Compliments of Johns Hopkins USA FALL 2010 Insight and news from Johns Hopkins Medicine Protect your voice for a lifetime Heavy health concerns surround metabolic syndrome Second opinions give second chances Medical Mysteries It’s not “all in your head.” Beware of five conditions that cause hard-to-diagnose pain for women FdJHFA1003_01_Cover.indd 1 9/29/10 8:40:30 AM Contents High Blood FALL 2010 QUICK CONSULT | Talking Points Pressure 4 You don’t have to be a performer to need to keep May Take your voice in shape. | Weighing the Risks Its Toll 5 Are you at risk for meta- bolic syndrome? The scale may tell the tale. on Your FIRST PERSON | Four-Time Survivor Kidneys 1 0 Multiple bouts of bladder cancer couldn’t stop Steve Winick from reclaiming his life. SECOND OPINION | Second Opinions, 11 Second Chances Recently diagnosed with cancer? Discover why you may want to ask for a second opinion. T’S NOT NEWS that hypertension previously undiagnosed high blood pressure also increases your risk for heart disease suff ered from kidney disease. ON THE COVER and stroke, but new research is discov- e message is clear: “If you’re a patient with Medical ering it can also increase your risk for high blood pressure, ask your doctor to test for 6| Mysteries kidney disease. kidney disease, too,” Crews says. It’s time to stop living I“Hypertension is the second leading cause And even if you haven’t been diagnosed, know with unexplained of kidney disease in America after diabetes,” what your blood pressure is. Chronic kidney disease pain—and get to the says nephrologist Deidra Crews, M.D. can lead to kidney failure, and even those with pre- bottom of ve hard-to- Crews and her Johns Hopkins colleagues hypertension are at risk. diagnose conditions. recently completed a study on the link Risk factors for both hypertension and kidney between high blood pressure and kidney disease include obesity, inactivity and heart disease. disease, showing that 27.5 percent of people with diagnosed hypertension also suff er from HEAR FROM OUR PATIENTS Visit hopkinsmedicine.org/heart and watch videos kidney disease. But even more startling is of our patients sharing their stories. For appointments that 22 percent of study participants with and consultations, call 877-546-1872. The year Johns Hopkins researchers developed cardiopulmonary 196 0 resuscitation, or CPR. | 2 | johns hopkins health fall 2010 877-546-1872 | hopkinsmedicine.org FdJHFA1003_02-3_Insight.indd 2 9/29/10 8:37:55 AM Towers Rising healthinsights HEALTH ADVICE THAT TEENAGE BOYS NEED EENAGE BOYS are not receiving suf- fi cient sexual health counseling. According to a new study by Johns Hopkins researchers, only 21 percent of Tsexually active boys had discussed HIV and other sexually transmitted infections (STIs) with their health care providers. e problem isn’t merely that boys are more reluctant than girls to ask questions. Lead study author Arik Marcell, M.D., M.P.H., says boys don’t you’ve been to Johns Hopkins’ AMONG THE FEATURES ARE: encounter the same health care “triggers” that girls do. main medical campus during ■ Two connected 12-story towers, one for “Girls are coming in to see their doctors for If the past two years, you’ve no cardiovascular and critical care, one for contraceptive use and reproductive care,” he says. doubt noticed that the skyline is the children’s hospital Boys, on the other hand, don’t typically seek care undergoing a major transformation. ■ All-new emergency departments for their sexual That’s because a 1.6-million-square- ■ All private rooms health, and even foot hospital building is nearing ■ 33 operating rooms for general surgery, when they do completion. Slated to open in early cardiac surgery, neurosurgery, pediatrics visit medical 2012, the new building will present and obstetrics facilities their doctors are not a whole new “front door” for The To learn more, visit hopkinsmedicine. initiating the Johns Hopkins Hospital. org/newbuildings. conversations. Marcell says consistent guidelines are needed for providing sexual health care to boys, Should You Exercise and providers need to be trained and comfortable in off ering reproductive health services to young women and men. When You’re Expecting? “I don’t think boys understand the importance of the sexual health visit,” Marcell says. “But there IF YOU’RE EXPECTING a child and exercise for women and their are a core set of services young men should receive, wondering how safe it is to continue your fetuses and to develop better including a review of their sexual histories, screening exercise routine, a study now under way techniques for measuring fetal for STIs and HIV, counseling in STI prevention, a may provide some answers. response to exercise. genital exam and making sure all their vaccines are Recently, Andrew Satin, M.D., head Although the Department up to date.” of the Department of Obstetrics and of Health and Human Services Gynecology at Johns Hopkins Bayview currently recommends Medical Center, was asked to develop 2½ hours of moderate JOIN OUR ONLINE exercise guidelines for the American exercise per week for COMMUNITIES College of Obstetricians and pregnant women, these Gynecologists. But because there recommendations don’t hasn’t been much research take into account individ- @HopkinsMedNews on the subject, he ual differences in tness. YouTube.com/johnshopkinsmedicine has partnered with Satin and Szymanski hope a colleague, Linda to develop formulas for indi- Search Johns Hopkins Medicine Szymanski, M.D., vidual exercise prescriptions. and begun a study For now, Satin says, see to monitor 60 preg- your physician to deter- LEARN MORE nant women of mine the best plan for you. varying degrees of “Avoid dehydration,” News and publications physical tness. he adds, “and any activity Hopkinsmedicine.org/news Satin says where you could fall on the the two goals uterus or get hit.” He cites Clinical trials are to determine a downhill skiing and mountain Trials.johnshopkins.edu safe level of maternal biking as two sports to avoid. Health seminars Hopkinsmedicine.org/healthseminars hopkinsmedicine.org | 877-546-1872 fall 2010 johns hopkins health | 3 | FdJHFA1003_02-3_Insight.indd 3 9/29/10 8:37:34 AM quickconsult Talking Points Keep your voice in top shape by practicing good vocal health Unless you’re a professional performer, you might not pay much attention to your voice. But according to laryngolo- What if I still need to talk? gist Lee Akst, M.D., who directs the Johns Hopkins Voice Center, one in When your voice is feeling rough, speak normally. The worst thing you can do is push or talk louder to compensate for the roughness, four people—and one in two teachers which can cause vocal cord damage. Don’t whisper, either. It’s just —will experience a vocal problem another way of trying to squeeze out your voice. Use a microphone during his or her life. The good news is when addressing large groups, and prioritize your voice use by not talking when you don’t have to. you don’t have to suffer in silence. Akst shares some words of wisdom. Do some professions require greater attention to good vocal health? We’re in a communications-based society, so many people’s jobs involve talking to others. This is especially true for coaches, teachers, journalists, members of the clergy, attorneys, salespeople and, of course, singers and actors. But being able to use your voice is important for everyone. How do I know if I might have a vocal problem that should be looked at by a doctor? What lifestyle choices can I make to protect my voice? By definition, anyone whose voice isn’t working the way they’d like it to work has a voice problem. If your voice is rougher or quieter than you’d like it to be, Drink lots of water—which lubricates the vocal or if speaking requires more effort, then it’s a voice problem. Symptoms might cords and helps them vibrate better—don’t include hoarseness that lasts more than a couple of weeks or that is associated smoke, and limit excessive yelling and scream- with ear pain, difficulty swallowing or painful speaking. Even if you don’t have ing. Speak on full, deep breaths and pause to symptoms, have your voice evaluated and treated if it is keeping you from living take a breath before you run out of air. If your your life. n voice starts feeling fatigued or rough, your body is telling you to back off on how much you’re VISIT OUR VoiCE CENTER using your voice. For more information, appointments or consultations, call 877-546-1872 or visit hopkinsmedicine.org/voice. | 4 | johns hopkins health fall 2010 877-546-1872 | hopkinsmedicine.org FdJHFA1003_04_Consult.indd 4 9/29/10 8:31:09 AM Weighing the Risks Obesity can tip the scale toward metabolic syndrome COMMON KNOWLEDGE and 35 inches or less for women. Also, check that being overweight is a con- your body mass index (BMI), which uses your IT’S trollable risk factor in a host of height and weight to measure body fat. Aim for health problems. And if you’re keeping score on a BMI of less than 25. those problems, you can add one more, and it’s a e numbers won’t lie. If they tell you that biggie: metabolic syndrome. you’re overweight, it’s time to take action. Metabolic syndrome is a cluster of risk fac- “Acknowledge the truth,” Rodriguez says, “and tors that can signifi cantly increase your odds of get appropriate nutrition counseling, targets for developing type 2 diabetes, heart disease, stroke weight loss and exercises that are age-appropriate or peripheral artery disease.