Leading Medicine Spring 2015, Houston Methodist Baytown Hospital edition

leaDING MeDICINe Your link to health innovations, news and tips IN EAST HOUSTON/BAYTOWN

SP RING 2015

Game chanGers

your springtime guide to getting fit without injury

Stroke: The Female Factor

The CancerFighting Diet

healthy Eats

Strawberry-Peach Smoothie Spring is the peak season for strawberries. Try this recipe for a refreshing, low-fat smoothie.

Ingredients

Instructions

2 (6-ounce) containers strawberry yogurt (low-fat or nonfat optional)

Place all ingredients in a blender. Cover, and blend on high speed until smooth, about a minute.

Pour into glasses; serve immediately. Garnish with sliced strawberries if desired.

1 cup fresh peaches or 1 cup frozen peaches or 1 cup nectarine, pitted and sliced 1 cup fresh strawberries, stemmed and sliced 1 cup crushed ice Nutritional information

Makes two servings. Each serving contains: 229 calories, 2 g fat, 1 g saturated fat, 0.1 g monounsaturated fat, 10 mg cholesterol, 86 mg sodium, 48 g carbohydrates, 3.5 g dietary fiber, 6 g protein.

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Fitness Foils For every springtime sport, there’s an injury that can leave you sidelined. Learn how to prevent the pain and stay in the game.

ould It Be Sleep Apnea?

C Snoring, sweating and daytime tiredness are symptoms of the sleep-related breathing disorder

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Vision: To be a leader in delivering safe, patient friendly, best-in-class care and service. To be a trusted, first and lifelong choice for consumers who are seeking health care services and physicians who are seeking a health care partner. To be an employer of choice that attracts and houses the best and brightest talent and nurtures employee loyalty.

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omen, Take Note W Your symptoms of heart disease may not be the same as a man’s Improve Your Diet, Improve Your Health Understand metabolic syndrome and how to treat it edicine: A User’s Manual M Five ways to maximize benefits and minimize risk when taking medication

alendar of Events C Upcoming events and support groups at Houston Methodist San Jacinto Hospital

Compassion: We embrace the whole person and respond to emotional, ethical and spiritual concerns as well as physical needs.

Accountability: We hold ourselves accountable for our actions.

Respect: We treat every individual as a person of worth, dignity and value.

Excellence: We strive to be the best at what we do and a model for others to emulate.

photos by thinkstock

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The Cancer-Fighting Diet Want to amp up cancer protection in your diet? These foods can get you going in the right direction.

Mission: To serve our patients/ families, employees, medical staff and community in a spiritual manner that is consistent with our I CARE values of integrity, compassion, accountability, respect and excellence.

I CARE Values: Integrity: We are honest and ethical in all we say and do.

in this issue SPRING 2015 troke: The Female Factor S Learn about the risk factors that make women uniquely vulnerable to stroke

Houston Methodist San Jacinto Hospital Mission and Vision

Stroke: The Female Factor Learn about the risk factors that make women uniquely vulnerable to stroke

D

id you know that stroke kills twice as many women as breast cancer each year? Or that 55,000 more women than men will have a stroke in the coming year?

If this is news to you, it is to many women: 40 percent said in a recent survey that they were only somewhat or not at all concerned about stroke, and most were not knowledgeable about risk factors.

“Women and men share some of the same stroke risks, such as high blood pressure, heart disease, diabetes, obesity and a personal or family history of stroke,” explained Dr. Ruby Parveen, a board-certified physician who specializes in neurology and sleep medicine at Houston Methodist San Jacinto Hospital.

“But women also have other risk factors that don’t affect men. For one, they generally live longer, and the odds of having a stroke increase with age.”

Guidelines recently introduced by the American Heart Association/American Stroke Association outline the extra risks for women. Take note, and discuss these risks with your doctor.

photo by thinkstock

Risks for Women

If you’ve had preeclampsia — a common pregnancy complication that causes a sharp increase in blood pressure — your risk of having a stroke during your lifetime doubles.

Your odds of developing high blood pressure are four times higher, which means your stroke risk increases, too.

As a result, preeclampsia should be considered a risk factor throughout your life. If you have high blood pressure, taking birth control pills can also increase your risk of stroke.

Smoking is a stroke risk for everyone, but it’s multiplied if you are a woman prone to migraine headaches with aura.

Other risk factors that tend to be more pronounced or more common in women than in men include high blood pressure, atrial fibrillation, diabetes, depression and emotional stress.

Assess Your Stroke Risk

Dr. Ruby Parveen specializes in neurology and sleep medicine at Houston Methodist San Jacinto Hospital. To schedule an appointment with her and assess your stroke risk, please call 832.556.6535.

• Get your blood pressure checked annually. High blood pressure has no symptoms, so it is especially important to schedule a test if you haven’t had one recently.

• Slim down. Losing even 10 pounds can make a difference in blood pressure levels. n

Reduce Your Risk

For both men and women, high blood pressure is the leading cause of stroke.

When blood pressure is high, blood pumps harder than it should, straining the vessels of the circulatory system. A stroke can occur when the increased pressure either blocks or breaks vessel walls, stopping blood flow or causing blood to leak into the brain.

To reduce your risk of high blood pressure and stroke: • Understand your risk factors. Many of these, including smoking, drinking, obesity, and high cholesterol, can be controlled with lifestyle changes.

• Adopt a healthy diet. A low-fat, low-salt regimen that includes whole grains, fruits and vegetables can reduce elevated blood pressure.

check out our digital magazine at houstonmethodist.org/publications 3

Fitness Foils For every favorite springtime sport, there’s an injury that can keep you sidelined. Learn how to prevent the pain and stay in the game.

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or many of us, springtime means playtime. The sun is shining and the fields, paths and courts beckon. But one wrong move or too many years of pounding the pavement can leave you couch-ridden.

Here, we take a look at some of the most common sports injuries and how you can avoid them.

you love: Tennis You’re at risk for: Elbow pain

An injury so common it has its own name, tennis elbow is a condition caused by overuse of the arm, forearm and hand muscles. The weak grip strength and burning pain aren’t actually due to an injured elbow — these symptoms are telltale signs of damage to the forearm muscle that helps stabilize the wrist when the elbow is straight (during a ground stroke, for example). When this muscle is weakened from overuse, microscopic tears form in the tendon where it attaches to the joint, leading to inflammation and pain.

Get back in the game: Up to 95 percent of patients have success with nonsurgical treatment, but the first step is to put down the racket for a while. In addition to taking a break, drugs like aspirin or ibuprofen reduce pain and swelling. Be sure to have your tennis equipment checked for proper fit, too. Stiffer rackets that are more loosely strung may reduce stress on the forearm.

you love: Running

photo by superstock

You’re at risk for: Shin splints

Runners, admit it: You’re a wee bit crazy (in a good way, of course).

Mile after mile, rain or shine, you pound away at that pavement. So it’s understandable that you refuse to let a little shin pain keep you from your daily sweat session. When it comes to the all-too-common shin splint, there’s no true consensus among experts as to its

cause. Theories include small tears in the muscle that’s pulled off the bone, an inflammation of the muscle or a combination of the two. Fortunately, experts agree on one aspect of shin splints: how to treat them.

Get back in the game: When splints strike, stop running or decrease your distance, depending on the extent of the pain. From there, be sure to ice your shins regularly to decrease inflammation, practice proper stretching and try cross training like cycling, swimming or yoga. When you return to your regular running schedule, work your way up by increasing mileage slowly — aim for a 10 percent increase each week. Wear the right shoes for your feet and try to avoid hills and excessively hard surfaces.

you love: Cycling You’re at risk for: Knee pain

Cycling is practically the definition of a repetitive motion, with the average cyclist pedaling 3,600 times in an hour.

No wonder cyclists often experience knee pain from overuse. One common problem, patellofemoral pain syndrome, occurs when the patella (kneecap) gets out of alignment, causing wear on cartilage and pain around the kneecap.

Get back in the game: Knee injuries in cyclists are often caused by muscle imbalance. Exercises for the quadriceps and hips can strengthen the muscles that support the kneecap, keeping it in proper alignment. Ask a professional about your bike fit and cycling form.

A seat that’s too high or low can cause injury, as can pedaling with your knees facing inward or outward. n

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Common Exercise Mistakes Feeling more sore than sculpted? You may be committing these workout no-nos.

1

Going all-out, right away. Give your body about five minutes to warm up before you really hit it.

2

Running the same route. Variety is the spice of life. Mix up your workouts with some cross training.

the stretching.

3 Skipping Always end a workout with a good stretch. Your legs will thank you in the morning.

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Playing through the pain. A little discomfort is good; actual pain is not.

Respect your limits and give it a rest when you’re hurt.

See an Orthopedics Specialist

To make an appointment with one of the Houston Methodist San Jacinto Hospital board-certified orthopedic doctors, Dr. Mark Franklin or Dr. James Pyle, please call 281.427.7400.

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The CancerFighting Diet Want to amp up cancer protection in your diet?

These foods can get you going in the right direction.

Walnuts

“Walnuts have 2.5 grams of omega-3 fat per ounce, while most other nuts have around 0.5 grams per ounce,” Medellin said. Aim for 5 ounces of walnuts a week.

Broccoli

Broccoli is packed with antioxidants and phytochemicals, including sulforaphane. “Sulforaphane is proposed to stimulate enzymes that help detoxify potential carcinogens,” said Dr. Pamela Medellin, an oncologist at Houston Methodist San Jacinto Hospital. Vegetables like cauliflower and kale are also rich in sulforaphane.

Carrots

Tomatoes

Tomatoes are high in antioxidants and the phytochemical lycopene, which can prevent cellular damage and abnormal cell replication and growth. Lycopene is best absorbed in cooked tomato products. In one study, men who ate two or more servings a week of tomato sauce or other cooked tomato products had a 20 percent less chance of developing prostate cancer. Lycopene may also reduce breast cancer risk and is found in red grapefruit and watermelon as well as tomatoes.

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Blueberries

Blueberries are high in ellagic acid, a phenolic compound that protects cells from damage. Other sources are red grapes, raspberries, strawberries and blackberries.

Berries are also high in a class of phytochemicals called anthocyanins, which act as powerful antioxidants.

Celebrate Cancer Survivors

Are you or is someone you love a cancer survivor?

Join us at Houston Methodist San Jacinto Hospital to celebrate Cancer Survivors Day on June 5. Call 281.428.2273 for more information or to register for the event.

photos by thinkstock

Carrots are high in beta carotene, which helps plants absorb light. Beta carotene accumulates in the fat under the skin and seems to absorb some of the radiation energy from sunlight, possibly reducing the risk of skin cancer.

Squash, pumpkin and green, leafy vegetables are other sources of beta carotene.

Could It Be Sleep Apnea?

Snoring, sweating and daytime fatigue are symptoms of the sleep-related breathing disorder

photo by thinkstock

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ew things are scarier than waking up in the middle of the night to hear your loved one gasping for air.

“Obstructive sleep apnea — a sleep-related breathing disorder that causes your body to stop breathing during sleep — affects one-fifth of Americans,” said Dr. Ruby Parveen, a board-certified sleep specialist and neurologist at Houston Methodist San Jacinto Hospital.

You or your loved one may have sleep apnea, according to Parveen, if he or she snores or stops breathing while sleeping, or if you observe any of the following indications: • A rib cage that moves inward during inhalation • Sweating during sleep

• Body movements and arousals from sleep • Sleeping with the neck overextended • Excessive daytime sleepiness • Hyperactivity or aggressive behavior • Morning headaches If you have healthy lifestyle habits and are getting plenty of sleep but still wake up feeling tired, something else might be at work.

Feeling tired and sleep-deprived during the day isn’t normal, Parveen said. If you feel chronically tired, you may have sleep apnea. When you take shallow breaths or briefly stop breathing during sleep, it can take you out of deep sleep and into a lighter sleep.

“Deep sleep is restorative sleep,” Parveen said. “So, if you’re missing out

Study Your Sleep

Houston Methodist San Jacinto Hospital has a comprehensive sleep lab.

The hospital also offers a home sleep study.

For more information or to schedule an appointment, please call 832.556.6535.

on this quality sleep, it’s no wonder you might be tired during the day.”

Left untreated, the National Institutes of Health reports, sleep apnea can lead to an increased risk of high blood pressure, heart attack, stroke, obesity and diabetes. If you think you might have sleep apnea or another sleep disorder, talk to your doctor. n

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Women,

Take Note

Your symptoms of heart disease may not be the same as a man’s

H

eart disease is a problem for women, not just for men.

Surprised? Most women are.

But statistics show that heart disease is the leading cause of death for women, just as it is for men. One of three adult women has some form of cardiovascular disease. Dr. Walter O’Hara, a board-certified cardiovascular surgeon at Houston Methodist San Jacinto Hospital, said, “People don’t often realize that heart disease affects so many women; it’s important for women to know the signs of a heart attack along with the risk factors that are associated with heart disease.”

Risk Factors: The Same

Symptoms: Different

The sexes might not share the symptoms of heart disease and heart attacks. A

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Symptom Spotter In addition to chest pain, women are more likely to experience nontraditional symptoms of heart attack, including: Nausea Weakness Unusual fatigue Back, neck or jaw pain Dizziness Indigestion If you experience any symptoms of a heart attack, do not wait — call 911.

Minutes matter.

to know that these sometimes vague and undramatic symptoms may be associated with heart disease and that they need to seek medical care.” n

Assess Your Risk for Heart Disease

To schedule an appointment with a primary care physician to assess your risk for heart disease, call 281.428.2273.

photo by thinkstock

The major risk factors for heart disease are much the same for women and men.

Cigarette smoking, high blood pressure and high blood cholesterol levels, extra weight and physical inactivity all pave the way. Even just one risk factor will raise your chances of having heartrelated problems.

recent study found that many women start experiencing warning signs of an impending heart attack a month or more before the event.

Both men and women may have the classic symptom of pain that spreads to the shoulder, neck or jaw, but women may have more common sensations that show up all at once or suddenly increase in severity. The most common symptom that something was amiss, experienced by three-fourths of the female heart attack survivors in one study, was unusual fatigue. About half started having unexplained sleep disturbances and shortness of breath.

Only a third reported chest discomfort, and they described it as pressure, aching or tightness, not as pain.

“Certain heart attack symptoms are more frequently experienced by women,” said O’Hara. “It’s important for women

Just for Her:

Improve Your Diet,

Improve Your

Health Understand metabolic syndrome and how to treat it

H

igh blood pressure, high blood sugar levels and extra weight around the middle are three health conditions that can double your risk of heart disease and increase your risk of diabetes by five times. Those conditions are part of metabolic syndrome — a group of risk factors that increase a person’s risk for diabetes, heart disease and stroke — which affects 34 percent of Americans.

What else do they have in common?

All three can be improved with diet.

Dr. Manisha Chandalia, a boardcertified endocrinologist at Houston Methodist San Jacinto Hospital, shares four strategies to help you eat your way to better health.

Reduce calories. Those who cut calories improve blood pressure, insulin function, body composition and metabolism. A simple way to consume fewer calories is to reduce the fat in your diet.

photo by thinkstock

Focus on macronutrient composition. This means paying

attention to what you eat, particularly your intake of carbs, fat and fatty acids.

Consuming about 10 to 35 percent of calories from carbohydrate sources improves metabolic syndrome. Eating more protein helps dieters regulate insulin function and cholesterol levels, and healthy fats (like those from nuts

and fish, as well as healthy oils like olive oil) are also beneficial.

Get more functional foods and nutrients. This means eating plenty of

fruits and vegetables, which are loaded with antioxidants and fiber, and low-fat dairy and probiotics (bacteria that aid with digestion). In a recent study, eating more fiber and probiotics was found to reduce waist size, while dairy was found to improve insulin function.

Choose healthy dietary and lifestyle programs. The

Mediterranean diet has been found

to significantly reduce the risk of metabolic syndrome. That means lots of fruits, vegetables, whole grains and low-fat dairy products daily, as well as plenty of fish, poultry, tree nuts and legumes each week.

Research shows that when you eat is also important — consuming more calories early in the day is linked to a lower chance of metabolic syndrome.

Finally, exercise is a crucial piece of the puzzle. Get a minimum of 30 minutes of moderate activity at least five times a week. n

Help with Healthy Eating

To schedule an appointment with Dr. Manisha Chandalia, board-certified endocrinologist, call 713.790.3333. To inquire about the medical nutrition therapy program at Houston Methodist San Jacinto Hospital, call 281.420.8525.

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Manage Your Prescriptions

Medicine: A User’s Manual

Medications prescribed by different specialists can become confusing. Primary care doctors help you manage your medications and answer questions about their interactions. To make an appointment with a Houston Methodist San Jacinto Hospital primary care doctor, please call 281.428.2273.

Five ways to maximize benefits and minimize risk when taking medication

A

s with almost anything in life, your medications provide both benefits and risks. The benefits to your health must outweigh the risks, or your doctor wouldn’t prescribe the medication. But patients and doctors sometimes focus on benefits without fully discussing the risks.

There are several types of risks from medicine use, warns the U.S. Food and Drug Administration (FDA): • The possibility of a harmful interaction between the medicine and a food, beverage, dietary supplement (including vitamins and herbals) or another medicine • The chance that the medicine may not work as expected • The possibility that the medicine may cause additional problems The FDA offers a five-point plan to help you reduce those risks and get the greatest benefit from your medications.

1

Talk to your doctor, pharmacist

and other health care providers.

• Share a list of all medicines (prescription and over-the-counter) and dietary supplements, including vitamins and herbs, that you use — even those you only use occasionally.

• Discuss allergies or sensitivities or anything that could affect your ability to take medicines, such as difficulty swallowing or remembering to take them.

• Tell your health care provider if you are or might become pregnant, or if you are nursing a baby.

2

Know your prescriptions

and over-the-counter medicines.

• The brand and generic names.

• What they look like.

• How to store them properly.

• When, how and how long to use them.

• How and under what conditions you should stop using them.

• What to do if you miss a dose.

• What they are supposed to do and when to expect results.

• Side effects and interactions.

• Always ask for written information to take with you.

3

Read labels and follow directions.

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4

Avoid interactions.

• Ask if there are interactions with other medicines or dietary supplements (including vitamins or herbal supplements), beverages or foods.

• Use the same pharmacy for all medication needs whenever possible.

• Before starting any new medicine or dietary supplement, ask again if there are possible interactions with what you are currently using.

5

Monitor the effects of your medications and products:

• Ask what you can do to minimize side effects, such as eating before you take a medicine to reduce stomach upset.

• Pay attention to how you are feeling.

Write down changes so that you can remember to tell your health care professional.

• Know what to do if you experience side effects and when to notify your doctor.

• Know when you should notice an improvement and when to report back. n

photo by thinkstock

• Ask if you have questions or concerns.

• Always double-check that you have the right medicine.

• Keep medicines in their original labeled containers whenever possible.

• Never combine different medicines in the same bottle.

• If you stop the medicine or want to use the medicine differently than directed, consult with your health care professional.

THE RIGHT DOCTOR IS RIGHT HERE

HOUSTON METHODIST PRIMARY CARE GROUP

SAME DAY APPOINTMENTS AVAILABLE!

Houston Methodist Primary Care Group provides patient-centered, compassionate care to the Baytown community. Our board-certified health care providers enjoy getting to know their patients and listen attentively to develop personalized health plans. They are experts at guiding patients through the process of treating and preventing a wide spectrum of health issues.

Kimberlie Gonzalez, MD Family Medicine

G. Storm Walmsley, MD Family Medicine

Rebecca Dees, PA-C Family Medicine

3711 Garth Rd., Suite 306 | Baytown, TX 77521 Extended Hours available

Gregory Terry, MD Family Medicine

Trudy Istre, MS, RN, FNP-C Family Medicine

2610 N. Alexander Dr., Suite 201 | Baytown, TX 77520

Houston Methodist Primary Care Group is proudly supported by the leading technology and expertise of Houston Methodist San Jacinto Hospital and its medical professionals and staff. We look forward to taking care of you and your family. We are available to see you today!

Schedule online: houstonmethodist.org/primarycare or call 713.394.MPCG (6724)

calendar of events TYPE 2 DIABETES SEMINAR Date: March 31 Speaker: Dr. Manisha Chandalia pain management seminar Date: April 21 women’s health seminar Date: May 14

stroke awareness seminar Date: May 19 cancer survivors day Date: June 5 Time: TBD Location: Hospital lobby

Support Groups Ostomy Support Group Date: First Monday of the month Time: 6 p.m.

Information: 281.428.3033 Diabetes Support Group Date: First Tuesday of the month Time: 6 p.m.

Information: 281.420.8525

Cancer Survivors Support Group Date: First Thursday of the month Time: Noon Information: 832.556.6510 Grief Support Group Date: Third Thursday of the month Time: 7 p.m.

Information: 281.420.8811

All events take place in the Community Room from 6:30 to 7:30 p.m. unless otherwise noted.

To register for events, visit houstonmethodist.org/events or call 281.428.2273.

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