MedStar Health Blog

Preventing Colon Cancer

Colon cancer is one of the very few preventable cancers. However, it typically has no symptoms in its early stages, making it critical to take advantage of available screenings, namely colonoscopy.

Men and women of average risk should have regular screenings beginning at age 50. However, your doctor may recommend more frequent or earlier screenings if you have other risk factors, such as a family history of colon cancer.

Common symptoms of colon cancer may include:

• Change in bowel habits, including diarrhea or constipation
• Change in consistency of stool
• Rectal bleeding or blood in stool
• Persistent gas, abdominal pain or cramps
• Feeling that your bowel does not empty completely
• Weakness or fatigue
• Unexplained weight loss

Many people avoid the screening due to the inconvenience or perceived discomfort. But following this recommendation could very well save your life – twenty percent of those screened show a polyp or other growth. Caught early, it can be identified and removed before it becomes cancer.

For more information, or to schedule an appointment, call

202-877-3627

As heard on WTOP Radio:

Jennifer Ayscue, MD
Colorectal Surgeon

To make a screening appointment, call 202-877-3627

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SCAD—A Silent Killer of Healthy Young People

What is Spontaneous Coronary Artery Dissection (SCAD)?

Artery walls have three layers. When a tear or dissection occurs blood is able to flow through the inner most layer and become trapped and bulge inward. This narrowing of the artery or blockage can cause a heart attack because blood cannot flow to the heart muscle.

Spontaneous Coronary Artery Dissection or SCAD is an uncommon medical event because it occurs spontaneously in otherwise healthy younger people without prior symptoms.

Who is at risk for SCAD?

SCAD usually occurs in people who do not have the well known cardiovascular risk factors such as high cholesterol, atherosclerosis, high blood pressure and diabetes.

The average age of a SCAD patient is 42 years old, but it can occur in people in their twenties. SCAD is more than twice as common in women as men. SCAD may result from blood vessel changes, hormonal and other changes associated with pregnancy or menopause. Extreme exertion appears to play a role in both men and women.

What are the signs and symptoms of SCAD?

The signs and symptoms vary widely with some people reporting the classic heart attack symptoms of an “elephant sitting on my chest” to just mild discomfort. Many women still think that heart disease affects only men, but more than half of the 500,000 Americans who die each year of a heart attack are women. Women’s heart attack symptoms can be more subtle than men’s; so many women brush them off as insignificant because they don’t see themselves at risk. Women are more likely to experience the following:

• Chest discomfort or fullness
• Blackouts or fainting
• Shortness of breath during activities or upon waking up
• Chronic fatigue that interrupts routine activities
• Dizziness
• Swelling (especially the lower legs and ankles)
• Rapid heartbeats that may cause pain or difficulty breathing
• Nausea or vomiting that’s unrelated to diet, indigestion or abdominal pain
• Sweating
• Impending feeling of doom

If you experience any of these symptoms frequently (about once a day), don’t wait, call 911 immediately. Minutes count during a heart attack. Time is muscle. These symptoms are serious and should not be ignored.

How is SCAD diagnosed and treated?

Cardiac angiography or cardiac catheterization is the primary means of diagnosing SCAD. While this diagnostic test can identify the narrowing or blockage of the artery, it does not allow visualization of the vessel walls. Other imaging modalities such as intravascular ultrasound, optical coherence tomography and CT angiography may be ordered to assist your physicians in making the definitive diagnosis.

Treatment options vary by the type and severity of the SCAD event. Some patients respond favorably to conservative treatment using medication only. Certain drugs such aspirin, Coumadin, nitroglycerin, beta blockers and ACE inhibitors will be likely be given and some drugs may be prescribed for life. Some patients may undergo cardiac angioplasty and receive a stent or coronary artery bypass surgery.

For more information, or to schedule an appointment, call

202-877-3627

As heard on WTOP Radio:

Pictured: Susan K. Bennett, MD,
Cardiovascular Disease

To find a cardiac specialist, please call 202-877-3627

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Minimally Invasive Treatment
for A-Fib

Treating Atrial Fibrillation or A-Fib by Catheter Ablation

Catheter ablation is a minimally invasive procedure performed by an electrophysiologist, a cardiologist who specializes in treating heart rhythms. You will be totally or partially sedated for the procedure. A local anesthetic will be applied to the thigh area where the ablation catheter is inserted through little more than a pinprick. The catheter is gently guided to the left atrium heart chamber to map the abnormal electrical pathways in the heart tissue. Heating or cooling energy is then used to block abnormal signals that cause A-Fib.

Catheter ablation is safe, highly effective and requires very little recovery time. Most patients return to their normal lives the very next day.

What is atrial fibrillation?

The human heart is a pump controlled by electrical signals. During each heartbeat, the upper chamber (atria) and lower chambers (ventricles) contract pumping blood to the body. These contractions are timed in sequence by the electrical system of the heart. Atrial fibrillation or A-Fib disrupts the normal rhythm and causes the heart to beat irregularly.

A-fib may be episodic, for which the irregular heartbeat lasts less than seven days, usually less than 24 hours and has recurred at least twice or permanent lasting longer than one year and does not respond to treatment or treatment has not been attempted.

A-Fib affects nearly five million Americans and although not life threatening, it can have serious consequences. People with A-fib are at a much higher risk of stroke and left untreated, it can lead to heart failure.

What are the risk factors for atrial fibrillation?

There is no one cause for atrial fibrillation although there are many conditions that are risk factors in developing this condition, including:

• Aging: Three to five percent of people over age 65 have A-Fib and up to 10 percent of people over age 80 have A-Fib
• High blood pressure
• Coronary heart disease
• Previous heart attack
• Sleep apnea
• Heart valve problems
• Congenital heart defects
• Diabetes
• Other arrhythmias, including atrial flutter and ventricular fibrillation
• Inflammation, such as after heart surgery (CABG)
• Lung diseases, including pulmonary embolism
• Excessive alcohol use
• Viral infections
• Obesity

What are the symptoms and how is atrial fibrillation diagnosed?

The most common symptoms of atrial fibrillation include:

• Heart palpitations
• Tiredness or lack of energy
• Dizziness, light-headedness or feeling faint
• Chest pressure or discomfort
• Shortness of breath

However, some people may have atrial fibrillation and experience no symptoms at all

What are the treatment options?

Physicians prescribe medications such as aspirin, warfarin, beta blockers, calcium channel blockers and anti-arrhythmic medicines to treat A-Fib. If the medications do not work or are not tolerated, there are a variety of invasive and non-invasive procedures available. The ultimate goal is for patients to regain a normal heart rhythm, control the heart rate, prevent blood clots and thus, reduce the risk of stroke.

For more information, or to schedule an appointment, call

202-877-3627

As heard on WTOP Radio:

Pictured: Zayd A. Eldadah, MD, Cardiac Electrophysiology

To find a cardiac specialist, please call 202-877-3627

MISSED OUR OTHER TOPICS?

Abnormal but non-cancerous, uterine fibroids affect more than 50 percent of all American women, a figure that jumps to 80 percent among African Americans.  Fortunately, most women never even know they have the growths until their gynecologists tell them so.

But those who experience fibroid’s most troublesome symptoms crave relief from the abnormally heavy or long periods, intermittent bleeding, backaches, pelvic pain, uncomfortable sex and other problems caused by the benign masses. At their worst, fibroids can even result in infertility, premature labor and miscarriage. 

Not too long ago, a woman had two choices: Suffer through fibroid’s woes to preserve child-bearing and hormone-producing abilities, or undergo a hysterectomy to surgically remove the uterus, host to the unwanted growths.

Modern medicine offers many better, and less dramatic, options.

“Today, we have a range of approaches—medical, surgical and non-surgical— to help women with fibroids,” says James Robinson, MD, Director of Minimally Invasive Gynecologic Surgery at MedStar Washington Hospital Center. “When surgery is the answer, many procedures are minimally invasive, performed on an outpatient basis and using small incisions and precise targeting for less pain and a quicker recovery.

“Some procedures can even get rid of the tumors while preserving the uterus and ovaries. That allows for future pregnancies and hormone production, which is important for healthy aging.”

And if a woman and her doctor decide that removal of the uterus is the best approach? Fear not, Dr. Robinson says.

“This isn’t your mother’s hysterectomy. Whenever possible, we’ll leave the ovaries intact so you won’t automatically go into menopause.”

The exact cause of fibroids is still unknown, although heredity, race and obesity all play a role. While today’s procedures can successfully remove existing lesions, others may grow afterward.  At this time, the only way to rid the body of fibroids completely is a hysterectomy.

But Dr. Robinson cautions that a diagnosis of fibroids doesn’t mean you should be overly concerned.

“We can take care of your problem,” he says. “Our goal is to get you back to your life in the least disruptive, and fastest, way possible.”

We are here to help!

If you have any questions call MedStar Washington Hospital Center at 202-877-3627.

Transcatheter Aortic Valve Replacement (TAVR)

Proven Minimally Invasive Approach to Heart Valve Surgery

MedStar Heart & Vascular Institute was a pioneer in the development of TAVR becoming the fourth cardiac center in the country to begin clinical trials in 2007. MedStar Washington Hospital Center is now the highest volume center on the East Coast, performing 200 TAVR procedures each year.

TAVR is the world’s first heart valve replacement option for patients who are too ill to undergo traditional open-heart aortic valve replacement surgery.

During a TAVR procedure, a team of physicians replace the diseased aortic valve with a new valve. Physicians thread a little finger-sized catheter loaded with a new deflated balloon and folded replacement valve into the heart. Once the artificial valve is in place, the valve is expanded using the balloon. The new valve takes over from the diseased native valve restoring both blood flow and quality of life. Studies have shown that patients achieve better outcomes when they undergo a TAVR procedure than they do with medication alone.

Valvular Heart Disease

Birth defects, aging, infections and other conditions can cause heart valves to not open completely or let blood leak back into other heart chambers.

Older age is a risk factor for heart valve disease because heart valves thicken and become stiffer as people age. People who have a medical history of heart attack, heart failure, heart infections and rheumatic fever are at higher risk. Coronary artery disease risk factors such as high blood pressure, high cholesterol, smoking diabetes, obesity, lack of exercise and family history of early onset heart disease also increase the risk of valvular heart disease.

Valve defects, if not appropriately treated, can result in heart failure, stroke, blood clots or sudden cardiac arrest.

Evaluation for TAVR

Cardiologists, cardiac surgeons and interventional cardiologists work closely together to determine the best course of action for each patient based on what they have learned from the TAVR clinical trials.

The first step is to complete a TAVR Assessment, so we can gather information about your heart health. Once your TAVR Assessment is complete, the team will discuss all the information we have about you, your heart and your general health, to make a recommendation about the best treatment option. If you and your physician decide you will have a TAVR procedure, you will need the additional diagnostic tests including before the TAVR procedures is scheduled.

New TAVR Clinical Trial

Up to now, TAVR was reserved for patients who are too ill for traditional open heart aortic valve replacement surgery.

MedStar Heart & Vascular Institute at MedStar Washington Hospital Center is the first in the nation to launch a clinical trial, evaluating the use of a minimally invasive procedure to replace narrowed heart valves in patients who are considered at low risk for death from surgery. The Food and Drug Administration granted an Investigational Device Exemption, which allows MedStar Heart to enroll these patients into the study. The FDA approved the use of the TAVR for use in patients at intermediate surgical risk in August 2016.

For more information, or to schedule an appointment, call

202-877-3627

As heard on WTOP Radio:

Pictured (left to right): Paul Corso, MD, Cardiac Surgeon; and Ron Waksman, MD, Interventional Cardiologist

To find a cardiac specialist, please call 202-877-3627

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By Jennifer Davis

Elbow injuries tend to happen to active people, and 83-year-old Richard Wright of Montgomery Village, Md., certainly fits that profile.

The avid cyclist was out for a ride in the woods in November of last year when his bike drifted off a path obscured by leaves and jackknifed. He was thrown to the ground, breaking his arm.

“It was a pretty sharp pain when I hit the ground,” Richard says. “I actually thought about getting back on the bicycle, but I was feeling enough shock I thought that wouldn’t be a good idea. So, I called my daughter and got a ride home.”

Not one to slow down, the retired engineer had planned to read at his church that evening and went on as scheduled. But, the next morning, he knew he needed to head to his local emergency room when the pain wouldn’t subside. Doctors there recommended setting his arm, but Richard wanted a second opinion. That led him to the MedStar Orthopaedic Institute at MedStar Georgetown University Hospital.

“Most patients know something is wrong, because when they try to straighten their arm, they can’t do it and it’s extremely debilitating,” says MedStar Georgetown orthopaedic hand surgeon, Curtis Henn, MD. “They almost can’t do anything with their arm. There is a lot of swelling and it’s very painful.”

Richard had a displaced fracture at his elbow, rendering useless the muscle used to straighten his elbow. Dr. Henn recommended a surgery called open reduction and internal fixation of an olecranon fracture.

It restores proper alignment of bones, allowing movement of the elbow while the fracture is healing. This approach prevents joint stiffness. Without surgery, his elbow would be in a cast for four to six weeks, which could lead to profound and permanent elbow stiffness.

“Of all the joints in the body, the elbow is one most prone to stiffness after the shortest period of time,” explains Michael Kessler, MD, chief of Hand and Elbow Surgery in the Department of Orthopaedics at MedStar Georgetown. “Addressing this injury early with surgery allows patients to move their elbow right away. If you don’t do that, once the stiffness sets in, you can get stuck, and the only way to release that stiffness is another surgery.”

Richard’s operation was fairly standard, lasting less than two hours. Seven screws and a plate were used to put his elbow back together and he was out of the hospital that day.

Richard wore a splint for two weeks, but was able to write within a week. Ten days after surgery, once his postoperative dressing was removed, he began working on elbow motion through physical therapy. Three months later, his elbow was nearly back to normal, and his incision healed so well the scar is barely visible.

“This can be a home run of a procedure because patients can regain full motion and can get back to doing what they want to do, once the fracture is healed,” Dr. Henn explains.

Richard’s main focus was to get back on his bike. “We see a lot of patients like him who are still very active,” says Dr. Henn. “Part of our role is to help them stay active, which in turn keeps them healthy.”

Richard says he is working his way back to exercise. “I’m using a stationary bike now, but it’s nowhere near as much fun. I think, when the weather eases, I will give serious consideration to getting back on the bicycle, and I thank the great service I received at MedStar Georgetown for making that possible.”

Make an Appointment

To learn more about hand and elbow surgery at MedStar Georgetown, call

202-444-8766

Elbow Specialists

• Brent B. Wiesel, MD
• Michael Kessler, MD
• Curtis M. Henn, MD

Learn More

• Elbow conditions
• Elbow treatments

Meet Dr. Kessler

Meet Dr. Henn