Leading Medicine, Winter 2020, Houston Methodist Hospital edition

LEADING MEDICINE W INT ER 2020

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Factors That Could Sabotage

YOUR WEIGHT LOSS

Creating a Birth Plan Checkups Every Man Should Get YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS FROM HOUSTON METHODIST

NEWS & EVENTS JOIN US AT THESE UPCOMING EVENTS

Get your health questions answered. Houston Methodist Hospital physician experts will be featured at the following education events.

HEART SCREENING EVENT

Take the first step in protecting yourself against heart disease.

Join the experts at Houston Methodist DeBakey Heart & Vascular Center to: Learn your 10-year risk for heart disease with a free heart screening, including cholesterol and blood pressure readings.

Talk with an expert about your results.

COMPREHENSIVE LUNG SEMINAR

Lung disorders, such as chronic obstructive pulmonary disease (COPD), asthma and pulmonary hypertension affect quality of life for many people. We have the expertise to help. Please join our panel of pulmonary experts for a Q&A discussion focusing on top health concerns affecting people today.

Empower a Healthier You A WOMEN’S HEALTH AND WELLNESS EVENT

Talk with an all-female panel of doctors during a Q&A discussion focused on the most common health matters impacting women today, including gynecologic health, breast care and heart disease.

Visit events.houstonmethodist.org to register for these events or call 713.790.3333.

Tips for Staying Healthy and Fit in Winter

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ometimes it is hard to stay on track and work out during the winter months. By planning ahead and following these tips, you can continue toward your fitness goals.

Keep weight loss goals in mind and write them down. Establish specific weight loss goals with your doctor if you are suffering from health issues, such as diabetes or high blood pressure, that are exacerbated Dr. Adriana by your weight. (Read more about weight loss on Gomez page 4.)

Sign up for indoor classes now.* Aside from the treadmills and stationary bikes that most gyms offer, consider taking an indoor cycling or aerobics class, if you need to get your cardio in. It’s also a good time to focus on toning your muscles with a Pilates or yoga routine. “Cross-training is an excellent way to vary your exercise routine and keep you motivated during the winter,” said Dr. Adriana Gomez, primary Dr. Mariana care physician with Houston Methodist Primary Hurtado Care Group.

Keep workout gear ready. If your gym bag is packed by the front door or in your car, you have one less excuse. Keep a spare pair of sneakers at the office, too. Better yet, find a walking buddy at work who will step outside with you during the day.

Get proper rest. “In addition to regular exercise and eating a healthy diet, getting enough rest is important for staying healthy,” said Dr. Mariana Hurtado, primary care physician with Houston Methodist

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Make Time for an Annual Checkup

Starting the new year off with an annual checkup is an important step to staying healthy. Visit houstonmethodist.org/pcg or call 832.522.7800 to learn more or schedule an appointment.

Primary Care Group. “Talk to your doctor about how much sleep is right for you, and if you are having any problems sleeping.”

We all know how hectic life gets and how fitness plans can be derailed.

By setting goals in advance, researching alternate workout options and scheduling time each week to exercise — you can still stay active. * Talk with your doctor before starting any physical fitness program.

CREATING A BIRTH PLAN

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arenting is full of the unexpected, beginning with the timing of your baby’s birth. While you might not be able to know exactly when, or how your baby will be born, Dr. Kathleen it doesn’t mean you can’t Mundy be prepared. Creating a birth plan helps you to prepare for your baby’s birth by outlining your preferences in advance, and communicating those choices to everyone on your care team.

“The birth plan acts as Dr. Jennifer a guide for anyone who Stanley provides care throughout labor and childbirth,” said Dr. Kathleen Mundy, an obstetrician-gynecologist at Houston Methodist Hospital. “It’s a good idea to create your birth plan around 28 weeks, or the beginning of your third trimester of pregnancy, and discuss it with your doctor or midwife so they will be aware of the choices you have made.”

“It’s important for expecting mothers to understand that a birth plan is not a substitute for medical decision-making,” added Dr. Jennifer Stanley, an obstetriciangynecologist at Houston Methodist Hospital. “We do our best to honor every woman’s preferences, but ultimately we must do what is the safest choice for mother and child.”

WHAT SHOULD YOU INCLUDE IN YOUR BIRTH PLAN?

Your birth plan will include your preferences for pain relief, atmosphere, who is present and details pertaining to delivery. “If a woman has very strong preferences, she should talk about them with her provider before creating the birth plan.” Stanley noted, “This may clear up concerns or fears she has, as many techniques and tools only come into play for very specific reasons.” Mundy agreed, and added, “A highly specific birth plan is less important than open

Expect Personalized Care At Houston Methodist Hospital, our staff listens to you and works hard to ensure you have the best experience possible on the day of delivery. To schedule a tour or sign up for a childbirth class, visit houstonmethodist.org/events or call 713.790.3333.

communication, before and throughout the labor experience.”

YOUR BIRTH PLAN CHECKLIST

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Atmosphere. Will the labor room be dimly lit? Can music be used to create a soothing atmosphere? Are there any spiritual rituals or cultural norms that should be observed?

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Delivery plan. Ask your provider about his or her approach to procedures like episiotomies and C-sections. Find out what choices you can make if these become necessary. Also, if you've previously had a C-section, ask if having a vaginal birth after cesarean (VBAC) is an option.

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Pain relief. Ask your provider what options are available at the hospital or delivery center. Allow for the possibility that you may change your mind during labor.

Who is allowed in the room? Will your birthing partner be the only person attending? Are there any family members or friends you specifically don’t want present? If a cesarean section (C-section) becomes necessary, who can be in the room?

Documenting the birth. Ask your health care team if your partner will be allowed to take photos or video during the delivery. Hospitals often have policies that dictate this.

Cutting the cord. Would you like to cut the umbilical cord yourself or have your partner do it?

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Cord blood banking. If you’re interested in having your baby’s cord blood banked for future medical use, it should be outlined in your birth plan.

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

HIDDEN FACTORS THAT MAY CONTRIBUTE TO

WEIGHT GAIN Y

ou’ve tried everything from dieting and calorie counting to exercise boot camp and weight loss apps — but the numbers on the scale just won’t budge.

Dr. Nabil Tariq Could there be something else sabotaging your efforts to lose or maintain weight?

Let’s uncover some factors that could be holding you back. Although you have the power to change a few of these factors, some are beyond your control. Either way, finding out why weight loss is challenging can be helpful, especially when coming up with a plan or deciding when to seek help for weight loss.

LACK OF SLEEP

Your health suffers when you’re sleep deprived, and lack of sleep can affect your chances of losing weight, too. Research has shown that sleep deprivation can lead to increased cravings for high-carb foods and junk food. When you’re overtired, you may be more likely to reach for high-calorie beverages or a sugar fix for quick energy.

You may also lack the energy and initiative to make healthy food choices.

“At the end of a long day you may not have enough energy to go for a walk or make a healthy meal, and the choices you make when you’re tired and hungry can derail your efforts to lose weight,” said Dr. Nabil Tariq, medical director of bariatric surgery at Houston Methodist Hospital. √ Take control: Aim for seven to eight hours of sleep at night so you can function at your best during the day.

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YO-YO DIETING

Yo-yo dieting (a cycle of losing weight and gaining it back) can take a toll on your health and make it harder to lose weight. You may lose weight rapidly on a fad diet, but you’re not just losing body fat. You lose lean muscle as well, which in turn decreases your metabolism. The problem with yo-yo dieting is that it’s not sustainable. “When you stop the diet and start eating normally again, the metabolism is lower than before, and the weight you regain is mostly fat,” Tariq explained. √ Take control: Modify your diet in a way that’s sustainable for the long term.

You want to find solutions for managing your weight that will work for the rest of your life, not just dropping pounds for a special event or a few months.

BALANCING GYM TIME WITH MEAL PLANNING TIME

Have you been toiling away at the gym without losing any weight? If this sounds all too familiar, it may make sense to spend more time and energy on meal planning. “Weight loss is about food intake more than anything else,” Tariq explained. Exercise is good for your overall health and longevity, but it’s only a small component of weight loss. The majority of weight loss comes from making dietary changes and consuming fewer calories than you can burn in a day. √ Take control: By spending 30 minutes preparing a healthy meal, you can avoid consuming an extra 700-800 calories compared to eating fast food or takeout.

When you combine a healthy diet with exercise, it’s a win-win!

AGING

Controlling your weight can be an uphill battle as you age.

Even if you’re exercising and eating right, the pounds can still creep up. “As you get older, your metabolism decreases and your body doesn’t burn as many calories,” Tariq said. In addition,

you may lose muscle mass with age, and the problem is compounded if you’re less active. It all adds up to a recipe for weight gain. √ Take control: Cut back on portion sizes of higher calorie foods and increase portion sizes of lower calorie foods like non-starchy vegetables, such as broccoli, cauliflower, green beans and okra, etc. Try to exercise for 30 minutes every day — going for a walk is a great way to start.

MEDICATIONS

Did you know that weight gain is a side effect of certain medications?

Some medications taken for depression, inflammation, thyroid disorder or other conditions can make it difficult to maintain or lose weight. These medications may cause you to feel hungrier, burn calories slower or retain extra fluids. It’s important to continue taking your medications as directed by your doctor, but don’t hesitate to ask about alternatives. √ Take control: Talk to your doctor if you have questions about how your medications may be affecting your weight.

GENETIC INFLUENCES

Genes can influence appetite, metabolism, body-fat distribution and more, but genetic influences don’t tell the whole story. Environmental factors including eating habits formed in childhood, family and social connections, ways you cope with stress and other psychological factors can have an even greater impact on your weight. √ Take control: Even if you’ve been overweight for most of your life and struggle to lose weight, you can fight back.

It starts with making the decision to get help for losing weight.

START WINNING THE BATTLE TO LOSE WEIGHT If you feel like the deck is stacked against you to lose weight, talk to a health care professional who can help with medical weight management or bariatric surgery. With the right help, you can change your life for the better.

The Houston Methodist Weight Management Center offers the following weight loss services and programs: tepLITE is a program for anyone S who wants to lose a few pounds and needs help getting started. The program includes a diet plan and weekly check-in and group sessions with licensed professionals. edical Weight Management M is a three-phase weight loss plan that begins with a medically supervised, very low-calorie diet program and progresses to a personalized meal plan to help you maintain weight loss. ariatric surgery, or weight loss B surgery, can help you achieve significant weight loss and improve weight-related health problems.

Visit houstonmethodist.org/weightmanagement or call 832.667.LOSE (5673) to learn more.

Weight Loss Seminars

To learn more about your weight loss options, register for an upcoming weight loss information session at houstonmethodist.org/weight-losssurgery or call 832.667.LOSE (5673).

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When to See an Ear, Nose and Throat Doctor

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ow do you know what signs and symptoms warrant a visit to an otolaryngologist, or ear, nose and throat (ENT) specialist?

Most people are familiar with some common reasons for visiting an ENT, such as frequent ear infections, nasal obstruction and tonsillitis, but ENTs Dr. Mas treat a wide variety of conditions from Takashima allergies to sleep apnea.

“I think there are a lot of misconceptions about what services an ENT specialist can provide,” said Dr. Mas Takashima, an otolaryngologist and Department of Otolaryngology – Head and Neck Surgery chair at Houston Methodist Hospital. “We offer the full range of services all in one location — from allergy testing to hearing aids to facial spa services and facial rejuvenation provided by fellowship-trained ENT facial plastic surgeons.”

The ENTs at Houston Methodist Hospital have specialized equipment and facilities to better diagnose and treat a wide variety of disorders, from 4K UHD monitors to visualize sinus disease and vocal cord pathology, stateof-the-art vestibular balance chair to identify the cause dizziness, to two different surgical robots to help treat oral cancers and obstructive sleep apnea. When symptoms persist after seeing a primary care doctor, our doctors can diagnose and treat all ENT conditions.

TIME TO VISIT AN ENT SPECIALIST?

It can sometimes be confusing to know when to see your primary care doctor and when to visit a specialist.

If you’re experiencing the following symptoms, an ENT doctor can help.

A llergies – Clear nasal drainage, headaches, hearing loss, itchy or watery eyes, and recurring sinusitis D izziness – Feeling faint, weak or unsteady, or feeling like your surroundings are spinning or moving (vertigo) F acial pain – A headache that won’t go away, pain or pressure around the eyes and forehead, or jaw pain H earing loss – Trouble hearing in one or both ears, sudden loss of hearing, or tinnitus (ringing in the ear) S inusitis – Difficulty breathing through your nose, swelling or tenderness around the eyes and forehead, recurrent colored drainage from the nose S leep apnea – Loud snoring, gasping for air during sleep, dry mouth, excessive daytime fatigue or irritability

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ADVANCED TREATMENT AT ONE CONVENIENT LOCATION The ENTs at Houston Methodist Hospital offer treatment and services for: Acoustic neuroma (noncancerous brain tumor) Allergies Balance disorders, including Meniere’s disease Facial rejuvenation Head and neck cancers, including skin reconstruction after Mohs Hearing disorders, including cochlear implants Obstructive sleep apnea Rhinoplasty Sinusitis Smell and taste disorders (chemosensory disorders) Vocal disorders

Get the Expert Care You Need Visit houstonmethodist.org/ent-doctors for more information, or to schedule an appointment with an ENT specialist, call 713.441.1368.

Checkups Every Man Should Get

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aking a proactive approach to managing your health can make a big difference for men — and may even save your life. Men have unique health concerns, Dr. Brian Miles and some of the biggest health threats can develop without any red flags to warn you that something is wrong.

A ROUTINE CHECKUP

An annual checkup is an important starting point for assessing your overall health as well as discussing your family health history and other risk factors with your doctor. It also provides an opportunity to raise questions about your health and tackle any problems head-on.

If you’re due for any immunizations or preventive screening tests, your doctor can discuss those with you.

Ask your doctor about preventive screening tests that may be right for you.

Recommended screenings may include: Blood pressure Cholesterol levels D iabetes (if overweight or symptomatic) C olon cancer starting at age 50 or earlier for those with certain risk factors Prostate cancer, age 50+ Abdominal aortic aneurysm, age 60+ L ung cancer for smokers and others at risk, age 50+

FROM ACUTE ISSUES TO UNDERLYING PROBLEMS

“Men often come in when they’re experiencing some kind of sexual dysfunction, concerns about low testosterone or a urinary problem,” said Dr. Brian Miles, urologist and director of the Houston Methodist Men's Health Center. “They may feel more comfortable discussing these types of personal issues at a center for men.” Partnered with Miles in the Men’s Health Center is urologist and fellowship-trained

andrologist Dr. Nathan Starke, who specializes in male-specific health issues.

At the Men's Health Center, we specialize in personalized, confidential and quality treatment for reproductive, urological and weight-related issues, including: Bladder and prostate cancer Enlarged prostate Erectile dysfunction K idney issues, including cancers, stones and function Low testosterone (low T) M etabolic syndrome (an array of ailments that include high blood pressure, obesity and diabetes) Urinary incontinence

“While specializing in these areas, we also encourage men to be more proactive about their overall well-being,” Miles said. “When someone comes in with one concern, it’s an opportunity for us to address other health issues he may be having and that may be involved in the one he is concerned about.”

AN ENTRY POINT FOR CARE

The Men’s Health Center acts as a portal of entry that provides any additional resources men may need for care. Our team can provide referrals and help make appointments as needed with cardiologists, plastic surgeons, physical therapists, endocrinologists and andrologists and other specialists.

RECOMMENDED SCREENINGS AND SHOTS

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50s 60+

Abdominal aortic aneurysm screening Blood pressure screening Cholesterol test Colon cancer screening Diabetes screening (if overweight)

Lung cancer screening (for smokers and others at risk) Prostate cancer screening (if you have family history or are African American)

These are general guidelines and are not intended as medical advice. Talk to your doctor about screening tests that may be right for you. Sources: National Institutes of Health, American Heart Association and American Diabetes Association.

Learn More

For more information about services available at the Houston Methodist Men’s Health Center, visit houstonmethodist.org/mens-health or to schedule an appointment, call 346.238.1210.

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WE’ VE MADE ACCESSING US EASIER THAN EVER We know a busy lifestyle can make it challenging to find time to get health care. In addition to scheduling an appointment online or by calling one of our agents, we offer a variety of ways to get care from us, including:

Same-Day Primary Care

Urgent Care

We offer same-day sick visits for conditions like the flu, sinus infections, pink eye and more.

We’ve partnered with Next Level Urgent Care for urgent care services after hours and on weekends.

Virtual Urgent Care

Imaging Appointments

See our providers for non-emergency, urgent care needs via video visit — 24/7, even on holidays.

Schedule an imaging appointment online, including a mammogram, at a time and location convenient for you.

Orthopedic Injury Clinics Same-day orthopedic care for fractures and broken bones, injured tendons, dislocations, sports injuries and more.

Emergency Care Our Emergency Care Centers and emergency rooms are open to all patients 24/7/365.

Visit houstonmethodist.org/care-options for all the ways you can get care with us.

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