Leading Medicine Spring Summer 2019, Houston Methodist West Hospital edition

LEADING MEDICINE SPRI N G/SUM M ER 019

5 Survival Tips for Allergies Pelvic Floor Therapy Helps Postpartum Moms

Orthopedic and Sports Injuries

PROTECT YOURSELF FROM HEAD TO TOE

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

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Seasonal Allergies in Full Bloom

SURVIVAL TIPS FOR ALLERGIES

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ou know the feeling. The sun is shining and you’re feeling inspired to go for a walk in the park. Then it hits.

Sneezing. Itchy, watery eyes. Runny nose. Hives. Allergies have begun.

According to the Centers for Disease Control and Prevention, 50 million Americans suffer from allergies each year, with care Dr. Sima Momin costing an excess of $18 billion. Between the actual symptoms and the fuzziness that often accompanies common medicines, it can make allergies unbearable for some people. So what can be done to deal with the unwelcome sniffles? Here are five tips that can help.

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START TAKING MEDICINE EARLY IN THE SEASON

While you are at the doctor, ask what medicine works best for the allergies you are facing, and start taking it as soon as you can. “Being proactive can save you some frustration,” said Dr. Sima Momin, a primary care physician and internist with Houston Methodist Primary Care Group in West. Some of these medicines start becoming effective after a few doses, so the sooner you start them, the sooner you will feel relief. “Also keep in mind that different medicines work better for different people,” Momin said.

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Go online to schedule your appointment with a primary care physician. Visit houstonmethodist.org/ pcg/west-houston or call 832.522.8444.

KNOW THE CAUSE

Depending on your location, your allergies could actually be caused by a number of different factors. The best way to prepare for allergies is to know what you are up against. Visit with your doctor and ask for an allergy panel so you can know the source of your symptoms.

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Stop the Wheeze and Sneeze

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CHANGE YOUR CLOTHES WHEN YOU GET HOME AND WASH THEM OFTEN

Any time you leave your home, you are bringing pollen back with you on your shoes and clothing. Once you return home, change into clean clothes and put what you were wearing into a hamper or straight into the washing machine. Anything that limits your contact with the pollen can help.

USE YOUR AIR CONDITIONER

Running the air conditioner instead of opening windows keeps pollen outside. Make sure you clean your air conditioner’s filter to ensure the air coming into your home is allergen-free.

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CONSIDER A NASAL RINSE

Many people will shy away from the use of a neti pot or similar nasal saline rinse, but using one regularly during allergy season can help remove pesky allergens from your sinuses.

“Once you get the hang of using a nasal rinse, the relief you feel will make it worth it. Follow directions and use distilled or otherwise filtered water every time you use it,” Momin said.

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VIRTUAL URGENT CARE The next time you get sick, you can skip the waiting room. See our providers via video visit — 24/7, from wherever you are. Virtual Urgent Care is available through the MyMethodist app. Download it today or visit houstonmethodist.org/virtual-care to learn more.

Prostate Cancer: Early Detection Saves Lives

P Dr. Monty Aghazadeh

rostate cancer is the most common cancer in men. It’s also the second most deadly (after lung cancer).

The good news is that prostate cancer can be detected early, when treatment is most likely to be effective.

WHAT IS THE PROSTATE GLAND?

The prostate gland is a walnut-sized gland located in the pelvis. It can be found just under the urinary bladder, encircling the urethra (the duct that carries urine out of the body). That’s why disorders of the prostate — from benign enlargement to cancer — cause urinary symptoms, such as decreased strength of urine stream, difficulty starting to urinate and painful urination.

In terms of function — the prostate gland plays an important role in reproduction, contributing fluid to semen that allow sperm to survive the journey toward the egg.

important to note that just because the PSA is elevated, it does not indicate that prostate cancer is present. Other common causes of elevated PSA include benign prostatic hypertrophy (enlarged prostate) and prostatitis (a prostate infection).

Ultimately, determining whether cancer truly is present requires a prostate biopsy.

More recently, genomic testing and prostate MRI have helped guide which men need biopsies and improved our abilities to detect prostate cancer when a biopsy is performed.

TREATMENT OPTIONS

“Once prostate cancer has been diagnosed, treatment depends on a number of factors,” said Aghazadeh.

“It depends not only on the stage of the cancer, but also the man’s age, health, expected life span and level of concern about possible side effects.”

Hormone therapy, radiation and surgical removal of the prostate gland have traditionally been considered the mainstays of treatment. Of note, recent studies have demonstrated that not all prostate cancers behave aggressively, and

certain low-grade cancers can be watched safely using a strategy called active surveillance. This strategy employs a strict monitoring protocol where the cancer is followed closely, with treatment only if the cancer patterns worsen.

WATCH FOR THESE SYMPTOMS The majority of the time, men with prostate cancer have no symptoms, but symptoms may include: Weak or interrupted stream of urine A frequent urge to urinate, especially at night Difficulty in starting to urinate Blood in the urine Pain or burning upon urination

DIAGNOSING PROSTATE CANCER

“One difficulty with prostate cancer is that there’s typically no symptoms early in the disease,” said Dr. Monty Aghazadeh, a urologist at Houston Methodist West Hospital. “That’s what makes screenings so important. We recommend that all men at high risk get regularly tested for prostate cancer.” See “Guidelines for Early Detection” for more information.

Detection of prostate cancer has traditionally relied on a combination of two tests, both of which aim to find the cancer at an early stage. The first test is the digital rectal exam, or DRE. In DRE, a doctor feels the prostate through the wall of the rectum to check for abnormalities. The second test is the prostate-specific antigen (PSA) test.

This blood test measures a protein made only by the prostate and can be elevated in the setting of prostate cancer. It is

GUIDELINES FOR EARLY DETECTION: WHAT THE EXPERTS SAY The American Urological Association recommends prostate-specific antigen (PSA) testing every other year between the ages of 55 and 69.

Men at high risk, such as African Americans and men who have one or more first-degree relatives — a father or a brother — diagnosed with prostate cancer at an early age should begin testing earlier. Talk to your doctor about the risks and benefits of PSA screening so you can make an informed decision together.

Ask About Preventive Screenings

To schedule an appointment with a Houston Methodist West Hospital urologist, visit houstonmethodist.org/urology or call 832.522.8300.

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Orthopedic and Sports Injuries

Protect Yourself from HEAD TO TOE D ealing with orthopedic and sports injuries often comes with the territory for football players, marathon runners, gymnasts and other competitive athletes. But you don’t have to be on the field or court to end up with a painful or chronic injury. Everyday types of injuries from carrying groceries or unloading the dishwasher happen all the time and can also lead to longterm problems if not treated properly.

Dr. F. Alex Back problems, joint disorders and osteoarthritis are Schroeder among the top reasons for seeing a doctor. “Musculoskeletal issues result in millions of orthopedic visits every year,” said Dr. F. Alex Schroeder, an orthopedic surgeon specializing in sports medicine at Houston Methodist West Hospital.

KNOW YOUR LIMITS

Schroeder says it’s important to listen to your body when it’s telling you to slow down. “Sometimes we try to push through the pain, but you can end up doing more damage if you’re not careful. When you have joint and muscle pain, you can’t always walk off the pain or solve it by taking antiinflammatory medicines,” he noted.

“With age, our ability to heal is not as fast as it used to be and we don’t have as much elasticity in those tendons — like a rubber band that loses its elasticity over time. The best thing you can do is modify your activities or try a new activity that puts less stress on your body, such as biking or swimming,” Schroeder added.

WHEN TO GET CHECKED

Injuries are bound to happen whether you’re competing in sports or just taking a walk around the block. Minor injuries can often be treated at home with rest, ice, compression and elevation. But there are times when it’s important to see a doctor so you can avoid further damage and ensure that you can heal properly.

It’s wise to get medical help if you experience the following symptoms after an injury: Instability (unable to bear weight on your knee or ankle) Limited range of motion Numbness or tingling Persistent joint pain Significant swelling or tenderness Weakness or lack of strength while moving a limb or muscle In addition, any impact to the head should be taken seriously, whether it’s from a sports collision or a minor fall at home. “When it comes to head injuries, always seek medical help for signs of concussion, such as any loss of consciousness, confusion or dizziness following a bump on the head,” Schroeder said.

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ORTHOPEDIC INJURY CLINIC

Twisted ankle? Sprained knee?

Bad shoulder? You don’t need an appointment to see a specialist — just go to the Houston Methodist Orthopedic Injury Clinic in West Houston. For immediate orthopedic care, count on our experts to evaluate and treat your injury, so you can get back to your active life. Major insurance plans are accepted.

The injury clinic provides treatment for: Acute orthopedic injuries Fractures and broken bones Injured tendons Minor dislocations Painful or swollen joints Sports injuries Sprains and strains Torn ligaments Monday – Thursday: 8 a.m. – 4:30 p.m Friday: 8 a.m. – 4 p.m.

No Appointment Required Conveniently located at 18400 Katy Fwy., Suite 200, Houston, TX 77094.

Visit houstonmethodist.org/ orthopedics/locations/ katy-west or call 832.522.8280.

Chronic conditions, spine injuries, motor vehicle accidents and workers’ compensation injuries are not treated at the injury clinic. Please call 832.522.8280 to schedule an appointment with the appropriate physician for those conditions.

HEAD AND NECK

INJURY PREVENTION TIPS

Concussion Whiplash Injury prevention: Stay fit and maintain good posture for a strong neck and upper back. Wear headgear for contact sports or safety equipment for your activity.

Sarah Nonaka, a physical therapist and board-certified clinical specialist in Orthopaedic Physical Therapy at Houston Methodist West Hospital, shared the following injury prevention tips.

BACK Herniated disk Repetitive strain Injury prevention: Protect your back from injuries by strengthening your core muscles (the muscles that wrap around your entire torso) by doing exercises, such as planks and/or abdominal bracing exercises.

SHOULDER Rotator cuff injury Shoulder instability Injury prevention: Lift properly by picking up objects in front of you and as close to your body as possible.

ARM AND ELBOW

HIP AND LEG

Bursitis Golfer’s elbow Tennis elbow

Hamstring strain Hip flexor strain Shin splints

Injury prevention: Mix up your routine by doing a variety of arm movements to avoid repetitive injuries. Learning the proper mechanics for throwing and swinging is key to avoiding upper extremity injuries.

Injury prevention: Take care of your muscles and joints by warming up and stretching before exercise.

KNEE ACL injuries Jumper’s knee (patellar tendonitis) Osteoarthritis of the knee Injury prevention: Lose weight or maintain a healthy weight to take pressure off the knee and reduce wear and tear over time. Staying active helps protect the knee because you’re building muscles in the hips, quads and thighs to support the knee.

WRIST AND HAND FOOT AND ANKLE Ankle sprains Tendonitis Turf toe Injury prevention: Wear good shoes with solid support to absorb impact and prevent ankle injuries. Balance activities can help with stability — it can be as simple as standing on one leg.

Carpal tunnel syndrome Jammed fingers Skier’s thumb Wrist sprains Injury prevention: Take breaks from activity to rest the hands and wrists. If you spend a lot of time at a desk, set a timer throughout the day for every half hour to remind you to stretch and move.

KEEP MOVING Nonaka shared some additional tips to help you keep moving and stay injury-free: Warm up before you exercise — walking, squatting, cycling, jumping jacks, arm circles, shoulder rolls or lunges.

Get your heart rate up, such as a brisk walk in a park with friends.

A im for 30 minutes of exercise every day — you can break this up into smaller 10-minute bursts of exercise throughout the day.

B uild strength with weights a few times a week.

A dd balance activities at least once a week — stretching, yoga, tai chi.

F ocus on good posture — avoid the “head forward, rounded neck” posture when looking at your phone.

HOUSTONMETHODIST.ORG/WEST 5

PELVIC FLOOR THERAPY Helps Postpartum Moms

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he effects of pregnancy and childbirth are deeply personal and different for every woman. When you look in the mirror, you may notice changes to your body and struggle with body image. It is important to remember that these changes are natural and normal. Occasionally, some changes may signal a need for further attention Julie Brewer and care. Symptoms of pelvic pain, weakness in the core muscles, urine leakage, difficult bowel movements and painful sexual intercourse should be addressed.

As a new mom, you might ignore bothersome symptoms and hope they will go away with time as you focus on newborn care. “Women often don’t know about services that address and support a new mother’s physical challenges.

Katie Beckham Physical therapy has benefits at any stage of a woman’s postpartum journey,” said Julie Brewer, a pelvic health physical therapist with Houston Methodist West Outpatient Rehabilitation Services.

WHAT IS PELVIC FLOOR THERAPY?

Pelvic floor therapy is a form of physical therapy that can help correct problems with urinary incontinence and other issues for all women, including postpartum mothers. “We can usually make quick improvements within one or two visits, and most women complete their treatment in six weeks,” said Katie Beckham, a pelvic floor physical therapist with Houston Methodist West Outpatient Rehabilitation Services.

Your first visit may involve the following components: Discussion of symptoms and information about past pregnancies and deliveries Examination of C-section scars, if applicable Evaluation of the pelvic floor, including soft tissue around the vaginal and/or rectal area Assessment of lower body and abdominal strength Review of posture related to carrying a car seat, holding baby, breastfeeding, etc.

TREATMENT DESIGNED FOR YOU

Pelvic floor therapy empowers women to understand how to use their core, pelvic floor, abdominal muscles and breathing techniques. “In therapy, we address any biomechanics, movement strategies, nutrition, behavior changes and emotional support,” Beckham said. “Our goal is to have a well-supported new mom.”

6 LEADING MEDICINE IN WEST HOUSTON/KATY

Techniques may include: Hands-on, manual therapy Scar tissue mobilization, also called scar massage Myofascial release, or light manual pressure on the fascia, the connective tissue that wraps around muscles, to ease pain Palpating the pelvic floor muscles to contract and relax Biofeedback to help you monitor body functions like breathing and heart rate to reduce pain or relax Home program for exercise and self-care “Too often, women aren’t aware of the degree of trauma their bodies may sustain as a result of pregnancy and birth. Sometimes, problems present much later in life,” Brewer said. “If you have any bladder issues, painful sex, or just not feeling like yourself, pelvic floor physical therapy can help you heal.”

Transform Yourself with Therapy

Start by talking with your obstetrician or primary care physician about your pelvic floor concerns.

To learn more about therapy services offered at Houston Methodist West Hospital or to schedule an appointment, call 832.522.8200.

TREATMENTS FOR SORE FEET A re you sitting on the sidelines with chronic foot or ankle pain? It’s time to do something about it so you can return to the activities you enjoy.

Dr. Pedro Dr. Pedro Cosculluela, Cosculluela an orthopedic surgeon at Houston Methodist Orthopedics & Sports Medicine at West who specializes in foot and ankle problems, advises seeing a specialist whether your pain is from a new injury or chronic pain.

“We offer a number of treatments that can help patients find relief and avoid further injury.”

Learn about several foot and ankle conditions and how they’re treated at Houston Methodist West Hospital.

STRESS FRACTURES. This small crack or severe bruising in a bone can be a result of repetitive movements, but it’s most often caused by a sudden increase in activity. “The vast majority of cases are from runners who suddenly add a lot of mileage,” Cosculluela said. “Stress fractures also tend to happen to people who are usually inactive and start lifting heavy objects, such as during a move.”

Treatment: Treatment may consist of rest, protective footwear or casting, depending on the location and extent of the fracture. More serious breaks may require an operation and pins to keep the bones in place.

PLANTAR FASCIITIS. Causing severe pain on the bottom of the heel, plantar fasciitis occurs when the tissue connecting the heel bone to the base of the toes becomes inflamed. “Plantar fasciitis affects about 10 percent of the population, so it’s a very common problem,” Cosculluela said. Risk factors for the condition include having a very high arch, being obese, starting a new activity, increasing activity or partaking in a repetitive impact activity. It can occur in people with or without heel spurs.

Treatment: “Plantar fasciitis is a condition that typically goes away on its own,” Cosculluela said. “All most people need are some stretching exercises and perhaps anti-inflammatory medications.”

In some cases, cortisone injections and orthotic devices may be effective. If your condition is more severe, your doctor may recommend surgery to lengthen the calf or relieve tension in the tissue.

BUNIONS. Genetics, inflammatory conditions and narrow, pointed shoes can all potentially lead to a bunion, a painful enlargement of the joint at the base of the big toe. It’s a slow-forming condition that occurs when bones move out of alignment inside the foot.

Advanced bunions can change your foot’s appearance so that your big toe may angle under or over your second toe.

Treatment: Bunion pain can usually be managed by switching to shoes that don’t squeeze the toes and using protective

padding over the bunion. If nonsurgical options prove ineffective, bunion surgery can realign the joint and help relieve pain.

SPRAINED ANKLES WITH CHRONIC PAIN. Sprained ankles are common, and many people who suffer a sprained ankle are at risk of developing chronic ankle pain. This is especially true if the ankle is reinjured during the recovery period.

Treatment: Before turning to surgery, nonsurgical treatments, such as physical therapy and orthotic devices, may be considered. Orthotic devices may include foot and ankle supports for strengthening weak joints or limbs. If pain is persistent after months of nonsurgical treatment, arthroscopic surgery may be recommended to view and repair tears or ruptures in the tendons of your ankle.

If the Achilles tendon is torn, the tendon may need to be reconstructed using conventional surgery.

Put Your Best Foot Forward

If you’re suffering from chronic foot or ankle pain, don’t let it control your life. We offer a number of treatments that can get you back on your feet. Visit houstonmethodist.org/orthopedics/locations/katy-west or call 832.522.8280 to schedule a consultation.

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KEEP YOU MOVING

At Houston Methodist Orthopedics & Sports Medicine, we know your body is made to move.

Our specialists use the latest technology, perform minimally invasive procedures and develop customized treatment plans, including physical therapy. Whether you’re getting back in shape or back to work, we can help get you back on your feet — and keep you moving. houstonmethodist.org/orthopedics 20 convenient locations

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