From the category archives:

Ask the Expert

A bone marrow transplant is a lifesaving procedure used to treat and cure dozens of illnesses affecting all genders, ages and ethnicities. The Johns Hopkins Bone Marrow Transplant Program was founded in 1968 by George Santos, whose research paved the way for modern-day bone marrow transplant efforts. As a national referral center for bone marrow transplants, Johns Hopkins performs about 300 transplants a year.

Susan Crabbin, director of the Be The Match program at the Johns Hopkins Kimmel Cancer Center, weighs in on some questions about bone marrow and the process of becoming a bone marrow donor. Be The Match manages the world’s largest and most diverse registry of potential bone marrow donors.

For those interested in learning more and/or registering as a bone marrow donor, attend the bone marrow drive on Friday, Feb. 27, from 8 to 11 a.m. and 2 to 8 p.m. in Schaffer Auditorium in The Charlotte R. Bloomberg Children’s Center.

 

What is bone marrow? What does it do?

Bone marrow is the spongy tissue inside some of our bones that contains immature blood-forming cells known as stem cells. Stem cells develop into red blood cells, white blood cells and platelets. Healthy marrow and blood cells are needed to live.

Why would someone need a bone marrow transplant?

Bone marrow transplants are used as treatment for more than 70 diseases, including leukemia, lymphoma and sickle cell disease. Other diseases include aplastic anemia, myelodysplastic syndromes, immune deficiencies and inherited metabolic disorders.

How are bone marrow donors and recipients matched?

The best transplant outcomes are when the donor and recipient’s human leukocyte antigen (HLA) match closely. HLA is a protein found on most cells in the body. There are many HLA markers that make someone’s tissue type unique.

When someone joins the Be The Match Registry, a sample of his or her DNA is provided through a cheek swab, which is tested for six basic HLA markers.

When a patient is in need of a bone marrow transplant, his or her doctor will choose several potential donors from the Be The Match Registry, which matches the patient at the basic level. These donors will be asked to have additional testing done to see which donor matches the patient most closely. Eight percent of registered donors will go on to actually make a donation.

Is a bone marrow drive at all like a blood drive?

No, not really. During a bone marrow drive, interested people do not actually donate bone marrow. A bone marrow drive offers people the opportunity to learn more about the Be The Match Registry and if interested, they can register to become a member.

What is the process like to donate bone marrow? Does it hurt?

Once someone joins the registry, he or she will be contacted by a local donor center if a possible match for a patient. The first step is to have a blood sample drawn for additional testing. From this testing, the decision is made as to which potential donor will be asked to consider donating.

There are two possible ways of donating bone marrow. Before donation, the donor will be evaluated to make sure that the donation is a safe procedure for them. The average time commitment to attend appointments and donate is 30 to 40 hours over a four- to six-week period.

The two types of donation are:

  1. Marrow donation is a surgical procedure under anesthesia and is usually an outpatient procedure. During the procedure, needles are used to withdraw liquid marrow from the back of the pelvic bone. You will not feel this being done. After the procedure, there will be some soreness in the lower back. Donors are usually back to their normal routine in two to seven days.
  2. Peripheral blood stem cell donation is the most common way to donate. It is a nonsurgical outpatient procedure. For five days prior to the procedure, the donor receives daily injections of a drug that increases the number of cells in the bloodstream needed for transplant. On the fifth day, blood is removed from one arm, passed through a machine that separates out the blood forming cells and then is returned to the donor through the other arm. The procedure takes about four to six hours. Donors are usually back to their normal routine in a day or two.

What advice would you give to someone who is considering joining the registry?

My advice is to understand what you are signing up for. You are making a commitment to help any patient in need. If we contact you, we hope you’ll be willing to give a blood sample for further testing. If you are the best match, we hope you’ll be willing to become a donor.

Once I have joined the registry, what do I need to do?

Once you join the registry, you stay on it until you are 61 years old or until you tell us otherwise. You could be contacted in a few months or maybe years from now. Should you be a match for a patient, it is critical that we are able to contact you as quickly as possible. If you change any contact information, it is important that you contact us so we can update your information. When you register, we will give you ways to do this.

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Rachel WaldmanThe Johns Hopkins Integrative Medicine and Digestive Center features a team of board-certified physicians, licensed massage therapists, acupuncturists, psychotherapists and nutritionists who share a goal of working to treat the whole person.

Integrative medicine combines the best of biomedicine with a broader understanding of the nature of illness, healing and wellness. It makes use of all appropriate therapeutic approaches and evidence-based modalities to achieve optimal health and healing.

Rachel Waldman, an acupuncturist at the Integrative Medicine and Digestive Center, provides insight on receiving acupuncture treatments, as well as recent developments in the fields of acupuncture and integrative medicine.

Waldman and her team are currently accepting patients seeking acupuncture treatment. To learn more about acupuncture and other resources available through the Integrative Medicine and Digestive Center, visit hopkinsmedicine.org/integrativemed or call 410-828-3585.

How do you know if you should seek acupuncture treatment?

Acupuncture can be beneficial for a wide range of conditions but isn’t necessarily right for everyone. The best way to determine if acupuncture treatment can help you reach your health goals is to talk to your doctor or consult a licensed acupuncturist. They can evaluate your individual needs and make the appropriate recommendations. Generally speaking, acupuncture is most effective for chronic conditions that impact a person’s quality of life, such as chronic pain, digestive disorders, infertility, arthritis, migraines, insomnia and hot flashes.

Won’t acupuncture hurt?

No, acupuncture needles are tiny—much thinner than a human hair. They are about 10 times smaller than a typical hypodermic needle. They’re so thin, in fact, that they are actually quite flexible. Many patients say they don’t even feel when the needle is inserted. The effect of a treatment is—counterintuitively, perhaps—quite relaxing; some patients even fall asleep during sessions.

How many treatments will it take to work?

The number of treatments required to achieve a desired outcome varies widely, just like it does with any kind of medicine. There is no one-size-fits-all answer. But it's important to understand that the effect of acupuncture is cumulative—kind of like exercise. You wouldn’t go to the gym once and expect to see dramatic changes in your body. Similarly, your current of state of health and your health goals will determine the frequency and number of sessions required to achieve the desired effect.

Does acupuncture work for everyone?

Acupuncture is associated with improved outcomes for a variety of conditions, but it isn’t magic—it is a medical modality, and it has strengths and limitations. Nothing, not even antibiotics, work for everyone all of the time. But acupuncture is often very successful at reducing pain, accelerating healing and improving quality of life for patients. Start by talking to your doctor or consult a licensed acupuncturist to see if acupuncture would be a good choice for you.

What are some tips on preparing for an acupuncture treatment?

Make sure that you’ve had something to eat and are well hydrated. I also recommend avoiding caffeine and alcohol before and after treatment. If possible, don't schedule anything strenuous for at least a few hours following treatment. On the initial visit, patients should bring a complete list of their medications, including prescription drugs, vitamins and supplements, along with their dosages and any relevant health history like recent lab results, MRI or X-ray reports.

Are there any side effects?

Adverse effects (side effects) of acupuncture are extremely rare when performed by a well-trained, licensed acupuncturist. Actually, one of the things I like most about practicing acupuncture is that patients often experience so many side benefits. It is very common for sleep, digestion, mood or energy to improve along with whatever the chief complaint happens to be. This is the essence of integrative, holistic medicine.

What are some recent developments in the fields of acupuncture and integrative medicine?

In 2014, the Joint Commission published revisions to pain management standards that included the statement that care strategies should reflect a patient-centered approach and include nonpharmacologic interventions like acupuncture and massage.

Last year, the National Institutes of Health changed the name of the National Center for Complementary and Alternative Medicine to the National Center for Complementary and Integrative Health. It may seem like a minor difference, but the new name more accurately reflects the agency’s mission and the fact that people aren’t using therapies like acupuncture as an alternative to conventional care. They are using it in conjunction with conventional care, and we are seeing improved outcomes and higher levels of patient satisfaction as a result.

There is also a lot of fascinating clinical research going on at top institutions nationwide exploring possible mechanisms of action of acupuncture. Some of the most exciting ideas are moving way past the endorphin and gate control theories, instead looking at patterns of embryological growth and development to understand how acupuncture works. Researchers are also using functional MRIs to study brain activity when acupoints are stimulated, and we are finding some startlingly accurate correspondences with the “traditional” indications/actions of the points.

 

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Argye Hillis “I’m a vegetarian and I run at least five miles every day, but I don’t get enough sleep,” says Argye Hillis, director of the cerebrovascular division at Johns Hopkins Medicine. “Recently I’ve taken up horseback riding, which is a good challenge for my brain. I can meditate on long rides and find I’m happier, calmer and have less back pain.” 

Whatever healthy change you want to make, it’s not too late to start and to see the benefits. It’s time to take charge and not let your age stop you, because there’s surprisingly not that much difference between an 18-year-old brain and a 100-year-old brain.

Here are five lifestyle changes you can make, at any age, to keep you healthy and possibly even extend the length and quality of your life.
 

1. Be active more often
Exercise lowers your risk of many conditions including heart disease, type II diabetes, high blood pressure, and even some cancers. This powerful effect leads to something experts call “compression of morbidity,” which means you say healthy longer in your later years compared to someone who spends many years of their life battling one of these chronic illnesses.

Exercise is one of the best tools to prevent dementia and other cognitive changes. Set a goal for at least 30 minutes of physical activity most days of the week.

 

2. Improve Your Diet
Not every diet is about losing weight. Hillis recommends a Mediterranean-style diet, which minimizes many health risks and can help prevent dementia. This diet is rich in fruits, vegetables, whole grains, olive oil and fish, and is low in meat, sugar and processed foods. Altogether, this helps your cells function better. You can even s
earch for Mediterranean-style recipes in the Health Library.

3. Get Quality Sleep
Not getting enough sleep has a negative effect on your memory, emotions, weight and even your appearance. You need the same amount of sleep even as you grow older, though it may be more difficult to fall and stay asleep as you age.

The National Sleep Foundation suggests that most sleep problems are caused by snoring, medication side effects and underlying medical conditions, which can all be addressed by your doctor. You can better your sleep by creating a calm, sleep-friendly environment, setting aside enough time to fall asleep and practicing relaxation techniques.

 

4. Stop Smoking
Within 24 hours of stopping smoking, there is a decreased risk of a heart attack. Johns Hopkins researchers found that quitting smoking decreased middle-aged smokers’ risk of dying early by almost half. Exercise can help you combat smoking cravings and withdrawal symptoms, so plan your fitness activities around the time you will most likely want a cigarette. Soon your cravings may turn to those of physical activity instead. You can also check with your doctor about smoking-cessation programs and aids.

 

5. Challenge Your Brain
Your brain needs exercise just like your body. Whether it’s learning a language or driving a new route to work, your brain loves tackling fresh tasks. It’s never too late to learn a new language – make it a goal to keep learning as you age.

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Terry Langbaum is the chief administrative officer of the Johns Hopkins Kimmel Cancer Center and one of the lead developers of the Managing Cancer at Work Program.  Read more about the new benefit program in DOME.

  1. What inspired you to create this program?
    One in two men and one in three women will face a cancer diagnosis, and for most, it will occur during working age. That means all of us are experiencing cancer at some level. We’re either dealing with it ourselves, caring for a loved one with it, or working with someone who has it or is in the role of caregiver. As a three-time cancer survivor, I’ve experienced firsthand what it’s like to hold a job, raise a family and juggle cancer treatments. I’ve also worked closely with individuals who have faced cancer or have been responsible for a loved one with it. It’s challenging. Cancer turns your life upside down and that includes your work life. Employees are stressed about what they should or should not tell their supervisors and co-workers. Managers often feel unsure about how to respond to such news from an employee and what, if anything, they can do to support him or her. Co-workers are asked to “step up” while someone is out with cancer. The Managing Cancer at Work program fills in those gaps and provides the resources and support both employees and supervisors need.
  2. How does the program work?
    The program combines personalized nurse navigation with a unique Web-based educational program for employees and managers, designed specifically for the workplace environment.  Our goal for all employees is to prevent cancer, or to detect it at its earliest stage, so that it is curable.

    • A nurse navigator is available by telephone to provide confidential guidance to employees on medical and work issues while being treated or when serving as a caregiver, as well as access to support groups and other resources. To speak with Marie Borsellino, the nurse navigator, call 410-955-6229 or email her at managecancer@jhmi.edu.
    • The Managing Cancer at Work website, managingcanceratwork.com, provides comprehensive information and videos for employees, including types of cancer, screening, prevention and caregiver education. A separate portal on the website is available for managers. It offers guidance and resources on how best to support and manage when an employee has cancer or is caring for someone with cancer. Access the employee and manager portals on the website with PIN 6229.
  3. What do you hope to achieve with Managing Cancer at Work?
    We want to create a supportive and flexible work environment that will enable the employer and employee to maximize their goals. That’s possible when managers and supervisors are better prepared to support employees during their treatment and plan appropriately, even if the employee is unable to work, and when employees understand their options. For instance, employees may assume that they cannot work during cancer treatment, and often this is not the case. Many employees find it important to work because it keeps their lives “normal” while they undergo treatment.
    We want all of our employees to have the most up-to-date information about cancer — how to prevent it, detect it early and get treatment if necessary. Optimizing care and avoiding waste are important factors today in health care delivery.
  4. Do I have to pay for the services in this program?
    No. It’s free to you as an employee of Johns Hopkins.
  5. Am I required to participate as part of my insurance plan?
    No. The Managing Cancer at Work program is an added benefit for Johns Hopkins faculty and staff that is provided at no cost to you and accessing the services is completely voluntary.
  6. How can I be sure my supervisor will keep my information confidential?
    Federal law requires that personal health information be kept confidential unless a written consent form is signed indicating certain information can be shared with others. As your employer, Johns Hopkins is bound by that law, known as the Health Insurance Portability and Accountability Act (HIPAA). You can learn more about your rights and how your information is protected here: www.hhs.gov/ocr/privacy/hipaa/understanding/.
  7. Will Johns Hopkins be providing my cancer care?
    It is completely your decision where you decide to receive care. Johns Hopkins is not offering this service to increase patient volume. However, employees are welcome to access the expertise that the Johns Hopkins Kimmel Cancer Center provides.
  8. If I’m part of union (bargaining unit), can I receive these services?
    Yes. Johns Hopkins has made the Managing Cancer at Work Program available to every employee, union and non-union.
  9. Can I use the Managing Cancer at Work resources (web site, navigator) while I’m at work?
    Yes. Johns Hopkins has made a financial commitment to all its employees to provide this program free of charge. Your employer wants to make it as easy as possible for you to access the services Managing Cancer at Work offers.
  10. How much time off will I get if I use the Managing Cancer at Work program?
    That is a decision for you and your supervisor to make. Each individual situation is different and depends on many factors, including an employee’s current amount of allotted time off for vacation and sick time. For more information about talking with your supervisor if you or a loved has cancer, visit:
    www.managingcanceratwork.com. Use access PIN: 6229 to navigate through the site.
  11. Will the nurse navigator for Managing Cancer replace the other support nurse navigators and coordinators that are already in place at Johns Hopkins?
    No. This role is not intended to duplicate existing navigators but instead to make sure patients and caregivers understand what’s available to them and assist them in making connections to those resources.

  

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Did you know as a Johns Hopkins employee you could receive money toward the down payment or closing costs of a home through the Live Near Your Work Program? Learn more about this program offered by the Office of Work, Life and Engagement from Karen Salinas, communications manager from the Office of Work, Life and Engagement, in today’s Hopkins Happenings’ Ask the Expert.

  1. What is the Live Near Your Work program and who is eligible?
    The Live Near Your Work program (LNYW) provides financial assistance to fully-benefited Johns Hopkins University faculty and staff and Johns Hopkins Hospital and Health System employees toward the purchase of homes in specific Baltimore City neighborhoods near Johns Hopkins campuses. For full eligibility details, please review the LNYW program information.
  2. What is the overall goal (or goals) of the program?
    Down payment and settlement costs are one of the biggest barriers to homeownership, especially for first-time home buyers. LNYW strives to assist Johns Hopkins employees with these expenses and to enhance their overall WorkLife satisfaction by providing housing grants in neighborhoods close to their places of employment. The program also intends to strengthen the connections between Johns Hopkins and its surrounding communities.
  3. What are the grant amounts for each target area near the Homewood and East Baltimore campuses?
    Our current grant amounts/locations are found here: web.jhu.edu/lnyw/neighborhoods.
    *Tier A1 (Harwood, Barclay, and Greenmount West) - $23,000.
    *Tier A2 (East Baltimore Development Inc.) - $36,000.
    *Tiers B1 (Remington) and B2 (Better Waverly, and a section of Abell) - $10,000.
    *Tier C (sections of Baltimore Linwood and Baltimore Highland) - $6,000.
    *Tier D Perimeter Areas (within the LNYW footprint but beyond those of the other tiers) - $5,000.
    Our LNYW Neighborhoods web page includes maps of program boundaries and tier areas.
  4. If I’m interested in using a LNYW grant, what steps must I take?
    Interested employees should contact Sandy Jenkins, LNYW program coordinator at sljenkins@jhu.edu or 443-997-7000 prior to begin the search for a new home. It is recommended that you also familiarize yourself with program boundaries, target areas and grant amounts. Visit jhu.edu/lnyw to view this information. Home ownership counseling must be completed before entering a contract of sale.
  5. What are the benefits of urban living?
    Urban living offers considerable advantages especially when you live close to your place of work, including cutting commuting costs and travel time. Through LNYW, Johns Hopkins employees can select from an array of Baltimore’s housing options including historic properties, new construction, free-standing single family houses, row homes and condos. Additionally, convenient access to many cultural amenities such as the arts, entertainment, museums, diverse dining and retail shopping is a significant benefit of urban life. Visit Living in Baltimore for links to several community resources.
  6. Which neighborhoods are hot?
    Over the past 12 months, approximately 75 percent of LNYW grants awarded have been split equally between the A1 and A2 tier areas (Harwood, Barclay, Greenmont West and East Baltimore Development Inc.), likely a result of their high grant amounts, proximity to the Homewood and East Baltimore campuses, and significant residential, commercial, and retail development.
  7. What are residents of LNYW target areas talking about?                                                                                                                                            Residents are talking about restaurants such as Teavolve, the new Henderson-Hopkins School and Harry and Jeanette Weinberg Early Childhood Center.
  8. How many employees have received a LNYW grant?
    Since fiscal year 2009, nearly 400 employees have received LNYW grants totaling over $3,500,000.

 

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Corrective eye surgery has become a more accepted option for people looking to improve their vision in the last 20 years. The Johns Hopkins Wilmer Eye Institute is considered a leader in eye care and offers a wide spectrum of vision correction treatments.

Wilmer Eye Institute ophthalmologist and cornea specialist Christina Prescott specializes in medical and surgical management of corneal diseases, laser vision correction and cataracts. Prescott earned her M.D. and Ph.D. from the University of Colorado. After performing her ophthalmology residency at Yale, she completed a fellowship in cornea, refractive surgery and external disease at the Massachusetts Eye and Ear Infirmary of Harvard University before joining the Wilmer faculty in 2012. In this edition of Ask the Expert, she discusses laser vision treatments and how you can determine if a corrective eye procedure is right for you.

How does someone know if laser vision correction is the right procedure for them?

People pursue laser vision correction for a variety of reasons. Those who have good vision with glasses or contact lenses but have trouble tolerating them are usually great candidates. Others, such as pilots or police officers, may need to improve their vision for professional reasons. Some athletes may choose to improve their vision so they can excel at their chosen sports, such as swimming or martial arts. One woman wanted to be able to see her baby when she woke up in the middle of the night. Many patients tell me after surgery that they love being able to wake up and see their alarm clock. Everyone has his or her own reasons for wanting to see clearly.

Unfortunately, not everyone is a good candidate for refractive surgery; those who do not see well even with glasses or contact lenses are usually not good candidates for refractive surgery. Additionally, there are both medical and ophthalmic contraindications to refractive surgery, which is why it is so important to have a complete ophthalmic exam as part of your refractive surgery evaluation.

What are the main differences between LASIK (laser-assisted in situ keratomileusis) and PRK (photorefractive keratectomy) procedures?

The main difference between LASIK and PRK is the site of the excimer laser treatment. In LASIK, a femtosecond laser—previously, a microkeratome—is used to make a flap. The flap is lifted, and an excimer laser is used to treat the central cornea. The flap is then replaced. In PRK, the epithelium—front layer of tissue covering the cornea—is removed, and the surface is treated with the excimer laser. The epithelium then heals over the treated area. At Wilmer, we offer LASIK, PRK and today’s other advanced surgical technologies for vision correction.

How do you determine the preferred procedure?

A complete ophthalmic exam, including wavefront imaging and topographic mapping of the cornea, is performed. Specific findings on exams or imaging may lead your ophthalmologist to recommend one procedure over another; patient occupation and lifestyle considerations are also important. Ultimately, after a discussion with a surgeon about specific options, patients choose which procedure is right for them.

What is the recovery process like?

The recovery process varies depending on the surgical procedure chosen. One of the reasons for the popularity of LASIK is that there is virtually no pain, and the visual improvement is almost immediate. With PRK, there is some discomfort for three to five days, and the vision can fluctuate for several days to weeks following the surgery. Patients may experience some dry eye symptoms following either procedure, especially if they had problems with dry eye prior to surgery, so use of artificial tears is often recommended.

How long does corrective sight last following the procedure?

Refractive correction is permanent, and the vast majority of patients will enjoy their new vision as long as they do not develop any other ophthalmic pathology, such as cataracts, glaucoma or macular degeneration. Approximately 5 percent of patients, most often patients who had a high refractive error prior to surgery, may experience some regression and may choose to have an enhancement. One unique aspect of refractive surgery at Wilmer is that we include two-year follow-up care, including complimentary enhancements if needed, for all of our patients.

Make an appointment with Prescott by calling 410-893-0480 or by visiting the Wilmer Eye Institute at hopkinsmedicine.org/wilmer/.

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Winter is now officially here and before the chilly climate truly takes form, you'll want to make sure your home is fully prepared for the season. Take note of some common and some little known tips on winterizing your home for the next three months.

  • Insulate! Insulating your water lines can help reduce hot water costs and can help decrease the chances of your pipes freezing. As water freezes inside a pipe, it expands, potentially causing damage to the pipe and serious water damage inside your home. Use pre-slit pipe foam and secure it with duct tape. The insulation check also goes for your walls and plug/switch outlets, which could release a ton of heat if the insulation within is not up to par.
  • Check your gutters to clear them of any clutter, which may include dirt and leaves, in order to help prevent stoppage that may lead to water damage to your roof, ceilings and walls.
  • The U.S. Department of Energy says that drafts that flow through under your doors can waste 5% to 30% of your energy use. Use a draft snake to help block this flow and save some money on your energy bills.
  • Many ceiling fans are able to reverse the direction of the blades. Switching the rotation of the blades to clockwise actually makes it warmer and helps curb a reliance on your heating system.
  • It may sound like common sense, but installing a storm door and windows can increase energy efficiency by shutting out the cold and letting light and ventilation enter your home at the same time.
  • Clean your deck.  Mold and mildew can form on deck surfaces, leading to wood rot. Cleaning and sealing these surfaces can help extend the life of your deck. Mildew-covered surfaces can become really dangerous as they freeze in the winter causing them to be extra slippery.
  • Check your furnace and change the filter regularly. New furnaces can go up to five years without professional maintenance, but keeping the filter changed regularly helps it perform best during the cold months. Older furnaces may need a professional check-up. You can have someone inspect your furnace and look for carbon monoxide leaks to insure that it’s performing at its best efficiency.

Hopefully these tips can help you enjoy a safe and - most importantly - warm winter in 2015!

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With the holidays fast approaching, Corporate Security would like to remind you of some crime prevention tips. As we have monitored both criminal and non-criminal activity over the years, we’ve typically seen a slight increase in thefts and other crimes of opportunity on and around the East Baltimore campus during the holidays. Most recently, we have observed a slight uptick in attempted cell phone thefts north and east of our patrol boundaries. We would like to take this opportunity to share the following crime prevention tips in hopes you will partner with us in helping to create a safe environment for everyone.

  • Always be aware of your surroundings.
  • When out and about, stay in well-lit, well-traveled areas.
  • Do not use cell phones, iPods, or tablets as you move about. Doing so will distract you from what is occurring in your surroundings.
  • Whenever possible, travel with a partner or in groups.
  • Use Corporate Security’s escort services when on or around the East Baltimore or Bayview campuses. To request a security escort, call 5-5585 (East Baltimore campus) or 0-0333 (Bayview).
  • When parking, secure items or packages left behind in the trunk or cover them to keep them out of sight. As an alternative, leave these items at home or carry them with you as you leave your vehicle.
  • When leaving your office, secure property and lock office doors, even if you will only be gone for a short time.
  • If you become a victim of a crime, try to stay calm, surrender any property that is requested of you and immediately notify security or the police.

For more information and additional safety tips, please visit hopkinsmedicine.org/security_parking_transportation

All faculty, staff and students are reminded to alert Security Communications immediately (5 5585 – E. Baltimore; 0-0333 - Bayview) of any suspicious persons or activity.

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Sure, getting gifts for your friends and family may seem difficult enough, but exchanging gifts with co-workers in the office can be a whole different level of stress. Don't fret, here are five tips that can help you determine the best practices for holiday gift giving in the workplace this holiday season.

Have any tips of your own? Let us know in the comments section below.

 

Be Thoughtful

You don't have to get too personal, but it's always nice to show you know a little something about the person receiving the gift, even if it's something specifically related to what they do on the job. Gift cards to an eatery or store they talk about are perfect examples.

Give gifts in a private setting

If you're only giving gifts to a select person or group in the office, it's best not to do it in front of others. Some in the office may not be receiving gifts at all, or may be jealous of the gifts given to co-workers around them. When possible, try to give gifts equal in value when giving to a group.

Think of your assistants

It's a great way to show your gratitude for all of the work they do in putting up with you! All jokes aside, even a small token of appreciation goes a long way in saying "thank you" for their efforts during the year.

Go in with a group

When considering a gift for your boss or supervisor, let the team be represented as whole. It won't come off as self-serving as an individual gift could and can help get your boss a really great gift while keeping everyone within a budget.

Pass on gag gifts

It's generally a bad idea to gift something that could be seen by anyone in the workplace as offensive. While these types of gifts can be funny when exchanging with friends and family, they should stay out of the office.

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As we get older, our knees, hips, ankles and other joints begin to wear down from years of use and stress - sometimes causing great pain. What causes joint pain and what can be done to help prevent and alleviate joint pain? Assistant professor of orthopaedic surgery Robert Sterling answers some questions about best practices for keeping our joints healthy in today's Ask The Expert.

What are some variables that lead to joint pain?

SterlingThere are numerous potential causes of joint pain, including pain from ligaments, tendons, bones and sources within the joint itself, such as the cartilage and joint lining. Overuse injury is a very common cause of joint pain, as is repetitive trauma. For example, jackhammer operators have an increased incidence of wrist and elbow pain.

The most common cause of joint pain in adults is osteoarthritis. Being overweight has been shown to be a risk factor for development of arthritis in the knee. Arthritis becomes more common as people age, and arthritis is more common in women than men. Trauma, genetics, hormones and nutrition are other contributors to the development of joint pain and arthritis.

 

How can highly active people help preserve their joints though the added strain?

Maintaining a healthy lifestyle is critical to joint health. Highly active people can preserve their joints best by avoiding injury. Many sports have been tied to knee injuries, including soccer and competitive basketball. Proper preparation before participating in sports and proper muscle recovery after activity can help prevent injury and preserve joint function.

 

What can people do to alleviate pain from arthritis if they have it?

Unfortunately, there is no way to “cure” osteoarthritis. However, people can do some simple things to slow the progression and limit the pain.

Weight control is one factor that can help ease arthritis pain. In the knee joint, for each pound of weight, the joint can feel 1.5 to 3 pounds of pressure when climbing a step. Maintaining a healthy weight can help slow the progression of osteoarthritis.

An exercise program for the muscle around the knee and hip will improve strength and often decreases joint pain from arthritis. The use of a simple knee sleeve can also improve pain by providing compression at the joint. Over-the-counter medications, such as acetaminophen or anti-inflammatory medications, are also commonly used to relieve arthritis pain.

 

What are the best supplements available for joint pain relief?

There are numerous supplements available that are advertised for relief of joint pain—glucosamine, chondroitin sulfate, ginger, methylsulfonylmethane, etc. However, there are no rigorous clinical research trials that consistently demonstrate positive effects of supplements.

The clinical practice guideline on treatment of osteoarthritis of the knee published by the American Association of Orthopaedic Surgeons does not recommend use of glucosamine and chondroitin sulfate due to a lack of evidence. That said, many individuals do feel relief from taking supplements, and the effect in an individual cannot be discounted.

Supplements can have side effects—for example, ginger can cause blood thinning—or interact with prescription medications. Anyone interested in adding supplements to a health regimen should be aware of this and make sure that the supplement will not interfere with any prescription medications.

 

Some food and drinks, such as fish and milk, are thought to help prevent wear on bones and joints. Is this true? If so, are there any others?

The risk of developing rheumatoid arthritis, an autoimmune disorder affecting the joint lining, has been show to be lower in people who consumed higher levels of vitamin D, Vitamin C and omega-3 fatty acids.

A study from one center found that eating cruciferous vegetables, such as broccoli and cauliflower, had a protective effect on the development of arthritis. There are numerous other foods that may help ease joint pains due to their natural anti-inflammatory properties, such as onions, leeks, extra-virgin olive oil, fatty fish, walnuts and soy beans.

 

What are the most common joints that require replacement?

The knee is the most commonly replaced joint, followed by the hip, shoulder and ankle. In 2010, there were more than 700,000 total knee replacements and more than 300,000 total hip replacements performed in the U.S.

 

If joint replacement is necessary, what recovery tips do you have for people who have received replacement surgery?

Proper presurgical preparation is critical to making the recovery easy. Ask questions. Patients who are better informed and participate in the development of their treatment plan have better outcomes.

Losing weight before surgery is critical for obese patients, both to ease the recovery and reduce the risks of surgery. A preoperative exercise program involving the arthritis joint helps improve postoperative recovery. A simple program of stretching and gentle strengthening can go a long way postoperatively.

If you are having surgery on your hip, knee, or ankle, find out how to prepare your home before surgery to prevent falls. Find a “coach” who will be available to assist you after surgery, and who can help you at home with both your personal care and home exercises.

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