WHAT’S INSIDE……………………..?

Happy Birthday!!

December:Mojibade, Thom-as, Francine, mona, Karen, sotunji, donnae, david, afii-wa, dana, martina, shamia, rufus, james, chante, don, Gloria, Margaret, Celina, trina, Gregory, Camille, Breona, William, dion, joi, queen, donatey, Ashley, Annette, aaron, takeyla, Linda, florecita, kimberly

January:Adenike, mojisola, Antonia, tiffany, Glenda, astou, Danielle, james, rog-er, david, ricci, carlton, samia, takehia, keith, ra-ther, Lucinda, Kimberly, ehizogie, chantia, tamika, Samuel, Antoinette, shaneekiia, Beverly, thomasine, vertino

February:

Quarterly, Issue 2

Marijuana, Risk and Benefits..…………...….….. .pg. 2

Open Enrollment Reminders……………………..pg 3

Blood Clots in Sickle Cell….……………………….pg 4-5

Fashion Show Highlights…………….………..…...pg. 6

Welcoming our new nurse………………..………..pg 7

The Sickle Cell Team …………………….………...pg. 8-9

HAPPY THANKSGIVING!!!

Welcome to our Fall Edition: November 2012

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 contribu-tions 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.

sickle cell infusion center open 7 days a week

Monday- friday 9-am-5pm

Saturday –Sunday 10am-8pm

Call ahead to be seen 443-287-8288

———————————

Holiday closures:

Dec 24 : 9am-12 noon

Dec 25 : Closed

Dec 31 : 9am-12 noon

jan 1 : closed

Infusion center Re-open: dec 26 and Jan 2nd

Script pick up days for holidays:

Mon, wed, fri

1-4pm

Happy holidays !

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 ma-rijuana” is a controversial topic. Some people feel its benefits justify its legali-zation 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 decision-making. 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 20-100 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 motivation-al incentives. If you want to learn more, please make an appointment and dis-cuss with your provider at your next visit. http://www.drugabuse.gov

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/ Medi-caid/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.

Health insurance reminder:

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 develop-ment 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

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.

Welcome our new nurse: Dzifa Dordunoo

sickle cell team: providers

Sophie Lanzkron, M.D.

Director of the Sickle Cell

Center for

Adults at Johns Hopkins

Yvette Roane, PA-C

Physician Assistant/

Program Manager

(right)

Candice Fori, MPAS, PA-C

Physician Assistant/Clinical Coordinator

John Strouse, M.D.,

PhD

Hematologist

Pius Afriyie, PA-C

Physician Assistant/

Clinical Coordinator

Linda Smith-Resar,

M.D.

Hematologist

Pat Carroll, M.D.

Chronic Pain Specialist,

Psychiatrist

(left)

Mandy David, PA-C

Physician Assistant/

Clinical Coordinator

the Sickle Cell Team……..

Dawn Hatcher

BSW, Social Worker

Sickle Cell Center for Adults at

Johns Hopkins:

Phone: (410)502-7770

Fax: (410)-614-8601

Nicklaine Paul

Lead

Registered Nurse

Sickle Cell Infusion Center:

Phone: (443)-287-8288

Fax: (410)-614-0686

Sadie Molock

Sr. Medical Office

Terri Blackwell

Clinical Associate

Cynthia Washington

Registered Nurse

Dominique Lyles

Clinical Associate

Cody Cichowitz

Research Assistant Cedron Williams

Clinical Research Consultant

Romaine Bradshaw

Clinical Coordinator

Dzifa Dordunoo

Registered Nurse