Leading Medicine Fall 2017, Houston Methodist Baytown Hospital edition

LEADING MEDICINE FA LL 2017

BREAST CANCER:

Is Prevention Possible?

QUIT SMOKING ON YOUR TERMS 4 HOLIDAY HEART DANGERS

YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN EAST HOUSTON/BAYTOWN

HEALTHY EATS

Tuna Apple Salad Sandwich Give your lunch some crunch with a sandwich that combines crisp apples and walnuts in a tuna salad that’s rich in omega-3 fatty acids.

INGREDIENTS 1 apple (such as Fuji or Pink Lady Washington) 1 can 12-oz chunk light tuna (drained) 2 tablespoons low-fat plain yogurt 2 tablespoons reduced-fat mayonnaise ½ cup raisins (or chopped figs) ¼ cup chopped walnuts ¼8 teaspoon ground black pepper 2 tablespoons chopped fresh parsley (optional) ½ teaspoon curry powder (optional) 8 leaves lettuce (bibb, romaine, green or red leaf) 8 slices whole-grain bread DIRECTIONS 1. Cut apple in quarters; remove core and chop.

2. In a medium-size bowl, mix all salad ingredients, except tuna.

NUTRITIONAL INFORMATION PER SERVING

3. Gently fold in tuna.

Number of servings: 4 380 calories; 10 g total fat; 2 g saturated fat; 25 mg cholesterol; 550 mg sodium; 48 g carbohydrates; 7 g dietary fiber; 9 g total sugars; 3 g added sugars; 27 g protein; 4 mcg vitamin D; 100 mg calcium; 4 mg iron; 608 mg potassium.

4. Make sandwiches using lettuce and whole-grain bread (toasted, if desired), and fill with tuna apple salad.

Recipe courtesy of the U.S. Department of Agriculture, whatscooking.fns.usda.gov

IN THIS ISSUE - FALL 2017

3 4 5

I s Your Job a Pain in the Wrists?

Carpal tunnel syndrome can strike anyone who uses their hands vigorously or repetitively.

P ut Midlife Expansion into Reverse Many women in their 40s and 50s notice an increase in their waistlines.

Return to an Active Lifestyle Quickly and with Less Pain Get answers to common minimally invasive robotic-assisted surgical questions.

6

Breast Cancer: Is Prevention Possible?

Learn more about steps you can take to reduce your risk of breast cancer.

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8 9

Q uitting on Your Terms The average smoker tries to quit at least seven times before succeeding.

I rritable Bowel Syndrome: 5 Ways to Take Control People with IBS needn’t suffer in silence from embarrassment.

There’s help.

10

4 Holiday Heart Dangers Holiday season is fast approaching, and so is an increased risk for heart attack.

Protect yourself.

6

CARPAL TUNNEL

IS YOUR JOB A

PAIN IN THE WRISTS? I n our technologydriven world, spending hours upon hours, day after day on our computers, phones or tablets is resulting in new or more advanced “overuse” Dr. Jennifer issues in our hands and Wagner wrists. Carpal tunnel syndrome, a disorder of the wrist and hand characterized by pain, tingling and muscular weakness, can strike anyone who uses their hands vigorously or repetitively — from office workers and mechanics to musicians and gardeners.

“In its early stages, carpal tunnel syndrome is not necessarily painful,” said Dr. Jennifer Wagner, an orthopedic surgeon specializing in surgeries of the hand and upper extremities with Houston Methodist Orthopedics & Sports Medicine at Houston Methodist San Jacinto Hospital. “At first, you may notice tingling or numbness in your hand, wrist or fingers at nighttime or when you wake up in the morning. As carpal tunnel progresses, symptoms become more painful and noticeable during the day. In severe cases, you may experience weakness

in your hands and loss of dexterity or fine motor skills.”

The following steps may help relieve symptoms of carpal tunnel syndrome and prevent further injury: If you work at a computer, set up your desk and keyboard so that your wrists are in a neutral position — neither bent up nor down Use a headset instead of holding the phone to your ear If you use tools on the job, make sure they fit your hand correctly and use anti-vibration tool wraps and gloves as needed Use automated tools (electric staplers, hole punches, can openers, etc.)

Take frequent breaks and alternate activities to give your hands a rest Do hand exercises and stretches several times a day. For example, make a fist and release it, then stretch wrists

GET RELIEF FROM PAINFUL SYMPTOMS

If left untreated, carpal tunnel syndrome may lead to permanent nerve damage, and the longer you wait, the worse it gets.

“You should seek treatment if hand pain interferes with your normal activities or

disrupts your sleep for more than three or four weeks,” Wagner said. “We can do a nerve study to find out if your carpal tunnel is mild, moderate or severe, which helps determine the right treatment plan. In some cases, anti-inflammatory medicines or cortisone injections may be used to ease symptoms.”

Surgery is another option for moderate to severe cases, and for those who do not respond to conservative measures. “Carpal tunnel release is a simple procedure that can be done in just a few minutes to relieve pressure on the median nerve,” Wagner said.

We Can Help

If you're experiencing the symptoms of carpal tunnel syndrome, call 281.427.7400 or visit houstonmethodist. org/orthopedics/locations/ baytown to schedule an appointment with an orthopedic specialist at Houston Methodist San Jacinto Hospital.

CHECK OUT OUR DIGITAL MAGAZINE AT HOUSTONMETHODIST.ORG/PUBLICATIONS HOUSTONMETHODIST.ORG/SANJACINTO 3

Menopausal Weight Gain, Explained

Put Midlife Expansion

INTO REVERSE

F Dr. Laura Choi

inding it harder to fit into your favorite jeans? Many women in their 40s and 50s notice an increase in weight that tends to settle at the waist. The good news: By understanding what’s happening to your body during menopause and making a few simple changes in diet and exercise, you can get back into those jeans. What’s more, you’ll steer away from many life-threatening or debilitating illnesses associated with excess fat.

WHAT CAUSES MENOPAUSAL MUFFIN TOP?

“Hormonal changes during menopause, such as a drop in estrogen and a rise in follicle-stimulating hormone (the hormone that controls egg production), cause women to lose muscle mass and accumulate fat around the waist,” said bariatric surgeon Dr. Laura Choi, director of the Houston Methodist Weight Management Center at San Jacinto. Age-related muscle-mass loss and the tendency to be less active can cause your metabolism — the rate at which your body uses energy — to slow down.

“Excess weight also increases your risk for type 2 diabetes, heart disease, problems breathing and developing breast, colon and other cancers,” Choi explained.

TAME YOUR TUMMY

With a healthy diet and regular exercise, you can keep the weight from creeping on. Take these three important steps to drop extra pounds.

1

Do the math. Portion control is vital. Mentally divide your dinner plate into quarters: One quarter should have a portion of lean meat or fish about the size of your palm; another quarter should have a fist-sized portion of carbohydrates, preferably whole grains like brown rice or whole-grain pilaf; and the remaining two quarters should be filled with colorful vegetables.

2

Get active. Regular physical activity strengthens your heart and bones, reduces your cancer risk and controls weight. It also improves sleep, boosts energy, lessens hot flashes and helps elevate mood. Most healthy adults benefit from 150 minutes a week of moderate-intensity aerobic activity, such as brisk walking or water aerobics, or 75 minutes a week of vigorous-intensity aerobic activity, such as jogging or swimming laps.

3

Build muscle. Because muscle burns more calories than fat, strength training at least twice a week will help raise your metabolism so you can burn fat more efficiently. Using a weight you can lift comfortably 12 to 15 times builds muscle and increases your strength.

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NUTRITION COUNSELING AT HOUSTON METHODIST SAN JACINTO HOSPITAL Houston Methodist Weight Management Center at San Jacinto utilizes a team of dietitians, diabetes specialists, physicians, bariatric surgeons and mental health professionals who work together to help patients manage their weight through nonsurgical and surgical methods.

By providing medical weight management and bariatric surgical procedures, we help patients lose weight and keep it off. An essential part of our comprehensive treatment plan includes individual nutrition counseling from our highly skilled diet and nutrition experts. This includes a metabolic analysis; a simple test to determine the rate at which your body burns calories.

The center also offers its diabetes education program — recognized by the American Diabetes Association — which focuses on personalized treatment plans for patients with diabetes to help them self-manage the disease and improve their overall health.

Houston Methodist Step LITESM Program at San Jacinto is a moderate weight loss program staffed by licensed, registered dietitians and professional counselors who share tools to help you improve your health and produce the weight loss results you want via self-monitoring and exercise.

Houston Methodist Weight Management Center at San Jacinto can assist patients whose weight loss may require surgery. Patients with a body mass index (BMI) of 40, or those who have a BMI of 35 to 39.9 with the presence of obesity-related conditions, including high blood pressure, diabetes, sleep apnea, reflux disease or heart problems, may be eligible for weight loss surgery.

We're Here to Help

To schedule an appointment with a Houston Methodist San Jacinto Hospital weight management specialist, visit houstonmethodist.org/weight-management, or call 832.556.6046.

Return to an Active Lifestyle Quickly and with Less Pain

G

ynecologic conditions, such as fibroids, endometriosis, pelvic prolapse and other uterine issues, shouldn’t get in the way of life, and neither should the surgery to treat them. By choosing minimally invasive robotic-assisted surgery for your gynecologic procedure, you may be able to get back to your active lifestyle quicker and with Dr. Paul less pain than traditional options.

Redman Many people may have questions and concerns about what robotic surgery is and whether it is an option for them and their condition. To help you decide if robotic surgery is right for you, Dr. Paul Redman, an obstetriciangynecologist who practices at Houston Methodist San Jacinto Hospital, answers a few questions you may have.

Q: What is robotic-assisted surgery?

A: Robotic-assisted surgery is a type of laparoscopic — also known as minimally invasive — surgery that is performed using a robotic system that translates your surgeon’s hand movements into precise movements of tiny instruments. These instruments, which can bend and rotate at angles a human hand can’t, are combined with a magnified, 3-D image to enable your surgeon to perform with more precision during complex and delicate procedures, and use small, dime-sized incisions.

Q: How long is the recovery period?

A: Patients typically go home from the hospital the same day or the next, and recover in as few as one to two weeks, compared to a recovery time of four to six weeks after traditional open surgery.

You may be able to return to work within one to two weeks.

Q: Are there any other advantages to robotic surgery?

A: Other benefits of robotic gynecologic procedures include the potential for less postsurgical pain; lower risk of infection; reduced loss of blood, which reduces the need for transfusion during surgery; and significantly less scarring.

ASK YOUR DOCTOR ABOUT DA VINCI At Houston Methodist San Jacinto Hospital, our surgeons use the state-of-the-art da Vinci® Surgical System to perform hundreds of robotic procedures each year. The da Vinci system empowers our surgeons with these features: magnified vision system that provides a 3-D, A high-definition view inside the body I mproved anatomical access compared to other minimally invasive systems obotic instruments that translate the surgeon’s hand R movements in real time into small, precise movements

Q: What gynecologic procedures does Houston Methodist San Jacinto offer as robotic surgery?

A: A number of gynecologic procedures that were traditionally performed using open-surgery techniques can also be performed robotically. These include: Hysterectomy (removal of uterus) Myomectomy (removal of noncancerous uterine fibroids) Sacrocolpopexy (repair of pelvic organ prolapse) Removal of the ovaries or ovarian cysts

Q: Does my insurance cover roboticassisted surgery?

A: In general, if your insurance covers minimally invasive surgery, Houston Methodist San Jacinto Hospital’s roboticassisted gynecologic surgery procedures are also covered. Many common insurance plans, such as Medicare, cover this type of surgery, but be sure to verify your coverage by checking your plan and benefits package.

Schedule a Consultation

Houston Methodist San Jacinto Hospital offers a full spectrum of gynecologic services and procedures.

To schedule an appointment with one of our OB-GYN specialists, visit houstonmethodist.org/womensservices/pregnancy-childbirth or call 281.420.5760.

HOUSTONMETHODIST.ORG/SANJACINTO 5

BREAST CANCER:

IS PREVENTION POSSIBLE?

W

hen it comes to breast cancer, certain risk factors are out of your control, such as your genes and age, as well as starting your first period young. Yet even more risk factors are within your control, and every day new research is emerging that suggests breast cancer may be more preventable than experts originally Dr. Mary thought.“Women can take steps to mitigate their Goswitz risk of developing breast cancer and increase their chances of survival if it occurs,” said Dr. Mary Goswitz, radiation oncologist with the Houston Methodist Cancer Center at San Jacinto. Here are some steps you can take to reduce your risk of breast cancer:

BE (REALLY) PHYSICALLY ACTIVE

Exercise, especially vigorous exercise, could be the single most important weapon in your arsenal.

“Exercise is an important factor when it comes to

6 LEADING MEDICINE IN EAST HOUSTON/BAYTOWN

reducing a woman’s risk of breast cancer,” Goswitz emphasized.

“Some studies estimate a 15–30 percent risk reduction with moderate exercise.”

Doctors think the exercise-estrogen link may account for the reduced risk. Here’s why: The greater your lifetime exposure to estrogen, the greater your risk for breast cancer. Exercise appears to alter the metabolism of estrogen.

MAINTAIN A HEALTHY WEIGHT

Being overweight increases your risk of developing a variety of serious diseases, and breast cancer is one of them. Women who have more fat cells produce more estrogen and tend to have higher insulin levels, both of which are linked to an increased breast cancer risk. “Maintaining a healthy body weight throughout her lifetime, with a body mass index of 18.5–24.9, has many health benefits,” Goswitz said.

LIMIT ALCOHOL

In addition to exercise and maintaining a healthy body weight, limiting alcohol to three or less alcoholic drinks per week can lower a woman’s risk. Compared with nondrinkers, women who consume two to five alcoholic drinks a day have about 1.5 times the risk of developing breast cancer. Goswitz recommended that women who don’t want to abstain take a daily multivitamin with folate (folic acid). Studies have shown that an adequate daily folate intake may mitigate the risk of breast cancer associated with alcohol consumption.

CHOOSE TO BREASTFEED

Goswitz encouraged new mothers to breastfeed their babies if they’re able. “Evidence suggests that breastfeeding reduces a woman’s risk of developing breast cancer,” she said. “We know that the longer a woman breastfeeds, the greater the protective effect.” The reasons why aren’t clear, but one possible explanation is that women who breastfeed have fewer menstrual cycles throughout their lives, and thus less exposure to estrogen.

CONSUME OLIVE OIL

Studies have suggested that consuming more monounsaturated fats, such as olive oil, may help protect against breast cancer, too. Houston Methodist is conducting a clinical trial, led by Dr. Tejal Patel, examining how a major component of olive oil, hydroxytyrosol, affects breast density in women at high risk of breast cancer. Women with higher breast density have a higher breast cancer risk.

REDUCE STRESS

For many women, juggling work and family commitments may lead to excessive stress. With stress comes higher cortisol levels and, eventually, other hormonal changes that can lead to estrogen dominance. Slow down. Learn to say “no” and delegate.

TAKE PREVENTIVE MEDICATIONS

If you’re at higher risk for breast cancer, your doctor may recommend medications such as tamoxifen and raloxifene to lower your risk. However, these medications can produce symptoms of menopause, so it’s important to discuss the risks and benefits with your doctor to make an informed decision.

GENETIC TESTING AND INTERVENTION

If you have a strong family history of breast cancer, talk with your doctor about whether genetic testing is right for you. Mutations in certain genes, such as the BRCA genes, increase the risk of breast cancer. Women with this gene mutation may opt for more frequent screenings or prophylactic surgery (breast removal). Removing the ovaries and fallopian tubes is also an option; in addition to reducing the risk of ovarian cancer, it helps prevent breast cancer by eliminating a source of hormones that can fuel some types of the disease.

TAKE CHARGE OF YOUR BREAST HEALTH Mammography is the most effective tool available in diagnosing breast cancer at an early stage. Because many women will have no symptoms, regular annual mammograms are key to detecting the disease in its earliest stages.

Patients at the Houston Methodist Breast Care Center at San Jacinto have Dr. Hannah access to the technological advances Chung provided by 3-D mammography, or digital breast tomosynthesis (DBT).

“DBT separates the layers of the overlapping tissue, which improves the ability to find early cancers, which directly correlates with cancer survival,” said fellowshiptrained breast radiologist Dr. Hannah Chung, director of the Houston Methodist Breast Care Center at San Jacinto. “One potential limitation of a traditional 2-D mammogram is that fibrous tissue can mimic or hide a mass, but with DBT, each layer of the breast is separated. It’s simply a better mammogram and one I would get myself.”

Women seeking mammography services at the Breast Care Center also benefit from Chung’s expertise as a breast imaging specialist. A breast radiologist is specifically trained to interpret imaging studies of the breast. This kind of expertise leads to improved breast cancer detection rates while having fewer false alarms. The end result is a better patient outcome and experience, and an improved chance for survival.

Mammograms Save Lives

Houston Methodist Cancer Center at San Jacinto Breast Oncology Surgeon Dr. Esther Dubrovsky says: Women should have yearly mammograms beginning at Dr. Esther Dubrovsky age 40.

Encourage your friends and family to have them as well.

Being proactive about mammograms can save your life and the lives of your loved ones, too.

Schedule Your 3-D Mammogram

To schedule a mammogram at the Houston Methodist Cancer Center at San Jacinto, visit houstonmethodist.org/breast-care, or call 844.454.PINK (7465).

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QUITTING ON YOUR TERMS T he average smoker tries to quit at least seven times before succeeding. “Many people find quitting so hard because of their body’s physical addiction to nicotine,” said thoracic surgeon Dr. Shawn Tittle, medical director of the Houston Methodist Cancer Center at San Jacinto. “That’s when nicotine replacement therapy, or NRT, can help.”

By replacing cigarettes with alternative sources of Dr. Shawn Tittle low-dose nicotine, you can stop smoking without the worst effects of withdrawal. And studies have found that NRT can increase your chance of quitting by 50 to 70 percent.

Ask your doctor about the nicotine replacement therapy options listed below to make the choice that’s best for you:

PATCH An over-the-counter option, nicotine patches deliver a small, steady amount of nicotine through the skin, and you can use either a 16-hour or 24-hour patch to alleviate withdrawal symptoms.

Some brands offer step-down patches, which have you progress from higher dosages of nicotine to lower dosages over several weeks.

GUM Nicotine gum is a quick-relief, over-the-counter NRT. It’s slowly chewed until the user notices a tingling feeling or peppery taste, at which point the gum is placed between the cheek and gums so the nicotine can be absorbed. Not only is the release of nicotine quicker than patches, but it can also help satisfy the oral urge of smoking.

LOZENGE Available without a prescription, nicotine is slowly absorbed through the mouth as the lozenge dissolves, similar to hard candy. It should take about 20 to 30 minutes for the lozenge to fully dissolve.

INHALER A nicotine inhaler is an NRT that can be obtained with a prescription. It looks like a plastic cigarette holder and comes with nicotine cartridges. You can “puff ” the inhaler over a period of 20 minutes or for just a few minutes at a time.

NASAL SPRAY Nicotine nasal spray is another prescription-only NRT. It immediately relieves withdrawal symptoms by providing nicotine rapidly. Most people are told to use one or two sprays in each nostril once or twice every hour, with at least eight doses per day when first starting.

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Are You a Candidate for Lung Cancer Screening?

We all know that smoking increases your chance of lung cancer. It’s one of the many reasons you’ve tried to quit over the years. As you work with your doctor to successfully beat your nicotine addiction, it’s also a good idea to schedule a lung cancer screening.

The goal of the comprehensive Houston Methodist Lung Cancer Screening Program at San Jacinto is to help high-risk patients receive a diagnosis and treatment plan at an early stage. The program for current and former smokers includes annual low-dose CT scans, consultations with health care providers, access to tobacco cessation programs and referrals to physician specialists if the disease is found. To find out if you’re a candidate for a screening, visit houstonmethodist.org/cancer/lung-cancer/ screening/ or call 832.556.6300.

Irritable Bowel Syndrome:

5 WAYS TO TAKE CONTROL

M

aybe your digestive system is so temperamental you’re afraid to travel.

Or perhaps frequent bloating, cramps and unpredictable bowel movements force you to stay close to a restroom at all times.

If these scenes could be copied from your life, you may have irritable bowel syndrome (IBS).

Often called “spastic colon,” IBS is a Dr. Rashid Khan common intestinal disorder that causes abdominal cramps, diarrhea, gas, bloating and constipation. Although help is available, embarrassment causes many people with IBS to suffer in silence rather than seek treatment.

THE ROOT OF THE PROBLEM

3

Limit spicy foods.

Since large meals often cause cramping and diarrhea, try eating a few small meals throughout the day instead of three large courses.

4

Control tension levels. Because of the brain-bowel connection, high stress levels can trigger IBS symptoms.

To unwind, go for a daily walk, talk with a friend, dust off an old hobby or listen to music.

5

Although antidiarrheals and laxatives may ease symptoms, they are not long-term solutions. Instead, your doctor may prescribe antispasmodics for relief. In severe cases, antidepressant medication may help soothe distress.

“The condition occurs when the delicate interplay among the nerves, hormones and electrical activity that link the bowel and the brain is disrupted,” said Dr. Rashid Khan, a gastroenterologist at Houston Methodist San Jacinto Hospital.

If you never thought about the connection between the brain and the stomach before, just imagine the butterflies you feel before making a speech or the bellyache that might come on during a heated argument.

“In IBS, pain sensors in the colon are more sensitive than normal, causing them to respond strongly to stimuli that don’t affect most people,” Khan said. In short, a breakfast of scrambled eggs and milk can spell disaster for those with the disorder.

WHAT YOU CAN DO

See your physician as soon as symptoms appear. Your physician will know what treatment course is best for you.

And since the signs of IBS may mimic those of a serious disease, it’s important to rule out any underlying disorder.

1

Write down the foods that seem to bring on symptoms and discuss your findings with your doctor. Once you identify the foods that trigger symptoms, scale back your intake. Common culprits are dairy products, caffeine, beans, cabbage, fat and alcohol. Remember that many of the nutrients you need may be in the foods you are avoiding, so be sure to make healthy substitutions.

2

Schedule Today

To schedule an appointment with a gastroenterology specialist with Houston Methodist Gastroenterology Associates, visit houstonmethodist.org/doctor/rashid-khan or call 281.422.7970.

HOUSTONMETHODIST.ORG/SANJACINTO 9

4 DANGERS

HOLIDAY HEART

Choose your indulgences wisely so you don’t fall victim to these health hazards

H

oliday season is fast approaching, and so is an increased risk for heart attack. During November, December and January, more people die from heart attacks than at any other time of the year, according to Duke University researchers. Don’t let the winter take a toll on your heart. Avoid these four seasonal pitfalls:

1

Too much food and too little exercise. “A little indulgence on special occasions is OK, but don’t entirely abandon your healthy lifestyle,” said cardiologist Dr. Nadia Fida, director of the Heart Failure Clinic at Houston Methodist San Jacinto Hospital. Substitute low-fat or nonfat yogurt for mayonnaise in dips and dressings. Replace some of the bread in your stuffing recipe with chopped vegetables. Put on your sneakers and head for the mall to do some holiday speed-shopping.

Dr. Nadia Fida

2

Too much alcohol and smoke exposure. Drinking too much alcohol can raise the level of some fats in the blood and increase the risk of high blood pressure, alcoholism, obesity, stroke, suicide and accidents. More parties during the holidays may mean more exposure to secondhand smoke, which has been linked to cardiovascular-related death and disability.

3

Stress and anxiety. Family conflicts, traveling, shopping, cooking and parties can make it seem impossible to relax, as can worrying about how to pay for everything. “Acute and chronic stress may contribute to high blood pressure, so it’s important to head it off. Relaxation techniques like deep breathing or a yoga class may help,” Fida said. Accept your limits and don’t aim for perfection.

4

Exposure to germs. Crowded malls, school plays, indoor parties and visiting relatives: It’s no surprise that respiratory infections like colds and flu are more common during the winter months. People with heart disease have increased risk for dying of complications from the flu, so get a flu shot! In addition, cut your risk by washing your hands frequently, getting enough sleep and making sure other family members are up to date on their vaccinations. If you do get sick, be cautious if you have high blood pressure and are taking cold medicines. Decongestants can raise your blood pressure.

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Dedicated to Your Heart Health

To schedule an appointment with a Houston Methodist San Jacinto Hospital heart specialist, visit houstonmethodist.org/ heart-vascular/locations/ san-jacinto-baytown or call 281.837.7587.

INTERVENING WHEN YOUR HEART IS AT RISK An interventional cardiologist is a doctor with advanced training in diagnosing and treating cardiovascular disease as well as structural heart conditions through minimally invasive procedures, such as angioplasty and stenting. These procedures use catheters (thin tubes) and small incisions instead of traditional “open” surgery.

Dr. Raghunandan Dr. Raghunandan Muppidi, an Muppidi interventional cardiologist with Houston Methodist DeBakey Cardiology Associates at San Jacinto, provides advanced treatment options in all catheter-based techniques and implantable medical devices, to repair the full spectrum of heart and vascular damage and defects.

Coronary artery disease, which occurs when the arteries of the heart become narrow and harden, and can lead to blockages and blood clots, is one of the most common

conditions he treats. Muppidi said recognizing the presence of risk factors and symptoms is crucial in avoiding a medical emergency, such as a heart attack.

“Angina — chest pains with exertion or after having a meal or after exposure to cold — is the most common symptom associated with coronary artery disease, but symptoms can be quite different from patient to patient,” Muppidi said.

The best strategy to avoiding heart disease is to work on lifestyle modifications, such as: Improving your diet Losing weight Properly managing diabetes Lowering high blood pressure and high cholesterol Treatment options for coronary artery disease include medications to help lower cholesterol levels and high blood pressure and surgery to insert a tiny device called a stent to open blocked arteries.

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MAKING TIME FOR YOUR MAMMOGRAM MAY ADD YEARS TO YOUR LIFE. At Houston Methodist Breast Care Centers, scheduling your mammogram online is an important first step for early detection. It’s easy, and — with eight locations across the Greater Houston area — more convenient than ever.

Our Breast Care Centers offer: • Specially trained breast imaging radiologists • Advanced technology in a spa-like atmosphere HOSPITALS SPECIALTY HOSPITAL EMERGENCY CARE CENTERS IMAGING CENTERS COMPREHENSIVE CARE CENTERS

Just around the corner

• Access to our breast specialists at Houston Methodist Cancer Center Visit houstonmethodist.org/breast-care and schedule your mammogram at a location near you.

Houston Methodist has locations throughout the Greater Houston area to best serve you near your home or workplace.

HOSPITALS

SPECIALTY HOSPITAL

1. Houston Methodist Hospital 2. Houston Methodist San Jacinto Hospital 3. Houston Methodist St. John Hospital 4. Houston Methodist Sugar Land Hospital 5. Houston Methodist The Woodlands Hospital Now Open 6. Houston Methodist West Hospital 7. Houston Methodist Willowbrook Hospital

8. Houston Methodist St. Catherine Hospital

IMAGING CENTERS 9. Houston Methodist Breast Care Center 17. Houston Methodist Imaging Center

COMPREHENSIVE CARE CENTERS 18. Houston Methodist Comprehensive Care Center in Conroe 19. Houston Methodist Comprehensive Care Center in Pearland

EMERGENCY CARE CENTERS

TEXAS MEDICAL CENTER • BAY AREA • BAYTOWN • SUGAR LAND THE WOODLANDS • UPPER KIRBY • WEST HOUSTON • WILLOWBROOK

713.441.ER24 (3724) 9. Houston Methodist Emergency Care Center at Kirby 10. Houston Methodist Emergency Care Center at Voss 11. Houston Methodist Emergency Care Center in Cinco Ranch 12. Houston Methodist Emergency Care Center in Cypress 13. Houston Methodist Emergency Care Center in Pearland 14. Houston Methodist Emergency Care Center in Sienna Plantation 15. Houston Methodist Emergency Care Center in Spring 16. Houston Methodist Emergency Care Center in The Woodlands

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