Leading Medicine Fall 2019, Houston Methodist West Hospital edition

LEADING MEDICINE FA LL 019

Recognize the Warning Signs of Stroke 20 Tips for a Healthy Pregnancy WIN A $100 AMAZON GIFT CARD See inside for details.

Breast Cancer Surgery

A Treatment Plan Designed

JUST FOR YOU YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN WEST HOUSTON/KATY

RECOGNIZE THE WARNING

SIGNS OF STROKE

E

very 40 seconds, someone in the U.S. has a stroke.

Every 4 minutes, someone dies of stroke.* The chances of surviving a stroke are much greater when treatment begins Dr. Quoc Pham quickly, so it’s important to learn the signs of stroke and act fast.

“When it comes to stroke, every minute that passes increases the loss of brain function,” said Dr. Quoc Pham, a specialist in emergency medicine at Houston Methodist West Hospital. “Knowing the warning signs, and acting on them, can have a real impact on the outcome for a stroke patient.”

UNDERSTANDING STROKES

Strokes are sometimes called “brain attacks.” A stroke occurs when a blood vessel bringing oxygen and nutrients to the brain is clogged (ischemic stroke) or bursts (hemorrhagic stroke). According to the Centers for Disease Control and Prevention, about 87% of strokes are ischemic strokes due to blocked blood flow to the brain. The damaged or blocked vessel doesn’t deliver the blood and oxygen the brain needs, and nerve cells in the affected area of the brain die within minutes.

ARE YOU AT RISK FOR STROKE?

“Anyone can have a stroke,” said Pham, “but there are factors, such as age, a history of heart attack, untreated atrial fibrillation or a family history of stroke that increase your risk.” While some risk factors are beyond your control, there are some you can work with your physician to control or treat, including: Atrial fibrillation (an irregular heartbeat) or other heart disease Carotid or other artery disease Diabetes

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THINK FAST Learn to recognize a stroke.

?

FACE

Does the face look uneven?

Ask the person to smile.

ARMS

Does one arm drift down?

Ask the person to raise both arms.

SPEECH

Does their speech sound strange?

Ask the person to repeat a simple phrase.

TIME

If you observe any of these signs, it’s time to call 911 and to be taken to the nearest emergency room.

DO NOT DELAY. DO NOT DRIVE YOURSELF. DO CALL 911.

Be Prepared

Houston Methodist West is a designated Primary Stroke Center, meaning that when seconds count, you have access to the best rapidresponse stroke treatment and resources in the West Houston-Katy area.

Visit houstonmethodist.org/stroke to learn more about the prevention and treatment of strokes at Houston Methodist West Hospital.

High blood cholesterol High blood pressure Overweight and obesity Physical inactivity Sickle cell disease Tobacco use

WATCH FOR WARNING SIGNS

During a stroke, blood deprivation to the brain can affect a person’s senses, motor activity, speech and ability to understand speech, behavior and thought patterns, memory and emotions. Paralysis or weakness on one side of the body is common. “Memorize the ‘Think FAST!’ guidelines to recognize and take action as quickly as possible,” said Pham. “It could save a life, or at least minimize disability.”

FAST stands for face, arms, speech and time (see sidebar) — a quick and simple check of vital functions and a reminder to get help quickly. Other stroke symptoms that may occur include: A severe headache of unknown cause Confusion; trouble speaking or understanding Loss of balance or coordination, trouble walking or dizziness Numbness or weakness of the face, arm or leg, especially on one side of the body Trouble seeing out of one or both eyes; blurred or double vision * S ource: Centers for Disease Control and Prevention

Harvesting Autumn’s

HEALTHY BOUNTY

Y Dr. Angela Chen

ou may not think of autumn as a time to get healthy. But with kids going back to school, the leaves changing color and the air feeling cooler, autumn can be a time for new beginnings.

Make a fresh start this fall by modifying some of your eating habits — the results can get you on the way to a healthy heart.

MAKE GOOD CHOICES

“While some fat is essential to your diet, eating too much saturated fat and transfat can contribute to high cholesterol and obesity, which can lead to heart disease, diabetes and stroke,” said Dr. Angela Chen, primary care physician with Houston Methodist Primary Care Group.

Instead use heart-healthy oils, such as canola, corn, olive, peanut or safflower. Omega-3 fatty acids found in fish, such as lake trout, salmon and sardines, are also beneficial to health.

Sauté in olive oil instead of butter, and serve fish at least twice a week.

Grains are an important part of a healthy diet, but some are better choices than others. Refined white flour has fewer nutrients and less fiber than whole-grain options. Choose delicious and healthy alternatives, such as brown rice, whole-grain breads and pasta, and grains like barley and quinoa.

“Try filling half of your plate with fruits and vegetables. While that may sound like a lot, eating more fruits and vegetables is a great way to protect your heart,” Chen said. They are low in calories and full of antioxidants, essential vitamins and minerals, and fiber. Add a few of these tasty fall foods to your diet: Apples – fiber and vitamin C Cranberries – vitamin B6, potassium and vitamin C Brussels sprouts – vitamin C, vitamin A and folate Sweet potatoes – vitamins A, C and B6, fiber and potassium Swiss chard – vitamins A and C, and iron By making small tweaks to your diet, you’ll reap big rewards.

Check Up on Your Health

Fall is great time to schedule health checkups for you and your family. Schedule online at houstonmethodist.org/pcg/west or call 713.394.6724 to find a primary care provider close to home.

Easy Butternut Squash Soup This butternut squash soup is simple to prepare and chock-full of nutrients, such as beta carotene, calcium, vitamin C and potassium.

Ingredients 2 pounds butternut squash, peeled and chopped 5 cups of low sodium chicken stock 1 teaspoon dried rosemary 1 teaspoon ground sage ¼ cup 1% or skim milk Salt and pepper to taste Directions 1. Add butternut squash and chicken stock to a stockpot or sauce pan. Make sure the stock covers the squash.

2. Add a pinch of salt.

3. Cook on high heat until it boils. Reduce heat to a simmer and cover.

4. Add herbs and pepper.

5. Simmer for 30 minutes, or until squash is tender.

6. Remove from heat and cool. Then mix soup in a blender until smooth, or use an immersion blender.

7. Stir in milk, and add salt and pepper to taste.

Nutritional information per two-cup serving: 92 calories, 1 g fat, 19 g carbohydrates, 20 g protein.

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Breast Cancer Surgery

A Treatment Plan Designed Just for You A breast cancer diagnosis can stop you in your tracks and leave you wondering: What does this mean for my future? How will my body change? You may Dr. Candy be flooded with emotions Arentz about the future, and this is completely natural.

If surgery is part of your treatment plan, you might worry about what you will look like afterward.

“Surgery can leave scars, and for those who Dr. Warren need to have a significant Ellsworth part of their breast or breasts removed, it’s normal to have some anxiety about how your appearance may change,” said Dr. Candy Arentz, a breast surgeon with Houston Methodist West Hospital. The psychological impacts of mastectomy can touch various aspects of your life, from body image and selfconfidence to sexuality and intimacy.

MORE OPTIONS, BETTER RESULTS Women undergoing breast surgery have more options with far better results than in the past. “The technology and surgical techniques we use today have dramatically improved and changed what’s possible for patients,” said Dr. Warren Ellsworth, a plastic surgeon with Houston Methodist West Hospital.

“Every woman’s goals are different, and we design each treatment plan based on your individual characteristics. Some women come into the first appointment expecting me to tell them what the plan is, and they’re shocked when it’s an hourlong discussion about what they want,” Arentz said.

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CONSERVING THE BREAST

Radar and radioactive seeds are used to isolate abnormal tissue and protect healthy breast tissue. “Wireless localization techniques using radar, magnets or radioactive seeds make it easier to pinpoint and remove breast cancers with surgical precision while preserving healthy tissue,” Arentz said. For most breast cancers detected early on a mammogram, survival with a breast conserving surgery is the same as mastectomy.

Hidden Scar™ surgery involves making an incision in a discreet location under the breast fold or around the areola, resulting in a scar that is hidden by the skin fold of the breast. “This approach allows us to preserve a natural-looking breast while sparing the nipple, areola and surrounding tissue,” Arentz said.

BREAST RECONSTRUCTION

Women who opt for a mastectomy have a range of options available for breast reconstructive surgery with implants, natural tissue or a combination of both.

“When we’re putting together a plan for reconstructive surgery, we review multiple options, how they would look and feel, and what to expect from surgery,” Ellsworth said.

Surgical options include: Autologous or flap reconstruction uses tissue from another area of the body to reconstruct the breast, making it appear and feel natural. This procedure involves moving tissue, often from the abdomen, to the chest and reattaching the arteries and veins in the area. “This type of microsurgery allows us to preserve the muscles of the abdomen while only transferring the skin and fat,” Ellsworth explained.

Breast resensitization helps restore sensation to the reconstructed breast. “With a mastectomy, the nerves that give sensation to the breast are removed. We attempt to recreate sensation by connecting nerves

in the chest to those in the reconstructed breast,” Ellsworth said.

CHOOSING WHAT’S RIGHT FOR YOU When weighing your options, your doctor can help you make an informed decision based on facts, not fears. Together, you can review the factors that will impact your choices: P hysical characteristics — age, your overall health, breast size, breast density, the size and location of your breast cancer and the amount of tissue available for reconstruction.

P ersonal preferences — aesthetic goals, how you want your breasts to look and feel, symmetry and breast reduction options.

L ogistical factors — timing of surgery, additional treatments, having a support system and returning to work.

Recovery time is an important factor if you need to get back to your life faster and have fewer restrictions. “In those cases, breast conserving surgery may be a good option, especially for older women and those whose health can make recovery difficult,” Arentz said.

Breast cancer surgery and reconstructive surgery can be performed at the same time or separately. Your treatment plan can be designed so you can keep living your life.

Take Control of Your Treatment

Rely on our expertise to help you personalize your breast cancer treatment. Visit houstonmethodist.org/ cancer-west to learn more about Houston Methodist Cancer Center at West and our team of experts.

LUMPECTOMY VS. MASTECTOMY WITH RECONSTRUCTION What’s the difference?

Lumpectomy Surgery to remove the tumor while leaving healthy breast tissue surrounding it.

Total mastectomy Surgery to remove the entire breast, including the skin, nipple and areola.

Nipple-sparing mastectomy Surgery to remove the breast while leaving the skin, nipple and areola in place.

Why consider it: When breast cancer is detected early and the tumor is small.

Benefits: Conserving your natural breast; faster recovery times.

Why consider it: If you’re choosing breast reconstructive surgery immediately following the mastectomy.

Benefits: Preserving your breast skin and nipple; potential to regain sensation in the nipple when combined with flap surgery.

Flap reconstruction Surgery to reconstruct your breast after mastectomy using abdominal tissue through a tummy tuck incision.

Double (bilateral) mastectomy Surgery to remove both breasts.

Why consider it: May be best for treating invasive breast cancers.

Benefits: Breast reconstructive surgery may be performed at the same time or a later date.

Why consider it: An option for women choosing preventive mastectomy to reduce risk if they have a BRCA gene mutation.

Benefits: Achieving a symmetrical appearance with options for breast reconstructive surgery.

Why consider it: It offers the most natural reconstruction possible, with hidden scars, and the possibility of returned sensation.

Benefits: This type of breast reconstruction involves hidden scars, the most natural result, and a lifelong lasting outcome.

BREAST RESENSITIZATION TECHNIQUES AFTER MASTECTOMY If you have a mastectomy, the nerves that provide feeling to the breast and nipple are removed. This loss of sensation can feel unnatural and may alter the way you experience everyday activities like putting on clothes or hugging someone.

Breast resensitization can be performed during flap breast reconstruction surgery, a type of surgery that uses your own abdominal tissue to rebuild the breast. The procedure involves reconnecting the nerves on the chest to give the possibility of returning sensation to the breast.

“We don’t know the exact degree or type of sensation that can be returned to the breasts. However, if we can give a patient the ability to feel a hug from a child or spouse, that’s a very big deal,” Ellsworth said.

Call 832.522.8400 to schedule an appointment with one of our reconstructive surgeons or visit houstonmethodist.org/breast-reconstruction to learn more about other innovative breast reconstruction treatments offered at Houston Methodist West Hospital.

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Imaging Tests Help Detect Disease

W

hen facing an injury, unexplained illness or worrying symptoms, you want to know what’s wrong and what can be done to fix it. Diagnostic imaging gives health care providers an inside look at the body to locate broken bones, pinpoint diseases, guide cancer treatments and much more. Above all, diagnostic imaging aids in saving lives.

Most diagnostic imaging exams result in little or no discomfort.

For those who are sensitive to sounds or uncomfortable in tight spaces, our expert team helps you prepare for your test and addresses your concerns so you can have the best experience possible.

Here are some common imaging exams you and your loved ones may need.

COMPUTED TOMOGRAPHY (CT). During a CT scan, an X-ray tube inside the machine rotates around your body and produces detailed images of your internal organs. → WHY IT’S USED: Doctors use CT scans to detect cancer and heart disease; diagnose muscle and bone disorders; detect internal injuries; and locate tumors, infections and blood clots.

MAGNETIC RESONANCE IMAGING (MRI). This tunnel-shaped machine uses a magnetic field and radio waves to take pictures of your brain, neck, spinal cord and soft tissues. → WHY IT’S USED: MRIs produce high-resolution images to diagnose central nervous system disorders, such as multiple sclerosis and brain tumors. MRI also assists in identifying disorders of blood vessels and internal organs.

ULTRASOUND. A computer creates images from patterns created by the sound waves. During an exam, warm gel is applied to the skin and a hand-held device (a transducer) is pressed against the part of the body being examined.

→ WHY IT’S USED: Although often used during pregnancy to check on the fetus, ultrasound exams can also be used to study the heart, diagnose some forms of infection and cancer, guide biopsies and treatment of tumors, check the thyroid gland, diagnose gallbladder disease and reveal abnormalities in the scrotum and prostate.

POSITRON EMISSION TOMOGRAPHY (PET). A type of nuclear medicine that uses radioactive materials, a camera and a computer to create 3D images of internal organs and tissue. → WHY IT’S USED: PET scans help doctors detect cancer, assess the effectiveness of cancer treatment, or determine if cancer has spread. It’s also used to assess how well blood flows to the heart, and checks for brain abnormalities that may result from some memory and seizure disorders.

X-RAY. An X-ray machine uses electromagnetic radiation to create images of your bones, teeth and internal organs. → WHY IT’S USED: X-ray images assess for bone problems, joint infections, lung and heart diseases, abdominal pain, dental conditions and more.

INTERVENTIONAL RADIOLOGY. Utilizes multiple imaging technologies to assist and guide radiologists and physicians in minimally invasive procedures. → WHY IT’S USED: Assists doctors in procedures, such as the collection of specimens from internal organs and the placement of catheters and stents. With this technology, a variety of procedures that once required open surgery can be done with reduced pain, shorter hospital stays and quicker recovery times.

Advanced Imaging When You Need It Most

If your doctor recommends diagnostic imaging, you can rely on the expertise of the board-certified radiologists and advanced technology at Houston Methodist West Hospital. Visit houstonmethodist.org/imaging or call 832.522.1234 to schedule an appointment.

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20 Tips for a Healthy Pregnancy Take good care of yourself and give your baby a healthy start with these tips.

1 | Schedule prenatal visits with your health care provider.

2 | Stay up-to-date with vaccines and screenings.

11 | Add more fiber to your diet.

12 | Eat 2 to 3 servings of fish per week, but avoid fish high in mercury, such as king mackerel and swordfish.

3 | Take a prenatal vitamin.

13 | Limit coffee to 1 cup per day.

4 | Brush your teeth twice a day and floss once a day.

14 | Don’t drink alcohol.

5 | Stay hydrated by drinking six to eight 8-ounce glasses of fluid per day.

15 | Don’t smoke and avoid secondhand smoke.

6 | Exercise for 20 to 30 minutes on most days (with your doctor’s approval).

16 | Ask your doctor before taking prescription and over-thecounter drugs.

7 | Eat a healthy diet with lots of fruits and veggies.

17 | Avoid harsh cleaners and toxic chemicals.

8 | Eat calcium-rich foods, such as low-fat dairy or soy.

18 | Have someone else change the cat litter box.

9 | Don’t eat soft cheeses, such as brie and feta.

19 | Ask your doctor about air travel late in pregnancy.

10 | Don’t eat lunch meat unless it’s heated until steaming hot.

20 | Rest when you feel tired; take a nap if you can!

You’re in Good Hands

The Houston Methodist Childbirth Center at West is here to help you prepare for a smooth transition from pregnancy to parenthood. To find out more about our childbirth classes or schedule a tour of our expanded Childbirth Center, visit houstonmethodist.org/childbirth-west or call 832.522.4784.

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The expertise to

KEEP YOU MOVING At Houston Methodist Orthopedics & Sports Medicine at West, we know every movement matters. Our specialists offer: • The latest imaging and technology • Advanced nonsurgical treatments • Minimally invasive procedures

• Customized treatment plans • State-of-the-art physical and occupational therapy

Whether you’re suffering from simple aches and pains or dealing with a complex injury, we can get you back on your feet — and keep you moving.

West Houston-Katy

Schedule an appointment: houstonmethodist.org/sportsmed | 832.522.8280

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