Leading Medicine Spring-Summer 2017, Houston Methodist Sugar Land Hospital edition

LEADING MEDICINE SPRI N G/SUM M ER 217

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

Celebrating 10 Years of Excellence in Heart and Vascular Care

TEST YOUR BREAST CANCER KNOWLEDGE

YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN FORT BEND AND SURROUNDING COUNTIES

CELEBRATING 10 YEARS of Excellence in Heart and Vascular Care

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n 2007, Leszek Gorski needed heart valve replacement surgery. He consulted with Dr. Mahesh Ramchandani, cardiothoracic surgeon at Houston Methodist Sugar Land Hospital. “Dr. Ramchandani told me this would be the first open heart surgery at Houston Methodist Sugar Land, and he asked me if I would agree to be patient No. 1,” Gorski recalled.

Dr. B. Keith Ellis “I said, ‘I’m always No. 1! Definitely, let’s do it!’”

PATIENT NO. 1

Gorski knew it was time to consult a specialist when he started having difficulty breathing and even lost consciousness several times. Tests revealed that Gorski’s aortic valve was abnormally small, a condition he was likely born with. Valve disease can affect any of the four heart valves and may be the result of a birth defect, aging or infections. In addition to shortness of breath and fainting, other symptoms of valve disease may include fatigue, chest pain and swelling of the ankles, feet or abdomen.

For Gorski, the best treatment option was to replace his defective aortic valve with a pig valve. Ramchandani and his associate, Dr. Uttam Tripathy, a cardiothoracic surgeon at Houston Methodist Sugar Land, performed the surgery with Dr. Zbigniew Wojciechowski, the anesthesiologist in charge.

The surgery was a success and marked not only a return to health for Gorski, but the beginning of 10 years of leading heart and vascular care at Houston Methodist Sugar Land.

THE FOUNDATIONS OF EXCEPTIONAL CARE

“The Heart & Vascular Center really started in 2006,” said Dr. B. Keith Ellis, medical director of cardiovascular services at Houston Methodist Sugar Land. “That’s when we instituted the STEMI program,” Ellis explained. ST-elevation myocardial infarction (STEMI) heart attacks involve a complete blockage in a coronary artery and carry a high risk of death or disability.

To handle STEMI heart attacks, a hospital must have a cardiologist and cardiac surgeon on call and must meet the national benchmark of treatment within 90 minutes. “To get that program up and going and deliver good results was a major accomplishment. It helped us solidify our relationships with surgeons and improve outcomes for patients,” Ellis said.

CONTINUING TO ADVANCE

Using its STEMI and open-heart surgery programs as a springboard, the Heart & Vascular Center continues its pursuit of excellent care and leading-edge medicine. “We work hard to make sure patients receive the most technologically innovative care available,” Tripathy added. To that end, the Heart & Vascular Center creates a heart team consisting of a general cardiologist, an interventional cardiologist, a cardiovascular anesthesiologist and a cardiovascular surgeon for every patient who needs open heart surgery.

“The team discusses each case and decides the best treatment strategy, so patients aren’t getting just one doctor’s opinion, but are accessing a collaboration of doctors across various specialties,” Tripathy explained. “It really ensures that patients get the latest and most evidence-based treatment strategy.” Plus, the doctors

Innovative surgery for an innovative man

WHERE IS HE NOW?

Houston Methodist Sugar Land’s first open-heart surgery patient, Leszek Gorski, hasn’t been idle since his heart valve replacement surgery in 2007.

An avid scuba diver, he designed a commercial scuba diving helmet. Now at age 63, Gorski lives in the Florida Keys.

To see Houston Methodist Sugar Land Hospital’s world-class team of cardiologists, surgeons, specialists and support staff in action, visit bit.ly/heartvideo-sl.

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L-R are Uttam Tripathy, MD; Zbigniew Wojciechowski, MD; and Mahesh Ramchandani, MD. Front is Janet Leatherwood, RN, Chief Nursing Officer at Houston Methodist Sugar Land.

at the Heart & Vascular Center at Houston Methodist Sugar Land work closely with their colleagues within Houston Methodist Hospital in the Texas Medical Center, creating a supportive and collaborative environment that ensures top-notch patient care.

SPECIALIZED CRITICAL CARE

“We’ve grown our expertise not only by recruiting more surgeons of the highest quality but by adding the intensivist program to deliver the best postoperative care,” said Ramchandani, now vice chair and section chief for cardiovascular surgery at the Houston Methodist DeBakey Heart & Vascular Center. Intensivists — doctors specializing in critical care in the intensive care unit (ICU) — ensure that postoperative patients and the critically ill get round-the-clock medical care adapted to the unique needs of ICU patients — typically found in only the largest teaching hospitals.

ADVANCED CARDIOVASCULAR CARE

Patients with the following medical conditions receive innovative care at the Heart & Vascular Center: Acute stroke Coronary artery disease Cardiac arrhythmias Peripheral arterial disease Chronic total occlusion Pulmonary embolus Congenital heart defects

WARNING SIGNS OF A HEART ATTACK

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Although symptoms vary depending on the specific type of disease, general warning signs of heart disease include: Chest pain Shortness of breath Pain in the neck, jaw, throat, back or upper abdomen Lightheadedness, dizziness or fainting Pain, numbness, weakness in legs or arms Irregular heart beat Fatigue Swelling of the ankles, feet or hands Indigestion or heartburn Nausea or vomiting

Listen to Your Heart

To schedule an appointment with a cardiologist at Houston Methodist Sugar Land Hospital, visit houstonmethodist.org/spg or call 281.205.4514 to find a doctor in your area.

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

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Ways to Boost Bedtime

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ew things feel as good as a restful night’s sleep. The restorative power of sleep can help you feel refreshed and ready for the day. But, if you find yourself groggy and crabby in the morning, you may not be getting enough sleep. If you’re often having issues with sleep, it’s time to make a change.

“Getting the right amount of sleep is important for everyone,” said Dr. Raziuddin Ahmed, a board-certified sleep medicine specialist with Houston Methodist Pulmonary and Sleep Medicine Specialists. “Sleep helps your brain remember information and better allows you to pay attention during the day.”

What’s considered a good amount of sleep? The Centers for Disease Control and Prevention recommends 7 to 9 hours of sleep for adults, 8.5 hours or more for teens and 10 hours or

4 LEADING MEDICINE IN FORT BEND AND SURROUNDING COUNTIES

more for children. Getting less sleep than you need could lead to an increase in blood pressure and stress hormones, lower glucose tolerance and weight gain.

To improve your odds of getting a better night’s rest, try these tips:

1

Be consistent. Make it a habit to go to sleep and arise at the same time every day — even on the weekends.

2

Keep a sleep-friendly bedroom. Keep your bedroom dark, free of distracting noise and at a comfortable temperature.

3

Unplug early. Shut down screens (TVs, laptops, cellphones, etc.) an hour or more before bedtime.

4

Get exercise. Regular exercise often can help you sleep better and reduce your stress level.

SLEEP AND YOUR HEALTH By the Numbers 50-70 MILLION U.S. adults have sleep or wakefulness disorders

z z z

1 IN 3 AMERICANS get < 7 hours of sleep a night

1 IN 3 ADULTS

12-18 MILLION

are sleepy during the day

U.S. adults have sleep apnea

80% people with undiagnosed obstructive sleep apnea

100,000

motor vehicle crashes a year caused by drowsy drivers

SLEEPING LESS THAN 7 TO 8 HOURS has been linked to these health risks: heart disease stroke diabetes obesity cancer high blood pressure

Sleep disorders may also: Increase stress on the heart

Increase insulin resistance for people with diabetes

Reduce the body’s response to flu vaccine

Sources: National Heart, Lung, and Blood Institute, Centers for Disease Control and Prevention, Cleveland Clinic and the National Sleep Foundation.

IS IT A SLEEP DISORDER?

Dr. Raziuddin Ahmed

For some people, poor sleep may be caused by an untreated sleep disorder, such as insomnia, narcolepsy, sleep apnea or restless legs syndrome. If you wake up frequently at night, snore loudly, wake up exhausted or nod off during the day, you may have a sleep disorder.

“Sleep disorders can make you feel like you’re never going to get a good night’s sleep again. That’s simply not true,” Ahmed said. “With treatment, many patients can get back to better sleep and improve their quality of life.”

To schedule an appointment with Dr. Raziuddin Ahmed at Houston Methodist Pulmonary and Sleep Medicine Specialists, call 281.242.2444 today.

HOUSTONMETHODIST.ORG/SUGARLAND 5

IS JOINT REPLACEMENT

SURGERY RIGHT FOR YOU? Dr. Ashvin K. Dewan

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 — joints can wear down 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. Ashvin K. Dewan, a fellowshiptrained orthopedic surgeon at Houston Methodist Orthopedics & Sports Medicine at Sugar Land. Here, he 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. Everyone can expect some wear and tear on their knees with time. For those with a

genetic predisposition to osteoarthritis however, the rate of joint degeneration can be higher. Osteoarthritis is typically passed down on the maternal side. Many people with osteoarthritis are active even though increased activity can make the problem worse.

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 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. Some high impact exercises, such as running, can be more taxing on your knees. A lower impact exercise, such as swimming, is preferable for a person with knee arthritis.

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. But 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 or older since the lifespan of a replacement is around 20–25 years. Also, it helps when a person is a healthy weight, with minimal medical problems, a nonsmoker and comes in ready to work through the recovery process.

RAPID RECOVERY PROGRAM Over the last few years, we’ve transformed our joint replacement recovery process to get otherwise healthy people back to their lives sooner by reducing their hospital stay. While not for everyone, the Rapid Recovery program is for those joint replacement candidates who are at an ideal weight, are nonsmokers and aren’t managing other medical conditions.

Benefits of the Rapid Recovery program include: using intravenous sedation during joint replacement

6 LEADING MEDICINE IN FORT BEND AND SURROUNDING COUNTIES

surgery, instead of traditional general anesthesia, to aid in waking up more alert and with less nausea being up and walking with a nurse up to three times the same day as surgery beginning physical therapy almost immediately, which can help speed healing While all recoveries take time, this program can help get you home more quickly, so you can continue healing where you’re most comfortable.

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 piece could be made of metal and snap into a plastic base plate on the tibia.

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 or 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 the evening after surgery with physical therapy to follow for as long as necessary. The more time and energy you invest in the early recovery period to work through

the post-operative pain and regain strength, the better the outcome is in the long run. 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 high impact sports activities like running or basketball. However, things like walking, elliptical, swimming, bicycling, tennis and recreational skiing can be fine.

See a Specialist

For an appointment with Dr. Ashvin K. Dewan at Houston Methodist Orthopedics & Sports Medicine at Sugar Land, visit houstonmethodist.org/ orthopedics-sl to easily schedule online or call 281.690.4678.

HOUSTONMETHODIST.ORG/SUGARLAND 7

KEEPING KIDS SAFE From Sports Injuries

Schedule Today

To schedule an appointment with Dr. Nader Ayub at Houston Methodist Orthopedics & Sports Medicine at Sugar Land, visit houstonmethodist.org/ orthopedics-sl or call 281.690.4678.

8â&#x20AC;&#x201A; LEADING MEDICINE IN FORT BEND AND SURROUNDING COUNTIES

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taying active through sports and other physical activities is one of the best ways to lead a long, healthy life. But in the blink of an eye, a sports injury can leave you sidelined for weeks, months or even years. Heading off a sports injury before Dr. Nader Ayub it happens can be one of the best ways you can stay active and in the game.

Injury prevention education needs to start early, especially for young athletes.

START WITH A GREEN LIGHT.

Get a physical to make sure you’re healthy before the season starts.

ALWAYS WEAR PROPER PROTECTIVE EQUIPMENT, clothing and well-fitting shoes

designed for the sport you are playing. Protective eyewear and helmets are key for many sports.

A PARTNERSHIP FOR STUDENT ATHLETES

Houston Methodist Orthopedics & Sports Medicine at Sugar Land works hard to help prevent sports injuries and promote sports safety in our community. As part of this mission, we partner with Fort Bend Independent School District to provide assistant athletic trainers at each high school to ensure their student-athletes receive fast, comprehensive care for sports injuries.

“Our unique partnership gives students access to sports medicine experts right away,” said Dr. Nader Ayub, a board-certified primary care sports medicine doctor with Houston Methodist Orthopedics & Sports Medicine at Sugar Land and team physician for Fort Bend ISD schools.

“We can cover more games and practices to help in case of injury and educate on injury prevention.”

A big part of Ayub’s work as a team physician is preventing injuries. Ayub’s tips for preventing sports injuries are simple:

WARM UP AND STRETCH BEFORE AND AFTER EXERCISING. Warming up gradually

increases the heart rate and can prevent muscle strain and joint injury.

STAY HYDRATED. Drink lots of water before, during and after your activity.

AVOID PLAYING WHEN YOU’RE TIRED OR IN PAIN. Listen to what your body tells you and you can avoid pushing too far.

STUDENT PHYSICALS Saturday, July 29 • 9 a.m. – noon Houston Methodist Orthopedics & Sports Medicine at Sugar Land 16811 Southwest Frwy., Sugar Land, TX 77479 Extracurricular preparticipation physicals will be available for all students ages 12-18. Cost is $20 (cash only)*. Orthopedic, sports medicine and cardiology specialists will be on-site to provide additional clearance as needed. For more information, email athletictrainer@houstonmethodist.org or call 281.275.0447. * Proceeds generated from the physicals are donated back to the athletic training program of the school the student attends.

HOUSTONMETHODIST.ORG/SUGARLAND 9

Test Your Breast Cancer Knowledge How well do you understand your risks?

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ost of us know someone who has faced breast cancer, but many don’t understand what we can do to lower our risk of the disease diagnosed in 1 in 8 American women. Take our quiz to test your knowledge.

Consult an Expert

Dr. Sandra Templeton, a boardcertified surgeon with Houston Methodist Breast Surgery Partners, specializes in diseases Dr. Sandra and surgery of the breast and is a Templeton well-respected breast surgeon of Fort Bend County. Her clinical expertise includes advanced breast surgery techniques, nipplesparing mastectomies, skin-sparing mastectomies, oncoplastic procedures and benign breast diseases to include high-risk patients.

To schedule an appointment with Templeton, call 281.494.3000.

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1. Most cases of breast cancer are diagnosed in women 50 and older.

At what age should you start getting annual mammograms that can reveal breast cancer in the earliest stages?

A. 60 C. 40 B. 50 D. 30 ANSWER: C. Most women should have an annual mammogram starting at age 40. If you are at high risk, ask your doctor about starting sooner.

2. Are mammograms the only way to detect breast cancer at an early stage?

A. Yes C. Sometimes B. No D. It depends on the woman’s age ANSWER: B. In conjunction with annual mammograms, annual breast exams at your doctor’s office and monthly breast self-exams can also help identify lumps or changes in your breasts that could be signs of cancer.

3. What steps can you take to lower your risk of breast cancer?

A. Don’t use deodorant or antiperspirant B. Avoid wearing underwire bras C. Maintain a healthy weight and get regular exercise D. Avoid airport scanners that use X-rays ANSWER: C. These healthy behaviors can lower your risk. The other answers are myths.

4. Which race has the highest death rate from breast cancer?

A. African-American B. Caucasian C. Hispanic D. Asian-American/Pacific Islander ANSWER: A. While race does not affect breast cancer risk, African-Americans have a higher death rate from the disease than any other group: 31.6 percent, compared with 22.4 percent for Caucasian women and 14.9 for Hispanic women.

5. Inheriting harmful mutations in the BRCA1 or BRCA2 gene is one of the main risk factors for breast cancer. Which of these other factors can also increase your risk?

A. Family or personal history of breast cancer B. Drinking alcohol C. Long-term use of hormone replacement therapy D. All of the above ANSWER: D. All of these play a part in your risk for developing breast cancer. Other risk factors include dense breasts and having undergone treatment with radiation therapy to the breast and chest.

6. Should I have a test to find out whether I carry the BRCA1 or BRCA2 gene mutation that can cause breast cancer?

A. Yes B. No C. Maybe, if you have a strong family history of breast cancer D. Only if you know someone in your family carried the gene mutations ANSWER: C. “Strong family history” includes close relatives diagnosed before age 50, a family member with the gene mutations, or family members with multiple breast cancers, cancer in both breasts, or both breast and ovarian cancers. You should have genetic counseling before deciding to get tested.

7. If the disease is detected early, what is the five-year survival rate for breast cancer?

A. 98 percent C. 80 percent B. 85 percent D. 75 percent ANSWER: A. Stage 1 breast cancer, in which the cancer has not spread beyond the original cancerous cells, is highly treatable when detected early through a mammogram or other screening.

8. How many breast cancer survivors are in the United States today?

A. 1 million C. 2.3 million B. 1.7 million D. 2.8 million ANSWER: D. Although breast cancer remains the second leading cause of cancer death in women (behind lung cancer), far more women have survived the disease.

HOW TO PERFORM A BREAST SELF-EXAM While lying down, place a pillow under your right shoulder and your right arm behind your head. With your left hand, move the pads of your fingers around your right breast area and armpit, using circular motions. Repeat with opposite sides for your left breast.

Standing in front of the mirror, look for any changes in breast appearance by examining them with your arms at your sides and again with your arms raised overhead.

Perform these checks monthly, looking for the following signs: A lump in the breast Any unexplained change in breast size or shape Dimpling anywhere on the breast Unusual nipple tenderness or discharge A nipple that is turned slightly inward or inverted Skin that’s become scaly, red or swollen, or any change in skin texture These signs do not necessarily mean you have cancer, but you should see your doctor to discuss them.

CANCER SURVIVORS DAY CELEBRATION Friday, June 2 10 a.m. – 1:30 p.m.

Sugar Land Marriott Town Square 16090 City Walk, Sugar Land, TX 77479 Join us for a tropical celebration and luncheon with keynote speaker LaDonna Gatlin. Activities include a cancer survivor resource fair and Hawaiian-style lunch. Don’t forget to wear a floral shirt, grass skirt or colorful lei! Registration required. Visit events.houstonmethodist.org/ survivorluncheon-sl or call 281.205.4514.

HOUSTONMETHODIST.ORG/SUGARLAND 11

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LEADING MEDICINE IN GREATER HOUSTON

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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 281.205.4514 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 . 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 1. 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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