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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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  • June 05, 2021

    By MedStar Team

    Congratulations to all MedStar researchers who had articles published in May 2021. The selected articles and link to PubMed provided below represent the body of work completed by MedStar Health investigators, physicians, and associates and published in peer-reviewed journals last month. The list is compiled from PubMed for any author using “MedStar” in the author affiliation. Congratulations to this month’s authors. We look forward to seeing your future research

    View the full list of publications on PubMed.gov here.

    Selected research:

    1. Sex and Racial Disparities in the Treatment and Outcomes of Muscle-invasive Bladder Cancer. 
      Urology, 2021. DOI: 10.1016/j.urology.2020.06.08
      Marinaro J, Zeymo A, Egan J, Carvalho F, Krasnow R, Stamatakis L, Lynch J, Hwang J, Williams S, Kowalczyk K.
    2. Orthobiologics in Hand Surgery.
      Journal of Hand Surgery, 2021. DOI: 10.1016/j.jhsa.2021.01.006
      Karim KE, Wu CM, Giladi AM, Murphy MS.
    3. HER2-positive breast cancer and tyrosine kinase inhibitors: the time is now.
      NPJ Breast Cancer, 2021. DOI: 10.1038/s41523-021-00265-1
      Schlam I, Swain SM.
    4. The impact of COVID-19 patients with troponin elevation on renal impairment and clinical outcome.
      Cardiovascular Revascularization Medicine, 2021. DOI: 10.1016/j.carrev.2021.05.004
      Case BC, Yerasi C, Forrestal BJ, Chezar-Azerrad C, Shea C, Rappaport H, Medranda GA, Zhang C, Satler LF, Ben-Dor I, Hashim H, Rogers T, Weintraub WS, Waksman R.
  • June 05, 2021

    By MedStar Team

    In May, investigators, educators, innovators, and associates came together virtually for three days at the 2021 MedStar Health-Georgetown University Research Symposium and CENTILE’S Colloquium for Educators in the Health Professions.

    Nearly 300 research posters and abstracts were submitted by MedStar investigators and residents in eleven research areas. The first day started with a viewing session for all posters and abstracts followed by opening remarks by both Kenneth Samet (President and Chief Executive Officer, MedStar Health) and Jack DeGioia (President, Georgetown University).  Our keynote address was presented by Dr. David J. Skorton, President of the Association of American Medical Colleges and past president of the Smithsonian Institutes. The first day also included the highest-scoring resident and oral presentations followed by a moderated research poster session and networking. These presentations allow residents and fellows to gain the experience of presenting their research and allow them to share their work with the larger MedStar Health & Georgetown University communities.

    Day 2 began with the Colloquium for Educators in the Health Professions, with opening remarks from Pamela A. Saunders, PhD, Programs Chair, CENTILE, Center for Innovation and Leadership in Education (CENTILE), Dr. Aviad Haramati, PhD, Director, Center for Innovation and Leadership in Education (CENTILE), and Dr. Edward B. Healton, Executive Vice President for Health Sciences, GUMC, Executive Dean, Georgetown University School of Medicine. After welcoming remarks, there was a presentation on racial and health justice discussing “Diversity, Inclusion and Anti-Racism: A Journey through Undergraduate Medical Education” including speakers Michelle Roett, MD; Sarah Kureshi, MD; Susan Cheng, Ed.L.D., MPP; Keisha Bell, MD; and Megha Fitzpatrick, MD. This was followed by educational plenary speakers including our new Dean of the Medical School, Dr. Lee Jones and Dr. Stephanie Detterline, along with workshops and networking.  

    The Symposium wrapped up on day 3, with research plenary speakers Jay Khanna, MD, MBA, and Aviram M. Giladi, MD, MS, followed by additional research posters and educational sessions. 

    You can still view the posters on the Attendee Hub for a limited time!  We will be able to offer all sessions as recordings in the future. For now, we are pleased to share the main stage remarks with you here, to watch, share or re-watch.

    View the Monday opening session: Ken Samet, Dr. Jack DeGioia, Dr. Steve Evans, and Dr. David Skorton
    View the morning session of the Colloquium for Educators in the Health Professions
    View the Tuesday Plenary speakers remarks: Dr. Lee Jones & Dr. Stephanie Detterline
    View the Wednesday Plenary speakers remarks: Dr. Jay Khanna & Dr. Avi Giladi

    In order to make future events better, we’d love to get your feedback in a short, anonymous survey: Complete the survey here.

    Thank you for your attendance, patience, and engagement in advancing health through research!

  • June 04, 2021

    By The MWHC Blog Team

    Kassie Savoy joined MedStar Washington Hospital Center 11 years ago as an executive coordinator in Human Resources. She had previously earned her bachelor’s degree in Health Care Administration from Towson University and was looking forward to starting her career here.

    “I was excited about the opportunity and was quickly drawn to the complexity and pace of the organization, the people who work here and the patients and community we serve.”

    In 2013, Kassie earned her master’s degree in Healthcare Administration from the University of Maryland, with assistance from MedStar Health’s tuition reimbursement program. While completing her master’s, Kassie began working with Dr. Arthur St. Andre on projects analyzing frequent users of the Emergency Room, reducing readmissions, and improving Quality & Safety.

    Kassie’s involvement in these projects resulted in a unique opportunity to create her next position. From September 2014 through May 2018, she worked first as a project manager and then assistant director with President Gregory Argyros, MD, then chief medical officer. In these roles, she oversaw projects related to physician engagement and performance improvement, quality and safety, patient throughput, patient experience, and population health.

    “I feel very fortunate,” said Kassie. “It was an invaluable experience, allowing me to work with many different people across the organization on strategic initiatives for the Hospital Center. I learned from the leaders and teams I worked with and was able to carry that knowledge into my next position.”

    Kassie credits Dr. Argyros with mentoring her interest in operations, and appreciates him taking a proactive approach, inquiring about her goals and determining how he could help her succeed.

    In 2018, Kassie transferred to Orthopaedics as the director of operations. After two years in that position, Kassie transitioned into her current role as director of Advanced Heart Failure and Ambulatory Operations with MedStar Heart & Vascular Institute. This expanded her responsibility to both ambulatory and programmatic operational oversight.

    “There are a lot of opportunities working for MedStar Health,” said Kassie. “Identify what motivates you, discuss your goals with your leaders, seek out feedback, and explore different pathways to learn and grow. I’ve loved my time here and am very thankful for the support I’ve received from my colleagues and leadership teams. I look forward to continuing my career at MedStar Health.”

    Looking for a new career opportunity?

    Join our team!

    Visit our Jobs Portal

  • June 04, 2021

    By MedStar Health

    Migraines are quite common, affecting 18 percent of women and 6 percent of men in the United States, according to the Migraine Research Foundation. It’s a more severe type of headache with moderate to severe pain on one or both sides of the head and usually is accompanied by an upset stomach, sensitivity to light and sound, and in some cases, vomiting. Thankfully, there’s a plethora of over-the-counter (OTC) and prescription medications available for treating it. But, what if you could lessen the pain ahead of time or at least prevent your migraine from interrupting your day and sending you to the nearest emergency room? Here’s everything you need to know about migraines and how to treat them.

    Migraines with aura vs. migraines without aura.

    Migraines can be broken down into two broad categories, migraine with aura and migraine without aura. A migraine with aura is a migraine that comes after a brain symptom, and often, that symptom is a change in vision. For example, you may see a bright flashing spot that turns dark. The spot might move for a few minutes or grow to the point where it’s difficult to see through that spot, and the aura will resolve within sixty minutes from when it started. Usually, a migraine follows immediately after or within an hour after the aura resolves itself.

    With aura:

    While visual aura is the most common, there are other types of aura. Some examples include a sensation of numbness, tingling, or weakness on one side of the body, dizziness or a sense that the room is moving, or difficulty speaking. The initial episode of migraine with aura can be especially frightening because the symptoms are similar to that of a stroke. Symptoms lasting longer than one hour should be evaluated by a medical professional. You should see your health care provider to discuss your symptoms if you’ve experienced what may be migraine with aura.

    Without aura:

    Migraine without aura, is more common, and occurs when there is no associated aura prior to the migraine. People experience head pain with nausea or vomiting and light and sound sensitivity. The pain is often one-sided, throbbing or pulsing in nature, and can worsen with physical activity. That said, people who have migraines without aura may also experience migraines with aura on occasion.

    Do you suffer from migraines? According to the Migraine Research Foundation, about 24% of adults in the U.S. are affected by them. Here’s everything you need to know about migraines, including what causes them and options for treatment: https://bit.ly/3vVA1xr.

    Click to Tweet


    Can certain things trigger a migraine?

    Migraine is a genetic disease that can be impacted by the environment. Often, migraine is the result of having a certain genetic makeup, through which you inherit a brain that is more sensitive, and changes in your behavior, habits, or the environment around you can cause a migraine cycle to occur.

    There are several environmental changes that can trigger migraines. Most often, these factors include:

    • Changes in the weather (i.e. before or after it rains or snows)
    • Dehydration
    • Hormonal changes, for women (before or during menstrual period, during early phase of menopause)
    • Lack of sleep
    • Overuse of OTC medications
    • Stress

    In addition, many people consider food as a trigger for migraines. But currently there is no substantial evidence to support this. It’s hard to say that particular foods always correlate with migraine attacks because symptoms and triggers can vary from person to person. It’s actually rare that migraines are caused by one particular thing. Usually, certain factors layer and feed off of each other, and when combined, they can trigger a migraine. For example, if you’re working long hours and under a lot of stress, have irregular sleep patterns, don’t exercise regularly, and don’t eat nutritious meals, then together these factors could trigger a migraine.

    What is recommended for pain relief?

    Depending on the severity of your migraine and how fast it starts, some relief methods will be more effective than others. Since migraine headaches can last for up to three days, it’s important to treat them as soon as they begin. If your migraine starts with moderate pain that builds gradually, consider taking an OTC medicine that includes one of the following ingredients:

    • Acetaminophen
    • Aspirin
    • Ibuprofen
    • Naproxen
    • Salicylic acid

    Before taking medication, it is important to always consult with your primary care provider about treatment options, especially if you’re already using prescription drugs for a different condition. When using any type of medicine, you should follow the directions stated on its label. You can also treat your symptoms using holistic and topical methods like taking deep breaths, sleeping, or applying an ice pack, heat pack, or mentholated cream to your head.

    If you’re still unable to relieve the migraine, speak with your provider about prescription options. Or, speak with a neurologist for a more targeted treatment. Ask your doctor or neurologist about a preventive method to decrease the frequency of the headaches so they don’t negatively impact your life.

    Request a consultation with a neurologist.

    Does gender play a role in causing migraines?

    Due to hormonal changes, migraines tend to be more common in women in comparison to men. Interestingly though, during childhood migraines occur more frequently in boys than in girls. But as they reach puberty, the reverse happens. As boys age, their frequency of migraines tends to decrease over time, and when girls begin their menstrual cycle, the possibility and frequency of migraines can increase as they get older. It’s possible that the frequency may be affected by the increase of testosterone in young men and the lack thereof in young women during puberty.

    While more research needs to be done on the effects of testosterone, some medical experts say it could reduce inflammation. And as a result, reduce the pain and other side effects of migraine attacks. However, at this time, there is no substantial proof to support that theory.

    Is it possible that migraines can be a sign of something more serious?

    If you’re concerned that you may have a more severe, underlying condition, a neurological exam can determine if anything else is going on in addition to your migraine. For adults over age 50 who have new onset headaches unlike anything they’ve experienced before, that could be a sign of something more serious. If you already have a history of migraines, but there’s a change in the pattern or frequency or they’re accompanied with fever, weight loss, or confusion, that’s also a concerning sign. If you have a preexisting condition that can compromise your immune system, your doctor may further investigate if anything else is causing the acute headaches. In any of these scenarios, we recommend that you get a neurological exam and seek specialized care from a physician.

    Take control of your migraines.

    Having a better understanding of migraines can make it easier to take control of your symptoms and tackle your migraines head on. For those with acute cases of migraine attacks, pain relief is attainable with the help of your primary care doctor or neurologist. With more knowledge and resources in tow, you have the advantage over your headaches and can maintain a great quality of life.


    Do you suffer from migraines?
    The neurologists at MedStar Health are here to help.

    Learn more or request a consultation.

  • June 03, 2021

    By James Robinson, MD

    Are you familiar with uterine fibroids?  

    If you’re a woman, chances are you may gain firsthand experience with fibroids at some point in your lifetime. In fact, the National Institutes of Health estimates that 80 percent of all women will develop one or more uterine fibroids by age 50.  

    Fibroids develop when a muscle cell in the uterus clones itself and expands. The good news is, these growths are not cancerous or even pre-cancerous, never spread beyond the womb, and are not life-threatening.  

    Many remain small and cause no symptoms or issues; however, others may enlarge and affect a woman’s quality of life by causing excess bleeding or by placing pressure on abdominal organs. Here are four things to know about uterine fibroids: 

    #1—Your Risk of Uterine Fibroids May Be Fairly High

    Because fibroids are so prevalent in adult females, every woman is considered potentially at risk. That risk increases if your mother or sister has experienced fibroids. African American women are more likely to develop fibroids and tend to experience them earlier as well, often by age 30.  

    What causes uterine fibroids? The female hormones estrogen and progesterone stimulate their growth, so fibroids may occur at any time during the reproductive years, from onset of menses through menopause. They rarely disappear on their own, although they do tend to shrink post-menopause. 

    It’s suspected that exposure to certain elements in the environment—for example, certain plastics, hair care products, cosmetics, and even repeated handling of printed cash register receipts—may affect hormone levels and increase a woman’s risk. 

    Diet may play a role, too. Foods containing plant-based estrogen, such as tofu and other soy products, could increase risk; likewise, diets high in red meat and low in fruit and vegetables are suspect, as is alcohol consumption. 

    To date, there are no known ways to prevent fibroids. But choosing a diet high in whole grains, vegetables, fruit, and lean meats; maintaining a healthy weight; and limiting alcohol are recommended to help protect against these growths and a host of other diseases. 

    #2—Uterine Fibroid Symptoms Can Vary

    Fibroids can develop anywhere in or on the womb and can range in size from undetectable by the human eye to much larger. Smaller fibroids with no symptoms may eventually be detected during a woman’s routine gynecologic visit or prenatal exam.  

    Other signs of uterine fibroids may be more problematic: 

    • If or when a larger uterine fibroid outgrows its blood supply and begins to die, it can cause sharp pain in the process. 
    • Heavy and prolonged bleeding during menstrual cycles is a common symptom of fibroids. As the uterus contracts in an attempt to slow the bleeding, pain from cramping can also occur. 
    • Depending on their size or location, one or more fibroids can create undue pressure on nearby organs. For example, if a fibroid presses on the bladder, it can cause urinary frequency or urgency. If the rectum is compressed, the patient may experience bloating and constipation. When a fibroid is low in the pelvic region, the patient may have discomfort sitting or during intercourse. And if a fibroid is high on the uterus, the patient may notice or feel an abnormal bulge in her belly. 

    #3—Uterine Fibroids Can Affect Pregnancy

    Fibroids within the womb may interfere with an embryo’s ability to attach to the uterine lining, resulting in infertility, miscarriage, or preterm labor. 

    When a woman with one or more uterine fibroids does become pregnant, the developing fetus is rarely affected; however, the fibroids can make the pregnancy more uncomfortable. Increased hormone levels during pregnancy can also accelerate fibroid growth. 

    And if a fibroid mass begins to die, the expectant mother may require pain management until it shrinks.

    Although uterine fibroids are not life-threatening, as many as 80 percent of females may experience them. Dr. James Robinson reviews four things women should know about these very common growths. @jimkrobinson3 https://bit.ly/3g31bMe via @MedStarWHC
    Click to Tweet

    #4—Treatment of Uterine Fibroids Has a High Success Rate

    If we suspect the presence of uterine fibroids, we first conduct a physical exam and a review of the patient’s personal and family history. If fibroids appear likely, we will typically perform some form of imaging to better characterize the fibroids. This might be an ultrasound or MRI.  In selected cases, we perform hysteroscopy in the office, using a thin tube with lights and a camera to examine the interior of the uterus.  

    Even when fibroids are found, not all growths call for treatment. Some women will choose to delay treatment until and unless they experience problematic symptoms.  

    In cases where uterine fibroid treatment is indicated, a main consideration is whether or not the patient plans to become pregnant. If she does:  

    • We can remove fibroids via a procedure called myomectomy, leaving the uterus intact and preserving potential fertility. In patients with fibroids in the endometrial cavity or womb, the same hysteroscope camera used during diagnosis can be fitted with instruments to aid fibroid removal. Patients typically recover quickly from this hysteroscopic same-day surgery, with all symptoms resolved.  
    • When a fibroid growth is too large to be removed via hysteroscope, we perform minimally invasive laparoscopic surgery using keyhole-sized incisions. Even large growths can be eliminated this way, with faster recovery time and fewer complications.  
    • Although oral contraceptives may be used to reduce bleeding, they may actually spur further growth of the fibroid. Oriahnn® is the only oral medication approved by the FDA to control heavy bleeding due to fibroids; it’s been well tolerated so far, and long-term studies are underway. Non-steroidal anti-inflammatory drugs like ibuprofen and naproxen can also help reduce a patient’s discomfort and bleeding. 

    If a patient does not plan to become pregnant, we can offer additional options such as laparoscopic hysterectomy, a measure that can resolve bleeding or fear of recurrence.  

    Be assured, today’s hysterectomy procedure is minimally invasive and very well tolerated by most women. Over 98 percent of hysterectomies are completed same day, laparoscopically, via keyhole incisions. Ovaries and the hormones they produce are left intact. The vagina is unaltered, so sexual function is preserved. Supportive pelvic structures are untouched, for less risk of prolapse or incontinence.  

    Recovery typically takes about two weeks, and many of our patients say they wish they’d had the procedure years earlier. 

    Other Approaches to Treatment

    In occasional cases where surgery is not viable, our interventional radiology team may be able to shrink the growth by inserting a small catheter into a blood vessel in the groin or wrist and threading it to the artery supplying oxygen to the fibroid. The procedure blocks the growth’s blood and oxygen supply, forcing it to shrink and die. Most patients who feel pressure from fibroid growths notice improvement following this treatment; 85 percent see a significant decrease in bleeding. 

    In addition, a new approach called The Sonata® Treatment can deliver radio-wave energy directly to a fibroid. This procedure can be performed in an outpatient setting with light anesthesia or sedation, similar to what is administered during a colonoscopy. This promising technology enables significant decreases in bleeding with very low complication rates. 

    Another approach to treatment is use of a drug such as Lupron to block production of the estrogen and progesterone feeding the fibroid; however, these drugs tend to be used for a short time because of potential side effects. We may use them, for example, to reduce bleeding while a woman recovers from anemia, or in cases when blood transfusion is not an option.  

    We’re Here for You

    If you endure routinely heavy menstrual bleeding, feel persistent pelvic pain or pressure, or have had recurring miscarriages, reach out to the team at MedStar Washington Hospital Center. Our multidisciplinary team includes gynecologists, interventional radiologists, and some of the best-trained surgeons performing minimally invasive surgery in the country, many of them at the forefront of research activities spurring advances in the field.  

    Team members collaborate to offer a full range of treatment options that meet the individual needs of every patient. Surgeons and specialists will often meet with the patient together.  

    Remember: it isn’t necessary to tolerate pain, bleeding, or discomfort from fibroids. The earlier we can work with you to address the issue, the more quickly we can have you comfortable and pain-free!

    Bleeding? Pain? Tenderness?

    Our gynecologic surgery team can help.

    Call 202-788-0402 or Request an Appointment

  • June 02, 2021

    By Emil S. Oweis, MD

    If anybody knows the rules of social distancing, it’s patients with cystic fibrosis (CF). Well before the pandemic, patients with this genetic condition were practicing the 6-feet apart rule to reduce their risk of serious respiratory infections.

    CF causes thick mucus secretions to develop in the lungs and other organs, often the pancreas. More than 300 known gene mutations are associated with CF, each causing slightly different severity and symptoms, such as:

    • Constipation
    • Frequent bulky, greasy stools
    • Frequent lung infections, such as bronchitis or pneumonia
    • Male infertility
    • Salty-tasting skin
    • Shortness of breath or wheezing
    • Persistent coughing with phlegm
    • Poor growth or weight gain in childhood

    Most patients are diagnosed in infancy. Just 50 years ago, having CF meant a child wasn’t expected to live to adulthood. Nowadays, thanks to medical advances and research made possible by the CF Foundation, patients are living into their 50s and older, giving rise to the relatively new field of adult CF care.

    My team and I see adult patients at our CF Foundation-accredited Level III Cystic Fibrosis Center at Children’s National Medical Center. Our multidisciplinary team helps guide patients through all facets of treatment, from exercise and physical therapy to nutrition, respiratory, and psychosocial support.

    Meet Ruby: Recent college graduate & CF ambassador.

    Ruby Steuart, a 21-year-old nurse technician at MedStar St. Mary’s Hospital, is one of 15,000 U.S. adults with CF. According to Ruby, she’s “on the healthier end in the grand scheme of CF.” Even so, she needs around two hours’ worth of treatments every day to control her symptoms.

    Diagnosed at 18 months old, Ruby has managed her own CF treatment routine since middle school. She’s going to give us a glimpse into her daily life with CF. Then we’ll regroup and discuss the latest in cystic fibrosis, including updates on the CF wonder-drug, TRIKAFTA.

    Just 50 years ago, having #CysticFibrosis meant a child wasn’t expected to live to adulthood. Today, patients are living to their 50s, thanks to medical advances and awareness: https://bit.ly/2SS51jr.

    Click to Tweet


    I’m Ruby—CF patient & future physician assistant.

    As an adult with cystic fibrosis, I’m fortunate to be fairly healthy. I haven’t experienced as many disappointments as my CF friends who are sicker than me—missing family vacations, proms, and sports because of illness or hospitalization.

    Even so, sticking to my daily treatment routine during college has been a difficult adjustment. I was sick for most of my first semester at the University of Maryland. Despite the safe, hygienic campus, I’d never been around so many people before—and so many germs. By the second semester, I got used to my busy schedule and made taking care of myself a priority.

    While challenging, my investment in self-care has evolved into a passion for health care. I’m graduating from UMD in May 2021 (joining the nearly 18% of CF patients my age who graduate college!). From there, I plan to attend Arcadia University to become a physician assistant (PA).

    My daily routine.

    Every day, I invest 90 minutes to two hours in my CF treatment plan—longer if I am sick with a respiratory infection—and I take about 30 pills a day. My routine includes:

    • Breathing treatments: I take three nebulized (inhaled) medications: Pulmozyme®, albuterol, and hypertonic saline 7%. These medications loosen the mucus in my chest so I can cough it out. I also take Advair and albuterol through an inhaler for the same purpose.
    • Digestive medications: I take pancreatic enzymes every day to help me digest food. Right now, I’m taking ZENPEP. Approximately two-thirds of adult patients with CF at MedStar Health take pancreatic enzymes.
    • Antibiotics: I take a few different kinds of antibiotics to help prevent lung infections. Currently, I’m on azithromycin and lansoprazole.
    • Supplements: CF can mess up how your body absorbs certain vitamins and minerals from food, so I take vitamins A, D, E, and K to compensate.
    • Vest: The vest vibrates my upper body, shaking and loosening the mucus off my chest wall and lungs.

    This might seem like a lot of work, and it is. But it’s the life I’ve always known, and it’s what I need to do to feel my best. When I feel healthy and strong, I can be a better partner for my patients and colleagues at MedStar St. Mary’s Hospital. When I become a PA, I’ll owe it to my patients to bring 110% of my energy every day.

    Prioritizing my treatments was a big part of me getting through the pandemic so far without catching COVID-19, even while taking care of sick patients at work. My supportive colleagues give me grace when I need to wear extra protective gear or help from a distance. Plus, I was used to social distancing and wearing personal protective equipment long before the world at large started hearing those terms.

    Giving back to the CF community.

    Volunteering with the CF Foundation is one of my biggest passions. In 2019, I became a CF Foundation Great Strides ambassador. My role involves fundraising, marketing, public speaking, and social media outreach to encourage people to attend our events.

    Ruby receiving a proclamation from Maryland’s First Lady Yumi Hogan declaring May Cystic Fibrosis Awareness Month in Maryland.

    Every year, Team Fireworks participates in the CF Foundation Great Strides walk in Annapolis. To date, our team has raised approximately $50,000 for cystic fibrosis research.

    Having CF also allows me to give back by participating in clinical trials. In 2019, I traveled to New York City for a clinical trial, and I’m currently enrolled in a study for a new combination of CF medications. Search the CF Foundation Clinical Trial Finder. 

    Ruby with friends and family at the 2017 CF Foundation Great Strides walk in Annapolis.

    I join clinical trials to help get better treatments for myself, my friends with CF, and even people I’ll never meet. Like many other patients with CF, optimism keeps me going. We must keep pushing forward, with patience. I know a cure will come someday, and when it does, it will be amazing.


    CF medication can transform patients’ lives.

    As Ruby mentioned, prioritizing self-care is essential for successful adult CF outcomes. And taking the proper medication combination is a large contributor to that success.

    Four drugs are approved by the US Food and Drug Administration (FDA) to treat CF. These drugs either:

    • Help the cystic fibrosis transmembrane conductance regulator (CFTR) proteins stay open longer at the cell surface (potentiators), or
    • Bind to the CFTR proteins to help them reach the cell surface better (correctors)

    The most recently approved drug was TRIKAFTA in 2019—a twice-daily pill that has transformed the lives of thousands of patients with CF. The three-drug combination CFTR-modulator is the first drug that addresses the most common CF mutation, F508del, which affects 90% of patients.

    Essentially, TRIKAFTA can stop the CF disease process in its tracks. In many patients who take it, their lungs stop producing excess mucus altogether—sometimes within a week of starting treatment. Patients who are eligible for TRIKAFTA include those with CF who:

    • Are 12 or older
    • Have at least one F508del gene mutation, or
    • Have at least one other newly approved mutation that is responsive to TRIKAFTA

    Ongoing research here at MedStar Health and around the country is looking at long-term outcomes with TRIKAFTA. We are working to better understand whether residual disease remains despite symptom improvement with the drug, and if so, how to treat it.

    Provider education for better outcomes.

    A continuing area of emphasis for our CF center is education: for patients, MedStar Health providers, and community providers throughout the U.S. Since the disease once had a short-term outlook, there is a great need for education in the provider community to prepare them for generations of adults with CF who will need primary, reproductive, and specialty care.

    Though these patients don’t necessarily need anything different, their providers should understand their condition and daily routine as it relates to planning medications and procedures. MedStar Health’s multidisciplinary CF team fans out to our network of system and referring providers in all fields to provide awareness, guidance, and support in the care of adult patients with CF.

    The future of CF treatment.

    Along with ongoing research around TRIKAFTA, we are also studying options to treat tissue long-term inflammation and organ damage once a patient’s symptoms are well-controlled. This relatively new area of study will become increasingly important as the life expectancy for patients with CF continues to extend.

    As patients grow into adults, they’ll get the chance to deal with all the typical health and lifestyle stressors many people take for granted: busy careers, raising families, developing arthritis and wrinkles. Just 50 years ago, children with CF might not have dreamed of such a future for themselves.

    Through the whole trajectory of life, from infant diagnosis to a ripe, older age, we consider it an honor to partner with patients in their management of cystic fibrosis. Looking forward, we expect our CF program to grow alongside our patients.

    Get exceptional adult cystic fibrosis care at MedStar Health.
    Our CF specialists help patients transition from pediatric to adult care. Click below to learn more about pulmonary care at MedStar Health or to find a specialist.

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