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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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  • December 10, 2020

    By Sara E. Berkey, MD, Colon & Rectal Surgery

    Coffee. It’s the beverage that helps so many Americans power through a busy day. More than half the population over 18 years of age—that’s over 150 million people—drink three or more cups of coffee every day, at an average of 9 ounces per cup. And another 30% of the population drink it occasionally.

    In medical circles, coffee wasn’t always regarded kindly. This beverage was once linked to an increased risk of cancer. But not anymore. Today, coffee has been found to have potentially protective properties in cases of coronary heart disease, stroke, diabetes, kidney disease and liver cancer.

    Recently, an interesting study published in JAMA Oncology looked at more than 1100 patients with metastatic colorectal cancer and concluded that “increased coffee consumption at the time of study enrollment was associated with lower risk of disease progression and death. Significant associations were noted for both caffeinated and decaffeinated coffee.”

    A happy connection, if it’s indeed true. But can we rely on this study to paint the full picture? Unfortunately, no.

    What the study ultimately indicates is that the greatest benefit seems to come in patients who drink more than four cups a day and in women with a normal Body Mass Index (BMI) of 25 or less. Sadly, in the case of patients with metastatic colon cancer, coffee drinkers nevertheless have a low likelihood to achieve a five-year survival rate.

    Coffee does have antioxidant, anti-inflammatory properties, and also causes the body to be more sensitive to insulin, all of which can help fight cancer. But the National Institutes of Health continues to state that coffee’s potentially positive effect on the progression of colon cancer remains inconclusive; additional research must be done.

    What Exactly Is Colon Cancer?

    Colorectal cancer is the third most commonly diagnosed cancer in Americans, according to the American Cancer Society (ACS). In the U.S., the ACS estimates that more than 104,610 new cases of colon cancer and 43,000 new cases of rectal cancer will be diagnosed this year, with existing cases causing well over 53,200 deaths.

    Cancer of the colon develops when a growth occurs in the lining of your colon. This growth usually starts out small and non-cancerous, then enlarges over time and can eventually spread to other organs. Early symptoms—blood in the stool or changes in bowel habits—may raise red flags, yet often, the patient is unaware that a cancer threat is present. This is why regular screening is critical.

    Leading a healthy lifestyle and getting screened on schedule can cut down your risk of colorectal cancer. Learn more from Dr. Berkey. @MedStarWHC via https://bit.ly/39Kjq7p.
    Click to Tweet

    Lowering the Risk

    Here are some key ways to lower your risk of colorectal cancer:

    • Maintain a healthy lifestyle and good nutrition: Excess weight, smoking and alcohol consumption are all associated with cancer in general, and with colon cancer in particular. Eating high quantities of red meat, as well as processed meats such as lunchmeats, also increases your risk. Consume nutritious, high-fiber foods to promote good colon health.
    • Get screened: New screening guidelines just released by the U.S. Preventive Services Task Force recommend that colorectal screenings begin for everyone at age 45. This is due to the recent rise in this cancer among patients in their mid-to-late 40s.
    • Know your family history: A family history of colon cancer or polyps can be a strong predictor, and we screen patients earlier in life if we learn this disease has occurred in their family. African Americans have a higher incidence of colon cancer, as well as a higher mortality rate from it, than the general population.When a patient has been affected by colon cancer, we generally recommend that other family members begin screenings at an age 10 years younger than the family member in whom it occurred. For example, if your father had colon cancer at age 45, we ask you to begin screenings at 35. Then, even if your screening is normal, we’ll continue to screen you every five years, with your family history in mind.

    Younger Adults: A Troubling Demographic

    Recently, the higher incidence of youth colorectal cancer deaths received national attention with the untimely death of actor Chadwick Boseman. In fact, since the mid-1980s, this cancer has increased in adults ages 20–39 years and, since the mid-1990s, in adults ages 40–54 years.

    We don’t yet know why these increases are happening, but we can guess that it involves lifestyle-related trends and the growing phenomenon of diabetes in younger people. Adults in their 20s and 30s are typically unaware of symptoms or unsure why they may be experiencing rectal bleeding. Ongoing research is important to shed light on specific criteria for risk in these age groups.

    Happily, with more senior adults, rates of colon cancer have been decreasing, as regular screenings catch potentially pre-cancerous polyps. Of course, for older patients who tend to get a lot of precancerous polyps, we screen even more frequently. If their screening is clean, they don’t have to return for another 10 years.

    Screening for Early Detection

    Three different types of screening are available:

    • Colonoscopy: We recommend that everyone get a colonoscopy every 10 years, beginning at age 45. Colonoscopy is the most accurate and dependable procedure to detect colorectal issues, helping us to easily spot and immediately biopsy or remove polyps. Also, if a patient receives a positive result from other screenings, colonoscopy is a must. It requires some prior preparation by the patient and, because the patient is sedated during the procedure itself, they need someone to transport them to and from the hospital.
    • Fecal Immunochemical Test (FIT): The FIT test examines blood rather than DNA. Done yearly, it checks for blood in your stool (although this is certainly not always an indicator of cancer).
    • Stool DNA Test: 10 types of larger polyps and tumors secrete certain DNA predictive of colon cancer. For this test, the patient submits a stool sample using a kit such as Cologuard®. The test looks for threatening DNA in the stool, as well as blood. If the test comes up negative, the patient repeats the test in three years.

    Which test do we recommend? The one that the patient, regardless of age, is the most comfortable with! While we encourage colonoscopy as the gold standard, the most important thing is that you complete some sort of reliable screening on a regular basis.

    When a Growth is Found

    If we detect a mass or a large polyp during colonoscopy, we biopsy it to check for abnormalities. We “tattoo” the relevant spot by injecting dye into the colon wall, allowing us to return to that spot when the tissue biopsy is complete. If we suspect the tissue to be cancerous, we send multiple sets of biopsied tissue to a pathologist for diagnosis.

    If confirmed to be cancer, the next step is surgery. We want to examine not just the tumor itself but the surrounding piece of colon that is removed with it—usually five centimeters or so on each side of the tumor to ensure that we captured all of it. This also gives the pathologist more tissue to examine for any indication that the cancer may have started to spread.

    We determine the stage of the cancer when the pathologist examines the specimen and surrounding tissue. If the tumor has only penetrated part of the colon wall, it is considered to be stage 1; if it has passed through the entire wall, stage 2. In stage 3, it has reached the lymph nodes and, of course, in stage 4, it has ultimately metastasized to other areas of the body.

    What to Expect at MedStar Washington Hospital Center

    If biopsy results show the presence of cancer, we order additional tests, blood work and scans of the rest of the body, to determine if and where the disease has spread. If the lungs, liver and other areas of the body visible via CT scan appear cancer-free, we surgically remove just the cancerous part of the colon and reconnect the remaining portions.

    When screening procedures catch the cancer early, we can typically address it using our minimally invasive surgical procedures, via laparoscopy or robotics. Patients can expect to spend two to five nights in the hospital following their procedure.

    At the Hospital Center, our gastroenterology team and colorectal surgeons typically perform our colonoscopies. Then, our surgeons, anesthesiologists and nursing staff are committed to delivering excellent surgical work for patients who need it, as well as our unique, enhanced recovery-after-surgery protocols—preoperative, intraoperative, and post-operative procedures that help decrease patient complications and length of stay. This may include everything from healthy nutritional “pre-hab” shakes before surgery, to a focus on multimodal pain medication that avoids the need for opioids or narcotics post-surgery. And we encourage activity, getting patients up and out of bed quickly so the patient is ready to return home as soon as possible.

    Despite COVID-19, the Hospital Center’s colorectal team has resumed normal operations, handling not just cancer cases, but screenings and elective surgeries that manage issues like diverticulitis and inflammatory bowel disease.

    If you are in need of attention, please reach out to us for a consultation. Above all, don’t delay your screenings!


    Notice bleeding in your stool?

    Our specialists can help.

    Call 202-788-5048 or Request an Appointment

  • December 09, 2020

    By Cheryl Hughes, Licensed clinical social worker, MedStar Georgetown University Hospital

    It’s never easy to deal with a loss, but the holiday season has a tendency to bring up painful reminders of deceased loved ones. And this year, many Americans may be dealing with grief over the holidays for the first time, as we mourn family and friends who lost their lives to COVID-19.

    It’s not just death that can cause grief over the holidays. In fact, it’s likely that most people are coping with a variety of losses this year, from the loss of a job to a loss of a relationship as a result of being geographically distant or feeling isolated from people they love.

    The #Holidays can intensify feelings of loss, whether it’s a loss of a job or a loved one. On the #LiveWellHealthy blog, two social workers share 4 tips for dealing with loss this holiday season: https://bit.ly/3qGLkaG.

    Click to Tweet


    The holidays can intensify feelings of loss, especially in 2020.

    Starting around Thanksgiving, many people who have lost loved ones experience sorrow as they’re reminded of memories from those who are no longer near. Holiday traditions meant to bring joy, like trimming the Christmas tree or listening to holiday music can trigger feelings of intense grief as we remember holidays past and wonder how to celebrate the festive season without the people we love.

    Grief is complicated and looks different for everyone. Sometimes, it’s surprising. Whether your loss is fresh or you’ve lost someone decades ago, unexpected feelings of sadness and loss can surface that aren’t necessarily attached to a specific memory. For some, these moments of grief can appear out of nowhere. For others, grief over the holidays is expected and dreaded. This year, the public health crisis that has affected all of us in different ways may result in added grief on top of an already emotionally-loaded time of year.

    There’s no right way to grieve, but there are things you can do to try to cope over the holidays while acknowledging and expressing your sadness.

    How to deal with grief over the holidays.

    1. Accept the emotions that you’re feeling.

    The holidays can generate exaggerated feelings as the pressure to “be merry” collides with the reality of our grief. Grief can present itself in a variety of emotions, from sadness or anxiety to irritability or anger. Everyone grieves differently. But that can be difficult when you’re around family members who expect you to show sadness in the same way—or even hide it. But, you’re human and allowed to feel a wide range of emotions, including both grief and joy. Sometimes you may even feel happy and sad within a few minutes. It’s healthy to acknowledge your emotions and accept how you’re feeling rather than try to escape it.

    2. Show yourself kindness.

    It may sound simple, but self-care is one of the best ways to deal with grief over the holidays. Think about how you would care for others in your life experiencing loss, then apply the same measures of compassion and grace to yourself. When grief hits hard, try to find things to do that help you to feel supported and restored, whether that means getting outside for some exercise, meditating, or journaling about someone—or something—you miss.

    3. Find ways to incorporate memories of your loved ones into holiday traditions.

    One way to deal with grief over the holidays is to memorialize the legacy of someone you’ve lost and keep their memory alive. Whether you incorporate them into existing traditions or establish new celebrations, it can be therapeutic to remember the lives of those who’ve died. Here are a few ways you can honor the life of loved ones over the holidays:

    • Set a place for them at the table
    • Tell stories about them related to the holidays
    • Create an altar with favorite pictures and mementos
    • Write them a letter or email
    • Prepare a lost loved one’s favorite holiday dish
    • Light a candle in their memory

    4. Talk to someone.

    Experts know that grief needs to be heard and witnessed. Try to find someone who you know is a good listener and admit to them when you’re having a hard time. Healing can begin when we’re able to speak our grief into existence.

    And, when you’re in the listener’s role, remember that it’s not up to you to fix it. There’s no fixing grief. Instead, listen without judgment and remember that anything they’re feeling is okay.

    This is especially true for parents of kids who may also be grieving. Kids need permission to feel all kinds of emotions, even if their grief manifests differently than yours. If you can help them normalize their feelings, whether that’s joy amidst sorrow or guilt coupled with happiness, you can help them to work through the grieving process in a healthy way.

    When to seek additional help for grief.

    If you don’t have anyone to talk to, or you’re experiencing overwhelming grief for weeks or months, it may be helpful to seek counseling services from a therapist or psychologist. It’s healthy to ask for support, even if it’s outside of your inner circle. A professional counselor can serve as an active listener who can help you find healthy ways to cope with your grief, especially over the holidays.

    Whether your grief is new this holiday season, or you struggle with sadness this time every year, know that you’re not alone. And, those feelings won’t last forever. While the holidays may never feel the same, time and support can help you to make it through to the New Year a little bit easier.


    Are you looking for help with dealing with grief this holiday season?
    Click below for more information on MedStar Health’s behavioral health services.

    Learn More

  • December 08, 2020

    By Arul M. Thomas, MD, Transplant Hepatology

    The liver isn’t just the largest internal organ, it’s among the most important. You can’t live without it.

    About the size of a football, it’s located in the upper right part of the abdomen and protected by the ribcage. As part of the digestive system, the liver must process everything that the stomach and intestines digest and absorb. For nutrition, one of its main jobs is to produce bile, a chemical that converts fat into fuel the body can use. Without your liver, eating a cheeseburger and milkshake would make you very sick.

    In fact, the liver can be credited with performing at least 500 vital functions. It regulates blood sugar, makes vitamins, maintains blood at the right thickness and keeps muscles from tremoring. It filters toxins from the blood and clears medications and alcohol. When your muscles grow with regular exercise, your liver makes it possible. It’s very important to heart health. The liver even helps us think more clearly.

    A healthy liver is undoubtedly a key element to a healthy life. But, when the liver gets sick, many problems can follow. And unfortunately, liver disease is on the rise for millions of Americans.

    The liver performs over 500 functions and, if it gets sick, problems can follow. Dr. Arul Thomas has the details. @MedStarWHC via https://bit.ly/3lKiWk2.
    Click to Tweet

    Autoimmune Liver Disease

    The liver is prone to autoimmune disorders—a situation that occurs when the body’s immune system gets confused and attacks healthy cells. These disorders include autoimmune hepatitis, when the immune system attacks the liver causing inflammation and damage; primary biliary cholangitis, a condition that inflames and destroys the bile ducts; and primary sclerosing cholangitis (PSC), another autoimmune liver disease that recently took the life of screenwriter James Redford, the 58-year-old son of actor Robert Redford.

    PSC is a rare liver disease, a chronic condition that attacks bile ducts, the network of vessels that transport bile to the intestine. It often strikes in young people. When healthy, the ducts keep bile moving. Problems occur when the bile backs up and lingers longer than it should. PSC can start in a patient’s 20s, and no lifestyle modifications can prevent it. It is highly associated with liver and bile duct cancer. We have some treatment options—for example, we can place stents to open the bile ducts and improve flow. But mortality rate is high, and most PSC patients require liver transplants and there aren’t enough available livers.

    Lifestyle and Liver Disease

    Liver problems can also be caused by inherited diseases like hemochromatosis and Wilson disease. In hemochromatosis, the body absorbs too much iron, which is toxic to the liver and other organs. In Wilson disease, the toxin is copper. Much more common are diseases that come from environmental factors, including alcohol-related liver disease, viral hepatitis and nonalcoholic fatty liver disease.

    It’s estimated that about 100 million Americans have nonalcoholic fatty liver disease. It is also the most common liver disease in children, with instances doubling in the past few decades. Obesity is suspect, but since the disease can also affect those of normal weight who exercise regularly, there are likely genetic or other factors at work. Those with high blood pressure and type 2 diabetes are also at higher risk for developing this disease.

    As fat builds up in the liver, the liver swells and works less efficiently. Over years, the swelling can lead to cirrhosis, irreversible scarring that further reduces liver function and can turn cancerous.

    Early detection is key. Any liver disease can progress to the point of no return; when the damage is done, it is unlikely to turn around. Caught early, some conditions can be reversed via a modified lifestyle. This is why it’s critical to have liver function tested on a regular basis—a simple blood test can indicate if a disease process is underway.

    The ABCs of Hepatitis

    Viral hepatitis is caused by certain viruses and, like other liver diseases, may cause inflammation that leads to cirrhosis and liver cancer.

    • Hepatitis A is the least dangerous form, and a modern-day success story. Since the vaccine was introduced in 1995, occurrences have dropped 95 percent. Hepatitis A is frequently linked to fecal-oral contamination; for example, eating raw shellfish is a risk if the clam or oyster lived in contaminated water. It’s a bigger problem in parts of the world with lower water quality standards. However, it has been increasing in incidence in the U.S.
    • Hepatitis B is spread via body fluids—blood, semen and vaginal secretions. Sexual activity, tattoos and intravenous drug use are risk factors. It can spread to healthcare workers exposed to infected blood. And women can pass it to infants during childbirth. Hepatitis B is best controlled through prevention. We have a vaccine, recommended for those with risk factors. Like hepatitis A, most adults will clear it on their own. But as many as 5 percent will not, and for them it becomes a chronic or lifelong condition that should be managed by a specialist.
    • Hepatitis C is our greatest concern. It is the leading cause of liver failure, end-stage liver disease, and liver transplants. And it can be a silent killer. The Centers for Disease Control and Prevention estimates 3.2 million Americans are infected, but, since the hepatitis C virus (HCV) shows no symptoms in its early stages, as many as three-quarters of them don’t know they have it. There are excellent treatments available now that can offer a cure to many infected patients.
      • It spreads through blood. IV drug users are at risk, as are healthcare workers exposed to infected blood. It can also spread through transfusion and was a significant risk before 1992, when we started screening the nation’s blood supply.
      • HCV infects 17,000 new patients each year and kills an estimated 12,000. There is no vaccine, and since so many Americans already have it, the best defense is education, awareness, and more widespread testing. It can be treated, if caught early enough.
      • Of those with the disease, three-quarters are Baby Boomers, born 1945–1965. Testing is recommended for everyone in that age group. We don’t know precisely why it’s so prevalent, but research suggests that the Boomer population is more likely to have tried recreational drugs, even if only once. Intranasal cocaine use can also be a risk factor for hepatitis C.

    Liver Cancer

    Almost all liver diseases can cause liver cancer. Liver cancer is dangerous and difficult to treat in its later stages—reinforcing the importance of keeping your liver healthy and getting regular screenings.

    The classic progression of primary liver cancer starts with damage caused by inflammation. As the liver tries to repair itself, scar tissue forms. As scarring increases, liver function decreases and the risk of cancer grows. Most liver cancer arises from cirrhosis, the more severe form of liver scarring.

    But every patient is unique. Someone with hepatitis well under control may still develop cancer, even in the absence of cirrhosis. And it’s not uncommon for cancer to spread to the liver from another part of the body.

    The liver is susceptible to more than one kind of cancer, and treatment depends on the type, stage, severity, and underlying medical conditions. It starts by making an accurate diagnosis, which we can often accomplish via CT and MRI imaging.

    Treatment options include surgery, radiation and targeted drug therapy. We can destroy small tumors by burning, with ablation or cutting off a tumor’s blood supply with embolization. Sometimes the diseased portion of the liver can be removed. But, for some, once cancer is discovered, it may be too advanced or the rest of the liver may be too damaged. Then, the best option may be liver transplant.

    The Miracle of Transplantation

    Medical science has a large tool kit to help sick livers. But when those tools fail, we can replace the liver completely through transplantation. Transplants have saved hundreds of thousands of lives. However, the demand for a healthy liver is always greater than the supply, and patients with the sickest livers take precedence.

    A patient’s place on the wait list depends on a numerical score that takes into account the severity of his or her condition. All candidates for transplant are thoroughly evaluated to ensure maximal success medically and psychosocially with the new liver. Donor and recipient must have the same blood type, and the new liver must be similar in size to the original. For patients at the top of the list, the wait time for a new liver can be days. For those farther down on the wait list, it may stretch into years.

    We still don’t have enough donors; most organs are available only when a donor dies and chooses to donate their organs. The exception is living donation, when a healthy person donates part of their liver. As much as 60 percent of a healthy liver can be donated. It will regrow over a few years. It’s a good option for conditions that strike younger people—rather than waiting for their liver to become damaged to qualify under standard protocols. In these situations, family members will often step up to donate.

    Because transplantation is one of the most complex surgeries, we try to get the patient as healthy as possible in advance of the surgery. The heart and lungs have to be in the best shape possible; blood sugar, blood pressure and weight must be under control. We want medical issues managed and the patient prepared emotionally for the best chance of success.

    It’s a huge undertaking, and no one can go it alone. The entire MedStar Washington Hospital Center team collaborates to improve the patient’s health while they await a transplant. The skills and experience of nurse coordinators, social workers, dietitians, interventional radiologists and many other experts support the patient’s needs throughout the process.

    Last Word: Act Early

    At one time, nearly every liver disease was fatal. Those days are behind us: better testing, medications and advanced knowledge have rendered many liver diseases treatable or reversible. But liver disease remains a serious killer and, wherever possible, prevention is always the best medicine.

    It comes down to common sense—controlling diabetes, weight and blood pressure, eating a good diet and exercising. Moderating alcohol is critical. Current guidelines recommend limiting alcohol to two drinks per day for men and one per day for women—but I can see that recommendation becoming one drink per day for everyone in the near future.

    Every adult should have an annual liver function blood test, which is especially important if you have additional risk factors. Be sure your primary care physician orders a liver panel during your annual physical—ask about it. And be honest with your healthcare provider. No one will judge you. We help you best when we know the whole story.

    This year, we’ve entered some uncharted territory with COVID-19. We know it can harm liver function and potentially initiate liver damage. Serious effects have been observed even in people who’ve recovered from the typical respiratory symptoms. It’s uncommon, but it’s happening. So, it’s more important than ever to stay in touch with us through the pandemic, particularly if you’ve been diagnosed with and recovered from the coronavirus.

    From screening, imaging and diagnosis to advanced medical treatment to complex transplantation surgery, we have the medical expertise and depth of personnel to manage every presentation of liver disease.


    Catch liver problems early.

    Schedule a screening today.

    Call 202-788-5048 or Request an Appointment

  • December 05, 2020

    By MedStar Team

    For the third quarter of 2020, we awarded two individuals with the SPIRIT Award for the first time in one quarter, Keith Moyer and Eva Hochberger. Keith Moyer was awarded the SPIRIT of Excellence Award for the third quarter of 2020 during the MHRI Virtual Town Hall. Keith is a regulatory affairs coordinator for the Baltimore Cardiology Research team. Nominated by Colleen Kelly, CCRC, CIMClinical Trials Manager and the Baltimore Cardiology Team, the award was presented by Tina Stanger, Assistant Vice President of Research Administration.

    Keith was recognized for being selfless and embodying a teamwork spirit. The Baltimore Cardiology team showed their appreciation and are glad to have Keith on their team.

    “Keith is the true definition of team player. He makes selfless contributions to the team. Helping other people without asking in return is a special quality that Keith consistently demonstrates, and I am sincerely grateful to have him on our Baltimore Cardiology team”, said Collen Kelly.

    The SPIRIT Award is given to recognize and reward one associate (management or non-management) each quarter, who excels in Service, Patient First, Integrity, Respect, Innovation, and Teamwork.

    Nominations are based on submission to the MHRI Kudos program. Each quarter, the MHRI Executive Team will review the KUDOS submissions and select an associate or manager who best exemplifies all our SPIRIT values.

     
  • December 05, 2020

    By MedStar Team

    The Georgetown-Howard Universities Center for Clinical and Translational Science (GHUCCTS) is now accepting applications for our 2021 KL2 Scholars Program. The pre-application is due December 31, 2020 with the final application due February 1, 2021. Funding is expected to begin in June 2021 pending the evolution of the COVID-19 pandemic.

    During our first ten years, we have been privileged to award KL2 support to 18 junior faculty colleagues from Georgetown and Howard Universities and from MedStar Health, who have leveraged this opportunity in order to publish >500 peer-reviewed manuscripts, receive over 50 extramural grants and conduct 30 sponsored clinical trials.

    This K-series career development award is nearly identical to our previous KL2 awards and analogous to individual K23K08, or K01 awards, with a focus on developing early-career (MD or equivalent; doctorally-trained nurses, pharmacists or dentists; and clinically or translationally-oriented PhD) faculty investigators through an inter- or multi-disciplinary mentored research experience so that they can become independent, extramurally-funded investigators. Given the goals of the GHUCCTS, awards will favor those: 1) who propose novel trans-, inter-, or multi-disciplinary and collaborative/team research projects, 2) from the entire T1-T4 translational continuum, 3) which span departments, disciplines, and institutions, and 4) address significant health disparities.

    After our 10th highly competitive application cycle, GHUCCTS recently announced the appointment of Dr. Haiyan He as a KL2 Scholar. Dr. He is an Assistant Professor in the Department of Biology at Georgetown University.

    For more details, including application instructions, visit our KL2 Scholars page or download the RFA announcement.

    QUESTIONS?
    Inquiries to Ms. Cyndi Campbell Cyndi.Campbell@georgetown.edu, or to any member of the KL2 Executive Committee (Jason G. Umans, MD, PhD: jgu@georgetown.edu Kathryn Sandberg, PhD: sandberg@georgetown.edu; Charles D. Howell, MD: charles.howell@howard.edu)

     
  • December 05, 2020

    By MedStar Team

    Recently published research evaluated pre-op and post-op patient questionnaires to identify if patient responses were related to subsequent emergency department visits 90-days after surgery. “Risk Factors for Emergency Department Visits After Upper Extremity Surgery” was published in Plastic and Reconstructive Surgery - Global Open. The research team included Pragna N. Shetty, MPH; Kavya K. Sanghavi, MPH; and Aviram M. Giladi, MD, MS, from The Curtis National Hand Center at MedStar Union Memorial Hospital.

    The researchers reviewed more than 2,000 medical records and collected the patient’s presenting diagnosis, preoperative and postoperative questionnaires, pain scores, and postoperative satisfaction scores.  The results show that sixty-one (3.0%) patients presented to the emergency department with hand-related or surgery-related complaints within 90 days after surgery. Preoperative pain scores were higher in the group that presented to the ED compared to those that did not. Patients who presented to the emergency department had significantly worse preoperative questionnaire scores, and significantly lower postoperative satisfaction scores.

    The research team concluded that those patients with worse preoperative questionnaire scores and lower postoperative satisfaction were associated with an increased likelihood of presenting to the emergency department for management of a hand or postoperative issue during the global period. These patients should be identified early and educated on their healthcare options in order to improve value-based care and decrease healthcare utilization.

    This research abstract was awarded “Best Hand Abstract” at the 89th Annual Plastic Surgery The Meeting, attended virtually this year.

    Plastic and Reconstructive Surgery – Global Open, 2020. DOI: 10.1097/01.GOX.0000720836.06040.bd