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.
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
“Stomach acid is an important part of digestion, but it belongs in the stomach,” said Dr. Hassan K. Dakik, a gastroenterologist with Houston Methodist The Woodlands Hospital. “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,” Dakik 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 Dakik:
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.
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,” Dakik 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, to so it’s important you talk with a doctor if heartburn just won’t quit.” •
Dr. Hassan K. Dakik
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,” said Dr. John Fackler, an orthopedic surgeon at Houston Methodist Orthopedics & Sports Medicine at The Woodlands. “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,” Fackler 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,” Fackler 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,” Fackler 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,” Fackler 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,” Fackler 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,” Fackler explained. “There is no one-size-fits-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.
or a light jog.
Dr. John Fackler
Before: Wear well-supported athletic shoes and warm up with stretches
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
Choosing a CANCER CARE TEAM
Hearing the news that you or a family member has cancer can take your breath away. And you may feel an urgency to get started with a cancer care team and treatment immediately. However, it’s important you take a few days to understand the diagnosis. Referrals from your primary care provider, family or friends and an online search are often good places to begin. Finding the right hospital and team of specialists can make a big difference in the type of care you receive. Dr. Priya Ramshesh, a board-certified hematologist-oncologist at Houston Methodist Neal Cancer Center at The Woodlands, offers advice for people just starting on their cancer journey.
A PERSONALIZED APPROACH
■ Nurse navigators
■ Physical, occupational or speech therapy
■ Registered dietitians
“Cancer treatment has a profound effect on the body, mind and spirit,” Ramshesh said. “Having these services are a part of our patient-centered approach to care.”
ADVANCED TREATMENT OPTIONS
Everyone’s cancer is one-of-a-kind, so people with the same kind of cancer may respond differently to the same treatment. “Every cancer has its own unique fingerprint, which influences how it grows and spreads,” Ramshesh explained. “At Houston Methodist, we use tissue-typing and molecular therapy to create personalized treatment plans that are highly precise for the individual’s specific cancer.”
HOW OFTEN DO YOU NEED A Well-Woman Exam?
When it comes to medical care, we all want to be treated like an individual, not a condition or disease. “A patient-centric, holistic approach to cancer treatment takes into account the whole person,” Ramshesh said. “This includes your medical history, your family, your job, your responsibilities and the activities you love.”
COLLABORATIVE CARE
Effective cancer treatment takes a team of experts working together, including hematologist-oncologists, radiation oncologists, surgeons, imaging specialists, nurses, pharmacists and many other specialists. “Having all these specialists collaborating together ensures no stone is left unturned,” Ramshesh explained.
Health conditions such as arthritis, neuropathy (nerve damage or dysfunction), diabetes and certain cardiac conditions can be affected by cancer treatment. “For example, a patient on blood thinners for vessel disease may be unable to have cancer surgery,” Ramshesh explained. “Since we are a comprehensive health system, I would invite a cardiologist to join the cancer team to ensure the patient’s safety.”
To address other needs that arise during your treatment, your cancer team may include additional members and services, including:
■ Fertility preservation
■ Financial navigators and social work
■ Integrative medicine (acupuncture or massage)
If surgery is part of your treatment plan, look for a cancer care team such as at Houston Methodist that offers minimally invasive surgical techniques to reduce complications and speed recovery.
CLINICAL TRIALS
Some people with rare or aggressive cancers may not respond as well as hoped to traditional treatments. “Clinical trials are an important part of advancing cancer care,” Ramshesh explained. “They allow us to develop new approaches to treating cancer, which means more options for the patient.”
“Most importantly, you should trust your cancer team and feel like an equal partner in all the decisions about your care,” Ramshesh said. “And don’t hesitate to get a second opinion, especially if you are contemplating which treatment path to take.” •
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. Patricia Laden, an obstetrician-gynecologist (OB-GYN) at Houston Methodist Obstetrics and Gynecology Associates at The Woodlands, 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.”
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,” Laden 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.
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,” Laden 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.
“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,” Laden 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,” Laden said. •
Personalized Care at Every Stage of Life
To schedule an appointment with a Houston Methodist OB-GYN near you, visit houstonmethodist.org/ ob-hmtw or call 936.270.3662.
Dr. Priya Ramshesh
Dr. Patricia Laden
MY SPORTS MEDICINE TEAM COULD
You don’t have to be Yordan Alvarez to get expert orthopedic care. As the official health care provider for the Houston Astros, your Houston Methodist sports medicine team will use the same advanced technology and minimally invasive treatments they use on the pros to keep you at the top of your game.
That’s the difference between practicing medicine and leading it. For you.
