Leading Medicine Spring 2015, Houston Methodist West Hospital edition

leaDING MeDICINe Your link to health innovations, news and tips IN west houston/katy

SP RING 2015

gaMe changers

your springtime guide to getting fit without injury

How to Reduce Back Pain

Stroke: The Female Factor

health break looking for a rewarding health care career?

your mammogram:

now in 3-d The Methodist Breast Care Center at West Houston now offers 3-D mammograms, using the lowest radiation exposure available in the market. Tomosynthesis provides uniquely high-resolution images, and more important, there is no increase in dose from a 2-D standard mammogram, which means there is no increased radiation to patients.

“We are committed to providing our community the very best in technology and expertise, and this helps us to fulfill that mission,” said Dr. Correna Terrell, medical director of the Breast Care Center.

Tomosynthesis provides clearer images and more accuracy in cancer diagnosis than traditional mammograms, especially in women who have dense breast tissue. Callbacks for further imaging are reduced as well, as radiologists can pull images

from varying perspectives to examine anything suspicious.

Houston Methodist’s technology uses a low-dose, short X-ray sweep around the positioned breast with nine exposures acquired, using a “step-and-shoot” method. This removes the potential motion from the tube, helping to reduce blur and increase image sharpness.

The Breast Care Center offers comprehensive services, including all-digital mammography, breast ultrasound, breast MRI, ultrasound biopsies, stereotactic biopsies and MRI-guided biopsies, all under one roof. If cancer is found, the campus provides the most advanced treatments available, including chemotherapy, access to clinical trials, and hormone, drug and radiation therapy. Pioneering surgical techniques and breast reconstruction surgeries are also available.

To schedule your annual mammogram, go to houstonmethodist.org/online-scheduling or call 832.522.1234.

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Control Seasonal Allergies Are you sneezing more often lately?

Do you have itchy eyes or a scratchy throat? If you have allergies, it’s not surprising. Plants and flowers are still producing pollen this time of year. Also, traffic and pollution are always around.

Allergies can feel like having a cold, but allergy symptoms usually last longer.

And they may get worse when you’re outside or close to what you’re allergic to. Other signs include coughing, swollen or watery eyes, or a runny or clogged nose.

To help reduce your allergies, shut your windows. Use an air conditioner or humidifier to keep the inside air clean and moist. Check the local news for smog or pollen counts. If you can, avoid going outside when these numbers are high. Your pets might make your allergies worse, so try to keep them clean and out of your bedroom.

Talk to your doctor if your allergy symptoms are getting in the way of your daily life. Your doctor might be able to help you avoid allergens. He or she may also be able to prescribe medicine to lessen your allergy symptoms.

photos by thinkstock

Schedule Your Mammogram

Houston Methodist West and Houston Methodist St. Catherine have numerous openings. Call 832.522.0330, email HMWRecruitment@ houstonmethodist.org or visit houstonmethodistcareers.org for more information.

facing a hysterectomy? you’ve got choices Women today have more options regarding their health, including hysterectomy procedures.

No matter how it’s performed, a hysterectomy involves the removal of a woman’s uterus. It is typically performed to treat problems such as heavy bleeding or uterine fibroids (benign tumors). Cancer of the uterus, cervix or ovaries also may make a hysterectomy necessary.

Traditional hysterectomies are performed with abdominal surgery — requiring a large incision — or a vaginal procedure, which can only be used in cases when the uterus is small and no cancer is present.

Many doctors now are trained in the use of robotic and laparoscopic techniques, which involve three to

five small incisions in the abdomen.

The uterus can be removed wholly through the vagina or in sections through the abdominal incisions.

“By using a minimally invasive approach, we think recovery times are shorter,” said Dr. Ann Bertles, board-certified obstetriciangynecologist. “Women can usually return to work in three or four weeks after a laparoscopic hysterectomy, compared with six to eight weeks with a traditional procedure.”

There also tends to be less bleeding with laparoscopic procedures, as well as less scar tissue. “And having a few very small incisions is much more reassuring for women who don’t want to be left with the scar from a big abdominal incision,” Bertles said.

Springtime Smoothie Ingredients 21⁄4 cups chopped or grated carrots 11⁄2 cups pineapple juice 1 cup fresh orange juice Instructions

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Place chopped or grated carrots in blender and turn on high.

Through lid of blender, slowly drizzle in about 2 to 3 tablespoons of the pineapple juice, allowing the carrots to be puréed until smooth.

Slowly pour in remaining juice with honey.

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2 teaspoons honey 3 to 4 ice cubes 1 ⁄2 cup vanilla low-fat yogurt

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Allow to blend until smooth and somewhat frothy; then with blender on high, add ice cubes. Blend until ice cubes are blended smooth.

Stop blender, add yogurt, return lid and blend until thoroughly mixed.

Pour into chilled glasses.

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photos by thinkstock

Recipe was developed for Produce for Better Health Foundation by Chef Carmen I. Jones, CCP, and appeared on the website morematters.org.

NUTRITIONAL INFORMATION (SERVES 4) Calories: 143; carbohydrates: 32 g; total fat: 0.7 g; cholesterol: 2 mg; saturated fat: 0.3 g; dietary fiber: 2 g; sodium: 75 mg; protein: 3 g.

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Fitness Foils For every favorite springtime sport, there’s an injury that can keep you sidelined. Learn how to prevent the pain and stay in the game.

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F

or many of us, springtime means playtime. The sun is shining and the fields, paths and courts beckon. But one wrong move or too many years of pounding the pavement can leave you couch-ridden.

Here, we take a look at some of the most common sports injuries and how you can avoid them.

you love: Tennis You’re at risk for: Elbow pain

An injury so common it has its own name, tennis elbow is a condition caused by overuse of the arm, forearm and hand muscles. The weak grip strength and burning pain aren’t actually due to an injured elbow — these symptoms are telltale signs of damage to the forearm muscle that helps stabilize the wrist when the elbow is straight (during a ground stroke, for example). When this muscle is weakened from overuse, microscopic tears form in the tendon where it attaches to the joint, leading to inflammation and pain.

Get back in the game: Up to 95 percent of patients have success with nonsurgical treatment, but the first step is to put down the racket for a while. In addition to taking a break, drugs like aspirin or ibuprofen reduce pain and swelling. Be sure to have your tennis equipment checked for proper fit, too. Stiffer rackets that are more loosely strung may reduce stress on the forearm.

you love: Running

photo by superstock

You’re at risk for: Shin splints

Runners, admit it: You’re a wee bit crazy (in a good way, of course). Mile after mile, rain or shine, you pound away at that pavement. So it’s understandable that you refuse to let a little shin pain keep you from your daily sweat session.

When it comes to the all-too-common shin splint, there’s no true consensus among experts as to its cause. Theories

include small tears in the muscle that’s pulled off the bone, an inflammation of the muscle or a combination of the two.

Fortunately, experts agree on one aspect of shin splints: how to treat them.

Get back in the game: When splints strike, stop running or decrease your distance, depending on the extent of the pain. From there, ice your shins regularly to decrease inflammation, practice proper stretching and try cross training like cycling, swimming or yoga. When you return to your regular running schedule, work your way up by increasing mileage slowly — aim for a 10 percent increase each week. Wear the right shoes for your feet and try to avoid hills and excessively hard surfaces.

Meet the Experts Houston Methodist West Hospital’s orthopedic team can treat virtually every need you may have. Meet our team below.

Dr. Winfield Campbell Orthopedics and Sports Medicine

you love: Cycling You’re at risk for: Knee pain

Dr. Pedro Cosculluela Foot and Ankle

Cycling is practically the definition of a repetitive motion, with the average cyclist pedaling 3,600 times in an hour.

No wonder cyclists often experience knee pain from overuse. One common problem, patellofemoral pain syndrome, occurs when the patella (kneecap) gets out of alignment, causing wear on cartilage and pain around the kneecap.

Get back in the game: Knee injuries in cyclists are often caused by muscle imbalance. Exercises for the quadriceps and hips can strengthen the muscles that support the kneecap, keeping it in proper alignment. Ask a professional about your bike fit and cycling form.

A seat that’s too high or low can cause injury, as can pedaling with your knees facing inward or outward. n

Dr. D. Dean Dominy III Hand and Upper Extremity

Dr. Christopher K. Smith Joint Replacement Adult and Pediatric Orthopedics

Make an Appointment

To meet with an orthopedic specialist, please call 832.522.8280. If you need rehabilitation services, call 832.522.8200.

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A Pain

Back in the

Keep moving to prevent these three common back pain complaints

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n the next three months, about a quarter of American adults will have an episode of back pain. By age 50, most people will have had at least one run-in with an aching back. The good news is that back pain often goes away on its own.

“One or two days of rest is helpful, followed by a gradual return toward normal activities,” said Dr. Alexander West, Department of Neurosurgery chief and director of the Spine Center at Houston Methodist West. “Antiinflammatory medications (like ibuprofen) can help too. Most people start getting better within a couple of days.”

So when should you give it time — and when do you know it’s time to see your doctor? Here’s the low-down on three common complaints.

Lower Back Pain, No Leg Symptoms

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Back and Leg Pain

Pain that travels down the leg, possibly with leg numbness or weakness, can be a sign of a herniated disk. This happens when a disk — the cushioning between bones in the spine — presses on the nerves around the backbone. These symptoms warrant a visit to the doctor.

“Your primary care physician should check for red flags such as severe weakness or loss of bladder control, and will likely start physical therapy and medications,” West said.

“Folks with red flags or who don’t respond to nonsurgical care after six weeks may need X-rays and an MRI.” Based on test results, your doctor may recommend injections of steroids or an anesthetic to relieve pain. Surgery is also an option.

Trouble Moving

If you have back and leg pain that makes it difficult to walk distances and stand for a period of time, it may be spinal canal stenosis. This condition can be caused by arthritis or thickening of ligaments.

West urged people to see their doctor soon after symptoms begin in order to rule out more serious conditions and start treatment.

Mild symptoms may be relieved with physical therapy, while injections or surgery may be needed for more severe symptoms.

The key to prevention, West said, is exercise like walking, running, biking, swimming and yoga. “This allows the nerves to be in the best shape possible,” he said. “One cannot prevent nerve pinching, but a nerve with good nutrition, secondary to exercise, is more likely to tolerate the pinching.” n

Make an Appointment

If you are experiencing back pain, call the Spine Center at 832.522.8500.

photo by thinkstock

The recommendations above are a good place to start. But if your symptoms linger for more than a few days, your doctor might recommend physical therapy or other medications, such as muscle relaxants. Most people will feel better quickly, West said, but for those who don’t, an X-ray or MRI

may be needed to get a closer look at the issue.

Opening Soon!

Stroke: The Female Factor Learn about the risk factors that make women uniquely vulnerable to stroke

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id you know that stroke kills twice as many women as breast cancer each year? Or that 55,000 more women than men will have a stroke in the coming year?

If this is news to you, it is to many women: 40 percent said in a recent survey that they were only somewhat or not at all concerned about stroke, and most were not knowledgeable about risk factors.

“Women and men share some of the same stroke risks, such as high blood pressure, heart disease, diabetes, obesity and a personal or family history of stroke,” said Dr. Nicolas Nammour, neurologist at Houston Methodist West.

But women also have other risk factors that don’t affect men. For one, they generally live longer, and the odds of having a stroke increase with age.

Guidelines recently introduced by the American Heart Association/American Stroke Association outline the extra risks for women. Take note, and discuss these risks with your doctor.

photo by Thinkstock

Risks for Women

If you’ve had preeclampsia — a common pregnancy complication that causes a sharp increase in blood pressure — your risk of having a stroke during your lifetime doubles. Your odds of developing high blood pressure are

four times higher, which means your stroke risk increases, too.

As a result, preeclampsia should be considered a risk factor throughout your life. If you have high blood pressure, taking birth control pills can also increase your risk of stroke.

Smoking is a stroke risk for everyone, but it’s multiplied if you are a woman prone to migraine headaches with aura.

Other risk factors that tend to be more pronounced or more common in women than in men include high blood pressure, atrial fibrillation, diabetes, depression and emotional stress.

Houston Methodist Cinco Ranch Emergency Care Center opens in April on FM 1093, between FM 723 and FM 1463. Board-certified emergency medicine physicians and specially trained staff will treat patients of all ages, 24/7.

• Adopt a healthy diet. A low-fat, low-salt regimen that includes whole grains, fruits and vegetables can reduce elevated blood pressure.

• Get your blood pressure checked annually. High blood pressure has no symptoms, so it is especially important to schedule a test if you haven’t had one recently.

• Slim down. Losing even 10 pounds can make a difference in blood pressure levels. n

Reduce Your Risk

For both men and women, high blood pressure is the leading cause of stroke.

When blood pressure is high, blood pumps harder than it should, straining the vessels of the circulatory system. A stroke can occur when the increased pressure either blocks or breaks vessel walls, stopping blood flow or causing blood to leak into the brain.

To reduce your risk of high blood pressure and stroke: • Understand your risk factors. Many of these, including smoking, drinking, obesity and high cholesterol, can be controlled with lifestyle changes.

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