LEADING MEDICINE SPRI N G/SUM M ER 2021
Get Ready for Your Telehealth Visit
When to See a Doctor for
ORTHOPEDIC INJURIES Overcoming Sleep Problems
YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN EAST HOUSTON/BAYTOWN
IN THIS ISSUE - SPRING/SUMMER 2021
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W hat Is Perimenopause? For most women, menopause, or the cessation of menstruation, is preceded by a transition period known as perimenopause. Learn more about the onset of certain symptoms that signal your reproductive years may be coming to an end.
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C olon Cancer in Younger Adults: Know the Risks It may be hard to believe that colon cancer could develop in your 20s, 30s or 40s — but the risks are real. Understanding possible risks can help you be proactive about prevention and early detection.
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C oronary Artery Disease: Can It Be Reversed? Left untreated, coronary artery disease (CAD) can lead to heart disease, heart failure and heart attack. Find out what steps you can take now to help prevent CAD and protect your heart, even if you’ve already been diagnosed with CAD.
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W hen to See a Doctor for Orthopedic Injuries When you have a joint injury, you may wonder what to do next. Should you just walk it off, schedule a doctor appointment or head to an urgent care clinic the same day, or even the ER, immediately? Your ability to bear weight on the joint is key.
NEWS & EVENTS
AN EMERGENCY IS ALWAYS AN EMERGENCY
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f you are experiencing concerning symptoms that require immediate medical attention, don’t let worry about the coronavirus keep you from heading to the emergency room right away, especially if you are at risk for heart attack or stroke. With enhanced safety measures in place at Houston Methodist Baytown Hospital, you can rest assured your safety is our priority. Our state-of-the-art emergency department includes: A full spectrum of emergency care 24/7 A staff of board-certified emergency doctors and nurses An on-site laboratory, full-service X-ray, CT and ultrasound Over 40 private treatment rooms Don’t ignore your symptoms! If you are experiencing a serious or life-threatening medical emergency, please call 911.
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Get Ready for Your Telehealth Visit Telehealth visits have been popular for years, but advances in telecommunications technologies — and the pandemic — have accelerated their use. These visits are useful for health and wellness checks, and they’re also helpful for managing chronic conditions. Learn more about how these visits can effectively help you get the care you need.
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Sleep Problems: Where to Turn When You’re Tossing and Turning Lack of sleep can contribute to more than a bad mood; it can also negatively affect your energy level, ability to concentrate and even your overall health. If you’re a weary, sleep-deprived person, learn about lifestyle changes you can take to help you rest easier.
WHAT IS PERIMENOPAUSE?
O
ur journey through life is full of transitions and changes that can affect our physical health, emotional well-being and social relationships. Dr. Faith For most women, Ighoyivwi menopause, or the cessation of menstruation, is preceded by a three- to 10-year transition known as perimenopause. “Although no two women experience perimenopause the same way, the onset of any of these symptoms is a signal that your reproductive years may be coming to an end,” said Dr. Faith Ighoyivwi, an obstetrician-gynecologist with Houston Methodist Baytown Hospital.
MENSTRUAL IRREGULARITIES
If you could always predict the onset of your period, irregular bleeding is a telltale sign of perimenopause. Your periods may begin arriving haphazardly, be longer or shorter, lighter or heavier, or perhaps more painful than usual. Keep a journal to record irregular periods. Noting any new patterns in your cycle can help your health care provider determine what kind of treatment, if any, may be appropriate.
HOT FLASHES
“During perimenopause, your body’s estrogen production begins to taper off. In response, the pituitary gland releases bursts of luteinizing hormone,” Ighoyivwi said. Hot flashes can last from a few seconds to a few minutes. Your face, neck and chest may redden, and your body temperature may rise slightly. At night, hot flashes may disrupt sleep. Tips to ease hot flashes and improve sleep include: Dressing in layers and keeping your bedroom cool. Practicing yoga or tai chi to help you relax. Meditating or practicing deep breathing exercises.
PLAN FOR MENOPAUSE The onset of perimenopause is an indication that menopause is coming. Use this knowledge to work with your health care provider to make decisions about this next life stage, such as: Evaluating your bone health with a bone density scan so your provider can identify and treat bone loss as you age. Understanding your heart health to learn what steps you can take to prevent or address problems that could lead to a heart attack or stroke. Continuing to use contraception until you no longer have a period for one year. Preparing emotionally for the transition to postmenopause. Limiting or avoiding energy drinks, caffeine, alcohol, smoking and spicy foods. If hot flashes continue to disrupt your life, talk to your health care provider about nonhormonal treatment options.
VAGINAL DRYNESS
Less estrogen causes the vulva and vagina to become less elastic. Vaginal tissues also become drier and thinner, which may cause burning and itching. As a result, perimenopausal women may have discomfort, possibly even bleeding, during intercourse.
“A water-based lubricant may help relieve this discomfort or your provider may prescribe an estrogen cream,” Ighoyivwi explained.
MOOD SWINGS, BRAIN FOG
Interrupted sleep may cause irritability and mild depression. Some women may also experience problems remembering or concentrating. Talk to your health care provider if you’re experiencing these or other changes. Although perimenopause will be the likely reason, they can rule out any other underlying conditions.
Live Life to the Fullest
Your health care provider can recommend ways to make your perimenopausal years less bothersome and ease the transition to menopause. To make an appointment, call 281.420.5760 or visit houstonmethodist.org/baytown to learn more about our services.
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Colon Cancer in Younger Adults:
KNOW THE RISKS I
t may be hard to believe that colon cancer could develop in your 20s, 30s or 40s — but the risks are real. In 2020, the death of actor Chadwick Boseman at age 43 from colon cancer underscored the threat of the disease to younger adults. With colon cancer increasing in younger adults, it’s important to raise awareness about the risks and be proactive about Dr. Ziad Kronfol prevention and early detection. The American Cancer Society estimates that 12% of all new colon cancer cases in the U.S. will be diagnosed in patients younger than 50. Lifestyle factors, such as having a poor diet and being overweight may be contributing to the increase in cases in younger adults; however, much is not known yet. Adults ages 50 and older are still the highest risk group for colon cancer, but the risk of colon cancer for younger adults is rising faster.
LOWER YOUR RISKS
COLORECTAL CANCER SCREENING
“Colon cancer is more likely to be overlooked in younger people and tends to be more aggressive, so it’s important to get checked out if you have concerns,” Kronfol added. Warning signs include: Rectal bleeding A change in bowel habits Unusual abdominal pains Unexpected weight loss
“Early screenings and detection of colorectal cancer make it possible to find the disease early when it’s more treatable,” said Dr. Ziad Kronfol, a colorectal surgeon with Houston Methodist Cancer Center at Baytown. The American Cancer Society recommends colorectal cancer screening starting at age 45 for people with an average risk of colon cancer. If you have an increased risk for colorectal cancer, screening should start before age 45. You may be at increased or high risk for colon cancer if you have: A strong family history of colon cancer A personal history of colorectal polyps A hereditary syndrome that increases your risk Inflammatory bowel disease, including ulcerative colitis or Crohn’s disease Radiation to your abdomen or pelvic area to treat a prior cancer. How do you know if you have a strong family history of colon cancer? “Having a first-degree relative (parent, sibling or child) diagnosed with colorectal cancer increases your risk. The risk goes up if your relative was diagnosed before age 50 or more than one relative was diagnosed,” Kronfol said.
Get Peace of Mind
Some of the factors that increase your risk for colon cancer are beyond your control. However, you have the power to make healthy lifestyle choices to help reduce your risk: Eat a healthy diet. A healthy diet with plenty of fruits, vegetables and whole grains may help prevent colon cancer. Avoid highly processed foods. Lunch meats and foods containing added chemicals and preservatives may increase colon cancer risk. Exercise regularly. Having a sedentary lifestyle has been linked to colon cancer. Lose weight. Being overweight or obese can also increase the risk of colon cancer. Quit tobacco and limit alcohol. Both are linked to many cancers, including colon cancer.
WATCH FOR WARNING SIGNS
If you’re having colon cancer symptoms — at any age — you should take it seriously and see your doctor. To schedule a colon cancer screening exam, contact a Houston Methodist Baytown Hospital colorectal specialist by visiting houstonmethodist.org/baytown or call 832.556.6046.
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Coronary Artery Disease:
CAN IT BE REVERSED?
T Dr. Reza Khoshnevis
here’s no doubt about it: Coronary artery disease (CAD) is serious business. Left untreated, the condition can lead to heart disease, heart failure and heart attack. The good news is, you can take steps right now to prevent CAD and protect your heart, even if you’re at risk for heart disease or you’ve already been diagnosed with CAD.
HOW ARTERIES BECOME DISEASED
When coronary arteries are healthy, their linings are clean, smooth and slick. The artery walls are flexible, and they expand easily to let more blood flow through during times of increased physical or mental stress. Eventually, plaque buildup causes cell damage that reduces the vessels’ diameter and makes them stiff. “Over time, arteries can become narrowed or blocked, causing a gradual onset of symptoms, such as chest pain and shortness of breath. Or it can lead to a sudden heart attack,” said Dr. Reza Khoshnevis, a cardiologist with the Houston Methodist DeBakey Heart & Vascular Center at Baytown.
HOW TO KEEP ARTERIES HEALTHY
It’s never too late to make healthy changes, and it’s possible to slow the progression of CAD and sometimes even reverse it. Research suggests that cholesterol-lowering medications may slow the narrowing of the blood vessels and even reduce the amount of plaque in the heart’s blood vessels. “Data shows that it’s possible to reverse and prevent the progression of CAD,” Khoshnevis said. He suggested the following lifestyle changes to protect your heart: Cut back on fat, saturated fat and cholesterol in your diet. Avoid eating trans fat and fried foods. Limit or refrain from eating refined carbohydrates, sugary foods and sweetened beverages. Eat a healthy diet rich in vegetables and fruits, whole grains and lean protein. Add more physical activity to your day. Control your weight. Keep diabetes under control. Drink alcoholic beverages in moderation only (up to one drink per day for women and two drinks for men). If you smoke, get support to quit.
CHECK YOUR HEART HEALTH
A few simple tests can check for early signs of heart disease. Your doctor may check your blood pressure, cholesterol levels, body mass and ask about family history of heart disease and other
Protect Your Heart
Whether you are at risk of developing CAD or have already been diagnosed with it, don’t delay getting care. Visit houstonmethodist.org/heart or call 281.837.7587 to schedule an appointment with a cardiologist today.
lifestyle factors that may put you at risk for heart disease. “A cardiovascular risk calculator is another great tool we can use to assess the 10-year risk of disease,” Khoshnevis said. Advanced imaging techniques allow us to see inside the heart’s blood vessels and evaluate your risk for CAD. A calcium score is a type of heart scan that provides important information about the heart’s blood vessels.
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When to See a Doctor for
ORTHOPEDIC INJURIES
W
hen you have an injury, you may wonder what to do next. Should you just walk it off, hope to get an appointment with a doctor the next day, go to an urgent care clinic the same day or head to the ER immediately? Every year, millions of people, who end up in the emergency room or doctor’s office with orthopedic injuries, have the Dr. Mark same debate. Franklin Injuries are bound to happen whether you’re competing in sports, exercising, moving furniture or simply stepping down from a curb. “Frequently following an injury, many people aren’t sure where to turn for medical treatment or if medical care is even necessary,” said Dr. Mark Franklin, orthopedic surgeon at Houston Methodist Orthopedics & Sports Medicine at Baytown.
WHAT TO DO AFTER AN INJURY
Whether you get hurt at home or while you’re out and about, deciding what to do after an injury can be stressful. You may feel compelled to push through the pain, but continuing to move the injured area could lead to further damage and a longer recovery time. “Pushing your body beyond its limits may result in injury and could be an indication that you are in need of more rest.” Franklin advises the following after an injury: Rest the injured area to avoid further injury. Apply ice or compression to reduce swelling. Elevate the injured area.
Protect your injury by wearing a cast or brace, or using crutches, if needed.
HOW SERIOUS IS IT?
How do you know if you have a minor injury that will heal on its own, or if you need further treatment from a doctor? Minor injuries can often be treated at home, but there are times when you should see a doctor to ensure proper healing. Your ability to bear weight on the joint is key. “Seek an evaluation and possibly X-rays at our injury clinic or a physician’s office for a knee or ankle injury that impairs your mobility,” Franklin said. “Use crutches and see your doctor immediately for injuries in which you can’t bear weight.” Any injury that triggers swelling in the ankle or knee should also be evaluated. The majority of these injuries don’t need to be evaluated in the hospital, but should be evaluated soon in a doctor’s office. The question is whether it should be evaluated right away, or if you should wait. Warning signs that you should seek medical help right away for more serious injuries include the following: Any deformity of the limb Inability to bear weight Persistent joint pain Significant swelling with inability to move fingers or toes Swelling of a joint that comes on rapidly Weakness when moving a limb or muscle “I recommend scheduling an appointment with an orthopedic specialist or sports medicine doctor if you have any concerns,” Franklin said.
SAME-DAY ORTHOPEDIC INJURY CLINICS The next time an injury slows you down, come in for quick and convenient same-day care at Houston Methodist Orthopedic Injury Clinics. Call to schedule same-day appointments for evaluation and treatment of your injury. Major insurance plans are accepted. The clinic provides treatment for: Acute orthopedic injuries Fractures and broken bones Injured tendons Minor dislocations
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Painful or swollen joints Sports injuries Sprains and strains Torn ligaments Visit houstonmethodist.org/osm-injury-baytown or call 281.427.7400 to get started. Chronic conditions, spine injuries, motor vehicle accidents and workers’ compensation injuries are not treated at the injury clinic. Please call 281.428.2273 to schedule an appointment with the appropriate physician for those conditions.
HOW LONG WILL IT TAKE TO HEAL? Some injuries take longer to heal compared to others, and this may depend on the location and severity of the injury, your age, overall health and other factors. In addition to home treatment with RICE (rest, ice, compression and elevation), a doctor may recommend anti-inflammatory medication, cortisone injections or surgery to repair torn muscles or ligaments. For injuries that don’t heal quickly on their own, physical therapy can be a key part of the recovery process. The following are a range of recovery times for common orthopedic injuries.
AVERAGE RECOVERY TIMES HAMSTRING STRAIN
a few days
A few days for a mild strain; up to 3 months for a partial or complete muscle tear. ANKLE SPRAIN
1-3 weeks
1-3 weeks for a mild sprain; up to several months for a severe sprain. TENNIS ELBOW
4-6 weeks
Most people improve in 4-6 weeks.
SHIN SPLINTS
3-6 months
Get Back in the Game
Don't let an injury keep you on the sidelines. To schedule an appointment with an orthopedic specialist at Houston Methodist Baytown Hospital, visit houstonmethodist.org/orthopedics or call 281.427.7400.
Up to 3-6 months.
ANTERIOR CRUCIATE LIGAMENT (ACL) TEAR
4-6 months
4-6 months for recovery from knee surgery. ROTATOR CUFF INJURY
4-6 months for recovery from rotator cuff repair surgery.
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GET READY FOR YOUR
TELEHEALTH VISIT W
hile telehealth visits are not new, advances in telecommunications technologies — and the pandemic — have accelerated their use. Telehealth visits range from online messaging to video visits where you meet with your doctor virtually — not in person. “Telehealth visits are useful for health and Dr. Mohammad wellness checks. And they’re especially helpful Ahmed for managing chronic conditions, such as diabetes, hypertension and chronic obstructive pulmonary disease (COPD), as well as conveniently seeing a physician for same day appointments when you are sick,” said Dr. Mohammad Ahmed, a family medicine and primary care physician with Houston Methodist Primary Care Group at Baytown.
Telehealth visits are a convenient way to get care when you’re sick, unable to travel or if you need after-hours care. In addition to telehealth visits with your primary care doctor, Houston Methodist also offers other types of virtual visits to help you get the care you need. V irtual Urgent Care connects you with board-certified providers when your doctor is not available or on holidays. They treat nonemergency conditions, such as sinus infections, nausea and vomiting, or skin rashes from poison ivy or other skin irritants. E -Visits are same-day sick visits conducted through an online form and guided messages from our virtual care team, not your specific doctor. E-Visits are for nonemergency, urgent needs and offer symptom-specific medical care via online messaging. M yChart video visits are video visits used for sick visits and primary care, and also for other types of consultations with a specialty physician, such as your cardiologist.
MAKE THE MOST OF YOUR TELEHEALTH VISIT WITH THESE TIPS: Choose a private and confidential space where you can talk openly about your health.
Make sure your phone or computer is fully charged or plugged in and ready to use.
Find a quiet area where you can minimize noise and distractions.
Position your camera and test your audio and video before your visit.
Ensure the area is well-lit and suitable for using a webcam.
Be ready to take notes and ask questions.
Download or install any updates or applications needed for your visit ahead of time.
Have a family member with you to also listen to the doctor.
Check that you have a high-speed internet connection to support a videoconference.
Watch for follow-up instructions. Your provider may share a summary of next steps on your electronic medical chart.
8 LEADING MEDICINE IN EAST HOUSTON/BAYTOWN
Safeguard Your Health
Schedule your virtual visit with a primary care doctor in the Greater Baytown area by visiting houstonmethodist.org/pcg/east or calling 832.556.6670. You may also visit houstonmethodist.org/virtual-urgent-care to learn more about virtual care and to download the MyMethodist app.
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Conquering Sleep Problems
WHERE TO TURN WHEN YOU’RE
TOSSING AND TURNING
I
f you’ve been getting up “on the wrong side of the bed,” it could be because you’re not getting much sleep on any side on the bed. Lack of sleep can contribute to more than a bad mood; it can also negatively affect your energy level, ability to concentrate and even your overall health. Most adults need seven to eight hours of Dr. Skantha sleep a night. If you regularly have trouble falling Manjunath asleep, waking up in the middle of the night, or feeling drowsy during most days, you likely aren’t getting the sleep you need. So, what’s a weary, sleep-deprived person to do?
START WITH LIFESTYLE CHANGES
“Some simple changes in your daily habits may be effective in helping you rest easier,” said Dr. Skantha Manjunath, a pulmonary, critical care and sleep medicine specialist with Houston Methodist Baytown Hospital. Exercise early. Activity too close to bedtime can wind you up, making it difficult to relax. Try to exercise in the morning or early evening — regular exercise at these times may even help you sleep better. Be aware of what you eat and drink. Eating a large meal or drinking caffeinated beverages a few hours before bedtime can
keep you up. Drinking alcohol may make you feel sleepy at first, but it could disrupt your sleep. Help your mind stop racing. Try not to take problems to bed. Instead, make time earlier in the evening to write down worries and potential solutions, or make a to-do list for the next day. Stick to a sleep schedule. If possible, try to go to sleep and wake up at the same times each day — even on the weekends. This can help your body set its biological clock for regular sleep. Create a prebedtime routine. Reading a book, listening to soft music, dimming the lights, brushing your teeth and washing your face can help your body slow down before going to bed. Avoid using electronic readers, if possible, as they may be more distracting than calming. (Read more in “Devices Disrupt Sleep.”) Make your bedroom comfortable. Many people sleep best in a room that is cool, dark and quiet. A fan or white noise machine can help block out distracting noises or help lull you to sleep. Focus on your breathing. Take deep breaths — you may even want to count them. Relax the muscles in your body — slowly working your way up from your toes to your head. Get out of bed if you can’t sleep. If you’re still awake after 20 minutes, go into another room to read or participate in another quiet activity. Go back to bed when you feel sleepy.
COMMON SLEEP DISORDERS If you or a loved one experiences persistent problems sleeping, such as the ones listed here, turn to a medical professional for help. Treatments are available to improve your sleep — and your quality of life. Insomnia. Almost everyone has occasional insomnia, which is marked by difficulty falling or staying asleep or waking up too early. Stress, jet lag, temperature extremes, noise and medication side effects are common culprits. If insomnia is chronic (occurring most nights and lasting a month or longer), the lack of
10 LEADING MEDICINE IN EAST HOUSTON/BAYTOWN
sound sleep may lead to excessive daytime sleepiness and fatigue. Memory problems, reduced ability to concentrate and more frequent illness may follow. Sleep apnea. People with sleep apnea experience pauses in breathing while asleep that last from several seconds to more than a minute. These may occur five to 30 or more times an hour and are often associated with loud snoring. Apnea sufferers sometimes gasp, snort or make a choking sound when breathing resumes. The breathing
disruptions interfere with the deepest and most restorative levels of sleep. Left untreated, sleep apnea can result in extreme fatigue and daytime sleepiness. Sleep apnea can lead to high blood pressure and increase the risk of heart attack and stroke. Restless legs syndrome (RLS). RLS is characterized by crawling, burning or tingling sensations in the legs and an irresistible urge to move the legs during rest. Leg movement may cause frequent awakenings and result in excessive daytime sleepiness.
DEVICES DISRUPT SLEEP Research shows that sleep and technology aren’t compatible bedfellows. Smartphones and tablets can interfere with sleep in several ways:
KEEP A SLEEP DIARY
“If you need more help to break the cycle of poor sleep, start a sleep diary to identify problems that you can discuss with your doctor,” Manjunath said. Your doctor may want to know: When you go to bed and when you get up How long you are in bed before falling asleep How often you wake up during the night What is your work schedule If you have physical pain What medications you take If you drink caffeinated beverages or alcohol If you smoke If events or problems in your life are upsetting you and making it harder to sleep If you have a bed partner, ask if you snore, gasp for air or move around during sleep. Make note of these occurrences in your sleep diary.
SEEK PROFESSIONAL GUIDANCE
Once you recognize that a sleep problem is ongoing, you don’t need to chalk it up to aging or learn to live with it. Not getting enough sleep can put you at higher risk for conditions, such as high blood pressure, heart disease and diabetes. In addition, insomnia can lead to falls or slow your reaction time when driving, increasing your risk for an accident.* “Consult your doctor and give as much information as you can — a detailed sleep diary can help pinpoint the cause. Your doctor may also do a physical exam,” Manjunath explained. In some cases, medication or behavioral therapy may be prescribed. Talk to your doctor before taking any over-thecounter sleep aids or herbal supplements to avoid a bad interaction with other medications you’re taking. Your doctor may recommend an overnight sleep study in a sleep lab to help rule out sleep disorders and/or determine effective treatment.
hey distract you. From games and social T media to news and books, today’s devices make boredom a thing of the past. But before you know it, it’s midnight and you still feel awake and alert. They inhibit sleep. Artificial light in the evening can stimulate the brain, disrupting sleep hormones. What’s more, using electronics right before bed also can make you more alert, shifting circadian rhythms and making it harder to fall asleep. They wake you up. If you sleep with your phone next to you, calls, texts and email alerts may wake you from slumber.
WHAT YOU CAN DO To improve sleep, resist the urge to work in bed and stop using electronics at least a half hour to an hour before you go to sleep. Silence your phone and turn it over so the backlight won’t interrupt your sleep.
Sleep Well Houston Methodist is one of only nine centers accredited by the American Academy of Sleep Medicine. Our board-certified physicians will work with you to create a personalized treatment plan to help you get a good night’s sleep. To make an appointment with a sleep specialist, visit houstonmethodist.org/baytown or call 281.428.4510.
* Source: National Heart, Lung, and Blood Institute.
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WE STAND BEHIND THE VACCINE Here’s why our experts support the COVID-19 vaccine:
TESTED
TRUSTED
EFFECTIVE
There has been thorough testing and rigorous external review. Previous research and new technology allowed the vaccine to be developed faster, yet still follow the standard FDA process for emergency review before approval.
Most side effects are minimal, like other vaccines — including sore arms, muscle aches and fever. These flu-like symptoms indicate that the vaccine is doing its job — helping your body develop immunity to the virus. Other side effects are rare.
Current evidence indicates the vaccine is safe and up to 95% effective. COVID-19 can be fatal or debilitating. The risks of experiencing serious symptoms or being hospitalized from the disease are far greater than the risks associated with getting the vaccine.
We encourage you to get the first vaccine available to you. Visit houstonmethodist.org/texas-vaccine-hub to sign up for the COVID-19 vaccine now. #ProtectedTogether
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