MedStar Health blog : MedStar Health

MedStar Health Blog

Featured Blog

  • 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

All Blogs

  • October 16, 2017

    By David H. Song, MD

    Women who have a mastectomy often are concerned with how their breast will look and feel after reconstructive surgery. About 80 percent of women choose to get a breast implant after having breast cancer surgery. While this is a great option for some women, it’s not for everyone.

    We offer an alternative to implants – autologous breast reconstruction – which uses tissue from a woman’s own body to reconstruct the breast. Nearly everyone is a candidate for this procedure, and I think it should be the standard of care in breast reconstruction.

    How does autologous breast reconstruction work?

    Autologous breast reconstruction involves rebuilding the breast using only a patient’s own body parts. No artificial breast implants are involved.

    Autologous #breastreconstruction involves rebuilding the #breast using only a patient’s own body parts. via @MedStarWHC

    Click to Tweet


    While there are several types of flap reconstruction for breasts, we use what’s called a DIEP flap. A DIEP flap uses blood vessels in the abdomen called deep inferior epigastric perforators, as well as the skin and fat connected to these blood vessels. We take these blood vessels, skin and fat and transplant them from the abdomen to the chest, molding them to rebuild the breast.

    DIEP flap surgery may be done at the same time as a mastectomy or at a later date, depending on what your doctor recommends and what you prefer.

    There are very few patients who aren’t good candidates for this procedure. We may not recommend autologous breast reconstruction if a patient has other health problems, such as heart or lung conditions. These conditions may prevent women from being good candidates for breast implants as well. And, of course, a patient needs enough extra skin and fat for us to transplant to the breast. So, for example, a 5-foot-5-inch woman who’s 98 pounds with D-cup breasts likely wouldn’t have enough tissue to borrow from. But aside from these two extreme types of cases, there aren’t any reasons why someone couldn’t consider autologous breast reconstruction.

    It’s important to talk to your doctor about the pros and cons of a breast reconstruction procedure.

    Request an appointment with me through our secure online form , or contact me at (202) 967-4575 so we can discuss whether autologous breast reconstruction is right for you.

     

    Request an Appointment

    How a DIEP flap compares to implants

    For a woman who’s had a mastectomy, a DIEP flap is the best option, in my opinion. A DIEP flap results in a nice, supple breast that a woman will have the rest of her life. Breast implants, in contrast, only last 10 to 15 years before needing to be replaced in an additional surgery.

    A #DIEPflap results in a nice, supple #breast that a #breastreconstruction patient will have the rest of her life. via @MedStarWHC

    Click to Tweet


    One potential side benefit of DIEP flap surgery is that patients get a sort of “tummy tuck” effect when we take the skin and fat from the abdomen to build their new breasts. If we can’t take enough skin and fat from the tummy to rebuild a patient’s breast, we can take it from the thighs or buttocks if necessary.

    Something to keep in mind is that breast implants aren’t compatible with radiation treatments. This means women with artificial breast implants may have issues if they need to have some forms of diagnostic imaging, such as CT scans or X-rays, as well as future cancer treatment with radiation oncology. These are some potentially serious downsides patients should consider before deciding to go with an implant.

    There are small chances of complications or failure in DIEP flap surgeries. Patients have a 0.8 percent chance of getting a hernia from transplanting the tissue from the abdomen. And in rare cases—about 1 out of 100 surgeries—the transplant can fail. Both of these are highly dependent on the skillset of the surgeon. That’s why it’s critical for patients who are interested in autologous breast reconstruction to choose a surgeon who has a great deal of experience with the procedure.

    Our expertise with autologous breast reconstruction

    My team and I have performed more DIEP flap surgeries than anyone else in the region. Between us, we’ve done somewhere between 3,500 and 4,000 of these technically challenging surgeries. The next-closest group to us in terms of the number of surgeries has only done 800 to 900 of these procedures.

    Patients from all over the country who have had mastectomies have come here for reconstruction. In fact, after I moved here from Chicago, my first 12 patients were women who followed me from there because they wanted me to complete their reconstructions.

    Every body shape is different. That means each breast we reconstruct is going to be just a little different than all the others. We go over the possibilities with each of our patients, walking them through their options and learning the goals they hope to accomplish with their reconstruction. That’s how we personalize our care and ensure women have an outcome they’ll be happy with for the rest of their lives.

    I wish no one had to go through breast cancer. But we have options available to rebuild patients’ breasts after the often painful and difficult process of being treated for the disease. Patients may sometimes feel like they’ve lost their femininity after treatment. But we’re able to help restore their senses of self-esteem and womanhood as they take the steps they need to reclaim their lives. If there’s a silver lining to breast cancer and its treatment, it’s that. And I’m glad to be a part of that process for my patients.

  • October 12, 2017

    By Andrew Sokol, MD

    Some women have to deal with unpleasant body issues every day. A common one is peeing when you sneeze, cough, laugh hard or exercise, otherwise known as stress urinary incontinence.

    This type of bladder leakage, or urinary incontinence, accounts for 50 percent of all the cases of incontinence I treat. Many women don’t think twice about crossing their legs when they cough hard or sneeze. It’s normal after having kids or as you age, right? No. It’s common, but it’s not normal.

    Pee a little when you cough/exercise? It may be stress urinary incontinence, an abnormal condition we can treat. via @MedStarWHC

    Click to Tweet


    Stress urinary incontinence happens when the muscle that closes off the bladder (the sphincter) doesn’t work as well as it should. This can happen when the sphincter nerves, muscle or both get damaged, which often is caused by vaginal childbirth. This type of bladder leakage also can happen because of intrabdominal pressures and other changes that happen as women age.

    But there are highly effective, minimally invasive treatments that can cure this common, but not “normal,” condition.

    What should you do if you have bladder leakage?

    First, see your primary care doctor or gynecologist to rule out possible infections, like urinary tract infections. If nothing is wrong, but you still experience symptoms, it’s time to see a urogynecologist.

    Urogynecologists are specially trained in pelvic floor conditions like stress incontinence. Medication usually won’t work to treat this type of bladder leakage, but there are many treatment options that we can recommend. Cutting down on fluid consumption, doing Kegel exercises to strengthen the pelvic floor muscles and urinating on a schedule can help keep symptoms at bay if you have just a little bladder leakage.

    But if the leakage is enough to affect your quality of life, I’ll be honest—none of these will be as effective over time as a simple outpatient procedure. Urogynecologists perform a higher volume of incontinence procedures compared to general gynecologists, which improves your chances of a good outcome.

    Request an appointment to discuss bladder leakage problems with a urogynecologist.

    Request an Appointment


    Midurethral sling surgery for stress urinary incontinence

    The gold standard of stress urinary incontinence treatment is a midurethral sling procedure. It’s the most studied, most effective treatment for stress bladder leakage, and it’s highly effective with low risk. Women’s happiness rate for the surgery is 80 to 90 percent.

    Please note: This is not the same mesh sling you may have seen in lawsuit commercials on TV or online. That’s for an entirely different issue called vaginal prolapse.

    Sling surgery for stress urinary incontinence takes just 20 minutes, and we do it in the office. You’ll get local anesthesia and light sedation, which means we don’t have to put you all the way to sleep. Then we make a half-inch incision inside the vagina to access the urethra—the tube through which pee exits your bladder. From there, we use a tiny mesh sling that supports the urethra to prevent bladder leakage from sneezing, coughing and other day-to-day functions.

    Most women can expect rapid recovery, including leaks stopping almost immediately. Half of our patients can urinate normally right after surgery. The other half go home with a 3-inch catheter for just a few days. Of those who take a catheter home, 90 to 95 percent of them can pee normally within three days. If they can’t go normally after three days, the mesh may be a little too tight, and we can loosen it to get them flowing normally again.

    I’ve learned in my long career never to tell people how much discomfort they’ll have after surgery, because everyone is different. But most women have minimal to no issues. Still, we recommend they avoid placing anything in the vagina for the first 2 weeks. That means avoiding sex and the use of tampons, for example. We also recommend avoiding extreme exercise, such as heavy weightlifting and endurance running. In the first few days after surgery, women can start back to light exercise, such as walking or moderate running.

    If you’ve had complications with synthetic mesh surgeries in the past, this may not be the right procedure for you. Your doctor can help you find an alternative to cure your urinary stress incontinence.

    Urinary leakage is a common problem, but it can be fixed. If you’re tired of crossing your legs to sneeze or losing urine when you exercise, come see us. We’ll find a solution to fit your condition and lifestyle.

  • October 11, 2017

    By MedStar Health

    The use of home oxygen has increased over the past decade. While oxygen itself is not flammable, an oxygen-rich environment can cause any material that catches fire to burn more readily, quickly and hotter. It’s critical that patients understand the risks associated with home use of medical oxygen. The Burn Center at the MedStar Washington Hospital Center has treated patients who were badly burned while using home oxygen.

    In 2003-2006, hospital emergency rooms saw an estimated average of 1,190 thermal burns per year caused by ignitions associated with home medical oxygen. 

    • Eighty-nine percent of the victims suffered facial burns
    • In most cases, the fire department was not involved

    The Burn Center team recommends these tips to help you take better precautions for oxygen safety in the home:

     


     

  • October 11, 2017

    By MedStar Health

    By Chris Goeschel, ScD, MPA, MPS, RN

    Earlier today Facebook reminded me of a memory from 2015. I am not a daily FB user, and I limit my posts to select, real friends, versus the “I know someone who knows you“ category social media tends to classify as “friends”. Ironic that the post referred to an Institute of Medicine (IOM) Panel on which I had served for 2 years, and the report that our committee released in September 2015 on “Improving Diagnosis in Health Care”. Two years ago an article discussing the findings and importance of our report appeared in the New York Times. My FB post included a link to the article.

    Today, as I write this I am sitting on a plane headed to Boston for the 10th annual meeting of the Society to Improve Diagnosis in Medicine(SIDM). My mind drifts to the ways in which life has a way of merging events that occur in isolation, but create reality for individuals. Thirty years ago today my 67-year-old father died from a cancer that was treated as an infection until just weeks before he died. Missed diagnosis? Delayed diagnosis? For me, the memory is he died too young, too quickly, and in a way that surprised his physician, who cried when he told our family that in fact, it was not an infection it was cancer. We have come a long way in 30 years, right? My father never knew a cell phone, TV remotes were the “new thing”, and computers were just starting to make a dent in how we work and live.

    In some ways progress has been astounding; in other ways the pace of change is frustratingly slow. Last week a team of MedStar Institute for Quality and Safety colleagues and I met with others from six healthcare organizations from across the country, SIDM leaders, and leaders from the Institute for Healthcare Improvement (IHI). Together we committed to 9 months of intensive work developing a “prototype” collaborative to guide organizations that are serious about improving diagnosis. The SIDM conference that I attended had more poster presentations than they could handle, and the lineup of speakers transcends from gurus in the quality and safety space (Don Berwick, Dave Mayer, and Amy Edmondson among others) to physicians, nurses and health services researchers in the trenches, who are all too aware that missed diagnosis, incorrect diagnosis, and delayed diagnosis remain a looming challenges.

    Perhaps I should not have been surprised that when I shared my Facebook “memory”, the comments from friends included new stories of how “we” got it wrong, got it “late” or didn’t listen when they tried to TELL us what was going on with their health. These stories are sources of real dissatisfaction.

    The report from our IOM panel suggested that each of us will experience at least one diagnostic error in our lifetime. An important way to help mitigate this reality is to acknowledge that diagnosis really needs to be a team endeavor. The ideal team benefits from patients and families at the center surrounded by physicians, nurses, allied health professionals and others, working together, sharing information, insights, concerns, and successes on behalf of better health for individuals and populations. Watch this space for how to join us on the journey.

    I welcome your comments, questions and stories at mailto:chris.a.goeschel@medstar.net.

  • October 10, 2017

    By MedStar Health

    Dr. Curl serves as assistant team physician for the Baltimore Orioles.

    When an athlete becomes injured, the first question their physician often hears is “how long will it be until I can get back out there?” The specialists at the MedStar Harbor Hospital Sports Medicine and Shoulder Center, part of MedStar Sports Medicine, understand that passion, and are committed to helping those who become injured get the treatment they need to heal and get back to what they love.

    “We work with each patient until he or she reaches their goals,” says Milford H. Marchant Jr., MD, an orthopedic surgeon who is part of the practice and specializes in sports medicine. “It doesn’t matter if you got hurt on the field, at work or at home; we will get you back to being able to do the activities that are important to you.”

    Perhaps it’s that “can do” attitude, along with the clinical excellence demonstrated by Dr. Marchant and his colleagues, Leigh Ann Curl, MD, and Jeffrey Mayer, MD, CAQSM, that has earned the Sports Medicine and Shoulder Center such a superior reputation. So superior, in fact, that many major and minor-league sports teams across the Baltimore and Washington areas have designated MedStar Sports Medicine as their preferred providers for treatment and ongoing care when shoulder, knee, ankle, foot, hip, hand, wrist, elbow or back injuries occur.

    “It is a great honor to care for so many local professional athletes and to know that the leaders of these teams are putting their trust in us,” says Dr. Curl, who serves as head orthopedic surgeon for the Baltimore Ravens and assistant team physician for the Baltimore Orioles.

    While Dr. Curl spends her time on the sidelines at M&T Bank Stadium and Oriole Parkat Camden Yards, Drs. Marchant and Mayer collaborate as team physicians for the Washington Valor. Dr. Marchant also assists with medical care for US Lacrosse. Dr. Mayer serves as team physician for the Maryland Jockey Commission, as well as Arundel, Chesapeake, Glen Burnie, Meade, North County and Northeast high schools.

    “We all truly enjoy working with athletes, however, this is just one part of what we do,” notes Dr. Mayer. “Our team is here to treat patients of all ages and activity levels, using the most advanced therapies and minimally invasive proceduresto reduce pain and get you moving again.”

    In other words, you don’t have to be an athlete to benefit from the wide range of services offered by the sports medicine program. If you are battling a knee injury, or experiencing recurring shoulder or elbow pain, consider scheduling an appointment. Drs. Curl, Marchant and Mayer can evaluate your condition, diagnose your injury and develop a treatment plan based on your personal goals.

    Location Information

    For more information, please call (410) 350-7550.

    MedStar Harbor Hospital
    3001 South Hanover St.
    Baltimore, MD 21225

    Get to Know Our Sports Medicine Physicians

    Leigh Ann Curl, MD, was trained at The Johns Hopkins Hospital and Hospital for Special Surgery. She specialized in sports-related injuries and complex medical conditions of the shoulder and knee and is the first woman ever to be named a head orthopedic surgeon for a National Football League team. She is a fellow of the American Academy of Orthopedic Surgery and a member of the American Orthopedic Society of Sports Medicine.

    Milford H. Marchant Jr., MD, specializes in both the surgical and nonsurgical treatment of injuries and arthritis of the shoulder, elbow, hip and knee. His medical training includes an orthopedic residency at Duke University Medical Center followed by a fellowship at the world-renowned Kerlan-Hope Orthopaedic Clinic.

    Jeffrey Mayer, MD, CAQSM, is a primary care sports medicine physician, specializing in nonsurgical treatment of musculoskeletal injuries and ailments. Following graduation from the University of Maryland School of Medicine, he completed a residency program at Carolinas Medical Center and then a fellowship at the University of Maryland Medical Center.

  • dr_kankam-251x300
    October 10, 2017

    By MedStar Health

    MedStar Harbor Hospital is pleased to introduce the two newest members of our Behavioral Health team.

    Jemima Kankam, MD, FAPA is a board-certified psychiatrist and a fellow of the American Psychiatric Association, specializing in adult and geriatric psychiatry. Before joining MedStar Harbor, Dr. Kankam worked in several psychiatric settings and was in private practice for 25 years. Her area of special interest is promoting public awareness of psychiatric illnesses with the goal of reducing stigma and misconceptions about mental illnesses. Dr. Kankam completed her psychiatric residency training at University of Maryland Medical System in 1990.
    Erica Matthews, PsyD

    Erica Matthews, PsyD is a board-certified clinical psychologist with extensive experience working with individuals who struggle with issues ranging from everyday stressors to traumatic events. She works with her clients to match the most effective approach and techniques to meet their needs, with an emphasis on restoring a sense of well-being and enhancing quality of life. Dr. Matthews received her doctorate degree in clinical psychology from Alliant International University, California School of Professional Psychology.

    Location Information

    For more information, please call (410) 350-7550.

    MedStar Harbor Hospital
    3001 South Hanover St.
    Baltimore, MD 21225