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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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  • July 15, 2020

    By Glenn W. Wortmann, MD

    Traveling by plane, train, or automobile isn’t what it used to be. With so many of us wanting to enjoy the beaches or visit family around the country, we need to be alert about avoiding an uninvited guest—coronavirus.

    A lot of people are asking: Can I travel during this pandemic? As a general rule of thumb, the answer is “yes,” but you should minimize the number of people with whom you interact. Avoid large groups. Seek a less crowded part of the beach if you can. Travel in your own car as opposed to a bus.

    About Family Gatherings

    It’s natural to want to enjoy time with family during these warm summer months. However, it’s critical that we take precautions around vulnerable family members. These include grandparents, aging aunts and uncles, and anyone with weakened immune systems or medical conditions.

    Here’s something you should know: A small percentage of people are testing positive for COVID-19 without displaying any symptoms. It’s important to be aware of the fact that people can be sick but not seem to be. This means you and your family could unknowingly be at risk for catching—or spreading—the disease wherever you go.

    So, even if you’re feeling well and don’t display any symptoms, take extra precautions when visiting those at higher risk. Wear masks and be diligent about washing your hands when you’re in others’ homes. The risk of a well person transmitting the virus while wearing masks and practicing physical distancing is low, but it’s not zero.

    If you’re hosting or attending a family get-together, do what you can to stay six feet apart from each other. Try to gather outside. Separate the chairs around the grill. Don’t engage in contact sports.

    Precautions Before Traveling

    • Consider testing: If you’re going to visit someone who is at high risk of developing complications from COVID-19 infection (such as an older person or someone with underlying health problems), you could consider getting tested five to six days before traveling. Some of the firehouses in Washington, D.C. offer free testing. If you’re exposed to somebody who has the coronavirus, it’s recommended that you quarantine at home for 10 to 14 days before your trip. Exposure is the key here. The risk of acquiring COVID-19 after a brief interaction is relatively low. On the other hand, if you’re indoors with somebody for an hour, the risk is much higher—which means you definitely need to quarantine.
    • Prepare a virus protection kit: If you must travel, make sure you pack a COVID-19 kit that includes face masks, wipes, and hand sanitizer to help you reduce the risk of exposure to the virus.
      • Cloth or single-use face masks must cover your mouth and nose.
      • Bring disinfecting wipes and wipe down high-touch surfaces like bathroom toilet and faucet handles, doorknobs, the phone, TV remote—and don’t forget your cell phone.
      • A hand sanitizer that contains at least 60% alcohol or 70% isopropyl alcohol is a must for those times when you can’t wash your hands.
      • Travel-sized laundry detergent will help keep your cloth masks clean.
      • In general, gloves aren’t recommended for routine use. It’s better to just wash your hands periodically. However, packing a set of latex gloves to use in case someone becomes sick is reasonable.
      • Nonperishable snacks and water may come in handy if restaurants are closed during your travel.
    • Go online: Check out the health department website of the location you plan to visit and get an idea of conditions in that location. Personally, I would have second thoughts about visiting states that are COVID-19 hotspots right now.
    • Contact your doctor: If someone in your family has a fever or other marker of the disease a day or two before your trip, call your doctor. He or she might suggest you come in for testing. Some people get very sick from this virus, and you wouldn’t want to be in a location far from home if you’re affected.
    Infectious diseases expert Dr. Glenn Wortmann recommends having a #COVID19 kit that includes face masks, wipes, and hand sanitizer if you travel. #TogetherApart https://bit.ly/3gJh1KC via @MedStarWHC
    Click to Tweet

    Precautions While Traveling

    • Air travel: The first concern is the airport. That’s a lot of people interacting indoors where the virus can be transmitted through droplets. Then there’s the airplane itself. If you consider that 1%–3% of people in general carry the virus and there are 100 people on the plane, the risk is that one to three of your fellow passengers are infected. The risk is relatively low if everybody’s wearing a mask—and I recommend staying masked for the entire flight. Still, I would think carefully about how much I want to fly versus going somewhere I can drive.
    • Hotels/motels: I actually had to travel recently and can share my personal experience. The rest stops along the New Jersey Turnpike had physical distancing measures, and the hotel I stayed at was very good. They had markers to assure you stayed six feet away from the other person in the check-in line. Check-in was quite fast because the hotel staff wanted to get you to your room as quickly as possible. There was no indoor dining—only room service. I think most hotels are moving in this direction, although every place has different standards of cleanliness.
    • At the pool or beach: The risk of acquiring COVID-19 from an outdoor environment appears to be very low. The virus is dispersed quickly in the breeze. Also there is no evidence that it can survive in a body of water. So, going to a pool or beach is potentially safer than being in a closed room for a long period of time. That said, I wouldn’t go to a beach where people are packed towel-to-towel. If you’re on a crowded beach, the CDC recommends wearing a mask. Use common sense and set up your beach blanket in a less populated area, trying to stay six feet away from others.
    • In your RV: Recreational vehicles are a great way to travel safely. You’re in your own space and don’t have some of the concerns that come with other forms of transportation.
    • Telehealth: If you’re feeling ill during your travels, you could probably seek out an out-of-town doctor in your insurance network to evaluate you. But you may find it easier and more reassuring to have a telehealth visit with your own doctor, which can be done using your cell phone. Remember, coronavirus is not the only threat out there: check with your provider for an accurate diagnosis.
    • Kids, toddlers, and babies: Children can definitely contract the coronavirus. Although they appear less at risk of severe disease, it unfortunately happens. My children are grown, but if I had young kids, I would definitely put a mask on them, and try to separate them from large groups. Newborns and toddlers are a different story. You can’t really mask them, but you can make a conscious effort not to let everyone hold them, so they aren’t exposed to a virus carrier who doesn’t show symptoms.

    Be Safe and Enjoy Your Summer

    I know these last few months have been difficult and everyone wants to get outside and enjoy the summer weather. Just make sure your safety and the safety of those around you is top of mind. Wear your mask. Stay six feet apart from others. Wash your hands frequently. These small steps can make a big difference.

    Feeling ill before you travel?

    Connect with one of our specialists.

    Call 202-644-9526 or Request an Appointment

  • July 10, 2020

    By Harjit K. Chahal, MD

    A healthy diet is important for maintaining weight, sleeping well, and fighting off disease, especially during COVID-19. A well-balanced diet can also improve your gut health, minimize your risk of heart disease and colon cancer, and lower your stress levels.

    That’s why I often tell my patients that the best medicine may be at the end of a fork. As a cardiologist, I always recommend that my patients “eat the rainbow”, choosing to fill their plates with nature’s colorful foods. Choosing to eat healthy ensures your body and mind function at it’s best, and you don’t have to compromise flavor!

    Eating healthy during #COVID19 can be easy, fun, and affordable. On the #LiveWellHealthy blog, Dr. Chahal shares 5 simple tips that will help you make faster, tastier, and healthier meals: https://bit.ly/2ANay1T.

    Click to Tweet

    Simple tips for eating healthy during COVID-19.

    You don’t have to let boredom from more time at home and uncertainty about the pandemic lead to overeating or stress-eating. Try these simple (and tasty) tips to eat healthy during COVID-19.

    1. Experiment with new foods and creative recipes.

    Preparing home-cooked meals is one of the best ways to eat healthy during COVID-19 because you have complete control over which ingredients you use. I often suggest that patients consider eating a plant-based or Mediterranean diet, which is low in cholesterol and high in fiber. When you expand your palate to include an assortment of colorful fruits and vegetables, you benefit from a variety of nature’s vitamins, minerals, and antioxidants that can improve your sleep, mental state, and physical body.

    Try a google search for creative recipes with unique foods that you don’t typically include on your grocery list. Figs, for example, can be a tasty way to mix up a bowl of oatmeal or top off a salad. Chickpeas and lentils are healthy protein alternatives to meat, and they’re also cheaper and last longer. Be creative about how you combine different foods to keep mealtime exciting and flavorful!

    2. Use spices and seasonings full of antioxidants.

    Antioxidants offer a wide range of health benefits, including improving skin and sleep. They’re found in fresh herbs, such as rosemary and mint, as well as spices and seasonings, like cinnamon and paprika. The amount of options provides lots of ways to add zestful flavor to your meals. You can also try pre-mixed spices, which are a convenient way to change up the taste of your favorite dish. Many times you can find low sodium options to minimize your salt intake.

    3. Swap processed foods for natural options.

    Pre-packaged foods may seem to make mealtime easier, but they’re often filled with fats and sugars that can be harmful to our bodies. Instead, try to limit processed foods that have a long list of ingredients you can’t pronounce.

    Finding a healthy alternative can be easy. To eat healthy during COVID-19, consider swapping in the following:

    • Freshly baked whole grain bread instead of a processed loaf
    • Natural sugars, such as dates or honey, instead of cake, candy, and soda
    • Fats that are liquid at room temperature (e.g. olive oil, avocado oil, etc.) instead of fats that are solid at room temperature (e.g. butter)
    • Fruit instead of fruit juice
    • Potatoes instead of potato chips
    • Fresh or frozen fruits and veggies instead of canned produce

    4. Make cooking and mealtime a family affair.

    The Mediterranean diet is popular because of its positive effect on overall health, from weight and sex to sleep and mood. But you may be surprised to learn it involves more than just cooking with fresh, healthy ingredients. The Mediterranean diet also reflects how many families in the Mediterranean region prepare their meals.

    Often, mealtime takes hours to prepare and involves the whole family. You may not have all day to cook a meal, but it’s easy to have your family participate in the process. Whether your little one helps to wash produce or your teenager sets the table, there are lots of ways to include your family members in the cooking process, from washing produce to setting the table. Involving your kids in meal preparation also teaches them about healthy nutrition which will help them make better food choices as they become adults.

    5. Simplify meal planning by following a formula and cooking in bulk.

    Cooking during COVID-19 doesn’t have to be complicated or time-consuming, and it’s much cheaper than eating out. To simplify meal planning, find a way to use what you have and cook your meal bases in bulk so that you have leftovers to use in other recipes. For example, if you’re following a recipe that uses quinoa, cook extra and get creative with the leftovers.

    An easy way to plan your meals is to consider filling your plate with the following formula:

    • ½ of your plate should be a vegetable (e.g. fennel, kale, cucumbers)
    • ¼ of your plate should be a protein (e.g. animal or plant-based)
    • ¼ of your plate should be a whole grain (e.g. quinoa, rice, barley, farrow)

    You can mix and match all kinds of foods within each category to get an endless supply of meal combinations that are flavorful and healthy.

    Easy recipes to try during COVID-19.

    One of my favorite places to look for innovative and healthy recipes online is Love & Lemons. Here are three of my favorites, one for each meal.

    Breakfast: Healthy Banana Muffins.

    Jeanine and Jack from Love & Lemons created this healthy banana muffin recipe which is a tasty and healthy option for breakfast or snack. You can also freeze them for a quick breakfast later on.

    Lunch: Caesar Salad.

    This caesar salad recipe from Love & Lemons is a lightened up version of the classic. It’s hearty enough to be a standalone meal or can pair as a side dish for dinner.

    Dinner: Spicy Mango & Avocado Rice Bowl.

    Rice bowls are easy to prepare because they rely on just a few elements—rice, a protein, veggie, and a sauce. This spicy mango & avocado rice bowl recipe was also created by Jeanine and Jack at Love & Lemons. Consider making your own combination by swapping in your favorite veggies or grains!

    Want more healthy eating tips and recipes?

    If you’re ready to take that next step into a healthier lifestyle, we are here to help. Backed by the doctors and dietitians of MedStar Health, we provide tips and tools to help you and those you care about get and stay healthy.

    On our health and wellness page, you will find recipes for MedStar Health approved meals. These meals make at least four servings — enough to share or save for later — and the recipes are easy to follow, regardless of your cooking experience.

    A meal is MedStar Health approved if it contains:

    • 350 to 600 calories
    • 30 to 60 grams of carbohydrates
    • Fewer than 750 milligrams of sodium
    • Maximum of 7 grams of saturated fat

    Try making some of our delicious meals like the buffalo chicken salad, the corn and black bean pizza, and more. All of our recipes have fewer than 12 ingredients, take 20 to 35 minutes to cook, and don’t require any complex equipment to make.

    Want to learn more about how we can help you live a healthy life?
    Click the button below to go to our health and wellness page.

    MedStar Health and Wellness.

  • July 09, 2020

    By Gregory J. Argyros, MD, MACP, FCCP, President, MedStar Washington Hospital Center

    Around the world, COVID-19 has put the entire healthcare system to the test. Here at MedStar Washington Hospital Center, our team mounted a comprehensive response quickly and effectively. That effort likely saved countless lives and would not have been possible without the culture of quality, safety and readiness built here over decades.

    At the Hospital Center, every member of the team is focused on patient safety. That’s what we do, every day. It drives every decision we make.

    Since March, our leadership team has met around the clock, solving problems and innovating solutions under constantly shifting conditions. Our bedside caregivers on the units and in the Emergency Department have shown phenomenal dedication, delivering an outstanding level of care for patients with COVID-19, while protecting those who were not infected. We remain flexible and responsive, reassigning our resources quickly to put associates wherever they’re needed.

    Of course, when it comes to this coronavirus, we’re not out of the woods yet. But I can say without hesitation that MedStar Washington Hospital Center delivered a stellar performance during the worst of the crisis—and we remain at the ready.

    I have no adequate words to express my pride, appreciation and gratitude for this team.

    Top-to-Bottom Approach to Safety

    We are doing everything in our power to provide the safest environment for our patients and staff. We have reinstated routine tests and other elective procedures carefully and thoughtfully. There is no reason to avoid the hospital or delay care for any health issue. In fact, delaying care for a serious problem can be significantly more dangerous than venturing out. Routine, easily treated problems may quickly become life-threatening if left unattended. I can’t emphasize this enough.

    I make regular rounds in the hospital and meet daily with the leadership team. We are well trained. We have the Personal Protective Equipment (PPE) that we need. And we have made a number of policy changes to stay ahead of the virus:

    • All patients, visitors and associates are required to wear masks in the hospital and Physicians Office Building.
    • Signs are displayed in areas that could become crowded so that we stay six feet apart.
    • Waiting rooms are redesigned for proper physical distancing.
    • Appointments are staggered to avoid crowding.
    • We sanitize and disinfect all patient exam and procedure rooms after each appointment.
    • High-touch areas are cleaned regularly.
    • All patients and approved visitors are screened for symptoms.
    • We have ramped up inpatient and outpatient COVID-19 testing.

    We took preventive steps early, including recognition of symptoms, carefully managing access to the hospital and contacts with patients, and conducting temperature screenings. We designated specific units to isolate patients who tested positive for COVID-19. Coupled with consistent use of PPE, these tactics have been important in protecting both our patients and our staff.

    We’ve also dramatically increased our use of telehealth. MedStar Health e-Visits and Video Visits have soared since March. Both of these platforms were in place before the pandemic, and I am thrilled that our patients were able to utilize these resources as the crisis unfolded. Telehealth kept them safe as we continued to learn more about the virus, and likely reduced the overall number of hospitalized patients.

    Probably the most important aspect is keeping patients connected with their providers. We don’t want to lose those relationships, which are so critical to health and well-being. Telehealth at the Hospital Center is a huge asset now and has tremendous potential for the future.

    MedStar Washington Hospital Center is carefully and thoughtfully restarting elective procedures and routine tests. Patient safety is our top priority. An update from President Dr. Gregory J. Argyros. https://bit.ly/2O9H69k via @MedStarWHC
    Click to Tweet

    Responding Quickly and Decisively

    As challenging as this crisis has been, especially for those who’ve lost loved ones, it pales in comparison to the 1918 Spanish flu pandemic. The CDC estimates that Spanish flu killed at least 50 million worldwide, although some evidence puts that number near 100 million.

    COVID-19 is a real challenge, but health care has improved dramatically since the turn of the 20th century. In today’s pandemic, most people who contract the disease will recover—a testament to the dedication, skill and resourcefulness of the global scientific and medical community.

    With all the advances in immunology, epidemiology and other health sciences, we know more about this 2020 virus than our predecessors could have imagined. And with millions of dedicated professionals working on it around the globe, we learn more every day.

    When this pathogen began to cause epidemic infections around the globe, and it became apparent that it would not behave like the average flu virus, we sprang into action. We activated a pre-planned Incident Command Structure, assigning very specific roles to managers in key areas. From supplies to lab testing, bed management to staffing, Incident Command optimizes at least two dozen critical areas to prepare for a potential wave of infection. This team has been the bedrock of our response to the pandemic.

    Our hospital has rigorously followed Centers for Disease Control and Prevention (CDC) recommendations. Early on, we also knew that recommendations would shift, as experts learned more about the virus and adapted workflows and procedures.

    From the beginning, our medical providers, nursing staff, technologists, nutrition associates, and environmental services specialists have had the training and PPE needed to protect themselves and their patients—including masks, eye protection, gowns, head covers, shoe covers and gloves.

    Our experts across the MedStar Health system worked hand-in-hand to share knowledge during this pandemic. Remember, this has been an ever-changing situation. We started by screening people who had traveled to China. Eventually, as the virus spread, travel became a non-issue. Although we learn more about the virus and possible treatments every day, success in treating our patients depends on expanding our knowledge. All our leaders continue to meet regularly to exchange information and request help, when needed.

    Preparation Makes All the Difference

    Preparedness for a community health crisis doesn’t happen overnight. At MedStar Washington Hospital Center, we excel at crisis management—the result of decades of making patient safety priority one. The entire MedStar organization is committed to that mission and every team member is empowered to support it.

    • Safety is data driven. We continually measure and report key quality indicators.
    • Our teams are experienced and, if they come across something unfamiliar, they work together to leverage their knowledge and deliver safe and quality care.
    • We partner with the MedStar Health Institute for Quality and Safety to improve monitoring and reporting. That sharpens our focus for addressing small issues before they become big problems.
    • We embrace the High Reliability Organization framework—an organizational system that airlines, nuclear energy and other commercial organizations implement to ensure safety.

    These and other initiatives are integral to our care delivery, giving us a proactive, nimble organization that stays on its toes, every minute of every day. We never rest on success.

    Staying Ready for a Healthy Future

    We have not seen anything on the scale of COVID-19 in our lifetime and, like most of my colleagues, I can’t point to any specific experience that prepared me for it. However, as Chief of Medicine at Walter Reed Army Medical Center and Director of Education, Training, and Research for the National Capital Region, I had the responsibility of merging Walter Reed with the National Naval Medical Center. Success in joining two distinct operations demanded exemplary organization, teamwork and having the right people in place to carry out a plan. The same components are required to effectively deal with the pandemic.

    Every day is a learning experience. We’ve learned that teamwork and clear, constant communication with our staff and our patients are imperative. Being part of MedStar Health’s distributed care delivery network has allowed efficient sharing of resources, from PPE to staff, to assure we deliver the best care possible.

    If you’ve ever been a patient of MedStar Health, you know that your providers care about you like family. We celebrate and share the joy when patients are discharged and able to go home. During this pandemic, our associates have planned weddings and birthday celebrations and helped facilitate virtual web meetings between patients and their families. They’ve responded and adapted to constant change and embraced the best-known standards of care. They have been diligent about cleanliness, assuring our facility is always clean and ready for patients.

    We know this has been a difficult time for our patients, especially with the suspension of visitation. We hope we’ve provided some measure of warmth and compassion in the absence of families and loved ones. And we’re grateful to those who chose our Hospital Center to provide that care.

    I know I’m biased. But I love this hospital and trust our providers and caregivers to keep our patients safe and well cared for. We will always be here for you, whenever you need us.

    Your health is important to us.

    Our care teams are ready to help.

    Call 202-644-9526 or Request an Appointment

  • July 08, 2020

    By Dr. Kari Kindschi, MD, Sports Medicine Physician at MedStar Union Memorial Hospital

    Summer is finally here, and the warm weather and longer days offer many reasons for families to get active outside.

    But along with all of the outdoor fun comes more opportunity for activity-related injury, especially if your kids have been less active while stay-at-home orders were in place. In addition to nature-related injuries and illnesses, such as tick bites and sunburn, summer activities present more chances for broken bones, concussions, and other bumps and bruises. As sports medicine physicians, here are some of the most common summer injuries we see in warm weather months and how you can help prevent them at home.

    Wearing a helmet while riding a #Bike can reduce your risk of head injury by up to 88%. On the #LiveWellHealthy blog, sports medicine physicians share more tips for preventing 5 common #SummerInjuries: https://bit.ly/3gByXqu.

    Click to Tweet

     

    Common summer injuries.

    1. Bicycle injuries.

    Bike accidents are one of the most common summer injuries because the warmer weather presents more chances for you and your kids to ride together. But, a fall from a bike accident can be dangerous, resulting in cuts, scrapes, fractures, or concussions. If vehicles are involved, a bike crash could even be fatal.

    Tips to prevent bicycle injuries: You can prevent severe head injuries from bike crashes by wearing a helmet. In fact, the Bicycle Helmet Safety Institute suggests that wearing a helmet can reduce the risk of head and brain injury by up to 88% for both adults and children. Other protective gear, such as knee and elbow pads, can also help to minimize injury from falls. And, a properly-fitted helmet and padding can reduce your risk of injury from skateboard and scooter accidents as well.

    Related article: Bicycle safety: 6 ways to ride safer.

    2. Playground injuries.

    More free time on summer vacation means more time spent visiting the local park or backyard playground. Unfortunately, monkey bars, slides, and swings commonly cause fall-related fractures and head injuries over the summer, even if the equipment is properly maintained.

    Tips to prevent playground injuries: Playground falls are inevitable, but choosing a playground built over soft surfaces can minimize the risk of severe injury. Avoid playgrounds on concrete or gravel and instead look for playgrounds that hover soft surfaces, like rubber or wood chips. Active supervision is also important, as you may be able to help prevent a fall if you’re within arms reach.

    3. Trampoline injuries.

    Concussions and fractures are also common in the summer months as a result of jumping on a trampoline. Bloody noses, bumps, and bruises may not be as serious but they’re also a concern.

    Tips to prevent trampoline injuries: Many trampoline injuries involve a collision between two or more people, so one of the best ways to minimize the risk of injury is to only allow one person to use the trampoline at a time. It’s also a great idea to attach a net around the outside of the trampoline to minimize falls.

    4. Water injuries and drowning.

    Swimming in a pool, lake, or ocean is great exercise but water-related injuries can be fatal. Drowning is the second most common cause of death by unintentional injury from kids between the ages of one and four, according to the Centers for Disease Control and Prevention (CDC). And, even good swimmers can get injured in and around water-related activities like diving, water sports, and boating.

    Tips to prevent water injuries and drowning: Adult supervision is the most effective way to prevent drowning accidents, whether you’re at the pool or in open water. Stay within arms reach when your kids are in or around the pool. If the pool is not fenced in, be sure to cover it when it is not being used. If your family is on a boat participating in or watching water sports, make sure everyone wears a Coast Guard-approved life jacket, even if you’re a good swimmer.

    5. Overuse injuries.

    While school sports may take a break from practices during the summer, travel teams or sports camps are in full swing. Overuse injuries, such as tendonitis or Osgood-Schlatter disease in the knee, can be painful and prevent your kids from fully participating in their sports. Shoulder and elbow overuse injuries are especially common in baseball players and pitchers because of the repetitive throwing motion.

    Tips to prevent overuse injuries: One of the best ways to minimize overuse injuries in kids and teenagers is to encourage them to play more than one sport. Cross-training can help prevent common ligament injuries in the knee, shoulder, and elbow. Additionally, if your child has been sedentary, it’s important to help them gradually return to their sports by slowly increasing the frequency and duration of their participation.

    When to see a doctor for a summer injury.

    If you suspect a head injury of any kind, call a medical professional to determine if they need additional care. It’s always better to seek care sooner rather than later.

    If your child had an activity-related fall, you should seek medical care if they are:

    • Limping
    • Unable to put use full range of motion in an extremity (e.g. arm or leg)
    • Experiencing pain or tenderness when pressure is applied to a joint
    • Having headaches or drowsy, as these could be signs of a concussion

    If you’re unsure if your child should see a doctor, a MedStar Health Video Visit may help you get the answers you need. During a video visit, you can talk to a physician about your child’s condition to find out if they need in-person care. If they do, your provider can direct you to the right orthopedic specialist, if necessary.

    Have a safe, injury-free summer!

    Does your child need medical care for a summer injury?
    Talk to a doctor today.

    Find an Orthopedic Specialist.

    MedStar Health Video Visits.

  • July 07, 2020

    By Lambros Stamatakis, MD

    Kidney (renal) cancer is on the rise. In Washington, D.C. alone, 100 to 150 people a year are expected to be diagnosed with this disease. That number doesn’t include potential new cases in our surrounding counties.

    On a broader scale, as one of the 10 most common cancers in the U.S., it will be newly diagnosed in about 75,000 Americans each year, and claim the lives of about 15,000 people annually. Although the reasons aren’t clear, more men than women are affected by this condition.

    Incidental Diagnoses

    In about half the cases, people discover they have the disease when they visit their primary care doctor for a separate reason. They may have back pain, abdominal pain, gastrointestinal upset. The kidney condition only becomes apparent when a scan reveals a tumor in the kidney. This is why it’s critical to have a good relationship with a trusted primary care doctor.

    When I receive a referral from a patient’s primary care doctor, I may order either a high-quality CT scan or an MRI. With those images, I am able to understand the stage of the cancer and surrounding areas with which it may be associated and can determine a path forward if surgery is a recommended option for that patient.

    In Washington, D.C. alone, 100 to 150 people each year are expected to be diagnosed with kidney cancer, according to @UroOncDC. https://bit.ly/2YT34Uv via @MedStarWHC
    Click to Tweet

    Symptoms to Be Aware of

    I want to make it clear that many patients in our community who are diagnosed with localized kidney tumors have no symptoms. They feel 100% normal. But as the cancer progresses—and particularly once it spreads to other areas of the body—some patients will experience a change in appetite and unintentional weight loss. They may also have:

    • Blood in the urine: This is a critical signal. If you see blood in your urine, make an appointment with your doctor
    • Pain in the side
    • Constitutional symptoms, such as fatigue and night sweats
    • A general sense of not feeling well

    Higher Incidence…or More Scans?

    The rate of renal cancer has appeared to be rising since the 1990s. Many people speculate that this is simply due to greater awareness of the disease and increased use of more advanced imaging.

    Because it’s become easier to obtain a CT scan, many patients who wouldn’t have been scanned 10 or 20 years ago are scanned today, allowing us to readily identify more cancers than in the past. It’s unclear whether the true number of cases is actually increasing.

    Stages, Sizes, and Survival Rates

    Once renal cancer develops, it can progress from Stage 1 to Stage 4.

    • Stage 1: Small tumors (less than 7 cm) contained within the kidney. Stage 1 cancers actually have a very good five-year survival rate if treated—probably 90%–95%. If you have a small tumor and it’s completely removed by surgery, your prognosis is generally very good.
    • Stage 2: The cancerous tissue is larger than in Stage 1, but still localized to the kidney.
    • Stage 3: These tumors display signs that they’re invasive. For instance, they may be moving into the surrounding fat or the central part of the kidney. There may also be evidence of local lymph node involvement.
    • Stage 4: When the disease has spread outside the kidney, we classify that as Stage 4. At this stage, we’re looking at a 10%–15% five-year survival rate, even with therapy. This is a deadly disease once it spreads from the kidney.

    A Range of Treatment Options

    Each patient receives a personalized treatment plan. We talk about their goals and create a plan that could provide the best outcome for them. There are several treatment options that we discuss:

    Minimally invasive and robotic surgery
    The mainstay of therapy for localized renal cancer tends to be surgery. Surgical options depend on many things, including the size of the tumor and its location within the kidney. Although complete removal of the kidney is sometimes warranted, in many cases, we can simply remove the tumor and spare the remainder of the kidney. This is known as a partial nephrectomy.

    For many patients who undergo this procedure, a minimally invasive robotic approach offers several advantages:

    • Improved visualization for the surgeon
    • Improved surgical dexterity for complex reconstruction of the kidney
    • Shorter hospital stay
    • Less blood loss

    Percutaneous ablation
    Rather than remove tumors, we can often work with our interventional radiologists to kill the cancer cells within the tumor. The interventional radiologist guides specialized needles into the tumor and either freezes it using a technique known as cryoablation or heats it through radiofrequency or microwave ablation.

    Active surveillance with appropriate interventions
    In certain scenarios, observation of the tumors can be an option because some kidney cancers can actually grow very slowly and remain in the kidney. The patient follows up with the urologic oncologist or medical oncologist with periodic scans to ensure the tumors are not growing. If a tumor starts to grow or if new symptoms develop, treatment may be called for.

    It’s difficult to know how a particular tumor will affect that patient. It could end up being life-threatening or relatively harmless. The choice of active surveillance is a decision made between the doctor and patient and is dependent on various factors.

    Immune-boosting agents
    For patients with more advanced disease, a variety of therapies can be delivered systemically. These aren’t traditional chemotherapy agents, they’re agents that work on the immune system and can be considered immune-boosting pharmaceutical agents to help attack metastatic cancers.

    Clinical trials
    For patients interested in a novel therapy, some clinical trials currently available for patients with locally advanced or metastatic renal cancer may be an option.

    What to Expect

    As the largest hospital in Washington, D.C., MedStar Washington Hospital Center is an excellent choice for kidney cancer treatment.

    If you opt for minimally invasive surgery, you will have smaller incisions, less pain, and improved convalescence. Within 24 to 48 hours, you’re eating a regular diet and able to take care of yourself.

    My major restriction is no heavy lifting for a period of time after surgery so the incisions can heal. Within a week or two, most of our patients feel almost 100%. And those without a lot of strenuous activity at work can return to the job within two or three weeks.

    Looking Forward to Truly Personalized Medicine

    Within the next decade or two, we hope to be able to characterize each patient’s tumor at a molecular level. That means we’ll be able to provide targeted, specialized therapy to each patient for his or her unique tumor.

    To me, targeted therapy is really fascinating because it unites clinicians like myself with the translational science teams who work to develop drugs and other therapeutic agents. As we move forward in the 21st century, I’m excited about how we’ll become even better enabled to use personalized medicine to care for our patients with kidney cancer.

    Experiencing blood in the urine?

    Our specialists can help.

    Call 202-644-9526 or Request an Appointment

  • July 04, 2020

    By MedStar Team

    MedStar Health researchers published a report highlighting two cases of COVID-19 infection with myocardial involvement with distinct mechanistic pathways and outcomes. The cases discussed the important decision strategies for these critically ill patients, such as the timing of cardiac catheterization (when indicated) and requirement of early hemodynamic support. “COVID-19 (SARS-Cov-2) and the heart – An ominous association” was published in Cardiovascular Revascularization Medicine.

    Cardiovascular manifestations of COVID-19 can be diverse and complex, including myocardial injury, infarction, myocarditis simulating ST-segment elevation myocardial infarction, non-ischemic cardiomyopathy, coronary vasospasm, pericarditis, or stress(takotsubo) cardiomyopathy.  The publication discussed that based on the initial experience from Wuhan, China, that approximately 27.8% (52/187) of patients with COVID-19 exhibited myocardial injury. Myocardial injury was associated with worse out-comes of COVID-19, whereas the prognosis of patients with underlying cardiovascular disease but without myocardial injury was comparatively favorable.

    The cases described in this report are patients with COVID-19 infection and myocardial involvement. The authors indicated that during the COVID-19 pandemic, management of patients with acute coronary syndrome and COVID-19 remains critically important.  Underlying cardiovascular disease and associated risk factors such as hypertension, coronary heart disease, and cardiomyopathy put patients at higher risk of developing myocardial injury during the course of their COVID-19 infection.

    The team included Nauman Khalid, MD; Yuefeng Chen MD, PhD; Brian C. Case, MD; Evan Shlofmitz, DO; Jason P. Wermers, Toby Rogers, MD, PhD; Itsik Ben-Dor, MD; and Ron Waksman, MD.

    Cardiovascular Revascularization Medicine, 2020, DOI: 10.1016/j.carrev.2020.05.009