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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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  • November 01, 2018

    By MedStar Health

    The safety of our patients and associates is the most important thing we do. Drug diversion is the theft, misuse, or tampering of a controlled substance. It is a real risk for everyone in health care. As a High Reliability Organization (HRO), MedStar is committed to preventing, detecting and responding to drug diversion.

    Education and training for all associates are the foundation of our system-wide Drug Diversion Prevention program, and all MedStar associates have been enrolled in a required online course with SiTEL. This course provides information about drug diversion, warning signs, and what to do if you have a diversion concern. 

    This course is now live. It must be completed before December 14th, 2018. Please reach out to your supervisor with any questions about this course or MedStar’s Drug Diversion Prevention program. To access the course, please sign in to https://www.sitelms.org/ and click on Drug Diversion Prevention Awareness.

  • November 01, 2018

    By MedStar Health

    The Delivery System Science Fellowship application cycle for the 2019 cohort is NOW OPEN! MedStar Health Research Institute is one of ten participating host sites. The AcademyHealth Delivery System Science Fellowship (DSSF) provides a paid post-doctoral learning experience in conducting research within one of ten delivery system settings. This year-long fellowship enhances fellows’ training by applying their analytic skills to relevant and timely topics prioritized by delivery systems.

    MedStar Health Research Institute is one of ten cohort host sites for the 2019 fellowship.

    Researchers with a doctoral degree in health services research or a related field are encouraged to apply. Applicants are eligible to apply for the fellowship if they will receive a doctoral degree before the fellowship start date, which is expected to begin in fall of 2019. Experienced candidates considering a career shift are also encouraged to apply.

    Submit an Intent to Apply
    Once applicants submit a brief Intent to Apply form, they will receive a link to the full application.

    Application Deadline: Monday, January 14, 2019, at 5:00 p.m. ET
    Questions? Please contact DSSF staff at dssf@academyhealth.org.

  • October 31, 2018

    Trick-or-treating is one of the most fun times of the year for kids and parents alike. However, one caveat to the fun can be the masses of sugary treats kids have at their fingertips.

    With childhood obesity affecting about 18.5 percent of children and teens in the U.S., it’s smart to consider ways for kids to consume less sugar during and after trick-or-treating. Use this list of alternatives to make your Halloween handouts a little healthier and find tips to manage how much candy your children are taking home and consuming.

    With childhood obesity rates around 18.5 percent in the U.S., it’s important to monitor the types of #Halloween candy you give out and how much your children are taking home, via @MedStarHealth https://bit.ly/2CV0aUG.

    Click to Tweet

    Healthier Candy Alternatives

    Start with candy that includes less sugar or choose alternatives that substitute fruit for sugar. Or better yet, non-food items have no sugar at all and can surprise kids who are used to receiving candy at Halloween. Some fun options include:

    • Bubbles
    • Crayons
    • Glow bracelets
    • LED light up rings
    • Mini packs of play dough
    • Plastic spider rings
    • Stamps
    • Vampire teeth

    You tell us: Do you give out fun, healthy items on #Halloween? Tell us on Twitter or Facebook by tagging @MedStarHealth.

    How to Manage Portions

    While you can decide to give out healthier treats, you can’t change how your neighbors celebrate Halloween. As a result, it’s important to manage how much candy your child takes home (or keeps) and the amount they eat each day.

    I suggest creating a half-tub rule for your children. If they carry a bag or basket, allow them to fill it only halfway with treats. In the coming days and weeks, store their candy so they must ask you before eating it. I suggest allowing them to eat one to two small pieces of candy per day.

    While you and your child are out trick-or-treating, consider making a goal to go through as many neighborhoods as possible. The more you walk, the more calories you burn, which is a great way to cut the extra calories your child will be consuming–at least over the next few days.

    Whether you’re giving out candy or accompanying your children while they trick-or-treat, try to strike a healthy balance during the holiday fun.

    To learn more about the Good Health Center at MedStar Good Samaritan Hospital click the button below.

    Learn More

  • October 30, 2018

    By MedStar Health

    By Anne Gunderson Ed.D, MS, GNP

    Since the official creation of The Academy for Emerging Leaders in Patient Safety: The Telluride Experience in 2009, over 800 health science students and residents have attended one of our immersive sessions.  The program is intended to fill gaps in health sciences education where formal, systematic patient safety and quality curriculum is lacking. Learners leave with the tools, knowledge, support, and enthusiasm to make a difference at their institution or school, and a commitment to make patient safety a focus of their medical careers.  While in attendance, each learner is asked to blog nightly to provide an outlet for their reflections and the impact of its curriculum in their own words.  These powerful glimpses into their thoughts and experiences formed the inspiration for our new book, Shattering the Wall: Imagine Healthcare without Preventable Medical Harm.

    Shattering the Wall is a collection of works created by these young healthcare learners and the faculty members who taught them.  Each chapter is deeply rooted in the healthcare domains of safety, quality, and leadership. No matter what type of reader you may be—healthcare professional, health science educator, or a patient who uses health services—this book will hopefully open your eyes to many of the intricacies of our current healthcare system, as well as the challenges faced by all of us in delivering safe, high-quality care. In this book, you will be exposed to first-hand accounts of real-life situations involving learners, professionals, patients, and their families, which reflect the historical background, current state, and lessons learned of each prevalent topic in healthcare practice.  The chapters do not have to be read in order. Feel free to pick a chapter on a topic that intrigues you, or start from the beginning and immerse yourself in a learning experience similar to what our learners experience while attending The Telluride Experience.

    The future is limitless for these young leaders. The leaders of tomorrow have the opportunity to create a culture that is safe, and, most importantly, patient-focused. By stretching the boundaries of traditional thinking and acting, learners and professionals can deliver higher-quality care to patients and their families, thus transforming and improving healthcare culture and practices for future generations.

    We hope you will accept this work in the spirit in which it was intended: to give a larger platform to the voices of our future healthcare leaders—voices that will carry the much-needed healthcare culture change forward. Our faculty strongly believes in the “Educate the Young” premise – providing the future generation of health care leaders the knowledge, tools, techniques, and behaviors associated with high-quality, safe care.

    Whether you are a healthcare learner, a healthcare professional, or a patient or family member interested in learning more about our current healthcare culture, you will appreciate Shattering because we all have one thing in common - we are all affected by the health of our current healthcare system, and we will all, one day be patients.

    Please note: Any and all proceeds from book sales will go directly to support future Telluride Scholars in their quest to become the safest, most patient-centered caregivers they can be. We are, in turn, grateful for your support.

    Purchase book here: amazon.com

  • October 30, 2018

    By Patricia B. Wehner, MD

    Surgery is the gold-standard breast cancer treatment, but some techniques leave women flat-chested or with lopsided breasts. Today, many women can benefit from oncoplastic surgery, or oncoplasty, which offers a more natural breast shape so patients can look and feel more confident after surgery.

    Oncoplasty is a combination of a cancer surgery (onco) and plastic surgery. The goal is to achieve a natural look after breast cancer removal by reconstructing the patient’s breast tissue to retain a cosmetically-pleasing shape without using implants. This technique is a major advancement for women with breast cancer. Years ago, all patients received mastectomies in an attempt to reduce the risk of recurrence as much as possible.

    Today, we know that less radical techniques are effective and that it’s important for women to feel like themselves again after treatment is complete. Additionally, plastic surgery that is done as part of breast cancer treatment is covered by insurance. The beauty of oncoplasty is twofold:

    • The cancer removal and breast reconstruction can be done in one procedure so a woman doesn’t have to deal with a misshapen breast or multiple surgeries.
    • We can perform the procedure in such a way that scars are nearly unnoticeable and, for many patients, leave the nipple and surrounding tissue intact for a more natural look.

    Not all patients are candidates for a partial mastectomy. Some patients may need to undergo a mastectomy or complete removal of the breast. For those patients we also have many reconstructive options where we recreate a breast in a cosmetically favorable way.

    LISTEN: Dr. Wehner Discusses How Oncoplastic Surgery Can Benefit Breast Cancer Patients in the Medical Intel Podcast.

    How Does Oncoplastic Surgery Work?

    Oncoplastic surgery begins with a partial mastectomy to remove the cancer. An incision is designed to help minimize scaring in the most visible areas of the breast. The surgeon then removes the cancer. Once the surgeon is happy with the amount of tissue removed, the surgeon will rearrange the breast tissue that is left. The goal is to fill in the created defect so that the remaining breast retains a natural shape and contour. The patient then goes home the same day with nothing more than a supportive bra. I tell all patients they can shower the next day, and very few patients require strong pain medication after the procedure.

    When patients have very large, heavy breasts, we have the option to give the patient a breast reduction and a lift during the same surgery when we remove their breast cancer. This allows the surgeon to remove the tumor, decrease the weight burden from the previously large breast, and make radiation therapy easier and more effective.

    Some breast surgeons partner with plastic surgeons to perform oncoplasty together. Other surgeons, myself included, have advanced training in plastic surgery and can perform the entire oncoplastic procedure. In either approach, the goal is to treat breast cancer while giving patients the opportunity to retain their self-confidence and sensuality after surgery.

    What If I Need a Mastectomy?

    When the size and location of the tumor allow, we can make an incision below the affected breast between the muscle and skin and work toward the top of the breast to remove tissue while leaving the breast envelope—the skin, nipple, and areola complex (the colored area around the nipple)—intact. We then recreate the breast tissue with an implant or other tissue from the body. This technique often is called a skin- and nipple-sparing mastectomy. I tell women it’s like wearing earrings—the nipple doesn’t perform like it used to, but having it there can make a patient look and feel better.

    The best candidates for nipple-sparing surgery are thinner women who have smaller breasts, generally between an A and C cup. For women with larger breasts, we can use a two-stage approach in which we first surgically reduce the size of the breast before doing the nipple-sparing surgery.

    Oncoplastic #surgery combines #plasticsurgery and partial #mastectomy so women can look like themselves and feel more confident after #breastcancer treatment, via @MedStarWHC

    Click to Tweet


    What to Expect During Recovery

    Most patients go home the day of surgery with minimal pain. Women who have breast reductions as part of oncoplastic surgery might experience more pain because the procedure is more extensive. It’s important to remember that before cancer, the breasts are not identical—they’re not twins, but sisters. One is typically fuller or larger than the other. After breast cancer surgery, the breasts will not be identical, either. However, we work to make them as similar in size and shape as possible.

    Every woman with breast cancer who needs surgery is offered oncoplastic options at MedStar Washington Hospital Center. Curing cancer is our primary goal for breast surgery. But it’s important that patients can wake up every day after recovery looking and feeling like themselves without a constant reminder that they went through cancer treatment.

    Considering breast reconstruction surgery? Call 202-877-3627 or click below to make an appointment with a breast surgeon.

    Request an Appointment

  • October 29, 2018

    By Stephanie Jacobs, MD

    High blood pressure is a serious problem that continues to grow in our country. Among women of childbearing age, we see about 20 percent with high blood pressure, whether they know it or not. Many pregnant women are aware of preeclampsia, a type of high blood pressure that endangers both the mother and her baby. But actually, there are four main categories of high blood pressure, also known as hypertension, that are associated with pregnancy:

    • Chronic hypertension: high blood pressure diagnosed before the 20th week of pregnancy, which means the mother had high blood pressure before conceiving
    • Preeclampsia: high blood pressure that develops after the 20th week of pregnancy or after delivery and is a risk factor for serious complications
    • Preeclampsia superimposed on chronic hypertension: preeclampsia that develops in a woman who already had high blood pressure before she became pregnant
    • Gestational hypertension: high blood pressure that develops after the 20th week of pregnancy but does not have the same effects on mothers or babies as preeclampsia

    High blood pressure during pregnancy is a dangerous risk factor for serious and life-threatening complications, including heart attack, stroke, development of heart disease, and cerebral aneurysm, a weakened, bulging area in the wall of an artery in the brain that may rupture.

    Risks of High Blood Pressure During Pregnancy

    Mothers and babies tend to have normal, healthy outcomes in cases of gestational hypertension. However, the other types of hypertension can be very dangerous for the expectant mom and the baby without regular monitoring.

    Pregnant women with preeclampsia are at increased risk for a number of complications, such as organ or brain damage. Preeclampsia also can develop into eclampsia, which is when elevated blood pressure can result in seizures. Babies whose mothers have preeclampsia might be at risk for:

    • Bleeding in the brain
    • Premature birth
    • Low birth weight
    • Retinopathy of prematurity, an eye disorder that can lead to lifelong vision problems or blindness
    • Death

    The first stage of high blood pressure starts at 130 over 80, or 130 millimeters of mercury (mmHg) of systolic pressure and 80 mmHg of diastolic pressure. Most Ob/Gyns use a cutoff of 160 over 100 as an indication that a pregnant woman needs medical treatment for high blood pressure.

    In addition to the risks of high blood pressure, we also have to monitor these patients for dangerously low blood pressure. It’s normal for an expectant mom’s blood pressure to drop from the time of conception through the second trimester—about 28 weeks. This is because her blood vessels dilate, or expand, to allow more blood to flow to the baby through the placenta. However, a woman who is on medication for high blood pressure before pregnancy should work with her doctor to adjust her dosage to avoid passing out or not providing enough blood to her baby.

    Call 202-877-3627 or click below to make an appointment with a cardiologist.

    Request an Appointment


    Cardiology Care Can Pinpoint Hypertension Warning Signs

    An Ob/Gyn might refer an expectant mom to a cardiologist if she needs monitoring or treatment for high blood pressure beyond what the Ob/Gyn can provide. In addition to regular blood pressure monitoring, expectant mothers receive a number of tests to determine whether they have a form of high blood pressure or to make sure we are keeping it under control. These may include:

    • Blood tests to determine how well the liver and kidneys are functioning, as well as levels of blood cells called platelets (which help blood clot). Platelet levels that are too low can be a sign of preeclampsia.
    • Fetal ultrasounds to keep track of baby’s growth. If the baby isn’t growing well, it can be a sign of high blood pressure preventing nutrients from flowing through the placenta.
    • Urine tests to measure protein levels. Excess protein in the urine can be a sign of kidney problems associated with preeclampsia.
    Blood tests, ultrasounds, and urine testing help #cardiologists monitor expectant moms for #preeclampsia and other forms of high #bloodpressure during #pregnancy. via @MedStarWHC

    Click to Tweet


    I also educate my patients to watch for swelling of the arms or legs—a common warning sign of preeclampsia. Many pregnant women have some degree of swelling, especially around the ankles, so it can be tough for women to know what’s normal, especially during a first pregnancy. As a general rule, swelling is a concern if they are swollen up to the knee and can press on the swollen area for five seconds and leave a mark, or if the swelling is associated with other symptoms such as breathlessness or difficulty laying flat at night due to breathing. Always err on the side of caution and check with your doctor if you are not sure whether something is normal or serious.

    Treatment Options for Managing Blood Pressure During Pregnancy

    High blood pressure during pregnancy often can be safely managed with medication, which can be scary for some women. I take patients through the data on medications that have been thoroughly studied and found to be safe for both pregnant women and their babies. Then, we discuss the risks of uncontrolled blood pressure. We work together to come up with the right plan for them, including regular Ob/Gyn and cardiologist visits, to keep both mom and baby safe.

    For preeclampsia, the only safe course of action for the mother is delivery of the baby. We work closely with patients’ Ob/Gyns to get their babies to fetal lung maturity, or the point at which the lungs can function well enough for the baby to breathe on their own. That’s usually at about 34 weeks of pregnancy.

    Though high blood pressure often doesn’t cause noticeable symptoms, it’s important for pregnant women to control their blood pressure. Hypertension without the right treatment can lead to heartbreaking complications for pregnant women and their unborn babies. If you are not sure about what you are feeling, ask your Ob/Gyn or a cardiologist for help.

    Call 202-877-3627 or click below to make an appointment with a cardiologist.

    Request an Appointment