Leading Medicine Spring Summer 2018, Houston Methodist West Hospital edition

LEADING MEDICINE SPRI N G/SUM M ER 018

ALLERGIES OR SOMETHING ELSE? OVERCOMING NECK PAIN

BREAKING THE BARRIERS TO JOINT REPLACEMENT

What’s holding you back from considering a joint replacement?

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

ALLERGIES OR SOMETHING ELSE?

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t’s that time of year again. Your eyes itch, your nose is runny, you sneeze constantly and your head is congested — all-toofamiliar symptoms for more than 50 million Americans who suffer from allergies each year.* But when you’re used to coping with miserable symptoms from spring through fall, how do you know when you’re really sick?

Dr. Jennifer “Call your doctor any time your symptoms Garrison worsen, your medication no longer provides relief or you develop new symptoms, such as a rash or wheezing,” said Dr. Jennifer Garrison, a family medicine doctor at Houston Methodist West Hospital.

Key warning signs that your symptoms are not from your allergies include: Body aches Yellow or green nasal Fever discharge Malaise (feeling unwell) Use the chart below to see whether your symptoms are from allergies or something else.

Area of Discomfort

It may be an allergy if you experience:

Nose

neezing, sinus congestion, clear S nasal discharge Heavier symptoms in the spring and fall, which suggest sensitivity to outdoor allergens like tree, grass and weed pollen Year-round symptoms that may also include cough, headache or facial pain, which suggest sensitivity to indoor allergens like dust mites, mold and pet dander

Eyes

Itchy, watery eyes, redness, swelling or dark under-eye circles (allergic shiners), which suggest allergies or allergic conjunctivitis

Lungs

Wheezing, coughing, mucus and other asthma-like symptoms, which can be triggered by an allergy to pollen, mold, dust mites, animal dander or certain foods

* Centers for Disease Control and Prevention.

2 LEADING MEDICINE IN WEST HOUSTON/KATY

Stop the Wheeze and Sneeze

Go online and schedule your appointment with a primary care doctor. Visit houstonmethodist.org/ appointments or call 832.522.8751.

It may not be an allergy if you experience: Fever, body aches, sore throat and thick, colored nasal discharge Sinus pain, fatigue, head and ear congestion, toothache and bad-tasting postnasal drip

A thick, yellow discharge that crusts over the eyes, especially during sleep

Increased difficulty breathing A continual cough that produces large amounts of mucus

It could be: n upper-respiratory infection, such A as a cold, flu or sinusitis; a cold will pass in about seven to 10 days, and the flu lasts a week or two; sinusitis can last longer Nonallergic irritation caused by pollution, strong smells, aerosol sprays and smoke or changes in temperature, humidity and air pressure Hormonal changes during menstruation or pregnancy Conjunctivitis caused by a virus or bacteria

Asthma, emphysema or chronic bronchitis

Wound Care

Small Wounds — BIG PROBLEMS S mall or large, wounds take time to heal.

Some wounds, like small cuts, can usually heal on their own.

More serious wounds, like diabetic foot wounds, Dr. Fatima leg wounds, surgical Jaffer wounds, infections or rashes, may require urgent medical attention. Your overall health may depend on how well you take care of wounds.

HELP FOR CHRONIC WOUNDS

As a general guideline, chronic wounds are wounds that fail to progress through a normal reparative process over four weeks. “All wounds have the potential to become chronic, and factors that may contribute to poor wound healing include diabetes, neuropathy, leg swelling, obesity, and circulation problems, including venous stasis, peripheral vascular disease, infection and immunosuppression,” said Dr. Fatima Jaffer, medical director of the Houston Methodist Wound Care Program at West.

Specialized care can help heal wounds and prevent more complex medical problems. Some strategies used for treating chronic wounds include: W ound dressings – cleansing, covering the wound with an advanced wound care dressing D ebridement – scraping away dead tissue to allow growth of new tissue C ompression therapy – wearing compression bandages to improve blood flow, reduce swelling and promote healing O ffloading – using protective footwear, casts, crutches, walkers, wheelchairs to keep weight off legs and feet

Diabetic Foot Ulcers

For people with diabetes, wounds may not heal normally due to nerve damage and poor blood circulation. Diabetic foot ulcers can cause long-lasting effects like tissue damage or even amputation.

If you have diabetes, schedule an annual foot exam (visit your doctor sooner if you notice any cuts or sores) and ask about steps you can take to keep your feet healthy.

H yperbaric oxygen therapy – delivering more oxygen to the wound by having patients breathe 100 percent oxygen in a special chamber

FOCUS ON PREVENTION

“You may be able to promote healing and help prevent wounds from becoming chronic by making simple lifestyle changes,” Jaffer said.

Maintain good health. Eat a balanced diet and exercise regularly. If you use tobacco, make a plan to quit. If you have diabetes, monitor your blood sugar as recommended by your doctor and take medication as prescribed to reduce the risk of complications.

Keep up with hygiene. Shower or bathe often and wash your hands and feet.

Elderly people and those with diabetes should check for small cuts, cracks, tenderness, redness or swelling on a daily basis. (See “Diabetic Foot Ulcers.”)

Schedule regular doctor appointments. If you have diabetes, ask your doctor to check for early signs of nerve damage or other issues.

Take your injuries seriously. “If you injure yourself, don’t hesitate to reach out to your doctor right away. Your wound may require immediate attention,” Jaffer added.

Get Help for Your Wounds

Contact a wound care specialist at Houston Methodist West Hospital by calling 832.522.7302.

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BREAKING THE BARRIERS TO JOINT REPLACEMENT What’s holding you back from considering a joint replacement?

I

f you’ve been living with chronic joint pain for months or years — making it difficult to move about easily or even just walk normally — you may keep a running list of reasons in your head Dr. Christopher why you haven’t had joint Smith replacement surgery. But most of these are unnecessary barriers, because this highly common surgery usually vastly improves patients’ lives and allows them to resume their favorite activities without pain, according to Dr. Christopher Smith, an orthopedic surgeon at Houston Methodist West Hospital.

More than 7 million Americans are living with an artificial knee or hip, the two joints most often replaced through surgery, according to the National Institutes of Health. At Houston Methodist, orthopedic surgeons perform over 4,000 joint replacements each year, predominantly knees, hips and shoulders.

This high volume translates into high levels of experience and high success rates, Smith said.

“Joint replacement surgery is one of the true miracles of modern medicine,” Smith added. “It gets people back to their lives doing the things they want to do and used to take for granted. That’s good for society, for the workforce and for patients’ quality of life.”

WHY JOINT REPLACEMENT BECOMES NECESSARY

Affecting 1 in 5 Americans, arthritis is typically the culprit in causing joints

4 LEADING MEDICINE IN WEST HOUSTON/KATY

GET RELIEF FROM YOUR JOINT PAIN At Houston Methodist West, we offer a full spectrum of services, from conservative, nonsurgical treatment options to the most advanced surgical techniques, which include: Minimally invasive knee replacement Advanced techniques to minimize postoperative discomfort and accelerate recovery Partial knee replacement Complex joint revision surgery Physical therapy for arthritic knees Knee-preservation surgery

to become so stiff, tender and painful that joint replacement surgery is considered. An artificial joint used in joint replacement surgery can be made of plastic, metal and/or ceramic, according to Smith. Either the usual “wear and tear” type of arthritis (osteoarthritis) is at play, he noted, or so-called traumatic arthritis brought on by an injury that makes the joint increasingly unstable over decades.

But the resulting pain can be so pervasive and excruciating that

nonsurgical measures meant to manage it — such as pain medications and creams, exercise, physical therapy, steroid or other injections, and bracing the joint — provide only brief relief, if at all.

“By the time people get to a conversation about joint replacement, they have pain on a daily basis and it’s occupying a disproportionate part of their lives,” Smith explained. “It’s the kind of pain that leads them to become less active, whether athletically or socially, and can include everything from going grocery shopping to going to church, being able to prepare their own meals or even being able to walk outside.”

“It basically narrows their lives and limits their movement,” he added. “A lot of people get to the point where mentally, the pain becomes such a big part of their lives they become unhappy.”

JOINT SURGERY VS. FACTS

While many would say their joint pain is difficult and debilitating, surgery is often viewed as an absolute last resort. Here, Smith debunks the most common misconceptions.

Short-term discomfort from surgery beats a lifetime of debilitating pain.

For every person who says joint replacement is a miserable procedure, many more have said they’re glad they had it done, and the majority of their pain is now gone. We’re also able to better control patients’ pain before, during and after surgery with new medications and by using older medications a bit differently depending on the patient’s needs.

Recovery doesn’t take as long as it used to.

Improvements in surgical techniques and technology have reduced recovery time making it more efficient, predictable and generally less painful. This enables a more rapid return to function. Many patients are concerned they won’t get back to work in a prescribed amount of time, but national and international data show they usually return to their jobs within six weeks.

Most insurance covers it.

While insurance plans vary, joint replacement is one of the most established procedures in the United States, meaning reimbursement isn’t often a problem regardless of age.

Newer technology means longer lasting artificial joints.

As technology improves, joint durability continues to improve as well. An artificial joint probably has a life expectancy that matches the patient’s most of the time, and most who receive one will never need another.

READY? NO NEED TO WAIT

Regardless of what misconceptions may hold them back, most patients who need joint replacement typically reach the point where they’re ready to do it.

“It’s not uncommon for a patient to be ready to commit to joint replacement within a year or so of an arthritis diagnosis,” Smith said. “There’s not necessarily a medical rush for this, a time frame where a patient’s outcome will be sacrificed as a result of waiting.

However, the decision to proceed with joint replacement — sooner than later — will eliminate the pain and suffering of a prolonged waiting period.

“I schedule a follow-up visit with every patient one year after joint replacement surgery, and during this visit, I commonly hear ‘I wish I had done this sooner.’”

Considering Joint Replacement Surgery?

To schedule an appointment with one of our joint specialists at Houston Methodist West Hospital, visit houstonmethodist.org or call 832.522.BONE (2663).

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OVERCOMING NECK PAIN

B

eing able to turn your head is not something you probably think much about — until you can’t do it or it causes pain. You may experience neck pain at some point in your life. Fortunately, it usually eases over time.

However, lingering neck pain may signal a serious underlying health condition or stem Dr. G. Alexander from a previous untreated injury. “Knowing West when to seek medical care can prevent further complications and help you regain range of motion,” said Dr. G. Alexander West, a neurosurgeon at Houston Methodist Spine Center at West.

CAUSES OF NECK PAIN

Neck pain can result from an injury or wear and tear on the bones, joints, muscles and ligaments along the spine. “Neck problems can even affect other parts of the body,” West said.

Some of the most common causes of neck pain include: M uscle strain is mild discomfort that typically resolves or improves within a few days.

R heumatoid arthritis can destroy joints and cause severe stiffness.

O steoarthritis causes disks between vertebrae to wear away.

Disks can become herniated, bulge or rupture, causing more intense pain and/or numbness in the arms or legs.

C ervical stenosis is a narrowing of the spinal canal that may cause stiffness and numbness in the neck, arms and legs.

M inor injuries, such as a fall or sudden impact during an athletic activity, typically affect muscles and ligaments.

S erious injuries, such as from a car or diving accident, can result in fracture or dislocation, which may damage the spinal cord.

WHEN TO GET HELP

Neck pain often subsides on its own, but get help if you experience: Serious injury from an accident to prevent further injury R adiating pain or numbness in the arms or legs causing weakness — even if your neck doesn’t hurt C ontinuous, persistent, severe pain accompanied by pain that radiates down the arms or legs, and/or headaches N eck stiffness with fever, headache, nausea and/or vomiting may be a sign of meningitis, a serious infection that requires prompt medical care A specialist will perform a physical exam to find the cause of your pain. “You may need a CT scan or MRI of the structures and soft tissue inside your neck. If you’re experiencing numbness or weakness, your doctor may order testing to check nerve and muscle function,” West explained.

6 LEADING MEDICINE IN WEST HOUSTON/KATY

Get Relief for Neck or Back Pain Board-certified doctors at Houston Methodist Spine Center at West work together to provide comprehensive, personalized care to help you return to a productive lifestyle. For more information, or to begin treatment, email spinecenterwest@houstonmethodist.org or call 832.522.BACK (2225).

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.

Treatment for neck pain can be as simple as rest. You may also need medication to reduce inflammation and physical therapy. Patients rarely require surgery to relieve neck pain.

Reducing stress may also help — high stress levels can make neck pain feel worse.

Women’s Health

YOUR ANNUAL

EXAM IS ESSENTIAL

Y

our annual well-woman exam is important, even if you don’t have any health concerns.

“Every woman should schedule an annual Dr. Torri-Ja’Net exam to maintain Pierce overall health and stay up to date on recommended screening tests, which can save money, time and ultimately your life,” said Dr. Torri-Ja’Net Pierce, an obstetrician-gynecologist at Houston Methodist West Hospital. Here she answers some common questions about this essential medical appointment.

Q

What happens during my annual exam?

A: Your annual exam is a chance to focus on preventive care. It’s separate from doctor appointments you may have for sickness or injury. Your checkup will include: Services, such as vaccines to prevent disease Screenings, such as mammograms and cholesterol screenings may be scheduled to check for potential health problems Education and counseling to help you make informed health decisions

Q

hat screenings and/or exams W may occur at my visit?

A: Talking with your doctor, you’ll determine which screenings (or exams) are needed. Generally, these will depend on your age and current health status. Your doctor may also suggest other screenings that aren’t part of your annual well-woman exam.

The American College of Obstetricians and Gynecologists recommends the following:

Cervical cancer screening Ages 21–29: Pap test every three years Age 30+: Pap and HPV cotesting every five years. If you’re 65 years or older, talk with your doctor about whether you need to continue testing Clinical breast exam Ages 25–39: Every one to three years Ages 40+: Yearly Mammogram (X-ray of the breast) Ages 40+: Yearly or every two years, however if you’re 75 years or older, talk with your doctor about whether you should continue mammograms Colonoscopy Ages 50+: Every 10 years. Procedure scheduled separately. Note: AfricanAmerican women should start screening at age 45 Thyroid-stimulating hormone screening Ages 50+: Every five years Bone density screening Ages 65+: No more than once every two years, unless new health risks develop “This is not a complete list. Ask your doctor about other tests you may need,” Pierce explained.

Q

What should I expect to discuss with my health care provider?

A: You’ll be asked questions about: Medical history Family health history Sexual health and partners Last period (the first day of your last period) Changes in your health, such as eating habits, toileting habits, fatigue or problems sleeping Use of alcohol, tobacco or other drugs Mental health history Relationship and safety Medications you’re taking, including prescription, over-the-counter or supplements

Q

Should I prepare questions ahead of time?

A: Yes, making a list of questions will help you remember everything you intended to talk about. “Don’t be embarrassed or afraid to ask questions. Open communication builds trust between you and your doctor,” Pierce added.

Request an Appointment Call 832.522.5522 or visit houstonmethodist.org/ appointments and take care of your health by requesting an appointment for your annual exam today.

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LIVE A LIFE WITHOUT

JOINT PAIN We can help you get there.

Conroe The Woodlands

If you’ve suffered from years of joint pain and struggled to find relief, we have the joint care expertise to get you back to your everyday life. With treatment plans customized for you, our specialists offer a full range of advanced nonsurgical and surgical techniques, including: • • • •

Innovative pain control methods Physical therapy to improve mobility and range of motion Latest technology, including minimally invasive surgical techniques Presurgical education programs for joint replacement

Willowbrook

Memorial City Bellaire

Katy

Baytown

Texas Medical Center Pearland Sugar Land

Clear Lake

Schedule an appointment to discuss your options with a joint specialist.

Houston Methodist Orthopedics & Sports Medicine at Katy 18500 Katy Freeway | Houston, TX 77094 | 832.522.BONE (2663) houstonmethodist.org/jointpain

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