Leading Medicine Spring-Summer 2021, Houston Methodist Willowbrook Hospital edition

LEADING MEDICINE SPRI N G/SUM M ER 2021

Relief for Headache Sufferers

When to See a Doctor for

ORTHOPEDIC INJURIES Don't Delay Routine Cancer Screenings

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

RELIEF FOR HEADACHE SUFFERERS

H

eadaches can be a painful and confusing ailment. Often, they seem to come and go mysteriously. Have you struggled to find out what’s causing your Dr. Susanne headaches? In some cases, Gonzalez making changes to diet, Gallardo lifestyle or sleep habits can help provide relief. Here are some of the most common headache types, causes and treatment options.

TYPES OF HEADACHES

“Not all headaches are created equal.

Some can be dull and throbbing, while others may be sharp and intense,” said Dr. Susanne Gonzalez Gallardo, a board-certified neurologist at Houston Methodist Willowbrook Hospital.

“Different headaches have varying symptoms and may require different treatments to find relief.”

When headaches aren’t due to another medical condition, most generally fall within one of the following categories: Tension headaches are fairly common and can feel like a tight band is wrapped around your head. They involve a mild to moderate pain on both sides of the head.

Migraines can cause moderate or severe throbbing or a pulsing sensation in one or both sides of the

head. They are often accompanied by nausea, vomiting and increased sensitivity to light and sound.

Migraine headaches can last for hours or even days.

Trigeminal autonomic cephalalgias (TACs) are some of the most painful headaches. Pain is typically on one side of the head, around or behind the eye. This may come with eye tearing, runny nose, facial swelling or redness.

Attacks may last for a few minutes or a few hours and may cluster or occur in cycles.

Note that if you ever experience a sudden and extremely painful headache or you have a headache after injuring your head, you should seek immediate emergency care.

CAUSES OF HEADACHES

Headaches can be caused by a range of triggers. Secondary headaches are a symptom of another condition, such as infections, medications, head and/or neck injury. Primary headaches can run in families and are commonly triggered by: Alcohol, especially red wine Bad posture Certain foods, such as processed meats Changes in estrogen levels Changes in the weather Lack of sleep Missed meals/dehydration Overuse of pain medication Stress

WHAT CAN I DO?

“Finding relief from a headache isn’t always easy,” said Gonzalez Gallardo. “You may need to try one or multiple treatment options to relieve the pain.”

Headache treatment can include: O ver-the-counter medications, such as aspirin, ibuprofen and acetaminophen, are often the first treatment considered when dealing with headaches. These medications can be effective in relieving headaches, especially tension headaches and migraines. They’re generally not effective in treating TAC headaches.

S tress-reduction techniques, such as meditation or relaxation training, can also help to relieve some headaches.

L ifestyle changes can also be effective in preventing or providing relief from some headaches. Getting enough rest, eating a healthy diet and maintaining good posture can all provide improvement.

P rescription medications may be used to provide relief when at-home methods aren’t effective.

B otulinum toxin treatment, also known as Botox®, can help reduce headaches for people who experience migraines 15 or more days a month.

I njections of the occipital nerve may be used to treat chronic and severe headaches that don’t respond well to other forms of treatment.

Stop Suffering If you’re suffering from severe or chronic headaches, a specialist at Houston Methodist Willowbrook’s neurology services can help you find relief. Call 281.737.1167 or visit houstonmethodist.org/headache-doctors-wb to schedule an appointment.

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COULD IT BE HEART DISEASE?

Y Dr. Mukarram Baig

ou may know that chest pain, heartburn and nausea are common symptoms of heart attack. But do you know the other symptoms that can signal different forms of heart disease? Often, heart disease symptoms are “silent,” meaning they are too subtle to notice, but there are some symptoms to watch for.

ADDRESS SYMPTOMS BEFORE THEY WORSEN

“Our hope is that if people experience heart disease symptoms, they recognize them and take them seriously,” said Dr. Mukarram Baig, cardiologist with Houston Methodist DeBakey Heart & Vascular Center at Willowbrook.

“The current health crisis shouldn’t keep people from seeing their doctor to discuss Dr. Clifford possible heart disease symptoms,” added Kitten Dr. Clifford Kitten, vascular surgeon with Houston Methodist DeBakey Heart & Vascular Center at Willowbrook. “If we catch heart or vascular disease earlier, we may have more treatment options.”

COMMON SYMPTOMS, CAUSES AND TREATMENTS Symptom: Chest pain (angina) Cause: atherosclerosis, a hardening of the arteries caused by plaque buildup on the insides of blood vessels Treatments: “For mild angina, lifestyle changes like quitting smoking and switching to a healthy diet may be effective,” said Kitten. Your doctor may recommend aspirin or prescription drugs to improve blood flow or lower blood pressure. In some cases, angioplasty or surgery may be necessary.

4 THINGS YOU MIGHT NOT KNOW ABOUT

HOUSTON METHODIST DEBAKEY HEART & VASCULAR CENTER

How much do you know about the wealth of medical expertise and resources right here in your community?

1. Dr. Michael E. DeBakey, for whom our heart center is named, performed many groundbreaking procedures, including the first: Successful removal of a blockage in the carotid artery Aortocoronary artery bypass Multi-organ transplant of a heart, one lung and both kidneys from one donor to four recipients 2. Within the center, we have many subspecialty programs and clinics, to deliver the highest-level care available for heart-related conditions, such as valve disease, aortic conditions, adult congenital conditions and more.

3. We have seven locations throughout the Greater Houston area, including a location at Houston Methodist Willowbrook.

4. Clinical trials and research conducted at the center provide opportunities to access leading medical treatments and new procedures steeped in a tradition of innovating and leading medicine.

Talk to Your Doctor

Symptom: Palpitations, fluttering or heart racing Cause: arrhythmia, an abnormal heartbeat. The heart’s electrical impulses don’t begin or travel as intended. It can occur in association with different cardiac conditions or it can present by itself without concurrent cardiac problems.

Treatments: “A wide range of rhythm abnormalities can be associated with these symptoms,” said Baig, “ranging from benign to more serious conditions, which require prescription drugs and/or ablation procedures.” Medications are often necessary to control the heart’s rate or the rhythm or both, depending on the symptoms. Some people may need pacemakers or implantable cardioverter defibrillators.

type of cardiomyopathy. Some patients need pacemakers or in extreme cases, heart transplants.

Symptom: Feeling out of breath, either from exertion or at rest Cause: cardiomyopathy, the thickening, enlarging or stiffening of the heart muscle, or coronary artery disease. Conditions, such as high blood pressure and heart-valve problems, may be contributing factors.

Treatments: Your doctor may prescribe medications, including ACE (angiotensin-converting enzyme) inhibitors, calcium-channel blockers or diuretics, depending on your

Symptom: Fluid retention Cause: heart failure, which prevents the heart from pumping enough blood around the body. As a result, salt and water build up in the body, causing swelling in the feet, ankles or legs.

Treatments: “Lifestyle changes like being more active and eating a low salt, low-fat diet may help,” said Kitten. Your doctor may prescribe diuretics and other medicine, including digoxin and beta blockers.

If you experience unexplained symptoms, talk to your doctor.

The team at Houston Methodist DeBakey Heart & Vascular Center at Willowbrook can provide expert diagnosis and treatment to help you manage heart disease. Call 713.DEBAKEY or visit houstonmethodist.org/debakey/willowbrook to schedule a consultation with a cardiologist.

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

When to See a Doctor for

ORTHOPEDIC INJURIES

W

hen you have an injury, you may wonder what to do next. Should you just walk it off, hope to get an appointment with a doctor the next day, go to an urgent care clinic the same day or head to the ER immediately? Every year, millions of people, who end up in the emergency room or doctor’s office with orthopedic injuries, have the Dr. Scott Rand same debate.

Injuries are bound to happen whether you’re competing in sports, exercising, moving furniture or simply stepping down from a curb. “Knowing where to go and what to do next is the big question following an injury,” said Dr. Scott Rand, a board-certified primary care sports medicine specialist at Houston Methodist Orthopedics & Sports Medicine at Willowbrook.

WHAT TO DO AFTER AN INJURY

Whether you get hurt at home or while you’re out and about, deciding what to do after an injury can be stressful. You may feel compelled to push through the pain, but continuing to move the injured area could lead to further damage and a longer recovery time.

“When you experience an injury, it’s a sign you’ve pushed your body too far and you need to rest.” Rand advises the following after an injury: Rest the injured area to avoid further injury.

Apply ice or compression to reduce swelling.

Elevate the injured area.

Protect your injury by wearing a cast or brace, or using crutches, if needed.

HOW SERIOUS IS IT?

How do you know if you have a minor injury that will heal on its own, or if you need further treatment from a doctor? Minor injuries can often be treated at home, but there are times when you should see a doctor to ensure proper healing.

Your ability to bear weight on the joint is key. “You should go to our same-day injury clinic or see an orthopedic specialist promptly for a knee or ankle injury that makes it difficult to walk normally,” Rand said. “In those cases, it’s a good idea to get an orthopedic evaluation and possibly X-rays.” Any injury that triggers swelling in the ankle or knee should also be evaluated.

The majority of these injuries don’t need to be evaluated in the hospital, but should be evaluated soon in a doctor’s office.

The question is whether it should be evaluated right away, or if you should wait. Warning signs that you should seek medical help right away for more serious injuries include the following: Any deformity of the limb Inability to bear weight Persistent joint pain Significant swelling with inability to move fingers or toes Swelling of a joint that comes on rapidly Weakness when moving a limb or muscle “If you’re not sure about the severity of an injury, it’s a smart move to get checked out by an orthopedic specialist or sports medicine doctor,” Rand said.

SAME-DAY ORTHOPEDIC INJURY CLINICS The next time an injury slows you down, come in for quick and convenient same-day care at Houston Methodist Orthopedic Injury Clinics. Simply drop in for evaluation and treatment of your injury. Major insurance plans are accepted.

The clinic provides treatment for: Acute orthopedic injuries Fractures and broken bones Injured tendons Minor dislocations Painful or swollen joints

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Sports injuries Sprains and strains Torn ligaments Visit houstonmethodist.org/osm-injury-wb or call 281.737.6824 to get started.

Chronic conditions, spine injuries, motor vehicle accidents and workers’ compensation injuries are not treated at the injury clinic.

Please call 281.737.0999 to schedule an appointment with the appropriate physician for those conditions.

HOW LONG WILL IT TAKE TO HEAL? Some injuries take longer to heal compared to others, and this may depend on the location and severity of the injury, your age, overall health and other factors. In addition to home treatment with RICE (rest, ice, compression and elevation), a doctor may recommend anti-inflammatory medication, cortisone injections or surgery to repair torn muscles or ligaments. For injuries that don’t heal quickly on their own, physical therapy can be a key part of the recovery process.

The following are a range of recovery times for common orthopedic injuries.

AVERAGE RECOVERY TIMES HAMSTRING STRAIN

a few days

A few days for a mild strain; up to 3 months for a partial or complete muscle tear.

ANKLE SPRAIN

1-3 weeks

1-3 weeks for a mild sprain; up to several months for a severe sprain.

TENNIS ELBOW

4-6 weeks

Most people improve in 4-6 weeks.

SHIN SPLINTS

3-6 months

Up to 3-6 months.

ANTERIOR CRUCIATE LIGAMENT (ACL) TEAR

4-6 months

4-6 months for recovery from knee surgery.

ROTATOR CUFF INJURY

4-6 months for recovery from rotator cuff repair surgery.

HOUSTONMETHODIST.ORG/WILLOWBROOK 5

Taking Steps Toward Good

Reproductive Health

Y

ou probably keep track of birthdays and anniversaries, and those virtual coffee dates may get the star treatment.

But when was the last time you visited your gynecologist?

If you’ve skipped your annual gynecologic exam out of embarrassment or the belief that “just this once” is OK, gambling with your Dr. Chuong reproductive health is risky.

Pham Although most women ages 20 to 39 receive a clean bill of health — conditions like endometriosis — can lead to infertility, if left untreated. And diseases like cancer, can be life-threatening. “Keeping your doctor appointments can help catch problems early when they’re often most treatable,” said Dr. Chuong Pham, an obstetrician-gynecologist with Houston Methodist Willowbrook Hospital.

COMMON CAUSES OF INFERTILITY Two of the most common causes of infertility can be detected and treated early by your gynecologist, often restoring the ability to conceive. Pelvic inflammatory disease (PID) is an infection that starts in the cervix and may spread to other organs. PID may cause infertility and may even be life-threatening.

Symptoms: Lower abdominal pain or tenderness Heavy vaginal discharge with a strong odor Irregular or heavy menstrual periods Pain during intercourse Frequent, painful urination Fatigue, back pain, diarrhea or vomiting Endometriosis causes endometrial tissue to grow outside the uterus, implanting itself on organs, such as the fallopian tubes and the intestines.

Symptoms: Painful, heavy or irregular periods Chronic pelvic pain or abdominal tenderness Painful intercourse Lower back pain Painful bowel movements during periods Inability to conceive If you experience any symptoms of PID or endometriosis, see your gynecologist or primary care physician right away.

BE PREPARED

Here are some things you can do to ensure a successful gynecologic appointment and more accurate test results: Check timing. The ideal time to schedule your annual exam is 10 to 14 days after the first day of menstruation. “During this phase of your cycle, your breasts won’t be as tender or lumpy as they might be other days. Your cervix is more open, allowing your doctor to take a good sample,” Pham explained.

Remove roadblocks. A number of factors, including douching, medications and spermicides can interfere with Pap test results.

Write it down. Jot down any concerns or questions you have for your doctor.

YEARLY GYNECOLOGIC EXAM

First, you’ll be weighed and may be asked for a urine sample. Your doctor may feel your throat to check if your thyroid is enlarged and listen to your heart and lungs. Then they will move on to four basic tests that comprise the gynecologic exam: Pelvic exam. Your physician will check in and around the vagina for any abnormal discharge, sores, bumps or skin changes.

Pap test. This test detects early signs of cancer by identifying cell changes on the cervix. Sometimes it can detect other infections, including sexually transmitted diseases.

Digital rectal exam. Your doctor will check for any tumors or abnormalities.

Clinical breast exam. Your doctor will examine your breasts to feel for any lumps and look for skin changes, nipple discharge or other abnormalities. “Depending on your age and health history, your doctor may recommend a mammogram,” Pham added.

PLANNING FOR PREGNANCY

If you’re trying to conceive, take steps to prepare for a healthy pregnancy. Ask your doctor about maintaining a healthy weight, taking a daily folic acid supplement, avoiding alcohol and nonprescription drugs, stopping smoking and reducing stress.

Protect Your Reproductive Health

Make an appointment with an obstetrician-gynecologist at Houston Methodist Willowbrook Hospital by visiting houstonmethodist.org/gynecology-wb or calling 281.737.2500.

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DON'T DELAY ROUTINE

CANCER SCREENINGS

P

ostponed and canceled events have become the norm during the COVID-19 pandemic.

But when it comes to your health, delaying tests or treatments may have Dr. Diego negative consequences Marines later on.

“Cancer isn’t stopping or slowing down in this pandemic. And that’s why we need to be vigilant about cancer prevention and screening,” said Dr. Diego Marines, board-certified Dr. Arvind colorectal surgeon with Reddy Houston Methodist Cancer Center at Willowbrook.

“Early detection is key to identifying cancer when it’s most treatable. That’s why it’s important to keep up with appointments and continue to follow your doctor’s recommendations for cancer screening tests,” added Dr. Arvind Reddy, board-certified gastroenterologist with Houston Methodist Willowbrook Hospital.

DON’T SKIP SCREENINGS

There are plenty of excuses for not following through with recommended cancer screenings, but ultimately your health is at stake. Here are some common excuses and ways to overcome those hurdles: “I don’t have time.” When you’re juggling many responsibilities, scheduling a mammogram or colonoscopy may not rank high on the list. However, you should always prioritize your health, even when life is busy. You may be surprised by how quickly you can get it done and move on with the rest of your day.

“I don’t want to feel uncomfortable.”

The fear of pain or embarrassment is a common reason why people don’t get

screened regularly. You might be worried about discomfort during a mammogram or the inconvenience of preparing for a colonoscopy. “Talking to your doctor about what to expect can help remove the unknowns and relieve those fears. Even if you do feel uncomfortable for a short time, it’s a small price to pay for the peace of mind you get from knowing your results,” said Marines.

“I don’t need a cancer screening test.”

You might be thinking you’re too young or healthy to even worry about cancer. If you don’t have a family history of cancer, you might believe you have no risk of developing cancer yourself. “However, there are many factors that can affect

your cancer risk. That’s why routine cancer screenings are recommended — to find cancer before you have symptoms,” Reddy said.

“I’m worried about COVID-19.” At Houston Methodist Willowbrook, we’re taking every precaution to prevent the spread of illness and make your visit as safe as possible. Some of the ways we’re protecting patients and staff include: Screening all patients when scheduling appointments and upon arrival.

Wearing masks and other personal protective equipment.

Implementing additional sanitation processes for disinfecting equipment and surfaces.

CANCER CARE NEAR YOU Our teams of medical oncologists and skilled support staff offer patients advanced cancer care in a compassionate environment, using leading-edge technology. Three convenient locations are available for your care.

HOUSTON METHODIST ONCOLOGY LOCATIONS Willowbrook 18220 State Hwy. 249 Ste. 130 Houston, TX 77070 281.737.0435

Tomball 14211 FM 2920 Ste. 100 Tomball, TX 77377 281.737.0435

Towne Lake 9915 Barker Cypress Rd. Building 5, Ste. 200 Cypress, TX 77433 281.737.0435

Connect With Your Doctor

Don’t let fear or embarrassment keep you from getting cancer screening tests. If you have concerns about your cancer risks, talk to your doctor about a screening schedule that’s right for you. Visit houstonmethodist.org/cancer-wb or call 281.737.2500 to make an appointment.

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WE STAND BEHIND THE VACCINE Here’s why our experts support the COVID-19 vaccine:

TESTED

TRUSTED

EFFECTIVE

There has been thorough testing and rigorous external review. Previous research and new technology allowed the vaccine to be developed faster, yet still follow the standard FDA process for emergency review before approval.

Most side effects are minimal, like other vaccines — including sore arms, muscle aches and fever. These flu-like symptoms indicate that the vaccine is doing its job — helping your body develop immunity to the virus. Other side effects are rare.

Current evidence indicates the vaccine is safe and up to 95% effective. COVID-19 can be fatal or debilitating. The risks of experiencing serious symptoms or being hospitalized from the disease are far greater than the risks associated with getting the vaccine.

We encourage you to get the first vaccine available to you.

Visit houstonmethodist.org/texas-vaccine-hub to sign up for the COVID-19 vaccine now. #ProtectedTogether

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