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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 26, 2018

    By Carlos A. Garcia

    In 2006, the latest technology available for PET-CT scans was the time-of-flight scanner. At the time, this scanner compared to older PET models was like comparing old, heavy TVs of the 1980s to the first generation of flat screens. We made the jump to the time-of-flight scanner when it first became available, and we were the only center in our area to have the technology for many years.

    But just like TV technology, PET-CT scanners have continued to get better since the time-of-flight scanner. Today’s digital PET-CT scanners provide a huge improvement in image quality.

    We’re now able to detect smaller cancer lesions we might not have seen before. MedStar Washington Hospital Center was one of the first in the region to have the most advanced digital scanning unit in the world. Think of it as the ultra-high-definition, curved-screen TV of the imaging world—it’s a night-and-day difference over what we had previously.

    PET-CT scanning is the gold standard of cancer imaging today. It’s approved for detecting and monitoring virtually every type of cancer. The advanced digital scanners offer many benefits over time-of-flight scans.

    The patient gets:

    • Half the time in the scanning machine
    • Half the dose of radiation
    • Images that are 10 times crisper

    The digital scanner makes it possible for us to better detect cancer lesions—even smaller ones that we might not have been able to see before. Detecting these lesions early means doctors may be able to treat a patient’s cancer sooner and more effectively.

    LISTEN: Dr. Garcia discusses advances in PET-CT technology in the Medical Intel podcast.

    How PET-CT scanning helps us detect tricky thyroid tumors

    Our expertise with PET-CT scanning also can benefit some patients with thyroid cancer. Thyroid cells sometimes can lose the ability to absorb iodine in certain types of thyroid cancer. Normally, thyroid cancer cells are easy to track with radioactive iodine in a test called radioiodine imaging because of their unique ability to absorb iodine, which they use to make thyroid hormone. If that ability is gone, we have to turn to PET-CT scanning.

    The PET-CT test uses a form of radioactive sugar, rather than regular iodine, to locate cancer cells. Normally, patients are given a radioactive iodine pill, and the body treats it like regular iodine, sending it anywhere in the body where there is thyroid tissue. Wherever the cancer cells have spread, the cancer cells will act like thyroid cells, just growing elsewhere in the body; for example, the lungs or the bones. The radioactive iodine is chemically altered to get “stuck” in the cell, once absorbed, and not made into thyroid hormone, so we can spot it on imaging.

    Even if the cells are no longer able to take up iodine, the cells might still be able to take up glucose, which cancer cells use for energy. We can use PET-CT scanning to watch the metabolic reaction of cells throughout the body to spot cancers and determine the best course of care for individual patients. Basically, we trick the body into doing what it normally does, and we use that information to treat patients’ cancer.

    Sharing our PET-CT knowledge with future doctors

    The field of nuclear medicine grows and evolves all the time, and doctors need to grow along with it. We’re involved in that process, by helping to organize the continuing medical education courses all nuclear medicine doctors have to take, to stay up-to-date with the latest scientific advances. In this way, we’re shaping the direction of nuclear medicine. Much of our research surrounds determining how much radiation is delivered into lesions, so we can begin to tailor those levels to specific patients’ needs.

    In addition, we worked extensively with the second installment of the National Oncologic PET Registry (NOPR) in a six-year process to analyze the use of PET-CT scanning for cancers that appear on the bone, whether they’ve started there or spread from other areas. We were one of the major cancer treatment centers that helped collect this sort of information. This effort leads leads developing of guidelines other doctors and hospitals can use, to direct them when testing for bone cancers, or cancers that tend to spread to the bones when they reach more advanced stages.

    We worked with the first installment of NOPR on a previous six-year process of establishing when to use PET-CT scans to locate virtually any type of cancer in the body. I am proud to say that now almost every cancer in any stage is approved to be examined with a PET-CT scan, which was an enormous accomplishment and a nationwide team effort.

    Staying ahead of the latest uses for PET-CT and the technology that makes these developments possible is critical for us, as nuclear medicine doctors. We’re able to provide better care and outcomes for the patients of today, and we’re helping prepare future doctors to provide that care to patients for many years to come.

  • June 21, 2018

    By Tonya Elliott, RN

    Left ventricular assist devices (LVADs) have saved and extended the lives of thousands of patients with heart failure. These small, surgically-implanted mechanical pumps have internal and external pieces that help the heart pump blood throughout the body when the heart is too weak to pump on its own. While LVADs are revolutionary in heart failure care, the external components carry a risk of infection—the leading cause of hospital readmission for LVAD patients.

    A large part of my role as a VAD coordinator is helping patients understand how to care for their devices and their bodies to prevent infection. I work with a 50-person team who is dedicated to every aspect of LVAD patient care. We do extensive work with patients to prevent LVAD infection, much of which involves sterile care at the exit site.

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    How we help LVAD patients avoid dangerous infections

    We developed a website, MyLVAD.com, which includes LVAD Dos and Don'ts for daily living and infection control:

    Dos:

    • Change your exit site dressing as instructed by your LVAD team
    • Clean and inspect your equipment daily
    • Notify your LVAD team immediately if you see any signs of injury, trauma or infection
    • Use the MyLVAD.com community forums to meet and share your experiences with other LVAD patients and caregivers

    Don’ts:

    • Disconnect the driveline from the controller (under normal circumstances)
    • Kink, bend or pull your driveline
    • Sleep on your stomach
    • Take a bath or swim

    Related reading: Living with an LVAD: 5 tips to make it easier

    The driveline requires special care to prevent it from catching on something and to keep it from moving around too much. These precautions are important because if the driveline is pulled or snagged, the skin could tear at the exit site, which can increase the risk for infection. VAD companies make canvas bags and straps to help support the equipment. We help patients learn to adapt the way they do daily activities to prevent their external components from catching on things like doorknobs when they’re walking by.

    Our patients receive special site dressing kits to keep the driveline and surrounding area sterile. The kits have securement devices to hold the driveline from accidental pulling or moving around. Patients are given two kits per week with everything they need to keep the area secure and clean. There are steps to change the dressing safely, and our team will make sure caregivers and patients are confident in the process.

    We do extensive work with patients to prevent #LVAD infection. As part of that care, we’ve developed a website, MyLVAD.com, which includes LVAD Dos and Don'ts for daily living. bit.ly/2K0Vb9E via @MedStarWHC
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    LVADs have come a long way in the past 30 years. They are much smaller than they were even 10 years ago. It’s possible that in the future the internal pump would not need external components. Until then, we’ll continue to educate LVAD patients and their families to reduce infection risk and keep them out of the hospital.

  • June 19, 2018

    By Keith M. Horton, MD

    As men get older, many of us find that we have to use the bathroom more often than we used to or get up more frequently in the middle of the night to go. These are common signs of benign prostatic hyperplasia (BPH), also known as an enlarged prostate. The prostate is a walnut-sized gland in the male reproductive system that can enlarge and put pressure on the bladder and urethra, causing urinary symptoms such as:

    • Dribbling
    • Straining
    • Trouble emptying the bladder
    • Urgent need to pee
    • Weak urine stream

    As many as 60 percent of men in their 60s have symptoms of BPH, as do up to 90 percent of men in their 70s and 80s. Many men are wary of BPH treatments because they can cause side effects such as headaches, nausea or inability to maintain an erection. But in 2017, the FDA approved a new procedure called prostatic artery embolization that can provide relief from symptoms in about 90 percent of men—without causing unpleasant side effects.

    LISTEN: Dr. Sabri and Dr. Horton discuss prostate artery embolization for enlarged prostate in the Medical Intel podcast.

    How does prostatic artery embolization work?

    Once you come into our clinic, we’ll do several tests to make sure you’re a good candidate for prostatic artery embolization. A good candidate for prostatic artery embolization:

    • * Wants to preserve normal sexual function
    • * Doesn’t want BPH surgery or isn’t a candidate
    • * Doesn’t respond well to BPH medications
    • * Doesn’t want to or no longer can use catheters (small tubes inserted in the penis to urinate)

    First, we have to make sure you don’t have prostate cancer, which has many of the same symptoms as BPH. We also need to perform tests on your urine, such as how strong your stream is, to make sure the procedure will benefit you.

    On the day of your procedure, you’ll be given a sedative and local anesthetic, but you won’t be asleep. We’ll make an incision in an artery in your upper thigh and insert a catheter. Using X-ray images to guide us, we’ll thread the catheter into the arteries that bring blood to the prostate. Next, we’ll release tiny particles through the catheter and into the arteries. These particles, about the size of grains of sand, decrease the amount of blood that comes to the prostate. The procedure takes just a couple of hours, and you can go home afterward once we make sure you are OK. The prostate will begin to shrink because of its decreased blood supply. This will put less pressure on the bladder and urethra, relieving the symptoms of BPH.

    Men often start seeing improved symptoms within a few days or weeks after the procedure. In a nine-year study, 78 percent of patients who had the procedure experienced long-term relief of their BPH symptoms. That’s better than or on par with the other minimally invasive therapies that are available today. Among the patients we’ve seen, about 90 percent have had improved symptoms after prostatic artery embolization.

    90% of our patients who have prostatic artery embolization for #BPH have improved symptoms within a few weeks of the procedure. bit.ly/2tml34z via @MedStarWHC

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    For many men with BPH, prostatic artery embolization provides a much-needed alternative to medications or prostate surgery. If you’re struggling with BPH symptoms, talk to your urologist to find out if this simple procedure can help you find relief.


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

    Request an Appointment

  • June 18, 2018

    By Richard T. Benson, MD

    Having a stroke can be a life-changing experience. Nobody wants to go through it twice. Upon recovery, one of the first things we do is try to help patients reduce their risk through education about secondary stroke prevention. These are the steps patients can take to potentially avoid having another stroke and to reduce the symptoms of a previous stroke.

    Key risk factors for stroke have been identified over the years that have resulted in patients receiving better preventative and post-stroke treatment. For example, when I became a doctor in the mid ‘90s, stroke was the third most common cause of death. Now, it’s the fifth most common.

    Because a patient’s risk for stroke increases after their first (or primary) stroke, it’s important that doctors and patients work together to reduce the risk of a secondary stroke. The doctors in our Comprehensive Stroke Center typically begin with education and recommendations around three specific steps.

    3 steps to prevent a secondary stroke

    1. Take an antithrombotic medication, if appropriate Antithrombotic medications can reduce the formation of blood clots, which cause the majority of strokes. Antithrombotic agents include anticoagulants and antiplatelets.
    2. Consider taking a statin Many patients who have had a stroke can benefit from statin agents. These medications have many positive effects, such as decreasing bad cholesterol (LDL), increasing good cholesterol (HDL), neuro-protection, and in some instances, regressing athero-sclerotic plaque.
    3. Learn about and manage personal risk factors We categorize the risk factors for stroke into modifiable and non-modifiable risk factors to help patients better understand how much they can affect their stroke risk.

    Modifiable risk factors:

    These are risk factors that can be controlled through behavior and lifestyle. We often discuss the following modifiable risk factors with patients:

    • Hypertension: This is by far the most common risk factor for stroke. Patients usually get treated first by taking antihypertensives, and then we offer them lifestyle suggestions, such as exercise and incorporating a Mediterranean diet to help ensure they have a healthier blood pressure down the road.
    • Lack of exercise: If you compare people who are the same age and have the same risk factors, those who exercise have a decreased risk in having a stroke.
    • Diabetes: Patients with diabetes are two to four times more likely to have a stroke than those who don’t.
    • Heavy alcohol consumption: Excessive drinking can lead to conditions that increase the risk of stroke, such as high blood pressure, diabetes, and obesity.
    • Obesity: Carrying too much body fat can contribute to high blood pressure and often is associated with decreased exercise and a poor diet.
    Secondary stroke prevention starts by taking the right medication after your first stoke and learning about and managing personal risk factors, says, Dr. Richard Benson. bit.ly/2lj2f2p via @MedStarWHC

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    Non-modifiable risk factors:

    These are risk factors we cannot change or reverse. However, patients can benefit from understanding them, as this education often encourages patients to more seriously adopt healthy behavioral changes. Non-modifiable risk factors include:

    • Age: After the age 65, stroke risk goes up one percent each year.
    • Gender: Strokes are more common in men. But prevalence, or the number of survivors, is higher in women because they tend to live longer.
    • Race/ethnicity: Studies show that African-Americans and Latinos are much more likely to have strokes than patients of other ethnic backgrounds.
    • Socioeconomic status: For a variety of reasons, the lower someone’s financial or education status, the higher their risk of stroke.

    Expert stroke prevention and care in the District

    A unique thing about MedStar Washington Hospital Center is that about 50 to 70 percent of our patients are African-American. This is important because African-Americans are at increased risk for strokes—in fact, about two times more than Caucasians. This allows us the opportunity to help educate our patients on their individual risk factors.

    When it comes to stroke prevention and treatment, where a patient receives care can make a huge difference in their outcomes and recovery. MedStar Washington Hospital Center received the Washington, D.C., region’s first comprehensive stroke center certification from the Joint Commission for caring for patients with complex stroke cases, demonstrating our level of commitment in caring for patients with complex stroke conditions.

    Due to our expertise and exceptional care, we get referrals from 9 MedStar Health hospitals. We’re also a regional referral center, which means approximately another 35 hospitals send patients to us for advanced stroke care. Patients can feel safe, as complex stroke cases are treated here through services, such as:

    • A state-of-the-art neurological intensive care unit.
    • Nurses who specialize in stroke care.
    • Vascular cardiology.

    Additionally, we’re affiliated with the National Institutes of Health, meaning we’re one of the select medical facilities in the U.S. where patients who we suspect have had strokes are screened with magnetic resonance imaging (MRI) right away. This process allows us to clearly visualize and confirm the signs of a stroke and implement the most appropriate course of care.

    We are also one of the select sites in the U.S. that provides embolectomy, or thrombectomy, procedures in the early research stages, which is an incredibly effective intervention for clot-related strokes. With these procedures, we can restore blood flow to the brains of patients who suffer strokes, even up to 24 hours after the stroke began.

    A stroke can be life-changing. If you or a loved one have had a stroke, you can significantly reduce the risk of having another by understanding personal risk factors. Take control of your health future by managing your overall health together with your doctor.

    Call 202-877-3627 or click below to meet with a specialist who can assess your secondary stroke risk.

    Request an Appointment

  • June 15, 2018

    By Selena E. Briggs, MD

    Between 2000 and 2010, data from the U.S. Census Bureau show huge increases in the numbers of older Americans between the ages of 80 and 99. Today, more people than ever need solutions for hearing loss caused by aging or as a result of injuries, infections or other conditions.

    But the most common therapy—hearing aids—don’t work for everyone. Hearing aids simply make sounds louder, so if you have little to no hearing now, they might not do you much good. For these patients, cochlear (COKE-lee-ur) implants may be able to restore hearing.

    A cochlear implant is a device implanted surgically in the ear that can send sound signals to the auditory nerve and restore hearing. It’s often thought of as a childhood treatment, and they’re approved by the Food and Drug Administration (FDA) for children as young as 12 month. But adults can benefit from cochlear implants as well.

    Let’s walk through how we determine whether a patient is a good candidate for a cochlear implant, as well as what to expect from the surgery and the device itself, such as how your implant can interface with your smartphone, TV, or other Bluetooth-connected devices.

    Call 202-877-3627 or click below to learn more about cochlear implants and hearing restoration.

    Request an Appointment

    Who is a good candidate for cochlear implants?

    Edna Whitted enjoys her cochlear implant

    Edna Whitted with her cochlear implant.

    A person has to have some level of hearing for hearing aids to work. We determine this from a baseline hearing test, then we typically recommend trying hearing aids for three to six months. If they don’t give significant benefit, we consider cochlear implants.

    Unlike hearing aids, cochlear implants don’t make sounds louder. Instead, they bypass the damaged ear cells of the inner ear, sending the sound signals directly to the auditory nerve, which delivers sound signals to the brain. As long as there’s some level of activity between the auditory nerve and the brain, even if you can’t recognize specific words, cochlear implants may be able to help you. A cochlear implant has exterior and interior components. The exterior pieces send sound signals to the interior pieces through a specialized transmitter and receiver system.

    Implantation surgery and the programming process

    Cochlear implants are advanced technological devices. Choosing the right implant depends on many factors, such as:

    • How much you can hear currently
    • The status of the cochlea and other physical features
    • Particular features of the implant

    After you and your doctor choose a device, the next step is surgical implantation. Cochlear implant surgery is an outpatient procedure that takes about two hours to complete. You’ll be under general anesthesia in most cases, so you’ll be asleep during the surgery. In rare cases, the surgery can be performed under local anesthesia with sedation. Afterward, we’ll monitor you in the hospital for a few hours before we send you home.

    Cochlear implants can have a dramatic effect on a patient’s quality of life. One patient’s speech and understanding test showed he was at less than 15 percent hearing in one ear. Within six weeks of his cochlear implantation, he was already up to 90 percent hearing in that ear. We scheduled an implantation for his other ear, which had initially scored at 20 percent in his testing, and he got up to nearly 100 percent after that procedure with both ears together.

    Programming and new features of cochlear implants

    Once you recover from the implantation surgery, you’ll have a series of appointments over four to six weeks to adjust your device. We’ll fine-tune your device to help you hear better in certain settings, such as quiet restaurants or loud concerts. These adjustments can make the difference between hearing at 75 percent capability and 100 percent. We recommend seeing your audiologist once or twice a year after that for regular reprogramming.

    While the average hearing aid will last three to seven years before it needs to be replaced, cochlear implants are designed to last 80 years. But that’s a long time to be stuck with one piece of technology, considering most of us don’t even wait two years before upgrading our smartphones.

    Though the interior components of cochlear implants are designed to stay in place for the rest of a patient’s life, manufacturers now are creating their products, so that the exterior components can be upgraded. For example, several newer models have Bluetooth compatibility. These devices can stream sound directly from your phone, computer, TV or other device.

    If you have hearing loss and hearing aids haven’t worked, don’t give up hope. We have the technology to help people hear better, and more advanced cochlear implants are coming out every year.

    Call 202-877-3627 or click below to request an appointment with one of our audiologists.

    Request an Appointment

  • June 14, 2018

    By MedStar Health

    Customized Solutions Provide Needed Relief

    Pain is our body's way of telling us there’s something wrong. If it’s long lasting, it can have a profound impact on an individual’s quality of life.

    “If pain is affecting your everyday activities, your personal life, or your ability to work, you should seek help from a specialist,” says Rajat Mathur, MD, a MedStar National Rehabilitation Network physiatrist and pain management specialist who sees patients at MedStar Good Samaritan Hospital. “Understanding the pain—how and when it started, where it occurs, what makes it better or worse, and whether it’s constant or occasional—is key to determining the most effective treatment. There are so many ways to treat pain that there is no reason for anyone to live with it.”

    With every new patient Dr. Mathur performs a thorough physical exam and may order x-rays, an MRI, a CT scan, or other tests to check for nerve damage. Depending on the diagnosis, the source of pain, and its severity, treatments are customized for each patient.

    This approach to pain management is why 69-year-old Joyceann Wright-El is now pain free. “I had lower back pain that was so bad I could barely stand,” she says. “Physical therapy wasn’t helping, and I couldn’t take pain medication because of other health issues. Surgery wasn’t an option either.” Wright-El’s doctor referred her to Dr. Mathur, who recommended electrodiagnostic testing, which measures the electrical activity of muscles and nerves to determine if there is nerve injury or damage.

    Rajat Mathur, MD

    “She had what is called low back radicular pain, a type of pain that is caused by compression, inflammation, or injury to a spinal nerve root. She had experienced a lot of trauma over the years and had severe arthritis of the spine, all contributing to her condition,” Dr. Mathur explains. “This led to a series of spinal interventions to try to control, and hopefully, eliminate the pain.”

    The first step was an epidural injection to decrease the swelling in her lower back and the pain associated with it. This was followed by a medial branch nerve block, a primarily diagnostic procedure in which an anesthetic is injected into the spine to identify the specific nerve involved.

    “Based on this, we determined she was a candidate for a procedure for longer term pain relief called radiofrequency rhizotomy or ablation,” says Dr. Mathur. “This involves destroying the nerves causing the pain with highly localized heat generated with radiofrequency. By destroying these nerves, pain signals are prevented from being transmitted from the spine to the brain. A successful procedure reduces pain without reducing nerve function.”

    Today, Wright-El is pain free. She is extremely happy with the care she received and the outcome. "Dr. Mathur really took the time to talk to me and was able to keep me focused. His team worked so well together and made me feel so comfortable," she says. "They straightened me up!"

    “Pain can be very complex and may require a combination of therapies,” Dr. Mathur notes. “Building rapport with a patient is essential to understanding the pain so that the best treatment plan can be developed for that individual."

    Speaking of Pain

    Karen Droter, MSN, RN

    Improving communication about pain between caregivers and patients is the focus of a new initiative of MedStar Good Samaritan Hospital and MedStar Union Memorial Hospital. Led by Karen Droter, MSN, RN, performance improvement manager at MedStar Good Samaritan, the Patient Experience Pain Management Team is working to ensure that the needs of every patient are anticipated and addressed when dealing with pain. The ultimate goal is increased patient satisfaction.

    To that end, the team, representing a cross section of employees and caregivers, meets monthly to review what is currently being done to promote effective communication about pain and identify ways to augment and enhance those efforts. Their work to date has resulted in:

    • The use of a pain tool guide to assist providers in better assessing pain
    • The increased use of white boards in patient rooms to post pain scores and inform patients about daily pain control plans
    • The adoption of a comfort brochure to educate patients and families about non-pharmacological therapies for treating pain and improving comfort
    • More frequent use of the C.A.R.E. (Continuous Ambient Relaxation Environment) Channel in patient rooms to create a relaxing environment that reduces anxiety and alleviates pain
    • Pain champions are also being identified, who will be trained in pain management to serve as resources to patients, family members, and providers.

    For a physician referral, complete this form or call 410-248-8322.

    This article appeared in the summer 2018 issue of Destination: Good HealthRead more articles from this issue.

    Call Us Today

    For a physician referral or to learn more about pain management, call:

    410-248-8322