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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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  • February 15, 2021

    By Ellie Kelsey, RD, LD, CNSC

    The American Heart Association (AHA) estimates that 50 percent of calories consumed by the average American come from ultra-processed foods. And it’s become fairly common knowledge that ultra-processed foods are not good for us.

    With new research into processed foods and health risks, we’re starting to understand just how detrimental they can be, particularly in increasing the chance of heart attack and stroke. In fact, recent studies show a link as high as 62 percent between consumption of ultra-processed foods and increased risk of death from cardiovascular disease.

    Ultra-Processing

    Today’s ultra-processed foods are made not so much from food as from ingredients extracted from food, like fat, sugar, and starch. Also, they often contain additives such as artificial flavors, colors, and emulsifiers.

    Take, for example, nacho tortilla chips. The recipe starts with corn but includes only a small portion of the seed grain itself. The chips are fried in oil, also processed. Some brands are seasoned with cheese product (not real cheese), and plenty of salt, of course. Additional ingredients read like a shopping list for a chemical laboratory: maltodextrin, MSG, protein concentrate, colorings, and several others that are difficult to spell and pronounce.

    Nearly all “convenience foods” fall into the ultra-processed category: salty snacks, soft drinks, boxed baked goods, deli meats, sausages, chicken nuggets, frozen pizza, and instant soup, as well as shelf-stable and frozen TV dinners. So do most condiments: ketchup, mustard, barbecue sauce, buffalo sauce, and ranch dressing.

    And processed foods can certainly contribute to weight gain. With its blend of salt, carbohydrates, and chemicals, the average ultra-processed food item delivers plenty of “empty” calories and comes up short on fiber, vitamins and minerals. There’s also evidence that processed foods may spur us to consume more, since they’re engineered to tempt us with taste and texture and are often missing ingredients like protein and fiber which keep us fuller longer.

    The Perils of Sodium

    Almost all processed foods are high in sodium, primarily from salt (sodium chloride).

    The average person likes salt. And it’s an inexpensive way to improve a food’s flavor. But Americans consume far more salt every day than the body requires—an average 3,400 milligrams versus a recommended daily limit of 2,300 mg. A movement is underway to reduce that recommendation to 1,500 mg/day, a move that’s being contested by the food industry.

    A high-sodium diet increases your risk of high blood pressure, making the heart work harder to circulate blood. It’s a precursor to heart attack and stroke and can weaken the heart muscle over time.

    There’s an excess of salt in certain products like supermarket bacon, which contains not just salt but sodium phosphate, sodium ascorbate, and sodium nitrite. Deli meats have similar ingredients. Consumption of processed meats is not only bad for heart health, it also raises the risk of developing colon cancer.

    Dining out can be problematic, too. One reason that restaurant food “tastes better” than homemade is salt—professional chefs tend to use more. You may get as much as 3,500 mg from a single restaurant meal, far more than you need for an entire day.

    Bottom line: if processed foods or restaurant meals make up a large portion of your diet, you will have a challenge controlling sodium.

    The Trouble with Trans Fat

    Fats are broadly categorized as saturated or unsaturated.

    Saturated fats are solid at room temperature, and include fat from meat, butter, and cheese. They can elevate bad cholesterol (LDL) levels and lower good cholesterol (HDL) levels, and tend to be less healthy than unsaturated fats.

    Liquid at room temperature, unsaturated fats are typically considered heart heathy and help maintain good cholesterol levels. But not all unsaturated fats are created equal: certain blended vegetable and seed oils are, themselves, highly processed. And processing can change the molecular structure, creating one of the least healthy fats we know—trans fat.

    Over a century ago, scientists treated vegetable oil with hydrogen to create margarine, an unsaturated fat that’s solid at room temperature. It was a food-engineering marvel—a healthier alternative to butter, with no animal fat.

    That all changed in the 1990s when we discovered that trans fat is even worse for humans than saturated fat. Although it is technically an unsaturated fat, trans fat raises LDL and lowers HDL. That increases the risk of heart disease and stroke, as well as type 2 diabetes, which is also a cardiovascular risk.

    Since then, although many trans-fatty foods have been reformulated, trans fats can still be found in some. Keep an eye on labels: the words “partially hydrogenated” in the ingredients, as in partially hydrogenated soy oil, indicates trans fat. It may also lurk in foods claiming to be “trans-fat free.” If the product contains less than half a gram, manufacturers are permitted to round it down to zero. So some trans fat may still be present, even if advertising says otherwise.

    Hazards of High-Fructose Corn Syrup

    High-fructose corn syrup (HFCS) itself is also an ultra-processed food and a notorious nutritional villain. Like salt, it is often a prime ingredient in the most highly processed food products. It’s everywhere, in almost every food product that comes in a box or bag.

    HFCS begins as cornstarch, treated with acids and enzymes to convert it to sugar. What we eat and drink is processed in the stomach, intestines, and liver, where starches and other sugars are converted to glucose—fuel that the cells need for many functions.

    While too much of any sugar is generally considered poor for your health, processed sugars are considered particularly dangerous because the liver handles fructose differently. It can convert it directly to fat. This puts a strain on the liver. And too much fat in the system can contribute to high cholesterol and coronary artery disease. Consumption of simple sugars can also raise blood triglyceride levels (fat circulating in your blood), which also increases the risk for heart disease.

    When comparing products, look at the new Added Sugars section of the food label. This will help you distinguish between carbs that are naturally in foods (like fruits) versus carbs that were added. Also look at the ingredients list for natural sources of sugar like honey, maple syrup, dates, organic cane sugar, and coconut sugar. Avoid corn syrup, HFCS, artificial sweeteners (aspartame, sucralose, saccharin), and sugar alcohols (erythritol, sorbitol, mannitol).

    Too much processed food could increase risk of cardiovascular disease and take years off your life. More from Registered Dietitian Ellie Kelsey. https://bit.ly/3p9Yxqr via @MedStarWHC
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    Some Tips for Healthy Eating and Living

    The evidence is compelling: too much processed food can be very bad for you. It may increase your risk of cardiovascular disease and even take years off your life.

    Make a commitment to limit processed foods—an essential step toward a healthier, longer life. Here are some helpful tips and recipes:

    • Lifestyle check: Consider processed foods and restaurant dining as occasional treats, rather than staples of your regular diet.
    • Read labels: Look for total sugars, added sugars, corn syrup, fats, and red flags like “hydrogenated.” This is good practice for all foods, including those with a healthy reputation, like yogurt or granola. As a snack, low-fat Greek yogurt is great—high in protein and low in fat. But some flavored yogurts are loaded with sugar or artificial sweeteners. Some granolas have way too much sugar as well. Fortunately, new labeling standards make it easy to compare.
    • Watch serving size: Labels still fall short of properly communicating serving size. Sometimes the indicated “serving” is an unrealistically small portion, much less than we’d actually eat. Take this into consideration.
    • Substitute: Start small, with achievable goals. For a snack, grab some fruit or veggies instead of crackers or chips. Do the same with meals—eat one healthy meal this week, instead of something processed. Next week, make it two meals. Keep that up, and soon you’ll be consuming fewer processed foods.
    • Plan: Make a grocery list and stick to it. Try to shop the perimeter of the grocery store—the outer aisles are generally where the healthier foods are stocked. Plot out your meals and snacks ahead of time. If you like carrot sticks, for example, have them easily at hand to avoid grabbing a less healthy option.
    • Be aware of false advertising: The claim “all natural” is not regulated by any government agency and typically doesn’t mean that much of the ingredients are natural at all. The statement “lower in sodium” can also be misleading. It doesn’t necessarily mean the item is a low-sodium product, just that it’s lower in sodium than the original.
    • Practice balanced healthy eating: I often recommend the Mediterranean diet, a common-sense approach emphasizing wholesome foods—fish, whole grains, fruit, vegetables, oils, and nuts. It delivers the well-balanced nutrients we need and is low in saturated fat and processed foods.
    • Seek the affordable: Farmers’ markets are a great place to find affordable, fresh foods, even for those on assistance. In D.C., many farmers’ markets will offer extra benefits for SNAP participants, such as 50% off produce or a $10 voucher at the market when used for healthy foods, helping your allocation go further.
    • Get moving: Activity can help burn the calories you consume—and exercise is great for the heart. The AHA recommends 150 minutes of moderate exercise, each week. Consult your doctor before starting any exercise program.
    • Know your numbers: Schedule yearly (or more often, if needed) physicals and lab tests with a primary care physician and possibly a cardiologist, regardless of how healthy you think your diet is. It is important to know your lipid panel (HDL, LDL, VLDL, triglyceride levels, and total cholesterol levels), weight, blood pressure, waist circumference, hemoglobin A1C, fasting blood glucose, and other tests as recommended by your doctor. Knowing your risk and following up with your physician is one of the best ways to prevent and treat heart disease.
    • Give it time: It can take time to cut down on processed foods. Be patient with yourself!
    • Do your own cooking: When you make your own meals, you have the control to limit unhealthy ingredients.

    Here are some recipes for healthy snacks:

    Healthy Cookies/Scones

    2 ripe bananas
    2 cups dried rolled oats
    Dash of cinnamon
    ⅓ cup of blueberries, or ¼ cup dark chocolate chips (cacao nibs work nicely!)
    Optional: ¼ cup unsweetened unsalted nut butter

    Mash the bananas with a fork until smooth. Blend with remaining ingredients. Roll mixture into balls about 1.5 inches in diameter, and place on cookie sheet. Bake at 375 degrees for 10–15 minutes or until the bottoms are golden brown (may take longer depending on oven).

    Healthy Sugar-Free Ice Cream

    1 cup frozen berries or any fruit (for bananas, use 2 frozen bananas)
    ¼–½ cup skim milk or non-dairy milk such as almond milk
    Optional: 1 tablespoon unsweetened unsalted nut butter; 2 tablespoons unsweetened cacao nibs or coconut flakes

    Place frozen fruit in blender. Beginning with ¼ cup of milk, blend until smooth, adding milk as needed. If adding nut butter, do so before blending. For other optional ingredients, mix in after blending.


    Know your heart risks.

    Our cardiologists can help.

    Call 202-788-5048 or Request an Appointment

  • February 12, 2021

    By Linda C. Wieczynski, MS, RN

    Nearly one in eight women in the U.S. will develop breast cancer in their lifetime, and it’s the second leading cause of cancer death in women, next to lung cancer. Yet many women ask themselves, “Do I really need to get a mammogram?”

    A mammogram is an imaging test used to screen women for breast cancer. In fact, it’s your best chance of detecting breast cancer early when treatment is most effective.

    That’s why the American Cancer Society recommends that women begin breast cancer screening with mammograms around age 40 and commit to getting yearly mammograms by age 45. While women aged 55 and older may switch to screening every two years, routine screening every year is the best way to prevent breast cancer.

    A mammogram may not be your idea of fun, but it could mean the difference between life and death. Here are six reasons to get a mammogram—and what to expect when you do.

    1. A lump can’t always be felt.

    Mammograms can find breast cancer long before you or your doctor would be able to feel a lump in your breast. While breast self-exams are important, you may not feel any changes until a sizable lump has formed. By the time that happens, breast cancer is already growing, spreading, and harder to treat.

    A mammogram can see changes to your breast tissue as small as grains of rice, making it the best tool for detecting cancer as early as possible.

    2. When caught early at a non-invasive stage, breast cancer can be 99% curable.

    While mammograms can’t prevent breast cancer, they can help detect it early when there are more treatment options—and before it spreads to other parts of the body. According to the American Cancer Society, when breast cancer is detected while it’s contained to the breast, the survival rate is 99%. The five year relative survival rates for women with invasive breast cancer is 90%, and the ten year is 83%.

    The breast cancer survival rate can be 99% when detected early, according to the American Cancer Society. On the #LiveWellHealthy blog, Nurse Linda Wieczynski explains this and 5 other reasons to get a #Mammogram: https://bit.ly/3d7dfMt.

    Click to Tweet


    3. A mammogram can save your life—and your breasts.

    When breast cancer is detected early, you probably won’t need a mastectomy, or surgical removal of the affected breast(s). Instead, a procedure called a lumpectomy may be used to remove only the cancerous tumor while preserving the healthy tissue around it.

    4. Your risk of developing breast cancer increases as you age—even if no one else in your family has it.

    The older you get, the more you are at risk of developing breast cancer. That’s why mammograms aren’t a one-and-done test. It’s important to get screened for breast cancer every year starting at the age of 40.

    While being a woman and advancing age are the most significant risk factors, there are others, including:

    • Obesity
    • Alcohol use
    • Physical inactivity
    • Family history

    However, women without a family history of breast cancer aren’t necessarily in the clear. About 85% of women with breast cancer have no family history of the disease. So even if no one in your family has breast cancer, you are still at risk for developing it yourself.

    5. It only takes 20 minutes of your time.

    It may not be the most comfortable procedure, but a mammogram only takes 20 minutes —and can give you more time with the people you love most.

    6. It’s free for eligible patients.

    We offer free clinical breast exams and mammograms at MedStar Harbor Hospital and MedStar Good Samaritan Hospital for women who meet certain criteria.

    You may be eligible for a free mammogram if you are:

    • A woman aged 40 or older
    • A Baltimore City or Baltimore County resident
    • Living on a limited income
    • Uninsured or underinsured

    What to expect at your first mammogram.

    With a little preparation, your first mammogram can be less stressful than you think.

    Here’s what you can expect:

    • Scheduling your mammogram: If you haven’t started menopause, it’s a good idea to schedule your mammogram for the week after your menstrual period when your breasts are less sensitive.
    • Getting ready: Avoid using deodorants, perfumes, or lotions under your arms or around your breasts, as they can interfere with the picture quality. If you are concerned about feeling discomfort, you may want to take Tylenol before your screening. And, if you are sensitive to caffeine, consider delaying your morning coffee until after your test. In addition, you may want to wear a two-piece outfit instead of a dress, as you’ll remove your top during the screening but can keep everything else on.
    • Arrival: Once you arrive, you’ll answer a few questions about your medical history and your family’s medical history. Then, you’ll change into a gown for the screening.
    • During the exam: A trained technician will place your breast on the flat surface of the mammography machine. They’ll take two images, compressing your breasts from the top first and then the sides. The right amount of compression will help to ensure clear images, which is important for accuracy. You will feel pressure on your breasts, but it shouldn’t be painful. Try to relax during the test, if you can. This will make it more comfortable and easier to get a good picture.
    • After the exam: Your healthcare provider will follow up with your results in a few weeks. It is common for the first mammogram to reveal suspicious findings because they can’t be compared to a previous exam. In most cases, those results are not cancerous. If something abnormal is detected, you’ll come back for a diagnostic mammogram that will take more detailed pictures and possibly, an ultrasound. Your radiologist will review your scans immediately, so you’ll be able to leave with your results.

    Your safety is our top priority.

    It’s important that you don’t delay your medical needs or ignore symptoms that would typically make you seek care. Early detection and treatment improve our ability to provide the most comprehensive and effective care.

    Since the COVID-19 pandemic reached our region, MedStar Health has made innovations to ensure we are still the best and safest place to receive care.

    We’re open and prepared to safely offer the same high-quality care you expect from MedStar Health, when you are ready to see us.

    Thinking about your first mammogram may be intimidating, but the reasons to get a mammogram far outweigh the temporary discomfort you might feel. After all, it could save your life.

    This is an updated version of an article previously posted on January 31, 2020.


    Increase your chance of detecting breast cancer early by scheduling your mammogram today.
    Click below to see if you’re eligible for a free mammogram with MedStar Health.

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  • February 11, 2021

    By Jeffrey Shupp, MD

    If you’ve ever received an electrical shock, even a minor one, you know what a jolt to your system it can be. Even at low intensity, direct exposure to electrical energy can cause injury. At a higher voltage, electric shock injury can be deadly or cause life-altering damage to the body—and may have additional, long-range effects, even after the more obvious injuries have healed. 

    Although death by electricity is rare, the National Institutes of Health (NIH) reports that as many as 1,000 Americans die from electrical injuries annually. About 30,000 non-lethal injuries are associated with electricity each yearand electrical burns account for 5 percent of burn center admissions.  

    But most of these injuries are not the result of electric shock itself; rather, they’re traditional burn injuries caused by the heat that untethered electricity can generate. That heat can burn an individual directly or trigger flame in something nearby. It’s not unusual for injuries to be caused by burning clothing, leaves, and brush, or another source of fuel that the electrical energy has ignited.  

    Injuries that result from direct electrical shock are different. Electricity can cause a wide range of damage as it flows through the body—damage that can be severe, sudden, and irreversible.  

    Humans are composed of 70 percent water, which makes us good conductors of electricity. And electricity always takes the path of least resistance; if a person is in that path, electricity will flow through the body on its way from point A to point B.  

    Potential injury from electric shock can vary. Fortunate individuals may simply receive a momentary tingling after electric shock that causes no damage. Others who are less fortunate may experience a more concentrated burn that will damage muscle, nerves, and blood vessels, or may even cause organ failure.  

    At higher voltage, disfiguring injury can also occur. Different body parts conduct differently. When the electrical energy encounters resistance in the form of dense tissue, like bone, it can destroy it in a fraction of a second, leaving amputation as the only treatment course. Or we may see severe wounds at the spot where the electricity exited the body, as it sought the least resistive path.  

    And you don’t actually need to receive a huge jolt of electric current to be in trouble. Even at low intensity, electricity that reaches the heart can lead to cardiac arrest by creating an arrhythmia that leaves the heart unable to pump blood. Fortunately, such catastrophic injuries are rare.  

    Electricity can cause deep burn damage, sometimes with no surface evidence. @ShuppMD explains. https://bit.ly/2Z0xbbJ via @MedStarWHC
    Click to Tweet

    Who's at Risk?

    With electricity surrounding us every day, it’s possible for electrical injuries to affect anyone. At the Burn Center here at MedStar Washington Hospital Center, we treat a number of injuries to trade professionals, such as electricians, construction workers, engineers, and landscapers. But homeowners are also at risk, particularly those who do their own renovation and repair work.  

    In the U.S., the NIH estimates that as many as 20 percent of electrical injuries affect children, although this number is a significant drop since the 1980s, when parents of young children began to place plastic covers on outlets and other electrical devices in the home.  

    Nature’s Electricity

    The energy potential of electricity is measured in volts. A car battery has about 12.5 volts; most household electrical appliances operate on 120 volts. On an industrial level, higher voltage allows power to be transported over distances; power from a generating station is measured in hundreds of thousands of volts.  

    However, the most powerful electricity comes from lightning, which can generate a charge of hundreds of millions of volts. 

    For a person who’s in the wrong place at the wrong time, lightning can pass through the entire body. The Centers for Disease Control and Prevention reports that, remarkably, 90 percent of the estimated 300 people struck each year survive. This is likely because lightning delivers a very quick exposure, measured in milliseconds

    Unfortunately, for some, that quick exposure is enough time to initiate cardiac arrest. Although arrhythmia can often be corrected with a portable automated external defibrillator (AED), AEDs are rarely available at the scene of a lightning strike 

    lightning strike can also cause burns, muscle injuries, and even cataracts and long-term vision problems. Patients with artificial pacemakers can experience damage to the device from the jolt. Lightning also creates a shockwave of expanding air, a thunderclap that may damage the hearing of anyone nearby. 

    Also, both lightning and manmade electricity can physically move the victim, resulting in blunt-force trauma if the body collides with the ground, a wall, tree, or another stationary object. Electricity can also cause loss of consciousness that precipitates a fallwith potentially serious injury if the victim falls from a ladder or roof. 

    Among electric shock symptoms, some patients also express neurological or vision issues after highvoltage exposure. At the Burn Center, we have observed patients who’ve lost dexterity or grip strength or reported changes in eyesight, taste, and smell after exposure. 

    Degrees of Burn

    Burns caused by electrical accidents are given the same classifications as burns from other heat sources: 

    • First degree burn injuries affect the top layer of skinfor example, sunburn. When electricity is involved, the hair is sometimes singed as well, by a short blast of intense heat.  
    • Second degree or partial thickness burns cause blistering, resulting in a wet and weepyinjury.  
    • Third degree burns affect the full thickness of the skin. They make the skin have a dry, leathery appearance and may also cause discoloration and swellingBecausa third degree burn can damage nerve endings, it is not always painful.
      Both second and third degree burns can occur when electricity ignites clothing or other fuel sources nearby. 
    • Fourth degree burns are even more severe, when prolonged exposure to heat destroys parts of the body. These are seen in contact electrical injuries. Sometimes these can also occur in the absence of electrical injury—for example, when a person is stuck in an automobile or structural fire. 

    Compartment Injuries

    In addition to burn injuries, another common electric shock symptom is increased pressure within a muscle compartment, a disorder known as compartment syndrome. Each large muscle group in the body is essentially a compartment—the muscle is surrounded by fascia, a tough membrane that encloses and supports the muscle group. Traumatic damage from electricity can cause the muscle to swell—but because the fascia does not stretch, the swelling has nowhere to go. Pressure increases, creating pain and potentially pinching nerves and blocking blood vessels. Untreated, this scenario can spur long-term muscle or nerve damage and could go on to result in limb loss or even death. 

    Considered a surgical emergency, compartment syndrome can result in the loss of a limb. At the Burn Center, we assess the severity of the damage via physical examination, including sophisticated pressure testing and identifying markers in the urine, even in an unconscious burn victim 

    A common procedure to treat this type of damage is fasciotomy, making an incision through the skin and fascia to reduce pressure. Although this is a complex surgery, the Burn Center team works to lessen any potential for post-recovery scarring. 

    Take Electrical Burns Seriously

    If you receive an electrical injury, no matter the severity, I recommend having it assessed at a highly qualified burn center like the one here at the Hospital Center. Burn injuries can cause damage not readily evident on the surface.  

    Our approach to treatment depends on the severity and location of the burn injury. We are experienced at cardiac testing and monitoring for injuries unique to electrical exposure. Every burn is unique, but long-term goals for recovery always include managing pain, limiting scarring, and improving function and range of motion. And our team of support specialists—nurses, rehabilitation therapists, nutritionists, pharmacists, psychologists, and social workershave the experience and knowledge to help manage the most complex cases.  

    Some electrical injuries may be preventable by following a few commonsense tips:

    • Around the home, leave electrical work to the professionals. Stay away from overhead wires.  
    • Keep children away from electrical devices; cover outlets and unplug appliances not in use. 
    • At work, follow all safety protocols to avoid encounters with both electrical power and lightning. Always use any personal protective equipment issued. 
    • Follow updates from weather professionals when camping, hiking, boating, playing golf, or any other outdoor activity, and seek shelter if thunderstorms are imminent 

    Electrical burn?

    Reach out to our Burn Center team.

    Call 202-788-5048 or Request an Appointment

  • February 10, 2021

    By Beje Thomas

    There are currently over 100,000 people waiting for a kidney transplant. And, unfortunately, many of those people could be waiting up to nine years to receive a donation from someone who passed away.

    However, for those who are committed to finding a living donor, a kidney transplant could occur in as little as four to six weeks.

    There are over 100,000 people waiting for a #KidneyTransplant. On the #LiveWellHealthy blog, transplant nephrologist Dr. Thomas shares how finding a #LivingDonor can shave years off your wait time: https://bit.ly/2MS2kM1.

    Click to Tweet


    Who is eligible for a kidney transplant?

    If you have a kidney disease that causes your kidney to function at 20% or less, you may be eligible for a kidney transplant. A timely kidney transplant can help you to avoid dialysis and related complications. While you won’t be eligible for a transplant until your kidney function has decreased below 20%, you may want to consider proactively beginning your search for a living kidney donor before then.

    What are the benefits of finding a living kidney donor?

    Many patients on the kidney donor waitlist eventually receive a kidney transplant from someone who passed away and donated their organs. This can take years and many people with kidney disease don’t have years to wait. Additionally, patients who are waiting may spend quite a bit of time on dialysis, which can be challenging emotionally and physically.

    Finding a living kidney donor offers many advantages. Not only can it help you to receive your transplant much faster, but it can also decrease the amount of time you need to spend on dialysis—or eliminate your need for dialysis altogether. In fact, recipients of a living kidney donation find that their new healthy kidney works immediately because it’s coming from someone who has already been screened and identified as healthy. In comparison, nearly one-third of patients who receive a kidney donation from a deceased donor still need dialysis after the transplant, which is called a delayed function of kidney transplant. That’s because the kidney may have traveled a long distance or needs some time to return to full function.

    How do you find a living donor?

    Many people don’t know they have kidney disease. And even once you’ve been diagnosed, it’s not always obvious to people around you, even if you’re on dialysis. They won’t know you need a living donor unless you ask.

    It can be intimidating to put yourself out there, but having the courage and taking the initiative to ask can help to save your life. As a transplant nephrologist, I’ve witnessed some incredibly creative ways that people have asked for a kidney donation—and successfully found one.

    In one instance, a man wore a cardboard sign that told his wife’s story of needing a kidney, walking up and down the streets of Greenville, North Carolina. As a result, nearly 100 people called the kidney center to donate! In another case, a woman wrote her son’s story on her car and an employee at Walmart saw the car and wanted to donate.

    The opportunities to ask are limitless, but other ideas for finding a living donor include:

    • Sharing your story with family and friends via word of mouth
    • Wearing a t-shirt with your story in a large gathering (e.g. at Disney)
    • Creating a social media page on Facebook, Instagram, or YouTube to tell your story
    • Posting your story in a church, work, or school bulletin or newsletter
    • Publishing a small web page that shares your story

    There are also a variety of resources that can help you to ask for a living donor. At MedStar Georgetown University Hospital, we help interested patients create a personal website for free where they can share their story. The National Kidney Foundation also offers a variety of tips for “The Big Ask” on their website.

    Who can be a living donor?

    A living donor could be your personal trainer, a sorority sister, someone you meet at Disney, or a complete stranger. The only qualifications are that your living donor is:

    • Willing
    • Of sound mind and body
    • Over the age of 18
    • Identified as healthy through our thorough screening process

    When you’re searching for a living donor, you can trust that your healthcare team will do the work to ensure a good match. In fact, you don’t have to worry about even sharing your blood type—or identity, if you don’t want to.

    That’s because there’s a Paired Kidney Exchange program that allows your living donor volunteer and you to be entered into a national registry. If a living donor who responds to your request doesn’t match your blood type, they may end up matching someone else in the registry who found a donor that didn’t match them. And, since you’ve been entered into the registry as well, you can be matched with someone else. Not only do you and someone else find a match, but others on the list move up. Everyone benefits!

    Read Kenneth’s story.

    How can my living donor start the process?

    The first step to starting the living donation process is filling out a questionnaire. There’s no limit to the number of people who can submit a questionnaire in response to your ask, and we’ll do the work to find and screen the best candidates of those who volunteer.

    After that, we conduct a comprehensive screening process to ensure that your living donor’s kidney is healthy. In most cases, the screening process could be completed in a month—or sooner if it’s an emergency situation. And, your living kidney donor doesn’t have to be local. If it’s someone in a different state who sees your story online, we can help them complete their screening at a nearby clinic, and we’ll help to cover any related costs for them to travel for the procedure. Once approved, the transplant procedure could occur within four to six weeks.

    Surgery generally takes two to three hours, and in many cases, patients are discharged the next day. Your living donor will need to take it easy for a few weeks, and we’ll follow-up at regular intervals to check their labs and overall health.

    Interested in being a kidney donor? Here’s what you should know.

    If you’re considering being a kidney donor, there are a few things that may help you to make your decision.

    • You can choose to donate anonymously or reveal your identity.
    • Your testing and procedure costs are covered by the recipient’s insurance.
    • We offer a stipend program to help cover any related costs for travel, recovery, etc.
    • Your donation will only affect 20 to 40% of your kidney function, not half.
    • If you later develop kidney disease and need a transplant yourself, you advance to the top of the transplant list.

    In 2020, we were pleased to have over 100 living kidney donors, despite the challenges of the worldwide health pandemic. Our transplants are performed on a COVID-free floor with strict precautions that limit visitors to ensure everyone’s safety. It’s never been safer to save someone’s life by becoming a living donor.

    Watch our Facebook Live broadcast with Dr. Thomas to learn more about finding a living kidney donor:


    Are you looking for a living kidney donor or interested in being one?
    Click below to learn more.

    MedStar Georgetown Transplant Institute

  • February 09, 2021

    By Ankit B. Shah, MD, MPH, FACC

    Performance athletics—in fact, any form of intense exercise—increases the body’s need for oxygen. Elite and endurance athletes, in particular, experience unique adaptations; for example, their leg and arm muscles increase in strength and size.

    The heart responds, too. It’s the engine that keeps oxygen-rich blood supplied to the muscles. With regular, vigorous aerobic activity, the athlete’s heart begins to change over time, growing larger and stronger, with increased capacity.

    As athletes exert, the heart rate must naturally increase in order to move more blood. Every athlete, however, has his or her own unique maximum heart rate that cannot be modified. It’s a genetic preset: no matter how much or how hard you train, your heartbeat will never exceed its genetic limit.

    But if an athlete’s maximum heart rate has already been reached, how is it possible to increase blood flow and meet the demands of even more strenuous training? The heart itself makes it possible, literally by remodeling. In response to prolonged endurance training, the heart’s four chambers dilate to accommodate the higher blood flow. Thus, at any given heart rate, the heart is able to pump more blood.

    This remodeling has a positive effect on the resting heart rate as well, which tends to drop significantly. While resting beats-per-minute in the 70s or 80s are considered normal for most people, an athletic person’s rate may dip as low as 30.

    The heart becomes better equipped to transport oxygen and support the higher metabolic demands of the exercising muscles. The net result is an increase in VO₂ max—a true measure of cardiopulmonary capacity and an important determinant of endurance exercise performance. The VO₂ max can be objectively measured with a specialized exercise test.

    1. “Athlete’s Heart”…or Something More Concerning?

    Athletes who pursue intense endurance exercise for five hours or more per week may develop exercise-induced cardiac remodeling—often referred to as athlete’s heart—a physiologic response where the heart becomes larger and more efficient than average as a natural response to intensive exercise.

    But is athlete’s heart dangerous? In most cases, no.

    It’s important to distinguish between normal and abnormal enlargement of the heart muscle. For example, hypertrophic cardiomyopathy is an abnormal thickening of the heart that results from a genetic disorder, and may occur in as many as one in 200 people. An abnormally enlarged heart doesn’t function as efficiently as a healthy one—so with advanced testing, we try to differentiate athlete’s heart from a pathologic condition.

    Sudden cardiac death in performance athletes sometimes does occur, even in a young athlete considered to be in his or her physical prime. In athletes under age 35, we often find genetic or congenital cardiovascular conditions, including coronary artery anomalies, hypertrophic cardiomyopathy, and inherited arrhythmia syndromes. With athletes 35+, the culprit tends to be a condition acquired over time, such as coronary artery disease.

    Whether you’re a weekend warrior or seasoned professional, Dr. Ankit Shah covers five things athletes should know about their hearts. https://bit.ly/2MNSfjb via @MedStarWHC
    Click to Tweet

    2. Athletes Can Have High Blood Pressure

    Intense exercise over decades certainly reduces the risk of cardiovascular disease. But it doesn’t completely eliminate it.

    Some components of cardiovascular disease are genetic—for example, hypertension (high blood pressure) and high cholesterol. Both can affect even the fittest athlete.

    In one study, researchers found that as many as ⅓ of competitive athletes met criteria for elevated blood pressure based on the current U.S. hypertension guidelines. Male athletes—as well as athletes with a high body mass index (BMI)—showed a greater risk of elevated blood pressure, though it’s not apparent whether the related BMI was high due to the athlete’s musculature or excess fat.

    Even in younger athletes, elevated blood pressure has been shown to alter the structure and function of the heart, an indicator that their elevated blood pressure had existed for some time.

    Blood pressure for many athletes tends to be taken in a single visit; however, a diagnosis of hypertension requires measurement over at least two visits. Athletes who seem to be in a hypertension “gray area” should be monitored consistently to assure that they don’t develop frank hypertension. Regular exams, bloodwork, and a detailed cardiovascular history can help identify possible issues that call for further investigation.

    3. An Athlete’s Age Makes a Difference in Heart Health

    As athletes age, they’re naturally more prone to developing cardiovascular disease, regardless of how strong their heart may be. Fitness and an active lifestyle can help to protect against this, but not entirely.

    Again, vigilance is essential. Besides seeing a physician for annual checkups, regular screenings, and bloodwork, it’s important that the older athlete seeks attention immediately if he or she experiences any of these warning signs:

    • An abrupt performance decrease—for example, the cyclist who suddenly falls short of normal times or the runner who can’t keep up as usual with other team members
    • Feeling greater tiredness than usual
    • Abnormal shortness of breath during or following a workout
    • A burning sensation in the chest or upper abdomen, especially in athletes with no history of gastrointestinal problems or heartburn

    The issue may be nothing more than indigestion, joint pain, dehydration, or a bit of over-training. But consulting a medical professional is much safer for the aging athlete than avoidance or denial.

    4. Symptoms May Not Be Present…and It’s Hard to Screen for Everything

    Sudden cardiac arrest or death in the athlete is a rare but tragic event. These deaths are met with a sense of confusion as being an athlete is thought to be synonymous with health and immunity from cardiovascular disease. While routine exercise has consistently been shown to be beneficial for cardiovascular health and longevity, it does not provide complete immunity.

    So, should we subject every performance athlete to intensive cardiac screenings? Probably not. But every athlete should certainly see a provider with knowledge of what they do and have a regular checkup at least annually. Those with specific concerns or risks can benefit from seeing a cardiologist with an understanding of exercise physiology and the cardiac demands of sport.

    Worthy of emphasis, though, is emergency preparedness for athletes, coaches, trainers, parents, and spectators. In the hands of just about anyone, an automated external defibrillator (AED) is simple to deploy and can have enormous life-saving potential. The AED delivers a controlled electrical shock that can correct arrhythmia and get the heart pumping again.

    Getting more AEDs onto the athletic field and raising awareness of their usefulness is where we can and should focus. With more immediate attention, started even before qualified medical help arrives, more athletes can be saved.

    5. COVID-19 May Impact an Athlete’s Heart

    Most medical issues spurred by COVID-19 are caused by a severe inflammatory response. Evidence in hospitalized patients shows that as many as 30 percent of coronavirus patients will experience some type of impact to the heart, one of them being myocarditis or inflammation of the heart muscle.

    Data on the prevalence and severity of myocarditis in athletes and active people after having COVID-19 are still limited and given this, we recommend vigilance for athletes who have contracted COVID-19. Whether or not the athlete has had cardiac testing after the illness and full recovery, the best approach to return to athletics is to start slow and rebuild endurance over days to weeks. If any unusual symptoms appear, athletes, trainers, and coaches should immediately stop the training and contact a medical professional.

    We’ll know more with time. Thousands of recovered athletes are now being monitored via cardiovascular testing, which will advance our knowledge of the effect of COVID-19 on athletes.

    Effective & Safe Exercise for All

    Although strenuous exercise can pose an element of heart risk for some, it’s important to keep this in perspective.

    Very reliable data compiled over many years has shown that regular exercise is truly one of the best things we can do for our health. It increases lifespan by reducing the risk of cardiovascular disease. We also know it can improve mental health and prevent cancer and other diseases.

    The American Heart Association recommends at least 150 minutes of moderate exercise, or 75 minutes of vigorous exercise, each week. It’s best to keep a consistently spaced routine each week, rather than trying to pack all your workouts into the weekend. However, no matter how and when you are able to fit in your exercise, it’s good for you.

    MedStar Heart and Vascular Institute is fully equipped to deliver the best possible care to performance athletes. We work regularly with most of this region’s professional and college sports teams—offering advanced capabilities such as VO₂ max testing, where we push an athlete to the limit on a stationary bike or treadmill as we monitor his or her oxygen uptake and other parameters.

    Of course, we specialize in the cardiovascular caring for athletes at all levels, from recreational to Olympic. Our goal: working together with our patients to keep them active and safely enjoying their favorite forms of exercise.

    Keep your heart healthy.

    Contact our cardiology team today.

    Call 202-788-5048 or Request an Appointment

  • February 08, 2021

    By MedStar Health

    Samir Sur, MD, has been immersed in science for as long as he can remember. So it’s appropriate that as the newest member of MedStar Washington Hospital Center’s Department of Neurosurgery, he’s applying groundbreaking microsurgical and endovascular technologies to treat brain aneurysms, tumors, and similar complex conditions.

    With a physical chemist mother and neuroscientist father, Dr. Sur spent much of his childhood in basic science and neurology labs. He majored in molecular biophysics and biochemistry at Yale University, and decided that medicine was the best match for his personality. He earned his medical degree from Boston University’s School of Medicine. It was then on to the University of Miami’s Miller School of Medicine for his neurosurgery residency, followed by fellowships in cerebrovascular, skull base, and endovascular neurosurgery.

    Dr. Sur says the Hospital Center is the ideal location to begin his career. “It’s a nice combination of a tertiary hospital’s high-level, multi-disciplinary care with an academic and research mission, in the setting of a major Level 1 trauma center that serves most of this city and region,” he explains. “It’s the way I want to practice medicine.”

    As a specialist in the transradial approach that has been adapted for neuroendovascular procedures, Dr. Sur also brings expertise in minimally invasive approaches to treat skull base lesions, cerebrovascular diseases, and brain and spine tumors. He’s also skilled in neurosurgical treatments for epilepsy and pain management.

    “Whenever possible, I use the transradial approach for endovascular surgeries, making them safer and more comfortable for patients,” he adds.

    In his dual role as assistant professor of Neurosurgery at Georgetown University School of Medicine, Dr. Sur looks forward to researching the outcomes and techniques of these approaches, and how they compare with conventional surgical methods.

    “We’re fortunate to have a unique, very collaborative group of specialists,” Dr. Sur says of his colleagues. “I’m looking forward to sharing my expertise and expanding the range of treatment options for the region’s patients.”

    With a hoped-for end to the pandemic in sight, Dr. Sur is eager to return to participating in team sports, such as soccer and basketball.

    “I also like to eat—everyone’s a foodie these days, it seems—and travel,” he says. “For now, I’m just trying to find ways to stay active as safely as possible.”


    Neurosurgery questions?

    Schedule an appointment with Dr. Sur.

    Call 202-788-5048 or Request an Appointment