Leading Medicine Summer 2020, Houston Methodist Baytown Hospital edition

LEADING MEDICINE SUM M ER 2020

In Case of Emergency, Don’t Wait Breast Cancer Screenings Save Lives

PRIORITIZE YOUR HEALTH

How to Handle Your Health Care Needs During a Pandemic

YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN EAST HOUSTON/BAYTOWN

IN THIS ISSUE - SUMMER 2020

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I n Case of Emergency, Don’t Wait If you’re experiencing concerning symptoms that require immediate medical attention, don’t let your fear of catching COVID-19 keep you from heading to the emergency room or calling 911.

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Q &A: Navigating Pregnancy During COVID-19 Learning how to protect yourself and your baby can help you be calm and confident as you navigate pregnancy and childbirth.

D on’t Let an Injury Keep You Down One of the most important ways to stay healthy and boost your immunity is through regular exercise. If you’re experiencing acute joint pain, don’t wait to have it checked out.

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P rioritize Your Health When you need health care, it’s important to take action right away. Learn how to handle urgent health care needs during a pandemic.

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W hat Is Your Body Trying to Tell You? Your body sends messages about what’s going on with your health every day. By listening to your body, you can learn more about the state of your health.

Breast Cancer Screenings Help Save Lives While you may know about the importance of regular breast cancer screenings, do you actually take the time to have a yearly mammogram? This patient’s story reinforces the importance of an annual mammogram.

NEWS & EVENTS

KEEP YOURSELF IN THE KNOW

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tay connected with Houston Methodist year-round for medical, health and wellness information to help you and your loved ones be healthy. Our e-newsletter and blog cover current health and medical trends as well as timely, accurate and actionable information you can rely on, such as new treatments and upcoming events.

Visit houstonmethodist.org/blog to learn more about a wide range of topics, such as heartburn, injury prevention, COVID-19, stress and ways to boost your immune system. By signing up at houstonmethodist.org/subscribe, you will receive information on upcoming events and health tips.

Visit houstonmethodist.org/blog-stay-connected to sign up to receive the Houston Methodist On Health blog. Don’t worry. We will not sell your information, and you can opt out at any time.

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IN CASE OF EMERGENCY,

DON’T WAIT T

hroughout the coronavirus (COVID-19) pandemic, you’ve probably made decisions about which risks to take. Is it worth it to go to the grocery store, or should you order online? Should you wear a face mask when you go for a walk, or not? These are personal decisions and your choices depend upon your own health and other factors.

However, there is one choice that should be clear: If you’re experiencing concerning symptoms that require immediate medical attention, don’t let your fear of catching COVID-19 keep you from heading to the emergency room or calling 911.

IT’S SAFE IN THE EMERGENCY ROOM

Our top priority in the ER, whether or not there is a pandemic, is your safety. We’ve taken extra precautions to ensure that all Houston Methodist emergency departments, including at Houston Methodist Baytown Hospital, and all Houston Methodist Emergency Care Centers, are safe.

Those precautions include: Requiring masks and ensuring social distancing in waiting rooms. If you forget your mask, we can provide one, if needed.

Increasing levels of cleaning in our facilities.

Screening visitors before entering our clinics.

Isolating suspected coronavirus patients.

KNOW WHICH SYMPTOMS ARE CONSIDERED AN EMERGENCY

When you are experiencing a medical emergency, time is of the essence. Many conditions or illnesses can worsen if you wait too long to seek treatment. It’s important to recognize the onset of serious or debilitating symptoms that require immediate attention, including: Abdominal or stomach pain accompanied by nausea and vomiting Bodily trauma, especially to the head or spine Constant pain or pressure in the chest Fever of 100.4 F or higher that persists Severe burns Severe unrelenting headaches, especially if accompanied by fever or confusion Stroke symptoms, including face drooping, arm weakness, difficulty talking, dizziness, blurred vision, intense headache and confusion Sudden shortness of breath or trouble breathing If you,re experiencing any of these symptoms, seek emergency care as soon as possible. Some serious symptoms, such as chest pain and those associated with stroke, are time sensitive, and you should call 911.

Know Where to Go

We’re doing everything we can to keep Baytown-area residents safe and healthy. Visit houstonmethodist.org/ baytown for more information on the Houston Methodist Baytown Hospital Emergency Department. If you are experiencing a serious or life-threatening medical emergency, please call 911.

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Q&A: Navigating PREGNANCY During COVID-19

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hen you’re expecting a baby, you have a million questions on your mind. In addition to all the usual concerns during pregnancy, you’re also thinking about how to reduce the risk of COVID-19. Learning how to protect yourself and your baby can help you be calm and confident as you navigate pregnancy Dr. Paul and childbirth.

Redman Dr. Paul Redman, obstetrician-gynecologist at the Houston Methodist Childbirth Center at Baytown, understands the stress new mothers are going through during this challenging time. He answered some common questions about preparing for a healthy and safe birth experience.

Q: What can I do to protect against COVID-19 during pregnancy?

A: You can prevent illness by avoiding people who are sick and limiting social contact with others, especially in large groups.

Avoid public spaces and protect yourself and others by keeping a safe distance. Clean and disinfect frequently touched surfaces daily and continue to be extra vigilant about handwashing.

Q: Should I continue with prenatal care visits?

A: It’s important to stay on track with your prenatal visits. Some of your prenatal care visits may be done virtually, which allows you to see your doctor while staying at home. In-person visits are needed for ultrasounds, fetal testing and blood work.

Q: Why choose a hospital birth over a home birth or other setting?

A: Having your baby in a hospital gives you peace of mind knowing that if complications arise, you and your baby are in good hands with physicians and nurses trained to handle complex cases. In a hospital setting, you’ll have the support you need during a critical time for you and your baby.

Q: Should I consider breastfeeding?

A: Breast milk protects against many illnesses and provides all the nutrition most infants need. If you’re worried about breastfeeding after being sick with COVID-19, talk to your doctor. In early studies, COVID-19 has not been detected in breast milk, but researchers are still learning more.

Q: What should I do if I’m having trouble breastfeeding?

A: If you choose to breastfeed your baby, you’ll have breastfeeding support from a lactation consultant if you need help getting started. After you go home, a lactation nurse can consult with you over the phone or on video conference to address any challenges with feeding your baby.

Q: Is it safe to give birth in a hospital?

A: Houston Methodist Childbirth Center at Baytown has protections in place to provide a safe and secure birth experience.

There’s an essential visitor policy that allows maternity, postpartum and NICU patients to have one healthy partner or parent visitor. All patients and essential visitors are screened for elevated temperatures and other symptoms before entering the hospital and are required to wear a mask. All staff members use safe social distancing best practices and wear protective gear when interacting with you and your baby. Mothers and babies stay together in the same room, and your baby’s routine care will be provided in the same room.

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Be Prepared

Have questions? Please call Houston Methodist Obstetrics & Gynecology Associates at 281.420.5760 for more childbirth information.

It’s Important to Keep Moving

DON’T LET AN

INJURY KEEP YOU DOWN

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ne of the most important ways to stay healthy and boost your immunity is through regular exercise. However, joint pain and other orthopedic injuries can keep you from getting your steps, hitting the treadmill or jumping on the bike.

If you’re experiencing acute pain, don’t wait Dr. Mark to have it checked out. Depending on your Franklin medical history and the kind of injury or pain you are experiencing, there are many ways to work with our orthopedic departments during the COVID-19 pandemic.

O rthopedic Injury Clinics: “We provide expert care for patients who suffer acute orthopedic injuries, fractures, broken bones, sprains and painful or swollen joints,” said Dr. Mark Franklin, orthopedic surgeon at Houston Methodist Baytown Hospital. See the sidebar for details.

V ideo visits: Our orthopedic providers can perform an examination virtually and, when needed, order diagnostic studies (X-ray or MRI).

I n-clinic appointments: We can still schedule in-clinic appointments for patients. Patients experiencing COVID-19 symptoms should not come to the clinic.

To ensure the safety of our patients and staff, patients who come to the clinic will be thoroughly screened, including temperature checks.

Home deliveries: To provide additional safety and convenience, patients can receive crutches, braces and boots delivered directly to their homes.

We Can Help

Not sure what type of care is right for you?

Visit houstonmethodist.org/baytown or call us at 281.427.7400 for help finding an orthopedic specialist and the right appointment type for you.

SAME-DAY ORTHOPEDIC INJURY CLINICS Our orthopedic specialists are available to safely see patients. We recommend that all new and established patients call to schedule a same-day appointment at their nearest Houston Methodist Orthopedic Injury Clinic. Major insurance plans are accepted.

The clinic provides treatment for: Acute orthopedic injuries Fractures and broken bones Injured tendons Minor dislocations Painful or swollen joints Sports injuries Sprains and strains Torn ligaments To get started, call 281.427.7400.

Chronic conditions, spine injuries, motor vehicle accidents and workers’ compensation injuries are not treated at the injury clinic. Please call 281.428.2273 to schedule an appointment with the appropriate physician for those conditions.

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PRIORITIZE YOUR HEALTH How to Handle Your Health Care Needs During a Pandemic

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he COVID-19 pandemic has changed our communities and reshaped how we get health care. While social distancing remains important as we move Dr. Shawn Tittle forward, taking care of ongoing health needs should also be a top priority. When you need care, it’s important to take action right away.

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Postponing health care visits or treatments may actually hurt your health in the long run. If you delay going to the doctor for small problems like a rash, an infected toenail or urinary tract infection, these issues can become bigger problems and may require urgent attention.

Now is the time to be proactive about identifying health risks and following through on treatment plans. “Preventive care, health screenings, vaccinations, medications and treatments are essential health management steps to take,” said

Dr. Shawn Tittle, a thoracic surgeon and the chief medical officer at Houston Methodist Baytown Hospital. “Postponing screening tests or neglecting health issues could result in bigger problems down the road.”

If you have a chronic condition, you should work with your doctor to improve your health. Managing your existing health conditions may help you be healthier and stronger if you need to fight off an illness or infection in the future.

PUTTING SAFETY FIRST

As we navigate how to interact within the community, we’re learning that COVID-19 may be with us for a long time. While we wait for answers on vaccines and immunity, we’re finding ways to adjust to a new normal and return to our daily activities in a safe manner. This involves wearing masks in public, keeping 6 feet apart from others and staying vigilant about handwashing and wiping down surfaces. Keeping these social distancing practices in place is essential to our efforts to slow the spread of the virus.

“Your health and well-being are our top priority — now more than ever as we work to meet the challenges of the pandemic,”

Tittle said. “We are dedicated to providing you with exceptional care, and you can be confident that we are taking every necessary precaution to keep you safe during your visit.”

All Houston Methodist campuses are focused on making your visit as safe as possible, and we are taking extra precautions, such as: Requiring all patients, visitors and employees to wear a mask.

Elevating our cleaning and housekeeping practices.

Health screenings for patients, visitors and staff.

Isolation measures for COVID-19 patients.

Adhering to a strict essential visitor policy.

Implementing social distancing in our waiting rooms and elevators.

Minimizing waiting in public spaces.

Offering remote check-in.

WAYS TO GET CARE

At Houston Methodist Baytown, we’re expanding virtual services and staggering in-person appointments with your safety in mind.

Connect with us in the following ways to schedule your next appointment: Doctor appointments – Schedule a virtual video visit or in-person appointment with your primary care doctor or specialist. Simply call your doctor’s office or use the “Schedule an Appointment” button in MyChart. If you need to find a doctor, visit houstonmethodist.org/find-a-doctor or call 281.428.2273.

Virtual Urgent Care – Nonemergency urgent care is available 24/7 via video visit. Download the MyMethodist app or visit houstonmethodist.org/ virtual-care to learn more.

Same-Day Clinics – To schedule an appointment at the Baytown Primary Care Clinic, call 832.556.6670. To schedule an appointment at the Mont Belvieu Primary Care Clinic, call 832.556.6936.

Orthopedic Injury Clinics – Schedule a same-day appointment at your nearest orthopedic injury clinic. Visit houstonmethodist.org/osm-injurybaytown for clinic locations.

Emergency Care – Open 24/7 to provide a full spectrum of medical services if you need emergency care. Visit houstonmethodist.org/er to find your nearest Houston Methodist Emergency Care Center or ER. E-visits – Same-day visits for nonemergency urgent care through online messaging. Sign up for MyChart to get started, and then log in to complete an e-visit through MyChart. Visit mychart.houstonmethodist.org to log in or register.

HOUSTON METHODIST

INNOVATIONS FIGHTING COVID-19 When facing a pandemic strain of a novel virus, every second is critical. Since the outbreak started, Houston Methodist’s physicianscientists have been working around the clock on investigating potential therapies for COVID-19.

VACCINE RESEARCH AND DEVELOPMENT Houston Methodist researchers are partnering with GeneOne Life Science Inc. to develop an RNA vaccine against COVID-19.

Houston Methodist developed an RNA therapeutics research program to design, manufacture and test clinical-grade RNA.

REMDESIVIR CLINICAL TRIAL Houston Methodist was the fifth clinical trial site in the U.S. to offer the antiviral drug Remdesivir as an investigational therapy for COVID-19 patients. Investigators say the goal is to hold off the deadly inflammatory cascade that leads to respiratory failure and the need to be intubated and put on a ventilator. Early results of the trial are promising, with patients responding to the antiviral drug.

PLASMA INFUSION THERAPY Houston Methodist was the first academic medical center in the nation to transfuse donated plasma from a recovered COVID-19 patient into a critically ill patient. Like a blood donation, physicians use plasma from patients who have recovered from COVID-19, in the hope that their blood plasma contains antibodies to fight the virus. The donor's plasma is then infused into ill COVID-19 patients, who are not yet immune to the virus. One of the major advantages of this treatment approach is that it can be used right now, while vaccines and antiviral drugs can take from months to years to develop.

DEVELOPMENT OF INNOVATIVE TOOLS Houston Methodist and its partners have worked on prototyping and developing a variety of clinical devices to address immediate needs brought about by COVID-19.

Houston Methodist created a plexiglass box in-house to reduce the risk of exposure to COVID-19 for doctors and hospital staff. The container uses plexiglass barriers and a vacuum device to filter the air before releasing it back into the room.

Houston Methodist’s new Engineering Medicine Program (EnMed), a collaboration with Texas A&M University College of Medicine, acquired and tested a helmet made from a lightweight, transparent plastic aerosol box, which is used to keep patients off ventilators and stabilize them in the ICU. In addition, EnMed faculty used 3D printing technology to produce 3D printable spacers, which are in high demand for treating COVID-19 patients. The spacers are needed to safely administer bronchodilator drugs through inhalers instead of using nebulizers, which release a mist into the air.

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WHAT IS YOUR BODY TRYING TO TELL YOU? Y our body sends messages about what’s going on with your health every day. By listening to your body, you can learn more about the state of your health.

Dr. Sanjeeda “Health problems can Jabeen typically be managed better when diagnosed early,” said Dr. Sanjeeda Jabeen, board-certified primary care physician at Houston Methodist Primary Care Group at

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Baytown. “Paying attention to clues your body sends may allow early intervention, preventing more serious issues from developing.”

Uncover clues about your health by taking a look at the following:

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Your tongue should be pink and covered with small nodules. If you’re noticing changes in appearance or pain in your tongue, it could be a sign of a bigger issue.

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Your sweat is essential for keeping your body cool. But there are times when sweating is a sign of something more serious.

Sweating excessively may be a symptom of a condition called hyperhidrosis. People with hyperhidrosis may sweat so much that it soaks through their clothes or drips off their hands.

Being unable to produce sweat means the body can’t cool itself (due to heat stroke, diabetes, a genetic disorder or something else), and immediate medical help is needed.

Heavy sweating that comes on suddenly could be a symptom of a heart attack, or it could be linked to metabolic issues, cancers, menopause and stress disorders.

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Your urine’s color can tell you about the general state of your health and your level of hydration.

Clear or transparent yellow urine indicates that you’re well-hydrated.

Dark yellow or amber urine usually means that you should drink more water.

Pink to reddish urine may be due to blood in your urine, and could be related to urinary tract infections, prostate problems, kidney disease or something else.

Dark-brown urine can indicate a liver disorder.

Cloudy or milky urine can be a result of inflammation in the prostate or vagina, kidney stones, diabetes or a urinary tract infection.

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Your nails can provide clues to your overall health. Nails that turn yellow or red could indicate nail fungus or even skin cancer. Clubbing of the nails, which is severe curving, can be a sign of lung disease or heart disease. Dimpling, splitting or indentation of the nails could

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How You Can Connect

Preventive care is more important than ever. This is especially true for vaccines that may have been put on pause and should now be pursued. Check with your primary care provider for scheduling necessary vaccines for you or members of your family, or for scheduling other primary care appointments.

Here are some options: An in-person visit with your primary care provider A virtual visit with your primary care provider A MyChart video virtual visit Learn more by visiting houstonmethodist.org/pcg/baytown or by calling 832.556.6936 or 832.556.6670. New and existing patients can also text these numbers to schedule an appointment.

point to psoriasis or an inflammatory skin disorder.

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Your eyes are a reflection of many other aspects of your health.

During an eye exam, your doctor checks for clues in the eyes that may point to conditions elsewhere in the body.

Inflammation, damage or swelling within the eye may be a warning sign of diabetes,

high blood pressure or inflammatory conditions, such as inflammatory bowel disease, Crohn’s disease and ulcerative colitis.

Sometimes it’s hard to know what’s normal and what’s not. A doctor can help answer your questions, check out your symptoms and refer you to a specialist, if needed.

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BREAST CANCER

SCREENINGS

HELP SAVE LIVES BREAST CANCER SCREENING RECOMMENDATIONS

Barbara Fregia, breast cancer patient

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Some overall recommendations about breast cancer screening include: Use breast self-exams to become familiar with your breasts. Women should become familiar with their breasts to identify changes by checking their breasts during a breast self-exam.

If there is a change, lumps or other unusual signs in your breasts, talk to your doctor right away.

Have an annual mammogram once you turn 40 if your risk of breast cancer is average.

Houston Methodist follows the American College of Radiology's recommendations that all women should get an annual mammogram starting at age 40.

Consider scheduling an annual mammogram earlier than age 40 if you have a higher risk of developing breast cancer due to family history or other factors. In addition, your doctor may also recommend a MRI screening in combination with a mammogram to create a more detailed image of the breast.

W Dr. Esther Dubrovsky

hile you may know about the importance of regular breast cancer screenings, do you actually take the time to have a yearly mammogram?

If it’s been a while since your last exam, then consider Barbara Fregia’s experience with breast cancer. She credits her passionate commitment to yearly mammography with helping her reach survivor status after she was treated for breast cancer in 2019 at the Houston Methodist Cancer Center at Baytown.

A STARTLING DISCOVERY

Dr. Ana Benveniste

Fregia, a 62-year-old Dayton resident, was diagnosed with stage 1 breast cancer in January 2019 despite not having a family history of the disease. “Since I didn’t have a family history of cancer, I never thought it could happen to me,” Fregia said.

“Exams, such as mammograms, are able to find cancer when it’s very small and often before symptoms are present,” said Dr. Esther Dubrovsky, breast surgeon with Houston Methodist Baytown Hospital and a member of Fregia’s treatment team.

SCREENINGS ARE KEY

Recommendations on when women should begin screening mammograms and how often they should be done vary, so it’s important to check with your doctor. (See “Breast Cancer Screening Recommendations.”) “Talk with your doctor about your risk factors and personal preferences to decide on a screening schedule that is right for you, especially if you have a family history of breast cancer,” said Dr. Ana Benveniste, breast radiologist with Houston Methodist Baytown, and another member of Fregia’s team.

During the COVID-19 crisis, our imaging and radiology services are available. The safety of our patients and staff is our first priority, and we are taking every precaution to keep everyone safe. We are: Screening all patients when scheduling appointments and upon arrival.

Wearing masks and other personal protective equipment while providing care.

Implementing additional sanitation processes to disinfect all equipment and surfaces.

Redesigning waiting rooms to ensure social distancing.

A TEAM APPROACH TO CARE

After her diagnosis, Fregia’s treatment began with surgery, followed by chemotherapy and radiation treatments. In addition to Dubrovsky and Benveniste, other members of her treatment team included Dr. Cesar De Las Casas, medical oncologist-hematologist, and Dr. Mary Goswitz, radiation oncologist.

This team, together with the nursing staff, guided Fregia through the treatment regimen that concluded with her “ringing the bell” in November 2019 to signify the end of her chemo and radiation treatments.

“If you’re diagnosed with breast cancer, it’s so important to take care of yourself,” Fregia said. “Many women are so busy taking care of their families that they forget to take care of themselves.”

These days, Fregia does not hesitate to offer advice for women who aren’t as diligent in scheduling yearly mammograms, “Women shouldn’t wait to schedule their mammograms. They might not find the cancer in their self-exams, so there’s no telling how widespread it could be by the time it’s discovered.”

REDUCE YOUR RISK FOR BREAST CANCER Even though each woman’s risk for breast cancer is different, some changes may help prevent cancer. Controlling weight, limiting alcohol and exercising regularly are the most common ways to help prevent cancer, but there are a few others to consider:

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Breastfeed. The longer mothers breastfeed, the greater the protection against breast cancer.

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Know the risks of hormone therapy. If you’re taking hormone therapy for menopausal symptoms, consult with your doctor about the risks and benefits, and ask about other options. Long-term hormone therapy may increase your risk for breast cancer.

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Avoid exposure to environmental pollution. Our environment exposes us to dangers like car exhaust and air pollution.

Limiting your exposure may help protect against an increased risk of breast cancer.

Keep Healthy by Continuing Screenings A healthy lifestyle and regular breast cancer screenings are good ways to keep your health in check. Partner with your doctor to discuss your health history and stay on top of your recommended screenings.

Houston Methodist Breast Care Center at Baytown, located in Houston Methodist Baytown Hospital’s outpatient center, is a nationally accredited facility offering comprehensive imaging services, including all-digital mammography, 3D imaging, breast ultrasound and breast MRI. To schedule a mammogram, visit houstonmethodist.org/ imaging or call 346.292.PINK (7465).

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KEEP YOU MOVING without joint pain

Live life without joint pain.

At Houston Methodist Orthopedics & Sports Medicine at Baytown, we know that joint pain affects every part of your life. With treatment plans customized for you, our specialists offer a full range of advanced nonsurgical and surgical techniques. Our expert joint care includes:

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• Innovative pain control methods • Physical therapy to improve mobility and range of motion • The latest technology, including minimally invasive surgical techniques that help reduce recovery time During the COVID-19 crisis, Houston Methodist has implemented additional safety precautions to ensure that we provide safe and effective care to our patients.

Schedule an appointment: houstonmethodist.org/jointpain 281.427.7400

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