Leading Medicine, Winter 2020, Houston Methodist The Woodlands Hospital edition

LEADING MEDICINE W INT ER 2020

6

Factors That Could Sabotage

YOUR WEIGHT LOSS

Relief From Lower Back Pain Peripheral Artery Disease: The Silent Threat YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN THE WOODLANDS AND MONTGOMERY COUNTY

Peripheral Artery Disease:

The Silent Threat

I

f you’re concerned about your heart health, especially if you’re an older adult with high blood pressure or high cholesterol, pay attention to your legs and feet. They’re the most likely targets for peripheral artery disease (PAD), a narrowing of the blood vessels that puts you at greater risk for certain heart issues.

PAD involves the buildup of plaque in the Dr. Thomas Loh peripheral arteries outside your heart. As the arteries become blocked, they are less able to transport nourishing blood to the legs and other body parts. The most common symptom of PAD is pain in legs or feet that subsides with rest.

Other signs include sores or wounds on the toes, feet or legs that heal slowly, poorly or not at all, and poor nail growth on toes.

“Early signs and symptoms are often mistaken for other conditions,” said Dr. Thomas Loh, a vascular and endovascular surgeon at Houston Methodist The Woodlands Hospital.

“Therefore, it’s important to know the risk factors. The majority of patients I see have at least one cardiovascular risk factor, such as smoking, high blood pressure, diabetes or high cholesterol.”

A CUSTOMIZED TREATMENT APPROACH

Because no two patients’ disease is identical, Loh uses a customized approach to treating PAD with the goal of opening clogged arteries and improving blood flow.

“Our interventional therapies are evolving rapidly, giving rise to the advent of a new line of hybrid procedures,” Loh said.

“These procedures entail a combination of endovascular and surgical interventions to treat difficult lesions.”

Medical management involves minimizing the buildup of plaque in arteries and can include smoking cessation as well as blood pressure, diabetes and cholesterol control.

Minimally invasive endovascular therapy uses catheters, balloons and stents to treat the disease from within the blood vessels. Surgical intervention involves removing the plaque from the body or creating bypasses around plaque that cannot easily be removed. More frequently, a combination of therapies is used to get optimal results.

“There is no one-size-fits-all procedure to improve symptoms,” Loh said. “At Houston Methodist The Woodlands, our multidisciplinary teams offer the gamut of procedures to provide the best possible therapy for a patient.”

LIFESTYLE CHANGES MAKE A DIFFERENCE

The surest way to prevent PAD is to regularly see your doctor and control as many of your risk factors as possible. If you’ve been diagnosed with PAD, check your feet often, especially if you have diabetes. PAD may damage the blood vessels of the legs and feet.

“When the flow of blood to the extremities drops below a certain threshold, the body can no longer repair itself, so any small injury will no longer heal normally,” Loh explained.

“In addition to improvement of blood flow to the extremity, good wound care is necessary to preserve as much of the limb as possible.”

HEART HEALTH SCREENINGS Date: Tuesday, Feb. 25, 5:30-7:30 p.m.

Location: Houston Methodist The Woodlands Hospital, 3rd Floor Conference Center Schedule an appointment to learn your 10-year risk for heart disease and receive cholesterol and blood pressure screenings. Registration is required.

Visit us online at houstonmethodist.org/events to register.

Stay a Step Ahead

To learn more about PAD, talk to your doctor or see a cardiovascular specialist for an evaluation at Houston Methodist DeBakey Heart & Vascular Associates in The Woodlands. For an appointment, call 936.270.3933.

2 LEADING MEDICINE FROM HOUSTON METHODIST THE WOODLANDS HOSPITAL

PHYSICAL THERAPY FOR CANCER I f you or someone you love has cancer, you know that going through treatment can be challenging.

Medical interventions, such as chemotherapy, can leave you weak, Dr. Priya V. exhausted and with a Ramshesh compromised immune system, making even simple and routine tasks fatiguing. Staying active and working with a physical therapist before, during and after your treatment can help ease symptoms and even speed up recovery.

“Physical activity is now part of the treatment plan for any cancer,” said Dr. Priya V. Ramshesh, an oncologist with Houston Methodist Cancer Center at The Woodlands. “The American Cancer Society recommends regular exercise to reduce fatigue, depression and muscle weakness. However, it’s important to work with a physical therapist to determine what exercises and therapies are right for you.”

BEFORE, DURING AND AFTER CHEMO

Ramshesh often recommends physical therapy before cancer treatment begins, as well as during and after, to combat “chemo brain”— a common term used to describe thinking and memory problems that can occur during cancer treatment.

“Even if someone has been inactive their entire life, I say it’s never too late to start an exercise program. But, they need the guidance and support of a physical therapist,” Ramshesh said.

Physical therapy can especially help patients with or recovering from breast, colon, prostate or ovarian cancer, according to Ramshesh, because the chemotherapy used to treat these types of cancers can cause loss of muscle tissue and weakness.

CUSTOMIZING YOUR THERAPY PLAN

Physical therapists at Houston Methodist The Woodlands understand cancer impacts and treatment methods and will work with you to develop a specialized treatment plan. In addition to traditional therapy methods, the latest unloading technology, such as anti-gravity treadmills, is also available for helping patients strengthen muscles.

“Our physical therapists help people diagnosed with cancer before and after surgery,” said Benjamin Renfrow, a physical therapist and director of rehabilitation at Houston Methodist The Woodlands. “Before surgery, they evaluate individuals and discuss any concerns they’re having, and how to address them.

After surgery, physical therapists can help increase strength and mobility, as well as reduce pain.”

MANY THERAPY OPTIONS According to Benjamin Renfrow, a physical therapist and director of rehabilitation at Houston Methodist The Woodlands Hospital, in addition to helping you increase overall strength and flexibility, a physical therapist can work with you to improve the following: Aerobic capacity. Aerobic exercise, such as walking on a treadmill for at least 20 minutes, three times a week, may help reduce fatigue and optimize healing. Your physical therapist can assess your aerobic capacity and determine the best activities for you.

Balance. Cancer treatment can often affect balance. Your physical therapist can recommend exercises to use in the clinic and at home to improve balance and prevent falls.

Bone density. Lack of activity and certain cancer treatments can cause

Benjamin weakening of Renfrow bones, which could lead to fractures. Certain exercises can build bone strength.

Comfort and well-being. Manual therapy and comfortable exercise may ease pain.

“Despite your affliction, we have a multi-disciplinary team comprised of physical therapists, occupational therapists and speech therapists to treat your physical and cognitive needs,” said Renfrow.

One Convenient Location

Our new, freestanding location — Houston Methodist Physical Therapy & Rehabilitation at The Woodlands — is located on the Houston Methodist The Woodlands campus at 7990 State Hwy. 242, The Woodlands, TX 77385.

For more information or to schedule an appointment, call 936.270.3520.

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HIDDEN FACTORS THAT MAY CONTRIBUTE TO

WEIGHT GAIN Y

ou’ve tried everything from dieting and calorie counting to exercise boot camp and weight loss apps — but the numbers on the scale just won’t budge. Could Dr. Nisha there be something else Sidhwani sabotaging your efforts to lose or maintain weight?

Let’s uncover some factors that could be holding you back. Although you have the power to change a few of these factors, some are beyond your control. Either way, finding out why weight loss is challenging can be helpful, especially when coming up with a plan or deciding when to seek help for weight loss.

LACK OF SLEEP

Your health suffers when you’re sleep deprived, and lack of sleep can affect your chances of losing weight, too. Research has shown that sleep deprivation can lead to increased cravings for high-carb foods and junk food. When you’re overtired, you may be more likely to reach for high-calorie beverages or a sugar fix for quick energy.

You may also lack the energy and initiative to make healthy food choices.

“We all know what it’s like to work a long day and have no energy left to exercise or make a healthy meal, but keep in mind, the choices you make when you’re tired and hungry can sabotage your efforts to lose weight,” said Dr. Nisha Sidhwani, an obesity medicine specialist with Houston Methodist Primary Care Group in The Woodlands. √ Take control: Aim for seven to eight hours of sleep at night so you can function at your best during the day.

4 LEADING MEDICINE FROM HOUSTON METHODIST THE WOODLANDS HOSPITAL

YO-YO DIETING

Yo-yo dieting (a cycle of losing weight and gaining it back) can take a toll on your health and make it harder to lose weight. You may lose weight rapidly on a fad diet, but you’re not just losing body fat. You lose lean muscle as well, which in turn decreases your metabolism. The problem with yo-yo dieting is that it’s not sustainable. “And, when you suddenly start eating normally again, the metabolism is slower than before, and you are likely to regain mostly fat,” Sidhwani explained. √ Take control: Modify your diet in a way that’s sustainable for the long term.

You want to find solutions for managing your weight that will work for the rest of your life, not just dropping pounds for a special event or a few months.

BALANCING GYM TIME WITH MEAL PLANNING TIME

Have you been toiling away at the gym without losing any weight? If this sounds all too familiar, it may make sense to spend more time and energy on meal planning. “Food intake is the most important thing you can focus on when trying to lose weight,” Sidhwani explained. Exercise is good for your overall health and longevity, but it’s only a small component of weight loss. The majority of weight loss comes from making dietary changes and consuming fewer calories than you can burn in a day. √ Take control: By spending 30 minutes preparing a healthy meal, you can avoid consuming an extra 700-800 calories compared to eating fast food or takeout.

When you combine a healthy diet with exercise, it’s a win-win!

√ Take control: Cut back on portion sizes of higher calorie foods and increase portion sizes of lower calorie foods like nonstarchy vegetables, such as broccoli, cauliflower, green beans and okra, etc. Try to exercise for 30 minutes every day — going for a walk is a great way to start.

MEDICATIONS

Did you know that weight gain is a side effect of certain medications?

Some medications taken for depression, inflammation, thyroid disorder or other conditions can make it difficult to maintain or lose weight. These medications may cause you to feel hungrier, burn calories slower or retain extra fluids. It’s important to continue taking your medications as directed by your doctor, but don’t hesitate to ask about alternatives. √ Take control: Talk to your doctor if you have questions about how your medications may be affecting your weight.

GENETIC INFLUENCES

Genes can influence appetite, metabolism, body-fat distribution and more, but genetic influences don’t tell the whole story. Environmental factors including eating habits formed in childhood, family and social connections, ways you cope with stress and other psychological factors can have an even greater impact on your weight. √ Take control: Even if you’ve been overweight for most of your life and struggle to lose weight, you can fight back.

It starts with making the decision to get help for losing weight.

START WINNING THE BATTLE TO LOSE WEIGHT If you feel like the deck is stacked against you to lose weight, talk to a health care professional who can help with medical weight management or bariatric surgery.

With the right help, you can change your life for the better.

The Houston Methodist Weight Management Center at The Woodlands offers the following weight loss services and programs: S tepLITE is a program for anyone who wants to lose a few pounds and needs help getting started. The program includes a diet plan and weekly check-in and group sessions with licensed professionals. edical Weight Management is M a three-phase weight loss plan that begins with a medically supervised, very low-calorie diet program and progresses to a personalized meal plan to help you maintain weight loss. ariatric surgery, or weight loss B surgery, can help you achieve significant weight loss and improve weight-related health problems.

Visit houstonmethodist.org/weightmanagement or call 832.667.LOSE (5673) to learn more.

AGING

Controlling your weight can be an uphill battle as you age. Even if you’re exercising and eating right, the pounds can still creep up. “It’s just a part of getting older.

Your metabolism decreases and your body doesn’t burn as many calories,” Sidhwani said. In addition, you may lose muscle mass with age, and the problem is compounded if you’re less active. It all adds up to a recipe for weight gain.

CUSTOMIZED WEIGHT MANAGEMENT

Houston Methodist Weight Management Center at The Woodlands develops a personalized weight loss plan that helps you lose weight and improve your health. To schedule a consultation with a bariatric surgeon or to learn more about weight loss surgery options, visit houstonmethodist.org/ weight-management or call 832.667.5673.

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Relief From Lower

BACK PAIN I

t’s as common as the common cold, and one of the top reasons Americans miss work.

Yet while a cold will come and go within the span of a week, lower back pain can linger for much longer. Your pain may be dull, sharp, confined to one specific area or radiate to your upper back or even your legs.

According to Dr. Kenneth Palmer, an Dr. Kenneth orthopedic surgeon who specializes in Palmer spine conditions at Houston Methodist The Woodlands Hospital, nearly 80% of the population will experience lower back pain at some point in their lives. The good news is that lower back pain is typically a short-lived and benign condition. However, it’s important to see your doctor to determine the exact cause of your pain and the best treatment options.

The most common causes of lower back pain, according to Palmer, are minor injuries from physical activities or sports.

Less frequently, lower back pain can indicate a more serious medical problem, such as a pinched nerve. People with diabetes should tell their doctor about any back pain or pain radiating down the leg because it may indicate nerve damage. “One of the most common misconceptions about lower back pain is that degenerative disks will always cause pain and surgery is the only option for relief,” Palmer said. “That’s simply not true.”

FLEXIBLE TREATMENT OPTIONS

“Once a patient is evaluated and a diagnosis is obtained, the most frequently prescribed treatment will include physical therapy and/or medications,” Palmer said. “These treatments are very effective, and symptoms typically resolve in just a few weeks at the most.”

6 LEADING MEDICINE FROM HOUSTON METHODIST THE WOODLANDS HOSPITAL

Houston Methodist The Woodlands offers a variety of minimally invasive treatment options for lower back pain, including medication, muscle relaxants, electrical stimulation, massage, steroid injections and/or physical therapy to prevent future injury if your lower back pain stems from an accident.

LIFESTYLE CHANGES CAN HELP

Lifestyle changes are important factors in how quickly your body can heal from an injury.

Consider: W alking, swimming and biking may all help reduce lower back pain.

A healthy diet with plenty of fruits, vegetables and lean protein may help reduce inflammation in the body.

R egular exercise and making nutritious food choices can lead to weight loss.

M aintaining a healthy weight makes you less likely to experience lower back pain.

No matter the cause of your lower back pain, our orthopedic experts can work with you to determine the best treatment plan to get you back to doing the activities you love, pain free.

Schedule an Appointment

You can get help for your lower back pain at Houston Methodist Orthopedics & Sports Medicine at The Woodlands. Schedule an appointment online at houstonmethodist.org/osm/woodlands or call 936.321.8000.

Is Vaping SAFE? N o. What was originally promoted as another tool to help people quit smoking has become its own epidemic — especially among young people.

Electronic cigarettes, or e-cigarettes, once marketed as a “safer” alternative to cigarette smoking are batteryDr. Jason powered inhalers filled with a Knight liquid mix of nicotine, flavoring and/or other additives. A heater within the device creates a vapor, which is inhaled — or “vaped” — just like cigarette smoke. However, vaping exposes users to many potentially harmful substances, including flavorings, nicotine, cannabinoids and solvents.

A GATEWAY TO CIGARETTES

According to Dr. Jason Knight, an emergency medicine doctor and chief medical officer at Houston Methodist The Woodlands Hospital, vaping has a number of adverse health risks. The nicotine in e-cigarettes has at least 35 known adverse toxic effects. In fact, there is substantial evidence that exposure to certain chemicals in e-cigarettes (like THC or CBD oils) may cause damage to the lungs, which could increase your risk of cancer and other health problems over time.

“Vaping-related health problems are similar to cigarette-related problems in that both vaping and smoking can cause or worsen respiratory disease and cardiovascular disease,” Knight said. “The Centers for Disease Control and Prevention (CDC) is currently investigating over 2,000 cases of lung injury related to vaping with at least 18 deaths. Comprehensive testing in these patients strongly implicates that the damage was done from vaping.”

VAPING INCREASES AMONG YOUNG ADULTS

Knight finds vaping among people younger than age 35 particularly troubling.

“There was a 10% increase in young people vaping between 2017 and 2018, which is about 1.3 million teenagers,” Knight explained.

The CDC, which has warned against the dangers of vaping since e-cigarettes first appeared, recently released a statement reiterating the dangers in light of the cluster of pulmonary illnesses linked to vaping, primarily among adolescents and young adults.

“The lung damage from vaping most resembles chemical burns,” added Knight. In late 2019, a Michigan teen received a double lung transplant due to lung injury from vaping.

HOW HEALTHY ARE YOUR LUNGS?

Lung cancer screenings are covered by most insurance plans and can provide early detection to help you live the life you want.

Criteria for screening: Age 55-77 years No current signs or symptoms of lung cancer Current smoker or former smoker who has quit within the last 15 years Tobacco smoking history of at least 30-pack years (calculated by multiplying the number of packs smoked per day by the number of years smoked) Have not had a chest computed tomography (CT) scan in the last year For more information or to schedule an appointment, call our imaging scheduling department at 936.270.2204.

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WE’ VE MADE ACCESSING US EASIER THAN EVER We know a busy lifestyle can make it challenging to find time to get health care. In addition to scheduling an appointment online or by calling one of our agents, we offer a variety of ways to get care from us, including:

Same-Day Primary Care

Urgent Care

We offer same-day sick visits for conditions like the flu, sinus infections, pink eye and more.

We’ve partnered with Next Level Urgent Care for urgent care services after hours and on weekends.

Virtual Urgent Care

Imaging Appointments

See our providers for non-emergency, urgent care needs via video visit — 24/7, even on holidays.

Schedule an imaging appointment online, including a mammogram, at a time and location convenient for you.

Orthopedic Injury Clinics Same-day orthopedic care for fractures and broken bones, injured tendons, dislocations, sports injuries and more.

Emergency Care Our Emergency Care Centers and emergency rooms are open to all patients 24/7/365.

Visit houstonmethodist.org/care-options for all the ways you can get care with us.

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