Leading Medicine Winter 2021, Houston Methodist Willowbrook Hospital edition

LEADING MEDICINE W INT ER 2021

Advanced Treatment for Back Pain

STAY ON TOP OF YOUR HEALTH 15 Tips for a Healthy Pregnancy YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN THE WOODLANDS AND MONTGOMERY COUNTY

Advanced Treatment

FOR BACK PAIN

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hether it’s a dull ache, a sharp pain or throbbing sensation, back pain can make it hard to get through the day. Simply getting older, having poor posture or being overweight or out of shape can cause back pain, but you could have a slipped disk or other more serious spine problems.

Dr. Fernando Whatever the source of your back pain, Silva it’s important to allow yourself time to rest and recover. “Almost 80% of the time back pain resolves in six weeks on its own with conservative treatments like antiinflammatory medications, heat or ice and physical therapy,” said Dr. Fernando Silva, neurosurgeon with Houston Methodist The Woodlands Hospital.

TRY CONSERVATIVE TREATMENTS FIRST

The following conservative treatments can help ease discomfort and improve function: Pain management. Over-the-counter or prescription medications, such as pain relievers, muscle relaxants, corticosteroids (injections or pills), antidepressants or epidural injections can help.

Heat-and-cold therapy. Alternate applying cold and hot packs for 15 minutes at a time and note if one helps more than the other.

Exercise. Strengthening your back and abdominal muscles to better support and stabilize your spine can help relieve pain. Ask your doctor or physical therapist for guidance about how to exercise safely.

DO YOU NEED SURGERY?

If pain persists and you’re experiencing weakness or difficulty performing basic activities like standing or walking, you should see your doctor. “Your doctor, pain specialist or spine surgeon may order an MRI to look for structural issues that are causing back pain,” Silva said.

When nonsurgical treatments haven’t worked, surgery may be recommended for certain types of back problems, such as: Degenerative disk disease or herniated disks Fractures or injuries to the bones in the spine Scoliosis (a sideways curvature of the spine) and other spinal deformities Spinal stenosis (narrowing of the spinal canal) Spondylolisthesis (when one vertebra in the lower back slips forward on top of another) Weak or unstable spine caused by infections or tumors

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MINIMALLY INVASIVE SPINE SURGERY

There are risks involved as with any surgery, but advancements in spine surgery have made it possible to use minimally invasive techniques that allow for smaller incisions, less pain and shorter recovery times. “Spine surgery can relieve symptoms and restore function, so people with chronic back pain can enjoy life with less pain,” Silva said.

During minimally invasive spine surgery, the surgeon makes smaller incisions instead of one long incision down the back for open surgery. A lot of this minimally invasive work has changed dramatically. “Image-guided technology allows the surgeon to view CT images while using small tools to perform surgery on the spine,” said Silva.

Several types of spine surgery can be performed using minimally invasive techniques to help with the following: Repair or remove the herniated portion of a disk pressing on a nerve Relieve pressure caused by spinal stenosis by removing bone to enlarge the spinal canal Stabilize and fuse two vertebrae together to eliminate painful movement between them

Explore Treatment Options

Our team of pain specialists and spine surgeons can help uncover the cause of your back pain. To make an appointment with a spine specialist at Houston Methodist The Woodlands Hospital, visit houstonmethodist.org/spine-doctors-woodlands or call 936.270.3333.

DON'T DELAY RECOMMENDED

CANCER SCREENINGS

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t’s easy to put off tasks on your to-do list until next week or next month, when there’s more time. But when it comes to your health, delaying tests or treatments may have Dr. Mohammed negative consequences Khalil in the long run. Cancer doesn’t stop or slow down when life is busy, and that’s why we need to be vigilant about cancer prevention and screening.

“Keeping up with preventive care and cancer screening tests can save your life,” said Dr. Mohammed Khalil, a hematologist-oncologist with Houston Methodist Cancer Center at The Woodlands. “This is so important because early detection makes it possible to identify cancer in early stages when it’s most treatable.”

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 and prioritizing your to-do list, 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. Finding out 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

Leading Cancer Care

Talk to your doctor about a screening schedule that is right for you.

If you don’t have a primary care physician, you can find one by visiting houstonmethodist.org/pcg/north or by calling 713.394.6791.

If you or a loved one has been diagnosed with cancer, call 936.270.3413 to schedule an in-person or virtual appointment with a specialist at Houston Methodist Cancer Center at The Woodlands.

price to pay for the peace of mind you get from knowing your results.

“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 assume you have no risk of developing cancer yourself. “Cancer can affect anyone, even if you have no symptoms or family history of cancer.

That’s why routine cancer screenings are recommended to detect cancer early,” Khalil said.

“I’m worried about COVID-19.” At Houston Methodist The Woodlands, 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.

CONNECT WITH YOUR DOCTOR

If you have concerns about your risk for cancer, you should talk to your doctor about a screening schedule that’s right for you.

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STAY ON TOP OF

YOUR HEALTH 7 Ways to Improve Your Health

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anaging your health should always be a top priority, even when there’s a lot going on in life. This is especially true during a pandemic when it’s Dr. Marlaina important to do what Bonnesyou can to stay healthy Neumann and safe. Focusing on preventive care can help you be prepared and protect yourself and others.

Dr. Marlaina Bonnes-Neumann, a primary care, internal medicine doctor with Houston Methodist Primary Care Group, says the goal of preventive care is to provide guidance for optimal health and well-being. “Your primary care doctor can help you manage health risks and live a healthier life,” Bonnes-Neumann said.

AN ANNUAL 1SCHEDULE CHECKUP You may be reluctant to go in for

a checkup when you’re feeling fine healthwise. But, being proactive about your health can prevent bigger, more expensive health problems down the road — and it can even save your life.

Essential tip: Managing your health is easier when you build a relationship with a primary care provider who knows you and your health history.

Did you know: Virtual visits allow you to see your doctor from the comfort of home via phone or computer.

2 KEEP UP WITH HEALTH TESTS Your doctor may recommend a cholesterol test, blood pressure screening, blood glucose test, mammogram, colonoscopy, prostate screening or other health tests. These tests can identify potential health problems so they can be prevented, treated or managed.

Essential tip: Ask your doctor about recommended screening tests for you based on your age, health history and other factors.

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Did you know: Screening tests increase the chances of detecting certain cancers early, which provides more treatment options because they can be addressed sooner.

3 GET A FLU SHOT

Vaccines provide protection for you and others against infectious diseases, such as flu, measles and pneumonia, which can be particularly dangerous for older adults and those with underlying health conditions. “It’s important to protect your health by getting your flu vaccine and other vaccines recommended by your doctor,” Bonnes-Neumann added.

Essential tip: Contact your primary care office to schedule flu shots and other vaccines for yourself and your family.

Did you know: It’s not too late to get a flu shot if you haven’t already. Although it’s best to get your flu shot as soon as it’s available in the fall, getting a flu shot later still provides protection for the rest of flu season into April and May.

HOW TO CHOOSE YOUR PRIMARY CARE DOCTOR Staying on top of your health during these challenging times starts with having a quality primary care doctor.

Here’s what to consider when determining the best one for you: B oard certification. Is the doctor board certified? This means he or she has proven expertise and can provide the highest quality care possible.

OVID-19 safety measures.

C Does the primary care doctor’s office have safety measures in place, such as enforcing social distancing and implementing disinfectant protocols for the staff?

Convenience and accessibility.

How accessible is the doctor?

Access to virtual visits, text-toschedule, online scheduling and

multiple locations across the Greater Houston area make a difference when you see your doctor on a regular basis.

We’re Here for You

Our physicians are safely seeing patients in-person and virtually with safety measures in place to protect patients from COVID-19.

Stay connected with your health by subscribing to our e-newsletter. Visit houstonmethodist.org/blog-stay-connected to sign up to receive the Houston Methodist On Health e-newsletter.

MEDICATIONS 4 TAKE AS DIRECTED

Following your doctor’s instructions for taking medications is an essential step in managing diabetes, heart disease, asthma and other conditions. Unfortunately, up to one-half of all prescribed medications are not taken as prescribed, according to a study in the American Journal of Accountable Care. “Always be careful with your medications, because there are risks when you don’t take your medications as directed,” Bonnes-Neumann said.

Essential tip: Have an honest conversation with your doctor or pharmacist to address any questions or concerns about your medications.

Did you know: Talk to your doctor if you’re having side effects or other concerns about your medications, including costs. Your doctor may decide to make adjustments to the dosing or prescribe a different medication that works better for you.

Did you know: In a poll by the American Psychiatric Association, 68% of Americans reported feeling anxious about the possibility of family or loved ones getting COVID-19. If you feel overwhelmed or unable to function, talk to your doctor.

6 MAKE HEALTHY CHANGES

If you need some motivation and support for making changes, such as losing weight or quitting smoking, talk to your primary care provider first. He or she can provide guidance to help you get started and support with tools or medications to help you be successful.

Essential tip: Your chances of success go up when you have medical support for quitting smoking or losing weight.

Did you know: If you’re overweight or obese, losing 5% of your body weight can have some big benefits for your health, including lower cholesterol, lower

blood pressure, reduced inflammation, reduced cancer risk and improved diabetes management.

7 DON’T DELAY HEALTH CARE

You may be inclined to “wait it out” and delay getting medical care when something is wrong. However, it’s important to seek medical care when you have concerns about your health. When in doubt, get it checked out.

Essential tip: Don’t hesitate to call 911 for emergency medical help.

For nonurgent health issues, make an appointment with your primary care doctor and write down some questions and notes about your symptoms.

Did you know: Worrying about the costs of health care shouldn’t be a barrier to your health. Detecting a health issue early can help avoid bigger problems later on, saving you money and improving your life in the long run.

5 TALK ABOUT MENTAL HEALTH

Millions of people are affected by mental health issues, including anxiety, depression and mood disorders. Talking about what’s going on and getting help with therapy or medications can help you start feeling better.

Essential tip: Your primary care doctor can help with mental health concerns, including screening for depression.

Make an Appointment

Schedule an appointment with a Houston Methodist primary care doctor in The Woodlands or a surrounding community by visiting houstonmethodist.org/pcg/north or calling 713.394.6791.

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WHEN BUNIONS BECOME A PROBLEM I f your bunion aches, you may have tried to address it with over-the-counter pain medications, wider shoes, gel pads or even toe spacers to relieve pressure. However, if the pain from bunions interferes with your ability to do your job or the activities you enjoy, it may be time to consult an orthopedic surgeon.

Dr. Alex Davis

WHAT IS A BUNION?

A bunion is a bony protrusion of the big toe. It results from the big toe deviating toward the second toe. Due to the bone and soft tissues affecting the toe position, bunions can gradually worsen over time.

Bunions may be caused or aggravated by a variety of factors, including: Genetics – the structure of some feet may make them more prone to developing bunions Activities – for example, spending long periods of time on your feet Lifestyle – wearing ill-fitting shoes or high heels that put added pressure on the toes Injury or conditions, such as osteoarthritis “A bunion can cause significant discomfort because of the bump itself rubbing in a shoe. It can also cause changes in the weight distribution in the foot during weightbearing.

Sometimes it can lead to other deformities in the smaller toes,” said Dr. Alex Davis, a fellowship-trained orthopedic surgeon specializing in foot and ankle surgery at Houston Methodist The Woodlands Hospital.

Some noninvasive ways to help relieve pain may include: Pads that reduce pressure on the bunion from shoes A silicon sleeve placed over the toe that’s rubbing on the other toe A spacer between the big toe and the second toe “It’s time to consider surgery when the discomfort and deformity are not managed with those simple strategies,” added Davis.

WHAT’S INVOLVED IN BUNION SURGERY?

Bunion surgery involves more than just trimming the bump.

Tendons and ligaments may need to be adjusted.

“A bunion is a complex deformity that involves bone and soft tissue abnormalities,” said Davis. “There are nearly 100 ways to fix a bunion. However, orthopedic surgeons have the ability to utilize a variety of different approaches that will produce the best outcome for an individual patient.”

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Dealing with Bunion Pain?

If you are dealing with bunion pain, call 936.321.8000 to schedule an appointment with an orthopedic surgeon for an evaluation.

BE REALISTIC ABOUT RECOVERY

Depending on the procedure, initial recovery — which generally involves putting no pressure at all on the affected foot — may be as little as two weeks or up to eight weeks. “It’s important to be prepared for the recovery period,” Davis explained. “There is usually swelling that lasts even after the patient is allowed to put pressure on the foot. Most patients get 90% of recovery within three to four months, but it may take longer.”

Even though bunions are unsightly, Davis discourages patients from considering surgery purely from a cosmetic perspective — primarily due to the extensive recovery period.

“However, for those whose bunion pain is affecting their quality of life, surgery can provide relief and allow them to resume their desired activities and occupation,” he said.

15PREGNANCY

TIPS FOR A HEALTHY

W Dr. Kellyn Rielly

hether you’re thinking about trying to become pregnant or already expecting a baby, you likely have a million questions about having the healthiest pregnancy possible.

“It is ideal to optimize your health going into a pregnancy by managing any current medical conditions and having a good support system

1 | Schedule prenatal visits with your health care provider. Some appointments may be done virtually, while in-person visits are needed for ultrasounds, fetal testing and blood work.

2 | Stay up-to-date with vaccines and screenings.

3 | Take a prenatal vitamin.

4 | Stay hydrated by drinking plenty of fluids.

5 | Exercise for 20 to 30 minutes on most days (with your doctor’s approval).

6 | Eat a healthy diet with lots of fruits and veggies.

in place,” said Dr. Kellyn Rielly, a board-certified obstetriciangynecologist at Houston Methodist The Woodlands Hospital.

“Then staying on schedule with your prenatal visits is one of the best steps you can take for your baby as well as focusing on good nutrition, exercise and healthy lifestyle habits.”

Rielly recommends following these tips for taking good care of yourself to give your baby a healthy start.

8 | Add more fiber to your diet.

9 | Try to limit coffee intake to 1 cup per day.

10 | Don’t drink alcohol.

11 | Stop smoking and avoid secondhand smoke.

12 | Ask your doctor before taking prescription and over-the-counter drugs.

13 | Avoid harsh cleaners and toxic chemicals.

14 | Have someone else change the cat litter box.

15 | Rest when you feel tired; take a nap if you can!

7 | Eat calcium-rich foods, such as low-fat dairy or soy.

You’re in Good Hands

Houston Methodist Childbirth Center at The Woodlands is here to help you prepare for a smooth transition from pregnancy to parenthood. Visit houstonmethodist.org/childbirth-thewoodlands to learn more about the services we offer, or call 936.270.3333 to find an OB-GYN in your area.

PROTECTION AGAINST COVID-19 DURING PREGNANCY You may also have concerns about protecting yourself and your baby from the risk of COVID-19. You can help prevent illness by avoiding people who are sick and limiting contact with others, especially in large groups. Avoid public spaces, wear a mask and practice social distancing. Clean and disinfect frequently touched surfaces daily and continue to be extra vigilant about handwashing.

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SEEING A PRIMARY CARE DOCTOR Is Still Important

For everything from annual checkups to managing chronic conditions, taking care of your health should always be a priority.

Houston Methodist primary care doctors are still available to provide personalized care for you and your family — safely.

We offer a variety of convenient ways to get care from us, from same-day sick visits to extended hours at select locations.

And, you can be confident that we are taking every necessary precaution to keep you safe during your visit, including:

patients virtually only — allowing us to treat everyone safely

Ensuring social distancing in waiting rooms

Wearing masks while providing care

Offering video visits with your doctor

Enhanced cleaning of equipment and surfaces

Adding evening and Saturday hours to space out appointments

houstonmethodist.org/pcg/north Call or text: 713.394.6791

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