Benefits of a Certified Athletic Trainer On & Off the Field

University of Maryland’s Department of Orthopaedics provides state-of-the-art sports medicine care to athletes and active individuals of all ages on and off the field. Our sports medicine physicians and orthopaedic residents work directly with many of the athletic trainers in Baltimore County, Howard County, and Baltimore City to ensure the same level of care offered to the University of Maryland Terp athletes.

Michael Smuda, MSAT, ATC, LAT is a certified atheltic trainer/physician extender with the University of Maryland Orthopaedics.  As fall sports are getting in full swing, he explains how an athletic trainer can keep athletes of all ages at their best.

 

 

Q: What is an Athletic Trainer (ATC) and what can they do?

A: An Athletic Trainer, or ATC, is a multi-skilled healthcare professional that provides medical services and treatment under the direction or collaboration of a physician within their state statutes. Treatments includes injury prevention, emergent care, clinical evaluation of injuries, therapeutic intervention, and rehabilitation of injuries and medical conditions.

Q: Where do Athletic Trainers work?

A: Athletic Trainers are currently working within several different settings.  They can be found working in educational institutions like high schools and colleges where they provide support for all of the student athletes at their respective institutions.  ATCs can also work along physicians in the clinical setting, acting as physician extenders to improve the efficiency and flow of clinic, as well as acting as patient liaisons managing post-operative care. They are also working with the military and with other first responders to help keep them safe on and off duty. Additionally, Athletic Trainers work with all professional sports teams and are also working within the performing arts.

University of Maryland Athletic Trainers, along with our physicians, currently serve as the official medical provider of the Terps, and support Howard County Public Schools’ sports teams, in addition to providing care in the clinical setting.

Q: Why are Athletic Trainers important?

A: Athletic Trainers are the ones who quickly respond to injuries on the field or in the workplace, and have the knowledge base to appropriately treat critical injuries.  ATCs develop rehab and injury prevention programs for athletes and weekend warriors to ensure proper movement mechanics and proper form during sport and activity. They are able to diagnosis concussions and know the steps to follow to get that person back to activity.

The American Academy of Pediatrics demonstrated that having an Athletic Trainer available for student athletes helped lower injury rates, provide more precise and accurate evaluations and proper return to play outlines for concussions and other injuries.

Q: Are Athletic Trainers and personal trainers the same thing?

A: No, Athletic Trainers and personal trainers are not the same role. An Athletic Trainer needs to graduate from an accredited Athletic Training program and take a board exam in order to treat patients. While there is some overlap with the sports performance aspect of each job, Athletic Trainers have a wider scope to their practice, and personal trainers are focused on improving physical fitness and wellness in the lay population.

For more information about University of Maryland Orthopaedics or to schedule an appointment, call 410-448-6400 or click here.

Setting Families Up for Breastfeeding Success

Every day, at 9 am and 9 pm, the nurses on the mother/baby unit at the University of Maryland Medical Center (UMMC) huddle for what they call the “Milk Minute.” They gather to exchange breastfeeding tips and other helpful information. This quick, daily training encourages communication between day and night shift staff, and keeps breastfeeding best practices top of mind.

Why the emphasis on breastfeeding? It can significantly reduce infant mortality rates, as well as childhood obesity and related chronic diseases in adulthood.

Based on research, staff has worked to modify practices in order to change the breastfeeding culture.  Why? Clinical practices and processes have evolved to promote success in infant/mom bonding and breastfeeding. This includes skin-to-skin contact, rooming in, and educating moms on baby’s feeding cues.

Here are some changes you may notice:

OLD WAY BABY-FRIENDLY WAY
Historically, it had been standard practice for newborns to receive a lot of their care in the nursery – away from their mothers. This practice unintentionally created a barrier to breastfeeding and newborn care education. Babies spend as much time as possible with their mothers. In fact, within five minutes of delivery, the infant is placed on the mother’s chest. After delivery, mom and baby are transferred to the mother-baby unit and room in together. Almost all of baby’s tests and procedures happen at the mother’s bedside.
OLD WAY BABY-FRIENDLY WAY
During daily rounds, the mother-baby care team used to bring all the babies into the nursery (away from their mothers) for assessment. If the babies cried, they would be given pacifiers. The care team visits each mother and baby in their hospital room and exams take place there with mom and other family members present. This process takes longer, but allows for better dialogue and education.
OLD WAY BABY-FRIENDLY WAY
All staff members had basic breastfeeding training. Lactation consultants were called in to visit breastfeeding mothers while in the hospital. All staff members have received additional education and are considered breastfeeding experts. They are equipped to provide moms with 24/7 breastfeeding education and support. Lactation consultants are still available for moms who need more intensive support.

New parents are often worried about whether their babies are getting enough to eat during breastfeeding. Staff use the picture chart below to help parents understand that newborns have tiny stomachs and that breastfeeding allows them to naturally stop eating when satisfied.

 

 

 

 

 

 

 

 

Breastfeeding success starts even before baby is born. Doctors discuss infant-feeding choices with moms-to-be during their prenatal care appointments. UMMC offers free breastfeeding classes for women receiving prenatal care at University of Maryland Redwood office, Penn St. office, Edmonson office, or Family Medicine. Once at the hospital for delivery, mothers continue learning about the benefits of breastfeeding from nurses.

A breastfeeding support group is also available so women have the opportunity to discuss any challenges they’re having with a breastfeeding expert. The support group meets every Thursday from noon to 1 pm at 29 S. Paca St. Moms can also get breastfeeding help by calling the UMMC Warmline at 410-328-3512 or emailing their questions to lactationsupport@umm.edu.

The Stork’s Nest, sponsored by the March of Dimes and Zeta Phi Beta, is a program that provides education to moms living in West Baltimore. Mothers are awarded points when they attend classes, attend prenatal care appointments and adopt healthy behaviors like breastfeeding. The points can be used toward baby items such as diapers, a playpen, a breast pump, and more.

Learn more about breastfeeding.

Sofia’s Lemonade Stand

Sofia Joslin, a seven year Patterson Park native and daughter of child life manager Shannon Joslin, has raised an incredible amount of money to support the University of Maryland Children’s Hospital. Sofia decided that the day her neighborhood was having a large scale yard sale day (3 blocks long), she would use the opportunity to help give back to kids who may not be as fortunate as herself.

Sofia (left) and her friend pose with their lemonade stand they used for their donation to UMCH

From there, Sofia gathered up her friends and they began to play a part in the process as well. Sofia and her friends sold all of their lemonade and raised $250 which made all the effort she put in a positive experience.

After the fundraiser’s huge success, Sofia was determined to donate toys  of all different diversities to the Children’s Hospital.

She sought help from her parents who were quick to remind her there are all types of kids at the hospital: she needed to find toys that both girls and boys of different ages would like. The family headed to Target to maximize the most they could out of $250.

Staying true to her word Sofia went shopping and stuck to the basics. She set out to get dolls, craft kits amongst other items for girls, and Legos and cars for the boys.

After Sofia and her family purchased the toys, they were collected in UMCH’s red wagon and transported to the hospital. Sofia got to see her work go full circle when her parents took her down to the hospital to deliver the toys in person.

Following such a positive turn out, Sofia’s neighborhood wants to ensure that this is not a one-time donation. Inspired by the children’s involvement and by UMCH’s great care, adults in the neighborhood would like to make this a tradition and make even bigger donations going forward.

Many thanks to Sofia, her family and neighbors! Your continued support of the Children’s Hospital ensures we have the resources available to make every patient’s stay comfortable and fun.

 

Learn more about the Child Life Program and meet the team.  http://www.umm.edu/childlife

Interested in giving to the Children’s Hospital? Here’s how you can help. http://www.umm.edu/programs/childrens/services/child-life/how-to-help

 

 

Where to go During an Emergency

Asthma attacks. Broken bones. Dehydration. Ear infections. Irregular heartbeat. Infectious diseases. Uncontrollable vomiting. This is a short list of the medical problems that are handled each year in the Pediatric Emergency Department at the University of Maryland Children’s Hospital.

Children and adults have different needs. This is why the University of Maryland Children’s Hospital has an exclusively pediatric emergency department staffed by highly experienced nurses and health care professionals trained to put children at ease. What makes this pediatric emergency department unique is the access to a large network of pediatric specialists who make up the Children’s Hospital. We are a resource for other physicians. When a case is very complicated, we are often called to help diagnose or treat complex problems. We pride ourselves on delivering care and compassion that can only come from an institution with a primary focus on providing the highest quality of care to children and their families.

Because we have access to specialists in more than 20 areas of pediatric medicine, we provide the most advanced care. The Pediatric Asthma Program is one example of how patients benefit from the close collaboration of physicians in the emergency department and other specialties. This asthma program, which is the first of its kind in the region to be awarded the Joint Commission’s Disease-Specific Certification, assures that children admitted to the emergency department not only leave breathing easier – they are also given the tools, knowledge and medication to improve their long-term asthma control.

During a medical emergency, there is little time to consider where to take your sick child. Remember the University of Maryland Children’s Hospital is here for you and your family.

Learn more about the University of Maryland Children’s Hospital by visiting www.umm.edu/pediatrics.

Men’s Health Month: Getting Back to the Basics

You know the type. The macho guy who’s rough, tough, go-it-alone, leader-of-the-pack, help-not-wanted. Macho man may put off seeing a doctor for a checkup – because he thinks he’s invincible, doesn’t get sick, it’s a waste of time, only for the weak.

Physicians at the University of Maryland Medical Center say some men only give in when they have symptoms, when major treatments are required, or when preventive steps are more demanding. Even so, it’s never too late to start on the road to health.

June, Men’s Health Month, is a great time to focus on preventable health problems and encourage early detection and treatment of disease among men of all ages.

So, you’re out of shape?

Heart disease kills 1 in every 4 men in the US. One clue to heart health is endurance. Can you walk up two flights of stairs or four city blocks without stopping (barring traffic lights, etc.), or has there been a change in your activity level over the past 6-12 months? A man may shrug off the changes and blame them on being “out of shape,” but these changes could signal changes in heart health, says Michael Miller, MD, professor of cardiovascular medicine, epidemiology and public health at the University of Maryland School of Medicine and director, Center for Preventive Cardiology at the University of Maryland Medical Center.

Dr. Miller: “If the answer to both questions is ‘no’ (presuming they have no other limitations such as joint disability, emphysema, etc.), then their heart is considered to be in reasonably good shape and no further workup is usually necessary.  If the answer to either question is ‘yes,’ then further questioning and/or workup is indicated.”

The paunch and the pound

Dr. Miller: “I ask men what their weight and waist size was when they considered themselves to be in good physical health (often in their early-to-mid-20s). If either their current weight or waist size exceeds 10 pounds or 2 inches, the risk of Type 2 diabetes and heart disease begins to increase.  After checking for the major cardiovascular risk factors (cigarette smoking, high blood pressure, high cholesterol, diabetes), we make recommendations aimed at improving their cardiovascular health.”

Recommendations: Eat a big breakfast or lunch with a light dinner, have a snack between meals, take a walk after dinner, and relax 30-60 minutes before bedtime to increase the odds of getting at least seven hours of uninterrupted sleep.

All or nothing

Diabetes in men jumped 177 percent in the US from 1980-2014, fueled in part by weight gain and obesity. Shedding the pounds is often a struggle, but If your ideal, normal body weight is 180 pounds, and you’re 300, it may be unrealistic to set a goal of getting back to 180, says diabetes expert Kashif M. Munir, MD, assistant professor of medicine at the University of Maryland School of Medicine and medical director of the University of Maryland Center for Diabetes and Endocrinology.

Dr. Munir: “Of course, getting back to 180 is worth striving for, but to make differences that affect your risk for diabetes and heart disease, we’ve shown in studies that if you lose just five or 10 percent of your body weight, you can reduce those risks in a big way and improve your overall health, often within weeks.”

Exercise snacks. Diet is the main mechanism for losing weight, but the other side of the equation is exercise and doing more.

Dr. Munir: “What I tell people is to take exercise snacks. Instead of snacking on peanuts or cookies or whatever, do a 5-10 minute moderate-to-high-intensity workout. And if you can do that several times per day, all the better. Most people can spare 5-10 minutes here and there, so I tell people in the morning before you go to work, do a quick 5-minute jog, or something like that. At work, if you have a lunch break, go out for a walk, or get in some activity, and in the evening try to do the same thing.”

Lung Cancer: Put out the fire before it starts

Lung cancer is the leading cause of cancer death in Maryland men, yet men tend to wait longer to seek medical treatment for the condition than women, says Gavin L. Henry, MD, assistant professor of surgery at the University of Maryland School of Medicine and thoracic surgeon at the University of Maryland Medical Center.

Dr. Henry: “Many men who are referred to us have symptoms, but the referral is often a good sign because it likely means the cancer is in an early stage when there’s time to take action. As surgeons, we always say ‘the chance to cut is the chance to cure.’”

Annual lung cancer screening. Low-dose screening CT scans have become the standard for detecting early lung cancer.

Dr. Henry: “We recommend that men get a primary care physician, get regular checkups and screening, especially for men ages 55-70 with a significant history of smoking, (greater than 30 packs of cigarettes a year), and those with a family history of lung cancer.

Quit smoking. 80-90 percent of patients with lung cancer have a history of smoking.

Henry: “If a man is a smoker, the best thing he can do for himself is to quit. Many of my patients know smoking is bad for them. But it’s tough, it’s a habit. We recognize it’s a struggle, and we try to help with a variety of smoking cessation tools and techniques.

A man’s a man, and all that

Prostate cancer, the second leading cause of cancer death in Maryland men after lung cancer, is one of three major issues in urology for men, including sexual dysfunction and prostate enlargement, also known as BPH. “These three areas can disrupt men’s lives significantly; the incidence really starts to go up when men are in their 50s-60s-70s,” says Michael J. Naslund, MD, professor of surgery and chief of the Division of Urology at the University of Maryland School of Medicine and director of the Maryland Prostate Center.

Prostate cancer:  Cancerous cells develop in the prostate, one of the male sex glands. There’s not good data on preventing prostate cancer, and since there are no specific signs or symptoms, screening is the best way to detect it early. If it’s found, there are many treatment options, depending on health, age, expected life span, personal preferences, state and grade of cancer and the anticipated effects of treatment.

Dr. Naslund:  “When a man gets to age 50, he should be getting prostate cancer screening that includes a rectal exam and PSA blood test once a year, along with a blood and urine check. If there’s anything abnormal, then he’ll need further testing.”

Sexual dysfunction: It usually takes the form of erectile dysfunction, the inability to sustain or maintain an erection.

Dr. Naslund: “There are many things a man can do to prevent sexual dysfunction: maintaining good physical shape, not gaining a lot of weight will lower the risk of getting sexual dysfunction later in life. Not smoking is key: that helps prevents all kinds of vascular disease including erectile dysfunction. Eating smart, exercise, don’t smoke are the things men can do. Those three benefit men in a lot of other ways as well. As for treatment, pills are the first option and probably solve the problem three times out of four.”

Prostate enlargement (BPH): Partially block the bladder, resulting in a weak stream of urine and frequent urination

Dr. Naslund:  “Virtually all men get prostate enlargement, when compared to young men in their 20s. I would estimate that half of men don’t have any effects from it. They urinate normally and it never becomes an issue. Men often ignore symptoms and may not realize that treatment, if required, is less invasive with fewer side effects than it used to be.”

 

What Parents Need to Know About Dry Drowning

Dr. Christian Wright is an Assistant Professor of Pediatrics at the University of Maryland School of Medicine and specializes in pediatric emergency medicine at the University of Maryland Children’s Hospital. Below he answers everything parents need to know about “dry drowning.”

What is dry drowning?

“Dry drowning” is actually an outdated term. These days, research and health organizations prefer to simply define drowning as a process where being submerged or immersed in liquid leads to respiratory impairment—that is, difficulty breathing. Drowning can be fatal or nonfatal. Sometimes a person can develop difficulty breathing after they have left the water, sometimes even hours later, and sadly there have been cases when children have died of drowning hours after being exposed to water.

In the media, a distinction is often made between “dry drowning” and “secondary drowning.” Again, these are outdated terms, but they do attempt to explain two physiological processes that occur in drowning.

When water is inhaled, it causes a spasm of the airways which causes them to close, which makes it difficult to breathe. This usually happens right after the water has been inhaled, so the person could still be in the water or they could have just left it. In the past, it was thought that in this way a person could drown without water entering the lungs, so this was called “dry drowning.” In reality, though, water enters the lungs in almost every drowning death.

When water gets into the lungs, it interferes with our lungs’ ability to exchange oxygen and carbon dioxide, so oxygen levels in the body drop. Water also washes out surfactant, which is a substance in our lungs that prevents the small air sacs (alveoli) from collapsing when we exhale. This leads to pulmonary edema, or a buildup of fluid in the lungs, and difficulty breathing. A child could develop these symptoms up to 24 hours after exposure to water, and in rare cases this results in death. This has been referred to as “secondary drowning,” though it is really just the culmination of the drowning that started when the child was in the water.

How common is it?

“Secondary drowning” is rare, so there aren’t good statistics about how frequently it happens.

What are the symptoms?

Any time water enters our airway, our body has reflexes that kick in to clear the water. So a child could have coughing, gagging or difficulty breathing. Usually, this is sufficient to clear the airway. However, if water got into the lungs, the child could develop symptoms hours later. These include coughing, difficulty breathing, chest pain, vomiting, irritability or fatigue.

How does someone become a victim of dry drowning?

Any time water is inhaled, it could cause delayed symptoms. This could be after swimming or bathing or even after a short exposure to water like being dunked or the face being submerged in a puddle.

How’s it treated?

Drownings are treated by monitoring lung function and treating as necessary. A patient without symptoms may only need to be monitored. Patients with symptoms will need to have their lung functions monitored and supported. They might need supplemental oxygen, noninvasive forms of ventilation like CPAP, or a breathing tube may need to be placed. These patients will need to be monitored until their symptoms go away and their lungs are working normally again.

What’s the best way to prevent dry drowning?

The best way to prevent “dry drowning” is to exercise good water safety principles, including the following:

  • All children should be closely watched whenever they are are in or near water. Never leave children unattended near water.
  • Swim where there is a lifeguard, but don’t rely on the lifeguard alone to watch your child—continue to closely monitor your child.
  • Make sure pools are properly fenced and guarded. Fences should completely surround the pool area, be at least 4 feet tall, and gates should be self-closing and self-latching.
  • Teach teenagers the dangers of drinking alcohol while engaging in water activities.
  • Teach children to not roughhouse in the water
  • Enroll children in swimming lessons as early as possible
  • Have young or inexperienced swimmers wear U.S. Coast Guard-approved life jackets
  • Learn CPR

To learn more about Pediatric Emergency Medicine at the Universtiy of Maryland Children’s Hospital, please click here.

Summer Safety: How to Treat Your Child’s Cuts and Scrapes

More outdoor playtime usually brings more cuts and scrapes for kids. Here are some tips from the experts at the University of Maryland Children’s Hospital on the best way to treat your child.

What’s the best way to treat a small cut or scrape?

If the wound is bleeding, keep the area elevated and apply pressure to the site with a clean cloth or gauze. Most minor wounds will stop bleeding in about 5 to 10 minutes. Continue to hold pressure until the bleeding stops.

After the bleeding stops, wash the wound with lots of water. Soaking the wound in water can be helpful if there is dirt or other debris in the wound. You can use mild soap to clean the wound but don’t use rubbing alcohol or hydrogen peroxide —they irritate the tissue in the wound, which causes pain.

After cleaning the wound, apply antibacterial ointment and cover it with a clean dressing.

How do I know if my child needs stitches?

Here are some examples of wounds that probably require stitches:

  • Cuts that go all the way through the skin
  • Cuts with visible fat (yellow) or muscle (dark red)
  • Cuts that are gaping open
  • Cuts longer than half an inch. Note that smaller cuts can often benefit from butterfly closures or skin glue

Your doctor can examine the wound and help decide the best way to close it.

What is the process for getting stitches?

Getting stitches can be scary for children, but there are many ways to make the experience easier. These include numbing the area, distracting and coaching the child, and giving medications to decrease the child’s anxiety or even help them sleep through the procedure.

There are two options for stitches: absorbable and non-absorbable sutures. Absorbable sutures don’t need to be removed. Non-absorbable sutures need to be removed; how long they stay in depends on where the wound is, so your doctor will tell you when to come back to have them taken out.

What other options will a doctor use to close a cut?

  • Skin glue is helpful for minor cuts. It is applied to the cut while the cut is held closed and allowed to dry. Skin glue is not as strong as stitches, so it is not good for cuts that are under tension from a nearby muscle. But when the cut can be appropriately closed with skin glue, the cosmetic result can be just as good as with stitches.
  • Butterfly closures are narrow adhesive strips that are placed across a cut to keep it closed. They are helpful for small cuts or areas over joints. They aren’t as strong as stitches and can fall off early. Stitches provide a strong closure for wounds and almost always stay in place until they are removed.
  • Staples are a fast way to close certain wounds. In children, they are used most often to close cuts on the scalp.

How soon does my child need to see their doctor for stitches?

While it’s ideal to close the wound as soon as possible after an injury, wounds up to 8 hours old can still be closed. Some wounds can be closed up to 24 hours after the injury.

How can I make my child’s scar less visible?

While your child’s skin won’t look exactly the same as it did before the injury, there are some steps you can take to make the scar less visible. Sunlight can make the scar turn dark, so protect the scar from the sun by covering it with a hat, clothing or sunscreen. You can also massage the scar or apply silicone scar sheets.

For more information, visit umm.edu/childrens.

To make an appointment at one of our locations, call 410-328-6749.

Summer Safety: How to Treat Your Child’s Sunburn

Pool time and outdoor play may increase your child’s chance for developing sunburn. Here are some tips from the experts at the University of Maryland Children’s Hospital on the best way to treat your child.

What causes sunburn?

Sunburn appears within 6 to 12 hours after the skin is exposed to ultraviolet (UV) rays from the sun. Artificial light sources like sun lamps and tanning beds can also cause sunburns. The skin becomes red and painful, and swelling of the skin, tenderness and blisters can develop. Severe sunburn can also cause nausea, chills and malaise (“feeling sick”). The burned area remains red and painful for a few days. Later, peeling may occur as the skin heals.

What are the risks of sunburn?

Exposure to the sun can harm children even when they don’t get sunburn. Over the years, the effects of sun exposure build up and can lead to wrinkles, freckles, tough skin and even skin cancer later in life. Some medications and medical conditions can also make people more sensitive to sunlight. Since people get most of their sun exposure as children, it’s important to teach children sun safety early on so they can be protected from these problems in the future.

Sunlight contains both UVA and UVB rays. UVB rays cause sunburn. However, UVA rays also cause damage in the long run, including skin cancer. Since tanning beds use UVA light, they aren’t healthy and should be avoided.

How is sunburn treated?

If your child has sunburn, he or she should stay out of the sun until the burn has healed completely. Once it’s healed, be sure your child is wearing sun protection, including sunscreen, before going out in the sun again.

You can control pain from sunburn by applying cool washcloths to the area. Over-the-counter sunburn sprays that contain numbing medications like benzocaine or lidocaine can help, although they may also cause irritation to the skin. You can give anti-inflammatory medications like ibuprofen by mouth to help with the pain. As the burn heals, apply a moisturizing lotion. Products that contain aloe vera can be helpful in soothing the skin.

How is sunburn prevented?

The sun doesn’t need to be shining brightly to be dangerous. Children can be exposed to UV rays even on foggy or hazy days, and exposure is greater at higher altitudes or when UV rays are reflected off of water, snow, sand, or other surfaces. UV rays are strongest when the sun is the most intense, so try to keep your child out of the sun between 10 am and 4 pm. Infants and young children can quickly develop serious sunburns.

Dermatologists recommend using a sunscreen with a sun protection factor (SPF) of at least 30. Check the label to make sure the sunscreen blocks both UVA and UVB rays. Apply sunscreen 15-30 minutes before going outside. Reapply sunscreen every 2 hours. Since no sunscreen is waterproof, you may need to reapply sunscreen more frequently if your child is spending lots of time in the water.

Appropriate clothing is also important for sun protection, such as wide-brimmed hats and lightweight cotton clothes with long sleeves and pants.

Keep babies under six months of age out of the sun and in the shade as much as possible. Avoid sunscreen in babies less than six months old.

For more information, visit umm.edu/childrens.

To make an appointment at one of our locations, call 410-328-6749.

 

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.