LEADING MEDICINE
KNOW WHERE TO GO
We’ve all been there: You wake up feeling off, or you sustain an unexpected injury and the panic sets in. Should you rush to the emergency room (ER), make an appointment with your primary care provider, or access virtual urgent care? The uncertainty can be overwhelming.
It’s important to know where to go for care before you’re sick or experiencing an emergency. Knowing this can save you precious time, make sure you get the right care promptly and ultimately make a world of difference when it matters most.
GOODBYE HEARTBURN: Home Remedies for Acid Reflux
Heartburn is the uncomfortable burning feeling in your chest that results from gastric secretions (stomach acid) moving from the stomach into the esophagus. Even though it can feel like chest pain, heartburn has nothing to do with the heart — it’s a symptom of acid reflux.
“Stomach acid is an important part of digestion, but it belongs in the stomach,” said Dr. Valentine Ongeri Millien, a gastroenterologist with Houston Methodist Gastroenterology Associates at Clear Lake.
“When the lower esophageal sphincter relaxes abnormally, stomach contents, including acid, back up into the esophagus.”
Heartburn symptoms include:
■ A burning sensation in your chest
■ Burning pain that rises toward your throat
■ Having a bitter or sour taste in your mouth
While an underlying medical condition, obesity or a medication can trigger acid reflux, most often it’s caused by your diet and lifestyle choices, such as the food and drinks you consume, and how much.
“That’s good news,” Millien said, “because it means there are ways you can prevent heartburn and find relief for symptoms on your own.”
To avoid heartburn or find fast relief, consider these tips from Millien:
AVOID TRIGGER FOODS
Certain spicy or acidic foods, caffeine, chocolate and alcohol can trigger reflux. Once you identify a food or drink that causes reflux, avoid it whenever possible.
EAT LESS AND EAT SLOWLY
Having more food in your stomach puts more pressure on the valve that keeps acid inside, making heartburn more likely. Avoid tightfitting belts and clothes that put pressure on your stomach and that can contribute to heartburn.
MAINTAIN A HEALTHY WEIGHT
Extra weight puts pressure on your stomach, increasing the chance of reflux. Eat a balanced diet of fresh foods and get 150 minutes of physical activity each week to achieve and maintain a healthy weight.
ADJUST YOUR SLEEP
A foam wedge under your mattress or blocks under the bedposts can help prevent and ease reflux by raising your chest. Sometimes, sleeping on your left side can aid in digestion and limit reflux. In addition, you should avoid eating for two to three hours before bedtime, so your stomach has time to empty.
STOP SMOKING
Quitting smoking can make reflux less severe and less frequent, and in some cases even stop it altogether.
WHEN TO TALK WITH A DOCTOR
Over-the-counter medications such as antacids can provide temporary relief for mild heartburn, but you should talk with your doctor if your symptoms don’t go away or get worse.
“Daily antacid use is a sign that it’s time to be evaluated by a gastroenterologist,” Millien said. “Your doctor can help you determine whether you need additional treatment for acid reflux. Chronic heartburn can change the inner lining of the esophagus and lead to serious conditions, like esophageal cancer, so it’s important you talk with a doctor if heartburn just won’t quit.” •
Get Help With Heartburn
It’s important to pay attention to your symptoms. To schedule an appointment with a gastroenterologist near you, visit houstonmethodist.org/gastro-hmcl or call 281.523.3320
Dr. Valentine Ongeri Millien
Do You Have a KNEE INJURY or Something Else?
That sluggish feeling after an injury is hard to avoid. How do you know if you have a minor injury that will heal on its own or if it’s more significant and needs treatment from a doctor? “Knee injuries are common in recreational athletes, and they tend to be bothersome, as the knees are used for almost every daily activity, in addition to sports,” Dr. David Wallace, a sports medicine physician at Houston Methodist Orthopedic & Sports Medicine at Clear Lake. “However, your knee pain could also be osteoarthritis.”
The most common causes of knee pain include:
■ Acute injury (to the meniscus, ligaments or cartilage)
■ Arthritis or osteoarthritis
Growing pains
■ Overuse (too much activity) Knowing how to get rid of knee pain starts with trying to get to the bottom of why your knee hurts in the first place and then determining if the pain warrants seeing a doctor.
COMMON SIGNS OF OSTEOARTHRITIS
Osteoarthritis is the disease process of losing the cartilage in your knee — the tissue that cushions the ends of bones to decrease friction with joint movement. This is different from rheumatoid arthritis, a condition where the immune system attacks joints and their lining.
You should consult a doctor who can diagnose your knee pain as a symptom of osteoarthrosis or something else.
Osteoarthritis has hallmark signs, which may include:
■ Inflammation and swelling
■ Joint tenderness or a feeling of the joint giving out
■ Pain described as deep and aching
■ Stiffness at times, though more common with rheumatoid arthritis
■ Varying amounts of discomfort during an activity or prolonged inactivity
“While pain often occurs while standing or walking, it can also occur when sitting for extended periods,” Wallace explained. “Symptoms are often most noticeable when using the stairs.”
Family history, aging and injury are common causes of osteoarthritis. Strength training and exercise can help reduce pain.
“Maintaining a healthy weight also helps. If you’re overweight, any amount of weight loss will make a difference on your knees,” Wallace added.
SIGNS OF A KNEE INJURY
Whether it’s a strained muscle, broken bone, injured tendon or minor dislocation, some injuries need to be evaluated and treated. Signs that indicate you should immediately seek medical help after an injury include:
■ Any deformity of the limb
■ Inability to bear weight
■ Persistent joint pain
■ Significant swelling with inability to move fingers or toes
■ Swelling of a joint that comes on rapidly
■ Weakness when moving a limb or muscle
“In general, if you have an injury that causes new pain that exceeds normal soreness, results in the feeling that your joint is giving way or leads to swelling, it is important to be evaluated sooner rather than later,” Wallace said.
AT-HOME CARE
Continuing to move an injured knee area could lead to further damage and a longer recovery time. Many people use the home management treatment known as RICE (rest, ice, compression and elevation) to help relieve knee pain.
“In some cases, an injury is acute and obvious,” Wallace added. “But sometimes, the pain creeps up on you
gradually, and you might not even know what brought it on. It can also linger for a while without you being able to pinpoint the source of the pain.”
PUSHING THROUGH THE PAIN
If you’ve tried at-home remedies and are still trying to stay active through the pain, it’s time to see a doctor. Pushing through injuries or pushing too hard can only make an existing injury worse or increase the risk of additional injuries.
“Even if your pain is minor and not improving, you need it evaluated,” Wallace said. “If caught early, many times we can help
guide you through a recovery process that allows you to get back to being active sooner.”
HEALING TIME
Some injuries take longer to heal compared to others, depending on the location and severity of the injury, your age, overall health and other factors.
“Depending on the injury, your doctor may recommend anti-inflammatory medication, cortisone injections or surgery to repair torn muscles or ligaments,” Wallace explained. “There is no one-sizefits-all approach, but we will find the best course of action for your knees.” •
KNEE INJURY PREVENTION
Sticking to a regular exercise routine helps to keep your knee muscles strong and flexible. Add the steps below to help prevent knee pain.
Make an Appointment
Don’t suffer in pain and discomfort. Take control of your pain and stay in the game. To schedule an appointment with an orthopedic specialist, visit houstonmethodist.org/osm-hmcl or call 713.363.9090
Dr. David Wallace
Before: Wear well-supported athletic shoes and warm up with stretches or a light jog.
During: Avoid activities that hurt your knee. Don’t try to work through the pain.
After: Pay attention to any early signs of pain and use the RICE treatment.
Rest Ice Compression Elevation
6 SIGNS It's Time to See a Urologist
You don’t need to suffer from uncomfortable bladder problems, pelvic pain, sexual dysfunction or other urologic symptoms — talk to your primary care provider. If further evaluation or treatment is needed, he or she may refer you to a urologist.
4. PROSTATE PROBLEMS
Men should see a urologist for issues such as:
■ A weak urine stream
■ Blood in urine
■ Difficulty emptying the bladder
■ Painful urination
A urologist is a specialist who provides medical and surgical treatment for both men and women experiencing problems with their bladder, kidneys, urinary tract system or reproductive system. He or she will review your symptoms, ask about your health history and perform a complete physical exam.
“Based on how you’re feeling, we might suggest some blood or urine tests, imaging like CT scans, or even carry out some diagnostic procedures to help us understand your health better,” said Dr. Gabriel Rodriguez, a urologist at Houston Methodist Urology Associates at Clear Lake.
Here are six signs you should consider seeing a urologist.
1. INCONTINENCE
If you’re experiencing urine leakage or the need to go frequently or urgently, a urologist can help.
“Making some lifestyle changes, along with the right medication or surgical options, can really help improve your bladder health symptoms,” Rodriguez explained.
2. PELVIC PAIN
Unexplained pelvic pain can be related to benign conditions, or it could be a warning sign of a more serious issue concerning the pelvic organs.
3. KIDNEY STONES
Symptoms of kidney stones include:
■ A burning sensation or pain while urinating
■ Fever, chills and vomiting
■ Frequent urination
■ Incomplete or small amounts of urination
■ Sharp pain in the lower abdomen, typically on one side
■ Smelly or cloudy urine
■ Urine that is brown, red or pink Rodriguez cautioned that any blood in the urine, in the absence of a urinary tract infection (UTI), should be evaluated as soon as possible.
“These symptoms can be a sign of benign prostatic hyperplasia (BPH), also known as an enlarged prostate,” Rodriguez said, “BPH symptoms can be treated with a combination of medications or minimally invasive surgical techniques.”
5. SEXUAL DYSFUNCTION IN MEN
Urologists are experts in sexual and reproductive health for men, including treatment of:
■ Erectile dysfunction
■ Low testosterone
■ Male infertility
■ Vasectomy (surgical contraception)
6. RECURRING UTI s
Women who experience two or more UTIs within a six-month period or three or more episodes within a year may be referred to a urologist for further evaluation.
For men, any UTI is considered complicated and should be evaluated by a urologist.
If you’ve struggled with any of these six signs, it’s time to consider scheduling an appointment with a urologist. “If your condition is chronic, your doctor will help you manage the condition over time,” Rodriguez added. •
We’re Here to Help
If you’re concerned about any of your symptoms, let our doctors help you find relief. To schedule an appointment with a urologist near you, visit houstonmethodist.org/urology-hmcl or call 713.441.6455.
HOW OFTEN DO YOU NEED A Well-Woman Exam?
Looking after your gynecological health is a vital part of every woman’s wellness journey. You may wonder how often you should see your gynecologist for a well-woman exam. According to Dr. Ines Tamzali, an obstetrician-gynecologist (OB-GYN) at Houston Methodist Obstetrics and Gynecology Associates at Clear Lake, every woman should aim for a well-woman exam every year. “It’s great to have a partner in your health and preventive care to ensure necessary screenings,” she said. “That connection with your provider is important as a woman’s health changes over time.”
FROM YOUNG WOMANHOOD TO MENOPAUSE AND BEYOND
No matter the stage of your life, your OB-GYN provider can help guide you. Menstrual cycle changes, STIs and contraceptives are common topics. So is family planning.
“Women may seek help to conceive and ensure a safe pregnancy,” Tamzali explained. “In addition, we address questions and concerns surrounding menopause such as, ‘What will your menopausal transition look like? And are you struggling with hot flashes, brain fog or mood changes?’”
PAIN, INCONTINENCE AND OTHER SYMPTOMS
Don’t be shy, bring your most sensitive questions.
Understanding that your needs can change from year to year, women should arrange screenings to align with the physiological and hormonal shifts that occur during pregnancy, childbirth and aging.
THE IMPORTANCE OF WOMEN’S HEALTH SCREENINGS
Breast and pelvic exams are a routine part of the annual wellwoman checkup, but the recommended regularity of some other screenings, such as Pap smears and co-testing for the human papillomavirus (HPV), can depend on your age, risk factors and prior Pap smear results.
Like many types of cancer, the earlier breast cancer is detected, the better the outcome. One of the best ways to catch breast cancer early is by having mammograms every year after age 40 — or even earlier, if you have a family history of breast cancer. Start talking to your primary care provider or gynecologist in your 20s to help determine your risk level and if you should start getting screened sooner.
“Visit your OB-GYN for sexually transmitted infection (STI) testing as needed, and also to get the HPV vaccine,” Tamzali said. “You can get this vaccine up to age 45 to lower the risk of cervical cancer, head and neck cancers and genital warts.”
Your OB-GYN provider can also recommend colon cancer screenings and bone density testing depending on age range and risk factors.
“Whether it’s urinary or fecal incontinence, vaginal discharge, vulvar complaints, burning, pelvic pain or sexual dysfunction, I encourage patients to discuss everything, as it may signal an underlying medical issue,” Tamzali added.
Even unrelated symptoms may signal serious issues, so it’s important to consult your doctor.
SCHEDULE YOUR NEXT WELL-WOMAN EXAM
What occurs during an annual well-woman exam may change depending on your life stage, but the importance of routine OB-GYN care to your overall health remains the same.
“Take the time to care for yourself, ask the questions you need answered and learn about your body. Your OB-GYN is here to help,” Tamzali said. •
Personalized Care at Every Stage of Life
To schedule an appointment with a Houston Methodist OB-GYN near you, visit houstonmethodist.org/ob-hmcl or call 832.783.2330
Dr. Inez Tamzali
Dr. Gabriel Rodriguez
That’s