Leading Medicine Summer 2015, Houston Methodist Sugar Land Hospital edition

LEaDiNg MEDiCiNE Your link to health innovations, news and tips IN FORT BEND And Surrounding COUNTies

SUM M ER 2015

health tuneup

Make summer the time for a family wellness check

Joint Health at Every Age

Docs Team Up on Complex Cancers

Peace of Mind

Headaches and other neurological conditions don’t need to disrupt your life Headache is one of the most common disorders worldwide, affecting nearly half of the adult population in a given year.

Yet it’s frequently underrecognized Dr. Rajesh Bindal and undertreated.

Migraine is a form of headache that affects 29.5 million Americans. Despite its prevalence, the exact causes of migraine are not well understood.

However, researchers Dr. Amitabh know that certain Shukla triggers, which vary between patients, can lead to migraine.

A combination of them is more likely to cause a migraine than a single factor.

Typical triggers include irregular sleep patterns, skipped meals, stress, weather, bright lights, strong odors, hormonal changes, or consuming alcohol, caffeine or certain foods. Keeping a headache diary can help you identify your particular triggers.

Where to Seek Treatment

Our team of neurosurgeons, neurologists, orthopedic spine surgeons and interventional pain specialists treats a wide variety of disorders: Alzheimer’s and memory disorders Amyotrophic lateral sclerosis (ALS) Back and neck pain Brain and spinal tumors Epilepsy and seizures Migraines and headaches Multiple sclerosis (MS) Muscle and nerve injuries Parkinson’s disease and movement disorders Peripheral neuropathy Stroke “Our approach is very patient-centric, with a dedicated focus on improving quality of life,” said neurologist Dr. Amitabh Shukla. “Our goal is to provide the best possible care through collaboration and sharing.”

To schedule an appointment with a specialist at our Neuroscience & Spine Center, call 281.205.4662. n

Attend a FREE Stroke Seminar

Thursday, Sept. 10 • 6 p.m.

Houston Methodist Sugar Land Hospital Conference Center Join neurologist and stroke expert Dr. James Ling for a discussion on the symptoms, prevention and treatment of stroke. To register, visit houstonmethodist.org/events or call 281.274.7500.

2 LEADING MEDICINE IN FORT BEND And Surrounding COUNTies

photo by thinkstock

Whether you are experiencing migraines or seeking treatment for a complex neurological condition, Houston Methodist Sugar Land Hospital’s Neuroscience & Spine Center offers sophisticated therapies and advanced, multidisciplinary treatment options

to patients in the Fort Bend and surrounding areas.

The center’s doctors treat a wide range of neurological diseases and conditions, with specialized clinics for spine, headache and stroke patients.

The center also provides comprehensive treatment and services for patients with multiple sclerosis, epilepsy, Parkinson’s disease and other movement disorders.

“What sets us apart is our subspecialty expertise,” said neurosurgeon Dr. Rajesh Bindal. “Many of our physicians are fellowship trained with experience at some of the country’s most elite institutions. Working as a team and collaborating on patient care, we treat even the most complex cases right here in Fort Bend, close to the patient’s home.”

Patients also benefit from access to full-time care navigator Maureen Lall, a registered nurse who expedites appointments — ensuring that patients see a specialist within five days — and serves as a liaison between physicians and patients.

what we treat

When Less Is More

Differences That Matter

Minimally invasive hernia procedures make sense for some patients A hernia occurs when an organ protrudes through the wall of the cavity that contains it, usually occurring in the abdomen.

“They can be Dr. Timothy very uncomfortable Oppermann and painful, and may lead to dangerous complications if not addressed through surgery,” according to Dr. Timothy Oppermann, a general surgeon with Houston Methodist Dr. Michael Surgical Associates.

Yaakovian Learn more about one type of procedure that can help.

Q

What is laparoscopic hernia surgery?

photo by thinkstock

With the help of a small camera called a laparoscope, the surgeon is able to repair the hernia from the inside instead of making a large incision. “This type of surgery drastically reduces the recovery time and risks of surgery for some patients,” said Dr. Michael Yaakovian, a general surgeon with Houston Methodist Surgical Associates.

Q

What makes it different?

Instead of one large cut, it uses a series of smaller incisions, about one-half inch each, Yaakovian explained. The

body is not opened to the air; instead, the instruments required to perform the surgery are inserted through these holes and the doctor operates while observing through the laparoscope.

Q

Why opt for laparoscopy?

This technique has many benefits for the patient: • Shorter recovery time: The nature of the incisions makes laparoscopic hernia surgery much less traumatic to the body and speeds healing.

• Less pain: The precision of this surgery allows the surgeon to fix the problem while leaving the rest of the surrounding tissue relatively untouched.

• Lower risk of infection: Smaller, quicker-healing incisions give infections less opportunity to cause complications. “It’s an outpatient procedure, and most patients can return to nonstrenuous activities the very next day,” noted Oppermann.

“It also doesn’t require as much incision care as with open surgery.”

Undergoing hernia surgery can be a daunting prospect. Concern about pain and scarring leave many worried and reluctant. With minimally invasive techniques such as laparoscopic surgery, patients experience an easier recovery and other benefits: Shorter hospital stays Smaller surgical scars and less scar tissue Fewer traumas to the body Less pain and need for pain medication Less blood loss and decreased need for transfusions Reduced risk of infection Quicker return to normal activities and diet

Q

Are all hernia surgeries done this way?

No. There are certain types of hernias that require open surgery, and other patients may still prefer open surgery for a variety of reasons. But many find laparoscopic hernia surgery to be the more attractive option for them. n

Consult an Expert

To schedule an appointment with Dr. Timothy Oppermann or Dr. Michael Yaakovian with Houston Methodist Surgical Associates, please call 281.275.0860.

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Your Family’s

Summer Health D Tuneup

Think beyond the paper and pencils and make back-toschool season the time for a family health check

ust off your daily planner: Back-toschool 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.

Dr. Adrianne Scruggs with Houston Methodist Primary Care Group recommends following these guidelines for yourself and your family.

4 LEADING MEDICINE IN FORT BEND And Surrounding COUNTies

For Her

“Moms usually put the needs of everyone else before their own,” Scruggs said. She suggests putting these screenings 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.

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,” warned Scruggs. 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

Student Physicals Saturday, Aug. 1 • 9 a.m. – noon Houston Methodist Orthopedics & Sports Medicine 16811 Southwest Frwy., Sugar Land Extracurricular preparticipation physicals will be available for all students ages 12–18. Cost is $20 (cash only accepted).

Orthopedic, sports medicine and cardiology specialists will be on-site to provide additional clearance as needed. For more information, email athletictrainer@houstonmethodist.org or call 281.340.6420.

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, Scruggs said 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,” added Scruggs. “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 sports-specific 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 them — 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

To schedule an appointment with Dr. Adrianne Scruggs or another physician with Houston Methodist Primary Care Group, visit houstonmethodist.org/online-scheduling or call 281.276.0933.

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A Joint

Approach

Osteoarthritis isn’t inevitable. At every age and stage, you can fight back.

Dr. Timothy Sitter

Hips, knees and shoulders — they’re the stuff of mobility and independence, and keeping them in tiptop shape is vital. Not doing so could lead to osteoarthritis, a progressive, degenerative disease in which joint cartilage breaks down. Though the condition may seem inevitable as we age (more than 27 million Americans have it), we can do a lot to prevent osteoarthritis.

Dr. Timothy Sitter, a knee and shoulder surgeon with Houston Methodist Orthopedics & Sports Medicine, shares a by-the-decades plan for keeping joints strong for the long haul.

20s and 30s:

Protect Your Joints

“Exercise regularly and lift weights to strengthen muscles that support joints,” Sitter said. He also recommended maintaining a healthy weight and getting enough calcium, magnesium and vitamin D in your diet to support bone and joint health.

Though many people are fit at this age, Sitter noted that those who are overweight or have experienced a severe injury within the past 10 years may begin to develop early signs of osteoarthritis, including joint pain and stiffness.

40s and 50s:

Keep a Healthy Weight

60s, 70s and Beyond:

Stay Active

As you age, the chances are greater that you’ll develop osteoarthritis in your hips, knees or shoulders, Sitter said.

“Genetics, past injuries, excess weight and physical inactivity all play a role in its development and severity.”

Severe symptoms, like constant pain and very limited mobility, aren’t uncommon, but anti-inflammatory medication, weight loss, physical therapy and exercise can help. “Even in late age, losing weight can help decrease joint pain in the knees and hips, while regular stretching

Tuesday, Sept. 15 • 5–7 p.m.

Houston Methodist Orthopedics & Sports Medicine 16811 Southwest Frwy.

Meet the physicians and tour our new state-of-the-art facility now located on the Houston Methodist Sugar Land campus. Refreshments, door prizes and free gifts for attendees. To RSVP, visit houstonmethodist. org/events or call 281.275.0751.

and strengthening can help lubricate hip, knee and shoulder joints and increase flexibility,” Sitter said.

Unfortunately, some people will reach a point where the pain is unbearable.

“In the most severe cases, osteoarthritis can make it hard to walk, lift or reach, or even be self-sufficient,” he said. “In these cases, joint replacement can provide pain relief, improve range of motion and mobility, and restore independence.

Joint replacement is a good option to have down the road in a worst-case scenario, but the opportunity to decrease your chances of needing one is in your hands today.”

To schedule an appointment with Dr. Timothy Sitter or another specialist with Houston Methodist Orthopedics & Sports Medicine, visit houstonmethodist.org/orthopedics or call 281.690.4678. n

Free joint pain seminar Wednesday, Sept. 30 • 6 p.m.

Houston Methodist Sugar Land Hospital Conference Center

Is chronic joint pain slowing you down? From diagnosis to rehabilitation, Dr. Timothy Sitter will discuss the latest medical advances to help you get back to the active life you enjoy. To register, visit houstonmethodist.org/events or call 281.274.7500.

6 LEADING MEDICINE IN FORT BEND And Surrounding COUNTies

photos by thinkstock

The toll of earlier injuries or joint damage related to excess weight over time starts to mount.

You may notice creaking or popping in your knees when climbing stairs, stiffness for a few minutes after waking, or a dull ache in your hips after exercise. Weight loss, physical therapy or anti-inflammatory medications may alleviate these mild symptoms.

“Every extra pound puts four pounds of pressure on your knees and

can further exacerbate osteoarthritis symptoms,” Sitter said. “This is the time to do all you can to help your joints last as long as possible, so eat right, stay active and do what it takes to maintain a healthy weight.”

Attend an Open House!

Better

Together Physician collaboration improves treatment of gynecologic cancers When Dr. Kimberly Evans encountered a patient in her mid-50s with an enlarged uterus, large fibroid tumors and abnormal bleeding, she performed an initial Dr. Kimberly workup, including Evans blood work for a known tumor marker.

The lab results showed no evidence of cancer.

However, the Houston Methodist Sugar Land Hospital obstetriciangynecologist Dr. Tarrik Zaid suspected there was more to the story. Evans referred her patient to Dr. Tarrik Zaid, who specializes in gynecologic oncology.

Zaid performed surgery to remove the mass and found one fibroid tumor that was cancerous. He skillfully removed the tumor and dissected nearby lymph nodes in order to stage, or identify, the type and severity of the cancer.

provide better care, even in situations where cancer is not present but surgery is complicated by other factors.”

In some cases, Evans and Zaid perform surgery together; other times, the patient is referred to Zaid for surgery and then returns to Evans for ongoing care. The two doctors collaborate frequently to determine the best approach for patients with complex anatomies or when there is a possibility of cancer.

“Studies show that survival rates increase dramatically when patients are treated by a specialist in gynecologic oncology,” said Zaid. “By working together with obstetrician-gynecologists such as Dr. Evans, we are improving the speed and thoroughness with which we identify and treat ovarian, uterine, cervical and other gynecologic cancers.

That level of collaboration and teamwork is vitally important.” n

don’t dismiss symptoms You have a Pap test regularly, so you’re covered when it comes to gynecologic cancers, right? Wrong.

The only cancer for which a Pap test screens is cervical cancer. It doesn’t screen for ovarian, uterine, vaginal or vulvar cancers. So if you have abnormal vaginal bleeding or any of these symptoms for two weeks or longer and they’re not normal for you, see a doctor: Pelvic pain or pressure Abdominal or back pain Bloating Changes in bathrooms habits Itching or burning of the vulva Changes in vulva color or skin, such as a rash, sores or warts

photo by thinkstock

The Power of Team

“Our team approach to complex cases provides numerous benefits to patients,” said Evans. In this patient’s case, the end result was a faster, more accurate diagnosis and an enhanced, more effective treatment plan.

“I could have performed the surgery to remove the mass,” Evans explained, “but if we find it is cancerous, then the patient must undergo a second surgery, which is stressful and delays ongoing care. Working closely with Dr. Zaid allows me to provide the best possible outcomes for my patients. Together, we

Schedule Now

To make an appointment with Dr. Kimberly Evans or another obstetrician-gynecologist in your area, please visit houstonmethodist.org/sugarland or call 281.274.7500 for a physician referral.

To schedule an appointment with Dr. Tarrik Zaid with Houston Methodist Gynecologic Oncology Associates, call 281.275.0880.

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