- Orthopedics, Women's Health, Pediatrics, UncategorizedGeneral Page Tier 3BlogOsteoporosis: It’s a disease that manifests later in life, but the foundation of healthy bones begins at a young age. Characterized by weak bones, osteoporosis can cause fractures and chronic pain. Here’s how it works: Your body is constantly breaking down and rebuilding your bones. For the first 25 to 30 years of your life, your body makes more than enough new bone to replace the bone it loses. Around this time, you reach what’s called “peak bone mass,” meaning your bones are at their strongest. But after age 30, the pendulum swings the other way and you start to lose more bone than you gain. This process continues for the rest of your life. For women, the most rapid bone loss is in the years around menopause. For those who haven’t built up their bones enough during those first 30 formative years, that’s when osteoporosis can set in. Known as the silent disease, osteoporosis can strike without warning. In fact, many people don’t know they have it until after they suffer a fracture. And while there’s no cure for the disease once you get it, there’s plenty you can do to prevent it in both yourself and your kids. A parent’s role to prevent osteoporosis in kids As a parent, you can greatly reduce your child’s chance of developing this disease later in life. Christina Morganti, MD, orthopedic surgeon at Anne Arundel Medical Center (AAMC), says, “The fact of the matter is, the exercise and dietary habits you instill in your children can either be a powerful mechanism to prevent osteoporosis or a perfect storm for the disease to develop.” There’s no surefire way to determine whether or not you or your children will develop osteoporosis later in life. The best solution? Do everything you can to prevent the disease early in life. If you’re a parent, make sure you’re helping your kids build strong, healthy bones. Your guide to building strong, healthy bones Luckily, preventing the disease isn’t complicated. But it does require some self-discipline and, depending on your current habits, shifts in your diet and exercise routine. Here’s what you can do for yourself and your children to help fend off the disease: Know your family history. “If you have a parent or sibling with osteoporosis, you’re at a higher risk of developing it yourself,” says Dr. Morganti. Knowing empowers you to take extra measures to ensure you’re keeping your bones as strong as possible. Exercise! The more you use your muscles, the stronger they become. Same goes for your bones. Weight-bearing exercises help improve your bone density to form stronger bones. This includes any exercise that uses resistance to make you exert effort. Resistance can come from dumbbells, your own body, fitness machines, etc. The result? New bone tissue forms as your muscles push and pull on the bones around them, strengthening both bone and muscle.Your action plan: Mix it up! Variety keeps exercise exciting and ensures you’re using a variety of muscles. Try a stair workout, hiking, running, walking, weight training or dancing to reduce your risk of osteoporosis. “While swimming and biking are great low-impact exercises, they don’t have the same effect on your bones as weight-bearing exercises do,” says Dr. Morganti. “Children should be active for at least 60 minutes a day. For adults, the recommendation is at least 30 minutes a day of aerobic exercise like walking, supplemented with strength training two to three days a week and balance training one to two days per week.” Know what to avoid. While there’s plenty you can do to keep osteoporosis at bay, don’t forget about what not to do if you want strong, healthy bones. “Some studies have linked salt, caffeine, carbonated soda and alcohol consumption with accelerated bone loss,” says Dr. Morganti. “If your children have a diet heavy in salty, processed food or drink caffeinated or carbonated drinks, this could affect their bone density.” And add this to your list of reasons not to smoke: Multiple studies reveal that smoking can actually limit your body’s ability to absorb calcium. Calcium, calcium, calcium. We’ve heard it all before. Drink your daily glass of milk to nourish your body with adequate calcium. But did you know there are plenty of non-dairy sources of calcium? Or that your body needs a certain amount of vitamin D in order to absorb the calcium you consume? “To make the most of the calcium you eat, pair calcium-rich foods with foods high in vitamin D, like tuna, shrimp and eggs (yolk included),” explains Ann Caldwell, nutritionist and registered dietitian at AAMC. Sunlight can also help the body produce more vitamin D, which is why it’s not uncommon for people to be vitamin D deficient in the winter. If you have a desk job, try taking a walk or eating your lunch outside to soak up some rays. Just don’t forget the SPF. No dairy, no problem Besides the beloved trio of milk, cheese and yogurt, there are plenty of non-dairy sources of calcium out there, including: Canned salmon. Half a can contains 23 percent of your daily value of calcium. It’s important to note that other forms of salmon won’t reap the same calcium-rich benefits as canned salmon. Figs. Pick up a bag of dried figs for a sweet, fibrous snack to keep bones strong. Cut them up into small pieces and mix with nuts and other dried fruits for a homemade trail mix your children will love. Kale, spinach, bok choy and turnip greens. There’s a reason why leafy greens are one of the healthiest foods you can eat. But there’s no need to limit yourself to the same green salad. Sauté greens with some sea salt and olive oil, or add them to a stir-fry. If you’ve passed the 30-year mark of your body making plenty of new bone tissue, taking preventative measures against osteoporosis can still be effective, and are vital to maintaining healthy bones. But the reality is that calcium and weight-bearing exercises will have a more dramatic effect on the strength of children’s bones than those of older adults. “The lesson here is to make sure you’re helping your children develop habits that create strong bones to last a lifetime,” explains Dr. Morganti. Recipe: Salmon Pasta Salad This pasta salad includes a healthy dose of calcium from the canned salmon. Plus, it’s easy to pack up the leftovers for a healthy work-day lunch the next day. Dietitian’s tip: For added calcium and health benefits, serve this on a bed of baby spinach. It’s delicious! INGREDIENTS 1 (8-oz.) package of farfalle or bow tie pasta2 heads broccoli, chopped into florets2 carrots, peeled and chopped2 teaspoons soy sauce2 tablespoons olive oil3 tablespoons red wine vinegar2 cloves of garlic, crushed/pressed¼ cup fresh lemon juiceSalt and pepper to taste10-oz. canned salmon, rinsed, drained and broken into small pieces INSTRUCTIONS Bring a large pot of water to boil. Add pasta and cook until al dente, 8-10 minutes. Bring a separate large pot of water to boil. Add broccoli and carrots, cook in boiling water for 2 minutes and drain. Combine soy sauce, olive oil, vinegar, garlic and lemon juice in a sealable container and shake vigorously. Add salt and pepper to taste. Toss together the drained pasta, vegetables, salmon and dressing in a large bowl. Store in the refrigerator. Want to eat healthier but not sure what to cook? Try more of these healthy, delicious recipes from our registered dietitians. Contributor Christina Morganti, MD, is an orthopedic surgeon at Anne Arundel Medical Center and has developed a dedicated osteoporosis program at her practice, Luminis Health Orthopedics. You can reach her office at 410-268-8862. Contributor Recipe author Ann Caldwell is a registered dietitian and nutritionist. Originally published November 29, 2016. Last updated July 5, 2023.
- Pregnancy & Birth, Women's HealthGeneral Page Tier 3BlogYou’re pregnant – congratulations! Whether it’s your first baby or you’re adding a brother or sister to the family, having a safe, healthy and positive labor experience is what every family wants. One option for many women and their partners is to include a doula as part of their care team. A doula is a trained, non-medical, professional who nurtures, supports and offers guidance for families throughout labor and delivery, and after the birth. Doulas offer a wide range of services, including help with breastfeeding as well as postpartum care. Studies show a doula’s continuous labor support benefits mom and baby in many ways. It can often mean: • A more satisfying birth experience• Less need for pain medications• Less likelihood of needing a cesarean delivery• Shorter labor Finding the right person to be part of one of the most important events of your life may feel overwhelming. So, where do you start and how should you choose? Here are six tips to guide you in your search. Start looking early in your pregnancy It’s good to begin the process of finding a doula at your fourth to fifth month of pregnancy. Finding someone who’s the right fit may take more time than you think. Doulas work on-call, so they have a limit on how many clients they can serve at one time. Choosing a doula early in your pregnancy will give you time to get to know each other and get comfortable with your birth plan. Talk to other families As with most things, word-of-mouth referrals are gold. Talking with friends who have used a doula about their experience can help you start and even narrow your search. Technology – Facebook groups, a Google search for other online groups and forums – can connect you with other moms in your area. Keep in mind that everyone’s experience can be different. A good match for someone else may not be a good match for you, and vice-versa. Talk with the provider who’s caring for you during your pregnancy You’ll need to let your doctor or midwife know you’re planning on having a doula as part of your labor and delivery team. And if your provider has worked with a doula in the past, they may be able to offer a recommendation. The hospital’s lactation consultants and childbirth educators are also good resources. Check with doula certification programs Most doulas will have completed a certification program and are continually participating in education to increase their knowledge. These programs offer national, and even global, online directories of certified doulas that you can search by location. Some well-known programs include: • Birthing From Within• Childbirth and Postpartum Professional Association (CAPPA)• DONA International• DoulaMatch.net• International Childbirth Education Association (ICEA) Interview potential doulas Spending face-to-face time with the person who will be part of your baby’s birth is a must. You not only want to gather important information about them and their background, but you also need to get a feel for whether your personalities are a good fit.Prepare for the interview by thinking about why you want a doula and what you them to do for you. Spend time on the doulas’ websites. DONA International recommends asking potential doulas about: • Availability• Certification status• Experience• Fees• Services offered• Training Trust your gut When you choose someone to provide any service, there’s no doubt experience and technical skills are must-haves. But soft skills, such as communication, empathy and teamwork, come into play too. Pay attention to how you connect with and feel when you’re with them. No one knows you and what you need better than you do. Listen to and follow your instincts. Learn more Sara Shaffer is a Certified Nurse Midwife (CNM) at Luminis Health Anne Arundel Medical Center.
- Behavioral Health, PediatricsGeneral Page Tier 3BlogAs parents, we put our children’s medical needs first. When our kids have a tummy ache or fever, we don’t hesitate to call the pediatrician. These health needs are easy to identify. But when it comes to our children’s mental and emotional health, symptoms and signs of distress may not be as easy to spot. A mental health crisis occurs when a child has thoughts and feelings that can lead them to hurting themselves or others. That interfere with their ability to do everyday things or present a deterioration in their functioning. Here are tips to help you recognize the signs before and if a mental health crisis in your child occurs. Signs of distress Pay attention to behaviors that are contrary to your child’s baseline behavior, such as: Persistent physical aches that continue after a visit to your pediatrician Sudden changes in sleeping or eating patterns Bed wetting that is inconsistent with expected age development Unusual clinginess, whining or crying While signs vary from young children to teenagers, signs of a mental health crisis where you should seek immediate professional help include: Significant distress and/or out of control behavior that is difficult to calm down Verbalizing suicidal thoughts or plans Self-injury Harming others and/or animals Signs you might see in teenagers in need of mental health support include: Isolation and avoiding social activities Drastic mood swings Excessive irritability, anger, worry or fear Distress Deviant or odd behavior or ideas Signs of a mental health crisis requiring immediate professional help include: For example, your child is not able to complete school work or study, maintain relationship with others or take care of themselves. Dangerous thoughts or behaviors. This often means thoughts of death and suicide, and/or self-injury Violence Panic attacks Feelings of hopelessness, helplessness, worthlessness or pessimism Prevention Become informed on mental health and mental illness through books, credible websites, workshops, speaking to professionals, and by speaking to other parents who are in similar situations. You can also build protective factors around your child. Building protective factors are as simple as having family meals together, giving specific praise to your child, monitoring their use of technology and engaging in mindfulness activities. Equally important is being present in your child’s life. This means spending quality time together, fostering open communication, listening without judgment and providing support. Don’t be afraid to seek help If you think your child is experiencing a mental health crisis, don’t be afraid to seek professional help. For immediate help, call 911, the Crisis Response Team for your county, or crisis a hotline like the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). Author Maria Winters, LCPC, is a mental health clinician at AAMC. You can reach her at 667-204-7311.
- Orthopedics, Senior Care, Women's Health, UncategorizedGeneral Page Tier 3BlogFor some people, having a heart attack can be life changing, spurring them on to healthier life choices, like regularly exercising, starting a heart-healthy diet and taking medication. A bone fracture is not unlike a heart attack — they are both a sign that something is wrong. In the case of a fracture, it could mean you have osteoporosis or a weaker form of bone loss called osteopenia. Bones shouldn’t break with low-energy falls such as from standing height or less. When they do, your doctor may want to run blood and bone density tests to determine if you have osteoporosis. If diagnosed, you should learn about weight-bearing exercise, fall prevention and nutrition for healthy bones. In addition, you may be a candidate for an osteoporosis medication. There are several medications available to treat osteoporosis: Bisphosphonates make up the largest class of drugs. This includes Fosamax (Alendronate), Actonel (Risendronate), Boniva (Ibandronic acid), and Atelvia, which are pill form, and Zometa and Reclast (Zoledronic acid), which are once-yearly injections. These drugs have been studied in large clinical trials for up to 10 years, and complications are rare. We typically recommend patients cycle on and off bisphosphonates in three- to five-year cycles. You can take a “drug holiday” with careful follow up and strict attention to weight-bearing exercise and good calcium and vitamin D intake. Prolia (Denosumab) is a newer treatment option administered through a shot every six months. It is very effective in protecting bone mass and is well tolerated by patients. There is a slight risk for patients who are prone to infection or who are on immunosuppressive therapy, since it is an antibody therapy. It acts on the same cells as bisphosphonates, so it could have similar risks. Hormone replacement therapy for women after menopause may help protect bones. Evista (Raloxifene), a pill taken daily, affects the estrogen receptors on breast and bone tissue and helps protect against both breast cancer and osteoporosis. Forteo (Teriparatide) is the only medicine currently available that builds bone. It is an injection self-administered daily. It is limited to two years of use. Once the two years of therapy are complete, you switch to one of the other medicines to maintain the gains you made with Forteo. Most of the medications reduce the risk of having a new fracture by about 50 percent. If you’ve had a fracture from a low-energy injury and you have osteopenia, you’re also a candidate for one of these medications. Osteoporosis is one of the most undertreated diseases of modern times, despite the abundance of good treatments. Fractures from osteoporosis lessen your quality of life with each new fracture. We must treat fractures as a life-altering event triggering treatment of osteoporosis, just like a heart attack triggers treatment of cardiac disease. Author Christina Morganti, MD, is an orthopedic surgeon at Anne Arundel Medical Center. She has opened a dedicated osteoporosis program at her practice, AAMC Orthopedics. To reach her office, call 410-268-8862. Originally published Sept. 25, 2015. Last updated Oct. 12, 2018.
- Women's HealthGeneral Page Tier 3BlogWhether it’s a ‘small tinkle’ with a sneeze or a ‘potty dance’ while headed toward the bathroom, the uncontrolled leakage of urine is called urinary incontinence. This condition can be a real bother for many ladies. Do you skip gym class for fear of leaking urine? Are your daily trips planned around restroom breaks? Have you ever heard yourself say, “Stop, don’t make me laugh!”? When the bladder is functioning normally, you should be able to delay a bathroom break until a socially acceptable time and not worry about leaking during activity. You do not need to have pelvic organ prolapse (or a collapsed bladder) for urine to leak. You may look and feel the same, however, the dampness signals a problem. Sometimes this condition can be temporary, such as with a urinary tract infection or during pregnancy. If so, urinary incontinence will quickly resolve after the temporary condition has passed. At other times, leakage may start slowly and worsen over time. Many women wear panty-liners or change their underwear frequently because of urinary incontinence, a condition that according to the National Association for Continence affects close to 18 million women. Urinary incontinence may be common but it’s not normal and, thankfully, there is often a cure. Here are some things you can do to help: Do Kegel exercises. These exercises help muscle strength and endurance training for the pelvic floor. Try core muscle strengthening exercises, like Pilates and yoga. The core muscle and pelvic floor muscles work closely together. Getting one region stronger can help the other. Wear a tampon during exercise, or a pessary vaginal insert made to help with stress leakage. Achieve normal body weight through nutrition or lower impact exercise. Consider a surgical procedure to support the urethra (the tube that empties urine from the body). READ MORE: Bladder control problems: 5 ways women can manage There are other cases when medical conditions or prior surgeries are causing the leakage. Even issues that limit the speed and ease of walking can contribute to leakage. Urinary incontinence and constant dampness can cause skin irritation in the regions of dampness. I have seen firsthand how urinary incontinence can affect day to day activities, plans for the future and even self-esteem. If this problem continues, talk to your healthcare team. Details about treatment can be discussed with your provider or a pelvic floor physical therapist. Leakage can control your life. Even though you can live with these problems, ask yourself, ‘Why should I?’ Would you give your daughter or girlfriend the same advice? Let’s do better for ourselves. For more information on urinary incontinence, visit us today! Author Kay Hoskey, MD is a board certified urogynecologist at the Women’s Center for Pelvic Health at Anne Arundel Medical Center.
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