High Blood Pressure Has No Minimum

How tall is your child? How much does he or she weigh? Most parents can answer those questions easily. But here’s a tougher question: what is your child’s blood pressure?

High blood pressure, or hypertension, is often considered an adult health problem. But this serious condition is no longer adults-only.

“The number of children with high blood pressure is rising,” says Susan Mendley, MD, head of the Division of Pediatric Nephrology at the University of Maryland Children’s Hospital and an associate professor of pediatrics at the University of Maryland School of Medicine. “Left unchecked, high blood pressure can result in lifelong health complications including heart disease, stroke and kidney failure. Fortunately, small changes now can turn this trend around.”

What’s Normal?

For adults, 120/80 or lower is normal blood pressure and 140/90 or greater is high blood pressure. But for children, high blood pressure is determined differently.

“Children are not little adults,” says Dr. Mendley. “High blood pressure for children is defined as a blood pressure reading greater than the 95th percentile for their age, height and gender.”

It’s estimated that about 2 million kids in the U.S. have high blood pressure, and many of those children-and their parents- don’t know it.* That’s because high blood pressure, also known as the “silent killer,” has no symptoms. However, childhood high blood pressure often has a common clue: obesity.

Predicting hypertensions

A growing number of children are eating more, exercising less and weight in above their ideal weight range. As a result, obesity rates have been rising in the U.S. for the past two decades.**

“Obesity is one of the highest predictors of high blood pressure in children,” says Dr. Mendley. “It’s difficult for parents to tell on their own if their child has health risks related to weight.”

The American Academy for Pediatrics recommends screening children for high blood pressure annually starting at age 3. “It’s really important to keep up with your child’s annual checkup,” Dr. Mendley says. “Don’t wait until there is a problem. There are many small things that parents can do to prevent big problems later.”

To make an appointment with Dr. Mendley or the Nephrology team call 410-328-6749 or visit umm.edu/PediatricNephrology

*Source: The Journal of the American Medical Association

**Source: Centers for Disease control and Prevention

 

 

Joint Replacement Q&A with Dr. Theodore Manson

Theodore Manson, MD is an Orthopaedic Surgeon at the University of Maryland Medical Center and an Associate Professor of Orthopaedics at the University of Maryland School of Medicine.

Dr. Manson specializes in hip and knee replacements and orthopaedic trauma. Below he answers the most common questions about joint replacement.

 

Q. What advances have there been in joint replacements including new technologies, changes in patient-management and rehabilitation?

A. One significant advancement in the last 10 years has been around pain management and early recovery protocols. The goal is to minimize the amount of narcotics patients require after surgery. Today, we manage pain through many different types of medicines in addition to narcotics. There’s been a lot of success recently with joint (intra-articular) injections of anesthetic around the hip or knee joint at the time of surgery. This injection limits the amount of pain patients have when they first wake up from surgery. We know that if you limit that first pain sensation, it helps with the whole pain management process going forward.

Another significant advancement is infection prevention. Patients’ skin is now pre-operatively prepped with the antiseptic and disinfectant chlorhexidine both at home prior to surgery and at the hospital as well. In addition, we optimize patients’ nutrition and health pre-operatively. These two things have drastically cut down on infection rates. We did not use to address patient nutrition. Now, we assess patients’ nutritional status before surgery. If a patient is at a higher risk for nutritional deficiencies – those with chronic illness, diabetes or poor appetite, we then work in conjunction with a nutritionist so their infection rates are lower.

Borrowing from the aviation industry, there have been substantial improvements to patient safety in the hospital postoperatively as well.  Standardized protocols, safety checklists and quality control monitoring have dramatically reduced untoward events in joint replacement patients.

Q. What new innovations in joint replacement surgery (hardware and techniques) are noteworthy and why?

A. There is a lot of marketing material on the internet regarding various joint replacement approaches, minimally invasive surgery, robotic surgery and use of custom hip and knee replacement parts.  It is important to realize that none of these things has been shown to be of any benefit. When considering joint replacement, choose a surgeon who performs a high volume of hip and knee replacement surgeries and who you get along with well on a personal level.

While there haven’t been any substantial innovations with implants in the last five years, we do have long-term data on our current implants and techniques that shows them to be functioning extremely well.

Q. Who should get a joint replacement? What factors should a person consider? How should a potential patient decide?

A. In general, joint replacement is an elective procedure. If the patient is falling due to their hip or knee arthritis, it can be a very dangerous situation, so falls are an indication they should go ahead with a joint replacement. If a person is no longer able to climb stairs, if the hip/knee pain keeps him/her up at night, or if s/he is constantly dependent on an assistive device like a cane, then I think they should strongly consider a joint replacement. For others with less severe symptoms, a joint replacement may still be of great benefit to them, but they should consider surgery when the time is right and shouldn’t feel pressured into a surgical option.

Q. What should a patient expect?

A. Once they have scheduled the surgery, most patients undergo pre-habilitation prior to the joint replacement. Many patients find it useful to go to a preoperative joint class at the hospital where they’re going to have the surgery. This helps to alleviate anxiety about the procedure and educate them on what is to come. For those who are substantially debilitated preoperatively, going to prehab (physical therapy) to strengthen the operative leg is helpful and helps us foresee any challenges that may arise postoperatively.

If you have a body mass index (BMI) of 40 or greater, you should delay joint replacement until you can get below 40. This is because infection rates increase substantially for people who have a BMI of 40 or greater.

Q. Does the type of implant used depend on patient activity and age? How?

A. In the past, different implants were used based on age, but for the vast majority of surgeons we use the same type of implants no matter the age. Occasionally patient with poor bone quality will require different implants, but usually we use the same regardless of age or activity level.

Q. What is the target recovery period and regimen for various categories of patients?

A. Patients see the majority of their improvement six to 12 weeks after surgery. They reach their maximum improvement six to 12 months after hip/knee surgery.

Q. What is the lifespan of replacement joints and do you expect the lifespan to grow longer soon?

A. The lifespan of replacement joints have a 1-percent-per-year failure rate, so with 20 years, you have a 20 percent risk of needing the joint replacement redone. I expect this will grow longer as we get better at preventing infection rates. If you are over 60 years old, the odds are you’ll probably never need to have the joint redone.

Q. Have risk factors (infections, failures, etc.) declined or increased (and for whom)?

A. Risk factors have declined because of more critical evaluation and optimization of risk factors for infection around the time of surgery.

Q. Are revision surgeries more or less common these days and why? Do you expect that to change? How and why?

A. Revision surgeries are more common these days simply because of the number of people who have gotten a joint replacement is increasing, and the number of baby boomers having joint replacement is increasing. I expect the number to continue to go up just because the number of people having a joint replacement is going up.

To make an appointment with Dr. Manson or one of our other orthopaedic specialists, please call 410-448-6400.  For more information on joint replacement or other orthopaedic issues, check out the University of Maryland Orthopaedics’ website.

Building Better Breastfeeding Awareness at UMMC

breastfeeding2Breastfeeding is recognized as the best nutritional source for healthy infants. Unfortunately, breastfeeding rates in Baltimore city are well below the national average, so the University of Maryland Medical Center acknowledges the need to focus efforts on breastfeeding practices and do more to educate and support mothers within the community.

After a thorough evaluation, UMMC kicked off a commitment to embark on the journey to become a Baby Friendly designated hospital. UMMC follows the “10 Steps to Breastfeeding success” as outlined by the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF).   The “10 Steps” involve all aspects of breastfeeding and include the efforts which begin in the pre-natal period and go beyond birth and delivery until breastfeeding is well established.

A mother’s choice to breastfeed is heavily influenced by education, cultural norms and how well the mother is supported in learning to breastfeed.  Although breastfeeding is a natural process, its success does take some practice and support.  UMMC saw the need to do more to support mothers from the prenatal phase through labor and delivery and beyond hospitalization in those early post-partum weeks.   In cohesive efforts to influence breastfeeding rates, UMMC nursing and medical staff have partnered with affiliated pre-natal clinics, called B’More Health Babies, as well as the Baltimore City Health Department and University of Maryland School of Nursing colleagues to approach breastfeeding education and support across the continuum of care.

UMMC nursing and provider staffs are in the process of completing specialty training on breastfeeding. This is an endeavor that includes all staff who works with nursing mothers with the highest level of training demanded of maternal/newborn nurses who all have completed 20 hours of didactic and practical training on breastfeeding.   Pediatric nurses, midwives, obstetricians, pediatricians, family practice providers, medical assistants and nursing assistants also receive additional training on how to support nursing mothers – a topic glossed over up to now in most nursing and medical school curricula.

Onsite Lactation Support

University of Maryland Medical Center has expanded lactation support to include six days a week of onsite coverage, a telephone hotline, and lacatationsupport@umm.edu email for questions and advice.  UMMC nursing and provider staffs are committed to extending this support to community mothers with the kick off of both inpatient breastfeeding support groups held weekly on the Mother Baby unit and a monthly community breastfeeding support group free to the public within the Family Medicine clinic.  UMMC is also committed to supporting our staff with the employee lactation lounge located on first floor of the Weinberg building where hospital grade breast pumps are available for our own UMMC community of nursing mothers.

Having health professionals, sudavis-and-boypport persons, peer mentors and others who can assist in teaching and reinforcing skills are critical to maternal success.   In partnering with providers, advocacy groups and agencies, UMMC staff are working to ensure patients are provided the education and resources needed for success.

For more information on UMMC’s lactation support programs, email us at lactationsupport@umm.edu .

Remembering Dr. R Adams Cowley: A Revolutionary & Pioneer of Trauma Medicine


Dr. Cowley in the old CCRU

Dr. Cowley (center) instructing in the old CCRU

Dr. R Adams Cowley passed away 25 years ago today, but his contributions will live on forever in the form of thousands of lives saved.

R Adams Cowley, MD, a cardiothoracic surgeon, was the founder of United States’ first trauma center, University of Maryland R Adams Cowley Shock Trauma Center, and the Maryland EMS System. He revolutionized trauma medicine and is responsible for the development of the “Golden Hour” concept. As Dr. Cowley explained in an interview: “There is a golden hour between life and death. If you are critically injured you have less than 60 minutes to survive. You might not die right then; it may be three days or two weeks later — but something has happened in your body that is irreparable.”


Drs. Gens and Cowley

Dr. Cowley (left) with fellow trauma surgeon Dr. Gens in 1983

“R Adams Cowley was a pioneer, a man of immense vision and the father of American trauma care systems,” Dr. Thomas Scalea, Shock Trauma Physician-in-Chief, said. “At a time when we take organized trauma care for granted, it is important to remember that none of this would have happened without him and a few others who refused to take no for an answer. They fought the political and medical battles to demonstrate that organized trauma care saves lives. I am privileged to continue his legacy.”


Open Heart Surgery

A Baltimore Sun photo shows Dr. Cowley performing open-heart surgery on a 2-year-old boy

After many years of research and discussion, in 1958, the Army awarded Dr. Cowley a contract for $100,000 to study shock in people. He developed the first clinical shock trauma unit in the nation; the unit consisted of two beds (later four beds). By 1960, staff was trained and equipment was in place.

In 1968, Dr. Cowley negotiated to have patients brought in by military helicopter to get them to the shock trauma unit more quickly. After much discussion with the Maryland State Police, the first med-evac transport occurred in 1969 after the opening of the five-story, 32-bed Center for the Study of Trauma.

In 1970, Dr. Cowley expanded his dream, feeling that not a single patient should be denied the state-of-the-art treatment available at his trauma center in Baltimore. He envisioned a statewide system of care funded by the state of Maryland available to anyone who needed it.

Airport Drill

Dr. Cowley leads a drill at the airport

His dream became a reality with the intervention of former Governor Marvin Mandel. Governor Mandel became interested in Dr. Cowley’s program when a close friend was severely injured in a car crash. In 1973, the Governor issued an executive order establishing the Center for the Study of Trauma as the Maryland Institute for Emergency Medicine. The order simultaneously created the Division of Emergency Medical Services. Dr. Cowley was appointed as director.

Maryland had the first statewide EMS system, and it, like the Shock Trauma Center, has become a model worldwide. Countless lives have been saved due to Dr. Cowley’s vision.

r-adams-cowley-studentsWe thank you, Dr. Cowley, and will always remember your legacy.

400-victims-in-2-years

 

a-better-chance-of-living-than-ever-before-1970s

a-better-chance-of-living-than-ever-before-1970shospitals-special-trauma-unit-has-saved-lives-of-400-accident-victims-in-2-years-1971

Signs of Bullying

This information is provided by University of Maryland Children’s Hospital, the Center for Infant and Child Loss and the Maryland Department of Health and Mental Hygiene.

As a parent, there are many things you need to diligently watch for in your child. One of them is to look for signs of bullying.

There are health risks related to depression for the victim, bully, and those who witness bullying, which may include:

  • Irritability or angerdoctor-consoling-patient-126648704
  • Nightmares
  • Headaches
  • Stomachaches
  • Inability to concentrate
  • Multiple joint and muscle pains
  • Weight gain or loss
  • Depression
  • Difficulties in falling and/or staying asleep
  • Self-injury (i.e., cutting)
  • Impulsivity
  • Suicide attempts
  • Homicidal thoughts

If your child is experiencing any of the above, talk with them, and contact their pediatrician or teacher. For more information call 800-808-7437.

 

 

Kathy’s Story: Living Better with Mesothelioma – Possible with the Right Team of Experts

Kathy Ebright was enjoying life with her husband, 2 kids and 7 grandchildren in rural Pennsylvania, when everything changed suddenly.  This is true for thousands of people fighting cancer across the world, but hearing the word “mesothelioma” is not common.

“I went numb, I might have said a few words, but I couldn’t put words together to speak,” Kathy said.

Kathy and her husband, Doug

Almost everyone has been touched by cancer, but Kathy and her husband didn’t know anyone with mesothelioma in their small town of Richfield. They only heard of the disease from commercials for lawyers who specialize in asbestos lawsuits.

Kathy’s mesothelioma was discovered during a scan of her abdomen, which she has regularly to monitor a heart condition.  Her vascular doctor saw unusual spots on her scans, which her primary care doctor and oncologist reviewed, and they determined it was pleural mesothelioma.  This means the cancerous cells are located in the chest cavity, and sometimes the lung.  Usually, those with pleural mesothelioma experience shortness of breath, but Kathy was lucky enough to catch her mesothelioma before experiencing any symptoms.

Kathy’s daughter, Ally, who works with the tumor registry at the Geisinger Medical Center, sprang into action after the initial shock.  They attended tumor boards at Geisinger, where physicians from multiple disciplines (radiation, medical, and surgical oncology) meet to discuss cases.  Kathy’s medical oncologist, Dr. Rajiv Panikkar, suggested to Kathy that she go to the University of Maryland Greenebaum Comprehensive Cancer Center in Baltimore, where she would see a team skilled and experienced in the most novel treatments for mesothelioma.

On December 20, 2015, about a month after her initial diagnosis, Kathy had her first appointment with Dr. Joseph Friedberg, a nationally known expert in mesothelioma and head of thoracic surgery at the University of Maryland Medical Center.

Kathy and her family were nervous, but mesothelioma nurse navigator Colleen Norton helped them navigate the unfamiliar and frightening process of a mesothelioma diagnosis.  She made sure they were prepared for their appointment beforehand, and Colleen even handled authorization with their health insurance company.

“We just felt we were along for the ride because Colleen always had everything taken care of,” said Kathy’s husband Doug.

And they were just as impressed with Dr. Friedberg, who was calm, reassuring and explained Kathy’s situation very clearly.

“On the back of his folder, he hand drew a lung to display what was going on with me, and it could’ve been taken right from a textbook it was so good,” Kathy said.

Kathy’s granddaughter, Carleigh, who serves as her main cancer-fighting motivator

They were also impressed with Dr. Friedberg’s tenacity and understanding.  Kathy wanted to spend Christmas with her family, but Dr. Friedberg didn’t want wait too long to perform the lung sparing surgery.

Her surgery was scheduled for January 5, 2016.

Throughout the surgery, Kathy’s family couldn’t have been more comfortable and informed.

“We camped out in the Healing Garden just about the entire time,” Doug said. “Melissa Culligan, Dr. Friedberg’s nurse, was in and out of the operating room, updating us every two hours.  We were never left wondering how Kathy was doing.  We also had the option to call into the operating room if we had any questions.”

During Kathy’s recovery in the hospital, she said the nurses were “phenomenal.”  Colleen also came to see her several times a day, and they added a La-Z-Boy to Kathy’s room so her husband could more comfortably spend the nights with her.

While there is no cure for mesothelioma, yet, Kathy and her family couldn’t be happier to have the UMGCCC team in their corner.  She now returns every 3 months for the next 2 years for check-ups, and Dr. Friedberg describes her scans as “pristine.”

“It’s very reassuring to know we have such caring people looking out for my health,” Kathy said.

Learn more about the Mesothelioma and Thoracic Oncology Treatment Center at the University of Maryland Marlene and Stewart Greenebaum Comprehensive Center by clicking here, or calling 410-328-6366.

Protect Your Skin This Summer

By Kirsten Bannan, System Communications Intern

As the summer progresses the initial sunburn has faded and it’s time to think about protecting your skin. Everyone wants that bronze glow that comes with a summer tan, but most people are sun picnot aware of the damage the sun can cause to your skin and your health. Here are some facts and tips that will help you protect your skin this summer.

Skin Cancer is the most common cancer in the United States. Most skin cancers are caused by exposure to Ultraviolet (UV) rays. The sun emits these rays and you can get extra exposure from using tanning beds or sun lamps. “People who use tanning salons are 2.5 times more likely to develop squamous cell carcinoma, and 1.5 times more likely to develop basal cell carcinoma. According to recent research, first exposure to tanning beds in youth increases melanoma risk by 75 percent” (Skin Cancer Foundation). There are two types of UV radiation that affect the skin: UVA and UVB. Both kinds of rays can cause skin cancer, weaken the immune system, contribute to premature aging of the skin, and cataracts (See our Cataract Awareness Article).

UVA Rays– they are not absorbed by the ozone layer and penetrate skin to contribute to premature aging. “They account for up to 95 percent of the UV radiation reaching the Earth’s surface” (Skin Cancer Foundation). UVA is the prevalent tanning ray; tanning itself is actually damage to the skin’s DNA. The Skin gets darker in an attempt to protect from further DNA damage.

UVB Rays– they are partially absorbed by the ozone layer and are the primary cause to sunburn. They play a very large role in the development of skin cancer. The most intensive UVB rays hit the Earth around 10am to 4pm from April to October.

There are protective measures that you can take to prevent against damage and skin cancer. Since the sun can damage your skin in as few as 15 minutes, it’s important to put sunscreen on when you know you will be outside for an extended period of time. Sunscreen works by absorbing, reflecting, or scattering sunlight. They contain chemicals that interact with the skin to protect it from UV rays.
Here are some other tips from the Centers for Disease Control and Prevention on sun safety:

A wet T-shirt offers much less UV protection than a dry one, and darker colors may offer more protection than lighter colors.

A regular T-shirt has an SPF rating lower than 15, so use other types of protection as well.

Sunglasses protect your eyes from UV rays and reduce the risk of cataracts. They also protect the tender skin around your eyes from sun exposure.

o Sunglasses that block both UVA and UVB rays offer the best protection. Most sunglasses sold in the United States, regardless of cost, meet this standard. Wrap-around sunglasses work best because they block UV rays from sneaking in from the side.

SPF. Sunscreens are assigned a sun protection factor (SPF) number that rates their effectiveness in blocking UV rays. Higher numbers indicate more protection. You should use a broad spectrum sunscreen with at least SPF 15.

Reapplication. Sunscreen wears off. Put it on again if you stay out in the sun for more than two hours and after swimming, sweating, or toweling off.

Cosmetics. Some makeup and lip balms contain some of the same chemicals used in sunscreens. If they do not have at least SPF 15, don’t use them by themselves.

Sunscreen is one of the best ways of protecting yourself from the sun’s harmful rays. Make sure to get a sunscreen that protects against UVA and UVB rays. Sunscreen labels that have “Broad Spectrum” means they protect against both kinds of rays. You also want to make sure to know the difference between “water resistant” and “waterproof”. The American Cancer Society says that “No sunscreens are waterproof or “sweat proof,” and manufacturers are no longer allowed to claim that they are. If a product’s front label makes claims of being water resistant, it must specify whether it lasts for 40 minutes or 80 minutes while swimming or sweating”. They recommend reapplying every two hours and even sooner if you are sweating or swimming.

No matter what summer activities you have planned this summer, make sure you protect your skin from the sun’s harmful rays. It takes 2 minutes to apply sunscreen and that can help save you from a lifetime of skin damage or even skin cancer.

Take a Sun Safety IQ Quiz from the American Cancer Society:
http://www.cancer.org/healthy/toolsandcalculators/quizzes/sun-safety/index’

Sources:
http://www.cdc.gov/cancer/skin/basic_info/sun-safety.htm
https://www.epa.gov/sites/production/files/documents/sunscreen.pdf
http://www.cancer.org/cancer/cancercauses/radiationexposureandcancer/uvradiation/uv-radiation-avoiding-uv
http://www.cancer.org/cancer/news/features/stay-sun-safe-this-summer
http://www.skincancer.org/prevention/uva-and-uvb

Safe Firework Fun

FireworkSafetyBy Kirsten Bannan, System Communications Intern

Summer is in full swing and as the temperature increases, so does the amount of summer events happening. The 4th of July is right around the corner and everyone knows it is a popular holiday to spend time with family and friends and enjoy some summer traditions such as fireworks.

Sometimes holiday fun is not as harmless as you might think. Even though fireworks seem like a safe and fun way to spend the holiday, “230 people on average go to the emergency room with firework-related injuries in the month around the July 4th holiday” (US Consumer Product Safety Commission).

A sparkler, popular to most at-home firework displays, can heat up to about 1,200 degrees Fahrenheit, which can cause serious burns especially if in the hands of children. Kids aren’t the only ones who need to be careful; the age group most susceptible to injuries by fireworks is the 20-40 age groups which are usually the age group responsible for lighting fireworks at home. Sometimes the influence of alcohol can contribute to high numbers of injury during at- home firework displays.

Karen Hardingham RN, BSN, CPST Safe Kids Baltimore Coalition Coordinator has some helpful tips for those who still want to include fireworks in their 4th of July experience. She is most adamant about attending professional firework displays rather than at-home shows. She says, “leave it to the professionals, do be aware of labels and laws of the area, and look at alternatives.”

Some events in the Baltimore area to attend are as follows:

  • Baltimore’s Fourth of July Celebration presented by Ports America Chesapeake
    Location: Baltimore Inner Harbor, 561 Light Street, Baltimore, MD 21202
  • Fullerton Park
    Location: 4304 Fullerton Avenue, Baltimore 21236
    Rain Date: July 5
  • Loch Raven Academy
    Location: 8101 Lasalle Road, Towson 21286
    Rain Date: July 5
  • Catonsville High School
    Location: 421 Bloomsbury Avenue, Catonsville 21228
    Rain Date: July 9

For a full list of public firework displays in Maryland click here.

If you are determined to have an at-home firework show, consider substituting hand-held sparklers with glow sticks, which decreases the chance of hands or clothes getting burned. Here are some other safety tips about fireworks to help get the best out of the holiday the safe way, courtesy of Safe Kids Worldwide:

  •  If you plan to use fireworks, make sure they are legal in your area.
  •  Do not wear loose clothing while using fireworks.
  •  Never light fireworks indoors or near dry grass.
  •  Point fireworks away from homes, and keep away from brush, leaves and flammable substances
  •  Stand several feet away from lit fireworks. If a device does not go off, do not stand over it to  investigate it. Put it out with water and dispose of it.
  •  Always have a bucket of water and/or a fire extinguisher nearby. Know how to operate the fire  extinguisher properly.
  • If a person is injured by fireworks, immediately go to a doctor or hospital. If an eye injury occurs, don’t allow the person to touch or rub it, as this may cause even more damage.

Being aware of the local firework laws are especially important. The Baltimore City Fire Department confirms that all fireworks, even sparklers are against the law in Baltimore City unless a permit and approval is given from the office of the Fire Marshall. Depending on the area, it is important to know the firework laws before having a display of your own. Violators of these laws are subject to a misdemeanor fine of up to $250. The holidays are about spending time with friends and family, so before deciding to make your own firework display, consider the consequences and alternatives for a safe and fun 4th of July.

For a PDF with more statistics on Firework Injuries from the US Consumer Product Safety Commission click here.

Sources:

http://www.baltimorecountymd.gov/Agencies/fire/safety%20education/fireworks.html
http://www.fireworkssafety.org/
https://www.safekids.org/tip/fireworks-safety-tips
http://www.cpsc.gov/en/Safety-Education/Neighborhood-Safety-Network/Posters/Fireworks-Injuries/

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.

UM Children’s Hospital Patient Gives Back in a Big Way

Michelle Kaminaris, a kindergarten teacher at Hampstead Hill Academy in East Baltimore, has seen kids miss school for all kinds of reasons. Like most of us, she never expected her own child to miss school due to a serious illness. But when her daughter Eva (an eighth grader at Hampstead Hill Academy) started showing flu-like symptoms, a trip to the doctor confirmed that Eva would be missing school due to pneumonia.

From there, Eva had more tests and doctors found a tumor on her ovaries. The tumor was removed after an emergency surgery, but she still had to spend time recovering at the University of Maryland Children’s Hospital (UMCH). While she endured a slew of poking and prodding and scary medical diagnoses, it was the Child Life team and other skilled nurses at UMCH who made her hospital stay a positive experience.

Group Photo

Eva (fourth from left) and Hampstead Hill Academy’s Kiwanis Builders Club pose with their donation to UMCH

“We had unbelievably phenomenal care. I never had to leave my daughter,” Michelle said. “One of the nurses even gave up his lunch hour to take Eva to play and walk around.”

Post-discharge and feeling better, Eva was determined to give back to the place that took such great care of her. She started looking online for ways to help and found UMCH’s toy wish list.

She sought help from her school’s Kiwanis Builders Club, and recruited some of her friends and classmates to help. The club, seven members strong, started planning fundraisers, bake sales, art supply and Band-Aid drives, and a paint night.

Shannon Joslin Builders Club

Shannon Joslin, Child Life Manager, describes the Child Life Program to the Hampstead Hill Academy Kiwanis Builders Club

The students stayed after school one day to stretch the canvases for the paint night by hand and helped cook food for the event. Thirty-five families came out after school to support the club and raise money for the cause.

The club went shopping for items on the UMCH wish list with the money from the fundraisers. They picked out high-demand items like DVDs, video games, building block sets and card games, all which they personally delivered to the hospital.

As Eva heads to high school, she wants to ensure that this is not a one-time donation. Even if she can’t start the club at her new high school, she plans to keep in touch and continue giving back to UMCH. Michelle’s youngest child, inspired by Eva’s involvement and by UMCH’s great care, plans continue the family tradition and join the Hampstead Hill Builders Club next year.

Many thanks to the Hampstead Hill Academy’s Kiwanis Builders Club! 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.

Interested in giving to the Children’s Hospital? Here’s how you can help.