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  • January 14, 2022

    By Allison Larson, MD

    Whether you’re a winter sports enthusiast or spend the season curled up by the fireplace, the low humidity, bitter winds, and dry indoor heat that accompany cold weather can deplete your skin’s natural moisture. Dry skin is not only painful, uncomfortable, and irritating; it also can lead to skin conditions such as eczema, which results in itchy, red, bumpy skin patches. 


    Follow these six tips to prevent and treat skin damage caused by winter dryness.


    1. Do: Wear sunscreen all year long.

    UV rays can easily penetrate cloudy skies to dry out exposed skin. And when the sun is shining, snow and ice reflect its rays, increasing UV exposure. 


    Getting a sunburn can cause severe dryness, premature aging of the skin, and skin cancer. Snow or shine, apply sunscreen before participating in any outdoor activity during the winter—especially if you take a tropical vacation to escape the cold; your skin is less accustomed to sunlight and more likely to burn quickly.


    The American Academy of Dermatology (AAD) recommends sunscreen that offers protection against both UVA and UVB rays, and offers a sun protection factor (SPF) of at least 30.


    That being said, if you are considering laser skin treatments to reduce wrinkles, hair, blemishes, or acne scars, winter is a better time to receive these procedures. Sun exposure shortly after a treatment increases the risk of hyperpigmentation (darkening of the skin), and people are less likely to spend time outside during the winter.


    Related reading: 7 Simple Ways to Protect Your Skin in the Sun

    2. Do: Skip products with drying ingredients.

    Soaps or facial products you use in warm weather with no issues may irritate your skin during colder seasons. This is because they contain ingredients that can cause dryness, but the effects aren’t noticeable until they’re worsened by the dry winter climate.

    You may need to take a break from:

    • Anti-acne medications containing benzoyl peroxide or salicylic acid
    • Antibacterial and detergent-based soap
    • Anything containing fragrance, from soap to hand sanitizer

    Hand washing and the use of hand sanitizer, which contains a high level of skin-drying alcohol, cannot be avoided; we need to maintain good hand hygiene to stop the spread of germs. If your job or lifestyle requires frequent hand washing or sanitizing, routinely apply hand cream throughout the day as well.


    During the COVID-19 pandemic, I have seen a lot of people develop hand dermatitis—a condition with itchy, burning skin that can swell and blister—due to constant hand washing. Sometimes the fix is as simple as changing the soap they're using. Sensitive-skin soap is the best product for dry skin; it typically foams up less but still cleans the skin efficiently.


    3. Do: Pay closer attention to thick skin.

    Areas of thin skin, such as the face and backs of your hands, are usually exposed to the wind and sun the most. It’s easy to tell when they start drying out. But the thick skin on your palms and bottoms of your feet is also prone to dryness—and tends to receive less attention.


    When thick skin gets dry, fissures form. You’ll see the surface turn white and scaly; then deep, linear cracks will appear. It isn’t as pliable as thin skin. When you’re constantly on your feet or using your hands to work, cook, and everything in between, dry thick skin cracks instead of flexing with your movements. 


    To soften cracked skin, gently massage a heavy-duty moisturizer—such as Vaseline—into the affected area once or twice a day. You can also talk with your doctor about using a skin-safe adhesive to close the fissures and help them heal faster.


    Related reading:  Follow these 5 Tips for Healthy Skin

    4. Don’t believe the myth that drinking more water will fix dry skin.

    Contrary to popular belief, the amount of water or fluids you drink does not play a major role in skin hydration—unless you’re severely dehydrated. In the winter, especially, dry skin is caused by external elements; it should be treated from the outside as well. 


    The best way to keep skin hydrated and healthy is to apply fragrance-free cream or ointment—not lotion—to damp skin after a shower or bath.
    Some people need additional moisturizers for their hands, legs, or other areas prone to dryness.

    While some lotions are made better than others, most are a combination of water and powder that evaporates quickly. Creams and ointments work better because they contain ingredients that can help rebuild your skin barrier. 

    Look for products with ceramide, a fatty acid that helps rebuild the fat and protein barrier that holds your skin cells together. The AAD also recommends moisturizing ingredients such as:

    • Dimethicone
    • Glycerin
    • Jojoba oil
    • Lanolin
    • Mineral oil
    • Petrolatum
    • Shea butter

    For severely dry skin, you can try a “wet wrap” technique:

    1. Rinse a pair of tight-fitting pajamas in warm water and wring them out so they’re damp, not wet.
    2. Apply cream or ointment to your skin.
    3. Put on the damp pajamas, followed by a pair of dry pajamas, and wear the ensemble for several hours.

    Dampness makes your skin more permeable and better able to absorb hydrating products. If the wet wrap or over-the-counter products aren’t working for you, talk with a dermatologist about prescription skin hydration options. 

    Drinking more water isn’t the answer to dry winter skin. The best solution is to apply fragrance-free cream or ointment directly to damp skin. Get more cold weather #SkinCareTips from a dermatologist in this blog: https://bit.ly/3KbVUA1.
    Click to Tweet

     

    5. Don’t confuse skin conditions with dryness.

    Skin conditions are often mistaken for dry skin because peeling or flaking are common symptoms. Redness of the skin or itching in addition to dryness and flaking indicates a skin condition that may need more than an over-the-counter moisturizer.


    Skin cells are anchored together by a lipid and protein layer (like a brick and mortar wall). With very dry skin, the seal on this wall or barrier is not fully intact and water evaporates out of the skin’s surface. The skin will become itchy and red in addition to scaly or flaky. If you experience these symptoms, visit with a dermatologist.

    6. Don’t wait for symptoms to take care of dry skin.

    Be proactive—the best way to maintain moisture is to apply hydrating creams and ointments directly to your skin on a regular basis. Start by applying them as part of your morning routine. Once you get used to that, add a nighttime application. And carry a container of it when you’re on the go or keep it in an easily accessible location at work.

     

    You can’t avoid dry air, but you can take precautions to reduce its harsh effects on your skin. If over-the-counter products don’t seem to help, our dermatologists can provide an individualized treatment plan. Hydrated skin is healthy skin!


    Does your skin get drier as the air gets colder?

    Our dermatologists can help.

    Call 202-877-DOCS (3627) or Request an Appointment

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  • August 13, 2021

    By Vadim V. Morozov, MD

    As a gynecologic surgeon, one of the best parts of my job is getting this joyful email from patients who’d had reproductive concerns: “We’re pregnant!”

    So, when Shayna Frost, a Diabetes Educator at the MedStar Diabetes Institute and my patient, shared that she was expecting, we were touched and humbled. She had visited us just two months prior, and we had removed a very large dermoid cyst from her right ovary.

    Also called mature teratomas, dermoid cysts are present at birth in approximately 10% of women. These cysts are most common in women ages 20-40. While 98-99% of dermoid cysts are benign (non-cancerous), the growths can make it difficult to become pregnant.

    Dermoid cysts can grow to 10cm around or bigger, which is large enough to disrupt ovulation—the release of eggs from the ovary. Though Shayna’s cyst was large enough to press against her uterus, she had no symptoms other than irregular periods.

    Dermoid cysts arise from germ cell tissue, which is the starter material for skin, fat, hair, muscle, bone, or thyroid tissue. While most are filled with fat, it’s not uncommon that dermoid cysts contain bits of teeth or hair. However, a dermoid is not an egg, and it could never have developed into a baby.

    When Shayna visited our office, she was concerned that she might lose her ovary. But in our minimally invasive gynecologic surgery program at MedStar Health, more than 99% of patients with large ovarian cysts keep their ovary and experience excellent healing.

    For Shayna and her husband, making the choice to seek subspecialty gynecologic care paved the way to achieve their dream—becoming parents to a precious baby boy just two days before Mother’s Day 2021.

    A perfect Mother’s Day, two years in the making.

    I spent my first Mother’s Day snuggling my 2-day old son, Ryan. I wouldn’t have gotten to feel that joy without the compassionate care I got from Dr. Morozov.

    My husband and I had been trying to get pregnant since the summer of 2019, and we weren’t having any luck. By February 2020, my periods had become very irregular, and I felt depressed and defeated. Well-meaning friends told me to relax, that I was probably stressed out and I would get pregnant when the time was right. But I know my body and I knew that something was wrong.

    In March 2020, the COVID-19 pandemic hit the U.S. in full force, and the stress of it all made us feel even worse about our situation. So, in April 2020, we decided to visit a local fertility clinic for help. Unfortunately, I had to go to all the appointments alone due to pandemic protocols.

    I got all the typical workups—lab testing, physical exam, ultrasound—at the fertility clinic. After reviewing my results, the fertility doctor dropped a bombshell on me: “There is a mass that looks like a tumor in your ovary.”

    I was floored. The mass, they said, was in my right ovary, and I hadn’t felt so much as an ache or pain. Sitting alone on the exam table, my thoughts began to race. How could I have an ovarian mass? Was it cancer?

    Then it hit me like a ton of bricks: I might never be able to get pregnant. Before I fell apart, the fertility doctor suggested I see a gynecologic surgeon who could examine the mass and remove it. Rattled, I left the clinic with a referral card for Vadim Morozov, MD, at MedStar Health.

    Though I didn’t know it at the time, Dr. Morozov and his team would restore my hope and set me on the path toward holding Ryan in my arms less than a year later.


    Shayna’s first #MothersDay couldn’t have been sweeter. Her son was born 1 year after she was diagnosed with a dermoid #OvarianCyst. See how specialized #gynsurgery with Dr. Vadim Morozov helped make her #pregnancy possible: https://bit.ly/3CKowNa.

    Click to Tweet

    My visit with Dr. Morozov.

    The minimally invasive gynecologic surgery team put me at ease immediately. Dr. Morozov listened to me with empathy, answering all my questions about COVID-19 safety protocols and whether surgery would be better for me than continuing to try to hope my functioning ovary would pick up the slack.

    Left alone, Dr. Morozov explained, dermoid cysts will continue to grow, albeit slowly, and the option to save the affected ovary later would be much slimmer. Also, the dermoid cyst could cause ovarian torsion—a condition in which the ovary twists unnaturally, making simple movements like standing up excruciatingly painful. Ovarian torsion requires emergency surgery, and I’d almost certainly lose my ovary.

    However, Dr. Morozov reassured me that if I chose to have laparoscopic cystectomy surgery, the risk of losing my ovary was less than 1%. Though this procedure is complex, it involves just a few steps:

    • I’d be placed under general anesthesia, and he would make a few small incisions near my belly button.
    • Then, he would inflate my abdomen with carbon dioxide gas to pull my abdominal muscles away from my ovaries for a better line of sight.
    • Through the small openings in my abdomen, he would insert tiny surgical tools under visual guidance and make an incision on my ovary.
    • Then, he would open the ovary, “like a clamshell,” he said, peeling away the healthy tissue to expose the cyst.
    • He would then surround the cyst in a special surgical bag and remove it carefully to avoid spilling any of its contents into my abdomen.
    • Finally, he would close up the ovary, allowing it to heal naturally over the next few weeks.

    Dr. Morozov said that the ovaries have a remarkable ability to heal after laparoscopic cystectomy, and most women have excellent outcomes. To me, the risks of leaving the cyst alone and potentially being unable to get pregnant weighed heavier than having surgery. My procedure was scheduled in early June 2020, just two weeks after my first visit with Dr. Morozov.

    Preparing for the big day.

    The whole team at MedStar Health made me feel very prepared and comfortable leading up to the surgery. They’d given me a surgical package that contained pain medication, an anti-nausea patch to wear during surgery, and a special soap to sterilize my abdomen for the procedure.

    The package also included directions to MedStar Health at Lafayette Centre, as well as parking information and the cell phone numbers of my core care team. Those extra touches made me feel calm and cared for on what could have been a very stressful day.

    Right before the procedure, Dr. Morozov stepped into my room and kindly asked, “Are you ready to go?” I was more than ready—I was eager for the opportunities and excitement that laid ahead.

    Recovery, and a big surprise.

    After surgery, my diet consisted mainly of liquids and soft foods for the first few days because I was a little queasy. But it only took about three days before I started to feel like myself again. I was restricted from sexual activity and lifting anything over 10 pounds for eight weeks—just in time to get ready to move an hour away.

    In August 2020, with the pandemic in full swing, we started packing up our home. I was supposed to go back to the fertility clinic that month to follow-up on another hormonal issue they thought I might have. With everything going on, I decided to postpone the appointment until we were settled in our new community.

    As I was packing in the bathroom, I found a pregnancy test kit in the vanity drawer—something that never would have happened in 2019 when I was frantically taking tests every time I missed a period. I decided to take the test and braced myself for disappointment.

    Instead, I saw tiny lines forming in the viewer window. The test was positive. It was unbelievable—the happiest day of my life up to that point! Once my Ob/Gyn confirmed the pregnancy, I sent Dr. Morozov a note. He was thrilled for us and eager for updates.

    Difficult journey, beautiful ending.

    Ryan was born May 7, 2021, almost a year from the day I found out about the dermoid cyst. Now, he’s almost three months old and starting to babble—what a difference a year can make!

    Shayna and baby Ryan.

    Raising a baby takes a village, and I am so glad Dr. Morozov was in ours from the start. The journey to become pregnant was difficult, but it was so worth it. I felt extremely cared for, and my sweet baby brings me so much joy.

    Please go see Dr. Morozov if you develop an ovarian cyst. He is an expert in fertility-sparing cyst removal, and he will help you understand all your options before you make the choice to have surgery.

    Expert gynecologic surgery at MedStar Health.

    Stories like Shayna’s remind me of why I became a gynecologic surgeon—to help patients live life to the fullest. Our team works hard to make sure every patient feels supported, reassured, and confident in making healthcare decisions.

    Though many women’s health providers may recommend removing the entire ovary (oophorectomy) to treat a large cyst, that is rarely the case at MedStar Health. Our gynecologic surgeons are fellowship-trained in the most delicate and complex surgeries. In more than 99% of patients, we can remove the cyst, sparing the ovary and preserving fertility.

    MedStar Health is one of the country’s leading training sites for minimally invasive gynecologic surgery. We are pioneers in the latest techniques and technology. Our team is equipped with the energy and expertise to manage the most challenging and unique gynecologic conditions, and we are eager to support you in making your dreams a reality.

    Even in complex cases, there is rarely just one treatment option. If you are uncomfortable with the solution a doctor suggests, seek a second opinion. Getting more information takes a little extra time, but it will be time well spent if you can avoid an unnecessarily invasive or permanent procedure.


    Do you need to see a gynecologic surgeon?

    Visit the experts at MedStar Health.

    Call 202-877-DOCS (3627) or Request an Appointment

  • August 11, 2021

    By Sarah Heins, Medical Student, COVID Recovery Program

    As the status of the COVID-19 virus in the United States continues to improve amidst widespread vaccinations and the fresh outdoor air of the warm summer months, many people’s lives are beginning to approach a welcomed sense of pre-pandemic normalcy. However, for many Americans suffering from new or persistent symptoms after an initial COVID-19 infection, such normalcy feels much farther from reach.

    While a majority of people fully recover from COVID-19 infections, it is increasingly evident that many experience symptoms that last long after recovering from the virus. These post-COVID conditions are often referred to as “long COVID” or “long-term COVID,” and have been officially entitled by the CDC as PASC (Post-Acute Sequelae of COVID-19). PASC is defined as a “wide range of new, returning, or ongoing health problems people can experience more than four weeks after first being infected with the virus that causes COVID-19.”

    As we learn more about the effects of #COVID19, it’s increasingly evident that many people’s symptoms last long after testing negative for the virus. Read more about the symptoms and treatment of long-term COVID on the #LiveWellHealthy blog: https://bit.ly/3jMeZwn.

    Click to Tweet


    Long-term COVID symptoms.

    These symptoms occur in anywhere from 5-80% of patients, and are seen in patients who experienced COVID at all levels—from those who had no symptoms, to people with very serious illness.

    The long-term symptoms patients experience are wide-ranging, and include:

    • Anxiety
    • Blurry vision
    • Chest pain
    • Chills
    • Cough
    • Depression
    • Difficulty focusing (sometimes called “brain fog”)
    • Fatigue
    • Fever
    • Gastrointestinal changes
    • Headache
    • Heart Palpitations
    • Lightheadedness or dizziness
    • Loss of appetite
    • Loss of smell or taste
    • Memory impairments
    • Painful joints or muscles
    • Post-exertional malaise (PIM)
    • Sinus congestion
    • Shortness of breath
    • Trouble sleeping

    MedStar Health COVID Recovery Program.

    The COVID Recovery Program is a collaboration among medical specialists across all MedStar Health hospitals. The program aims to treat those struggling with PASC and guide them through the care needed for recovery.

    Our team is led by physical medicine and rehabilitation physicians, and advanced practice providers who specialize in the rehabilitation of patients with a variety of physical impairments. We will perform a detailed evaluation and provide necessary referrals to specialists who can further address your symptoms. A patient navigator and community health advocate will assist you with scheduling and managing your plan of care.

    Who can participate in the program?

    Patients interested in this program should be at least 6 weeks from the start of COVID symptoms and should have documentation of at least one positive COVID-19 test. Your doctor can also state that your symptoms indicated COVID without a positive test. If you do not have a documented positive test, a referral from a provider will be necessary to enter the program.

    Our patients have demonstrated a wide variety of post COVID-19 symptoms, similar to the ones listed above. However, some of these manifestations have proven to be especially prevalent, namely, fatigue, shortness of breath, and brain fog. Our COVID Recovery Program has drawn on a variety of resources and treatment techniques to help patients overcome them.

    Fatigue.

    Chronic fatigue is the most prevalent and substantial symptom seen in patients in our program. It may involve constant low-energy levels, exhaustion, and/or tiring more easily when performing daily functions such as housework or exercising. Oftentimes, the fatigue worsens substantially after minor exertion and does not improve with sleep. While the causes of this fatigue are still unknown, it may be related to the body’s initial reaction to the viral infection, such as a dysregulated immune-system response and associated inflammation.

    Although there are not yet any specific treatments for post-COVID fatigue, our program has developed various strategies that can bring short term relief and enhance long-term recovery. Treating any additional conditions—such as autoimmune diseases, diabetes, or other chronic illnesses—is an important step. Additionally, referring to specialists to perform sleep studies are also valuable tools in combating fatigue.

    Our program also refers patients to physical and occupational therapy to provide hands-on rehabilitative care to help patients improve their energy levels and functional abilities. Patients with recurring and chronic fatigue are often referred to neuropsychologists or psychologists to provide more specific therapy. They may also be placed on medications that can help combat fatigue.

    Shortness of breath and breathing difficulties.

    Following the acute respiratory symptoms of COVID-19, many patients continue to face troubles with breathing. These long-term respiratory manifestations include shortness of breath, coughing, wheezing, and chest heaviness. Our COVID-19 Recovery Program helps patients struggling with catching their breath during exertion. This may occur while doing daily activities, such as walking up stairs or exercising. Patients often notice that they cannot capture a full breath, or consistently feel that their airway is trapped or congested.

    There are many treatments that our program uses to relieve patients’ breathing difficulties. The program often refers patients to specialists, such as pulmonologists and cardiologists, who can perform various tests on the lungs and respiratory system, as well as order imaging such as chest X-Rays or CT scans. Providing patients with physical therapy and speech therapy are common and helpful ways to restore lung function and bring patients back to their baseline function levels.

    Brain fog.

    Another frequent symptom is a set of cognitive difficulties commonly referred to as “brain fog.” Patients often come to our COVID-19 Recovery Program reporting lapses in their memory, difficulty focusing, easily losing their train of thought, increased forgetfulness, challenges with finding words when speaking, and other changes. These symptoms appear with various levels of severity. From trouble focusing on tasks at work, to forgetting to pay bills, or turning off the stove.

    One of the main strategies our program employs to help with these symptoms is providing speech therapy and occupational therapy. These are used to develop new strategies to successfully prioritize, organize, and attack complex needs at work or at home. Patients struggling with more substantial symptoms will be referred to a neurologist who can perform further testing, imaging, and advanced treatments.

    MedStar Health is here to help.

    Because of the novel nature of COVID-19 and its long-term effects, there is still much to learn about the manifestations and causes of post-COVID symptoms. The techniques and rehabilitative strategies our program employs to help patients today are constantly evolving and improving, following information from current research, CDC guidelines, and the needs and stories of the patients it serves. Our goal is to provide patients with a one-stop service to bring resources and care to you. We understand you and your family have been through a life-changing experience with all the challenges a new virus and pandemic bring, and we are ready to help.


    Interested in the MedStar Health COVID Recovery Program?
    Click the button below.

    MedStar Health COVID Recovery Program

  • August 04, 2021

    By Andrew Radu, MD, MBE, Psychiatrist at MedStar Washington Hospital Center

    Did you know that most Olympic hopefuls begin intense training in their sport before their tenth birthday? After years of unrelenting pressure and stress related to athletic performance, it should come as no surprise that many elite athletes struggle with their mental health.

    Today, athletes are increasingly sharing their “humanness” with the public. They’re exposing mental health issues caused by a variety of factors. From toxic coaching and pressure from family, to scrutiny on social media. However, even athletes with strong support systems can suffer from feelings of depression and anxiety as they strive to meet their own expectations.

    It’s encouraging that elite athletes are finally stepping up to acknowledge their own mental health challenges. But calling them “brave” or “strong” may perpetuate the false narrative that individuals who are struggling in private with their mental health are weak or abnormal. It’s time to reframe how we prioritize our mental health, and that starts with elevating self-care in young athletes.

    It’s time to reframe how athletes address #MentalHealth. Sports psychiatrist Dr. Radu shares 3 ways to elevate self-care in young competitors on the #LiveWellHealthy blog: https://bit.ly/3A7x1jl.

    Click to Tweet


    Changing the narrative starts with prioritizing wellness above winning for young athletes.

    As a sports psychiatrist, I often see retired collegiate or professional athletes years after the demands and pressure of their sport has affected their psyche. While it’s never too late to seek help, there are preventative measures we can take to start showing young athletes that they are more than just winning machines.

    A true change in mental health and sports requires a shift towards ensuring we meet the developmental needs of young athletes, rather than teaching them that winning is everything. By preparing kids for the challenges they’re going to face early and equipping them to prioritize self-care above reaching a podium, we can help them support their holistic personal growth through participation in sports.

    1. Set achievable goals that go beyond “turning pro”.

    Many athletes define success for themselves as winning a particular event or title. And for the most elite, the pinnacle of achievement is becoming a professional athlete. Yet fewer than seven percent of high school athletes play their sport in college and fewer than two percent of college athletes go on to achieve professional status, according to the National Collegiate Athletic Association (NCAA).

    In that context, competitive sports have a tendency to create more losers than winners. That’s why it’s important for an individual athlete to set attainable goals and find meaning and value in the process, rather than the outcome. Setting goals that help you stay intrinsically motivated to get better or achieve mastery can ensure you feel successful, win or lose.

    I’ve found this to be true for myself. As a college fencing athlete, it wasn’t until my third and final appearance at the NCAA championships that I achieved my long time goal of becoming an All-American. I’d like to think that even if I had not accomplished my goal, I’d be able to look back on my career as an unmeasured success in terms of the life skills I attained and the relationships I forged.

    2. Evaluate your purpose for competing.

    Sports teach us a lot about camaraderie, the human spirit, and perseverance through adversity. But, often the intrinsic value of sports is overshadowed by the pressure to perform. If you start believing that your athletic achievements are all you have to offer the world, you can lose sight of what is good about you as a person. And, if you perform solely to meet someone else’s expectations, you might choose to push through a serious injury and cause long-term damage to your body.

    Some young athletes start out by having fun but continue pursuing competitive achievements. They may do this out of pressure from family members or coaches who are living vicariously through them. Kids can easily feel the weight of pressure when the focus shifts from friendly competition to a pre-professional atmosphere where they’re treated like adults before their brains are developmentally ready. If your participation in a sport is no longer fun, it’s time to reevaluate why you’re doing it in the first place.

    Do you enjoy competing? Are you having fun in your sport? Losing is often painful but can be transformative. Training and competing should bring you joy and meaning. If you’re not passionate about what you’re doing, consider stopping or taking a break before it begins to take a toll on your mental health.

    3. Keep the bigger picture in mind.

    We incorrectly assume that achieving a performance goal, like winning a national championship or an Olympic medal will bring happiness. But in reality, it often does the opposite. Many elite “winners” acknowledge that a feeling of emptiness can come even after accomplishing a lifelong goal.

    When playing a sport is all you know, it can be hard to figure out where you belong in the world after your career ends. Many elite collegiate and professional athletes struggle to adjust to “civilian” life after they’re no longer competing. I know this struggle firsthand, having transitioned abruptly from my collegiate fencing career to medical school. The world goes on as it did before, and many retired competitors will admit that something is lacking in their current life. Or, they look back on their career with regret at what they were unable to accomplish.

    Even if you do reach the pinnacle of your sport, you’ll still come face-to-face with the end of your elite athletic career at some point. In case you get injured or age or your abilities decline, what do you want your life to look like? Although many of us would like to stay young forever, all of our bodies will age eventually. Staying involved as a coach or a mentor can help ease the challenges of this difficult transition.

    One of the ways we can help athletes avoid struggles with mental health or burnout is to reframe the role sports should play in our lives while kids are still young. Instead of making a professional career the end-all-be-all measure of success for youth athletes, we can encourage kids to diversify their passions with non-competitive hobbies, like art or music. This helps shape well-rounded individuals who have a variety of interests that bring a sense of fulfillment in any stage of life.

    Shed the stigma of seeking help.

    Historically, mental health has been overlooked in athletes who are otherwise deemed to be exceptionally physically healthy. For professional athletes living in the public eye, many hesitate to seek care for mental health struggles for fear of judgment or perception of weakness.

    However, it is completely normal and valid to experience bouts of depression, anxiety, or burnout when competing in sports. Whether you feel self-induced pressure to perform or you’re bearing the burden of living up to the expectations of those around you, you don’t need to feel ashamed to acknowledge when it’s too much.

    Mental health challenges look different for everyone, but if you’re feeling hopeless, finding it hard to concentrate at school, or struggling with everyday activities, don’t be afraid to seek professional help from a psychologist or counselor.

    Mental toughness is a necessary quality of all high-performing athletes. But having a strong mind that’s capable of overcoming struggle doesn’t mean that you have to—or should—do it alone.


    Are you an athlete struggling to care for your mental health?
    Click below to learn more about MedStar Health’s behavioral health services.

    Behavioral Health

  • August 02, 2021

    By Glenn W. Wortmann, MD

    The Delta variant is the fourth known mutation of the COVID-19 virus. Like any mutated virus or bacteria, each strain of the COVID-19 virus behaves a little differently than the others. While data on the variant are still being analyzed, it appears to spread more easily than the other variants and may cause more severe disease in people who have not been vaccinated.

    All forms of the current vaccine offer protection against severe COVID-19 infection from all strains of the virus. While you may still catch the Delta mutated virus if you are vaccinated, you will be more protected against getting hospitalized or dying.

    However, more than one-third of the U.S. population is not vaccinated, so the virus continues to spread. As long as spreading continues, the virus will keep mutating. Future, stronger mutations may necessitate tweaking of the vaccine—just like we do with the flu vaccine each season.

    The cycle can be stopped.

    We can stop this cycle, just like we have with other nefarious diseases in the past, such as polio, measles, chickenpox, and diphtheria. All it will take is more people age 12 and older getting the free vaccine.

    The Mid-Atlantic has, so far, avoided a spike in Delta variant infections. Our communities have been highly receptive overall to getting vaccinated. However, the south and central U.S. are seeing continuously increasing numbers.

    As we say in the world of infectious disease medicine, an outbreak is just a plane ride away. Exposure to a spreading, mutating virus can cause a new wave of illness in our vaccinated and unvaccinated populations. Even people who have had COVID-19 should get vaccinated so as not to spread the Delta variant to others.

    The COVID-19 vaccine is proven safe and effective. If you or a loved one have been on the fence about getting vaccinated, now is the time to do it. I’ve laid out some data-driven points on some of the more common concerns we’ve heard from patients about the vaccine.

    1. Why is the CDC recommending masks for the vaccinated?

    Throughout the COVID-19 pandemic, guidance has changed as new data becomes available. The re-recommendation of wearing masks is one of those instances—and it’s the right thing to do. Though we are over a year into the pandemic, the virus is still relatively new and we are still learning about it.

    However, we know that certain safety protocols work, including masking, social distancing, and getting vaccinated. It’s like the safety elements of a car: the brakes, seatbelt, airbag offer multiple levels of cumulative protection:

    • Vaccines are like the airbag: You get it, and it stays with you, protecting you behind the scenes.
    • Masking is like the seatbelt: You have to remember to put it on, but when you do, it adds an extra layer of protection for yourself and others near you.
    • Social distancing is like following traffic signals: If everyone plays it safe, we will all be safer.
    The #COVID19 #vaccine is like your car’s airbag. It protects you behind the scenes. Masks are like seatbelts—wear them for extra protection, for yourself and others. – Glenn Wortmann, MD: https://bit.ly/3lnKhMH.

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    2. Will I need a COVID-19 booster shot?

    Pfizer released a small study in which they suggest that a third “booster” shot of the vaccine may increase the antibodies developed as part of the recommended vaccine schedule. The size of the study was too small to recommend booster shots as of now.

    MedStar Health follows the CDC’s Advisory Committee on Immunization Protocols (ACIP), which is the organization that recommends vaccinations. ACIP’s national guideline remains the same as it has been since the vaccines were released: two doses of the MRNA-technology vaccines (Moderna or Pfizer) or one dose of the Johnson & Johnson vaccine. If these recommendations change, ours likely will as well.

    Related reading: COVID-19 Vaccine FAQs – Part 1 and Part 2.

    3. Why do students need to wear masks at school?

    Public schools in Baltimore County, Washington, D.C., Prince George’s County, and Montgomery County have decided that masks will be required for fall 2021.

    Children who get COVID-19 tend to have very low rates of hospitalization or death. Severe illness, including multisystem inflammatory syndrome in children (MIS-C), is rare. So, the goal of masking is not necessarily protecting kids from each other. It is largely to protect their classmates’ families, as well as school staff and their families.

    4. How many more mutations will there be?

    Unfortunately, as long as a large population of people remain unvaccinated, the virus can continue to mutate. We cannot predict what the specific mutations will be or how many, but similar to the flu, the more the virus spreads, the more it will mutate and potentially grow stronger.

    This frustrating situation is not unique to COVID-19. Any virus that is not properly controlled can mutate to become resistant to medication. For example, if a patient with HIV is prescribed three medications but only takes one of them regularly, their virus may mutate to become resistant to that medication.

    The best chance we have to avoid future, strong mutations is to get more of the population vaccinated against COVID-19.

    5. What should immunocompromised people do now?

    Patients with chronic and immunocompromising conditions are at increased risk of severe COVID-19 infection. However, these patients do not have a robust immune system that the vaccine can “train” to handle the virus. So, it will be less effective for them, making it even more important for everyone around them to get vaccinated.

    The vaccine provides some protection and is highly recommended—along with continued masking—for patients who have chronic conditions such as:

    • Heart or lung disease
    • HIV
    • Lupus
    • A bone marrow or organ transplant
    • Multiple sclerosis
    • Rheumatoid arthritis
    • Type 2 diabetes
    • Cancer

    A few closing thoughts.

    People are understandably tired of the virus and its restrictions. And after the euphoria of the release of the vaccines and some of the subsequent lessening of certain restrictions, taking a step backwards can be frustrating.

    Here is the bottom line. The vaccines, social distancing, and masking are proven safe and effective. COVID-19 and all its variants are proven deadly, contagious, and capable of mutating. If a large population of U.S. patients choose to remain unvaccinated, the virus likely will ping-pong around the country growing stronger.

    The vaccine remains our best hope to defeat COVID-19 once and for all. I can’t stress this enough. If you still have not received your vaccine, please make a plan to get vaccinated today. It’s easy and it’s free. And most importantly, it will help protect you and your community.


    Do you have questions about the COVID-19 vaccine?

    Visit https://www.medstarhealth.org/mhs/about-medstar/covid-19-vaccine-information for more information.

  • July 23, 2021

    By Andrew Sokol, MD

    Women today face many contradictions about how to handle their personal health, especially when it comes to common—but not normal—pelvic floor disorders such as pelvic organ prolapse and urinary incontinence (UI).

    Society says these conditions are a “normal” part of aging or an expected outcome of having children. So, many women avoid getting help because they’re embarrassed or don’t feel good about getting care “just to feel more comfortable.”

    It’s true that prolapse and UI are common. Approximately half of women will develop a pelvic floor disorder in their lifetime, and 20-50% of them will have symptoms that disrupt their daily life.

    But these conditions aren’t normal or inevitable. You have options to reduce or eliminate uncomfortable, isolating symptoms such as:

    • A bulging sensation in the vagina
    • Pelvic pressure
    • Constipation due to reduced pelvic support
    • Low-back pain
    • Urinary leakage, urgency, or frequency
    • Urinary tract infections or skin irritation from frequently wearing pads

    If your symptoms don’t bother you, treatment isn’t necessary. But if symptoms keep you from exercising, doing errands, or spending time with friends, it’s time for a change.

    The urogynecologists at MedStar Health are internationally recognized experts in pelvic floor disorders. We are one of just 66 urogynecology fellowship training sites in the U.S., which means we teach the latest, most advanced medical and surgical treatments.
    As an academic medical center, all the specialty care you might need is available under one roof.

    Today’s treatments are safer, more effective, and less invasive than ever before—there have been at least 2,000 studies on UI treatments since the 1990s. Most patients don’t need surgery, and those who do can get minimally invasive outpatient procedures with no need for a hospital stay.

    Let’s discuss the causes, symptoms, and risk factors of prolapse and UI, as well as treatment options to help you get back to doing what you love.

    You don’t have to live with annoying, uncomfortable #PelvicOrganProlapse or urinary #incontinence. Get safe, effective treatment options from an expert #urogyn team that cares about you: https://bit.ly/3xY0fR4.

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    Pelvic organ prolapse.

    What it is.

    Prolapse is a weakening of the walls of the vagina. Sometimes this condition is called “bladder prolapse” because the bladder presses into the vagina—in severe cases, it protrudes from the vaginal opening. Approximately 3% of women develop pelvic organ prolapse in their lifetime.

    Non-surgical treatments.

    Maintaining a healthy weight is important, and so is controlling diseases such as diabetes that reduce your ability to heal. Many women get substantial symptom relief by using a pessary, which is a device (much like a diaphragm) you insert in the vagina to help support the vaginal wall muscles and hold up the bladder. A pessary can relieve symptoms, but it will not cure the underlying vaginal wall weakness.

    Having a strong pelvic floor can help reduce urine leakage and prolapse symptoms. Your pelvic floor muscles are the muscles you squeeze when you are trying to keep yourself from urinating or passing gas. You can tone these muscles by doing Kegel exercises—squeezing and releasing the pelvic floor muscles several times per day. Kegels only work if they’re done properly. Your urogynecologist can refer you to a pelvic floor physical therapist who can teach you the proper way to do Kegels.

    Surgical treatments.

    The most common procedure we do is native tissue repair. We elevated the vaginal walls to their normal position, and we use dissolvable stitches to hold the tissue in place. As the stitches dissolve, the tissue naturally heals in its proper place.

    Other procedures are performed laparoscopically (with keyhole surgery). While grafts may sometimes be used, these are different from “vaginal mesh” procedures (which are no longer performed). Many studies have shown that quality of life significantly increases after prolapse repair surgery, including physical, emotional, and sexual health.

    Tired of dealing with pelvic pressure? Request an appointment.

    Urinary incontinence.

    What it is.

    More than 40% of women will develop urinary incontinence in their lifetime. There are two main types of urinary incontinence, and some women have a mix of both:

    • Urgency incontinence: An overwhelming urge to urinate RIGHT NOW. Urgency UI may be a result of excess fluid intake or complications with diabetes, stroke, or constipation that increases abdominal pressure. However, it can be caused by abnormal communication between the bladder nerves and brain, making you feel like you constantly have to go when your bladder is not full.
    • Stress incontinence: Leakage when you cough, jump, laugh, or sneeze. Stress UI is caused by extra abdominal pressure and improper closure of the bladder sphincter—the ring that opens and closes to the urethra. Half of women with UI have stress incontinence.

    Non-surgical treatments.

    Urgency incontinence is frequently treated without surgery. Behavior and habit changes can go a long way toward improving symptoms. Your urogynecologist will work with you to establish good habits for:

    • Managing fluid intake—most people don’t need to drink eight glasses of water a day, even though we’ve heard that all our lives!
    • Using the bathroom on a schedule to avoid that “gotta go now!” feeling.
    • Avoiding diuretics such as excessive alcohol and caffeine.
    • Empty your bladder fully, even if it takes a little longer in the bathroom.
    • Achieving and maintaining a healthy weight.
    • Kegel exercises.

    Medications can help reduce the sensation of having a full bladder when you don’t. Other nonsurgical options include BOTOX injections to relax the bladder muscles (giving you more time to get to the bathroom) and acupuncture in the tibial nerve of the ankle to control overactive bladder symptoms.

    Stress incontinence symptoms may be relieved by using a pessary. However, pessaries do not address the underlying cause of incontinence.

    Surgical treatments.

    For urgency incontinence, a small, implanted bladder pacemaker (such as InterStim II) can help alter abnormal messages between the bladder nerves and the brain.

    Stress incontinence is often treated with an outpatient “sling” procedure, and we do thousands of these surgeries each year. The urethra (the tube you urinate through) extends from the bladder like a short garden hose, and the sling holds it in the proper place. When you cough, laugh, jump, or sneeze, the urethra bends around the sling like putting a kink in a garden hose, reducing leakage.

    Struggling with UI? Request an appointment.

    Causes and diagnosis.

    It’s easy to see why so many women think prolapse and UI are normal after childbirth. Vaginal delivery does stretch the pelvic muscles and nerves, as well as the urethral sphincter.

    However, giving birth is just one of a list of risk factors for these conditions. Other common causes include:

    • Aging
    • Collagen disorders, such as Ehlers-Danos syndrome, which relax the tendons too much
    • Family history—if your mom or grandma had prolapse or incontinence, your risk is higher
    • Forceps- or vacuum-assisted childbirth
    • Long-term conditions that cause abdominal pressure, such as chronic coughing
    • Obesity—even a 10% weight loss can drastically improve symptoms
    • Pregnancy in general, with more pregnancies increasing the risk

    Diagnosing prolapse and UI does not involve fancy tests or equipment. For most patients, a physical exam and thorough discussion of your symptoms is all we need to diagnose your condition.

    See a urogynecologist for problematic symptoms.

    Thousands of women struggle with uncomfortable, annoying prolapse or UI symptoms that keep them from doing what they want and need to do. But you don’t have to live that way.

    Most women who come to us wish they had come to us years sooner. MedStar Health urogynecologists are specially trained to help you discover the cause of your condition. Our dedicated pelvic floor experts will listen to you and help you find the best treatment to reduce or eliminate prolapse and UI symptoms.


    Tired of dealing with pelvic pressure and leaking urine?
    Visit a urogynecologist for expert care and get back to doing what you love!

    Pelvic organ prolapse.

    Bladder leakage.

  • July 21, 2021

    By Taryn E. Travis, MD

    Whether it’s the first day of summer or the end of a weekend beach getaway, nearly everyone has experienced the painful discoloration of a sunburn. But far fewer people know when, “Whoops, I forgot my sunscreen” should become, “I need to go to the doctor.”

    The average sunburn behaves like a first-degree burn, meaning only the outer layer of the skin, the epidermis, has been damaged. Burns that reach deeper than the epidermis are at least a partial thickness burn, also known as a second-degree burn. These can often be recognized by blisters or breaks in the skin. If you experience a burn that reaches this depth, you should seek care from a doctor who specializes in burn treatment.

    Experienced providers at the Burn Center at MedStar Washington Hospital Center—the only adult burn treatment center in the Washington, D.C., metropolitan area—treat all types of burns 24/7, 365 days a year. We can quickly and accurately interpret the depth of your burn before providing treatment based on the location and extent of your burn, as well as any other medical conditions you might have.

    Seek immediate care if you experience these symptoms after a sunburn:

    • Fatigue
    • Nausea
    • Dizziness
    • Headache

    With a severe sunburn, you may be in danger of dehydration, especially as we more frequently experience record-high temperatures.

    Without proper treatment of broken or blistered skin, risk increases for infection, scarring and permanent skin color changes. Other long-term risks of sunburn include skin cancer. In fact, the American Academy of Dermatology has shared that experiencing five or more blistering sunburns between ages 15 and 20 increases one’s melanoma risk by 80% and non-melanoma skin cancer risk by 68%.

    As we resume normal summertime activities amidst the pandemic, we must also reinstate good sun-safety and sunburn care habits. The next time you overdo it in the sun, use this list to find the best ways to treat sunburn at home, what not to do, and when to visit the Burn Center.


    A severe #sunburn can cause not only #infection and permanent skin damage but also internal complications like #dehydration. Seeking professional help greatly decreases this risk: https://bit.ly/3BvSt38.

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    Dos and don’ts.

    Taking—and avoiding—specific actions as soon as you realize you have a sunburn can make a difference in how fast you heal. A quick internet search or conversation with a friend might tempt you to try different “hacks” using common items you likely have in your home, but many of these myths can actually harm your skin further.

    Dos: Home remedies that can help sunburn.

    1. Run cool or room-temperature water over the burn to soothe the pain.
    2. Keep the skin clean using soap and water.
    3. Moisturize the burn area using non-dyed, non-perfumed lotions, such as Aquaphor or Aveeno.
    4. Take an over-the-counter medication, such as ibuprofen, at the first sign of sunburn to reduce pain and inflammation, as long as you don’t have any health reasons to not use these medications.
    5. Seek professional care if you think you have an infection or severe sunburn.

    Don’ts: Never try these unhelpful treatments.

    1. Ice: This can lead to frostbite, converting one injury to another.
    2. Food products: Foods, beverages, or condiments such as mustard, ketchup, butter and honey will not do your skin any favors.
    3. Unusual chemicals: Such as gel from air fresheners, or rubbing alcohol or hydrogen peroxide. This will irritate your skin even more.
    4. Antibiotics or antibiotic ointments: Especially if you’ve never used these types of treatments before. If you put them on irritated skin, you can get a skin rash, which will worsen the burn.
    5. More sun: Don’t re-expose the burn to the sun while it’s healing.

    How the Burn Center can help.

    Our goal is to provide patients with wound care approaches that are as simple as possible. We often employ wound care regimens that allow dressings to be left in place for multiple days at a time to minimize the amount of care required by patients at home. If someone does have a regimen that needs to be performed more often, we can involve the MedStar Visiting Nurse Association to help.

    Patients who have a bad sunburn in addition to medical conditions that make it harder to heal, such as diabetes, vascular insufficiency, or heart, lung, or kidney problems, can receive IV and nutrition support to promote healing, as well as pain medication. They may also need to stay in the hospital or get follow-up care in our outpatient clinic.

    As part of the MedStar Health system, patients have streamlined access to a collaborative team of providers who will deliver all the care they need under one roof.

    How to prevent sunburn.

    After spending more time indoors than usual during the past year and a half, many people are a little out of practice when it comes to sun protection. Build better habits by following the tips below:

    • Use a mineral-based sunscreen in the 30 – 50 SPF range that blocks both UVA and UVB rays. This is just as important for people with darker skin tones, as they can also develop skin cancer as a result of long-term sun exposure.
    • Re-apply sunscreen every two hours. Most people don’t apply as much as they need.
    • Pay attention to sunscreen expiration dates; once you hit that date, replace it.
    • Don’t neglect the most commonly forgotten areas when applying sunscreen: your ears and neck, the tip of your nose, and the tops of your hands and feet.
    • Hats and sleeves go a long way in protecting your skin. Wear both as much as possible.
    • If you have diabetic neuropathy, which alters the sensations in your hands and feet, keep a close eye on your skin, as you won’t be able to rely on how it feels.
    • Be careful while walking on hot sand and pavement. People don’t typically put sunscreen on their palms or the bottoms of their feet, but you could damage your skin in less than a minute with hot contact.

    Related reading: 7 simple ways to protect your skin in the sun.

    People often avoid professional medical treatment for a sunburn because they’re embarrassed or think it’s not a big deal, but large surface-area burns or blisters are always worth seeking care for. We can provide the care you need and educate you on how to prevent complications moving forward.


    Has your sunburn turned into a sun blister?

    Our Burn Center specialists are here to help.

    Call 202-877-DOCS (3627) or Request an Appointment