January 20, 2022MedStar Georgetown University Hospital names Lucy M. De La Cruz, MD, chief of Breast Surgery Program and director of the Betty Lou Ourisman Breast Health Center
The renowned 39-year-old breast surgeon becomes youngest Latina woman to lead breast surgery program in U.S. at major academic medical center
WASHINGTON – Lucy Maria De La Cruz, MD, has joined MedStar Georgetown University Hospital as chief of its Breast Surgery Program and director of the Betty Lou Ourisman Breast Health Center. Dr. De La Cruz is a fellowship-trained breast surgeon who specializes in advanced breast surgery procedures, including wireless lumpectomies, hidden scar technique, oncoplastic breast conservation, and nipple-sparing mastectomy. She has been published in more than two dozen peer-reviewed scientific journals, and her pivotal papers on nipple-sparing mastectomy and oncologic outcomes have been cited worldwide. She will also direct the hospital’s breast surgery fellowship program.
“I am honored and excited to lead the breast surgery program and the Betty Lou Ourisman Breast Health Center at MedStar Georgetown University Hospital,” said De La Cruz. “It has been my life-long dream to bring my passion for medicine, helping others and building a state-of-the-art breast surgery program to advance breast health. I look forward to working with our multidisciplinary team of breast health experts to compassionately care for, educate and empower my patients in their health journey.”
Dr. De La Cruz is an academic breast surgeon who conducts outcomes-focused research, and among her special interests are the impact of genomic mapping to guide breast cancer treatment and male breast cancer treatment. Her work is guided by a long-standing commitment to promoting equity and efficacy in breast cancer care delivery, using the principles of value-based health care.
“The Betty Lou Ourisman Breast Health Center and MedStar Georgetown University Hospital are thrilled to have Dr. De La Cruz lead the breast surgery program. Her commitment to patients, their journey, and their outcomes are unmatched; and her expertise in novel surgical techniques brings new and beneficial options to patients,” said David H. Song, MD, MBA, FACS, Physician Executive Director, Plastic & Reconstructive Surgery, MedStar Georgetown University Hospital, Professor and Chair Department of Plastic Surgery, and Interim Chair, Department of Surgery, Georgetown University School of Medicine.
Dr. De La Cruz’s story
Dr. De La Cruz, 39, started her journey towards becoming the youngest Latina woman to lead a breast cancer surgery program at a major academic medical center at young age. As the daughter of international physician researchers, she spent a lot of time in labs where her parents worked, sparking her passion for medicine and “making a difference in people’s lives.” She grew up in Cuba, Mozambique, Spain, and Miami.
In college, she studied abroad in the Dominican Republic at the Universidad Central Del Este School of Medicine, where students were involved in patient care very early in their education and training. There, she completed her medical degree, founded an American Medical Student Association chapter and raised scholarship funds to help those who couldn’t afford tuition.
After graduation, she was told becoming a surgeon would be nearly impossible as a foreign medical graduate and a female. Despite this, De La Cruz obtained research fellowships from the University of Miami and George Washington University in Washington, D.C. She continued her journey by obtaining a one-year residency internship at Jackson Memorial Hospital at the University of Miami, where she earned the Intern of the Year award and an AOA medical honor society membership for her dedication to medical student teaching. During her residency, she worked on an award-winning oncologic outcomes research project for nipple-sparing mastectomy that continues to be cited worldwide.
That same year, Dr. De La Cruz started her breast surgery fellowship at the University of Pennsylvania. Following graduation, she worked in private practice for a year before returning to the University of Pennsylvania as a faculty member in the associate program director of the breast cancer surgery fellowship program.
After relocating to Washington, D.C., to be close to her family, she founded the breast cancer fellowship program curriculum at the Inova Health System. Now at MedStar Georgetown University Hospital and The Betty Lou Ourisman Breast Health Center, she continues to teach residents and fellows, pursue research, and care for patients – the fulfillment of her lifelong dream.
September 02, 2016
Pelvic Floor Disorder: A Common Problem
It’s a fact that one in three women over the age of 45 suffers from a pelvic floor disorder (PFD). The most common pelvic floor disorders are urinary incontinence, fecal incontinence, and pelvic organ prolapse. The condition can significantly impact a woman’s quality of life. There are easy ways to treat the disorder, but women are oftentimes unwilling to discuss the symptoms they are experienceing because they are too embarrassed.
The older a woman gets, the greater the chance of developing a PFD. In general, pelvic floor disorders are caused by a laxity in the pelvic floor ligaments and connective tissue in the lowest part of the pelvis and weakness of the pelvic floor muscles. The pelvic floor supports organs, including the bowel, bladder, uterus, vagina, and rectum. But when the muscles are weakened or the connective tissue tears, that's when problems can begin. Why does this happen? It’s a natural part of the aging process, hormonal changes after menopause plays a role as well pregnancy, childbirth and obesity.
Pelvic organ prolapse is the most common disorder, and it happens when the pelvic floor muscles and ligaments become too weak to hold organs in the correct position in the pelvis. As the condition progresses, women can feel bulging tissue protruding through the opening of the vagina. When this happens, women may have problems controlling their bladder and bowels. Also, some have pain in the lower back, pelvis or bladder. All women may not experience the same symptoms, but it’s important to seek help if any pain or discomfort persists.
While an OB/GYN may be aware of the symptoms, women should seek out a urogynecologist, a physician with special training and significant expertise in female pelvic medicine and reconstructive surgery, if symptoms persist.
They used to just say it was a ‘female problem,’” said Jeanne McMahon, 58, who lived with bladder and uterine prolapse for more than 20 years before having surgery in the fall of 2015. With the help of nationally-recognized and highly skilled urogynecologist at MedStar Washington Hospital Center, Dr. Cheryl Iglesia, Jeanne is now playing tennis and hiking again, and is grateful she has her life back.
Dr. Iglesia, and her patient Jeanne, discuss PFDs in this Washington Post article.
We are here to help! Contact us for more information about pelvic floor disorders or to schedule an appointment. Call us at 202-877-3627.
September 01, 2016
Special Care for Special Deliveries
It’s a scene that parents-to-be imagine hundreds of times: the day they welcome their little one into their family and meet their new baby face to face. Sometimes, however, reality is a bit more complicated. When a baby is born early or needs some extra support, the dedicated professionals at MedStar Southern Maryland Hospital Center’s special care nursery are there to help.
Melanie Bush knows. After a difficult pregnancy, she began having contractions early – at only 34 weeks’ gestation – and labor was progressing rapidly. With one of her twins in breech position, she delivered by emergency cesarean section. Melanie and her husband Benny Bush Jr. welcomed their new son and daughter, Brentley and Brooklyn Bush, at 1:06 and 1:08 a.m. respectively on August 23, 2014. Brentley weighed 5 pounds, 4 ounces at birth, and Brooklyn weighed just 4 pounds, 2 ounces.
Without the full 40 weeks to develop in their mothers’ bodies, babies born early can face a variety of challenges including low birth weight, breathing problems, infections, and vision or hearing loss. About one baby in ten is born prematurely in the United States, and rates have been rising, according to the March of Dimes.
A Special Place
MedStar Southern Maryland Hospital Center’s special care nursery is a level II neonatal intensive care unit (NICU) that cares for babies born at 32 weeks or later, or who weigh at least 1,500 grams (about 3.3 pounds). The special care nursery is led by a team of on-site neonatologists from MedStar Georgetown University Hospital, who bring their specialized expertise in helping the smallest babies thrive, and has a staff of experienced NICU nurses.
Having an experienced team of doctors and nurses at a location close to home means that new parents can spend more time with their babies while they are still in the hospital. The hospital’s special care nursery is known for maintaining a compassionate, welcoming atmosphere. “Highly specialized expertise, strong nursing skill, and warm, family-centered care is all wrapped up in one big, beautiful package here at MedStar Southern Maryland Hospital Center,” said Mahoganey McCrae, BSN, RN, CPN assistant director of nursing for the special care nursery.
The Bush twins had ups and downs during the 11 days they stayed in the special care nursery, particularly Brentley, who struggled with breathing and eating. The special care nursery team helped Brentley breathe using several treatments, including a breathing tube and ventilator, continuous positive airway pressure (CPAP) therapy, and supplemental oxygen through a nasal canula. On day 7, his lungs were able to tolerate regular air.
Because he wasn’t able to eat for over a week, the team gave Brentley the nutrition and hydration he needed through an IV. Phototherapy was used to treat their jaundice. Warm, enclosed incubators called isolettes helped the little twins regulate their body temperatures.
Although there were scary moments, the special care nursing staff were there every step of the way. “Even though I have a healthcare background, I wasn’t thinking like a nurse while I was watching my babies struggle,” Melanie said. “The staff talked to both of us as parents. Everyone was very responsive, and no one rushed us or made us feel unwelcome.”
Encouraged by the special care nursing staff, Melanie and her husband Benny were active participants in caring for their babies, holding them, feeding them, changing their diapers and taking their temperatures.
Melanie also appreciated the neonatologists’ approach. “They were available to answer questions and did a lot of education” to help them care for their new son and daughter. “They were amazing.”
Brentley and Brooklyn are now a pair of active and happy 23-month-old toddlers. Although they don’t remember those first days, their grateful mom and dad will never forget.
Visit MedStarSouthernMaryland.org/Nursery to learn more about our special care nursery.
September 01, 2016
Care Worth Sharing
“Would you recommend this doctor to a friend?” It’s a common question found on satisfaction surveys delivered to inboxes or mailboxes. A better, more telling question – especially in the world of health care - might be, “Would you recommend this doctor to your family?”
Following the care she received from Arthur Flatau, MD, general and vascular surgeon at MedStar St. Mary’s Hospital, Eleanor Mistretta, of Hollywood, Maryland, answered that second question with a resounding, “Yes!”
Eleanor came to MedStar St. Mary’s Emergency Department in February with stomach pains. Dr. Flatau removed her gallbladder the next day. “We were having a discussion about surgery afterward,” said Eleanor, “and I asked him if he did aneurisms and he said, ‘Yes, I do.’ ”
Eleanor’s husband of 54 years, Sonny, knew he would eventually need surgery for his aortic aneurism, which had been found by his urologist about four years ago, but he admits to trying “to stretch it out” to delay the procedure. “When I did Eleanor’s surgery and everything went ok, she asked me about Sonny’s abdominal aortic aneurysm and I explained to her that was actually the type of surgery I was brought here to do,” said Dr. Flatau.
An abdominal aortic aneurysm occurs when a section of the aorta, the main blood vessel to the abdomen, pelvis and legs, enlarges. Often discovered through an ultrasound or CT scan, patients who have these types of aneurisms are typically followed closely by their doctor until the aneurysm reaches between 5 and 5.5 cm.
“Once the aneurysm is a size we know puts the patient at risk, we will fix the aneurysm electively,” said Dr. Flatau.
After recently traveling into Washington, D.C., for her own health concerns, Eleanor didn’t want Sonny’s surgery done in the city. “I preferred he have the surgery done right here in St. Mary’s,” said Eleanor. “The hospital’s only two miles away!”
Sonny’s surgery was performed on a Thursday morning in mid April, and he was released from the hospital late Friday night. “When we talked, Dr. Flatau told me exactly what was going to be done and showed us the stent he was going to use,” said Sonny. “He told me if the aneurysm ruptured, it would be an emergency situation, and if I went to the emergency room, there might not be a doctor available who could fix it.”
“If a patient comes in with a rupture, we will certainly treat it here as long as it’s within our capabilities,” said Dr. Flatau. “It’s actually safer to treat patients here than to send them somewhere else. The quicker a patient goes from the ER to the OR, the better their outcome.
“We have definitely increased the complexity of what we are doing here and the bottom line is that we are able to do much of the same surgery here that is also done in larger hospitals,” said Dr. Flatau, “and we are happy to do it if that’s what the patient wants.”
Sharing More than a Brotherly Bond
When you are brothers you share a lot of things – family, hobbies, friends, likes and dislikes. But the Baird brothers of Avenue shared a medical condition which would ultimately lead them both to John Harvey, MD, general and vascular surgeon with MedStar Shah Medical Group. Both brothers suffer from peripheral artery disease, a narrowing of the peripheral arteries to the legs, stomach, arms, and head.
Dr. Harvey was recommended to Bernie Baird by his primary care physician after Bernie started having intense pain in the back of his left leg. “I would work a little bit and it would start hurting so badly it was unbelievable,” said Bernie, who is 65. “I didn’t know what it was and at first I thought it might have something to do with my back.”
Testing determined Bernie had a blocked artery behind his knee. Metal stints or a balloon procedure called angioplasty are often the first choices for opening a clogged artery. Relatively simple procedures, patients usually don’t require lengthy hospital stays or long recovery times. “He put a stent in and it worked well for a couple of weeks, then it started to hurt again,” said Bernie. “My cardiologist said that for some reason my body just rejected that stent.”
“With stents or angioplasty, patients are in and out,” said Dr. Harvey. “We can fix the problem right away and they get better right away. The down side is they don’t necessarily last as long.”
When Bernie went back to Dr. Harvey, the decision was made to perform a bypass of the clogged artery. “The bypass surgery is a bigger operation and may require several days in the hospital and maybe rehabilitation,” said Dr. Harvey, “but it is more durable in the long term.”
Much like his brother, Robbie Baird was also looking for a long-term solution to similar issues he was facing. Almost 20 years ago, Robbie, 60, had an aorta bypass surgery, which is a y-shaped graft that bypasses the blocked arteries in order to return blood flow to the legs.
“I wish Dr. Harvey had been here 20 years ago,” said Robbie. “I had been through it before and I knew what it felt like. I couldn’t work or do anything.”
“The surgery he had worked very well, but it doesn’t necessarily last for many years. Robbie’s concern was that he might have to go up to Washington to have a big redo surgery,” said Dr. Harvey. “We decided to insert a tube to take the blood from the left arm down to the left leg. The good thing about that surgery is it is fairly simple and it doesn’t involve being in the hospital for weeks.”
Robbie was in the hospital for several days and was out of work for a few weeks while he recovered. Today, he and his brother, are both back to their normal lives. “We can do complex surgeries at the hospital now, that keep patients in the county,” said Dr. Harvey. “We can take care of things that have been fixed a long time ago and do the revision or the repeat procedure and people can recover very well. If we can find a surgery that can fix their problem and keep them in the county, I am sure they will be very happy.”
August 30, 2016
Absorb™ Stent Opens Clogged Arteries, then Gradually Dissolves in the Body
Washington, D.C., August 30, 2016 – A heart stent that slowly dissolves into the body is now available for patients with clogged arteries. MedStar Heart & Vascular Institute became the first in the Baltimore-Washington area to offer the Absorb scaffold, the first bioresorbable stent recently approved by the FDA. MedStar Heart was one of the top enrollers in the pivotal clinical trial that led to the scaffold’s approval.
Currently, MedStar Washington Hospital Center and MedStar Union Memorial Hospital in Baltimore offer the new stent. At the Hospital Center, a man in his 80s became the first patient to receive the dissolvable stent a month after the FDA approval.
Stents are small scaffolds that prop open a clogged artery to restore blood flow to the heart. Traditionally, they are made of metal and remain permanently inside a patient’s artery. Absorb is made of a naturally dissolving material, similar to dissolving sutures. Absorb gradually dissolves after one year and completely disappears in the body in approximately three years, leaving nothing behind. Only four tiny metallic markers remain in the artery to identify its prior location.
“The Absorb scaffold is a major advancement in the treatment of coronary artery disease that has the potential to affect quality of life and address patients’ desire to leave no metallic stent behind,” said Ron Waksman, MD, director of Cardiovascular Research at MedStar Heart & Vascular Institute, and the principal investigator of the ABSORB III trial. “The fact that no metal material is left in the body allows the vessel to heal itself and reduces adverse side effects of permanent implants.”
However, the new treatment option isn’t for everyone. Patients who received Absorb fared similarly as those receiving a conventional metal stent after one year in the ABSORB study. But heart-related complications were slightly higher with Absorb versus those patients with the metal stent. In addition, patients with very small vessels or those who can’t take blood-thinning medication for long periods are not good candidates.
Dr. Waksman added that the MedStar interventional cardiology team will still rely on traditional types of stents for the majority of the patients with coronary heart disease. A long-term safety assessment on Absorb may take several years.
August 29, 2016
Cardiology Terms to Know
By: Athanasios Thomaides, MD, FACC
Heart attack: The medical term for a heart attack is myocardial infarction (MI). MIs are caused by blocked arteries supplying the muscle of the heart (myocardium). The blockages are caused by plaque formation and plaque rupture secondary to high cholesterol and hypertension. Symptoms of a heart attack include chest pain (which may be felt in the shoulder, arm, jaw, or upper back), difficulty breathing, sweating, and nausea.
A heart attack is an emergency. If you, or someone around you, develop these signs, call 911 immediately.
Sudden cardiac death (SCD) is the result of heart rhythm disturbance. The electrical system of the heart suddenly stops working, causing the heart to quiver and not be able to pump blood throughout the body. Examples of SCD include ventricular tachycardia and ventricular fibrillation. These often lethal arrhythmias cause the sufferer to suddenly collapse and lose consciousness.
If you experience a sudden loss of consciousness (fainting), you should come to the hospital for evaluation. Although fainting is harmless in many cases, we should make sure that it’s not a sign of a heart rhythm problem.
If you see someone collapse, and they are not breathing, call 911 and look to see if an automated external defibrillator (AED) is available nearby. If not, start CPR immediately and continue until the ambulance arrives.
Congestive heart failure (CHF), or simply heart failure, is a term used to describe hearts when they no longer function/pump effectively. This syndrome is frequently caused by weakening of the muscle of the heart, a condition known as cardiomyopathy. Symptoms of congestive heart failure include difficulty breathing, fatigue, and swelling. Heart failure is a chronic condition that can often be managed with medication.
August 29, 2016
Auxiliary Celebrates 100th Anniversary of Caring for our Community
MedStar St. Mary’s Hospital would not be where it is today without the continued support of the hospital’s Auxiliary. Since the very beginning of the Auxiliary in 1916, patient comfort has been its primary focus. Throughout the past 100 years, the Auxiliary has donated funding for projects small and large – from breast pumps to building renovations. It is likely, that at some point during the hospital’s history, the Auxiliary has touched almost every department at the hospital. The Auxiliary has donated more than $5 million to the hospital during the past 100 years.
“Our hospital, its associates and the community can never repay the Auxiliary for everything they have done – for the millions of dollars they have raised and the countless hours they have donated,” said Christine Wray, president of MedStar St. Mary’s Hospital. “All we can do is say thank you to them. They have given us a priceless gift and we are eternally grateful.”
Contributions Throughout the Years