Leading Medicine Fall 2021, Houston Methodist The Woodlands Hospital edition

LEADING MEDICINE FA LL 2021

Help for Heart Rhythm Problems

Your Health — by the Numbers

MAMMOGRAM FAQs

Your Breast Cancer Screening Questions Answered Visit houstonmethodist.org/lmn/fall-2021 to read more online.

YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN THE WOODLANDS AND MONTGOMERY COUNTY

GET YOUR SLEEP BACK ON TRACK AFTER THE PANDEMIC

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or many of us, the circumstances of the pandemic have taken a toll on sleep habits. A combination of heightened stress levels and disrupted routines led to many restless nights. It can be hard to turn off the constant stream of thoughts going through your mind as you try to fall asleep, and this can contribute to insomnia.

Dr. Randall Insomnia is defined as having difficulty Wright falling asleep or staying asleep throughout the night. “We’re seeing lots of people dealing with insomnia that started during the pandemic and turned into a chronic problem,” said Dr. Randall Wright, a board-certified neurologist at Houston Methodist The Woodlands Hospital.

As life starts to get back to normal, it’s important to focus on sleep and address what’s at the root of the problem.

Stress is a big contributor to insomnia. “The 24-hour news cycle and social media often keep us up at night, especially when the content is stressful,” Wright said.

Screen time before bed can make it hard to fall asleep.

“The blue light from devices is a stimulant that can prevent us from going to sleep,” added Wright.

Sleep patterns are important too. “The brain is best on a regular pattern. Anything that disrupts our pattern, from napping during the day to binge-watching TV at night, can disrupt the natural sleep cycle,” Wright explained.

SOLVING SLEEP PROBLEMS

“Some people ask for sleeping pills to help them sleep, but this is not a long-term solution. Sleeping pills are designed for short-term use and may perpetuate sleep problems if you become dependent on the pill. You need to understand what’s contributing to your sleep disorder and solve those problems,” Wright said.

It helps to understand what set off the sleep problem initially, and what is perpetuating it. “You can have a stressful moment that initiates insomnia, and then something else perpetuates it,” explained Wright. Treating the underlying issues contributing to sleep problems is a good starting point.

Find ways to cope with stress.

Get treatment for anxiety and depression.

Ask about cognitive behavioral therapy for insomnia (CBT-I).

Seek treatment for chronic pain that keeps you up at night.

If you snore, find out if sleep apnea treatment could help.

SLEEP AND YOUR HEALTH

“We often think of sleep in relation to how we feel after a good (or bad) night’s rest. But sleep is about more than how you feel from one day to the next,” Wright said. “Sleep is an essential

2 LEADING MEDICINE FROM HOUSTON METHODIST THE WOODLANDS HOSPITAL

Get Help

For help with insomnia or other sleep disorders, visit houstonmethodist.org/woodlands-neuro or call 936.270.3333 for more information.

function of our bodies that is linked to many aspects of health, from your heart and brain to metabolism and memory.”

Having difficulty falling asleep and staying asleep, daytime fatigue, unusual breathing patterns and increased movement during sleep may be signs of a sleep disorder. If sleep problems persist for more than a couple of weeks, you should talk to your doctor or see a sleep specialist.

LUNG CANCER: A DANGER FOR NONSMOKERS

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or someone who has never smoked, hearing the words “you have lung cancer” can be a complete shock. It may seem impossible, but it’s a reality for far Dr. Mohammad too many people. Lung Khalil cancer in nonsmokers and never-smokers is a devastating trend that requires more research and data to fully understand.

“About 10-20% of lung cancers happen in people who never smoked or smoked fewer than 100 cigarettes in their lifetime,” said Dr. Mohammad Khalil, a boardcertified medical oncologist with the Houston Methodist Cancer Center at The Woodlands.

LUNG CANCER RISKS FOR NONSMOKERS

Smoking is the biggest risk factor for lung cancer, but it’s not the only risk factor.

Other risk factors for lung cancer include: Radon gas. Radon is a radioactive gas that is colorless, odorless and occurs naturally from the breakdown of uranium in soil. Radon gas can become trapped indoors and seep into buildings through cracks and holes in the foundation. “Most radon gas exposure happens inside homes and other buildings, and it’s a good idea to test the level of radon in your home,” Khalil said.

Secondhand smoke. Secondhand smoke is a major threat to health and can cause lung cancer in people who don’t smoke. “For some people, exposure to secondhand smoke can have a significant impact on lung cancer risk,” said Khalil.

Air pollution. Exposure to air pollution in cities and near heavily trafficked roads may increase the risk of lung cancer.

Exposure to carcinogens at work. Some people are exposed to carcinogens (cancercausing agents), such as arsenic, asbestos and diesel exhaust at their workplace. Steps

LUNG CANCER SCREENING The American Cancer Society does not recommend routine lung cancer screening for people who have never smoked. The current recommendation is for smokers or former smokers between ages 55 to 74 who are high risk defined by smoking history to have an annual low-dose lung CT scan.

If you have symptoms related to lung disease, you should be evaluated by your doctor, which could lead to testing for lung cancer and other conditions.

Connect With Your Doctor

If you have concerns about your risk for lung cancer, you should talk to your doctor. If you don’t have a primary care physician, you can find one by visiting houstonmethodist.org/pcg/north or by calling 713.394.6724.

have been taken to reduce exposure to harmful substances in the workplace, and it’s important to be aware of the risks and protect yourself.

Genetic and family risks. Some people have a genetic predisposition to lung cancer that makes them more likely to have abnormal changes in lung cells.

“If you have a family history of lung cancer, talk to your doctor about your risk and any steps you should take now to stay healthy,” Khalil added.

WATCH FOR WARNING SIGNS

“Nonsmokers may dismiss symptoms of lung cancer and assume it must be something else, and this can lead to delays in detecting cancer,” explained Khalil. Symptoms of lung cancer in nonsmokers may include: A persistent cough that gets worse over time Chest pain or discomfort Coughing up blood Difficulty breathing Hoarseness Weight loss for no reason

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MAMMOGRAM FAQs

YOUR BREAST CANCER SCREENING QUESTIONS ANSWERED

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hen life is busy, it’s easy to put everyone else’s needs before your own. But it’s important to make time for yourself — and your annual screening mammogram. If you’re not sure when to start getting mammograms or what to expect, we’re here to help.

Dr. Magda Ghobashy, a specialist in diagnostic Dr. Magda radiology and breast imaging, and medical Ghobashy director of Houston Methodist Breast Care Center at The Woodlands, answered some common questions women have about getting mammograms.

PREPARING FOR YOUR MAMMOGRAM When should I start getting screening mammograms and how often?

Your doctor may recommend annual mammograms starting at age 40 if you have an average risk for breast cancer. Ask your doctor about your risk for breast cancer and the screening schedule that’s right for you.

Why should I get an annual mammogram?

Getting regular mammograms makes it possible to detect breast cancers when they are small and easier to treat. It’s also helpful to be able to review your mammogram history and track any changes in the breasts over time.

What do I need to know about scheduling my mammogram?

It may be helpful to avoid scheduling a mammogram the week before your period, when breasts may be more tender. However, it’s important to get in for a mammogram whenever it works with your schedule.

What should I wear for my exam?

Life is busy and it’s OK if you show up as you are for your mammogram. Wearing a two-piece outfit makes it easier to remove your top for your mammogram and it’s best to avoid wearing deodorant, powders or lotions. You’ll be offered wipes to remove deodorant, if needed.

Learn More Online Visit us online at houstonmethodist.org/lmn/fall-2021 to read more about breast health, screening options and the early detection of breast cancer.

4 LEADING MEDICINE FROM HOUSTON METHODIST THE WOODLANDS HOSPITAL

TYPES OF MAMMOGRAPHY AND BREAST IMAGING Whether you need a screening mammogram or other breast imaging test, we have the technology and expertise to guide you through the next steps.

3D mammogram is a highly efficient and accurate digital technology used to identify smaller tumors sooner for earlier breast cancer detection.

Breast ultrasound is an imaging test that can determine if a lump or mass is filled with fluid.

Does my insurance cover a mammogram?

Most major insurance plans cover an annual screening mammogram, but it’s important to call and verify your coverage.

CREATING A COMFORTABLE EXPERIENCE What should I expect during my visit?

You can get a mammogram done quickly. Prior to your appointment, you’ll be asked to complete your registration through the patient portal MyChart. After checking in, you’ll be escorted to a private room to change into a robe before meeting with the mammography technologist.

What happens during a screening mammogram?

The technologist will ask you some questions related to your health, including birth control, family history of breast cancer and any symptoms you may be experiencing. These questions are important to help make sure we’re doing the right type of mammogram. Next, you’ll be asked to stand in front of a 3D mammography machine and the technologist will take X-rays of two different views of each breast.

Are mammograms painful?

Some women may find the breast compression to be uncomfortable or painful, but the experience is different for everyone. The compression takes about 10 seconds for each image, and our technologists are trained to listen to you and make the experience as comfortable as possible.

UNDERSTANDING MAMMOGRAM TECHNOLOGY

reast MRI is an extremely sensitive test to B look for breast cancer and may also be used for breast cancer treatment planning.

Contrast-enhanced mammogram is an alternative to breast MRI that uses an injection of dye to see if there’s abnormal blood supply in the breast.

Molecular breast imaging (MBI) is a technique used to identify tumors in dense breasts.

a screening mammogram, you may be asked to come back for further testing. A diagnostic mammogram may be ordered after a screening mammogram shows a questionable area, if you feel a lump in your breast or have other symptoms.

GETTING YOUR RESULTS Who will review my images?

Board-certified breast radiologists are specially trained to interpret breast mammogram results.

How will I get my results?

Once reviewed by a doctor, you can view your results in the patient portal. If further testing is needed, the lead technologist will call you within two to three days to share findings and schedule additional testing.

What does it mean to have dense breast tissue on a mammogram?

Density refers to how much fibrous tissue is in the breast. Having high density on a mammogram makes it more difficult to see a mass. In some cases, we may order a breast ultrasound in addition to a mammogram for women with high breast density.

What if I get called back for a second mammogram?

Getting called for a second mammogram doesn’t mean you have cancer. It means we need more information to see what’s going on. When you come in for a diagnostic mammogram, a breast radiologist will meet with you to share the results and answer your questions.

What is a 3D mammogram?

A 3D mammogram is the latest, most advanced technology to detect breast cancer with the greatest accuracy. 3D technology uses a low dose of radiation, yet allows for more targeted views that help find small cancers.

What is the purpose of a screening mammogram vs. diagnostic mammogram?

A screening mammogram is done when you have no symptoms of breast cancer. The purpose is to find cancers in an early stage before you can feel a lump. If we find an irregularity on

Scheduling Your Mammogram To schedule your mammogram at Houston Methodist Breast Care Center at The Woodlands, visit houstonmethodist.org/breast-care or call 936.270.3600.

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YOUR HEALTH —

BY THE NUMBERS

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ou can tell a lot about a person by looking at the numbers from routine health screenings. Your vital stats — blood pressure, cholesterol levels, blood Dr. Elizabeth sugar level and body Bond mass index (BMI) — provide an insightful picture of your health and well-being. Here are some important figures you need to know:

BLOOD PRESSURE

Your blood pressure readings measure the force of blood against artery walls.

As blood vessels become stiffer with age, your heart works harder to pump blood through the veins and your blood pressure increases.

“High blood pressure, or hypertension, can lead to heart disease or stroke. You probably won’t know whether you have high blood pressure until you have it measured,” said Dr. Elizabeth Bond, a primary care physician with Houston Methodist Primary Care Group in The Woodlands.

Normal: Less than 120/80 mmHg Check it: At least every two years or as recommended by your doctor.

What you can do: Exercise regularly, eat a balanced diet, restrict sodium, limit alcohol and maintain a healthy weight.

What your doctor may do: If your blood pressure is above 120/80 mmHg, he or she will recommend lifestyle changes and may prescribe blood pressurelowering drugs.

CHOLESTEROL

Cholesterol is a type of lipid, or fat, produced by your liver and sent through your bloodstream to the rest of your body.

Too much cholesterol can build up in your arteries and lead to heart disease.

Healthy level: Total cholesterol less than 200 mg/dL Check it: Every five years or more often if it’s high.

What you can do: Limit saturated fat in your diet, eat more fiber, lose excess pounds and exercise regularly.

What your doctor may do: If your total cholesterol is more than 200 mg/dL, your doctor may prescribe cholesterollowering medication.

BLOOD GLUCOSE

Your body converts food into glucose, a sugar that circulates in your blood. “It’s possible to have diabetes or prediabetes and not even know it, which is why blood glucose testing is so important,” Bond explained. “When diabetes is treated and managed with medications and lifestyle changes, you can live a healthier life and reduce the risks of diabetes complications.”

Normal: Fasting blood glucose tolerance test 99 mg/dL or below Check it: Get a fasting blood glucose test every year if you’re age 45 or older.

Your doctor may recommend screening for diabetes earlier if you have major risk factors for diabetes.

What you can do: Eat a balanced diet, exercise regularly and, if you use nicotine products, quit.

What your doctor can do: If your blood glucose levels are above 100 mg/dL,

Schedule Your Next Checkup

your doctor may counsel you on lifestyle changes or prescribe medication.

BODY MASS INDEX

Your BMI is a measure of your body fat based on your height and weight. An unhealthy BMI is linked to numerous health issues like heart disease, stroke, osteoarthritis, cancer and diabetes. “If you’re overweight or obese, even a weight loss as small as 5% can reduce your risk of disease,” Bond said.

Normal: 18.5-24.9 Overweight: 25.0-29.9 Obese: 30.0 and above Check it: Discuss your BMI and target weight at your next checkup.

What you can do: Make a plan for healthy eating and increasing your activity level.

What your doctor can do: If you are overweight, your doctor can recommend a healthier diet or refer you to a medically monitored weight loss program. Your doctor should screen you for underlying conditions that may be causing your weight gain.

To schedule an appointment with a Houston Methodist Primary Care Group physician near you, visit houstonmethodist.org/pcg/north or call 713.394.6724.

6 LEADING MEDICINE FROM HOUSTON METHODIST THE WOODLANDS HOSPITAL

HELP FOR HEART RHYTHM PROBLEMS D o you ever feel like your heart skips a beat? Atrial fibrillation (AFib) is a common problem that causes an irregular heartbeat. It’s important to pay attention to your heart because AFib can lead to blood clots, stroke, heart failure and other heart-related complications.

Normally, your heart pumps blood through Dr. Rajesh its four chambers by contracting and relaxing Venkataraman to a regular beat. With atrial fibrillation (often referred to as AFib), the upper chambers of the heart (the atria) beat irregularly or quiver instead of beating effectively to move blood into the lower chambers (the ventricles).

“Left untreated, AFib doubles the risk of heart-related death and increases your risk of stroke five times. AFib is also associated with heart failure, sudden cardiac death, heart attack and chronic kidney disease,” said Dr. Rajesh Venkataraman, a board-certified cardiologist and electrophysiologist at Houston Methodist DeBakey Heart & Vascular Center at The Woodlands.

AFIB SYMPTOMS

Some people don’t notice any symptoms, but AFib often feels like a fluttering in the chest. Other symptoms may include: Chest pain or pressure — this is a medical emergency since it may indicate that you’re having a heart attack.

Call 911 immediately.

Dizziness, fainting or confusion Fatigue (tiredness) Feeling that your heart is skipping a beat, fluttering or beating too hard or fast Shortness of breath and anxiety Sweating Weakness “Being proactive is so important — talk to your doctor about your heart health and report any symptoms right away,” Venkataraman said.

TESTING FOR AFIB

Your doctor may recommend several tests to detect problems with your heart rhythm. A physical exam involves checking your pulse, blood pressure and lungs. In addition, your doctor may order an electrocardiogram (EKG), a test that measures the heart’s electrical impulses for a short period of time.

“If AFib doesn’t show up on an EKG, a portable EKG monitor or other tests may be needed to diagnose the problem,” Venkataraman added.

Don’t Ignore AFib When it comes to your heart, you want expert advice and treatment options. Our experienced cardiologists and electrophysiologists specialize in treating abnormal heart rhythms. Talk to your doctor or visit houstonmethodist.org/debakey/woodlands to learn more. Call 713.DEBAKEY to schedule an appointment with a cardiologist at Houston Methodist DeBakey Heart & Vascular Center at The Woodlands.

TREATMENT OPTIONS

“A diagnosis of AFib doesn’t have to slow you down or change your outlook on life. With the right treatment, you can manage symptoms and live an active life,” Venkataraman said. Treatment varies for each patient, but options may include: Lifestyle changes, such as reducing or eliminating caffeine or alcohol in your diet and losing weight.

Medications, including blood thinners, heart rate controllers and heart rhythm controllers.

Nonsurgical procedures, such as ablation, which destroys malfunctioning heart tissue with bursts of energy delivered through a catheter.

Surgical procedures, such as implanting a pacemaker (small electrical device) under the skin to regulate the heartbeat.

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Early Detection Starts With Your

ANNUAL MAMMOGRAM Advanced Breast Screenings Close to Home

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The TheWoodlands Woodlands

At Houston Methodist Breast Care Center at The Woodlands, our specialists review your mammogram history and track results over time — detecting changes earlier.

That’s why getting your mammogram starting at age 40 — or earlier, if you have a family history — is so important.

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Our Breast Care Center offers:

• The latest 3D mammogram technology • Board-certified breast imaging radiologists

• Acceptance of most major insurance plans

Your health is our priority. To better protect you, we took it one step further by requiring COVID-19 vaccinations for all of our physicians, staff and employees.

Scan the QR code, visit houstonmethodist.org/breast-care or call 936.270.3600 to schedule your mammogram today.

We do not require a doctor’s order for your annual screening mammogram.

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