing wrong with you.

7. The overall rate of infertility hasn’t changed

Although more are seeking treatment. In this age, more women may be delaying fertility because of better access to education and career opportunities. The average age of a woman when she has her first child has gone up over the last few decades. Delaying childbearing increases the likelihood for a woman to experience fertility issues. There also may be more people pursuing fertility treatment now because there is better access to treatment.

8. Egg freezing is much better than it used to be

Typically, egg freezing is recommended for those who desire it when a woman is between the ages of 35 and 38. If a woman is interested in having eggs frozen, she should speak with a fertility specialist. This technology has gotten better in the last several years and there has been better success. Fertility specialists can now freeze eggs without having to fertilize them. Insurance generally doesn’t cover egg freezing unless there is a medical reason.

9. Fertility treatments have come a long way

Overall, fertility treatment has high success rates these days. In vitro fertilization (IVF) has a very high success rate. Even for women who have premature ovarian failure, which is loss of ovary function before the age of 40, can opt for a donor egg and carry a pregnancy. Sometimes it depends on what a person is willing to go through and what you can afford, although many insurances cover some fertility treatment. Most don’t cover everything and it can be expensive.

10. There are reasons not to consider fertility treatment

Some treatments can be quite expensive. Some people may have moral objections. In some cases, a woman may have a chronic condition that it wouldn’t be recommended or safe to pursue pregnancy, such as certain heart conditions. Sometimes if either partner has a genetic disorder that is hereditary, they may not want to risk passing it along to a child. If a couple chooses not to pursue fertility treatment but still wants to have children, adoption or a donor egg are also options.

11. Fertility treatments aren’t just physically demanding

They’re also mentally draining. There have been studies that have shown a woman going through fertility treatments may experience the same level of depression as someone going through cancer treatment. The psychological aspect of fertility treatments is under-recognized. We view pregnancy as a positive thing because you get a baby at the end, but fertility treatment can make a person anxious and terrified – while trying to conceive and also during pregnancy and after the baby is born. Some women are traumatized from the experience and develop an anxiety disorder. Women often go through these struggles in private because they often don’t want to tell anyone. The same is often true with miscarriages. Many women experience very real grief and depression during these times. It’s important to make sure people are getting counseling because a lot of times they aren’t even talking to their friends or family about it. If you have breast cancer, people bring you food. There is no greeting card for infertility.

12. Don’t shy away from a friend who’s having trouble conceiving

If you someone close to you who is going through fertility issues, don’t completely ignore it or become distant. Be a friend, act normal and open yourself up to the person for conversation if he or she wants to talk. A lot of times people want to talk about it but don’t know how. Give them the hope and space to talk as much or as little as they want. Everyone deals with a loss and struggles differently; some are private about it and don’t want to talk about it, but others do.

Don’t ever ask a woman when she’s going to have a baby

For someone who is going through fertility treatment, being constantly asked when they’re going to have a baby can be devastating. You don’t know what someone may be going through.

Dr. Katrina Mark is an OB-GYN at University of Maryland Medical Center and Assistant Professor of Obstetrics, Gynecology and Reproductive Sciences at the University of Maryland School of Medicine.

 

 

 

All About Infant Immunizations: Q&A with Pediatrician Dr. Adam Spanier

 

Adam Spanier, MD, PhD, MPH is an Associate Professor of Pediatrics at the University of Maryland School of Medicine and a Pediatrician with University of Maryland Medical Center.

What vaccines are recommended for infants and children?

The Centers for Disease Control and Prevention (CDC) has a group of medical and public health experts called the Advisory Committee of Immunization Practices. They develop and regularly review vaccine recommendations. Parents should talk to their pediatrician or family doctor, or reference the CDC or American Academy of Pediatrics. It’s important to know the vaccine schedule is reviewed every six months and often gets updated to reflect new evidence.

Are there any recent changes to the vaccine schedule?

In fall 2016, there was a decrease in the amount of HPV vaccine children need. The guidelines used to recommend three doses, now it’s only two. Everyone’s happy when there’s fewer shots!

Why should infants get immunized?

Vaccines protect children. They help infants develop immunity to serious diseases that we don’t want them to get. One example is polio. Because of immunization, we’ve almost wiped out polio.

Why are some parents choosing not to have their infants immunized?

My experience has been that some people don’t trust the medical system. Sometimes people read something on the Internet that wasn’t necessarily fact-based. There was a paper published in a prominent medical journal many years ago that showed an association between vaccinations and autism. But the paper was withdrawn for inaccuracies in the data and there have been many studies since that have disproven it. Unfortunately, it’s like Pandora’s Box and it is hard to put the cork back the bottle (a mixed metaphor). There is a lot of misinformation on the Internet. I always refer my patients and their families to the CDC’s vaccine information statements (VIS), which provide everything you need to know in an easy-to-digest format. We’re required to give them to parents. It’s also just good practice.

What are some of the myths out there around infant immunization?

The most common myth is that vaccines cause autism, which is false. Autism is not something that can be diagnosed at birth; the child has to show signs. Signs of autism usually start around age 1 to 2 years, which is also a period where children are receiving immunizations frequently. So parents might assume they’re related. But this possible relationship has been thoroughly evaluated and they’re not related.

Is spacing out your infant’s immunizations a good idea?

No, it’s not a good idea for a few reasons. First, there is no evidence to support changing the spacing between vaccinations. Second, it may affect a child’s response to the vaccinations. The spacing recommendations are based on medical studies with years of data behind them. The timing is important too, in order for the vaccines to be effective. And there are certain windows of exposure. For example, the Rotavirus vaccine must be given within the first four months of life; once you get past that age, you aren’t able to get it. You don’t want to miss your opportunities to prevent serious illnesses.

What if a family can’t afford to have their child vaccinated?

These days, no child should be without insurance, but even without insurance, there are places to get free vaccinations. Vaccines for Children is a program that helps doctors’ offices get free vaccines for children whose families can’t afford them. Health departments also provide free vaccines to children in need.

Is there any reason a child should not get vaccinated?

There are very few reasons why a child shouldn’t be vaccinated. Usually it is related to specific vaccines and specific health conditions. A few vaccines are live vaccines and we don’t give them to a child who is immunosuppressed. When a child is on cardiac bypass, live vaccines are not recommended. These are rare, complicated issues. Most healthy kids can and should get vaccinated.

Can a vaccine make a baby or child sick?

Some parents have this misconception. The average child gets eight to 10 colds per year, so it’s more likely the child caught a cold around the time of the shot. If you have an infant and he or she is getting vaccines every couple of months, it’s statistically likely you’ll be getting a vaccine and also happen to have a cold. The regular vaccines do not have anything in them that cause cold symptoms.

Are there any side effects to infant vaccines?

The most common side effect of a shot is a little pain and sometimes swelling at the site of the shot, or a low-grade fever. It usually only lasts a couple of days. Most of the vaccines can’t cause illness because they’re not live viruses. Only a few vaccines are live viruses, and even those are very inactive viruses so the risk of getting the actual illness is practically nonexistent and transmission to anyone else is unlikely.

What are some ways to reduce child anxiety or fear around vaccinations?

Here are some suggestions:

  • Comfort techniques, such as a position where the baby or child can be held while getting a shot
  • Numbing medication
  • Distraction techniques, such as the Buzzy®
  • Sugar water solution, such as Sweet-Ease®

Often, kids are too young to be scared. Parents on the other hand sometimes get nervous when their child needs shots. There are some children who have anxiety related to shots and often they say afterward that it was no big deal. I don’t think it’s a good idea to surprise the child, but you also don’t want to build them up too much. Explain to children that they need a shot and it’s going to keep them healthy. Some kids get anxious, but most of the time they do just fine.

What’s the bottom line?

The vaccine schedule was based on decades of scientific evidence and expert guidance.  It is not a good idea for families to try to take medical practice into their own hands by making up a new schedule. Trust your doctor – he or she has the most up-to-date medical advice. When it comes to infant immunization, the problem is if too many people don’t get vaccinated, we start to see disease outbreaks. There have been mumps and measles outbreaks – many more in recent times and it happens where people haven’t had their shots and immunization coverage isn’t as great.

To make an appointment with Dr. Spanier or one of our other pediatricians, please call 410-225-8780.  Visit our website for more information. 

Minority Health Month



By Jameson Roth, Communications Intern

Each April marks the beginning of Minority Health Month at UMMC, when we strive to celebrate and acknowledge the initiatives in place to reduce health disparities among minority groups in the greater Baltimore area. UMMC also seeks to honor the service of the individuals who work tirelessly to bring these initiatives to deserving communities across the city.

One of these hardworking individuals is Anne Williams, DNP, RN, whose current role is director of community health improvement at University of Maryland Medical Center.

Williams perfectly sums up her mission at UMMC, “I am committed to trying to decrease the levels of health disparities across West Baltimore communities.”

Thanks to the contributions of dozens of full time staff, UMMC can facilitate multiple community outreach programs designed to decrease health disparities of minority groups. These widely acclaimed programs include:

  • Stork’s Nest , a series of perinatal education classes for low-income, minority women
  • Violence Intervention Program, an R Adams Cowley Shock Trauma Center initiative that aids victims of violent injuries
  • MD Health Men program, a citywide health initiative to decrease rates of hypertension in African American males
  • Breathmobile, a custom-built asthma and allergy clinic that provides preventive asthma care to over 500 children in 2016, increasing access to critical evaluations, testing and ongoing treatment

“We are able to offer care to individuals age 2-18 at 17 schools in Baltimore,” said Lisa Bell, MSN, CPNP, AE-C, and Breathmobile nurse practitioner. “The outcomes we measure are ER visits, hospitalizations and missed schools days; all of which significantly decrease after participating in the program.”

While the Breathmobile is responsible for serving Baltimore city youth, the MD Healthy Men program, of which Williams is especially proud, is responsible for serving the population of African American adult males.

“With MD Healthy Men, 35% of the African-American men who participated decreased their blood pressure,” said Williams. “Two individuals who participated in the program were sent directly to the emergency room after evaluation because their blood pressure was so high that they were in immediate danger of experiencing major cardiac events. This program provides immediate and impactful health benefits to African-American males in West Baltimore.”

Mariellen Synan, UMMC’s Community Outreach Manager, is responsible for the coordination, staffing and operation of UMMC community health fairs. As a 34 year veteran of community outreach, Synan is regularly tasked with administering blood pressure screenings at community outreach events. One of Synan’s major upcoming events to debut in August is the back to school community health fair, designed to provide immunizations and encourage school attendance in children who attend the Samuel Coleridge Taylor Elementary and James McHenry Elementary schools in West Baltimore. This community health fair will feature fun, games and health education alongside critical vaccinations.

“With this outreach event, we hope to reach the kids before school starts so that more children are able to attend school without interruption,” said Synan. “My favorite part of my job here at UMMC is being able to make a difference in reducing unhealthy behaviors in the lives of West Baltimore residents.”

For more information on UMMC’s community outreach programs, please visit: http://www.umm.edu/about/community

Brain Injury Awareness Month

By Jameson Roth, Communications Intern

At UMMC, we recognize individuals who have experienced Traumatic Brain Injury, directly and indirectly, throughout the month of March with the acknowledgment of Brain Injury Awareness Month.

Traumatic Brain Injury (TBI) is defined as a complex injury caused by an outside force on the brain, which can result in the permanent or temporary loss of brain functions. Individuals who have survived a TBI may experience symptoms such as memory loss, impaired cognition, headaches and mood swings following their injury.

The leading causes of TBI include motor vehicle crashes, said Karen McQuillan, lead clinical nursing specialist at the R Adams Cowley Shock Trauma Center. As a 30-year veteran of trauma nursing, McQuillan has seen it all. Other causes of TBI include sports activity, physical assault, gunshot wounds, domestic violence and falls. “Falls dominate the cause category for individuals aged 65 and over for TBI,” McQuillan said.

McQuillan is an active proponent of TBI prevention tactics. To prevent TBI in individuals age 65 or older, McQuillan suggests removing floor obstacles and installing wall railings in home hallways and bathrooms. One way to prevent motor vehicle crash-related TBI is by putting a stop to distracted driving. “A motor vehicle crash is 23 times more likely while texting,” McQuillan said. For individuals who ride bikes or drive motorcycles, McQuillan suggests wearing a helmet for head protection.

While not all individuals diagnosed with TBI make a full recovery, McQuillan suggests for an optimal recovery:

  • When appropriate, formalized rehabilitation
  • Plenty of rest
  • Reliance upon a strong support system
  • Patient-specific cognition activities to help patients overcome deficits

To learn more about the R Adams Cowley Shock Trauma Center’s role in TBI recovery, please visit http://umm.edu/programs/shock-trauma/patients/survivors-network