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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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  • May 23, 2017

    By MedStar Health

    Diane Lucey has long hair. That's not noteworthy in itself — after all, so do lots of women. But long hair is significant for a woman who has just undergone cancer treatment, which Lucey has. A combination of precision medicine and immunotherapy not only saved her life, but spared her the difficult side effects that are common for cancer patients.

    From Stage 1 to Stage 4

    Lucey's cancer journey started in January of 2014, when she asked her dentist to check out a spot that had recently developed in her mouth. He sent her to an oral surgeon. A biopsy revealed a diagnosis of neuroendocrine carcinoma.

    While there was some good news – it was stage one – she still had to undergo a stressful process of surgery to remove the spot, endure 30 sessions of radiation, and deal with weight loss and fatigue. However, it all seemed worth it as subsequent scans performed in 2014 and 2015 found no signs of cancer.

    She said yes to a new job, moved to Leonardtown, Maryland, and moved forward with her life.  Life was going very well for Lucey. Unfortunately, that all changed abruptly in 2016. 

    Lucey went in for a routine scan with Amir Khan, MD, an oncologist at MedStar St. Mary’s Hospital. Dr. Khan discovered that not only had Lucey's cancer come back, but it had metastasized and spread to other parts of her body – specifically in her lungs and liver. Her diagnosis? Stage four.

    Lucey remembers her sister, who had accompanied her to her appointment, starting to cry. But she didn't allow herself to do the same. "I’m not going to cry about this," she remembered thinking. "This is what it is, and we just gotta go from here."

    Finding Answers in New Treatments

    Dr. Khan formed a treatment plan right away and sent Lucey to Louis Weiner, MD, director of MedStar Georgetown University Hospital’s Lombardi Comprehensive Cancer Center. Dr. Weiner was able to precisely analyze her cancer on a molecular level and found that it had mutated around 17 times.

    Her body was fighting back.

    While precision medicine and immunotherapy aren’t as widely known as treatment options like chemotherapy and radiation, Lucey had learned about them while researching her choices. She was hopeful that a combination of precision medicine and immunotherapy might work for her, and she was prepared to advocate for herself. 

    As it turned out, she didn't need to fight for the treatment that she wanted. "When I met with Dr. Weiner, I was prepared to bring up precision medicine and immunotherapy — but he initiated the conversation," she recalled. 

    She was relieved: "I wanted to hear something other than chemotherapy and radiation, which can really be devastating."

    The Treatment Journey and Her Outcomes

    In October, she began her immunotherapy treatment. Every two weeks, she would make the 10-minute drive from her home to MedStar St. Mary's, where she received injections of the immunotherapy nivolumab. Other than treatment days, she didn't have to miss any work. 

    Having cancer never affected her daily routines, and she never suffered any major side effects except one small rash on her stomach.

    As optimistic as Lucey was about the treatment, the results have exceeded even her expectations. Six weeks into the process, a scan revealed that the mass on her liver had shrunk by half, and the tumors on her lungs were shrinking too. After an additional six rounds of treatment, even better news: The lung tumors were gone, and the liver mass – while still present – had continued to shrink.

    Lucey is incredibly grateful for the success of her treatment, and for the people who have cared for her and supported her along the way. "Everybody at MedStar has been wonderful. The doctors, the nurses, even the receptionist, Rachel — I love her!"

    If she could say one thing to the staff at MedStar, it would be a simple message: "Thank you," she said. "Dr. Weiner and Dr. Khan especially, but the whole staff. I'd hug them all. And I probably have!"

    We are here to help.


    If you have questions about the MedStar Georgetown Cancer Network or are ready to schedule a consultation with one of our specialists, call us at 202-295-0513.

  • May 22, 2017

    By MedStar Health

    What comes to mind when you think of clinical trials? If you’re like most people, you think of cancer or other longer-term diseases in which people have time to weigh the benefits and risks before signing the forms to participate.  

    This isn’t how it works when it comes to clinical trials for stroke – at least when initially treating a stroke.  

    Strokes typically strike out of the blue. Because time is of the essence, we have to give patients and families a crash course in stroke treatment. We’re sensitive to the fact that our patients and their loved ones must absorb a lot of important information very quickly. But we also know that at times a clinical trial may be a patient’s best chance for recovery – and there’s limited time to decide whether to participate.  

    Hopefully, you’ll never need to put this information to use, but if you or a loved one is at risk for stroke, take time to learn what questions to ask about clinical trials in the short time you have to make a decision.  

    Questions to ask when considering a clinical trial

    We participate in observational trials as well as trials in early and later phases through our National Institutes of Health (NIH)-funded stroke clinical research programs: NIH/NINDS Intramural Stroke Program and NIH StrokeNet: Stroke National Capital Area Network for Research (SCANR).

    We conduct trials at every stage of stroke:

    • Acute, or immediately after it happens
    • Rehabilitation
    • Preventing another stroke  

    Read more about our current and completed stroke trials and studies or find additional stroke-related clinical trials.  

    In trials for acute stroke, the decision to participate needs to be made quickly. When it comes to rehabilitation and preventing another stroke, you may have some time to research and think through your options. We know you’re getting a lot of information thrown at you in a short time, but there are a few things you should ask and understand before you decide – whether for yourself or a loved one. 

    What’s the standard treatment?

    There are two main types of stroke:  

    • Ischemic, in which a clot blocks blood from reaching the brain
    • Hemorrhagic, in which a blood vessel bursts and leaks blood into the brain  

    Treatment for either type of stroke may include a clot-busting drug, such as tissue plasminogen activator (tPA), which is the gold standard for treating ischemic strokes. We also may be able to physically remove the clot or repair the vessel to prevent further bleeding.  

    Why would a clinical trial be better than the standard treatment?

    Some people may not be good candidates for standard stroke treatment. For example, tPA must be given within four-and-a-half hours of the onset of the stroke, and clot retrieval for a subset within six hours of the onset of the stroke, as the bleeding risk and other potential complications may outweigh the potential benefit after that time for most patients. In these cases, a clinical trial may be your best or only option.  

    In some situations, a clinical trial may offer a better chance of recovery than the standard treatment, and your doctor should explain why this may be.

     What are the risks and benefits to participating?

    Every treatment has potential side effects. Ask what these may be in the short-term and the long-term. Also, learn how the possible risks and benefits compare to those of the standard treatments.  

    The benefits can range from the potential for a better recovery or, in the case of an observational study in which you’ll get standard treatment, contributing to and advancing our knowledge of stroke care.  

    Advocate for yourself and loved ones

    Unfortunately, if you’re told that you or a loved one is not a candidate for standard stroke treatment, there’s no time to go home and Google “clinical trials.” However, that doesn’t mean there’s nothing you can do. You’re your best advocate.  

    First, research your local hospitals to learn what stroke resources they offer in the way of specialists, treatments and clinical trials. Ask which facilities they turn to for additional guidance.

    If you’re taken to a hospital that doesn’t offer clinical trials, ask the doctor if there is one available in the greater area that you may be eligible for. Our StrokeNet clinical trials network includes multiple hospitals in the mid-Atlantic region, so depending on the trial, you may be closer to a participating hospital than you think.  

    We want to help as many stroke patients as possible, but we can’t help if we don’t know who they are. We rely on emergency medicine doctors to notify us about potential candidates – and quickly. We are developing a process through our telestroke program to expand clinical trial access to stroke patients at other hospitals. But for now, asking about potential trials in the area may prompt the doctor to give us or another facility a call.  

    While you likely will never be fully prepared for the shock of having a stroke, having some knowledge of clinical trials in the back of your mind may make an emergency situation a little less stressful.  

    Request an appointment to learn more about our stroke clinical trials and to discuss whether you or a loved may be a candidate for one.

    Request an Appointment

  • May 18, 2017

    By MedStar Health

    About 48 million Americans, or approximately 20 percent of the population, have some degree of hearing loss. According to the Centers for Disease Control and Prevention, hearing loss is now the third-most common chronic health condition in the United States.

    Many cases of hearing loss are preventable. And many more are treatable. We often have an easier time treating hearing loss if you have hearing exams on a regular basis. Talk to your doctor if you think you have hearing loss or if you’re at risk for it.

    “Talk to your doctor if you think you have #hearingloss or if you’re at risk for it.” via @MedStarWHC

    Click to Tweet


    Hearing loss can be a symptom of many other conditions. Some, like diabetes, we know a lot about. And some we’re just recently beginning to understand.

    Lesser-known causes of hearing loss

    Iron-deficiency anemia

    Hearing loss has been in the news recently because of the results of a recent study linking it to iron-deficiency anemia. This study found that iron-deficiency anemia was associated with an 82 percent higher chance of sensorineural hearing loss. In cases of sensorineural hearing loss, there is damage to the inner ear or the nerves leading from the inner ear to the brain. The study didn’t determine that iron-deficiency anemia definitely causes hearing loss, but it suggested that the lack of iron may reduce blood flow to the inner ear.

    Several groups of people are at particular risk for iron-deficiency anemia, including:

    • Babies and young children, especially premature babies or those with a low birth weight
    • People who get kidney dialysis treatment
    • People who have internal bleeding because of colorectal cancer, bleeding ulcers or other medical conditions
    • People whose diets don’t contain enough iron
    • Women of childbearing age who have regular menstrual cycles

    Otosclerosis

    Another cause of hearing loss that most people don’t know about is otosclerosis. Otosclerosis is a condition in which one of the ossicles, or the tiny bones in the middle ear, gets stuck and isn’t able to vibrate normally. This normally happens to the ossicle called the stapes. When these bones can’t vibrate, sound can’t travel through the ear to the auditory nerve, which carries signals to the brain that allow us to hear. This is a type of conductive hearing loss.

    Otosclerosis tends to occur in people with a family history of the condition. Researchers think otosclerosis also could be associated with previous cases of measles, stress fractures to the bony area around the inner ear and immune disorders. Some researchers also believe a lack of fluoride in drinking water can contribute to the development of otosclerosis.

    Better-known causes of hearing loss

    Unfortunately, numerous factors can cause or contribute to hearing loss. Some of the better-known ones include:

    • Ototoxins
    • Ear infections and cholesteatomas
    • Microvascular disease
    • Age

    Ototoxins

    One fairly common cause of hearing loss is exposure to chemicals or medications that can damage the ear. We call these ototoxic substances or ototoxins. Many medications and chemicals can cause either temporary or permanent ear damage, including:

    • Aspirin
    • Certain antibiotics, including gentamicin and vancomycin
    • Cisplatin and carboplatin, used in chemotherapy for cancer treatment
    • Loop diuretics, used to treat some kidney and heart conditions
    • Quinine, used to treat malaria
    “One fairly common cause of hearing loss is exposure to chemicals or medications that can damage the ear.” via @MedStarWHC

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    Ear infections and cholesteatomas

    Untreated ear conditions like ear infections can also lead to hearing loss without proper treatment. Ear infections are a common childhood illness, but some adults continue to get them as they age. This can be linked to a condition called Eustachian tube dysfunction, which happens when the tube that links the nose to the middle ear doesn’t open or close properly. Adults with Eustachian tube dysfunction are at higher risk for ear infections.

    Chronic ear infections can lead to the development of a cholesteatoma. A cholesteatoma is a cyst of skin in the middle ear space, or mastoid. Someone with a cholesteatoma might have painless ear drainage that they just might get used to over time. But without treatment, the cholesteatoma can break down the bones in the middle and inner ear. Not only can this cause hearing loss, but a cholesteatoma also can cause:

    • Brain infection, or encephalitis
    • Dizziness or a lack of balance
    • Facial paralysis, resembling Bell’s palsy
    • Meningitis

    Diabetes, high blood pressure and high cholesterol

    Hearing loss is linked to several fairly common conditions, including diabetes; high blood pressure, also known as hypertension; and high cholesterol, also known as hyperlipidemia. All of these conditions can cause microvascular disease, which is a problem with the tiny blood vessels that supply blood to the inner ear. Microvascular disease of the ear’s blood vessels can narrow these inner-ear blood vessels, which can either cause hearing loss or cause it to get worse.

    Age

    Of course, perhaps the best-known cause of hearing loss has to do with the aging process. Our risk for hearing loss goes up as we get older. This is called age-related hearing loss, also known as presbycusis. Almost 25 percent of Americans between 65 and 74 have some degree of hearing loss. And nearly half of Americans 75 and older have hearing loss.

    “Nearly half of Americans 75 and older have #hearingloss.” via @MedStarWHC

    Click to Tweet


    Lower your risk of hearing loss

    Of all the causes of hearing loss, exposure to loud noises is one of the most common. We can minimize this risk by protecting ourselves from loud noises when possible. Keep the volume down on your devices when listening to them with earbuds and headphones. And wear earplugs or other ear protection when you know you’ll be exposed to loud noises, like at a concert or while using noisy equipment.

    Microvascular disease from diabetes, high blood pressure or high cholesterol also is something we can work to reduce or eliminate. Talk to your doctor about keeping your blood sugar, blood pressure and cholesterol under control through lifestyle changes, medications and other treatments to reduce your risk of microvascular disease.

    Unfortunately, the most common cause of hearing loss is the aging process, and there isn’t much we can do to stop that. But we may be able to stop the aging process’s effects on hearing sometime in the future. During my PhD studies at the University of Minnesota, I created an antioxidant medication that was able to prevent the onset of age-related hearing loss and keep it from getting worse. The goal of my research is for people to one day have a supplement they can take to reduce their risk for age-related hearing loss.

    Hearing loss can result from a number of factors. When we identify which of these factors apply to you, we’re one step closer to finding treatment options to either cure or manage your condition.

  • May 17, 2017

    By MedStar Health

    “Steroids.” For many people, even the word is enough to make them recoil. They’ve heard stories from friends and family members about the side effects and want to avoid them if possible.

    This is something I hear every day from my patients. But there’s no need to be afraid of nasal steroids. When used properly, nasal steroids are extremely safe and don’t have the same side effects as oral steroids. In fact, they’re one of the safest medications available for patients.

    When used properly, nasal steroids are extremely safe and don’t have the same side effects as oral steroids. via @MedStarWHC

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    Talk to one of our doctors about whether nasal steroids are a good option for treating your allergies.

    How do nasal steroids work?

    Nasal steroids relieve inflammation in the nasal airway caused by allergies and other irritants. Inflammation can cause the nasal passages to swell. Nasal steroids, like other forms of steroids, have the following benefits:

    • Decrease inflammation
    • Reduce swelling
    • Reduce the upper respiratory system’s production of inflammation-causing chemicals  

    Doctors prescribe nasal steroid sprays to help patients breathe through the nose. These nasal steroid sprays are different than saline or other nasal sprays available at the drugstore. Saline sprays rinse and moisturize the interior of the nose, but they don’t treat swelling or inflammation like nasal steroids do.  

    We also use nasal steroid sprays to reduce swelling caused by benign, or noncancerous, polyps inside the nose or sinuses. Though we don’t know the exact cause of nasal polyps, they appear to be more likely to develop in people who have long-term swelling from allergies, asthma or infections.

    How are nasal steroids different from oral steroids?

    I have patients who are afraid to take nasal steroids when I prescribe them. They tell me they have family members or friends who have taken steroids and had problems with them. These patients don’t want that to happen, so they don’t take their prescribed medication, and their allergies continue to bother them.  

    Nasal steroids are much safer than oral steroids because they work differently. Oral steroids, or steroids taken by mouth, are what we call systemically active medications. That means they work throughout the whole body, not just where you have a particular condition.  

    For example, a doctor may prescribe an oral steroid for a patient with rheumatoid arthritis. The medication works by reducing inflammation and swelling in the patient’s arthritic joints. But oral steroids’ effects work everywhere in the body, not just the problem areas. This can lead to some of the side effects many people associate with steroids, including:

    • Decreased healing after injuries
    • Easy bruising of the skin
    • Increased chances of infections
    • Weight gain  

    But nasal steroids aren’t systemically active drugs. They’re what we call topical medications. Topical medications are those applied directly to the area being treated. They don’t affect the whole body, like systemically active medications do. Topical medications like nasal steroid sprays work where you put them and nowhere else. 

    opical medications like nasal steroid sprays work where you put them and nowhere else. via @MedStarWHC

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    Topical nasal steroids have been on the market for more than 30 years. In that time, researchers have studied the medications extensively to verify their safety.  

    I like to compare nasal steroids to hydrocortisone cream. Hydrocortisone cream is sold under many brand names, including Cortizone, and it’s a common remedy during the summer months for mosquito bites. The hydrocortisone is a topical steroid that relieves the swelling and itching of the insect bite. People aren’t worried about gaining weight or bruising more easily because they put cream on a mosquito bite, even if they get bitten and put the cream on every day.

    Sadly, even other doctors aren’t immune to this sort of well-intentioned misinformation when it comes to nasal steroids. A patient may get a prescription for fluticasone, a common nasal steroid better known as Flonase. Their doctor may tell them, “Just take it for two weeks, and then stop,” to alleviate the patient’s fears about the medication. But for some people, fluticasone has barely started working within that two-week span. It can take time for the effects to be noticeable. And some people need to take fluticasone every day, all year round, and they do fine.  

    Open, honest communication with your doctor

    Open, honest communication with your doctor

    This is not to say that people should just take whatever the doctor prescribes without asking any questions. It’s good to be mindful of the medications you take. You should ask your doctor regularly about your medications you take and why they’re important. Ask questions like:

    • What does this medication do?
    • Why is this medication the best option?
    • Is there another medication I could be taking instead?
    • Is there a lower dose I could be taking instead?
    • Should I still be taking this medication?

    I value these sorts of questions from my patients. My job as a doctor is to give my patients honest advice about their medical conditions. I work with my patients to find the best treatments to address their unique symptoms.  

    Unfortunately, not everyone asks their doctors these questions. And so people don’t learn about what they’re taking and how it can help or harm them. That’s how myths about the harm of nasal steroids come about: a lack of real information. But having a good, honest, open relationship with your doctor can go a long way toward clearing up these misunderstandings and helping everyone get the most effective treatments possible.  

  • May 12, 2017

    By MedStar Health

    If you think you’re too young to have a stroke, think again. A study published in April 2017 showed that the rate of stroke among young people has risen dramatically in the past 15 years. The data didn’t surprise me at all. I’ve witnessed this trend firsthand in Washington, D.C.,

    Most people think of stroke as something that strikes older adults, but the study showed that between 2003 and 2012, stroke rates increased nearly 42 percent among men ages 35 to 44, and 30 percent for women in that age group.

    A recent study shows that #stroke rates are increasing in younger adults – up to 42% in men ages 35-44 since 2003.

    Click to Tweet

    I’d say the average age of our patients is 40 to 60. When you compare this with our National Institutes of Health extramural stroke program partner Suburban Hospital in nearby Bethesda, Md., you can see where demographics and overall health comes into play. The average age of their stroke patients is 70 to 90.

    The Bethesda community is primarily made up of white residents who have fewer health complications. D.C. has a larger population of African-Americans, who are at greater stroke risk overall, and more people with stroke risks such as obesity and high blood pressure.

    Let’s take a closer look at why younger adults are at greater risk for stroke than ever before, and what you, health professionals and the community at large can do to turn this trend around.

    Why stroke risk has increased in younger people

    Stroke risks fall mainly into two levels: non-modifiable risks, which you have no control over, and modifiable risks, which are within your control to manage and treat.

    Non-modifiable risk factors include:

    • Age: Your risk of stroke nearly doubles every 10 years after the age of 55.
    • Gender: Men have a higher stroke risk than women.
    • Race and ethnicity: The risk for stroke is two times higher for African-Americans and 1.5 times higher for Hispanics than for whites.
    • Family history: If a grandparent, parent or sibling has had a stroke, particularly before the age of 65, you may be more at risk.

    Modifiable risk factors include:

    It’s these modifiable risks that are the primary reason stroke rates for younger adults are rising. The 2017 study found that the number of men and women between age 18 and 64 with these conditions increased across the board, as did the prevalence of having three or more of these risk factors. 

    The danger of overlooking stroke symptoms

    While not a true risk factor, younger adults often face another danger: their feeling of invincibility. Young adults tend to overlook the signs of a stroke. They think they’re too young and what’s happening couldn’t possibly be a stroke. This can lead to a delay in treatment, and in a condition where seconds matter, this can be devastating to survival and recovery.

    The gold standard for treating ischemic strokes is tissue plasminogen activator (tPA), a clot-busting drug. However, tPA must be given within four and a half hours of the onset of stroke to work effectively. Younger people, if treated in a timely manner, often have a better chance of recovery because their brains have greater plasticity. The surviving cells take over for those that are killed off by the stroke. We lose some of that regeneration as we age.

    Rehabilitation also can be impeded by the presence of health problems such as diabetes, high blood pressure or cholesterol.

    Stroke is the fifth leading cause of death in the United States, and the leading cause of disability. It costs the country $33 billion a year in healthcare services, medicines and missed days of work. When someone has a stroke during their most productive years, it can cost even more – not just in money but in quality of life as they may require more years of care and missed work.

    Know the signs of stroke and never think you’re too young to have one. Use the acronym FAST to quickly identify common stroke symptoms:

    • Face: Can you smile? An inability to smile or a one-sided expression can indicate a stroke.
    • Arms: Can you raise both arms? One-sided muscle weakness or paralysis can indicate a stroke.
    • Speech: Can you say a simple sentence? Slurred speech or difficulty speaking are signs of a stroke.
    • Time: Call 911 immediately if you notice these symptoms.

    Other signs to be aware of include:

    • Sudden vision trouble in one or both eyes
    • Sudden severe headache with no known cause
    • Sudden confusion or trouble understanding
    • Sudden trouble walking, dizziness or loss of balance or coordination

    How young adults can reduce risk factors for stroke

    As with any health condition, prevention is the best medicine, and stroke is no different. Fortunately, many stroke risks can be prevented, managed or treated if they appear.

    A good start to reduce your risk of stroke is to develop a healthy lifestyle:

    • Eat a healthy diet.
    • Stay physically active.
    • Don’t smoke. Ask for help to stop smoking.

    One in three adults in the U.S. have high blood pressure, but only about half have it under control. And many younger adults don’t even know they have it. See your doctor for an annual exam, and if it’s discovered that your blood pressure is high, follow recommendations to lower it.

    If you’ve been diagnosed with diabetes, monitor your blood sugar and use medicine, diet and exercise to keep it within the recommended range. One in three people have prediabetes, a condition in which blood glucose levels are higher than normal. Talk with your doctor about how to prevent or delay the onset of diabetes.

    There are also steps we can take as a community to lower stroke risk. One is to continue and expand nutritional programs, especially in our schools. We want our children to learn healthy eating habits early in life. It should be a given that any meal served in our schools is a healthy one.

    We also must work together to address food deserts, those neighborhoods in which there is a lack of fresh fruit and vegetables and other healthy foods. These areas lack grocery stores and farmers’ markets, so people can’t buy healthy foods to make at home. Vending machines in our public spaces and workplaces often offer few healthy choices, so we can work to improve the available options.

    Exercise does wonders for our health. It lowers weight, stress, blood pressure, blood sugar and cholesterol. We must create opportunities to promote physical activity and access to suitable spaces – indoors and out.

    This trend of younger people having strokes is alarming, but it’s reversible. With hard work from younger adults, health professionals and the community, we can better manage those modifiable risk factors and reduce our risk of stroke.

  • May 11, 2017

    By MedStar Health

    An April 2017 report from the Centers for Disease Control and Prevention (CDC) found that 1 in 10 pregnant women in the U.S. who contracted Zika virus in 2016 had a fetus or baby with Zika-related birth defects. News about this primarily mosquito-borne infection had died down some over the winter, but this report reminds us that the threat is not over.

    Of the 5,238 Zika cases reported in the U.S. between Jan. 1, 2015, and April 19, 2017, 40 were in the District of Columbia. The vast majority of people picked up the infection during travel to an area with Zika, although a few cases were acquired through sexual transmission in the States. The virus made its way to the U.S. mainland in summer 2016, with infected mosquitoes found in Miami and Brownsville, Texas.

    As the days get warmer and we once again begin shooing away mosquitoes, how concerned should D.C. residents be about Zika? While a local outbreak is not likely anytime soon, that doesn’t mean our community should ignore this serious infection. Let’s look at what we know, what we don’t, and how you can protect yourself, your partner and, potentially, your unborn child.

    Zika-infected mosquitoes may not live in D.C., but we shouldn’t ignore the threat of #Zika virus, says Dr. Glenn Wortmann. https://bit.ly/2lUVjZN via @MedStarWHC

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    What we know about Zika

    The Zika virus is primarily transmitted through the bite of an infected Aedes aegypti or Aedes albopictus mosquito. It can’t be spread through skin-to-skin or respiratory contact, such as a handshake or droplets from a sneeze, but it can be passed through unprotected sex.

    The virus is not dangerous for most people. In fact, only one in five people infected will have symptoms, which can include:

    • Conjunctivitis (red eyes)
    • Fever
    • Headache
    • Muscle pain
    • Rash
    Only 1 in 5 people with #Zika virus will have symptoms, but it can harm unborn babies. https://bit.ly/2lUVjZN via @MedStarWHC

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    Zika poses the greatest danger to unborn children. When a pregnant woman is infected, Zika can cause birth defects such as microcephaly, in which a baby’s head and brain are unusually small. Microcephaly has been linked to problems such as seizures, developmental delays, hearing loss and vision problems. Zika also has been associated with miscarriage and stillbirth.

    What we don’t know about Zika

    While we’re learning more about Zika every day, we still don’t have firm answers to many questions.

    So far, infected mosquitoes have been found only in small geographic areas of the U.S. While the potential range of Aedes aegypti and Aedes albopictus mosquitoes includes the D.C. area, it doesn’t mean that infected mosquitoes are guaranteed to come.

    We know Zika can be spread through sex, but we aren’t exactly sure how long someone may be contagious. It appears that the virus can stay in semen longer than in other bodily fluids. Current guidance from the CDC for couples attempting to conceive is that women should wait at least eight weeks after the last possible exposure to Zika before trying to conceive, and that men should wait at least six months after the last possible exposure before trying to conceive. During this waiting period, couples should use condoms or not have sex.

    It appears that Zika does the most harm to an unborn baby when contracted during the first trimester. But while it’s been shown that Zika can cause birth defects, we’re still learning about the range of birth defects it can cause. The effects of the virus may not be obvious at birth, or they may develop later. We’ll have to track these children over the years to learn exactly what damage this virus can cause.

    There is no current treatment for Zika, but the good news is that researchers are working on a vaccine. Vaccine trials are underway, and I’m optimistic one will be approved in the next several years.

    How to prevent Zika and other mosquito-borne infections

    Right now, the best way D.C.-area residents can prevent contracting Zika is to avoid traveling to Zika-infected areas, especially if you are pregnant or planning to become pregnant. The CDC has a searchable map to check travel recommendations for Zika in a particular country. Find the map here.

    Avoid travel to Zika-infected areas if you are pregnant or planning to become pregnant. https://bit.ly/2lUVjZN via @MedStarWHC

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    If you must travel to one of these areas, talk to your healthcare provider. If you’re pregnant, the CDC recommends you be tested for Zika when you return, even if you don’t have symptoms.

    Request an appointment to talk to a doctor about future travel or if you have returned from a trip to an area affected by Zika.

    Request an Appointment


    Because Zika can be passed through sex, if your partner has been to a Zika-infected area, protect yourself by using condoms or dental dams and not sharing sex toys. Again, the CDC recommends women wait at least eight weeks and men wait at least six months before trying to conceive after possible Zika exposure or after symptoms start.

    Zika isn’t the only disease spread by mosquitoes – West Nile virus is one of the most common mosquito-borne infections. No matter whether you travel to a Zika-infected area or relax in your backyard, take precautions to avoid mosquito bites:

    •  Use insect repellents that contain DEET. Follow the instructions when applying it to children.
    • Wear long-sleeved shirts and long pants in the evening.
    • Dispose of standing water around your house where mosquitoes can breed.
    • Use screens on windows and doors, or sleep under a mosquito bed net if screens are not available.

    Fortunately, Zika-infected mosquitoes have not been found in our community, nor are they expected to be soon. But that doesn’t mean we can let our guard down. By avoiding travel to affected areas and taking preventive measures if you or your partner must travel, we can keep our babies healthy and help slow the spread of this disease.