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Miss Jillian L. Zamer, MMS, PA is in Washington, DC specializing in spine surgery and neurosurgery. Miss Jillian L. Zamer, MMS, PA is affiliated with MedStar Washington Hospital Center and MedStar Health.
MedStar Health
Angiogram (Angiography)
Angiography is the use of x-rays to examine blood vessels, especially in order to identify any blocked or misshapen vessels that may cause problems. The test itself is called an angiogram. Some of the disorders that angiograms can be used to diagnose include:
During an angiogram, the doctor inserts a very thin, flexible tube called a catheter into a blood vessel through an opening in the groin or arm. The catheter is threaded through the body to the site of the suspected problem, where a small amount of dye is injected into the bloodstream and x-rays are taken. The dye makes the surrounding blood vessels visible via x-ray.
If necessary, certain procedures can be performed after an angiogram while the catheter is in place. Angioplasty is the use of a catheter to widen narrowed or blocked arteries. Stents are like tiny coiled springs that hold blood vessels open, and they can be placed during a catheterization. Damaged heart valves can also be repaired or replaced.
A typical angiogram takes about an hour to perform, but it may be longer if the catheterization is used to perform procedures on the blood vessels. It may be uncomfortable at times but is usually not painful. Afterwards, patients may be monitored for up to six hours to make sure any bleeding from the insertion site has stopped. They are given fluids to help flush the dye from their body. For a day or two after an angiogram it is important for patients to drink plenty of fluids and keep strenuous activity to a minimum.
Hydrocephalus
Normally, the brain is bathed in a liquid called cerebrospinal fluid. This fluid cushions and nurtures the brain cells as it flows around and through the brain. Sometimes, cerebrospinal fluid does not get reabsorbed into the body properly, or a blockage in the brain can stop it from flowing. This causes a buildup of pressure called hydrocephalus. This condition affects a wide range of people, but it is much more prevalent among infants and older adults. Left untreated, hydrocephalus can cause uncomfortable symptoms, such as headaches and blurred vision, and eventually may cause brain damage.
Hydrocephalus is most often treated with an implanted device called a shunt. A shunt is a long, thin tube that is used to drain excess fluid. One end is placed within the brain. The tube runs under the skin, along the neck behind the ear, and to another part of the body where the fluid can be reabsorbed. Most often this is the abdomen, but the chest or other areas can also be used. Shunts have a valve that allows doctors to monitor and control the pressure within the brain. Insertion of a shunt is a surgical procedure that takes one to two hours. Incisions are made in the head and the abdomen, and the shunt is threaded into place before the openings are stitched closed.
In cases where hydrocephalus is caused by a blockage, a procedure called endoscopic third ventriculostomy, or ETV, may be performed. During this procedure, a surgeon makes a dime-sized hole in the skull and uses a thin tube with a camera on the end (called an endoscope) to see inside the brain. The surgeon punctures a hole in the floor of the third ventricle, a fluid-filled space within the brain. The hole provides an opening for cerebrospinal fluid to flow around the blockage, normalizing pressure. The entire procedure usually takes less than an hour and patients can often go home the following day. ETV can provide a permanent and safe alternative to a shunt, but it is only useful for patients whose hydrocephalus is caused by a blockage.
Stroke
A stroke is a medical emergency that occurs when a blood vessel supplying oxygen and nutrients to the brain is ruptured or blocked. The brain cannot function without a steady supply of oxygen and nutrients, so when the blood supply to the brain is interrupted, even for a brief moment, brain cells begin to die. When a sufficient number of brain cells die, the brain itself can no longer function, meaning that strokes are very dangerous. Strokes can result in impaired movement, speech, cognitive ability, the impairment of important physical functions, and even death.
Anyone can have a stroke, regardless of age and health. Strokes are known to happen at random. However, certain conditions and behaviors can increase one's risk of stroke over time.
Risk factors for stroke include:
There are two main types of stroke: ischemic stroke and hemorrhagic stroke. Ischemic stroke occurs more commonly and is when a blood vessel in the brain becomes blocked. Blockages are caused by blood clots and built-up plaque (deposits of fat and cholesterol), which leads to atherosclerosis, a condition where the blood vessels narrow and harden. The resultant restricted blood flow may lead to an ischemic stroke by blocking essential oxygen to the brain, causing the heart to exert more effort to pump blood.
Hemorrhagic stroke occurs when a blood vessel in or around the brain ruptures. The burst vessel leaks blood into surrounding brain tissue, causing irreparable brain damage.
Hemorrhagic strokes are less common and may occur from head injuries, brain aneurysms, brain tumors, and bleeding disorders, amongst other conditions.
Both ischemic and hemorrhagic strokes require immediate medical treatment. Medical intervention can prevent severe and life-threatening brain damage. Signs of stroke include:
-Disorientation or confusion
-Difficulty speaking
-Difficulty walking
-Impaired vision
-Weakness in the face, legs, or arms
-Severe headaches
When someone suspected of having a stroke reaches the hospital, the patient will usually receive a CT or other scan that provides an image of the brain. The scan results can reveal clotted or leaking blood in the brain. Physical exams, neurological exams, and blood tests may also be used to check for blood clotting and sugar. Treatment begins generally immediately if a stroke is detected.
Medical treatment for ischemic strokes includes a thrombolytic medicine which breaks up and disperses blood clots. This medicine can greatly improve stroke recovery and long-term health. However, the thrombolytic medicine must be administered as soon as possible to achieve these results. Other treatments for ischemic strokes are blood thinners and thrombectomy, a surgical procedure to remove a blood clot in the brain. Thrombectomy is performed by inserting a catheter (thin needle) into the artery to reach the blood clot and mechanically remove it. With the clot removed, normal blood flow to the brain resumes. Thrombectomy is typically performed at most six hours after a patient shows signs of a stroke.
Hemorrhagic strokes are treated with blood-saving medication and surgery. For a hemorrhagic stroke caused by the rupture of an aneurysm (blood vessel bulges), surgery to stem the bleeding aneurysm and vessel may be used. One surgical technique is stent-assisted coiling, which adds a stent (small wire-meshed tube) into the blood vessel to block the leaking opening of the aneurysm. A non-surgical procedure is endovascular coiling, where a catheter (thin, hollow needle) places a platinum wire coil at the spot of the aneurysm. The coil blocks bleeding and prevents the aneurysm from continuing to leak blood. These procedures are usually combined with blood-thickening medications. Blood transfusions may be administered if substantial blood loss has occurred.
Since stroke patients may have lost some essential functions while the blood flow to their brains was obstructed, both ischemic stroke and hemorrhage stroke patients may receive post-stroke rehabilitation to rebuild their physical and mental abilities. Some restorative treatments include occupational, physical, and speech therapy. Patients may also receive care from neurologists, who can assist patients in recovering certain brain functions and cognitive abilities, and rehabilitation psychologists, who may help patients with their emotional, behavioral, and cognitive recovery. Some stroke patients require lengthy rehabilitation and may never fully regain function, while others may recover more quickly. While the fastest recovery improvements are usually seen in the first three or four months, stroke rehabilitation can last for years.
If someone begins to show signs of stroke, contact emergency services and call 9-1-1 immediately since blood flow must be restored as soon as possible to help avoid significant brain damage. If an ambulance takes the person to the hospital, paramedics can initiate stroke treatment as soon as the patient enters the ambulance, allowing for more prompt medical intervention and care.
She is certified by the Board Certification: National Commission on Certification of Physician Assistants and has a state license in Maryland.
Board Certification: Board Certification: National Commission on Certification of Physician Assistants
Licensed In: Maryland
Miss Jillian L. Zamer, MMS, PA is associated with these hospitals and organizations:
Miss Jillian L. Zamer, MMS, PA appears to accept the following insurance providers: MultiPlan, Optimum Choice, Optima Health, MAMSI, Magellan Health Services, United Healthcare Choice Plus, United Healthcare Choice, First Health PPO, Blue Choice, Great-West Healthcare, TRICARE, Coventry, TRICARE Reserve Select, Anthem, Aetna Managed Choice POS, Beech Street PPO, Aetna HMO, Kaiser Permanente, CIGNA PPO, CIGNA EPO, Aetna Medicare PPO, Aetna Medicare PFFS, CIGNA Indemnity, AmeriHealth, AARP, Medicare Advantage, TriWest, Coventry National Network PPO, Highmark, Amerigroup, United Healthcare, Medicaid, Humana, Cigna, Sentara Health Plans, WellPoint, United Healthcare Community Plan (AmeriChoice), Humana Medicare Advantage PPO, Blue Cross and Blue Shield of Michigan, CIGNA PPO Plus, HealthyBlue PPO, Aetna Premier 200PD, MedStar Family Choice - Maryland Health Choice, CareFirst NASCO, Private Fee-for-Service Plans (PFFS), M.D. IPA Preferred (POS), CareFirst Maryland Indemnity or PPO, IH-PPO, DC/MD SHOP QHP Small Business Plans, Aetna Advantage 6350PD, MedStar Family Choice DC Healthy Families, CareFirst EPO, Optimum Choice Preferred (POS), OCI Direct (HMO), Medicare Direct, Alterwood Advanatge HMO & DSNP Plans, Aetna Open Choice (PPO), OA Plus, CareFirst Administrators, United Student Resources, IH-Network Only Plus, IH-POS, Aetna Classic 5000, Aetna Signature Administrator PPO/TPA, Healthy Blue (HMO, POS), CareFirst Community Health Plan of Maryland, IH-POS Plus, Jai Medical Systems - Maryland Health Choice, Aetna HMO-Open Access/Select OA/HealthFund/Health Network Option OA, CareFirst Maryland Point of Service Plan, Health Services for Children with Special Needs, Choice POS II, CareFirst Blue Card Program, Choice Fund PPO, IH-EPO Plus, Aetna VA Exchange, Aetna Managed Choice Open Access (POS), CareFirst BlueCross BlueShield Advantage Core/Enhanced, Aetna Better Health of Virginia, Aetna Worker's Compensation Network, Options PPO Cardiac Global, Uniformed Services Family Health Plan, Aetna Advantage 5750, IH-Open HMO Option, HumanaChoice Honor's plan PPO, Aetna Basic, CareFirst FEP Blue Focus, MedStar Family Choice DC Healthcare Alliance, Optimum Choice & Optimum Choice Preferred (POS) Cardiac Global, Core Essential (HMO), IH-Open EPO Plus, IH-Open POS Plus, Johns Hopkins Advantage MD PLUS PPO, Select HMO/HealthFund/Health Network, MD IPA (HMO) & MD IPA Preferred Cardiac Global, CareFirst Blue Preferred PPO, Aetna Elect Choice/ Open Access (POS), IH-Open HMO, Aetna Advantage 6350, M.D. IPA (HMO), Erickson Advantage Plans, POS OA, Aetna Elect Choice/ EPO (Aetna Health Fund), Aetna Quality Point of Service (POS), IH-Open POS II, Aetna Classic 5000PD, Johns Hopkins Advantage MD HMO, CareFirst Dual Prime HMO-SNP, Priority Partners - Maryland Health Choice, Aetna Student Health Insurance, Private Health Care Systems (PPO), Choice POS, Lasso Healthcare - Medicare Medical Savings Account, IH-Indemnity, CareFirst MedStar PPO, Aetna Traditional Choice (PPO), CareFirst (NCA) Indemnity, United Medicare Private Fee-for-Service (PFFS) plans, IH-HMO, IH-Open Network Only Plus, HumanaChoice PPO, CareFirst Federal Employee Program (Std. & Basic PPO), Johns Hopkins Advantage MD PPO, Medicare FFS, Maryland Physicians Care MCO, Veterans Affairs Community Care Network, Advantra Platinum (PPO), Aetna Better Health of Maryland, BCBS Out-of-State Medicare Plans (Blue Advantage), Employee Health Plan, Choice POS II Open Access, Navigate, Police and Fire Clinic, Network OA, CareFirst MedStar Select PPO and Aetna Classic 3500.
According to our sources, Miss Jillian L. Zamer, MMS, PA accepts the following insurance providers:
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Ms. Jillian Zamer practices spine surgery and neurosurgery. Clinical interests for Ms. Zamer include laminectomy, cervical herniated disc, and brain aneurysm. Ms. Zamer is professionally affiliated with MedStar Washington Hospital Center. She can take several insurance carriers, including Anthem, Blue California, and Coventry.
