Leading Medicine Spring 2016, Houston Methodist Hospital edition

LEADING MEDICINE SP RING 06

DON'T FALL FOR THESE WORKS OF FICTION

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SIGNS IT’S TIME FOR JOINT REPLACEMENT

Why You’re Not Getting the Sleep You Need

YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS FROM HOUSTON METHODIST

HEALTH BREAK

HOUSTON METHODIST HOSPITAL RECEIVES NATIONAL AWARD Diane (right), who donated her kidney to someone she’d never met, with her sister, Suzy (left)

GIVE THE GIFT OF LIFE! APRIL IS NATIONAL DONATE LIFE MONTH

This April, people and organizations across the country will celebrate the incredible generosity of organ donors as part of National Donate Life Month.

Dr. A. Osama Gaber, director of Houston Methodist J.C. Walter Jr. Transplant Center, says he hopes individuals will take the time to learn more about living organ donation, and consider becoming a living donor or registering to become a donor after their death.

Diane, of Austin, Texas, decided to become a living donor after she read an article about a couple who had both donated a kidney in honor of their child with special needs. “I had reached a point in my life where giving back was very important,” she recalled. “And I thought, ‘Wow, maybe I could do that, too.’ ” In November 2014, Diane donated her kidney to someone she’d never met: Dolly, a grandmother of five who had been battling kidney disease for 40 years.

“Stories like these highlight the tremendous impact of this generous and selfless gift,” Gaber said.

Give the Gift of Life

To learn more about living donation or to register to become a living donor, visit houstonmethodist.org/living-donor-center or call 713.441.5451.

2 LEADING MEDICINE FROM HOUSTON METHODIST

For the second consecutive year, University HealthSystem Consortium (UHC), an alliance of the nation’s leading academic medical centers, has selected Houston Methodist Hospital as one of 13 recipients of its 2015 Bernard A. Birnbaum, MD, Quality Leadership Award for high performance in quality and safety.

The award is given to academic medical centers that have demonstrated outstanding performance as measured by the UHC Quality and Accountability Study, which has been conducted annually since 2005.

This year, 102 institutions were included in the study. Houston Methodist Hospital ranked No. 8. Below are four key stats.

BY THE NUMBERS

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Houston Methodist has received this award for two consecutive years.

Houston Methodist has appeared in UHC’s top group four times. here were six criteria used T in the study: safety, timelines, effectiveness, efficiency, equity and patient centeredness.

Houston Methodist Hospital ranked No. 8 among 102 national peer hospitals.

Why You’re Not Getting

THE SLEEP YOU NEED Take our quiz to see if sleep apnea could be affecting your ZZZs 1. DO YOU OFTEN WAKE UP EXHAUSTED EVEN AFTER A FULL NIGHT’S SLEEP?

❏ Yes ❏ No If you answered yes, you could be suffering from sleep apnea, a common disorder in which you stop breathing one or more times while sleeping. These pauses in your breathing may last up to a few minutes, and can happen as often as 30 times per hour, causing you to move out of deep sleep. And without some solid hours of deep sleep under your belt each night, you may find yourself nodding off at your desk during the day.

“We know that not getting enough sleep can impact a person’s entire life, including their mental and physical well-being,” said Dr. Clinton Doerr, a pulmonologist at the Houston Methodist Lung Center. “If you’re tired all the time, you will have a hard time focusing at work and at home, so it’s important to find out the cause.”

2. DOES YOUR SPOUSE COMPLAIN ABOUT YOUR SNORING?

❏ Yes ❏ No While not all people who snore have sleep apnea, it is one of the most common symptoms of the disorder and can be a sign that you’re not breathing well while sleeping. Sleep apnea snoring usually includes occasional pauses followed by choking or gasping sounds, and it may be worse when you’re on your back.

3. DO YOU HAVE A FEW POUNDS TO LOSE?

❏ Yes ❏ No Sleep apnea is more common in people who are overweight, and it can be a double-edged sword — being overweight can cause sleep apnea, and sleep apnea can contribute to weight gain. As fat builds in the throat, airway obstruction becomes more likely, making it more difficult to breathe.

And when your quality of sleep is poor, you may experience hormonal changes that make you hungrier and increase the risk of weight gain.

PHOTO BY THINKSTOCK

4. ARE YOUR MOODS ALL OVER THE MAP?

❏ Yes ❏ No Daytime sleepiness isn’t the only symptom of sleep apnea. If you feel extra irritable or depressed, or find yourself waking up in the morning with a headache and dry mouth, talk to your doctor. n

NOW OPEN:

NEW LUNG CENTER AT HOUSTON METHODIST HOSPITAL The Houston Methodist Lung Center offers one-stop access to expert diagnosis and management for all diseases that affect the lungs — from the most common to the most complex breathing and respiratory conditions. Our team of specialized doctors and surgeons employs a collaborative approach, ensuring that you receive the utmost in personalized care based on your unique needs. We specialize in the following conditions: Asthma Bronchiectasis Chronic obstructive pulmonary disease (COPD) Chronic blood clots to the lung Emphysema Lung cancer, including pulmonary nodules Lung transplant Occupational lung diseases Pulmonary fibrosis Pulmonary hypertension Sleep disorders Strictures and masses in the airways Location: Houston Methodist Outpatient Center 6445 Main St., 22nd Floor Houston, TX 77030 Hours: Monday – Friday, 8 a.m. – 4 p.m.

Breathe Easier

For more information on the Houston Methodist Lung Center or to schedule an appointment, call 713.441.7779 or visit houstonmethodist.org/ lung-center.

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

Women’s Health

MYTHS Don’t fall for these works of fiction

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MYTH #

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NOTHING CAN BE DONE ABOUT URINARY INCONTINENCE.

FACT: While the condition is common, you don’t have to live with it.

Urinary incontinence, which is the involuntary leakage of urine, has a number of treatment options. “Patients may benefit from behavior modification techniques, physical therapy, medication or surgical procedures depending on the type of urinary incontinence and their symptoms,” said Muir.

Some people also believe that urinary incontinence can occur only after a vaginal delivery or when you are older. But whether you gave birth through a vaginal delivery or a cesarean section, you might experience urinary incontinence. Talk to your doctor about what you can do.

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MYTH #

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MOST BREAST CANCER IS HEREDITARY.

FACT: Only 5 to 10 percent of breast cancers are hereditary.

Even so, it’s certainly useful to recognize if breast cancer runs in your family. After all, “if a woman does have an affected gene for breast cancer, she has a 40 to 80 percent chance of having breast cancer in her lifetime,” said Dempsey.

Whether you have a genetic risk or not, you have control over factors such as exercising, limiting alcohol intake, maintaining a healthy weight, breastfeeding, and limiting use of combined hormone replacement therapy after menopause, Dempsey explains.

But the biggest risk factors for breast cancer are two things you can’t do anything about: being a woman and getting older. So make sure

PHOTO BY THINKSTOCK

here’s a lot of misinformation about women’s health out there, making it difficult to know what’s true. So we asked a panel of experts to weigh in on some of the biggest misconceptions. Here, from Houston Methodist Hospital, Dr. Tristi Muir, a urogynecologist; Kate Dempsey, a genetic counselor; and Dr. M. Kathleen Borchardt, an obstetriciangynecologist, help us separate fact from fiction.

you talk to your doctor about your situation and the best age to begin screening mammograms.

MYTH #

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WOMEN DON’T HAVE TO WORRY ABOUT HEART DISEASE.

FACT: Heart disease is the leading killer of women.

It’s especially important for women to know the signs of a heart attack because they are more likely to have more subtle symptoms, such as jaw pain (instead of the classic chest pain), increased shortness of breath, nausea or vomiting, or extreme fatigue.

Plus, you need to understand your personal risk for heart disease and have your blood pressure, cholesterol and blood sugar levels checked regularly.

And as women get older, they should consider seeing an internist or a primary care provider in addition to their OB-GYN, recommends Borchardt.

“Medicine is becoming more specialized, and because of this, gone are the days when one doctor can manage all of your different needs,” she said. “Make sure you’re getting the specialized care you need. If you have cardiac risk factors, you want to make sure you have a doctor who can follow you and work with you to prevent a major cardiac event such as a heart attack.”

IF YOU’RE DONE MYTH HAVING CHILDREN, # 4 YOU DON’T NEED AN ANNUAL WELLWOMAN EXAM.

FACT: These annual exams are potentially even more important as you get older.

“Yearly exams are designed to help catch things early,” said Borchardt. “As a woman ages, her risk for female cancers (breast, uterine, ovarian, cervical and

Your Needs Are Unique

Houston Methodist Hospital offers comprehensive care to keep you healthy from head to toe. For a physician referral, visit houstonmethodist.org/womens-services or call 713.790.3333.

UNDERSTANDING GYNECOLOGIC CANCERS You’ve heard it time and time again: Listen to your body. That’s because it’s true. Symptoms, such as abnormal bleeding or pain, are trying to tell you something. They could signal something harmless and easy to treat, but they can also be signs of cancer. Our chart highlights a few women’s cancers and the symptoms to watch for.

Symptoms

Cervical Cancer

vaginal) also increases. We do the exam to check for signs and symptoms.”

Menstrual irregularities, which are important to review with your doctor yearly, can signal other health issues, she notes.

And don’t confuse the well-woman exam with a Pap test. While a Pap test might not be necessary every year, the well-woman exam remains important.

MYTH #

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CALCIUM ALONE WILL KEEP YOUR BONES STRONG.

FACT: Calcium is important, yes, but vitamin D and lifestyle choices are also essential.

“Women reach their peak bone mass by their 30s, and bone mass drops significantly the year leading up to menopause,” said Borchardt. “So it’s important not to wait until after menopause to worry about your bone health.”

Doing regular weight-bearing exercise, such as walking, jogging, hiking and weight training, and not smoking are key to having strong bones. So is making sure you’re getting enough calcium and vitamin D. Premenopausal women need 1,000 milligrams of calcium daily, and postmenopausal women, 1,200 milligrams — preferably through diet.

And 800 IU is a good daily goal for vitamin D, Borchardt recommends. n

Ovarian Cancer

Uterine Cancer

Vaginal Cancer

Vaginal bleeding or discharge that isn’t normal for you Pelvic pain Back pain Bloating A change in bathroom habits (increased frequency or urgency with urination or constipation or diarrhea)

HOUSTONMETHODIST.ORG 5

Is It Time?

We break down the top four signs it might be time for a joint replacement

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ches and pains are all just a part of getting older, right? Not necessarily.

Dr. Stephen Incavo, section chief of adult reconstructive surgery at Houston Methodist Hospital, specializes in joint procedures and says there are some tell-tale signs that you might need a joint replacement.

Read on to find out if it’s time to talk to your doctor about upgrading your treatment options.

SIGN #1: JOINT PAIN HAS STARTED AFFECTING YOUR QUALITY OF LIFE.

When the pain in your knee, hip or shoulder becomes so bad that it limits everyday activities like walking, bending, climbing stairs, raising your arm and getting in and out of a chair, it could be time to seek help. Also, if the pain continues even when you’re resting or sitting down, or wakes you up at night, go ahead and call in the pros.

SIGN #2: YOU’VE TRIED OTHER TREATMENTS BUT NOTHING SEEMS TO HELP.

Ibuprofen can only do so much. The same can be true for prescription medications, cortisone injections and physical therapy. For some people, these treatments can effectively delay joint replacement, but for others, relieving the pain from osteoarthritis may require exploring surgical options.

“Some patients wait too long after nonsurgical options stop helping to come back in,” said Incavo.

SIGN #3: YOU’VE LOST THE WEIGHT, BUT YOU’RE STILL IN PAIN.

Ready to Discuss Joint Replacement?

Schedule an appointment with one of our joint specialists at houstonmethodist.org/ orthopedics or call 713.790.3333.

Every extra pound you carry around puts an extra four pounds of pressure on your knees, according to the Arthritis Foundation, so it’s a no-brainer that losing excess weight can help relieve joint pain. But if you find that you’re still suffering, it may be time to consider surgery.

SIGN #4: JOINT PAIN IS AFFECTING YOUR PERFORMANCE AT WORK.

Most jobs require some movement throughout the day. Joint pain can make standing or bending down seem nearly impossible. If joint pain is making daily tasks difficult, consult a physician about the possibility of joint replacement surgery. n

PHOTO BY THINKSTOCK

6 LEADING MEDICINE FROM HOUSTON METHODIST

GOOD REASONS Why you shouldn’t put off your colonoscopy any longer

SYMPTOMS TO WATCH FOR

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Screening is important because early stages of colon cancer do not often cause symptoms. As it advances, the disease may cause these symptoms:

ou’ve already thought up plenty of reasons not to have a colonoscopy, but have you considered all the reasons you should do it? Here, we explore four of the most important ones.

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COLONOSCOPY SAVES LIVES.

PHOTO BY THINKSTOCK

“There is compelling evidence that colonoscopy has reduced the colon cancer mortality rate as the fall in colon cancer deaths coincides nicely with how long we’ve been doing screenings,” said Dr. Eamonn M. Quigley, chief of the Division of Gastroenterology and Hepatology at Houston Methodist Lynda K. and David M. Underwood Center for Digestive Disorders. “It may be one of the most effective prevention tools and screenings that we have in medicine.”

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IT ACTUALLY PREVENTS CANCER.

Colonoscopy is the only screening that not only detects cancer, but also prevents it.

“Most colon cancers start out as polyps, small growths inside the

colon,” said Quigley. “The key to cancer prevention is to remove the polyps before they become malignant, which we can do during colonoscopy.”

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ONE TEST WILL LAST YOU 10 YEARS.

Unlike other cancer screenings that you must repeat annually or biannually, you only need a colonoscopy every 10 years.

“The general population should begin colon cancer screening at age 50,” said Quigley. “The frequency is dependent on the screening’s findings. But if you have no risk factors and normal colonoscopy results, you only need to repeat it every 10 years.”

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IT’S NOT THAT BAD.

True, before the procedure you’ll need to do some prep in order to completely empty your bowels.

But once you get to the examination room, the colonoscopy itself is a breeze.

“The procedure takes only about 20 to 40 minutes,” said Quigley. “You’ll be given some level of sedation and should be comfortable throughout the entire process.” n

Rectal bleeding Bloody stools Dark or black stools Cramping in the lower abdomen n urge to move the bowels even A when they are empty ong-lasting constipation or L diarrhea (more than a few days) Decreased appetite Unexplained weight loss

No More Excuses

Make your colonoscopy appointment today. For a physician referral, visit houstonmethodist.org/ gastroenterology or call 713.790.3333.

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713.790.3333

LEADING MEDICINE IN GREATER HOUSTON HOSPITALS

Just around the corner

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Houston Methodist has locations throughout the Greater Houston area to best serve you near your home or workplace. Our locations include hospitals, and emergency care and imaging centers.

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2. Houston Methodist San Jacinto Hospital 3. Houston Methodist St. John Hospital . Houston Methodist Sugar Land Hospital

6. Houston Methodist West Hospital 7. Houston Methodist Willowbrook Hospital

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HOSPITALS

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5. Houston Methodist The Woodlands Hospital Opening in 2017

. Houston Methodist St. Catherine Hospital

SPECIALTY HOSPITALS EMERGENCY CARE CENTERS IMAGING CENTERS

EMERGENCY CARE CENTERS 713.441.ER24 (3724)

. Houston Methodist Kirby Emergency Care Center

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0. Houston Methodist Pearland Emergency Care Center . Houston Methodist Sienna Plantation Emergency Care Center 2. Houston Methodist Voss Emergency Care Center

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3. Houston Methodist Cinco Ranch Emergency Care Center NOW OPEN! . Houston Methodist Cypress Emergency Care Center NOW OPEN! 5. Houston Methodist Spring Emergency Care Center NOW OPEN!

IMAGING CENTERS 5. Houston Methodist Breast Care Center at The Woodlands

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. Houston Methodist Breast Care Center 6. Houston Methodist Imaging Center

For more information about Houston Methodist or for a physician referral, please visit houstonmethodist.org or call 713.790.3333.

LEARN MORE about our complimentary concierge services for out-of-town patients at houstonmethodist.org/usa or 877.790.DOCS (3627). facebook.com/houstonmethodist

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Taking care of the entire family With locations throughout Greater Houston, Houston Methodist Primary Care Group is dedicated to providing care for the entire family and proud to ensure efficient access to specialty and hospital services whenever the need arises.

To schedule an appointment, visit houstonmethodist.org or call 713.790.3333.

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