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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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  • August 17, 2017

    By MedStar Health

    You sprained an ankle. Or suffered a cut that needs stitches. Or have a nasty rash. In the past, these conditions might have sent you to the Emergency department (ED). Today, there is another option—urgent care. “Emergency departments play a critical role in our healthcare system, but going to the ED may not be the best choice if you have an injury or illness that is not life-threatening. Urgent care centers provide quick and convenient access to health care for minor illnesses and injuries, right when it’s needed,” says Kevin Scruggs, MD, chairman, Emergency Medicine, at MedStar Good Samaritan Hospital.

    MedStar Health offers urgent care through MedStar Health Urgent Care, a network of centers located in the central Maryland and Washington, D.C., metro regions. The network provides walk-in, extended-hour access to medical care for most illnesses and injuries, as well as physicals for sports, camp and pre-employment, concussion evaluations, flu shots, laboratory and X-ray services.

    “No one ever plans on having a sudden illness or injury. Often, these happen after-hours when your doctor is not available. Choosing the right facility for the right care can be critical to one’s health. That is why when a medical emergency happens, it is important for you to know which type of facility will provide you with the best medical care,” Dr. Scruggs notes.

    “Remember that the missions of EDs and urgent care centers differ. Emergency care is meant for serious medical conditions where delaying care could cause permanent harm or even death. So the ED focuses on seeing the most critical cases first. Urgent care is for more minor problems. If you go to the ED for a minor condition, you may have to wait some time to be seen. Offering both provides greater access to care for everyone, where and when it’s needed,” adds Dr. Scruggs.

    For illness and injuries that are not life-threatening but still need immediate attention, MedStar Health Urgent Care sees individuals of all ages. When in doubt, call 911. 

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

    Location Information

    5601 Loch Raven Boulevard
    O'Neill Building, 1st Floor
    Baltimore, MD 21239

    Emergency Department

    Broken bones High fever
    Chest pain Loss of unconsciousness
    Difficulty breathing Severe burns
    Extreme pain Uncontrolled bleeding

    Urgent Care

    Bug and minor animal bites Minor burns
    Cold and flu symptoms Minor head injuries
    Concussions Pink eye
    Ear infections Rashes
    Mild fevers Sprains and minor injuries
    Minor allergic reactions Urinary tract infections
    Minor broken bones  
  • August 15, 2017

    By Namratha Turlapati, MD

    People in the United States will be treated to an awesome show in the sky Aug. 21, 2017: a solar eclipse.  

    A solar eclipse occurs when the moon passes between Earth and the sun, blocking the sun from view. The U.S. hasn’t seen a total solar eclipse since 1979, and it’s the first time one has moved from coast to coast in nearly a century. We won’t see another one until 2024.  

    Those of us in the Washington metropolitan area can expect to see about 80 percent coverage of the sun.  The eclipse will be visible in Washington, D.C., from 1:17 pm to 4:01 pm EDT, with a maximum eclipse at 2:42 pm EDT. Even though we’re not in the path of totality, in which the sun is completely covered by the moon, it will still be a sight you’ll want to see. However, before you look up, take some safety precautions to protect your eyes. Even the small amount of sunlight we’ll get on this day can damage the sensitive tissues of the eyes.  

    1. Do not look at the sun with the naked eye

    On a normal day, looking directly at the sun is uncomfortable, causing us to blink and look away. But as the moon blocks more and more of the sun’s light during a solar eclipse, your pupils become larger to let in more light. This disengages the normally protective pupillary response to keep out harmful unnecessary light rays, allowing the sun’s ultraviolet rays to enter your eyes.  

    Your lens acts like a magnifying glass by focusing light onto the retina. The retina is the layer of cells at the back of the eyeballs that are sensitive to light and trigger nerve impulses to the brain, forming a visual image. When sunlight enters the eye, it can burn a hole in the retina, much like using a magnifying glass to burn holes in leaves or paper.  

    Eye damage caused by looking directly at the sun is known as solar retinopathy. Because the retinas lack pain receptors, you can permanently damage your vision without even feeling it. Once the cells are dead, the damage can’t be undone. And it only takes a few seconds.  

    The degree of damage can vary. Symptoms can include:

    • A blind spot in your central vision
    • Blurred vision
    • Difficulty discerning shape and detail
    • Discomfort with bright light  

    The only time you can look at the sun with your naked eye is if you’re in the path of totality. And even then, you can only do it during the short time the sun is completely covered—around two minutes, depending on where you are.

    2. Wear eclipse glasses that meet international standards

    Put away your sunglasses. They won’t protect your eyes from looking directly at the sun—even during an eclipse. Looking through multiple pairs of sunglasses won’t work either.  

    You have a couple protective eyewear options. The first is No. 14 welder’s goggles, the only goggles dark enough for safe solar viewing.  

    Your other option is eclipse glasses that contain special-purpose solar filters that meet international standard ISO 12312-2 for safe viewing. These glasses filter out the majority of natural light but will allow you to see the eclipse.  

    Inspect your eclipse glasses before using them on the big day. You shouldn’t be able to see anything through these glasses except the sun. If you can, they won’t protect you. Also, check for scratches or other damage.  

    Eclipse glasses are in high demand right now, and unfortunately, there have been reports of companies selling products labeled as if they conform to international safety standards, but they actually do not. Check out the American Astronomical Society’s list of companies whose products have been verified by a testing laboratory to meet these standards.  

    Finding eclipse glasses may take some work. Many retail stores have sold out. The good news is that all sorts of organizations are handing out free eclipse glasses, including the Smithsonian’s National Air and Space Museum. You also can check out your local library. Thousands of libraries across the country are giving away the glasses. Find a map of participating libraries.

    3. Make a pinhole camera

    You don’t need to look straight at the sun to watch a solar eclipse. You also can watch it indirectly with a handmade pinhole camera.  

    NASA’s Jet Propulsion Laboratory recommends this easy process:  

    Materials 

    • 2 pieces of white card stock (white paper plates work)
    • Aluminum foil
    • Tape
    • Pin or paper clip 

    Directions

    1. Cut a square out of the middle of one of the pieces of cardstock.
    2. Tape a piece of aluminum foil over the square.
    3. Poke a hole in the foil using the pin or paper clip.
    4. Place your second piece of cardstock on the ground. 
    5. Stand with the sun behind you and hold the cardstock with the aluminum foil hole above your shoulder, allowing the sun to shine through the hole and onto the cardstock on the ground. The eclipse will be projected onto the cardstock on the ground.

    4. Watch the eclipse on a monitor

    If you can’t get your hands on protective eyewear or don’t want to make a pinhole viewer, you can watch the solar eclipse on TV, a computer or your smartphone. It may not be the same as seeing it firsthand, but your eyes will be protected.

    The Smithsonian’s Air and Space Museum is hosting a viewing of the eclipse at the the Smithsonian’s National Zoo’s Pachyderm Plaza from 1 to 4 p.m. and offers a view of the solar eclipse through a safe solar telescope.

    5. Use a solar filter on your camera, telescope or binoculars

    A solar eclipse can make for a stunning photo but will require a few extra safety precautions. Just like you need to wear eclipse glasses, you’ll also need to attach a solar filter to your camera (yes, this includes your smartphone), telescope or binoculars to protect the device from damage as well.  

    Don’t look at the eclipse through an unfiltered camera, telescope or binoculars—even if you’re wearing your eclipse glasses. The concentrated solar rays could damage the glasses’ filter and injure your eyes.  

    Bonus safety tips

    While the solar eclipse poses the greatest danger to your eyes, there are a few other things to keep in mind:

    • Prepare for a drop in temperature: In the path of totality, temperatures likely will drop 10 degrees or more. Even in D.C., where the moon will cover the sun only partially, we’ll feel a slight chill. Grab a jacket or blanket before you head out, just in case.
    • Drive safely: If you want to see the eclipse, pull over. Don’t watch and drive. Even if you’re not watching the eclipse, expect other drivers to be doing so. Pay extra attention to the road and those around you.
    • Wear sunscreen: Even though the sky will turn dark during the eclipse, the sun’s rays will still be hitting your skin. Don’t forget to apply some sunscreen.  

    By following these simple tips, you can stay safe and comfortable during this awe-inspiring event. Enjoy the show!

    If you experience discomfort or vision problems after the eclipse, request an appointment for an eye exam.

     

    Request an Appointment

  • August 14, 2017

    By Oliver Tannous, MD

    Living with severe back pain can be debilitating. If left untreated, the pain can make it difficult or impossible to perform everyday tasks.

    There are a number of treatments that can address the many causes of back pain, including surgery. While surgery can make a big difference with certain kinds of pain, people sometimes think it will make all their discomfort go away. Surgery is not always a cure-all. And it’s important to understand what you can (and shouldn’t) expect from spine surgery, so you go into the procedure prepared for what comes next.

    One of the most important parts of my job is helping patients understand their back and spine conditions and what’s causing their symptoms. With that in mind, let’s look at the most common causes of back pain in adults, and how we treat these conditions.

    What causes back pain in adults?

    Some back pain in adults is normal. In fact, 80 percent of adults will experience lower back pain at some point in their lives. As we age, back pain often occurs due to degenerative conditions such as arthritis. Degenerative conditions cause parts of the back to gradually break down, becoming weak and painful.

    Degenerative disc disease, for example, causes the discs (vertebrae) that hold the spine together and absorb shock to gradually degenerate. They become less effective at performing their function over time, which causes pain. When people have a sedentary lifestyle and lose strength and flexibility in their core muscles (abdominal, low back and oblique muscles), this places more stress on the degenerative spine and accentuates the back pain.

    Spine conditions that cause degeneration often cause pain in the arms or legs. That’s because as the disc wears down and loses height, the neuroforamen (the space where the nerves exit the spine) narrows and pinches on the nerves. As a result, pain radiates down the length of the nerve and makes the arm or leg numb and weak.

    One of the most common – and most painful – of these nerve symptoms is called sciatica, in which the sciatic nerve in the spine is pressed or pinched, causing pain to shoot down the lower back and legs. Sciatica is caused by degenerative back diseases, such as herniated or degenerative discs.

    Can surgery help any kind of back pain?

    We almost never recommend surgery as a first step for treating back conditions. Traditional spine surgery is invasive and, like any surgical procedure, it comes with the risk of complications. Patients need weeks or months to recover, depending on the procedure.

    Most often, we prescribe non-narcotic pain medications, physical therapy and steroid injections to help strengthen problematic areas and alleviate the local inflammation of our patients’ bodies. If none of our non-surgical pain relief methods are effective, we’ll consider surgery.

    Are you experiencing back pain? Schedule an appointment with one of our orthopedic surgeons.

    Request an Appointment

    Why can back pain persist after surgery?

    While we can fix some painful, nerve-pinching conditions with surgery, the degenerative diseases that cause them don’t just go away.

    Let’s say I’m treating a patient’s sciatica through spinal fusion surgery. This procedure involves removing arthritic bone that is pinching on the spinal nerves, as well as joining several vertebrae in the lower back, using bone from another area of the body to help the spine “bridge” the area that’s pressing on the spinal nerve to relieve that pressure. This surgery is effective at treating the leg or arm pain that radiates into the extremities, because the nerves are no longer pinched or compressed.

    But surgery does not necessarily stop degeneration in other discs or joints, which is the condition that caused the patient’s back pain and sciatica in the first place. Essentially, spine surgery can treat the symptoms of degenerative diseases, but usually not the cause, which is usually genetic.

    Spine surgery can treat the symptoms of degenerative diseases, but usually not the cause. https://bit.ly/2KL8wiL via @MedStarWHC

    Click to Tweet

    What to expect from surgery

    Some people find their back or neck pain temporarily improves after surgery. But this is not something I can tell all patients to expect. For most people, even those who see improvements, surgery won’t be a permanent back pain solution.

    I tell patients to focus on what I can fix. Surgery is incredibly effective at treating pinched nerves and associated pain, weakness or numbness that occurs in the arms or legs. Many patients wake up from their procedures and have instant pain relief in their arms or legs. Weakness tends to get better after a few weeks, but numbness can take longer to fade away, and sometimes doesn’t ever go away completely.

    But I make sure my patients understand that they may need to rely on other treatment methods to address chronic back pain. I show my patients images of their spines, explain that pain may arise in the future and point to where it could happen.

    As with anything in life, the fear of the unknown makes dealing with pain scary. But once you really understand your condition and know what to expect, the pain can become easier to handle.

  • August 10, 2017

    By Dr. Loral Patchen, PhD, MSN, MA, CNM Certified Nurse Midwife, Vice Chair, Innovation and Community Programs, and Section Director for Midwifery at MedStar Washington Hospital Center

    A “retro” form of pain control is making a comeback in the United States: nitrous oxide, often known as laughing gas.

    Nitrous oxide was used to ease the pain of labor since the early 1900s. It fell out of favor in the United States as alternative pain relief methods were developed and culture shifted to women becoming less involved during the birthing process. However, it continued to be used in other countries. In fact, 60 percent of women in the United Kingdom, 48 percent in Finland and 43 percent in Canada give birth with the help of nitrous oxide.

    A movement to revive its use in the U.S. began a few years ago as women sought to take a more involved role in labor. Our team added nitrous oxide as a pain control option for labor in 2014. It’s proved very popular, with about one-third of patients in our midwifery practice using it during labor.

    About 1/3 of our pregnant patients use nitrous oxide as a pain control method. via @MedStarWHC

    Click to Tweet


    Does using nitrous oxide mean you’ll laugh your way through labor? Not quite, but it can take the edge off enough to keep going if you don’t want to use another pain relief method, such as an epidural. Let’s talk about how nitrous oxide works during labor, as well as its benefits and potential side effects.  

    How nitrous oxide works as pain control during labor

    First of all, this is not the laughing gas you get at your dentist’s office. It’s a much lower concentration –  50 percent nitrous oxide and 50 percent oxygen. Because of this, women who use it during labor rarely act loopy or experience memory loss afterward.  

    Nitrous oxide doesn’t actually reduce pain, but instead seems to alter the way women perceive pain. My patients tell me that they still feel their contractions, but they just don’t care about them anymore.  

    Some women don’t even realize they’re reaping the benefits of nitrous oxide, telling us later, “I don’t think it did anything.” But their partners and care team often have a different perspective, noting something along the lines of, “Well, it certainly seemed to help!”  

    Nitrous oxide is absorbed through the lungs as you inhale and excreted shortly after as you exhale. Just before a contraction, you hold the mask to your face and breath in and out. You should feel the effects of the gas in less than a minute. Once you put the mask down, the effects wear off after a few breaths of room air.  

    Only a woman in labor can hold the mask. Your partner, nurse, doctor or midwife is not allowed to help. This is a safety precaution to prevent you from breathing in too much nitrous oxide. You’ll drop the mask if you become over-sedated and begin to breathe room oxygen, resolving the symptoms.  

    Benefits to using laughing gas during labor

    I think one of the biggest pluses to nitrous oxide is the sense of autonomy that it gives women in labor. You decide when you need the gas and how long you need it.  

    But there are additional benefits to nitrous oxide compared with other forms of pain relief such as an epidural.

    • Maintain mobility: Nitrous oxide doesn’t numb a part of your body like an epidural or tie you to an IV or catheter, so with help from your support team you can still move and reposition easily.
    • Low long-term commitment: Once you get an epidural or pain-relieving drug through an IV, you’re in it for the long haul – or until the drugs wear off. Not so with nitrous oxide. If you don’t like it or find it isn’t working for you, you can stop and try something else.  

    Nitrous oxide has few side effects, but some women report feeling nauseated, dizzy or drowsy.  

    If you’re interested in midwifery care, join our practice for a monthly meet-and-greet at 6 p.m. on the second Wednesday of every month in the Medical Affairs conference room 121 A/B located in the Physicians Office Building.  

    Who can use nitrous oxide during labor successfully

    Very few women can’t use nitrous oxide. But it’s not recommended for women who have:

    • A severe vitamin B12 deficiency, because the gas can further lower those levels.
    • Had a collapsed lung or certain surgeries that can create air pockets in the body where the nitrous oxide can enter and expand.  

    Some women find nitrous oxide doesn’t provide what they need. I’ve found that women are more likely to be successful with nitrous oxide, meaning they don’t require an alternative pain relief method such as an epidural, if they start using it after they are about  5 to 6 cm dilated. It’s may not be as effective if you have a lot of labor left in front of you.  

    If you’re exhausted, remember that nitrous oxide is an active form of pain control – you must hold the mask yourself. You may be disappointed to find it doesn’t give you the rest you’re hoping for.  

    However, most of our patients are happy with their nitrous oxide experience. In fact, a February 2017 study published in Anesthesia & Analgesia showed women who used nitrous oxide alone were more likely to indicate high satisfaction compared with women who got an epidural.  

    A nitrous oxide program requires the coordination and partnership of everyone who works with pregnant patients: Ob/Gyns, midwives, anesthesiologists, neonatologists and nurses. I think it’s a testament to our team’s progressive and women-centered approach to care that we are able to offer nitrous here.  

    I also take to heart that other regional hospitals have taken notice of our nitrous oxide program, calling us for advice to start their own. And I hope in the future that this pain control option is available to more women in labor in the District and the rest of the country.  

  • August 09, 2017

    By MedStar Health

    Clinics Offer Treatment Options Not Widely Available

    At MedStar Good Samaritan Hospital, one of our main goals is to help you take charge of your health so you can get the most out of life. That’s why we established the Good Health Center 25 years ago. One of the most comprehensive, low-cost health enhancement facilities in Maryland, the center provides free and low-cost community screenings, support groups and seminars throughout the year.

    The Good Health Center also partners with hospital physicians to make specialized outpatient care easily accessible by offering a variety of clinics focused on specific health conditions. Through these clinics, many individuals are getting the treatments they need to live better lives.

    Tackling Hepatitis C

    Hepatitis C is a virus that can damage the liver and cause serious liver disease. Many people don’t know they have hepatitis C because they don’t have symptoms. The good news is that hepatitis C is now curable, thanks to new treatments that have been approved in recent years.

    These major advances in treatment are now available at the Hepatitis Clinic at the Good Health Center. Opened in collaboration with the Division of Gastroenterology, the clinic is run by Lawrence Mills, Jr., MD, the hospital’s chief of Gastroenterology. “We can cure hepatitis C in the majority of patients we see with almost no side effects. These new treatments work much better and faster than those used in the past,” says Dr. Mills.

    Raisa Stefanuca, MD, a 67-year-old retired ophthalmologist, is proof of the effectiveness of the new drugs. She had no idea she had hepatitis C until abnormalities in her liver enzymes were found during routine blood work.

    Raisa Stefanuca, MD

    Hepatitis C is transmitted via exposure to infected human blood, most commonly through needles (intravenous drug use, tattoos from unsterilized equipment, accidental needle sticks, etc.) or a blood transfusion prior to 1990. Dr. Stefanuca had always lived a healthy lifestyle and had no idea how she got infected.

    Her primary care physician referred her to the Hepatitis Clinic where, after further testing, Dr. Mills put her on a six-month regimen of one of the recently approved medications. During her treatment, her blood was tested regularly. Today, she is healthy and free of the virus.

    “Just a few years ago, hepatitis C patients had to take a combination of pills and injections for almost a year. Most weren’t cured and many experienced serious side effects. Now, we have treatments that offer a very high cure rate even if previous treatments have failed,” notes Dr. Mills.

    Battling Migraines

    Carolina De Jesús-Acosta, MD

    Experiencing a migraine headache once or twice a month is bad enough. Living with a migraine nearly every day can be debilitating. Megan Mioduzewski knows first-hand what it is like.

    “I started getting migraines in 2012 during my senior year of high school and they were almost constant. The pain was so bad that I was often hospitalized. But, my headaches did not respond to any of the normal treatments,” Mioduzewski says.

    Despite the pain, she went on to college at Stevenson University, struggling for the next three years. When her doctor ran out of options, Mioduzewski was referred to the Migraine Clinic at the Good Health Center, where she met with Carolina De Jesús-Acosta, MD, the neurologist who leads the program.

    “Megan had one of the most disabling forms of headache. Patients with chronic migraines experience a headache more than 14 days of the month, which can greatly affect family, work and social life. So she met the diagnostic criteria for Botox® treatment,” Dr. De Jesús-Acosta explains.

    Megan Mioduzewski

    In June of 2016, Mioduzewski began receiving multiple Botox injections around the head and neck every three months to dull future headache symptoms. The treatments worked, and since then she has been nearly headache free.

    Now age 22, she just graduated from college and is pursuing a career as a medical lab scientist, a profession she chose as a result of her experience. “The causes of conditions like Megan’s can be very complex, and many patients spend years chasing treatments,” adds Dr. De Jesús-Acosta. “I am glad we were able to help her get her life back.”

     

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

    Make an Appointment

    Click below to learn more about our Hepatitis Clinic or call 443-444-3991 for a referral to the Clinic.

    Location Information

    The Good Health Center - O'Neill Building, 2nd Floor
    5601 Loch Raven Blvd.
    Baltimore, MD 21239
    443-444-1817

  • August 08, 2017

    By Caitlin Zarick, DPM

    It’s August—the height of summer—and many of us are taking advantage of the longer days to cram in more outdoor activities. For many, it just seems easier, and definitely more enjoyable, to go for an early morning run when it’s already light outside versus the dark days of winter.

    But that increased activity also increases the risk of foot and ankle injuries, particularly among weekend warriors.

    Aching Ankles

    Sprains, which can vary widely in severity, are among the most common foot and ankle injuries. For minor problems, time-honored home remedies like icing, elevating, resting the foot and over-the-counter (OTC) anti-inflammatories are often all that’s needed. But if you don’t notice much relief after a few days of self-care, you should seek a professional opinion from a podiatrist, a doctor who specializes in foot and ankle care.

    It may be that you need an ankle brace to support and protect the ligaments that were stretched or torn during the injury. More severe sprains may require a device called a CAM boot—basically a walking cast that relieves the ankle from bearing weight while it heals.

    The good news is that most sprained ankles will getter better in a month or two.

    Sometimes, however, what first seems like a badly sprained ankle may actually be a broken metatarsal—one of the long bones in the middle of the foot. Because the symptoms of a break, especially a Jones’ Fracture, and a sprain can be so similar, some fractures don’t get the early medical attention they may need, including surgery.

    Individuals with chronic lateral ankle instability may also benefit from surgery to repair the damaged ligaments and return to a more active lifestyle. The condition is the result of cumulative injuries to the ligaments from frequent sprains, mostly due to overuse. That leaves the ankle more susceptible to chronic swelling, pain, tenderness and weakness, leading to even more sprains in the future.

    Healing Sore Heels

    Another quite common injury is plantar fasciitis, which occurs when you strain the ligament that connects the heel bone to the metatarsals. In 95 to 99 percent of people, it goes away with simple, conservative treatment like stretching, OTC inserts and physical therapy. If such steps don’t provide relief, however, I’m a big proponent of a promising new treatment called PRP.

    PRP, or platelet-rich plasma injections, can often decrease or completely eliminate the pain of plantar fasciitis and other conditions, contributing to a speedier recovery. In the 30-minute procedure, some blood is withdrawn from the patient and then placed in a centrifuge to separate out the platelets, the component that helps with clotting, healing and tissue growth. Then the platelet-rich plasma—now containing three to five times more growth factors than normal— is injected into the affected area.

    Most patients can get back on their feet within a few days and can resume regular activity within a month.

    Experiencing foot or ankle pain when you run? Request an appointment with one of our podiatric surgeons.

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    If the Shoe Fits…

    Feet are the foundation of your fitness. If they’re in pain or stressed, you can’t do much of anything. But properly supported, your feet can conquer miles in comfort.

    That’s where the right shoes come in to play. And it’s tricky. Some lucky people are born with a perfectly normal foot; however most of us need some sort of assistance to help achieve the right mechanical balance. For instance, a bunion, flat foot or a really high arch can put extra strain on different tendons and ligaments, leading to arthritis, pain and degeneration.

    But finding that sweet spot is a matter of trial and error. Sneakers that I regularly recommend to my patients don’t work at all for my wide, highly-arched feet. You need to take time to find that brand and style that is going to be the best fit for your foot’s particular structure.

    Orthotics can also help. I typically recommend that patients first try out an OTC support with a rigid sole, something like a piece of plastic, to see if that helps. In some cases, that may be all the arch support they need, while others may benefit more from a custom-made orthotic. Just be sure to avoid inserts that you can bend in half, which provide cushioning versus support.

    The bottom line: Enjoy your summer activities, but don’t beat up your feet in the process. And always see a doctor in the event of any significant swelling, bruising or pain.

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