WASHINGTON — MedStar Georgetown University Hospital, the first hospital in the Washington, D.C. Metropolitan Area to offer convalescent plasma therapy, has discharged its first patient who received the investigational treatment.
While there is no proven treatment for this virus, researchers are optimistic that the antibodies in convalescent plasma, a component of blood, collected from individuals who have recovered from COVID-19, can lead to more positive outcomes.
Anecdotal evidence suggests that a patient’s ability to recover is due, in part, to the existence of antibodies in blood that are capable of fighting viruses that cause illness. While use of convalescent plasma for COVID-19 was just recently approved by the FDA for clinical trials and expanded clinical use, the use of convalescent plasma has been successful in the past for treating diseases like hepatitis B, influenza and Ebola.
Patrick Bright, the first patient to receive convalescent plasma at MedStar Georgetown was discharged on May 2 after spending 3 weeks in the hospital. Before receiving the convalescent plasma, Bright was in the ICU where doctors told him and his family that they were not optimistic about his recovery from acute COVID-19 infection.
Despite the bleak prognosis, Bright was determined to fight. He recalls lying in his hospital bed, holding his fist up like a boxer and telling his family, who were on a video call, “I’m a fighter. I’m not going anywhere.” Today he credits his recovery to getting convalescent plasma. “I was on a ventilator for five days and I started turning around after getting the convalescent plasma. My doctors told me the plasma therapy was a crucial part of my recovery.”
MedStar Georgetown has treated more than 30 COVID-19 patients with convalescent plasma and is encouraging more people to donate. Anyone who has recovered from COVID-19 and has been symptom free for 14 days can be considered to donate plasma and help save the lives of severely ill patients like Patrick Bright.
Bright and his wife, who also had COVID-19, are eager to donate their plasma in the future to help other people recover.
Interested donors who meet the outlined criteria should email their name and phone number to [email protected]for pre-screening and directions on where to donate. Your single plasma donation may be used to treat up to three other COVID-19 infected patients who need your help.
Article written by Meaghan Canton Feder, NP, Department of Dermatology
Tips on how you can stay safe in the Summer Sun!
Summer is officially here and that means it is time to slather on the sunscreen. Like many people, I love the sun. But whether I am chasing my two toddlers around the playground, spending time with them at the beach or pool, or on a Saturday morning family walk, I always wear sunscreen, a hat, and sunglasses—and I make sure my husband and children do the same. It is important to teach children early on about safe sun practices and never too late to start practicing them yourself. Ultraviolet sun rays can cause skin cancer, eye damage and premature aging. Here are some ways to help protect yourself and your family from the harmful rays while still enjoying the summer sun.
Choosing a sunscreen can be overwhelming. Should I buy a physical block or a chemical block? Should I use a spray, lotion or stick? The key to sunscreen, however, is simply to use it. Sunscreen is essential for preventing both melanoma and non-melanoma skin cancers. Use a sunscreen with both UVA and UVB protection or broad spectrum sunscreen and a sun protective factor (SPF) of 30 or higher. Apply sunscreen 30 minutes prior to going outside, reapply every two hours, and reapply after swimming or sweating. Chemical sunscreens absorb UV rays decreasing the amount penetrating into your skin. They rub in to your skin more easily and are more likely to hold up to their SPF claim. La Roche Posay, with Mexoryl, is a great option. Physical block sunscreens lay on top of your skin and act as a barrier, deflecting the sun. They are great for kids and people with sensitive skin or who prefer chemical-free sunscreens. Cerave and Aveeno baby lotion are great options. Note, however, that babies six months of age or younger should not use sunscreen. Staying out of the sun or using protective clothing is best for that age group.
Sunscreen lotions, sprays and sticks are all great choices. For lotions, you need to use at least two tablespoons of sunscreen lotion to protect your whole body. Sunscreen sprays should be sprayed into your hands and then rubbed in to your face and body. Never spray directly into your face. Sunscreen sticks also need to be rubbed in for even distribution.
Wearing protective clothing is another important component of sun safety. Your clothes are the first line of defense from the sun. Look for clothes with ultraviolet protection factor (UPF). The higher the UPF the better. Always wear a hat, preferably one with a wide brim. Keeping the sun off your face is the #1 way to avoid wrinkles.
Of course, do not forget to wear sunglasses. Exposure to UV rays over time may cause cataracts and macular degeneration. It is particularly important to protect the eyes of children under age 10 because they are at higher risk of vision and other eye damage as result of UV exposure. Look for sunglasses that block 99 – 100 percent of both UVA and UVB rays. For children, make sure the sunglasses are durable with plastic, scratchproof lenses.
Importance of Vitamin D
Many people worry they will not get enough Vitamin D if they protect themselves from the sun. Vitamin D is essential for bone growth and other aspects of wellness, but it does not take much sun exposure to get the right amount. The human body absorbs sufficient vitamin D from 10 to 15 minutes of sun exposure, two to three times a week. That does not mean you have to skip the sunscreen to get Vitamin D though. No sunscreen blocks 100 percent of UVB rays, so even with sunscreen your body will get Vitamin D. You can also get the recommended daily dose of 600 IU of vitamin D from eating fatty fish, egg yolks and fortified milk and cereal.
Have a wonderful summer and take care of yourself in the sun!
Healthy App of the Month - Sunwise UV Index
Summer holidays mean more time outside enjoying sunny weather, but sun safety is key when thinking about skin health. Sunwise UV Index, a mobile app created by the Environmental Protection Agency (EPA), predicts ultraviolet radiation levels on a scale of one to 11+. The Sunwise app delivers information on changing weather conditions in specific locations, giving useful, up-to theminute tips and reminders on how to stay safe in the sun. This app is free, and available for Apple and Android devices.
It seems like more people are living longer than ever before. Is that really the case?
It’s true, people are living longer. An estimated 4.2 million U.S. residents now fall into the “oldest old” age group—85 years and older—with centenarians (those 100 and older) becoming the fastest-growing subpopulation of the elderly. According to census projections, by 2050, 1 million Americans will celebrate their 100th birthday.
Is it possible to stay healthy as you grow old?
Yes! Most people can live long, healthy lives if they eat a proper diet, get regular exercise and maintain involvement in their families and communities. However, some factors that affect the “normal” process of aging—such as genetics, lifestyle choices and diseases—can vary from individual to individual. In other words, most people can live long lives, but no two will age the same way.
Can you offer some basic advice for staying healthy as you grow old?
Talk to your doctor for specific suggestions on maintaining a healthy lifestyle and about appropriate screenings and immunizations based on your health history. Some basic recommendations for healthy living include:
Living tobacco free
Being physically active
Eating a healthy diet
Consuming alcohol only in moderation
The recommendations for medical exams, screening procedures and routine tests generally begin around age 50 and vary depending on your age, your family history, your overall health and your personal risk factors.
Contact your physician to discuss your questions or concerns about staying healthy as you age.
For more information, or to make an appointment with a physician, please call 202-342-2400.
With a Simple Click of a Button, Upper Airway Stimulation Improves Sleep Apnea, Restores Energy
Virginia businessman Sid Ghatak experienced years of restless nights due to his sleep apnea, a shallow breath or pause of 10 seconds or more while sleeping, until a new minimally-invasive treatment, upper airway stimulation, recharged and rejuvenated his body. The Inspire Upper Airway Stimulation (UAS) system uses sensors to prevent the tongue from blocking the upper airway, which helps patients continue to breathe while sleeping. This FDA-approved treatment now available at Medstar Georgetown University Hospital has allowed Ghatak to combat the exhaustion that impacted every area of his life.
"Before, I was constantly tired at the office, while driving and really exhausted all the time," Ghatak said. "But now, it's like my sleep apnea has been taken away. I have more energy, and overall, I'm a much a happier person. Everyone in my family has noticed my change in mindset and mood."
Ghatak was one of the first patients to undergo the UAS procedure at MedStar Georgetown. With a BMI of less than 32, a moderate level of sleep apnea, and an incompatibility with continuous positive airway pressure (CPAP), Ghatak was the perfect candidate for the procedure, according to Suzette Mikula, MD, otolaryntologist and ENT surgeon. Dr. Mikula has been specially trained in UAS and surgically implanted Ghatak's stimulator.
"Many of my patients with obstructive sleep apnea syndrome suffer from sleep deprivation, are exhausted and have cognitive impairment, and it affects their everyday life. Upper Airway Stimulation improves sleep apnea, quality of life and, we hope, prevention against other problems caused by apnea and lack of sleep. This procedure’s benefits could be life changing," said Dr. Mikula. "And the most exciting thing about upper airway stimulation is the potential to successfully treat patients with moderate to severe apnea without painful upper airway surgery or the CPAP device."
When Dr. Mikula first learned about the procedure, she was immediately interested in incorporating the procedure into her practice. More than half of the patients diagnosed with sleep apnea do not use CPAP, according to Dr. Mikula, so she knew that many of her patients with sleep apnea could benefit. The UAS system's less invasive approach and faster recovery than other upper airway surgeries is only for patients who meet the following criteria:
have a BMI of less than 32
pass a drug-induced sleep endoscopy
have moderate to severe level of sleep apnea
have failed or are noncompliant with CPAP
The design of the UAS surgery requires only three small incisions made in the chest and neck. Dr. Mikula uses two incisions to implant a small stimulator in the chest and a small sensor in the muscles around the lung. The incision in the neck gives the surgeon access to the hypoglossal nerve, which controls the tongue's movement and plays a key role in fighting a patient's sleep apnea. A relaxed tongue can block breathing through the throat. To combat the blockage of the upper airway, the UAS device is attached to the hypoglossal nerve to sense a shortness of breath or shallow breath while a patient is asleep. Once a pause in breathing is detected, the sensor triggers the stimulator, forcing the tongue forward in the mouth. This triggering action allows patients to continue breathing while asleep.
"I would recommend this procedure to anyone because there is no discomfort, the procedure was easy, the 10 days of recovery was fine and it's easy to use."
Ghatak's device was implanted in September. After waiting the required 30 days for healing, his stimulator was activated, and Dr. Mikula gave him a remote for his stimulator. Each patient with an implanted stimulator is given a hand-held remote to power on and off the stimulator. The stimulator is programmed to automatically turn off after eight hours, so the remote is usually used once a day. Patients can expect easy usage with UAS, as they are instructed to simply turn on the device before going to sleep.
"After I brush my teeth, I push the button on the stimulator remote, read for a little bit and eventually fall asleep," said Ghatak. "I'm very pleased because I'm really getting all the benefits I expected and I have more energy!"
MedStar Georgetown Offers More Convenient Option to Allergy Shots
(Washington, D.C.) - Michelle Gottke is an elementary school art teacher in Fairfax, Virginia with little time for weekly trips to an allergist for shots to relieve her debilitating seasonal allergies, including ragweed.
“It’s hard and exhausting at times,” said Michelle. “The kids know I sometimes pull on my ear because I can’t hear due to yet another sinus infection or I’m just totally congested and I get this squeaky voice. I’ve been taking antibiotics for nearly two years now because every time I’m exposed to an allergen, I get an infection. I’ve also had two sinus surgeries but I still get congested and infected.”
Michelle is the first patient at MedStar Georgetown and one of the first in the United States to begin taking a daily ragweed pill, not for allergy symptoms, but to build her immune system to the ragweed pollen.
The pill called RAGWITEK was approved by the U.S. Food and Drug Administration in April 2014 for hay fever in patients age 18 through 65. The pill contains an extract from short ragweed pollen (Ambrosia artemisiifolia). Michelle started taking the pills in May to prepare her for ragweed season in August.
“I’m very excited about this immunotherapy pill option for my patients,” said Suzette Mikula, M.D., an Otolaryngologist at MedStar Georgetown University Hospital with specialties in allergy and rhinology.
“The regular allergy medications work but they can have side effects and they don’t help you build any immunity,” said Dr. Mikula. “You only treat the symptoms. About 80% of people who take allergy shots respond to them, but many people have problems getting to a doctor’s office once a week and the injections can take years to work.”
Patients start taking RAGWITEK about three months before the start of ragweed season, which is in mid-August. They continue taking it through the ragweed season until the first hard frost. Then they stop the medication and can start it again the following year.
“If I can make it through a ragweed season without a sinus infection I will be really excited,” said Michelle. “I just feel like I’m in a constant allergy fog.”
Patients are prescribed RAGWITEK which they can get at their pharmacy. They take their first pill in the physician’s office in the event they have a negative reaction. The pill easily dissolves under the tongue in about two minutes. If they have no severe reaction they can take the pill daily at home.
Patients are also prescribed an EpiPen in the event of a negative reaction.
“Immunity therapy works by building what are called ‘blocking antibodies’ to the agent,” said Dr. Mikula. “After a period of time it has a long lasting effect and people feel better. By continuing the exposure we develop immunity. With allergy shots you build up slowly and it can take years. RAGWITEK is one single dose of the allergen; ragweed in a pill. The goal is for patients to have significantly improved allergy symptoms, use less rescue medications and overall feel better much sooner.”
Next winter, Dr. Mikula will offer her patients with grass allergies a similar treatment in time for spring. In April 2014 the FDA also approved allergen extracts in pill form for grass.
A “Bionic Eye” for Leading Cause of Blindness in Americans Over Age 65
(Washington, D.C.) A tiny device is making a big difference in the lives of people with end-stage macular degeneration (AMD), the leading cause of blindness in people over the age of 65 according to the Centers for Disease Control and Prevention.
“Macular degeneration is a disease of the retina where there is a change in the cells on the macula which is the center part of the retina,” said Jay Lustbader, MD, Ophthalmology chair and director of Cornea and Refractive Surgery at MedStar Georgetown University Hospital. “In some patients the macula will scar in the center of the retina and result in a large blind spot in the central part of their vision.”
Ann Montefusco of Clearwater, Florida has been legally blind for eight years due to macular degeneration. She is unable to see the faces of her loved ones, read a menu, drive a car or sign her own checks.
On October 2, 2013 Ann became one of the first people in the Washington, DC area to receive an implantable miniature telescope (IMT) at MedStar Georgetown University Hospital. The IMT was recently FDA approved and is part of a treatment program called CentraSight (www.CentraSight.com).
“I was so excited to have this done,” said Ann. “I’m an avid golfer and I really look forward to being able to see normally again.”
To implant the tiny telescope, Dr. Lustbader makes a 12 mm incision in the cornea of one eye, removes the lens and replaces it with the telescope implant. “The idea of the telescope is to magnify the view and make that blind spot smaller so patients can see. The eye with the telescope will replace their central vision, while the other eye will maintain the person’s peripheral vision. In the weeks after the surgery patients perform eye exercises to learn how to balance the two fields of vision."
CentraSight, which includes the implantation of the eye telescope, is a four-step program.
“First the patient receives the medical diagnosis of AMD,” said Dr. Lustbader. “Then the patient is evaluated to see if the implantable telescope is likely to be successful. The surgery is next, followed by weeks of rehabilitation where the patient learns how to use their new vision.”
“I am now working with my occupational therapist, learning how to use my new telescope,” said Ann. “If I focus using the telescope everything is larger. Eventually my brain will work with me. I’m very encouraged.”
The telescopic implant isn’t for everyone. “Patients are screened and tested in advance to make sure they’re good candidates for the procedure to be successful. Occupational therapy after the surgery can take as long as three to four months,” said Dr. Lustbader. “Patients must be motivated and committed to the therapy program after the surgery.”
The CDC reports that an estimated 1.8 million people age over the age of 40 have macular degeneration; a little more than a half a million have end-stage AMD and are potentially candidates for the implant. The number of people with end-stage AMD is expected to reach 2.9 million by 2020, according to the CDC and age- related cases of AMD are projected to double in people over the age of 50 by 2050.
To be evaluated for CentraSight, call 1-877-99-SIGHT (1-877-997-4448).
About MedStar Georgetown University Hospital
MedStar Georgetown University Hospital is a not-for-profit, acute-care teaching and research hospital with 609 beds located in Northwest Washington, D.C. Founded in the Jesuit principle of cura personalis—caring for the whole person—MedStar Georgetown is committed to offering a variety of innovative diagnostic and treatment options within a trusting and compassionate environment.
MedStar Georgetown’s centers of excellence include neurosciences, transplant, cancer and gastroenterology. Along with Magnet® nurses, internationally recognized physicians, advanced research and cutting-edge technologies, MedStar Georgetown’s healthcare professionals have a reputation for medical excellence and leadership. MedStar Georgetown University Hospital—Knowledge and Compassion Focused on You.
About MedStar Health
MedStar Health combines the best aspects of academic medicine, research and innovation with a complete spectrum of clinical services to advance patient care. As the largest healthcare provider in Maryland and the Washington, D.C., region, MedStar’s 10 hospitals, the MedStar Health Research Institute and a comprehensive scope of health-related organizations are recognized regionally and nationally for excellence in medical care. MedStar has one of the largest graduate medical education programs in the country, training more than 1,100 medical residents annually, and is the medical education and clinical partner of Georgetown University. MedStar Health is a $4.5 billion not-for-profit, regional healthcare system based in Columbia, Maryland, and one of the largest employers in the region. Its almost 30,000 associates and 6,000 affiliated physicians all support MedStar Health’s Patient First philosophy that combines care, compassion and clinical excellence with an emphasis on customer service.