MedStar Health Blog

What do music artist Missy Elliot and Olympic gold medalist Gail Devers have in common? Besides being successful public figures, they’ve both battled a common enemy. At the peak of their careers, they were diagnosed with Graves’ disease—an autoimmune disorder of the thyroid gland that can impact overall health and productivity. Despite this diagnosis, they stayed in the game, delivering chart-topping hits and winning medals on the track.

You or your loved one can bounce back too, with a little help from your medical team. Let’s look at what Graves’ disease is and the signs to watch for.

What is Graves’ disease?

Graves’ disease is a condition in which the body’s immune system mistakenly attacks the thyroid gland. As a result of this attack, the gland produces an excess of thyroid hormone, causing hyperthyroidism. Hyperthyroidism negatively impacts overall health.

As the most common cause of hyperthyroidism, the disease affects approximately 1% of the population, with a higher incidence in women of reproductive age. However, it can occur in males and females at any age.

What signs should you look for?

We still do not know the exact cause behind this illness, but common signs and symptoms might include some of the following:

• • Heart palpitations
  • Unusual weight loss
  • Excessive sweating
  • New-onset anxiety
  • Weakness
  • Fullness in the neck
  • Changes in the appearance of your eyes

How is it diagnosed and treated?

If a patient exhibits symptoms of hyperthyroidism, we usually prescribe specific blood tests and imaging to check for Graves’ disease or other conditions. There are two types of treatment options to control an overactive thyroid gland:

Anti-thyroid medications: As an initial measure, medications are prescribed to lower the levels of thyroid hormone and maintain normal metabolism and bodily functions. However, this is not a long-term solution since the hyperthyroidism returns in most people with Graves’ disease after stopping the medication.

The downside of using medications is that prolonged use may further impact overall health by causing side effects to the liver and bone marrow.

Definitive treatment: Long-term interventions include radioactive iodine therapy, which destroys the thyroid gland with radiation, or surgery to remove the thyroid gland to stop production of the hormone.

Radioactive iodine takes around three months to show results and may require repeated treatments to take effect. Some patients, after radioactive iodine therapy, will have to take supplemental thyroid hormone.

We recommend surgery over radioactive iodine for patients who:

• • • • Are trying to get pregnant or are breastfeeding
      • Have multiple nodules inside the thyroid gland
      • Already have eye disease due to Graves’ disease
      • Don’t want to undergo radiation therapy
      • Have other medical reasons why radioactive iodine therapy would not be in the patient’s best interest

It is important to have a discussion with your physician to choose the right treatment.

What is recovery after surgery like?

It typically takes just one to two weeks to recover from surgery under general anesthesia. You can resume normal activities as soon as you feel better.

After successful removal of the thyroid gland, the thyroid hormone is not produced in the body anymore, so the chance of Graves’ disease returning is very low. Because the thyroid is not present and making hormone anymore after surgery, you will need to take a thyroid supplement, which is safer and easier to manage than anti-thyroid medications.

Can complications occur if it’s left untreated?

If you don’t have any symptoms and a routine blood test indicates hyperthyroidism, don’t be surprised. During early onset, there are often no symptoms. Over time, however, it can have a negative impact on the heart, muscles, bones and eyes. One-third of patients develop bulging eyes due to fibrosis. So, it’s important to have routine checkups and look for unusual signs.

Graves’ disease is a lot more common than you think.

Schedule regular checkups with your doctor and keep track of your thyroid hormone levels. Early detection, timely treatment and post-surgery management go a long way to ensuring a quick recovery.

LISTEN: Dr. Lai discusses Graves’ disease in the Medical Intel podcast.

In early spring 2020, COVID-19 began to assert itself across the country. As it did, medical facilities nationwide experienced a sudden decrease in traffic to outpatient services and Emergency Departments (EDs). At the same time, there was a surge in visits from people with infectious issues (coughs, colds, fever), fearing they might have the coronavirus.

Yet even at that early stage of the pandemic, MedStar Washington Hospital Center was well prepared to manage all patients, COVID-19 or otherwise. Without hesitation, we immediately implemented safe protocols for incoming patients. We also ramped up our telehealth support, helping patients with non-critical conditions to stay connected with their providers and maintain good health during that uncertain period.

Fast forward to fall 2020. As health care professionals gain greater insight into COVID-19 every day—and as instances of the virus stabilize a bit in our area—we’re encouraging patients to return with confidence to on-site visits at MedStar Washington.

If you have not yet resumed visits with us on-site, we look forward to seeing you!

Have you avoided medical care during the pandemic? Don’t let these common misconceptions cause you to avoid treatment or neglect your health issues:

#1: If I go to the hospital, I may get COVID-19.

We are 100% committed to containing COVID-19 and preventing its transmission among patients and caregivers.

We’re incredibly vigilant about this, employing strict protocols that keep our patients and staff safe. Our Quality and Safety Department is rigorously committed to this mission, and all Centers for Disease Control and Prevention (CDC) guidelines for distancing, masking, hand-washing, and sanitizing are, of course, mandatory throughout MedStar Washington.

We require all patients to be masked and receive a temperature check. All seats in waiting rooms are six feet apart. Anyone entering the hospital is required to respond to COVID-19 screening questions.

#2: COVID-19 patients need help more than me right now. I should probably avoid putting unnecessary strain on the healthcare system.

We are well prepared to care for you!

As the pandemic spread throughout the spring, operations at many medical facilities were quickly strained, particularly in regions hit hard by the virus early on, like Italy and New York City. Here at MedStar Washington Hospital Center, we saw what might be coming our way and took it very seriously, quickly preparing to accommodate a surge of patients.

A local leader in disaster management, the Hospital Center was able to immediately activate its disaster plan, putting energy and urgency into addressing our surge capacity.

MedStar Health’s strength lies in its network of 10 hospitals. In any major emergency, we’re able to think beyond the capacity at the Hospital Center, across the entire MedStar Health system, where we have access to a vastly expanded number of intensive care unit beds, ventilators, and negative pressure rooms.

To handle the surge in patient load, we transferred patients across the system, preventing any one facility from being overwhelmed. With our large network of available resources, we’re uniquely positioned to accommodate ebbs and flows in the virus across our region.

We took additional preparedness measures as well, including quickly creating a temporary auxiliary ED where patients with minor, non-coronavirus-related complaints could be treated. We also implemented a COVID-19 clinic specifically for testing people who were not critically ill. If a patient did require treatment for COVID-19—or was suspected of having COVID-19 but still awaiting test results—we placed them in isolation rooms to keep other patients and staff safe from infection. Even at the height of the pandemic around our region, Hospital Center resources were never stretched in this regard.

#3: This pain I’m feeling is probably nothing. If I wait, it will probably just go away.

If you think you are having an emergency, it’s not safe to wait.

For many medical issues, there’s a tremendous risk in delaying treatment. In fact, that’s almost the definition of an emergency: a situation in which it’s too risky to wait.

If you have trouble breathing or severe, persistent pain—let’s say, at a level you’ve never felt before or it frightens you—come to the ED immediately and let us check it out. If you come to us and discover it’s not an emergency, it’s still better that you came. Don’t risk your health or life.

Is it COVID-19?
If you have mild symptoms that you think might be COVID-19, you have many options for seeking care. Call your primary care provider’s office to seek guidance, go to a MedStar Health Urgent Care location or use a MedStar Health Video Visit for medical advice and assessment.

However, you should come to the ED if you have or suspect COVID-19 and also are extremely short of breath; have a high fever; or suffer from asthma, diabetes, hypertension, heart disease, or another chronic illness, as these conditions can complicate coronavirus.

Let’s look at some other situations when you should immediately seek emergency care:

• You have chest pain or suspect a heart attack: If you neglect to seek help, you may find that your chest pain actually subsides over the next few days, leaving you convinced that you dodged a bullet. But know this: your heart muscle is not in a normal state, it’s been compromised. By avoiding treatment, you’re now in danger of fatal arrhythmias and other aftershocks from that assault on your heart. Ignore the pain, and you may risk death within days or even hours. Or, left untreated, a heart attack may weaken the heart muscle to the point where you have long-term congestive heart failure. Chest pain is a signal to head to our ED, where we can work to halt further damage to your heart muscle.
• You suspect a stroke: Again, an immediate trip to the ED is in order. Ignoring signs of a stroke can cause permanent disabilities, from limb and muscle weakness to speech problems.
• You suspect an infection: Infections are frequently neglected until the patient is in a real danger zone—at risk for septic shock and, potentially, death. So, report to the ED when you experience high fever; uncontrollable chills, burning, or pain; troubling redness or swelling; excessive vomiting; or other important signs that infection has set in.

#4: My health screenings can wait until COVID-19 is no longer a threat.

It’s time to get back on track with health screenings.

The whole purpose of screening is early detection. Let’s consider two critical conditions: hypertension and cancer. Both screenings are important because these are frequently symptom-free diseases that can deliver severe long-term consequences.

Blood pressure: If you don’t experience headaches or dizziness, you might think your blood pressure is just fine.  But chronically elevated blood pressure is not something you can feel. Bit by bit, it can gradually damage your heart muscle, kidneys, and brain, and you may have no warning that it’s happening until months or years down the road, when ultimately a crisis occurs. If it spikes very high, it could result in stroke, heart attack, or acute heart failure when your lungs fill with fluid. So, monitoring and treating your blood pressure are the most important actions you can take.

Cancer: Cancers, too, can be completely painless and without symptoms until they reach an advanced stage. When symptoms finally do appear, it may be much harder to treat or manage the cancer.

During the pandemic, your doctors at the Hospital Center are careful about when we recommend you get your important screenings. Have a “shared decision-making” chat with your primary care physician or specialist to determine the best time to get your screenings. You can also put our telehealth services to good use to discuss things like medication management.

And don’t be shy about telling your doctor where and how you may have dropped the ball in managing your health during the pandemic. Remember: your doctor is experiencing COVID-19 stress just like you. He or she understands that pandemic conditions may make it more difficult than usual to exercise, eat right, and maintain health routines. Regardless of whether we’ve contracted the virus or not, COVID-19 is impacting all of us.

#5: Telehealth visits seem too complicated.

Telehealth is an easy, effective way to stay connected with your doctor.

As the coronavirus began to spread, the Hospital Center’s telehealth options—already popular with some patients—suddenly emerged as an efficient option for many others. In those challenging first few months, telehealth was an invaluable resource for patients concerned about leaving home, and as many as 90% of our outpatient visits were conducted in that manner. It continues to be a great choice for certain situations.

For example, if you have a mild case of COVID-19, telehealth can be a viable way to check in quickly and report changes in symptoms to your health care professional. Your respiratory pattern, respiratory rate, the cadence of your conversation—all can be markers telling us if you’re struggling to breathe and whether you need to come to the hospital for more advanced medical care. (Of course, remember: if you’re in distress, come directly to the ED.)

A Word About Flu Season

Although flu season is upon us, we never know how it will evolve until it’s in full swing. But because the flu and COVID-19 have many similar symptoms, patients should be cautious. If you’re quite ill, come in for an assessment and testing. We’ll determine if it’s the flu or COVID-19 and how quarantining should be handled, since isolation is very important for both conditions.

Rest assured, though: if the region experiences another wave of coronavirus, even during flu season, we’re ready. All the protocols and systems are in place and effective.

We’ve expanded our testing capacity for COVID-19 and offer multiple ways for you to be monitored for COVID-19 or treated for other issues, whether through our ED, your primary care doctor or specialist, or Urgent Care. And we have the entire MedStar Health system behind us, extending our care opportunities as needed.

Most importantly, don’t delay care. Do the right thing when it comes to your health, not just for yourself, but for the people who care about you.

If you have found yourself mindlessly finishing off a big bag of chips or a quart of ice cream during these unsettling times, you are not alone. Many of us turn to food for comfort when we are experiencing stress.

But emotional eating can negatively affect your health—both physically and mentally. It can lead to weight gain, or worsen pre-existing conditions like diabetes, especially if you aren’t able to do as much physical activity as usual. Those things, in turn, can cause or exacerbate depression or anxiety.

The solution? Mindful eating. At times like this, it’s essential to pay attention to what, when, how, and why you’re eating.

What is mindful eating?

Mindful eating is an approach to food that brings mindfulness to food choice and the experience of eating, so you eat healthier and enjoy your food more. When you slow down and pay attention to how and what you eat, you’re more likely to make better decisions that will nourish your body.

5 tips for practicing mindful eating.

Unsure how to eat mindfully? Here are a few tips to help get you started:

1. Unplug.

Avoid watching TV and talking on the phone or texting while you eat. Stop working and step away from the computer. Set everything aside and take a break to enjoy and savor your food. Focus on your meal.

2. Slow down.

Your brain needs time to register that you’re eating and to communicate to your body when you are full. Set your fork down between bites. It’s likely that you’ll eat a lot less. This helps prevent overeating, weight gain, and digestive stress.

3. Chew well.

Devouring food without chewing very well can trigger unpleasant symptoms like bloating, gas, and indigestion. The saliva in your mouth is full of active enzymes that help break down food, making it easier to digest and allowing for better absorption of vitamins and nutrients.

4. Only eat when you’re hungry.

Ask “why am I eating?” before you take a bite. If your answer is boredom, stress, or another emotion, try redirecting yourself by calling a friend or taking a walk. This helps you avoid emotional eating and mindless snacking.

Related: Easy ways to eat healthy during COVID-19.

5. Be present.

Notice the colors, shapes, and aroma of your food. As you take a bite of food, think about the flavors and textures as you chew. Truly focusing on your food will also encourage you to slow down and enjoy the experience of eating.

Mindful eating can be a magical, stimulating experience that supports good health. By tapping into all of your senses, you will begin to appreciate your food more, and decrease your emotional eating habits and their negative side effects.

Colon cancer is the third most commonly diagnosed type of cancer in men and women in the United States, according to the American Cancer Society. But a diagnosis doesn’t have to be a death sentence when caught early. In fact, people who are diagnosed with stage one colon cancer have an 80 to 90 percent chance of survival.

And, unlike other forms of cancer, there are things you can do to prevent a diagnosis altogether.

Colon cancer is preventable.

Using a flexible tube attached to a small camera, doctors can search for and remove abnormal growths in the colon called polyps during a screening test called a colonoscopy. Polyps aren’t cancerous but when left in the colon, some types of polyps can develop into cancerous tumors. Removing any polyps before they have a chance to turn into cancer eliminates your risk of colon cancer.

Because doctors can remove any signs of polyps during the screening test, you can leave the appointment reassured that you won’t have to come back for an additional procedure until your next screening. But if you begin to develop symptoms of colon cancer before your next screening, contact your physician to see if you need to be evaluated.

Related: Five ways to make colonoscopy prep easier.

Early detection through colonoscopy can save your life.

Some people delay colon cancer screening because they’re afraid of a diagnosis. But waiting to get screened gives polyps time to grow into cancer and spread, which is harder to treat.

If you follow recommended screening guidelines, you have a better chance of detecting signs of colon cancer early when it’s most curable. Once colon cancer has grown in size or spread to other parts of the body, treatment becomes more difficult. If colon cancer progresses to stage four, the five-year survival rate is less than 10 percent.

Don’t wait for symptoms to get screened.

Colon cancer symptoms may include:

• Rectal bleeding
• Blood in stools
• Thinning stools
• Unexplained weight loss
• Nausea or vomiting

However, it’s important to get screened for colon cancer early before any symptoms develop. Getting screened before symptoms ensures your doctor can remove any polyps before they have a chance to grow into cancer, or detect and remove early stages of colon cancer when treatment is most effective.

If you wait until colon cancer symptoms appear, it’s likely cancer has begun growing and spreading. That’s what happened to a patient who canceled her colonoscopy last year. Despite experiencing rectal bleeding, she delayed her colonoscopy for one year. After 12 months, she returned to get screened and discovered she has stage four colon cancer. Because the disease has now spread to other parts of her body, she is currently fighting cancer with chemotherapy.

When to start getting screened for colon cancer.

The American Cancer Society recommends most people begin regular colon cancer screenings via colonoscopy starting at age 45. Depending on what your doctor finds during the procedure, you may not need another screening for one to ten years.

If you are younger than 45 but have a family history of colon cancer or symptoms of colon cancer, talk to your doctor about getting screened early. While colon cancer is commonly diagnosed in adults over the age of 50, it’s still possible to develop the disease at a younger age. Black Panther star Chadwick Boseman’s private battle with colon cancer began in his 30s, and he was only 43 years old when he tragically passed this summer.

See if you’re eligible for a free colonoscopy

Risk factors for colon cancer.

It’s unclear what causes colon cancer to develop, but certain risk factors increase your chances of being affected by colon cancer. Risk factors include:

• Age – Your risk increases as you get older.
• Race or Ethnicity – The incidence of colon cancer is higher in Black Americans.
• Lifestyle – Smoking and excessive alcohol consumption increasea your risk.
• Medical history – A family history of colon cancer, or a personal history of other colon-related illnesses, such as ulcerative colitis or Crohn’s disease, increases your risk. Likewise, if you’ve been diagnosed with colon cancer in the past, you have a greater risk of developing it again.

How to minimize your risk of colon cancer.

The best thing you can do for your health is to stay up-to-date on colon cancer screenings. Getting regular colonoscopies ensures your doctors can find and remove any polyps or early signs of cancer before it worsens.

In addition to getting colonoscopies, you can minimize your risk of colon cancer by:

• Eating a healthy diet high in fiber (fruits, vegetables, and whole grains) and low in fat
• Exercising regularly
• Avoiding smoking or excessive alcohol use
• Maintaining a healthy body weight

The earlier colon cancer is detected, the better it’s defeated.

Colon cancer screening can save your life, and you shouldn’t wait to get screened. The Colon Cancer Screening Program at MedStar Health is able to provide no-cost colon cancer screening for Baltimore City, Baltimore County, and Anne Arundel County residents who are uninsured or underinsured and have limited income.

We offer screenings at four of our local hospitals, and free transportation to and from your appointment.