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  • January 14, 2022

    By Allison Larson, MD

    Whether you’re a winter sports enthusiast or spend the season curled up by the fireplace, the low humidity, bitter winds, and dry indoor heat that accompany cold weather can deplete your skin’s natural moisture. Dry skin is not only painful, uncomfortable, and irritating; it also can lead to skin conditions such as eczema, which results in itchy, red, bumpy skin patches. 


    Follow these six tips to prevent and treat skin damage caused by winter dryness.


    1. Do: Wear sunscreen all year long.

    UV rays can easily penetrate cloudy skies to dry out exposed skin. And when the sun is shining, snow and ice reflect its rays, increasing UV exposure. 


    Getting a sunburn can cause severe dryness, premature aging of the skin, and skin cancer. Snow or shine, apply sunscreen before participating in any outdoor activity during the winter—especially if you take a tropical vacation to escape the cold; your skin is less accustomed to sunlight and more likely to burn quickly.


    The American Academy of Dermatology (AAD) recommends sunscreen that offers protection against both UVA and UVB rays, and offers a sun protection factor (SPF) of at least 30.


    That being said, if you are considering laser skin treatments to reduce wrinkles, hair, blemishes, or acne scars, winter is a better time to receive these procedures. Sun exposure shortly after a treatment increases the risk of hyperpigmentation (darkening of the skin), and people are less likely to spend time outside during the winter.


    Related reading: 7 Simple Ways to Protect Your Skin in the Sun

    2. Do: Skip products with drying ingredients.

    Soaps or facial products you use in warm weather with no issues may irritate your skin during colder seasons. This is because they contain ingredients that can cause dryness, but the effects aren’t noticeable until they’re worsened by the dry winter climate.

    You may need to take a break from:

    • Anti-acne medications containing benzoyl peroxide or salicylic acid
    • Antibacterial and detergent-based soap
    • Anything containing fragrance, from soap to hand sanitizer

    Hand washing and the use of hand sanitizer, which contains a high level of skin-drying alcohol, cannot be avoided; we need to maintain good hand hygiene to stop the spread of germs. If your job or lifestyle requires frequent hand washing or sanitizing, routinely apply hand cream throughout the day as well.


    During the COVID-19 pandemic, I have seen a lot of people develop hand dermatitis—a condition with itchy, burning skin that can swell and blister—due to constant hand washing. Sometimes the fix is as simple as changing the soap they're using. Sensitive-skin soap is the best product for dry skin; it typically foams up less but still cleans the skin efficiently.


    3. Do: Pay closer attention to thick skin.

    Areas of thin skin, such as the face and backs of your hands, are usually exposed to the wind and sun the most. It’s easy to tell when they start drying out. But the thick skin on your palms and bottoms of your feet is also prone to dryness—and tends to receive less attention.


    When thick skin gets dry, fissures form. You’ll see the surface turn white and scaly; then deep, linear cracks will appear. It isn’t as pliable as thin skin. When you’re constantly on your feet or using your hands to work, cook, and everything in between, dry thick skin cracks instead of flexing with your movements. 


    To soften cracked skin, gently massage a heavy-duty moisturizer—such as Vaseline—into the affected area once or twice a day. You can also talk with your doctor about using a skin-safe adhesive to close the fissures and help them heal faster.


    Related reading:  Follow these 5 Tips for Healthy Skin

    4. Don’t believe the myth that drinking more water will fix dry skin.

    Contrary to popular belief, the amount of water or fluids you drink does not play a major role in skin hydration—unless you’re severely dehydrated. In the winter, especially, dry skin is caused by external elements; it should be treated from the outside as well. 


    The best way to keep skin hydrated and healthy is to apply fragrance-free cream or ointment—not lotion—to damp skin after a shower or bath.
    Some people need additional moisturizers for their hands, legs, or other areas prone to dryness.

    While some lotions are made better than others, most are a combination of water and powder that evaporates quickly. Creams and ointments work better because they contain ingredients that can help rebuild your skin barrier. 

    Look for products with ceramide, a fatty acid that helps rebuild the fat and protein barrier that holds your skin cells together. The AAD also recommends moisturizing ingredients such as:

    • Dimethicone
    • Glycerin
    • Jojoba oil
    • Lanolin
    • Mineral oil
    • Petrolatum
    • Shea butter

    For severely dry skin, you can try a “wet wrap” technique:

    1. Rinse a pair of tight-fitting pajamas in warm water and wring them out so they’re damp, not wet.
    2. Apply cream or ointment to your skin.
    3. Put on the damp pajamas, followed by a pair of dry pajamas, and wear the ensemble for several hours.

    Dampness makes your skin more permeable and better able to absorb hydrating products. If the wet wrap or over-the-counter products aren’t working for you, talk with a dermatologist about prescription skin hydration options. 

    Drinking more water isn’t the answer to dry winter skin. The best solution is to apply fragrance-free cream or ointment directly to damp skin. Get more cold weather #SkinCareTips from a dermatologist in this blog: https://bit.ly/3KbVUA1.
    Click to Tweet

     

    5. Don’t confuse skin conditions with dryness.

    Skin conditions are often mistaken for dry skin because peeling or flaking are common symptoms. Redness of the skin or itching in addition to dryness and flaking indicates a skin condition that may need more than an over-the-counter moisturizer.


    Skin cells are anchored together by a lipid and protein layer (like a brick and mortar wall). With very dry skin, the seal on this wall or barrier is not fully intact and water evaporates out of the skin’s surface. The skin will become itchy and red in addition to scaly or flaky. If you experience these symptoms, visit with a dermatologist.

    6. Don’t wait for symptoms to take care of dry skin.

    Be proactive—the best way to maintain moisture is to apply hydrating creams and ointments directly to your skin on a regular basis. Start by applying them as part of your morning routine. Once you get used to that, add a nighttime application. And carry a container of it when you’re on the go or keep it in an easily accessible location at work.

     

    You can’t avoid dry air, but you can take precautions to reduce its harsh effects on your skin. If over-the-counter products don’t seem to help, our dermatologists can provide an individualized treatment plan. Hydrated skin is healthy skin!


    Does your skin get drier as the air gets colder?

    Our dermatologists can help.

    Call 202-877-DOCS (3627) or Request an Appointment

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  • December 20, 2017

    By MedStar Health

    This Christmas will be extra-special for Barbara Lott. For the first time in several years, the 68-year-old Washington, D.C., resident will be cooking dinner and desserts for her family and friends, free of the arthritis pain in her knees that had kept her from standing unassisted even short periods.

    Ms. Lott’s arthritis started innocently enough about 14 years ago—some occasional pain in her right knee that she attributed to having been on her feet a lot. Over-the-counter medications worked for awhile, but the pain gradually grew worse, defying cortisone shots and other treatments.

    Eventually, both knees were affected. But Ms. Lott was undaunted.

    “I wanted to stay active and do as much as I could,” she recalls. “As I told my friends, ‘no pity party for me!’”

    Deciding to Pursue Surgery

    By early 2017, however, Ms. Lott’s arthritis appeared to have gotten the best of her. With both knees now deformed by pain, she was dependent on a rolling walker to get around her house. Even her never-give-up spirit began to wane, making her dubious about pursuing surgery to correct the problem.

    Ms. Lott even admits that she almost skipped her appointment to see Savyasachi C. Thakkar, MD, a specialist in adult hip and knee reconstructive surgery at the MedStar Orthopaedic Institute at MedStar Washington Hospital Center.

    But she decided to go, and she’s glad she did.

    “I immediately felt comfortable with Dr. Thakkar,” says Ms. Lott. “He was very friendly, yet he didn’t talk down to me.”

    Diagnosis

    Dr. Thakkar diagnosed Mrs. Lott’s condition as “windswept knees,” an arthritis-related deformity that leaves both knees severely out of alignment. The right side was knock-kneed and the left side was bow-legged. Due to her unique problem, Dr. Thakkar suggested performing surgery on both knees at the same time, a procedure called “bilateral total knee arthroplasty,” which would reduce surgical risks and speed her recovery. The degree of deformity required her to undergo bilateral simultaneous total knee arthroplasty, as operating on just one knee would not provide the maximum functional benefit that she could achieve.

    "Everything he said made sense to me,” she adds. “I wouldn’t have done the surgery without him.”

    After some initial physical therapy evaluations confirmed that her knees were strong enough for the surgery, Ms. Lott joined other orthopaedic patients for a pre-operative joint replacement class designed to educate patients about what would take place during the procedure. She also met with special social workers called Post Acute Care Coordinators (PaCC) who arranged for her rehabilitation needs and home care needs after surgery. Dr. Thakkar also made sure he and his assistant were always accessible to answer questions.

    "That helped get my mind ready,” Ms. Lott says. “I wasn’t afraid at all.”

    The procedure to correct the deformity in Ms. Lott’s knees lasted about three hours. Another welcome surprise awaited when she awoke from anesthesia without experiencing any post-operative pain.

    “That surprised even the nurse,” she says with a laugh. “She gave me a Tylenol later on, but to this day, that’s all I’ve really needed.”

    Post-Surgical Recovery Progress

    Ms. Lott’s recovery unfolded exactly as planned. Within six weeks of her surgery, Ms. Lott could walk short distances without a walker. Three months post-surgery, she could walk unassisted. Her overall health improved along the way, as did her anticipation about resuming those neglected holiday cooking traditions.

    "I’m able to stand, do my grocery shopping, and walk from one end of the store to the other,” Ms. Lott says proudly, adding that she also keeps Dr. Thakkar’s business card in her wallet to share whenever she hears of someone else being debilitated by arthritis in the knees and the hips.

    “I know what kind of pain they’re having, and how it controls your life,” she says. “And you really don’t know how much it does until you have the surgery.”

    Schedule an appointment or call 202-877-3627 to see if you could be a candidate for arthroscopic knee surgery.

    Request an Appointment

  • December 18, 2017

    By Jewel Francis-Aburime

    In July 2016, I attended a bariatric surgery information session with my mom. I went to support her, but I guess I looked like I needed help, too. Someone handed me a weight-loss surgery form to fill out, and I did. I was 17.

    Weight has been an issue for me for a long time, and while the thought of weight-loss surgery had briefly crossed my mind at times, I had never seriously considered it until that day.

    Obesity increases the risk of multiple health problems, such as diabetes, high cholesterol and high blood pressure. These conditions run in my family. I knew if I stayed on the path I was on, those risks could become reality for me down the road. And I’d be lying if I said I didn’t want to buy cute clothes in smaller sizes.

    I also had another reason to consider bariatric surgery: I plan to become a physician, and I want to follow the healthy lifestyle I recommend to my future patients. For example, if I recommend that a patient reduce carbs from their diet, I’ll have the insight to be able to say, “Here’s how I go about it.”

    I know some people may raise an eye at the thought of a teen or young adult having bariatric surgery. It’s a big life decision for anyone, no matter their age. As with any surgery, there are risks. And it’s a lot of work to prepare for surgery and maintain a healthy lifestyle once it’s over. But I look at it as a chance to give myself a longer, healthier life.

    Taking the first steps toward weight-loss surgery

    During the MedStar Washington Hospital Center bariatric surgery information session my mom and I attended, we met the bariatric team and learned about the surgical options and the process leading up to and after surgery.

    It got me thinking that I could do this. So I spent the next couple months doing loads of research. I watched countless YouTube videos of doctors discussing the surgery and people describing their experiences with it.

    In fall 2016, my mom and I scheduled our initial appointment with Dr. Timothy Shope. During that meeting, we discussed the health complications obesity can cause, and he told me that I didn’t need to wait until I developed such conditions to have bariatric surgery. In my case, it was a preventive measure.

    Read and watch: Learn more about Jewel’s bariatric surgery journey in this Vox story.

    My mom and I both decided to have gastric sleeve surgery, also known as sleeve gastrectomy. Over the winter and spring, we underwent various medical exams and attended monthly classes that covered nutrition, diet and exercise.

    I was lucky to have gone through the entire process with my mom. It was comforting to have someone who truly understood what I was going through at each step of the journey. She had her surgery a month before me, so I also got to see firsthand what I would be experiencing soon.

    What others thought of my decision

    Before my bariatric surgery, my program required me to see a psychologist. The psychologist I saw initially was concerned about someone so young making such a life-changing decision. However, after speaking with my mom and me at length, she agreed that I had done my research and was mature enough to know what I was doing.

    That initial concern was expressed by others as well. But most people didn’t say anything to me—they told my mom. I think some people wanted her to pressure me not to have the surgery because they thought I was too young.

    My immediate family and friends were extremely supportive. I was nervous about telling my friends. I worried they would think I was taking the “easy way out” or urge me to lose weight on my own without surgery. When I asked one of my best friends what she would say if I told her I was thinking about bariatric surgery, she responded, “I would say, ‘What time should I be at the hospital?’” I love her for that. While many friends had questions, they all accepted my decision immediately.

    Surgery and recovery

    Going through bariatric surgery requires a six- or seven-month preparation process. To reduce the amount of fat around the liver and spleen, I had to follow a liquid diet for a few weeks before surgery. The low-carb beverages made me feel lethargic and miserable! But I reminded myself that it was only temporary and the surgery would make a long-term impact on my health and life.

    I had gastric sleeve surgery in April 2017. Eight months post-op, I feel great! That’s not to say there haven’t been bumps in the road, but they’ve all been worth it. Bariatric surgery isn’t magic. You still have to put in the work to reach your weight goal.

    "Bariatric surgery isn’t magic. You have to put in the work to reach your weight goal.” - Patient Jewel Francis-Aburime via @MedStarWHC

    Click to Tweet


    While most weight-loss surgery patients find they can eat less food and still feel full after surgery, I have not experienced this. I’m often hungry and thirsty. Because of this, my weight loss has been a little slower than most. However, the scale is moving in the right direction, and I’m OK with that.

    After bariatric surgery, patients continue to see a dietitian periodically. My dietitian recommended that I include more protein in my diet to curb my hunger. I was born in Nigeria, and while I’ve lived most my life in the U.S. and became a citizen in 2009, my family has generally followed an African-style diet—and that means lots of rice! I’ve had to adjust to eating smaller portions of carbohydrates as side dishes of the proteins I eat, instead of the other way around. This has been a challenge, but I’m getting used to it.

    Before surgery, I struggled a bit with mobility. I couldn’t run or even walk very far without getting winded. Stairs were difficult. But surgery has motivated me to take control of my health. My mom and I finally are putting to use the treadmill we’ve had for years!

    My advice for young adults considering bariatric surgery

    Bariatric surgery is not a decision to be taken lightly. While people of all ages may be met with skepticism from others about their decision, I think younger weight-loss surgery patients face even more of this.

    You may find that people will try to sway you with statements such as, “You don’t know what you’re getting yourself into.” To combat these arguments, genuinely do your research and be confident in your decision.

    I recommend watching YouTube videos and reading and listening to others’ experiences with these types of surgeries, including videos of people who regret having bariatric surgery. Think about the reasons they give, and ask yourself if those are things you can see yourself feeling. However, keep these stories in perspective. For example, if someone complains that they are in constant pain after surgery, look at how long post-op they are. If it’s only two weeks, maybe take it with a grain of salt.

    And remember, your experience may be different from the positive stories you see. For example, my mom and I had the same surgery, but she had less pain post-op, feels less hunger and has lost more weight. This doesn’t mean my surgery was a failure. I’m doing the work, and it’s doing what it’s supposed to be doing, just in a slightly different way.

    Be aware that there may be bumps in the road or less-than-fun moments in the process, but remember these are short-term negatives in what will be a long-term investment in a healthier future.

    Finally, follow the diet prescribed by your healthcare team. It’s not always fun—especially the liquid diet right before surgery—but there’s a reason for it. I admit I’ve fallen off the wagon a couple times, but you can learn from my mistakes. If you eat or drink something you shouldn't, forgive yourself, and reach out to your dietitian for advice. Also, take your multivitamins. They’ll make you feel better and keep you healthy.

    My advice for loved ones of bariatric surgery

    I mentioned that my mom encountered some people who doubted my decision to have bariatric surgery. I think she would tell other parents in this situation that they need to determine if their teen is emotionally mature enough to make such a decision, and then trust and support that decision.

    If a loved one tells you they are considering weight-loss surgery, keep an open mind. Help them with their research as you may be able to uncover different angles to consider. Ask questions, but be patient and give them room to make the decision on their own.

    And be supportive after surgery, but don't be the “diet police.” It’s a myth that bariatric surgery patients can never have dessert again, but that doesn’t mean they should eat the entire box of cookies. So if you see your friend or family member reaching for another cookie, gently remind them of this.

     
    Jewel a few months after her weight loss surgery.
     

    My goals going forward

    I graduated from high school in June 2017, and I’m deferring college for a year to work and make money. I’m also using the time to prepare myself to become a pre-med student by using online resources to beef up my knowledge in a few subjects I’m not as strong in, such as physics. I know that by fall 2018, I’ll be pumped to get back in the classroom and start the next chapter in my life!

    As for my health, the diet and exercise changes I’ve made since surgery are little by little becoming second nature. I’m seeing progress and that motivates me to continue on this path. I don’t let the short-term challenges derail me. I look forward to continuing to live a healthier, more active life—and buying new clothes!

    Considering weight loss surgery? Take your first step by attending our online seminar.

    Get Started

  • December 14, 2017

    By Lambros Stamatakis, MD

    In the 1990s, the Food and Drug Administration (FDA) approved a treatment for bladder cancer called Bacillus Calmette-Guerin therapy, or BCG, which stimulates the immune system and helps keep patients’ cancer from coming back.

    Until recently, BCG was still the newest FDA-approved treatment for bladder cancer. But about one-third of patients won’t respond to BCG. This can limit patients’ treatment options to bladder removal surgery, but many people with bladder cancer are older and not able to handle such a major procedure. And many patients don’t want to undergo the surgery even if they’re healthy enough for it.

    In recent years, however, we’ve begun to find alternatives to BCG. Beginning in 2015, several new therapies have been approved that have revolutionized the way we treat bladder cancer. And like BCG back in the ’90s, these treatments harness the power of the immune system to battle this disease.

    As of November 2017, these immunotherapy treatments currently are approved for patients whose disease is further along and hasn’t responded well to other treatments, such as traditional chemotherapy and surgery. But we’re currently investigating new ways to use immunotherapy, as well as how to use it sooner in the disease process.

    How does immunotherapy work to treat bladder cancer?

    One of the ways cancer can survive and grow within the body is by deactivating the immune system. The bladder’s cells, like all cells in the body, have a system to prevent them from growing out of control. Like inserting a key into a lock, immune cells can bind to bladder cells that are growing too much and kill them without harming healthy cells.

    But in cases of bladder cancer, the cancer cells can “trick” the immune system by hijacking this process. Bladder cancer cells use certain proteins to turn off immune system cells before they can destroy the cancer cells. This allows the cancer cells to grow out of control, forming tumors that can spread from the lining and connective tissue of the bladder into the muscle.

    The latest immunotherapy treatments work by preventing this interaction. By stopping the cancer cells from turning off the immune system cells, we can increase the immune system’s ability to find and destroy cancer cells.

    Personalized treatments for bladder cancer

    There are multiple clinical trials going on with the hope of expanding our use of immunotherapy. Some examples of these potentially expanded uses include:

    • Combining immunotherapy with other treatments to kill cancer cells even more effectively
    • Treating someone with a new diagnosis of metastatic bladder cancer, or cancer that is spreading beyond the bladder wall
    • Treating someone with immunotherapy before surgery
    • Treating someone with immunotherapy before their bladder cancer spreads into the bladder muscle

    Here at MedStar Washington Hospital Center, we’re participating in a clinical trial for patients whose bladder cancer hasn’t invaded the bladder muscle. In particular, this trial is examining patients who haven’t responded to BCG, the standard of care for bladder cancer approved back in 1990. Patients who don’t respond to BCG may be candidates for this new treatment, called Vicinium. Though this isn’t a form of immunotherapy, it’s an exciting approach to targeting bladder cancer cells. When we introduce Vicinium into a patient’s system, it makes its way to bladder cancer cells, avoiding healthy cells along the way. Next, it blocks the cancer cells from creating the proteins they need to survive, which causes the cancer cells to die off.

    The new treatments we have available for bladder cancer and those currently being tested all are part of a growing wave of personalized medicine in cancer care. Until very recently, although we customized each patient’s particular treatment strategy for that patient, we’ve had the same sorts of treatments available to choose from.

    Many researchers are studying information we can get from the patient during the first bladder cancer biopsy to see if we can recommend particular treatments based on whether the patient will benefit from them. For example, if we could identify whether a patient is likely to benefit from the chemotherapy treatment, we could know whether we should recommend that or go straight to surgery. Like immunotherapy, this is another way we can tailor care to the individual patient.

    The field of bladder cancer treatment has made great strides forward in the last few years. In the next five to 10 years, it could look radically different than it does today. I’m excited for the chance to help more of my patients, and I’m eager to see what happens next.

    Request an appointment with one of our urologic oncologists for more information about available treatments for bladder cancer.

    Request an Appointment

  • December 12, 2017

    By MedStar Health

    James was told he had advanced liver and kidney failure, but the team of MedStar Georgetown knew that an urgent liver transplantation could restore his liver function and salvage kidney function as well.
  • December 12, 2017

    By MedStar Health

    The benefits of minimally invasive skull base surgery for the patient include faster recovery, less risk of stroke and no disfigurement or scarring.
  • December 12, 2017

    By MedStar Health

    Dominic Nwanji has loved playing basketball since he was a child.

    “It means everything to me,” says the 28-year-old. “When I play, any stress, concerns, deadlines or anything going on in my life takes a back seat. I am able to relax.”

    Things came to a screeching halt on the court for Dominic during a game at his local YMCA. Two players tried to cut him off as he was heading for the basket. Dominic skidded to a stop so suddenly that his knee buckled as he twisted to pass the ball, causing him to fall to the floor in pain.

    “When it first happened, I thought it was just a bad knee tweak but the pain didn’t subside,” Dominic says. “Then I realized, maybe this isn’t something simple.”

    Dominic had a torn anterior cruciate ligament (ACL), an injury common among athletes. The ACL and posterior cruciate ligament (PCL) are tissues that hold the knee together and stabilize it in different directions.

    Dominic was told he needed reconstructive surgery at his first consultation in North Carolina, where he lives. So he traveled to Washington, D.C., where he has family and went to MedStar Georgetown University Hospital, part of the MedStar Orthopaedic Institute. He was shocked when William F. Postma, MD, chief of Sports Medicine in the Department of Orthopaedic Surgery at MedStar Georgetown, told him that instead of reconstructing his ACL, he could possibly repair it.

    “I hadn’t even heard of a repair,” Dominic says. “So, I asked Dr. Postma to explain the procedure to me a few times before ultimately deciding it was my best option.”

    “The gold standard is still to reconstruct ACL injuries and at MedStar Georgetown we perform all kinds of reconstructions,” Dr. Postma explains. “But a repair can be an alternative for some individuals and the type of tear Dominic had is amenable to that. Most people are not candidates for it because of the location of the tear, but for patients that are, there are some benefits.”

    The ACL attaches to bone in two places—the tibia (leg bone) and the femur (thigh bone). In a repair, strong stitches help anchor the ligament back onto the bone, leading to a faster recovery of about four to six months and more natural-feeling knee movements.

    “Repair techniques are now done arthroscopically with a small camera and better instruments so we can see what we are doing without harming a lot of other tissue,” says Dr. Postma.

    Dr. Postma says that all of his patients to date have had successful repairs. That has certainly been the case for Dominic, who was back on the court six months after his repair surgery.

    “It is easy to become discouraged because the recovery process challenges you in ways that you are naturally unaccustomed to,” Dominic says.

    “However, your confidence rises as you keep a positive attitude and notice your progress from week to week. People have actually told me I’ve gotten better as a player since the surgery,” he says with a laugh.
    “I feel just as happy on the court as I did before the injury. It hasn’t held me back at all.”

    Learn more

    To learn more about orthopaedic treatments offered at MedStar Georgetown, visit MedStarGeorgetown.org/ACLRepair or call 202-295-0549 to make an appointment.

    Meet William Postma, MD

    Dr. Postma is an orthopaedic surgeon at MedStar Georgetown University Hospital, part of the MedStar Orthopaedic Institute.

    Watch Dr. Postma discuss hip, knee and shoulder surgical options.

    Watch Dominic’s Story