Leading Medicine Winter 2019, Houston Methodist The Woodlands Hospital edition

LEADING MEDICINE W INT ER 201

Help for Stroke Is Here

Strength in Numbers:

LOSING WEIGHT TOGETHER Is Stress Hurting Your Heart?

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

Is Stress

HURTING

Your Heart?

Y

ou face many types of stress each day — emotional stress from life pressures or physical stress caused by overexertion. Occasional stress can be normal. But unmanaged and excessive stress can cause short- and long-term effects on your health, including your heart health.

Dr. Ali Rizvi

HOW STRESS AFFECTS THE HEART

“Most stresses affect the heart, whether it’s directly or indirectly,” said Dr. Ali Rizvi, interventional cardiologist at Houston Methodist DeBakey Cardiology Associates in the Woodlands. “Stress can increase heart rate, elevate blood pressure and aggravate underlying issues to cause a heart attack. Even without underlying health issues, extreme stress can lead to a heart attack.”

Persistent or sudden and severe stress may put the heart and cardiovascular system at greater risk of: Arrhythmia, or irregular heartbeat Worsened preexisting coronary artery disease High blood pressure Increased cholesterol and triglycerides (fat in the blood) Stress cardiomyopathy, also known as takotsubo cardiomyopathy, or broken heart syndrome — mimics a heart attack without blockage of a heart artery

STRESS MANAGEMENT TIPS

STRESS-INDUCED TRIGGERS

Excessive exertion — performing extreme physical activity after being inactive. “This can happen when inactive, older people do heavy exercise which may trigger plaque rupture and a subsequent heart attack,” Rizvi said. “If you don’t exercise, it’s important to get an evaluation from a cardiologist prior to becoming active.”

Extreme emotion — intense grief or anger can affect the heart’s electrical impulses and potentially trigger a heart attack Overeating — a heavy meal can increase cholesterol levels and cause a heart attack Cold weather — heart arteries can constrict and raise blood pressure, increasing the risk of a heart attack

2 LEADING MEDICINE FROM HOUSTON METHODIST THE WOODLANDS HOSPITAL

xercise regularly. Physical activity releases endorphins and E decreases blood pressure and cholesterol levels, therefore reducing the risk of heart events.

Practice positivity. Researchers have found links between happiness and reduced heart disease risk. Every day, list things for which you’re thankful and look for the silver lining in negative events to improve your mood.

Watch what you eat. Use smaller plates and avoid eating second helpings to prevent overeating. Most meals should be low-calorie and include nutrient-rich foods.

Dress for the weather. Wear layers of warm clothes and a hat to stay insulated in cool weather. Take frequent breaks to avoid overstressing yourself when physically active in the cold.

Heart Screening Event

Tuesday, Feb. 5, 5:30-7:30 p.m.

Houston Methodist The Woodlands Hospital 17201 I-45 S. The Woodlands, TX 77385 Sign up for this free event. Receive cholesterol and blood pressure screenings and learn your 10-year risk for heart disease. Registration is required.

Register online at events.houstonmethodist.org/ heart-tw or call 936.270.3333.

Help for Stroke Is Here

I

mmediate care is critical for stroke survival.

A stroke occurs after blood flow to the brain is cut off (ischemic stroke) or a blood vessel ruptures (hemorrhagic stroke). Brain cells begin to die without adequate blood supply.

Someone in the U.S. has a stroke about every 40 seconds.* Where you go for treatment can be lifesaving.

Dr. Sabih “We’ve worked very hard to build a Effendi comprehensive neuroscience center in Montgomery County,” said Dr. Sabih Effendi, neurosurgeon at Houston Methodist The Woodlands Hospital, which offers a range of neurosurgery and stroke care. “Because time is so critical for effective stroke care, having access to every option can make a real difference in the success of the treatment.”

THE FIRST 24 HOURS

Two treatment options can lessen ischemic stroke damage within the first 24 hours after occurrence.

A medication called tPA (tissue plasminogen activator) quickly dissolves the blood clot and restores blood flow to the brain. It must be given within the first 4½ hours after stroke onset.

Since 2015, a procedure called a thrombectomy has reduced poststroke disability and improved quality of life. The procedure can be performed within the first 24 hours after stroke onset.

“If you had a stroke 20 years ago, there was no treatment,” Effendi said. “You were simply sent to the nursing home to recover. The thrombectomy procedure now provides remarkably good outcomes for many stroke survivors.”

Thrombectomy, a minimally invasive procedure, is usually performed in less than an hour. Doctors thread catheters, or very small tubes, through the groin and to the blood clot in the brain.

They then remove the clot to restore blood flow to the brain.

“Thrombectomy is not available everywhere,” Effendi said.

“We are proud to be one of the first hospitals outside the Texas Medical Center to offer it.”

SIGNS OF STROKE? BE FAST! If someone has a stroke, remember BE FAST when checking symptoms, including:

B alance — loss of balance or coordination?

E yes — blurred, double or loss of vision?

F ace — one side of the face droops?

A rms — one arm drifts down or cannot move?

— slurred speech? Difficulty repeating S peech a sentence?

— call 911. Time lost is brain lost. Note T ithemetime when symptom(s) first appeared. This information affects treatment decisions.

* Stroke ranks No. 5 among all causes of death in the U.S., killing nearly 133,000 people a year. Heart Disease and Stroke Statistics 2018 At-a-Glance. American Heart Association.

Learn More

Visit houstonmethodist.org/neurowoodlands or call 936.270.3333 for information about the Neuroscience Department at Houston Methodist The Woodlands.

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. Nisha suggests that couples have Sidhwani 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. Nisha Sidhwani, an obesity medicine specialist with Houston Methodist Primary Care Group in The Woodlands. 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

Get Started Jump-start your weight loss by making an appointment with Dr. Sidhwani by calling Houston Methodist Primary Care Group at 713.394.6776. Free orientations are also available at Houston Methodist Weight Management Center at The Woodlands. Learn about our medical weight management, StepLITESM and surgical weight-loss programs to help you get started.

Visit houstonmethodist.org/ weight-management or call 832.667.LOSE (5673) to register.

goals. Weight loss with a partner provides motivation, support and even a little healthy competition.

1MOTIVATION

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

2A STRONG SUPPORT SYSTEM

“When you embark on this journey together with family members, you have a built-in support system,” Sidhwani 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.

3EAT BETTER TOGETHER

Changing the way you eat starts with meal planning, grocery shopping and a commitment to cooking meals at home.

4 LEADING MEDICINE FROM HOUSTON METHODIST THE WOODLANDS HOSPITAL

“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,” Sidhwani 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,” Sidhwani 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. “Also seeing health numbers improve and high blood pressure, cholesterol and blood sugar go down is our top priority,” Sidhwani said. “It’s really about achieving a better quality of life and a better state of health.”

Picture this: Co-workers start a weight-loss challenge to lose 150 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.

LOSING WEIGHT AND GROWING THEIR FAMILY Couple lost 265 pounds after weight-loss surgery

A HEALTHY 6 MAINTAIN LIFESTYLE

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

Oscar and Arlena Laguna of Conroe tried unsuccessfully to lose weight for a long time through regular dieting and exercise. Already parents of an 11-year-old son, the Lagunas wanted more children but feared their extra weight would prevent them from growing their family.

In 2015, Arlena had gastric bypass surgery. After losing 165 pounds, she and Oscar welcomed a baby in 2017. Inspired by his wife’s success, Oscar had a sleeve gastrectomy in 2017 at Houston Methodist The Woodlands Hospital and lost nearly 100 pounds.

“My health was becoming an issue with diabetes and high blood pressure,” Oscar said. “I wanted to do this so I can make sure I can be there for my wife and my kids.”

The family has benefited from the couple’s commitment to lifestyle changes.

“Our kids are picking up the habits of eating better,” Oscar said. “My wife and I have more energy to keep up with the kids, play outdoors and go for bike rides together.”

Oscar credited his wife and family for supporting and motivating him to move forward.

“Having her there has helped me push through and keep going,” Oscar said.

“We help each other stay on track.”

HOUSTONMETHODIST.ORG/THEWOODLANDS 5

HPV: Why Get Vaccinated?

H

uman papilloma virus (HPV), spread through skin-toskin contact during sexual activity, is highly contagious, but preventable.

Dr. Jenna Some HPV types Everson cause cervical cancer in women as well as genital warts, and mouth and throat cancers in men and women. Most people will not experience symptoms and unknowingly pass HPV to sexual partners.

“HPV is responsible for over 33,000 cancers in the U.S. each year, and the majority of these cancers can be prevented by the vaccine,” said Dr. Jenna Everson, obstetrician-gynecologist and member of Houston Methodist Physicians’ Alliance for Quality.

HPV PROTECTION

The Centers for Disease Control and Prevention recommends the HPV vaccine be given to girls and boys ages 11 or 12 who receive two doses at least six months apart. The vaccine is also approved for unvaccinated men and women up to age 45, even if they are already sexually active.

HPV exposure prevention is key. The vaccine does not treat existing HPV infections, precancers, cancer, genital warts or other sexually transmitted diseases. “Women still need regular Pap tests and cervical cancer screening after the vaccine because it doesn’t prevent against all types of HPV that can cause cervical cancer,” Everson said.

Learn More

Protect yourself or a loved one if you are concerned about HPV-related cancers.

Call 936.270.3333 to learn about cancer screenings at Houston Methodist Cancer Center at The Woodlands.

HPV AND THROAT CANCERS: ARE THEY RELATED? Human papillomavirus (HPV) infection is linked to oropharyngeal cancers, occurring in the throat, soft palate, base of the tongue and tonsils. The virus causes about 70 percent of oropharyngeal cancers.

“Nearly 3 in 4 Americans will have HPV at some point in their lives, and a small number of these will go on to develop a chronic viral infection. Some of these chronic infections in the tonsils or at the base of the tongue can evolve over time into an oropharyngeal cancer,” said Dr. Ryan Neilan, otolaryngologist and member of Houston Methodist Physicians’ Alliance for Quality.

Doctors treat HPV-related throat cancer with combinations of methods, including transoral surgery, chemotherapy and radiation.

“HPV-related throat cancer is becoming more common, and the number of cases will likely continue to rise,” Neilan said. “I hope that more young people getting the HPV vaccine will help reverse this trend.”

6 LEADING MEDICINE FROM HOUSTON METHODIST THE WOODLANDS HOSPITAL

Secrets to Race PREPARATION Avoiding Injury as Race Day Approaches

A Dr. Alex Davis

n injury can become a runner’s ultimate race-day spoiler. But there are simple ways to avoid injuries and enjoy running.

“Most people who get injuries are new to running,” said Dr. Alex Davis, orthopedic surgeon at Houston Methodist The Woodlands Hospital who specializes in foot and ankle surgery. “But all runners should be conscious of their foot health while training, so they can perform their best on race day.”

FOUR STEPS TO PAIN-FREE TRAINING

1

Choose proper footwear. “It starts with the shoes,” Davis said. “When you are entering any new athletic activity, head to an athletic or specialty running shoe store where the sales staff is knowledgeable about what shoe type works best for your running style.” Every shoe brand or model doesn’t work for every foot type. Trained salespeople know which shoes to recommend.

Additionally, socks are also important since they protect the skin and keep feet dry to avoid blisters.

Race-day tip: Ideally, your shoes should be between three and six months old. Do not try to break in new shoes on race day.

2

Assess your fitness level. “Before you sign up for your race, assess your overall fitness level,” Davis said. An assessment provides a benchmark of your fitness based on strength, flexibility and cardiovascular endurance to help you set realistic training goals. It may include heart rate measurements and flexibility tests.

“Make sure to assess the flexibility of your calf and leg muscles,” Davis said. Ask your doctor or a certified trainer how to perform an assessment and set training goals.

4

Stretch. “Stretching before and after training is one of the simplest and most important ways to avoid an injury,” Davis said. Stretch your feet and ankles as well as major muscle groups.

“The day of a race, with all the excitement, it can be easy to forget to stretch,” Davis said. “Also, remember to hydrate.”

Race-day tip: Make time for stretching in your race-day routine.

THE WOODLANDS MARATHON The Woodlands Marathon is more than a race. It is an annual celebration of healthy, active lifestyles and includes something for everyone. Houston Methodist is proud to provide medical coverage for each of these events: F eb. 23 — Fleet Feet Sports 5K Run F eb. 23 — 2K Family Fun Run and Walk M arch 1 — Houston Methodist Health & Fitness Expo M arch 2 — The Woodlands Race Day Marathon, Houston Methodist Half-Marathon and Marathon Relays Go to thewoodlandsmarathon.com to learn more and register.

Race-day tip: Track your mileage and taper, or reduce, the length and intensity of your workouts in the weeks leading to the race.

3

Cross-train. “One danger of training for a race is overusing the muscles that are used in running,” Davis said. “Crosstraining with an elliptical machine or bike can help you increase cardiovascular endurance while letting your running muscles rest.”

Race-day tip: Cross-train as you taper to maintain flexibility and strength without fatiguing your running muscles.

Care for Your Feet

If you suffer with chronic foot or ankle pain, Houston Methodist Orthopedics & Sports Medicine at The Woodlands can help you find relief. Visit houstonmethodist.org/ ortho-woodlands or call 936.321.8000 for information.

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