Leading Medicine Winter 2019, Houston Methodist Willowbrook Hospital edition

LEADING MEDICINE W INT ER 2019

Treating Arthritis Aches

Strength in Numbers:

LOSING WEIGHT TOGETHER Get Back in Rhythm

Electrophysiology and Managing Arrhythmia YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN NORTHWEST HOUSTON

NEWS & EVENTS EVENTS VEIN SEMINAR

Date: Jan. 29 | Time: 6 p.m.

Location: Lindsay Lakes Banquet Center in Cypress

BEAT THE PACK SMOKING CESSATION SESSIONS Session 1: Feb. 5 Session 2: Feb. 12

Houston Methodist Willowbrook has full-service emergency care centers in Spring and Cypress for you and your family’s medical needs. We provide the care you expect — for minor conditions to lifethreatening emergencies — close to home. Visit houstonmethodist.org/ER for more information.

Session 3: Feb. 19 Session 4: Feb. 26

HEART SEMINAR

Date: Feb. 12 | Time: 6 p.m.

Location: Houston Methodist Willowbrook Conference Center

HEART SCREENING

Date: Feb. 28 | Time: 6 p.m.

Location: Houston Methodist Willowbrook Conference Center

DIGESTIVE HEALTH SEMINAR

Date: March 19 | Time: 6 p.m.

Location: Lonestar College, Tomball Beckendorf Conference Center

MOTHER DAUGHTER SYMPOSIUM

Date: April 6, 2019 | Time: 10 a.m.

Location: Lindsay Lakes Banquet Center in Cypress For information about our events and to register, visit houstonmethodist.org/events or call 281.737.2500.

HOUSTON METHODIST EMERGENCY CARE CENTER IN SPRING 5303 FM 2920 Spring, TX 77388

NEWS GASTROPARESIS

Gastroparesis, sometimes called stomach paralysis, affects the stomach muscles’ normal contractions, preventing food from properly emptying into the small intestine. It can cause nausea, vomiting and blood sugar and nutritional abnormalities.

Houston Methodist Willowbrook Hospital Dr. Dexter offers a treatment for chronic nausea and Turnquest vomiting associated with gastroparesis.

The gastric neurostimulator is a programmable, implantable device placed under the skin, usually in the lower abdomen.

The device stimulates stomach muscle movement with mild electrical impulses. It can be turned on and off without surgery and easily removed, if necessary. Dr. Dexter Turnquest, bariatric and general surgeon, performs this short procedure at Houston Methodist Willowbrook.

You may be eligible for the neurostimulator device if you have gastroparesis-associated chronic nausea and vomiting, and medications have not provided relief. Ask your doctor for information.

To make an appointment with a gastroenterologist at Houston Methodist Willowbrook, call 281.737.2500.

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HOUSTON METHODIST EMERGENCY CARE CENTER IN CYPRESS 27560 US-290 Frontage (at Fairfield Creek) Cypress, TX 77433

Treating Arthritis Aches

A

rthritis pain and stiffness can make it hard to get through your day.

Getting out of bed can even be challenging.

Although arthritis has Dr. Niharika no cure, treatment Ganti options are expanding as researchers find new and better ways to manage symptoms.

“It’s important to work closely with your rheumatologist on ways to manage the disease and ease your discomfort,” said Dr. Niharika Ganti, rheumatologist at Houston Methodist Willowbrook Hospital. More than 100 arthritis forms exist, and every person with arthritis responds differently.

COMMON ARTHRITIS TYPES

Osteoarthritis (OA) also known as wearand-tear arthritis, often affects middleaged to elderly people. Caused by joint cartilage breakdown, it tends to affect commonly used joints like hands, spine and large, weight-bearing joints like knees and hips. “OA causes stiffness and joint pain as well as decreased range of motion resulting from a joint injury or overuse over time,” Ganti said.

Treatments may include: M edications – acetaminophen, oral anti-inflammatory agents S teroid injections S urgery Rheumatoid arthritis (RA) is the most common autoimmune arthritis. The immune system attacks tissue around the joint, causing inflammation that damages bones, cartilage, ligaments and tendons.

“RA typically affects small joints, including hands, wrists and feet. Sometimes RA can affect other organs, including eyes, skin or lungs,” Ganti said. “It tends to occur at a younger age than OA because it’s triggered by an immune response and not joint wear and tear.”

Treatments may include: D isease-modifying antirheumatic agents (DMARDs)

FIGHT BACK AGAINST ARTHRITIS Dr. Niharika Ganti, rheumatologist at Houston Methodist Willowbrook Hospital, recommends taking steps to reduce arthritis risk by: 1. M aintaining a healthy weight — easing joint pressure and minimizing your osteoarthritis risk 2. Exercising regularly — strong muscles support joints 3. Improving range of motion — physical therapy and rehabilitation can help 4. Quitting smoking — smoking increases your risk of rheumatoid arthritis and can lead to more aggressive disease

B iologic response modifiers (Biologic agents) Gout is a painful disease caused by uric acid deposits in joints and connective tissue. It causes flare-ups with sudden onset joint swelling, redness, pain and stiffness, typically starting in the big toe or feet. “If untreated, gout attacks may progressively get worse as the uric acid crystal deposits in the joints cause damage over time,” Ganti said.

Treatments may include: D ietary modifications M edications to help with acute flare-ups, including colchicine, steroids U ric-acid lowering drugs

Manage Your Symptoms Don’t let arthritis slow you down. A rheumatologist can develop a treatment plan to help manage your symptoms.

Call 281.737.2500 to make an appointment with a rheumatologist at Houston Methodist Willowbrook Hospital.

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

STRENGTH IN NUMBERS:

Losing Weight Together

M

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. Todd Worley 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. Todd Worley, bariatric surgeon at Houston Methodist Willowbrook Hospital. Whether you’re planning to lose weight, considering weight-loss surgery or needing a new outlook on weight loss, partnering can improve your odds of reaching your goals. Weight loss with a partner provides

Get Started Learn about the advantages of a team approach to reaching your weight-loss goals by attending a free weight-loss surgery orientation at Houston Methodist Willowbrook. Visit houstonmethodist.org/ events or call 281.737.2500 to register.

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motivation, support and even a little healthy competition.

1 MOTIVATION

“Motivation is often tied to experiences with our loved ones,” said Worley. “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,” Worley 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,” Worley 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.

4TEAM 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,” Worley 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.

5TRACK YOUR PROGRESS

Keeping track of total pounds and inches lost as a group can be highly motivating. “Losing weight is great, but our main priority is improving your health numbers. That includes lowering high blood pressure, cholesterol and blood sugar,” Worley 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.

TEAMING UP FOR A HEALTHIER LIFE Ready for a 5K after extreme weight loss

A HEALTHY 6 MAINTAIN LIFESTYLE

“Losing weight and keeping it off requires working through a different relationship with food,” Worley 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.

Before having weight-loss surgery, it was a challenge for Barbra and Chris Smerz to participate in Boy Scout activities with their son. “I didn’t have a lot of energy, and outdoor activities like going camping were daunting,” Barbra said. “I avoided canoeing and tubing not only because it was hard to balance, but also because I worried about tipping over and not being able to pull myself back up.”

The turning point was when the couple attended a weight-loss surgery seminar together. “We decided it was time to make a major change in our life,” Chris said. They both had sleeve gastrectomy with Dr. Todd Worley, bariatric surgeon at Houston Methodist Willowbrook Hospital, in the fall of 2017.

One year after surgery, Barbra and Chris lost nearly 300 pounds total and are ready to take on new adventures with their family. The family enjoyed an “extreme” Boy Scout camp that included tubing, wall climbing, river rafting and more. “We also did a lot of hiking, and the boys actually complained that I was walking too fast!” Barbra joked.

In addition to losing weight and feeling great, the couple have improved their health and lowered their blood pressure. Barbra’s type 2 diabetes is in remission and Chris no longer has to use a CPAP device for sleep apnea.

“We’ve been successful because we’re in this together,” Chris said. “We try to participate in a different 5K walk/run event every month. This definitely keeps us moving and allows us to have fun, with a little healthy competition too.”

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Get Back IN RHYTHM

Electrophysiology and Managing Arrhythmia

Y

ou probably know the feeling. Occasionally, your heart may race, pound, flutter, pause or skip a beat.

Caused by abnormal electrical impulses in the heart, unusual heart rhythms — or arrhythmia — often are minor and harmless.

However, long-lasting or more serious irregular rhythms can be dangerous and lead to cardiac arrest.

Dr. Joe Fahed Not all arrhythmias require treatment, but patients should address those that cause significant symptoms, increase risk for a more serious condition or impair the heart’s efficiency as well as circulation. After a cardiologist diagnoses your arrhythmia, you may be referred to a cardiac electrophysiologist to manage your condition.

YOUR HEART’S ELECTRICIAN

A cardiac electrophysiologist specializes in the electrical impulses that regulate heart rhythm.

“All cardiologists have some training in electrophysiology,” said Dr. Joe Fahed, electrophysiologist with Houston Methodist DeBakey Heart & Vascular Center at Willowbrook. “But electrophysiologists have two years of additional training dedicated to the diagnosis and treatment of heart rhythm disorders.”

Fahed performs tests, such as electrophysiology (EP) studies, to evaluate your heart’s electrical system and figure out the cause of your arrhythmia. Doctors put catheters — very thin tubes — in different areas of the heart and then send electrical signals to record heart activity. The EP study determines: A n arrhythmia’s source Th e effectiveness of certain medicines to control your heart rhythm W hether cardiac ablation is a potential cure for the arrhythmia

ARRHYTHMIA TYPES

Houston Methodist Willowbrook is an accredited Chest Pain Center with Primary PCI and Resuscitation by the American College of Cardiology.

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The treatment your electrophysiologist recommends will depend on the type of arrhythmia you have as well as other factors.

Arrhythmias include: Atrial fibrillation (AFib) — The most commonly known and complex atrial arrhythmia is atrial fibrillation, in which the heart beats too fast and irregularly in the upper chambers, increasing stroke risk and heart failure.

Bradycardia — The heart beats too slowly, which can indicate another problem, including an underactive thyroid or a potassium imbalance. A heart attack or medications, such as beta-blockers, also can cause the condition. Extreme bradycardia is treated with a pacemaker.

Tachycardia — The heart beats faster than normal.

Types include: P aroxysmal atrial tachycardia — A fast heartbeat that suddenly starts and ends, often causing no problems. It’s more common in young people and may occur during exercise.

S upraventricular tachycardia — a benign and non-lifethreatening fast heartbeat. Also common among young people.

A trial flutter — The condition causes rapid heartbeats and also predisposition of some to stroke if not treated adequately.

Cure rate with a cardiac ablation procedure is greater than 90 percent.

V entricular tachycardia and ventricular fibrillation — One of the most dangerous rhythms, in which the heart beats very fast or quivers rather than pumps, quickly leading to loss of consciousness or death if not immediately treated with a shock to the heart. Patients at risk for this condition usually have cardiomyopathy (weak heart muscle) and a defibrillator implanted.

TREATING YOUR ARRHYTHMIA

“Arrhythmias fall into two categories,” Fahed said. “Simple arrhythmias like supraventricular tachycardia (SVT), atrial tachycardias (AT) or flutter (AFL) can be treated with a single ablation and have a very high success rate.” Other arrhythmias, such as AFib or ventricular tachycardia, are more complex.

“More complicated arrhythmias require longer procedures and personalized treatment plans that take into account a patient’s risk factors and health history, as well as the source of the arrhythmia,” Fahed said.

Your electrophysiologist may recommend treatments, including: Vagal maneuvers — stimulation of the vagal nerves — the part of the nervous system regulating heart rate — slows heart rate and treats some tachycardia types. Maneuvers include holding your breath and bearing down (Valsalva maneuver), immersing your face in ice-cold water (diving reflex) and coughing. These maneuvers are most effective in SVT. Medications — sodium channel blockers, beta-blockers, potassium channel blockers, calcium channel blockers and digitalis may slow or suppress tachycardia. However, these drugs can produce side effects.

Lifestyle changes — more exercise, weight loss (5-10 percent of body weight) and less caffeine and alcohol can reduce arrhythmia episodes arising from underlying heart disease. More recent evidence points to obstructive sleep apnea playing a role in exacerbating arrhythmia, especially AFib. Catheter ablation — Catheters threaded through blood vessels (usually the groin area) are advanced to the heart and deliver radiofrequency energy to destroy, or ablate, the part of the heart causing the arrhythmia. An electrophysiologist may perform the procedure during or after the EP study.

Doctors at Houston Methodist Willowbrook’s Department of Electrophysiology use advanced technology to get a clear picture of the heart.

“With 3D mapping catheters, we can create a highly detailed view of the heart and display it on a computer screen,” Fahed said.

“This mapping helps us track the catheters within the heart with amazing accuracy — less than 1 millimeter in three-dimensional space. This has allowed us to minimize the use of fluoroscopy, or X-rays, significantly to track catheters in the heart chambers and ablate more safely.”

This technology enhances the ability to perform highly accurate ablation procedures and treat most arrhythmias.

THE BOTTOM LINE

Tell your doctor about any arrhythmia symptoms, even those that pass quickly. Over time, a harmless arrhythmia could lead to a more serious condition.

FEELING LIGHTHEARTED?

Did your heart just skip a beat? You may have an arrhythmia.

Arrhythmia’s most common symptoms include heart palpitations, a feeling your heart skipped a beat or beats too hard. Other symptoms may include: A slow heartbeat or pauses between heartbeats F atigue or light-headedness L oss of consciousness or feeling faint S hortness of breath C hest pain E xcessive sweating A nxiety

Free Heart Events in February

Houston Methodist Willowbrook is hosting two free heart events.

Heart Seminar: Feb. 12 Hear from our panel of cardiology experts and ask your questions.

Heart Screening: Feb. 28 Learn your 10-year risk for heart disease.

Visit houstonmethodist.org/events or call 281.737.2500 for information.

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