Leading Medicine Winter 2019, Houston Methodist Hospital edition

LEADING MEDICINE W INT ER 2019

A Look at Rising Colon Cancer Rates

Strength in Numbers:

LOSING WEIGHT TOGETHER Take the Confusion Out of Cholesterol YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS FROM HOUSTON METHODIST

IN THIS ISSUE - WINTER 2019

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C ommon Pelvic Conditions You Should Talk About Up to 40 percent of women between ages 50 and 70 suffer from pelvic organ prolapse, and 1 in 3 women have stress urinary incontinence.

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5 Reasons to Donate a Kidney and Become a Superhero A living kidney donor is someone who donates one of his or her two healthy kidneys to a waiting recipient.

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A Look at Rising Colon Cancer Rates It doesn’t seem possible for colon cancer to develop in your 20s, 30s or 40s, but new research shows this is happening at an alarming rate.

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trength in Numbers: Losing S Weight Together Maybe it feels like you’ve tried everything to lose weight. But have you unleashed the power of your family and social network?

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T ake the Confusion Out of Cholesterol Cholesterol can be confusing — especially when you’re trying to make sense of your cholesterol test results.

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G et Help for Foot and Ankle Pain Does chronic foot or ankle pain have you sidelined?

Time to See a Neurologist?

What You Should Know Learn more about the conditions neurologists treat and when to make an appointment.

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5 Flu Facts: Protect Your Health Flu season is going strong.

Take steps to stay healthy by learning the facts.

NEWS & EVENTS A FREE HEART SCREENING EVENT

Date: Tuesday, Feb. 26 | Time: 5-7 p.m.

Location: Paula and Joseph C. “Rusty” Walter III Tower First Floor, Challenger Conference Room 6551 Bertner Ave. Houston, TX 77030 You’ve got big plans. Take steps so that heart disease doesn’t ruin them. Join heart experts from DeBakey Heart & Vascular Center for: A free heart screening, including cholesterol and blood pressure readings O ne-on-one consultations with a heart specialist to review results Heart health tips Free valet Refreshments and light bites

INJURIES DON’T HAPPEN ON A SCHEDULE

Specialized Orthopedic Care for Unexpected Injuries At the Houston Methodist Orthopedic Injury Clinic in Bellaire, you can see a specialist without making an appointment. When you need immediate orthopedic care, count on our experts to evaluate and treat your injury, so you can get back to your active life.

The clinic provides treatment for: Acute orthopedic injuries Fractures Injured tendons Joint pain

Minor dislocations Sports injuries Sprains and strains Torn ligaments

Monday – Thursday | 8 a.m. – 5:30 p.m.

Friday | 8 a.m. – 3 p.m.

No appointment required Office visit pricing | Major insurance plans accepted Reserve your spot at houstonmethodist.org/heart-event to help you understand your 10-year risk for heart disease.

2 LEADING MEDICINE FROM HOUSTON METHODIST

Conveniently located at 5505 W. Loop South. To learn more, visit houstonmethodist.org/osm/bellaire or call 346.238.5300.

COMMON PELVIC CONDITIONS

YOU SHOULD TALK ABOUT

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ome disorders may not be the easiest topic to discuss with your doctor, but problems like incontinence or dropped pelvic organs are more common than you may Dr. Danielle think. Up to 40 percent Antosh of women between ages 50 and 70 suffer from pelvic organ prolapse, and 1 in 3 women have stress urinary incontinence.

“My hope is that women will feel more comfortable talking about these issues with each other and their doctor,” said Dr. Danielle Antosh, urogynecologist and director of the Houston Methodist Center for Restorative Pelvic Medicine.

“Because of embarrassment, women often put up with this problem for much longer than necessary.”

Antosh describes the most common pelvic problems for women.

PELVIC ORGAN PROLAPSE

This condition occurs when the pelvic floor muscles weaken, and ligaments that hold the organs in place become damaged. The uterus, bladder or rectum then can bulge into the vagina. Moderate to severe bulging may cause a pressurelike discomfort as well as difficulty urinating or moving your bowels.

Treatment options include physical therapy, nonsurgical procedures and minimally invasive surgery.

STRESS URINARY INCONTINENCE

This type of incontinence is involuntary urine loss when you cough, sneeze, laugh, exercise or lift something heavy. This is a common problem after childbirth.

Treatments include physical therapy, nonsurgical procedures and minimally invasive sling surgery. Surgical procedures are done as outpatient surgery where women go home the same day with approximately 80 percent having the issue resolved.

OVERACTIVE BLADDER

Also known as urge incontinence, overactive bladder is when women have frequent urination, sudden urgency to rush to the bathroom and urinary leakage on the way to the bathroom. Treatments include Kegel exercises, pelvic physical therapy, topical vaginal estrogen cream, oral medications and some minor surgical procedures. “We have innovative

treatments for incontinence, including Botox injections and peripheral nerve stimulation,” Antosh said. “With many options to choose from, there’s hope for any woman suffering from incontinence.”

ACCIDENTAL BOWEL LEAKAGE

Accidental bowel leakage, also known as fecal incontinence, is a distressing problem that causes involuntary leakage of stool. This is more common in women because of childbirth and more common in women as they age as the pelvic floor muscles weaken. Options include dietary changes, fiber supplementation, physical therapy, nerve stimulation and surgery.

TREATMENT OPTIONS

A urogynecologist — a gynecologist with special training in pelvic floor disorders — can help you explore options and proceed with a treatment plan that’s right for you.

“The conditions that affect women’s bladder and pelvic health can really limit their enjoyment of life,” Antosh said. “It just doesn’t have to be that way when there are so many ways we can help.”

Schedule an Appointment If you have any of the symptoms above, our specialists can recommend a treatment option that is right for you. Call 713.441.5800 to schedule an appointment with a urogynecologist.

CHECK OUT OUR DIGITAL MAGAZINE AT HOUSTONMETHODIST.ORG/NEWSROOM/NEWSLETTERS 3

5 Reasons to Donate a Kidney and Become a Superhero

P Dr. A. Osama Gaber

atients with advanced kidney disease may feel like their lives are on hold while they wait for a transplant. A living kidney donor is someone who donates one of two healthy kidneys to someone whose kidneys are failing. The donor may be a family member, friend or, in some cases, a complete stranger, called an altruistic or Good Samaritan donor. Donors may not wear masks and capes, but they save lives.

Five reasons why living organ donation is heroic include:

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Bypasses, or cuts short, dialysis With a living donor, kidney patients may avoid dialysis or shorten time spent on it. While dialysis saves lives, transplant recipients have a life expectancy 2.6 times longer than those on dialysis.*

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It's safe for the donor Living donor surgery has the same risks as any surgery. Even 35 years after surgery, living kidney donors have a slightly higher survival rate than the general public.

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Living donor kidneys last longer Those who choose to donate a kidney go through health screenings to ensure the donor and kidney are in good health. The surgery is carefully planned, so the kidney can be transplanted quickly and safely. These precautions may contribute to the fact that living donor transplants last twice as long as deceased donor transplants.

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Shortens wait times The waiting list for transplant from deceased donors is long.

With a living donor, a patient's average wait time can shorten from years to only months.

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Saves two lives with one kidney For every living kidney donation, one waiting transplant recipient is removed from the long deceased donor list, freeing up the spot for another recipient. Further, a living donor pair can start a chain of transplants - called a kidney swap - and help others with willing donors who may not be the best match.

Houston Methodist J.C. Walter Jr. Transplant Center performs over 200 kidney transplants each year, making it one of the busiest transplant centers in Texas. Nearly half of these are from living donors. “Organ donation is perhaps the greatest gift one human could offer another,” said Dr. A. Osama Gaber, director of the transplant center. “Literally giving a piece of yourself in order to save another person’s life — it is remarkable.” * Transplant recipients 40-65 years old

4 LEADING MEDICINE FROM HOUSTON METHODIST

GIVE THE GIFT OF A LIFE This April, people and organizations across the country will celebrate the generosity of organ donors as part of National Donate Life Month.

What can you do?

1. Register at donatelifetexas.org for organ donation after death.

2. Visit houstonmethodist.org/living-donor or call 713.441.5451 to learn more about living donation.

A LOOK AT RISING Colon Cancer Rates

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t doesn’t seem possible for colon cancer to develop in your 20s, 30s or 40s, but new research shows this is happening at an alarming rate. Young adults born in 1990 have double Dr. Eric Haas the risk of colon cancer and quadruple the risk of rectal cancer as those born around 1950 did at the same age.* Dr. Eric Haas, chief of the division of colon and rectal surgery at Houston Methodist Hospital, sees this trend playing out, more young adults in the Houston area diagnosed with colon cancer.

“Overall, the highest risk group is still adults over age 50,” Haas explained. “But when you look at younger age groups, the rate of colon cancer is going up — alarmingly. The risk of getting colon cancer in your 30s is much higher today than it used to be.”

WHY IS THIS HAPPENING?

“We don’t have all the answers to this perplexing question, but there are theories about what may be contributing to the increased risk,” Haas stated. Lifestyle factors that may be linked to increased risk include: A Western diet with highly processed foods, lunch meats and foods containing chemicals and preservatives may increase colon cancer risk. “A high-fat, low-fiber diet increases risk for people of all ages,” Haas added.

Obesity may also increase the risk of colon cancer. “The obesity problem in America is growing, especially in younger people and even with teenagers and young children,” Haas said.

A sedentary lifestyle has also been linked to colon cancer. “In today’s techdriven society, kids and adults spend

NEW SCREENING GUIDELINES more time indoors, and this lack of exercise increases risks for cancer and other health problems,” Haas noted.

Tobacco and alcohol use are linked to many cancers, including colon cancer.

“Smoking and alcohol use are actually lower in this younger generation compared to others, but this is still an important factor,” Haas explained.

The American Cancer Society changed its guideline to start colon cancer screening at age 45 instead of age 50 for people with average risk. For anyone with a family history of colorectal cancer, Haas recommends screening 10 years younger than the age when your family member was diagnosed with cancer.

WATCH FOR WARNING SIGNS

“Colon cancer is difficult to detect in younger people, and the cancer tends to be more advanced than in the 50+ population,” Haas cautioned. Warning signs to watch for include rectal bleeding, change in bowel habits, unusual abdominal pains and unexpected weight loss. “If you’re having symptoms — at any age — take it seriously and see your doctor,” Haas said. * Source: American Cancer Society

Don’t Wait to Ask Do you have questions about colorectal cancer symptoms or screening tests?

Call 713.790.3599 to find a Houston Methodist gastroenterologist or primary care doctor near you.

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STRENGTH IN NUMBERS:

Losing Weight Together

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aybe it feels like you’ve tried everything to lose weight. But have you unleashed the power of your family and social network? Research Dr. Vadim suggests that couples have Sherman a higher likelihood of losing weight when they team up to adopt healthy behaviors. More research is needed to understand the power of community and its effects on weight loss, but it’s clear that friends and family have a strong influence in this area.

“When people decide to make a committed step to change their lives, it definitely has ripple effects on their relationships,” said Dr. Vadim Sherman, bariatric surgeon at Houston Methodist Hospital. Whether you’re planning to lose weight, considering weight-loss surgery or needing a new outlook on weight loss, partnering can improve your odds of reaching your goals. Weight loss with a partner provides motivation, support and even a little healthy competition.

Get Started Jump-start your weight loss by attending a free orientation at Houston Methodist Weight Management Center. We can answer questions about our medical weight management, StepLITESM and surgical weight-loss programs to help you get started.

Visit houstonmethodist.org/ weight-management or call 832.667.LOSE (5673) to register.

6 LEADING MEDICINE FROM HOUSTON METHODIST

1 MOTIVATION

“Motivation is often tied to experiences with our loved ones,” said Sherman. “We want to be there for the big moments in life, and we want to go places and enjoy time together.” Whatever your motivation to lose weight, you can put more power behind it when your loved ones know what you’re fighting for.

Picture this: A busy mom wants to lose weight so she can set a healthier example for her kids. The changes she makes with nutrition and exercise have an impact on her whole family. Try it: Keep a visual reminder, such as a family photo, vacation destination on a map, etc., in a special place so you can stay committed when you need it.

2 A STRONG SUPPORT SYSTEM

“When you embark on this journey together with family members, you have a built-in support system,” Sherman said.

“For anyone considering weight-loss surgery, it’s a big decision and a lifelong commitment that affects everyone in the family. Having a great support system can amplify the benefits of surgical weight loss.”

Picture this: A husband struggling to lose weight on his own decides to explore weight-loss surgery. He signs up for an informational session. Try it: A spouse can provide mental and emotional support by attending the orientation session, going to appointments and committing to a mutually changed lifestyle after surgery.

3 EAT BETTER TOGETHER

Changing the way you eat starts with meal planning, grocery shopping and a commitment to cooking meals at home.

“Food is central to our day-to-day life and family interactions, so it’s vital to involve

others in your life when making significant dietary changes,” Sherman said.

Picture this: A mother and daughter both had weight-loss surgery about six months apart. Planning meals and cooking together helped them adjust to their new diet plan. Try it: Attend a healthy cooking class with friends or family members.

4 TEAM UP FOR EXERCISE

Being active together and exercising regularly is key to success with weight loss. “Having someone else to hold you accountable might be exactly what you need to show up and challenge yourself more than you would when working out alone,” Sherman added.

Picture this: Two friends who played football in high school gained a lot of weight in their 20s and 30s. After one friend started a new exercise program, the other friend joined, too and both lost weight. Try it: Transform couch time into something more active. Meet at the gym to watch your favorite TV shows while walking on a treadmill, or throw a football around before watching the game on TV.

5 TRACK YOUR PROGRESS

Keeping track of total pounds and inches lost as a group can be highly motivating. “Also seeing health numbers improve and high blood pressure, cholesterol and blood sugar go down is our top priority,” Sherman said. “It’s really about achieving a better quality of life and a better state of health.”

Picture this: Co-workers start a weightloss challenge to lose 500 pounds total among the group. Try it: Talk to your doctor about your target numbers and attend support groups, nutrition or fitness classes, or start a friendly competition among friends.

APPLE OR PEAR SHAPE? What it means for your health

A HEALTHY 6 MAINTAIN LIFESTYLE

“Losing weight and keeping it off requires working through a different relationship with food,” Sherman said. “Having someone on your side can help you get back on track after slip-ups or setbacks.”

Picture this: Three sisters join forces to plan healthy food alternatives for a family gathering. Try it: Keep the lines of communication open with family and friends so they understand what you’re doing to change old habits and why it matters to you.

You might be focused on trimming your tummy or slimming your thighs to feel good and fit in your favorite clothes. But it’s not all about looks.

Where you carry extra fat can make a big difference for your health, too.

With an apple shape, excess fat is stored around your abdomen. This type of fat (called visceral fat) lies beneath your muscles and surrounds your abdominal organs. It has been shown to increase the risk of cardiovascular disease, diabetes and other metabolic diseases. Having a pear shape and carrying more weight around the hips doesn’t increase those health risks.

What can you do about it? Genetics, hormones and age all play a part in how your body stores fat. These factors are beyond your control, but you can combat belly fat with diet and exercise. Try adding more moderate-intensity exercise to your day, watching portion sizes, limiting sugar, refined carbohydrates and avoiding trans and saturated fats.

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TAKE THE CONFUSION OUT OF CHOLESTEROL

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holesterol can be confusing, especially when you’re trying to make sense of your cholesterol test results.

Dr. Ahmed Soliman, a cardiologist with Dr. Ahmed Houston Methodist Soliman Hospital, explains what you need to know about cholesterol and why it matters for your health.

Q: What is cholesterol?

A: Cholesterol is a soft, waxy, fat-like substance that can clog arteries and increase risk for heart disease and heart attack. Cholesterol is produced by the liver and is essential for the body, but it becomes harmful when levels are too high.

Q: When should I get a cholesterol test?

A: Everyone should have a cholesterol test at least once after age 21. Based on your age and risk factors, your doctor will determine how frequently you should be tested.

Q: Do I need to fast before a cholesterol test?

A: Fasting used to be the norm, but that’s not always the case today. Check with your doctor and follow instructions about fasting before your test.

Q: What do my cholesterol numbers mean?

A: Your results from a cholesterol test typically include numbers for total blood cholesterol, LDL cholesterol, HDL cholesterol and triglycerides. Even if you’re in the normal range for total blood cholesterol, it’s possible to have high LDL, which puts you at risk for heart disease.

Review these numbers with your doctor so you understand what they mean for your health.

Q: What can I do to lower my cholesterol?

A: Eat a healthy diet that’s low in saturated fat and high in fiber. Gradually reduce red meat consumption to less than one serving per week. Swap in vegetarian or Mediterranean-inspired meals, including fish, nuts, fruits and vegetables. Aim for 150 minutes of moderate-intensity exercise per week and quit smoking. In some cases, medication is needed to help lower cholesterol levels.

GET SMART ABOUT CHOLESTEROL L DL cholesterol is known as the “bad” cholesterol because it is deposited in artery walls and causes plaque buildup. Normal level: Less than 100 mg/dL. H DL cholesterol is called “good” because it helps to remove some cholesterol from your system. Normal level: More than 40 mg/dL. T riglycerides are a type of fat that binds with protein in the bloodstream to form LDL cholesterol. Normal level: Less than 150 mg/dL. T otal blood cholesterol is the overall level of cholesterol, including LDL, HDL and triglycerides.

Normal level: Less than 200 mg/dL.

Do You Need a Heart Screening?

If you have high cholesterol or other risk factors, we can perform a heart and vascular screening to analyze your risk for heart disease. Visit houstonmethodist.org/heart-scans for more information and to schedule online.

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GOING TOE-TO-TOE WITH FOOT AND ANKLE PAIN

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as chronic foot and ankle pain sidelined you?

According to the American Orthopaedic Foot & Ankle Society, half of adults said foot pain has restricted their Dr. Jason activities. More than Ahuero one-third said they would exercise more if it weren’t for their foot pain. If this sounds familiar, it’s time to address your pain so you can return to the activities you enjoy.

Dr. Jason Ahuero, orthopedic foot and ankle surgeon at Houston Methodist Hospital, says it’s never too late to seek care for an old injury or chronic pain. “We provide a number of advanced treatments that can get you back on your feet,” he said. Common foot and ankle problems can be treated with a range of surgical and nonsurgical solutions.

Tight calf muscles can also lead to plantar fasciitis. “It’s one of the most common causes of heel pain and usually presents as pain in the bottom of the heel that is worse with first steps in the morning or after prolonged sitting” Ahuero said.

Treatment: Rest and stretching exercises usually alleviate plantar fasciitis, though it frequently takes at least six to nine months for resolution. In some cases, anti-inflammatory medications, corticosteroid injections and orthotic devices may be effective. If your condition does not resolve with time and conservative treatment, surgery may be recommended to either release the tight plantar fascia or lengthen a tight calf muscle, which may be the underlying cause. “Platelet-rich plasma treatment, often used by the doctors at Houston Methodist, may also be considered as a less invasive option to promote healing of the plantar fascia,” Ahuero added.

STRESS FRACTURES

TENDINITIS OF THE FOOT AND ANKLE

This hairline crack in a bone is usually the result of overuse. It's most often caused by a sudden increase in activity, such as exercising more days a week or running longer distances than usual. “Osteoporosis or biomechanical issues like having high arched feet may predispose one to developing a stress fracture,” Ahuero said.

Treatment: Treatment may include rest, protective bracing or casting, depending on the location and extent of the fracture.

More serious stress fractures may require surgery. “We use the latest techniques to promote healing of the most difficult stress fractures,” Ahuero added.

PLANTAR FASCIITIS

Plantar fasciitis occurs when the tissue connecting the heel bone to the base of the toes becomes inflamed due to tiny tears.

Achilles tendinitis is a common overuse injury; however, certain inflammatory conditions may also predispose someone to develop it. “Having tight calf muscles or problems related to foot structure can also increase your risk,” Ahuero said.

Treatment: Immobilizing the affected ankle, as well as using orthotics, can help take stress off the tendon. Physical therapy can help improve flexibility and eccentric strengthening exercises can improve the structural integrity of the tendon. If those measures don't work, surgery may be needed to reconstruct the tendon.

CHRONIC ANKLE INSTABILITY

Sprained ankles are common, and increase risk for developing chronic lateral ankle instability, which leads to recurrent

sprains. This is especially true if the ankle is not properly protected or reinjured during recovery.

Treatment: Initially, nonsurgical techniques, such as physical therapy and bracing, are used to treat chronic ankle instability. If symptoms persist for months, reconstruction of the lateral ankle ligaments may be recommended. Newer techniques allow for earlier movement and return to activity after this surgery.

Take the Next Step To schedule an appointment to discuss your options with a foot and ankle specialist at Houston Methodist Orthopedics & Sports Medicine, call 713.441.9000 or visit houstonmethodist.org/ orthopedics to find a specialist near you.

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TIME TO SEE A NEUROLOGIST?

WHAT YOU SHOULD KNOW

N Dr. William Ondo

eurologists treat diseases of the brain and spinal cord, peripheral nerves and muscles. Neurological conditions include epilepsy, stroke, Parkinson’s disease, Alzheimer’s disease and dementia and multiple sclerosis (MS) and various others. You may also benefit from seeing a neurologist for the following issues:

HEADACHES

When a headache occurs several times a month and includes light sensitivity, vomiting or vision changes, it could be a sign of something more serious.

CHRONIC PAIN

Chronic pain can result in an illness or injury, but when it lasts longer than the normal recovery time, it can be a sign of a problem.

MOVEMENT PROBLEMS

Difficulty walking, shuffling your feet, tremors and unintentional jerks and an urge to move, can be signs of a nervous system problem. “Movement disorders are often misdiagnosed at first because the symptoms can mimic a range of other conditions,” said Dr. William Ondo, a neurologist and director of the Movement Disorders Clinic at the Houston Methodist Neurological Institute.

DIZZINESS

Occasional light-headedness is normal. If you feel like things around you are spinning or you have difficulty keeping your balance, it’s time to see a neurologist.

NUMBNESS OR TINGLING

It's not uncommon to experience numbness or tingling from sitting too long in a position that cuts off your blood circulation.

If numbness continues, only occurs on one side of the body or comes on suddenly, it could be a sign of a stroke or other serious condition.

Moving Forward

ADVANCED TREATMENTS FOR MOVEMENT DISORDERS Managing symptoms of Parkinson’s disease, essential tremor or other movement disorders can feel like an uphill battle. But there’s hope for new and expanded treatment options.

Dr. Brian Dalm, a neurosurgeon Dr. Brian Dalm who specializes in movement disorders at Houston Methodist Hospital, encourages patients and their families to search for solutions. “Every patient is unique, and we can achieve the best results with a personalized approach,” Dalm said.

Deep-brain stimulation therapy is considered an effective treatment for some movement disorders.

“New FDA-approved devices for deep-brain stimulation with smaller components allow for increased precision,” Dalm said. “In addition, intraoperative imaging technology provides real-time images for highly targeted therapies.”

The latest medication therapy involves using a gastric tube (similar to an insulin pump) to administer levodopa, a common medication for Parkinson’s disease. “Clinical trials are in progress to determine the effectiveness of wearable devices as well as stem cell research for treatment of Parkinson’s disease and other movement disorders,” Dalm added.

MEMORY PROBLEMS OR CONFUSION

Signs of Alzheimer's or dementia include significant problems with memory, personality changes or mixing up words.

Learn More Visit houstonmethodist.org/ni for more information on our neurological services.

10 LEADING MEDICINE FROM HOUSTON METHODIST

5 FLU FACTS PROTECT YOUR HEALTH

A

re you worried about getting the flu? Flu typically peaks between December and February so don’t delay. Learn the facts about flu and how you can avoid getting sick.

1

FACT

Flu affects millions of people every year. Most people recover from the illness in less than two weeks, but it can lead to more serious conditions, such as pneumonia.

Flu-related illnesses result in hundreds of thousands of hospitalizations and tens of thousands of deaths every year.*

2

FACT

Everyone ages 6 months and older should get a flu shot every year.** Vaccinations are especially important for people at high risk for flu-related complications, including: Those with chronic conditions, such as asthma, diabetes, heart disease, kidney disease and liver disease Children younger than age 5, especially those younger than age 2 Adults at least age 65 Nursing home and other long-term care residents Pregnant women and women up to two weeks after delivery.

3

FACT

A flu vaccine can’t cause the flu. The vaccine is made from inactivated, noninfectious viruses or no viruses at all.

4

FACT

A vaccination isn’t a guarantee against the flu. Besides getting a flu shot, you also should avoid contact with people with the flu, wash your hands often and maintain a healthy lifestyle to support your immune system.

Get a Flu Shot

Eat right, exercise, get enough sleep and manage your stress.

5

FACT

The Centers for Disease Control and Prevention (CDC) recommends flu vaccination begin soon after the vaccine becomes available, if possible, by the end of October. Immunity lasts through a flu season for most people. However, it’s not too late to be vaccinated, even in January or later, since flu viruses are still circulating. * Centers for Disease Control and Prevention. ** People with severe allergies to chicken eggs, as well as certain other individuals, should talk to their doctors before getting vaccinated.

Take steps to protect yourself and your family from the flu. Get vaccinated. Houston Methodist Primary Care Group makes getting a flu shot quick and easy. Call 713.394.6724 or visit houstonmethodist.org/ pcg to schedule an appointment.

FLU SYMPTOMS CAN TAKE YOU

BY SURPRISE Flu is different from a cold.

It usually comes on suddenly.

People with flu often experience: Body aches Chills Cough Fatigue Fever Headache Runny or stuff nose Sore throat U pset stomach, vomiting or diarrhea

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