LEADING MEDICINE SPRI N G/SUM M ER 018
IMAGING: WHERE YOU GO MATTERS GET A GRIP ON HAND CONDITIONS
BREAKING THE BARRIERS TO JOINT REPLACEMENT
What’s holding you back from considering a joint replacement?
YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN THE CLEAR LAKE AREA AND SOUTHEAST HOUSTON
NEWS & EVENTS PRIMARY STROKE CENTER DESIGNATION EARNED
Houston Methodist St. John Hospital has earned designation as a primary stroke center by the global health care consulting firm DNV-GL. DNV-GL’s stroke certification program is a comprehensive overview of stroke treatment quality that incorporates recommendations and guidelines from the American Stroke Association, the Brain Attack Coalition and the National Integrated Accreditation for Hospitals Organization. “We have a strong commitment to neurological care at Houston Methodist St. John,” said CEO Dan Newman. “This designation is recognition that we have the necessary staffing, infrastructure and programs to provide a high standard of stroke care, and it is a testament to the efforts and dedication of our physicians, nurses and staff.”
WHERE SURVIVORS GATHER, HOPE SOARS!
Houston Methodist Cancer Center at St. John welcomes local cancer survivors and a guest to attend a celebration and luncheon as we honor those living with a history of cancer. Please join us! CELEBRATION & LUNCHEON Date: Friday, June 1 Time: 11:30 a.m. – 1 p.m. Location: Houston Methodist St. John Hospital West Building 2035 Space Park Dr. Nassau Bay, TX 77058 RSVP required. Visit houstonmethodist.org/events or call 281.333.8899.
FREE HEALTH EDUCATION EVENT JOINT PAIN SOLUTIONS
If you suffer from joint pain and have struggled to find relief, then plan to attend this informative event. Hear from our team of joint-replacement experts and learn more about: Latest technology and techniques Presurgical education programs Innovative pain-control methods Physical therapy and rapid recovery Clinical and administrative members of the stroke care team at Houston Methodist St. John Hospital. Front row (l-r): Dr. Nadim Islam, director of emergency medical services; Dr. Akhila Vijayakumar, medical director of inpatient neurology and stroke; Maria Socci, RN, Accreditation/ Certification Department of Quality Management; Allison Capetillo, director of quality and systems improvement for AHA/ASA; Serenity Glazer, RN, director of critical care and emergency services; and Dan Newman, CEO.
Date: Wednesday, Sept. 12 Time: 5:30-7 p.m. Location: Houston Methodist St. John Hospital 18300 St. John Dr. Main Lobby Nassau Bay, TX 77058 Visit houstonmethodist.org/events or call 281.333.8899.
FREE PREGNANCY E-NEWSLETTERS 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 boardcertified emergency medicine doctors. Visit houstonmethodist.org/ stjohn-er to learn more.
2 LEADING MEDICINE IN CLEAR LAKE AND SOUTHEAST HOUSTON
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.
IMAGING: Where You Go Matters
edical imaging, such as a mammogram or CT scan, isn’t the same experience at every hospital, clinic and imaging center. Dr. John Depending on where Gillespie you go, your scan times, comfort level and even results can differ. “The advanced imaging technology at our hospital makes it possible to make diagnoses that couldn’t be done with older technology,” said Dr. John Gillespie, a radiologist at Houston Methodist St. John Hospital. “And we offer full interventional capabilities to ensure we can address any issues that are found.” Here is a look at advanced imaging options available at Houston Methodist St. John.
Magnetic resonance imaging (MRI) uses high-strength magnets and radio waves to produce images of organs and structures without ionizing radiation, such as X-rays. MRI scanners have varying field strengths (measured in Tesla) typically ranging from 0.5-3T. Today’s clinical standard is 1.5T but some facilities, including Houston Methodist St. John, also have the capability to utilize 3T MRI technology. “3T MRI is state-of the-art technology that’s ideal for musculoskeletal,
neurological and vascular imaging,” Gillespie said. “Quite simply, the images are better with higher resolution and, in many cases, it is like looking at an anatomy textbook.” The greater field strength of the 3T scanner means more signal from body tissue being scanned. This allows for greater resolution and increased contrast. Diagnostic accuracy is often substantially improved over 1.5T scanners.
Computerized tomography (CT) is a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce cross-sectional images (called slices) of the body. Newer generations of CT technology allow for safer, more effective imaging that can detect a wider range of conditions. “Our LightSpeed CT scanners have very fast scan times, meaning we can accommodate many people without the need for a long wait,” Gillespie said. Scanning often is completed in only a few seconds. Images are acquired using techniques to reduce radiation exposure to a minimum. The 64-slice CT scanners available at Houston Methodist St. John are capable of providing sharp, clear, 3-D images of various parts of the body. “The CT scanners at St. John are also capable of doing high-definition CT angiography — meaning imaging of arteries and veins — for the brain and body, and soon, the heart,” Gillespie
said. CT angiography can help diagnose and assess blood vessel conditions and diseases.
A mammogram is a low-energy X-ray that can show abnormal areas in breast tissue. Starting at age 40, women should begin annual mammograms in order to detect breast cancer before lumps can be felt or cancer symptoms appear. Most mammograms produce images from only the front and the side of the breasts. But 3-D mammograms, also known as tomosynthesis, provide images of the breasts from many different angles. This can make it easier for doctors to find abnormalities in the breast and better determine whether they are a concern. Houston Methodist St. John provides the option of 3-D mammography in addition to other breast diagnostic imaging tests. Speak to your doctor to determine the right test for you.
Schedule an Imaging Appointment
In need of an MRI, CT scan, mammogram or other imaging test? To schedule an appointment, visit houstonmethodist.org/imaging today or call 281.333.8858.
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BREAKING THE BARRIERS TO JOINT REPLACEMENT What’s holding you back from considering a joint replacement?
f you’ve been living with chronic joint pain for months or years — making it difficult to move about easily or even just walk normally — you may keep a running list of Dr. Michael reasons in your head Monmouth why you haven’t had joint replacement surgery. But most of these are unnecessary barriers, because this highly common surgery usually vastly improves patients’ lives and allows them to resume their favorite activities without pain, according to Dr. Michael Monmouth, an orthopedic surgeon at Houston Methodist St. John Hospital. More than 7 million Americans are living with an artificial knee or hip, the two joints most often replaced through surgery, according to the National Institutes of Health. At Houston Methodist, orthopedic surgeons perform over 4,000 joint replacements each year, predominantly knees, hips and shoulders. “This high volume translates into high levels of experience and high success rates,” Monmouth said. “Joint replacement surgery is one of the true miracles of modern medicine,” Monmouth added. “It gets people back to their lives doing the things they want to do and used to take for granted. That’s good for society, for the workforce and for patients’ quality of life.”
WHY JOINT REPLACEMENT BECOMES NECESSARY
Affecting 1 in 5 Americans, arthritis is typically the culprit in causing joints to become so stiff, tender and painful
GET RELIEF FROM YOUR JOINT PAIN At Houston Methodist St. John, we offer a full spectrum of services, from conservative, nonsurgical treatment options to the most advanced surgical techniques, which include: Minimally invasive knee replacement Advanced techniques to minimize postoperative discomfort and accelerate recovery Partial knee replacement Physical therapy for arthritic knees Knee-preservation surgery
that joint replacement surgery is considered. An artificial joint used in joint replacement surgery can be made of plastic, metal and/or ceramic, according to Monmouth. Either the usual “wear and tear” type of arthritis (osteoarthritis) is at play, he noted, or so-called traumatic arthritis brought on by an injury that makes the joint increasingly unstable over decades. But the resulting pain can be so pervasive and excruciating that
4 LEADING MEDICINE IN CLEAR LAKE AND SOUTHEAST HOUSTON
nonsurgical measures meant to manage it — such as pain medications and creams, exercise, physical therapy, steroid or other injections, and bracing the joint — provide only brief relief, if at all. “By the time people get to a conversation about joint replacement, they have pain on a daily basis and it’s occupying a disproportionate part of their lives,” Monmouth explained. “It’s the kind of pain that leads them to become less active, whether athletically or socially, and can include everything from going grocery shopping to going to church, being able to prepare their own meals or even being able to walk outside.” “It basically narrows their lives and limits their movement,” he added. “A lot of people get to the point where mentally, the pain becomes such a big part of their lives they become unhappy.”
JOINT SURGERY FACTS
While many would say their joint pain is difficult and debilitating, surgery is often viewed as an absolute last resort. Here, Monmouth debunks the most common misconceptions.
Short-term discomfort from surgery beats a lifetime of debilitating pain.
For every person who says joint replacement is a miserable procedure, many more have said they’re glad they had it done, and the majority of their pain is now gone. We’re also able to better control patients’ pain before, during and after surgery with new medications and by using older medications a bit differently depending on the patient’s needs.
Recovery doesn’t take as long as it used to.
Improvements in surgical techniques and technology have reduced recovery time making it more efficient, predictable and generally less painful. This enables a more rapid return to function. Many patients are concerned they won’t get back to work in a prescribed amount of time, but national and international data show they usually return to their jobs within six weeks.
Most insurance covers it.
While insurance plans vary, joint replacement is one of the most established procedures in the United States, meaning reimbursement isn’t often a problem regardless of age.
Newer technology means longer lasting artificial joints.
As technology improves, joint durability continues to improve as well. An artificial joint probably has a life expectancy that matches the patient’s most of the time, and most who receive one will never need another.
READY? NO NEED TO WAIT
Regardless of what misconceptions may hold them back, most patients who need joint replacement typically reach the point where they’re ready to do it. “It’s not uncommon for a patient to be ready to commit to joint replacement within a year or so of an arthritis diagnosis,” Monmouth said. “There’s not necessarily a medical rush for this, a time frame where a patient’s outcome will be sacrificed as a result of waiting. However, the decision to proceed with joint replacement — sooner than later — will eliminate the pain and suffering of a prolonged waiting period. “I schedule a follow-up visit with every patient one year after joint replacement surgery, and during this visit, I commonly hear ‘I wish I had done this sooner.’”
Considering Joint Replacement Surgery? To schedule an appointment with one of our joint specialists at Houston Methodist St. John Hospital, visit houstonmethodist.org/ jointpain or call 713.363.9090.
GET A GRIP ON Hand Conditions Y ou rely on your hands for so many daily activities, including writing, dressing, bathing and eating. So when your hands are impacted by a condition or disorder that prevents you from using them normally, it can significantly hinder your quality of life. Dr. Jamie Alexander, a hand-and-wrist Dr. Jamie specialist for children and adults at Houston Alexander Methodist St. John Hospital, explains some of the most common hand conditions and how they’re treated.
About 1 in 4 people over the age of 18 have been diagnosed with arthritis (joint inflammation). “Arthritis in the hand is really common, both in males and females,” Alexander said. The condition can occur in various parts of the hand and wrist and may have more than one cause. Arthritis treatment focuses primarily on relieving pain and improving function. “In the case of early stage arthritis in the base of the thumb, we typically try treatments like braces or injections to help relieve some common symptoms,” Alexander said. She noted that occupational therapy and medications may also be appropriate treatment options. When more conservative options aren’t helping, surgery may be recommended.
CARPAL TUNNEL SYNDROME
The carpal tunnel is a narrow passageway from the wrist to the hand made of ligaments and bones. When the carpal tunnel is squeezed or pinched, causing pain, weakness or numbness that can travel into the fingers, it’s known as carpal tunnel syndrome. Some risk factors for carpal tunnel syndrome include family history, pregnancy, having diabetes or a thyroid condition and repetitive hand movements over a prolonged period of time. “It’s one of the most common conditions we see patients for. They come in saying their hands feel constantly tingling or numb or are cramping up,” Alexander said. “I take things conservatively until I figure out the severity of the syndrome and then have them get a nerve conduction test to find out if there’s any other compression happening, such as in the neck or arm.” Treatments for carpal tunnel syndrome can include wrist splinting, occupational therapy and injecting corticosteroids. “If the condition appears severe, I may recommend surgery before things get worse,” Alexander said.
6 LEADING MEDICINE IN CLEAR LAKE AND SOUTHEAST HOUSTON
Trigger finger, also known as stenosing tenosynovitis, is a condition in which any of your fingers gets locked in a bent position. “It can get pretty disabling,” Alexander said. “Patients can have trouble performing simple tasks like grabbing a cup.” People at greater risk for trigger finger include women, those with diabetes or rheumatoid arthritis, and people who do repeated, prolonged gripping on a regular basis. Treatments for less severe cases can include avoiding repetitive hand motions or using a splint. “A fairly conservative approach to treating more severe trigger finger is the use of steroid injections,” Alexander said. “It’s a common treatment that can be effective for a year or more. Patients looking for a permanent fix to the condition can opt for surgery.”
HAND PHYSICAL THERAPY & REHABILITATION You may be referred to hand occupational therapy after your appointment with a hand-and-wrist specialist. At Houston Methodist St. John, our team of hand therapists are all certified and specially trained in providing education on hand-related conditions, wound care, splinting, managing rehabilitation and developing postsurgical rehabilitation plans. Throughout your care with one of our certified hand therapists, your doctor will work closely with him or her to make sure you are progressing appropriately.
Schedule a Hand Examination
To schedule an appointment with a hand-and-wrist specialist at Houston Methodist St. John Hospital, visit houstonmethodist.org/appointments or call 713.363.9090.
Questions to Ask at Your Next Annual Checkup
alking with your doctor about any health concerns you have can be a powerful tool when it comes to catching health problems early and preventing disease. Dr. Hong Le “An annual checkup is an opportunity to strengthen a partnership with your health care provider and discuss questions that can help you assess your health outlook,” said Dr. Hong Le, an internal medicine doctor with Houston Methodist Primary Care Group, practicing at Houston Methodist St. John Hospital.
COVERING YOUR BASES
“Think of your annual checkup as a two-part process. First, is the exam itself,” Le said. “The second part is getting a thorough understanding of your health and what you can do to improve it.” Here are some questions to ask your doctor:
family medical history, which shows if grandparents, parents or siblings had heart attacks, breast or prostate cancers and other illnesses.
Given my age and health, what symptoms may indicate the onset of an illness? Knowing what symptoms to look for can empower you to take charge of your health.
Given my medical status, what specific symptoms may indicate a health emergency? Discuss health emergency warning signs, especially if you have a family history or medical condition that puts you at greater risk.
What screenings should I have? “Depending on your medical history, age and health status, your doctor may recommend certain screenings, such
Are all my vital signs normal or within the accepted range? Ask about your body mass index (BMI), a formula that tells if your weight is appropriate for your height as well as blood pressure and pulse and lung function. Is my health better, worse or the same since my last visit? Ask how your numbers compare to your last checkup.
What are the best ways I can maintain my health or manage my condition? “I recommend speaking to your doctor about your diet, your level of physical activity and any other concerns you have,” Le noted.
Given my personal and family medical history, do I have a higher than normal risk for certain illnesses? Review with your doctor your
as a mammogram for breast cancer, a bone density scan for osteoporosis or a colonoscopy for colorectal cancer,” Le said. Should I be seeing a specialist for any reason? Ask if you feel you need help managing a chronic condition or have a disease that may require the expertise of a specialist. What new therapies or changes in treatment have come up since my last checkup? Medicine is constantly evolving. Be sure you know about any new technologies or treatment options for your condition. Should I get a flu shot or other vaccines? Your doctor can tell you if you are up-to-date on your vaccinations, based on your age, risk factors and overall health status.
Schedule a Checkup Today
Regular checkups and communicating openly with your doctor is just as important as eating right, exercising and watching your weight. Schedule an appointment with a Houston Methodist primary care doctor. Visit houstonmethodist.org/pcg to request an appointment online or call 713.394.6724.
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LIVE A LIFE WITHOUT
JOINT PAIN We can help you get there.
Conroe The Woodlands
If you’ve suffered from years of joint pain and struggled to find relief, we have the joint care expertise to get you back to your everyday life. With treatment plans customized for you, our specialists offer a full range of advanced nonsurgical and surgical techniques, including: • • • •
Innovative pain control methods Physical therapy to improve mobility and range of motion Latest technology, including minimally invasive surgical techniques Presurgical education programs for joint replacement
Memorial City Bellaire
Texas Medical Center Pearland Sugar Land
Schedule an appointment to discuss your options with a joint specialist. Houston Methodist Orthopedics & Sports Medicine Locations in Nassau Bay and Clear Lake | 713.363.9090 houstonmethodist.org/jointpain
Read about advanced imaging options available at Houston Methodist St. John Hospital, which include magnetic resonance imaging (MRI), comput...
Published on May 16, 2018
Read about advanced imaging options available at Houston Methodist St. John Hospital, which include magnetic resonance imaging (MRI), comput...