Leading Medicine Spring-Summer 2023, Houston Methodist Baytown Hospital

LEADING MEDICINE

JOINT PAIN: Your Body’s Signals to Consider Surgery

A Solution to Sleeping Problems

Get Proactive in Your Health

Your Community Health Partner for 75 Years

In April, Houston Methodist Baytown Hospital celebrated 75 years of service to Baytown and the surrounding communities. Thank you for allowing us to provide care and healing to you and your family. Your partnership helped Houston Methodist Baytown play a pivotal role in writing the history for Houston Methodist as it was the first community hospial and set the stage for our eventual growth into other communities.

Our founders vision was to build you a state-of-the-art hospital with the very best in innovation and modern health care. On April 18, 1948, the doors of our hospital opened, and their vision became a reality. As we emerge from a global pandemic, we continue to honor their vision as one of the country’s top complex care medical centers.

Late last year, we marked a new chapter in our history with the opening of Unity Tower. This new space not only increased our capacity to continue our mission, but it also enhanced our ability to serve the growing demands of Baytown, east Harris, Liberty and Chambers counties. Today, we stand proud and well-positioned to continue providing Leading Medicine for you well into the future.

Leading-edge technology and facilities may define our history, but without a doubt Houston Methodist

Baytown is distinguished by the amazing staff and physicians who provide personalized care to you throughout your life journey. They are truly the heart and soul of our great institution, and it is my honor to lead and work alongside our amazing staff and physicians as we serve those in need.

Our hospital has been an icon in the Baytown community since it was first built on Decker Drive and to this day serves as an integral part of our community — improving quality of life and promoting health and safety to all.

As we draw from the i n fl uences of our long and rich history, we look to the future as we strive to lead medicine in Baytown and the surrounding communities through innovation and unparalleled patient care. I would like to thank you, the members of our community, for your trust and support over these many decades. We look forward to serving you for many years to come.

David P. Bernard, MBA/MHA, FACHE Chief Executive Office Houston Methodist Baytown Hospital

WHAT IS A DEVIATED SEPTUM & WHEN IS SURGERY NEEDED TO FIX IT?

Your struggles with nasal congestion, poor sleep or trouble breathing through your nose could point to something you may not have considered — a deviated septum.

WHAT IS A DEVIATED SEPTUM?

“ The thin wall of bone, cartilage and tissue that separates our two nasal passages is called the septum,” explained Dr. Danny Wong, an ear, nose and throat (ENT) specialist with Houston Methodist Baytown Hospital. “When a septum is deviated, it is displaced or off-center, so the nasal passages are uneven. And any deviation can cause symptoms.”

Deviated septum symptoms include:

■ Stuff y nose (on one or both sides)

■ Trouble breathing through the nose

■ Mouth breathing, especially noticeable during exercise

■ Trouble sleeping or snoring

■ Higher incidence of nosebleeds and nasal infections

■ Headaches

■ Poor sense of smell

■ Postnasal drip or runny nose

WHAT ARE DEVIATED SEPTUM SYMPTOMS?

“You can be born with this condition, or a deviation can occur as a result of trauma or injury,” Wong clarified. “A contact injury can change the shape of the flexible cartilage that makes up the septum. And if the injury occurs during childhood, the cartilage and bone are spongier and more easily manipulated.”

So me deviations are easy to see, but in many cases, deviations aren’t noticeable since the nasal cavity and nasal passages stretch back inward about three inches.

The best course of action for those experiencing symptoms of a deviated septum is to consult an ENT doctor. These specialists have the necessary tools to rule out or confirm whether your septum has deviated and, if so, how severe.

HOW IS A DEVIATED SEPTUM TREATED?

Treatment depends on the severity.

You can manage minor deviations with nasal steroid sprays, decongestants or antihistamines.

According to Wong, deviated septum surgery — also called septoplasty — is the only way to open an obstructed nasal airway. Ths outpatient surgery takes about an hour and involves correcting structural problems using special surgical instruments. There are no incisions on the outside as the surgery occurs through the inside of the nose.

WHEN IS DEVIATED SEPTUM SURGERY NECESSARY?

Many people fid symptomatic relief with medications, but surgery is for those with major structural issues or those who don’t respond to medications.

“For patients really obstructed, we recommend surgery,” said Wong. “We let the patient know that we can try medications, but to fid true symptom relief, severe displacement problems in the septum almost always require surgery.”

“After this outpatient surgery, you’ll need to rest and avoid full-on exercising, but symptom relief can be noticed in as little as one or two weeks,” Wong added. “By three months, the improvements are so great that people tell me what a game changer this surgery was for them.” •

Schedule a Visit

DON’T LET COPD TAKE YOUR BREATH AWAY

Chronic obstructive pulmonary disorder (COPD) isn’t one disease but a group of conditions, such as emphysema and chronic bronchitis that block airflw and cause breathing difficulties. The No. 1 risk factor for COPD is being a current or former smoker. However, environmental pollutants, such as those found in some industrial work environments, can also increase your risk.

SYMPTOMS AND DIAGNOSIS

The earliest symptoms of COPD are easy to mistake for other conditions. Symptoms include:

■ Shortness of breath

■ Wheezing

■ Chronic coughing that produces mucus

■ Chest tightness

■ Fatigue

■ Rapid weight loss

■ Swelling in ankles, feet, or legs

“Symptoms often don’t appear until signifiant lung damage has occurred,” Dr. Anastasiia Rudkovskaia, an interventional pulmonologist at Houston Methodist Baytown Hospital, said. “And they will worsen over time, making it difficult to perform everyday tasks.”

It is important to talk with your doctor if symptoms persist and progressively get worse so that, together, you can come up with a treatment and management plan.

If your doctor suspects your symptoms are pointing to COPD, he or she may order several tests to diagnose your condition. Lung function tests are the most common and measure how much air you can inhale and exhale.

It also measures how quickly you can exhale air to stage your condition. If needed, your doctor may also order lung X-rays.

TREATMENT AND MANAGEMENT OF COPD

While there’s no cure for COPD, there are ways to slow its progression, reduce flareups, and improve your quality of life.

■ Quit smoking. The most essential thing you can do to manage COPD is to quit and avoid being anywhere near smoke.

■ Medications. There are several kinds of medications used to treat symptoms of COPD. Some are to be taken on a

regular basis, while others are on an as-needed basis.

■ Lung therapies. In moderate to severe cases, patients can participate in therapies such as oxygen therapy and pulmonary rehabilitation to help them perform everyday tasks.

■ Surgery. Surgery is an option for severe cases for which medications alone are not effective.

“COPD is a progressive disease, but it is treatable,” Rudkovskaia said. “With prompt and proper management, most people can effectively manage their symptoms to achieve a better quality of life and reduce the risk of developing other associated conditions.” •

BRONCHOSCOPIC LUNG

VOLUME REDUCTION

(BLVR)

A cutting-edge, minimally invasive procedure is available for patients who suffer from severe emphysema and hyperinflation and meet cer ain criteria. BLVR places valves in the airways leading to the diseased parts of the lung. This procedure helps patients breathe easier and improves their quality of life. You must meet the following criteria in order to qualify for the surgery:

■ Emphysema must be localized, and there must be adequate healthy lung tissue

■ Cannot have significant heart failur

■ Quit smoking

■ Participate in pulmonary rehabilitation

Get Relief from COPD

To schedule an appointment with a pulmonologist at Houston Methodist Baytown, visit houstonmethodist.org/pulmonology or call 281.428.4510

Rudkovskaia

THE IMPORTANCE OF CANCER CLINICAL TRIALS

The term “clinical trial” can bring to mind risky treatments being tested on seriously ill patients as a last resort. However, that image can’t be further from the truth. Rather, a clinical trial is a way for people who are ill to access potentially groundbreaking approaches or therapies currently being developed.

WHAT IS A CANCER CLINICAL TRIAL?

Cancer clinical trials are voluntary research studies where doctors fid new ways to understand cancer and how to improve treatments. The trials often test new kinds of surgery or combinations of chemotherapy, radiation therapy and immunotherapy.

Clinical trials aren’t just for late-stage cancers. Houston Methodist Baytown offers clinical trials for various stages of cancer that addresses the full spectrum of cancer care close to home.

WHY CONSIDER PARTICIPATING IN A CLINICAL TRIAL?

“When participating in a clinical trial, not only are you taking an active role in your treatment plan, but you’re also contributing to furthering cancer research,” said Dr. Nirav Naik, hematologistoncologist at Houston Methodist Baytown, “ultimately helping the future of others who have been diagnosed with the same illness.” Some of the benefits of participating in a clinical trial include:

■ Access to the newest treatments

■ Closer monitoring

■ Reduced cost of treatment

■ Contribute to research that will help future generations

During a trial, the research staff eets with you regularly to monitor your health and safety. You will continue to work with your primary care provider or oncologist, who will make sure any research medication doesn’t interfere with your other medicines. You can stop participating at any time.

DOES CLINICAL TRIAL PARTICIPATION COME WITH RISKS?

Participating in clinical trials does pose some risks, and the treatment you receive doesn’t guarantee effectiveness. There are government regulations and review processes in place to protect participants from making sure risks are as low as possible and are worth potential benefits.

“Clinical trials are essential to making progress against cancer,” Naik said. “However, there is a risk that you could suffer side effects or a bad reaction to the treatment you are receiving.”

Talk at length with your doctor to determine whether a trial is right for you.

Plan to ask your doctor:

■ What is the trial’s purpose?

■ Why do doctors and researchers believe the experimental treatment will be effective?

■ How do the possible benefits, risks and side effects compare with those of my current medication?

■ How long is the trial?

■ Who pays for the treatment and will I be reimbursed for other expenses?

■ How will I know the treatment is working and will I receive the trial results?

The more you know, the better prepared and more at ease you’ll be about participating in a clinical trial. •

AVAILABLE TRIALS

For more information about active clinical trials at Houston Methodist, visit houstonmethodist.org/ cancer/clinical-trials or call 346.292.2073.

Dr. Niravkumar Naik

JOINT REPLACEMENT: GettingYou Back to an Active Lifestyle

Severe joint pain can keep you from enjoying life to the fullest. But thanks to advances in less invasive replacement surgery, you can get back to an active lifestyle with less downtime than you might think.

“Advancements in minimally invasive surgical techniques have led to smaller incisions, less tissue damage, reduced blood loss, and faster recovery times for patients undergoing joint replacement surgery,” explained Dr. David Sun, an orthopedic surgeon at Houston Methodist Orthopedics &

Joints are the parts of the body where two bones meet, enabling movement and stability. If a joint is damaged, it can cause signifiant pain and limited mobility that can negatively impact quality of life. Hip and knee replacements are the most commonly performed joint replacements, but replacement surgery can be performed on other joints as well, such as the ankle, wrist, shoulder and elbow.

Common reasons joint pain develops include:

1. Arthritis

2. Overweight or obesity

3. Past injury

Without treatment, joint pain gets worse over time. Having surgery can seem daunting, but the results can be life-changing. Advancements in technology and techniques have made joint replacement procedures much safer and more effective, with quicker recovery times.

WHY SURGERY COULD BE YOUR NEXT STEP

“We always want to exhaust conservative treatment options as much as possible before we consider surgery,” Sun said. “However, it’s important that patients know the benefits of joint replacement, as early intervention can lead to better outcomes and an improved quality of life.”

Essentially, joint replacement is more like joint resurfacing. When a joint becomes worn out, the nerve endings in the bones become exposed, causing pain. The surgeon places a new surface on the end of the bones, like a cap that is designed to cover up and protect the nerve endings.

There are several reasons to consider joint replacement surgery, including:

1. L ong-lasting results. In many cases, people can enjoy improved joint function and relief for upwards of 20 years. Over 80% of patients who have undergone surgery are very happy with their knee replacement and would do it again.

2. Minimal recovery time. Advances in surgical techniques have led to the development of less invasive joint surgery options that offer quicker recovery times and reduced risk of complications compared to traditional surgery.

3. Increased activity. New technology and approaches make joint replacement outcomes feel more natural. Most patients who

have joint replacement surgery can get back to low-impact activities, such as swimming or walking within four to six weeks.

Houston Methodist developed a Rapid Recovery Program to streamline healing after joint replacement surgery. Patients who are relatively healthy and have good family support are eligible to go home on the same day as the surgery. With telemedicine connectivity, patients can attend follow-up visits with their care team from the comfort of home.

For inpatient procedures, many patients are up and walking within hours after surgery. Whether you recover in the hospital or at home, your care team is dedicated to your success.

While surgery is an effective treatment option, it is important to have realistic expectations about living with the updated joint.

“Working closely with your healthcare team, setting realistic expectations, and committing to the rehabilitation process can help ensure a positive outcome and a return to the activities you enjoy,” Sun said.

The sooner you talk to an orthopedic specialist about your persistent joint pain, the quicker you’ll be back to enjoying life to the fullest. •

SIGN S IT ’S TIME TO CONSIDER SURGERY:

1. Difficulty performing daily activities due to pain

2. Limited range of motion

3. Swelling in the joint

4. Pain while resting or sleeping

5. Persistent or worsening pain

6. Medications, such as over-the-counter or injections, are no longer effective

7. Instability of the hip or the knee

Need Same-Day Orthopedic Care?

Houston Methodist

Guys: 5 Signs It’s Time to Talk to The Doc

Hey guys, can we get real for a minute? I know checking in on your health isn’t always the fist thing on your long to-do list. Guys, you are strong and resilient, but those annoying aches and pains you’re ignoring could be a lot more than just normal aging, so it’s really important to see your doctor regularly.

According to data from the U.S. Centers for Disease Control and Prevention, 13% of men over age 18 are in poor health and only about 28% meet physical activity guidelines. To make things worse, about one-third of men don’t even have a primary care doctor. That’s a recipe for sickness.

“Do not put yourself behind, when you work together with your doctor, we can spot any health problems before they become serious and keep you in top shape for everything you love to do,” said Dr. Samantha Malave, a family medicine physician at Houston Methodist Primary Care Group at Baytown.

In the meantime, here are a few warning signs every man should take seriously.

SKIN CHANGES: SKIN CANCER

White men older than age 50 are more than twice as likely as women to develop and die from skin cancer, yet when surveyed men admit to not wearing sunscreen or knowing cancer warning signs.

Look out for subtle skin changes, such as new growths, spots, bumps or patches. Take note of slow-to-heal sores or cuts and remember the ABCDE guide:

■ Asymmetry: One part of the mole is shaped differently than the rest.

■ Border: Edges of the mole are irregular or blurred.

■ Color: Take note of moles that are more than one color.

■ Diameter: Is it larger than a pencil eraser?

■ Evolving: Note changes in shape, size or color

“During your annual check-up, explain to your doctor any mole or skin spot that worries you. We can examine the area and see if you need further testing,” said Malave.

BACK NUMBNESS, TINGLING: STENOSIS, HERNIATED DISK

If it feels like your back is trying to tell you something, pay attention. If you experience tingling or numbness, this nerve superhighway could be on the way to herniated disks or spinal stenosis, which share symptoms.

The rubbery disks between the bones of your spine can give out over time, spilling their jelly-like center and irritating nearby nerves. This herniation can also cause ongoing pain along the sciatic nerve, which runs from the lower back down the leg.

Spinal stenosis is when the open spaces in the spine get narrower, putting pressure on the nerves and spinal cord. “ The result can be numbness in the neck, back and arms as well as problems with bladder and bowel function,” explained Malave.

LEG PAIN, POPPING, OR SNAPPING: ACHILLES TENDON RUPTURE

The cord connecting your calf muscle to your heel at the back of your leg is called the Achilles tendon. It can tear or stretch too far, usually during sports involving pivoting, jumping and sudden acceleration.

“See a doctor if you feel a sudden pain in your lower leg or hear a pop or snap. Treatment, which could involve surgery, is required,” said Malave.

SHORTNESS OF BREATH: HEART ATTACK

A heart attack doesn’t always feel like a sudden, intense pain in your chest, so it’s important to know other signals. Sometimes a heart attack can feel like pneumonia, asthma or fatigue. Shortness of breath may be your only sign to call 911 and get lifesaving treatment in time.

Men are at a greater risk for heart attack than women, and at earlier ages. “Be especially aware of these symptoms if you smoke, are physically inactive or overweight, or if you have high cholesterol, high blood pressure or diabetes,” said Malave. “All these things increase your risk of a heart attack.”

URINE CHANGES: PROSTATE PROBLEMS, CANCER

Guys, if you’ve been rushing off o urinate more frequently or urgently or have trouble emptying your bladder, your prostate gland could be the reason and it isn’t always cancer.

Conditions sometimes share symptoms, so having an enlarged prostate doesn’t mean you have cancer or are more likely to get cancer. The most common culprit is benign prostate hyperplasia, in which abnormal cell growth causes the enlarged gland to press against the bladder and urethra.

“Don’t wait — troubling symptoms like bloody urine, pain when urinating, or inability to urinate should send you to the doctor immediately so we can get you checked out,” said Malave. •

Dr. Samantha Malave

GET PROACTIVE IN YOUR HEALTH

Even the healthiest men should be checked regularly to help ensure they stay that way. Schedule a physical exam with your doctor every two years until age 50 and annually after that.

The following screenings will help keep you in top shape:

■ Blood Pressure: Every two years, more often if it’s high.

■ Cholesterol & Heart Disease: Every five year after age 34, more often with certain conditions.

■ Diabetes: Every three years after age 45, sooner if you are overweight or obese.

■ Colorectal Cancer: Starting at age 45, earlier if you have a family history of colon cancer or polyps.

■ Prostate Cancer: Talk with your doctor starting at age 45 if you’re African American or have a family history. Starting at age 50 otherwise.

■ Lung cancer: Every year starting at age 50 if you have a 20 pack a year smoking history and currently smoke or have quit within the past 15 years.

WHY YOU SHOULDN’T IGNORE PROSTATE PROBLEMS

Most men don’t start thinking about their prostate until they begin experiencing problems. The prostate is a walnut-shaped gland under a man’s bladder that plays a critical role in the male reproductive system. But, given its location, changes in the prostate gland can affect other important functions — like urination.

“Prostate problems can be serious,” said Dr. Chris Kannady, a urologist at Houston Methodist Baytown Hospital. “If you have a frequent need to urinate, painful urination and incomplete emptying of the bladder, you may have issues with your prostate.”

The three most common prostate problems men face include:

■ Prostatitis

■ Benign prostatic hyperplasia (BPH) or enlarged prostate

■ Prostate cancer

HOW IS PROSTATITIS TREATED?

Prostatitis is prostate inflammation usually caused by an infection. Ths condition is fairly common and can lead to difficulty passing urine and sexual problems.

Typically treated with antibiotics, prostatitis has a treatment duration extending two weeks or more in some cases — depending on whether the infection is sudden or chronic. Anti-inflammatory medication and medications that relax prostate muscle tissue may also be recommended to ease urine passage.

HOW IS BPH TREATED?

Many men experience prostate enlargement as they age. Ths condition can cause a squeezing of the urethra as well as bladder weakening, which can leave urine in the bladder.

Although BPH is not cancerous, many of its symptoms are like those of prostate cancer. BPH can lead to life-disrupting and life-threatening problems, such as:

■ Voiding difficulty

■ Bladder or kidney infections

■ Urinary blockages

■ Kidney failure

According to Kannady, you can lessen BPH symptoms by making a few lifestyle changes, such as limiting alcohol or caffeine.

“Medication, or sometimes surgery, may be recommended to ease discomfort and urine flw issues,” he said.

In some cases, noninvasive options may be considered:

■ Green light laser procedures

■ Transurethral resection of the prostate (TURP)

■ Button procedure

■ Aquablation (see sidebar)

HOW IS PROSTATE CANCER TREATED?

Prostate cancer can slowly grow and never cause symptoms or threaten a man’s health. However, sometimes, it can aggressively attach and require treatment.

How prostate cancer is treated depends on the tumors location, whether the cancer has spread, the man’s age and his overall health. Treatment options include:

■ Watchful waiting and symptom monitoring

■ Surgical removal of the prostate gland

■ High-intensity focused ultrasound (HIFU) treatment

■ Radiation therapy

■ Chemotherapy

■ Testosterone-blocking hormone therapy

“ The side effects of prostate cancer treatment can include problems with bladder control,” added Kannady. “Before choosing a course of therapy, men should consult their doctors.” •

ADVANCED TREATMENT OPTIONS

Houston Methodist Baytown now offers Aquablation therapy for patients with BPH, or benign prostate hyperplasia, also known as an enlarged prostate. “It is basically using high-pressure water to destroy the unwanted tissue,” said Kannady. “And, because we aren’t using heat, we don’t damage the nerves of the prostate.”

This procedure uses an image-guided robotic arm entering through the urethra, resulting in no incision. The arm holds the water jet and camera to help precisely remove the excess prostate tissue.

“Aquablation is a remarkably effective procedure,” said Kannady. “When we look at men five year postsurgery, 95% still don’t need re-treatment.”

Schedule an Appointment

To get more information about treating an enlarged prostate, please visit houstonmethodist.org/ urology or call 832.556.6046

Dr. Chris Kannady

5 Breastfeeding Tips for New & Expectant Moms

Choosing breastfeeding or formula-feeding is an important decision for all new or expectant mothers.

“Breastmilk is a baby’s best source of nutrition, containing antibodies that can protect your baby from illnesses,” explained Dr. Faith Ighoyivwi, an obstetrician-gynecologist with Houston Methodist Obstetrics & Gynecology Associates at Baytown. “It can also reduce the risk of developing certain health conditions, such as asthma, obesity and type 1 diabetes.

Here are five tips for navigating how to breastfeed your newborn.

1. TAKE A BREASTFEEDING CLASS

Start thinking about breastfeeding before you give birth. An early class, either in person or virtually, will show you what to expect about breastfeeding and give you all your options.

“Breastfeeding isn’t always easy and some issues may only occur after birth,” said Ighoyivwi. “Taking a class while still pregnant may help you successfully navigate those early days and weeks.”

2. LET YOUR CHILDBIRTH TEAM KNOW YOU WANT TO BREASTFEED

Be sure to let your doctor and care team know if you want to breastfeed exclusively, so they can help you receive all the instruction necessary if feedings become tricky.

“Usually, the fist feeding goes pretty well, and your baby latches on right away,” Ighoyivwi noted. “But subsequent feedings can be challenging in a busy hospital environment.”

3. HAVE AN IDEA OF WHAT TO EXPECT DURING THE FIRST WEEK

Again, an early breastfeeding class helps you understand how to get through those fist few days. You’ll learn about your baby’s appetite, the number of wet diapers and feedings to expect each day, and how to feed a sleepy baby, among other things.

“Knowing what’s considered normal in your baby’s fist five days can be invaluable, though it’s okay if your baby deviates slightly from the norm,” Ighoyivwi added.

4. KNOW WHEN TO CALL YOUR DOCTOR OR LACTATION CONSULTANT

It may be time to reach out for help with breastfeeding after the fist week if:

■ Your baby always seems hungry

■ You’re worried about your milk supply

■ Your baby has fewer than six wet diapers or three yellow stools per day

■ You experience pain in your nipples while feeding or they are cracked and bleeding

Your early checkup with your baby’s pediatrician can also help determine how breastfeeding is going.

5. HAVE A RETURN-TO-WORK PLAN

The most important part of continuing to breastfeed when you return to work is learning the details of collecting and storing your milk, including the purchase or rental of a breast pump.

“You’ll want to begin building up your breast milk supply a few weeks beforehand,” Ighoyivwi said. “Slowly ease your baby into taking a bottle of breastmilk around week three or four.”

The fist day of being away from your baby will likely be overwhelming, so have a plan for your baby’s feedings to help relieve some of the stress. •

Dr. Faith Ighoyivwi