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  • January 14, 2022

    By Allison Larson, MD

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


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


    1. Do: Wear sunscreen all year long.

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


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


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


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


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

    2. Do: Skip products with drying ingredients.

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

    You may need to take a break from:

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

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


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


    3. Do: Pay closer attention to thick skin.

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


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


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


    Related reading:  Follow these 5 Tips for Healthy Skin

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

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


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

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

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

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

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

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

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

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

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


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

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

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

     

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


    Does your skin get drier as the air gets colder?

    Our dermatologists can help.

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

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  • August 30, 2017

    By Allen J. Taylor, MD

    As more people survive and live longer with heart disease, adult children are increasingly becoming involved in their parent’s health care. They support their parents in making diet and lifestyle changes, taking multiple medications, recognizing side effects or new symptoms, figuring out health insurance claims – the list goes on.

    Having a parent with a chronic health condition is one many people can relate to – including myself. I know it sometimes can be difficult to know how to help – or how much to help – but your care and support can make an enormous difference in managing their health, as well as retaining their independence.

    Some of the most successful outcomes I’ve seen in patients came in large part because an adult child was keeping tabs on how the patient was feeling, managing medications and, in some cases, making key medical decisions for them.

    Helping a parent with #heartdisease can range from watching for symptoms to ultimately making medical decisions for them. via @MedStarWHC

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    Let’s discuss five ways you can assist in the care and support of an aging parent – and what you can do if you don’t live nearby. These suggestions can be scaled up or down depending on your parent’s health. And while I may be talking specifically about heart disease, these tips could be modified to work with any chronic health condition.

    1. Learn about their heart condition

    Heart disease can seem overwhelming – for the patient and their loved ones. If your parent agrees, accompany them to doctor appointments. It can help to have a second person in the room while a doctor explains things. You can take notes and ask questions. The information is more likely to stick if there’s more than one person listening in the room.

    You know your parent and their needs better than the doctor. This insight can be especially valuable as health care continues to move toward a shared decision-making model, in which the doctor and patient work together to make decisions based on best practices and patient preferences and values.

    It also may be a good idea to schedule an appointment in which there will be no physical exam or tests, but to simply get you up to speed on your loved one’s condition. Explain that you’re Mom’s or Dad’s helper and while they will join you, the appointment is for you.

    Along with asking about what symptoms to watch for and what role you can play in their recovery and health, ask what the future looks like. This topic may be uncomfortable to discuss, but can be useful for planning if the condition progresses.

    If you care for an ill parent, ask the doctor what the future may hold. It can help with planning if the condition worsens. via @MedStarWHC

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    2. Watch for signs of heart problems

    Providing a second set of eyes and ears may be the best way you can help a parent who has heart disease. Catching problems early can mean the potential for a better outcome.  

    Symptoms of heart problems may not be as obvious in older people. They may be subtler than chest pain. But if you know your parent’s health baseline, you may notice changes before a doctor – or in some cases – even your parent does.  

    Signs to be aware of, particularly if they appear suddenly, include:

    • Do they seem fatigued? Are they sleeping more or longer?
    • Does their breathing seem labored or “off”?
    • Has their appetite declined?
    • Is there increased swelling in the legs or ankles?  

    Your parent may not mention changes in their health. We often see in this in the “Greatest Generation.” They don’t want to be a bother. “It was just a little chest pain. I didn’t want to worry you.” Ask them direct questions about their health. For example, when I talk to my father, I ask, “How are you feeling, Dad? Anything bothering you?” And, include even more specific questions that relate to their personal health problems. For example, “How is your breathing today?”  

    3. Address potential heart problems

    Don’t ignore warning signs. Encourage your parent to seek help, even if the symptom seems minor. Doing so could prevent a more dangerous situation.  

    Create a plan with your parent’s doctor to address potential problems. Ask the doctor:

    • How can we reach you during the day or after hours?
    • Do you offer same-day appointments?
    • When should we go straight to the emergency room?  

    Knowing these answers can result in more streamlined and effective treatment. For example, a patient’s daughter may call and say, “Mom’s having some of the same symptoms she had previously when she was admitted to the hospital. But I think it’s too early to go to the ER. Can I bring her to the clinic?” We may be able to prevent an unnecessary hospital admission.  

    4. Assist with treatment, recovery and prevention efforts

    Your parent’s doctor likely will send them home with a treatment and prevention plan. But there are all kinds of ways that a plan can be derailed. You can plan an important role in keeping their health plan on track.  

    • Track doctor appointments: Add your parent’s doctors’ appointments – or reminders to schedule appointments – to your personal calendar. This way you can help them remember and ensure they have transportation. If your parent agrees, join them at appointments as a second set of eyes and ears.  
    • Manage medications: Medication adherence is crucial in preventing secondary events. Your parent may get frustrated or confused if they are taking multiple medications. Make sure you understand the drug’s purpose, how and when to take it, the potential side effects, and when it needs to be refilled. And, don’t be afraid to ask if any medications can be safely stopped.  This can help in several ways including helping control the number of pills your family member takes, and ensuring that each pill provides a meaningful health benefit. Find more tips to improve medication management.
    • Monitor blood pressure: Blood pressure is a vital measurement we use to assess heart health. But sometimes, the readings may not be accurate during a doctor’s visit. The stress of being in a doctor’s office can cause blood pressure to rise, a condition we call “white-coat hypertension.” The doctor may recommend regular blood pressure monitoring at home. Learn how to monitor your blood pressure at home.
    • Support lifestyle changes: Your parent may be asked to make significant changes in diet and exercise. Offer to help with grocery shopping or cooking. When possible, join them in diet changes or physical activity. The American Heart Association says people are 76 percent more likely to follow a walking program if someone is counting on them to show up.  

    5. Organize health-related records such as insurance, advance directives

    Navigating health insurance plans can be confusing for anyone. But it may be especially difficult for your 85-year-old mother or father. Look at their plan and know what benefits are included. This can become useful, for example, to ensure they don’t defer care they should be getting.  

    Discuss your parent’s preferences regarding end-of-life-care. Who would they like to make medical decisions for them should they be unable, and which treatments would they want and not want? Although these conversations can be painful, they’re important decisions that will help ease the burden on the family should your parent’s condition worsen. Prepare an advance directive and make their wishes known to close family. 

    End-of-life planning discussions can be painful, but the decisions made can help ease the burden on family later. via @MedStarWHC

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    What if you don’t live near your parent?

    There are all sorts of creative ways to communicate and keep tabs on someone in our tech-enabled world. Many jokes are made about older generations not being able to use technology, but I’ve found my elderly patients remarkably adaptable when it comes to learning how to use some of these devices, especially if it allows them to see and talk with their children and grandchildren.

    Make use of apps such as FaceTime, WhatsApp or Skype to not only talk with your parent, but also to physically check for symptoms. You could set up a standing time to talk each day to make sure they have taken their medication or completed their physical therapy.

    Wearable healthcare monitoring devices, which are constantly evolving and growing in use, may allow you to remotely track your parent’s blood pressure, pulse and heart rhythm. I’ve even seen one that alerts you to someone’s body position, so if it’s noon and Mom is lying down, you can check on her. One note of caution about these devices and apps: Check out the privacy policy and be sure your parent is willing to share their healthcare information with the company.

    You also could use video monitoring for some details. This may sound spooky, but it could be as simple as mounting a camera over the pill organizer to ensure that your parent is taking their medication every day.

    Finally, don’t forget to look after yourself as well. Surround yourself with a support system that can give you a break from caring for a parent when you need it and to help you manage the emotions you may face from day to day. Also, heart disease can run in families, so talk to your doctor about your own heart risks and what you can do to prevent future problems.

    Request an appointment to discuss your heart health or to learn more about a parent’s heart condition and treatment.

    Request an Appointment

  • August 28, 2017

    By Edward Woo, MD

     The trend in surgery today is to use the least-invasive procedures possible. The reasoning is simple: It’s usually better for patients to return home and get back to their normal lives faster than for them to spend long periods recovering in the hospital.  

    In the field of vascular surgery, which deals with conditions of the blood vessels, we refer to minimally invasive surgery as endovascular surgery. Endovascular surgery involves small punctures, usually in the groin area, as opposed to the large incisions on the abdomen or chest that open surgery for blood vessels requires.

    This type of surgery has seen a huge surge in the past few decades. That’s because it’s often safer and better for patients. But endovascular surgery isn’t the best option in all cases. Below, I’ll discuss when we use endovascular surgery, why it’s beneficial, when the traditional open approach might be better and what’s to come for this area of surgery.  

    When we use endovascular surgery

    We can use these surgical techniques for virtually the entire range of vascular treatments. These include:

    The field of vascular surgery started seeing a surge in less-invasive surgical techniques in the early 1990s. Since then, endovascular surgery has grown from something reserved for simple cases to being used for complex issues today. Our rule of thumb is this: If a vascular surgery can be done with an endovascular technique, that’s probably the way to go.  

    A vascular surgeon’s work now consists of about 75 percent endovascular surgery and perhaps 25 percent open surgery. That’s almost the opposite of the way it was just a few decades ago.  Using less-invasive techniques involves a much different skillset for vascular surgeons. I must be able to clearly see the area where I’m operating on an X-ray screen, rather than operating on the patient and looking directly. Advanced imaging technology, like what we use in our Hybrid Suite, can make this easier for vascular surgeons.  

    Request an appointment to learn if endovascular surgery can treat your vascular condition.

    Request an Appointment

    How endovascular surgery benefits patients

    The main benefit of endovascular surgery is that it’s less invasive. Open surgery for blood vessels can involve large incisions, major scarring and long recovery periods. But less-invasive techniques are all done through a small puncture or incision, usually in the groin area. We can thread our tools through the blood vessels to access the area where we’re working with the use of catheters—thin, flexible tubes we insert into this small incision.

    Many patients who have this type of surgery go home the same day. Some have short stays in the hospital afterward, but it’s a huge improvement over those who have open vascular surgery. Endovascular surgery can make a big difference in patients’ recovery and quality of life.  

    #Endovascular surgery can make a big difference in patients’ recovery and quality of life. via @MedStarWHC

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    A great example is surgery to treat aortic disease. Traditionally, correcting it involved an open surgery with a large incision and long recovery period. Patients were usually in the hospital for seven to 10 days, and they usually took three to four months to fully recover. But with an endovascular surgical procedure, these patients go home the next day, and they’re usually back to themselves within four to five days.

    Limitations of less-invasive blood vessel surgery

    While there’s been tremendous growth in this area of surgery, it does have a few limitations. One example is if we can’t reach an area through a minimally invasive approach. Because we thread our surgical tools from the groin to the area where we operate, we must make sure we can access the blood vessels we need to treat and that blood continues to flow to the body’s organs and tissues during surgery. With an open approach, we can directly access the area where we need to work, which can be easier in some cases.

    A patient’s age and overall health also can factor into the decision on whether to use a less-invasive technique or an open surgical technique. Though endovascular surgeries can be easier on patients, some patients find that the results don’t last as long as the results after open vascular surgery. So we may have to weigh a patient’s particular options when we decide which approach is better. For a 75-year-old who’s a smoker, I probably would choose a less-invasive approach to be easier on the patient. For a 35-year-old who’s in otherwise excellent health, it may make sense to perform an open surgical procedure that will last a lifetime.

    New treatments on the horizon

    Researchers hope to make endovascular surgery a good option for treating even more cases of blood vessel conditions. It’s a constant process of changes and improvements to make this possible.

    As of January 2017, we have initiated a clinical trial for a new device to treat aortic aneurysms in the aortic arch, which is the area of the aorta that curves between the ascending aorta (which carries blood up from the heart) and descending aorta (which carries blood down through the chest and abdomen). The aortic arch has three blood vessels that branch off of it to carry blood to the arms and brain.

    Traditionally, we haven’t been able to put a stent (a device used to hold blood vessels open) there, because it would cover those branching arteries. But we’ll be testing a new device that allows us to maintain this circulation with a minimally invasive approach.

    We’re also involved in the clinical testing of different balloons used to treat peripheral artery disease. During a procedure called angioplasty, we use a balloon to push arterial blockages aside to improve blood flow. But these blockages may come back over time. We helped test a balloon coated with a medication to prevent blockages from reforming in treated blood vessels.

    And we’re about to help test another type of angioplasty balloon called a lithotripsy device. This balloon uses sound waves to break up blockages that have hardened because they have calcium in them, similar to a process used to treat kidney stones.

    Endovascular surgery is a great option in many cases. And as technology and techniques continue to improve, I’m looking forward to it being an option for even more conditions and patients.

  • August 24, 2017

    By David H. Song, MD

    Keeping our feet strong and healthy is an important goal for us all. For people with diabetes, good foot health is even more important. That’s because people with diabetes are at an increased risk for developing problems with their feet. Without the right treatment, diabetic foot problems can lead to serious consequences, including amputation.  

    We never want to see patients deal with the loss of a body part. That’s why my colleagues, Dr. Christopher E. Attinger and Dr. John S. Steinberg, work to save patients’ feet as part of our Center for Limb Salvage. I oversee this program in my role as regional chief of MedStar Plastic Surgery.  

    Diabetes and its risk to the feet

    Diabetes affects the body’s ability to process glucose. Glucose is a type of sugar that the body creates from food to fuel the body’s cells.  

    If you have diabetes, your body has too much glucose in the bloodstream. These high glucose levels can lead to nerve damage in patients with diabetes. This condition, called diabetic neuropathy, makes it hard or impossible to feel pain in the feet. People who have diabetes are at higher risk for a number of foot conditions or injuries, such as:

    • Bunions, corns and calluses
    • Cuts and sores
    • Ingrown toenails
    • Fungal infections
    • Hammertoes  

    Without pain, even small injuries to the foot of someone with diabetes can turn into major issues. Maybe you step on a tack or nail, or your shoe doesn’t fit properly and causes a sore on your toe from rubbing. You don’t feel pain, so you don’t treat it. The injury grows and becomes infected. Diabetes lowers the body’s ability to heal properly, so this infected wound doesn’t get any better. 

    Even small injuries to the foot of someone with #diabetes can turn into major issues. via @MedStarWHC

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    By the time patients notice these sorts of wounds, they’ve often developed into a foot ulcer. Diabetic foot ulcers can involve:

    • Ascending infection, or an infection that spreads up the leg
    • Exposed bone or tendon from the wound
    • Gangrene, or the death of skin and tissue  

    Request an appointment with one of our doctors if you have diabetes and you’ve noticed any of the symptoms of diabetic foot ulcers.

    Request an Appointment

    Amputation: The worst-case scenario for diabetic foot problems

    The average surgeon who sees a patient with a bad diabetic foot ulcer will immediately begin thinking about amputation. Depending on how far the patient’s infection has spread, amputation could involve:

    • A portion of the foot
    • The entire foot
    • The foot plus part of the leg  

    Diabetic foot ulcers frequently lead to what’s called a below-knee amputation (also known as a transtibial amputation). A below-knee amputation involves removing the leg at some point along the tibia, one of the two bones that run from the knee to the ankle. This can be a devastating loss for patients. With the loss of that much of the leg, patients have to work much harder to do what they were able to do before their amputation—expending 50 to 125 percent more energy just to maintain their previous activity levels.

    In addition, below-knee amputations have been linked with an increased risk of death following the surgery. One study conducted in the Netherlands found that the median survival time after having a below-knee amputation was just 27.8 months—a little more than two years.

    Amputation can lead to a sort of vicious cycle for patients. Because it’s harder to walk after an amputation, patients often are less mobile afterward. This can increase the risk of more infections, which can lead to more amputations. More amputations can lead to different prostheses as more of the leg is removed, which can make it harder to walk. It’s a painful series of events we try to avoid for our patients.

    How we save diabetic feet

    We try to avoid these sorts of problems through limb salvage, or treating diabetic foot ulcers before amputation is necessary. Dr. Attinger and Dr. Steinberg are internationally known experts in the area of limb salvage. More than 1,000 patients per year benefit from their expertise. The Center for Limb Salvage brings together a team of doctors from a variety of medical disciplines, including:

    • Diabetology, or the study of diabetes
    • Plastic surgery 
    • Podiatric (foot) surgery
    • Radiology, or medical imaging
    • Rheumatology, or the study of problems affecting the joints, muscles and bones, as well as the immune system
    • Vascular surgery  

    The best case is when we can treat foot problems before surgery is needed. We use a number of advanced treatments to make this possible, including:

    • Braces or orthotics, which can help protect and support the foot and leg
    • Gait evaluation, or a specialized analysis of a patient’s walking pattern to correct problems
    • Hyperbaric oxygen therapy, which can stimulate the body’s natural healing processes

    If surgery is needed, we can transplant tissue from other areas of the body to save a patient’s toe, heel, hindfoot or the entire foot. In other words, we can save patients’ feet when other surgeons can’t. This requires advanced microsurgical skill to remove dead or diseased tissue while preserving as much healthy tissue as possible. If tissue transplants aren’t possible, we may be able to use skin substitutes temporarily or permanently to correct wounds. We also may be able to improve blood flow to the foot with vascular surgery, which can promote healing.  

    The benefits of limb salvage

    Saving the foot increases mobility, which leads to a higher quality of life. When it’s not as hard to walk, you’re much more likely to be active and fit. This means limb salvage can help patients be healthier and live longer.  

    On top of all that, limb salvage tends to be less expensive than amputation over the long run. If we can save your foot with one or two surgeries, that’s the end of the surgical process. But if we have to amputate, it tends to start that vicious cycle of developing more infections and needing more amputations. The costs of amputations—in terms of both money and quality of life—can be crushing to patients.  

    No one wants a patient to go through the pain and difficulty of an amputation. I’m hopeful that our limb salvage expertise will help more patients stay mobile, active and healthy.  

  • August 22, 2017

    By Andrea Goergen, RD

    According to the National Health Interview Survey—conducted annually by the CDC’s National Center for Health Statistics—Americans spent $12.8 billion on natural product supplements in 2012 alone. Altogether, more than one-half of Americans take a multi-vitamin/mineral supplement in the pursuit of better health.

    Yet most of us can get all the nutrients we need to live better, longer and heathier right in our grocery stores. And for far less money.

    It all depends upon making the right choices and finding a healthy eating style that works for you, long-term.

    Food for Thought

    Vitamins, minerals, protein, carbohydrates and fat are the essential building blocks for good nutrition. A healthy diet strikes a balance with all elements working together to help optimize every function in your body. From producing energy to promoting strong bones and teeth to protecting your heart, brain and nervous system, the right nutrition helps everything work a little bit better.  

    Fluids also play a large role in overall health.  Your body needs water to boost the function of vitamins and minerals and help you maintain your energy.  If you’re feeling sluggish, fatigued or foggy, you may actually be dehydrated, a far more common condition than you might think. In fact, by the time you realize that you’re thirsty, your body is already crying out for relief.  

    But when you quench that thirst, make sure that you’re not drinking up part of your daily calorie allotment in the process!  Sodas, juices and frappuccinos can really add up without contributing much in the way of fiber, vitamins or minerals. Stick to water and save the calories for whole foods.  

    Carbs: Friend or Foe?

    Carbohydrates have gotten a bad rap, particularly among some weight-loss diet devotees. But the fact is carbs are good for energy production, reducing inflammation in the body and supporting a healthy cardiovascular system.  

    Unless you have some sort of major allergy or intolerance, you really don’t need to cut out healthy ingredients that contain carbs. Complex carbohydrates—like those in broccoli, carrots and many other fruits and vegetables—are loaded with fiber, lots of vitamins and minerals. However, many people don’t realize that there’s also room in a healthy diet for starchy carbs like whole-grain breads, pasta, fortified cereals, rice and potatoes.

    The key is moderation.

    As a rule of thumb, half of your plate should be made up of vegetables, with one quarter devoted to lean protein and the remaining portion to starch. To counteract today’s “supersize” mentality, I also recommend that my patients dump the dinner dishes and use a side or salad plate instead. That strategy will give you all the energy you need, without leaving room for things that are not going to be your friend in the weight-loss or healthy-eating department.  

    Three Squares a Day

    Many dieters think “If I eat less, I’ll weigh less.” So, they skip meals.  

    Unfortunately for them, that’s not exactly how the body works. And worse, it sets them up for failure.

    Why?  If your body isn’t getting the nutrition it needs, it starts to panic and goes into starvation mode. Basically, your body slows down its metabolism and starts hoarding nutrients—stored as fat, just what you want to get rid of—to keep a nutritional reserve for the even leaner days it imagines ahead. So, to get the protein it needs, your body starts burning off your muscles instead of the fat.  

    There’s a better way.

    Make sure you’re eating three meals a day and that each one contains some protein. That will relax your body’s defenses and fulfill its appetite for protein, protecting your muscles from harm while it burns off fat stores for extra energy.

    Vitamins, Minerals and Supplements, Oh My!

    For the most part, if you’re eating a balanced diet—a good combination of leafy green vegetables, citrus and other fruits, lean protein (including beans and eggs), and some starchy carbs—it’s highly unlikely that you’ll be lacking in magnesium, calcium, B-vitamins and other vital vitamins or minerals.

    One exception may be vitamin D. According to the Centers for Disease Control and Prevention, approximately 33 percent of the population has either an inadequate or deficient level of vitamin D. I’m one of them, and take a supplement upon the advice of my personal physician.  But don’t start taking vitamin D on your own. Instead, see your doctor and get a blood test—the only surefire way to know if you’re deficient.  

    Beyond vitamin D, Americans rarely lack enough vitamins or minerals. However, if you experience persistent fatigue, muscle cramping or weakness, tingling or numbness in your hands or feet, nausea or vomiting, you should contact your doctor. Nutritional deficiency could be one of any number of potential causes.

    Finding the Right Balance

    To establish a healthy eating pattern you can adopt for life, make sure you:

    • Get plenty of vitamins and minerals through fruits and vegetables
    • Consume enough protein
    • Eat a variety of foods
    • Have regular, consistent meals, three times a day
    • Drink lots of water

    Equally important, though, is the satisfaction factor: Are you enjoying your meals?  If not, it’s too easy to give up on your good intentions. What you need is a routine you can live with.

    So, if you’re struggling to find that right balance or a nutrition plan you can stick with, consider consulting a professional dietitian for guidance. We have all the information you need and can help you focus on what works for you.   

    Listen to the full podcast with Andrea Goergen.

  • August 17, 2017

    By MedStar Health

    It’s hard to say whether Ivanesa Pardo, MD, FACS, chose surgery as her medical specialty, or if surgery chose her. An attending surgeon in Advanced Laparoscopic and Bariatric Surgery at MedStar Washington Hospital Center, Dr. Pardo had already set her sights on becoming a physician while growing up in her native Venezuela. And after her first surgical rotation in medical school, Dr. Pardo was convinced she had found her future.

    But more important was the fact that Dr. Pardo also had a knack for manipulating the advanced laparoscopic and robotic technologies increasingly used for minimally invasive procedures.

    “All I know is that it just came easy to me,” she says, “and the more training I got, the more I wanted to learn.”

    After receiving her medical degree from Universidad Centroccidental Lisandro Alvarado, in Barquisimeto, Venezuela, Dr. Pardo completed her general surgery residency at Indiana University School of Medicine, where she also served as a research resident. Because bariatric surgery offered opportunities to apply her skills with advanced minimally invasive technology, Dr. Pardo focused on that specialty during her fellowship at Albany Medical Center in New York.

    Why MedStar Washington Hospital Center?

    The Hospital Center offers the best of all worlds, Dr. Pardo says, as it also provides an academic setting for pursuing another professional passion, surgical education. She has written and contributed to articles in peer-reviewed publications, and spoken before professional audiences across the country.

    But being a good teacher requires Dr. Pardo to be a perpetual student, which means keeping up with near-continuous advancements in minimally invasive bariatric surgery.

    Keeping Up with Minimally Invasive Bariatric Surgery

    “It is a fast-changing field,” she says. “New procedures are developed, but not performed very often as they are often considered experimental for a long time. So it’s only in places like the Hospital Center where you get the opportunity to perform and evaluate those kinds of cases.”

    “Obesity is an epidemic that involves and complicates so many other health issues,” she says. “It’s good that surgical options are available, but not everyone has access to them.” And even if a patient is a good candidate for surgery, Dr. Pardo adds, a bariatric procedure is only one facet of treating the condition.

    “The drive for surgery comes from the patient,” she explains. “A successful outcome involves adopting and maintaining significant lifestyle changes, and the patient needs to understand and prepare for them. Fortunately, we have the resources to help them through that process, before and after surgery.

    Dr. Pardo adds that by evaluating patient outcomes and comparing them with the professional standard, “we are better able to identify areas where we can improve.”

    Outside the Hospital

    Away from the Hospital Center, Dr. Pardo devotes her attention entirely on her family. She and her husband have two children, a three-year-old girl, and 21-month-old boy. “At those ages, they’re pretty much the center of everything we do,” she says with a laugh. “But like surgery, there’s always something interesting going on.”

  • August 17, 2017

    By MedStar Health

    One of the best ways to stay healthy is to stay hydrated. In fact, it’s vital during the summer months when our bodies need more fluids to counteract the warmer temperatures and higher humidity. “In addition to helping the body function properly, water helps regulate body temperature and flush out waste. But most people do not drink enough water. Without sufficient water in your body, your cells get congested, your skin can’t detox, and your bladder and kidneys can’t work properly. You feel tired and less able to concentrate. People often confuse hunger for thirst and overeat. Drink some water or a beverage like water that is low in calories, sugar, sodium and fat first,” explains Karen Kansler, RN, nurse wellness coordinator in the Good Health Center at MedStar Good Samaritan Hospital.

    “Good hydration is especially important if you are active or exercising in the heat. During hot and humid weather, the risk of dehydration and heat-related illnesses, including cramps, heat exhaustion and heat stroke, is higher. In severe cases, dehydration can be life-threatening. You need to consume water to replace the fluids lost during physical activity,” she adds. Whether you’re an avid athlete or just enjoy getting out during the summer months, Kansler offers these general suggestions to ensure you stay hydrated:

    • Drink six to eight 8-ounce glasses of water each day. You may need more or less based on your age, weight, health and activity level so, if unsure, check with your doctor.
    • Carry a reusable water bottle with you and drink from it throughout the day, refilling as needed.
    • Drink water during meals. It will help you stay hydrated and make you feel more full, which can prevent overeating.
    • Not a fan of plain water? Consider flavoring it with veggies, citrus fruit or a splash of real fruit juice. Try fresh mint with sliced cucumber.
    • Drink water before, during and after exercise or any physical activity.

    “Thirst isn’t always a reliable early indicator of the body’s need for water. Many people don’t feel thirsty until they’re already dehydrated. That’s why it’s so important to increase water intake during hot weather,” Kansler notes.

    Signs of Dehydration

    Confusion Dark-colored urine
    Dizziness Extreme thirst
    Fatigue Less frequent urination

    Heat illnesses can be serious. Call your provider if symptoms persist.

    This article appeared in the summer 2017 issue of Good HealthRead more articles from this issue.

    Location Information

    The Good Health Center - O'Neill Building, 2nd Floor
    5601 Loch Raven Blvd.
    Baltimore, MD 21239
    443-444-4663

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