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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.
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    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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  • June 17, 2020

    By John F. Lazar, MD

    MedStar Washington Hospital Center’s newly opened Lung and Esophageal Center provides comprehensive care for patients with the full range of benign and malignant thoracic conditions, with a focus on diagnostics and surgical treatments. Conditions we commonly treat include lung nodules and cancer, esophageal cancer, hiatal hernia and GERD, achalasia, chest wall deformities, and airway disease, among other conditions. Our providers, three board-certified thoracic surgeons, an interventional pulmonologist, and two advanced practice providers work together to create individualized treatment pathways for each patient.

    Close collaboration with colleagues in specialties such as medical oncology, radiation oncology, gastroenterology, and interventional radiology, as well as participation in weekly interdisciplinary thoracic oncology conferences, ensures that our patients are presented with the best possible treatment options for their unique condition.

    We employ a breadth of novel and traditional diagnostic and surgical tools in caring for our patients. Our Center was one of the first in the nation to receive the Auris Monarch Navigational Bronchoscope that allows us to navigate more precisely within the lung and biopsy nodules that previously would have been unreachable or too small to sample. Our surgeons are well versed in the use of both open and minimally invasive, including robotic, thoracoscopic, and laparoscopic, surgical techniques, in addition to endoscopic and bronchoscopic treatment options.

    Our Doctors

    The core of the Lung and Esophageal Center is a group of four fellowship-trained surgeons and an interventional pulmonologist who together offer unmatched, collaborative expertise. Our sub-specialty training and unique interests allow us to offer expert care for a wide variety of thoracic conditions.

    I’m John F. Lazar, MD, and I am a board-certified thoracic surgeon and the Director of Thoracic Robotics at MedStar Washington Hospital Center. I am an Assistant Professor of Surgery at the Georgetown University School of Medicine and serve on the executive board of the Eastern Cardiothoracic Surgical Society. My interests are in surgical innovation and the treatment of early stage lung cancer utilizing both surgical and endo-bronchial robotic platforms. I have interest in applying minimally invasive surgery to the treatment of airway diseases.

    Puja G. Khaitan, MD, FACS, is the Director of Esophageal Surgery at MedStar Washington Hospital Center and Associate Professor of Surgery at the Georgetown University School of Medicine. Her practice interests include minimally invasive treatment of lung and esophageal cancer, including mesothelioma. Her research interests include the treatment of esophageal cancer from a molecular standpoint and markers for long-term survival.

    Marc Margolis, MD, FACS, is a board-certified thoracic surgeon and Associate Professor of Surgery at Georgetown University. His surgical interests include robotic lobectomy for lung cancer and treatment of benign and malignant esophageal disease. He has extensive experience working with chest wall disorders (both benign and malignant) that require complicated reconstruction, as well as surgery for thoracic outlet syndrome.

    Jessica Wang Memoli, MD, is the Director of Bronchoscopy and Interventional Pulmonology at MedStar Washington Hospital Center. She specializes in the diagnosis and management of pulmonary diseases, as well as the evaluation of lung cancer and lung nodules.

    Announcing the new Lung and Esophageal Center @MedStarWHC! Our surgeons are dedicated to applying their skills to the unique profile of every patient. https://bit.ly/2BhQLYx via @MedStarWHC @jflazar
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    How We Work With You

    Every patient that receives care in our Center is unique in their anatomy and underlying condition, whether benign or malignant. The expertise of our clinicians allows us to recognize the unique profile of each patient and their overall goals to ensure excellent outcomes.

    Let’s look at how this works for a typical patient with possible lung cancer. A life-long smoker is seen in the Lung Cancer Screening Program and their CT scan detects a suspicious lung nodule. The patient is then referred to the Lung and Esophageal Center where they would meet both me, the surgeon, and Dr. Wang Memoli, the interventional pulmonologist, on the same day. We call this a multi-disciplinary visit where two specialists work together to create an individualized plan to biopsy the nodule. Any additional necessary pre-procedure testing is coordinated for the patient while they are here for their visit.

    A multi-disciplinary visit and in-person care coordination can reduce additional appointments and the time to diagnosis, allowing for more expedited treatment. Dr. Wang Memoli and I will perform the biopsy together, usually within one week of the patient’s initial clinic visit.

    If the biopsy results show cancer—and surgery is indicated—the patient has already established a rapport with me and we can proceed with scheduling the surgery, avoiding the typical two- to three-week delay between diagnosis and procedure. When the biopsy reveals later stage disease or when surgery is not the best treatment option for a patient, their case is discussed at our multi-disciplinary thoracic oncology conference and alternative treatments, such as radiation and/or chemotherapy, are promptly initiated. A weekly tumor board creates a platform for each case to be critically evaluated from multiple angles within a single discussion. Our collaboration with the Washington Cancer Institute allows for our patients to participate in cutting-edge clinical trials, when applicable.

    Our patients have been extremely satisfied with the flow and continuity of this multi-disciplinary approach. We pride ourselves on ensuring that our patients do not get lost to follow-up and our close collaboration with related specialties allows our patients to be seen and treated in a timely manner.

    Continuously Serving Patients Better

    When we work with a patient who requires a surgical procedure, a key determination is deciding when it’s time to bring a patient into the operating room. I discuss each case with my partners and frequently consult with my colleagues in radiology, gastroenterology, and medical oncology.

    With many experienced resources at hand, we develop informed recommendations about whether surgery is indicated and share our rationale with the patient. This empowers the patient to make the most educated decision about their treatment and care.

    Our staff looks forward to serving the community. We encourage patients to contact us for help in considering the options that are most likely to produce a successful outcome.

    Experienced Surgeons. Innovative Technology.

    Connect with our Lung and Esophageal Center today.

    Call 202-644-9526 or Request an Appointment

  • June 17, 2020

    By Dr. Maggie Arnold, MD, Vascular Surgeon

    Summer is just around the corner, and the warmer weather means it’s time to break out those shorts hidden in the back of your closet.

    Unfortunately, many people will be apprehensive about reaching for those shorts and showing off a little more skin due to their varicose or spider veins. But luckily there are treatments that can help get rid of them and leave you feeling more confident, especially during the hot summer months.

    An estimated 25 million people have #VaricoseVeins. Though often harmless, their appearance and uncomfortable symptoms can cause frustration. Dr. Arnold discusses causes, treatments, and more via #LiveWellHealthy blog: https://bit.ly/30Mkcwq.

    Click to Tweet

    What are varicose and spider veins?

    Both varicose and spider veins are enlarged superficial veins that most commonly develop on the legs. Varicose veins tend to be larger and described as “ropey”, whereas spider veins are smaller and look more like plant roots. Other vein qualities that are identifying factors include:

    • Bulging
    • Blue or red color
    • Starburst pattern (spider veins)

    Most varicose and spider veins are easily visible through the skin, but they’re sometimes more difficult to identify if you’re lying down or your legs are elevated. So if you’re concerned and want to check for yourself, stand up for a few minutes in the same position and then take a look. Standing and putting pressure on your legs will allow them to be more visible.

    Are they just cosmetic or something more serious?

    When most people first seek help for their varicose veins, it’s because of a cosmetic issue. However, they can cause other uncomfortable symptoms, such as:

    • Painful sores
    • Heaviness in their legs
    • Burning sensation
    • Leg cramps

    Experienced symptoms vary by patient, and some of these can also be symptoms of other serious issues, which is why it is important to see a board-certified vascular surgeon if you have concerns.

    What causes varicose and spider veins, and can they be prevented?

    While the exact cause is unknown, a contributing factor to them is excess pressure on the veins. Veins are responsible for returning blood from your feet back to your heart, but they don’t have the muscle to get that blood to your heart. Your calf muscle acts like a pump and squeezes the blood to push it up every time you step. You have valves inside of the veins that prevent the blood from moving backwards, but over time they can weaken, which causes the blood to pool. This can lead the veins to distend and the walls to weaken, which then leads to varicose veins.

    Factors that can lead to developing varicose and spider veins.

    Although anyone can develop varicose and spider veins, there are some who are more prone than others, including those that are:

    • Female
    • Pregnant
    • Overweight
    • Smokers

    Men can certainly develop varicose and spider veins, but many female patients say they got their first varicose veins after their first pregnancy. Weight gain during pregnancy, as well as being overweight, increases the pressure on the veins which leads to the formation of varicose veins.

    Ways to prevent varicose and spider veins.

    As mentioned earlier, varicose and spider veins are formed because of increased pressure on the legs and weakened vein walls. Doing little things such as wearing compression stockings, walking, and elevating your legs can help prevent them. Since being overweight is a common cause of them, watching your weight and exercising can also help prevent them from forming. Getting up and moving around rather than sitting all day is one of the best ways to decrease your chances of developing varicose and spider veins.

    But sometimes, despite doing all the right things, people still develop them. It’s frustrating, but we can help treat the ones you do have, and hope to help you prevent new ones from forming.

    Watch the video below with Dr. Arnold to learn more about varicose and spider veins.

    How do you treat varicose and spider veins?

    The first step towards treatment for varicose and spider veins is scheduling an appointment to talk with a vascular surgeon so they can determine the best treatment option for you. During this appointment, your doctor will ask you questions about your daily routine like “are you on your feet a lot?” and “do you spend a lot of time sitting at a desk?”, along with questions about symptoms. They will then take a look at your legs and evaluate your varicose or spider veins. After, they typically will order a test called a venous reflux ultrasound study, which takes a closer look at your veins to assess whether or not they’re functioning properly. It is a simple, painless test that takes about 45 minutes to complete.

    After your examination, your doctor will be able to better determine the best treatment option for you. Here are the three main types of treatment.

    1. Conservative management.

    This is usually the first line of treatment, and includes making lifestyle changes. Most of us have jobs where we spend all day sitting at a desk. Getting up and walking around is a great way to activate your calf muscle so that you return the blood back to your heart. Another thing you can do is elevate your legs for a bit on a stool or something at the office or at home. Just doing this for five minutes every hour can make a big difference to help the blood drain.

    Compression stockings are another form of conservative management, and it is something I prescribe to all my patients. They work by squeezing the vein to help the blood from pooling and prevent the wall from getting weak. While compression stockings are very effective, they won’t get rid of varicose veins, but they can help manage the symptoms.

    2. Venous closure.

    If conservative management doesn’t work, venous closure is another treatment option that is very successful. During this procedure, a small tube is inserted into the vein and heat is used to close it. This prevents blood from going into the vein that is not working properly, and forces it to go to the veins that are.

    This procedure is low-risk, done in the office, causes only minimal pain or discomfort, and patients are up and moving the same day. Most patients experience mild bruising with this form of treatment, but it typically lasts only a couple weeks.

    3. Sclerotherapy.

    Sclerotherapy is the procedure used to treat spider veins. A chemical is injected into the little spider veins, which closes off the vein. The procedure itself only takes a few minutes.

    This procedure is also a well tolerated, low-risk procedure with a fast recovery. Some patients may experience minor side effects such as bruising, swelling, and skin discoloration.

    Why is it important to see a vascular surgeon about varicose and spider veins?

    Even though a lot of providers can perform vein treatment options, it is best to see a board- certified vascular surgeon if you have concerns about your veins and are seeking treatment. As mentioned earlier, non-cosmetic symptoms of varicose veins can be signs of more serious issues, and vascular surgeons are better able to look for other problems that may be going on with your legs. What you may think is a problem your veins could be a life-threatening arterial problem. Vascular surgeons can not only diagnose that, but can also potentially treat it. They offer a full spectrum of care, and are the ones who can help you best.

    If you want to schedule an appointment with Dr. Arnold, please call her office at 443-777-1900.

    Want more information on varicose veins and available treatments?
    Click the button below.

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  • June 12, 2020
    Every day, millions of Americans experience the debilitating symptoms of irritable bowel syndrome (IBS). If you have recurrent abdominal pain at least once a day over the course of three months, you may be suffering from this chronic gastrointestinal (GI) disorder.

    It affects the large intestine, causing two major symptoms—abdominal pain/cramping and a change in bowel movement frequency or form. Other symptoms can include:

    • Abdominal bloating
    • Straining
    • Urgency with bowel movements
    • Passage of mucus
    • Sense of incomplete evacuation

    Underlying Causes

    Patients may not be aware they have IBS because several different GI issues may cause similar symptoms. It may overlap with another underlying disorder that hasn’t been diagnosed, or it may develop after an acute episode of gastroenteritis, aka, the stomach flu.

    A growing body of literature indicates that small intestinal bacterial overgrowth, or SIBO, may be a major overlapping cause of similar symptoms. Treating SIBO can actually help improve chronic underlying bowel issues.

    The disorder may also be accentuated by the gut-brain axis, meaning the nerves in the gut react to stress, depression, anxiety, and other mental stresses felt in the brain.

    Women and Younger People Are Affected Most Often

    This disorder has a 30% higher prevalence in women. And although my practice has a predominance of females with this disorder, it certainly can affect males as well.

    Also, the incidence is traditionally lower in people over the age of 50 compared with patients younger than that.

    How MedStar Health Can Help

    MedStar Health has a comprehensive approach to patients suffering from this GI disorder. We want to make sure we conduct a full history and physical exam, to identify the red flags and apply appropriate interventions or diagnostic procedures, such as a colonoscopy or endoscopy when appropriate.

    At MedStar Health, we have the ability to diagnose SIBO via an objective test called the lactulose breath test. Using the lactulose breath test, we can objectively diagnose or rule out SIBO as an underlying cause of gastro-intestinal issues and begin to treat patients appropriately.

    We have a registered dietitian as part of our team, which means that a patient who may need to go on a low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet—one that avoids complex carbohydrates and alcohols that trigger digestive symptoms—can do so under supervision and guidance. Our team also has physicians who have advanced training in diagnosing and treating inflammatory bowel disease (IBD), if that’s pinpointed as the underlying cause of a patient’s symptoms.

    Identifying Inflammatory Bowel Disease

    Generally, physicians can check for blood markers to look for inflammation, a good way to differentiate between IBS and inflammatory bowel disease.

    A stool study called the fecal calprotectin test can help with this differentiation and potentially avoid unnecessary diagnostic testing, while at the same time pointing toward the need for endoscopy, if abnormal.

    Discovering the Right Treatment Approach

    First and foremost, we look to rule out SIBO, which is increasingly identified as the cause of bloating and diarrhea in patients with irritable bowel syndrome.

    We usually treat SIBO with a non-absorbable antibiotic, meaning an antibiotic not absorbed out of the GI tract. It stays in the GI tract. We may follow that with a low-FODMAP diet for a short period of time under the guidance of our dietitian.

    The low-FODMAP diet has been shown to decrease symptoms of bloating and diarrhea in patients with SIBO and IBS. But rigorous trials of dietary manipulation in patients with the syndrome are lacking, so it’s difficult to make strong recommendations, but certainly helpful to try, especially with diagnosed SIBO.

    Identifying Anxiety and Depression

    If patients are suffering from concurrent anxiety or depression, their existing IBS may be exacerbated. Treating the anxiety or depression, in conjunction with treating the disorder both pharmacologically and with dietary manipulation, leads to a longer and more durable road of recovery.

    Diagnosing the Disorder: What to Expect

    No one specific test can diagnose this syndrome. Physicians may take an extremely detailed medical history and perform a thorough physical exam. The point of the physical exam and diagnostic testing is to make sure another disease isn’t causing similar symptoms—for example, celiac disease, IBD, microscopic colitis, or lactose intolerance.

    Generally, physicians can check blood markers to look for inflammation, a good way to differentiate between the disorder and inflammatory bowel disease. If symptoms began after an episode of gastroenteritis, the physician may sample the fecal matter to ensure there’s no lingering infection.

    The syndrome may not be very apparent from the physical exam, but your doctor may ask if you’re experiencing additional symptoms that may occur concurrently with the disorder and affect your quality of life:

    • Fatigue
    • Brain fog
    • Headaches

    Because patients with the syndrome may also have a higher prevalence of other functional diseases, your doctor may also ask you about your experience with:

    • Fibromyalgia
    • Chronic fatigue syndrome
    • Functional dyspepsia
    • Non-cardiac chest pain

    Therapies to Relieve Symptoms

    For constipation

    Certain FDA-approved drugs may help with constipation associated with this disorder. If a patient has constipation, we can prescribe linaclotide (brand name LINZESS®) or lubiprostone (brand name AMITIZA®). If a patient has pain as a major symptom, we can use an antispasmodic or a neuromodulator.

    For diarrhea

    An FDA-approved medication called eluxadoline (brand name VIBERZI®) can be helpful for diarrhea. Approaches such as using purified peppermint oil granules (brand name IBGard®) and other products that contain peppermint that are naturally antispasmodic can also be helpful.

    Exercise has a huge role in treating diarrhea. Moderate-level exercise, yoga, meditation, and acupuncture can all help patients via the mind-body connection.

    For associated urgent symptoms

    Natural therapies such as caraway seed oil, menthol, and ginger supplements may help if patients have concurrent nausea.

    Lifestyle changes can help

    Patients can take steps to work with their doctors in managing IBS, including:

    • Use of some prebiotics and probiotics
    • Avoiding foods with preservatives and additives
    • Adhering to a natural and clean diet
    • Staying away from foods loaded with sugar because high sugar content tends to cause a lot of bloating, diarrhea, and pain
    • Incorporating at least low- to moderate-intensity exercise into their daily routine
    • Practicing mindfulness to tackle the subconscious

    Also, I would advise patients to find a gastroenterologist they truly connect with. Mutual trust and respect can go a long way to help patients with irritable bowel syndrome and improve their quality of life.

  • June 12, 2020

    By Rebecca Schwender, PT, DPT, Clinic Coordinator

    As many of us are spending our days at home, finding new ways to exercise is increasingly important, especially with gyms and fitness centers being closed. Running is a great option for staying physically fit and healthy. It requires no equipment, and can be easily done while following physical distancing guidelines. Running is also a great way to get outside, get some fresh air, and enhance your mental well-being during this difficult time.

    With gyms closing due to #COVID-19, many people are starting to run as a way to stay fit. Whether you are an experienced or new runner, here are 7 tips from physical therapists to prevent injuries while running via #LiveWellHealthy blog: https://bit.ly/3cQKhgc.

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    If you’re interested in running, but haven’t been a runner in the past, don’t let that stop you. We’ve outlined some easy recommendations to get you started, while avoiding potential injury.

    7 tips to prevent getting injured while running.

    As with any new fitness routine, make sure that you have no underlying medical conditions that would make starting a new running routine unsafe. If you have any questions, consult your medical professional.

    1. Wear proper footwear.

    A safe and effective run starts with the appropriate footwear. Find yourself a pair of running shoes that fit well. Your shoes should provide you with enough stability and cushion to complete your training session comfortably.

    2. Warm-up before you run.

    You want to actively stretch muscles you will use while running, while also getting your heart and lungs pumping. A dynamic warm-up is a great way to accomplish this. Try butt kickers, high knees, skips, side lunges, and hip swings.

    Watch the videos below for demonstrations of possible warm-ups.

    Butt kickers:

    Skips:

    Side lunges:

    3. Start with run-walk intervals.

    If you are just starting out with running, a run-walk program is a great way to begin your training. As you become more conditioned, you can increase your running workout intensity by either increasing your run interval, decreasing your walk interval, or increasing total session time as tolerated. Try starting with a one-minute run followed by a two-minute walk. Repeat the intervals five times for a great 15-minute workout.

    4. Stretch post run.

    Stretching after a run is just as important, if not more important as before your run. Post-run stretching can help improve and maintain muscle flexibility as well as reduce muscle soreness post-workout. Below are a few key stretches to include in your routine:

    • Hamstring stretch
    • Calf stretch
    • Quadriceps stretch
    • Piriformis stretch
    • Hip flexors stretch
    • Three-way child’s pose

    Perform all of these stretches for a minimum of 30 seconds each.

    5. Progress gradually.

    When increasing distance or duration, follow the 10% rule. The total distance or time of your workout should increase by no more than 10% per week to avoid potential overuse injury. Also, be gradual as you work in other changing variables to your program, such as increased speed and different terrain, like running hills or trails instead of flat ground.

    6. Rest and recover.

    Whenever beginning any new fitness routine, your body will require recovery time. Allow your muscles to recover from the new stress. Begin by running every third day to see how your body responds to these new physical demands. Progress to running every other day until you feel comfortable running on consecutive days —this may take several weeks. Try taking an easy 15 minute walk on your recovery days to help with muscle soreness.

    7. Know the difference between soreness and pain.

    Muscle soreness and fatigue are normal responses to any new activity, pain is not. Muscle soreness can last for 24-48 hours after exercise, and you should modify your training program accordingly. If you are having pain, hold off on additional running until you can consult with a medical provider.

    If you are experiencing pain related to running, you can call 888-44-SPORT (888-447-7678) to schedule an appointment with one of our many MedStar Health sports medicine physicians or physical therapists.

    Want to learn more about physical therapy services at MedStar Health?

    Click here.

  • June 10, 2020

    By Zayd A. Eldadah, MD, PhD, Director of Cardiac Electrophysiology, MedStar Heart & Vascular Institute

    A steady, rhythmic heartbeat in you or someone you love may be the most reassuring sound on earth. Yet some people experience a heart rhythm that is occasionally too fast, too slow, or irregular—for no apparent reason. Any of these symptoms may indicate atrial fibrillation (or AFib), the most common abnormal heart rhythm in adults.

    This blog focuses on this condition, which—because of its widespread prevalence—is one we treat daily at the MedStar Heart & Vascular Institute. While the majority of Afib patients are older (70 years and up), we also see patients in their 40s, 50s, and 60s with this arrhythmia. Indeed, the primary driver of AFib is advancing age, and by the time we’re 80, about 15–20% of us will have this rhythm disorder.

    What Causes Heart Palpitations?

    The heart is an exquisite muscle that collects oxygen-depleted blood from the body, pumps it to the lungs for a refill, then propels this freshly aerated, life-giving blood back to our organs and tissues. Orderly flow of electricity though the heart muscle generates this squeezing sequence, a perfect choreography of electrical flow and mechanical contraction that emerges in the earliest weeks of life within the womb and continues until our last breath.

    AFib is an electrical “hijacking” of this process, rendering the organized and regular flow of electricity through the heart completely chaotic. While the pulse in these patients may be rapid, slow, or even within the normal range, it becomes irregular. The result is a heartbeat that resembles an engine that suddenly starts knocking because its pistons are firing out of sequence. In some people, this inefficient heart pumping may be barely noticeable, while in others, it can be debilitating.

    Did you know that atrial fibrillation can cause your heart to flutter, beat too fast, or beat too slow? Learn more from Zayd Eldadah, MD, PhD. https://bit.ly/3cNYaf4 via @MedStarWHC
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    Symptoms and Timing

    Severe presentations of Afib can make patients feel very tired, even with minimal activity. Other symptoms may include lightheadedness, dizziness, shortness of breath, and a sensation of heart racing or “flip-flopping.” In milder cases, any of these symptoms may be present but not as severe. Patients may even just feel a generalized malaise. And in some lucky patients, there may not be any symptoms at all. They may have atrial fibrillation that progresses to being permanent without ever noticing anything wrong.

    For some individuals, symptoms during the day are more common—for instance, during physical exertion. In others, symptoms emerge at night, when the body is less active and the heart rate is slower.

    Two Types of Afib

    The combination of aging and an individual’s genetics underlies the most common type, known as Primary Afib, because no discrete, reversible cause for the rhythm disturbance can be identified. As noted, about 15–20% of people will experience Primary Afib by the time they’re 80 years old.

    Then there’s “Secondary Afib,” meaning the heart reacts to a trigger, such as an external insult. Once that provocation fades, so too does the Afib. Some examples of insults to the heart that can cause secondary Afib include alcohol intoxication, high fevers, extreme exhaustion, and too much caffeine. Other temporary conditions like a pulmonary embolus or chest surgery of any kind can also cause atrial fibrillation because the heart can become inflamed or irritated.

    Be Aware of the Risk of Stroke

    The single most severe risk of Afib is stroke. Patients with Afib are five times more likely to have a stroke than patients without it. Stroke is no joke. It can be debilitating and even deadly. Stroke is defined as the death of brain tissue that can result when a blood clot forms in the heart, breaks free, then lodges in a brain blood vessel, stopping the vital flow of oxygen and nutrients to brain cells. If the damage is small, mild symptoms, like weakness or minor visual loss, might occur.

    But if the tissue damage is extensive, symptoms could be extremely serious, such as permanent blindness, paralysis, or even death. If the blood vessel blockage is temporary and resolves on its own (for instance, a small blood clot that travels to the brain then dissolves after a short period of blood vessel blockage), the condition is called a transient ischemic attack (TIA). In TIAs, brain tissue is injured but recovers, and the symptoms may be mild, for example, brief visual loss or speech slurring that gets better.

    Strokes caused by AFib are twice as likely to kill patients and twice as likely to cripple them than strokes caused by other conditions. At MedStar Heart & Vascular Institute, our priority is our patients’ safety above all else. This compels us to put our full attention and effort into diagnosing atrial fibrillation in patients who may have it—and protecting them.

    A Message for the Community

    Our message is simple. Afib is serious, but it does not have to be scary. The body undergoes many changes as it ages, and an increasing risk of Afib is one of them. As our population gets older, more of us will develop it, so it is important that we be aware and ready, not upset or alarmed.

    We ask that you recognize possible signs—an irregular pulse, feeling unusual fluttering within your chest, having noticeable reduction in your energy or ability to exert yourself physically. These should be addressed promptly by a healthcare team that you trust. If you witness or experience any signs of brain symptoms like sudden visual or speech changes, that is a medical emergency that requires an immediate call to 911.

    Diagnosing and Dealing with Atrial Fibrillation

    We now have many tools to detect atrial fibrillation, even if it happens infrequently, and to assess symptoms and risks, then treat patients accordingly. If changes to your heart rhythm or unusual symptoms like those described above develop, please see your doctor right away. Like so many conditions, this one is better managed the earlier it is addressed.

    Our practitioners at MedStar Washington Hospital Center—whether primary care or internal medicine doctors, cardiologists, or heart rhythm specialists—are experts at dealing with heart rhythm disorders. Together, we’ll use the best tools, techniques, and scientific evidence to tailor our approach to the individual needs and risks of each of our patients. And we commit to follow the best science, practice with the best ethics, and deliver care with the greatest compassion.

    Erratic heartbeat?

    Talk with a specialist.

    Call 202-644-9526 or  Request an Appointment

  • June 10, 2020

    By Dr. Shweta Kurian, MD

    When you’ve been diagnosed with cancer, a second opinion can give you the information you need to make the best decisions about your cancer treatment. And, when you get a second opinion using video visits, you can consult a cancer expert from the safety and comfort of your home.

    Getting a second opinion ensures you receive the most accurate diagnosis and advanced treatment plan.

    Whether you’ve been diagnosed with a common or complex type of cancer, an accurate diagnosis is essential to getting the most effective treatment. That’s why it’s important to ask an additional cancer specialist to review your case and offer recommendations.

    A second opinion can confirm your initial diagnosis and assure you that you’re receiving the most up-to-date information about your cancer type and stage. In other cases, a second opinion can reveal additional treatment options that may not be available elsewhere.

    If you’ve been diagnosed with cancer, getting a second opinion via video can confirm you’re taking the right next steps—or reveal other treatment options—from the safety and comfort of your home. Oncologist Dr. Kurian shares how via the #LiveWellHealthy blog: https://bit.ly/3dQxdsD.

    Click to Tweet

     

    A second opinion is especially important if you are:

    • Diagnosed with a rare or unusual cancer.
    • Required to get a second opinion for insurance purposes.
    • Interested in clinical trials or alternative therapies.
    • Curious about other oncologists and cancer centers that specialize in treating your cancer type.
    • Seeking confirmation and peace of mind about your treatment plan.
    • Uncertain about your options.

    Video visits offer compassionate and comprehensive cancer care without environmental risks.

    Because cancer can negatively impact your immune system, it’s important to minimize your exposure to COVID-19 and other infections. At MedStar Health, our cancer teams are working diligently to offer the same safe and high-quality care as before coronavirus affected our communities. However, there are many benefits for patients who want to get a second opinion using video visits, including:

    • Convenient access to cancer specialists without the stress, time, and costs associated with travel.
    • Peace of mind about your diagnosis and treatment while reducing your risk of exposure to harmful infections.
    • Personalized care from the comfort of your home where you may be most relaxed and surrounded by loved ones.
    • Comprehensive answers about your unique cancer type, stage, and treatment options within a short time-frame.
    • Emotional support from friends and family who can participate in the appointment with you virtually.

    A video visit is similar to getting a second opinion in the office but instead of traveling to the appointment, you can see and talk to your oncologist from home via video. Before the visit, your current doctor will send any scans, biopsies, and lab work ahead of time so that the specialist providing the second opinion can review your case.

    At MedStar Health, each cancer case is reviewed by a tumor board. That means that a team of medical, surgical, and radiation oncologists meet to discuss a coordinated treatment plan based on your unique needs. This ensures you get comprehensive and coordinated care throughout your entire fight against cancer. During your second opinion video visit, an oncologist will walk you through the tumor board’s recommendations, including your treatment options, and they’ll answer any questions you have.

    Here’s what you need to know to get a second opinion using video visits.

    The best time to get a second opinion. 

    When you need a second opinion, time is of the essence. Depending on the severity of your cancer stage, you may need to start treatment right away. And, some therapies may need to begin within a certain time frame. However, in most cases, you have enough time to get a second opinion—and your doctor will probably encourage you to.

    Still, the best time to get a second opinion using video visit is as soon as you can after receiving your initial diagnosis. When you’re looking for a second opinion, it’s best to choose a doctor or cancer center who can review your case within a few days. Talk to your doctor about how much time is appropriate to delay treatment while you seek a second opinion for your situation.

    What to look for when seeking a second opinion.

    When you choose the right doctor for a second opinion, you can confidently make educated decisions about your care. Your current doctor may recommend other cancer experts who you can trust to provide a thorough second opinion. Or, you may want to do your own research on other oncologists you find online or through word-of-mouth.

    Here are a few things you should look for when you’re deciding where to get a second opinion.

    • What are their areas of expertise? Do they specialize in the type of cancer you have?
    • What are their credentials? Are they board-certified?
    • What are their outcomes for past patients?
    • What are their patient ratings?
    • Where do they work? What kind of cancer support services do they offer?
    • Do they offer clinical trials or other advanced treatment options that may be hard to find elsewhere?
    • How easy is it to schedule an appointment?

    How to prepare for a second opinion via video visit.

    You can get the most out of your video visit by preparing ahead of time. Before your second-opinion consultation, you should:

    • Check that your current doctor sent over all copies of all medical records, lab results, scans, biopsies, and any other relevant information.
    • Provide a summary of any current medications to the new doctor.
    • Write down any questions you have for the new doctor, such as:
      • Are there additional tests you think I need?
      • What treatment do you recommend?
      • Are there other treatments I should consider, such as clinical trials?
      • What are the risks and/or side effects of the recommended treatment?
      • What is the goal of the recommended treatment?
    • Ensure you have access to a phone, laptop, or computer with a camera and microphone, as well as a strong internet connection.

    You may also want to consider asking a family member or friend to join the video visit for support. When your loved ones attend virtually, they can help you process the information and encourage you as you make decisions throughout your journey to and through recovery.

    How to schedule a second opinion using video visits.

    In most cases, your video visit is covered by insurance. And, it’s easy and fast to schedule an appointment for a second opinion using video.

    1. Call the office to schedule your appointment.
    2. The office will walk you through the process of sending over copies of your health records and necessary information.
    3. You’ll receive a link via email or text message when it’s time for your appointment.
    4. Click on the link to open up the secure video visit app using your smartphone, tablet, or computer.

    Don’t let uncertainty about the pandemic delay your choice to get a second opinion. Our cancer team is here to help you feel assured and equipped to make informed decisions about your cancer care.

    Contact us today to schedule your second opinion consultation.
    Click the below for more information.

    MedStar Health Cancer Network

    MedStar Health Video Visits