Leading Medicine Fall 2015, Houston Methodist Sugar Land Hospital edition

LEADING MEDICINE YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN FORT BEND AND SURROUNDING COUNTIES

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Take action against these men’s health symptoms

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Fort Bend’s Best Resource for Cardiac Care

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IS IT INDIGESTION OR A HEART ATTACK? A 54-year-old grandmother of three felt discomfort in her midsection while picking up her 2-year-old grandson. After a few days in pain, she went to the ER, where she collapsed. She was having a heart attack.

Although men are at greater risk for a heart attack, women are more likely to die from one.

This may be because the signs are usually different in women and men.

Many women don’t recognize the symptoms of a cardiac event, often believing it’s a virus, a gastrointestinal bug or some other problem.

Men usually experience crushing chest pain, making the need for a trip to the ER obvious.

Women tend to experience abdominal pain, nausea or unexplained fatigue. They also are more likely to have heart attacks later in life when other diseases, such as arthritis or diabetes, can disguise symptoms.

Realizing the symptoms are occurring and getting to a hospital with expertise in cardiology are crucial.

Insist on Houston Methodist Sugar Land Hospital

Call 911 immediately and ask to be taken to Houston Methodist Sugar Land Hospital if you experience any of the following heart attack symptoms: Chest pain or pressure, which may radiate down the arm Shortness of breath Nausea, vomiting and/or severe indigestion Breaking out in a cold sweat

PHOTO BY THINKSTOCK

In a cardiac emergency, a fast, comprehensive response can be the difference between life and death.

That’s why there’s only one place Fort Bend County residents need to be — Houston Methodist Sugar Land Hospital.

Our newly expanded, state-ofDr. B. Keith Ellis the-art Heart & Vascular Center opened in August to expedite care for cardiac patients.

As a nationally accredited Chest Pain Center, Houston Methodist Sugar Land demonstrates the highest level of expertise in treating heart attack patients, exceeding national standards in the most critical components of cardiac care.

In fact, patients are typically evaluated and treated in our cardiac catheterization lab in less than one hour after arriving at our emergency room — well below the national average.

“In a cardiac emergency, minutes count. When a heart attack patient arrives in our ER, our Emergency Cardiac Response Team is prepared to stabilize heart attack patients quickly and provide immediate intervention, including cardiac catheterization or surgery, if necessary,” said Dr. B. Keith Ellis, medical director of the hospital’s Chest Pain Center. “Other facilities in the area have cardiac emergency services but lack the surgical component, which is critical. We are the only hospital in the area to have 24/7 coverage with both interventional cardiologists and cardiac surgeons — all supported by the latest and most sophisticated technology and facilities.”

Adjacent to the hospital’s emergency room, the new Heart & Vascular Center includes a 19-bed observation unit, where patients are closely monitored by highly trained and experienced physicians, nurses and support staff, and four state-of-the-art cardiac catheterization labs.

Houston Methodist Sugar Land is also the only facility in Fort Bend County that performs open-heart surgery, including the most complex cases.

Patients undergoing non-emergency procedures also benefit from the expertise at Houston Methodist Sugar Land. “If there is a complication during a planned cath lab procedure, for example, other hospitals would have to transport you by helicopter or ambulance to another facility,” said Ellis. “That takes away precious time, which can increase the damage to your heart. We handle everything right here under one roof.”

For more information about our new Heart & Vascular Center, visit houstonmethodist.org/sugarland or call 281.274.7500 for a physician referral.

Spotting

Lung Cancer Early Dr. Robert Malone

BREATHE RIGHT

Lung cancer is the leading cause of death from cancer among men and women in the United States. More people die each year of lung cancer than of colon, breast and prostate

cancer combined.

Despite new diagnostic techniques, most patients are still diagnosed at an advanced stage of the disease.

Lung cancer screenings help high risk individuals receive a diagnosis and treatment plan at an early stage, when the disease is easier to treat — and possibly cure.

If you’re a current or former smoker, you may be eligible for lung cancer screenings that Medicare and private insurance now cover.

Following a U.S. Preventive Services Task Force recommendation, insurers this year began covering annual low-dose computed tomography (CT) scans for certain patients.

PHOTO BY THINKSTOCK

Q

WHO IS ELIGIBLE?

For Medicare beneficiaries, it’s those ages 55 to 77 who currently smoke or have quit in the past 15 years; who have a tobacco smoking history of at least 30 “pack years” (an average of one pack a day for 30 years, two packs a day for 15 years, etc.); and who receive a written order from a physician.

Under private insurers — which are required by the Affordable Care Act to cover lung cancer screenings — policyholders are eligible through age 80.

Q

WHAT DOES IT COST?

Lung cancer screenings are covered by private insurance and Medicare for eligible patients, but a copay or deductible may apply.

Medicare requires providers to include smoking cessation counseling prior to the scan. Call your insurance company for more information.

Q

WHAT HAPPENS DURING SCREENING?

A CT machine, using low-dose radiation, scans and takes pictures of the lungs while patients lie on a table and hold their breath for a few seconds.

“Aside from giving up cigarettes, lung cancer screening with CT is the most significant development in reducing deaths from lung cancer,” said Dr. Robert Malone, medical director of Radiology at Houston Methodist Sugar Land Hospital.

“Through screenings, we can detect lung cancer when it is small — long before

In addition to not smoking, you can do more to protect your lungs from cancer, asthma and other conditions. Adopt these habits to keep your lungs healthy.

G et moving. Stay active to boost your lung strength.

Consider swimming, which requires rhythmic breathing, or yoga, which can improve respiratory function.

E at right. Dietitians say foods such as broccoli, cabbage, salmon and eggs support lung health.

S trategize outdoor time.

Consider staying indoors when pollution and allergens are at higher levels. Check alerts by ZIP code at airnow.gov.

it becomes symptomatic or spreads outside the lungs.”

Ask your physician if lung cancer screening is right for you. n

Lung Cancer Awareness Event

Thursday, Nov. 12 • 6 p.m.

Houston Methodist Sugar Land Hospital Conference Center Meet the specialists involved in the diagnosis and treatment of lung cancer. Special recognition for any veterans who attend!

To register, visit houstonmethodist.org/events or call 281.274.7500.

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e Can Help W You Bounce Back

Get Back in the Game

To schedule an appointment with one of our specialists at Houston Methodist Orthopedics & Sports Medicine, visit houstonmethodist.org/ orthopedics for easy online scheduling or call 281.690.4678.

New Sugar Land orthopedics and sports medicine facility is a “home run” for patients

H

ouston Methodist Orthopedics & Sports Medicine’s new 75,000-square-foot facility — on the Houston Methodist Sugar Land Hospital campus — was designed to meet the growing orthopedic needs of the Fort Bend community.

Our new facility is nearly twice the size of our former building. It includes office and patient care space for Houston Methodist Orthopedics & Sports Medicine’s board-certified and fellowship-trained physicians and surgeons, along with dedicated areas for physical and occupational therapy, which include an indoor batting cage and golf net; an indoor pool with built-in treadmill for aquatic therapy; and an outdoor, 40-by-20-yard training field for athletes recovering from injury.

The outside training field will be used to more effectively rehabilitate athletes in the later stages of recovery.

“We’ll be able to better implement our ‘return to play’ testing, acquire more precise functional objective measures and create more effective performancebased rehabilitation protocols,” said

Dr. Timothy Sitter, an orthopedic surgeon and sports medicine specialist.

“All of which will ensure the athletes’ return to their pre-injury level of participation — or better.”

“This is an amazing facility,” said Dr. Carl Hicks, a joint replacement surgeon. “Our goal was to bring together all of our resources and provide the full range of services that patients need in a comfortable, convenient setting. This building is a definite home run.”

Houston Methodist Orthopedics & Sports Medicine has long been a leader in helping patients from Fort Bend and surrounding areas recover from sportsrelated or other orthopedic injuries or

conditions. The practice includes 13 experienced physicians — many with a long history of helping professional, college and high school athletes — along with specially trained physical therapy staff.

“From diagnosis through treatment and rehabilitation, we have everything a patient needs right here,” said Hicks.

“Whether the patient is a professional or amateur athlete, or just someone with an injury or chronic condition, we can provide the best possible medical care and treatment right here in Sugar Land.” n

CONDITIONS TREATED Achilles tendon rupture ACL repair Arthroscopy Back and neck pain Concussion

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Foot and ankle injuries Muscle strains Plantar fasciitis Rotator cuff injuries Rotator cuff tendinitis

SLAP tears Stress fractures Tendinitis Total joint replacement Wrist, elbow and hand injuries

Is Minimally Invasive Spine Surgery Right for You? Houston Methodist Sugar Land Hospital’s Neuroscience & Spine Center can help you find the best option Millions of people experience back problems that cause pain or disability.

Most patients find relief through conservative measures, such as Dr. John Park therapy, exercise and medication. But for the 10 to 15 percent of sufferers who need surgery to alleviate the pain, minimally invasive spine (MIS) surgery can be far less traumatic than traditional methods, according to Dr. John Park, a boardcertified neurosurgeon at Houston Methodist Sugar Land Hospital’s Neuroscience & Spine Center.

Before MIS surgery was developed, conditions such as degenerative disk disease, spinal stenosis, nerve compression, recurrent herniated disks, and trauma were treated with standard open surgery, which involved larger incisions, long surgery times and lengthy recovery periods. “With MIS surgery, these same conditions can by operated on through keyhole incisions no larger than a quarter,” Park said.

ADVANTAGES OF MIS SURGERY SHORTER HOSPITAL STAYS. MIS fusion

patients typically leave the hospital in

one to two days compared with three to five days for open spinal fusions. MIS decompressions and discectomies can be performed as outpatient procedures.

FASTER RECOVERY. MIS fusion patients typically return to normal, unrestricted activities and work much sooner. Patients undergoing one- or two-level spinal fusion can return to work within four to five weeks (eight to 10 weeks if their jobs require manual labor), as opposed to three to five months for open surgery.

SMALLER INCISIONS. With MIS surgery, muscle fibers are gently dilated to allow surgeons to visualize the necessary spinal anatomy with ½- to 1½-inch incisions. Traditional open surgery requires muscle stripping (muscle is removed from the bone) to expose the anatomical landmarks required for both bone removal and fusion.

LESS PAIN. Patients recover from postoperative pain more quickly.

Muscle stripping causes devitalization (death) of the soft tissues, which can jeopardize relief of mechanical back pain. Because MIS surgery avoids muscle stripping, patients don’t tend to have the chronic muscular fatigue during and after their recovery that often accompanies open surgery. n

PHOTO BY THINKSTOCK

See One of Our Specialists

If chronic back pain is affecting your quality of life, contact our care navigator at 281.274.7979. Our team of neurosurgeons, orthopedic spine surgeons, neurologists and interventional pain specialists works together to provide comprehensive, personalized care.

DEALING WITH MINOR BACK ACHES Most of us will experience back pain at some point. Prepare for this almost inevitable fact of life by learning how to safely relieve lower back pain. est right: Take pressure and R weight off your back by lying flat on your back and placing pillows under your knees.

Keep moving: Resting your back for a day or two is fine, but any longer, and your back muscles could weaken. Be sure to walk around for a few minutes every hour.

Stretch: Lie on your back with your knees bent and slowly raise your left knee to your chest. Press your lower back against the floor and hold for five seconds. Do 10 of these exercises with each leg.

Find comfort: Medications that relieve pain and swelling can make staying active easier. For painful back spasms, use a heating pad for about 20 minutes.

If your pain lasts longer than a few weeks, make an appointment with your doctor.

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Be a

Wise Guy Take action against these men’s health symptoms

G

uys, it’s not just the women in your life who frown on your tough-it-out approach to health problems.

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

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.

“Many of the health risks men face can be prevented or treated successfully if identified early,” said Dr. Paul Tse, a primary care physician with Houston Methodist Primary Care Group. “Warning signs aren’t always obvious, and symptoms that seem minor can indicate a larger health problem.” Here are several to take seriously:

SYMPTOM: SKIN CHANGES HEALTH RISK: SKIN CANCER

White men older than 50 are more than twice as likely as women to develop and die from skin cancer, the Skin Cancer Foundation says.

Yet nearly half of men said in a foundation 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,” said Tse. 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?

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,” advised Tse. Treatment, which may involve surgery, depends on the severity of the rupture.

SYMPTOM: BACK NUMBNESS, TINGLING

HEALTH RISKS: HERNIATED DISK, SPINAL STENOSIS

The spine is a superhighway that transports information from your brain to the rest of your body. Pay attention to the messages it sends. “If you are experiencing numbness or tingling, these may be signs of herniated disks or spinal stenosis,” said Tse. “Both conditions 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: 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,” warned Tse. “Sometimes they masquerade as pneumonia, for example, or as asthma, fatigue or chronic obstructive pulmonary disease (COPD).”

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.

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 are overweight.

C OLORECTAL 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 are African-American or have a family history of prostate cancer).

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,” said Tse. “Nor does it increase odds for developing the 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.

Treatment options can be complex. For either problem, close monitoring by your doctor may be the initial response.

NEED A PRIMARY CARE PHYSICIAN?

To make an appointment with Dr. Paul Tse or another physician at Houston Methodist Primary Care Group, visit houstonmethodist.org/pcg for easy online scheduling or call 281.276.0933. n

Free Flu Shot and Toy Drive Saturday, Oct. 24 • 8 a.m. – noon Houston Methodist Sugar Land Hospital Conference Center Bring a new, unwrapped toy or clothing item in exchange for a free flu shot. Toys and clothing will benefit local children in the Fort Bend area. No appointments necessary. Call 281.274.7972 for more information.

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