MedStar Health Blog

The Farming Life of Melissa Fries, MD

  It’s 5:30 a.m. on a weekday morning, and Melissa Fries, MD, sits in a metal shed on her rural western Montgomery County farm, hand-milking Leaf, an Oberhasli milk goat. Moon, a LaMancha, waits her turn nearby. Once the milk has been collected, filtered and stored in the refrigerator, Dr. Fries will kiss her husband, Ronnie, goodbye and make her way to I-270 for the drive to MedStar Washington Hospital Center, where a busy day awaits her as chair of the Ob/Gyn Department.

There will be other farm chores to do when she gets back this evening—another round of milking, feeding a menagerie of agricultural animals, picking vegetables and taking care of whatever else can be done on the 25-acre spread, before bedtime at 9:30 p.m.

For now, however, Dr. Fries savors the early morning serenity, a quiet broken only by the rhythmic ring of new milk squirting in the pail, her reassurances to Leaf and the occasional cluck, baa, and moo from the farm’s other “residents.”

“This is a very peaceful time of day,” says Dr. Fries as she squeezes the last few drops from Leaf, who has nonchalantly been munching on grain. “The animal is giving you the blessing of her milk, while a new day is getting started around you. It couldn’t be better.”

Her colleagues at the Hospital Center would certainly agree, as they often get to share in the farm’s bounty—homemade goats’ milk, cheeses and yogurt; eggs, courtesy of the farm’s free-range chickens; honey from a start-up beehive; and fresh vegetables from a garden that Dr. Fries laments, “went to weeds for the summer,” but vows will be back next spring.

Dr. Fries joined the Hospital Center in 2006 after a 26-year career as an Air Force Ob/Gyn. She and her husband had little collective farm experience to draw on when they purchased the property in Montgomery County’s Agricultural Reserve in 2013.

“I’d always loved growing things, and we did have a few chickens and sheep in Mississippi,” she says. “My husband grew up on Long Island near German communities, where growing and sharing crops was common. Working with animals was his dream, and it became mine too.”

Fortunately, the couple had some time to get up to speed on their adopted lifestyle. They spent the first six months clearing portions of the property, and setting up fencing to make space for various animal enclosures, as well as a barn and other storage areas. The house was expanded, to include a shop and an industrial kitchen for processing and preparing everything from cheese to soap.

Meanwhile, they sought advice from the County Agricultural Extension service, which provided guidance on everything from soil testing for locating gardens, to identifying sources of farm animals.

“Once you find a person who sells a certain type of animal, they become a mentor to you,” Dr. Fries says. “We’ve also received a lot of help from area vets, who help with health assessments and illnesses. And, we’ve read books—a lot of books.”

Since the first animals began moving in last spring, the Fries farm’s zoological census has expanded to two cows, 11 goats, 11 turkeys, three pigs, two dogs, an indeterminate number of bees and 35 chickens, though that number fluctuates.

“The chickens are free-range, which means we occasionally lose one to a fox,” Dr. Fries says with a sigh.

Otherwise, the animals have their separate areas, with shelters and troughs for food and water. They’re fed twice a day, with Ronnie typically handling the other daytime chores during the week. This summer, however, he’s juggled the farm duties with his studies to become an Emergency Medical Technician.

When the weekend rolls around, there’s plenty of work to go around. On a recent summer Saturday, for example, Dr. Fries weeded the garden, made batches of goat milk cheese and tomato sauce, and milked the goats, while Ronnie mowed the property’s open areas and worked on restoring an old truck and a horse trailer.

“Every day, we’re doing something different,” Dr. Fries says. “There’s not much downtime, and no vacation in the summer. We have to plan our trips for the winter months when the animals are pregnant, but not ready to deliver, and we can get some help with the feeding.”

Dr. Fries says she and Ronnie have learned a great deal as part-time farmers, particularly the importance of fresh, non-processed food. “There’s no comparison between what you grow yourself or buy from a neighbor, and what’s available in the grocery store,” she says. “We really are what we eat, and so much of our health is affected by it.”

Dr. Fries has also gained a gAreater respect for those whose livelihoods depend on growing food. “It takes 20 tomatoes to make a quart of sauce,” she says, “so you can imagine how much someone has to produce to make an operation economically viable. And that’s on top of the inherent challenge of growing the crop.”

There are many other lessons yet to be learned, which is why Dr. Fries and her husband are “testing the waters” when it comes to breeding their animals and expanding their farm population. “If the turkeys do well, Ronnie has plans for more of them next year,” Dr. Fries says, admitting that most will be fated to end up on holiday dinner tables. She is also contemplating getting a third milk goat, and erecting framing so that she can start growing hops next year.

Then, there’s coming up with new ways to use the approximately four quarts of goats’ milk Leaf and Moon produce each day.

“We go through the milk pretty quick, but we can’t sell it because it’s not pasteurized,” Dr. Fries says, “We may be able to sell cheese if I can get good at it.”

Asked if she doesn’t already feel her daily schedule is busy enough, Dr. Fries just smiles.

“Everything we do here brings us joy,” she says. “Why not do more of it?”

Pelvic Floor Disorder: A Common Problem

It’s a fact that one in three women over the age of 45 suffers from a pelvic floor disorder (PFD). The most common pelvic floor disorders are urinary incontinence, fecal incontinence, and pelvic organ prolapse. The condition can significantly impact a woman’s quality of life. There are easy ways to treat the disorder, but women are oftentimes unwilling to discuss the symptoms they are experienceing because they are too embarrassed.

The older a woman gets, the greater the chance of developing a PFD. In general, pelvic floor disorders are caused by a laxity in the pelvic floor ligaments and connective tissue in the lowest part of the pelvis and weakness of the pelvic floor muscles. The pelvic floor supports organs, including the bowel, bladder, uterus, vagina, and rectum. But when the muscles are weakened or the connective tissue tears, that's when problems can begin. Why does this happen? It’s a natural part of the aging process, hormonal changes after menopause plays a role as well pregnancy, childbirth and obesity.

Identifying Symptoms

Pelvic organ prolapse is the most common disorder, and it happens when the pelvic floor muscles and ligaments become too weak to hold organs in the correct position in the pelvis. As the condition progresses, women can feel bulging tissue protruding through the opening of the vagina. When this happens, women may have problems controlling their bladder and bowels. Also, some have pain in the lower back, pelvis or bladder.  All women may not experience the same symptoms, but it’s important to seek help if any pain or discomfort persists.

While an OB/GYN may be aware of the symptoms, women should seek out a urogynecologist, a physician with special training and significant expertise in female pelvic medicine and reconstructive surgery, if symptoms persist.

They used to just say it was a ‘female problem,’” said Jeanne McMahon, 58, who lived with bladder and uterine prolapse for more than 20 years before having surgery in the fall of 2015. With the help of nationally-recognized and highly skilled urogynecologist at MedStar Washington Hospital Center, Dr. Cheryl Iglesia, Jeanne is now playing tennis and hiking again, and is grateful she has her life back.   

 Dr. Iglesia, and her patient Jeanne, discuss PFDs in this Washington Post article.

 https://www.washingtonpost.com/local/social-issues/a-hidden-epidemic-millions-of-women-suffer-pelvic-floor-disorders-silently/2015/12/22/f5997966-a6d5-11e5-b53d-972e2751f433_story.html

Have any questions?

We are here to help! Contact us for more information about pelvic floor disorders or to schedule an appointment. Call us at 202-877-3627.

Three confirmed cases of the Zika virus have now been reported in D.C., all from people who have traveled outside of the United States, according to the D.C. Department of Health. One of the three cases came in 2015 and the other two were confirmed this year. All three cases involve people who took trips to Central and South America. One case involved a woman who was pregnant.

While the virus has been fast-spreading in the Americas, it is important to remember that the virus poses no immediate threat to the health and well being for many of us in the United States. It’s also crucial to note that the Zika virus is not an airborne pathogen, which means it’s not contagious. Here are some things you need to know about the Zika virus.

How is the virus transmitted?The Zika virus is a mosquito-borne virus that is transmitted to people through the bite of an infected Aedes mosquito. This same mosquito spreads dengue and chikungunya viruses. There is no strong evidence of fluid-to-person transmission, and the virus cannot be passed by skin or respiratory contact or through droplets from a sneeze. But in the wake of news out of Dallas of a suspected case of transmission of the Zika virus through sexual contact, the U.S. Centers for Disease Control and Prevention (CDC) issued new guidelines for how pregnant women should protect themselves from getting infected, if their partner has traveled to an area with active transmission of the virus and has had symptoms. If that is the case, using condoms during sex is an easy way to protect oneself.

If I am pregnant and have traveled to an area where Zika is prevalent, should I get tested?If you are pregnant and develop fever, rash, headaches and have joint pain within two weeks after traveling to an affected country, it’s important to call your health provider right away and discuss your exposure and your travel history. If you’ve had symptoms and traveled to an infected area in the Americas, the CDC will test the serum to determine if the virus is present.

What are the symptoms?Only one in five people infected with Zika virus will have symptoms and become ill. The symptoms are mild and can last several days up to a week. Again, the most common are fever, rash and headaches. There’s no treatment for the virus. The disease has to run its course.

How to protect yourself?If you are pregnant, the CDC recommends that all women postpone their travel abroad to Zika-infected regions. If you’re not pregnant, there’s no need to change your travel plans, but it is important to protect yourself in order to avoid mosquito bites. Mosquito repellents like Deet are the best protection against the Zika virus.

Is their definitely a link between the Zika virus and microcephaly, the birth defect that causes babies’ heads to be smaller than expected?

A lot remains unknown about the Zika virus. We have associations, but there are no definite confirmations. The huge spike in the numbers of children born with microcephaly in the Americas is alarming and is reason for concern. Evaluations and investigations are ongoing in this country and abroad. It’s important that women remain calm and stay informed.

Stay Informed

Bookmark www.MedStarWashington.org/CenterView to return for additional updates as they become available.

MedStar Heart & Vascular Institute at MedStar Washington Hospital Center is one of only two hospitals in the nation selected to partner with the American College of Cardiology (ACC) on the Find Your Heart a Home™ pilot program. This project will help patients when they are trying to choose the right hospital for their heart care.

Find Your Heart a Home is a first-of-its-kind online tool that allows patients and caregivers to search and compare hospitals based on the cardiac services they provide and the quality of care they deliver.  The database is populated with information from the National Cardiovascular Data Registry.  This registry tracks the results of certain heart care procedure such as cardiac catheterizations, angioplasty and implantable cardiac defibrillators.  The tool is part of ACC’s CardioSmart initiative, a website full of educational information and tools to help guide patients on their heart health journey.

"Patients need and deserve access to accurate information that helps them make informed decisions," said Allen J. Taylor, MD, chief of Cardiology at MedStar Heart & Vascular Institute.  “In this era of healthcare transparency, patients and their families want access to credible information about quality of care when they are choosing hospitals.  Consumers use online search tools to make decisions about everything from restaurants to hotels, but until recently, it has been difficult to find useful and understandable information online about hospitals. As health care becomes more and more transparent, this is changing, and MedStar is proud to be leading the way."

"MedStar Heart & Vascular Institute is a pioneer in this effort to give patients the tools they need to become an active participant when mapping out their cardiac care plan,” said ACC President Kim Allan Williams, MD, FACC. “They are showing a true commitment to transparency and quality and serving as an example to hospitals across the country.”

The registry rates MedStar Washington Hospital Center, the founding hospital of MedStar Heart & Vascular Institute, based on 1,810 cardiac cath and angioplasty procedures, and 520 implanted cardiac defibrillators.  For each aspect of care evaluated, the Hospital Center's performance earned the maximum four stars.

MedStar Washington Hospital Center’s heart data can be found here, or visit FindYourHeartaHome.org.