Leading Medicine Spring-Summer 2017, Houston Methodist Baytown Hospital edition

LEADING MEDICINE SPRI N G/SUM M ER 2017

IS JOINT REPLACEMENT SURGERY RIGHT FOR YOU? Get Answers to Common Joint Health Questions

ARE YOU HEART SMART? ZIKA UPDATE What Pregnant Women Need to Know

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

HEALTHY EATS

Avocado Melon Breakfast Smoothie Go green with this refreshing concoction of green fruits and veggies!

INGREDIENTS 1 large, ripe avocado 1 cup honeydew melon chunks (about 1 slice) Juice from ½ lime (1½ teaspoons lime juice) 1 cup nonfat milk 1 cup nonfat plain yogurt ½ cup 100 percent apple juice or white grape juice 1 tablespoon honey DIRECTIONS 1. Cut avocado in half, remove pit.

2. Scoop out flesh, place in blender.

3. Add remaining ingredients; blend well.

NUTRITIONAL INFORMATION PER SERVING

4. Serve cold. (Keeps well in refrigerator up to 24 hours.

If made ahead, stir gently before pouring into glasses.)

Number of servings: 2 320 calories, 11 g total fat, 1.5 g saturated fat, 5 mg cholesterol, 170 mg sodium, 46 g carbohydrates, 5 g dietary fiber, 37 g total sugar, 4 g added sugars, 13 g protein, 80 percent vitamin C, 40 percent calcium, 4 percent iron.

Percent daily values are based on a 2,000 calorie diet.

Recipe courtesy of the U.S. Department of Agriculture, recipefinder.nal.usda.gov

IN THIS ISSUE - SPRING/SUMMER 2017

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S leep Woes? Rest Easy Sleep disorders are more common than people think.

A re You Heart Smart?

Take our quiz and answer these questions about heart disease.

Is Joint Replacement Surgery Right for You? Get answers to common joint health questions.

Asthma Triggers You Need to Know Learn more about common causes behind your asthma.

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Z ika Update: What Pregnant Women Need to Know If you are thinking of trying to conceive, learn more about Zika prevention tips first.

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When the Problem Is Your Prostate As men grow older, this small gland can start producing troubling symptoms.

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2 LEADING MEDICINE IN EAST HOUSTON/BAYTOWN

Keeping Colorectal Cancer at Bay Screening for colorectal cancer can detect it in its early stages and even help with prevention.

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Sleep Woes?

REST EASY A Sleep Study Can Help Find the Solution

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eeling tired during the day?

Like no amount of sleep is giving you the rest you need?

You may want to talk with your doctor about the possibility of a Dr. Ruby sleep disorder.

Parveen “Sleep disorders are more common than people think,” said Dr. Ruby Parveen, medical director of the Sleep Lab at Houston Methodist San Jacinto Hospital.

Sleep disorders are treatable, and sleep specialists at the American Academy of Sleep Medicine-accredited Sleep Lab have completed extensive training in the diagnosis and treatment of a variety of disorders.

Sleep disorders do not discriminate and can be found in children, adults, men, women, small and large body types. This also means that there is not a “one size fits all” style of treatment.

“The important thing is to seek help when you experience symptoms such as snoring, un-refreshing sleep or daytime sleepiness,” said Parveen, a board-certified sleep specialist. “Special testing, called a sleep study, can help get to the bottom of what’s causing the disturbances.”

INSIDE A SLEEP STUDY

A sleep study monitors your sleep activity and records vital measurements as you slumber, such as oxygen and carbon dioxide levels in the blood, brain wave activity, breathing, heart rhythm monitoring and leg movements via wires, sensors and other devices attached to your body. Sleep study (sometimes referred to as nocturnal polysomnography, or nPSG) may be done at home or in a sleep lab. In both cases, the information gathered will

be interpreted by a board-certified sleep specialist, who will share the results with your doctor. Daytime nap testing is also available to diagnose primary disorders of daytime somnolence such as narcolepsy.

“Some patients may feel more comfortable having the test in the comfort of their own home rather than trying to sleep in an unfamiliar place,” Parveen said.

“The added benefit of at-home testing is that it’s less expensive for insurance carriers. However, the at-home test doesn’t gather as much information as an in-lab study done in an accredited center under supervision of registered technologists, which remains the most reliable and robust means for diagnosing sleep disorders. Which study is more suitable for a particular patient would depend on a number of factors including the presence of other underlying medical conditions and is best determined by a sleep specialist.”

Parveen stressed not waiting to undergo testing. “The sooner we know the cause, the sooner we can treat it — and the sooner you can get the rest you need.”

We Can Help

If you’re having sleep issues, ask your doctor about whether a sleep study is right for you.

For a consultation with a sleep specialist at Houston Methodist San Jacinto Hospital, visit houstonmethodist.org/ neurology/sleep-disorders/, or call 832.556.6535. For more information about our in-home and sleep lab-based sleep studies, call 832.556.6483.

SLEEP AND YOUR HEALTH BY THE NUMBERS 50-70 MILLION U.S. adults have sleep or wakefulness disorders

32 MILLION

U.S. adults have restless leg syndrome

42 MILLION

U.S. adults suffer from snoring and sleep apnea

SOME SLEEP DISORDERS, SUCH AS SLEEP APNEA, ARE LINKED TO: high blood pressure heart disease type 2 diabetes memory problems

100,000

motor vehicle crashes a year caused by drowsy drivers. People with undiagnosed sleep apnea are 15 times more likely to be involved in a traffic accident.

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

Are You

HEART SMART? Answer These Questions About Heart Disease

H

eart disease — it’s a stealthy foe.

“Unfortunately, some people don’t know they have heart disease because symptoms may not always be apparent or they may be too vague to cause much concern,” said Dr. Nadia Fida Dr. Raghunandan Muppidi, an interventional cardiologist with Houston Methodist DeBakey Cardiology Associates at Houston Methodist San Jacinto Hospital.

“In some cases, people may only discover they have heart disease after they suffer a major event, such as a heart attack.”

The good news is that you can Dr. Raghunandan take steps to prevent heart disease Muppidi or keep it from progressing.

“Health lifestyle habits, such as eating a diet rich in fruits and vegetables and staying active can go a long way,” said Dr. Nadia Fida, an advanced heart failure, pulmonary hypertension and cardiac transplant cardiologist with Houston Methodist DeBakey Cardiology Associates and director of the Heart Failure Clinic at Houston Methodist San Jacinto. “If you’ve been diagnosed with heart disease or you’re at risk, sit down with your doctor and talk about what you should do next. Get educated on the disease.”

Looking for a little heart education yourself? Take this quiz to find out just how much you know.

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1. Heart failure refers to when

a. The heart stops beating b. The heart can no longer pump efficiently c. Irregular heartbeats occur d. None of the above

2. Angina is a symptom of heart disease that causes a. Loss of consciousness b. Irregular heart beats c. Chest pain or discomfort d. Slurred speech

3. Which of the following is not true about trans fats? a. They raise your LDL cholesterol. b. They lower your HDL cholesterol. c. Your body doesn’t need them to function. d. None of the above

4. Which of the following are potential complications of atrial fibrillation, a common type of heart arrhythmia? a. Stroke and heart failure b. High cholesterol and high blood pressure c. Seizures d. None of the above

5. True or false: Heart attack and cardiac arrest are the same thing.

6. At what age does the average woman’s heart disease risk increase? a. 55 b. 65 c. 75 d. 85

7. Which of the following minerals may help improve blood pressure? a. Potassium b. Calcium c. Magnesium d. All of the above

8. How many Americans die of heart disease each year? a. 100,000 b. 300,000 c. 500,000 d. 1 million

9. Statins are drugs that are used to a. Lower cholesterol b. Lower blood pressure c. Help people lose weight d. Improve heart strength

ANSWERS

1. (b) Heart failure doesn’t mean the heart has stopped working. Rather, heart failure occurs when the heart can’t pump enough blood to meet the body’s needs or can’t pump blood to the rest of the body with enough force. This is most often caused by damage to the heart stemming from coronary heart disease, high blood pressure and diabetes.

2. (c) Angina is a common symptom of heart disease, causing chest pain or discomfort because the heart muscle is not getting enough oxygen-rich blood. These symptoms may radiate down to the arms or be felt in the neck, jaw, throat, abdomen or back, as well. Angina can occur during physical activity or while resting.

3. (d) Trans fats are unhealthy fats: Your body doesn’t need them and they raise bad LDL cholesterol levels and lower your good HDL cholesterol levels. Fried and battered foods, shortening and stick margarine, cakes, cake mixes, pies and pie crust are some of the most common trans fats culprits.

4. (a) Because atrial fibrillation allows blood to pool in the atria of the heart, there’s a greater risk of clots forming. If one of these clots breaks off and travels to the brain, it can trigger a stroke. The very fast beating of the heart’s ventricles means that the heart can’t properly fill with blood and, in turn, may not be able to pump enough blood to the body, leading to eventual heart failure.

5. False. A heart attack is a circulatory problem that occurs when blood flow to the heart is blocked, leaving a portion of the heart without oxygen-rich blood. Cardiac arrest is triggered by an electrical problem in the heart, causing the heart to stop beating.

6. (a) Before menopause, women tend to have a lower risk of heart disease because of estrogen’s protective benefits. As you get older, however, the risk rises because of plaque buildup in the heart’s arteries. You’re also more likely to develop other risk factors for heart disease as you age, such as high blood pressure and diabetes.

7. (d) Food sources are your best bet for these minerals.

Potassium-rich foods include apricots, bananas and avocados, while low-fat and fat-free milk are good sources of calcium, and whole-grain products, dark green, leafy vegetables, fish and dry beans will help you stock up on magnesium. (If you have kidney problems, speak with your doctor about potassium intake first.)

8. (c) Another startling statistic: 50 percent of men and 64 percent of women who die suddenly of heart disease had no previous symptoms.

9. (a) The most commonly prescribed medications for people with high cholesterol, statins lower cholesterol by 20 to 60 percent and can decrease your chances of dying from heart disease.

Improve Your Heart Health

To learn more about ways to improve your heart health, schedule an appointment with a Houston Methodist San Jacinto Hospital heart specialist by calling 281.837.7587.

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IS JOINT REPLACEMENT

SURGERY RIGHT FOR YOU? Get Answers to Common Joint Health Questions

O

ur joints are pretty impressive. They can hold weight, help us move and link the bones in the body.

But over time — or even through trauma — Dr. Mark joints can wear down Franklin and become damaged.

If that happens, it can cause joint stiffness, swelling or even pain.

In these cases, it’s important to know your options. That’s why we’ve enlisted the help of Dr. Mark Franklin, an orthopedic surgeon with Houston Methodist Orthopedics & Sports Medicine at Houston Methodist San Jacinto Hospital.

Here, Franklin answers questions about joint health and leading-edge techniques in joint replacement surgery.

THE BASICS

Q

How do joints become damaged?

A: Joints can wear down in a variety of ways, but the most common way is through osteoarthritis, known as wear and tear arthritis. Osteoarthritis occurs over time and can result from getting older; being overweight; from a joint injury from sports or other activities; or genetic predisposition.

Q

hat are a few ways W people keep joints healthy as they age?

A: There’s a lot of interest around this, especially as it relates to diet and nutrition.

But there isn’t great proof that dietary

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or nutrition changes make a definitive impact on joint health. And while joint injuries should be avoided, no one goes out intending to cause damage to one area or another. Still, excessive weight can put undue pressure on joints, so it’s important to maintain an ideal weight as you age.

Q

What are some warning signs that tell people they should see a doctor?

A: As we age, we feel achy and sore after activity. That’s natural. When you feel like your knee is swollen, have trouble getting in and out of a chair or car, or it limits your activity, it’s time to see a doctor.

JOINT REPLACEMENT TALK

Q

hat makes someone W a good candidate for a joint replacement?

A: It’s preferable if a patient is 55 years old or older since the lifespan of a replacement is around 20 to 25 years.

Also, it helps when a person is a healthy weight, with minimal medical problems, is a nonsmoker and comes in with a positive attitude about the recovery process.

Q

What is a new joint made of?

A: Metal, plastic or both, depending on the replacement. In a knee replacement, for example, the femoral (femur or thigh bone) and tibial (tibia or shinbone) components are made of metal. A plastic bearing surface is snapped into the tibial base plate.

Q

Can someone be too old for a joint replacement?

A: This is determined on a case-by-case basis. While surgery becomes riskier as we age, there isn’t an age limit on joint replacement. To decide whether or not to perform a joint replacement, we’ll ask you about your medical history, risk factors and how old your parents are now or when they passed.

Q

What are the alternatives to joint replacement?

A: If you have early arthritis, the focus should be on maintaining an ideal weight with exercises that safely stretch and strengthen your joints. People can also add anti-inflammatory medicine like ibuprofen and naproxen if necessary. In more advanced cases, a doctor may recommend injections that mimic joint fluid or provide pain relief for six to 12 months.

SURGERY SPECIFICS

Q

How does joint replacement surgery improve someone’s health?

A: The main goal is to reduce pain so you can perform the natural activities of living.

Surgery won’t turn a sedentary person into a world-class athlete, but you can become much more physically functional and stable when your joints no longer hurt.

Q

hat should people W know about the recovery process?

A: You’ll typically be on your feet soon after surgery, with physical therapy to follow for as long as necessary. Pain can also be an obstacle when someone leaves the hospital, so it’s important to stay ahead of it with the medication we prescribe.

Q

Are there any permanent restrictions after surgery?

A: You can pursue what you want. But most people don’t return to heavy sports activities like running or basketball.

However, things like walking, elliptical training, swimming, bicycling, tennis and skiing can be fine.

Take the First Step

To learn more about joint health and surgical options, visit houstonmethodist.org/ orthopedics/locations/ baytown/. To schedule an appointment with a Houston Methodist San Jacinto orthopedic specialist, call 281.427.7400.

HOUSTONMETHODIST.ORG/SANJACINTO 7

8You Need to Know ASTHMA TRIGGERS

I

f you have asthma, your airways — the tubes that carry air in and out of your lungs — are inflamed and narrowed. During an asthma flare-up or attack, the airways Dr. Kalil become even more Al-Nassir swollen and the muscles around the airways can tighten. This often triggers wheezing, coughing, tightness in the chest and shortness of breath.

anti-inflammatory drugs, such as ibuprofen, and beta-blockers, which are used to treat heart disease, high blood pressure, migraine headaches or glaucoma

CONTROL EXPOSURE TO YOUR ASTHMA TRIGGERS

Medical conditions such as colds, flu, sinus infections, acid reflux and pregnancy hormones

“Identifying and reducing exposure to asthma triggers can help minimize flare-ups and improve your quality of life,” said Dr. Kalil Al-Nassir, a pulmonologist with Houston Methodist San Jacinto Hospital. Here are some of the leading triggers: Air pollution, vehicle exhaust, smog, strong odors and fumes

1 2

Allergens, such as house dust mites, animal dander, molds, pollen, cockroach droppings and certain foods — if you have allergies, as many people with asthma do

3

Certain medications, including aspirin or other nonsteroidal

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4

Emotions, including anger, fear, stress, anxiety and laughing or crying too hard

5

Exercise, but since you shouldn’t avoid it, you may be able to manage symptoms by using a quickrelief medicine, if prescribed, before physical activity

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Smoke from cigarettes, fireplaces, campfires and burning leaves

MANAGING YOUR ASTHMA

“Asthma can’t be cured, but it can be managed so you can live a normal, healthy life. A comprehensive approach to managing asthma is required because it’s a complex, chronic disease and it’s different for every person,” Al-Nassir said.

In addition to controlling your exposure to triggers, using medications properly is another key to managing asthma. Most people with asthma need two kinds: quick-relief medicines to stop asthma symptoms and long-term control medicines to prevent symptoms. Also vital is maintaining a healthy lifestyle. Proper rest, diet and exercise are not only good for your overall health, but also can help you manage your asthma.

Weather conditions such as cold, dry air; high humidity; and sudden or extreme temperature changes

Take Advantage of Our Special Expertise

The Lung Center at Houston Methodist San Jacinto Hospital offers comprehensive asthma services to evaluate and manage the condition using the most advanced treatment options. Each patient receives a personalized treatment plan based on their unique needs. For more information and to schedule an appointment, call 281.420.7394.

ZIKA UPDATE What Pregnant Women Need to Know

O

n Nov. 28, 2016, the Texas Department of State Health Services reported the state’s first case of local mosquito-borne Zika virus infection in Brownsville, Texas. While that’s far from the Houston area, those who are pregnant might still be feeling apprehensive about the news, given the birth defects linked to Dr. Roderick the virus.

Diggs “In our area, there’s really no need to panic.

The risk of getting Zika from a mosquito bite is extremely low,” said Dr. Roderick Diggs, an obstetrician-gynecologist who practices at Houston Methodist San Jacinto Hospital. “Right now we’re counseling patients on travel advisories such as not traveling to places like Brownsville and Florida. We also write letters to airlines on behalf of patients to get our patients out of their scheduled trips when necessary.”

This affects significant others, as well, who can sexually transmit the virus to their loved one who’s pregnant. Experts recommend waiting six months after traveling to an affected area before trying to conceive.

ARE YOU AT RISK?

Anyone who hasn’t had Zika before can be infected; being pregnant doesn’t necessarily make you more susceptible. In addition to mosquito bites and sexual transmission, the Centers for Disease Control and Prevention say it’s likely Zika can be spread through blood transfusions.

Many people who are infected don’t know they are because Zika doesn’t always produce symptoms. Common symptoms include fever, rash and joint pain, among others.

Since there’s currently no vaccine for Zika, the best way to prevent it includes these tips: Avoid areas where the virus is present.

Use EPA-approved insect repellants (such as those containing DEET or picaridin).

Wear clothing treated with permethrin that covers your arms and legs.

Spend time indoors in spaces protected by window and door screens.

Be diligent about removing areas of standing water around your home, where mosquitoes can lay eggs.

A BIRTHING CENTER SECOND TO NONE At Houston Methodist San Jacinto Hospital, we know deciding where to have a baby is a big decision, and when moms choose us, it’s an honor we take to heart.

From childbirth and breastfeeding education classes to a wide array of pain relief options available 24/7 for the big day, our goal is compassionate care for you and your newborn. We’re unique in that our moms are able to experience labor, delivery, recovery and postpartum in the same room, encouraging mother-baby bonding.

And should your baby need additional medical support, our level II neonatal intensive care unit is staffed with highly trained nurses and neonatologists who are committed to helping your baby get strong enough to go home.

Baby on the Way?

To find a Houston Methodist San Jacinto Hospital obstetrician-gynecologist who’s right for you and to schedule a tour of the Childbirth Center, call 281.420.8538.

Discuss Prevention with Your Doctor

If you’re pregnant and concerned about your Zika risk, or planning to travel to an affected area, make sure to call your doctor to discuss prevention. For more information on services provided by our Childbirth Center, call 281.428.2273.

HOUSTONMETHODIST.ORG/SANJACINTO 9

When the Problem

IS YOUR PROSTATE

Y

ou probably won’t think much about your prostate in your younger years, when it’s least likely to cause any problems.

But as you grow Dr. Bayo older, this small gland Tojuola can start producing troubling symptoms.

“The prostate gland tends to grow larger with age, so you may experience problems with urinating due to obstruction from the prostate,” said Dr. Bayo Tojuola, a urologist with Houston Methodist San Jacinto Hospital. “An infection or tumor can also increase the size of the prostate and cause discomfort.”

Three of the most common prostate conditions men face are prostatitis, an enlarged prostate, also known as benign prostatic hyperplasia (BPH) and prostate cancer.

PROSTATITIS

Prostatitis is inflammation of the prostate stemming from a bacterial infection. It’s a common condition that can lead to difficulty passing urine, sexual problems and more.

How it’s treated: Depending on whether the infection comes on suddenly (acute) or is more chronic in nature, you may need antibiotics for one to two weeks or longer. Anti-inflammatory medication and medication that relaxes muscle tissue to ease urine passage may also be recommended if your prostatitis is chronic.

BPH OR ENLARGED PROSTATE

As the prostate enlarges with age, some men may experience a squeezing of the urethra and eventual weakening of the

10 LEADING MEDICINE IN EAST HOUSTON/BAYTOWN

bladder, which can result in urine being left in the bladder.

“Though the symptoms can be similar, BPH is not prostate cancer nor does it increase your risk of cancer,” Tojuola said. BPH can lead to bladder or kidney infections, urinary blockages or kidney failure.

How it’s treated: Not all men will need treatment for their BPH; for some, lifestyle changes, such as limiting alcohol or caffeine and going to the bathroom often, can lessen symptoms. For others, medication and surgery can help reduce discomfort. Medications can help increase urine flow and reduce symptoms. Several surgery methods are available; the most common, transurethral resection of the prostate (TURP), involves removing extra prostate tissue.

PROSTATE CANCER

Prostate cancer is a slow-growing cancer that forms in prostate tissues. For most men, these cancers will never cause symptoms or threaten their health. For some, however, symptoms such as a frequent urge to urinate (particularly at night), pain when urinating and blood in the urine or semen, may signal a cancer that’s already advanced.

How it’s treated: How prostate cancer is treated depends on where the cancer is or if it has spread, your age and your overall health. Some treatments can lead to side effects such as impotence, so you’ll need

to discuss these with your doctor before making a treatment decision. Watchful waiting (regular monitoring), surgical removal of the prostate, radiation and testosterone-blocking hormone therapy may be options.

Concerned About Prostate Symptoms?

To schedule a preventive prostate screening with a Houston Methodist San Jacinto Hospital urologist, call 832.556.6046.

KEEPING COLORECTAL CANCER AT BAY Why Screenings Are Important

D

iscussing issues relating to your colon or rectum can be an embarrassing conversation to start with your doctor, but it’s a necessary one.

Of cancers that affect both men and women, colorectal cancer is the second leading cause of cancer-related deaths in the United States and the third most common cancer, according to the Centers for Disease Control and Prevention.

The good news? Colorectal cancer is one of the few cancers that has a screening method that not only detects the cancer in its early stages, but also helps prevent the cancer in the first place.

SCREENING RECOMMENDATIONS

Colorectal cancer almost always develops from polyps in the colon or rectum. With screening tests such as colonoscopy, polyps can be found and removed before they become cancerous.

Unfortunately, fewer than half of adults age 50 and older get the recommended screenings, according to the Health Resources and Services Administration.

Expert Gastroenterologists

The physicians with Houston Methodist Gastroenterology Associates bring decades of experience to the treatment of a wide range of gastroenterology conditions. For more information on colorectal cancer screening and prevention, and to schedule an appointment, visit houstonmethodist.org/ doctor/atul-shah, or call 281.422.7970.

The physicians with Houston Methodist Gastroenterology Associates recommend colorectal cancer screening for men and women at average risk beginning at age 50 and continuing until age 75. Continuing beyond this age should be considered on an individual patient basis, and only after considering the patient’s overall health and other factors.

People at an increased risk of developing colorectal cancer should discuss screening earlier, and may require more frequent tests. Talk to your doctor about a screening schedule that’s right for you.

RISK FACTORS

The exact causes of colorectal cancer are not known. However, certain factors increase your risk of developing the disease.

According to the National Cancer Institute, they include: Age. Most people who develop colorectal cancer are over 50.

P olyps (abnormal growths that protrude from the inner wall of the colon or rectum). While most polyps are noncancerous, the majority of colorectal cancers develop from polyps.

P ersonal history of colorectal cancer. Women who have had ovarian, uterine or breast cancer also have a higher risk.

Family history of colorectal cancer.

Ulcerative colitis or Crohn’s disease Diet. Eating a lot of red and processed meats, and not many whole grains, fruits and vegetables may increase risk.

Sedentary lifestyle Smoking

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EXPERT JOINT REPLACEMENT ACCELERATES YOUR RECOVERY. At Houston Methodist, our Rapid Recovery program for joint replacement gets you back to your active lifestyle — faster. Personalized to your specific needs, this comprehensive approach: • Utilizes the latest pain control methods before, during and after surgery • Starts rehabilitation sooner to accelerate recovery HOSPITALS EMERGENCY CARE CENTERS SPECIALTY HOSPITALS IMAGING CENTERS COMPREHENSIVE CARE CENTER

Just around the corner

• Gets you home quickly, often in one day To find a joint doctor in your area, call 713.790.3333 or visit houstonmethodist.org/rapidrecovery to learn more.

Houston Methodist has locations throughout the Greater Houston area to best serve you near your home or workplace. Our locations include hospitals, emergency care and imaging centers.

HOSPITALS 1. Houston Methodist Hospital 2. Houston Methodist San Jacinto Hospital 3. Houston Methodist St. John Hospital 4. Houston Methodist Sugar Land Hospital 5. Houston Methodist The Woodlands Hospital Opening July 1, 2017 6. Houston Methodist West Hospital 7. Houston Methodist Willowbrook Hospital

SPECIALTY HOSPITAL 8. Houston Methodist St. Catherine Hospital

IMAGING CENTERS 5. Houston Methodist Breast Care Center at The Woodlands

EMERGENCY CARE CENTERS 713.441.ER24 (3724) 9. Houston Methodist Emergency Care Center at Kirby 10. Houston Methodist Emergency Care Center at Voss 11. Houston Methodist Emergency Care Center in Cinco Ranch 12. Houston Methodist Emergency Care Center in Cypress 13. Houston Methodist Emergency Care Center in Pearland 14. Houston Methodist Emergency Care Center in Sienna Plantation 15. Houston Methodist Emergency Care Center in Spring

9. Houston Methodist Breast Care Center

COMPREHENSIVE CARE CENTER

16. Houston Methodist Imaging Center

17. Houston Methodist Comprehensive Care Center at Pearland

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