Leading Medicine Fall 2019, Houston Methodist Sugar Land Hospital edition

LEADING MEDICINE FA LL 219

Your Birth Story Starts Here Get the Facts on Herniated Disks WIN A $100 AMAZON GIFT CARD See inside for details.

Breast Cancer Surgery

A Treatment Plan Designed

JUST FOR YOU YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN FORT BEND AND SURROUNDING COUNTIES

Childbirth Center Tours

Come see our facility and meet our dedicated nursing staff. Tours are offered weekly and depart from the Sweetwater Pavilion Atrium.

Visit houstonmethodist.org/ events or call 281.274.7500 for upcoming dates and times, more information, or to register.

Your Birth Story Starts Here

2  LEADING MEDICINE IN FORT BEND AND SURROUNDING COUNTIES

W

hen you’re expecting a baby, you have a lot on your mind. You might have a checklist of things to do before baby arrives — and let’s face it, you might not get all of those things done! Above all, you want to be confident about your plans for childbirth as your due date gets closer. That’s why it’s so important to know what to expect and the choices you have for creating an optimal childbirth experience for yourself.

Your delivery experience may turn out differently than you expect, but it can still be helpful to write down your preferences for pain management during labor, bonding with baby immediately after delivery and for breastfeeding.

READY FOR THE UNEXPECTED

Whether you’re a first-time or experienced parent, there are always unknowns when you’re welcoming a new baby. Labor could progress faster or slower than you anticipated, or you might change your mind about having an epidural or other pain management options. If baby isn’t in the right position or if other complications occur, you might need a cesarean section (C-section) delivery.

When challenges arise, there’s peace of mind knowing that you and

your baby are in good hands with expert doctors and nurses trained to handle complex cases and specialty care in a neonatal intensive care unit (NICU) which provides round-theclock services for your little one’s special needs.

The birth of a child is a time when families need support — particularly when a newborn has health complications. All of the amenities available at a NICU help your baby continue to grow stronger until the time comes that he or she is ready to go home.

FOCUSED ON YOUR FAMILY

The newly expanded Houston Methodist Childbirth Center at Sugar Land has a family-centered approach, which means mom and baby are cared for together, allowing minimal separation for families. If you choose to breastfeed your baby, you’ll have breastfeeding support from a lactation consultant who will help you get started.

Helping moms feel comfortable is an essential part of a positive labor and delivery experience. Choosing a hospital that’s close to home — and where you feel at home — makes a big difference. Plus, you have your community of family and friends nearby if you need extra support.

CHILDBIRTH CENTER EXPANSION The newly expanded Childbirth Center includes more labor and delivery rooms, antepartum rooms, additional operating rooms for C-sections, dedicated obstetrical (OB) emergency rooms, OB hospitalists, postpartum rooms, expanded level II NICU and well-baby nurseries.

In addition, the expansion brings the hospital one step closer on their journey to opening a level III NICU, which will allow for a level of care that is not yet available in Fort Bend County.

IN GOOD HANDS IN THE NICU Kaelyn and Andrew Bujnoch were calm and confident as they prepared for the arrival of their second baby. “We already knew what to expect, and we couldn’t wait to finally meet our baby,” said Kaelyn, a Houston Methodist Sugar Land Hospital employee.

After having a smooth delivery, what unfolded in the next few minutes was completely unexpected. Their newborn son was having trouble breathing and needed to go to the neonatal intensive care unit (NICU) for further observation.

“Hearing that your baby is going to the NICU is terrifying as a parent,” Kaelyn shared. “The NICU doctor explained our baby had a tiny hole in his lung, making it very difficult for him to breathe. He needed to be on respiratory support with oxygen while the hole healed up on its own.”

During those stressful moments while their newborn was being assessed in the NICU, the nurses stayed by Kaelyn’s side to keep her informed.

“Once I was able to get into a wheelchair, the first thing they did was wheel me over to the NICU,” she said.

“The nurses made sure I was cared for emotionally and physically, which helped me stay strong and focused on my baby,” Kaelyn said. “My nurse, Chelsea, went above and beyond to help us have the best experience possible, even when things didn’t go according to plan.”

For Kaelyn and Andrew, knowing they have a hospital in their community that’s prepared to handle life’s unexpected challenges is a blessing that gives them peace of mind as they watch their two boys grow.

CHECK OUT OUR DIGITAL MAGAZINE AT HOUSTONMETHODIST.ORG/NEWSROOM/NEWSLETTERS 3

Fight the Flu

T

he muscle aches. The fever. The tiredness.

No one likes having the flu. If you do catch the bug, it’s important to know how to care for yourself. It’s also important to learn how the flu virus spreads and how it can be prevented.

Dr. Asisat Ope

FLU BASICS

“The influenza virus, more commonly known as the flu, is contagious and usually spreads through the air, by coughing, sneezing, talking or touching a contaminated surface,” said Dr. Asisat Ope, board-certified primary care physician with Houston Methodist Primary Care Group in Sugar Land.

People who catch the flu have different symptoms, but many complain of a fever, cough, muscle aches, headache and sore throat. Some adults feel better in a week or two, while others, including small children, the elderly and the chronically ill, may have a harder time recovering.

STOP FLU IN ITS TRACKS

COMMUNITY TOY DRIVE AND FLU SHOT CLINIC Date: Saturday, Oct. 12 l Time: 8 a.m. – noon Location: Brazos Pavilion Conference Center Bring a new, unwrapped toy or children’s clothing item in exchange for a free flu shot. Toys and clothing will benefit local children in the Fort Bend area.

Flu shots are for persons age 18 and older, with no history of Guillain-Barré syndrome or rubber latex allergy, and who are not pregnant. No appointments necessary.

Visit events.houstonmethodist.org/flushot-sl for more information or call 281.274.7976 with questions.

4 LEADING MEDICINE IN FORT BEND AND SURROUNDING COUNTIES

You can help guard yourself against the flu. “The best methods are getting a yearly flu vaccination and keeping your immune system healthy,” Ope said.

Get a flu shot. A flu shot can lower your risk of catching the virus. It’s best to get the shot by the end of October, before the flu season reaches its height. A flu shot is especially important for people at high risk for flu complications, including adults age 65 or older, children younger than age 5, pregnant women and those with chronic health problems.

Steer clear of germs. Unfortunately, sick people don’t always keep their germs at home. You can help keep yourself flu-free by washing your hands frequently and following a healthy lifestyle. Carry hand sanitizer with you in case you can’t wash your hands right away after being around those who are showing signs of being sick. You may also want to use disinfecting wipes to wipe down surfaces or shopping carts when you’re out and about.

If you do get the flu, drink plenty of fluids. Your doctor can prescribe antiviral drugs that may make the illness milder and shorten the time you are sick if you go in right away.

Questions?

If you have questions about the flu shot, talk to your doctor. To schedule an appointment with Dr. Asisat Ope or another primary care physician at Houston Methodist Primary Care Group, visit houstonmethodist.org/pcg/southwest or call 832.416.1678.

Is It Diabetes?

Y ou may have no symptoms at first.

When they do appear, they may come on gradually. That’s the danger of diabetes. While the disease may not alert you to its presence early on, it’s doing damage all the same.

According to Dr. Deepshikha Sharda, board-certified family medicine physician with Dr. Deepshikha Houston Methodist Primary Care Group in Sharda Riverstone, “Because of high levels of glucose in the system, people who develop diabetes have a higher risk of developing heart disease; nerve damage in areas, such as the feet and legs; kidney or eye damage; skin or mouth infections; hearing problems; osteoporosis; and Alzheimer’s disease.”

U.S. government estimates put the number of people with diabetes at 30.3 million, of which 7.2 million don’t know they have it. Are you one of those unsuspecting people? Ask yourself two important questions — do you have symptoms of diabetes and are there risk factors present?

SYMPTOMS OF DIABETES

You may experience the following symptoms: Blurry vision Slow-healing sores and Dry, itchy skin bruises Fatigue Tingling or numbness in Frequent urination the hands or feet Increased thirst and hunger Unexplained weight loss Infections of the bladder, gums, skin or vagina If you’re experiencing unusual or multiple symptoms, see your health care provider.

IDENTIFYING RISK FACTORS

“Certain factors make you more likely to develop diabetes,” explained Sharda. Important risk factors for type 2 diabetes are: Being African American, Hispanic American, Native American, Asian American or Pacific Islander Being overweight Giving birth to a baby weighing 9 pounds or more, or having gestational diabetes while pregnant Having a first-degree relative, such as a parent, brother or sister with diabetes Not exercising The exact cause for type 1 diabetes is unknown but possible causes include genetics and exposure to viruses and other environmental factors.

If you haven’t already, discuss your risk factors with your health care provider. To schedule an appointment with Dr. Deepshikha Sharda or another primary care physician with Houston Methodist Primary Care Group, visit houstonmethodist.org/pcg/southwest or call 832.416.1678.

Diabetes Education Seminar

Date: Thursday, Oct. 10 | Time: 6 p.m.

Location: Brazos Pavilion Conference Center If you think you or a loved one might be at risk for developing diabetes, we encourage you to join us for an educational seminar to discuss: Identifying risks Methods of diagnosis Difference between prediabetes, type 1 and type 2 Living with diabetes Register online at events.houstonmethodist.org/ diabetes-sl or call 281.205.4514.

RULING OUT DIABETES To test for diabetes, your health care provider will likely have you take a hemoglobin A1c (HbA1c) blood test, which indicates your average blood sugar level for the past three months. If you have an abnormal reading on two separate tests, you’ll be diagnosed with diabetes. A random blood sugar, fasting blood sugar or oral glucose tolerance test may be ordered if you can’t take the HbA1c test or it’s unavailable.

HOUSTONMETHODIST.ORG/SUGARLAND 5

Breast Cancer Surgery

A Treatment Plan Designed Just for You A Dr. Sandra Templeton

breast cancer diagnosis can stop you in your tracks and leave you wondering: What does this mean for my future?

How will my body change? You may be flooded with emotions about the future, and this is completely natural.

If surgery is part of your treatment plan, you might worry about what you will look like afterward.

Surgery can leave scars, and for those who need to have a significant part of one or both breasts removed, it’s normal to have some anxiety about how your appearance may change.

The psychological impacts of a mastectomy can touch various aspects of your life, from body image and self-confidence to sexuality and intimacy.

Dr. Melissa Crosby

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MORE OPTIONS, BETTER RESULTS

Women undergoing breast surgery have more options with far better results than ever before. “Advances in technology have dramatically improved results for patients undergoing breast cancer surgery and reconstruction,” said Dr. Melissa Crosby, board-certified plastic surgeon with Houston Methodist Sugar Land Hospital.

“You’re in control of your treatment plan, and we work with you to personalize your plan based on your individual characteristics, preferences and expectations,” said Dr. Sandra Templeton, board-certified surgeon with Houston Methodist Breast Surgery Partners at Sugar Land.

NEW BREAST CARE CENTER Houston Methodist Sugar Land Hospital’s new and expanded Breast Care Center offers the area’s most advanced imaging technologies in a calm, comfortable, spa-like environment.

Our specialized breast radiologists and advanced technology can detect breast cancer at its earliest stage even in dense tissue, while using the lowest radiation exposure available.

We also offer evening and Saturday appointments.

Schedule your 3D screening mammogram online at houstonmethodist.org/imaging or call 281.242.PINK (7465).

CONSERVING THE BREAST

Radar and radioactive seeds are used to pinpoint abnormal tissue and preserve healthy breast tissue. “Instead of relying on wire localization, we now use radioactive seeds and radar waves to pinpoint breast cancers while preserving healthy tissue,” Templeton said. For most breast cancers detected early on a mammogram, survival with a breast conserving surgery is the same as mastectomy.

Hidden Scar™ surgery involves making an incision in a discreet location under the breast fold or around the areola, resulting in a scar that is hidden. “Something as simple as hiding a scar can help a woman move forward without having a constant reminder of her breast cancer treatment,” Templeton said.

BREAST RECONSTRUCTION

Women who opt for a mastectomy have a range of options available for breast reconstructive surgery with implants, natural tissue or a combination of both. “Making the right choice is easier when you have a clear understanding of what to expect before and after surgery,” Crosby said.

Surgical options include: I mplant-based reconstruction involves rebuilding the breast using saline or silicone implants. “Options include having implant reconstruction at the same time as mastectomy, in a staged approach or after mastectomy and other treatments are done,” Crosby said.

A utologous or flap reconstruction uses tissue from another area of the body to reconstruct the breast, making it appear and feel natural. This procedure involves moving tissue, often from the abdomen, to the chest and reattaching the arteries and veins in the area. “Flap reconstruction may be a good option for women who want a natural-feeling breast and have enough tissue available to use for breast reconstruction,” Crosby explained.

CHOOSING WHAT’S RIGHT FOR YOU

When weighing your options, your doctor can help you make an informed decision based on facts, not fears. Together, you can review the factors that will impact your choices: P hysical characteristics — age, your overall health, breast size, breast density, the size and location of your breast cancer and the amount of tissue available for reconstruction.

P ersonal preferences — aesthetic goals, such as how you want your breasts to look and feel, symmetry and breast reduction options.

L ogistical factors — timing of surgery, additional cancer treatments, having a support system and returning to work.

Recovery time is an important factor if you need to get back to your life faster and have fewer restrictions. In those cases, breast conserving surgery may be a good option, especially for older women and those whose health can make recovery difficult.

Breast cancer surgery and reconstructive surgery can be performed at the same time or separately. Your treatment plan can be designed so you can keep living your life.

FACTORS TO CONSIDER WHEN CHOOSING BREAST RECONSTRUCTION Newly diagnosed breast cancer patients often feel like it’s an emergency and they need to be in the operating room as fast as possible. “That’s not usually the case, and it’s OK to take your time to absorb the information before making a decision,” said Dr. Sandra Templeton.

If you’ve decided to proceed with breast reconstruction, there are factors to discuss with your doctor to help determine what type of reconstruction is best for you. Here are some factors to consider: Overall health, including conditions that could affect healing Size and location of your breast cancer Breast size Whether you will need treatments other than surgery for your cancer Amount of tissue available for reconstruction Whether you want reconstructive surgery on one or both breasts Desire to match the look of the unaffected breast How quickly you want to be able to recover from surgery Willingness to have potentially more than one surgery as part of the reconstruction Insurance coverage and related costs for the unaffected breast To schedule an appointment with Dr. Sandra Templeton, call 281.494.3000.

Source: American Cancer Society

Take Control of Your Treatment

Rely on our expertise to help you personalize your breast cancer treatment to fit your life. Visit houstonmethodist.org/breast to learn more or call 281.205.4514 to find a surgeon in your area.

HOUSTONMETHODIST.ORG/SUGARLAND 7

Get the Facts on Herniated Disks

Y

ou pick up a package on your doorstep — and you’re surprised by how heavy it is — but you manage it anyway. The next thing you know, the dull ache in your lower back suddenly turns into a sharp pain running down the back of your leg.

Could it be a herniated disk?

The spinal column consists of vertebrae Dr. Karl separated by softer, cushiony disks. A herniated Vega-Lelkes disk occurs when that softer material slips outside the vertebral column and presses against nerves causing pain.

“Disk pain is often the result of a gradual, age-related wear and tear called disk degeneration,” explained Dr. Karl Vega-Lelkes, board-certified orthopedic spine surgeon at Houston Methodist Neuroscience & Spine Center at Sugar Land. “A herniated disk in the lumbar or lower back is common, but disks in the neck can also slip or herniate. The thoracic or mid-back disks are rarely affected.”

Symptoms of a herniated disk include: Arm or leg pain, depending on the location of the affected disk, can radiate from the buttock to the foot or through the shoulder and arm Numbness or tingling can occur in the limb that is served by the nerve the disk is pressing against Weakness can occur in the muscles served by the affected nerve, causing you to stumble or have difficulty lifting or holding items

NONSURGICAL TREATMENT

“Treatment varies based on your overall health, age, activity level and severity of the symptoms. Initially a short period of rest and pain medications, such as anti-inflammatory drugs or painkillers, may be followed by physical therapy,” explained Vega-Lelkes.

Taking into consideration your condition, physical therapists may combine exercise with: Bracing of the neck or lower back Electrical stimulation Heat or ice treatment Traction (a mechanism to pull a vertebrae back in place and hold it there) As the pain improves, they will teach you core-strengthening exercises to help avoid a recurrence. Generally most people’s symptoms improve within a month of nonsurgical treatment.

“If physical therapy doesn’t relieve the pain, steroid injections may help control the pain,” Vega-Lelkes added. These injections, given in the doctor’s office, reduce swelling around the disk to

8 LEADING MEDICINE IN FORT BEND AND SURROUNDING COUNTIES

relieve symptoms. Your doctor may use X-ray or fluoroscopy to locate where the injection is needed.

SURGICAL TREATMENT

“For the patients whose symptoms do not subside with other treatments, surgery may be necessary,” Vega-Lelkes said.

Your doctor may recommend surgery if: Symptoms haven’t improved after six weeks of nonsurgical treatment A disk fragment lodges in your spinal canal and presses on a nerve, causing progressive weakness You have difficulty performing basic activities, such as standing or walking In most cases, the surgeon removes the protruding section of the disk. Rarely, the entire disk must be removed and the vertebrae fused with metal hardware to stabilize the spine.

Your surgeon could also suggest implanting an artificial disk.

WATCH FOR EMERGENCY WARNING SIGNS Sometimes low back pain can be a sign of something more serious. Seek medical attention right away if you experience: Back pain that does not go away Changes in bladder or bowel function Numbness, loss of movement or weakness

We’ve Got Your Back

If back pain has sidelined you from daily activities, our spine specialists can put you back in the game. To schedule an appointment with Dr. Karl Vega-Lelkes or another specialist at the Houston Methodist Neuroscience & Spine Center, visit houstonmethodist.org/neuro-sl or call 281.205.4662.

SPINE CONDITIONS WE TREAT Our specialists provide innovative, minimally invasive treatment options. We treat a range of injuries and degenerative problems of the back, neck and spine, including: Herniated disks Low back pain Neck pain Neuropathic pain Sciatica Spinal congenital deformity Spinal stenosis Spinal tumors

HOUSTONMETHODIST.ORG/SUGARLAND  9

Should I Be Screened for Prostate Cancer?

P Dr. Laura Martinez

Dr. Neel Srikishen

rostate cancer is the second most commonly diagnosed cancer in American men, but screening for prostate cancer may or may not be right for all men. It’s important to consider your personal risk factors, age, health and the reasons for testing when thinking about whether or not to have prostate cancer screening done as there are pros and cons of each approach. It’s also important to note that most prostate cancers are found before ever causing

any symptoms.

“Prostate cancer can be a slow-growing cancer that, for some men, will never cause symptoms or threaten their health,” explained Dr. Neel Srikishen, boardcertified urologist with Houston Methodist Urology Associates at Sugar Land.

“However, in cases when prostate cancer is aggressive and fast growing, making the diagnosis and getting the recommended course of treatment started right away is essential.”

WHO’S AT RISK?

Risk factors for prostate cancer include: Age. The older you are, the greater your risk of prostate cancer. Before age 40, the chance of having prostate cancer is rare. Most cases are found in men age 65 and older.

Family history. If a close family member, such as a father, brother or son, was diagnosed with prostate cancer before turning 65, you have a higher-than-average risk of prostate cancer. If more than one close family member was diagnosed, your risk is even greater.

Race. The risk of developing and dying of prostate cancer is higher for African American men than any other race.

SCREENING TESTS

Two tests are commonly used to screen for prostate cancer: Digital rectal exam (DRE). The doctor inserts a gloved, lubricated finger into the rectum to feel the prostate for any abnormalities in terms of texture, shape, size and/or presence of any lumps or nodules.

Prostate specific antigen (PSA) blood test. A blood sample is drawn and analyzed for PSA, which is made only by the prostate. Higher levels of PSA can indicate prostate cancer or noncancerous conditions, such as prostate enlargement, infection or inflammation.

TALK TO YOUR DOCTOR ABOUT SCREENING

“It is recommended that men starting at age 50 be informed about the risks and benefits of screening before making their own decision,” said Dr. Laura Martinez, board-certified urologist with Houston Methodist Urology Associates at Sugar Land. “High-risk and very high-risk men may consider screening even sooner after having an informed discussion with their doctor.”

If you do have concerning symptoms, regardless of your age, you should see your doctor for evaluation. Symptoms of prostate cancer can include difficulty urinating, a decreased flow of the urine stream, more frequent urges to urinate and/or blood in urine or semen.

If you’re concerned about prostate cancer, make an appointment with your doctor to discuss your risks and whether prostate cancer screening may be right for you. To schedule an appointment with Dr. Neel Srikishen or Dr. Laura Martinez, call 281.746.6611.

10 LEADING MEDICINE IN FORT BEND AND SURROUNDING COUNTIES

UROLOGY HEALTH SEMINAR Date: Thursday, Sept. 12 | Time: 6 p.m.

Location: Brazos Pavilion Conference Center If you are struggling with urology health issues, join us as two of our leading specialists discuss urinary incontinence and prostate cancer: S igns and symptoms R isk factors S creening tests T reatment options REGISTRATION REQUIRED Visit events.houstonmethodist.org/ urology-sl or call 281.205.4514.

Time for a Joint Replacement?

10 Signs You Need a Hip or Knee Replacement

J

oint discomfort can put a damper on your day-to-day activities. Basic movements, such as walking up and down a flight of stairs or sitting in a low chair can become obstacles. Plus, you may feel discouraged when you’re unable to participate in your favorite sports or activities. Hip or knee replacement surgery can offer pain relief, better mobility Dr. Mark Maffet and an improved quality of life — but is it right for you?

WEAR-AND-TEAR ON JOINTS

“The natural cushioning in your joints can wear out over time or due to injuries, and the experience can be excruciating,” said Dr. Mark Maffet, board-certified orthopedic surgeon with Houston Methodist Orthopedics & Sports Medicine at Sugar Land. “With joint replacement surgery, an orthopedic surgeon removes the damaged joint surfaces and replaces them with an artificial joint made of plastic or metal parts.”

Here are 10 signs that it might be time to consider joint replacement surgery: 1. Frequent or intense joint pain with activity 2. Difficulty walking, sitting down or standing up 3. Suffering with pain while at rest (day or night), or pain that interferes with sleep 4. Inflammation, stiffness and swelling in the joint 5. Symptoms have been long-lasting or progressively getting worse 6. Tests show that osteoarthritis is causing wear-and-tear damage to your joints 7. Rest and medications to reduce inflammation hasn’t worked 8. Steroid injections and medications no longer provide adequate pain relief 9. Suffering side effects from pain medications 10. Joint pain is taking a toll both physically and mentally

OTHER FACTORS TO CONSIDER

If pain is interfering with your daily life and your symptoms haven’t responded to nonsurgical treatments, surgery may be recommended as a next step. “Your age, the condition of your joints and other health factors are also taken into consideration when evaluating you as a candidate for joint replacement surgery,” Maffet said.

Having a hip or knee replacement can change your life, but it’s not something you want to rush into. The timing is important, because planning for joint replacement surgery requires thinking

JOINT PAIN SEMINAR Date: Tuesday, Sept. 17 l Time: 6 p.m.

Location: Brazos Pavilion Conference Center Is chronic joint pain slowing you down?

Dr. Michael Kent and Dr. Thomas Rivers, boardcertified orthopedic surgeons with Houston Methodist Orthopedics & Sports Medicine at Sugar Land, will discuss the latest medical advances to help keep you moving and doing the things you love.

To register, visit events.houstonmethodist.org/ jointpain-sl or call 281.205.4514.

Considering Joint Replacement Surgery?

To schedule an appointment with Dr. Mark Maffet or another joint specialist at Houston Methodist Orthopedics & Sports Medicine at Sugar Land, visit houstonmethodist.org/orthopedics-sl or call 281.690.4678. about how your recovery may affect your ability to work or perform tasks at home. To achieve your best recovery, you’ll need to follow through on your doctor’s instructions and do daily exercises as part of a rehabilitation program.

HOUSTONMETHODIST.ORG/SUGARLAND 11

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The expertise to

KEEP YOU MOVING At Houston Methodist Orthopedics & Sports Medicine in Sugar Land, we know every movement matters. Our specialists offer: • The latest imaging and technology • Advanced nonsurgical treatments • Minimally invasive procedures

• Customized treatment plans • State-of-the-art physical and occupational therapy

Whether you’re suffering from simple aches and pains or dealing with a complex injury, we can get you back on your feet — and keep you moving.

Long Meadow Farms Sugar Land

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Schedule an appointment: houstonmethodist.org/sportsmed | 281.201.0396

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