Leading Medicine Winter 2016, Houston Methodist West Hospital edition

LEADING MEDICINE W INT ER 06

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

WAYS TO HELP YOUR HEART TODAY

READY, SET, RUN TO BETTER HEALTH

YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN WEST HOUSTON/KATY

HOW CAN YOU PREVENT INJURY?

Ready, Set

Run Start today to reap endless health benefits

If you’ve always wanted to call yourself a runner, the time is now. It’s easy to start a running routine. It’s relatively inexpensive, you don’t need hightech equipment, Dr. Pedro you can do it almost Cosculluela anywhere, and you don’t have to learn special techniques — after all, you already know how to run.

To get you started, we answer some top questions about how to begin a running program and how to best protect your joints from injury during exercise.

Besides helping you lose or maintain weight, stave off stress, improve cholesterol and lower blood pressure,

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HOW CAN YOU START RUNNING IF YOU NEVER HAVE BEFORE?

First, you will need to plan your running schedule. Mark exercise appointments on a calendar or in your smartphone to be sure you don’t miss a workout.

“The key to beginning running — and being able to stick with it — is to start slowly,” Cosculluela advised. Whether you are on a treadmill or outdoors, try interval training to build endurance.

Begin with a five-minute walk and add one-minute increments of jogging, switching back to a brisk walk. Try this workout several times your first week for at least 15 minutes and slowly replace time walking with time jogging, and also slowly increase distance.

Consider joining a running club in your city. “Running clubs give you a sense of camaraderie and can make running more enjoyable,” Cosculluela said. “In addition, you will be running with others who have your similar fitness level, so you can share tips on how to get through obstacles and encourage one another’s accomplishments.” n

Talk to a Doctor

Learn more at houstonmethodist.org/west or make an appointment with Dr. Pedro Cosculluela by calling 832.522.BONE (2663).

PHOTO BY THINKSTOCK

WHAT HEALTH BENEFITS DOES A REGULAR RUNNING ROUTINE PROVIDE?

running ultimately can help you live a longer and healthier life. In fact, Stanford University researchers found that runners had a lower risk of dying an early death compared with other healthy adults their same age.

But before you hit the ground running, consult with your doctor to be sure it’s the best exercise for you, said Dr. Pedro Cosculluela, an orthopedic surgeon specializing in the foot and ankle at Houston Methodist West Hospital. “If you have known arthritis in ankles or hips or a heart condition, running may not be the best exercise regimen choice.”

Despite what your grandmother may have told you, researchers have found that running and other weight-bearing exercises are beneficial for your bones regardless of your age. What is key, Cosculluela said, is that runners choose shoes that provide cushion and switch them out every six months to ensure feet and joints are well supported. In addition, be sure to stretch before and after workouts, Cosculluela added.

Increased flexibility helps prevent injury because your joints are able to move through a full range of motion while you run.

Vanquishing

Veins

PHOTO BY THINKSTOCK

Varicose veins are easier to treat than ever before With so many treatment options available, varicose veins don’t have to be a pain.

Varicose veins aren’t only unsightly. For some patients, they Dr. Houssam K. Younes can cause persistent, aching pain and discomfort. Dark blue, and near or raised above the surface of the skin, they often appear on the back of the calf or inside of the leg, but can form anywhere from the groin to the ankle.

If you have varicose veins — like 25 percent of American women and 15 percent of men — know that you don’t have to suffer. Dr. Houssam K. Younes, an assistant professor of cardiovascular surgery at Weill Cornell Medical College and a vascular and endovascular surgeon at Houston Methodist West Hospital, understands the pain and other problems varicose veins can cause.

“Varicose veins can significantly compromise the quality of life of patients. At the end of a stressful day, varicose veins increase discomfort, burning and heaviness in the legs. Also, they can cause painful venous ulcers that are difficult to heal. Luckily, advanced minimally invasive treatments have replaced old techniques of stripping or removing varicose veins through large incisions. The treated patients are thrilled that there is a simple solution to relieve their symptoms and cosmetic problem at the same time,” said Younes.

Patients seeking relief from throbbing or cramping in the legs, disrupted sleep

due to leg pain or discolored skin should contact Younes for a consultation.

TREATMENT OPTIONS

For small varicose veins and spider veins, which are smaller and more common, Houston Methodist West Hospital offers the following: SCLEROTHERAPY: A procedure in which the veins are injected with a solution that closes them, allowing veins to fade.

For larger varicose veins, we offer these treatments: VENOUS ABLATION: A minimally invasive treatment in which the vein is sealed by light or radiofrequency instead of traditional vein stripping.

MICROPHLEBECTOMY: A procedure in which small incisions are used to remove bulging veins.

RISK FACTORS

There are many risk factors that increase your chances of developing varicose veins.

YOUR JOB. An occupation that requires standing for long periods may put you at risk.

OBESITY. Extra weight puts more pressure on your veins.

AGE. The normal process of aging causes wear and tear on the valves in your veins that regulate blood flow.

GENDER. Because of hormonal changes, varicose veins affect 25 percent of women ages 20 to 40 and one out of two older than 50.

GENETICS. Check to see whether your family members have varicose veins — heredity plays a significant role.

Other factors that can contribute to varicose vein development include pregnancy and trauma.

Varicose veins may also indicate that an individual is at a higher risk of other disorders of the circulatory system. Talk to your doctor. n

Attend a Free Vein Seminar

Join Dr. Houssam K. Younes on Thursday, Jan. 28, at 6 p.m., to learn more about the causes, symptoms, risk factors, treatments and prevention of varicose and spider veins.

Registration is required. Call 832.522.5522 or register online at houstonmethodist.org/events.

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Weighing the

T

Risks

he 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. “Obesity affects the entire body, from head to toe,” said Dr. Hema Patel, an internist at Houston Methodist West Hospital.

Most dangerous is “central obesity” in the midsection. “As we gain belly fat, we increase our insulin resistance,” Patel said. “We increase our risk of high blood pressure and cholesterol. Central obesity is a direct marker for fat depositing in our organs.”

Not all obesity is equal: Overweight patients with a normal waist size and blood pressure and cholesterol levels are at far lower risk than those with central fat. People who carry extra weight in their bellies are at higher risk for diabetes, heart disease and stroke.

How do you know where you stand? Know these two numbers: your waist size and your body mass index (BMI), a measure of body fat based on height and weight. Talk to your doctor about what your results mean for your health and the screenings you need to make sure you’re not in danger.

“You have the power to effect change,” said Patel, who recommends avoiding liquid calories like soda and following a Mediterranean diet heavy in fresh produce, healthy fats such as olive oil, and proteins like fish. Following a low-carbohydrate diet and doing exercise to build lean muscle, like resistance training, will help reduce belly fat.

Just how much damage can obesity do? Here’s a look at the body’s obesity burden.

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How extra pounds can affect nearly every part of the body

NUMBERS CAN LIE Even if your body mass index (BMI) number falls within the healthy range, that may not mean you’re in the clear — or that you have license to eat junk food at will. It’s possible to be unhealthy even if the scale says otherwise.

Some people call it “skinny fat.” It’s the idea that you can look perfectly healthy while being at risk for chronic conditions because of diet, lack of exercise and genetics.

“High blood pressure and high cholesterol are called silent killers for a reason,” said Dr. Hema Patel, an internist at Houston Methodist West Hospital. “Everyone, no matter your size or weight, needs an annual visit with their doctor.”

THE DANGER ZONE Women

WAIST > 35 in.

BMI > 25

Men

WAIST > 40 in.

BMI > 25

HOW EXTRA POUNDS AFFECT THE ENTIRE BODY Throat

Brain

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

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

Obesity has been linked to colon cancer.

Knees

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

A Slimmer You Is in Sight

Start the New Year off right. Enjoy a free healthy cooking demonstration and learn about your weight loss options. Join us Thursday, Jan. 14, at 6 p.m. Registration is required.

Register at houstonmethodist.org/events or call 832.522.5522.

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Four Women,

Four Hearts...

And the changes they made to help keep them healthy

Y

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CHANGED HER DIET AT 34

Lisa competed in triathlons, prepared home-cooked meals and scheduled regular medical checkups. With no family history of heart disease, she thought she was the picture of health.

When she learned about the unhealthy ingredients in common foods, she decided to cut out sweeteners, such as sugar and corn syrup, as well as refined grains, including white flour.

“The pledge was about eating a really good diet to improve my health, not to lose weight,” Lisa says.

Within weeks, Lisa had more energy and improved sleep. Her HDL, or “good” cholesterol, increased almost 50 percent, significantly reducing her risk of heart disease.

“Diet impacts your cholesterol, blood pressure and blood sugar, so making small changes to what you eat has big benefits when it comes to protecting against heart disease,” said Dr. Kamalakannan Desikan, a cardiologist at Houston Methodist West Hospital.

PHOTO BY THINKTOCK

ou may think that a heart is just a heart. But just like the people they belong to, each organ is a little different.

That’s why, when it comes to taking care of our hearts — reducing the risk of heart disease, for instance — we may all walk to our own, individual beat.

Meet four inspiring women who took different approaches to improving their heart health.

LISA

LAURA

DENIED HEART DISEASE SYMPTOMS AT 60

Although her father died of a heart attack and her mother had blockages in her arteries, Laura skipped medical checkups and routine tests. When she started experiencing shortness of breath and sweating, she attributed the symptoms to menopause, not heart disease.

“I had all of the signs, but I ignored them because I thought it couldn’t happen to me,” she recalled.

In 2010, Laura had trouble breathing and felt pressure in her chest while working in the yard. Her husband called 911 and she was rushed to the hospital, where doctors discovered that one of her arteries was 99 percent blocked.

After recovery, she lost 30 pounds, adopted a low-sodium diet and reduced stress to protect her heart.

“Regular checkups are an important part of being heart-healthy,” Desikan said. “Your doctor can check your blood pressure and cholesterol and manage potential problems that may prevent a heart attack.”

DEB

A 50-YEAR-OLD SMOKER

No one needed to tell Deb that smoking is a top contributor to heart disease. She knew she was putting her health at risk with each puff.

Even though her father died of heart disease, she thought it would be too hard to quit. It was a doctor who persuaded Deb to kick her two-pack-a-day habit. “He said, ‘If you quit smoking now, you can still have a long and healthy life.’ ” Since quitting in 2009, her health has improved, her chronic cough has disappeared, she sleeps better and she finds it’s much easier to breathe.

“As soon as you stop smoking, your heart benefits,” Desikan said. “Within 20 minutes, your blood pressure starts to fall and 12 hours after your last cigarette, the carbon monoxide levels in your blood return to normal.

Your heart disease risk falls within the first year.”

ANDREA HEART ATTACK DESPITE A HEALTHY LIFE AT 42

When Andrea walked into an ER seven years ago, she thought she was suffering from severe pregnancy-related heartburn. Doctors hooked her up to an EKG and discovered she was having a heart attack.

Andrea was healthy and active with no family history of heart disease, but her body produced too many platelets, which formed a blood clot that caused her heart attack.

Though she had always maintained a healthy lifestyle, this tragic event spurred her to kick her fitness regimen up a notch. She joined a gym, signed up for fitness boot camps and started training to run a half-marathon.

Desikan noted: “Your heart is a muscle. The more you move it and train it, the stronger it is. Exercise at least 30 minutes per day, several times per week. Walking, biking and swimming are cardiovascular workouts that will strengthen the heart and reduce the risk of heart disease.” n

Attend a HeartHealth Screening

Knowing your risk is the first step to heart health. Join us to learn your 10-year risk for heart disease and receive cholesterol and blood pressure screenings. The event will be Thursday, Feb. 18, at 5 p.m. Attendance is free; Registration is required. Register at houstonmethodist.org/events or call 832.522.5522.

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Staying healthy begins with knowing your risk.

Protect yourself from heart disease with a preventive heart screening.

Heart disease is the leading cause of death for both men and women in the United States, with it being the culprit behind one in four deaths. Join us for a free heart seminar and screening event to learn your 10-year risk for heart disease.

For more information or to register for the heart seminar and/or screening, visit houstonmethodist.org/events or call 713.790.3333.

. Houston Methodist Breast Care Center 6. Houston Methodist Imaging Center

For more information about Houston Methodist or for a physician referral, please visit houstonmethodist.org or call 713.790.3333.

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