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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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  • March 24, 2017

    By MedStar Health

    For 21 years, Ali Wisseman had type 1 diabetes. A kidney and pancreas transplant in 2009 cured her condition, but she still battles the chronic effects.
  • March 24, 2017

    By MedStar Health

    Alexandra Learned Preston and her husband, John Preston, were longtime residents and supporters of the Georgetown community.
  • March 23, 2017

    By MedStar Health

     By Emily Turk

    At just 54 years old, Brian Wallace was far from ready to shut the door on his active life. But his constant ankle pain was threatening his ability to function. “I would wake up in the middle of the night in excruciating pain,” Brian says. “It became so debilitating, and it was difficult to walk.”

    When multiple trips to the chiropractor and shots of cortisone finally proved useless, Brian asked his uncle, an orthopaedic surgeon in New York, for a referral. “He told me to see Paul Cooper, MD, at MedStar Georgetown University Hospital, and I’m very glad I did,” Brian says. “I thought I would have to have a joint fusion. But then Dr. Cooper told me I could have an ankle joint replacement. I didn’t even know that was available!”

    Dr. Cooper, director of the Foot and Ankle Center at MedStar Georgetown, is one of just a handful of orthopaedists in the region who specializes in foot and ankle disorders.

    “Often, patients with ankle pain visit a general orthopaedist and are told that joint fusion is their only option,” says Dr. Cooper. “But that’s simply not true. Ankle joint replacement is a very good option for patients with end-stage ankle arthritis—the result of trauma, sports injury or deformity.”

    “We have a generation of healthy, athletic baby boomers whose active lives can cause wear and tear on joints that lead to arthritis,” he says. “Cartilage disappears, leaving bone moving against bone, causing significant pain. For patients like Mr. Wallace—who played basketball and football—joint replacement may be necessary to sustain quality of life,” Dr. Cooper notes.I went into the hospital one day and was discharged the next. I'm walking pain-free for the first time in years.

    At MedStar Georgetown, nearly all of Dr. Cooper’s patients receive the STAR™ joint. Dr. Cooper was the first surgeon in the U.S. to implant this revolutionary joint in a patient. The STAR™ implant more closely mimics the three bones that make up the ankle joint. It is a three-piece, mobile-bearing ankle made of metal and polyethylene—older implants consist of just two parts.

    “The parts move independently for increased mobility and movement that is closest to the real ankle,” Dr. Cooper adds. “It also wears better and is easier to upgrade.”

    Fortunately, Brian was an ideal candidate for the implant. During the 45-minute procedure, Dr. Cooper made a three-inch incision at the ankle, cut bone at the joint and inserted the new ankle joint.

    Brian has been a model patient at his physical therapy appointments—and his persistence has paid off. “I’m pain-free for the first time in years—walking my dog and planning to replace my roof,” he says. “Now when I see people suffering from ankle pain, I enthusiastically tell them to go to Dr. Cooper.”

     

    Learn More

    Visit MedStarGeorgetown.org/FootInjury or call 202-295-0549 to make an appointment. 

    Meet Our Foot and Ankle Specialists

    Visit MedStarGeorgetown.org/PCooper to learn more about Paul Cooper, MD, and his areas of clinical expertise. 

     

  • March 23, 2017

    By MedStar Health

    As recently as 15 years ago, if you had severe aortic stenosis but were considered too ill or weak to survive surgery, there was little else we could do for you. Since then, transcatheter aortic valve replacement (TAVR) has come on the scene as a less-invasive option to traditional open heart surgery.

    This has been a game-changer for many people. Because it’s so new, not every facility offers this procedure. We have treated more than 1,300 patients with TAVR, and many of them travel here because they can’t get it closer to home or are interested in a less-invasive option.

    TAVR currently is approved for patients with severe aortic stenosis who are at intermediate or high risk of complications during surgery, in addition to surgically inoperable patients. We have launched a clinical trial in 2016 to study the procedure’s safety and effectiveness in a wider range of patients. TAVR may become the new standard of care for more patients with this serious heart condition.

    In the meantime, learn how TAVR works and whether you or a loved one might be a candidate for this procedure.

    What is aortic valve stenosis and how is it treated?

    Aortic stenosis occurs when the heart’s aortic valve doesn’t open fully, preventing blood from flowing freely into the rest of the body. This causes the heart to have to work harder and eventually weakens the heart muscle.

    Aortic stenosis is a progressive disease, and as it worsens, symptoms may include:

    • Abnormal heartbeat (known as a heart murmur)
    • Chest pain
    • Dizziness or fainting
    • Fatigue
    • Shortness of breath
    • Sudden death

    These symptoms can affect your daily life in many ways, from making it difficult to walk to the mailbox to adding stress from worrying about your health.

    In the early stages of aortic stenosis, you may not need treatment. In that case, we’ll monitor the condition to ensure it’s not getting worse. Medications can ease symptoms, but will not fix the problem. The only way to do that is through surgery.

    In a traditional aortic valve replacement, the surgeon makes a large incision in the chest, cracks the breastbone to reach the heart, removes the damaged valve and replaces it with a new one. This surgery typically requires a five-day hospital stay and four-week recovery.

    TAVR doesn’t require a large chest incision or broken bones – making the recovery time much shorter.

    How does TAVR work?

    TAVR Procedure

    In transcatheter aortic valve replacement, the doctor inserts a catheter into an artery through a small incision in your groin or chest. At the end of the catheter is a deflated balloon with an artificial valve wrapped around it. The doctor guides the catheter through the artery to the aortic valve, at which point the balloon is inflated and the new valve expands, pushing the damaged valve out of the way. The doctor then deflates the balloon and removes the catheter.

    This procedure typically requires a three- to five-day hospital stay. But because no bones need healing, most patients can resume normal activities soon after.

    All surgical procedures carry risk. But a 2016 study showed that patients at intermediate risk for complications during surgery who received TAVR had slightly lower rates for death and stroke as those who had had a traditional aortic valve replacement. And for patients whose TAVR was done through the femoral artery in the groin, the rate was even lower.

    Though TAVR is less invasive than traditional surgery, it’s not yet approved for all patients with severe aortic stenosis.

    Who is a candidate for TAVR?

    TAVR currently is approved by the Food and Drug Administration (FDA) for people with severe aortic stenosis who are at high or intermediate risk of complications during open heart surgery. These patients often are older or have other medical conditions that make surgery more dangerous.

    Even then, not every patient who fits these criteria is a candidate for TAVR. You may have anatomical features or other conditions that may not make this procedure the best option. For example, if there’s significant disease in multiple arteries, you’d likely benefit from more than just valve replacement, in which case open surgery likely would be required.

    One reason TAVR is currently restricted to patients at higher risk is that it’s a pretty new procedure, so we don’t have established data for how it compares over the long term to traditional surgery. One of the questions up in the air surrounds the durability of the valves used in TAVR. Valves used in a traditional surgical replacement last 10 to 15 years. We’ve only been performing TAVR for about a decade, so we don’t have long-term data on these devices yet.

    For patients at high or intermediate risk during surgery, TAVR is quickly becoming the standard of care for severe aortic stenosis. The purpose of the latest studies is to determine whether TAVR is equal or superior to surgery for low-risk patients. Our trial will evaluate the safety and efficacy of the procedure in these patients.

    TAVR is an exciting development in the treatment of aortic stenosis, and we’re hopeful that our study will help demonstrate that less-invasive procedures are safe and effective for as many patients as possible.

  • March 22, 2017

    By MedStar Health

    By Jennifer Davis

    Brenda Hudson of Owings, Md., was the first person ever to receive a life-saving kidney transplant from a living donor at MedStar Georgetown University Hospital. Her sister, Michelle, donated a kidney to save Brenda’s life.

    The average life of a living donor kidney is 17 to 18 years, but Brenda’s kidney lasted a staggering four decades before failing in 2015. She began dialysis but was in need of a new kidney. Now, at the age of 57, her husband of seven years, Dana Hudson, stepped forward. Last summer, he gave Brenda her second life-saving gift—a new kidney, 40 years after her first transplant surgery.

    "To be fortunate enough to get this gift from a second living donor—I am still in disbelief."  - Brenda Hudson, Patient

    “It works beautifully,” Brenda says. “As soon as you get that new kidney in, you start feeling better right away. To be fortunate enough to get this gift from a second living donor—I am still in disbelief. I didn’t think it would happen.”

    MedStar Georgetown transplant surgeon Seyed Ghasemian, MD, says Brenda is a two-time miracle.

    “The miracle of her first transplant is that it lasted so long,” he says. “And then to get a second from another living donor is just wonderful. Now she has a perfectly functioning kidney again.”

    “I am so blessed,” Brenda agrees. “It’s just so hard to believe there were two people willing to do this for me.”

    The experience has given Brenda a unique view of medical advancements in the world of transplants over the last four decades. “The tools available now are so much simpler than 40 years ago,” she says.

    “There wasn’t as much known back then about transplants, and people were very wary,” explains Matthew Cooper, MD, director of Kidney and Pancreas Transplantation at the MedStar Georgetown Transplant Institute. “Back then, Brenda had her own special nurses and was practically wrapped in a plastic bubble because there was such a fear of the unknown. Her sister also had a much larger incision than we use now.”

    Brenda, right, received the first living donor kidney transplant at MedStar Georgetown when her sister, Michelle, left, donated her kidney. Nearly 40 years later, Brenda returned to MedStar Georgetown for her second kidney transplant.

    After her first transplant surgery, Brenda was in the hospital for a month. This time it was just five days, and she started feeling better right away. Her husband, Dana, spent only three days in the hospital following his procedure as her donor.

    Dana says he recovered quickly from a surgery he describes as painless. Surgeons made only four incisions, all 1 cm or less, to laparoscopically remove his kidney. He encourages anyone who might be interested in becoming a living donor to consider the benefits of this life-saving surgery. “It makes me feel so good,” he says. “I know what she was going through on a daily basis, and I am so glad I could help her.”

    Brenda is now seeing just how far post-transplant care has come. Instead of large amounts of steroids, she is taking a more advanced immunosuppressant medication to reduce the risk of the body rejecting the organ, which she says is much easier on her system.

    “It’s so exciting how far we’ve come in 40 years,” Dr. Cooper says. “When patients take their medication and stay in touch with their doctors about post-operative care, results are excellent.”

    Brenda says her life hasn’t just returned to normal—it’s gotten better. She’s now planning to travel and apply for her first-ever passport. “Now that I feel so good, I have to get one and travel,” she says. “I feel awesome.”

    Learn More

    For more information about living donor transplants, visit MedStarGeorgetown.org/GiveLife or call 202-444-3714 to make an appointment with one of our physicians at the MedStar Georgetown Transplant Institute.

  • March 22, 2017

    By MedStar Health

    Sarah Bessin, a 47-year-old breast cancer survivor, received her diagnosis in July 2015. In October, Bessin opted to begin breast reconstruction at the same time as her mastectomy. The team at MedStar Georgetown University Hospital was able to save Bessin’s breast tissue and improve her breast reconstruction outcome through the unique combination of the following two tissue-saving technologies to diagnose and avoid serious complications:

    • The SPY Elite fluorescent imaging system that gives breast surgeons and plastic surgeons the ability to assess the quality of blood flow in the breast tissue in order to make the critical decision on whether to insert implants immediately or wait.

    • Hyperbaric oxygen therapy to facilitate the healing process.

    “My surgeon told me he would decide during surgery whether or not I could undergo breast reconstruction immediately, but I’m so glad he decided to wait before proceeding with implants. It gave me a chance to heal, and the results of my reconstruction are just remarkable,” Bessin shared.  

    “Everything that we do in plastic surgery involves blood flow. If blood flow is disrupted, the overlying skin can die. This is the reason we need to be able to anticipate these problems intraoperatively so we can act quickly,” said Troy Pittman, MD, Bessin’s breast reconstruction surgeon. 

    SPY Elite: A New Valuable Player in the Operating Room

    After a mastectomy, the plastic surgery team enters the operating room with a fluorescent imaging system called SPY Elite. SPY Elite has a long arm that connects to an infrared lamp device, which is used for scanning over a patient’s body. A special contrast is injected through the patient’s IV line, and a TV monitor shows the scans of breast tissue and blood vessels in real time.

    A breast reconstruction surgeon will move the SPY Elite lamp over different areas of the breast to detect the quality of blood flow in breast tissue before proceeding with the surgery. The system’s monitoring of the blood flow helps surgeons determine if the patient’s tissue is in a safe state to move forward with surgery and place an implant.

    If blood flow is limited, surgeons will add hyperbaric oxygen therapy after surgery to promote healing in the tissue.

    “SPY Elite lets me look at the blood supply of the breast tissue and the nipple in real time,” Dr. Pittman said. “This helps us diagnose a problem early on and initiate hyperbaric oxygen therapy within 24 hours, if we need to.”

    SPYing a Problem During Bessin’s Procedure

    During Bessin’s procedure, the SPY Elite imaging system informed Dr. Pittman’s team that there were worrisome vascular changes in her breast skin following the mastectomy. To avoid compromising the vascular health of the skin, Dr. Pittman decided on a different plan.

    The new breast reconstruction approach for Bessin meant waiting on the implants and placing tissue expanders, a type of deflated temporary implant, in the surgery site. This plan allows for healing time in the hyperbaric oxygen therapy chamber. 

    “Our goal is to get patients in for treatment as soon as possible. We are aggressively treating the patient to save their breast tissue and augment their healing,” said Kelly Johnson-Arbor, MD, medical director of Hyperbaric Medicine in the Department of Plastic Surgery. “Our dedicated team of physicians, nurses and technicians work to ensure that patients remain safe and comfortable during their treatment regimen.”

    Healing Tissue Within Days with Hyperbaric Oxygen Therapy

    Hyperbaric oxygen therapy exposes patients to pure oxygen in a pressurized space. Sending patients to the hyperbaric oxygen chamber treats the initial blood flow issue and can help the patient avoid future healing problems. Treatment begins within  24 hours after surgery and does not require patients to stay in the hospital. 

    Bessin’s tissue healed in only 13 hyperbaric oxygen therapy treatments. Her hyperbaric oxygen therapy schedule began with two visits to the hospital per day, which later decreased to one visit per day near the end of her treatment.  

    “I bounced back quite quickly. I’m already working my normal schedule, and my energy level is back to normal,” Bessin shared. “I’m so grateful to my doctors for providing this therapy!”

    Hyperbaric Oxygen Therapy: Rest and Relaxation Time

    Bessin recalled that she spent most of her time relaxing in the hyperbaric oxygen therapy chamber, which is a large glass tube. In the chamber, patients cannot wear makeup, lotion, nail polish or outside clothing, nor can they bring in a cellphone, books or paper. A glass of water and a cotton gown are permitted inside the chamber. During treatment, a nurse or technician stays in the room the whole time to administer the hyperbaric oxygen therapy, answer questions or assist with movie selections.

    “Georgetown has a great movie selection,” Bessin pointed out.

    Access for Every Breast Reconstruction Patient at MedStar Georgetown

    Dr. Pittman has used SPY Elite with hyperbaric oxygen therapy at MedStar Georgetown for five years. For breast reconstruction, Dr. Pittman’s team uses SPY Elite on almost every patient, but particularly in those who want to begin breast reconstruction with an implant immediately after a mastectomy.

    “SPY Elite and hyperbaric oxygen therapy allow us to aggressively treat patients safely and predictably,” said. Dr. Pittman. “This approach gives our patients the best chance for success.”

    To date, MedStar Georgetown University Hospital is the only center in the greater Washington, D.C., region to offer both SPY Elite and hyperbaric oxygen therapy for patients with breast cancer.