Leading Medicine Fall 2019, Houston Methodist Willowbrook Hospital edition

LEADING MEDICINE FA LL 2019

How’s Your Gut Health?

4 Fast Facts About Colds

WIN A $100 AMAZON GIFT CARD See inside for details.

Breast Cancer Surgery

A Treatment Plan Designed

JUST FOR YOU YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN NORTHWEST HOUSTON

IN THIS ISSUE - FALL 2019

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H ow’s Your Gut Health? When to See a Gastroenterologist If unpleasant gastrointestinal distress becomes part of your everyday life, there could be something more going on.

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B reast Cancer Surgery: A Treatment Plan Designed Just for You A breast cancer diagnosis can stop you in your tracks and you might worry about your appearance if surgery is required.

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iabetes and Peripheral Neuropathy: D What You Should Know Taking steps to better your health is a great way to help manage diabetes, but complications can still develop.

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Essential Steps for a 5 Healthy Pregnancy The way to a healthy baby begins with a healthy mom, and the journey starts long before a positive pregnancy test.

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4 Fast Facts About Colds

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he cold may be common, but that doesn’t make the runny nose, coughing and sneezing any easier to take when the inevitable illness hits.

“Most people can expect Dr. Minesh to get at least a couple of Desai colds each year,” said Dr. Minesh Desai, primary care physician with Houston Methodist Primary Care Group in Willowbrook. Here are some cold, hard facts: You don’t need to be sneezed on. Even if you avoid sick people, the cold virus can live on surfaces they touch for hours afterward. “You can help yourself and others by washing your hands often or by using an alcohol-based hand sanitizer, if soap and water aren’t convenient,” said Desai. “Cover your nose and mouth with a tissue, or sneeze or cough into your upper arm rather than into your hand.”

Antibiotics are worse than useless on colds. Colds are caused by many different viruses — most commonly, the rhinovirus. “Antibiotics work against bacteria and not viruses, so they don’t work against colds,” said Desai. “Plus, overuse of these drugs can promote antibiotic-resistant ‘superbugs,’ so don’t expect your doctor to prescribe an antibiotic for a cold.”

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Some meds may overtreat. Many over-the-counter (OTC) cold medications claim to relieve everything from congestion to cough to fever and pain.

“Why treat symptoms you don’t have?” said Desai. “For a cough, try cough medicine or cough drops. Consider using a nasal decongestant if you’re stuffy, but not for more than a few days as it can make congestion worse. Acetaminophen can help relieve a headache.” Note: Be sure to check with your primary care physician before taking any OTC medications if you are pregnant or nursing, have high blood pressure, diabetes or other chronic medical conditions.

Colds usually aren’t serious. Unlike flu, which can result in tens of thousands of deaths each year,* the common cold is usually just annoying. “However, young children, the elderly, those with weakened immune symptoms and people with lung conditions, such as asthma, may be subject to secondary infections,” said Desai. “Most cold symptoms will get better in about a week on their own. But see your primary care physician if you are having trouble breathing, have a high fever or your symptoms are getting worse rather than better.”

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* Source: Centers for Disease Control and Prevention.

Schedule an Appointment To schedule an appointment online with a Houston Methodist primary care doctor in the Willowbrook area, visit houstonmethodist.org/pcg/ northwest. Or to find a doctor, call 713.394.6724.

HOW’S YOUR GUT HEALTH? When to See a Gastroenterologist

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igestive problems often strike at the worst possible time.

You might have a gas attack at the movies, indigestion at a dinner party or diarrhea while Dr. Rajeshwar on vacation. Unpleasant Abrol gastrointestinal (GI) symptoms are bound to happen from time to time. However, if GI distress becomes part of your everyday life, there could be something more going on.

WHAT’S CAUSING YOUR SYMPTOMS?

If you’re struggling with unexplained symptoms, your doctor may recommend seeing a gastroenterologist, a specialist who has experience diagnosing and treating diseases affecting the esophagus, stomach, intestines, liver, pancreas and gallbladder.

GI disorders can be classified into two main groups: Functional GI disorders occur when the GI tract isn’t functioning as it should.

“When there’s a functional problem, the GI tract typically looks normal and diagnostic tests show normal results, making it harder to pinpoint the cause of persistent and recurrent symptoms,” said Dr. Rajeshwar Abrol, a gastroenterologist with Houston Methodist Willowbrook Hospital. Irritable bowel syndrome (IBS) and chronic constipation are examples of functional disorders. Treatments may include lifestyle changes, medicines and other therapies to keep the digestive system in balance.

Structural GI disorders happen when there’s a structural problem in the digestive organs that needs medications, or endoscopic procedures or surgery to be healed or repaired. This includes conditions, such as ulcers, anal fissures, hemorrhoids, colitis, diverticular disease, gallstones and colon polyps. “Improving bowel habits can help with symptoms of hemorrhoids and anal fissures, but surgery may be needed in some cases,” Abrol explained.

GI issues can be difficult to diagnose and treat, so it’s important to listen to your body and talk about your symptoms with a doctor. If you experience any of the following symptoms, it may be time to see your doctor or a gastroenterologist: Abdominal pain or bloating Changes in bowel habits Diarrhea Difficulty controlling bowel movement urges Excessive gas or belching Heartburn Loss of appetite Rectal bleeding Unexplained weight loss Vomiting “Abdominal pain can mean any number of things — from constipation to more serious conditions, like appendicitis

or diverticulitis,” Abrol said. Call your doctor right away when abdominal pain is severe, getting worse or recurring, or accompanied by dizziness, high fever or shortness of breath.

TRUST YOUR GUT

You know your digestive system better than anyone, and you may have the best insight (or at least a gut feeling) about what’s going on. Use this knowledge to your advantage by keeping a journal of your digestive episodes, including what you are eating and drinking.

Record the time of day and frequency of symptoms, such as frequent or loose bowel movements, constipation, cramps or heartburn.

A gastroenterologist will review your symptoms, ask about your health history and perform a complete exam. “Blood tests, X-rays, ultrasound exams and GI endoscopic procedures may be ordered to determine the cause of symptoms,” Abrol explained. “If needed, GI motility tests may be recommended to evaluate for problems with gastric emptying.”

Uncover the Problem At Houston Methodist Willowbrook Hospital, our doctors work with you to solve the mystery of GI problems. Call 281.737.2500 to find a gastroenterologist in the Willowbrook area.

WHAT DOES A GASTROENTEROLOGIST TREAT? A gastroenterologist has specialized training to treat and manage digestive disorders, including: Acid reflux Bile duct stones Celiac disease Crohn’s disease

Hemorrhoids Irritable bowel syndrome Pancreatitis Polyps or growths

Ulcerative colitis Ulcers

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Breast Cancer Surgery

A Treatment Plan Designed Just for You A breast cancer diagnosis can stop you in your tracks and leave you wondering: What does this mean for my future? How will my body change? You may Dr. John Shuck be flooded with emotions about the future, and this is completely natural.

If surgery is part of your treatment plan, you might worry about what you will look like afterward.

Surgery can leave scars, and for those who Dr. Liza need to have a significant Thalheimer part of their breast or breasts removed, it’s normal to have some anxiety about how your appearance may change. The psychological impacts of mastectomy can touch various aspects of your life, from body image and selfconfidence to sexuality and intimacy.

MORE OPTIONS, BETTER RESULTS Women undergoing breast surgery have more options with far better results than in the past. “Thanks to advancements in technology and surgical techniques, we can provide dramatically improved results for patients,” said Dr. John Shuck, a plastic and reconstructive surgeon with Houston Methodist Willowbrook Hospital.

“When a patient is diagnosed with breast cancer, we have an initial consultation that typically takes about an hour where we review the pathology report, talk about surgical options and discuss how our multidisciplinary team works together,” said Dr. Liza Thalheimer, a breast surgical oncologist with Houston Methodist Willowbrook Hospital.

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CONSERVING THE BREAST

Radar and radioactive seeds are used to pinpoint abnormal tissue and preserve healthy breast tissue. “For nonpalpable tumors, we can use radioactive seeds or radar localization to pinpoint the cancer in the breast during surgery, without the need for wire localization,” Thalheimer said.

Hidden Scar™ surgery involves making an incision in a discreet location under the breast fold, in the axilla or around the areola, resulting in a scar that is hidden by the skin fold of the breast. “We can make incisions on hidden areas of the breast so the scars are not a constant reminder of surgery,” Thalheimer said.

BREAST RECONSTRUCTION

Women who opt for a mastectomy have a range of options available for breast reconstructive surgery with implants, natural tissue or a combination of both.

“We review and compare all of your options for breast reconstruction so you feel confident and prepared for surgery,” Shuck said.

Surgical options include: Autologous or flap reconstruction uses tissue from another area of the body to reconstruct the breast, making it appear and feel natural. This procedure involves moving tissue, often from the lower abdomen to the chest, and reattaching the arteries and veins in the area. “This type of microsurgery allows us to remove the skin and fat that is usually discarded in the setting of a tummy tuck, and transplant it into the breasts for a natural breast reconstruction,” Shuck explained.

Breast resensitization helps restore sensation to the reconstructed breast.

“Breast resensitization involves connecting nerves to the reconstructed breast, making it possible to restore some sensation after a mastectomy,” Shuck said.

CHOOSING WHAT’S RIGHT FOR YOU When weighing your options, your doctor can help you make an informed decision based on facts, not fears.

Together, you can review the factors that will impact your choices: P hysical characteristics — age, your overall health, breast size, breast density, the size and location of your breast cancer and the amount of tissue available for reconstruction.

P ersonal preferences — aesthetic goals, such as how you want your breasts to look and feel, symmetry and breast reduction, lift or augmentation options.

L ogistical factors — timing of surgery, additional cancer treatments, having a support system and returning to work.

Breast cancer surgery and reconstructive surgery can often be done at the same time to streamline the whole experience, or in a staggered approach if you want to put off reconstructive surgery to a later date.

“Some patients choose to have a mastectomy without breast reconstruction, and that’s OK too,” Thalheimer added. Your treatment plan can be designed so you can keep living your life.

Take Control of Your Treatment

Rely on our expertise to help you personalize your breast cancer treatment. Visit houstonmethodist.org/ cancer-wb to learn more about Houston Methodist Cancer Center at Willowbrook and our team of experts.

LUMPECTOMY VS. MASTECTOMY WITH RECONSTRUCTION What’s the difference?

Lumpectomy Surgery to remove the tumor while leaving healthy breast tissue surrounding it.

Total mastectomy Surgery to remove the entire breast, including the skin, nipple and areola.

Nipple-sparing mastectomy Surgery to remove the breast while leaving the skin, nipple and areola in place.

Why consider it: When breast cancer is detected early and the tumor is small.

Benefits: Conserving your natural breast; faster recovery times.

Why consider it: If you’re choosing breast reconstructive surgery immediately following the mastectomy.

Benefits: Preserving your breast skin and nipple; potential to regain sensation in the nipple when combined with flap surgery.

Flap reconstruction Surgery to reconstruct your breast after mastectomy using abdominal tissue through a tummy tuck incision.

Double (bilateral) mastectomy Surgery to remove both breasts.

Why consider it: May be best for treating invasive breast cancers.

Benefits: Breast reconstructive surgery may be performed at the same time or a later date.

Why consider it: It offers the most natural reconstruction possible.

Why consider it: An option for women choosing preventive mastectomy to reduce risk if they have a BRCA gene mutation.

Benefits: Breast appears and feels natural with hidden scars and the possibility of returned sensation.

Benefits: Achieving a symmetrical appearance with options for breast reconstructive surgery.

BREAST RESENSITIZATION TECHNIQUES AFTER MASTECTOMY If you have a mastectomy, the nerves that provide feeling to the breast and nipple are removed. This loss of sensation can feel unnatural and may alter the way you experience everyday activities like putting on clothes or hugging someone.

Breast resensitization can be performed during flap breast reconstruction surgery, a type of surgery that removes excess abdominal skin and fat to rebuild the breast. The procedure involves reconnecting the nerves on the chest to give the possibility of returning sensation to the breast.

“This cutting-edge technique is performed at only a handful of centers in the United States and we are investigating its ability to restore sensation to the breast,” Shuck said.

Call 281.737.4560 to schedule an appointment with one of our reconstructive surgeons or visit houstonmethodist.org/breast-reconstruction to learn more about other innovative breast reconstruction treatments and procedures offered at Houston Methodist Willowbrook Hospital.

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DIABETES AND PERIPHERAL NEUROPATHY:

WHAT YOU SHOULD KNOW

A Dr. Susanne Gonzalez

diabetes diagnosis is often a lifechanging experience. Besides altering your grocery shopping routine, it can motivate you to exercise more, quit smoking and improve your overall quality of life.

Taking steps to better your health is a great way to help manage diabetes, but complications can still develop. Fortunately, treatments are available to help ward off or reduce troubling symptoms.

WHAT IS PERIPHERAL NEUROPATHY?

Among the complications associated with diabetes, generalized neuropathies are common and peripheral neuropathy is the most common. According to the Centers for Disease Control and Prevention, about 50% of people with diabetes will develop the condition, which causes damage to the peripheral nerves in the feet, legs, hands and arms.

“The peripheral nervous system works with the central nervous system (your brain and spinal cord) to move your muscles and feel sensations. When blood vessels that bring oxygen to the peripheral nerves are damaged, the nerves can’t process the signals sent by the brain, leading to a loss of feeling and pain,” said Dr. Susanne Gonzalez, a neurologist at Houston Methodist Willowbrook Hospital.

A RANGE OF SYMPTOMS

Peripheral neuropathy is often caused by consistently high blood sugar levels. The odds for developing diabetes-related nerve damage increase with age, so the best way to ensure a healthy nervous system is to monitor your blood sugar levels and keep them in the normal range. If left untreated, elevated blood sugar levels can harm the sensitive peripheral nerves. Symptoms of damaged nerves may include: Loss of sensation Muscle weakness Numbness in the affected area Pain or burning Skin sensitivity Tingling Symptoms often develop slowly over time. For instance, a patient may experience numbness in the feet that slowly extends up to the hands. In the early stages, these symptoms may seem like minor annoyances. The treatment for diabetic neuropathy is optimal glucose control. Uncontrolled glucose for extended periods increases the risk of worsening neuropathy. Those who have neuropathy are at greater risk for developing cuts and sores on the feet. “Lacking feeling in the area, patients may not even know they have a sore, which can lead to infections or ulcers on the feet,” Gonzalez added.

STAY INFORMED

If you have diabetes and are concerned about the risk of peripheral neuropathy, a medical professional can help you monitor your blood sugar levels and keep your diabetes under control. If you have diabetes-related neuropathy, your physician may prescribe a treatment to help manage your symptoms based on the extent of the damage.

“Be sure to look at your hands and feet every day for damage to your body that you may not notice or feel,” Gonzalez explained.

Prevent Diabetes-Related Nerve Damage

If you have diabetes, have your feet examined at least four times a year, and get your feet tested for nerve damage every year. Call 281.737.2500 to find a neurologist at Houston Methodist Willowbrook Hospital.

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5 Essential Steps for a Healthy Pregnancy

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he way to a healthy baby begins with a healthy mom, and the journey starts long before a positive pregnancy test. Caring for yourself before you conceive can help you avoid complications like preeclampsia (the development of high blood pressure and protein in the urine after the 20th week of pregnancy), gestational diabetes Dr. Lexanne G. and preterm delivery, and reduce your chances Mauney for having a baby with birth defects.

The early stage of pregnancy, the first two to eight weeks after conception, is a critical time for fetal development. “But because you may not realize you’re pregnant until three weeks or more after your conception, your health status before pregnancy is key,” said Dr. Lexanne G. Mauney, an obstetrician-gynecologist at Houston Methodist Willowbrook Hospital.

If you’re thinking about having a baby, take five steps to help ensure good health for you and your future little one: See your doctor for a preconception visit. This checkup includes a complete physical exam and blood tests to look for infections and your immunity to certain diseases. Your doctor will update your vaccinations and discuss any medical issues, your medications, family history, body weight, fitness level and lifestyle.

Eat a well-balanced diet, which includes a wide variety of fruits, vegetables, whole grains, low-fat dairy products and protein-rich foods like lean meats and fish. Starting your pregnancy at a healthy weight can reduce your risk for complications. Cut back on caffeine by limiting or avoiding coffee, tea, sodas, chocolate and certain medications.

Take folic acid. Studies show that women who don’t get enough folic acid are more likely to have babies with neural tube defects, such as spina bifida or anencephaly.

“Because the neural tube, which becomes your baby’s spinal cord and brain, forms within the first three weeks of pregnancy, it’s critical you get enough folic acid before you conceive. Take a daily supplement or a multivitamin with 400 micrograms of folic acid. Most, if not all, prenatal vitamins have this,” Mauney said.

Get moving. When pregnant, women should get at least 30 minutes of exercise on most, if not all, days of the week. Exercising during your pregnancy can reduce your chances for developing preeclampsia and gestational diabetes.

It can help ease constipation, varicose veins, backaches and fatigue.

Quit bad habits. Smoking, drinking alcohol or abusing drugs can cause miscarriage, premature birth, infant death, birth defects, and growing and learning problems. Ask your doctors about programs to help you quit.

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COMPREHENSIVE CARE FOR YOU AND YOUR BABY From prenatal to postpartum care, the experts at Houston Methodist Willowbrook Hospital offer the highest quality care for expectant mothers and their babies in a family-centered, supportive environment. Our services and facilities include: A wide array of childbirth classes to help prepare you for labor and delivery, plus relaxation and breathing techniques.

A highly experienced team of board-certified obstetricians, maternal-fetal medicine specialists, anesthesiologists, nurse practitioners, lactation consultants, pediatricians, certified nurse midwives and 24/7 obstetric hospitalists focused solely on expectant mothers.

T he newly renovated Houston Methodist Childbirth Center featuring a calming, comfortable redesigned waiting room, six fully remodeled birthing suites and nine new postpartum suites to create the best possible birthing experience for you and your baby.

L evel III NICU in partnership with Texas Children’s Hospital, should you need it, offering the latest in neonatal care, state-of-the-art equipment and pediatric subspecialists to assist in the care of your baby.

Childbirth Center Classes and Tours

To find out more about our childbirth classes or schedule a tour of the Houston Methodist Childbirth Center, visit houstonmethodist.org/childbirth-wb or call 281.737.2500.

If you’re thinking about having a baby, make the effort now to seek preconception care and improve your lifestyle to give your child his or her best start.

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The expertise to

KEEP YOU MOVING At Houston Methodist Orthopedics & Sports Medicine, we know every movement matters.

Our specialists offer: • The latest imaging and technology • Advanced nonsurgical treatments • Minimally invasive procedures

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Whether you’re suffering from simple aches and pains or dealing with a complex injury, we can get you back on your feet — and keep you moving.

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