Leading Medicine Winter 2017, Houston Methodist Clear Lake Hospital edition

LEADING MEDICINE W INT ER 017

TIPS FOR BUSY WOMEN Why You Need an Annual Well-Woman Visit

FROM EVERYDAY ATHLETES TO OLYMPIC

CHAMPIONS

How Simone Biles Discovered Another Winning Team

GET THE FACTS ABOUT STROKE

What You Don’t Know Can Hurt You

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

KEEPING THE FAITH Bay Area couple experiences the spiritual side of healing during Emergency Room visit

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urtis Dishman did not want to go to the emergency room.

The Seabrook resident began experiencing back pain, which quickly escalated to the point of agony.

His wife, Lisa, convinced him to go to the emergency room at Houston Methodist St. John Hospital. As soon as they walked through the doors, Curtis was unable to stand any longer and collapsed.

The emergency room team immediately took action, lifting Curtis into a wheelchair so nurses could take him to an exam room. Only after he was stable and resting did anyone ask Lisa about registering.

“I was so impressed with the staff and the way they responded,” she said.

“Curtis was clearly in a lot of pain, and everyone’s first instinct was to make him as comfortable as possible rather than ask about his insurance. That doesn’t happen everywhere, and it says a lot about Houston Methodist St. John and its mission.”

GOING ABOVE AND BEYOND

Dr. Sandeep Duggal was the emergency room doctor who cared for Curtis.

Duggal not only treated Curtis, he also held hands and prayed with the Dishmans.

“Dr. Duggal’s care was above and beyond what we expected,” Lisa said. “He spent a lot of time with us, answered all our questions. And he checked back with us several times to make certain the pain medication was working properly before we were released.”

Curtis’ primary nurse stayed with the couple throughout the ordeal, reassuring them and explaining each step in the treatment process. Follow-up care instructions included seeing his orthopedic doctor.

HEALING THE BODY AND THE SOUL

Rev. Richard T. Maddox, MDiv, BCC, is director of Spiritual Care and Values Integration at Houston Methodist St. John Hospital. Maddox cares for the spiritual and emotional needs of patients at the hospital.

“We try to be a nonthreatening, calming presence,” Maddox said.

“Sometimes a patient just wants to be heard, but often they want to explore their feelings. We go on that journey with them to help strengthen their values and beliefs and reach a deeper understanding of what they’re going through.”

Dr. Sandeep Duggal with Curtis and Lisa Dishman.

Lisa said she and Curtis were comforted by the calm and healing environment at the hospital. “The spiritual side of healing is present in the way the staff interacts with patients and family members, and both Curtis and I felt it very deeply in our hearts,” Lisa said.

In addition to offering one-on-one prayer with patients and families, the Department of Spiritual Care and Values Integration oversees programs and services that provide around-theclock resources and support.

“It was so hard to see Curtis in such pain,” Lisa said. “But the way everyone responded to us — in such a genuine, wholehearted manner — made the experience so much easier. We left feeling so thankful that we have a hospital like Houston Methodist St. John here in our community.”

Emergencies Can’t Wait and Neither Should You At Houston Methodist St. John Emergency Room, your patient care begins within two minutes, and you will see a provider within seven minutes. Visit houstonmethodist.org/stjohn-er to learn more about our expertise and quality of care.

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GET THE FACTS ABOUT STROKE What You Don’t Know Can Hurt You

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s with most things in life, a little awareness can go a long way. This is especially true when it comes to your health.

While it may not get as much attention as other serious diseases, stroke is the fifth leading cause of death and the primary cause of serious long-term disability for Americans. And it’s not just older adults who are at risk. In fact, about a third of strokes occur in people under the age of 65.* So no matter your age, it’s never too early to learn what you can do to prevent stroke.

STROKE 101

A stroke occurs when blood flow in the brain is interrupted and brain cells die.

There are two main types of stroke: An ischemic stroke results when an artery in the brain becomes blocked by a blood clot.

A hemorrhagic stroke is caused by a blood vessel in the brain that bursts.

PREVENTABLE STROKE RISK FACTORS

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High blood pressure increases stroke risk by two to four times. The condition weakens and narrows blood vessels in the brain and increases the risk of blood clots.

What you can do: Maintain a healthy blood pressure by exercising regularly, eating a healthy diet low in sodium and taking blood pressure medication as prescribed.

Obesity increases your risk of stroke. Studies suggest this is due to obesity’s strong association with other conditions that raise your stroke risk, such as heart disease and diabetes.

What you can do: Help your waistline by cutting your calorie intake, limiting foods high in saturated and trans fats and cholesterol, and being physically active.

Smoking puts you at greater risk for stroke — and the more you smoke, the greater the risk. The chemicals in tobacco smoke damage your cells, thicken your blood and increase the plaque in your arteries, increasing the likelihood of blood clots.

What you can do: Counseling, nicotine patches and medicine can help you quit.

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TREATING STROKE IN THE NICK OF TIME If you or a loved one suffers from a stroke, every minute counts.

Getting immediate medical treatment at the right facility is essential.

So it’s good to know that Houston Methodist Dr. Akhila St. John Hospital Vijayakumar is an acute strokeready designated hospital. Dr. Akhila Vijayakumar, a fellowship-trained neurologist, serves as medical director of inpatient neurology and stroke at the hospital.

“The key to minimizing the impact of stroke is to recognize its symptoms and seek care immediately,” Vijayakumar said. “We are committed to ensuring that Houston Methodist St. John Hospital is leading the way in identifying and utilizing clinical best practices in neurology and stroke care to deliver the best possible patient outcomes.”

When a patient comes to the emergency room at Houston Methodist St. John, the emergency medicine team can administer life-saving medications, like the clot-busting drug “tissue plasminogen activator,” or TPA. The hospital also offers a full range of rehabilitation services that can help stroke survivors regain their lost skills, such as physical, occupational and speech therapy.

* Source: Centers for Disease Control and Prevention.

Be Stroke Smart

The Emergency Room at Houston Methodist St. John Hospital can administer medications that may be able to stop a stroke in progress, limiting the damage and possibly saving a life. These drugs are most effective when given as soon as possible after the onset of symptoms.

Visit houstonmethodist.org/stjohn-er to learn more. To schedule an appointment with a Houston Methodist St. John neurologist, call 281.333.8899.

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FROM EVERYDAY ATHLETES

TO OLYMPIC CHAMPIONS How Simone Biles Discovered Another Winning Team

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hether you’re shooting hoops in the neighborhood with friends or training for a marathon, physical activity provides many benefits, both short and long-term. But as Olympic Gold Medalist Simone Biles discovered, pushing your body can also occasionally mean dealing with injuries. Getting the right care can help you get back into the game faster and more safely.

Houston Methodist Orthopedics & Sports Medicine offers unparalleled care thanks to a diverse team of doctors and health care professionals that works together to ensure you are able to safely participate in the activities you enjoy.

Our all-star team includes P rimary care sports medicine doctors who combine orthopedic knowledge with holistic primary care F oot and ankle specialists who expertly treat ankle sprains and other injuries

Taking Care of Houston’s Best By studying elite athletes and helping them stay at the top of their game, we’re improving the quality of care for all athletes. To schedule an appointment with one of our specialists at Houston Methodist St. John, call 713.363.9090.

O rthopedic surgeons who perform precise surgeries to relieve pain and increase mobility N eurologists who ensure a safe return to play after a concussion H and and wrist specialists who provide relief for arthritis and nerve injuries P hysical and occupational therapists who create customized rehabilitation plans specially tailored for each patient Our team is trusted as the official health care provider for the Houston Texans, Houston Astros, Houston Dynamo, Houston Dash, Rice University Athletics, RodeoHouston® and Houston Ballet, among others. Just as we help those elite athletes, our team ensures that every patient receives the same standard of excellent care, so they can cross their own finish line, whatever it may be.

CARING FOR AN OLYMPIAN

Among the most recognizable athletes whom Houston Methodist Orthopedics & Sports Medicine has treated is 19-year-old Olympic gymnast Simone Biles. As a world-class competitor, Biles is no stranger to the ailments that can accompany rigorous training.

Shortly before she was to compete in the 2013 World Gymnastics Championships, Biles “landed short,” damaging the neck of the talus, one of the bones in the ankle. As a result, she sought care from her primary care sports medicine physician, Dr. Scott

4 LEADING MEDICINE IN THE BAY AREA AND SOUTHEAST HOUSTON

Rand, who has been Biles’ doctor since 2012.

With World Championships looming, Rand knew that a surgical option was out of the question for Biles.

Instead, Rand was able to administer ultrasound-guided injections to reduce inflammation and provide her with pain relief. With her pain in check, Biles went on to win an individual all-around gold medal that year.

PREPARING BILES FOR GOLD

After the competition, Rand enlisted the help of Houston Methodist foot

PREVENTING COMMON SPORTS INJURIES You don’t have to be an elite athlete like Simone Biles to suffer an injury.

Houston Methodist St. John primary care sports medicine specialist Dr. Javier Rios reminds us that playing a sport Dr. Javier Rios or getting in shape is a worthwhile fitness goal, as long as inadequate stretching, poor training habits, outdated gear or accidents don’t trip you up on the way to good health.

“Sprains, strains and stress fractures are all common,” Rios said. “They’re also, in many cases, preventable.” Rios offers these tips for avoiding common sports related injuries.

Get the go-ahead from your doctor. Schedule a physical to make sure you’re in good health before starting a new sport.

Wear the right gear. Make sure you have the proper protective equipment, clothing and well-fitting shoes designed for the sport you are doing. Protective eye wear is important for impact sports.

Helmets are a must for bicyclists.

Play by the rules. Know and follow the basic rules of the sport to avoid accidents.

Simone Biles pictured with Dr. Travis Hanson (l) and Dr. Scott Rand (r).

and ankle specialist Dr. Travis Hanson to remove the bone spur. For an elite gymnast like Biles, the surgery had to be as minimally invasive as possible to minimize scar tissue and achieve better range of motion.

After surgery and rehabilitation at Houston Methodist Willowbrook, Biles went on to make the cut to become one of the “Final Five” on the U.S. women’s gymnastics team at the 2016 Olympics in Rio, competing in and earning gold medals in the team and individual all-around, vault and floor exercise

as well as earning a bronze medal for balance beam.

“As athletes, we’re always going to have aches and pains, but when your teammates cheer you on, you don’t think about it,” Biles said recently. “The Houston Methodist team really helped me as well. They kept me focused on my goals and I trusted them — they really care and are an amazing team to work with. I had complete confidence in them and just didn’t worry about the injury.”

Warm up and stretch. Warming up gradually increases the heart rate and can prevent muscle strain and joint injury.

Stay hydrated. Don’t forget to stay hydrated by drinking lots of water before, during and after your activity.

Tune in to your body. Be aware of any aches or pains you’re experiencing.

Avoid playing when you’re too tired or in pain.

Strengthen your muscles.

Resistance training using weights can make you stronger and less prone to injury.

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Don’t Put Your

HEALTH ON HOLD

Why You Need an Annual Well-Woman Visit

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hort on time? Between work and family obligations, it can be tempting to forgo an annual health exam. But an annual checkup not only keeps your medical history up to date and identifies any health issues early — when they’re most treatable — it also provides the perfect venue to discuss any questions or Dr. Sri concerns you have about your health.

Gottimukkala “Women come with questions or just for checkups,” said Dr. Sri Gottimukkala, an obstetriciangynecologist at Houston Methodist St. John Hospital. “We can address any concerns they have.”

For younger women, these visits tend to focus on menstruation, conception and pregnancy, with common questions about vaginal discharge and weight gain or mood swings. Gottimukkala gives prepregnancy advice, including nutrition and medication information. She and her colleagues also discuss with patients the timing of family planning and maternal age.

CARE THROUGHOUT LIFE STAGES

Pap tests start at age 21. If a Pap test is normal, women are recommended to get their next one in three to five years; if it’s abnormal, another should be performed in six to 12 months.

Doctors at Houston Methodist St. John also check for breast lumps starting as young as 16 and throughout a woman’s life.

“I check the breasts and teach women to perform their own breast exams,” Gottimukkala explained.

In the next stage of life, usually around age 45, women benefit from well-woman visits because of perimenopause and menopause issues and questions.

OVER 40? MAMMOGRAMS ARE A MUST Women ages 40 and older should have an annual mammogram, Dr. Sri Gottimukkala advised, even without a family history of breast cancer.

“Annual mammograms are best because breast cancer can be treated, and lives can be saved if you catch it early,” she explained.

If breast cancer is found and treated early, it can result in a lumpectomy rather than a mastectomy. Early exams also give doctors a baseline of your breast health so they can watch for future changes that may indicate cancer.

Beyond menopause, vaginal itching and postmenopausal bleeding are common problems as women age. Older women may also have incontinence problems, Gottimukkala said, due to the tendency toward weight gain as they grow older.

REGULAR CHECKS, BETTER OUTCOMES

“Women who have had hysterectomies often think they don’t need a well-woman exam or a Pap test, but these are important for women who still have ovaries,” Gottimukkala said. “Annual well-woman visits are necessary to help diagnose and treat problems earlier, which can benefit long-term health.”

Schedule Your Well-Woman Visit Online

cheduling your well-women appointment is quick and easy. Visit houstonmethodist.org/ S appointments or call 832.783.2330.

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Could You Have METABOLIC SYNDROME?

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t affects more than one in three Americans.* It often goes undiagnosed.

But if you have just three of the risk factors, you could have it. “It” is metabolic syndrome, which is not a disease itself, but a combination of health conditions that together raise your risk of developing heart disease and other serious Dr. Rosemary health problems.

Eseh-Logue Talk to your primary care physician if you have three or more of these risk factors: blood pressure — greater than 130/85 mmHg 1 High (millimeters of mercury) Central obesity — excess fat around your abdominal (stomach) area — equal to a waist circumference of 40 inches or above in men, and 35 inches or above in women triglyceride level — a type of fat found in 3 Abnormal the blood — of 150mg/dL or greater HDL cholesterol level — the “good” cholesterol 4 Low that helps remove “bad” cholesterol from your body — less than 40 mg/dL in men or less than 50 mg/dL in women fasting blood sugar level of 100 mg/dL or 5 Elevated greater — may also be a sign of diabetes or prediabetes.

“Metabolic syndrome is a serious health condition that often goes undiagnosed,” said Dr. Rosemary Eseh-Logue, internist at Houston Methodist St. John Hospital. “Many people think that as long as they don’t have high blood pressure, they’re fine. But if they have three or more of the risk factors, with or without high blood pressure, they meet the criteria.”

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DECREASING YOUR RISK

What can you do to decrease your risk of developing metabolic syndrome? Eseh-Logue recommends starting with annual visits to your primary care physician.

“Prevention is key,” she said. “If you wait until it’s too late, it can be hard to make necessary lifestyle changes. If you see your doctor regularly, there’s a good chance that he or she can catch metabolic syndrome early, when it’s more easily treatable and less likely to become a chronic disease like diabetes.”

If you’re diagnosed with metabolic syndrome, Eseh-Logue said, it’s all about making lifestyle changes. “Weight loss, combined with a low-salt, low-fat diet and exercise can make a big difference. Treatment depends on the individual, but I usually suggest small, consistent changes, like replacing soda with water.”

Eseh-Logue works closely with patients to develop a personalized treatment plan that often includes meeting with a nutritionist. After an initial plan is established, follow-up visits are important. “I recommend coming in every six months or more, depending on how a patient is doing,” Eseh-Logue said. “In this way, we can monitor the patient’s progress and make adjustments to help him or her stick with the plan.” * American College of Cardiology, https://www cardiosmart.org/ News-and-Events/2015/06 One-in-Three-Americans-Has-Metabolic-Syndrome

Schedule an Appointment

For more information or to schedule an appointment with a primary care physician, visit houstonmethodist.org/appointments or call 713.394.6638.

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WHAT IF ONE DOCTOR COULD CONNECT YOU WITH THE EXPERTISE OF MANY?

HOSPITALS EMERGENCY CARE CENTERS SPECIALTY HOSPITALS IMAGING CENTERS COMPREHENSIVE CARE CENTER

Just around the corner 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 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

At Houston Methodist, your primary care doctor collaborates with world-renowned specialists every day, bringing you wideranging medical expertise, personalized for you, with convenient locations and same-day appointments you can schedule online. Your health, your way — that’s how the highest ranked hospital in Texas puts you first.

Accepting most major insurance plans.

Choose your doctor or schedule online at houstonmethodist.org/primarycare or call 713.394.6638.

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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