LEADING MEDICINE
Emergency Care, Virtual Urgent Care or Primary Care:
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. Samir Nath, a gastroenterologist at Houston Methodist Baytown 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,” Nath 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 Nath:
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 tight-fitting 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,” Nath 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.” •
It’s important to pay attention to your symptoms. To schedule an appointment with a gastroenterologist near you, visit houstonmethodist.org/gastro-hmb or call 281.422.7970
Dr. Samir Nath
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. Michael Hopson, an orthopedic surgeon with Houston Methodist Orthopedics & Sports Medicine at Baytown. “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,” Hopson 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,” Hopson 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,” Hopson 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,” Hopson 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,” Hopson 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,” Hopson 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.
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.
Dr. Michael Hopson
SPRING INTO ACTION: Get Your Lungs Screened
Dr. Anastasiia Rudkovskaia
Breathing in the clean spring air can help you feel refreshed and alive. But making sure your lungs are healthy goes beyond fresh air.
Because more people are quitting smoking or simply not starting in the first place, lung cancer cases are on the decline. Unfortunately, it still remains the leading cause of cancer death in the U.S. The good news is, however, that thanks to lung cancer screenings, even more can be done to reduce lung cancer deaths.
“We’ve always known that catching lung cancer early leads to better outcomes,” said Dr. Anastasiia Rudkovskaia, a board-certified interventional pulmonologist at Houston Methodist Baytown Hospital. “There’s a big difference in survival rates between an early diagnosis and a late one.”
WHAT ARE THE SYMPTOMS?
While screening catches more lung cancers, anyone can still develop it.
“Lung cancer isn’t caused only by smoking,” Rudkovskaia said. “Environmental factors — such as exposure to asbestos, smoke from fires and industrial pollution — also increase your risk.”
Everyone should take lung cancer symptoms seriously, which include:
■ Chest pain not explained by other findings
■ Chronic cough
■ Coughing up blood
■ Unintentional weight loss
It’s important to talk to your doctor if you have symptoms. He or she will determine if you qualify for a screening.
WHAT IS LUNG SCREENING?
In the 1990s, chest X-rays and sputum samples (a mixture of saliva and mucus) were used to detect lung cancer. In the early 2000s, computed tomography (CT) scans became the primary method for lung cancer screening.
“Lung cancer screening only requires a low-dose CT scan,” Rudkovskaia said. “This type of scan uses much less radiation than a regular CT.”
A large study showed that this screening method improved the lifespan of lung cancer patients. Initially, CT screening was limited to very high-risk individuals — those ages 55-77 with a 30-pack year smoking history. The current guidelines have relaxed the age criteria, while still targeting high-risk groups (see sidebar).
If something appears abnormal on a CT scan, the next step is to perform a biopsy.
The advancement of robotic bronchoscopy, a minimally invasive procedure that uses a robotic system to guide a thin, flexible tube
into the lungs, allows a person to undergo a lung biopsy without surgery. Additionally, safer biopsy procedures have led to new guidelines about who should be screened for lung cancer.
WHO IS ELIGIBLE TO GET SCREENED?
Smoking cigarettes is the number one risk factor for lung cancer, and screening eligibility hinges on this.
“Currently, we only screen individuals who are current or former smokers,” Rudkovskaia noted. “Age and the time since quitting are also important factors.” (see sidebar)
Importantly, lung cancer screening isn’t just a one-time thing. You must do it every year until you’re out of the age range or it’s been more than 15 years since you quit smoking. This annual requirement is crucial, but it often limits adherence to lung cancer screening.
“Bottom line: If you have any symptoms, such as persistent cough, coughing up blood, shortness of breath, chest pain or unexplained weight loss, you should get evaluated right away,” Rudkovskaia said. “Don’t wait.” •
DO YOU QUALIFY FOR A SCREENING?
Most health insurance plans cover lung cancer screenings, provided you meet the following criteria:
• Between the ages of 50 and 80
• Currently smoke or have quit within the last 15 years
• Have at least a 20-pack-year smoking history, which could look like:
– 2 packs a day for 10 years
– 1 pack a day for 20 years
– ½ pack a day for 40 years
HOW OFTEN DO YOU NEED A Well-Woman Exam?
Daphne Tamir, NP
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.
FROM YOUNG WOMANHOOD TO MENOPAUSE AND BEYOND
According to Daphne Tamir, a nurse practitioner with Houston Methodist Obstetrics and Gynecology Associates, every woman should aim for a well-woman exam every year.
“It’s great to have a provider 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.
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,” Tamir 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,” Tamir 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 OBGYN 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,” Tamir said. •
Don't Hold Back
Don’t let anything hold you back from coming in for lung screening. To find out if you qualify, visit houstonmethodist.org/lung-screening or call 713.441.LUNG (5864)
“Visit your OB-GYN for sexually transmitted infection (STI) testing as needed, and also to get the HPV vaccine,” Tamir 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.
Personalized Care at Every Stage of Life
To schedule an appointment with a Houston Methodist OB-GYN near you, visit houstonmethodist.org/ ob-hmb or call 281.420.5760
MY SPORTS MEDICINE TEAM COULD
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