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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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  • March 26, 2019

    By Jennifer Ayscue, MD

    The techniques used to diagnose and treat colorectal cancer have become better each and every year—in fact, many of them didn’t exist or were in early research stages 10 to 20 years ago. As a result, we’re able to diagnose smaller lesions at earlier stages resulting in superior treatments.

    Colorectal cancer is a common disease that’s expected to affect about 146,000 Americans in 2019 and occurs when the inner lining of the colon or rectum develops abnormal cells. The most common symptoms that I see in patients with colorectal cancer include:

    • Abdominal pain or rectal pain
    • Constant urge to use the bathroom
    • Mucus, sometimes mixed with blood
    • Persistent change in bowel habits, usually lasting more than a few days
    • Rectal bleeding

    For a number of years, we’ve noticed colorectal cancer rates decrease, likely because of the increase in people undergoing colorectal cancer screenings. However, as overall rates have gone down, the number of cancers diagnosed in young people—from their 20s to 40s—has risen. We’re not entirely sure why this is, but it might have something to do with increasing rates of:

    • Drinking alcohol (especially in men)
    • Eating processed food and red meats
    • Obesity
    • Sedentary lifestyles
    • Smoking

    LISTEN: Dr. Ayscue discusses common techniques to diagnose and treat colorectal cancer in the Medical Intel podcast.

    How We Diagnose Colorectal Cancer

    We typically diagnose colorectal cancer through fecal tests or a virtual colonoscopy. Fecal tests can include a:

    • Fecal occult blood test: This test checks for blood in the stool that’s typically not visible to the naked eye, which can suggest the presence of polyps or cancer. Fecal occult blood tests require some dietary restrictions and multiple stool samples, are relatively affordable, and only are performed annually. Some polyps and cancers are difficult to detect using this method, however, compared to other methods.
    • Fecal immunochemical test (FIT): The FIT test screens for blood that comes from the rectum and colon. It’s offered for free through our community program for patients who qualify in certain wards in D.C. And it’s usually covered by insurance for those who do have insurance. The only downside of the FIT test is that it’s not great for smaller polyps.
    • Fecal DNA test: This tests for both blood and fecal DNA, is able to detect over 90 percent of colorectal cancer, and can identify more polyps than the FIT test can. One thing to keep in mind is the fecal DNA test, which only is required every three years, is more expensive than other fecal tests if it isn't covered by insurance.

    A virtual colonoscopy uses a computerized tomographic (CT) scan to generate images of the colon in the hopes of spotting polyps. A virtual colonoscopy is recommended every five years, can spot up to 94 percent of larger polyps and cancer, and generally requires a bowel prep similar to colonoscopy.

    If any of these minimally or less invasive tests are positive, then the patient must undergo a video colonoscopy so that lesions can be biopsied—tested for abnormal tissue or cancer—and possibly removed. A colonoscopy is performed with a small flexible tube called a colonoscope that’s passed through the rectum and into the last part of the small intestine. Using video technology and advanced endoscopic equipment, we both take tissue samples and remove polyps whenever possible.

    How We Treat Colorectal Cancer

    We typically treat colorectal cancer through minimally invasive techniques, such as laparoscopic surgery, where we remove colon or rectal cancer by placing instruments into the abdomen and then remove the colon through a relatively small incision. In some cases, radiation or chemotherapy is used before or after surgery to treat any possible cancer cells that might have been left behind because they were too small to see.

    Additionally, we can use robotic techniques in which the instruments are connected to robotic arms that are controlled by a surgeon, allowing them to have even finer control of the instruments and tissues and get into spaces that otherwise wouldn’t be reached as well.

    Treatment for #colorectalcancer typically involves surgery that rids the cancer by removing part of the colon or rectum. Learn how #roboticsurgery can help this operation. https://bit.ly/2OsN44o via @MedStarWHC

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    Recovery typically involves staying at the hospital for one to four days after surgery, and most patients use non-narcotic pain medications only while in the hospital. People typically are on their feet and can eat within a day of surgery.

    A Success Story

    We saw one woman in her mid-50s who received a FIT test that came back positive. As a result, we did a colonoscopy and identified and removed several polyps. We then performed a robot-assisted colon resection to remove one large polyp that couldn’t be removed with the colonoscope, and this ended up containing precancerous cells. She did well and was home within three days. Had this patient waited another year or two to get screened, she might have had cancer that required more intensive treatment.

    Why It’s Important to Get Screened Early

    In 2018, the American Cancer Society released new colonoscopy recommendations that adults with average colorectal cancer risk should begin getting colonoscopies at 45 instead of 50, due to the trend we’re seeing of younger people developing colorectal cancer.

    If people get screened before they experience any symptoms, we’re more likely to be able to remove any polyps we find, helping prevent cancer from forming. And if we do find a cancer, it’s more likely to be in an early stage—meaning that it’s more curable.

    Expert Care at MedStar Washington Hospital Center

    We focus on treating colorectal cancer at MedStar Washington Hospital Center, and it starts with our robust screening program in which a nurse navigator helps ensure you receive the right screening. We also have a strong team of gastroenterologists, surgeons, radiologists, and, if needed, cancer treatment doctors who all are dedicated to preventing and treating colorectal cancer with the latest techniques.

    Treating colorectal cancer today is much easier than it was years ago. Make sure you receive screenings when they’re recommended to ensure the best possible outcomes.

    Are you due for your colonoscopy? Call 202-877-3627 or click below to request an appointment with a gastroenterologist or colorectal surgeon.

    Request an Appointment

  • March 21, 2019

    By Taryn E. Travis, MD

    When someone comes into the emergency department (ED) with major burns over a large area of their body, it’s obvious that they need immediate medical attention. However, smoke inhalation—though less obvious to detect—is just as dangerous.

    People who breathe in smoke during a fire can have life-threatening consequences even if they have no other injuries. As the National Fire Protection Association notes, twice as many people die from smoke inhalation in fires than from burns. Fortunately, people who live in the D.C. area can turn to the specialists at our regional Burn Center, the only adult burn treatment facility in the Washington metropolitan area, for quick recognition and treatment of smoke inhalation.

    #Smokeinhalation in fires kills twice as many people as #burns, according to @NFPA. If you’re ever in a fire, get out right away to save your life. https://bit.ly/2WhKuBk via @MedStarWHC

    Click to Tweet

    Who’s at Risk for Smoke Inhalation?

    A typical patient with smoke inhalation is someone who’s been trapped in a closed-space fire, such as in a home or vehicle fire. Fire consumes oxygen for fuel, and as a fire grows, less oxygen is left for the person to breathe.

    Along with inhaling smoky air, the patient may breathe in harmful, noxious chemicals from items burned in the fire’s path, such as carpet, curtains, and furniture. Some of the many chemicals that can be found in the smoke of a house fire include:

    • Ammonia
    • Carbon monoxide
    • Chlorine
    • Hydrogen chloride
    • Hydrogen cyanide
    • Hydrogen sulfide
    • Sulfur dioxide

    This poisonous smoke can make the victim feel lightheaded, dizzy, or disoriented, making it harder for them to escape. If a person faints or falls unconscious, they will continue to breathe in the harmful smoke, which only compounds its effects. If you are ever in a fire, make every effort to get out right away. Even if you are not close to the flames, the smoke can cause serious or even fatal injuries on its own.

    How Smoke Inhalation Affects the Body

    The poisonous chemicals in smoke can damage a person’s airway and lungs, as well as reduce the amount of oxygen available to the body. A person may develop carbon monoxide poisoning, cyanide poisoning, or complications of exposure to another harmful chemicals from the smoke.

    Smoke inhalation’s symptoms aren’t as obvious as those of a major burn, so many people think they are fine as long as they get out of a house fire before suffering skin injury. Unfortunately, smoke inhalation injuries, while not typically visible, can still be fatal without expert diagnosis and treatment. There are a number of symptoms we advise patients to watch for after they’ve been exposed to smoke in an enclosed space. These include:

    • Changes in skin color (pale, bluish, or reddened skin)
    • Chest pain
    • Cough
    • Confusion or fainting
    • Headache
    • Irritated eyes
    • Nausea or vomiting
    • Noisy breathing or hoarse voice
    • Shortness of breath

    People who have heart failure, arrhythmia, or other forms of heart disease are especially at risk from smoke inhalation. Their lungs are put under greater stress from lack of oxygen, which also strains the heart and could even trigger a heart attack. But even otherwise healthy people can develop heart-related complications from smoke inhalation due to the lack of oxygen being supplied to the body.

    Diagnosing and Treating Smoke Inhalation

    During the past decade, we have realized that patients with smoke inhalation benefit from being taken care of by burn specialists who are experienced in dealing with the effects of fire and smoke.

    When someone who could have smoke inhalation comes into the Burn Center, our first step is to supplement the oxygen they are breathing. We often examine a patient’s airway with a scope to look for internal evidence of smoke injuries. If a patient has evidence of this type of injury, a chest X-ray and blood tests are common to determine whether:

    • They have been poisoned from chemicals in household smoke
    • Their oxygen levels are too low
    • Their lungs, heart, or kidneys have been injured from lack of oxygen

    Our top priority for any patient with smoke inhalation is to open their airway as soon as possible. If the airway is swollen or damaged, we might need to place a tube down the patient’s throat to allow oxygen to enter the lungs. This procedure is called intubation. We also can provide medications to relax the lungs and widen the airways.

    Next, we focus on raising the patient’s oxygen levels. The most common way we do this is through supplemental oxygen, either through a mask over the patient’s nose and mouth or through a tube called a nasal cannula that sends oxygen through the patient’s nostrils. If the patient is having trouble getting oxygen throughout their body, we can provide medications to neutralize chemicals they have inhaled.

    Smoke inhalation injury might not be as obvious as a major burn. If you have been in an enclosed-space fire and have any of the symptoms of smoke inhalation, get help fast to prevent serious injury or death from this often silent fire risk.

    Call 202-877-3627 or click below to make an appointment with a burn specialist.

    Request an Appointment

  • March 20, 2019

    By MedStar Health

    Millions of people have a loved one with Alzheimer’s disease or another type of dementia. As the disease progresses, many choose to become caregivers. This can be deeply rewarding, but it is a challenging journey for all involved.

    Sometimes the most significant challenge caregivers face is finding time to care for themselves. Caregivers may put their loved one’s needs first and neglect essential parts of their lives, such as their:

    • Diet
    • Exercise
    • Health conditions
    • Sleep
    • Social lives

    There is never enough time, but you cannot give the best care unless you also take care of yourself.

    At the Center for Successful Aging at MedStar Good Samaritan Hospital, we work with people with dementia and their caregivers to try to find the balance. Read on for some recommendations.

    Caring for a loved one with #Dementia can be a challenging but rewarding task. Learn tips to take better care of your loved one and yourself via @MedStarHealth #LiveWellHealthy

    Click to Tweet

    1. Don’t Argue, Redirect

    Your loved one may experience something or believe something that is not true–it is tempting to try to reason with them, to explain it to them again and again. Many times, it is better to just agree and change the subject. Even if you convince them, many times they will not remember, and you will have to convince them again and again, creating frustration for everyone.

    1. Reach Out to Family and Friends for Help

    Depending on how severe your loved one’s dementia is, it can be challenging to find time to step out of the house for a workout, to go shopping, or even for some alone time. Asking your family and friends for help is essential. Any time family and friends can spend time with your loved one—even if it’s just for an hour or two—can make a big difference in your life. If you’re short on family and friends who can help, consider asking people from your church or other social groups or in your community.

    1. Use a Supportive Tone When Speaking to Your Loved One

    A person with dementia may not understand everything you tell them, but they will feel and recognize the emotions you express. Even if you feel angry or frustrated, try to keep your tone neutral or positive. If you cannot stay calm, it is often better to walk away than to yell. When your loved one tells you they don’t want to take medications or get dressed, resist the urge to argue or yell. Instead, just walk away, return in five minutes, and try again. You may find things go better the second or third time around.

    1. Implement Routines

    People with dementia may find new activities and unfamiliar environments stressful. Keeping a daily routine can make things easier for caregivers and their loved ones. Since Alzheimer’s typically affects short-term memory first, remembering a routine can be effective well into the middle stages of Alzheimer’s. Additionally, the sleep cycle can often be affected by dementia–bright light and stimulation throughout the day followed by a consistent bedtime routine can help reduce sundowning and behavioral problems.

    1. Seek Advice for Problem Behaviors

    Behavioral problems can occur as part of dementia. We often provide caregivers with strategies and resources to help them address them. Understanding triggers for the behaviors and the times and situations in which they occur can lead to strategies to reduce the number of episodes. Sometimes medications can be helpful as well. Speak to a medical professional or seek advice from an advocacy group such as the Alzheimer’s Association. Many people have likely struggled with the same issues and have discovered some helpful strategies–seek them out.

    1. Join a Support Group

    Support groups offer you the opportunity to meet people who are going through similar situations. They provide emotional support and validation, and often people learn how to cope with the day to day challenges of caring for someone with dementia. Learn about our Alzheimer’s and related dementia support groups.

    You Tell Us: Have you ever joined a support group related to caring for people with Alzheimer's and related dementia? Tell us about it on Twitter or Facebook using the hashtag #LiveWellHealthy.

    Is There Anyone Who Can Help?

    Caring for someone with dementia can become overwhelming. Fortunately, there is some support available through various organizations and local and state programs. A social worker with experience in dementia care can help you determine if your loved one qualifies for certain services. Paid help is also available in several forms. Seek advice from a social worker or your local Area Agency on Aging.

    If your loved one needs more support than you can provide, other options may exist in your community, such as memory care, assisted living, or a nursing facility.

    Are you looking for care or support services for a loved one with Alzheimer’s disease or dementia? Click below to find out more about the Center for Successful Aging.

    Learn More

  • March 19, 2019

    The popularity of vaping continues to soar. From 2017 to 2018, vaping increased by nearly 80 percent among high schoolers and 50 percent among middle schoolers. And while the implications vaping has on people’s lungs are well documented, the effects it can have on dental health are less known.

    Vaping is done through devices such as the Juul and Cig-A-Likes and contains nicotine, just like cigarettes. In fact, a JuulPod, which often lasts between four and six days, contains about 20 cigarettes worth of nicotine.

    More than 7,000 types of vaping flavors exist, most of which were developed for the food industry—not vaping. While we are aware of potential short-term implications of vaping, the 20- to 30-year health implications are less clear.

    LISTEN: Dr. Giurintano discusses vaping and dental health in the Medical Intel podcast.

    Top Health Concerns of Vaping

    The most common dental health implications we see with vaping are irritation of the oral mucosa and higher rates of overgrowth of a fungus called Candida albicans. The overgrowth of this fungus can result in oral thrush, an infection in the mouth that requires treatment with anti-fungal medication.

    Additionally, the vape substances that carry nicotine also usually contain glycerin and propylene glycol. While these chemicals aren’t dangerous in and of themselves, they can cause:

    • Potentially cancer-causing molecules to be released into the body when you vaporize them
    • Irritation in the upper aerodigestive tract, which includes the inside of the mouth, lips, nose, esophagus, and windpipe
    • Severe inflammation of the bronchi and lungs

    Many people who vape also transition to smoking cigarettes for the nicotine. As a result, they face the long-term complications of smoking cigarettes, which include:

    • Lung cancer
    • Oral cancer
    • Periodontal disease, or a severe gum infection
    • Laryngeal (voice box) cancer

    Is Vaping Better Than Smoking Cigarettes?

    While we are still early in the process regarding research into the long-term implications of vaping, the short-term effects and lack of knowledge are enough for people to avoid it. In fact, the American Head & Neck Society says that the lack of clear scientific evidence regarding the safety and effectiveness of vaping leads the organization to not endorse using e-cigarettes as a safer alternative to cigarettes.

    While research is ongoing, we know enough now to not recommend #vaping as safe alternative to #smoking, says Dr. Jonathan Giurintano. https://bit.ly/2W7NtMo via @MedStarWHC

    Click to Tweet

    Vaping also presents secondhand smoke concerns. Studies have shown that e-cigarettes are not emission-free, as ultrafine particles formed from the vapor from e-cigarettes can be deposited into the lung. While we need more research to conclude the long-term effects of this, it is likely that being around the vapor from e-cigarettes could have negative effects on the lungs.

    Get Help to Quit Vaping

    To help people quit vaping—and smoking cigarettes—we offer smoking cessation programs that provides adults counseling, support, and the encouragement needed to quit. Please speak to your doctor for more information on enrolling in these programs.

    The Food and Drug Administration (FDA) only began regulating the e-cigarette industry in 2016. While vaping is regularly advertised as harmless, it is important that people both understand the effects it can have on our health and be on the lookout for what future research might reveal.

    To request an appointment with an otolaryngologist, call 202-877-3627 or click below.

    Request an Appointment

  • March 15, 2019

    By MedStar Health

    Patients often ask us, “Why do I cough?” or wonder when a cough should require medical attention. Truth is, if you have existing medical conditions or have been coughing for many weeks, it might be time to see a doctor.

    We typically use one of three categories to describe a cough, depending on how long it lasts:

    • Acute: Less than three weeks
    • Subacute: Between three and eight weeks
    • Chronic: More than eight weeks

    We see people all the time who visit the hospital with coughs in all three categories. In most cases, we can determine the reason for their cough based on their symptoms, examination, and imaging tests, such as an X-ray, if necessary. Let’s discuss common causes of a cough and what treatment options exist.

    When to See a Doctor for a Cough

    As a general rule, you should see a doctor if you’ve had a cough for more than eight weeks. Prolonged coughing for that amount of time could be a sign of conditions such as post-nasal drip, acid reflux, or a side effect from certain high blood pressure medications. This could also be a sign of an underlying lung infection.

    Could your #Cough be a symptom of a simple viral infection or is it something more serious? Jasmeet Bhogal, MD, explains more and shares when you should see a doctor in @MedStarHealth’s #LiveWellHealthy blog.
    Click to Tweet

    Additionally, we typically suggest that you see a doctor if you have chest pain along with your cough, as there’s a chance you’ve suffered a rib fracture due to prolonged coughing. Other symptoms that you might experience with a cough that could signify an underlying condition, such as pneumonia, bronchitis, and more, include:

    • Body aches
    • Coughing up blood
    • Difficulty breathing
    • Dizziness
    • Fatigue
    • Headaches

    For someone with an existing condition such as asthma or chronic obstructive pulmonary disease (COPD), a persistent cough or a change from the normal pattern of their cough could signify an acute worsening of their existing condition.

    In more serious cases, if you’ve previously had a “smoker’s cough,” which is common in long-term smokers, and you are experiencing a new coughing pattern or a cough that’s worsening with additional symptoms, it might be a sign of a much serious condition such as lung cancer.

    Effective Cough Treatments

    If you have a cough due to a basic viral infection—which usually goes away on its own within a week or two—we typically recommend over-the-counter cough remedies to help relieve your symptoms, such as Guaifenesin, which you can purchase at local stores. Simple at-home treatment options can also be effective, such as:

    • Avoiding certain irritants: Pet and seasonal allergies can cause some individuals to develop a cough.
    • Consuming honey: This can help soothe some coughs. Do not give honey to babies less than one year old.
    • Having warm drinks: Fresh tea or warm water can help soothe the throat.
    • Staying hydrated: We recommend drinking between a half-gallon and gallon of water each day.

    For more severe coughs, prescription medications can be prescribed. Furthermore, if you are diagnosed with a more serious condition, a variety of treatment options exist, including antibiotics. Like with most conditions, the sooner you are treated, the better your outcome will likely be. Make sure to speak to your doctor to learn which treatments might be best for you.

    Coughs in Children

    If you have children, there’s a good chance they have had a cough. In most cases, the cough is because of a simple viral infection that goes away on its own in a week or so. However, it’s important to be sure they aren’t experiencing any symptoms that they can’t communicate to us, such as chest pain or shortness of breath, which can be a sign of croup, an upper-airway infection that blocks breathing and causes children to have a cough that sounds like a dog’s bark.

    You can check for these symptoms by examining your child’s chest and ensuring they’re inhaling and exhaling normally. If they’re not, they need to be seen by a doctor right away.

    While a cough often seems like an everyday illness, it’s important to keep in mind when medical attention is likely necessary.

    Have you or a loved been coughing for a prolonged period of time? Consider getting medical attention at a MedStar Health Urgent Care location near you. Click below to learn more about their services, check in online, and find out which of their 14 locations is closest to you.

    Learn More

     
  • March 14, 2019

    By Edward F. Aulisi, MD

    The pituitary gland is about the size of a pea, and it’s located behind the eyes and the bridge of the nose on the bottom side of the brain. Though it’s tiny, it can cause huge problems if a tumor develops there.

    When someone finds out that they have a pituitary tumor, their first reaction usually is one of fear or worry. They might wonder, “What’s going to happen to me? Where do I go to get help?” At other centers, answering these questions can be a challenge. It’s often difficult to navigate complex routes of testing, diagnosis, and treatment for pituitary tumors.

    But it’s different for patients at the MedStar Pituitary Center at MedStar Washington Hospital Center. Our center brings together pituitary specialists with a single goal: giving patients expert care for pituitary tumors, including surgery, if needed. And our dedicated team produces results:

    • Less than five percent of our pituitary surgery patients need hormone replacement therapy after surgery, compared to 15 to 20 percent at other centers
    • The typical rate of pituitary tumors recurring, or coming back after surgery, is less than 15 percent, but ours is less than two percent; and for our patients who make it to five years after surgery without recurrence, their risk drops to less than one percent

    WATCH: Dr. Aulisi discusses the MedStar Pituitary Center

    Understanding Pituitary Tumors

    The pituitary gland is what we call the “master gland,” as it produces hormones that help control many of the body’s processes, including:

    • Healthy bone and muscle mass
    • Normal function of the reproductive system
    • Temperature regulation
    • Thyroid function

    It’s often surprising to people when I tell them how common it is to have a pituitary tumor. One review of multiple studies found that the prevalence of noncancerous pituitary tumors is about 17 percent. But the real number might be even higher. The American Cancer Society notes that as many as one in four people might have a pituitary tumor without knowing it.

    According to @AmericanCancer, as many as one in four people might have a #pituitary #tumor, whether they know it or not. https://bit.ly/2HxObOW  via @MedStarWHC
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    Fortunately, most of these tumors never cause problems and don’t need treatment. In fact, we often see patients with pituitary tumors that are picked up during imaging tests for some other reason, such as a head injury or a car accident.

    On occasion, some patients will notice the effects of pituitary tumors and get checked out by their primary care doctors, who refer them to us. Once a patient is referred to the Pituitary Center, we move quickly:

    • They’ll likely see me and one of our endocrinologists on the same day to determine whether the tumor is affecting their hormones.
    • They’ll see our neuro-ophthalmologist to evaluate their eye function within the same week, as large pituitary tumors can press on the optic nerve and cause vision problems.
    • In most cases, patients can avoid surgery by taking highly effective medications to control tumor growth.

    But if a patient needs surgery due to severe symptoms or uncontrolled tumor growth, we’ll schedule it within a couple of weeks of their first appointment with us.

    WATCH: Learn about the team approach at the MedStar Pituitary Center

    We are a national referral center for pituitary tumors, and part of the reason for that is our high level of expertise in treating them surgically. We see 400 to 500 patients in the Pituitary Center each year. Of those, about a quarter to a third need surgery.

    Pituitary Surgery Options

    My colleague, otolaryngologist Stanley Chia, MD, and I most often remove pituitary tumors with a minimally invasive approach, which involves smaller incisions and less pain for patients. For many patients, it’s more like sinus surgery than brain surgery in terms of the impact on them. We use two minimally invasive techniques:

    • Transsphenoidal: through a small incision in the nose or under the upper lip, along the cartilage that separates the nostrils, and into the brain
    • Endonasal, or neuroendoscopic: through a small incision in the back of the nose and into the brain

    If a patient isn’t a good candidate for one of these minimally invasive techniques, I can operate through an approach called a craniotomy, which is an opening I make in the patient’s skull.

    We also have an advantage over every other hospital in the mid-Atlantic region: our advanced imaging tool, the Airo Mobile Intraoperative CT system. The Airo scanner gives us 3D image guidance that’s accurate to less than a millimeter. We can scan our patients during surgery to make sure we removed all of their tumor, and the 3D guidance gives us never-before-achieved surgical accuracy amid the delicate tissues around the pituitary gland to reduce the risk of damage to the blood vessels or nerves around the eyes and brain.

    Recovery after Pituitary Tumor Surgery

    We usually keep patients in the hospital for at least a few days after surgery. It’s important to monitor changes in endocrine function that can occur within the first two to three days after removal of a pituitary tumor. Patients need expert, inpatient care during this time because they can get sick quickly at home without monitoring.

    After our patients go home, they are usually off work for one to two weeks after minimally invasive surgery or several weeks after a craniotomy. During this time, they are under activity restrictions, which typically include no:

    • Bending at the waist
    • Blowing the nose
    • Heavy lifting
    • Twisting at the waist

    We also tell patients to watch for clear, watery drainage from the nose, which could be a sign of a leakage of cerebrospinal fluid (CSF), a potentially life-threatening condition. Some centers’ rates of patients with CSF leaks after surgery is as high as 30 percent, whereas ours is less than five percent.

    A small number of patients will need to start hormone-replacement therapy (HRT) after their pituitary surgery, depending on the location of their tumor and how it affected their body’s hormone levels. And some patients who were on HRT before their surgery can stop taking it afterward. One of the more common benefits of pituitary surgery we see is increased fertility in women whose tumors affected their hormone levels.

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    Better Results for Patients after Pituitary Surgery

    We are aggressive with tumor removal and treatment after surgery, such as radiation therapy, to provide the best results for our patients. And our persistence and precision pay off in successful patient outcomes. I recall a patient who previously had undergone pituitary surgery at another center. The surgeons there failed to remove her entire tumor, and she also experienced a CSF leak that wouldn’t stop, putting her at serious risk for meningitis. She was near death when she came to us, and her family was understandably hesitant for her to have another surgery. After answering their questions and thoroughly explaining the recommended procedure, we were able to find and remove what remained of her tumor and repair her CSF leak. Ten years later, this patient is doing well, but there’s no question she would have died without the care she received at MedStar Washington Hospital Center and the MedStar Pituitary Center.

    Through this process of diagnosis, treatment, and follow-up care, all of us at the Pituitary Center form lifelong bonds with our patients. We check in with our patients over the years, and many refer their friends and loved ones to us if they develop pituitary issues of their own.

    Everything has to come together for patients who have pituitary tumors. Someone has to notice their condition, they have to get an accurate diagnosis, and they have to find a team of experts to provide the care they need. My teammates at the MedStar Pituitary Center and I are dedicated to making that happen every day for each of our patients.

    Request an appointment with a pituitary specialist at the MedStar Pituitary Center.

    Call 202-877-5026