Leading Medicine, Winter 2020, Houston Methodist Baytown Hospital edition by Houston Methodist

LEADING MEDICINE W INT ER 2020

Factors That Could Sabotage

YOUR WEIGHT LOSS

Choosing a Primary Care Provider Taking Aim at Cancer YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN EAST HOUSTON/BAYTOWN

IN THIS ISSUE - WINTER 2020

C hoosing a Primary Care Provider Whatever your age or health status, seeing a primary care provider regularly is one of the best things you can do for your health. Here are some reasons why.

P eripheral Vascular Disease: A Silent Threat If you’re concerned about your heart health, keep an eye on your arms and legs. They’re the most likely targets for peripheral vascular disease (PVD), a condition that can lead to serious health complications.

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H idden Factors That May Contribute to Weight Gain You’ve tried everything from dieting and calorie counting to exercise boot camp and weight loss apps — but the numbers on the scale just won’t budge. Could there be something else sabotaging your efforts to lose or maintain weight?

Know Your Asthma Triggers If you suffer from asthma, you probably know what it’s like to be caught off guard by an asthma attack. Every case of asthma is different, and knowing what triggers your asthma can help you control it.

D oes Foot Pain Keep You From Walking? Walking is one of the best forms of exercise, offering many mental and physical health benefits. Keep common foot injuries and conditions from sidelining your ability to walk.

Taking Aim at Cancer If you’ve been diagnosed with cancer, your treatment will likely be guided by several experts, including doctors, nurses, dietitians, therapists and others. Here is a look at the team and their roles in helping you fight cancer.

NEWS & EVENTS NEW UNIT ELEVATES WOMEN’S HEALTH SERVICES

The Houston Methodist Baytown Hospital Obstetric Emergency Department (OBED) is committed to providing the highest quality comprehensive women’s health services. The department was established in 2019 in partnership with the OB Hospitalist Group (OBHG) and includes board-certified obstetrician-gynecologists, who work in tandem with Houston Methodist Baytown nurses and physicians, as well as the patient’s doctor, to enhance the care of obstetrical patients in Baytown and surrounding communities. The physicians examine and treat all patients regardless of time, complication, circumstance or insurance status, with all patients treated as quickly as possible by a physician upon arrival in the OBED. “The OBED physicians work with our nursing staff and physicians to collaborate on any issues that may require intervention and also work on the unit to help physicians with any special or emergency cases that may occur,” said Karen Childs, MSN, RNC-OB, director, Houston Methodist Childbirth Center at Baytown. “The OBED eliminates the old triage system of elevating the care of patients by having board-certified OB physicians treat all patients as quickly as possible after they arrive on the unit.” The specially trained obstetrician-gynecologists are available on-site 24/7 to be at the mother’s bedside to help in times of emergency during labor and delivery, as well as after delivery. For more information on the full range of services offered by the Houston Methodist Childbirth Center at Baytown, visit houstonmethodist.org/baytown or call 281.420.8625.

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CLUES TO CARDIOVASCULAR HEALTH Routine screening tests can reveal your risk factors for cardiovascular disease, so be sure to ask your doctor at your next checkup to assess your weight and BMI (body mass index), waist circumference, blood pressure, cholesterol and fasting blood glucose level. All of these tests offer important clues to cardiovascular health as well as your overall health. Houston Methodist Baytown Hospital celebrates its ninth anniversary of performing heart surgery procedures and provides on-site heart health screenings during the Heart Month Celebration on Wednesday, Feb. 26, in the Plaza II Conference Center. Cholesterol and blood pressure screenings will be provided, and Baytown area residents will be able to learn their 10-year risk of heart disease during the free event. To register for the Heart Month Celebration, visit houstonmethodist.org/events or call 281.428.2273.

PROTECT YOUR HEALTH: Choose a Primary Care Provider

hatever your age or health status, seeing a primary care provider regularly is one of the easiest and best things you can do for your health. Your primary care provider (PCP) is often your first contact when you have questions about your health or need treatment for an illness or injury. He or she can help you stay Dr. Eleazar healthy today and see the big picture when Flores it comes to your health over time. When selecting a PCP, depending on your health needs, you might choose a provider who is trained in family medicine, geriatric medicine, internal medicine, obstetrics and gynecology, or pediatrics.

BENEFITS OF A PRIMARY CARE RELATIONSHIP

Building a relationship with a PCP can help you manage your health in the following ways:

medical provider who sees you regularly gets to know A you, your family and your health history. “These long-term relationships between providers and patients are extremely important,” said Dr. Eleazar Flores, a primary care physician

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in Baytown with the Houston Methodist Primary Care Group. “When a doctor knows a patient’s background, he or she can positively impact the patient’s health and provide the necessary support. This leads to greater satisfaction and improved outcomes for individuals and families.” our PCP keeps a record of your medications, screenings, Y vaccines and health history, which is important in providing you with the right care. Well checkups with your PCP can help identify potential health issues early so you can be treated right away. Your PCP can coordinate the health services you need and arrange your care with specialists. hoosing a PCP who is covered in your health plan’s C network of providers can help you save money on health care.

“Your primary care provider is a dedicated part of your care team, with the expertise and resources to help you find the specialist care you need — and improve your care experience in a cost-effective way,” Flores said.

Start One of the Healthiest Relationships of Your Life

Take the first step to better health and well-being. Visit houstonmethodist.org/pcg/baytown or call 832.556.6936 to choose the right primary care physician for you.

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Peripheral Vascular Disease:

A SILENT THREAT I

f you’re concerned about your heart health, keep an eye on your arms and legs. They’re the most likely targets for peripheral vascular disease (PVD), a narrowing of the blood vessels that can lead to serious health complications. PVD commonly involves the buildup of plaque in the peripheral arteries, i.e., those Dr. Sara M. outside your heart. As the arteries become Edeiken blocked, they are less able to transport nourishing blood to the arms, legs and other body parts. PVD sometimes runs its course silently until the blood vessels become so clogged that treatment is required to avoid permanent damage to the surrounding tissues and limbs.

RECOGNIZING PVD SYMPTOMS

PVD commonly occurs in the legs. Sufferers often complain of a cramping pain (called claudication) when they walk. This is a message from your muscles that they’re not getting enough nutrients to do their job properly. “In addition to claudication, PVD sufferers may also experience numbness, tingling or weakness in the legs; foot pain that wakes the patient from sleep; pale, red or blue skin discoloration of the extremities; changes in skin temperature; wounds that won’t heal or gangrene; buttock pain; impotence; and loss of leg hair,” said Dr. Sara M. Edeiken, a vascular surgeon at Houston Methodist Baytown Hospital.

DIAGNOSING PVD

Doctors can use several diagnostic tests to determine if you are suffering from PVD: Th e ankle-brachial index is a simple, noninvasive test that compares blood pressure in your ankle and your arm. D oppler ultrasound can help determine if a specific artery is clogged by providing an image of the blood flow inside the vessel using sound waves. P ulse volume recordings use blood pressure cuffs to measure blood pressure in the limb and to calculate blood volume changes in the legs using a recording device that displays the results as a waveform. A n angiogram can provide a blueprint of any narrowing or blockage present. During this procedure, a doctor injects dye into an artery to identify blockages using a special kind of X-ray.

TREATING THE CONDITION

If you are diagnosed with PVD, your doctor will consider a variety of treatments. Sometimes he or she may combine

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LIFESTYLE CHANGES MAKE A DIFFERENCE If you’ve been diagnosed with PVD or you want to reduce your risk for the condition, consider these lifestyle changes: I f you smoke, stop. Nicotine narrows the blood vessels, and carbon monoxide from the smoke damages the artery lining. C heck your feet, especially if you have diabetes. PVD may play a role in damaging the blood vessels of the legs and feet. This condition can go unnoticed until an infection or sore develops. K eep your blood pressure in check to ensure proper circulation. W atch your cholesterol. Work with your doctor to get and keep your numbers in the normal range. E xercise. Walking will help you maintain a healthy weight, decrease your cholesterol buildup and improve your overall circulation. E at a low-fat, low-salt diet with plenty of vegetables, fruits, whole grains, fish and low-fat meats. G et regular checkups if you have a family history of coronary artery disease.

therapies to achieve the best results possible. This may include lifestyle changes, medications and surgery. Cholesterol-lowering drugs, called statins, can reduce the plaque that forms in the arteries. Your doctor may prescribe medications to help lower your blood pressure and improve circulation. He or she may also direct a clot-busting drug directly into a blood vessel if it is blocked by a clot. Your doctor may choose to perform angioplasty. During this procedure, her or she inserts a tiny balloon into the blood vessel and then inflates the balloon to open the clogged area. Sometimes, the doctor will permanently place a tiny metal cylinder or “stent” in the vessel to help keep it open.

Another therapy, called atherectomy, involves inserting a special device on the end of a catheter directly into the vessel to shave down the hard plaque. “In some cases, patients may need bypass surgery to build detours around the blocked and damaged vessels so the blood can continue to reach and nourish various parts of the body,” Edeiken said.

A CUSTOMIZED TREATMENT APPROACH

There is no one-size-fits-all procedure to improve symptoms. At Houston Methodist Baytown, our multidisciplinary teams offer a range of procedures to provide the best possible therapy for a patient.

Reduce Your Risk and Symptoms

If you are experiencing symptoms of peripheral vascular disease, talk to your primary care doctor or schedule an appointment with a vascular surgeon at Houston Methodist Baytown Hospital for an evaluation. Visit houstonmethodist.org/baytown or call 832.556.6625.

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HIDDEN FACTORS THAT MAY CONTRIBUTE TO

WEIGHT GAIN Y

ou’ve tried everything from dieting and calorie counting to exercise boot camp and weight loss apps — but the numbers on the scale just won’t budge. Could Dr. Laura Choi there be something else sabotaging your efforts to lose or maintain weight? Let’s uncover some factors that could be holding you back. Although you have the power to change a few of these factors, some Dr. Kendell are beyond your control. Sowards Either way, finding out why weight loss is challenging can be helpful, especially when coming up with a plan or deciding when to seek help for weight loss.

LACK OF SLEEP

Your health suffers when you’re sleep deprived, and lack of sleep can affect your chances of losing weight, too. Research has shown that sleep deprivation can lead to increased cravings for high-carb foods and junk food. When you’re overtired, you may be more likely to reach for high-calorie beverages or a sugar fix for quick energy. You may also lack the energy and initiative to make healthy food choices. “When you’re tired at the end of your day, you may not feel like going for a walk or exercising. You may also not have the energy to make a healthy meal — choosing fast, convenient food instead, which disrupts efforts to lose weight,” said Dr. Laura Choi, bariatric surgeon and medical director of Bariatric Surgical Services at Houston Methodist Baytown Hospital.

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√ Take control: Aim for seven to eight hours of sleep at night so you can function at your best during the day.

YO-YO DIETING

Yo-yo dieting (a cycle of losing weight and gaining it back) can take a toll on your health and make it harder to lose weight. You may lose weight rapidly on a fad diet, but you’re not just losing body fat. You lose lean muscle as well, which in turn decreases your metabolism. The problem with yo-yo dieting is that it’s not sustainable. “Once a diet is discontinued and regular eating resumes, the body’s metabolism is lower than before, and any pounds regained consist mostly of fat,” Choi explained. √ Take control: Modify your diet in a way that’s sustainable for the long term. You want to find solutions for managing your weight that will work for the rest of your life, not just dropping pounds for a special event or a few months.

BALANCING GYM TIME WITH MEAL PLANNING TIME

Have you been toiling away at the gym without losing any weight? If this sounds all too familiar, it may make sense to spend more time and energy on meal planning. “How much and the types of food consumed has more to do with weight loss than anything else,” explained Dr. Kendell Sowards, bariatric surgeon at Houston Methodist Baytown Hospital. Exercise is good for your overall health and longevity, but it’s only a small component of weight loss. The majority of weight loss comes from making dietary changes and consuming fewer calories than you can burn in a day. √ Take control: By spending 30 minutes preparing a healthy meal, you can avoid consuming an extra 700-800 calories compared to eating fast food or takeout. When you combine a healthy diet with exercise, it’s a win-win!

AGING

Controlling your weight can be an uphill battle as you age. Even if you’re exercising and eating right, the pounds can still creep up. “With each passing year, metabolism decreases and the body doesn’t use as

many calories,” Sowards said. In addition, you may lose muscle mass with age, and the problem is compounded if you’re less active. It all adds up to a recipe for weight gain. √ Take control: Cut back on portion sizes of higher calorie foods and increase portion sizes of lower calorie foods like nonstarchy vegetables, such as broccoli, cauliflower, green beans and okra, etc. Try to exercise for 30 minutes every day — going for a walk is a great way to start.

MEDICATIONS

Did you know that weight gain is a side effect of certain medications? Some medications taken for depression, inflammation, thyroid disorder or other conditions can make it difficult to maintain or lose weight. These medications may cause you to feel hungrier, burn calories slower or retain extra fluids. It’s important to continue taking your medications as directed by your doctor, but don’t hesitate to ask about alternatives. √ Take control: Talk to your doctor if you have questions about how your medications may be affecting your weight.

GENETIC INFLUENCES

Genes can influence appetite, metabolism, body-fat distribution and more, but genetic influences don’t tell the whole story. Environmental factors including eating habits formed in childhood, family and social connections, ways you cope with stress and other psychological factors can have an even greater impact on your weight. √ Take control: Even if you’ve been overweight for most of your life and struggle to lose weight, you can fight back. It starts with making the decision to get help for losing weight.

START WINNING THE BATTLE TO LOSE WEIGHT If you feel like the deck is stacked against you to lose weight, talk to a health care professional who can help with medical weight management or bariatric surgery. With the right help, you can change your life for the better. The Houston Methodist Weight Management Center at Baytown offers the following weight loss services and programs: S tepLITE is a program for anyone who wants to lose a few pounds and needs help getting started. The program includes a diet plan and weekly check-in and group sessions with licensed professionals. M edical Weight Management is a threephase weight loss plan that begins with a medically supervised, very low-calorie diet program and progresses to a personalized meal plan to help you maintain weight loss. B ariatric surgery, or weight loss surgery, can help you achieve significant weight loss and improve weightrelated health problems.

Customized Weight Management

Houston Methodist Weight Management Center at Baytown develops a personalized weight loss plan that helps you lose weight and improve your health. To learn more about your weight loss options, register for an upcoming weight loss information session at houstonmethodist.org/weight-loss-surgery or call 832.667.LOSE (5673).

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KNOW YOUR ASTHMA TRIGGERS I f you suffer from asthma, you probably know what it’s like to be caught off guard by an asthma attack — and it can be very scary. The airways become narrowed or inflamed Dr. Skantha and you may experience Manjunath wheezing, coughing, shortness of breath or other symptoms. Every case of asthma is different, and knowing what triggers your asthma can help you control it.

DO SOME DETECTIVE WORK

You may need to do a bit of detective work to help you understand all of the factors that trigger your asthma. Asthma can be tricky, because symptoms may not always appear directly after exposure and different factors (e.g., pollen, mold, exercise, smoke) can cause different reactions. Dr. Skantha Manjunath, pulmonologist at Houston Methodist Baytown Hospital, shared the following steps you can take to better understand and manage your asthma for easier breathing.

K eep an asthma journal. When you have an asthma episode, take notice of your surroundings and write down potential triggers, such as being close to a pet, stirring up dust while cleaning or exercising outside. A void asthma triggers. Identifying your asthma triggers can help you avoid them. (See “10 Common Asthma Triggers.”) For example, if you know your asthma is triggered by air pollution, watch the weather for air quality updates and stay indoors when air pollution levels are high. U se your inhaler properly. “Ask your doctor or nurse to watch your technique to make sure you are receiving the full benefits of

your medication,” Manjunath said. “Also, be careful to adhere to the recommended dosage.” R ecognize warning signs. An asthma episode may come at any time and could develop into a life-threatening situation within a matter of seconds. Ask your doctor what the right steps should be in such an emergency. M ake an asthma action plan. Create your personalized Asthma Action Plan with tools available from the American Academy of Allergy, Asthma and Immunology.

If you or a loved one has asthma, talk to a doctor about ways to manage asthma safely so you can enjoy an active lifestyle.

Take Advantage of Our Expertise

Houston Methodist Baytown Hospital offers comprehensive asthma services to evaluate and manage the condition using the most advanced treatment options. Visit houstonmethodist.org/baytown for more information or call 281.428.4510 to schedule an appointment.

10 COMMON ASTHMA TRIGGERS 1 A llergens, such as pollen, animal dander, dust mites and mold, can aggravate airways that may already be inflamed due to asthma. 2 Weather conditions, such as dry air, high winds, cold temperatures or sudden changes in weather patterns, can sometimes trigger an asthma episode. 3 Pollution, such as strong fumes from paint or other chemicals, smoke, smog and even perfume, may trigger asthma symptoms. 4 Tobacco smoke irritates the airways and can trigger asthma symptoms. 5 Anxiety or stress can increase asthma symptoms.

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6 E xercise can trigger an asthma episode for some people, with symptoms usually starting after a few minutes of physical activity. 7 Laughing or crying can change the pattern of breathing and trigger an attack. 8 Medications, such as aspirin and ibuprofen, may cause or worsen asthma symptoms for some people. 9 Viral and bacterial infections, such as the common cold and sinusitis, can aggravate symptoms. 10 Acid reflux (with or without heartburn) can cause coughing and other asthma symptoms.

Does Pain Keep You FROM WALKING? W alking is hands-down one of the best forms of exercise, offering a host of potential mental and physical health benefits. It’s easy and — other than the cost of a good pair of walking shoes — free. “Unfortunately, pain in one of the many joints, muscles and tendons involved in Dr. Andrew walking can sidetrack even the most Friedmann determined walker’s routine,” said Dr. Andrew Friedmann, an orthopedic surgeon specializing in foot and ankle surgeries at Houston Methodist Baytown Hospital. A sore back, aching knees, stiff hip, tender ankle or throbbing toe can make taking a stroll difficult. Fortunately, most common injuries are treatable.

GETTING A LEG UP ON COMMON INJURIES

Here are some injuries and conditions that may have an impact on your ability to walk comfortably: S hin splints. Common in new walkers, shin splints is pain in the lower leg. It may be caused by overstriding or wearing heels that are too high. P lantar fasciitis. Plantar fasciitis can cause severe pain and occurs when the tissue connecting the heel bone to the base of the toes becomes inflamed. “Walkers who exhibit overpronation (rolling the foot inward excessively with each step) may be prone to plantar fasciitis,” Friedmann added. A chilles tendon injuries. The Achilles tendon — the thick tendon that connects the heel and foot to the back of the calf muscles — can become inflamed or even rupture due to repetitive stress, an accident or injury, or improper footwear. K nee and hip pain. Pain in the knees and/or hips may be the result of arthritis, an accident or injury, inflammation or misalignment of the joints. F oot pain. Bunions, toe fracture or ill-fitting shoes can contribute to aching feet.

THESE BOOTS AREN’T MADE FOR WALKING

“If you suffer from foot or ankle pain, walking can range from mildly or moderately uncomfortable to extremely agonizing. One of the simplest ways to prevent walking injuries is to wear comfortable, sturdy shoes that have a low heel and flexible sole. Avoid high heels and shoes that are too tight, too loose or are old and have lost their inner support,” Friedmann said. Other tips: Stretch your calves and shins before you start your walk. Start off slowly and increase walking speed gradually.

Watch out for cracks, uneven areas or other obstacles on the sidewalk or walking path. Be aware of your surroundings and don’t wear headphones (they can block out the sound of approaching traffic or bicyclists). Dress appropriately for the weather. Stay hydrated. Walk in a safe place, preferably with a walking partner (or take the dog along for company).

THE BENEFITS OF WALKING Need a reason to take a walk? Studies indicate that a regular walking program (working up to at least five walks a week of at least 30 minutes each) may: E nhance your mood. H elp you lose weight. H elp control blood pressure and cholesterol levels. I mprove fitness and stamina. I mprove sleep. I ncrease your energy level. L ower your risk of certain diseases, such as breast cancer, heart disease and type 2 diabetes. L ower stress. P rovide an outlet for socializing. R educe depression. S trengthen your muscles and bones and reduce your risk for osteoporosis. Be sure to consult your doctor before beginning an exercise program.