Leading Medicine Spring-Summer 2021, Houston Methodist Hospital edition

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LEADING MEDICINE SPRI N G/SUM M ER 2021

Relief for Chronic Sinus Infections

When to See a Doctor for

ORTHOPEDIC INJURIES How COVID-19 Affects Heart Health

YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS FROM HOUSTON METHODIST


New Location Now Open

human body is made to move. At Houston Methodist Orthopedics and Sports Medicine, our highly trained therapy Methodist Orthopedics &sports-related Sports Medicine alists help Houston patients recover from arthritis, orthopedic surgery and injuries. By incorporating nced techniques and technology into personalized treatment plans, our therapists get patients back to their day routines and the activities they enjoy.

Physical Therapy in Memorial City

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Visit houstonmethodist.org/orthopedics/physical-therapy for more information. To schedule an appointment, call 832.522.8777.

HOUSTON METHODIST ORTHOPEDICS & SPORTS MEDICINE

FRIES RD.

BRIAR BRANCH

CAMPBELL RD.

er G treadmill • Sports specialists Specialty services at this location include: ood flow • Trigger point Manual therapy Alter G treadmill Blood flow restriction striction therapy dry needling Sports specialists therapy Trigger point dry needling anual therapy

WESTVIEW DR.

BLALOCK RD.

he human body is made to move. At Houston Methodist Orthopedics &at Sports Medicine,City our highly trained therapy ston Methodist’s therapists Memorial specialists help patients recover from arthritis, orthopedic alize in: surgery and sports-related injuries. By incorporating advanced techniques and technology into personalized treatment orts medicine • Hand/Occupational therapy plans, our therapists get patients back to their everyday routines and thopedics the activities they•enjoy. Spine Our new location in Memorial City has Houston Methodist therapists specializing in: ialty services at thismedicine location include: Hand/occupational therapy Sports Orthopedics Spine

Houston Methodist Orthopedics & Orthopedics & Houston Methodist Sports MedicineSports in Memorial City Medicine in Memorial City 9090 Katy Fwy., Suite 9090120 Katy Fwy., Suite 120 Houston, TX, 77024 Houston, TX 77024

STAY SAFE DURING A HEAT WAVE

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45 4 5 ot weather can the exposure, and the more vigorous the 8 be dangerous activity, the higher the risk of developing Pearland to your health — a heat-related illness.” especially a KNOW THE SIGNS OF heat wave in Texas that Houston Methodist HEAT ILLNESS Emergency Departments can last for several days. Heat illness can cause a range of Recognizing the risk Houston Methodist conditions with different levels of severity. Emergency Care Centers factors for developing Dr. Jeremy stonmethodist.org/orthopedics/physical-therapy Heat cramps are the milder form of heat-related illness Finkelstein illness. When you sweat a lot, your body have a high fever over 104 F. Confusion and taking steps to 012021 522.8777 | Fax: 832.522.8778 loses important fluids and electrolytes. and an altered level of consciousness may protect your health can help you stay You may have muscle cramping and be present. Seizures, coma and multisafe this summer. flushed red skin. organ failure may lead to cardiovascular “Young children and older adults are Heat exhaustion is more serious. It can collapse and death, if not treated. at greater risk of serious illness during a involve many symptoms, such as general “Heat stroke is a life-threatening heat wave,” said Dr. Jeremy Finkelstein, weakness, cramps, nausea and vomiting, condition that requires treatment in an emergency medicine physician with headache and fainting. emergency room. Treatment involves rapid Houston Methodist Hospital. Heat stroke is the most severe form lowering of the core body temperature Infants need to be protected because of disease. It’s caused when the body can’t by cold water baths, evaporative cooling they can’t tell us when they’re feeling ill effectively cool itself. The skin may be pale with water and fans and using cooled IV and they can’t control body temperature and dry due to lack of sweating. You could fluids,” Finkelstein said. as well. Older adults tend to have more medical conditions that can put them at risk for heat illness. They’re also more likely to take prescription medications that can worsen dehydration. Our Emergency Care Centers and Emergency Departments are safe and ready “The reality is that anyone who is active during the day in Texas during summer is to help you whenever you need care. Visit houstonmethodist.org/er to find at risk of heat-related illness,” Finkelstein emergency care near you. If you are experiencing a serious or life-threatening warned. “The longer the duration of medical emergency, please call 911.

Act Fast in an Emergency

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Relief for Chronic

SINUS INFECTIONS

W Dr. Omar Ahmed

hen nasal congestion causes pain and pressure in your face that lasts for days or weeks, you know it’s probably more serious than a cold. A sinus infection, or acute sinusitis, causes the spaces inside your nose (sinuses) to become inflamed and swollen. This blocks drainage and causes mucus to build up. It might be difficult to breathe through your nose or you might have throbbing facial pain or a headache.

WHAT CAUSES A SINUS INFECTION?

“Sinusitis occurs when your sinus membrane lining becomes inflamed, making tissues swell and preventing mucus from draining properly through your nasal passages,” said Dr. Omar Ahmed, an ear, nose and throat (ENT) specialist with Houston Methodist Hospital. Dr. Mas “Anything that prevents the sinuses from Takashima draining can lead to an infection,” Ahmed said. A cold virus can lead to bacterial overgrowth and cause a sinus infection. Allergies may cause inflammation that can lead to a sinus infection, or an infected tooth or altered nasal anatomy may cause an infection.

RECOGNIZING A CHRONIC PROBLEM

Sometimes sinus infections keep coming back, and antibiotics don’t seem to help. “Having three to four sinus infections in a year is a warning sign of chronic sinusitis. Recurring infections can trigger an inflammatory process that can’t be treated with antibiotics,” Ahmed explained. “Once it becomes a chronic issue, we need to understand the root of the problem rather than just treating it with medication,” said Dr. Mas Takashima, an ENT specialist and Department of Otolaryngology – Head and Neck Surgery chair at Houston Methodist Hospital. “Taking a lot of antibiotics can harm your natural biome, which includes good bacteria, making it more difficult for the body to mount an immune response. “A comprehensive evaluation can help us determine the best treatment plan,” Takashima said. If you have recurring symptoms, you may need diagnostic tests, such as a mucous culture, allergy testing or a CT scan of the sinuses.

FINDING THE RIGHT SOLUTIONS

Having a team approach can help uncover the cause of chronic sinus infections and identify the right treatment. “We work together with oral surgeons, allergists and pulmonologists as needed to provide a full picture of your health,” Ahmed said.

Get Help

If you’re suffering from sinus pain, contact us. Our specialists can help you explore additional treatment options to ease your symptoms. Visit houstonmethodist.org/ent for more information, or to schedule an appointment with an ENT doctor, call 713.441.1368.

Treatments for chronic sinusitis may include a combination of the following: H ome remedies. You may be able to find some relief by inhaling warm water vapor, using a saline rinse, applying a warm compress and drinking plenty of fluids. M edications. Over-the-counter products, such as corticosteroid nasal spray and nasal decongestants, may help with nasal stuffiness. Your doctor may prescribe antibiotics to fight a bacterial infection or topical or oral decongestants to ease sinus pressure. O ffice procedures. There are many new office procedures which can treat both recurring or chronic sinusitis, including balloon sinuplasty. There are also other conditions that can mimic sinusitis, such as post nasal drainage or a runny nose, which can be treated with procedures including turbinate reduction or cryotherapy to the nerves in the nose. These procedures are simple and can improve symptoms significantly. S urgery. In some cases, sinus surgery may be recommended to open the nasal passages.

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When to See a Doctor for

ORTHOPEDIC INJURIES

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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. David same debate. Lintner Injuries are bound to happen whether you’re competing in sports, exercising, moving furniture or simply stepping down from a curb. “The big question after an injury is often where to go for medical care, or whether medical care is needed,” said Dr. David Lintner, orthopedic surgeon and chief of sports medicine at Houston Methodist Hospital.

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. “It’s important to recognize that an injury is a sign you’ve pushed your body too far and you need to rest.” Lintner 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. “For a knee or ankle injury that’s causing you to walk with a limp, you should go to our injury clinic or see a physician for evaluation and possibly X-rays,” Lintner said. “If you can’t bear weight, you should use crutches and see a doctor promptly.” 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 “If you have any doubts, it’s a good idea to get checked out by an orthopedic specialist or sports medicine doctor,” Lintner 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. Simply drop in 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-bellaire or call 346.238.5300 to get started. Chronic conditions, spine injuries, motor vehicle accidents and workers’ compensation injuries are not treated at the injury clinic. Please call 713.441.9000 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

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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How COVID-19 Affects Heart Health

T Dr. Stanley Duchman

Dr. Maan Malahfji

he way the body reacts to a COVID-19 infection may increase the risk for heart and vascular problems. Inflammation is one of the body’s responses to the immune system’s attack on an infection, which may cause the blood vessels and surrounding tissues to function abnormally.

INFLAMMATORY RESPONSE TO COVID-19

A COVID-19 infection can put the heart at risk, especially severe infections that require hospitalization and trigger a significant inflammatory response. “Inflammation can weaken the heart muscle or damage blood vessel walls. This may lead to chest pain or heart failure and cause blood clots that could reduce blood flow to the heart or brain, increasing the risk for a heart attack or stroke,” said Dr. Stanley Duchman, cardiologist with Houston Methodist DeBakey Heart & Vascular Center. COVID-19 can worsen heart problems, including blockages or narrowing in coronary arteries. “Someone fighting a COVID-19 infection is more likely to have heart injury due to heightened stress environment in the body or inflammation that involves the entire body,” said Dr. Maan Malahfji, cardiologist with Houston Methodist DeBakey Heart & Vascular Center.

WHO IS AT RISK?

“It is possible for someone with no history of heart problems to experience heartrelated complications due to COVID-19.

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Watch for Symptoms

If you experience chest discomfort, heart palpitations, lightheadedness, swelling in the legs or difficulty breathing, seek immediate medical attention and follow up with your doctor or cardiologist. Call 713.DEBAKEY or visit houstonmethodist.org/debakey/tmc to make an appointment and learn more.

However, this risk increases when a person has underlying health issues or existing heart and vascular conditions,” Duchman said. Diabetes, obesity, heart disease, high blood pressure, high cholesterol and other risk factors can put you at a greater risk for heart complications with COVID-19. “People with heart disease are more likely to experience heart-related complications from COVID-19. They are about 30% more susceptible to having an injury to the heart muscle while hospitalized with COVID-19,” Malahfji said.

PROTECT YOUR HEART

You can reduce the risks to your heart by taking care of your health. “Keep your heart in good shape by controlling high cholesterol, reducing high blood pressure, losing excess weight, staying active and managing diabetes,” Malahfji said. “It’s also important to prevent the spread of illness by getting recommended vaccines, staying home when you’re sick, washing hands frequently, practicing social distancing and wearing a cloth mask in public,” Duchman added.


Benefits of TeleNeurology for Stroke

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hrough telemedicine technology, doctors and hospitals can evaluate and treat stroke when and where it matters most. TeleNeurology makes it possible for neurovascular specialists to see patients on-site and at other hospital locations quickly, providing lifesaving stroke care when every minute counts.

Dr. Rajan Gadhia

TELENEUROLOGY IN ACTION

Hospital physicians use live two-way audio and video conferencing to transfer information about the patient’s condition to a stroke specialist, who works with the team to provide expert stroke care. Technology makes it possible to have a comprehensive stroke evaluation, including a physical exam, monitoring of vital signs, imaging, consultation with a specialist and discussion of risks and benefits of treatment options. “The platform helps us provide seamless care in neurological emergencies to all patients who come through Houston Methodist’s doors,” said Dr. Rajan Gadhia, a vascular neurologist and director of Acute TeleNeurology at Houston Methodist Hospital. The TeleNeurology Program at Houston Methodist provides a full spectrum of care, including: Acute Telestroke Network. Acute TeleNeurology is used for acute stroke emergencies in the emergency department, intensive care unit and inpatient hospital settings. Outpatient TeleNeurology. The same platform connects patients in an outpatient setting with neurovascular providers for follow-up appointments. TeleRehabilitation. New advancements include using virtual reality avenues for the latest in stroke rehabilitation.

ACCESS TO EXPERTS

The major benefit of using TeleNeurology is immediate access to care. “You have an expert virtually at the bedside within seconds. This ensures qualified and highly trained practitioners who deal with stroke on a daily basis are right there and making key decisions,” Gadhia said.

QUICK CARE

Using telemedicine can speed the process of diagnosis and treatment through access to a network of stroke specialists. “The advantage of the TeleNeurology Program is that it gives

Providing Personalized Care

At Houston Methodist Hospital, we are always working to bring the latest advancements to our communities. The opportunities in telemedicine are rapidly expanding with the potential to improve stroke care and provide personalized care, close to home. Visit houstonmethodist.org/neurology/stroke or call 832.416.8479 to learn more about stroke care and rehabilitation.

us a head-start — and time is critical when treating a stroke,” Gadhia said. “Providing stroke care as quickly as possible allows us to improve outcomes and minimize the potential for disability and death.”

EFFICIENCY AND SAFETY

With an increased need to be efficient and preserve personal protective equipment (PPE), such as gowns and masks for health care workers during the pandemic, it became clear that TeleNeurology was a natural solution to save time and resources. “It takes time for providers to don protective gear, which can lead to delays in care delivery. We can provide more efficient care with TeleNeurology, even when neurovascular specialists are on-site.”

CLOSE TO HOME

TeleNeurology has enormous potential to improve access to stroke care close to home. “We can’t be at every physical location, but we can be virtually present at a moment’s notice,” Gadhia said. “TeleNeurology allows you to get care in your local hospital with an experienced specialist on the case to make key decisions. It’s our mission to provide the best possible care across geographical barriers and minimize disparities in care.”

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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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