Leading Medicine Spring-Summer 2017, Houston Methodist West Hospital edition

LEADING MEDICINE SPRI N G/SUM M ER 017

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

HIS AND HERS

CHECKUP CHECKLIST PLAY IT SAFE Summer Safety Guide

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

Play It Safe

Summer Safety Guide W Dr. Carolyn Galloway

arm weather and sunshine are a perfect setting for picnics, parades and pool parties. But they also call for taking a few precautions.

Dr. Carolyn Galloway, an emergency medicine physician at Houston Methodist West Hospital, offers tips for staying safe as you enjoy summer’s pleasures.

BE MINDFUL OF HEAT EXPOSURE

“Heat-related illness is progressive. It may start with cramps and progress to heat exhaustion and heat stroke, which are severe forms of dehydration,” Galloway said. “The young, the elderly and pets are particularly vulnerable.” To prevent heat-related illness: Stay hydrated. “Hydration starts before you begin your activity,” Galloway advised. “You need to drink enough water that you’re not feeling thirsty right away when you go into the heat.”

Never leave children or pets unattended in a car.

Avoid strenuous activities during peak temperatures.

LIMIT SUN EXPOSURE

Ultraviolet rays can damage the skin in only 15 minutes. “Limit exposure to sunshine,” Galloway said. “If you anticipate prolonged exposure, wear sunscreen with an SPF greater than 15 and protective clothing, wide-brimmed hats and sunglasses.”

DEFEND AGAINST INJURY

“People are out and about more in the summer, and any number of activities, such as swimming, biking or boating, can potentially result in injury,” Galloway cautioned. “The best defense is to be prepared.”

Wear appropriate protective gear, such as helmets and life vests.

Never leave children unattended near pools or bodies of water.

Swim in designated areas only and never swim alone.

If shooting off fireworks, position yourself out in the open, use protective eyewear and keep away from children.

2 LEADING MEDICINE IN WEST HOUSTON/KATY

Avoid alcohol and drugs, which can impair judgment, balance and coordination, increasing injury risk.

PREVENT BITES AND STINGS

“It’s a good idea to carry an emergency kit so you’re prepared,” Galloway suggested. “Include items like Benadryl, topical steroid cream, an EpiPen if someone has a severe allergy, plus vinegar for jellyfish stings.” To avoid attracting insects, steer clear of scented soaps and lotions.

To protect against mosquito bites and mosquito-borne diseases such as Zika, eliminate exposure to mosquitoes. Wear EPA-registered repellent and destroy mosquito breeding grounds by emptying any containers holding stagnant water, such as birdbaths, toys, kids’ pools and planters.

WHEN TO VISIT THE ER “We encourage people to use their best judgment about coming to the emergency room, but when in doubt or when in need of an evaluation, the ER is the best place to start,” said Dr. Carolyn Galloway, an emergency medicine physician at Houston Methodist West.

Symptoms that may warrant a trip to the ER include shortness of breath, difficulty breathing, sudden confusion or a deep wound. Houston Methodist Emergency Care Center in Cinco Ranch and Houston Methodist Emergency Department at West are open 24/7 to meet any emergency that may arise.

To learn more about our full-service emergency rooms, please visit houstonmethodist.org/er and remember to always call 911 in the case of heart attack or stroke.

WIN BY LOSING How to Tip the Scale in Your Favor

H

ave you tried fad diets over the years only to find the weight comes back more quickly than you lose it? Have you been looking for a way to lose weight that is safe and lasting? Permanent weight loss takes time, effort and a commitment to making small changes that are sustainable over a lifetime. There has to be a plan and you need support to make changes that will result in long-term weight loss. The weight management services offered at Houston Methodist West Hospital can help.

START YOUR JOURNEY

At every step of the way, Houston Methodist West has resources that can help you lose the weight. We offer a comprehensive program, facilitated by experts in the treatment of weight management, moving you in the direction of long-term weight control.

Some of our services include: Start-up behavioral assessments StepLITE, a calorie controlled weightloss program for individuals who need structure and guidance on their moderate weight loss goals.

Medical weight management, a medically monitored liquid beverage program facilitated by a multidisciplinary team of clinical experts, supervised by a physician.

You’re Worth It

Diabetes education, individual and small group classes providing education and support for diabetes management.

Medical nutrition therapy, a physician referral service provided by licensed, registered dietitians.

Houston Methodist Weight Management Center at West gives you access to medical professionals who can help you safely lose weight with an individualized program.

MAKE SMALL CHANGES

If you are ready to get started, here are a few easy changes you can make today: E at slowly. Studies suggest it takes the brain almost 20 minutes to register fullness in the stomach. Eating meals slowly, mindfully and free from distraction (such as watching TV) can help you cut down on calorie consumption. This gives your body a chance to send your brain signals that you’re full and you’ll pick up on those signals when you’re not distracted.

I ncrease protein and fiber. Reaching for protein or fiber-filled foods, like chicken breast, apples or berries, can help you feel satisfied for longer than with processed and refined foods.

S ize for your eyes. Use smaller plates, bowls and serving utensils, making it appear to the brain as though you’re eating more than you actually are.

Sign up for a free orientation session at houstonmethodist.org/ weight-management to learn about how our weight-loss services can help or call 832.667.LOSE (5673).

RAINBOW FRUIT SALAD Brighten your day with this colorful fruit salad!

Prep time: 20 minutes Number of servings: 12 Serving size: 4 ounces INGREDIENTS For salad: 1 large mango, peeled and diced 2 cups fresh blueberries 2 bananas, sliced 2 cups fresh strawberries, halved 2 cups seedless grapes 2 nectarines, peeled and sliced 1 kiwi fruit, peeled and sliced For honey orange sauce: 1 ⁄3 cup unsweetened orange juice 2 tablespoons lemon juice 11⁄2 tablespoons honey 1 ⁄4 teaspoon ground ginger Dash nutmeg DIRECTIONS 1. M ix the fruit together in a large bowl.

2. I n a small bowl, combine all the ingredients for the honey orange sauce and mix well.

3. J ust before serving, pour the honey orange sauce over the fruit.

Nutritional information per serving: 96 calories; 1 g total fat; 0 g saturated fat; 0 mg cholesterol; 4 mg sodium.

Recipe courtesy of the National Heart, Lung, and Blood Institute.

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

IS JOINT REPLACEMENT SURGERY RIGHT FOR YOU? Dr. Winfield Campbell

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 Orthopedic Surgeon, Dr. Winfield Campbell, of Houston Methodist West Hospital. 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, known as wear and tear arthritis. Osteoarthritis occurs over time and can result from getting

older; being overweight; from a joint injury from sports or other activities; or genetic predisposition.

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.

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

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 (femur or thigh bone) and tibial (tibia or shinbone) components are made of metal. A plastic bearing surface is snapped into the tibial base plate.

ADVANCED ACL SURGERY Like joints, our ACL ligaments do a lot for our knees — from maintaining stability to supporting rotation.

That’s why it’s important to protect them as we age.

As Dr. Winfield Campbell, an orthopedic surgeon at Houston Methodist West Hospital, explained, “The best way to prevent ACL injury is to maintain good leg strength, physical fitness and a healthy weight.”

But when an ACL becomes injured, it can require surgical intervention. “Since the ACL doesn’t heal, a torn one must be ‘reconstructed,’” Campbell said.

4 LEADING MEDICINE IN WEST HOUSTON/KATY

“In other words, a new one has to be put in its place.”

There are a lot of variables to the surgery, though. “The decision on how to replace an ACL is based on surgeon and patient preference,” Campbell noted. “The good news is most techniques work quite well.”

A successful recovery depends largely on a patient’s motivation and commitment to physical therapy. But as Campbell highlighted, at Houston Methodist West, “We have a partner in recovery every step of the way.”

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 and 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 soon after surgery with physical therapy to follow for as long as necessary. 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 heavy sports activities like running or basketball.

However, things like walking, elliptical training, swimming, bicycling, tennis and skiing can be fine.

Take the First Step

Learn more about joint health and surgery by visiting houstonmethodist.org/ orthopedics or calling 832.522.BONE (2663).

HOUSTONMETHODIST.ORG/WEST 5

His and Hers

CHECKUP CHECKLIST CHECKUPS FOR MEN AND WOMEN

R

outine medical screenings are a powerful tool for taking charge of your health. “A lot of medical illnesses don’t cause symptoms initially and by the time people Dr. Adil notice they aren’t well, Asaduddin the disease may already be advanced,” said Dr. Adil Asaduddin, internist and primary care physician at Houston Methodist West Hospital.

“Screenings can catch medical issues early so you can get them corrected before they cause long-term complications.”

How do you know which screenings you need and when? Your medical history, family history and lifestyle will determine your screening schedule, but here’s a general guide of recommended health screenings for women and men.

INDIVIDUALIZED CARE

Having regular checkups with a primary care doctor is one of the best ways to stay up-to-date on the right screenings for your individual needs. “Conditions such as thyroid disease, anemia, hepatitis B and hepatitis C may develop slowly or be asymptomatic at first but can cause serious complications over time,” Asaduddin said.

“Your doctor can help you determine if you should be screened for those conditions, as well.”

Blood pressure – starting at age 18 Cholesterol test – starting at age 20 for women and age 35 for men, or earlier if you’re at increased risk of heart disease Colorectal cancer screening – starting at age 50 iabetes screening – beginning at age 18 if your blood D pressure is higher than 135/80 mmHg or you take medication for high blood pressure HIV – at least once ung cancer – testing between ages 55 and 80 if you’ve smoked L a pack a day for 30 years and currently smoke or quit within the past 15 years Sexually transmitted infection (STI) – consult your doctor

SPECIFICALLY FOR WOMEN Bone mineral density test (osteoporosis screening) – at least once at age 65 or older Breast cancer screening (mammogram) – yearly starting at age 45, or sooner if you have a family history or other risk factors Cervical cancer screening (Pap test) – every three years starting at age 21

SPECIFICALLY FOR MEN bdominal aortic aneurysm screening – a one-time A test between ages 65 and 75 if you’ve ever smoked

Find a Doctor

Visit houstonmethodist.org/find-a-doctor or call 832.522.5522 to find a primary care doctor.

6 LEADING MEDICINE IN WEST HOUSTON/KATY

Is Your Body BABY READY?

M

aking sure your body is ready to support a healthy pregnancy is an essential aspect of pregnancy planning.

“Addressing modifiable Dr. Sarah risks and making dietary Andrews changes can have a measurable benefit for mom and baby,” said Dr. Sarah Andrews, an obstetriciangynecologist with Houston Methodist West Hospital. “And the benefit is not just for the first baby, but for all subsequent babies, too. Putting the effort in up front can mean an important pay-off in your children’s health.”

So is your body baby-ready? Answer these questions to find out.

Do you smoke?

“The No. 1 change a woman can make before she gets pregnant is to stop smoking,” Andrews said. Smoking can cause low birth weight, premature birth and an increased chance of cesarean section. Your baby is also at greater risk for asthma and ear infections if smoking occurs in the home.

Are you taking folic acid?

Inadequate folic acid intake is linked to spina bifida and other birth defects, many of which occur before a woman even knows she’s pregnant. “Before you even start trying to get pregnant, take folic acid to build up a reserve,” Andrews advised. Andrews recommended taking 0.8 mg of folic acid or 4.0 mg if you have a family history of spina bifida. Taking a prenatal vitamin ensures that you’re getting optimal nutrition and it will meet most women’s needs for folic acid.

Do you exercise regularly?

Developing the habit of regular exercise before pregnancy makes it more likely you’ll continue to exercise after you’re pregnant. “Physical exercise is important because it decreases the risks of cesarean section and gestational diabetes,” Andrews explained.

If you have a chronic medical condition, is it under control?

Seizure disorders, diabetes, high blood pressure and asthma are examples of chronic conditions that may impact your pregnancy. “Often the medications for chronic conditions can have an effect on the fetus, so it’s a good idea to work with your doctor to create a plan,” Andrews said. A preconception consultation with your obstetrician-gynecologist can help you determine how to best handle chronic conditions during pregnancy.

Is this the right time in your life to get pregnant?

“I encourage women to put real thought into their life course, and when and how children will fit into their plans. Keep in mind that difficulty conceiving and the risks of miscarriage and chromosomal abnormalities increase significantly after age 40,” Andrews cautioned.

Take a Tour!

As you prepare for your baby, you want a childbirth center that can match your commitment. Houston Methodist Childbirth Center at West offers expectant mothers state-of-the-art care, a comforting environment and a dedicated team.

To register for a class or to schedule a tour, call 832.522.4784. Visit houstonmethodist.org/west for more information on our services offered.

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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 713.790.3333 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 . Houston Methodist San Jacinto Hospital . Houston Methodist St. John Hospital 4. Houston Methodist Sugar Land Hospital 5. Houston Methodist The Woodlands Hospital Opening July 1, 2017 . 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

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 1. Houston Methodist Emergency Care Center in Cypress 1. 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

1. Houston Methodist Imaging Center

17. Houston Methodist Comprehensive Care Center at Pearland

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