Leading Medicine Fall 2018, Houston Methodist Clear Lake Hospital edition

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Your Journey for

CANCER

CARE 4 Common Questions About Weight-Loss Surgery Concussion: Tackling a Tough Issue

YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN THE CLEAR LAKE AREA AND SOUTHEAST HOUSTON

NEWS & EVENTS DON’T MISS THESE FREE HEALTH EDUCATION EVENTS!

Unless otherwise noted, all events will be hosted at: Houston Methodist St. John Hospital Main Lobby 18300 St. John Dr. Nassau Bay, TX 77058 Register online for all events at houstonmethodist.org/ events or call 281.333.8899.

SATURDAY SPORTS INJURY CLINICS

Date: Every Saturday through Nov. 10 Time: 8-10 a.m.

Location: 2020 NASA Pkwy., Suite 230 Nassau Bay, TX 77058 This fall, athletes at all levels can get back in the game faster with an evaluation by one of our orthopedic doctors. Imaging services also available. No appointment necessary.

Visit houstonmethodist.org/athlete for more information.

ASK THE DOCTOR: SURGICAL WEIGHT-LOSS SOLUTIONS

Date: Every other Wednesday Time: Afternoon and evening sessions available Dr. Kyle Stephens, bariatric surgeon, will provide information on the health benefits of medical weight-loss surgery and address your questions.

JOINT PAIN SOLUTIONS

Date: Wednesday, Sept. 12 Time: 5:30-7 p.m.

If you suffer from joint pain and have struggled to find relief, then plan to attend this informative event. Hear from our joint replacement team of experts and learn more about: Latest technology and techniques Presurgical education programs Innovative pain control methods Physical therapy and Rapid Recovery

BACK PAIN? NECK PAIN?

Date: Thursday, Sept. 20 Time: 5:30-7 p.m.

Hear from our orthopedic specialist and physical therapist to learn more about nonsurgical and surgical solutions to alleviate chronic back and neck pain.

CHECK IN ONLINE TO RESERVE YOUR TIME IN THE ER

Now you can use our online scheduling reservation service, designed to offer faster, more convenient medical treatment by one of our board-certified emergency medicine doctors. Visit houstonmethodist.org/stjohn-er to learn more.

2 LEADING MEDICINE IN CLEAR LAKE AND SOUTHEAST HOUSTON

FREE PREGNANCY E-NEWSLETTERS

Are you pregnant or planning your pregnancy?

Then take advantage of our “Pondering Pregnancy” and “Celebrating Your Pregnancy” e-newsletters.

They offer valuable information on topics ranging from conception, preparing for a healthy pregnancy, choosing care providers, month-by-month changes inside your body as well as getting ready for your birth experience. Visit houstonmethodist.org/stjohn/ childbirth to subscribe.

PATIENT SAFETY GRADE ‘A’

For the second consecutive period, Leapfrog Group, a national nonprofit health care ratings organization, awarded Houston Methodist St. John Hospital the highest patient safety grade based on performance in preventing medical errors, infections and other harms.

ARE YOU AT HIGHER RISK? Knowledge is power when it comes to these four unchangeable factors in developing breast cancer.

Y

ou might think you’re safe from breast cancer if no one in your family has had the disease. Most women with breast cancer, however, do not have any family history of cancer. In fact, 1 in 8 women in the U.S. will be diagnosed with breast cancer in her lifetime.

“It is up to us as medical professionals to educate Dr. Esther women about their personal risk of breast cancer,” Dubrovsky said Dr. Esther Dubrovsky, a breast surgeon with Houston Methodist Surgical Associates. “The American College of Radiology (ACR) and Society of Breast Imaging (SBI) are now recommending that all women have a risk assessment at age 30 to see if screening earlier than age 40 is needed.”

Here, we put the spotlight on four of the greatest risk factors for breast cancer.

1 YOUR AGE

Unfortunately, the number of candles on your birthday cake affects your risk level most. The majority of women diagnosed with breast cancer are older than 50, and the risk increases as you age. What’s more, 2 out of every 3 invasive breast cancers found are in women ages 55 and up.

2 YOUR ETHNIC BACKGROUND

Asian, Native American and Hispanic women have lower odds of developing breast cancer and dying from the disease. On the other hand, Caucasian women are more likely to be diagnosed, and African-American women are at greater risk of dying from breast cancer. These are factors that may be important to consider if another risk factor exists.

3 YOUR FAMILY TREE

If your mother, sister or daughter has had breast cancer, your risk is doubled. But if that’s not the case, you’re not necessarily in the clear. Less than 15 percent of women diagnosed with breast cancer have a family history of the disease, which means it’s important to schedule the screenings that are right for you.

SCREENING SENSE BREAST SELF-EXAM: Check yourself to become familiar with your breast tissue.

Report changes to your doctor immediately.

AGE: 20-40+. . . . . . . . . . . . . . . . . . . . . Monthly (optional) CLINICAL BREAST EXAM: Your health care provider examines the breasts, collarbone and underarm area for lumps.

AGE: 20-39 . . . . . . . . . . . . . . . . . . . . . . Every three years AGE: 40+ . . . . . . . . . . . . . . . . . . . . . . . . Annually MAMMOGRAM: This X-ray exam looks for early signs of breast cancer.

AGE: 20-39 . . . . . . . . . . . . . . . . . . . . . . Only for those at high risk AGE: 40+ . . . . . . . . . . . . . . . . . . . . . . . . Annually* * Please talk to your doctor to determine at what age you should begin receiving an annual mammogram.

Paint the Night Pink

You and your friends are invited to this celebration of breast cancer awareness and breast health. Meet our panel of breast health experts and vendors, enjoy hors d’oeuvres and drinks, giveaways and a fun and informative evening.

Date: Thursday, Oct. 25 Time: 6-8 p.m.

Location: The Lawn at Baybrook Mall Register at houstonmethodist.org/events

4 YOUR GENES

Thanks to celebrities like Angelina Jolie, you might know that a woman who has the BRCA1 or BRCA2 gene mutation is at higher risk for breast cancer — by 55 percent to 87 percent — and for ovarian cancer, as well.

“The goal is to find the mutation in women before they develop cancer,” Dubrovsky said. “A simple blood or saliva test is meant to tell a woman whether she’s at high risk.”

If your personal and family history warrants it, your physician may recommend genetic testing, which looks for altered BRCA genes and other mutations. The results can help your doctor determine whether you would benefit from preventive surgery, additional screenings or medications to reduce the risk of a cancer diagnosis.

Talk with your doctor if you have a family history of the following: Breast cancer at age 50 or younger Ovarian cancer at any age Male breast cancer at any age Ashkenazi Jewish ancestry and a personal or family history of breast or ovarian cancer Two breast cancers in the same person or on the same side of the family Triple-negative breast cancer at age 60 or younger A previously identified BRCA1 or BRCA2 mutation in the family

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

Support for Your Journey

from Diagnosis to Survivorship Choosing a hospital for cancer care

H

1

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 comes through in everything we do,” said Dr. Jitesh Joshi, oncologist and hematologist at Houston Methodist Cancer Center at St. John.

Joshi is board certified by the American Board of Internal Medicine in medical oncology and hematology.

4 LEADING MEDICINE IN CLEAR LAKE AND SOUTHEAST HOUSTON

2

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, which includes the following: M eet with your doctor to ask questions about Dr. Jitesh Joshi your diagnosis and make sure you understand his or her recommendations for treatment.

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

T alk to family and friends about your diagnosis and how this may impact 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 loved ones 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 and bring a support person 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. At Houston Methodist, top-ranked physicians and cancer specialists have a high level of expertise and input on your treatment plan. Whether your cancer diagnosis is common, rare, or in an early or advanced stage, you can benefit from the leadingedge 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,” Joshi said.

Oncologists, surgeons, pulmonologists, pathologists, radiologists, internal medicine doctors and other specialists at Houston Methodist collaborate and consult on treatment plans for patients, and this team aspect is a powerful tool in the fight against cancer.

STEP

3

LEARN ABOUT TREATMENT OPTIONS

COMPREHENSIVE SERVICES AND SUPPORT

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 top hospital in Texas,” Joshi said.

Treatment options may include: A dvanced treatments in I maging technology immunotherapy advancements Bone marrow transplantation Latest radiation techniques Chemotherapy Leading surgical techniques Clinical trials Targeted therapies

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

Genetic 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.

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

Support 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,” Joshi 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 of 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,” Joshi 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 cancer treatment and bringing that integration to the communities across Houston,” Joshi 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,” Joshi 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. Our goal is to be able to get you 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,” Joshi 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 Contact us at 832.783.1190 to find an oncologist at Houston Methodist Cancer Center at St. John.

HOUSTONMETHODIST.ORG/STJOHN 5

4

Common Questions About WEIGHT-LOSS SURGERY

D

iet and exercise are commonly recommended methods of reaching and maintaining a healthy body weight. However, if you suffer from extreme obesity, diet and exercise may not be enough to achieve the weight loss needed to reach a healthy body weight. If, despite efforts to shed pounds, your health is compromised by Dr. Kyle your weight, you may be considering weightStephens loss surgery. Weight-loss surgery is a major decision, and you’re bound to have questions. Here is information that can help you decide whether weight-loss surgery is an option for you.

Can anyone get weight-loss surgery? “We perform weightloss surgery on patients as young as age 18. You may have to meet certain criteria to qualify for insurance coverage of weight-loss surgery, which is usually determined by your body mass index, or BMI, and whether you have other medical conditions,” said Dr. Kyle Stephens, a bariatric surgeon at Houston Methodist St. John Hospital.

People are considered obese if their BMI is greater than 30 and severely obese if their BMI is 40 or above. To qualify for bariatric surgery you usually have to have a BMI greater than or equal to 40, or greater than or equal to 35 with a serious health problem linked to obesity.

How much weight will I lose? Your weight loss depends on many factors, including the type of surgery you have, how closely you follow postoperative nutrition and activity guidelines and other factors. Typical “maintenance” weight loss, meaning the percentage of excess body weight that is lost and kept off, is from about 40 to 50 percent. “Your doctor will speak with you about realistic expectations for weight-loss surgery,” Stephens said.

What will my long-term diet be like after surgery? You’ll focus on eating healthy, vitamin- and protein-rich foods.

Our nutritionists can help you create a customized eating plan. In general, your guidelines will be somewhere between 800 and 1,500 calories a day, eating a plant-based diet along with whole grains, occasional lean meats and healthy fats. You’ll want to avoid eating processed foods, and foods containing refined and added sugars.

What positive effects will weight-loss surgery have on my health? While results will vary, bariatric surgery can help with chronic conditions, such as diabetes, high blood pressure, high cholesterol, sleep apnea, urinary incontinence and joint pain. In addition, you may have improved mobility and mental health.

“Weight-loss surgery is a major decision that can change your life for the better — but it requires a lifelong commitment to a healthy lifestyle,” Stephens said.

Take the Next Step

Attend a free information session about minimally invasive weight-loss surgery at Houston Methodist St. John. For more information and to register, visit houstonmethodist.org/events or call 832.667.LOSE (5673).

6 LEADING MEDICINE IN CLEAR LAKE AND SOUTHEAST HOUSTON

CONCUSSION: Tackling a Tough Issue

B

umps, tumbles and falls are a normal part of growing up.

However, when a blow is severe enough to move the brain back and forth within the skull, it can Dr. Javier Rios cause a concussion — a temporary loss of normal brain function. Young athletes are particularly susceptible to concussion, and they may take longer than adults to recover. The key to a quick and complete recuperation is prompt medical attention.

“Diagnosing the condition early helps ensure that the brain has time to heal properly,” said Dr. Javier Rios, a primary care and sports medicine specialist at Houston Methodist Orthopedics & Sports Medicine at St. John. “A second head injury sustained before the brain has fully healed can be severe, sometimes causing swelling of the brain and longterm disability.” What’s more, having one concussion increases the odds of sustaining a second concussion, and repeated head injuries can cause serious problems, including headaches and chronic difficulty concentrating, remembering and even balancing.

WHAT TO WATCH FOR

“You do not need to lose consciousness to have a concussion,” Rios said. “Symptoms of a concussion often appear right away, but may also emerge only after the person returns to normal activities.”

Signs usually fall into four categories, according to the Centers for Disease Control and Prevention: Thinking/remembering Difficulty thinking clearly or concentrating Feeling slowed down Difficulty remembering new information

Physical Headache Fuzzy or blurry vision Nausea or vomiting Dizziness Sensitivity to noise or light Balance problems Feeling tired, having no energy Emotional/mood Irritability Sadness More emotional Nervousness or anxiety Sleep Sleeping more or less than usual Trouble falling asleep If a young athlete experiences one or more of these symptoms after a blow to the head, he or she should stay out of play until a trained health care professional can assess his or her condition.

RECOVERY

“The main course of treatment for a concussion is often physical and mental rest until symptoms subside,” Rios said.

“It may be necessary to keep children home from school or adults home from work, with a gradual return to normal activities.” Student-athletes often follow a five-step process for returning to play: baseline (no concussion symptoms for

at least 24 hours), light aerobic exercise, moderate exercise, noncontact exercise, practice, and finally, return to competition.

PREVENTION

The following steps can help reduce the chances of experiencing a concussion or other brain injury.

Wear a helmet when riding a bicycle, skateboard, scooter or motorcycle; playing contact sports, such as football, hockey or boxing; batting or running the bases in baseball or softball; riding a horse; or skiing or snowboarding.

Buckle up. Make sure everyone in the vehicle is wearing a seat belt or is secured in a child safety seat.

Keep your home safe. Install window guards so children cannot fall out, and use safety gates to keep young children away from steps. Remove tripping hazards and add handrails to stairways.

Saturday Sports Injury Clinics Offered

Houston Methodist’s world-class sports medicine specialists are offering Saturday Injury Clinics: When: Every Saturday, 8-10 a.m., through Nov. 10 Location: 2020 NASA Pkwy., Suite 230, in Nassau Bay The clinics are open to student and adult athletes of all ages who have suffered an injury and require prompt evaluation, including on-site X-ray and imaging capabilities. Evening appointments are also available every Monday until 7 p.m.

Youth, high school and adult athletes can be seen immediately by a board-certified Houston Methodist Orthopedics & Sports Medicine specialist. Visit houstonmethodist.org/athlete or call 713.363.9090 to learn more.

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KEEPING YOU AT THE TOP OF YOUR GAME When an injury has you sidelined, the world-class team of specialists at Houston Methodist Orthopedics & Sports Medicine will help you get back out there faster, with: • Expertise to treat common to complex injuries

• Minimally invasive procedures • State-of-the-art physical and occupational therapy

• Latest imaging and technology • Advanced nonsurgical treatments

Schedule an appointment to discuss your options with a specialist.

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