Leading Medicine Fall 2018, Houston Methodist Baytown Hospital edition

LEADING MEDICINE FA LL 2018

Your Journey for

CANCER

CARE Understanding Breast Cancer Be Heart Smart: Take the First Step

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

HEALTHY EATS

Honeydew Salad Wedges Ease into autumn with the freshness of a chilled fruit salad.

INGREDIENTS 1 honeydew melon 1 package gelatin, lemon flavored (3-ounce) ½ cup water (boiling) ½ cup water (iced) Ice cubes 1 cup whole strawberries (hulled)

NUTRITIONAL INFORMATION PER SERVING Number of servings: 8 93 calories; 0 g total fat; 0 g saturated fat; 0 mg cholesterol; 74 mg sodium; 22 g carbohydrates; 1 g dietary fiber; 20 g total sugars; 9 g added sugars; 2 g protein; 13 mg calcium; 0 mg iron; 313 mg potassium.

DIRECTIONS 1. Cut melon in half; scoop out seeds. Pat the inside of the melon dry using paper towels.

2. Dissolve gelatin in boiling water.

3. Combine ice water and ice cubes to make one cup. Add to gelatin and stir until slightly thickened. Remove any unmelted ice.

4. Place each melon half in a small bowl to hold straight and firm.

Place half of strawberries in each melon half. Pour gelatin mixture over berries.

5. Cover with plastic wrap and chill until firm, about 3 hours.

To serve, cut into wedges.

Recipe courtesy of the U.S. Department of Agriculture, whatscooking.fns.usda.gov

IN THIS ISSUE - FALL 2018

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U nderstanding Breast Cancer Women are bombarded with information about breast cancer — and much of it is wrong.

E veryday Arthritis Relief Arthritis pain and stiffness usually stem from joint inflammation, muscle strain and fatigue. Simple strategies can help you keep discomfort in check.

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N ew Blood Pressure Guidelines Leading heart experts have redefined high blood pressure (HBP) for the first time in 14 years.

Choosing a Hospital for Cancer Care Knowing where to turn for support after a cancer diagnosis can help you move forward with confidence.

2 LEADING MEDICINE IN EAST HOUSTON/BAYTOWN

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5 Essential Steps for a Healthy Pregnancy The way to a healthy baby begins with a healthy mom, and the journey starts long before a positive pregnancy test.

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W ake Up to the Power of Sleep Not getting enough sleep can be bad for your health.

Ready to Quit Smoking? We Can Help If you smoke, chances are you’ve lost count of the number of times someone has told you that smoking is bad for your health.

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Be Heart Smart: Take the First Step You can help prevent life-threatening heart disease and other related conditions from developing and progressing by taking these steps.

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UNDERSTANDING BREAST CANCER You have questions, we have answers

W

omen are bombarded with information about breast cancer — and much of it is wrong. Here, Dr. Esther Dubrovsky, a breast surgeon at the Houston Methodist Cancer Center at San Jacinto, answers some common questions women have about the disease.

Dr. Esther Dubrovsky

Q: Does finding a lump in your breast mean you have breast cancer?

A: If you find a lump or notice any other changes in your breasts, see your health care provider. The majority of lumps in women under the age of 30 are benign, or not cancerous, but they should still be checked. Don’t avoid seeing your doctor because you’re afraid of what he or she may find. If you are over the age of 40, and notice a new lump, then it is more concerning.

In that case, you should call your doctor for the next available appointment to determine if you need a diagnostic mammogram and ultrasound. Take charge of your health by knowing how your breasts normally look and feel, as well as having regular mammograms and other screening tests recommended by your health care provider.

Q: Do men get breast cancer?

A: Actually, this year, approximately 2,550 men will be diagnosed with breast cancer.* Men, just like women, should know their bodies and mention any breast changes, such as a lump or swelling, nipple discharge, skin dimpling or puckering, redness or scaling of the nipple or breast skin, to their doctors.

Q: Does pregnancy increase the risk of breast cancer recurrence?

A: There’s been a concern that if you were treated for breast cancer in the past, high hormone levels during pregnancy might increase the chance of the cancer coming back. But pregnancy doesn’t increase this risk — as long as the cancer didn’t spread beyond the breast and your treatment was successful. Doctors often counsel women to wait at least two years after breast cancer treatment before becoming pregnant, as most recurrences happen during that time.

Q: If you have a family history of breast cancer, does it mean you’re destined to be diagnosed, too?

A: Women who have a family history of breast cancer are at higher risk, but not everyone will develop the disease. If any of the women in your family have had breast cancer, it’s

important to get a risk assessment by your physician so they can develop an appropriate screening plan. Also, your physician might recommend genetic testing, which consists of a simple saliva or blood test. And even if you have a greater risk, your doctor may recommend preventive medications or surgery to lower your likelihood of developing the disease.

Q: Does using antiperspirants and deodorants cause breast cancer?

A: According to the American Cancer Society, there’s no proof that using antiperspirants or deodorants causes breast cancer.

Some people claim these products contain harmful ingredients that could be absorbed through small nicks in the skin caused by shaving, but there’s no evidence to support this. * Source: American Cancer Society.

What’s Your Breast Cancer Risk?

To schedule a mammogram at the Houston Methodist Breast Care Center at San Jacinto, visit houstonmethodist.org/ breast-care or call 844.454.PINK (7465).

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

Everyday Arthritis Relief 10 tips to ease your pain

A

rthritis pain and stiffness usually stemming from joint inflammation, muscle strain and fatigue doesn't need to keep you from activities you love.These simple strategies can help you keep discomfort in check: 1. Move it. Contrary to how your body may feel, exercise actually helps arthritis pain, Dr. Karthik increases range of motion and strengthens Jonna muscles around joints. “Try to be active every day. Low-impact exercises like walking, cycling, water aerobics or tai chi are great options,” said Dr. Karthik Jonna, an orthopedic surgeon at Houston Methodist San Jacinto Hospital.

2. Lose it. Eating right and shedding excess pounds takes undue stress off your joints. A low-fat diet, such as the DASH diet, which is based on National Heart, Lung, and Blood Institute-sponsored research, may decrease your body’s inflammatory response — reducing joint inflammation.

3. Go cold, go warm. Applying cold packs or warm compresses can relieve pain and stiffness. Cold packs work best within the first 24 hours of an injury or flare-up. Heat works well after that time. A warm shower can also provide some relief.

4. Rub it in. Massage eases pain and stiffness by helping your body produce painkilling endorphins. Look for a trustworthy massage therapist who has experience with arthritis sufferers.

5. Kick your pumps to the curb. Instead, opt for wellcushioned, well-fitting supportive shoes that give your feet and toes plenty of room.

6. Brace yourself. Braces for elbows, wrists, knees and other joints can take a load off your aching joints. “Check with your health care provider to see whether a brace might benefit you,” Jonna said.

7. Assess your space. Change your home to make it more user-friendly. Add a shower chair, install rails near the toilet, use a long-handled shoe horn and special grips to open jars and peel vegetables. An occupational therapist can make suggestions and help you find the items you need.

8. Stop smoking. Smokers face greater bone fracture risks because smoking can reduce bone mass. It can also lengthen your recovery time if you have joint surgery. Look into quitsmoking aids to kick the habit.

9. Boost your mood. Counteract stress and the negative mental effects of arthritis pain with relaxation techniques, such as meditation, yoga or deep breathing. Cognitive behavioral therapy may help you overcome feelings of helplessness.

10. Follow doctor’s orders. “Take arthritis medicine as directed. If the drug causes unwanted side effects, don’t stop taking it before talking with your provider,” Jonna explained.

“The same goes for prescriptions you may feel aren’t working.

Your provider can change your medicine or make other suggestions.”

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HAND ARTHRITIS Dr. Jennifer Wagner, an orthopedic surgeon specializing in surgeries of the hands and upper extremities with Orthopedics & Sports Medicine at San Jacinto, says osteoarthritis — defined as wear and tear arthritis — frequently affects the hands because we rely so heavily on them to perform a variety of tasks.

“These joints are used so frequently they Dr. Jennifer may become prone to injuries and strains, Wagner which can make them predisposed to arthritis,” Wagner explained.

Conservative treatment plans that include prescribing oral or topical anti-inflammatory medications or the use of braces and splints to immobilize the joint may be beneficial. If those methods don’t significantly relieve symptoms, steroid injections into the joint may be ordered. In more severe cases, surgical procedures that remove the arthritic bone or fuse the joints together to prevent movement may be performed.

Wagner said preventive measures are few, but include taking over-the-counter supplements, including glucosamine and chondroitin, which have been shown to slow the progression of arthritis and help keep joints mobile.

Hand arthritis is generally diagnosed through an X-ray of the hand, which may detect a loss of cartilage or bone spurs.

A physical exam may also detect the presence of bone spurs, while applying pressure and manipulating the hand may reveal pain that indicates bone-on-bone degeneration.

IS JOINT REPLACEMENT SURGERY THE ANSWER? For those suffering with daily, debilitating pain caused by arthritis, joint replacement surgery, primarily of the knees or hips, may bring relief and improve quality of life. Advances in technology have made these procedures very common and have reduced recovery times as well. Artificial joint durability is also vastly improved, so most patients who receive one will never need another.

Get Relief!

Visit houstonmethodist.org/sanjacinto or call 281.427.7400 to schedule an appointment with an orthopedic specialist at Houston Methodist San Jacinto Hospital today.

New Blood Pressure Guidelines What do they mean for you?

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eading heart experts have redefined high blood pressure (HBP) for the first time in 14 years. The new blood pressure guidelines from the Dr. Irfan American College of Dadabhoy Cardiology (ACC) and the American Heart Association (AHA) were released in late 2017, giving a lower definition of HBP. According to the ACC, this new definition may result in nearly half of U.S. adults being diagnosed with the condition.

Do you have HBP? Blood pressure is a measurement of the force of your blood pushing against your vessel walls. HBP, or hypertension, is diagnosed when that pressure is consistently too high.

“High blood pressure is sometimes called a ‘silent killer’ because it doesn’t cause symptoms and won’t be caught without regular blood pressure readings,” said Dr. Irfan Dadabhoy, a primary care physician at Houston Methodist San Jacinto Hospital. “Having HBP makes you four times more likely to die from a stroke and three times more likely to die from heart disease.* The only way to know whether you have HBP is to have it checked. Most likely, your blood pressure is measured and recorded every time you go to your health care provider’s office.”

KNOW YOUR NUMBERS

BLOOD PRESSURE CATEGORIES

MANAGING HIGH BLOOD PRESSURE

Your systolic pressure, or the top number of your reading, is the pressure in the arteries as the heart beats. Your diastolic pressure, or the bottom number, is a measurement of the pressure in the arteries as the heart muscle rests.

“Typically, the top number receives more attention, but elevated diastolic pressure alone also increases cardiovascular disease risk,” Dadabhoy said. Under the new guidelines there are now five categories of blood pressure. The prehypertension category has been removed from the guidelines. (See “Know Your Numbers.”)

Blood Pressure Category

Systolic mmHg (upper number)

Diastolic mmHg (lower number)

NORMAL

LESS THAN 120

and

LESS THAN 80

ELEVATED

120-129

and

LESS THAN 80

HIGH BLOOD PRESSURE (HYPERTENSION) STAGE 1

130-139

or

80-89

HIGH BLOOD PRESSURE (HYPERTENSION) STAGE 2

140 OR HIGHER

or

90 OR HIGHER

HYPERTENSIVE CRISIS (consult your doctor immediately)

HIGHER THAN 180 and/or HIGHER THAN 120

Source: American Heart Association.

Recent research by Dr. Robert A. Phillips, Houston Methodist’s chief medical officer, and his colleagues investigated the impact of the new blood pressure guidelines. While patients at higher risk for cardiovascular disease benefited from the stricter guidelines, those with lower risk had more harm than benefit from the intensive treatment recommendations. Talk with your doctor about guidelines for your personal health situation.

Get a Checkup

When it comes to blood pressure, there’s success in numbers.

Call 832.556.6936 or visit houstonmethodit.org/pcg to make an appointment for a physical with a primary care doctor at Houston Methodist San Jacinto Hospital.

It's important to talk with your doctor about the new HBP guidelines and how they may impact treatment for your personal health situation. The goal is that by defining HBP at a lower threshold people will start working with their health care providers sooner to find ways to successfully manage the condition through lifestyle changes.

“There’s no cure for high blood pressure, but you can successfully manage it with medication and living a healthy lifestyle,” Dadabhoy said.

The following changes can help you better manage HBP. Monitoring your blood pressure regularly Taking your medications as prescribed Eating a well-balanced, low-salt diet (DASH diet) Exercising regularly Maintaining a healthy weight that you and your doctor have agreed on Quitting smoking Increasing potassium intake, if recommended by your doctor Managing stress Limiting alcohol * Source: Centers for Disease Control and Prevention.

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Support for Your Journey

from Diagnosis to Survivorship Choosing a hospital for cancer care

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START YOUR SEARCH

Choosing where to go for cancer treatment is a big decision, and you want to feel secure about your choice. Most of all, you’re focused on finding the best path to treatment — as quickly as possible.

If you live in the Houston area, you have choices about where to go for cancer care, with convenient access to top-ranked physicians and cancer specialists, advanced treatments and research, and comprehensive services and support. Within Houston Methodist Cancer Center, our specialists are renowned for their research and treatment of cancer, and we are dedicated to providing each patient with the most advanced and collaborative care, all in a compassionate environment. In 2017, more than 2,000 patients from all over the United States and 37 countries traveled from outside of the Greater Houston area to Houston Methodist for their cancer treatment.

“Patients come from all over the world because we have leading cancer experts integrating the latest research and treatments on the forefront of the battle against cancer. Our commitment to providing high-quality and compassionate care

6 LEADING MEDICINE IN EAST HOUSTON/BAYTOWN

comes through in everything we do,” said Dr. Cesar De Las Casas, medical oncologist/hematologist at the Houston Methodist Cancer Center at San Jacinto.

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STEP

STEP

earing the news that you or a loved one has been diagnosed with cancer can turn life upside down. A thousand questions, worries and what-ifs may come to mind. Knowing where to turn for support after a cancer diagnosis can help you move forward with confidence. This may involve reaching out to your support network, including Dr. Cesar the following: De Las Casas M eet with your doctor to ask questions about your diagnosis and make sure you understand his or her recommendations for treatment.

C onsider getting a second opinion so you can feel wellinformed and confident with your treatment decisions.

T alk to family and friends about your diagnosis and how this may affect family life and work or school schedules.

F ind support to help you navigate next steps. Before you even begin treatment, a support group can help you learn how to share the news with your children or give you an idea of what to expect throughout treatment.

CONNECT WITH YOUR CARE TEAM

The doctor who diagnosed your cancer might refer you to a medical oncologist or surgeon who specializes in treating certain cancers. Before you visit a specialist, write out a list of questions. Bring a friend or loved one who can help you take notes on the doctor’s advice. If there’s something you don’t understand, make sure to ask. It’s important that you feel comfortable communicating with the doctors and nurses involved in your care.

There’s no question you want the best team on your side when fighting cancer. Top-ranked physicians and cancer specialists have a high level of expertise and input on your treatment plan.

Whether your cancer diagnosis is common or rare, or in an early or advanced stage, you can benefit from the leading-edge research, knowledge and experience of an academic medical center. “If you have multiple health complications or conditions, it is even more critical to have a team of specialists working together on a treatment plan for your unique needs,” De Las Casas said.

Oncologists, surgeons, pulmonologists, pathologists, radiologists, internal medicine doctors and other specialists at

Houston Methodist San Jacinto Hospital collaborate and consult on treatment plans for patients, and this team aspect is a powerful tool in the fight against cancer.

STEP

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COMPREHENSIVE SERVICES AND SUPPORT

LEARN ABOUT TREATMENT OPTIONS

With an experienced team on your side, you’re ready to review your treatment options. “We treat common and complex cases of cancer that touch every organ of the body — and every aspect of your life. Our specialists customize treatment plans to fight your cancer so we can achieve the best outcomes possible; that’s part of being a No. 1 hospital in Texas,” De Las Casas said. Treatment options may include: A dvanced treatments in I maging technology immunotherapy advancements B one marrow transplantation L atest radiation techniques C hemotherapy L eading surgical techniques C linical Trials T argeted therapies

A full spectrum of programs and support is available to help patients through their treatment path, including: A high-risk program is available for patients with a higher-than-average chance of developing breast, gastrointestinal, ovarian or uterine cancer.

G enetic counseling is offered for patients at higher risk for developing hereditary cancers.

O ncology nurse navigators guide patients through every step of the process from diagnosis to survivorship.

S ocial workers are here to support individuals and families with counseling and assisting with the transition to home.

P atient assistance for financial needs is available, including help with questions about health care coverage.

S upport groups provide a network of support for patients and their families coping with cancer.

“We are fighting the cancer with you, and we have a complete team of people to cover every aspect of life that can be affected by cancer,” De Las Casas said. “We’re here to make sure you get the most comprehensive care possible.”

Choosing a research-focused hospital system opens the door to new therapies that are not available outside a research setting.

For example, you may decide that you want to participate in clinical trials that involve medications as well as gene and cell therapy.

“We offer immunotherapy clinical trials to stimulate a stronger immune response to kill cancer cells in lung cancer, gastrointestinal cancers, breast cancer and brain tumors. We also have a triple-negative breast cancer clinic, sarcoma of the heart program and other programs designed for specific types of cancer,” De Las Casas explained.

“In addition to the research and clinical trials offered at our campus in the Texas Medical Center,® we have research programs at our community cancer center locations, and we are dedicated to bringing research and clinical trials closer to home. Our researchers are actively working on every aspect of the treatment of cancer and bringing that integration to the communities across Houston,” De Las Casas said.

Moving into the treatment phase of your journey takes courage, stamina and patience. The various components of a treatment plan may be spread out over weeks or months — and timing is key. That’s why it helps to choose a hospital system with convenient access to appointments for radiation therapy, infusion therapy and other treatments you may need.

“The specialists at all of our cancer center locations are connected with the same research, treatments and technology available throughout Houston Methodist, which means every patient benefits from seeing a doctor who is part of this larger system,” De Las Casas shared. You keep your physician throughout your journey and receive treatments at the location that’s most convenient for you.

“When you receive care locally, you benefit in many ways — being close to work, home, family and friends can minimize the interruption to your life. The goal is to be able to get back to yourself so you can focus on your life. Your cancer should not be the center of your life. That’s what we’re trying to accomplish,” De Las Casas said.

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STEP

STEP

4

START YOUR TREATMENT PLAN

BEYOND CANCER TREATMENT

Care for cancer patients doesn’t end when treatment does. At the end of treatment, you’ll have a survivorship care plan to help continue your ongoing care and help you follow your doctor’s recommendations. The Houston Methodist Cancer Survivorship Program addresses common quality-of-life issues related to cancer treatment so you can focus on surviving, thriving and living your best life.

Your Journey Begins Here To learn more about the full range of cancer care services provided by the Houston Methodist Cancer Center at San Jacinto, visit houstonmethodist.org/ sanjacinto or call 281.420.7394.

HOUSTONMETHODIST.ORG/SANJACINTO 7

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Essential Steps for a HEALTHY PREGNANCY

T

he way to a healthy baby begins with a healthy mom, and the journey starts long before a positive pregnancy test. Caring for yourself before you conceive can help you avoid complications like preeclampsia (the development of high blood pressure and protein in the urine after the 20th week of pregnancy), gestational diabetes and preterm delivery, and Dr. Paul reduce your chances for having a baby with Redman birth defects.

The early stage of pregnancy, the first two to eight weeks after conception, is a critical time for fetal development — when your baby’s facial features, brain, spinal column, heart and kidneys begin to form. “But because you may not realize you’re pregnant until three weeks or more after conception, your health status before pregnancy is key,” said Dr. Paul Redman, an obstetriciangynecologist at Houston Methodist San Jacinto Hospital.

If you’re thinking about having a baby, take these five steps to help ensure good health for both you and your future little one:

your fitness, get down to a healthy weight, reduce stress, and gain strength and balance. Continuing to exercise during your pregnancy can reduce your chances for developing preeclampsia and gestational diabetes. It can help ease constipation, varicose veins, backaches and fatigue.

5

Quit bad habits. Smoking, drinking alcohol or abusing drugs can cause miscarriage, premature birth, infant death, birth defects, and growth and learning problems. Ask your doctor about programs to help you quit.

If you’re thinking about having a baby, make the effort now to seek preconception care and improve your lifestyle to give your child his or her best start.

1

See your doctor for a preconception visit. This checkup includes a complete physical exam and blood tests to look for infections and your immunity to certain diseases like rubella and chickenpox. Your doctor will update your vaccinations and discuss any medical issues, your medications, family history, body weight, fitness level and lifestyle. Schedule a trip to your dentist now to have any needed X-rays or repair work done.

2

Improve your diet. Eat a well-balanced diet that includes a wide variety of fruits, vegetables, whole grains, low-fat dairy products and protein-rich foods like lean meats and fish. Starting your pregnancy at a healthy weight can reduce your risk for complications like preeclampsia, gestational diabetes or a difficult delivery. Cut back on caffeine by limiting or avoiding coffee, tea, sodas, chocolate and certain medications.

3

Take folic acid. Studies show that women who don’t get enough folic acid, a B vitamin, are more likely to have babies with neural tube defects, such as spina bifida or anencephaly. “Because the neural tube, which becomes your baby’s spinal cord and brain, forms within the first three weeks of pregnancy, it’s critical you get enough folic acid before you conceive. Take a daily supplement or a multivitamin with 400 micrograms of folic acid,” Redman said.

4

Get moving. When pregnant, women should get at least 30 minutes of exercise on most, if not all, days of the week.

Being active before you conceive will help you improve

8 LEADING MEDICINE IN EAST HOUSTON/BAYTOWN

Are You Ready for Pregnancy?

To schedule an appointment with a Houston Methodist San Jacinto Hospital obstetrician-gynecologist, visit houstonmethodist.org/sanjacinto or call 281.428.2273. To schedule a tour of the Houston Methodist Childbirth Center at San Jacinto, call 281.420.8625.

Wake Up to the POWER OF SLEEP

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ou head to bed early with the best of intentions for getting a good night's sleep. But endless tossing and turning make you feel even more tired by the Dr. Ruby time your alarm goes off.

Parveen That good night’s sleep evaded you after all — and you’re not alone.

Many people struggle with getting in a solid eight hours from time to time, but usually the problem is temporary. For others, chronic sleep disturbances are the norm and medical intervention is necessary.

Either way, not getting enough sleep can be bad for your health.

“If you wake up frequently at night, feel groggy and crabby in the morning or nod off during the day, you may not be getting enough quality sleep,” said Dr. Ruby Parveen, medical director of the Houston Methodist Sleep Lab at San Jacinto. “You might also need treatment for a sleep disorder, such as insomnia, narcolepsy, sleep apnea or restless legs syndrome.”

According to the Centers for Disease Control and Prevention (CDC), lack of sleep is associated with a number of chronic conditions, including diabetes, cardiovascular disease, obesity and depression.

What’s considered a “healthy” amount of sleep? See the CDC’s recommendations in the chart, “How Much Sleep Do I Need?”

STEPS TO BETTER SLEEP

For people who battle insomnia, interventions to create a good sleeping environment and a healthy sleep routine can improve the odds of getting a better night’s rest.

1

Be consistent. Make it a habit to go to sleep and arise at the same time every day, during the week and on weekends.

“If you don’t nod off after 15 minutes or so, get up and do something that relaxes

you — read a book, meditate — then return to bed once drowsiness sets in,” Parveen said.

Sleep Well

If you’re not waking up refreshed, contact a sleep specialist at the Houston Methodist Sleep Lab at San Jacinto to schedule a consultation.

Visit houstonmethodist.org/ sanjacinto or call 832.556.6483.

2

Create a cozy den. Keep your bedroom as dark and free of distracting noise as possible and at a comfortable temperature.

In general, having a room temperature around 68 degrees is best for sleep.

3

Unplug. Turn off TVs, laptops, cellphones and other electronic devices at least 30 minutes before bedtime. The artificial light generated by these screens interferes with the body’s sleepiness cues.

4

6

5

7

Limit napping. The more you sleep during the day, the less sleep you’ll likely get at night. Never take a nap after 3 p.m. and limit napping to less than one hour.

Get physical. Exercising regularly helps reduce stress (a key factor in sleep disturbance) by causing your brain to release stress-reducing endorphins.

Time your exercise to end at least six hours before your bedtime.

Avoid stimulants. Caffeine and nicotine stimulate the brain and interfere with sleep. Avoid caffeine after lunch and drink no more than about two cups of coffee daily. Remember, caffeine is also present in energy drinks, soft drinks, tea and pain relievers.

Manage stress. If you find yourself worrying at bedtime, try to designate a specific time during the day to write down your worries and get these feelings out of your system.

HOW MUCH SLEEP DO I NEED? The Centers for Disease Control and Prevention recommends the following hours of sleep based on age: Age Group

Hours of Sleep

Newborns

Birth to 3 months

14-17 hours (including naps)

Infants

4 months to 12 months

12-16 hours (including naps)

Toddlers

1 year to 2 years

11-14 hours (including naps)

Preschool

3 years to 5 years

10-13 hours (including naps)

School-age

6 years to 12 years

9-12 hours

Adolescents

13 years to18 years

8-10 hours

Adults

18 years to 60 years

7 or more hours

61 years to 64 years

7-9 hours

65 years and older

7-8 hours

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Ready to Quit Smoking?

WE CAN HELP I f you smoke, chances are you’ve lost count of the number of times someone has told you that smoking is bad for your health. And you may know firsthand that quitting smoking isn’t Dr. Shawn Tittle easy. If you are interested, Houston Methodist San Jacinto Hospital has the tools to make your journey a little smoother.

GETTING STARTED

“Whether it’s your first, second or third time, the first step is deciding to quit.

Then take time to focus on why you want to quit. Even better, write it down and be specific,” said thoracic surgeon Dr. Shawn Tittle, medical director of the Houston Methodist Cancer Center at San Jacinto.

These are all good reasons to quit: Improving your health, being able to breathe better, reducing your long-term health risks (lung disease, heart disease, cancer, etc.)

Reducing exposure of secondhand smoke, nicotine and chemical residue on furniture and other indoor surfaces left by tobacco smoke to your family, friends and pets Saving money and using your savings for something valuable (a trip or a down payment on a car) Saying goodbye to smelly clothes, breath, car, home and life

COME TALK WITH US

“We can help you figure out which strategies you can use to quit for life,” Tittle said. “Be honest about the reasons why you smoke, what triggers you to light up and what challenges you anticipate during the process. You’ll learn about the different tools and therapies available and the pros and cons of each. Your health care provider may recommend one therapy over another or a combination of therapies

10 LEADING MEDICINE IN EAST HOUSTON/BAYTOWN

SHOULD YOU SCHEDULE A LUNG CANCER SCREENING? The goal of the comprehensive Lung Cancer Screening Program at San Jacinto is to help high-risk patients receive a diagnosis and treatment plan at an early stage. The program for current and former smokers includes annual low-dose CT scans, consultations with health care providers, access to tobacco cessation programs and referrals to physician specialists if the disease is found. To find out if you’re a candidate for a screening, visit houstonmethodist.org/sanjacinto or call 281.428.4510.

based on your personal health history.”

Some of these options may include: 1. Nicotine patches. The patches adhere to your skin to deliver regular doses of nicotine into your system.

2. Nicotine gum and lozenges. These offer a short-term nicotine “fix” and can be taken when the craving strikes.

3. Nicotine inhalers. You puff on the inhaler and a nicotine vapor is released into your mouth and throat for another short-term craving buster.

4. Prescription medications. Certain drugs help reduce nicotine cravings in some patients but may come with side effects.

5. Cold turkey. This strategy works well for those who prefer to tough it out, head on.

DON’T GO IT ALONE

The Beat the Pack® smoking cessation program at Houston Methodist San Jacinto can help you stop smoking and reduce your risk of developing conditions, such as lung cancer and heart disease. The program offers: Counseling sessions and guidance based on exercise, nutrition and stress management strategies A fitness assessment and consultation Massage A session with a registered dietitian Progress monitoring with a specialist, who helps you set a quit date and develop a cessation plan

Say Goodbye to Tobacco Start your plan for quitting smoking today. Visit houstonmethodist.org/ sanjacinto or call 281.420.8557.

BE HEART SMART: Take the First Step M any people aren’t even aware they are at risk of cardiovascular disease until they suffer a major health event, such as a heart attack, aneurysm rupture or stroke. Because cardiovascular disease can be accompanied by vague symptoms or none at all, learning your risk can save your life.

Dr. Gholamreza Khoshnevis, a cardiologist Dr. Gholamreza at Houston Methodist San Jacinto Hospital, Khoshnevis says the good news is you can help prevent life-threatening heart disease and other related conditions from developing and progressing by taking steps, such as: Leading a healthier lifestyle by being active and following a heart-friendly diet Getting regular blood pressure and cholesterol checks Scheduling a heart scan and vascular screening Heart disease is the No. 1 killer of men and women in the U.S., according to the American Heart Association. “Being aware of your risk factors is key in preventing the onset of heart disease and other cardiovascular conditions,” Khoshnevis said.

SCREENINGS CAN HELP DETERMINE RISK

Houston Methodist San Jacinto Hospital offers heart and vascular screening services to help you understand your risk, which is one of the first steps toward prevention. The screenings use imaging technology, including CT scan and ultrasound, to test for signs like calcium buildup of plaque on the artery walls and thickness of the arteries, as well as checking for blockages and other potential signs of cardiovascular disease.

But should you schedule a heart scan? Khoshnevis answered some common questions about these minimally invasive procedures.

Q: Should everyone have a screening test?

A: No. Screenings are beneficial for men between 40 and 65 and women between 45 and 70, or if you’re at intermediate risk. Risk factors include family history, smoking, high cholesterol, high blood pressure and diabetes. This is a screening exam to assist in detecting potential diseases.

Q: If I have a known heart condition, can I still get these tests?

A: The Heart Scan and Heart Scan Plus are not necessary for those who have coronary artery disease, heart stents of any kind or have had coronary bypass surgery. For these patients, we recommend an evaluation by a cardiologist.

Q: How long will the test take?

A: The Heart Scan takes approximately 15 minutes. The Vascular Screening and the Vascular Age Screening (CIMT) each take approximately 30 minutes. The Heart Scan Plus takes about one hour.

Q: W hy should I have my screenings at Houston Methodist San Jacinto Hospital?

A: Your results will be processed in an accredited lab and evaluated by either a cardiologist, a vascular surgeon or a radiologist who specializes in heart and vascular conditions.

Your results will be sent to your doctor and/or you within seven business days. We suggest you also share the results with your primary care doctor or cardiologist.

Heart Health Screenings

To learn more about your risk of cardiovascular disease, or to schedule a screening at Houston Methodist San Jacinto Hospital, visit houstonmethodist.org/sanjacinto or call 713.790.3333.

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