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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:
    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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  • December 23, 2020

    By Lauren Maragh, MD, Internal Medicine Physician, MedStar Medical Group

    The cold, flu, and COVID-19 are all contagious viruses that can be spread through the air. And, because they share many of the same symptoms, it can be hard to tell which one you have when you’re sick.

    As we head deeper into the winter months, many people may be wondering, what’s the difference? How can I tell what I have when I’m sick?

    Here’s how to determine which you might have and when to seek medical care.

    Learn about our primary care and urgent care options:

    Find care now.

    The cold, flu, and COVID-19 are caused by different viruses.

    The cold is a result of over 200 viruses, including rhinovirus, or parainfluenza virus—which is different from the influenza virus.

    The flu, on the other hand, is caused by two strains of the influenza virus, which can affect us more severely than a cold. Type A influenza is the most common cause of flu spreads from person to person. Type B influenza is less common but still spreads among humans. It’s dangerous but less severe than Type A.

    The COVID-19 virus is entirely different compared to the influenza virus and viruses that cause colds. COVID-19 is an acronym created by the World Health Organization (WHO) to describe the virus, “coronavirus disease of 2019”, or the “severe acute respiratory syndrome coronavirus 2” (SARS-CoV-2). Several coronaviruses have affected the world in the past few decades. This includes MERS (Middle East Respiratory Syndrome) and SARS (Severe Acute Respiratory Syndrome). Every major disease outbreak is different, and it can be hard to know what to expect when it comes to severity and treatment.

    Colds are generally milder than flu or COVID-19 symptoms.

    Since many cold, flu, and COVID-19 symptoms are similar, it can be hard to distinguish which is the cause. It’s especially difficult to determine if you have the flu or COVID-19, as they’re the most similar. For some people, the flu and COVID-19 can cause moderate to severe symptoms, including:

    • Cough
    • Fever
    • Shortness of breath
    • Body aches

    In general, cold symptoms tend to be milder than the flu and COVID-19. And, the length of time it takes for symptoms to appear can indicate which infection you have. For example, a runny nose and mild cough that worsens gradually may indicate a cold. But a sudden onset of fever, fatigue, and shortness of breath may be a sign of the flu or COVID-19. In other words, a cold may take a few days to sink in, whereas the flu or COVID-19 may seem to appear abruptly out of nowhere.

    COVID-19 and the flu can both cause some gastrointestinal issues that aren’t typically present if you have a cold (or allergies). Similarly, a high fever is an uncommon cold symptom, whereas both COVID-19 and the flu can result in a persistent, high fever.

    While COVID-19 and flu symptoms may look similar, there are differences that can help you know what you’re dealing with. Some people with COVID-19 report a loss of taste and smell, although not everyone does. In comparison, the cold or flu should not cause a loss of taste or smell. COVID-19 can also cause shortness of breath. However, the cold or flu does not commonly result in difficulty breathing, unless you have a preexisting condition affecting the lungs, such as asthma or chronic obstructive pulmonary disease (COPD).

    There are also some people who get COVID-19 who report no symptoms, making them asymptomatic. If you do have cold, flu, or COVID-19 symptoms of any kind, it’s important to connect with your primary care provider early to rule out anything concerning.

    Cold, flu, or #COVID19? Internal medicine physician Dr. Lauren Maragh shares the differences on the #LiveWellHealthy blog so you know when to seek care:

    Click to Tweet

    It’s possible to get the flu and COVID-19 at the same time.

    Unfortunately, you can become infected with both the flu and COVID-19 simultaneously. In fact, having one infection may make you more susceptible to getting the other because being sick could weaken your immune system. That’s why now, more than ever, it’s critical to get a flu shot to keep yourself and others as healthy as possible. By getting a flu shot, you reduce your chances of getting seriously ill from the flu and being hospitalized. With fewer people hospitalized because of the flu, healthcare providers will have more time and energy to focus on caring for those who are seriously ill with COVID-19 or other diseases.

    Follow similar prevention strategies to limit the spread of the common cold, flu, or COVID-19.

    Fortunately, what you’re already doing to prevent COVID-19 spreading can also help you avoid catching a cold or the flu. Continue washing your hands, staying six feet apart, and wearing a mask to keep yourself and your loved ones healthy. And, if you’re sick, it’s best to stay home and isolate yourself. That way you don’t spread any virus to those around you.

    Practicing self-care can also help you to ward off any infections. Get enough sleep, exercise, and proper nutrition to keep your body functioning at it’s best and prepared to fight against any germs.

    Get vaccinated.

    Most importantly, getting your flu shot is one of the best ways you can protect yourself. Because it will minimize your risk of developing flu-related complications, you have less of a chance of developing a weakened immune system that could become more susceptible to other infections.

    And, as we begin to distribute the COVID-19 vaccine, stay up-to-date with the latest information from the Centers for Disease Control and Prevention, your local government, and Those resources will help you learn when, where, and how you can get protected against COVID-19 as the vaccine becomes more widely available.

    Stay connected to your primary care provider.

    Now is also a great time to find a primary care provider, even if you’re not sick. Having an established relationship with a primary care provider means you know where to go if you do come down with cold, flu, or COVID-19 symptoms. While you’re healthy, your primary care provider can ensure you’re up-to-date with preventative care, like cancer screenings, pap smears, and more, so they don’t become another concern you have to worry about this season.

    Watch our Facebook Live broadcast with Dr. Maragh to learn more about the differences between a cold, the flu, and COVID-19: 

    Don’t delay care if you’re sick.

    Typically, you can treat a cold at home with rest and over-the-counter medicine. Many times, flu and COVID-19 symptoms can be managed at home, too. However, the flu and COVID-19 can cause respiratory complications if symptoms are severe. You should see a doctor if you have trouble breathing or persistent high fever. If you’re hospitalized, there are a variety of therapies and steroids that may help to treat you.

    In any case, it’s best to discuss your symptoms with your primary care provider early on. They can help you determine whether or not you need to seek testing, in-person care, or treatment.
    If you have shortness of breath, seek emergent care by calling 911 or having someone take you to the nearest emergency room.

    If you have questions or are concerned about your health, don’t hesitate to reach out to your primary care provider. You can also talk to a board-certified physician 24/7 using on-demand video visits through MedStar eVisit. We’re here for you, whether you have the sniffles or suspect you have COVID-19.

    Do you need medical care for the cold, flu, or COVID-19?
    Schedule an appointment with your primary care doctor or click below to learn more about your care options.

    View care options.

  • December 21, 2020

    By Elspeth Cameron Ritchie, MD

    Estimated reading time: 4 minutes.

    It’s common to feel stressed and sad occasionally around the winter holidays. In most cases, those feelings are the result of having too many obligations, expenses or even expectations of what the holidays should bring. Sometimes, grief or loneliness feels extra hard. This year, many people will feel a unique holiday stressor from COVID-19, as we cancel traditional celebrations and gatherings to help protect each other’s health.

    There’s no question that this holiday season will be different for all of us. But simple steps can go a long way to help you and your loved ones find peace and joy and minimize negative feelings over the holiday period.

    1. Look for silver linings.
    Even during a pandemic, you may be experiencing a few temporary changes to your normal life that you feel good about. Take a moment to appreciate them! Maybe your schedule is more manageable, with less travel required or fewer big meals to prepare. Maybe you’re enjoying a less commercial holiday season, realizing some savings on going-out expenses, or appreciating the added flexibility or family time you get from working from home.

    I feel thankful for my job, and for the lighter traffic and cleaner air around the region with fewer cars on the road. Focusing on things you’re grateful for can help lift your mood and brighten your outlook.

    2. Choose healthier ways to deal with the blues.
    Anecdotally, alcohol consumption is way up in 2020, as is screen time. Approach both of these with caution, because too much of either can perpetuate feelings of sadness and anxiety. To help beat the blues, I often suggest finding ways to be active outdoors.

    Think about activities where you can stay safely separated, like kayaking, biking, hiking or camping. Or just get out for a daytime stroll or dog walk each day. Movement and sunshine are proven mood boosters. Also consider setting a limit to your daily intake of news and social media. Both share an excess of disaster and dismay and can increase feelings of anxiety.

    3. Create joy by finding new ways to celebrate and “give” this year.
    In-person visits and even lots of purchased gifts may be traditions you need to sacrifice this season. Think about ways you can make the holidays bright for yourself and others with simpler gifts and especially acts of unexpected kindness. Print and share photos or family recipes. Write personal letters. Shovel a sidewalk. Use video chats or phone calls to catch up with family and friends. And schedule some special one-on-one time with loved ones at home. Simple acts like these can bring joy as well as treasured new memories.

    Also, make this the year you refuse to do too much. Recruit your household members in some of the chores and feel good about gently saying “no” to obligations that trigger dread instead of delight. If you feel anxious that you’ll be letting people down, announce your plans to keep things simple and safe for everyone this year—because you care about them.

    The holidays will look different for many this year. Dr. Elspeth Ritchie has some simple steps to help you and your loved ones minimize negative feelings and find your own joy over this holiday period. @MedStarWHC via
    Click to Tweet

    4. Put things in perspective.
    Sacrifices can be hard to embrace and feel good about, but history shows that we’re tremendously resilient in difficult times. Sometimes it helps to consider other generations that faced even tougher holiday seasons. I often think about families during World War II, when many soldiers and their families had no way to connect or be certain of each other’s health and safety. Many people feared they might never see each other again because of the uncontrollable dangers at hand.

    Today, for most of us, the blues and sacrifices of this holiday season will be temporary. The promise of a vaccine on the horizon and finding alternate ways to celebrate and connect with each other are positives worth focusing on over the next few months. Things may not be ideal, but they can be better managed by choosing to change the way we think about them, and by taking action to control those that we know give us stress or anxiety.

    5. Talk it out.
    If feelings of anxiety or depression seem impossible to shake this holiday season, don’t keep them to yourself. Turn to a friend or other trusted person you feel comfortable talking to. Or mention it when you notice these signs in others (“You don’t seem like yourself lately. How is everything going?”). A simple conversation can open the door and allow you or a loved one to better weather the blues.

    If anxiety or depression interfere with your home or work life, professional counseling may be worth considering. Via telehealth appointments, our Outpatient Behavioral Health Clinic at MedStar Washington Hospital Center offers counseling services and can also review medication options with you. If you find yourself experiencing suicidal feelings, please seek help from a professional or come to the Emergency Department at the Hospital Center.

    Another excellent resource for grief and trauma counseling and for support groups that help both adults and children is the non-profit Wendt Center for Loss and Healing in Washington, D.C.,

    This holiday season, unique challenges are definitely in store for all of us. I hope these tips will help you find positive ways to manage them and also inspire you to be extra kind to yourself and to others. By caring for each other, we can help protect each other’s mental and physical health in the winter months to come.

    Holidays getting you down?

    Our team is here to help.

    Call 202-788-5048 or Request an Appointment

  • December 18, 2020

    By Daniel Marchalik, MD

    Burnout is twice as prevalent across workers in the healthcare industry than any other profession. And, the risk of suicide nearly doubles if you are a medical professional.

    If you’re having suicidal thoughts, help is available. Call the National Suicide Prevention Lifeline: 800-273-8255.

    There are a variety of reasons that doctors, nurses, and other clinical staff increasingly experience burnout. With many hospital caregivers working long and frequent 12-hour shifts, demanding hours can cause stress and exhaustion. Physical burnout is also coupled with the emotional and mental burden of caring for patients in their most vulnerable moments. Whether that’s caring for someone who’s experienced a tragic accident or consoling family members who have lost loved ones.

    The COVID-19 pandemic has significantly increased burnout among hospital caregivers.

    Burnout has been an underrecognized problem among hospital caregivers for decades. But the recent public health crisis has catapulted healthcare professionals into a flurry of chaos unlike anything our generations have seen before. Hospitals are seeing record-breaking numbers of patients seriously ill with a virus that has taken too many lives. Doctors and nurses are working around-the-clock to both treat patients medically, and serve as their support system as COVID-19 isolates them from their loved ones. The frequent and repetitive exposure to the virus that healthcare workers face also adds to their stress and burnout.

    The weight of bearing witness to such tragedy on a regular basis is enough to leave anyone feeling helpless, overwhelmed, and emotionally spent. Unfortunately, there’s little relief for hospital caregivers who have dedicated their careers to caring for people in their toughest moments. As a result, nearly two-thirds of physicians in the U.S. say the COVID-19 pandemic has amplified feelings of burnout, according to a survey conducted by the American Academy of Family Physicians.

    What does burnout in hospital caregivers look like?

    Burnout is a psychological response to prolonged feelings of stress on the job. Caregivers experiencing burnout may feel a sense of despair when they feel their time, effort, and energy aren’t making a difference.

    Burnout manifests itself differently in everyone, but generally includes:

    • Emotional exhaustion, or overwhelming feelings that you just can’t do it anymore
    • Depersonalization, in which an individual detaches from their job due to feelings of cynicism toward the work
    • Reduced personal accomplishment, or believing they are powerless to affect change

    How we’re helping our caregivers.

    MedStar Health is actively working to ensure our caregivers across all care sites have outlets to deal with the stress of the pandemic. We’ve set up multiple recharge stations across the system so our providers and associates have a space to relax, get a healthy drink or snack, and pick up materials about various ongoing wellness efforts.

    In an effort to make sure our caregivers are provided helpful wellness-focused resources, we launched an initiative called “wellness rounds”. During these rounds, our teams discuss various wellness resources that are available. It also gives providers and associates an opportunity to connect and discuss their concerns. These rounds were designed to focus a small part of the day on others’ wellbeing. Over time, this initiative has grown exponentially, and we have recruited large groups of volunteers to assist with the effort. All volunteers go through our peer support training. In fact, we established a 24/7 hotline for peer support to make sure this hub is available anytime someone needs it. For those who prefer a more formal mental health appointment to discuss their needs, we also put in place a mental health appointment program that ensures our associates and providers can speak with a provider within two business days.

    In addition to what we’re doing at MedStar Health and what other healthcare groups are doing to support their associates, there are ways patients and loved ones of those who are sick can help reduce caregiver burnout.

    Do you know a healthcare worker who has made a positive impact on your life or a loved one’s life? On the #LiveWellHealthy blog, learn why #GratitudeMatters to hospital caregivers and how you can express appreciation this holiday season:

    Click to Tweet

    A simple act of gratitude is proven to decrease burnout in hospital caregivers.

    Fortunately, there’s an easy way you can help doctors and nurses feel like they’re making a difference, and in turn, reduce their burnout. A simple expression of genuine gratitude can uplift hospital caregivers’ spirits and cause them to feel rewarded. In fact, studies demonstrate that showing gratitude can improve burnout among hospital caregivers.

    You can express gratitude after a positive care experience, or anytime, really. Even businesses nationwide are finding ways to thank healthcare workers throughout the pandemic. Some are doing things like offering free coffee or delivering care packages to show their appreciation.

    Ways you can express gratitude towards medical professionals.

    Gratitude can be expressed by patients and their loved ones, as well as colleagues working alongside each other. It doesn’t have to cost a thing, and there are many different ways to show caregivers they’ve made a difference.

    Here are a few ways you can demonstrate gratitude towards hospital caregivers in your community.

    • Verbal communication: One of the easiest ways to show gratitude towards a caregiver is by recognizing them verbally. Phrases like, “You’ve saved my life”, or “Thank you for all you’ve done to care for me”, show doctors and nurses that you acknowledge the meaningful work they’re doing. That recognition alone can put a smile on their face and positively impact the value they assign to their work.
    • Make a philanthropic contribution: Some individuals prefer to express gratitude through financial support. Defined as the love of humankind, philanthropy is one way you can respond through a monetary gift that helps healthcare professionals continue delivering the highest quality of medical care and compassion to patients every day.
    • Written acknowledgments: Many hospitals have gratitude boards where patients, loved ones, and co-workers can shout out doctors, nurses, and staff who have gone above and beyond to deliver compassion and care. Writing them a note can remind medical professionals why they chose this profession and give them strength to keep going.

    Now more than ever, healthcare professionals need to know they are appreciated and the work they do matters. This holiday season, an expression of gratitude towards a healthcare worker in your community could inspire them to keep going, knowing that they’re making a real difference in people’s lives.

    Would you like to thank a MedStar Health associate for making a positive impact on your life or a loved one’s life?
    Click below to share your gratitude.

    Share your gratitude.

  • December 17, 2020

    By Glenn W. Wortmann, MD

    Effective vaccines to fight COVID-19 have arrived, and they’re our best hope for bringing the current pandemic to an end.

    In recent news, vaccine manufacturers Pfizer and Moderna released data showing that their vaccines are up to 95 percent effective against the novel coronavirus. In other words, in 95 percent of people who received the shots, their immune systems prevented the development of COVID-19 disease. This is a much better average than we hoped for. The influenza vaccine, for example, tends to be about 60 percent effective.

    The FDA has issued emergency authorization to approve the Pfizer and Moderna vaccines here in the United States. The United Kingdom recently became the first nation to approve the Pfizer vaccine and began to administer it immediately.

    After 10 months of lockdowns, quarantines and social distancing, these vaccines—and others now in development—have real potential to help us begin defeating COVID-19.

    The Hope of Vaccines

    History has shown that vaccination works. From smallpox and polio to whooping cough and influenza, vaccines have saved millions of lives and routinely protect society from potentially harmful pathogens.

    Those of us working in infectious diseases are very optimistic about the COVID-19 vaccines. This pandemic has presented one unknown after another—yet most have been resolved. I believe that trend will continue as vaccines are administered to people around the world.

    Vaccination is the key to herd immunity, the tipping point when enough people (approximately 80 percent) have enough immune defense against a disease to protect the entire population. Providing immunization to so many will take time, as the nations of the world must meet the challenges of manufacturing, distributing and administering the shots.

    I recently heard an excellent analogy: Imagine fire trucks arriving at the scene of a raging wildfire. The vaccine is like the firefighters unrolling water hoses—it’s just the start of an intensive, challenging race to bring that fire under control.

    First Priority: Safety

    Although the new vaccines were fast-tracked, they underwent rigorous development just the same. We have Phase 3 trial data from 30,000–40,000 human test subjects—virtually the same standards used for vaccine development that typically occurs over a much longer period of time.

    Most people who received a trial vaccine have reported no serious issues. Occasional side effects were similar to that of other vaccines—pain at the injection site, muscle aches and low-grade fever for a day or two. These reactions aren’t just normal—they’re appreciated, as an indicator that the immune system is responding and building protection. Severe reactions were very uncommon in the trial groups.

    Safety remains a key tenet of FDA approval. Patients who volunteered for trial vaccines will be followed long-term, and our data stream will grow as the vaccine is more widely adopted. Individuals with an interest in volunteering for a trial have opportunities to do so. To participate in a trial, visit the website, the comprehensive national database of studies in search of trial candidates.

    COVID-19 vaccines are our best hope for bringing the current COVID-19 pandemic to an end. Learn more from Dr. Glenn Wortmann. @MedStarWHC via
    Click to Tweet

    How the New Vaccines Work

    The human immune system is miraculous—it neutralizes a variety of pathogens that could make you sick, day in and day out, from the moment you’re born. Troubles can begin when a new pathogen emerges that the body doesn’t recognize. Like sophisticated hackers breaching a computer network, some bugs can successfully infect a person whose immune system is not ready for them.

    To combat such a threat, the vaccine acts as a trigger, introducing to the body an agent that trains the immune system to recognize the target pathogen.

    The initial COVID-19 vaccines from Pfizer and Moderna employ messenger RNA (mRNA). The mRNA code is like sheet music telling a musician what to play. It instructs the cells to produce a tiny protein molecule, the same protein that COVID-19 uses to gain entry to the cells. It’s just the protein, not the whole virus, so it can’t give you the infection.

    In this way, mRNA vaccines differ from traditional ones. Rather than introducing a harmless piece of the target pathogen, they prompt the patient’s cells to make it instead.

    The immune system is programmed to isolate and destroy invaders, regardless of where they come from. As the proteins move through the bloodstream, the immune system learns to view them as bad actors and destroy them. When it has that knowledge, it can fight off the coronavirus, which is covered with the same protein molecules.

    The COVID-19 vaccine cannot trigger a false coronavirus test, the kind that shows you have an active infection. It may trigger a positive blood antibodies test, but that would be a welcome indicator that it did its job. And it is chemically impossible for the mRNA to enter your DNA and change your genetics.

    Also in Development

    In addition to the current vaccines from Pfizer and Moderna, at least 13 more large-scale studies are underway, each investigating a different vaccine. This is great news. This array of options can help get vaccines into the arms of more people.

    Some of the vaccines currently in trial follow traditional methods: The virus is grown in quantity, with tiny particles isolated and neutralized for the vaccine. The end result is the same—by managing a harmless piece of the virus, the patient’s immune system learns to recognize the real thing. But the production process for these vaccines takes longer; mRNA technology is faster, which is one reason why the initial vaccines we’re seeing are in that category.

    Double Dose

    Like the shingles vaccine, these initial COVID-19 vaccines call for two injections, three to four weeks apart (depending on the manufacturer). In the trial subjects, maximum immunity was achieved after the second shot, so it’s very important to receive both doses of the vaccine.  Also, it’s important to remember that while the vaccines had 95% protection, some people still developed COVID-19 (approximately 5%), so masking and social distancing remain extremely important.  Hopefully, once a large percentage of the population has been vaccinated, transmission of the virus will drop and we’ll eventually be able to stop masking and go back to normal.

    How long will immunity last? We don’t know yet.  But we’re hopeful it will be long enough to see the pandemic brought under control. We have little evidence to suggest the virus is mutating significantly, so we are confident that these initial formulations will remain effective.

    Vaccination injections are delivered into the muscle of the patient’s upper arm. So far, we have no indication that an oral or nasal alternative is on the horizon.

    The vaccination is not recommended for people actively ill with COVID-19 or another infection. In those cases, the immune system is already on overdrive, and a vaccine introduced at that point may not prove as effective. However, the vaccination is a good idea for those who have recovered from the coronavirus. Some patients in the Pfizer trial had antibodies, indicating they’d been infected before. The vaccine boosted any immunity built from fighting the virus itself.

    The initial vaccines are not yet approved for anyone under age 16, but ongoing studies are developing COVID-19 vaccines for children. We have not yet seen recommendations regarding pregnant women or patients with compromised immune systems.

    I recommend not receiving other vaccines—such as flu, shingles or immunizations needed for travel—at the same time as the COVID-19 vaccine. The COVID-19 vaccines are new and have not yet been studied when given at the same time as other vaccines.

    Vaccine Supply

    Because supply of the vaccine is just becoming available, its distribution must be prioritized. First to receive inoculation will be frontline healthcare workers who come in daily contact with COVID-19 patients, as well as nursing home patients and their caregivers.

    The second priority will likely be police officers, firefighters and other emergency responders and possibly schoolteachers in areas where school buildings remain open. As production increases and other vaccines gain approval, inoculations will become more widely available to the general population.

    Our Best Hope

    I have absolutely no qualms about the COVID-19 vaccine. I will take it when it becomes available to me—and I encourage you to do the same.

    Remember, we have no way to predict the severity of the virus; some people experience no symptoms, some suffer a mild case and some die. With that level of uncertainty in a disease that has already killed over 300,000 Americans, I would choose the vaccine. It remains our best hope against the pandemic, since research has not yet yielded a new drug to treat it and since prevention calls for consistent safety measures by all.

    With strong participation, we will see things improve. We don’t know if we will be able to completely eliminate COVID-19 from the world, but vaccination is the first step in protecting ourselves and getting back to normal.

    Front-line associates reflect on receiving the first dose of the COVID-19 vaccine.

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  • December 16, 2020

    By Theresa A. Stone, MD, FACP

    Eating healthy is one of the best things you can do for your health. In fact, consuming a healthy diet that prioritizes fruits, vegetables, and whole foods can reduce your risk of conditions like diabetes, heart disease, and even some cancers.

    While eating healthy can be a challenge anytime, it’s particularly difficult during the holidays. The average calorie intake during Thanksgiving alone is about 4,000 calories, and many people gain one to two pounds between Thanksgiving and New Year’s Day. As a result, it’s important to prepare your meals or snacks ahead of time so you can avoid eating tempting but unhealthy foods.

    Here are five healthy snack ideas you can try this holiday season.

    1. Date energy balls.

    Date energy balls are ideal for when you want a snack throughout the day or eating prior to a workout. Not only are they filling, but they are packed with carbohydrates, which are essential to consume before working out. To make date energy balls, combine the following ingredients and mix them together using a food processor:

    • 2 cups of walnuts (substitute almonds, peanuts, or other nuts you prefer)
    • 1 cup of shredded, unsweetened coconut
    • 2 cups of soft, pitted Medjool dates
    • 2 tablespoons of almond butter (or preferred nut butter)
    • ½ teaspoon of sea salt
    • 1 teaspoon of vanilla extract

    Scoop the dough using a tablespoon and roll it between your hands to form balls. Arrange them on a baking sheet lined with parchment paper, and place in the freezer for one to two hours before serving. If you want gourmet-looking date balls, you can also roll them in shredded coconut or cocoa powder before chilling.

    These snacks can be stored in a sealed container for about a week in the fridge or a month in the freezer.

    Eating healthy can be particularly difficult during the #Holidays. On the #LiveWellHealthy blog, we share 5 easy to make #HealthySnacks for you to try this holiday season:

    Click to Tweet

    2. Aromatic quick quinoa.

    Quinoa is gluten-free, high in protein, and a great source of carbohydrates. It can also work well as both a main dish and a side dish. To make this quinoa, use the following ingredients:

    • 1 cup of quinoa
    • Juice from one lemon
    • 3 tablespoons of tamari (soy sauce)
    • 2 medium-sized zucchini
    • 1 small broccoli head
    • 1 tablespoon of tahini
    • 1 teaspoon of olive oil
    • Salt and pepper

    You’ll want to place the quinoa in a sieve and rinse with cold water until the water runs clear. Place the quinoa in a saucepan with 1 ½ cups of water, lemon juice, and the tamari. Stir and cook on high heat until it comes to a boil. Then boil for one to two minutes and reduce to a simmer, covered, for 12 minutes (or until all the water is absorbed and the quinoa is fluffy).

    Now, slice the zucchini in half, chop it into half-moons, and cut the broccoli into florets. Heat your pan on medium heat. Add olive oil, tamari, salt, pepper, zucchini, and broccoli, and sauté for seven minutes. Mix the cooked quinoa together with the tahini and sautéed vegetables and drizzle with olive oil.

    3. Mango salsa.

    Salsa is good for almost any occasion—and, thankfully, it doesn’t contain many calories and can be relatively healthy when you make it yourself. Use the following ingredients for a delicious mango salsa:

    • 1 garlic clove, minced
    • 1 jalapeno, diced
    • 1 red onion, diced
    • 3 limes, juiced
    • 3 red mangos or 6 yellow mangos
    • 1 teaspoon of kosher salt
    • 1 ½ teaspoon of cilantro, chopped

    You’ll want to combine all of the ingredients together into a large bowl, mix them together, and chill in the refrigerator for an hour or two before serving with pita chips.

    4. Glowing turmeric latte.

    Some people may not initially consider lattes a snack, but they can be filling. A glowing turmeric latte is lightly sweetened with natural ingredients, and can contain a good amount of protein (if you opt for regular milk). Turmeric, a spice from eastern Asia and Central America, is an anti-inflammatory and a good source of antioxidants, or substances that can prevent or slow damage to cells caused by free radicals.

    Use the following ingredients to make a glowing turmeric latte:

    • 1 cup of milk (of your preferred milk type)
    • ½ teaspoon of turmeric
    • 1 teaspoon of honey
    • 2 teaspoons of ground cardamom

    To prepare the latte, combine all the ingredients into a saucepan over medium to high heat until the ingredients begin to boil. Then pour into a mug and serve.

    5. Zesty curried chickpeas.

    Zesty curried chickpeas is a wonderful dish that’s easy, fast, and tasty. Chickpeas contain many healthy nutrients, such as fiber, potassium, B vitamins, iron, and magnesium, making them an ideal main ingredient for any meal. To make this dish, use the following ingredients:

    • ½ teaspoon of salt
    • ½ teaspoon of turmeric
    • 1 ¼ teaspoon of cumin seed
    • 1 ¼ teaspoon of kalonji seed (also called black caraway or nigella)
    • ¼ cup of olive oil
    • 1 small onion, chopped
    • ½ chili pepper, chopped
    • One 15-ounce can of chickpeas
    • ½ cup of water
    • ¼ cup of cilantro

    Heat your saucepan and add olive oil, onion, and chili. Sauté on low heat or until onion starts to brown at the edges. Add in the remaining spices, and continue to sauté until the spices are well mixed. Then add chickpeas and mix in the saucepan, add water, and let it simmer, covered, for about 10 minutes. Let the ingredients cool for a few minutes, then add cilantro and serve.

    While the holidays can make it easier to eat unhealthy foods, you can still continue eating a healthy diet by planning your meals in advance and sticking to them. Make sure to consider these snacks during the holidays this year.

    This is an updated version of an article previously posted on December 23, 2019. 

    Looking for more healthy food ideas?
    Click below for other quick and easy healthy recipes from MedStar Health.

    MedStar Health and Wellness

  • December 15, 2020

    By Andrew Y. Lee, MD, Otolaryngology

    The season of allergies and colds is upon us and, with it, the all-too-familiar runny nose and its frequent companion, post-nasal drip. And adding an extra level of caution this year is the spread of COVID-19, which can cause symptoms similar to post-nasal drip at its onset.

    Let’s review a few facts behind post-nasal drip: what it is, what causes it, and what we can do about it.

    Why does mucus form? Mucus actually serves a healthy purpose. The glands within your sinus cavities produce it in order to trap foreign particles, eliminate debris from the sinuses, and help humidify the air you breathe.

    Typically, debris cleared from the nose is pushed into the nasopharynx, then into the back of your mouth as post-nasal drip, which you swallow like saliva. In general, this process is routine and beneficial. But it can become an issue when mucus secretion becomes excessive and causes serious nasal congestion or an irritated throat.

    Post-nasal drip can result from many factors, most of them not a serious threat to your health. The most common causes are allergies that cause inflammation or swelling of the lining of the nose, spurring overproduction of mucus.

    When this excess mucus is persistent—or if its thickness and frequency cause that constant drip in your throat—you may begin to experience additional symptoms, like an itchy throat, hoarseness, and the need to clear your throat constantly.

    Feeling that familiar drip in the back of your throat? Post-nasal drip is often triggered by seasonal allergies. Learn more from Dr. Lee. @MedStarWHC via
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    In addition to allergies, here are some other factors that may cause or aggravate your post-nasal drip:

    • Dehydration: Breathing a lot of dry air—very common when the heater goes on in the wintertime— can dehydrate the nasal passages or cause increased production of mucus. Being dehydrated can also cause the mucus that’s produced to be thicker.
    • Environmental conditions: Depending on the individual, the lining of the nose can be sensitive to changes in temperature, wind, and humidity. Fluctuations may affect when and how the nose produces mucus.
    • Seasonality: Some people are more affected in the spring if they’re allergic to tree pollen or in the fall if they’re allergic to weeds in bloom. Some suffer more in cooler, drier months, or get more sinus infections in winter. Every nose is different.
    • Sinus issues: Sinusitis, a sinus infection, or a structural problem with the nose that affects airflow (such as a deviated nasal septum) can cause swelling or edema of the nasal lining, and lead to more mucus production and more post-nasal drip.
    • Acid reflux: When acids rise from the stomach into the throat (especially after you eat spicy foods, large quantities of food, and/or greasy foods) your esophagus, the back of your throat, and even your nose may become irritated. Because the lining of the nose is not suited for exposure to such irritants, you may find that more mucus is produced, leading to post-nasal drip.
    • Age: Older patients are more prone to dehydration and have slightly thicker nasal secretions and drier nasal cavities, often spurring intermittent hoarseness, frequent throat clearing and chronic cough.
    • Smoking: A larger percentage of smokers tend to have post-nasal drip. Cilia—small hairs in the lining of the nose—propel mucus toward the back of the nose to clear it. Smoking can stunt the cilia’s ability to do their job, so secretions may become very thick and arrive at the back of the throat as post-nasal drip.

    When to Consult a Specialist

    If your post-nasal drip is a byproduct of a common cold and resolves on its own, it’s not likely to be concerning. But if it persists for more than two weeks, consider being evaluated by a doctor who can help you feel more comfortable.

    You should schedule an exam if:

    • Your post-nasal drip is accompanied by persistent dripping outside your nose as well
    • Your nasal passages have been stuffy for some time, especially on one side of the nose
    • Your post-nasal drip comes with chronic hoarseness or cough that’s been present for 3-4 weeks or may be worsening
    • Your excess mucus looks discolored or bloody, has a bad odor, or is accompanied by a fever

    At MedStar Washington Hospital Center, it’s very common for us to see these issues in patients with sinus or allergic rhinitis symptoms, and most of these issues are related to inflammation in the nose. But there could be other underlying reasons as well.

    Rinses and Sprays Can Help

    There are a number of ways to thin mucus, help the nose drain more efficiently, and prevent infections. Rinsing aids such as NeilMed® Sinus Rinse, neti pots, or Navage® can be used to beneficially irrigate the lining of your nose. The irrigation products come with little pre-made salt packets; you can add either distilled water or boiled tap water that you’ve let cool first.

    Mist sprays can also help, although they are typically not as effective as a rinse. The mist sprays function to help moisturize the nasal passages but may not be as effective in clearing the mucus secretions and getting into the sinuses.

    In addition to recommending a rinse or spray product, I typically prescribe Flonase®, azelastine, Atrovent®, or some combination. For people with posterior drip and sinus issues, these sprays can be very helpful. Continued use can help keep inflammation down and decrease mucus production to keep the nasal drip under control. And you don’t necessarily have to use these medications indefinitely. After we control the symptoms, we can start to decrease medications while continuing to observe how you’re doing.

    Can home remedies also help? Sometimes. “Non-drowsy” antihistamines, saline sprays, sleeping with your head elevated, using a humidifier, and drinking chicken soup and other hot liquids can work to thin mucus a bit. Avoiding cigarette smoke can help as well (and benefits your health in other ways).

    Is Post-Nasal Drip Curable?

    Unfortunately, no. So far, we can’t cure inflammation in the nose, only manage it by using the sprays and rinses. But it’s crucial to be consistent with their use and to discontinue them gradually and systematically. Stopping them prematurely may allow inflammation to return.

    If your nasal secretions are thin, white, and watery, you are generally OK unless they’re persistent. If you develop frequent or thick, yellowish, green, or other colored mucus, if it has a foul odor, if you feel facial pressure and pain, or if you experience a change in your sense of smell, seek medical care.

    Besides ongoing post-nasal drip, persistent or chronic throat irritation, voice irritation, nasal congestion, stuffiness, or difficulty breathing through the nose should be addressed before they potentially lead to other symptoms. For example, when you have difficulty breathing through your nose, you often end up breathing through the mouth, which can put you at a higher risk for sleep apnea and sleep disturbances.

    If you have the severe, progressive or persistent symptoms of post-nasal drip that I’ve described, I encourage you to work with a doctor, track your symptoms, and use your prescribed treatments regularly.

    What to Expect from an Examination?

    Post-nasal drip is so common that general practitioners and family medicine doctors see it much more frequently in their offices than we do, and they typically refer patients to us when they display symptoms that are persistent and not improving.

    When you come to MedStar Washington Hospital Center, we provide you with a comprehensive evaluation, as well as care that’s both empathetic and thorough. Throughout our department, my colleagues and I take pride in listening to our patients and developing a plan that works to control and improve your symptoms.

    We’re a collegial and collaborative team, experienced with disorders ranging from the benign to the most complex and critical. We stay up-to-date with the latest treatment options related to medical therapies, surgical therapies, and procedures to mitigate your symptoms and underlying problems.

    We like to see you in person for a physical examination of the nose and nasal lining, either via endoscopy or anterior rhinoscopy, to observe how the mucus is draining from the sinuses. A quick look at the back of the throat can help us note any thick secretions, irritation, or inflammation, and determine an appropriate treatment.

    In a small amount of cases, we may find that a situation is more complex—for example:

    • Allergic rhinitis with turbinate hypertrophy which can cause nasal obstruction
    • A septal deviation that’s aggravating the symptoms, and the patient is not improving on sprays
    • Nasal congestion or obstruction that can be improved by fixing the structures

    If the issue is sinus-related, we may recommend sinus surgery to bring relief.

    Remember: It’s not necessary to tolerate chronic post-nasal drip symptoms and related complications that could be affecting your quality of life. We have options that can alleviate your discomfort.

    Excessive post-nasal drip?

    Our specialists can help.

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