Leading Medicine Fall 2020, Houston Methodist West Hospital edition

LEADING MEDICINE FA LL 2020

Take Control of Your Heartburn Is It COVID-19 or the Flu?

BE VIGILANT ABOUT RESPIRATORY ILLNESS YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN WEST HOUSTON/KATY

TAKE CONTROL OF YOUR HEARTBURN I t’s back — that burning sensation deep in your chest.

Was it the chili at dinner or the coffee that ended your meal?

Heartburn not only causes pain and stress, Dr. Hani A. Zamil it can interfere with your social life and ruin a good night’s sleep.

On any day of the week, more than 15 million Americans experience heartburn, sometimes with acid reflux, which occurs when stomach acids flow back into the esophagus. Food usually triggers the pain, but for some people, exercising, stress, smoking or drinking alcohol also aggravate the condition.

WHAT CAUSES HEARTBURN?

Heartburn occurs when the lower esophageal sphincter (LES) muscle at the base of your esophagus relaxes and releases stomach acids into the esophagus.

Doctors aren’t clear about what causes the LES to slacken.

“If you have asthma, diabetes or a condition, such as a hiatal hernia or a peptic ulcer, you may also have a greater tendency to experience heartburn,” said Dr. Hani A. Zamil, gastroenterologist at Houston Methodist West Hospital.

Heartburn usually isn’t serious. Self-care measures, such as improving your diet or losing weight, often resolve the problem.

Over-the-counter medications can provide relief. But if you experience heartburn or acid reflux more than twice a week, or your discomfort is severe, you may have gastroesophageal reflux disease (GERD), and it needs to be treated.

Symptoms of GERD include: Chest pain Coughing, wheezing Difficulty swallowing Nausea Persistent acid regurgitation Sore throat, hoarseness

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“Acid reflux can irritate the bronchi and trigger breathing problems, such as asthma. Other times, acid reflux can cause stomach acid to enter the lungs during sleep and lead to breathing issues. Chronic acid reflux can also cause difficulty swallowing,” Zamil said.

CAN YOU PREVENT HEARTBURN?

Keeping track of what triggers your discomfort can help you avoid heartburn.

You can also make these lifestyle changes: Change your diet. Limit foods that trigger your heartburn and control portion sizes.

E levate the head of your bed.

Use blocks or foam wedges to raise your mattress.

L et your food digest. Avoid lying down for two hours after eating.

You may also want to refrain from exercising or bending over right after eating.

L ose weight, if needed. Excess pounds put pressure on your stomach and diaphragm, forcing the muscle at the bottom of your esophagus to open and allow acids to flow upward.

S top smoking. Smoking stimulates acid production.

W ear clothes that fit comfortably.

Avoid pressure on your stomach.

Talk to your doctor about your medications. Some antidepressants, antibiotics, sedatives and other prescription medications may contribute to heartburn. Nonsteroidal antiinflammatory drugs (NSAIDs), such as ibuprofen, can also cause heartburn.

FOODS THAT TRIGGER GERD Alcohol Caffeine Carbonated beverages Chocolate

Citrus and tomato products High-fat foods Onions, garlic Peppermint Spicy foods

FOODS THAT FIGHT GERD Bananas, melons, apples Broccoli, other green vegetables Egg whites Lean meats

Oatmeal otatoes, P cauliflower Whole-grain bread, rice

WHAT IF LIFESTYLE CHANGES AREN’T ENOUGH?

If your symptoms fail to improve with lifestyle changes, your doctor may suggest trying an over-the-counter medication that blocks, neutralizes or reduces stomach acid.

Your doctor may also order tests. A barium X-ray can reveal a hiatal hernia, a growth or esophageal narrowing. An endoscopy can help your doctor detect ulcers or inflammations. Ambulatory acid (PH) probe tests measure the amount and frequency of acid reflux.

For patients with extreme cases of GERD, minimally invasive procedures that tighten the muscle at the bottom of the esophagus can help to prevent reflux.

Get Relief from Our Experts

Call 832.522.8560 or visit houstonmethodist.org/gi-west to schedule an appointment with a Houston Methodist gastroenterologist.

Early Detection Is Key

Your Cancer Screening Checklist

E

arly detection is a powerful weapon in the fight against cancer. Cancers can develop slowly or rapidly, sometimes without any noticeable symptoms.

When cancer is found early, there is a much higher chance for effective treatment. That’s why it’s important to stay up to date with cancer screening tests.

Dr. Waqar Haque “Finding and treating cancer at an early stage means we can often avoid aggressive treatments, and the patient’s chances of survival are highest,” said Dr. Waqar Haque, a radiation oncologist at Houston Methodist Cancer Center at West.

KEEP UP WITH THE LATEST GUIDELINES

The American Cancer Society suggests the following general guidelines for the early detection of cancer. Depending on your family history and other risk factors, your doctor may recommend a different screening schedule for you.

Breast Cancer Screening Women age 40 should talk to their doctor about starting annual mammograms. At Houston Methodist, we recommend women with average breast cancer risk begin annual screening mammograms at age 40. Women ages 55 and older may want to talk to their doctor about continuing yearly screening or switching to mammograms every two years. Women at high risk for breast cancer should ask about adding MRI to their mammogram routine.

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Cervical Cancer Screening Starting at age 21, women should have a Pap test for cervical cancer every three years. From ages 30-65, it’s recommended for women to have a Pap test plus HPV test every five years. (This is the preferred approach, but it’s OK to have a Pap test alone every three years.) Women over age 65 may want to discuss stopping cervical cancer testing with their doctor. For some women, your doctor may recommend a different screening schedule due to your health history [HIV infection, organ transplant, diethylstilbestrol (DES) exposure to women born between 1938 to 1971, etc.].

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Endometrial Cancer The American Cancer Society recommends that all menopausal women understand the risks and symptoms of endometrial cancer. Due to their history, some women may consider having a yearly endometrial biopsy. Please talk with a health care provider about your family history.

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Colon Cancer Screening Men and women at age 50 should begin regular screening. You might need to be screened earlier and more often if you have a personal or family history of colorectal polyps (growths) or colorectal cancer. Common screening tests include fecal occult blood tests, flexible sigmoidoscopy and colonoscopy.

“Regular screening is the key — and essential — to preventing colon cancer. Colon screens help detect precancerous polyps (abnormal growths) so they can be removed before they turn into cancer,” Haque said.

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Prostate Cancer Screening For men age 50, now is the time to talk to your doctor about the pros and cons of prostate cancer testing. Men at higher risk (African American men and those with a father or brother who had prostate cancer before age 65) should discuss testing starting at age 45. The two main prostate cancer screenings are the digital (finger) rectal exam (DRE) and the prostate-specific antigen (PSA) blood test.

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Taking Care of You

To find a Houston Methodist doctor near you, visit houstonmethodist.org/west or call 832.522.5522.

CHECK OUT OUR DIGITAL MAGAZINE AT HOUSTONMETHODIST.ORG/NEWSROOM/NEWSLETTERS 3

BE VIGILANT ABOUT RESPIRATORY ILLNESS

Y Dr. Scott Olsson

ou’ve heard about the dangers of COVID-19, flu and other respiratory illnesses that affect the lungs, making it difficult to breathe. There are steps you can take today to prevent disease and boost your respiratory health in case you do get sick. Taking good care of your lungs can improve your quality of life and protect against respiratory illnesses that can take a toll on your lungs.

RECOGNIZE SERIOUS SYMPTOMS

It’s important to know that anyone can have mild to severe symptoms with either COVID-19 or flu. “We are seeing that older adults and people with underlying health issues are at greater risk for developing complications from respiratory illness. However, severe symptoms can be experienced at any age,” said Dr. Scott Olsson, a cardiothoracic and vascular surgeon with Houston Methodist West Hospital.

Monitor your symptoms if you’re not feeling well: Mild respiratory symptoms include having a low-grade fever, nasal congestion, runny nose, sore throat, mild cough and mild body aches. What to do: Get tested for COVID-19.

Stay home and isolate yourself from others to avoid spreading illness, even if you test negative for COVID-19.

Moderate respiratory symptoms include fever over 100.4 F, persistent cough, temporary shortness of breath and feeling like you need to stay in bed. What to do: Get tested for COVID-19 and contact your doctor about worsening symptoms.

Severe respiratory symptoms include difficulty breathing, shortness of breath, wheezing, pain or pressure in the chest, confusion, trouble staying awake and bluish lips or face. What to do: Seek emergency medical care for severe respiratory symptoms.

Mild cases of respiratory illness can often be managed with rest, fluids and fever-reducing medicines at home. However, don’t wait to see a doctor if you’re in a high-risk group and experiencing worsening symptoms. Mild or moderate symptoms can quickly become severe for older adults and those who have heart disease, diabetes, cancer or chronic respiratory problems.

MANAGE YOUR HEALTH CONDITIONS

If you have chronic respiratory conditions, such as asthma or chronic obstructive pulmonary disease (COPD), it’s important to manage the condition closely with your doctor. Keeping up with your regular checkups is essential in controlling symptoms and protecting your health. Continue taking medications as directed and contact your doctor with any questions or concerns about managing your condition.

“We understand patients need to feel safe when being seen.

Telehealth visits and video visits are ways we help patients feel more comfortable and reduce exposure,” said Olsson. Ask your doctor for recommendations before going in for appointments and consider having medications sent directly to your home so you don’t have to make extra trips to the pharmacy.

LUNG CANCER SCREENING A respiratory condition that often goes undetected until it spreads is lung cancer. That’s why staying on track with lung cancer screening is important. If you’re a current or former smoker, ask your doctor about lung cancer screening.

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Who Should Get Tested?

Testing may be recommended if you meet the following criteria: Age 55-77 years No current signs or symptoms of lung cancer Tobacco smoking history of at least 30 pack-years (calculated

by multiplying the number of packs smoked per day by the number of years smoked) Current smoker or former smoker, who has quit within the last 15 years Have not had a chest CT scan in the last year

Make an Appointment

A written order is required for all lung cancer screening procedures. Request an order or schedule an appointment by calling 713.441.LUNG (5864).

Visit houstonmethodist.org/lung-screening for more information.

PROTECT YOUR LUNGS EVERY DAY

Olsson recommends taking these steps to keep your lungs healthy:

1

Get regular exercise. Being physically active can increase lung capacity and improve lung function. Exercising makes your heart and lungs work harder, which increases oxygen and improves circulation around the lungs. Any form of exercise that involves taking deep breaths can help improve your lung capacity.

2

Quit smoking and vaping. Smoking irritates the airways and impairs lung function. Vaping releases chemicals that also cause long-term damage to the lungs. Smoking and vaping can lead to lung cancer and COPD, and worsen complications due to COVID-19 or other serious respiratory infections. It’s never too late to quit, and the benefits of quitting kick in right away.

Talk to your doctor about getting support to quit smoking.

3

Minimize exposure to allergens. Allergens can trigger respiratory problems and other issues. Keep allergies in check and improve indoor air quality with these tips:

Avoid mold spores Control dust mites Keep surfaces in home clean and uncluttered Minimize pet dander Prevent pollen from getting inside by keeping windows and doors closed Ventilate when using products with strong chemical odors

STAY HEALTHY

“Following good respiratory etiquette will go a long way in helping to protect ourselves and those around us,” said Olsson.

Stay vigilant with these tips to prevent the spread of illness: Stay home from work or school if you feel sick Practice social distancing Get a flu shot Wear a cloth mask in public Wash hands often Wipe down frequently touched surfaces

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IS IT COVID-19 OR THE FLU?

I

f you start feeling sick, your first thought might be, “Do I have COVID-19?” As we move into fall, there could be a rise in flu cases as well, and we need to be prepared for both. Knowing what to do if you experience COVID-19 or flu symptoms can help you protect yourself and others.

“Fall is often when flu viruses begin appearing Dr. Windsen K. in our community. To complicate things further, Pan this year we could also see a surge in COVID-19 at the same time,” said Dr. Windsen K. Pan, a primary care physician at Houston Methodist Primary Care Group at Towne Lake. “We need to be on our guard about identifying symptoms, getting tested and keeping illness from spreading to others.”

SLOW THE SPREAD

COVID-19 and the flu both spread easily from person to person in close contact (less than 6 feet apart). Both viruses are thought to spread mainly by droplets when people cough, sneeze or talk. Both COVID-19 and flu may be spread to others by people who are asymptomatic (having no symptoms) or those who are recently infected and not yet showing symptoms.

Although COVID-19 and flu viruses spread in similar ways, COVID-19 may spread more easily than flu among certain populations and age groups. COVID-19 is thought to be more contagious than flu because it might be spread through tiny droplets in the air. COVID-19 also has been linked to more superspreading events in which a single person can infect many other individuals.

A RANGE OF SYMPTOMS

Some people with COVID-19 or the flu have no symptoms, while others experience mild, moderate, severe, critical or lifethreatening symptoms.

COVID-19: The key symptoms of COVID-19 are fever, cough and shortness of breath. Some people with COVID-19 also report a lack of taste or smell.

Flu: The most common symptoms of flu include fever, chills, muscle aches and fatigue.

“It will be a challenge to know if you have COVID-19 or the flu based on symptoms alone since the symptoms are so similar,” explained Pan. Getting tested for COVID-19 is an important step in confirming the source of illness and seeking medical treatment, if needed.

WHAT TO DO

Most mild cases of COVID-19 and flu can be managed at home with rest, fluids and fever-reducing medicine. But those who are at risk for complications of COVID-19 should check in with their doctor. Monitor symptoms and seek medical care right away if you’re experiencing severe symptoms, such as: Difficulty breathing or shortness of breath Pain or pressure in chest New dizziness or confusion

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COMPARING SYMPTOMS OF COVID-19 AND FLU People may experience some, all or none of these symptoms ranging from mild to severe. Please note: This is not a complete list of symptoms. Talk to your doctor about concerns you may have about symptoms.

COVID-19

Flu

Incubation period (number of days until symptoms appear)

2-14 days

1-4 days

Onset of symptoms

Gradual

Abrupt

Fever or chills

Common

Common

Cough

Common

Common

Shortness of breath

Common

Sometimes

Tiredness

Common

Common

Muscle pain or body aches

Common

Common

Headache

Common

Common

New loss of taste or smell

Sometimes

Less common

Sore throat

Common

Sometimes

Congestion or runny nose

Common

Sometimes

Vomiting or diarrhea

Less common

Less common

Possible symptoms

Make an Appointment

If you’re experiencing flu or COVID-19 symptoms, schedule a virtual video visit with your primary care doctor. Simply call your doctor’s office or use the “Schedule an Appointment” button in MyChart. If you need to find a doctor with Houston Methodist Primary Care Group, visit houstonmethodist.org/ pcg/west, or call or text 713.394.6724.

Inability to wake or stay awake Bluish lips or face “Even though these two illnesses are similar in symptoms, COVID-19 presents the more severe and critical infection,” Pan said.

DON’T DISMISS ATRIAL FIBRILLATION

A

trial fibrillation (AFib), the most common type of arrhythmia, or abnormal heart rhythm, should not be taken lightly. If untreated, AFib can Dr. Nilesh become a potentially Mathuria life-threatening condition. AFib increases the risk of stroke fivefold, according to the American Heart Association. It can also lead to congestive heart failure and chronic fatigue.

“AFib happens when the heart’s upper chambers quiver instead of beat effectively,” said Dr. Nilesh Mathuria, a cardiac electrophysiologist with Houston Methodist West Hospital. “This can cause blood to pool and clot, potentially leading to a stroke. Normally, the heart contracts and relaxes in a coordinated rhythm.

AFib interferes with the heart’s normal electrical signals, causing an irregular, rapid heartbeat.”

ARE YOU AT RISK?

Approximately 2.7 million to 6.1 million people in the United States have atrial fibrillation.* The following factors increase your risk for AFib: Age (risk increases with age) Alcohol consumption (for some people, drinking alcohol can trigger AFib) Chronic conditions, such as thyroid problems and sleep apnea Family history of AFib High blood pressure History of heart disease, heart attack, heart surgery or valve problems Episodes of AFib may come and go in a matter of hours, or symptoms may persist for longer periods until treated. Palpitations, or the sensation of a racing, fluttering or irregular

Listen to Your Body

Don’t ignore a racing, fluttering heartbeat or other signs of AFib. Treatment helps you feel better now and prevents more serious complications down the road. Call 832.522.8355 or visit houstonmethodist.org/spg/heart-vascular/ debakey-katy to find a Houston Methodist cardiologist near you.

heartbeat, are a common symptom. Other symptoms include weakness, fatigue, lightheadedness, confusion, shortness of breath and chest pain. Call 911 if you experience chest pain, which may be a sign of a heart attack.

If you think you’re experiencing AFib, seek urgent medical care. A doctor can assess your condition and refer you to an electrophysiologist who specializes in diagnosing and treating heart arrhythmias. An electrophysiology study may be done to record electrical activity of your heart and uncover the cause of your symptoms.

RESTORING THE RIGHT RHYTHM

Treatments for AFib restore or reset the heart’s rhythm so your heart can pump blood effectively. A doctor can recommend the best course of treatment, which may include one or more of the following options:

Lifestyle modifications to reduce risk factors — a heart-healthy, low-sodium diet; exercise; smoking cessation; avoiding alcohol.

Medications may be used to slow down the rapid heart rate associated with AFib and/or prevent clotting.

Cardioversion may be used to restore normal heart rhythm using precise external electric shocks.

Radiofrequency ablation is a procedure that delivers a burst of radiofrequency energy through a thin, flexible tube inserted in a blood vessel. The treatment destroys tissue that triggers abnormal electrical signals.

Surgery can be performed to disrupt electrical pathways that cause AFib. Atrial pacemakers may be implanted to regulate the heart’s rhythm. * Source: Centers for Disease Control and Prevention.

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832.522.5522

LEADING MEDICINE IN GREATER HOUSTON

Getting your annual mammogram is still important.

Houston Methodist can see you safely.

Getting your annual mammogram is one of the most important steps you can take to stay healthy. That’s why our Breast Care Center is taking every necessary precaution during the coronavirus pandemic to keep you and our staff members safe.

HOUSTONMETHODIST.ORG/WEST

During the coronavirus pandemic, we are:

Screening all patients, ensuring only those without COVID-19 symptoms are seen in the office.

Wearing masks and other personal protective equipment while providing patient care.

HOUSTON METHODIST BREAST CARE CENTER AT WEST HOSPITAL

BARKER CYPRESS ROAD

GREENHOUSE ROAD

FRY ROAD

PARK ROW

Implementing additional sanitation processes to disinfect all equipment and surfaces.

Redesigning waiting rooms and check-in procedures to ensure social distancing.

Visit houstonmethodist.org/breast-care or call 832.522.7465 to schedule your mammogram today.

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