Leading Medicine Winter 2015, Houston Methodist Clear Lake Hospital edition

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

W INT ER 2015

THE HEART TRUTH

A guide to your heart and the procedure that can keep it beating strong

The Benefits of Cardiac Rehab

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Is It in

Your Head?

4 common conditions of ear, nose and throat — and when to see a doctor

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ead, shoulders, ears and throat, ears and throat. OK, maybe that’s not exactly how the song goes, but it’s a catchy way to remember what an otolaryngologist treats. Also called ENTs — which stands for ears, nose and throat —these physicians specialize in everything above the shoulders. That includes allergies, sinusitis, sore throats, acid reflux, ear infections, and head and neck cancers, to name just a few.

Dr. Melissa Hu, a Houston Methodist St. John Hospital otolaryngologist, shared insights about some of the most common ENT ailments and treatments.

EAR INFECTIONS

SYMPTOMS: Pain in the ear, fluid drainage from the ear, difficulty hearing WHAT TO DO: If pain is mild and there is no fever, take an over-the-counter medication. This typically means there is fluid behind the eardrum, which will usually clear up on its own. If pain is severe, fluid drainage develops from the ear or fever is high, get to the doctor.

Houston Methodist Nose Best

If you have ear, nose or throat issues and want to find an otolaryngologist, call 713.790.3333 for a physician referral.

ALLERGIES

SYMPTOMS: Red, itchy, watery eyes; sneezing; runny nose WHAT TO DO: Try to avoid the allergen by keeping windows and doors closed, keeping your home free from pet hair and dander, showering after being outside and leaving the dusting to someone else. Over-the-counter medications and nasal sprays are often effective. If they’re not, see your doctor.

SINUSITIS

SYMPTOMS: Nasal congestion that makes it difficult to breathe from the nose; thick, yellow or green mucus; pain or swelling around the nose, cheeks or forehead WHAT TO DO: See your doctor if you’ve have several episodes of sinusitis, if symptoms last more than seven days or if they don’t respond to treatment. ■

PHOTO BY THINKSTOCK

SYMPTOMS: Ringing, buzzing or other noise in the ear WHAT TO DO: See your doctor if tinnitus is accompanied by dizziness or hearing loss, if it begins suddenly without cause, or if the noise bothers you. Treatment depends on the cause of the tinnitus.

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PHOTO BY THINKSTOCK

TINNITUS

Take It

Easy

Going overboard with exercise is easy to do. But if it’s painful, it’s time to take a step back

PHOTO BY THINKSTOCK

PHOTO BY THINKSTOCK

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ost of us begin the New Year resolved to focus on health, improve fitness and enthusiastically hit the gym, the track or the court. But doing too much, too soon may derail your efforts and place you at risk for tendinitis.

Tendinitis is an inflammation or breakdown of the tendons that attach the muscle to the bone. “Tendinitis is most often caused by repetitive motions, like in a golf swing or climbing stairs,” said Dr. Kenneth First, an orthopedic surgeon and the director of sports medicine at Houston Methodist St. John Hospital. “Most of my patients can tell me a specific activity that troubles them, like shaking hands.”

Tendinitis can occur in almost any area of the body where a tendon connects a bone to a muscle. The most common places are the elbow, shoulder, hip, knee and Achilles tendon.

First uses medical history to help diagnose tendinitis. “Typically, not stretching before exercise or increasing your workouts suddenly leads to tendinitis,” he said. “Changing your activity surface or running shoes can also have an impact.”

SYMPTOMS

Tendinitis can affect anyone but becomes more common with age, as the tendons are less elastic, tolerate less stress and tear more easily. Symptoms may be gradual, or sudden and severe, and may include any of the following: • Pain that is dull or sharp and burning • Stiffness and swelling • Weakness • “Squeaking” or popping over the affected area

TREATMENT OPTIONS

There are several treatment options for tendinitis, including a few you can try at home: • Resting the injured area and avoiding repetitive motions

We Can Help

For more information or to schedule an appointment with our experts, call 713.363.9090.

• Icing for 15–20 minutes several times a day to reduce pain and inflammation • Nonsteroidal over-the-counter antiinflammatories, or NSAIDS • Physical therapy to increase range of motion and strength; bracing or splinting may also be an option • Corticosteroid injections to quickly decrease inflammation and pain ■

NEW WAVE TREATMENT FOR MUSCLES, TENDONS, BONES

ESWT (extracorporeal shock wave therapy) is a noninvasive method for treatment of localized musculoskeletal pain. A wide range of low energy shock waves are administered to the affected site to reduce pain and inflammation.

Dr. Kenneth First is one of the few physicians in the Houston area using this treatment in conjunction with other therapies, such as medications, bracing and physical therapy.

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FREE

GS

HEART SCREENIN

st is offering Houston Methodi ing events free heart screen reater Houston throughout the G r one near you, area. To register fo hodist.org/ visit houstonmet or call heartscreenings 713.790.3333.

The Heart Truth

A guide to conditions that can prevent your heart from beating strong the heart. If the heart can’t get the oxygen and nutrients it needs, it struggles to function properly. Worse yet, plaque can break loose and form a clot, causing a heart attack when the blood supply is cut off.

The best way to beat coronary artery disease? Prevent it from developing in the first place. You can do that by managing risk factors: Reduce high blood pressure or cholesterol levels, quit smoking, lose weight if overweight or obese, and lead an active lifestyle.

“There are some heart disease risk factors you can’t control, like family history, gender and aging. That’s why it’s vitally important to identify and address the ones you can influence,” said Nguyen.

Here, we take a closer look at how the heart works and what has the potential to harm it. ■

Heart

BASICS 1

The pulmonary artery carries blood out to the lungs, where it is oxygenated.

2

The pulmonary veins transport the oxygen-rich blood back to the heart.

3

The aorta then distributes this oxygenated blood to the rest of the body.

4

Once depleted of oxygen, blood returns to the heart and the process restarts.

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ILLUSTRATION BY JUDE BUFFUM

T

hink of your heart as your body’s delivery system. It pumps out the good stuff — oxygenated and nutrient-rich blood — to every inch of you via a network of arteries.

But heart disease throws a wrench into things. The most common form, coronary heart disease, is “the No. 1 cause of death for both men and women in most countries,” said Dr. Vince Nguyen, an interventional cardiologist at Houston Methodist St. John Hospital.

Coronary artery disease starts with artery damage caused by smoking, high blood pressure or a number of other factors. The damage triggers the buildup of plaque, which narrows the arteries and limits blood flow to

When it comes to the arteries, the aorta is the big cheese. This main artery is responsible for carrying most of the blood to the body. In a condition called aortic stenosis, calcium deposits can build up in the aortic valve, causing it to narrow and limit blood flow.

Atrial fibrillation

In people with atrial fibrillation, the heart’s upper chambers beat erratically, causing an irregular pulse. When left untreated, it can double the risk of a heart-related death and dramatically increase the chance of having a stroke.

Heart failure

In some cases, the heart struggles to pump enough blood to the body. Heart failure is measured by ejection fraction (EF), the percentage of blood pushed out with each heartbeat. An EF under 40 may indicate heart failure.

Cardiomyopathy

Cardiomyopathy is a disease that causes the heart muscle to become enlarged or stiff. Both blood flow and maintaining a regular heartbeat become tough tasks. The condition can be inherited, or it can surface because of another medical condition, such as high blood pressure. illustration by jude buffum

e art.

Aortic stenosis

Protect Your Heart

To schedule an appointment, call our Physician Referral and Health Information Line at 713.790.3333.

A Better Way to the Heart Your heart’s central location makes it convenient for tasks like pumping blood to your brain and stomach. But finding a way into the heart when something goes wrong can be challenging. Enter radial artery catheterization. Dr. Vince Nguyen, one of the few doctors in the greater Bay Area routinely performing the procedure, explains this new approach.

What is radial artery catheterization?

If a doctor needs to place a stent or clear a blockage, for example, he or she can access the heart via an artery in your wrist. A small tube is placed in the radial artery on the thumb side of the wrist. Using X-ray, the doctor guides the catheter up to the shoulder and then down to the heart.

What makes this approach different from the traditional procedure?

Traditionally, doctors used an artery in the groin to get to the heart. But going that route required patients to lie down for four to six hours after the procedure.

Plus, bleeding complications were difficult to identify. “Patients receiving the radial cath procedure are sitting up within minutes and leaving the hospital more quickly,” Nguyen said. “They are more comfortable both mentally and physically.”

What are the benefits for women?

“The radial artery approach is much safer for women, compared with accessing the femoral artery in the groin,” Nguyen said. “A recent study of more than 1,700 catheterizations in women showed the rates of bleeding or vascular complications were 59 percent lower when using this approach.”

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And the

Beat

Cardiac rehabilitation helps patients take the next step in reducing risk of recurring heart problems

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or patients who have suffered a heart attack or are living with a cardiac condition, treatment doesn’t end after leaving the doctor’s office or the hospital. In fact, the real work begins afterward in an effort to reduce the risk of future heart problems. For that reason, cardiologists often prescribe cardiac rehabilitation for their patients.

The Cardiac and Pulmonary Rehabilitation program at Houston Methodist St. John Hospital treats patients recovering from heart attacks, stable angina, coronary artery bypass surgery, valve repair or replacement, and heart surgery, including replacement and percutaneous coronary intervention

procedures, such as stenting and angioplasty. Patients go through a supervised exercise and education program three times a week for up to 12 weeks.

“Cardiac rehab programs provide education and counseling services to help heart patients increase physical fitness, reduce cardiac symptoms, improve health and reduce the risk of future heart problems, including heart attack,” said Joann Stroud, RN, the cardiac rehab coordinator at Houston Methodist St. John.

The cardiac rehab team is made up of a team of specialists, including physicians, nurses, exercise specialists and dietitians. n

Get Back to Good Health

In movies, when a character survives a heart attack, the person is elated, having been given a new lease on life. But in reality, heart attacks are traumatic events that can lead to depression and, in some, even posttraumatic stress disorder (PTSD).

A recent study found that one in eight heart attack survivors experiences PTSD, which is characterized by nightmares, elevated blood pressure, rapid heart rate and avoidance behaviors. Having PTSD after a heart attack doubles a survivor’s risk of having another heart attack within three years.

The best protection is to seek help if symptoms of PTSD last longer than a month.

Cognitive behavioral therapy can be effective. Talk to your doctor about your symptoms.

photo by thinkstock

Visit your doctor to find out whether you are a good candidate for cardiac rehabilitation. To schedule an appointment, call 281.523.2121.

Anxiety after Heart Attack

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photo by thinkstock

Goes on

Winning at Losing Tips to keep your weight loss resolution on track

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photo by thinkstock

photo by thinkstock

nly a few weeks after resolving to lose weight, you’re back in front of the TV, spoon in a bowl of ice cream while you ignore the dusty exercise bike in the corner.

Countless other would-be dieters join you in similar difficulties right about now.

Losing weight consistently tops lists of New Year’s resolutions. Just as consistently, about 35 percent of people who make resolutions break them by Jan. 31, one survey found.

More disheartening, only 20 percent of dieters succeed at long-term weight loss, according to the National Weight Control Registry.

Mimicking the habits of the successful 20 percent could move you into that exclusive group. Here’s a look at how to be a successful loser.

1

Keep It Positive

Think about the healthful behaviors you intend to create, not the bad ones you wish to break. Take a simple activity you already do daily, and create a new habit to accompany it.

For example, you might do five minutes of stretches immediately after waking up or eat a handful of baby carrots after taking your daily multivitamin.

2

Set Yourself Up for Success

Put your plan and your reasons for it in writing. Create modest, shortterm goals, such as skipping fast food one day a week or taking one flight of stairs at work.

Start Your Weight Loss Journey

Houston Methodist Weight Management Center knows weight loss is difficult, but we can help you. To learn more, visit houstonmethodist.org/weight-loss or call 832.667.LOSE (5673).

Prepare for success by stocking the kitchen with healthful, easy-to-prepare foods; keeping apples and nuts at hand to ward off snack attacks; and repackaging food into single servings.

Allow for an occasional treat, preferably planned, served in a single portion on a plate and savored one leisurely bite at a time.

3

Examine What Works

The National Weight Control Registry is a database of more than 10,000 adults who have lost at least 30 pounds and maintained the loss for at least one year.

Participants keep food diaries, stick to their diet even on weekends and get back on track quickly when their weight edges up.

Follow these other winning habits to stay on track: • 9 0 percent exercise an average of one hour daily.

• 7 8 percent eat breakfast every day.

• 7 5 percent weigh themselves at least once a week.

• 6 2 percent watch less than 10 hours of TV a week (the average American watches 28 hours a week). n

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Taking care of the entire family With locations throughout Greater Houston, Houston Methodist Primary Care Group is dedicated to providing care for the entire family and proud to ensure efficient access to specialty and hospital services whenever the need arises.

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