Medical Misconception: Advance Directives

Each month, a health care professional will weigh in on a health and wellness myth.

This month’s misconception: Advance Directives   

Advance directives are an important, but often misunderstood, tool in health care. This document specifies what actions should be taken in the event that you are no longer able to make health care decisions due to illness or incapacity, and it identifies a person of your choosing to make such decisions on your behalf.

Myth: I’m healthy so I don’t need an advance directive.

Anyone age 18 or older should have an advance directive, whether they are healthy or facing a chronic illness, says palliative care nurse Laurie Luellen, R.N. “We never know what tomorrow is going to bring,” she says. “If something happens and someone is not able to make their own decisions, it makes it easier for the family to know what to do.”

Myth: An advance directive needs to be completed by a lawyer.

Two witnesses are all that is needed in order to fill out an advance directive. These witnesses must be age 18 or older, and neither can be the person you’ve chosen as your medical advocate. One important note: these witnesses don’t need to read your advance directive or know what you’ve outlined in terms of your health care decisions. They are there to simply witness that you signed the document, Luellen says.

Once the advance directive is completed, Luellen recommends giving a copy to your medical decision maker and to your local hospital, even if you’ve never been a patient there. The hospital staff will scan and save your advance directive so that it is always on file in case of an emergency.

Myth: If you have an advance directive, medical staff won’t put the full effort in to saving your life.

A lot of people think this is the case, but it is simply untrue. Hospital staff will make every effort to fulfill the wishes you have outlined in your advance directive. In addition to the advance directive identifying a medical advocate, the document also allows for individuals to outline the type of care they would want if they have a terminal condition, an end-stage condition or if he or she is in a persistent vegetative state.



Medical Misconception: Breastfeeding Myths

Each month, a health care professional will weigh in on a health and wellness myth and will explain the real cause behind the malady.

This month, we debunk three common breastfeeding misconceptions.

Myth 1: Breastfeeding comes naturally.
Yes, breastfeeding is a natural process, but that doesn’t mean that it’s intuitive. It takes practice and persistence, and nearly every mother and baby has some sort of issue along the way. A lot of work and effort goes into breastfeeding, but the benefits are numerous for mom and baby. Take a breastfeeding class to familiarize yourself with techniques before you have your baby, and join us for our breastfeeding support groups to share tips and tricks with other moms. Learn more about breastfeeding classes and support.

Myth 2: Breastfeeding always hurts.
Being uncomfortable and sore can be normal as a woman begins to breastfeed for the first few days to weeks, as her body may experience sensitivity from hormones after delivery and is adjusting to the baby nursing frequently. However, if she has consistently painful breastfeeding sessions, it is important that she seeks help from a lactation consultant as soon as possible. Most of the time it is something easy to correct, such as a poor latch or poor positioning of either the baby or the mother.  A lactation consultant will be able to evaluate and help with making the nursing experience as comfortable as possible. In most cases, breastfeeding should not hurt.

Myth 3: I am not producing enough milk.
When it comes to milk production, colostrum (the first milk) is being produced by the mother as early as 26 weeks into her pregnancy and is ready for the baby immediately after birth. This thick liquid is loaded with protein, sugar and antibodies, and it’s helpful with keeping the baby healthy as he or she adjusts to his or her new world.

For the first two days, the baby will only be taking in about 1 teaspoon at each feeding; the size of the belly at this time is only the size of a cherry. Then, between days two and six, the baby will cluster feed or nurse frequently. This frequent nursing is necessary to establish your milk supply and increase the volume of milk for the baby.

Newborns eat anywhere from eight to 12 times a day. Keep a feeding log to determine if your baby is getting enough to eat through breastmilk.

By day four, if the baby is eating eight to 12 times a day, is having six to eight wet diapers and four or more yellow, loose, seedy bowel movements, this is a good indication that he or she is receiving enough milk.

The breastfeeding hotline at Carroll Hospital (410-871-7024) is available to provide support and to get your concerns addressed.

Angela Baublitz, R.N., is a lactation consultant with The Family Birthplace.

Inside Carroll Hospital: Vision 2020 Update

In 2013, Carroll Hospital unveiled Vision 2020, a seven-year strategy to create a new model of care: one that focuses not only on delivering exceptional care for the sick, but also on helping community members get healthy and stay well. Now three years into the ambitious plan, we sat down with Helen W. Whitehead, chair of the hospital’s board of directors, to see how Carroll Hospital is transforming that Vision into a reality.

Read More

Bariatric Surgery: A Possible Weight Loss Option

When it comes to losing weight, some people believe they’ve tried everything without success. For many, it’s just a matter of staying committed to your weight loss goal or visiting a dietitian to ensure you are on the right track. But for others, bariatric surgery is an alternative.

Bariatric surgery may be an option for adults who have a body mass index (BMI) over 40 or have a BMI of 35 or more with a serious health problem linked to obesity, such as type 2 diabetes, heart disease or sleep apnea.

Several different types of procedures are available, but all involve restricting the stomach’s volume either temporarily or permanently to make the person feel fuller sooner.

Four of the most common bariatric procedures are:

  • Gastric Bypass Surgery — this involves stapling the stomach to create a small pouch in the upper section and then cutting the person’s small intestine and rerouting it to a different area of the stomach so the body absorbs fewer calories.
  • Gastric Sleeve Surgery — this involves removing a large portion of the person’s stomach, leaving only a banana-shaped section that is closed with staples.
  • Laparoscopic Adjustable Gastric Band Surgery — this involves placing a ring with an inner inflatable band around the top of the stomach.
  • Intragastric Balloon Procedure — here, a saline-filled silicone balloon is placed inside the stomach and inflated. The balloon is left in place for six months.

At LifeBridge Health, all the above surgeries are performed minimally invasively at Northwest and Sinai hospitals, resulting in smaller incisions and faster recovery times. In general, people can return to their normal routines within two weeks, but should still take it easy for six to eight weeks while they heal.

While you will see a dramatic weight loss immediately after surgery, how long you will maintain that weight loss is up to you. Keeping those excess pounds from coming back still requires effort on your part. That means adopting a healthy lifestyle with regular exercise and eating nutritiously, long-term, is essential.

To learn more about bariatric surgery and which procedure may be right for you, attend a Bariatric Seminar, presented by bariatric surgeon Celine Richardson, M.D., the second Tuesday of each month from 5:30 to 6:30 p.m. at Carroll Hospital. To register or for more information, call 866-404-3627 (DOCS).