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  • January 14, 2022

    By Allison Larson, MD

    Whether you’re a winter sports enthusiast or spend the season curled up by the fireplace, the low humidity, bitter winds, and dry indoor heat that accompany cold weather can deplete your skin’s natural moisture. Dry skin is not only painful, uncomfortable, and irritating; it also can lead to skin conditions such as eczema, which results in itchy, red, bumpy skin patches. 


    Follow these six tips to prevent and treat skin damage caused by winter dryness.


    1. Do: Wear sunscreen all year long.

    UV rays can easily penetrate cloudy skies to dry out exposed skin. And when the sun is shining, snow and ice reflect its rays, increasing UV exposure. 


    Getting a sunburn can cause severe dryness, premature aging of the skin, and skin cancer. Snow or shine, apply sunscreen before participating in any outdoor activity during the winter—especially if you take a tropical vacation to escape the cold; your skin is less accustomed to sunlight and more likely to burn quickly.


    The American Academy of Dermatology (AAD) recommends sunscreen that offers protection against both UVA and UVB rays, and offers a sun protection factor (SPF) of at least 30.


    That being said, if you are considering laser skin treatments to reduce wrinkles, hair, blemishes, or acne scars, winter is a better time to receive these procedures. Sun exposure shortly after a treatment increases the risk of hyperpigmentation (darkening of the skin), and people are less likely to spend time outside during the winter.


    Related reading: 7 Simple Ways to Protect Your Skin in the Sun

    2. Do: Skip products with drying ingredients.

    Soaps or facial products you use in warm weather with no issues may irritate your skin during colder seasons. This is because they contain ingredients that can cause dryness, but the effects aren’t noticeable until they’re worsened by the dry winter climate.

    You may need to take a break from:

    • Anti-acne medications containing benzoyl peroxide or salicylic acid
    • Antibacterial and detergent-based soap
    • Anything containing fragrance, from soap to hand sanitizer

    Hand washing and the use of hand sanitizer, which contains a high level of skin-drying alcohol, cannot be avoided; we need to maintain good hand hygiene to stop the spread of germs. If your job or lifestyle requires frequent hand washing or sanitizing, routinely apply hand cream throughout the day as well.


    During the COVID-19 pandemic, I have seen a lot of people develop hand dermatitis—a condition with itchy, burning skin that can swell and blister—due to constant hand washing. Sometimes the fix is as simple as changing the soap they're using. Sensitive-skin soap is the best product for dry skin; it typically foams up less but still cleans the skin efficiently.


    3. Do: Pay closer attention to thick skin.

    Areas of thin skin, such as the face and backs of your hands, are usually exposed to the wind and sun the most. It’s easy to tell when they start drying out. But the thick skin on your palms and bottoms of your feet is also prone to dryness—and tends to receive less attention.


    When thick skin gets dry, fissures form. You’ll see the surface turn white and scaly; then deep, linear cracks will appear. It isn’t as pliable as thin skin. When you’re constantly on your feet or using your hands to work, cook, and everything in between, dry thick skin cracks instead of flexing with your movements. 


    To soften cracked skin, gently massage a heavy-duty moisturizer—such as Vaseline—into the affected area once or twice a day. You can also talk with your doctor about using a skin-safe adhesive to close the fissures and help them heal faster.


    Related reading:  Follow these 5 Tips for Healthy Skin

    4. Don’t believe the myth that drinking more water will fix dry skin.

    Contrary to popular belief, the amount of water or fluids you drink does not play a major role in skin hydration—unless you’re severely dehydrated. In the winter, especially, dry skin is caused by external elements; it should be treated from the outside as well. 


    The best way to keep skin hydrated and healthy is to apply fragrance-free cream or ointment—not lotion—to damp skin after a shower or bath.
    Some people need additional moisturizers for their hands, legs, or other areas prone to dryness.

    While some lotions are made better than others, most are a combination of water and powder that evaporates quickly. Creams and ointments work better because they contain ingredients that can help rebuild your skin barrier. 

    Look for products with ceramide, a fatty acid that helps rebuild the fat and protein barrier that holds your skin cells together. The AAD also recommends moisturizing ingredients such as:

    • Dimethicone
    • Glycerin
    • Jojoba oil
    • Lanolin
    • Mineral oil
    • Petrolatum
    • Shea butter

    For severely dry skin, you can try a “wet wrap” technique:

    1. Rinse a pair of tight-fitting pajamas in warm water and wring them out so they’re damp, not wet.
    2. Apply cream or ointment to your skin.
    3. Put on the damp pajamas, followed by a pair of dry pajamas, and wear the ensemble for several hours.

    Dampness makes your skin more permeable and better able to absorb hydrating products. If the wet wrap or over-the-counter products aren’t working for you, talk with a dermatologist about prescription skin hydration options. 

    Drinking more water isn’t the answer to dry winter skin. The best solution is to apply fragrance-free cream or ointment directly to damp skin. Get more cold weather #SkinCareTips from a dermatologist in this blog: https://bit.ly/3KbVUA1.
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    5. Don’t confuse skin conditions with dryness.

    Skin conditions are often mistaken for dry skin because peeling or flaking are common symptoms. Redness of the skin or itching in addition to dryness and flaking indicates a skin condition that may need more than an over-the-counter moisturizer.


    Skin cells are anchored together by a lipid and protein layer (like a brick and mortar wall). With very dry skin, the seal on this wall or barrier is not fully intact and water evaporates out of the skin’s surface. The skin will become itchy and red in addition to scaly or flaky. If you experience these symptoms, visit with a dermatologist.

    6. Don’t wait for symptoms to take care of dry skin.

    Be proactive—the best way to maintain moisture is to apply hydrating creams and ointments directly to your skin on a regular basis. Start by applying them as part of your morning routine. Once you get used to that, add a nighttime application. And carry a container of it when you’re on the go or keep it in an easily accessible location at work.

     

    You can’t avoid dry air, but you can take precautions to reduce its harsh effects on your skin. If over-the-counter products don’t seem to help, our dermatologists can provide an individualized treatment plan. Hydrated skin is healthy skin!


    Does your skin get drier as the air gets colder?

    Our dermatologists can help.

    Call 202-877-DOCS (3627) or Request an Appointment

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  • July 31, 2020

    By Ngozi Wexler, MD

    If you’re pregnant, you may have some questions about what’s next. Many women feel a mix of emotions, which is why it’s important to have a care team to guide you every stage of your journey to a healthy delivery.

    In part one of the 10 things to know when getting ready for baby series, I shared a few ways you can feel prepared to grow your family, whether you’re already pregnant or just starting to plan for a baby. Here are five more things that can help you feel ready to handle motherhood.

    Related post: 10 things to know when getting ready for baby. (Part one)

    6. Outline what you’d like to include in your birth plan.

    At some point in the second trimester, it’s helpful to start thinking about a birth plan. Ask your doctor questions to help determine what you want and don’t want, including:

    • Who you would like to be a part of your labor and delivery.
    • What kind of environment you prefer (lighting, music, etc.).
    • Whether or not you want pain medications.
    • How you would like to move around during labor.
    • What position you’d like to push in.
    • Who you want to cut the umbilical cord.
    • Whether or not you want to bank the cord blood.
    • Any other special concerns or preferences.

    Request an Appointment

    7. There are classes, groups, and specialists to support you at every stage.

    As you’re getting ready for baby, hospital and community classes can help you know what to expect throughout labor, delivery, and the first few weeks of caring for a newborn. Consider enrolling in a newborn class to learn tips for diapering, feeding, and understanding baby cries. And, from Lamaze to hypnobirthing, childbirth-education classes can help you prepare for a positive labor and delivery experience. Many classes are offered virtually so you can safely get the information you need while minimizing exposure to others.

    While you’re pregnant, it’s also helpful to identify a lactation consultation or nurse who can help you breastfeed during the first two weeks after the baby’s birth when it’s the hardest. Some hospitals also offer lactation consultants, but if yours doesn’t, consider finding one that offers in-home visits. There are also various postpartum and breastfeeding groups that can ensure you feel supported after the baby’s arrival.

    Click here to view upcoming classes and support groups.

    8. Put these things on your registry—and choose a retailer with affordable shipping.

    In the second trimester, it’s a good idea to start researching strollers, bassinets, and other items that will get the most use. Perhaps your most important purchase will be a car seat, which you’ll need in order to leave the hospital after delivery. Having these items ready to go will help you feel prepared in case the baby decides to come early.

    If you’re using a registry to let family and friends know how they can support you with gifts, it’s helpful to choose a retailer that offers free shipping for your loved ones, especially if they’re ordering from a different city or state.

    9. Understand how COVID-19 may affect your pregnancy and birthing experience.

    While there aren’t any known risks related to COVID-19 during the first trimester, as your belly grows, your lung capacity will shrink. That means that your risk of COVID-19 complications increases as your pregnancy progresses, and this risk is elevated if you have other comorbidities. You can minimize your risk of exposure by attending as many appointments as you can virtually, maintaining social distance, and wearing a facemask.

    COVID-19 may affect who and how many people can support you in the hospital and at home during and after labor and delivery. Ask your doctor if your partner can attend, and if they can’t, be prepared to plan for virtual support so you’re not alone. Since babies are born with very little immunity, consider how you will handle visits from your support network once you bring your baby home. It’s also a good idea to have a designated person and plan to help you care for the baby if you’re diagnosed with COVID-19.

    Pregnant and wondering how #COVID-19 may affect childbirth? Visit the #LiveWellHealthy blog to see what OB/GYN Dr. Wexler thinks you should know, plus how to get ready for baby amidst a pandemic: https://bit.ly/2EDe28S.

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    10. Know the signs of postpartum depression and anxiety ahead of time.

    Postpartum depression can actually start before the baby arrives, so it’s important to know the signs. Depression and anxiety look different for everyone, but common symptoms include:

    • Tunnel vision
    • Pounding heart
    • Difficulty sleeping
    • Intense irritability
    • Persistent feeling of overwhelm and sadness
    • Trouble concentrating
    • Changes to eating patterns (e.g. overeating or not eating enough)

    If you’re feeling stressed, try these five tips to manage pregnancy stress with the help of video visits with your doctor. Talk to your OB/GYN about how to differentiate between the baby blues and postpartum depression so that when the baby arrives, you’ll know how to seek help if you need it.

    By getting ready for the baby ahead of time, you can rest assured that you’ve done everything you can to prepare for the transition to motherhood. And when you have questions, we’re here for you in-person and virtually so you don’t have to worry about the “what if’s”.

    Whether you’re pregnant or just starting to plan for a baby, we can help you feel prepared to grow your family.
    Click below to learn more about pregnancy services at MedStar Montgomery Medical Center.

    Learn More

  • July 31, 2020

    By William Z. Gao, MD, Laryngologist

    When we face losing our voice, we may feel challenged not just functionally but emotionally as well. Our natural way of communicating—something most of us take for granted—is interrupted, which then affects all other facets of life. Even if it’s not a complete loss of voice, change in voice quality can lead to major impact on our sense of identity and quality of life. It’s common at this point to wonder if a return to “normal” is possible moving forward.

    The good news is that there are many effective modern treatments to restore the ability to speak and sing! But it’s important first to understand how voice is created as well as common causes of voice loss.

    How We Speak and Sing

    Production of a normal voice can be broken down into three processes, in this order:

    • First, our lungs generate a flow of air as we breathe out.
    • As the air flows through the voice box, it drives the vocal cords into vibration (like strumming a pair of guitar strings) in order to create sound.
    • The resonance of that sound is then shaped as it echoes through the throat and as words are articulated by movements of the tongue and lips.

    Causes of Voice Change or Loss

    Hence, voice may be “lost” in a number of ways—for example, if nerve impulses to the voice box are disrupted (vocal cord paralysis) or if the voice is severely affected by age-related changes (presbyphonia). In these situations, patients may have little to no voice or a very weak, “breathy voice”.

    Vocal “accidents” such as a bleed of the vocal cord and subsequent polyp formation can also lead to significant disruption of normal vocal quality. Polyps and other benign lesions are like blisters or calluses of the vocal cord related to voice use. Even small lesions can cause big problems for singers. Other causes include trauma to the voice box and vocal cord cancer.

    Even if it’s not a complete loss of voice, change in voice quality can lead to major impact on our sense of identity and quality of life. The good news is that there are many effective modern treatments to restore the ability to speak and sing, according to @WilliamGaoMD https://bit.ly/2CusGyk @MedStarWHC @MedStarGUH @MedStarHealth
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    Treatments to Restore the Voice

    Because voice disorders can be complex, a multidisciplinary approach is critical. At MedStar Washington Hospital Center, we regularly work with experienced speech language pathologists to achieve a tailored treatment plan for each patient.

    The best treatment option to achieve voice restoration depends on the diagnosis and individual patient factors. For example, a vocal cord injection using a filler material can be used to treat vocal cord paralysis to push a paralyzed vocal cord back toward the midline, where it can contact the vocal cord that is working normally. An advantage of this procedure is that it can often be performed in the office with local anesthesia, avoiding the need for an operation and general anesthesia.

    Medialization thyroplasty is a surgery that can create a similar effect by placing a permanent implant to push a paralyzed vocal cord to meet the normally functioning one. In certain cases, laryngeal reinnervation can be an effective surgery to restore nerve connections to the larynx.

    For other causes of vocal disturbance like benign lesions such as polyps, either laser treatment in the office can be used as a minimally invasive approach or phonomicrosurgery for precise removal of the lesion in order to restore voice. Even early vocal cord cancers can be successfully removed with laser microsurgery while restoring and preserving excellent voice quality.

    How We Can Help

    If you or a loved one has suffered from persistent hoarseness or lost your voice entirely, the first step is to figure out the exact cause. Our team employs comprehensive evaluation including advanced diagnostics such as laryngeal stroboscopy (a look at the voicebox) to determine a diagnosis.

    At MedStar Washington Hospital Center, we provide many state-of-the-art treatment options that let us address the needs of the individual patient and tailor an optimal approach.

    We are committed to improving and restoring the human voice, with the goal of having our patients reclaim their quality of life and resume a normal lifestyle as quickly as possible.


    Find your voice.

    Our specialists are here to help.

    Call 202-644-9526 or Request an Appointment

  • July 29, 2020

    By Ngozi Wexler, MD

    It’s common to feel uncertainty and anxiety while getting ready for a baby, especially if it’s your first. But, not knowing what to expect is often scarier than the facts.

    Even as an OB/GYN, there’s a lot I wish someone had told me before my first child. Understanding what you can do to prepare for a baby before their arrival can help you feel calm and confident as you enter motherhood. Here’s what you need to know when getting ready for baby, from pre-pregnancy planning and prenatal testing to how to care for you and baby in each trimester.

    It’s common to feel uncertainty while getting ready for a baby, especially if it’s your first. On the #LiveWellHealthy blog, OB/GYN Dr. Wexler shares 10 things to know about preparing for baby so you can feel confident as you enter #Motherhood: https://bit.ly/333WMDK.

    Click to Tweet

    1. You can start getting ready for baby before you’re pregnant.

    If you’re thinking about starting or growing your family, preconception counseling can ensure you’re prepared to have a healthy pregnancy. During preconception counseling, a maternal and fetal health specialist can help you understand your risk of passing along any inheritable diseases, manage your weight, and determine if you need to make any lifestyle changes before getting pregnant.

    Some ethnic groups have a higher risk of inheritable diseases, such as sickle cell disease and Tay-Sachs disease. Your doctor can determine if you are a carrier, and if you are, recommend partner testing to find out if you may pass along something to your baby. You can also get tested to see if you’re immune to certain vaccines, such as rubella and chickenpox.

    At a preconception consultation, your doctor will recommend taking a prenatal vitamin or folic acid supplement to ensure you’re getting the nutrients you need to help baby grow. And, you can discuss any current medications that you may need to avoid during pregnancy. They’ll also help you reach a healthy body mass index to minimize your risk of gestational diabetes, preeclampsia, and labor dystocia.

    We offer safe, convenient preconception appointments virtually, so you can start planning for your family from the comfort of your living room.

    2. Regular exercise and healthy eating can help you gain the recommended amount of weight.

    Too much weight gain can pose a risk to you and baby, and not enough weight gain is also harmful. It can be hard to find the motivation to work out in the first trimester when you feel fatigued and nauseous, but exercising is one of the best ways to ensure you manage your weight gain. Unless your doctor tells you that you can’t, aim for at least 30 minutes of moderate-intensity exercise every day. If that feels like too much at once, try breaking it into three ten-minute chunks of exercise.

    You might experience some unusual cravings, and it’s ok to give in to some of them. But, remember that you only need to eat for one and one-quarter of a person—not two!

    3. Prenatal tests can screen for any abnormalities early.

    Insurance covers many prenatal tests, but not all. That’s why it’s important to find out what’s included in your health plan. Most noninvasive screenings can be performed in the OB/GYN office as early as ten weeks and five days. Early testing allows you to identify any signs of gene abnormalities while giving you enough time to understand what to expect and address any concerns you may have.

    Request an Appointment

    4. There are things you can do to minimize nausea, aches, and pains.

    From nausea and round ligament pain to heartburn and hemorrhoids, pregnancy and birth can bring some uncomfortable side effects. But, there are many ways you can minimize discomfort. Here are some common pregnancy ailments and how to treat them.

    Nausea and vomiting: If you have severe morning sickness, consider trying a natural remedy, such as a ginger or vitamin B6 supplement.

    Round ligament pain: Between weeks 16 to 22, it’s common to feel round ligament pain as your uterus grows beyond the pelvic bone. A prenatal cradle or belt can support your lower abdomen and decrease aches and pains.

    Insomnia and trouble sleeping: Unisom is an over-the-counter remedy for aiding in sleep when you find yourself struggling to fall or stay asleep at night.

    Heartburn: You may experience some heartburn, especially after eating spicy or acidic foods. To minimize heartburn, I recommend giving your body 30 minutes to digest food after eating before laying down. At night, try sleeping at a 30-degree angle rather than flat. If you’re still having heartburn, you may consider taking an over-the-counter remedy, like Prilosec, Zantac, or something else on your approved medication list.

    Hemorrhoids: Stock up on witch hazel pads and Preparation-H to minimize any discomfort caused by hemorrhoids. You may benefit from a donut pillow that relieves pressure on your bottom.

    Prenatal yoga and physical therapy are also safe options for managing pregnancy ailments—even if you develop sciatica or carpal tunnel syndrome. A video visit appointment with a specially-trained physical therapist can help you learn ways to minimize aches and pains.

    5. Find a pediatrician during the second trimester.

    It’s never too early to establish a relationship with a pediatrician but aim to find one by the end of the second trimester. Many pediatricians offer get-to-know-you visits so you can ask questions about their care and experience. I recommend choosing a pediatrician who provides weekend hours so they’re available when you need them unexpectedly. It’s also a good idea to see if they have privileges to check-in on you in the hospital after delivery if that’s important to you.

    Read five more things you should know when preparing for baby in part 2 of the 10 things to know when getting ready for baby series.

    Whether you’re pregnant or just starting to plan for a baby, we can help you feel prepared to grow your family.
    Click below to learn more about pregnancy services at MedStar Montgomery Medical Center.

    Learn More

  • July 29, 2020

    By James Robinson, MD

    For centuries, women who experience severe menstrual pain have been told that the discomfort is just part of being a woman. It’s not. This level of pain could be endometriosis, and a woman who experiences it should not hesitate to seek help from a well-trained specialist.

    What Is It and Why Is It a Problem?

    The disease occurs when endometrial tissue—tissue from the lining of the uterine cavity—is found outside the uterus. In a normal cycle, it grows under the influence of estrogen as the ovaries are making an egg. It then stabilizes under the influence of progesterone. If a pregnancy does not occur, progesterone production eventually stops and the menstrual shedding of the tissue occurs.

    Endometrium that exists outside the uterus—regardless of whether it’s in the pelvis, or on the ovaries, colon, rectum, or bladder—goes through these same hormonal changes. And this process tends to cause pain, inflammation, scarring, and in many cases, infertility.

    Look For These Classic Symptoms

    The disease is complicated because the extent of the condition does not correlate well with the symptoms. There are women who have the disease and don’t suffer from symptoms, yet many women have minimal disease and horrendous, life-changing pain. Typically, though, there are common symptoms associated with this disease:

    • Debilitating menstrual cycle. In women with this disease, painful periods often present in their teen years. Periods that cause vomiting or send a girl or woman to bed in the fetal position are not normal. It is not normal for a girl to miss school because of the amount of pain she is having, or if her pain can’t be managed with an average dose of an over-the-counter pain reliever. Girls with these symptoms should seek help from a physician as soon as they can, to pinpoint underlying issues.
    • Progressive symptoms. These symptoms become more problematic over time as endometrium continues to grow outside the uterine cavity. The symptoms tend to extend beyond the menstrual cycle; rather than just being a cyclic pain, it begins to take over more and more of the patient’s life. We start to see secondary causes of pain, where the pelvic floor muscles become tight and the surrounding pelvic nerves become hyper-sensitized.
    • Urinary or bowel symptoms. Endometrial tissue can grow on major organs. We see it frequently on the colon, rectum, or bladder. When the disease manifests on those organs, people can have painful urinary or bowel symptoms. Many women also complain of painful bloating, which is worse cyclically.
    • Worsening pain with sex. Although not a classic symptom, the other thing we often see is that women have worsening pain with sex—both with deep penetration and with entry. And for many women, it starts to impact their mood and ability to live the life that they want.

    Many Possible Causes

    It’s hard to nail down just what causes the endometrium to grow in abnormal places in the body of any one individual. Reasons may include:

    • Genetic predisposition. The disease can often occur in women whose mothers also have it.
    • Fetal development. As we evolve as embryos, the reproductive organs descend through the developing body. All the tissue designed to be endometrium is supposed to end up in the uterus. In many women with the disease, some of that tissue becomes deposited in other parts of the body. It can then grow outside the uterus as soon as young women begin to menstruate.
    • Immune issues. In these cases, the bodies of people with the disease don’t clean up or eliminate the endometrium that ends up in their pelvis as effectively as the bodies of those people who don’t have the disease.

    Multipronged Approach to Treatment for Women of All Ages

    Although this is a disease that goes from menarche (the first menstruation) to menopause, women in their 20s, 30s, and 40s make up the vast majority of our patients.

    The pain and symptoms of this disease are often multimodal, impacting several organ systems. Therefore, the best treatment is generally multifaceted and may require multiple coordinated approaches.

    Exploring Dietary and Stress Connections

    Wellness is a holistic approach, and diet alone has never been shown to eliminate this disease. However, women with symptoms of the disease plus irritable bowel syndrome (IBS) symptoms often respond beautifully to a low-FODMAP diet (fermentable oligo-, di, mono-saccharides and polyols).

    Keeping stress levels down, exercising regularly to keep endorphins up, meditating, and eating in a way that doesn’t exacerbate bowel or bladder symptoms will help the patient better manage their pain.

    Hormonal Therapy Considerations

    If we catch the disease early, we can slow its progression and improve a patient’s quality of life. For instance, we may suggest that a girl begin birth control pills—even as young as the age of 14—if she suffers from debilitating periods. This can hugely benefit that young woman, giving her many more pain-free years than she may have otherwise experienced.

    A lot of parents are hesitant to start their daughters on hormonal therapy, partly because we tend to think of this treatment as simply birth control. But the fact remains that hormonal therapy or birth control pills are outstanding preventive treatments for women with the condition. This is especially important in our youngest patients to try and delay or avoid surgery.

    Physical Therapy

    In women with chronic pelvic pain, the pelvic muscles often respond by getting tight and tender. This leads to worsening low back, hip, and nerve pain. It also leads to worsening sexual dysfunction and pain. Even after adequate medical or surgical treatment of endometriosis, this pain can persist and often requires help from a specialized pelvic floor physical therapist.

    If we catch endometriosis early, we can slow its progression and improve a patient’s quality of life. Learn more from Dr. James K. Robinson. @jimkrobinson3 https://bit.ly/2CRpmgM via @MedStarWHC
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    What Comes First: Medicinal Therapy or Surgery?

    Hormonal suppression should be a first-line approach in most cases. On the other hand, if we already know that someone has an eight-centimeter endometrioma in one of their ovaries, no medicine we can give them will make that go away. As a result, they may go straight to the operating room without us initiating a trial of medical therapy.

    Minimally Invasive Is the Surgical Treatment of Choice

    Surgery, when it’s appropriate, can be life-changing for many women. It rids them of the disease and allows them to start fresh.

    In fact, when surgery is appropriate, nearly 100% of this disease can be managed through minimally invasive procedures. Surgically, we are able to do a much better job removing invasive endometrial tissue when it’s done laparoscopically or robotically, rather than through large incisions.

    Surgery Is Complicated—Seek a Specialist

    Because this disease is so complicated—in part, due to its potential to impact so many organs—and the surgery can be so complex, it is very important that women seek the services of a specialist.

    In most cases, the average Ob/Gyn should not be performing surgery to remove endometrial tissue growing outside the uterus. It should be left in the hands of specialists who regularly perform the procedure because it is among the most complex of surgeries we do.

    Speak Up, Be Your Own Advocate

    I would like to encourage more patients to advocate for themselves. If their Ob/Gyn suggests they need surgery to remove abnormal tissue growth, here are some questions to ask:

    • How often do you perform this type of surgery? Every month? Every week? Every day?
    • Are you comfortable performing a complete excisional surgery?
    • If it’s on my bowel, can you remove it and repair the bowel?
    • If it’s on my bladder or ureter, can you remove it and repair the bladder or ureter?
    • If not, can you refer me to a specialist who can perform that type of surgery?

    Patient Resources and Support

    A wide range of resources exists for women with endometriosis. For example, a Facebook group called “Nancy’s Nook” identifies expert excisional surgeons all over the country, and provides a forum for patients to listen to each other and exchange information.

    Patients can also check to see if a doctor has completed a fellowship in minimally invasive gynecologic surgery. These doctors complete two to three years of surgical fellowship above and beyond their Ob/Gyn residency. They manage 500 to 800 cases in those years and become experts.

    Most importantly, we can support our friends, family, and colleagues by not minimizing their period pain, and by encouraging them to seek an expert opinion. If you are experiencing this type of pain, find a specialist you are comfortable with; one who will spend time getting a thorough medical history from you and who will help you understand possible treatments for your condition. You want a doctor who is willing to work with you for the long term to help improve your quality of life.

    End the pain of endometriosis.

    Our specialists are here to help.

    Call 202-644-9526 or Request an Appointment

  • July 27, 2020

    By Dr. Laura Brookshire, DO, Pediatrician and Facility Medical Director at MedStar Medical Group at North Parkville Health Center

    While infants and kids can catch COVID-19, fewer than 5 percent of reported cases in the U.S. occur in children. And, kids that do catch the virus typically demonstrate much milder symptoms than adults. In fact, many children don’t show any symptoms at all.

    Still, it’s helpful to know what COVID-19 symptoms in kids look like so you can take precautions to minimize the risk of infecting someone else. Here’s what you need to know about COVID-19 signs, potential complications, and how to decrease your child’s exposure.

    Common COVID-19 symptoms in kids.

    We don’t know exactly why infants and kids are less likely to catch COVID-19 or become as sick as adults. While COVID-19 symptoms in kids and adults can be similar, most children experience fewer symptoms—or none at all.

    Kids who are 10 years and older may experience cold-like symptoms, such as:

    • Fever
    • Cough
    • Shortness of breath

    Babies and kids under the age of 10 often show fewer symptoms, which may include:

    • Fever
    • Runny nose
    • Headache
    • Diarrhea
    • Abdominal pain

    Babies under the age of one may show very subtle symptoms that can be confused with signs of other illnesses. Poor feeding or nursing could be additional signs of an infection.

    Risks of COVID-19 complications in kids.

    While kids are less likely to be severely affected by COVID-19, some children are at an increased risk of developing COVID-19 complications due to underlying health conditions, such as obesity, heart disease, or lung disease. Likewise, kids who are undergoing cancer treatment or living with immune disorders may be at a higher risk of more severe illness because of a weakened immune system.

    Early COVID-19 detection and prevention for kids.

    It can be hard to detect the virus early because COVID-19 symptoms in kids are often subtle. And, other viral illnesses are common this time of year which can make it tricky to determine what’s ailing your child.

    Instead of worrying about the “what ifs,” we recommend being vigilant about the things you can control to keep your family healthy, including:

    Practicing frequent hand washing: Frequently washing hands for at least 20 seconds at a time is the best way to keep illness at bay.

    Wearing masks: Kids over the age of two years old should wear a cloth face mask while in public or around others outside of the home. Children under the age of two and anyone with breathing conditions should not wear face masks.

    Limiting exposure to sick family members: Most kids who are infected by COVID-19 get it from someone at home. If a family member comes down with COVID-19, you can minimize the spread by having them sleep and eat in a separate area of the house. Even if they don’t show symptoms of COVID-19, be sure to clean high-touch surfaces and avoid sharing items.

    Safe socialization during COVID-19.

    Socialization is especially important for children, and there are safe ways to ensure your kids are still interacting with friends and family while limiting their risk of exposure to COVID-19. Honest and transparent communications with your families, neighbors, and community can help you make decisions about when and where it’s safe to spend time with others.

    How can I plan safe playdates?

    Social distancing and stay-at-home orders are necessary for reducing the spread of COVID-19. But when your local government lifts shelter-in-place protocols, use your best judgment to determine how to resume playdates and safe social activities.
    First, ask family members and friends if they’ve recently traveled, experienced COVID-19 symptoms, or have been tested for COVID-19. If they’re also consistently taking precautions to limit their exposure, such as wearing face masks and social distancing, then the risk is low.

    Is it safe for your kids to have playdates with their friends this summer? On the #LiveWellHealthy blog, two pediatricians share what you need to know about COVID-19 and kids: https://bit.ly/3f5F7Og.

    Click to Tweet

     

    Consider coordinating an outdoor playdate that allows kids to maintain a distance of six feet while enjoying each other’s company. This is harder for younger children, but there’s a variety of activities that don’t involve touching or sharing equipment. A bike ride, walk, or sidewalk game, like hopscotch, can be safe, fun ways for kids to stay connected with their peers.

    When should I send my kids back to school or daycare?

    Most daycares are open and closely following safety regulations to minimize the risk of COVID-19 exposure among children. And, many schools are resuming in the fall with proper guidelines in place to encourage frequent handwashing and social distancing.

    As both pediatricians and parents, we understand that resuming regular activities can cause some concern. However, because school-age children have a low risk of complications from COVID-19, we believe the educational and social benefits far outweigh any risks.

    It’s normal to feel hesitant about sending your kids back to school or daycare. We recommend asking your child’s school the following questions to understand how they’re implementing risk-reduction strategies.

    • What cleaning measures are in place?
    • How are you managing high-touch equipment, surfaces, or toys?
    • Are staff and/or children required to wear face masks? Will there be breaks built into the day?
    • How will you notify families if classmates get COVID-19?
    • How will you encourage frequent hand washing?

    You can also stay updated with the latest recommendations for COVID-19 and kids on the American Academy of Pediatrics’ website for families, HealthyChildren.org. The Centers for Disease Control and Prevention also publishes trustworthy information online related to keeping kids healthy during the pandemic.

    When to see a doctor.

    While severe symptoms are unlikely, if your child experiences breathing problems, chest pain, or worsening fever, go to the emergency room.

    In most cases, kids with COVID-19 can safely recover at home within one to two weeks. If symptoms worsen or your kids were exposed to someone who recently traveled or was diagnosed with COVID-19, call your pediatrician. Your pediatrician’s office can answer any questions you have using virtual visits to minimize the risk of exposure in the office setting. They can also direct to you a safe COVID-19 testing site nearby.

    Most importantly, if your child gets COVID-19, keep them home and away from others, even if they don’t have symptoms.

    With all of the uncertainty around the pandemic, be encouraged knowing that most kids aren’t at risk for developing severe COVID-19 symptoms. Continue modeling good hand hygiene and social distancing, and together, your family can help limit the spread.

    Have questions about COVID-19 and kids or need an appointment with a pediatrician?
    Click below for more information.

    Find a nearby pediatrician.

  • July 24, 2020

    By The MWHC Blog Team

    From his first introduction to cardiology at New York Medical College, Alexander Papolos, MD,knew he had found the specialty that would become his careerInspired by the physiology of the cardiovascular system and the field’s emerging technologies, hesays, “Cardiology really spoke to me from a scientific perspective.”

    Dr. Papolos’ career might easily have gone in another direction. He graduated from Ithaca College with a degree in biochemistry, and then returned to his hometown to work in a genetics lab at New York University.After a year,he realized that he wanted to pursue his love for science in a more tangible human way, which led him to medicine.

    Once he had discovered his passion for cardiology, Dr. Papolosstarted his residency at Mount Sinai Medical Center, then moved across the country for his fellowships in cardiology and cardiac critical care at the University of California,San Francisco.

    Joining MedStar Washington Hospital Center as a cardiac intensivist last year proved to be the perfect opportunity for Dr. Papolos to apply his skills and interests. “The large volume of cardiac cases is ideal for someone like me,” he says. “enjoy managing multidisciplinary teams that work together to care for criticallyill patients, pre- and post-surgery, using mechanical circulatory support devices and other advanced technologies.”

    Research Focus

    Dr. Papolos is investigating the application of a novelechocardiographic measure of pulmonary arterial capacitancefor treating patients with pulmonary hypertension and right heart dysfunction. He is also helping to develop a multidisciplinary cardiogenic shock team initiative,which focuses on the early identification of cardiogenic shockand facilitates the use of early invasive hemodynamics to guide treatment.

    “The sooner we can identify and diagnose the cause of shock, the faster we provide targeted therapy and prevent complications,” he says.

    Outside of Work

    Medicine isn’t the only skill Dr. Papolos has developed. He’s also an avid cook and considers barbecue to be his specialty. “Cooking was one way to help deal with the crazy hours during my training,” he says.

    Your heart deserves expert care.

    Connect with our cardiology team.

    Call 202-644-9526 or Request an Appointment