Leading Medicine Summer 2015, Houston Methodist Clear Lake Hospital edition

lEading MEdicinE Your link to health innovations, news and tips IN SOUTHEAST HOUSTON and the bay area

SUM M ER 2015

health tuneup

Make summer the time for a family wellness check

X-Ray, CT, MRI? Your Imaging Cheat Sheet

Metabolic Syndrome Risk Explained

Slow

Burn

steps to stop Reflux

What to do when heartburn gets out of control

Dinner out was a great idea. The food was delicious and the company entertaining.

But now, you’re paying the price. The burning sensation in your chest is all Dr. Kyle too familiar. So is Stephens the lingering, bitter taste. Whether you call it heartburn or reflux, it’s not the way to remember a good meal. Unfortunately, many people can relate.

Gastroesophageal reflux occurs when gastric acid, used by the stomach to digest food, escapes upward into the esophagus.

Lifestyle changes can help: Pass on spicy or fatty foods, eat smaller meals, and shed those extra pounds.

Over-the-counter medications help control symptoms.

When Small Changes Don’t Help

What Surgery Addresses

The lower esophageal sphincter is a muscle between the esophagus and the stomach. This valve, which allows food to pass into the stomach and closes immediately after a person swallows, provides a barrier to reflux. When the sphincter weakens and no longer closes correctly, acid and bile can reflux into the esophagus.

“The surgical gold standard is fundoplication,” Stephens explained.

“By wrapping part of the stomach tissue around the esophagus, we reinforce the sphincter muscle, preventing reflux.”

Some patients are candidates for an alternative procedure. A small, flexible band of interlinked titanium beads is placed around the esophagus just above the stomach. The magnetic beads expand and contract to allow swallowing. They resist gastric pressure and reflux.

After either procedure, most patients go home the following day on a soft diet, ready for moderate activity. n

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Free GERD Info Session

Oct. 21, 5:30–7 p.m.

Houston Methodist St. John Hospital Main Lobby Dr. Kyle Stephens will discuss GERD treatment options and answer questions. Registration is suggested. Visit houstonmethodist.org/ events or call 281.333.8899.

photo by thinkstock

If the symptoms become more frequent and more serious, such as regurgitation, sore throat, cough and chest pain, it’s time to see your doctor. You may have gastroesophageal reflux disease, or GERD, which is a chronic, and often progressive, problem. Gastric acid can damage the esophagus. Left untreated, it can aggravate asthma, cause Barrett’s esophagus (changes in the esophageal lining) and increase the risk of esophageal cancer.

Your doctor may recommend antacids or prescribe H2 blockers or proton pump inhibitors to help decrease the amount of acid your stomach produces. While medications help control symptoms, they don’t prevent GERD. When medications and lifestyle changes aren’t enough, Dr. Kyle Stephens, a Houston Methodist St. John Hospital surgeon, recommends anti-reflux surgery.

Laparoscopic anti-reflux surgery can restore the body’s ability to resist reflux.

Millions of people suffer from occasional heartburn, which results in a burning sensation in the chest and bad taste at the back of the throat. It’s caused when gastric acid from the stomach backs up into the esophagus. When heartburn becomes consistent and severe, you may have GERD (gastroesophageal reflux disease).

Lifestyle changes may help resist reflux: Avoid greasy, spicy foods and alcoholic drinks.

Eat small meals, but never before bedtime.

Remain upright after meals; sleep with your head slightly elevated.

Lose weight if you’re overweight.

Stop smoking.

Imaging IQ Having a diagnostic test done? Here’s what you need to know about common scans.

Until doctors themselves are equipped with X-ray vision, there’s a good chance you’ll need to undergo a diagnostic imaging test at one point or another.

Dr. John Gillespie It will help your physician determine the cause of your internal symptoms — whether it’s a worn hip, a suspicious lump or chest pain.

With today’s technology, your doctor can get answers earlier than ever about what is going on deep inside your body.

And that’s good news for you.

“The real key is early diagnosis,” said Dr. John Gillespie, chief of Radiology at Houston Methodist St. John Hospital.

“If you’re treated earlier, you’re likely to have a better recovery.”

Which Test is Which?

photo by thinkstock

Each imaging technology provides a different view of the body.

An X-ray is best for viewing bones for fractures, teeth for cavities and the chest for pneumonia. Mammography is a form of low-dose X-ray to examine breasts for cancer.

Magnetic resonance imaging (MRI) is ideal when it comes to soft tissue, such

as determining what might be going on inside a sore knee, hamstring, shoulder, or other joint or muscle. It also provides clear pictures of the spine and brain.

Ultrasound is best known for getting an early glimpse of a baby in utero, but it also can help assess internal organs for damage.

Positron emission tomography (PET) is often used to check for cancer and monitor its spread.

For years, computed tomography (CT) has been used to evaluate internal trauma and to detect cancer, but a newer version of the technology can identify plaque buildup in the arteries in the heart. The 64-slice CT creates a 3-D image by overlaying 64 X-rays on top of one another. “It creates a 3-D picture within seconds,” Gillespie said. n

Schedule Your Scan Online

Did your doctor order a diagnostic test? To schedule, visit houstonmethodist.org/online-scheduling for a CT scan, DEXA scan, mammogram, MRI, MRI 3T, ultrasound or X-ray appointment. You can also call 281.333.8858 to schedule.

finding a facility A diagnostic image is only a picture without a radiologist to interpret it. That’s why it’s important to choose an imaging facility like those at Houston Methodist, which are staffed by board-certified radiologists with fellowship training in subspecialties such as breast imaging and neuroradiology.

And not all images offer the same level of clarity. Houston Methodist’s nine imaging centers — including seven hospital centers and two stand-alone centers — partner with the world’s leading imaging companies to bring the latest technology available to patients.

A clear image, read accurately by an experienced radiologist, can lead to the diagnosis and treatment you need to ensure your health.

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Your Family’s

Summer Health Tuneup 4 LEADING MEDICINE IN southeast houston and the bay area

Think beyond the paper and pencils and make backto-school season the time for a family health check

D

ust off your daily planner: Back-to-school time means getting back to a routine, busy schedules and long to-do lists. But the season also offers a fresh start, making it a great time to take stock of your family’s health and ensure that everyone is up to date on exams, screenings and health goals. Not sure where to begin? We’ve got you covered.

For Her

Moms usually put the needs of everyone else before their own. Be sure these screenings are on your to-do list.

PAP TEST

Why it matters: A Pap test, which looks for cancer in the cervix, can save your life. If detected early, cervical cancer is highly treatable.

When to get it: After age 21, get a Pap test every three years. Once you hit 30, you can be tested once every five years.

Talk to your doctor about getting an HPV test at the same time.

Heads up on Concussions Injuries, including concussions, are part of sports at every level. But to prevent long-term damage, it’s important to understand the signs of a concussion — including confusion, amnesia, headaches, dizziness, nausea, or difficulty with balance or coordination — and what to do next.

If you think your child has suffered a concussion, make sure he or she sits out the rest of the game and sees a doctor right away.

If your son or daughter is an athlete, it’s wise to have a cognitive test on file as a benchmark. The Concussion Center at Houston Methodist St. John Hospital in the Orthopedics and Sports Medicine Program offers ImPACT Baseline Testing, a Web-based exam used to test cognitive ability.

The results provide a basis for comparison in the event that your athlete suffers an injury, requiring a postinjury test. Visit houstonmethodist.org/ impactbaseline or call 281.523.3355 to learn more.

MAMMOGRAM

Why it matters: These X-ray images are your first line of defense against breast cancer. Screening mammograms lead to early detection, which reduces the number of deaths from breast cancer. As screening rates have risen, the death rate has gone down — 34 percent since 1990.

When to get it: Schedule an annual mammogram starting at age 40. If you have a family history of breast cancer, your doctor may recommend you begin screenings earlier.

For Him

Men are known for avoiding doctor’s appointments. Not this year! Here’s what you need to know about the screening for the most common cancer in men.

PROSTATE CANCER SCREENING

photo by getty/Ariel Skelley

Why it matters: One in seven men

will be diagnosed with prostate cancer in his lifetime. Risk factors include being age 65 or older and having a family history of prostate cancer, abnormal prostate cells or certain genome changes.

Depending on your risk, your doctor may recommend a digital rectal exam or a blood test to measure the amount of the substance prostate-specific antigen, which can indicate prostate cancer.

When to get it: Houston Methodist recommends that men over 50 should discuss the PSA blood test with their doctors. African-American men and those with a family history of prostate

cancer should talk with their physicians about starting screenings at age 45.

For Both of You

In addition to scheduling regular checkups to test your cholesterol, blood pressure and other aspects of your health, don’t forget to schedule a colonoscopy starting at 50.

COLONOSCOPY

Why it matters: Like the majority of screenings, the goal of a colonoscopy is finding cancer early, when it is most treatable. A colonoscopy is the best way to look for (and remove) polyps, small growths that can become cancerous.

When to get it: Most men and women should start getting screened at 50, and then once every decade after that.

Those at high risk may require earlier or more frequent screenings.

For the Kids

Good health is a lifelong project.

Instill healthy habits in your kids by scheduling these appointments.

SPORTS PHYSICAL

Why it matters: If your teens will be joining a team (or two or three) this school year, they’ll need a doctor’s approval to participate. A Houston Methodist Orthopedics & Sports Medicine physician can address sportsspecific issues, like proper nutrition and hydration, injury prevention, training and good form.

When to get it: Although school district rules vary, one physical at the end of summer will typically cover your child for the school year.

IMMUNIZATIONS

Why they matter: Vaccines are a powerful tool for keeping your kids — and the kids around you — healthy.

By the time they hit school age, most children have had the majority of their immunizations, but there are a few to keep tabs on as they reach their teens.

When to get them:

• Annually: flu shot • Age 11: meningococcal conjugate vaccine • Age 16: booster shot n

Complete Your Health Checklist

Houston Methodist is here to keep you and your family healthy. Visit houstonmethodist.org or call 281.333.8899 to schedule an appointment with one of our board-certified physicians.

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Weighing Your Risk Identify and manage metabolic syndrome, a mix of potentially deadly risk factors

Did you know that one of the most deadly epidemics in health care also is one of the most preventable?

The growing obesity epidemic has increased incidence of metabolic Dr. Sonya Khan syndrome, a cluster of risk factors that can lead to poor health and premature death.

Here is what you need to know about metabolic syndrome.

What Is It?

“Metabolic syndrome is defined as having at least three of the following conditions: a large amount of abdominal fat, high blood pressure, high blood sugar, low levels of highdensity lipoprotein cholesterol and high levels of triglycerides,” said Dr. Sonya Khan, an endocrinologist at Houston Methodist St. John Hospital.

Having just one risk factor is cause for concern and makes you a more likely candidate for other risk factors. But the fact is that many American adults simply are not making this connection.

According to the American Heart Association, one in three American adults has metabolic syndrome, which significantly increases a person’s risk for the following:

Take Care of Yourself

To tackle the risk factors for metabolic syndrome, you’ll need to quit smoking, get more physical exercise and lose weight.

These steps will help reduce your blood pressure and levels of blood fat and blood sugar.

Cigarette smoking makes your body more resistant to the hormone insulin, which regulates blood-sugar levels.

Your doctor can suggest ways to quit, including smoking cessation drugs or programs, if you need help.

Get the all-clear from your doctor before you embark on an exercise program of moderate intensity, such as brisk walking, gardening, golfing or other activities. Aim to get 30 to 60 minutes of exercise most days of the week.

Choose fruits, vegetables and whole grains over processed foods, which tend to be filled with saturated and trans fats, salt and sugar.

“There’s no need to go to extremes on a starvation diet,” said Khan. Losing 5 to 10 percent of your body weight — safely — can make a difference. And there’s no need to deprive yourself of foods you love, so reach for a treat once a week or so. n

Healthy Solutions

Houston Methodist St. John Hospital offers a variety of services to help you get on track. From nutrition counseling and fitness classes to medical weight management programs, you can find health solutions to fit your needs. Call 832.667.LOSE (5673) to learn more.

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photo by thinkstock

What’s at Stake?

• Coronary heart disease and heart attack • Stroke • Type 2 diabetes • Atherosclerosis and peripheral vascular disease The good news is that metabolic syndrome can be prevented and controlled with lifestyle changes.

According to the National Cholesterol Education Program of the National Heart, Lung, and Blood Institute, the best prevention for metabolic syndrome is a healthy lifestyle: exercising, following a sensible eating plan and increasing physical activity, as well as regular physician visits to monitor blood pressure and cholesterol.

Emergency 101 Which symptoms should be considered an emergency and which can wait for your doctor?

In movies, it’s easy to identify emergencies.

They come in the form of horrendous car wrecks, dramatic heart attacks and suspenseful neardrownings. “While Dr. Sandeep these scenarios do Duggal occur in real life, most situations that require medical care are less black and white,” said Dr. Sandeep Duggal, chief of Emergency Medicine at Houston Methodist St. John Hospital.

Do you know what to do in an emergency? Duggal encourages everyone to take this quiz to learn which symptoms warrant a trip to the emergency department or a Houston Methodist Emergency Care Center — and which can wait for a visit to your primary care physician.

photo by photoshot

1

True or false: Unexplained chest pain is always an emergency.

Answer: True. Chest pain is the most common heart attack symptom for both men and women. Unless you’re certain the pressure is heartburn,

go to the hospital right away. Other symptoms may include shortness of breath, lightheadedness, fatigue, anxiety, sweating, nausea or vomiting, or pain in the back, neck, shoulders, arms, teeth or jaw. Women are more likely than men to experience these symptoms in addition to or in the absence of chest pain. Many women report just feeling tired leading up to a heart attack. Be vigilant about seeking care when you feel something is off with your health.

2

Which sports injury requires emergency care?

a. Mild concussion b. Sprained ankle c. Compound fracture d. All of the above

Answer: C. Compound fracture.

While serious concussions require immediate attention, mild concussions do not (although a follow-up visit to your doctor is recommended). Serious concussions should be treated right away. Symptoms of serious concussions include lasting confusion, seizure, unusual eye movement, unequal pupil

sizes, repeated vomiting, balance problems or loss of consciousness for more than a few seconds. Most sprains and strains can wait until your doctor can see you. While a broken bone can be treated at an urgent care facility, compound fractures — in which the bone protrudes through the skin — require immediate emergency treatment.

3

True or false: It’s OK to drive yourself or a loved one to the hospital during a potential stroke.

Answer: False. If you think you or someone you know is having a stroke, call 911. You may think driving to the hospital will be faster than waiting for an ambulance, but it’s not. Every minute counts when a stroke occurs, and when you call 911, medical care begins as soon as first responders arrive. On the way to the hospital, they perform vital tasks and alert the hospital to ensure that a stroke team is ready to treat you. n

How We’re Different Houston Methodist St. John Hospital Emergency Department boasts: Board-certified emergency physicians Nationally ranked in the 91st percentile of ED patient satisfaction Direct access to the top-ranked hospital in Texas Chest Pain Accredited facility Stroke Ready Designated

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