Leading Medicine Winter 2018, Houston Methodist Clear Lake Hospital edition

LEADING MEDICINE W INT ER 018

A LOOK AT STROKE IN YOUNGER PATIENTS PRIORITIZING WOMEN’S HEALTH

WHY WOMEN SHOULD LISTEN TO THEIR HEARTS Symptoms can vary when compared to men

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

NEWS & EVENTS

Awards & Accolades PATIENT SAFETY GRADE “A”

The 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.

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.

PARKINSON’S DISEASE AND MOVEMENT DISORDERS INFORMATION SESSION

Are you living with Parkinson’s or other movement disorder or essential tremor? If so, please join Dr. Leanne Burnett, neurologist and fellowship-trained movement disorder specialist, to learn more about early signs and symptoms, diagnosis and treatment options. Dr. Burnett will also discuss deep brain stimulation (DBS) therapy, including the benefits and risk of surgery and appropriate patient selection.

Date: Thursday, Feb. 8 Time: 5:30–7:30 p.m.

FREE HEART SCREENINGS

Learn your risk of heart disease with a preventive heart screening. You’ll receive free cholesterol and blood pressure readings and learn your 10-year risk for heart disease. Primary care physicians and cardiologists will be here and can discuss your results.

Date: Thursday, Feb. 15 Time: 5:30–7:30 p.m.

ASK THE DOCTOR: SURGICAL WEIGHT-LOSS SOLUTIONS

Dr. Kyle Stephens, bariatric surgeon, will provide information on the health benefits of medical weight-loss surgery and address your questions. Weight-loss surgery seminars are offered every other Wednesday in the hospital boardroom.

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 physicians. Visit houstonmethodist.org/stjohn-er to learn more.

PLANNING FOR BABY

If you are pregnant, or planning your pregnancy, don’t miss this informative evening. Our obstetrician-gynecologists will talk with you about planning and enjoying a healthy pregnancy. Join us for light bites and refreshments and bring your questions. Each guest will receive a gift.

Date: Thursday, Jan. 25 Time: 6–8 p.m.

Location: South Shore Harbour Resort and Conference Center 9th Floor (Harborview Room) 2500 South Shore Blvd., League City, TX 77573

2 LEADING MEDICINE IN CLEAR LAKE AND SOUTHEAST HOUSTON

FREE PREGNANCY E-NEWSLETTER SERIES

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.

A LOOK AT STROKE IN

YOUNGER PATIENTS Me? At risk for stroke? No way!

S

troke is often considered a condition that almost exclusively strikes older people. Although people over 50 still comprise the vast majority of stroke patients, research findings published in 2016 in the Journal of the American Heart Association suggest a disturbing trend that indicates an increase Dr. Akhila in stroke in younger age groups.

Vijayakumar “When people think of stroke, they think of grandpa who smokes and has hypertension,” said Dr. Akhila Vijayakumar, neurologist and medical director of the stroke program at Houston Methodist St. John Hospital, “And while he certainly carries a higher risk of stroke, it doesn’t mean that if you’re young you can’t be at risk of stroke, too.”

BE ALERT TO THE RISKS

Research indicates that 10 percent of all ischemic strokes (the most common type of stroke) now occur in adults under age 50. U.S. researchers attribute the apparent rise in strokes among younger adults to many of the same lifestyle risk factors commonly found in older patients: high blood pressure, obesity, high cholesterol levels, diabetes and smoking.

Vijayakumar said younger patients may have additional stroke risk factors, such as congenital or structural heart defects or injuries to the arteries in the neck possibly caused by even minor trauma. Another factor may be illicit drug use, including abuse of substances like cocaine and methamphetamines. Young people with blood coagulation defects or conditions, such as sickle cell disease, are more susceptible to stroke, and the risk also increases if they have developmental anomalies of the blood vessels of the brain.

TAKE STEPS TO PROTECT AGAINST STROKE

While the symptoms of stroke are the same for both older and younger adults (see “The FAST Test”), people may not readily recognize the symptoms in younger patients, which may lead to a delay in diagnosis that can cause permanent damage.

Vijayakumar said young adults should be aware of their stroke risk factors and the importance of maintaining a healthy weight, avoiding smoking and scheduling regular blood pressure, cholesterol and diabetes screenings.

THE FAST TEST

F A S T Face

Arms

Speech

Time

The “FAST” test from the National Stroke Association may help you determine if someone is having a stroke: Face: Ask the person to smile. Does one side of the face droop?

Arms: Does one arm drift downward when you ask the person to raise both arms?

Speech: Can he or she repeat a simple sentence correctly? Are the words slurred?

Time: If a person shows any of these symptoms, call 911 immediately. Carefully note the time when the first symptoms appeared. This information is critical for treatment decisions.

Get the Stroke Care You Need

Awarded by the American Heart Association as a Silver Plus Target: Stroke Honor Roll ELITE PLUS, Houston Methodist St. John Hospital is committed to helping stroke patients achieve the best possible long-term results. To learn more about our complete stroke care services, contact Maria Socci at masocci@houstonmethodist.org or 281.523.2471.

Please note that email is not a secure means to communicate confidential or health-related information, including Social Security number, date of birth, financial information, etc.

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WHY WOMEN SHOULD LISTEN TO THEIR HEARTS Symptoms can vary when compared to men

New High Blood Pressure Guidelines

Are you at risk?

The American College of Cardiology and American Heart Association released new scientific guidelines on what’s considered high blood pressure, lowering the threshold from 140/90 mmHg to 130/80 mmHg. Recommendations focus on making healthy lifestyle changes to lower blood pressure, including quitting smoking, managing weight, being active and eating a heart-healthy diet. Some patients may also need medication.

The new blood pressure categories consider both systolic (top number) and diastolic (bottom number) pressure.

Normal: Less than 120/80 mmHg levated: Systolic between 120–129 and diastolic E less than 80 mmHg igh Stage 1: Systolic between 130–139 or diastolic H between 80–89 mmHg igh Stage 2: Systolic at least 140 or diastolic at least H 90 mmHg Talk to your doctor to learn if you’re at risk and how you can protect your heart.

4 LEADING MEDICINE IN CLEAR LAKE AND SOUTHEAST HOUSTON

D

espite the perception that heart disease is a man’s disease, it’s the No. 1 killer of women, according to the American Heart Association.

Millions of women die of Dr. Selvin heart disease every year, Sudhakar yet many are unaware of their risk for the condition. Women often put off taking care of their health — and this inaction can put an extra burden on their hearts.

One form of heart disease, a heart attack, can strike suddenly and with no advance warning. Just like men, women often experience the crushing chest pain and discomfort typically associated with a heart attack. But, women are somewhat more likely than men to experience other common heart attack symptoms and often ignore them.

“A misunderstanding of gender-related heart attack symptoms could cause women to delay getting care because they aren’t sure if they’re having a heart attack, panic attack or indigestion,” according to Dr. Selvin Sudhakar, a cardiologist with Houston Methodist St. John Hospital.

“It’s key to learn and watch for signs that something may be wrong — and if you’re ever in doubt, don’t hesitate to seek prompt medical care.”

Use these heart health facts for women to bolster your prevention and treatment efforts:

HOW A WOMAN’S HEART ATTACK MAY FEEL

You may already be familiar with classic heart attack symptoms for men, such as crushing chest pain that radiates down the left arm associated with sweatiness, paleness and shortness of breath. “Women are more likely than men to describe chest pain that is burning and sharp, as well as experience extreme fatigue, pain in the neck, jaw, throat, abdomen or back,” Sudhakar said.

“Breaking out in a cold sweat is also more common in women, as is lightheadedness,” he explained.

RISK FACTORS OFFER CLUES

Managing your risk factors for cardiovascular disease is only possible if you know what they are, and routine screening tests can reveal the answers.

At your next checkup, ask your doctor to assess your weight and BMI (body mass index), waist circumference, blood pressure, cholesterol and fasting blood glucose level. “These tests offer important clues to cardiovascular health as well as your overall health,” Sudhakar said.

HEART ATTACK NOT SOLE SETBACK

With all the focus on heart attacks, some aren’t aware that cardiovascular disease can take many forms. Other heart problems include heart failure, in which the heart isn’t pumping as efficiently as it should; arrhythmia, a too-slow or too-fast heartbeat that can affect its ability to meet the body’s needs; and heart valve problems, which can impede proper blood flow through the heart.

Nearly all of these conditions are easily detectable with routine medical checkups,” Sudhakar said. “It’s yet another reason why establishing an ongoing relationship with a primary care physician is so critical to your heart health.”

MENOPAUSE TOO LATE TO PREPARE Women with heart disease risk factors, such as high blood pressure, high cholesterol and a family history, shouldn’t wait until menopause to start a dialogue with their primary care physician about a prevention regimen to keep them healthy.

A recent survey published in the Journal of the American College of Cardiology found that 74 percent of women in the United States had at least one heart disease risk factor, but only 16 percent told their doctor about it.

“Women have such a low prevalence of heart disease until menopause that often times, the topic is ignored until women are well into their 50s and 60s,” Sudhakar said.

“But those with risk factors need to be 10 years ahead of the game when it comes to prevention. Unfortunately, too many women already have heart disease by the time they’re tested.”

LEARN ABOUT YOUR FAMILY HEALTH HISTORY The role of genetics and family history is becoming increasingly clear when evaluating our risks of developing heart disease, said Houston Methodist cardiologist Dr. Selvin Sudhakar. “That’s why it’s imperative to delve into your family tree and determine what your ancestors died from — especially if they died at a young age — as well as what your family members may be living with right now,” Sudhakar emphasized. “Take the time to sit down with family elders and ask questions about what led to GreatUncle Henry’s and Grandma Mary’s deaths, for example. The answers may surprise you.”

If you learn that heart disease runs in your genes — especially through several generations — share that information with your doctors. They may recommend certain dietary or lifestyle changes, prescribe medications, and/or perform various heart disease screening tests earlier or more frequently. You may also be referred to a cardiologist for regular care.

Heart Health Screenings

Thursday, Feb. 15 5–7 p.m.

Houston Methodist St. John Hospital, Main Lobby 18300 St. John Dr. Nassau Bay, TX 77058 Schedule an appointment to learn your 10-year risk for heart disease and receive cholesterol and blood pressure screenings.

Registration required. Register online at houstonmethodist.org/ events or call 281.333.8899.

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PRIORITIZING WOMEN’S HEALTH From preventive care to tailored treatments, regular exams crucial

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rom job commitments to family responsibilities to leisure-time pursuits, women’s hectic lives often leave regular health care as one of their last priorities.

But this approach is a mistake, according to Dr. Elizabeth Cloninger, Medical Director, Women’s Services at Houston Methodist St. John Hospital.

Dr. Elizabeth “Neglecting well-woman care can have Cloninger serious negative consequences on, not only your physical health, but your vitality and sense of well-being,” Cloninger explained. “We all want to feel and function at our best, and prioritizing your health is one of the top ways to accomplish that.”

Through milestones, such as pregnancy and menopause, to potential trouble spots, such as incontinence or gynecological cancers, comprehensive well-woman care is crucial throughout the decades. “Many illnesses affecting women can be prevented with regular health exams and screenings, and women who prioritize this often know sooner if something has changed with their bodies and are typically more prepared for each life stage,” Cloninger said.

What does seeking comprehensive well-woman care entail?

OBSTETRICIAN-GYNECOLOGIST EXAMS

A successful doctor-patient relationship between a woman and her obstetrician-gynecologist often starts in the late teen years — particularly as an adolescent becomes sexually active — and continues through many key milestones, with annual exams offering an excellent opportunity to discuss issues such as birth control choices, painful or irregular periods, premenstrual syndrome (PMS), sexual difficulties and preconception measures, as well as pregnancy and menopause.

The American Congress of Obstetricians and Gynecologists (ACOG) offers recommendations for well-woman care starting at age 13 and extending to 65-plus, with guidelines for screening, laboratory and other tests, and immunizations based on each woman’s age and individual risk factors.

But an obstetrician-gynecologist — working solo or in cooperation with a team of health care professionals — often serves as a touchstone for each woman’s overall health as well.

6 LEADING MEDICINE IN CLEAR LAKE AND SOUTHEAST HOUSTON

Many obstetrician-gynecologists handle general health screenings for common conditions, such as high blood pressure, diabetes and bone density screening for osteoporosis. Additionally, they screen for, treat and/or make appropriate referrals for conditions such as depression, sexually transmitted infections (STIs), HIV and genetic counseling, among others.

“Pelvic exams and clinical breast exams are a central and expected part of annual well-woman checkups for many, but aren’t close to being all of the health aspects typical obstetriciangynecologists cover with patients,” Cloninger said. “They also assess factors, such as your diet and lifestyle, medical and family history, and any medications and supplements you take and why.

Obstetrician-gynecologists focus on the whole patient, even as they simultaneously concentrate on each woman’s sexual, hormonal and reproductive health issues.”

TAILORED TREATMENTS

Regular well-woman care can help women navigate through challenging times, offering targeted advice and treatments spanning issues from incontinence to menopause and more.

Often triggered by childbirth, which can weaken pelvic floor muscles, incontinence is a problem many women suffer with in silence, Cloninger said. They may leak urine when they laugh, cough or sneeze, or rush to the bathroom many times a day.

Incontinence also occurs more frequently as women age and other physical problems add to pelvic floor stress.

“But women may not realize that their obstetriciangynecologist is armed with a wealth of information and treatment approaches — ranging from lifestyle modifications to medication to surgical procedures — that can ease symptoms and help them reclaim their lives,” Cloninger said.

Similarly, perimenopause — the years before menstrual periods permanently cease — can present large and small challenges to women dealing with a variety of symptoms.

“Hot flashes, sleep problems and vaginal dryness can seem like a nuisance to bring up to your doctor, but we can ease you through a perplexing and challenging transition,” Cloninger said. “Your obstetrician-gynecologist can also offer an individualized approach to handling symptoms, guiding you on whether hormone replacement therapy or other medication- or supplement-based approaches are appropriate for you.”

Schedule Your 3-D Mammogram

To schedule a 3-D mammogram at the Houston Methodist Breast Care Center at St. John, visit houstonmethodist.org/appointments or call 281.333.8858.

CANCER SCREENINGS HELP SAVE LIVES By now, the statistics are quite familiar: 1 in every 8 women will be diagnosed with breast cancer at some point in their lives. Those numbers are lower for other types of reproductive or gynecological malignancies — about 22,000 are diagnosed each year with ovarian cancer, for example, and another 13,000 with cervical cancer — but an annual well-woman exam serves as a springboard for each patient to undergo cancer screenings appropriate to their age and individual risk factors.

Obstetrician-gynecologists perform Pap tests that screen for cervical cancer and pelvic exams to monitor ovarian health during well-women exams. They also perform clinical breast exams in-office, counseling and referring patients as needed regarding screening mammograms and other age-appropriate cancer screenings, such as colonoscopy for colorectal cancer in patients 50 and older.

Houston Methodist St. John Hospital offers the gold standard in mammography: 3-D digital mammograms.

Also known as digital breast tomosynthesis, 3-D mammography is one of the most effective tools available in detecting breast cancer at an early stage, before tumors are large enough to be felt or cause symptoms.

This advanced technology enables doctors to more accurately locate an abnormality in the breast, leading to fewer unnecessary callbacks for additional images.

“It can’t be stressed enough that early cancer detection is critical, even for cancers that can’t be prevented,” Cloninger said. “And if you are diagnosed with breast cancer or a gynecologic cancer, having a trusting ongoing relationship with an obstetriciangynecologist offers you stability, information and prompt care during a tumultuous time.”

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