Leading Medicine Fall 2015, Houston Methodist Clear Lake Hospital edition

LEADING MEDICINE YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN SOUTHEAST HOUSTON AND THE BAY AREA

BE A WISE GUY

FA LL 2015

Take action against these men’s health symptoms

WIN A KINDLE!

Test Your Breast Cancer Knowledge

SEE INSIDE FOR DETAILS.

Weight Loss Surgery Program Offers Hope

Working It Out Thanks to the sports medicine program, one student-athlete is back in the game

Paul Williams is a young man with dreams. His senior year, the quarterback transferred to Clear Falls High School for the challenge of playing 6A football.

Dr. Kenneth First He hoped to lead the team to a state championship.

But it wasn’t to be. In the third quarter of the first game, a tackle ended his season.

“His mother and I were at the top of the stands when I saw the coach waving frantically,” his father said. “Paul was down, with his leg at a 90-degree angle.

I started running.” So did Dr. Kenneth First, an orthopedic surgeon at Houston

Paul Williams

Methodist St. John Hospital.

“I was at the game as a volunteer,” explained First. “Seeing the severity of this injury, I put the ankle back in place to take pressure off the skin and improve circulation. We stabilized him and got him to Houston Methodist St. John Hospital.”

First operated the next morning and later put together a rehabilitation plan.

With the help of his team’s coaches and trainers, Paul got busy.

Where Does It Hurt?

If you’re in pain and need assistance to get back to doing the things you love, call the Orthopedics & Sports Medicine Center at 713.363.9090 or visit houstonmethodist.org/orthopedics today.

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TEAMWORK WINS

“This injury would have been catastrophic if it had happened on a hiking trip, farther away from help,” First said. “It demonstrates the beauty of our sports medicine program.

Trainers are in place and doctors volunteer at games for situations like this. Paul deserves a lot of credit. I can perform a successful operation, but if the patient isn’t compliant, we may not have a good outcome.”

Paul’s determination paid off. By the last game of the season, he was cleared to wear his uniform and walk — First stressed that he walk — through the tunnel with his teammates. “It was awesome to be on the field again,” he said. That was only the beginning. Paul ended his senior year at left field for the Clear Falls baseball team, and is now playing football for Southwestern University. He’s back in the game. n

Test Your Breast Cancer Knowledge How well do you understand risks and prevention?

M

ost of us know someone who has faced breast cancer, but many don’t understand what we can do to prevent the disease, which is diagnosed in one in eight American women. Take our quiz to see how much you know.

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Most cases of breast cancer are diagnosed in women 50 and older. At what age should you start getting annual mammograms that can reveal breast cancer in the earliest stages?

steps can you take to 3What lower your risk of breast cancer?

A. D on’t use deodorant or antiperspirant.

B. A void wearing underwire bras.

C. M aintain a healthy weight and get regular exercise.

ANSWER: C. These healthy behaviors can lower your risk. The other answers are myths.

A. 60 B. 50 C. 40

Inheriting harmful mutations 4 in the BRCA1 or BRCA2 gene is one of the main risk factors

ANSWER: C. Most women should have an annual mammogram starting at age 40. If you are at high risk, ask your doctor about starting sooner.

for breast cancer. Which of these other factors can also increase your risk?

A. F amily or personal history of breast cancer B. L ong-term use of hormone replacement therapy C. All of the above

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Are mammograms the only way to detect breast cancer at an early stage?

A. Yes B. No C. It depends on the woman’s age

ANSWER: B. Annual breast exams at your doctor’s office and monthly breast

PHOTO BY THINKSTOCK

self-exams can help identify lumps or changes in your breasts that could be signs of cancer.

ANSWER: C. Other risk factors include dense breasts and having undergone treatment with radiation therapy to the breast and chest.

We Are Here for You

For more information or to schedule an appointment with one of our experts, call 713.790.2700.

Visit houstonmethodist.org/cancer to learn all about our cancer services.

HOW TO PERFORM A BREAST SELF-EXAM While lying down, place a pillow under your right shoulder and your right arm behind your head. With your left hand, move the pads of your fingers around your right breast area and armpit, using circular motions.

Squeeze the nipple to check for discharge. Repeat for your left breast.

Standing in front of the mirror, look at your breasts with your arms at your sides and then raise your arms overhead.

Perform these checks monthly, looking for these signs: A lump in the breast Any unexplained change in breast size or shape Dimpling anywhere on the breast Nipple tenderness or discharge A nipple that is turned slightly inward or is inverted Skin that’s become scaly, red or swollen, or any change in skin texture These signs do not necessarily mean you have cancer, but you should see your doctor to discuss them.

I have a test to find 5Should out whether I carry the BRCA1

or BRCA2 gene mutation that can cause breast cancer?

A. Yes B. No C. Maybe, if you have a strong family history of breast cancer ANSWER: C. A “strong family history” includes close relatives diagnosed before age 50, a family member with the gene mutations, or family members with multiple breast cancers, cancer in both breasts, or both breast and ovarian cancers. You should have counseling before deciding to have genetic testing. n

CHECK OUT OUR DIGITAL MAGAZINE AT HOUSTONMETHODIST.ORG/NEWSROOM/NEWSLETTERS 3

6 STRATEGIES FOR HEADACHE PREVENTION

When Pain Is a Real

Headache Finding hope for migraines

disabilities,” Dr. Burnett says. “They can cause a throbbing sensation, nausea, and vision or sensory disturbances.

They may run in families and are more common in women than in men.”

WHAT’S NEW IN MIGRAINE TREATMENT?

Dr. Burnett says there is hope for migraine patients beyond daily medication for preventive measures or pain medications. “Patients who suffer from intractable migraines — headaches 15 days of the month, four hours or more in duration — are having success with two relatively new methods: Botox and Cefaly.

• Botox injections are FDA approved for patients with intractable migraines and may reduce headache frequency by up to 50 percent. Botox is injected into the muscles over and between the eyebrows, in the forehead, both temples, back of the head, upper neck and both shoulders. Dr. Burnett recommends two injection visits over the course of three months before determining whether the treatment

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is promising for an individual who has migraines.

• Cefaly, FDA approved in 2014, is a stimulator that fits over an adhesive electrode pad above the eyebrows (similar to a headband). Worn 20 minutes each day, it delivers electrical stimulation that provides feedback along the supraorbital nerves, which are hypersensitive for people with migraines. Cefaly takes two months to reach maximum effectiveness. n

Need Headache Relief?

Learn more about headache diagnosis and treatment at Houston Methodist St. John Hospital. Call 832.783.1999 or visit houstonmethodist.org/stjohn today.

PHOTO BY THINKSTOCK

You’re stressed, and you suddenly feel like a vise grip is tightening around the top of your head. Or your headaches occur with nausea, a change in your vision or Dr. Leanne Burnett increased sensitivity to light or sound. Maybe you are involved in a routine, non-stressful task when you’re struck by head or neck pain.

Sound familiar?

The National Institutes of Health (NIH) reports that nearly two out of three children will have had a headache by age 15. More than nine in 10 adults experience headaches. Headache is the most common form of pain and a major reason cited for days missed from work or school and for visits to the doctor. Without proper treatment, headaches can be severe and interfere with daily activities.

Dr. Leanne Burnett, a neurologist and medical director at Houston Methodist St. John Hospital, says headaches fall within two main categories. Most are primary, and it’s uncertain what sets them in motion. Migraines are the most common; while others are cluster and tension headaches. Secondary headaches are symptoms of another health disorder such as infection, hydrocephalus, hemorrhage or head injury.

“Among the many types of headaches, migraines produce the greatest

Headache treatment is a partnership between you and your doctor, and honest communication is essential.

It may take some time for your doctor to determine the best course of treatment. Dr. Leanne Burnett, a neurologist and medical director at Houston Methodist St. John Hospital, suggests these strategies to prevent and manage headache: 1. Avoid pain medications more than twice a week; they can increase the frequency of headaches (this is not to be confused with prescribed daily preventive medication) 2. Avoid alcohol and caffeine (gradually wean caffeine over a oneto two-week period) 3. Maintain a regular sleep schedule 4. Exercise daily (aerobic exercise is recommended) 5. Eat three or four healthy meals each day, avoiding known food triggers 6. Explore relaxation techniques, such as yoga and meditation, that ease stress and related symptoms

Weighing

Your Options

Our weight loss surgery program offers hope and health When it comes to weight loss, there’s no shortage of advice.

Magazines, books and websites all promise they’ve discovered the key to losing weight.

However, because of Dr. Kyle the shortcomings and Stephens failures of diet and exercise approaches, bariatric surgery has become recognized as the most effective solution for long-term weight loss. After a weight loss procedure, most patients can decrease the amount of — or even stop taking — prescribed medications for diabetes, high blood pressure and high cholesterol. Joint pain may lessen or disappear completely.

Weight loss surgery is a safe and effective treatment option for those

affected by severe and morbid obesity.

These same procedures have also been recognized for their impact on metabolic or hormonal changes that play a major role in hunger (the desire to start eating) and satiety (the desire to stop eating).

“Obesity is a complex disease caused by many factors,” said Dr. Kyle Stephens, a bariatric surgeon at Houston Methodist St. John Hospital. “It is not simply the result of lack of willpower, but rather a combination of cultural, environmental, genetic and individual factors.”

WHAT’S BEST FOR YOU?

Depending on the type of surgery, benefits may include improvement or remission of a number of obesity-related conditions such as type 2 diabetes, heart disease, sleep apnea, high blood pressure and high cholesterol. Stephens will help you determine which surgery is best for you.

1. ROUX-EN-Y GASTRIC BYPASS. With gastric bypass, the size of the stomach is reduced, and a section of small intestine

PHOTO BY THINKSTOCK

ARE YOU CONSIDERING WEIGHT LOSS SURGERY? Bariatric surgery is a recognized and accepted approach for weight loss, as well as many of the conditions that occur as a result of severe obesity; however, not all people qualify for bariatric surgery. You may be a candidate if: Your body mass index (BMI) is 40 or higher (extreme obesity).

Your BMI is 35 – 39.9 (obese) and you have serious weight-related health problems, such as type 2 diabetes, high blood pressure or severe sleep apnea.

You meet the above criteria and your efforts to lose weight with diet and exercise have not worked.

is bypassed to limit calorie absorption.

2. SLEEVE GASTRECTOMY. With the sleeve, a portion of the stomach is removed, reducing the amount of food that can be consumed.

Most weight loss surgery is performed using minimally invasive techniques that allow people to go home one or two days after surgery. “No matter what procedure a patient chooses, the key to weight loss surgery is to use it as a tool to help control hunger, portion size and implement permanent lifestyle changes,” Stephens advised. “Unfortunately, there is no magic pill. Weight loss takes commitment, dedication and hard work.” n

Attend a Free Bariatric Surgery Info Session

Join us for an informational session on Wednesday, Oct. 14, from 5:30 to 7 p.m. in the Houston Methodist St. John Hospital Main Lobby. Dr. Kyle Stephens will discuss bariatric surgery options and answer questions. Visit houstonmethodist.org/ events or call 281.333.8899.

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Be a

Wise Guy Take action against these men’s health symptoms Guys, it’s not just the women in your life who frown on your tough-it-out approach to health problems.

Men are more likely than women to smoke and drink, make unhealthy choices and avoid regular medical care, according to the National Institutes of Health.

The American Academy of Family Physicians reports that about a third of men don’t have a primary care doctor, and nearly 30 percent delay medical care as long as possible when they’re sick.

Dr. Sam “Having a primary care doctor can keep you healthier as you age,” Lingamfelter said Dr. Sam Lingamfelter, family medicine physician at Houston Methodist St. John Hospital. “Your health care provider gets to know you and your health goals and delivers continuity of care, which has been proven to positively impact overall health.”

Many of the health risks men face can be prevented or treated successfully if identified early. But warning signs aren’t always obvious — and symptoms that seem minor can indicate a larger health problem. Here are five to take seriously:

SYMPTOM: SHORTNESS OF BREATH HEALTH RISK: HEART ATTACK

Heart attacks don’t always announce themselves with sudden, intense pain or squeezing in the center of your chest.

Sometimes they masquerade as pneumonia, for example, or asthma or fatigue. Shortness of breath may be your only signal to call 911 for lifesaving emergency treatment.

Men — who are at greater risk for heart attack and at earlier ages than women — should be especially alert to the possibility if they smoke, are physically inactive or overweight, or have high cholesterol, high blood pressure or diabetes. Those factors increase heart attack risk.

SYMPTOM: LOWER LEG PAIN, POPPING OR SNAPPING NOISE HEALTH RISK: ACHILLES TENDON RUPTURE

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PHOTO BY THINKSTOCK

The Achilles tendon connects the calf muscle to the heel bone at the back of the leg. A tear or rupture occurs when the tendon is overly stretched, typically during sports involving jumping, pivoting or sudden accelerations.

See a doctor if you feel sudden pain in your lower leg or hear a pop or snap. Treatment, which may involve surgery, depends on the severity of the rupture.

SYMPTOM: BACK NUMBNESS, TINGLING

HEALTH RISKS: HERNIATED DISK, SPINAL STENOSIS

The spine transports information from your brain to the rest of your body.

Numbness or tingling may signal herniated disks or spinal stenosis, which share symptoms but have different causes.

Over time, the rubbery disks between the spine’s vertebrae may rupture, or herniate. The jelly-like center of the disk then leaks, irritating nearby nerves and sometimes causing persistent pain along the sciatic nerve from the lower back to the lower leg. Treatment may include rest, therapy or surgery.

Spinal stenosis is a narrowing of the open spaces inside the spine. The condition puts pressure on the nerves and spinal cord, sometimes resulting in pain or numbness in the neck, back, arms or legs as well as problems with bladder and bowel function. Treatment may include medication, physical therapy, braces or surgery.

SYMPTOM: URINARY CHANGES

HEALTH RISKS: ENLARGED PROSTATE OR PROSTATE CANCER

Have you been going more frequently or urgently? Do you have trouble emptying your bladder? The prostate gland could be to blame.

Although the conditions sometimes share symptoms, an enlarged prostate does not necessarily signal prostate cancer. Both conditions are common in men starting at midlife.

The most common culprit for an enlarged prostate is benign prostatic hyperplasia (BPH), a condition in which abnormal cell growth causes the enlarged gland to press against the bladder and urethra.

See your doctor about troubling symptoms — immediately if you have bloody urine, pain or burning with urination or are unable to urinate.

For either problem, doctor-monitored watchful waiting may be the initial response.

SYMPTOM: SKIN CHANGES

AN OUNCE OF PREVENTION Even the healthiest men need regular screenings to ensure they stay at their best. Men should schedule a physical exam every two years until age 50 and annually after that, along with the following screenings: B LOOD PRESSURE: Every two years, more often if it’s high.

CHOLESTEROL, HEART DISEASE: Every five years after age 34, more often with high cholesterol or certain other conditions.

D IABETES: Every three years after age 45, earlier if you’re overweight.

COLORECTAL CANCER: Starting at age 50, earlier with inflammatory bowel disease, polyps or family history of colon cancer or polyps. Frequency depends on test performed and your risk factors.

PROSTATE CANCER: Talk with your doctor starting at age 50 (45 if you’re African-American or have a family history of prostate cancer).

L UNG CANCER: Yearly starting at age 55 if you have a 30 “packyear” smoking history and currently smoke or have quit within the past 15 years.

HEALTH RISK: SKIN CANCER

White men older than 50 are more than twice as likely as women to develop and die from skin cancer.

Yet nearly half of men said in a survey that they hadn’t used sunscreen in the past 12 months, and 70 percent didn’t know skin cancer warning signs.

Red flags can be subtle and include new growths, spots, bumps and patches, plus slow-to-heal sores and shaving cuts. Remember this ABCDE guide when checking for skin cancer: • Asymmetry: Is one half of the mole shaped differently than the other?

• Border: Are the edges of the mole irregular, ragged or blurred?

• Color: Is the mole more than one color?

• Diameter: Is the spot larger than a pencil eraser?

• Evolving: Has the mole changed in shape, size or color? n

Get Him to the Doctor

To find a physician, visit doctors.houstonmethodist. org or call the Physician Referral and Health Information Line at 281.333.8899 to make an appointment.

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