The Vape Debate: This New Trend May Be Riskier Than You Think

The e-cigarette market has been on fire the past few years. With nearly 500 brands and 7,700 flavors of e-cigarettes on the market, according to the American Lung Association, these electronic nicotine delivery systems (ENDS) are sparking renewed interest and debates around the use of tobacco products and the harmful effects of nicotine.

“We feel that it is important to educate the community on the potential harms and risks of vaping,” said Angela Cochran, director of Chronic Disease Prevention & Control for St. Mary’s County Health Department. “As the research evolves we continue to gain more knowledge on how e-cigarette use affects our health.”

In 2015, the Health Department created the VapeAware awareness campaign to help provide the latest information on this trendy smoking alternative. It also works with the Tobacco Free Living Action Team of the Healthy St. Mary’s Partnership to improve tobacco-related health outcomes in the county.

“The Health Department works on reducing the use of all forms of tobacco products, including e-cigarettes,” Angela said. “We try to focus on population-level strategies such as including e-cigarettes into smoke-free indoor air policies and restricting youth access to e-cigarettes in retail settings.”

What is particularly disturbing is the trend among adolescents and teens. According to the Maryland 2016 Youth Risk Behavior Survey, 42 percent of teen respondents in St. Mary’s County had tried electronic vapor products within the 30 days prior to taking the survey. 

“Recent reports are showing substantial evidence that e-cigarette use increases the likelihood youth and young adults will eventually begin using combustible tobacco cigarettes,” Angela said. “Despite the popularity of e-cigarettes, we continue to promote awareness through a comprehensive tobacco control program that focuses on prevention and cessation of all tobacco products, including e-cigarettes, among youth.”

Know the Health Risks

New studies are also showing that e-cigarettes are not as harmless as many would like to believe. Although not as toxic as smoking regular cigarettes, use of ENDS still comes with many risks including exposure to nicotine and other aerosols which are known cancer causers.

“Research on this is still pending in a few areas because long-term effects haven’t had a chance to be studied,” said Pam Laigle, BSN, RN, PCCN, clinical leader of the Grace Anne Dorney Pulmonary & Cardiac Rehab Center. However, research has discovered other effects on the cardiovascular system as well as new evidence of what is called ‘popcorn’ lung, a serious and irreversible lung disease. “Anything other than breathing oxygen,” said Pam, “essentially is not good.”

Visit MedStarStMarys.org/Tobacco for more information on the Grace Anne Dorney Pulmonary & Cardiac Rehabilitation Center, the risks of tobacco use, and smoking cessation resources.

What is Vaping?

Electronic nicotine delivery systems, which include e-cigarettes, vape pens, e-hookahs, e-cigars, personal vaporizers, and electronic pipes, use a battery to heat liquid that contains nicotine, flavorings, and additives, which are inhaled into the lungs.

Know the Risks

► Exposure to Nicotine: Nicotine is highly addictive and adversely affects the heart, reproductive system, lungs, kidneys, etc., and may increase the risk of certain cancers.

► Exposure to Aerosols: Aerosols may contain harmful substances including cancer-causing chemicals and tiny particles that reach deep inside the lungs.

► Increases Risk of Using Other Tobacco Products: For teens and adolescents, serves as a gateway to using combustible cigarettes.

► Poisoning: Accidental exposure to even small amounts of liquid nicotine – as little as a teaspoon - can be fatal to children and a slightly larger amount could kill an adult.

► Burns: Batteries can explode causing severe injury.

Wound Healing Center Named Atlantic Zone’s Center of the Year

The Wound Healing Center at MedStar St. Mary’s Hospital was recently named the Atlantic Zone’s Center of the Year by Healogics. Pictured are staff members Shelby Morris, RN; Jodi Black, clinical coordinator; Lisa Nelson, RN, program director; Richard Greengold, MD, medical director; John Harvey, MD, vascular surgeon; Dawn Kilinski, RN; Denise Tucker; and Jamie Smith.

Leonardtown, Maryland – The Wound Healing Center at MedStar St. Mary’s Hospital was recently named the Atlantic Zone’s Center of the Year by Healogics, Inc. — one of only seven centers out of nearly 700 to achieve this status.

To qualify for Center of the Year, stringent quality measures must be met — among them achieving high healing outcomes, low days to heal, and excellent patient satisfaction ratings.

Additionally, the Wound Healing Center earned the Center of Excellence distinction and was named to the President’s Circle for its outstanding patient care.

“This is a tremendous honor for us,” said Lisa Nelson, operations specialist and clinical program director for the Wound Healing Center. “These accolades demonstrate our commitment to assisting patients in our community to live better by receiving specialized treatment at our facility. We are very proud to have been named the Center of the Year for the Atlantic Zone.”

MedStar St. Mary’s Hospital’s Wound Healing Center is a member of the Healogics network of nearly 700 wound care centers nationwide, offering highly specialized services to patients suffering from diabetic ulcers, pressure ulcers, infections, and other chronic wounds which have not healed in a reasonable amount of time.

Treatments include hyperbaric oxygen therapy, negative pressure wound therapy, growth factor therapies, and bio-engineered tissue substitutes. Patients receive customized wound care plans that may involve weekly treatments until the wound starts to heal. In some cases, this may prevent the need for limb amputation.

Visit MedStarStMarys.org/WoundCare to learn more.

OPIOIDS: The Youngest Victims of a Nationwide Crisis

When an expectant mother arrives at MedStar St. Mary’s Hospital, she will undergo a variety of tests prior to delivering, including a screening for drugs and alcohol. If a mother’s results are positive, her newborn child will also be tested.

“We are seeing episodes of babies testing positive for opioids much more frequently than several years ago,” said Jeanne Hill, MSN, RNC, director of MedStar St. Mary’s Hospital’s Women’s Health & Family Birthing Center. Babies born to drug-addicted mothers are the youngest victims of what continues to be a nationwide crisis and they are not difficult to identify, said Jeanne. “They have a high-pitched cry, they can’t calm themselves down, they have tremors, they often have diarrhea and tensed muscles,” she said. “It is just heartbreaking.”

MedStar St. Mary’s Hospital is among 30 birthing centers in Maryland joining forces with the Maryland Patient Safety Care Center to standardize care for babies suffering neonatal abstinence syndrome. As part of the hospital’s efforts, mothers are presented with information about how and where to get help with substance abuse. Although Jeanne feels their work is making a difference, there is still plenty to be done.

Fighting the Addiction 

“We need every single person in the community to recognize addiction is an illness, it is a brain disease and it requires an evidenced-based approach to treatment,” said Meenakshi G. Brewster, MD, MPH, St. Mary’s County Health Officer. The Health Department, MedStar St. Mary’s Hospital and Sheriff’s Department are among the many community organizations coming together to offer a comprehensive response to this epidemic. “It is a challenge like we have never seen before in the treatment community,” said Kathleen O’Brien, PhD, chief executive officer of Walden, which provides crisis, behavioral health, trauma, and recovery services to Southern Maryland. “Certainly, here, historically most of our treatment was related to alcohol and a mixture of some other drugs, but prior to about six years ago, we weren’t seeing opioids or heroin as a presenting problem. Now, that is about 70 percent of the primary substance abuse cases coming through our doors.”

Harry Gill, MD, PhD, medical director of Behavioral Health for MedStar St. Mary’s Hospital and president of Axis Healthcare Group, says he believes the opioid epidemic has gotten worse due to the prevalence of more lethal synthetic opioids. “Most patients have co-occurring disorders − they have a psychiatric disorder and addiction,” said Dr. Gill. “Going through substance abuse treatment provides temporary relief, but if the psychiatric condition is not treated, relapse is highly likely.”

Dr. Gill said many people who turn to opioids also have anxiety, depression, and post-traumatic stress disorders, all of which are treatable. In his work with the hospital, Dr. Gill is called in for psychiatric consultations with patients suspected of intentionally overdosing on opioids. These patients are typically discharged to outpatient substance abuse programs such as those provided by Walden, but often need treatment for co-occurring disorders. Support from their family and their community also plays a large role in the recovery process. “Family support is critical because it is such an isolating illness, such an isolating disorder that re-engaging with the world and, in particular, the people who love you unconditionally is a critical component of recovery,” said Dr. Gill.

Changing the Conversation

Winning the battle against opioid addiction means making sure those fighting their addictions know that assistance is available and they can receive help to access it. In addition, the community as a whole needs to accept that addiction is a disease, not a choice or a moral weakness, said Dr. O’Brien, and that treatment works and recovery is possible. “This disease doesn’t affect others, it affects all of us, and we all could possibly be afflicted by this disease,” said Dr. O’Brien. “In all my years in doing this, people think it’s the other who gets impacted, but we are all vulnerable.”

WHERE TO FIND HELP

Call the Maryland Crisis Hotline
at 1-800-422-0009 or visit
MedStarStMarys.org/Opioids
for information and links.

Note: This article concludes a four-part series on the opioid epidemic in our community. 

Experts in Healing: Center Offers Patients Advanced Wound Healing Treatments

The human body has the amazing ability to heal itself.

Sometimes, however, it needs a little extra help – especially when it comes to chronic wounds.

“When a person has a wound that isn’t getting better in a matter of two or three weeks, then it is time to ask the question, ‘What's getting in the way?’” said Richard Greengold, MD, medical director of the MedStar Health Wound Healing Center at MedStar St. Mary’s Hospital.

Elmer Bowling of Chaptico and Stephen Szepsi of Mechanicsville both turned to the Wound Healing Center following amputation of a toe due to infection. “I had a cut on my toe and 10 days later it looked like a shark bite,” said Stephen.

When treatment with antibiotics wasn’t helping, Stephen’s primary care doctor recommended surgery followed by a consultation with the Wound Healing Center.

 “When treatment with a primary care doctor doesn't result in wound closure, advance treatments including hyperbaric oxygen therapy, cellular based tissue products, wound vacs and compression dressings may be needed to improve a patient’s chance for healing,” said Alicia “Lisa” Nelson, the center’s program director.

“We diabetics take so much longer to heal and are much more susceptible to infection,” said Stephen, who received treatment with a wound vac three times a week for about about two months. “I can’t even say how many people were surprised at how well my foot healed, even the surgeon.”

Elmer’s recovery took much longer and involved multiple treatments and additional surgery to place stents in both sides of his leg to increase blood flow to his foot.

“The infection was climbing up my leg,” said Elmer, who is 72 and also diabetic.  A major component of Elmer’s treatment was hyperbaric oxygen therapy. “Being in the chamber never bothered me,” said Elmer.  “The therapy made my foot heal much faster.”

 “Most people can heal wounds with the right conditions,” said Dr. Greengold, “but sometimes getting the conditions right means stopping something that hasn't been effective and sometimes it means adding new treatments.”

“We understand how non-healing wounds impact your quality of life,” said Lisa, “and we want the community to be confident they can receive top-level care at our center.”

Visit MedStarStMarys.org/WoundCare for more information about the Wound Healing Center or call 240-434-7670.

Elmer Bowling, center, says the many hours he spent in the hyperbaric oxygen chamber were worth it to heal the wound on his foot. Wound Healing associates pictured with him are, from left to right, Jodi Black, RN; Emily Stiegman, RN; and Dawn Kilinski, RN.

MedStar Health Wound Healing Center
MedStar St. Mary's Hospital
25500 Point Lookout Road
Leonardtown, MD 20650
[Get Directions]
PHONE: 240-434-7670

Cardiac Rehabilitation Program Gives Patients Second Chance at Health

Beyond the Heart Attack

Pam Riley, BSN, RN, PCCN, clinical leader of the Grace Anne Dorney Pulmonary & Cardiac Rehabilitation Center, monitors Lew Armistead’s blood pressure as he exercises on the recumbent bike.

When you find something that works, you stick with it. Which is why when Lew Armistead needed cardiac rehab after his second heart surgery earlier this year, he returned to the Grace Anne Dorney Pulmonary & Cardiac Rehabilitation Center (GADC) at MedStar St. Mary’s Hospital.

Having participated in the center’s cardiac rehab program in 2014 following a heart attack and surgery to open a blocked artery, the 71-year-old Hollywood resident knew the program offered just what his doctor ordered to help him recover from surgery to repair an aortic aneurism.

“One of the things that really impressed me about the center was the staff,” said Lew, 71. “They have a lot of expertise in that room, and they are very committed to working with you. Usually, people who have to go to a workout don’t especially look forward to it. The people who staff the center have such a good attitude that I looked forward to going there much more than going to my regular health club.”

GADC’s program offers an individualized and personalized treatment plan, which incorporates evaluation and instruction on physical activity, nutrition, stress management and other health-related areas.  

“A lot of patients don’t know how much to push themselves after a heart attack,” said Pam Riley, BSN, RN, PCCN, clinical leader of GADC. “They have lost their confidence and self esteem. We can bring them in and show them how much they can push themselves and we can educate them on the signs and symptoms to look for so they don’t push too hard.”

Lew says he has always been a person who believes in staying in good physical condition, and he attributes completing the GADC program and the education he received there in 2014 to the quick recovery he made following his second surgery.

 “I thought my heart surgery was much easier than I anticipated,” he said. “People told me I would be in a lot of pain and I would have a long recovery period, but I went into my second surgery in much better physical condition than perhaps other heart surgery patients might.”

A Life-Saving Connection 

When Lew Armistead suffered a heart attack in 2014 he had already been under the care of a cardiologist, and he had met with a surgeon just eight days earlier to discuss correcting his aortic aneurism. So when he arrived at the Emergency Department of MedStar St. Mary’s Hospital in April 2014, he already knew who he would call next.

“Many cardiac patients who come to our Emergency Department can be treated here and follow up with a cardiologist after they leave,” said Dawn Yeitrakis, MS, RN, CEN, director, MedStar St. Mary’s Emergency Department. “Individuals with more complex cases, however, may need expedited treatment.”

MedStar St. Mary’s Hospital works closely with the MedStar Heart and Vascular Institute (MHVI) to ensure patients needing the highest level of care are quickly transported to MedStar Washington Hospital Center or the new Nancy and Harold Zirkin Heart & Vascular Hospital, a state-of-the-art cardiovascular care hospital offering expert cardiovascular services utilizing the latest medical technology.

“Being able to connect our patients quickly to the type of care available through the MedStar Heart & Vascular Institute can be life saving,” said Dawn.

Visit MedStarHeartInstitute.org to learn more about MHVI and the Nancy and Harold Zirkin Heart & Vascular Hospital.     

Learn more about cardiac and pulmonary rehabilitation programs offered at MedStar St. Mary’s Hospital on our website or call 240-434-7143.

 

Physical Therapist Earns McKenzie Institute Certification

 

IMG_3765_editedLeonardtown, Maryland – Patients suffering from neck and back pain now have a new option for treatment at MedStar St. Mary’s Hospital. Physical Therapist Jenna Holmes recently earned certification in Mechanical Diagnosis and Therapy (MDT) from the McKenzie Institute® USA.

To become a certified practitioner of the McKenzie Method of MDT, physical therapists must complete a series of advanced post graduate courses. The evidence-based patient management system has been proven to eliminate back, neck and extremity pain in fewer visits compared to traditional treatment.

The key distinction of the McKenzie Method is its initial assessment component – a safe and reliable means to accurately reach a diagnosis that will guide the appropriate treatment plan. Rarely are expensive tests required, as certified MDT clinicians have a valid indicator to know right away whether - and how - the direction-specific exercise treatment will work for each patient.

Holmes works primarily with patients who are experiencing low back pain that radiates down the leg or neck pain that radiates down the arm as well as patients experiencing pain primarily in their extremities.

“We see many patients who only want to treat their condition with conservative measures,” said Holmes. “Sometimes, however, we help them make decisions that lead them back to their physicians for further treatment.”

Holmes has been a physical therapist at MedStar St. Mary’s Hospital since 2012. She received the MDT Certification in December 2015. Dedicated to ongoing education and research, the McKenzie Institute is the center for postgraduate study in MDT. The McKenzie Method is a philosophy of active patient involvement and education for back, neck and extremity problems.

About MedStar St. Mary’s Hospital
MedStar St. Mary's Hospital (MSMH) is a full-service community hospital, delivering state-of-the-art emergency, acute inpatient and outpatient care in Leonardtown, Maryland. Nestled in a waterside community, MedStar St. Mary's provides advanced technology with a dedication to excellence in all services provided. The not-for-profit hospital has been named among the nation’s Top 100 Hospitals™ and is an eight time recipient of the prestigious Delmarva Medicare Excellence Award. In addition, MSMH received the Maryland Performance Excellence award at the Platinum level in 2014 – the highest in the state. Our staff is committed to providing quality and compassionate medical care for all patients by coupling innovation with our outstanding team of Medical Staff members, associates and volunteers.