Home Care In Ashton, MD

In our series, "Ask It Early," CBS News medical correspondent Dr. Jennifer Ashton answered questions from viewers and "Early Show" weather anchor and features reporter Dave Price.

Read more about Healthy LivingSend Dr. Jennifer Ashton your question for "Ask It Early"Dr. Jennifer Ashton's Twitter page

Chris in Florida asked Ashton if there are alternatives to insulin to control diabetes.

Ashton's Answer: There's insulin, and other types of medications in pill form. There's also a lot in the alternative or complementary world. Spices like cinnamon have started to be studied. People taking about a gram of cinnamon in capsule form have seen a reduction in their blood sugar levels. We want to caution people who are diabetic. They should not stop their insulin and start taking cinnamon.

The other thing that's kind of non-pharmacologic is bariatric surgery, also known as lap band surgery. We have seen amazing results with diabetics, even before they start to lose weight.

We don't know what it is about the surgery, but even within days of the surgery, people who are diabetic are seeing a normalization of their sugar levels.

There are different types of diabetes, but most promising for diabetes linked with obesity, dramatic weight loss, alternative and complementary things work well in conjunction with other medications.

Pam asked Ashton on Twitter, "How can I get help for tinnitus."

Ashton's Answer: Tinnitus, according to MedicineNet.com, is a ringing, swishing, or other type of noise that seems to originate in the ear or head. In many cases it is not a serious problem, but rather a nuisance that eventually resolves.

It is not a single disease, but a symptom of an underlying condition. Nearly 36 million Americans, according to MedicineNet.com suffer from this disorder. In almost all cases, only the patient can hear the noise.

There are lot of causes for it -- anything from wax in the ear to sometimes people get foreign bodies, such as things stuck in the ear, chronic inflammation or even loud music.

Really well-known musicians like Eric Clapton have gone public with tinnitus. This is very annoying, and anything from medication, antidepressants, tranquilizers, sedatives, antihistamines, are used to treat it. Obviously, you want to treat the problem if you know what that is, but I like the complementary round of tinnitus because it is a problematic thing for people to live with. Things like craniosacral therapy or biofeedback, even acupuncture can be really effective in lessening the symptoms. You want to see an ear, nose and throat therapist.

"Early Show" weather anchor and features reporter Dave Price asked Ashton, "Jen, I got frostbite in my toes 15 years ago covering Groundhog Day, and since then any time the temperature goes below 40 degrees, I go numb, my feet heat up and I have a painful itch below my skin. Are you more prone to get frostbite once you've gotten it -- and what's the difference between these symptoms and nerve damage?

Ashton's Answer: Be careful. This is a very serious issue. In fact, frostbite can present sometimes with numbness or tingling, but other times with itching. And it can be caused not only by freezing temperatures, but dehydration when you're in severe cold and extreme temperatures. And it really is like a one-two punch. It's the dehydration that comes with low temperatures, as well as the absolute temperature. And it does cause nerve and tissue damage. And it is really painful. If you think you are getting symptoms of frostbite, like itching, white discoloration of your skin, sometimes blisters, you want to get out of the cold, warm that body part up as quickly as possible, and see a professional medical person.

You can be more susceptible to it if you have had frostbite before because it does nerve and tissue problems. Some people may even need narcotic therapy.

In a clipopens in a new tab or window from an episode of the Paramount+ docuseries "The Checkup: With Dr. David Agus" actor Ashton Kutcher talks about a previous health struggle. About 3 years ago, the "That '70s Show" star "woke up one day and was having vision issues [and] could hardly see," he said. "[It] knocked out my hearing, which threw off my equilibrium, my balance, and I couldn't walk."

Kutcher was subsequently diagnosed, he explained, with a "rare form of [autoimmune] vasculitis."

Concern for Kutcher's health started in August, when "Access Hollywood" aired a sneak peak of a then-upcoming episodeopens in a new tab or window of the National Geographic show "Running Wild With Bear Grylls: The Challenge" (now streaming on Disney+), where he and Grylls had to navigate the jungles of Costa Rica. Kutcher told Grylls that he had "this weird, super-rare form of vasculitis that knocked out my vision, it knocked out my hearing, it knocked out like all my equilibrium," and that "it took me like a year to build it all back up."

Kutcher then elaborated on Twitteropens in a new tab or window: "Before there are a bunch of rumors/chatter/whatever out there. Yes, I had a rare vasculitis episode 3yrs ago. (Autoimmune flair up) I had some impairments hear, vision, balance issues right after. I fully recovered. All good. Moving on."

Kutcher told Grylls he believes he is "lucky to be alive," and that he is using the health scare as a learning experience: "The minute you start seeing your obstacles as things that are made for you, to give you what you need, then life starts to get fun, right? You start surfing on top of your problems instead of living underneath them."

Vasculitis

Vasculitis is an inflammation of the blood vessels (i.e., veins, arteries, and capillaries). The problem can affect blood vessels of any type, size, or location, including those in the brain and spinal cord. The primary site is the wall of the blood vessel.

Inflammation from vasculitis can cause the walls of blood vessels to weaken, stretch, thicken, swell, or develop scarring. This can narrow the vessel and slow or completely stop the normal flow of blood. Focal lesions within the vessel wall may also cause weakening with the subsequent development of aneurysms and/or rupture, with bleeding into surrounding tissues.

There are several types of vasculitis. The most commonly used classification system for vasculitis (2012 International Chapel Hill Consensus Conference Nomenclature of Vasculitidesopens in a new tab or window) is defined by the size of the vessel predominantly affected -- i.e., small, medium, large, or variable vessel disease. The classification is as follows:

Vasculitis can affect a single organ or involve several organs and systems. Systemic vasculitis is considered primary when no etiological factor is identified.

Secondary vasculitis can be related to infections (such as hepatitis C or HIV), drugs (propylthiouracil, hydralazine), drug abuse (levamisole-induced vasculitis), systemic autoimmune diseases (systemic lupus erythematosus, rheumatoid arthritis, and Sjogren's syndrome), or to cancer.

The exact pathogenesis of vasculitis is unknown, but several immunologic mechanisms are believed to play a role:

T cells can "polarize" into T1 and T2 effector cell types in response to distinct cytokines. Polarization restricts the ability of a T cell to produce either T1 or T2 patterns of cytokines. T1 cytokines participate in immune responses targeted at the destruction of cells infected with intracellular parasites such as bacteria and viruses.

T2 cytokines, on the other hand, are involved in immune responses effective against extracellular pathogens, such as antibody response or granulocyte activation. T1 cytokines include interleukin (IL)-2 and interferon γ. T2 cytokines include IL-4, IL-5, IL-6, and IL-10.

Symptoms

The symptoms of vasculitis vary depending on the type of vasculitis, the organs involved, and the severity of illness. Some people may have few symptoms, while others may have generalized or multiorgan symptoms.

Symptoms may develop suddenly over a few days or weeks, or gradually over months. Generalized symptoms may include any of the following:

Organ-specific symptoms include:

If inflammation blocks normal blood flow, it can cause damage to the part of the body involved. Serious, potentially life-threatening problems include aneurysms or aortic dissection, arrhythmias, coronary heart disease, deep vein thrombosis, myocardial infarction, myocarditis, high or low blood pressure, kidney disease, and strokes and transient ischemic attacks.

Treatment

The goal of treatment for vasculitis is to reduce inflammation and avoid possible long-term complications. The treatment approach for any vasculitis generally includes the three components of remission induction, remission maintenance, and monitoring.

Corticosteroids are the first line of treatment for many individuals with vasculitis, and may be used alone or with other immunosuppressive agents such as methotrexate, azathioprine, mycophenolate, cyclophosphamide, and rituximab.

Over the past decade, there have been major advances in the pathogenesis of vasculitis. The recent identification of target molecules is leading to novel therapeutic approaches that target key cytokine and cellular effectors of the inflammatory cascade.

An extensive list of clinical trials for patients with vasculitis can be found at ClinicalTrials.govopens in a new tab or window.

Michele R. Berman, MD, is a pediatrician-turned-medical journalist. She trained at Johns Hopkins, Washington University in St. Louis, and St. Louis Children's Hospital. Her mission is both journalistic and educational: to report on common diseases affecting uncommon people and summarize the evidence-based medicine behind the headlines.

Perhaps it isn’t surprising that the Eastern Elliptio — and other varieties of freshwater mussels — have disappeared from many streams and rivers in Maryland without a flicker of notice from the public.

The little known or appreciated mussel lies in stream bottoms for most of its life, out of sight and growing slowly for decades.

This year, though, it’s getting attention from the Maryland Department of Natural Resources and a couple of biologists-- who value mussels for keeping water clean and giving life to other species --and are attempting for the first time to grow tens of thousands in a hatchery.

“They filter water. They remove nutrients and sediment. . . . They give other animals habitat and food. Fish and muskrats, raccoons, they eat mussels,” said Matt Ashton, a DNR biologist with a specialty in freshwater mussels. “We are hoping to help the ecosystem out by restoring a keystone species.”

On an early May morning, Ashton and Jennifer Tam went to the green banks of Deer Creek in Harford County and gathered mussels, some small enough to be held easily in the palm of a hand, and pried open the shells with pliers looking for females full of larvae. They collected about 100 female mussels.

“We definitely got more than enough mussels that looked pregnant and were developing larvae,” Ashton said.

After the mussel harvest, they headed for another stream in Harford where they knew there were American eels to capture and serve as a host fish. After shocking a small population of eels, they netted them and headed with a truck of eels and mussels to the hatchery near Brandywine in southern Maryland. The mussels can’t survive without a host to grow and launch their young.

In the hatchery, scientists again pried open the mussels’ shells and pierced their gills to extract the larvae, which they inspected under a microscope to make sure they were active and plentiful, Ashton said.

They poured the larvae over a vat with foot-long eels, hoping the eels would breathe in larvae that then would attach to their gills. When the baby mussels grow to about the size of a grain of sand, they will drop out of the eel’s gills.

The scientists hope to produce 10,000 baby mussels to plant in the Patapsco River, which may not have hosted a mussel in about 100 years. They’re hoping for a 25 percent survival rate.

“We really have no clue what to expect in terms of numbers,” Ashton said. “We have to produce as many as we can.”

The mussel is prized for its ability to filter water in freshwater streams, much as oysters do in brackish waters of the Chesapeake Bay, but they have disappeared from some rivers in the state due to damming, pollution, runoff and the loss of host fish.

The fisheries scientists chose the Patapsco for their reintroduction because other species needed for the Eastern Elliptio to survive are beginning to make a comeback there, said James McCann, a zoologist with Maryland’s Wildlife and Heritage Service. The work to reintroduce the mussels is being paid for with the help of federal funds administered through the wildlife agency.

All but two of the river’s 12 dams that kept fish species from migrating have been removed. American eels, which had been missing from the river for at least 50 years and perhaps as long as a century, are now beginning to travel it. American shad and hickory shad, two other migratory species, are also present, McCann said.

“As the mussel population recovers, we think the Patapsco River will be a little cleaner,” he said.

The federal and state governments, as well as nonprofit groups, have been working to restore the Patapsco for 12 years, said Serena McClain, director of river restorations for American Rivers, a conservation organization.

The river, which flows 39 miles from its origins in Carroll and Howard counties down into Baltimore to form the city’s harbor, was targeted because three of its dams could be removed easily, she said. Taking out the dams opens historic migratory corridors for such fish as American eel, hickory shad and alewife, among others, and will help increase their populations in the Chesapeake Bay eventually, she said.

By this time next year, fisheries scientists think they will have been able to place thousands of penny-size mussels in the Patapsco. Ashton isn’t exactly sure where they will be placed, but it will be upstream of the Daniels Dam north of Ellicott City.

The mussels grow slowly, but once established can live for 20 to 30 years. After a couple of years, the scientists hope they will have a population large enough to reproduce and sustain itself. In five years, they hope to have created several self-sustaining populations. With an increase in mussels, other species that feed on them also could grow, including great blue herons, mink and catfish, the fisheries biologists said.

There are 300 species of freshwater mussels in the United States, but 30 are now extinct. Two thirds of the remainder are endangered or declining, McCann said.

Maryland has 16 native species, said McCann, 14 of them uncommon, threatened, rare or endangered.

“What this speaks to is the state of our streams and rivers,” he said. “They are telling us something is amiss.”

MedChi, The Maryland State Medical Society, installed James J. York, M.D. as the organization’s 175th President of the Board and named Ashton DeLong as general counsel.

An orthopedic surgery specialist in Anne Arundel County, York’s leadership in medicine is rich and varied and includes Associate Chair of Surgery and Past President of the Medical Staff at Baltimore Washington Medical Center.

During his tenure at MedChi, York served as chair of the Legislative Council and he is also a past president of the Maryland Orthopaedic Association. At the national level, York has served as Maryland representative to the Board of Councilors (BOC) of the AAOS and served as chair of the BOC State Legislative and Regulatory Issues Committee.

A specialist in sports medicine for all age groups, York has a clinical focus on care for the shoulder and knee. He specializes in cartilage transplants and joint repair and / or reconstruction. York is board certified in orthopaedic surgery and subspecialty board certified in orthopaedic sports medicine.

After serving three years in the Army and years in private practice with Chesapeake Orthopaedics, York later joined OSMC/Luminis Orthopaedics in 2014.

York is an active member of the American Academy of Orthopaedic Surgeons (AAOS), Arthroscopy Association of North America (AANA), and American Orthopaedic Society for Sports Medicine. He has participated as an Instructor at AANA Shoulder Surgical Courses. He has served as Clinical Assistant Professor in the Department of Orthopaedics at the University of Maryland School of Medicine and previously, the Uniformed Services University.

Throughout his career, York has demonstrated a special interest in the treatment and prevention of sports injuries. He served as team doctor for Archbishop Spalding HS for 26 years and has provided game coverage, preseason sports physicals, and coach training seminars at youth athletic organizations, high schools and the Anne Arundel Community College.

York served as a youth soccer coach for Severna Park Green Hornets organization for many years and earned a U.S. Soccer Federation ‘D’ coaching license. In his spare time, he enjoys martial arts (Chen style Taijiquan and Chen sword), golf, bicycling, the Irish language and medieval and military history.

Prior to joining MedChi, DeLong spent more than three years working on behalf of Maryland doctors as an associate attorney at Medical Mutual Liability Insurance Society of Maryland. She also served as senior law clerk to former Chief Judge Patrick Woodward at the Court of Special Appeals of Maryland and as law clerk to the late Judge Thomas Simpson Jr. at the Circuit Court for Charles County.

The town of Sandy Spring, Maryland was settled by religious Quakers in the 1720s. In 1777, the Quakers internally outlawed members of the church from enslaving people, and a community of formerly enslaved people settled alongside the Quakers in the area. These two groups would eventually work together to make the town a major waypoint on the Underground Railroad, helping enslaved people from the American South escape to the North.

Starting in the early-1800s and continuing through the Civil War until the eventual abolition of slavery, the Underground Railroad was a loosely structured network of routes and safehouses that people escaping slavery would use to travel north, sometimes as far as Canada.

The Underground Railroad Trail Experience was established by the Montgomery County Parks system to commemorate the county’s role in the historic operation, such as in 1857 when fugitive slave Dred Scott was given shelter at Sandy Spring and represented by the county attorney while the Supreme Court decided his fate.

The hike starts at the historic Woodlawn Manor, an old plantation whose owners were kicked out of the Quaker church for refusing to free their enslaved laborers. The trail traverses the dense woods and meanders across fields and streams, passing by hollowed out trees that may have been used as food caches, and boulders that marked property boundaries and may have been used as trail markers for escaping slaves.

Visitors will pass the small freshwater spring that gave Sandy Spring its name and finally end up at a large, 300-year-old white ash tree that stood in the center of the historic community and would have been a beacon, guiding those escaping slavery to a place where they could find some brief shelter and supplies before continuing their journey further north.

Know Before You Go

The park is open year-round but parking is limited, so if you visit on a weekend try to get there early. The trail itself is 2 miles one-way, 4 miles round trip. It crosses uneven terrain, creeks, and fields, so dress appropriately.Also in Sandy Spring are the historic Quaker Friends Meeting House and the Sandy Spring Slave Museum. The Meeting House can be seen with a short detour off of the trail and the Slave Museum is a short drive away.