Leading Medicine Winter 2018, Houston Methodist West Hospital edition

LEADING MEDICINE W INT ER 018

FIGHT BACK AGAINST COLON CANCER KEEP YOUR KNEES YOUNG (AND HEALTHY)

WHY WOMEN SHOULD LISTEN TO THEIR HEARTS Symptoms can vary when compared to men

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

10

Questions to Ask at Your Next Annual Checkup

T

alking with your doctor about any health concerns you have can be a powerful tool when it comes to catching health problems early and preventing disease.

Dr. Randa “An annual checkup Djendou is an opportunity to strengthen a partnership with your health care provider and discuss questions that can help you assess your health outlook,” said Dr. Randa Djendou, an internist with Houston Methodist West Hospital.

parents or siblings had heart attacks, breast, colon or prostate cancers, and other illnesses.

bone density scan for osteoporosis or a colonoscopy for colorectal cancer,” Djendou said.

5

Given my age and health, what symptoms may indicate the onset of an illness? Knowing what symptoms to look for can empower you to take charge of your health.

8

1

6

Given my medical status, what specific symptoms may indicate a health emergency? Discuss health emergency warning signs, especially if you have a family history or medical condition that puts you at greater risk.

9

2

7

10

COVERING YOUR BASES

“Think of your annual checkup as a two-part process. First, is the exam itself,” Djendou said. “The second part is getting a thorough understanding of your health and what you can do to improve it.”

Here are some questions to ask your doctor: Are all my vital signs normal or within the accepted range? Ask about your body mass index (BMI), a formula that tells if your weight is appropriate for your height, blood pressure and pulse and lung function.

Is my health better, worse or the same since my last visit? Ask how your numbers compare to your last checkup.

3

What are the best ways I can maintain my health or manage my condition? “I recommend speaking to your doctor about your diet, your level of physical activity and any other concerns you have,” Djendou noted.

4

Given my personal and family medical history, do I have a higher than normal risk for certain illnesses?

Review your family medical history with your doctor, which shows if grandparents,

2 LEADING MEDICINE IN WEST HOUSTON/KATY

What screenings should I have?

“Depending on your medical history, age and health status, your doctor may recommend certain screenings, such as a mammogram for breast cancer, a

Should I be seeing a specialist for any reason? Ask if you feel you need help managing a chronic condition or have a disease that may require the expertise of a specialist.

What new therapies or changes in treatment have come up since my last checkup? Medicine is constantly evolving. Be sure you know about any new technologies or treatment options for your condition.

Should I get a flu shot or other vaccines? Your doctor can tell you if you are up-to-date on your vaccinations.

Schedule a Checkup Today

Regular checkups and communicating openly with your doctor is just as important as eating right, exercising and watching your weight. Schedule an appointment with a Houston Methodist West primary care physician. Request an appointment online at houstonmethodist.org/online-scheduling or call 832.522.8751.

FIGHT BACK AGAINST

COLON CANCER

C Dr. Rachel Ellsworth

olorectal cancer is the third most common cancer diagnosed in men and women in the United States. It affects 1 out of 20 Americans and is the second leading cause of cancer-related deaths in both men and women. The good news is colorectal cancer is also highly treatable when caught early, and in some cases, even preventable. Here’s what you need to know to protect yourself.

TAKE AN ACTIVE APPROACH

According to Dr. Rachel Ellsworth, a colorectal surgeon at Houston Methodist West Hospital, being aware of the signs of colorectal cancer can make all the difference when it comes to your health. “Paying attention to just a few areas can dramatically cut your risk of colon cancer as well as improve your overall health,” she said. Here are some specific steps she recommends.

Add more vegetables, legumes, fruits and whole grains to your plate to cut fat and boost fiber intake. “Studies show that fiber helps by keeping the digestive process moving so cancercausing wastes spend less time in the colon,” Ellsworth said.

Take a 30-minute walk just three times a week to help lower your risk significantly, and reduce your risk for other diseases.

Limit your alcohol intake to no more than two drinks a day — having more appears to raise a person’s risk.

Take steps to stop smoking, which plays a role in 30 percent of all cancers.

EARLY DETECTION IS KEY

“Everyone should get screened for colon cancer at age 50,” Ellsworth urged. “If you’re at high risk, talk to your doctor about possibly getting screened earlier and more often.”

You may be at higher risk if you: Have a family history of colon cancer Have a family or personal history of polyps Suffer from ulcerative colitis or Crohn’s disease Eat a high-fat, low-fiber diet Are older than 50 A colonoscopy is the gold standard. “During a colonoscopy, your doctor looks inside the colon using a special camera (colonoscope) that can diagnose and treat polyps when they are detected,” Ellsworth said. “People who get screened regularly greatly reduce their risk of developing colorectal cancer.”

Ensure early detection by reporting any of the following symptoms to your doctor: Rectal bleeding Blood in the stool A change in bowel habits, including diarrhea and constipation Unexplained weight loss Anemia (low blood count) Fatigue

Request an Appointment

To schedule your colonoscopy, call 832.522.5522.

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

WHY WOMEN SHOULD LISTEN TO THEIR HEARTS Symptoms can vary when compared to men

New High Blood Pressure Guidelines

Are you at risk?

The American College of Cardiology and American Heart Association released new scientific guidelines on what’s considered high blood pressure, lowering the threshold from 140/90 mmHg to 130/80 mmHg. Recommendations focus on making healthy lifestyle changes to lower blood pressure, including quitting smoking, managing weight, being active and eating a heart-healthy diet. Some patients may also need medication.

The new blood pressure categories consider both systolic (top number) and diastolic (bottom number) pressure.

Normal: Less than 120/80 mmHg levated: Systolic between 120–129 and diastolic E less than 80 mmHg igh Stage 1: Systolic between 130–139 or diastolic H between 80–89 mmHg igh Stage 2: Systolic at least 140 or diastolic at least H 90 mmHg Talk to your doctor to learn if you’re at risk and how you can protect your heart.

4 LEADING MEDICINE IN WEST HOUSTON/KATY

D

espite the perception that heart disease is a man’s disease, it’s the No. 1 killer of women, according to the American Heart Association.

Millions of women die of Dr. Javier heart disease every year, Lafuente yet many are unaware of their risk for the condition. Women often put off taking care of their health — and this inaction can put an extra burden on their hearts.

One form of heart disease, a heart attack, can strike suddenly and with no advance warning. Just like men, women often experience the crushing chest pain and discomfort typically associated with a heart attack. But, women are somewhat more likely than men to experience other common heart attack symptoms and often ignore them.

“A misunderstanding of gender-related heart attack symptoms could cause women to delay getting care because they aren’t sure if they’re having a heart attack, panic attack or indigestion,” according to Dr. Javier Lafuente, a cardiovascular surgeon with Houston Methodist West Hospital.

“It’s key to learn and watch for signs that something may be wrong — and if you’re ever in doubt, don’t hesitate to seek prompt medical care.”

Use these heart health facts for women to bolster your prevention and treatment efforts:

HOW A WOMAN’S HEART ATTACK MAY FEEL

You may already be familiar with classic heart attack symptoms for men, such as crushing chest pain that radiates down the left arm associated with sweatiness, paleness and shortness of breath. “Women are more likely than men to describe chest pain that is burning and sharp, as well as experience extreme fatigue, pain in the neck, jaw, throat, abdomen or back,” Lafuente said.

“Breaking out in a cold sweat is also more common in women, as is lightheadedness,” he explained.

RISK FACTORS OFFER CLUES

Managing your risk factors for cardiovascular disease is only possible if you know what they are, and routine screening tests can reveal the answers.

At your next checkup, ask your doctor to assess your weight and BMI (body mass index), waist circumference, blood pressure, cholesterol and fasting blood glucose level. “These tests offer important clues to cardiovascular health as well as your overall health,” Lafuente said.

HEART ATTACK NOT SOLE SETBACK

With all the focus on heart attacks, some aren’t aware that cardiovascular disease can take many forms. Other heart problems include heart failure, in which the heart isn’t pumping as efficiently as it should; arrhythmia, a too-slow or too-fast heartbeat that can affect its ability to meet the body’s needs; and heart valve problems, which can impede proper blood flow through the heart.

Nearly all of these conditions are easily detectable with routine medical checkups,” Lafuente said. “It’s yet another reason why establishing an ongoing relationship with a primary care physician is so critical to your heart health.”

MENOPAUSE TOO LATE TO PREPARE Women with heart disease risk factors, such as high blood pressure, high cholesterol and a family history, shouldn’t wait until menopause to start a dialogue with their primary care physician about a prevention regimen to keep them healthy.

A recent survey published in the Journal of the American College of Cardiology found that 74 percent of women in the United States had at least one heart disease risk factor, but only 16 percent told their doctor about it.

“Women have such a low prevalence of heart disease until menopause that often times, the topic is ignored until women are well into their 50s and 60s,” Lafuente said.

“But those with risk factors need to be 10 years ahead of the game when it comes to prevention. Unfortunately, too many women already have heart disease by the time they’re tested.”

LEARN ABOUT YOUR FAMILY HEALTH HISTORY The role of genetics and family history is becoming increasingly clear when evaluating our risks of developing heart disease, said Houston Methodist West cardiovascular surgeon Dr. Javier Lafuente. “That’s why it’s imperative to delve into your family tree and determine what your ancestors died from — especially if they died at a young age — as well as what your family members may be living with right now,” Lafuente emphasized. “Take the time to sit down with family elders and ask questions about what led to Great-Uncle Henry’s and Grandma Mary’s deaths, for example. The answers may surprise you.”

If you learn that heart disease runs in your genes — especially through several generations — share that information with your doctors. They may recommend certain dietary or lifestyle changes, prescribe medications, and/or perform various heart disease screening tests earlier or more frequently. You may also be referred to a cardiologist for regular care.

Heart Health Screenings

Schedule an appointment to learn your 10-year risk for heart disease and receive cholesterol and blood pressure screenings. For a physician referral, call 832.522.5522.

HOUSTONMETHODIST.ORG/WEST 5

The Truth About

VASECTOMIES V Dr. Monty Aghazadeh

asectomies are a simple, commonly sought method of permanent contraception in males. “If you’re considering a vasectomy, you may be confused by conflicting information or misconceptions about the procedure,” said Dr. Monty Aghazadeh, urologist at Houston Methodist West Hospital.

Here are some of the most common misconceptions about vasectomies:

MISCONCEPTION #1: Vasectomies cause impotence.

Infertility does not mean impotence. The surgery only involves keeping sperm out of semen and doesn’t affect sex drive, performance or the ability to maintain an erection.

MISCONCEPTION #2: You will no longer be able to ejaculate. Sperm accounts for less than 3 percent of the volume of ejaculate. Semen is created in the prostate gland and seminal vesicles, which are unaffected by vasectomies.

MISCONCEPTION #3: Your testosterone will tank.

While it’s true that the testicles are responsible for both sperm and testosterone production, the way they’re transported is different.

“Testosterone is transported through the bloodstream, not the tubes that carry sperm from the testicles,” Aghazadeh said.

MISCONCEPTION #4: Vasectomies fail all the time.

Failure occurs when sperm find a new way into the vas deferens, called “recanalization,” and only happens in extremely rare cases.

Failure can also happen if the patient doesn’t wait long enough after the surgery to have sex.

MISCONCEPTION #5: Vasectomies instantly ensure infertility. After surgery, men may still have residual sperm in their systems that can cause pregnancy. “It can take about three months for a vasectomy to be completely effective,” Aghazadeh cautioned. “At the three-month mark, your doctor will test your semen to ensure there are no sperm present.”

MISCONCEPTION #6: There’s no going back. While

the surgery to reverse a vasectomy is more complicated, the experienced surgeons at Houston Methodist West have a high rate of success. However, the longer someone has lived with a vasectomy, the more difficult the reversal may be.

6 LEADING MEDICINE IN WEST HOUSTON/KATY

At Houston Methodist West, vasectomies are done as outpatient surgery, taking about 30 minutes to complete. In most cases, you can return to work and regular activities the next day. However, you may feel some discomfort after the surgery, so it’s a good idea to have someone accompany you and drive you home.

Request an Appointment With a Urologist If you or your loved one is considering a vasectomy, call 832.522.8300 for more information.

KEEP YOUR KNEES YOUNG (AND HEALTHY)

A

s you age, it’s common to start experiencing some pain in your joints, especially in the knees.

“But you can combat the wearing down of Dr. Pavel cartilage (osteoarthritis) Muradov and the general wear and tear that your knees go through,” said Dr. Pavel Muradov, an orthopedic surgeon at Houston Methodist Orthopedics & Sports Medicine at West. Muradov suggests taking the following steps to protect your knees as you age.

LOSE WEIGHT

STRENGTHEN YOUR LEGS

A mobile, conditioned knee is less likely to develop overuse problems. Whether you work out a lot or joint issues keep you mostly stationary, improving your flexibility can alleviate pain and stiffness. → TRY THIS: Work on improving flexibility by stretching the muscles in your legs (quadriceps, hamstrings and calves). Or, try a gentle yoga or tai chi class. Ask your doctor or a physical therapist about the types of exercises that are right for you.

“The main muscles I recommend patients focus on are the quadriceps (the muscles above your knee on the front of your thigh) and hamstrings (back of your thigh), though the muscles in your calves, hips and core also play important roles in stability,” Muradov said. → TRY THIS: If you’re experiencing leg pain and stiffness, start with low-impact exercises like walking and yoga to build strength. The physical therapists at Houston Methodist West can help you build a tailored strength-training regimen.

Extra weight puts more pressure on your knees than you may think. It’s estimated that for every extra pound we carry, we add 4 pounds of pressure to our knees.

That means a loss of even 10 pounds can relieve 40 pounds of pressure.

“Maintaining a healthy weight is the single most important thing a person can do for their knees,” Muradov urged. → TRY THIS: If you’re overweight, set a goal for weight loss that’s within your reach. You might aim to lose 5 to 10 percent of your current weight, for example.

IMPROVE FLEXIBILITY

FIND THE RIGHT SHOES

The right shoes distribute your weight evenly throughout your feet, promote proper leg and foot alignment, support your arches and provide adequate cushioning. → TRY THIS: Find a pair of shoes that fits well, supports you and distributes your weight evenly. Many specialty shoe stores can fit you with the right pair or offer high-quality insoles to adjust your weight distribution.

Learn More

The orthopedists and physical therapists at Houston Methodist Orthopedics & Sports Medicine at West can provide the guidance and resources you need to help you keep your joints healthy. For more information about services to help you increase the strength and flexibility in your knees, call 832.522.BONE (2663).

HOUSTONMETHODIST.ORG/WEST 7

NON PROFIT US POSTAGE

PAID

TWIN CITIES MN PERMIT NO 31657

Houston Methodist West Hospital 18500 Katy Fwy. Houston, TX 77094 houstonmethodist.org/west

IMAGES MAY BE FROM ©ISTOCK, ©FOTOLIA AND/OR ©GETTY.

832.522.5522

LEADING MEDICINE IN GREATER HOUSTON

HOUSTONMETHODIST.ORG/WEST

OUTSMARTING CANCER TAKES LEADING MEDICINE. At Houston Methodist Cancer Center, our teams of nationally recognized specialists are finding new ways to outsmart cancer, while delivering the most advanced treatments and comprehensive care available. From screenings to diagnosis and cutting-edge treatments, our leading cancer care is available at all seven locations across Greater Houston, so you can focus on healing, surviving and thriving.

The Woodlands

Willowbrook

Visit houstonmethodist.org/outsmartcancer or call 832.522.5522 to find a doctor in your area.

Houston Methodist Cancer Center at West 18400 Katy Fwy. Medical Office Building 1, Suite 120 Houston, TX 77094

facebook.com/houstonmethodist

twitter.com/methodisthosp

West Houston-Katy

youtube.com/methodisthospitalhou

Baytown Texas Medical Center

Sugar Land

Clear Lake

plus.google.com/+houstonmethodist