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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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  • February 03, 2017

    By MedStar Health

    A team of researchers from the MedStar National Rehabilitation Network (MNRN) have published their findings on utilizing an objective method of assessing mild traumatic brain injury (mTBI). Published in Experimental Brain Research, the research was led by Alexander W. Dromerick, MD, Vice President for Research at MNRN, in collaboration with Peter S. Lum, PhD, Chair of the Department of Biomedical Engineering at Catholic University of America.

    A TBI is defined as an injury or disruption of brain function due to an external force. TBI is rated by severity, categorized as mild, moderate, or severe based on the length of loss of consciousness, alteration of consciousness and/or mental state, or post-traumatic amnesia. A mild TBI (mTBI) is clinically synonymous with concussion.

    The article, “Dynamic motor tracking is sensitive to subacute mTBI”, showed that grip force metrics could provide a more accurate diagnosis of mTBI. Individuals with and without diagnosed mTBI were asked to squeeze a hand dynamometer, and change their grip force to match a variable target force for 3 minutes. A model of how participants’ changed their grip force in response to error classified mTBI with a sensitivity of 87% and a specificity of 93%, comparable to or better than several standard clinical scales. The same model was also sensitive to time post injury.

    The findings suggest that visuomotor (coordination of movement and visual perceptions) tracking could be an effective supplement to conventional assessment tools to screen for mTBI and track mTBI symptoms during recovery. “Effective screening for mild traumatic brain injury (mTBI) is critical to accurate diagnosis, intervention, and improving outcomes,” the authors said.

    The research team also included Anthony J. Metzger, PhD; Alexander V. Libin, PhD; Jill Terner, MPH; David Milzman, MD from MNRN, in addition to Michael S. Fine, from the MITRE Corporation. Additional researchers were Uniformed Services University of the Health Sciences, University of Tennessee Health Science Center, Naval Health Research Center and Naval Medical Research Center.

    Dr. Dromerick is also Professor of Rehabilitation Medicine and Neurology and Chairman of Rehabilitation Medicine at Georgetown University Medical Center and a Research Scientist at the Washington D.C., Veterans Affairs Medical Center. Dr. Lum is also Director the Center for Applied Biomechanics and Rehabilitation Research at MNRN. He is also a Research Health Scientist at the Washington D.C., Veterans Affairs Medical Center.

    Experimental Brain Research, 2016. DOI: 10.1007/s00221-016-4714-5

    This research was funded through the following: Dromerick AW, Lum PS, Tractenberg R, Libin AV: “Grip force control as a diagnostic tool for mild TBI. Naval Health Research Center W911QY-09-D-0041

  • February 03, 2017

    By MedStar Health

    Join more than 2,000 interventional and endovascular specialists at Cardiovascular Research Technologies Conference (CRT) 2017 for a comprehensive four-day interventional cardiology conference featuring cutting-edge data in a unique boutique setting.

    Attendees will have a great opportunity to share ideas and knowledge, collaborate on interventional cardiology solutions, receive interventional cardiology training and network with other professionals. Our interventional cardiology conferences feature focused educational and training sessions that discuss new trial data, explore evidence-based research, and demonstrate most up-to-date techniques that can be directly applied to clinical and academic practices.

    To learn more about the meeting as a whole, including the agendas, visit www.crtmeeting.org.  

    February 18-21, 2017
    Omni Shoreham Hotel
    2500 Calvert Street NW
    Washington, D.C., 20008

    This conference is a great opportunity to learn about the latest developments in your field, connect with colleagues, and earn CME credits. Register today.

  • February 03, 2017

    By MedStar Health

    As announced in early 2016, MedStar Health and Georgetown University are collaborating to implement OnCore, an enterprise-wide Clinical Trials Management System (CTMS).  Well, we are pleased to share with you that OnCore is now fully active and has started to be used for select clinical trials.

    OnCore will serve as a workflow manager and repository of all clinical research administrative and management activities. This new system represents a significant investment in our clinical research infrastructure and will greatly enhance and standardize our clinical trial management activities. In addition, OnCore will provide real-time analytics and reporting capabilities about our research activity across the system.

    What does this mean for MHRI associates? OnCore will be introduced in a phased roll-out approach to allow users more time to learn and adapt to the new system. Associates who are clinical research coordinators, regulatory coordinators, and budget/coverage analysts should expect to see communications regarding future user training sessions, as you are the primary users of OnCore.

    We encourage all associates to support one another during this transition period, especially those colleagues who are most affected. Associates can find more information on StarPort, including documentation, training tools, and dates for training. If you have any questions, please contact Research@MedStar.net.

  • February 02, 2017

    By MedStar Health

    When an individual has experienced a cardiac event, it is often life-changing. Recovering from such an episode can be a daunting process that impacts many aspects of a person’s life. Yet, many patients don’t get the help they need to successfully move forward with recovery. “Once a patient is discharged from the hospital after a heart incident, it should set in motion the next phase of treatment—participation in a structured cardiac rehabilitation program,” says Jelles Fonda, MD, a cardiologist at MedStar Good Samaritan Hospital.

    The hospital’s cardiac patients are encouraged to get the support they need by enrolling in a program that includes education, exercise, nutritional counseling, stress management and more. “Cardiac rehabilitation is a proven method for recovery, one that has been shown to make patients stronger, healthier and more confident,” Dr. Fonda notes. Bill Shaprow, an 80-year-old patient of Dr. Fonda’s, is a big fan of the cardiac rehab program at MedStar Good Samaritan. “Going through rehab gives you a better outlook on life,” Shaprow says. “The program helps you strengthen your heart while improving your overall health and well-being.”

    Shaprow with Program Coordinator Nicole McDonald

    Phase I of cardiac rehabilitation begins for each patient right in the hospital following a cardiac event. After discharge, the cardiac rehab services offered at MedStar Good Samaritan are provided through the Good Health Center, where a team of expert cardiologists, nurses, health educators, and health fitness specialists partner with patients, their families and their primary care doctors to develop individualized rehab programs. The program is certified by the American Association of Cardiovascular and Pulmonary Rehabilitation. The Phase II program, designed specifically for those recovering from a heart attack, coronary artery bypass graft, angioplasty or coronary stenting, heart valve replacement or repair, a left ventricular assist device (LVAD) implant, a heart or heart-lung transplant or heart failure, involves a carefully monitored combination of exercise therapy and education.

    “The program is designed to help patients feel better faster, get stronger, reduce stress, manage their blood pressure and increase their self-confidence,” explains Nicole McDonald, program coordinator at the Good Health Center. “Patients enrolled in the program attend structured sessions for one hour three times a week for 12 weeks. During these sessions, they exercise and they learn. We cover topics ranging from how to eat heart healthy to ways to make positive behavioral changes. Patients are evaluated at the start of the program, 30 days, 60 days and at discharge, and their physicians are kept informed of their progress.“ Shaprow has been through the Phase II program twice—after a coronary stenting when he was 75, and last year following a heart attack and treatment with another stent.

    Cardiologist Jelles Fonda, MD

    “When you get there, they take your blood pressure, put a monitoring unit on you, which is connected to your chest, and give you a variety of cardiovascular exercises to do. In the beginning, you might do 10 minutes each on a stationary bike, a treadmill and a hand bike,” he explains. “Then during the next visit, the time you spend doing each exercise slowly increases. It’s not vigorous—you’re closely watched and the staff is very caring.” Shaprow, an outgoing man who speaks fondly of his past as a former Porsche race car driver—he even named his daughter Portia—also appreciates the camaraderie at the Good Health Center. “Everyone is there for the same reason and that breaks down barriers. You encourage and check up on each other,” he adds. He credits the program with helping him maintain a positive attitude despite the fact that he also is dealing with several other health issues, including degenerative disc disease, which makes it difficult for him to walk without a cane. At the hospital, he is treated by a multidisciplinary team that includes Maneesh Sharma, MD, a pain management specialist, and Mohammad Khan, MD, his primary care physician, plus Dr. Fonda.

    “All of my doctors are with MedStar Good Samaritan Hospital. I’m over there all the time,” he notes. Since graduating from the Phase II cardiac rehab program, Shaprow has enrolled in Phase III, a less structured and more independent exercise program that patients follow on their own. “I work on my lower extremities…my legs and hips. I can really feel the difference.” While there, the Good Health Center staff continues to assist him with periodic exercise program updates and modifications. “Nearly everyone can benefit from cardiac rehab,” adds Dr. Fonda. “Unfortunately, it’s one of the most underutilized rehabilitation services in this country. A lot of patients just don’t want to take the time to do it, or think it won’t help. But here at MedStar Good Samaritan, we urge our patients to enroll. For improving quality of life, it’s better than any pill or procedure.” The Phase III program at the Good Health Center also is available for noncardiac clients who have a chronic condition for which exercise has been proven to be beneficial, such as arthritis, diabetes, high blood pressure and obesity. The Good Health Center accepts patients referred from any healthcare facility, not just MedStar Good Samaritan.

    This article appeared in the winter 2017 issue of Good Health. Read more articles from this issue.

    Location Information

    MedStar Good Samaritan Hospital
    Cardiac Rehabilitation Program
    5601 Loch Raven Blvd.
    Good Health Center, 2nd Floor, O'Neill Building
    Baltimore, MD 21239
    Call 443-444-3874 to register, by appointment only. 

    Three hourly sessions per week, Mondays, Wednesdays and Fridays
    9 a.m. to 10 a.m. or 11 a.m. to noon

    Cardiovascular Specialist

    Jelles N. Fonda, MD


    Related Services

  • February 02, 2017

    By MedStar Health

    Odds are you know at least one person with diabetes. And the odds are even greater that you know one of the 86 million Americans with prediabetes. Yes, that’s 86 million people. The thing is, only 9 million of those with prediabetes know they have it and 15 to 30 percent of them will develop type 2 diabetes within five years. It’s a big problem, especially when you consider that diabetes is one of the leading causes of death in the United States. The good news is that there are things you can do to prevent prediabetes from turning into full-blown type 2 diabetes.

    “Prediabetes is a condition in which an individual has high blood glucose or hemoglobin A1C levels but they are not high enough for the person to be classified as a diabetic,” explains Debbie Bena, MA, BSN, health ministries coordinator for MedStar Good Samaritan Hospital. “By developing and maintaining healthy lifestyle changes, prediabetes can be reversed.” To help area residents with prediabetes learn how to address the condition before it becomes more serious, MedStar Good Samaritan launched a Diabetes Prevention Lifestyle Change Program two years ago. A structured program, it was developed specifically for people who have prediabetes or are at risk for type 2 diabetes, but who do not already have diabetes. The hospital has applied for and anticipates recognition of the program by the Centers for Disease Control and Prevention (CDC). The year-long program features a CDC-approved curriculum and trained lifestyle coaches who closely support participants. And it’s not a quick fix. Rather, it’s focused on long-term changes and lasting results. Leslea Jackson is proof that the program works.

    “I had been diagnosed by my endocrinologist, who I see for another condition, as prediabetic. He told me I was going to develop diabetes if I didn’t do something about it. Diabetes runs in my family and I know how debilitating it can be. With a 13-year-old daughter, I didn’t want to face that,” she says. “Then I ran into Deb Bena at a wedding … she is married to a good friend of my family … and the topic of diabetes came up. When she told me about her program, I thought I’d give it a try.” Since starting the program, Jackson has lost 51 pounds and both her cholesterol and A1C levels are normal. The group-based program consists of 16 sessions, which are completed in six months, followed by six monthly sessions led by a trained lifestyle coach who facilitates a small group of people with similar goals. The group support is just as important as the coaching.

    Debbie Bena, MA, BSN

    “We discuss topics such as healthy eating, increasing physical activity and losing weight, as well as behavioral changes,” says Bena, who also is a trained lifestyle coach. “A goal of the program is to help participants lose five to seven percent of their body weight.” Research has shown that if a person with prediabetes loses just five to seven percent of their body weight through healthier eating and 150 minutes of moderate physical activity a week, it can cut their risk of developing type 2 diabetes by 58 percent. “For a person who weighs 200 pounds, that means losing just 10 to 14 pounds. It doesn’t take a drastic weight loss to make a big impact,” Bena notes. “Leslea lost more than 25 percent of her body weight!” Since the program at MedStar Good Samaritan began, 60 people have enrolled. Most people sign up because they are overweight. Classes are held at various community-based sites and new programs are always being started so that individuals interested in participating don’t have to wait long for a new class to begin. “The key to the program is to follow all the steps,” Bena says. “If you do that, the weight comes off in no time.”

    Jackson explained that one of the ways the program helped her was by forcing her to track everything she ate. “I became much more aware of what and how much I was eating,” she says. “Today I am eating a lot better. I eat less fat, smaller portions, more salad and fruit, and more white meat. Sharing the experience with other participants was helpful, too. We’d talk about different foods and exchange ideas about ways to prepare things.” Now averaging about 142 pounds, Jackson says she looks and feels a lot better. “My daughter, Marlee, teases me about my skinny legs. But she’s glad that I signed up for the program and knows I’m much healthier.”

    This article appeared in the winter 2017 issue of Good Health. Read more articles from this issue.

     

    Take Our Diabetes Risk Quiz

    This free online assessment will help you learn how to reduce your risk factors.

  • February 01, 2017

    By Tamika Auguste, MD

    Common tests during pregnancy include ultrasounds and blood sugar screenings. But heart tests – such as electrocardiograms (EKGs) – are also sometimes necessary.

    Obstetricians discuss and evaluate their pregnant patients’ heart health to gain knowledge of a woman’s family history and risk factors. In cases of prior heart problems, we need to take special care to manage heart health during pregnancy.

    As little as 15 years ago, a woman with a condition such as a congenital heart defect would have been advised to never get pregnant. We just didn’t think her heart could handle pregnancy, labor and delivery. But thanks to advances in medicine, growing expertise and doctors from multiple specialties – and facilities – working together, more and more of these women are able to safely give birth.

    I’ve cared for a woman who had a heart valve replacement when she was 26. She became pregnant and delivered a healthy baby a year later. There’s no getting around it, such pre-existing conditions add complications to a pregnancy. But in many cases, the staff and resources are available to care for these high-risk patients and help them plan for safe, healthy pregnancies and deliveries.

    The January 2017 guidelines issued by the American Heart Association agree, recommending that women with serious congenital heart defects work closely with their cardiologist and maternal-fetal medicine specialist before, during and after pregnancy. The guidelines also recommend giving birth at a larger medical center with specialists who have the necessary expertise to manage such a delivery.

    Planning for pregnancy with a heart condition

    Before you become pregnant, sit down for a discussion with a cardiologist and a maternal-fetal medicine specialist. It’s important that everyone is aware of your health history and the potential risks involved.

    We’ll also want to evaluate:

    • Medications: Some medications can harm a baby during pregnancy, so we’ll want to discuss changing a medication or adjusting the dosage.
    • Potential procedures: Certain conditions should be fixed before pregnancy. This could include repairing a hole in your heart or opening a blocked valve.
    • Genetics testing: This can determine your baby’s risk of inheriting a congenital heart defect.

    Your family doctor or general obstetrician may not have the expertise to plan for or manage such a complex pregnancy. It takes a unique understanding to optimize the care and outcomes for these women.

    We’ll help connect you with an experienced team through our Special Moms/Special Babies program, which offers coordinated care for moms with congenital health problems. We also partner with Children’s National Health System, with whom we share a campus, to care for pregnant women in their adult heart clinics.

    Learn more about our Special Moms/Special Babies program or call 202-877-3627.

    There are still some circumstances in which we may advise you to not become pregnant. If this is the case, talk to your doctor about reliable birth control options.

    Managing a heart condition during pregnancy

    Every pregnancy causes the heart to work overtime. For example, the amount of blood it pumps can increase by as much as 50 percent to sustain a growing baby.

    Physical changes during pregnancy affect which stressors the maternal heart faces. And when an underlying cardiac problem is in play, we become more worried about the potential for heart failure, heart attack and pulmonary hypertension, among other things.

    Your care team likely will include a maternal-fetal medicine specialist, obstetrician, cardiologist, neonatologist and other specialists as needed.

    Together, we’ll help you manage your heart health with medication, diet and exercise. You’ll likely need regular tests such as blood tests and EKGs to evaluate your heart function.

    And, of course, we’ll keep an eye on your baby. For example, we know that if mom has an arrhythmia, the baby can develop it as well, so we’ll monitor for that.

    Going into labor and delivery

    Your team will collaborate with you on a plan for labor and delivery based on your health. This will include deciding whether certain specialists need to be present, in which case we may plan to induce labor.

    We’ll monitor your and your baby’s hearts throughout the process. Pushing can put additional stress on the heart, so we might limit how long you push, or give you additional assistance using forceps or a vacuum extractor. In some cases, a cesarean section may be necessary.

    If you decide you would like to have another baby, talk with your cardiologist and maternal-fetal medicine specialist before you get pregnant again. Your heart health may have changed since your first pregnancy. And even if it hasn’t, every pregnancy is different. We want to prepare for all possibilities.

    With proper planning and precautions, more and more women who thought they could never give birth due to a heart condition are realizing their dreams and taking home healthy babies.