Leading Medicine Winter 2019, Houston Methodist West Hospital edition

LEADING MEDICINE W INT ER 019

Q&A on Carpal Tunnel Syndrome

Strength in Numbers:

LOSING WEIGHT TOGETHER Breastfeeding Survival Guide for Real Life YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN WEST HOUSTON/KATY

A Closer Look at Neurology

Neurologists Help

FIND ANSWERS

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ou probably have a lot of questions, if you or a loved one have unexplained symptoms that could involve the brain or nervous system. Your Dr. Usha Aryal doctor may refer you to a specialist for a neurological exam. Neurologists treat diseases of the brain, spinal cord, peripheral nerves and muscles.

Neurological conditions include epilepsy, stroke, multiple sclerosis (MS) and Parkinson’s disease.

Dr. Usha Aryal, a neurologist at Houston Methodist West Hospital, treats patients with uncontrolled headaches, memory loss, imbalance, numbness and pain. Degenerative nerve diseases can be life-altering and heartbreaking for patients and their loved ones, she said.

“In many cases, the cause of disease is not known and there is no cure,” Aryal said. “However, new research and treatments offer hope and help with managing symptoms.”

Common neurologic disorders include: A lzheimer’s disease — a form of dementia leading to memory, thinking and behavior decline: A ffects more than 5 million Americans O ne in 9 people older than age 65 have Alzheimer’s W omen account for 2 out of every 3 Alzheimer’s sufferers S ymptoms include: M emory loss that disrupts daily life P roblem-solving challenges M ood or personality changes T ime or place confusion

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A myotrophic lateral sclerosis (ALS) — a disease that damages motor neurons and affects muscle movement throughout the body: A ffects an estimated 20,000 Americans A verage age of onset is 55 M ilitary veterans are about twice as likely as the general population to develop ALS S ymptoms include: T rouble walking or running D ifficulty writing S peech problems H untington’s disease — an inherited brain disorder causing progressive loss of mental and physical control: A ffects more than 15,000 U.S. adults A verage age of onset is 40 C hildren of those who carry the Huntington’s disease gene have a 50 percent chance of inheriting the disease S ymptoms include: M ood swings B outs of depression F orgetfulness B alance problems I nvoluntary movements P arkinson’s disease — a nervous system disorder affecting movement: N early 1 million U.S. adults have Parkinson’s disease A verage age of onset is 60 M en are at greater risk than women of developing the disease S ymptoms include: T remors M uscle rigidity S lowed movement B alance instability

6 REASONS TO VISIT A NEUROLOGIST Consider making a neurologist appointment if you experience: Chronic or severe headaches — such as migraine headaches, are treated by neurologists Chronic pain — consider seeking a neurologist referral if your primary care doctor can’t help you manage chronic pain Dizziness — you feel like you’re spinning or having difficulty keeping your balance Numbness or tingling — especially if it occurs on one side of the body or is sudden. These could be a sign of stroke or other serious condition Movement problems — difficulty walking, tremors and jerking movements can be signs of nervous system problems Memory problems or confusion — worsening memory problems, personality changes or mixing up words

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Learn More

To schedule an appointment to discuss the latest treatment options with a neurologist, call 832.522.8520.

Sources: Alzheimer’s Association, ALS Association, National Institute of Neurological Disorders and Stroke and Parkinson’s Disease Foundation.

Q&A

ON CARPAL TUNNEL SYNDROME

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o you have pain, tingling or numbness in your hand or wrist? Everyday activities that strain your hands can contribute to carpal tunnel syndrome.

“If pain and tingling are interfering with your daily activities and/or interrupting your sleep, treatment can relieve these bothersome symptoms and prevent further injury,” said Dr. Matthew Dr. Matthew Burn, a hand, wrist and elbow Burn surgeon at Houston Methodist Orthopedics & Sports Medicine at West. Burn answered questions about carpal tunnel, a treatable condition.

Q: What is carpal tunnel syndrome?

A: There is a space in your wrist called the carpal tunnel through which tendons and the median nerve pass. Carpal tunnel syndrome is caused by swelling in this tunnel that squeezes or compresses your nerve.

Q: What does it feel like?

A: Carpal tunnel syndrome may start with aching wrist pain, which can send shooting pain or a tingling sensation to your hand or forearm. Long-term compression or squeezing of your nerve can cause weakness in your hands and a constant numbness in some fingers.

Q: When should I seek medical advice?

A: See your doctor if hand pain interferes with your normal activities or disrupts your sleep. Untreated carpal tunnel syndrome may get progressively worse, leading to possible permanent nerve and muscle damage.

Q: What can I do to manage symptoms?

A: Whether you’re on the job or enjoying leisure activities, take short, frequent breaks to give your hands a rest whenever you notice symptoms. Often, wearing a wrist splint at night (to keep your wrist straight) can help improve symptoms — even during the following day after removing the splint.

Q: What treatments are available?

A: Wrist splints (often marketed as a “carpal tunnel brace” and available at your local pharmacy or online) may help relieve symptoms in mild to moderate cases. In some cases, a doctor may inject cortisone to relieve pain. Carpal tunnel release surgery may be an option if symptoms persist for six months or longer.

Q: What causes carpal tunnel syndrome?

A: Repetitive hand movements are believed to contribute to carpal tunnel syndrome. These include prolonged use of computers or hand-held devices, or job- or hobby-related hand strain from sewing, crafting or woodworking. Hormonal changes during pregnancy can worsen symtoms. Some people may be genetically predisposed to developing carpal tunnel syndrome.

Treatment Starts Here

The orthopedic specialists at Houston Methodist Orthopedics & Sports Medicine at West can determine the cause of your pain and recommend treatment options for a faster recovery. Call 832.522.2663 or visit houstonmethodist.org/ orthopedics/locations/katy-west to schedule an appointment.

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STRENGTH IN NUMBERS:

Losing Weight Together

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aybe it feels like you’ve tried everything to lose weight. But have you unleashed the power of your family and social network? Research Dr. Laura Choi suggests that couples have a higher likelihood of losing weight when they team up to adopt healthy behaviors. More research is needed to understand the power of community and its effects on weight loss, but it’s clear that friends and family have a strong influence in this area.

“When people decide to make a committed step to change their lives, it definitely has ripple effects on their relationships,” said Dr. Laura Choi, bariatric surgeon and medical director of bariatric surgical services at Houston Methodist West Hospital. Whether you’re planning to lose weight, considering weight-loss surgery or needing a new outlook on weight loss, partnering can

Get Started Jump-start your weight loss by attending a free orientation at Houston Methodist Weight Management Center at West.

We can answer questions about our medical weight management, StepLITESM and surgical weight-loss programs to help you get started.

Visit houstonmethodist.org/ weight-management or call 832.667.LOSE (5673) to register.

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improve your odds of reaching your goals. Weight loss with a partner provides motivation, support and even a little healthy competition.

1 MOTIVATION

“Motivation is often tied to experiences with our loved ones,” said Choi. “We want to be there for the big moments in life, and we want to go places and enjoy time together.” Whatever your motivation to lose weight, you can put more power behind it when your loved ones know what you’re fighting for.

Picture this: A busy mom wants to lose weight so she can set a healthier example for her kids. The changes she makes with nutrition and exercise have an impact on her whole family. Try it: Keep a visual reminder, such as a family photo, vacation destination on a map, etc., in a special place so you can stay committed when you need it.

2 A STRONG SUPPORT SYSTEM

“When you embark on this journey together with family members, you have a built-in support system,” Choi said. “For anyone considering weight-loss surgery, it’s a big decision and a lifelong commitment that affects everyone in the family. Having a great support system can amplify the benefits of surgical weight loss.”

Picture this: A husband struggling to lose weight on his own decides to explore weight-loss surgery. He signs up for an informational session. Try it: A spouse can provide mental and emotional support by attending the orientation session, going to appointments and committing to a mutually changed lifestyle after surgery.

3 EAT BETTER TOGETHER

Changing the way you eat starts with meal planning, grocery shopping and a commitment to cooking meals at home.

“Food is central to our day-to-day life and family interactions, so it’s vital to involve others in your life when making significant dietary changes,” Choi said.

Picture this: A mother and daughter both had weight-loss surgery about six months apart. Planning meals and cooking together helped them adjust to their new diet plan. Try it: Attend a healthy cooking class with friends or family members.

4 TEAM UP FOR EXERCISE

Being active together and exercising regularly is key to success with weight loss. “Having someone else to hold you accountable might be exactly what you need to show up and challenge yourself more than you would when working out alone,” Choi added.

Picture this: Two friends who played football in high school gained a lot of weight in their 20s and 30s. After one friend started a new exercise program, the other friend joined, too, and both lost weight. Try it: Transform couch time into something more active. Meet at the gym to watch your favorite TV shows while walking on a treadmill, or throw a football around before watching the game on TV.

5 TRACK YOUR PROGRESS

Keeping track of total pounds and inches lost as a group can be highly motivating. “Also seeing health numbers improve and high blood pressure, cholesterol and blood sugar go down is our top priority,” Choi said. “It’s really about achieving a better quality of life and a better state of health.”

Picture this: Co-workers start a weightloss challenge to lose 500 pounds total among the group. Try it: Talk to your doctor about your target numbers and attend support groups, nutrition or fitness classes, or start a friendly competition among friends.

APPLE OR PEAR SHAPE? What it means for your health

A HEALTHY 6 MAINTAIN LIFESTYLE

“Losing weight and keeping it off requires working through a different relationship with food,” Choi said. “Having someone on your side can help you get back on track after slip-ups or setbacks.”

Picture this: Three sisters join forces to plan healthy food alternatives for a family gathering. Try it: Keep the lines of communication open with family and friends so they understand what you’re doing to change old habits and why it matters to you.

You might be focused on trimming your tummy or slimming your thighs to feel good and fit in your favorite clothes. But it’s not all about looks.

Where you carry extra fat can make a big difference for your health, too.

With an apple shape, excess fat is stored around your abdomen. This type of fat (called visceral fat) lies beneath your muscles and surrounds your abdominal organs. It has been shown to increase the risk of cardiovascular disease, diabetes and other metabolic diseases. Having a pear shape and carrying more weight around the hips doesn’t increase those health risks.

What can you do about it? Genetics, hormones and age all play a part in how your body stores fat. These factors are beyond your control, but you can combat belly fat with diet and exercise. Try adding more moderate-intensity exercise to your day, watching portion sizes, limiting sugar, refined carbohydrates and avoiding trans and saturated fats.

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5 FLU FACTS

YOU SHOULD KNOW

A Dr. Chante Ellison-Hodges

re you worried about getting the flu? Flu typically peaks between December and February so don’t delay.

Learn the facts about flu and how you can avoid getting sick.

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FACT

Flu affects millions of people every year. Most people recover from the illness in less than two weeks. However, the flu can lead to more serious conditions, such as pneumonia.

Flu-related illnesses result in hundreds of thousands of hospitalizations and tens of thousands of deaths every year.*

FACT

Get a Flu Shot

FACT

FACT

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A flu vaccine can’t cause the flu. The vaccine is made from inactivated, noninfectious viruses or no viruses at all. “People who develop flu-like symptoms after receiving a flu shot were going to get sick anyway,” Ellison-Hodges said. “Their illness is not a result of having received the vaccine.”

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A vaccination isn’t a guarantee against the flu. “Take additional steps to protect yourself, such as avoiding people who have the flu, washing your hands often and maintaining a healthy lifestyle to support your immune system,” Ellison-Hodges said. “That includes eating right, exercising, getting enough sleep and managing stress.”

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The Centers for Disease Control and Prevention (CDC) recommends flu vaccination begin soon after the vaccine becomes available, if possible, by the end of October. Immunity lasts through a flu season for most people. However, it’s not too late to get vaccinated, even in January or later, since flu viruses are still circulating.

FACT

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“Everyone ages 6 months and older should get a flu shot this flu season and every year,” said Dr. Chante Ellison-Hodges, a family medicine doctor with Houston Methodist West Hospital. Vaccinations are especially important for people at high risk for flu-related complications, including: ** Those with chronic conditions, such as asthma, diabetes, heart disease, kidney disease and liver disease Children younger than age 5, especially those younger than age 2 Adults at least age 65 Nursing home and other long-term care residents Pregnant women and women up to two weeks postpartum

* Centers for Disease Control and Prevention. ** People with severe allergies to chicken eggs, as well as certain other individuals, should talk to their doctors before getting vaccinated.

ONLINE SCHEDULING AVAILABLE Visit houstonmethodist.org/ pcg/west to choose your doctor, schedule an appointment online or to find additional locations.

KATY 23530 Kingsland Blvd., Suite 130 Katy, TX 77494 MEMORIAL CITY 9090 Katy Fwy., Suite 200 Houston, TX 77024 WEST HOUSTON 18400 Katy Fwy., Suite 300 Houston, TX 77094

Take steps to protect yourself and your family from the flu. Get vaccinated. Houston Methodist West Hospital makes getting a flu shot quick and easy. Call 713.394.6791 or visit houstonmethodist.org/primarycare for information.

6 LEADING MEDICINE IN WEST HOUSTON/KATY

Breastfeeding Survival Guide for Real Life C hoosing to breastfeed is one of the most loving decisions you can make for your newborn. In addition to meeting your baby’s nutritional needs, breast milk protects against infection, which can be crucial for preterm infants, and brings maternal health benefits. The skin-to-skin contact it provides also helps strengthen the bonds between you.

Dr. Nesochi Some new mothers run into obstacles when Adimorah learning how to breastfeed. “The decision to breastfeed is a personal one and we make every effort to support mothers that want to try,” said Dr. Nesochi Adimorah, an obstetrician-gynecologist at Houston Methodist West Hospital.

The first few days and weeks are often difficult with a newborn — it’s an emotional and sleep-deprived time for parents. Here are some tips to help you succeed.

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Start right away. If possible, put your baby to your breast soon after birth. It’s OK if you don’t know exactly what to do — it’s comforting for your baby to be close to you.

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Find the right position. Remember that both you and your baby are learning. “Breastfeeding is natural, but it’s a skill that takes practice. Ask a nurse or lactation consultant for help on different breastfeeding positions,” Adimorah said.

3

Get comfortable. You might try sitting up in bed or in an armchair that supports your back. Consider using a breastfeeding pillow to support your baby while you’re breastfeeding.

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Breastfeed every one to two hours. The more you breastfeed, the more milk your body will produce to meet your baby’s needs. Keep a log of feeding times and whether your baby fed on the left or right breast or both.

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Take a break. Breastfeeding is a demanding job, and you may benefit from taking a break to get some fresh air and exercise.

Ask your loved ones for their help if you need it. Utilizing a breast pump and storing milk will allow family members to participate in the care of your baby while giving you the opportunity to engage in self-care.

OVERCOMING COMMON PROBLEMS

Breastfeeding problems are common, and many challenges can be helped if you get the support you need.

Inadequate milk intake: You may worry about producing enough milk the first few days after delivery. Newborns have small stomachs, almost the size of a grape, which only hold close to half an ounce of milk and empty quickly. Supplementation with formula or donated milk is needed with poor weight gain, weight loss, and if your baby shows signs of dehydration.

Engorgement: Your breasts may feel full and tender when engorged with milk a few days after giving birth. Keep nursing regularly and alternate the breast your baby nurses on first from feeding to feeding. Apply warm compresses, or take a warm shower to ease discomfort.

Nipple pain: Nipple soreness is a sign that your baby is not latching onto your breast properly. Try changing positions to make sure you’re comfortable and your baby is supported. A lactation consultant can help you make sure your baby is latched on and sucking the right way.

Blocked milk duct: A hard knot forms in the breast if a duct becomes clogged with milk. To get the milk flowing again, offer the breast with the clogged duct first at feedings. Gently massage the breast and apply a warm compress to relieve pain. Kneading the breast during a warm shower is another good way to improve symptoms.

Schedule a Tour

Houston Methodist Childbirth Center at West invites you to experience our warm and caring environment by scheduling a tour. Visit houstonmethodist.org/events for upcoming dates and times.

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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.

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

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