MedStar Health blog : MedStar Health

MedStar Health Blog

Featured Blog

  • 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

All Blogs

  • October 27, 2021

    By MedStar Team

    In 2020, families had to get creative while celebrating Halloween amidst the COVID-19 pandemic. Whether your children participated in a virtual Halloween costume contest or stayed at home for a family scary movie night, most families didn't celebrate the fall holiday with traditional trick-or-treating.

    This year isn't quite as scary when it comes to the risks associated with getting COVID as vaccination rates continue to rise. This is good news for costume-lovers, but it's still wise to take some precautions, especially if you have young children who are ineligible for the COVID-19 vaccine.

    Is trick-or-treating canceled this year?

    While COVID continues to affect communities nationwide, cases are decreasing and the Centers for Disease Control and Prevention (CDC) say trick-or-treating is not canceled this year. Still, the decision to go trick-or-treating is a personal one that depends on a variety of factors, including:

    • Your family's vaccination status
    • Your proximity to others who are at a high risk of complications from COVID-19
    • The transmission rate in your community

    As a family, you'll need to decide which risks are worth taking when it comes to participating in the October holiday. However you chose to celebrate, make sure it's something the whole family can do so that no one feels left out. Thankfully, trick-or-treating and other Halloween festivities typically take place outside where fresh air mitigates some COVID-19 risks.

     

    #TrickOrTreating isn’t canceled this year! On the #LiveWellHealthy blog, infectious disease expert Dr. Ruth Kanthula shares how to celebrate #Halloween safely: https://bit.ly/3mjGdgg.
    Click to Tweet
     

    Here are a few other considerations that can help keep your family safe if you trick-or-treat.


    COVID-19 guidelines for trick-or-treating safely.

    Experts recommend trick-or-treating in small groups, such as just your own household. While the risk of COVID-19 transmission is much lower than it was this time last year, it's still wise to spread out and practice social distancing among other trick or treaters. That means you should try to avoid congregating with other groups on doorsteps.

    Vaccinated individuals don't need to wear masks while outdoors. But, family members with a greater risk of complications associated with COVID-19 or kids under 12 may want to consider wearing cloth masks that match their costumes. If you live in an apartment complex that offers trick-or-treating indoors, all family members should wear a face mask regardless of vaccination status, as indoor activities don't offer the same benefit of ventilation as the outdoors.

    Is it safe to hand out or eat Halloween candy?

    It's perfectly fine to hand out Halloween candy, but this isn't the year to make tasty homemade treats for neighbors stopping by. Instead, individually wrapped and store-bought candy is the safest way to go. Consider how you can distribute candy in a contact-free way, like laying out candy on a table for kids to pick up candy without touching pieces that will go home with other trick-or-treaters. If you are handing out candy, you may also want to set out some hand sanitizer so that kids can wash their hands before selecting their candy.

    When your children come home with candy that they can't wait to eat, everyone should wash their hands before handling the candy. There's no need to wipe down each wrapped candy, as surface transmission isn't a high concern. But it's still not a bad idea to be cautious about how you unwrap and eat each Halloween treat. As an infectious disease expert, I always err on the side of caution. To safely enjoy your Halloween candy, I recommend unwrapping what you want to eat, leaving it on a table while you throw away the wrapper, and then washing your hands before eating the candy.

    Additional Halloween safety considerations.

    In addition to COVID-19 precautions, the American Academy of Pediatrics offers a few tips to keep your loved ones safe during Halloween, such as:

    • Always accompany young children
    • Only go to lit-up porches
    • Avoid sharp costume accessories
    • Ration treats in the weeks after Halloween
    Visit HealthyChildren.org to learn more.


    Other low-risk fall activities.

    Public health and pediatric experts still encourage families to avoid large groups at indoor gatherings. Instead of attending a crowded Halloween party, plan to celebrate fall and Halloween at a safe distance from other small groups outdoors. From a neighborhood Halloween scavenger hunt to visiting pumpkin patches where your kids can carve pumpkins or take tractor rides, there are lots of low-risk options for your family to celebrate safely.

    Here are a few suggestions for seasonal outdoor festivities in the Maryland region:

    Stay safe but enjoy Halloween!

    Parents still have a lot of questions when it comes to caring for their children during a pandemic. “Should my kids still get the flu shot?” “Should my children attend school in person?” “Should my older kids get vaccinated?” And now, “Is it safe to celebrate Halloween?” A pediatrician or family medicine provider can help to answer those questions based on the individual needs of your family. 

    No activity is zero risk, but in general, it's safe to celebrate Halloween in 2021 provided you take precautions to protect your family. Stay in a small group, visit outdoor gatherings, and enjoy the holiday.


    Are you looking for compassionate pediatric care nearby?

    Click below to find a MedStar Health pediatrician close to where you live, work, and play.

    Find a Pediatrician

  • October 22, 2021

    By MedStar Team

    Choosing whether to have breast reconstruction surgery—and whether to get implants or autologous reconstruction—is one of many decisions patients with breast cancer face. 


    Though the majority of patients choose implants, more women are choosing autologous reconstruction, which uses tissues transplanted from the abdomen to shape breasts that look and feel more natural.


    Five to 10 years ago, patients who chose autologous reconstruction spent several days in the hospital and were prescribed narcotic medication for post-surgical pain, which could last up to a month. 


    Now, our patients who receive autologous reconstruction leave the hospital two or three days after surgery—and sometimes even drive themselves home. Many of them are going back to work or on long walks around the neighborhood just a week later because of:

    • Muscle-sparing surgical techniques
    • Precise pain targeting
    • Collaborative decision-making between patients and care providers

    By consistently listening to patients’ concerns about breast surgery, we have developed protocols to reduce patients’ pain and discomfort during recovery and help them feel more like themselves again faster.


    Minimally invasive technique spares muscles.

    MedStar Washington Hospital Center is one of only a few treatment centers that specializes in deep inferior epigastric perforator (DIEP) flap breast reconstruction. In these microsurgery procedures, a specialized plastic surgeon transfers abdominal fat, skin, and blood vessels to a patient’s chest, reattaches these tissues, and artfully shapes a new, natural breast. 


    In nearly every DIEP flap, nerves from the abdomen are also reconnected to the chest to enhance sensation in the new breast. 


    The surgeon does not remove a patient’s muscle during a DIEP flap procedure. This technique not only prevents the pain associated with removing muscle but also helps patients retain their core strength to resume physical activity faster. For some patients, this means getting back into triathlon training. For others, it means being able to lift their grandchildren again.


    Timing of the surgery.

    Plastic surgeons partner closely with breast surgery colleagues to determine the best time to perform the reconstruction, based on each patient’s cancer treatment plan. For example, radiation can increase the risk of surgical complications such as infection or wound healing issues. If a patient doesn’t need radiation therapy after mastectomy, we often recommend immediate DIEP flap reconstruction, which is performed at the same time as the breast cancer surgery. 


    For patients who need radiation therapy after their mastectomy, we’ll perform a delayed reconstruction. During the mastectomy, we place a temporary tissue expander in the chest to maintain the shape of the breast. After radiation is complete, we remove the expander and perform the surgery. 


    A DIEP flap procedure can take 6-10 hours, compared to a few hours for implant reconstruction. However, the results will last the rest of your life.



    Surgical procedures at @MedStarWHC help #BreastCancer patients recover from #BreastReconstruction faster and with less pain. Some patients even drive themselves home a few days after surgery: https://bit.ly/3B526V0.
    Click to Tweet
     


    Precise pain management improves recovery.

    The narcotic pain medication typically prescribed after autologous reconstruction can cause drowsiness and lethargy in addition to the physical pain and discomfort that follow surgery. 


    By reducing patients’ pain overall, we reduce their need for narcotics and help them get back to everyday life, from work to child care, faster—without sacrificing pain relief.


    We accomplish this through:

    • Nerve blocks: We inject numbing medication into nerves within the chest and abdomen that signal pain. The numbing effect lasts a few days after the surgery, lessening the patient’s pain—and the need to treat pain.
    • Over-the-counter medicine: Days before and after surgery, the patient takes a combination of non-narcotic medications, including Tylenol and anti-inflammatories, to lower their pain. 
    • Movement: Physical therapists help patients get up and moving as soon as possible to regain strength and mobility and reduce stiffness and swelling. The sooner you can get back to your normal activities, the better you’ll feel.

    Patient comfort is our priority.

    The last thing we want is for recovery to cause feelings of fear and anxiety. Our goal is to continually advocate for our patients and provide the highest level of comfort. My plastic surgery colleagues and I collaborate with breast surgeons, anesthesiologists, and physical therapists to ensure we’re listening and responding to each patient’s unique needs.


    Every step of the way, we’ll partner with you to help you make the best choice of all the options that might work for your body and lifestyle. In every discussion with patients, we explain the risks and benefits of all available reconstruction procedures. 


    Many patients don’t know what autologous reconstruction is until they meet with us. It’s not the best option for everyone, but you can’t make an informed decision without being properly educated.


    We encourage you to ask every question you have and are happy to share several resources, including pictures and videos. The more transparent we can be, the more confident you can feel in your decision. We’re here to guide you on your journey to a fulfilling life after cancer treatment.



    Breast reconstruction surgery is an important, personal decision.

    Meet with a team of surgeons and pain management specialists to learn all of your options.

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

  • October 21, 2021

    By Christopher M. Gallagher, MD

    From screening to treatment—and everything in between—breast cancer care is improving rapidly. And MedStar Health is at the forefront of the shift from “life-extending” treatments to giving patients more and higher-quality years of life. 


    As an academic medical center and comprehensive cancer program, we lead innovative research and clinical trials that allow us to provide the most cutting-edge treatments available and truly make a difference in our patients’ lives. Three areas of care experiencing significant progress include:

     

    • Medical oncology
    • Radiation
    • Surgery

    Breast cancer survival rates continue to improve along with our understanding of the disease. I’m excited to share how five recent innovations are helping our patients live longer and more comfortably.


    1. Medical oncology: New treatments reduce cancer recurrence.

    The number of drugs securing FDA approval to treat all types of breast cancer is increasing. One in particular— Enhertu—will drastically change treatment for patients with HER2-positive breast cancer, an aggressive type that grows quickly and has a high risk of recurrence. It affects up to 20% of all breast cancer patients.

     

    Twenty years ago, advanced HER2-positive breast cancer was the worst kind of breast cancer to have. And now we’re probably not too far from turning it into a chronic disease.


    HER2-positive cancer is diagnosed by cancer cells with high levels of a protein called HER2, which promotes cancer cell growth. Typical treatment to slow the growth of cancer combines HER2 targeted antibodies, which block HER2 protein growth, and chemotherapy


    This combination has been shown to increase survival rates to more than five years, but after about 18 months half of patients require a second line of treatment. They then usually receive a drug that stops the cancer’s progression for only an additional six to nine more months.


    Now, a new prescription medication that is approved as a third line treatment may become an alternative second line of treatment: trastuzumab deruxtecan, sold as Enhertu. It can stop cancer progression for many months over the previously approved second-line treatment. MedStar Health participated in the clinical trials for Enhertu; several women have received it and remained progression free for over two years.


    Second PARP inhibitor receives FDA approval.

    Following surgery, chemotherapy, and radiation, patients with BRCA1 or BRCA2 genetic mutations may soon be offered an FDA-approved daily oral pill to reduce their risk of cancer recurrence. This drug—olaparib (Lynparza)—is called a poly ADP-ribose polymerase (PARP) inhibitor. It’s one of two PARP inhibitors approved specifically for advanced breast cancer in patients with BRCA1 or BRCA2 mutations. 


    BRCA1 and BRCA2 genes produce proteins that assist cells with DNA repair. Mutations in these genes have been shown to increase cancer risk. When they cause cells to become cancerous, PARP inhibitors can further stop DNA repair proteins from helping the cancer cells repair and replicate.


    Up to 5% of U.S. breast cancer patients have BRCA1 and BRCA2 mutations. However, many patients don’t even know they have these mutations and could benefit from PARP inhibitors because they haven’t received genetic testing.


    As testing becomes vitally important, our cancer genetics program at MedStar Health is growing. We already recommend genetic testing for high-risk patients such as women who received a breast cancer diagnosis at a young age or have a family history of breast cancer. But I don’t think we’re too far from having so many treatments for gene mutations that many more women will benefit from genetic testing.

     


    New #BreastCancer medication available at @MedStarHealth has potential to turn one of the most aggressive types of cancer into a chronic disease, says Christopher Gallagher, MD, Medical Director of Cancer Services: https://bit.ly/3j2jxiM..
    Click to Tweet


    2. Radiation: A larger dose means fewer trips to the clinic.

    In the past, patients with smaller, less aggressive tumors who received a lumpectomy (surgery to remove the tumors) received radiation for their whole breast for five or six weeks. 

     

    Now, many patients can receive just one, larger dose of radiation during their lumpectomy. This treatment is called intraoperative radiation therapy (IORT) and is best suited for patients with early breast cancer and low risk factors for cancer recurrence.


    IORT delivers incredible time-saving benefits by eliminating the need to continually drive to the clinic to receive small doses of radiation. This has been especially helpful for patients who don’t receive paid time off from work or are single parents.

     

    3. Surgery: Lymph node transplants and time-saving technology.

    Breast cancer often spreads to the lymph nodes, so patients who have breast cancer surgery often also have a lymph node under their arm removed and examined. If cancer is found, more lymph nodes may need to be removed.


    An unfortunate but common long-term side effect of this process is
    lymphedema, or swelling in the arm. It’s caused by fluid buildup in the arm tissue that occurs when the lymphatic system is damaged. 


    MedStar Health now has a plastic surgeon—
    Laura Tom, MD—who specializes in an innovative lymphovenous bypass surgery that relieves the swelling. Transferring lymph nodes from a healthy part of the body into the swollen arm helps the fluid drain appropriately.


    More accuracy, fewer surgeries.

    Wire localization is often used to pinpoint the location of abnormal breast tissue that can be seen in a mammogram but not felt by your doctor. To ensure your surgeon removes the right breast tissue, a radiologist first inserts a wire into the breast and uses imaging technology to guide it to and mark the abnormal tissue. Later that day, you’ll undergo another procedure to remove the tissue.

    This method can be painful and uncomfortable. It also creates risk for less accuracy because the wire can be bumped or moved while the patient waits for surgery.


    A newer technology—magnetic seed localization (Magseed)—can locate the cancerous tissue days before it’s removed.
    Guided by imaging, a radiologist inserts a tiny magnet into the tissue. It does not move, and a surgeon can easily find it with a magnetic-detecting instrument.

    Magseed eases many patients’ anxiety; they’re not surprised by the location of their cancer the day it’s removed or upset by the sight of a wire protruding from their skin. And because the magnet stays in place, the surgeon is more likely to remove all of the abnormal tissue at once instead of performing another surgery to remove tissue that was missed the first time.

    This technology can also be used to identify cancerous lymph nodes, reducing the amount of lymph nodes that are removed and the level of disruption to the lymphatic system.

    4. Entering the next wave of research: Breast cancer and the brain.

    When cancer spreads into other parts of the body, such as the bones, liver, or lungs, treatment can stop the progression for long periods of time. But sometimes it appears in the brain because most of the treatments we provide cannot cross into the brain; it has a very protective barrier. 


    This is one of the biggest unmet needs for breast cancer patients, and new drugs are starting to fill the gap. A recent study showed that a combination of the drugs tucatinib, trastuzumab, and capecitabine
    resulted in better progression-free survival in HER2-positive breast cancer patients whose cancer had spread to their brain. 

    This specific drug combination received FDA approval in 2020 and is available at MedStar Health. We also have two ongoing studies to further understand the benefits of this approach.


    5. Innovation meets empathy and personal services.

    When a whole team of doctors specializes in exactly what you have, your care improves. That’s what you get at MedStar Health.


    Our tumor board—a group of health care providers, from plastic and general surgeons to medical and radiation oncologists—discusses every MedStar Washington Hospital Center patient who is diagnosed with breast cancer.


    We also work closely with our:

    • Cancer rehabilitation team from the MedStar National Rehabilitation Network, who screens patients for risks such as lymphedema or low blood sugar that may result in cancer patients who have diabetes and receive chemotherapy
    • Clinical research office, who screens every new patient for potential clinical trial participation
    • Social workers, who screen for barriers to care, such as other health conditions and financial or transportation challenges

    MedStar Health also recently partnered with the Georgetown University Law Center to create a program that helps our patients manage legal challenges. In the last year we’ve helped more than 100 patients, sometimes with multiple legal problems, and will add more resources to provide employment and medical disability law assistance.


    Our patients’ overall well-being is truly our top focus. We’ll continue to discover and provide the best treatments possible to improve breast cancer patients’ quality of life.


    Comprehensive cancer care makes a difference.

    Learn how MedStar Health providers team up to provide innovative, individualized breast cancer treatment.

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

  • October 20, 2021

    By John McBroom, MD

    Any cancer diagnosis is jarring to the patient and family. With women’s cancers – such as ovarian, uterine, or cervical cancer – the diagnosis can be particularly difficult. 


    Women often are the primary caregiver, family scheduler, and breadwinners of the home. When your life is disrupted by gynecologic cancer, everyone in the family is impacted.


    Aside from concerns about their own health, women with cancer often pivot their worries to how they will manage personal and professional responsibilities during treatment:

    • Who will take care of my projects at work?
    • How will the kids get to and from practice?
    • Will someone check on Aunt Susan?
    Unfortunately, there is no “magic bullet” to resolve these overwhelming concerns. However, with planning and support from your gynecologic oncology team, you can delegate your most pressing responsibilities and enter treatment with less stress so you can focus on personal healing. Consider these six tips.

     

    When a woman is diagnosed with #cancer, the whole family’s routine changes. Gynecologic oncologist Dr. John McBroom shares tips to delegate responsibilities and reduce outside stressors so you can focus on treatment and healing: https://bit.ly/3jnvXBM.
    Click to Tweet

     

    1. Assemble your squad.

    You do a lot for everyone around you – now it’s time to lean on your closest friends, family members, and co-workers for support. Start by making a two-column list. In the first column, list the daily household responsibilities that you manage – making meals, transporting kids to activities, taking elderly loved ones to doctor visits.

     

    In column two, write the names of loved ones who can fill in for you in each task. Reach out to them when you are ready to discuss your diagnosis. Asking for help may be difficult, but you’ll likely find your loved ones are happy to help you and your family.

     

    2. Reassign your work…or don’t.

    Some patients with cancer decide to take time off work and focus on healing. Others continue working, for the distraction, pay, or both. Either approach can work if you are honest with yourself about your physical health, stress levels, and emotional well-being. 

     

    If you plan to take medical leave, talk with your team about how long you might be off work and who can cover your responsibilities. You don’t have to disclose personal health information to your colleagues if you don’t want to, and you only have to give your employer required information for insurance, sick leave, wellness programs, or workers’ compensation. 

     

    If you plan to work through treatment, you may still need to plan for a few days or weeks off to have cancer surgery and/or attend treatment appointments. Quiet the inner monologue that might urge you to take on extra work. While the distraction might be nice, the stress of balancing everything can wear you out. Listen to your body – delegate tasks when you feel fatigued or overwhelmed, and plan downtime instead of consistently bringing work home.

     

    3. Ask for and accept support services.

    You are remarkable, but none of us can do everything on our own. That’s why MedStar Health patients get the support of nurse navigators who act as health liaisons during cancer treatment. 


    Our nurse navigators are passionate about connecting patients with the expert specialists, support services, and financial and insurance information they need to complete cancer treatment.


    Ask your nurse navigator about community resources, too. For example, there may be transportation, childcare, and meal services in your community to help relieve some of your daily stress. Start with this list from the American Cancer Society.


    4. Avoid new, extreme diets and exercise plans.

    Research shows that exercising during cancer treatment is associated with improved outcomes. However, there is no data to suggest that starting a hardcore diet or exercise routine will help you. In fact, injuries, fatigue, and the stress of shaking up your routine could potentially hinder your healing.


    If you’re already a very active person such as a triathlete or marathoner, you might feel up to continuing rigorous workouts. But you might not, and you’ll have to be ok with that as your body heals. 


    As for diet, there is a persistent myth that tumors “feed on” sugar, growing larger with every carb or treat you consume. The truth is, all cells use glucose (sugar) for energy, and avoiding sugar is not associated with better cancer outcomes. 


    However, while there is no “super” food or supplement that can defeat cancer, eating a healthy diet is proven to support optimal healing, potentially reducing the risk of infection, giving you more energy, and maintaining a healthy weight.


    During cancer treatment, a MedStar Health dietitian will guide you in eating a healthy diet. This expert may also recommend certain supplements to support general wellness, such as vitamin D for mental health and vitamins A, C, and E, which are antioxidants that can help boost your body’s natural defenses. Talk with your dietitian and doctor before taking supplements – overdoing it on certain vitamins or minerals may reduce the effectiveness of chemotherapy and radiation therapy.

     

    5. Keep other health conditions in check.

    Chronic conditions such as high blood pressure and diabetes don't go away when you develop cancer, and some may worsen due to stress or focusing on just your cancer care. However, unmanaged chronic conditions can cause serious complications, such as heart attack, stroke, or kidney problems. 


    Your oncologist will work with your primary care doctor and specialists to make sure all your health needs are covered during and after treatment. This includes your mental health, which may be particularly taxed during treatment. In fact, it’s not uncommon for patients to feel depressed during cancer treatment. If you need to see a psychologist or take antidepressant medication, we will connect you with personalized care, quickly and discreetly.


    6. Ask questions and get answers.

    No matter how big or small your question feels, your MedStar Health gynecologic oncologists are here to give you answers. We’re experts in female anatomy, women’s cancers, and effective treatments. If you’ve wondered about something, you can bet we’ve discussed it with many patients before.


    Our gynecologic oncology specialists are board-certified and fellowship-trained in the diagnosis and management of specific types of women’s cancers. We combine that expertise with our multidisciplinary team of dietitians, radiation and medical oncologists, surgeons, and fertility specialists. These experts can give you specific insights into any question or concern you have. This team meets frequently to make sure every patient gets the best care. 


    If you want to learn about a clinical trial opportunity, please don’t hesitate to ask. As an academic medical center, we are on the forefront of the latest innovations in gynecologic cancer prevention, diagnosis, and treatment – often, we can offer the most cutting-edge treatments before they are available at other medical centers.


    More than anything, we want to partner with you in achieving the best outcomes for your gynecologic cancer treatment. And that journey starts by entering treatment with as many outside stressors handled as possible.



    Are you preparing for cancer treatment or in need of a second opinion?

    MedStar Health’s expert gynecologic oncologists are here for you.

    Request an Appointment

  • October 13, 2021

    By Dahlia Halim, MD

    Sleep is essential for your child’s growth and development. When school-aged kids are rested, they are more likely to stay focused, store memories, think sequentially, and maintain positive social relationships, all of which are important for success at school. But, many kids aren’t getting enough sleep.


    If you have a school-aged kid who isn’t sleeping enough, they may struggle to concentrate and complete tasks in the classroom. And, children with sleep problems may exhibit behavioral issues ranging from poor decision-making and impulsivity to hyperactivity and aggression. If you’ve ever had a toddler who skipped a nap, this isn’t hard to imagine. While these behaviors look different in sleep-deprived kids and adolescents, they can be just as frustrating to resolve.


    Poor sleep can also affect kids’ physical health. Children and teenagers who aren't sleeping well may be more susceptible to mental health struggles or getting sick and missing school, which means they may miss valuable learning time. If your child is regularly absent from school because they’re sick or tired, they can quickly fall behind academically.


    The best way you can help your kids get enough sleep for school is by establishing healthy and consistent sleep routines that lead to quality sleep, night after night.

     

    How much sleep do kids need?

    Sleep needs vary by age and individual. Currently, the American Academy of Pediatrics suggests the following sleep guidelines for kids and teenagers:

    • Preschoolers (3 to 5 years old): 10 to 13 hours, with naps
    • Elementary school-aged (6 to 12 years old): 9 to 12 hours
    • Middle and high school-aged (13 to 18 years old): 8 to 10 hours 

    In 2015, the Centers for Disease Control and Prevention (CDC) analyzed sleep data for school-aged kids surveyed by the national and state Youth Risk Behavior Surveys. Nearly 60 percent of students ages 6 to12 reported fewer than 9 hours of nightly sleep and about 70 percent of high school students reported sleeping less than 8 hours, showing that many kids aren’t getting the sleep they need.

    Up to 70% of teens don’t get enough #sleep. On the #LiveWellHealthy blog, pediatrician Dr. Dahlia Halim shares how to create a #BedtimeRoutine that can improve the amount and quality of their sleep: https://bit.ly/3DuNW0W.
    Click to Tweet
     

    Maintaining a consistent schedule and predictable bedtime routine can help your school-aged child get enough sleep.

    One of the best ways to improve your child’s sleep hygiene is by setting a bedtime routine. Routines will look different depending on the age of your child but no matter how old your kid is, there should be a predictable pattern of steps before bedtime each night. You can help your student get the sleep they need by establishing healthy sleep habits that work best for your family.

     

    Establish a firm bedtime.

    Consistency is essential when it comes to helping your child get enough sleep. Whether they’re in elementary, middle, or high school, they should have an established bedtime and time to wake up that remains the same even on the weekend or holidays. Sticking to a predictable bedtime and wake time even on the weekends will prevent a disrupted sleep schedule that could affect how much sleep they get during the week.

     

    Provide opportunities to unwind.

    A good bedtime routine doesn’t have to be long. It just has to be in a predictable order and repeated nightly. Consider starting the bedtime routine about an hour before bed with a calming activity that helps your child wind down. A puzzle, board game, or good book can help them to relax. While physical activity earlier in the day may help them to sleep better at night, try to avoid high physical activity right before bed as that can have the opposite effect. If they need to move their body, low-intensity exercise, like stretching or yoga, may be beneficial before bed.


    For elementary-aged children, a healthy sleep routine may include a bath and story. For older children or teenagers, journaling or meditation may help them calm down before bed, helping them to process the day’s activities and clear their mind. A variety of free meditation apps, like Headspace or Calm, offer guided imaging or breathing which can prepare your child for sleep. Try relying on the audio prompts while setting the phone or tablet somewhere the screen isn’t visible to minimize stimulation or distraction.

    Avoid screen time and caffeine before bed.

    It can be harder for kids and teenagers to fall asleep at night if they’ve stayed up watching TV, texting, or playing video games because screens stimulate the brain. Turning off electronics at least one hour before bedtime will minimize the chances of disrupted sleep. And, keeping these devices out of the bedroom will reduce the chance for distraction in the middle of the night.


    Similarly, caffeine is a stimulant that can prevent kids from falling and staying asleep. In addition to coffee, caffeine can be found in chocolate, soda, iced teas, and other beverages. Ideally, encourage your child not to consume caffeine after noon.

     

    Create a comfortable sleeping environment.

    The ideal sleep environment can help your school-aged child or teen fall asleep more quicklyand get good quality sleep. Here are a few ways you can create an environment that encourages sleep:

    • Reserve the bed for sleeping only by keeping the bed off-limits for screen time, play, or homework.  
    • Keep the bedroom at a comfortable temperature.
    • Ensure the bedroom is dark by using room-darkening curtains or blinds. Remove anything with a glowing light, like alarm clocks, game consoles, or phone notifications.

    Consistency is key.

    Once you’ve established a bedtime ritual, stick to it every night. When bedtime routines are predictable, kids are more likely to cooperate because they know what’s coming next. Healthy sleep routines can encourage them to fall asleep earlier and stay asleep longer. If you have more than one kid, you may need to modify the bedtime routine for each kid. 


    A good night of sleep ensures the proper brain function necessary for concentrating in the classroom, regulating emotions, and sustaining energy for the day. When your child is well-rested, they will have an easier (and more enjoyable) time learning. As a bonus, if your school-aged kid is getting enough sleep, you might sleep better, too.


    Do you need support helping to establish healthy sleep habits for your school-aged child or teen?

    Find a MedStar Health pediatrician near you today. Click below for more about our locations in Harford County and throughout the Maryland and Washington, D.C., region.

    Learn More

  • October 07, 2021

    By Nicholas Samuel Streicher, MD, MPH

    Policymakers, parents, and athletes are talking about the risks of concussions more than ever before—partly because of growing public awareness of the relationship between concussions and the neurologic condition chronic traumatic encephalopathy (CTE). 

     

    CTE can be a fatal brain disease associated with traumatic brain injuries and dementia, along with various mood and behavior changes. The disease has been in the spotlight as the subject of the 2015 movie “Concussion” starring Will Smith and Brett Favre’s recent PSA campaign against youth tackle football. 


    As CTE continues to be studied, research shows that people who experience repeated concussions and sub-concussive blows (hits to the head that don’t result in a concussion) can develop CTE later in life.
    This is why concussion care early in life is so important. Better treatment may reduce the long-term risk.


    While concussions—mild traumatic brain injuries caused by a trauma directly or indirectly to the head—are most often
    caused by falls and car accidents, repeated concussions typically occur in people who play contact sports. 


    With fall sports such as football and soccer in full swing, let’s discuss the most common questions parents of student athletes typically ask this time of year.

     


    Early, effective #concussion care in #StudentAthletes grows more critical as more research links contact sport concussions to CTE (chronic traumatic encephalopathy): https://bit.ly/3oPhn9E.
    Click to Tweet

    Q1: What sports have high rates of concussions?

    All contact sports include the risk of concussion, from basketball to volleyball. In middle and high schools, concussions occur most frequently in football, soccer, and hockey.


    The position a student athlete plays is an important consideration. Goalies, for example, have higher rates of concussions because they’re constantly using their bodies to block people and objects. A 2019 study of
    concussion trends in 20 U.S. high school sports found that most concussions were caused by contact with: 

    • Another person (62%)
    • A surface (17%)
    • Equipment (15%)

    Good news from the study: Rates of recurrent concussions across all 20 high school sports have decreased, as have football practice-related concussions. But in almost every sport, concussion rates were higher during competition play than practice—and concussions sustained during football games increased. 


    In sports with quarters or halves, nearly 55% of concussions were reported during the last half or quarters of a game. This is probably because players are more tired, which makes them more likely to engage in reckless or sloppy play and less likely to defend themselves against possible collisions. 


    For college football players, however,
    growing evidence shows that concussions may occur more often during practice, which we typically think of a safe environment, and this may be an area for greater risk reduction.

    Q2: What are common symptoms of concussions?

    Concussion symptoms can appear within hours or days after a head injury, so it’s important to remain vigilant after a concussion. Signs of a concussion include:

    • Blurred vision
    • Confusion
    • Dizziness
    • Headache
    • Light sensitivity
    • Lost consciousness 
    • Memory loss
    • Mood or personality changes
    • Nausea
    • Vomiting

    The effects of concussion symptoms on students’ academic performance have been studied more in recent years. Research published in 2020 shows that high school students exhibiting signs of a concussion experienced more difficulty in language, math, and science classes. Students ages 11-17 required up to 21 days after a concussion to recover cognitive skills, and emotional instability in students ages 10-17 lasted up to five weeks following the injury.  

     

    Neuropsychological testing, which analyzes brain functions such as concentration, mood, problem-solving, and memory, is one of the best ways to assess these symptoms—especially if your child has had recurring concussions. 

     

    Q3: What should I do if my child is showing signs of a concussion?

    Every concussion should be taken seriously; take your child to the emergency room if they lose consciousness, become increasingly sleepy, or have persistent or worsening symptoms after a head injury.


    Contact your child’s regular health care provider to discuss the injury and symptoms.
    They may recommend making an appointment for further evaluation or monitoring the symptoms over the next several days. It’s never a wrong decision to be cautious and request an evaluation.


    The
    MedStar Health Concussion Clinic offers specialized care for people who experience long-term concussion effects. Providers can recommend timing and accommodations for returning to school and sports. They offer treatments such as physical and vestibular therapy, which can help your child restore movement and balance and safely get back into their sport.

     

    Concussion recovery care is also available at the MedStar Health Orthopedic and Sports Center at Lafayette Centre, where providers specialize in sports-related injuries.

     

    Q4: How soon can my child return to sports after a concussion?

    The worst thing we can do for athletes immediately after a head injury is send them back into the game, as older athletics will anecdotally tell you happened frequently. The best thing we can do is provide individualized neurologic care and allow them to recover. 

     

    If a basketball player breaks their arm but continues to play, they’re going to further damage that arm. Brains are the same; if a brain is hurt and then hit again, it’s only going to get worse. Most students need a brief period of rest, followed by individualized, symptom-guided progression back to their sport, with full symptom resolution before entering a contact situation—with their doctor’s approval.

     

    Based on research and experience, a gradual, sub-symptomatic return-to-play protocol is the safest, most effective method. In the past, all-or-nothing recovery was often recommended with long rest periods—no movement, no schoolwork, no regular activities for at least two weeks. But that can make a return to sports feel overwhelming and take away a vital part of the athlete’s life.

     

    The University of Michigan demonstrated that supervised exercise can significantly increase our ability to gauge student athletes’ physical and cognitive symptoms and determine readiness to return to play. This means having the athlete work out at a clinic with an athletic trainer or physical therapist, and using the data collected to guide recovery.

     

    In a supervised setting, providers gradually gave students more schoolwork and exercises to do while watching for signs of improvement, confusion, and frustration. They also tracked behaviors, moods, neurologic exams, and heart rates during exercise to ensure they had a view into the students’ overall health. This approach helped parents feel more comfortable about their children’s recovery and is one way to better prevent long-term effects of concussions.

     

    Q5: Should I let my kids play contact sports?

    The answer to this question is personal for every family. On one hand, kids have growing brains and can be very susceptible to head injuries. On the other hand, the benefits of exercise and teamwork can last a lifetime.


    Studies have shown that young athletes who participate in contact sports in high school or college
    were not more likely to meet criteria for CTE-like symptoms, compared to those in non-contact sports or who played no sport at all.

     

    At the same time, a Boston University study on the relationship between amateur and professional football players and CTE found that the risk of CTE doubles for every two and half years of play. This translates to other sports as well and represents a cumulative effect as players sustain injuries over time.

     

    Recognizing societal impact.

    As a society, we always expect our athletes to be at their best—even from an early age. I often feel that professional athletics, for some, serve the function of a modern Roman Colosseum: although a much safer version, risk is still present, and the effects trickle down to student athletes as well.

     

    While all 50 U.S. states now have youth concussion legislation in place, one study analyzed the speed of certain states enacting these laws. It found that states with more high school football participation—and a strong college football presence—passed concussion laws later than states with less focus on football.

     

    The pressure on performance may also factor into underreported concussions among young athletes. Several studies discovered two primary reasons students ages 13-18 do not report their concussion: a desire to remain in the game and a fear of the effect their report could have on their relationship with their teammates and coaches. Concussion education didn’t increase their desire to report.

     

    The future of concussion care.

    As health care experts collaborate more with families, organizations, and policymakers, we strive to develop better solutions, including improved diagnostics and treatments, and to improve education for student athletes, coaches, and parents.


    Three key areas of research I expect to conduct and see more of in the future will help me do this more effectively:

     

    • Standardized care: An extensive study of post-concussion management research concluded that we need to develop dependable guidelines to help health care providers better manage head injuries. I’m involved in ongoing studies that are reviewing electronic medical records to determine which types of treatments may work best for patients with certain characteristics and which factors may predict concussion outcomes in specific populations.
    • CTE treatment: Today, CTE can only be diagnosed after death. Until effective detection and treatment methods are developed, we can base care only on a patient’s risk factors (a history of brain injuries) and symptoms (memory loss, confusion, personality changes). Diagnosing CTE in living patients, potentially through blood tests or spinal fluid analyses, could make a considerable difference in their quality of life. 
    • Concussions and CTE in female athletes: Women make up a huge number of athletes of all ages, but they have been underrepresented in these studies—even though the limited data that exist show female athletes are more likely to get concussions.

    Sometimes, the more data we discover, the more questions we raise. Asking questions helps us learn and better care for patients. There are no easy answers to many questions about concussion care—but it’s important to keep asking so we can continue to improve our understanding of this common condition.

     

    Get expert concussion care at MedStar Health.

    Providers across specialties will work together to develop the safest recovery plan for your student athlete.

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