Leading Medicine Winter 2016, Houston Methodist Clear Lake Hospital edition

LEADING MEDICINE W INT ER 016

WEIGHING THE RISKS HOW EXTRA POUNDS CAN AFFECT NEARLY EVERY PART OF THE BODY

MIDLIFE SHOULDER CRISIS?

STUDENT ATHLETES: YOUR MUSCLES ALSO WORK AS A TEAM

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

SAFE, NATURAL RESULTS

Feeling Your

Best

Cosmetic surgery offers you change for the better Plastic Surgery found that people who had cosmetic surgery were perceived to be more likable than they were before surgery.

Modern techniques allow for lessinvasive procedures such as injections of fillers and neuromodulators (like Botox), with less downtime. Patients are increasingly seeking those options, and such quick-fix procedures can have significant benefits, but they may not be the best course for refreshing your look, said Dr. Daniel Casso, a boardcertified plastic surgeon at Houston Methodist St. John Hospital.

“The truth is that, in general, the less invasive a treatment, and the shorter the recovery time associated with it, the less impressive and enduring the results will be,” Casso said.

THE HOSPITAL ADVANTAGE

The option of having surgery in a full-service facility such as Houston Methodist St. John provides invaluable advantages for patients, Casso said.

Patients get the best care from fully trained and certified physicians using the most sophisticated technology, and their privacy and confidentiality is fully respected. And, if there is an unforeseen emergency, they’ll receive prompt and thorough attention. n

DOUBLE THE BENEFITS

Cosmetic surgery can require six weeks to two months’ recovery.

Oftentimes, however, it can be performed in conjunction with other medically necessary surgery, such as a hysterectomy or bladder surgery, and can allow for return to work or social activity without the need for additional recovery time.

Want to Discuss Your Options?

You can make an appointment to talk with one of our board-certified plastic surgery specialists by calling 281.333.8899.

2 LEADING MEDICINE IN SOUTHEAST HOUSTON AND THE BAY AREA

PHOTO BY THINKSTOCK

Changing one’s looks is a personal decision, which is why there are many reasons for choosing plastic surgery. Some may want to restore their youthful appearance.

Dr. Mark Barlow Others may dislike a particular feature or want to make physical improvements after surgery or an injury, such as a broken nose.

In 2014, more than 10 million cosmetic procedures were Dr. Daniel Casso performed in the United States, an increase of 274 percent since 1997, according to the American Society of Aesthetic Plastic Surgery.

When people have procedures to smooth out their facial wrinkles or restore the youthful contours to their figure, they appear not only younger but also happier, research shows. A study published in the journal JAMA Facial

Fortunately, modern surgical techniques safely and reliably produce pleasing and natural results, added Dr. Mark Barlow, a board-certified plastic surgeon at Houston Methodist St. John Hospital.

The modern comprehensive face-lift procedure uses the current understanding of facial anatomy to lift and reposition facial tissues. Eyelid rejuvenation surgery can safely restore youthful contours without unnatural-looking aftereffects that characterized some older techniques.

While some recovery time is required with these procedures, the results are typically substantial, Barlow said.

Patients usually go home the day of the surgery, but they also have the choice to stay overnight or longer.

Midlife Shoulder Crisis

Are You Ready for Pain Relief?

Act quickly when neck, back or shoulder pain or injury strikes.

To schedule an appointment with Dr. Edward Lee, call 713.363.9090.

Seek expert care when pain strikes this complicated joint

With age comes pain.

When it comes to wear and tear on the shoulders, the pain felt in the rotator cuff is very common among older adults. Because the shoulder has a Dr. Edward Lee wide range of motion and is used several times a day — every day — it is prone to problems over time.

According to Dr. Edward Lee, an orthopedic surgeon fellowship trained in shoulder arthroscopy and reconstruction at Houston Methodist St. John Hospital, many people don’t realize how highly complicated the shoulder, and more specifically the rotator cuff, actually is.

“There is a lot of misinformation and many misconceptions about exactly what the rotator cuff is and what it does,” explained Dr. Lee. “The rotator cuff is a term used to refer to four specific muscles around the

shoulder that serve as stabilizers of the shoulder joint and are instrumental in a person’s ability to raise the arm as well as perform lifting, pushing and pulling activities.”

Pain most commonly associated with the rotator cuff happens along the side and front of the arm and toward the elbow. If the pain is felt on top of the shoulder or at the side of the neck, other issues, such as problems with the cervical spine, may be present.

Available treatment options vary from medication and physical therapy to surgery. The most important step to take when you feel shoulder pain is to see an orthopedic surgeon with shoulder expertise, like Dr. Lee, who may properly assess the situation.

“Rotator cuff pain can progress very quickly,” Dr. Lee said. “That’s why it is imperative that patients seek medical attention sooner rather than later for pain that has been ongoing for more than just a few days.” n

PHOTO BY THINKSTOCK

STRETCH AND STRENGTHEN AGING SHOULDERS As people age, bones get weaker, and joints, such as the rotator cuff, are subject to wear and tear. Unfortunately, shoulder injuries and chronic conditions can develop even without a history of prior trauma. As a safe measure, Dr. Lee recommends stretching before any physical activity. He adds that light, weight-bearing exercises are also important to maintain good, general musculoskeletal health.

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

Weighing the

Dr. Sasikala Chittimireddy

Dr. Raj K. Bhalla

Q

The lives of millions of Americans are at risk every day. Why? More than 72 million adults are obese — and obesity is a gateway condition to a host of health problems that affect the heart, joints, internal organs and more.

Just how much damage can obesity do? Our experts answer three important obesityrelated questions.

The illustration on page 5 depicts the body’s obesity burden.

WHY IS IT IMPORTANT TO MAINTAIN A HEALTHY WEIGHT?

“As your body mass index rises, so does your risk for coronary heart disease, along with many other serious, obesityrelated conditions,” said cardiologist Dr. Raj K. Bhalla. “These include abnormal blood fats — high levels of triglycerides and LDL (bad) cholesterol, along with low levels of HDL (good) cholesterol — all risk factors for heart disease. Metabolic syndrome, the term for a group of risk factors, can

How extra pounds can affect nearly every part of the body

Risks lead to diabetes and stroke. Cancer, osteoarthritis, sleep apnea, gallstones, gout — all of these disorders are linked to obesity.

“The good news, though, is that weight loss can curtail some obesityrelated risks. Losing as little as 5 to 10 percent body weight offers meaningful health improvements.”

Q

WHAT ARE SOME OF THE BEST WAYS TO MAINTAIN A HEALTHY WEIGHT?

“There is no magic formula to achieve and maintain a healthy weight,” said Houston Methodist Primary Care physician Dr. Sasikala Chittimireddy.

“Regular physical activity and healthy diet choices are the time-tested and proven approach. Exercise increases your metabolism to burn extra calories and builds muscle — both help you look and feel good and keep the extra pounds off.”

Chittimireddy reminds us that exercise does not have to equal drudgery.

“Whatever your age or fitness level, and even if you’ve never exercised a day in your life, you can find enjoyable ways to add more movement into your life.

Gardening, group fitness and dance classes, even hula-hooping are options you might consider if hitting the gym is not your cup of tea. However, physical activity is just a small part of the

4 LEADING MEDICINE IN SOUTHEAST HOUSTON AND THE BAY AREA

equation. Cutting calories and making wise food choices is extremely important.

It’s easier to take out the calories than to try to burn them off.

“In addition, protein needs increase as we age. Muscle loss is a natural part of the aging process, so it’s important for older adults to eat more protein and nutrient-rich foods.”

Q

WHEN SHOULD SOMEONE CONSIDER SURGERY AS AN OPTION FOR WEIGHT LOSS?

“Weight loss surgery may be a valid option for those with a body mass index (BMI) of 40 or greater,” says bariatric surgeon Dr. Kyle Stephens. “A person with a BMI between 35 and 39.9 may be a candidate if he or she also suffers with obesity-related health conditions such as type 2 diabetes, high cholesterol, obstructive sleep apnea, high blood pressure, osteoarthritis or other disorders.

“Most patients see positive results when their decision to have weight loss surgery is combined with a commitment to a lifelong change in eating and exercise habits. Surgery is a very effective tool for weight loss but is not a magic bullet. After the surgery is when the real work begins. Developing and maintaining good behaviors that promote a healthy weight are crucial to patient success.” n

Brain

HOW EXTRA POUNDS AFFECT THE ENTIRE BODY

As BMI increases, so does the risk of stroke. Obesity can be tied to depression and anxiety.

Throat

Lungs

Sleep apnea, which can be due to an airway narrowed by neck fat, causes you to stop breathing multiple times during the night.

The possibility of developing asthma increases.

Heart

The long list of risks includes heart disease, heart attack, high cholesterol, high blood pressure and heart failure.

Esophagus

Gastroesophageal reflux disease (GERD) and esophageal cancer are sometimes linked to carrying extra weight.

Pancreas

Your body can lose the ability to properly use insulin, leading to diabetes.

Liver

Fatty liver disease and cirrhosis are risks.

Back

Being heavier means having a higher chance of back pain.

Gallbladder

You are at increased risk of gallstones and an enlarged gallbladder.

Reproductive Organs

Kidneys

ILLUSTRATION BY TRACI DEBARKO

Diabetes and high blood pressure due to obesity can lead to kidney disease and kidney failure.

Women can face abnormal periods and infertility.

Men may struggle with erectile dysfunction.

Colon

Knees

Obesity has been linked to colon cancer.

Extra weight can wear down the joints, leading to osteoarthritis.

FREE SURGICAL WEIGHT LOSS SEMINAR

Learn if bariatric surgery is right for you. On Feb. 11 from 5:30 to 7 p.m., Dr. Kyle Stephens will discuss your weight loss options and answer your questions. Sessions held often. Registration is required at houstonmethodist.org/events or call 281.333.8899.

Dr. Kyle Stephens  HOUSTONMETHODIST.ORG/STJOHN  5

Student athletes learn that muscles also work as a team

BUILDING MUSCLES A

ymiel Fleming seems destined to wear a Cougar jersey. As he ends his career as a La Marque High School Cougar, he’s already committed to a future as a Cougar at the University of Houston.

He was in peak condition for his last high school football season despite being sidelined with a lower-back sprain in the last game of the 2014–15 season.

An eclectic athlete, Fleming missed power lifting, track, tennis and baseball seasons before his doctor referred him to Rachel Lambert, a physical therapist at Houston Methodist St. John Hospital Orthopedics and Sports Medicine Center.

Fleming and Lambert were a good team, determined to get him back on the field stronger than ever. He was fascinated: “I outweigh her three times, but she could stop my forward motion with just two fingers.” And she

satisfied his insatiable curiosity: “Rachel showed me how my body works, how the smaller muscles control the bigger muscles. I took everything she taught me back to my teammates.”

Marcie Fleming believes physical therapy took her son to the next level of sports development. “Rachel explained everything in great detail, and he soaked it all up. It made a great difference in his UH football camp. Before he left, they offered him a full ride.”

Lambert and her colleagues aim for the same results with all their patients.

“We look at the entire body — how each part works as a team to support each other. We not only help rehabilitate our patients; we teach them how to strengthen their bodies to prevent further injuries. Parents see the difference. They ask us to work with our student athletes’ siblings before a problem occurs.” n

Get in the Game

When your doctor prescribes physical therapy, call the Houston Methodist St. John Hospital Orthopedics and Sports Medicine Center for your appointment at 281.333.8806.

6 LEADING MEDICINE IN SOUTHEAST HOUSTON AND THE BAY AREA

BACK IN ACTION If you live in the Greater Bay Area, there is no reason to be sidelined from an active lifestyle. Like Houston’s professional athletes — and your local Friday night heroes — you can rely on the experts at Houston Methodist St. John Hospital Orthopedics and Sports Medicine Center.

No matter your age or need, our licensed therapists work with your doctor to get you back on the field, the golf course or the dance floor. We have the program that is just right for you. In addition to our concussion and wellness centers, we offer comprehensive athletic development and training, as well as specialized therapies, including physical, neurological, joint replacement, speech-language, occupational and hand, pediatric and aquatic.

One of our eight convenient locations throughout Dickinson, Friendswood, La Porte, Nassau Bay, League City and Texas City is near you.

Ask your doctor for a referral.

Visit houstonmethodist.org/ orthopedics to learn more.

Woman-to-Woman Conversation Welcome

Dr. Francoise T. Vandaele welcomes your visit to discuss sexual dysfunction or other gynecologic issues you may be experiencing. To schedule an appointment, call 281.334.6875.

Women:

Take Note

PHOTO BY THINKSTOCK

Sexual function is a top area of concern for women, who say it contributes to their overall sense of well-being. We can help.

Sexual dysfunction is a relatively new term for an age-old problem. It refers to a condition in which a person does not experience pleasure from sexual activity Dr. Francoise T. and usually lacks the Vandaele desire or motivation to become sexually involved for a variety of reasons. While it occurs in both men and women, there is new information and new treatment for women that may help them overcome this problem.

Dr. Francoise T. Vandaele, a gynecologist at Houston Methodist St. John Hospital, has more than 30 years’ experience diagnosing and treating sexual dysfunction in women.

She believes it is important to note that while a woman may suffer from symptoms of sexual dysfunction, it does not necessarily mean she will be diagnosed with the condition.

“At some point in life, women will experience some symptoms that may

mimic sexual dysfunction,” explained Dr. Vandaele. “The diagnosis will only be made when the symptoms have been present for longer than six months and experienced on all or almost all occasions of sexual activity.”

These symptoms include a lack of motivation, lack of arousal and discomfort or pain during sex. These may occur at any time in a woman’s life and for a variety of reasons. It is important to note, according to Dr. Vandaele, that there is no one hormonal measurement that will positively confirm the diagnosis. It is best to discuss any signs with a gynecologist and, if necessary, take a screening test.

“It is a sensitive subject that women may not be willing to disclose easily,” said Dr. Vandaele. “Having the discussion with a gynecologist may help to better diagnose the problem and, more importantly, to find the best treatment for the patient.”

While there is no quick fix, there are several methods of treatment available ranging from alternative contraceptive treatment to counseling and, in some cases, hormone therapy. There is even a new “female Viagra” (see sidebar below) to treat sexual dysfunction. n

NEW TREATMENT FOR WOMEN’S SEXUAL HEALTH Medication is now available to premenopausal women suffering from hypoactive sexual desire disorder. HSDD is characterized by low sexual desire in a patient who previously had normal desire levels. Because of the risks involved when taken in conjunction with alcohol, antidepressants and other medications, only certified health care professionals and certified pharmacies are allowed to dispense the drug. Because it is the first drug of its kind to be approved by the Food and Drug Administration, Dr. Vandaele views it, as do most women, as an important step forward in the treatment sexual dysfunction.

HOUSTONMETHODIST.ORG/STJOHN 7

NONPROFIT ORG US POSTAGE

PAID

COLUMBUS WI PERMIT 62

Houston Methodist St. John Hospital 18300 St. John Drive Houston, Texas 77058-6302 houstonmethodist.org/stjohn

281.333.8899

LEADING MEDICINE IN GREATER HOUSTON

HOUSTONMETHODIST.ORG/STJOHN

HOSPITALS

Just around the corner Houston Methodist has locations throughout the Greater Houston area to best serve you near your home or workplace. Our locations include hospitals, and emergency care and imaging centers.

7 15

2. Houston Methodist San Jacinto Hospital

6. Houston Methodist Willowbrook Hospital

3. Houston Methodist St. John Hospital

7. Houston Methodist The Woodlands Hospital Opening in 2017

SPECIALTY HOSPITAL 8. Houston Methodist St. Catherine Hospital

SPECIALTY HOSPITALS EMERGENCY CARE CENTERS

6

5. Houston Methodist West Hospital

. Houston Methodist Sugar Land Hospital

HOSPITALS

14

1. Houston Methodist Hospital

IMAGING CENTERS

EMERGENCY CARE CENTERS 713.441.ER24 (3724)

. Houston Methodist Kirby Emergency Care Center 10. Houston Methodist Pearland Emergency Care Center

5 8

2

16 12

13

11. Houston Methodist Sienna Plantation Emergency Care Center 12. Houston Methodist Voss Emergency Care Center

9 1

13. Houston Methodist Cinco Ranch Emergency Care Center NOW OPEN! 1. Houston Methodist Cypress Emergency Care Center NOW OPEN! 15. Houston Methodist Spring Emergency Care Center Opening April 2016

IMAGING CENTERS 7. Houston Methodist Breast Care Center at The Woodlands Opening March 2016

4

10 11

facebook.com/houstonmethodist

3

twitter.com/methodisthosp

youtube.com/methodisthospitalhou

Protect yourself from heart disease with heartsmart behaviors and annual heart screenings.

Cardiovascular disease is the leading cause of death for men and women. Houston Methodist St. John Hospital provides heart scans for a calcium score, which can help you understand your risk and is a first step toward prevention. Screenings are beneficial for men between 40 and 65 and women between 45 and 70 or if you are considered intermediate risk. Risk factors include family history, smoking, high cholesterol, high blood pressure and diabetes.

For more information or to schedule a screening, visit houstonmethodist.org/heartscans or call 281.333.8899.

. Houston Methodist Breast Care Center 16. Houston Methodist Imaging Center

For more information about Houston Methodist or for a physician referral, please visit houstonmethodist.org or call 281.333.8899.

plus.google.com/+houstonmethodist