Leading Medicine Winter 2015, Houston Methodist Hospital edition

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

W INT ER 2015

THE HEART TRUTH

A guide to your heart and the procedure that can keep it beating strong

Keep Your New Year’s Resolution

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Addressing Alzheimer’s

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HEALTH BREAK

A LIFESAVING, ‘BLOODLESS’ CANCER TREATMENT Deanna Crigler, a 33-year-old hairstylist, had never really been sick. Toward the end of 2013, however, she was experiencing fatigue that she assumed to be the result of allergies. By January, when she could barely get out of Deanna Crigler bed and struggled even to breathe, it was clear she was suffering from something much worse. She went to her doctor in Mobile, Ala., where she was eventually diagnosed with leukemia.

Doctors in Mobile told her that she would die unless she received a blood transfusion — but because she is a Jehovah’s Witness, Crigler’s religious beliefs do not allow for treatment that involves receiving blood. Crigler then heard through Houston Methodist USA Patient Services about Dr. Kirk Heyne,

a Houston Methodist oncologist who could provide a “bloodless” treatment. Crigler was admitted to Houston Methodist Hospital in April.

“We began a blood conservation protocol involving the stimulation of erythropoietin, a natural hormone produced in the kidneys that interacts with bone marrow to stimulate the generation of red blood cells,” said Heyne. “She was also given folic acid, B12 and iron, along with half-doses of chemotherapy. Within a couple of weeks, we were pleased to see positive results.”

Crigler stayed in the hospital for two months before going home to Mobile. “Everything happened so fast,” she said. “I am just grateful Dr. Heyne could respect my beliefs and still provide such effective treatment.”

Crigler is now in remission and will return to Houston periodically for checkups.

Care for Patients from Around the World

Houston Methodist Hospital is privileged to treat thousands of patients from across the United States and more than 90 countries. To learn more about the special services we offer patients from outside of Houston, visit houstonmethodist.org/ usa or call 877.790.3627 (for domestic patients) and houstonmethodist. org/global or +1.713.441.2340 (for international patients).

Houston Methodist Expands to The Woodlands

The new hospital, which will be the eighth in the Houston Methodist system, will offer The Woodlands community a full-service, acute care hospital that will deliver the level of service and care for which Houston Methodist is known.

Visit houstonmethodist.org/hm-expansion or call 713.790.3333 to learn more.

PHOTO BY THINKSTOCK

Houston Methodist will build a 193-bed hospital in The Woodlands at the intersection of TX 242 and I-45. Groundbreaking for the 470,000-square-foot facility began in October, with completion of the hospital expected in 2017. The project also includes construction of a 135,000-square-foot medical office building scheduled to open in late 2015.

“Houston Methodist has served the greater Houston community for almost 100 years,” said Dr. Marc Boom, president and CEO of Houston Methodist.

“We are excited to bring our long history of leading medicine and excellent patient care to the residents of The Woodlands.”

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Winning at Losing Tips to keep your weight loss resolution on track

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nly a few weeks after resolving to lose weight, you’re back in front of the TV, spoon in a bowl of ice cream, ignoring the dusty exercise bike in the corner.

Countless other would-be dieters join you in similar difficulties.

Losing weight consistently tops lists of New Year’s resolutions. Just as consistently, about 35 percent of people who make resolutions break them by Jan. 31, one survey found.

More disheartening, only 20 percent of dieters succeed at long-term weight loss, according to the National Weight Control Registry.

Mimicking the habits of the 20 percent could move you into that exclusive group. Here’s a look at how to be a successful loser.

1

KEEP IT POSITIVE

Think about the healthful behaviors you intend to create, not the bad ones you wish to break. Take a simple activity you already do daily and create a new habit to accompany it.

For example, you might do five minutes of stretches immediately after waking up or eat a handful of baby carrots after taking your daily multivitamin.

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SET YOURSELF UP FOR SUCCESS

Put your plan and your reasons for it in writing. Create modest, shortterm goals, such as skipping fast food one day a week or taking one flight of stairs at work.

Prepare for success by stocking the kitchen with healthful, easy-to-prepare

PHOTO BY THINKSTOCK

Start Your Weight Loss Journey

Houston Methodist Weight Management Center knows weight loss is difficult, but we can help you. To learn more, visit houstonmethodist.org/weight-loss or call 832.667.LOSE (5673).

JOIN US for one of our We ight Management Open House Events

Visit houston methodist.org / wmc-events to find one near you.

foods; keeping apples and nuts at hand to ward off snack attacks; and repackaging food into single servings.

Allow for an occasional treat, preferably planned, served in a single portion on a plate and savored one leisurely bite at a time.

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EXAMINE WHAT WORKS

The National Weight Control Registry is a database of more than 10,000 adults who have lost at least 30 pounds and maintained the loss for at least one year.

Participants keep food diaries, stick to their diet even on weekends and get back on track quickly when their weight edges up.

Other winning habits include: • 90 percent exercise an average of one hour daily.

• 78 percent eat breakfast every day.

• 75 percent weigh themselves at least once a week.

• 62 percent watch fewer than 10 hours of TV a week (the average American watches 28 hours a week). ■

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

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FREE

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HEART SCREENIN

st is offering Houston Methodi ing events free heart screen reater Houston throughout the G r one near you, area. To register fo hodist.org/ visit houstonmet or call heartscreenings 713.790.3333.

The Heart Truth

A guide to conditions that can prevent your heart from beating strong the heart. If the heart can’t get the oxygen and nutrients it needs, it struggles to function properly. Worse yet, plaque can break loose and form a clot, causing a heart attack when the blood supply is cut off.

The best way to beat coronary artery disease? Never get it in the first place. You can do that by managing risk factors: Reduce high blood pressure or cholesterol levels, quit smoking, lose weight if overweight or obese, and lead an active lifestyle.

“The combination of living healthier, your blood pressure and cholesterol numbers and taking medication if you need to is the formula for prevention,” Quiñones said.

Here, we take a closer look at how the heart works and what has the potential to harm it. ■

Heart

BASICS 1

The pulmonary artery carries blood out to the lungs, where it is oxygenated.

2

The pulmonary veins transport the oxygen-rich blood back to the heart.

3

The aorta then distributes this oxygenated blood to the rest of the body.

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Once depleted of oxygen, blood returns to the heart and the process restarts.

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ILLUSTRATION BY JUDE BUFFUM

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hink of your heart as your body’s delivery system. It pumps out the good stuff — oxygenated and nutrient-rich blood — to every inch of you via a network of arteries.

But heart disease throws a wrench into things. The most common form, coronary heart disease, is “the No. 1 cause of death for both men and women in most countries,” said Dr. Miguel A. Quiñones, chairman of the Department of Cardiology at Houston Methodist.

Coronary artery disease starts with artery damage caused by smoking, high blood pressure or a number of other factors. The damage triggers the buildup of plaque, which narrows the arteries and limits blood flow to

When it comes to the arteries, the aorta is the big cheese. This main artery is responsible for carrying most of the blood to the body. In a condition called aortic stenosis, calcium deposits can build up in the aortic valve, causing it to narrow and limit blood flow.

Atrial fibrillation

In people with atrial fibrillation, the heart’s upper chambers beat erratically, causing an irregular pulse. When left untreated, it can double the risk of a heart-related death and dramatically increase the chance of having a stroke.

Heart failure

In some cases, the heart struggles to pump enough blood to the body. Heart failure is measured by ejection fraction (EF), the percentage of blood pushed out with each heartbeat. An EF under 40 may indicate heart failure.

Cardiomyopathy

Cardiomyopathy is a disease that causes the heart muscle to become enlarged or stiff. Both blood flow and maintaining a regular heartbeat become tough tasks. The condition can be inherited, or it can surface because of another medical condition, such as high blood pressure. illustration by jude buffum

e art.

Aortic stenosis

Protect Your Heart

Call 713.790.3333 to find a Houston Methodist cardiologist near you.

A Better Way to the Heart Your heart’s central location makes it convenient for tasks like pumping blood to your brain and stomach. But finding a way into the heart when something goes wrong can be challenging. Enter radial artery catheterization. Dr. Colin Barker, a cardiologist at the Houston Methodist DeBakey Heart & Vascular Center and one of the few doctors in Houston routinely performing the procedure, explains this new approach.

What is radial artery catheterization?

If a doctor needs to place a stent or clear a blockage, for example, he or she can access the heart via an artery in your wrist. “A small tube is placed in the radial artery on the thumb side of the wrist,” Barker said. “Using X-ray, the physician guides the catheter up to the shoulder and then down to the heart.”

What makes this approach different from the traditional procedure?

Traditionally, doctors used an artery in the groin to get to the heart. But going that route required patients to lie down for four to six hours after the procedure.

Plus, bleeding complications were difficult to identify. “The radial approach is much more comfortable for patients,” Barker said. “They are sitting up and out of bed within minutes.”

What are the benefits for women?

“The radial artery approach is much safer for women” compared with accessing the femoral artery in the groin, Barker said. “A recent study of more than 1,700 catheterizations in women showed the rates of bleeding or vascular complications were 59 percent lower when using this approach.”

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Addressing Alzheimer’s Houston Methodist researchers are studying a brain substance that may provide a warning for Alzheimer’s disease predisposed to Alzheimer’s have excessive amyloid in the brain, then remove amyloid with immunotherapy and see if we can delay tau buildup, which we can monitor with tau PET.” Although Alzheimer’s symptoms can be alleviated, the disease remains irreversible. Trying to prevent or delay it is very important. Ongoing research also focuses on ways to delay tau propagation that may help people who already have the symptoms of Alzheimer’s. From several large studies, we know that removing amyloid at this stage of the disease does not help.

“Amyloid must be removed before it has induced excessive accumulation of tau,” Masdeu said. “But other research focuses on stopping the spreading of tau in people with Alzheimer’s; we just don’t have yet therapies as effective to stop tau buildup as we do to remove amyloid.” ■

Do pre co res

The Nantz National Alzheimer Center at Houston Methodist Hospital is searching for an Alzheimer’s cure. Researchers at the center are studying an investigational drug, T-817MA, which seeks to slow brain cell deterioration in patients with mild to moderate Alzheimer’s disease. While existing treatment options can alleviate symptoms, T-817MA focuses on protecting brain cells, therefore preventing their loss and slowing the disease. Houston Methodist is the only location in Texas to offer this randomized, double-blind, placebo-controlled study.

Researchers and clinicians at the center also are working with General Electric to evaluate nextgeneration imaging technologies to improve diagnosis of concussions and mild traumatic brain injury. The Head Health Initiative, a collaboration between GE and the NFL, is a four-year, $60 million research and development program. The Nantz National Alzheimer Center is one of only three locations in the United States to participate in the first phase of this project.

Leading the Fight

PHOTO BY THINKSTOCK

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lzheimer’s disease attacks the brain cells, or neurons, often beginning with those important for memory,” said Dr. Joseph Masdeu, a neurologist and the director of the Nantz National Alzheimer Center at the Houston Methodist Neurological Institute.

“There is also a buildup in the brain of abnormal substances, commonly called amyloid and tau.”

Using a brain imaging technique, positron emission tomography (PET), Houston Methodist researchers can visualize amyloid in the brain. Amyloid PET has shown that buildup begins in the brain 10 to 20 years before any signs of Alzheimer’s, such as memory problems. Amyloid deposition is thought to predispose someone to Alzheimer’s disease, likely by increasing the amount of tau in the brain.

The more tau deposited in the brain, the more impaired the person is.

However, until recently, tau could not be visualized with imaging. “In 2013, the first PET agent for tau was discovered, and now at Houston Methodist, we have this technique to measure tau deposition in the brain,” said Masdeu.

“The research strategy is to determine with amyloid PET who among those

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HOPE AT HOUSTON METHODIST

For more information on Alzheimer’s disease and how Houston Methodist is leading the fight against dementia, visit houstonmethodist.org/alzheimers or call 713.441.1150 to schedule an appointment.

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Power

Screening Don’t let embarrassment prevent you from getting a colon cancer screening — the results could save your life

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e’ve all heard unsavory details about the colonoscopy and bathroom time required in preparation. It’s no wonder the No. 1 reason for skipping colon cancer screenings is fear of embarrassment during the procedure.

But a couple of uncomfortable days could save your life. As the third most common cancer in American men and women, colorectal cancer will cause about 50,000 deaths this year. Yet fewer than half of Americans 50 or older undergo recommended screenings.

A colonoscopy will never be pleasant, but knowing what to expect can make it more bearable. Here, we address common questions.

Q

Does a colonoscopy hurt?

Most patients experience little discomfort during the 30-minute procedure, where a doctor uses a

narrow, flexible, lighted instrument to exam the rectum and colon for abnormal growths. Patients are typically sedated and often don’t remember the experience.

Q

How do I prepare?

Patients are required to empty their colons, which means you can’t eat solid foods the day before a colonoscopy. The evening before, you will have to drink a substance to clean out the colon.

Q

What happens if they find something?

Doctors typically remove small polyps found during the test to prevent them from becoming cancerous. If doctors find a large polyp, tumor or other abnormality, they will

photo by thinkstock

What to Know About Colorectal Cancer

Houston Methodist Cancer Center is dedicated to diagnosing, treating and researching colorectal cancer, as well as many other types of cancer. For more information or to schedule an appointment, visit houstonmethodist.org/cancer or call 713.790.2700.

remove all or part of the growth and take a biopsy of it.

Q

How will I feel afterward?

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Are other procedures available?

You may feel woozy from the medication. Some patients also have cramps from the air that’s pumped into the colon to expand it to improve visibility for the doctor.

After your 50th birthday, the American Cancer Society recommends scheduling one of the following screenings: •E very 10 years: A colonoscopy.

•E very 5 years: A sigmoidoscopy is similar to a colonoscopy but only looks at the rectum and lower colon.

It requires only the lower colon to be cleared of stool and is usually done without sedation. very 5 years: A virtual colonoscopy •E can be done by taking X-rays of the colon. Patients are not sedated but still must cleanse their colon, which will be expanded with air during the procedure.

•E very 5 years: The double-contrast barium enema test also uses X-rays to provide images of the colon. n

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LEADING MEDICINE IN GREATER HOUSTON

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HOSPITALS

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Just around the corner 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.

2. Houston Methodist San Jacinto Hospital

6. Houston Methodist Willowbrook Hospital

3. Houston Methodist St. John Hospital

7. Houston Methodist The Woodlands Hospital Opening in 2017

SPECIALTY HOSPITAL

SPECIALTY HOSPITALS

8. Houston Methodist St. Catherine Hospital

EMERGENCY CARE CENTERS

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5. Houston Methodist West Hospital

4. Houston Methodist Sugar Land Hospital

HOSPITALS

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1. Houston Methodist Hospital

IMAGING CENTERS

EMERGENCY CARE CENTERS 713.441.ER24 (3724)

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2

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9. Houston Methodist Kirby Emergency Care Center

12. Houston Methodist Voss Emergency Care Center

10. Houston Methodist Pearland Emergency Care Center

13. Houston Methodist Cinco Ranch Emergency Care Center Opening in Spring 2015

11. Houston Methodist Sienna Plantation Emergency Care Center

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14. Houston Methodist Cypress Emergency Care Center Opening in Fall 2015

IMAGING CENTERS 9. Houston Methodist Breast Imaging Center

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15. 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 877.790.DOCS (3627) or visit houstonmethodist.org/usa. 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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