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.

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.

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

Child Life Month

How Play is Helping UMMC’s Youngest Patients

By: Colleen Schmidt, System Communications Intern

As many parents know, the hospital can be a scary and unfamiliar place for a child. To help relax these fears, UMMC’s team of child life specialists and assistants use a variety of techniques to help children adjust to the hospital setting. Child life specialists, or CLS, aim to provide a positive and non-traumatic hospital experience for all patients at the University of Maryland Children’s Hospital.  UMMC’s Child Life team consists of six CLS and two assistants. They work in the Pediatric Progressive Care Unit (PPCU), Pediatric Intensive Care Unit (PICU) and the Pediatric ER.

Members of the Child Life Team

 

Play is one technique often used by child life team to help normalize the child’s hospital experience.  Various types of play are thoughtfully used to help children meet developmental milestones, express emotions, and understand their medical situation.  For example, during a practice called medical play, a CLS will provide their patient with a “hospital buddy” or small doll that the child can decorate. Next, with the guidance of a CLS, the child is introduced to medical equipment that they can explore and use on their new hospital buddy.  According to Aubrey Donley, a CLS at the pediatric ER, medical play is helpful in addressing misconceptions the child has about medical equipment.

“It gives them a sense of control and mastery over their hospital experience and over what they’ve been through,” she explains. Medical play empowers patients and allows them to have an active role in their hospitalization. Helping the children understand their environment lessens the chances of confusing or traumatizing them.

In addition to medical play, the child life team uses therapeutic play to help children work through a variety of issues that may accompany hospitalization. Sometimes, children who are hospitalized have experienced severe trauma. Unlike adults, children may not be able to verbalize their feelings. Play is how they express themselves and work through their experiences. For instance, one of Donley’s young patients survived a house fire and used play to understand what happened to him. “He was running around in a fireman costume pretending to put out a fire. For an onlooker, it might seem like he was just playing but we understand he is trying to make sense of the chaos and trauma that he had witnessed,” she explained. Therapeutic play can also help children who are at the hospital for long periods of time meet their physical and cognitive milestones.

With backgrounds in child development, the child life team is able to make individual plans for each child that matches their medical, physical, and emotional needs.  The team advocates for the children they support, and work with an interdisciplinary team of medical professionals to provide a comprehensive plan for that child. Child life specialists also provide educational and emotional support for families. All services provided by the child life team come at no charge to families.


For more information on our child life services please visit: http://umm.edu/programs/childrens/services/inpatient/child-life

Occupational Therapist Brings Holiday Cheer to NICU with Photo Shoot

img_9300-3Just before the holiday season, Lisa Glass, an occupational therapist in The Drs. Rouben and Violet Jiji Neonatal Intensive Care Unit (NICU) set up a Christmas photo shoot to show off the festive side of some of our tiniest patients.

Glass, who enjoys photography in her spare time, developed the idea for the photo-shoot as a “cute way to give some nice holiday photos to parents”. Since NICU babies are often among the sickest children in the hospital, and need round the clock medical care, it can be difficult for parents to appreciate the traditional joys of having a newborn. Especially during the first few critical months of life, this can include newborn pictures. Glass and her coworkers wanted to be able to “highlight how beautiful [these] babies are,” and give parents a view of their child in a more upbeat and positive light.

img_9142-3After work hours, Glass and two physical therapy coworkers in the University of Maryland Department of Rehabilitation Services, Laura Evans and Carly Funk, went from room to room, and for four and a half hours, photographed over 30 babies. Following the photography session, Glass edited her pictures, emailed them to parents, and even printed a few copies to surprise parents in their babies’ rooms. Following the photo shoot, she received many happy emails thanking her for what she had done. But for Glass, going above and beyond to show compassion and joy was an easy feat.

“For me, it was a pleasure to interact with the babies and the parents”, said Glass. “Parents are used to seeing their children as sick patients, not as beautiful babies. It’s important to see your patients not just as patients, but as people, too.”

Glass also emphasized the importance of teamwork in this endeavor.

“I wouldn’t have been able to do this without [Laura and Carly’s] help the whole way through.” This NICU trio showcases the importance of working together to bring some extra joy to UMMC.

Glass’ photography serves as a great reminder to see patients as the people they are, and not simply for the medical treatment they are receiving. Although these babies may have breathing tubes and cords surrounding them, they are also enveloped in a multitude of love and support.

trilpets-single-photos



UMMC Hosts Paintfest America

By Kirsten Bannan, System Communications Intern

For patients diagnosed with cancer, treatment may mean having surgery, chemotherapy and radiation, or a combination of all three. But, cancer patients at the University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center (UMGCCC) recently were treated to another type of therapy — one that indulged their inner artist and helped them step away from their illness for a moment.

The UMGCCC hosted a PaintFest America event July 7, and dozens of patients, staff members and family members spent the morning painting colorful canvas murals set up on tables in two locations in the cancer center. Several patients who weren’t able to join in the group activity even had the opportunity to paint in their hospital rooms.

The Foundation for Hospital Art is bringing PaintFest to cancer centers in every state as part of a 50day national tour that will end in New York City August 23. The nonprofit organization’s goal is to bring together families, patients and staff at cancer facilities in each state though art. “Paintfest America was nothing short of fabulous,” says Madison Friz, a 16-year-old leukemia patient who took part in the UMGCCC event after a week-long hospital stay. “As a cancer patient, it feels really good to know there are people out there in this world who care about you. To leave my hospital room to paint a picture and forget my sickness is a feeling I can’t even describe.”

UMGCCC was the only stop in Maryland on the tour, and Madison was chosen to help paint the state’s panel featuring a Baltimore oriole and a black-eyed Susan. All of the state panels will be assembled into a 10- by-15-foot mural on the final day of the tour and then returned to the hospitals where they were painted.

One of the volunteers, Morgan Feight, whose grandfather John Feight started the Foundation for Hospital Art, says that artwork provides a welcome distraction to patients and family members once the art is mounted on the walls.”

“Oftentimes, patients view hospitals as drab, starkly sterile buildings. By hanging vibrant murals throughout the hallways, we hope to change patients’ perspective and give them a sense of rejuvenating joy and hope as they stare at the designs,” she says.

Peggy Torr, a UMGCC nurse for more than 30 years, says patients were excited to take up paintbrushes and paint to participate in this event. “They were a part of something much bigger for the moment – an opportunity to calm the spirit and fuel the soul. It was palpable!”

She adds, “As healthcare professionals, we can be so task-oriented that having the opportunity to do something for our patients, instead of to them, was just amazing.”

Taking Treatment & a Half Marathon, Together, One Step at A Time

The relationship between a cancer patient and their care provider is a special one.  Between radiation therapy appointments, hours of chemotherapy, and even sometimes surgery and recovery, there’s not much that can strengthen this bond, besides running a half marathon.

Dana and Tiffani

But Tiffani Tyer, a nurse practitioner in Radiation Oncology at the University of Maryland Greenebaum Comprehensive Cancer Center (UMGCCC), and Dana Deighton’s journey started long before this year’s Maryland Half Marathon & 5K.

About 3 years ago Dana was diagnosed with stage IV esophageal cancer.  At 43 years old with 3 young children, it was, in Dana’s words, “unfathomable.” She traveled up and down the East Coast looking for a treatment plan that would give her the most hope. Many acted like she was naïve and unrealistic for even seeking out treatments beyond palliative chemotherapy.

After much deliberation, Dana settled on a plan of 8 cycles of chemotherapy at one local hospital. During this treatment, a friend introduced Dana to Mohan Suntha, MD, a radiation oncologist at UMGCCC.

Within an hour of getting Dana’s information, Dr. Suntha gave her a call. While he agreed the appropriate preliminary step was chemotherapy, he did not close the door on her like many others.  Dr. Suntha and Dana continued to check in with each other throughout her chemotherapy treatments to see how things were going.

In December 2013, after Dana finished chemotherapy, she learned she would not be considered for radiation or surgery by the hospital where she was initially treated. She was told that the data did not support it. She was devastated. Dana returned to UMGCCC, where Dr. Suntha and Tiffani were always willing to reassess her situation and provide guidance when obstacles seemed insurmountable.  Knowing that every case is different, he agreed to reevaluate her.

tiffani dana and dr sunthaAfter careful consideration and determining that her distant disease had indeed resolved, he offered her local treatment with chemotherapy and radiation targeting the primary site in her esophagus.  While the local treatment helped, the primary site still showed evidence of persistent disease at the end of her treatment.  To try to avoid major thoracic surgery, an endoscopic mucosal resection was attempted, but was unfortunately unsuccessful. Dana was again devastated. She felt like it was just another blow to her journey to health and she was running out of options.

Dr. Suntha and Tiffani encouraged Dana to stay hopeful. They agreed along with many other providers that indeed she was in a difficult position. After many tumor board discussions and repeat imaging studies to confirm her extent of local disease thoracic surgeon Whitney Burrows, MD, was consulted. He discussed surgical salvage to address her only site of cancer.  Albeit risky, with no guarantee of a survival benefit, it was her only remaining local treatment option.  Recognized as a long shot with a real possibility of acute complications related to such a long and complicated surgery, she willingly consented to undergo the esophagectomy. From Dana’s view the benefit far outweighed the risk. She believed in her team and her surgeon, whose expertise is well established in post chemoradiation patients. It proved to be a good choice and offered a huge reward.  Dana recovered well and was cancer free and feeling great–until July 2015.

It was then that a routine interval scan revealed a new lymph node mass in her Axilla (near the armpit) was biopsied and confirmed to be recurrent esophageal cancer.  Dana had resigned herself to more draining rounds of chemotherapy after another surgery could not remove all of the cancer.  But again, Dr. Suntha, Tiffani, and medical oncologist, Dan Zandberg, MD, always made sure all options were presented and considered.

tiffani zandberg and sunthaDana’s case was represented to  their colleagues at a tumor board meeting on the Friday before she was supposed to start chemotherapy.  Drs. Suntha and  Zandberg called her that evening to  recommend  immunotherapy, which harnesses the power of a  patient’s immune system to fight cancer.  After a sleepless night, Dana agreed.   She now receives treatments of Nivolumab every 2 weeks for at least a year.

Dr. Suntha has always recognized that there’s something unusual about Dana’s case, and has often asked, “Is there something different about her biology? We don’t know.”

Dr. Suntha, he also believes that Dana’s strong will and clear ability to advocate for herself has facilitated part of the success of her care.

dana and tiffaniThroughout these three years, Dana describes herself as lucky enough to continue her usual regimen of walking, running, and exercising consistently.  She donated money to the Maryland Half Marathon & 5K to fund cancer research in the past, but feeling much healthier and up to a new challenge, she promised to run it in 2016. She has always ran 10 milers in her hometown of Alexandria, Virginia, but knew those 3 extra miles of hills in the Half Marathon would be challenging.
Despite her reservations, in a partnership with Tiffani, the Radiation Oncology Greene Street Dream Team was born. On May 14th, Tiffani and Dana ran the entire race together (even though, according to Dana, Tiffani could’ve run circles around her).  To date, they’ve raised more than $10,000. They’ve taken every step together in cancer treatment and every step in the half marathon & 5K – a true bond that will continue.

Fundraising for the Maryland Half Marathon and 5K that supports this Radiation Oncology Dream Team and their patients continues until June 30th.

You can donate to Tiffani & Dana’s team here.

Pediatric Residents at Univeristy of Maryland Reach Out and Read

A string of rainy days in Baltimore made Friday the perfect day to stay inside and read a good book. And thanks to the efforts of some hard-working Pediatric Residents at the University of Maryland School of Medicine, more than 200 students in Baltimore City had a new story to read!

Throughout the morning, the pediatricians-to-be visited several schools in the University of Maryland Children’s Hospital community, including James McHenry Elementary-Middle School and Franklin Square Elementary in West Baltimore. They spent time interacting with the students, with the hopes of promoting a healthy attitude toward development and literacy at a young age.

James McHenry students had a special visitor: Baltimore City Council President Jack Young handed out books and spent time reading to four classrooms of Pre-K and Kindergarten students.

The Maryland Book Bank and the Maryland Chapter of the American Academy of Pediatrics donated the 200 books that went home with students.

The day of reading was a part of a nationwide “ROAR: Reach Out and Read” effort, which is a non-profit that works to incorporate books and literacy into pediatric care.

Friday was also designated as a “Call to Action” Day by the American Academy of Pediatrics to F.A.C.E Poverty: promote Food Security, Access to Health Care, Community, and Education.

Celebrating Unsung Superheroes: Social Workers

By: Allie Ondrejcak, Communications Intern

“Never be afraid to do what’s right, especially if the health and happiness of another person or an animal is at stake. The punishments of the society are small compared to the damage we inflict on our soul when we look the other way and do nothing.” – Martin Luther King, Jr.

The profession of social work follows this mission: enhance human well-being and help people meet their basic human needs—particularly the needs and empowerment of people who are vulnerable, oppressed or living in poverty. At the University of Maryland Medical Center, this population is served by the Department of Social Work. The Department helps patients with complex psychosocial needs such as: lack of resources, limited family support, communication barriers or maladjustment to illness. The Department of Social Work believes that recognizing the relationship between social and emotional factors is an important aspect of helping patients. And, because they are aware of the relationship, they are able to understand how it impacts illness.social-work-7

Here at UMMC, social work has been an integral part of the care system since the early 20th century! The first Department of Social Work at the University Hospital was established in 1919. At that time the Department saw every patient who came to the hospital as they were admitted and they provided follow-up and home visits to all patients after discharge. These measures helped to prevent recurrence of illness and readmission to the hospital. Over the years, the Department grew to include teaching programs, casework discussions, community outreach and hospital-wide policies and procedures. Today, the Department is committed to promoting education, professional development and research, all of which are part of the commitment to excellence in medical social work. The Department of Social Work also oversees Palliative Care, Pastoral Care Services and the Patient Advocacy Department at UMMC.

I spoke with UMMC’s Social Work Manager, Catherine Miller, LCSW-C, and asked her to give me a closer look at the department. Here is an overview of what they do and why they are special:

  • Social workers at UMMC start their days at 9:00AM—often much earlier—with Interdisciplinary Rounds (social workers, doctors and nurses use their clinical expertise to coordinate patient care and discuss patients’ discharge). During these rounds, social workers meet with patients and families to prepare for discharge and to assess psychosocial barriers for a patient’s discharge. Oftentimes, social workers work with the outpatient population as well.
  • In addition to the complex needs of patients in hospitals and the psychological impact of hospitalization and injury, medical social workers have to know about all other facets of social work, such as family, community and child social work. These professionals have to work extremely fast to build relationships with patients because they may only get to meet with them a few times, sometimes less!

Ms. Miller explained that being a social worker at UMMC is very rewarding because they are able to help patients and family work through the most important events in their lives—from the joys of birth to the sorrows of death.

The Department is full of dedicated professionals but Ms. Miller wants to recognize a few “shining stars!”

  • Iris Smith—retiring in March after 45 YEARS of Social Work service at UMMC!
    • She was here when the first patient with HIV was treated at UMMC
    • Smith also was here during the Civil Rights movement
  • Justin Perry, Shannon Mullins and Crystal Johnson who have been vital in assisting with the Department’s restructuring with Care Management.
  • Kathy Klein, Chelsea Needle and Carlyn Mast, three social workers who worked very hard to plan the department’s first Social Work Month and organized an information booth at the hospital.

These amazing staff members are part of an equally amazing team. I know first-hand that social workers are passionate, committed and often underappreciated professionals. Social work is dear to my heart because my sister, a licensed clinical social worker, has dedicated her life to helping those who need it most. My sUM_School_SocialWork_RGB_webister earned her degree from the University of Maryland School of Social Work and has worked as a child and family therapist for a non-profit organization and as a Child Protective Services agent. She is now a Behavioral Health Case Manager for a hospital and works with their Outpatient Program. The passion she has for helping those who are too vulnerable to help themselves and her commitment to fairness and justice is so apparent. These values are in the hearts of all dedicated social workers and the world needs more people like this! Our Social Workers here at UMMC exemplify these traits every day in their work with patients and families.

You can reach the UMMC Department of Social Work at 410-328-6700 their hours of operation are Monday-Friday, 8:00 am – 4:30 pm. The Department also provides after-hour referrals, weekend in-house coverage in Shock Trauma and both the Adult and Pediatric Emergency Departments and on-call service.

Thank you to all social workers and a special thank you to our very own social workers at UMMC for all that you do! The world is a better place because of you!

Ear, Nose & Throat Team Returns from Medical Mission after Cyclone Winston Rocks Fiji


A 12-person team of nurses, surgeons, residents and anesthesiologists from the University of Maryland Medical Center have returned from their medical mission in Fiji.   Team members performed 15 surgeries and saw 150 patients before Tropical Cyclone Winston rocked the islands.   Watch the video above to hear about the mission from the team themselves.