Download November 2012

Quarterly, Issue 2
Welcome to our Fall Edition: November 2012
Happy
sickle Birthday!!
cell infusion
center open 7 days
a week
December:Mojibade,
Thomas, Francine, mona, Karen,
Monday- friday
sotunji, donnae, david, afii9-am-5pm
wa,
dana, martina, shamia,
rufus, james, chante, don,
Saturday –Sunday
Gloria, Margaret, Celina,
10am-8pm
trina,
Gregory, Camille,
Breona, William, dion, joi,
Call ahead
be
queen,
donatey, to
Ashley,
seen 443-287-8288
Annette,
aaron, takeyla,
Linda, florecita, kimberly
———————————
Holiday
closures:
January:Adenike,
mojisola,
Antonia,
Dec
24 : tiffany,
9am-12Glenda,
noon
astou, Danielle, james, rog-
er, david,
carlton,
Dec
25 : ricci,
Closed
samia, takehia, keith, ra-
Dec
31 : 9am-12
noon
ther, Lucinda,
Kimberly,
ehizogie, chantia, tamika,
jan
1 : closed
Samuel,
Antoinette,
shaneekiia, Beverly,
thomasine, vertino
Infusion center
Re-open:
February: dec 26 and
Jan 2nd
Our team at the Sickle Cell Center for Adults at Johns
Hopkins would like to wish you a wonderful holiday season.
One of our generous patients’ is donating 15-20 turkeys for the
holiday season. This individual has made numerous contributions to our sickle cell infusion center. We are thankful for each
of you throughout the year for your kind acts.
We will be raffling off these turkeys for you and your
family. Please stop by the infusion center to fill out your raffle
ticket. We will be picking our winners on December 14th and if
you are a winner we ask that you pick up your turkey on
Wednesday, December 19th between the hours of 3-5pm.
We are looking forward to the 5th anniversary of the
infusion clinic which we will celebrate in February 2013. We
have had a successful first 5 years and we hope to have many
more. We are planning a celebration and will fill you in on the
details as soon as they are finalized.
We hope you have a safe and healthy holiday season.
WHAT’S INSIDE……………………..?
Marijuana, Risk and Benefits..…………...….….. .pg. 2
Script pick up days
for holidays:
Open Enrollment Reminders……………………..pg 3
Mon, wed, fri
Blood Clots in Sickle Cell….……………………….pg 4-5
1-4pm
Fashion Show Highlights…………….………..…...pg. 6
Happy holidays !
Welcoming our new nurse………………..………..pg 7
The Sickle Cell Team …………………….………...pg. 8-9
HAPPY THANKSGIVING!!!
Marijuana: more risk than benefit?
Whether you call it pot, weed, grass, ganja, or skunk, marijuana by any other
name is a drug that affects the brain. More than 400 chemicals are in the average
marijuana plant. When smoked, heat produces more of them. How does those
chemicals affect you?
Marijuana has been thought to relieve pain and relax the body. But does it
benefits cause more damage than it is worth? When someone uses marijuana, these
chemicals travel through the bloodstream and quickly attach to receptors on the
brain’s nerve cells. Our receptors normally receive information from other nerve
cells and from chemicals. If marijuana is blocking the receptors from receiving
information, our understanding and response time is slower. Therefore, marijuana
causes parts of the brain that controls emotions, memory, and judgment to lose
balance and control.
The use of marijuana to treat various medical conditions, or “medical marijuana” is a controversial topic. Some people feel its benefits justify its
legalization as a medicine for patients. It is not approved by the FDA (Food and Drug
Administration), thus, it can’t be prescribed legally in Maryland. But why has it not
been approved yet? Because there have not been enough clinical trials showing its
benefits outweigh its risks.
Marijuana has certain adverse health effects that must be considered. It can
cause or worsen respiratory symptoms. It also impairs short term memory and
motor coordination, slows reaction time, alters mood, judgment, and decisionmaking. In some people it can cause severe anxiety (paranoia) or psychosis (loss of
touch and reality). Not to mention its addictive effect.
Research has shown that, in chronic users, marijuana’s adverse impact on
learning and memory can last for days to weeks after the acute effects of the drug
wears off. As a result, someone who smokes marijuana every day may be
functioning at a suboptimal intellectual level all of the time.
If marijuana is mixed with other drugs, such as narcotics, the combined effect
can decrease brain activity and breathing. Marijuana increases the heart rate by 20100 percent shortly after smoking. This effect can last up to 3 hours. One study
showed that marijuana users have a 4x increase in the risk of heart attack in the first
hour after smoking. It is more cancer causing than cigarette smoking. Marijuana
smokers show altered growth of cells in their lung tissue, which could lead to cancer.
Use of marijuana may lead to respiratory problems, daily cough, sputum
production, frequent acute chest illness, and increased risk of lung infections.
Treatment options are available such as behavioral interventions and motivational incentives. If you want to learn more, please make an appointment and discuss with your provider at your next visit.
http://www.drugabuse.gov
Health insurance reminder:
I would like to take this opportunity to remind everyone that as we embark upon the “New
Year” we should be mindful of health benefit changes.
Individuals insured under Medicare or private insurances should receive a benefits enrollment
package with updates.
Individuals insured through a MCO (Managed Care Organization) through Maryland/ Medicaid/Health Choice program should receive an annual right to change notice.
These packages usually contain important information about your health benefits. Open these
packages immediately. Enrollment only last for a brief period.
“Open Enrollment”
Open Enrollment is an opportunity generally offered once-a-year to change your medical plan.
Check with your human resources department to see when your company’s open enrollment
period begins and ends, and when the policy goes into effect.
You may enroll in the Medicare 2013 health plan from October 15, 2012-December 07, 2012.
Your new coverage starts January 2013. If you have questions regarding Medicare coverage
please call 1-800-633-4227.
“Annual Right to Change”
This is the only designated time allowed for you to change your MCO if you want for any
reason. Please contact the enrollment line @1-800-977-7388, to inquire about your enrollment
date. Participants are usually assigned a designated month to change if they choose.
Changes that may affect you:
Read completely through your open enrollment package because plans change yearly.
Be sure your provider participates and accepts your insurance. Doctors come and go.
Be aware that you might be paying more due to premium increases.
If you take prescription medication, check prescription drug plans. Some or new drugs may
have been added or deleted from the list and the cost might increase.
Review any pre-existing condition exclusions and prior authorization requirements.
If you are happy with your current health plan, you don’t have to change your plan but review
the packet for updates and increases.
“Important facts to remember”
The only opportunity you will have to make changes to your health plan is during the “open
enrollment” period or during your “annual right to change.”Exceptions are usually made if you
experience a qualifying Life Event (Please check with your insurer).
Don’t miss out on the opportunity to be insured. It’s a greater burden to pay out-of-pocket for
medical treatment, prescriptions and other expenses if you are uninsured.
If you have any doubt please contact customer service.
Submitted by,
Dawn Hatcher, BSW, L.S.W.A.
What you need to know about blood clots:
Blood clots can form in any vein of the body and most often occur as a
consequence of hospitalization, central venous catheters, surgery, or of chronic
illness itself. Patients with sickle cell disease are at high risk of developing blood
clots, not only because they require frequent hospital care, but also because sickle
cell disease itself can predispose to clot formation. In some circumstances, blood
clots can lead to life-threatening consequences such as lung disease, heart failure, or
death, therefore patients and providers need to be vigilant about preventing,
diagnosing, and treating blood clots.
Deep venous thrombosis (DVT) is the term used to describe the development of blood clots in the deep veins of the body. The most common sites for
DVTs to occur are the legs, thighs, and arms. Very commonly, DVTs, especially in
the arm, occur around central lines because catheters are foreign bodies that can
cause slow blood flow or can cause red blood cells to stick to the catheter surface.
The symptoms of DVT are pain or swelling in the affected limb or sluggish flow
from a catheter. Diagnosis is made by performing an ultrasound that can detect
slow or absent flow in the deep veins.
Pulmonary embolism (PE) is the term used to describe a blood clot in the
lungs. PEs occur because blood clots from the legs or arms dislodge and travel up
to the lungs. However, not all patients who experience a PE will have experienced
swelling or pain of the leg or arm before the PE. Symptoms of PE include
shortness of breath or chest pain. PEs are diagnosed by a special CT scan of the
lungs that requires intravenous (iv) contrast or a ventilation-perfusion (V/Q) scan
that requires a breathing test and an iv injection.
Luckily, there are some things you can do to prevent blood clots, especially
while in the hospital. People who are admitted to the hospital are at high risk of
developing blood clots because they are not feeling well so they don’t – or can’t –
move around a lot. They also often have worsening of their underlying disease
which increases their risk of clot. Because of this, physicians often prescribe daily
heparin injections, compression stockings, or compression devices during hospital
stays to decrease the risk of clots. The best way to prevent clots in the hospital is to
follow the recommendations made by the physicians and nurses
because the choice of preventive treatment is tailored specifically
for you as a patient.
Blood clots continued:
If you are diagnosed with a blood clot, prompt treatment is very important.
The goal of treatment is to prevent the clot from getting bigger and to prevent
future clots from occurring because people who develop one clot are at high risk of
developing a second one. For DVTs, treatment also helps prevent the clot from
traveling up to the lungs, and for PEs, it helps prevent the existing lung clot from
causing permanent heart or lung damage. Treatment usually consists of an iv drip
of heparin or subcutaneous injection of low molecular weight heparin (or Lovenox)
followed by long-term therapy with coumadin pills. These medications help thin the
blood. The reason why iv heparin or Lovenox injections must be given first is
because it takes several days for the effect of coumadin to kick in and during that
time, there is a high risk for the clot to get bigger or move around. Therefore, it is
very important to listen carefully to the instructions given to you after you develop a
blood clot and take the medications exactly how they are prescribed.
After you are started on blood thinners, you will need to be followed closely
in a clinic called an Anticoagulation or Coumadin Clinic to monitor your blood levels
of coumadin. In the beginning, you may need to come into clinic weekly or even a
couple times a week so that the coumadin can be adjusted into a safe range. The
frequency of visits will become much less as the team finds the right dose for you.
It is very important for you to come to all of your coumadin clinic appointments
because if the dose is too low, you will be at risk for more clots, and if your dose is
too high, you may bleed.
In summary, blood clots can occur in patients with sickle cell disease. You can
help prevent blood clots by listening to the recommendations made by your
providers in the hospital. Similarly, if you are diagnosed with a blood clot, it is
important for you to adhere to your treatment plan and to attend all coumadin clinic
appointments so that you can prevent severe complications.
By Rakhi Naik, M.D.
Fashion show by miracle bishop
Welcome our new nurse: Dzifa Dordunoo
Dzifa (pronounced "Jeefah") is originally from Ghana, grew up in Britain
and Canada. She earned her bachelor's degree in nursing from University of
Victoria, Canada and holds a master's degree in nursing from Duke University
with post master's certificate in clinical research management and teaching.
She has over 11 years experience as a registered nurse in cardiology and
has worked mainly with the cardiac population. She most recently held positions
in the coronary care unit at the Johns Hopkins Hospital with several years of
clinical research work with end stage heart failure patients at Johns Hopkins
University.
Dzifa is currently pursuing a doctoral degree from University of Maryland,
Baltimore. When she is not working, she loves spending time with her son,
traveling, reading and watching cartoons.
sickle cell team: providers
Linda Smith-Resar,
M.D.
Sophie Lanzkron, M.D.
Hematologist
Director of the Sickle Cell
John Strouse, M.D.,
PhD
Center for
Hematologist
Adults at Johns Hopkins
Yvette Roane, PA-C
Physician Assistant/
Program Manager
(right)
Pat Carroll, M.D.
Chronic Pain Specialist,
Psychiatrist
(left)
Pius Afriyie, PA-C
Mandy David, PA-C
Physician Assistant/
Physician Assistant/
Clinical Coordinator
Clinical Coordinator
Candice Fori, MPAS, PA-C
Physician Assistant/Clinical
Coordinator
the Sickle Cell Team……..
Cynthia Washington
Registered Nurse
Nicklaine Paul
Dzifa Dordunoo
Lead
Registered Nurse
Registered Nurse
Dominique Lyles
Clinical Associate
Dawn Hatcher
BSW, Social Worker
Terri Blackwell
Clinical Associate
Cody Cichowitz
Research Assistant
Sickle Cell Center for Adults at
Cedron Williams
Sadie Molock
Clinical Research
Consultant
Sr. Medical Office
Johns Hopkins:
Phone: (410)502-7770
Romaine Bradshaw
Fax: (410)-614-8601
Clinical Coordinator
Sickle Cell Infusion Center:
Phone: (443)-287-8288
Fax: (410)-614-0686