Leading Medicine Spring-Summer 2017, Houston Methodist Clear Lake edition

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LEADING MEDICINE SPRI N G/SUM M ER 017

IS JOINT REPLACEMENT SURGERY RIGHT FOR YOU? Get Answers to Common Joint Health Questions

TUNING IN TO TINNITUS IS YOUR BODY BABY READY?

YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN THE BAY AREA AND SOUTHEAST HOUSTON


SEMINARS & EVENTS All seminars are free. Please register to reserve your seat. Space is limited. To register, visit houstonmethodist.org/ events or call 281.333.8899.

BACK & NECK PAIN SEMINAR WEIGHT LOSS SURGERY SEMINARS

If you are thinking about weight loss surgery, plan to attend a free seminar and learn about your weight loss options and the benefits of choosing the Houston Methodist St. John surgical weight loss program. Upcoming dates and times: (Seminars are scheduled every other Wednesday) June 7, 5:30-6:30 p.m. June 21, Noon-1 p.m.

July 5, 5:30-6:30 p.m. July 19, Noon-1 p.m.

Presenter: Dr. Kyle Stephens, a board-certified surgeon specializing in bariatric surgery and advanced laparoscopy Location: Administration Board Room, 1st floor, Houston Methodist St. John Hospital

Whether you’ve had back and/or neck pain for a few days or several long years, we are here to help. Hear from our board-certified orthopedic surgeon and primary care sports medicine physician to learn about the latest information on nonsurgical and surgical treatment options and address any questions you may have. Date: Wednesday, July 19 Time: 5:30-7 p.m. Presenters: The Spine Program physicians at Houston Methodist St. John Hospital Location: Main Lobby, 1st floor, Houston Methodist St. John Hospital

MENOPAUSE AND PELVIC HEALTH SEMINAR

Join us for an informative evening dedicated to exploring and overcoming the health challenges that accompany menopause, including urinary incontinence and other pelvic health problems. Date: Monday, July 24 Time: 5:30-7 p.m. Presenters: Dr. Tristi Muir, board-certified urogynecologist and Dr. Francoise Vandaele, board-certified gynecologist Location: Harbourview Room, 9th Floor, South Shore Harbour Resort & Conference Center, 2500 South Shore Blvd., League City

JOINT REPLACEMENT SEMINAR

Our experts will share the common causes of joint pain and explain how an accurate diagnosis, paired with our Rapid Recovery program and individualized care plan, can get you on the path to quick recovery. Date: Thursday, June 29 Time: 5:30-7 p.m. Presenters: Dr. Michael Monmouth, board-certified orthopedic surgeon and a certified physical therapist Location: Main Lobby, 1st floor, Houston Methodist St. John Hospital

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SAVE THE DATE!

Date: Thursday, Oct. 5 Time: 5-7 p.m. Event: Paint the Night Pink Don’t miss this fun and healthy evening, dedicated to breast health and breast cancer prevention. Bring someone you love and join others in this celebration. A special event is planned to include: he pink lighting of the Houston Methodist T St. John tower Onsite mammograms Light bites and beverages Kendra Scott Gives Back trunk show Giveaways, fun vendors and other surprises Meet our panel of breast health experts and bring your health questions. All attendees will receive a special gift!


FATEFUL MORNING SHOWCASES STRENGTH of Houston Methodist St. John Emergency Department

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ay Area resident Bob Fischer was getting ready for work one morning in August 2016 when he felt an intense, searing pain in his chest. “One minute I was brushing my teeth,” the Boeing engineer remembered. “The next minute, with no warning at all, it hit me.” What hit Fischer was an aortic dissection due to aneurysm, although at the time he thought it was a heart attack. But he knew from the pain it was serious, and he immediately told his wife he needed to go to the hospital. Then he passed out.

EMERGENCY CARE AT WORK

The first few moments after a medical crisis are critical to discerning what type of care should follow. At the Houston Methodist St. John emergency department, the triage nurse examined Fischer and noted a significant difference in the blood pressure readings in each arm. She immediately recognized that this was a symptom of aortic dissection, a rare and often fatal condition in which the large blood vessel branching off the heart, tears. Diagnostic imaging confirmed the emergency medicine team’s suspicions, and a decision was made to secure air ambulance transport to Houston Methodist Hospital in the Texas Medical Center®. Renowned Houston Methodist cardiovascular surgeon, Dr. Michael Reardon, was alerted and began prepping for surgery. He was standing by to operate when Fischer arrived.

“My situation was somewhat rare, and not all doctors are aware of it, because the symptoms are much like a heart attack,” Fischer said. “I am so grateful to the staff at Houston Methodist St. John for recognizing what was happening and rapidly transferring me directly to one of the best cardiac surgeons in the world for emergency surgery. I know I am very lucky to be alive.” Fischer spent a total of three weeks in the hospital, and following intensive therapy, he returned to part-time work in November 2016.

LIVING A “NEW NORMAL”

Today, he is back working full-time, and is learning to live with what is often called the “new normal” — the changes in lifestyle and mood that accompany a neardeath cardiac experience. “Now, my biggest problem is emotional,” he said. “I have good days and bad, but most days tend to be ones laced with anxiety, especially whenever I feel weird things in my chest, which seems to be often.” But Fischer has found support and assistance from his wife, Carole, as well as a Facebook group composed of aortic dissection survivors. And he is grateful that the staff at Houston Methodist St. John Hospital — and their colleagues at Houston Methodist — were there for him. “Everyone was fantastic,” he said. “I can’t say enough good things about how Carole and I were treated. The nursing staff took care of every little thing and made the entire experience less stressful.”

Carole and Robert Fischer

MAJOR ER ADVANTAGES, CLOSER TO HOME The Houston Methodist St. John Emergency Department provides all of the major advantages of Houston Methodist Hospital — only closer to home. And should a rare medical emergency arise, they can provide seamless patient transfer to the Texas Medical Center. At Houston Methodist St. John Emergency Department, patient care usually begins within two minutes, and the ER is staffed with specially trained emergency medicine physicians and a fellowship-trained neurologist. On-site imaging and diagnostic technology also contribute to quick intervention during a health crisis.

Check in Online to Reserve Your Time in the Emergency Room

For critical medical health care needs, click on houstonmethodist.org/stjohn-er to reserve your time online.

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IS JOINT REPLACEMENT

SURGERY RIGHT FOR YOU? Dr. Kenneth Brooks

Get Answers to Common Joint Health Questions

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ur joints are pretty impressive. They can hold weight, help us move and link the bones in the body. But over time — or even through trauma — joints can wear down and become damaged. If that happens, it can cause joint stiffness, swelling or even pain. In these cases, it’s important to know your options. That’s why we’ve enlisted the help of Dr. Kenneth Brooks, an orthopedic surgeon at Houston Methodist St. John Hospital, who specializes in joint procedures. Here, he answers questions about joint health and leading-edge techniques in joint replacement surgery.

THE BASICS

Q

How do joints become damaged?

A: Joints can wear down in a variety of ways, but the most common way is from osteoarthritis, known as wear and tear arthritis. Osteoarthritis usually occurs

over time and can result from getting older; being overweight; from a joint injury from sports or other activities; or genetic predisposition.

Q

hat are a few ways W people keep joints healthy as they age?

A: There’s a lot of interest around this, especially as it relates to diet and nutrition. But there isn’t great proof that dietary or nutrition changes make a definitive impact on joint health. And while joint injuries should be avoided, no one goes out intending to cause damage to one area or another. Still, excessive weight can put undue pressure on joints, so it’s important to maintain an ideal weight as you age.

Q

What are some warning signs that tell people they should see a doctor?

A: As we age, we feel achy and sore after activity. That’s natural. When you feel like your knee is swollen, have trouble getting

in and out of a chair or car, or it limits your activity, it’s time to see a doctor.

JOINT REPLACEMENT TALK

Q

hat makes someone W a good candidate for a joint replacement?

A: It’s preferable if a patient is 55 years or older since the lifespan of a replacement is around 20–25 years. Also, it helps when a person is a healthy weight, with minimal medical problems, is a nonsmoker and comes in with a positive attitude about the recovery process.

Q

What is a new joint made of?

A: Metal, plastic or both, depending on the replacement. In a knee replacement, for example, the femoral (femur or thigh bone) and tibial (tibia or shinbone) components are made of metal. A plastic bearing surface is snapped into the tibial base plate.

RAPID RECOVERY PROGRAM Over the last few years, we’ve transformed our joint replacement recovery process to help otherwise healthy people get back to their regular activities sooner by reducing their hospital stay. While not for everyone, the Rapid Recovery Program is for those joint replacement candidates who are at an ideal weight, are nonsmokers and aren’t managing other medical conditions. Benefits of the Rapid Recovery Program include: using intravenous sedation during joint replacement

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surgery, instead of traditional general anesthesia, to aid in waking up more alert and with less nausea being up and walking with a nurse up to three times the same day as surgery beginning physical therapy almost immediately, which can help speed healing While all recoveries take time, this program can help get you home more quickly, so you can continue healing where you’re most comfortable.


Q

Can someone be too old for a joint replacement?

A: This is determined on a case-by-case basis. While surgery becomes riskier as we age, there isn’t an age limit on joint replacement. To decide whether or not to perform a joint replacement, we’ll ask you about your medical history, risk factors and how old your parents are now or when they passed.

Q

What are the alternatives to joint replacement?

A: If you have early arthritis, the focus should be on maintaining an ideal weight with exercises that safely stretch and strengthen your joints. People can also add anti-inflammatory medicine like ibuprofen and naproxen if necessary. In more advanced cases, a doctor may recommend injections that mimic joint fluid and may provide pain relief for six to 12 months.

SURGERY SPECIFICS

Q

How does joint replacement surgery improve someone’s health? A: The main goal is to reduce pain so you can perform the natural activities of living. Surgery won’t turn a sedentary person into a world-class athlete, but you can become much more physically functional and stable when your joints no longer hurt.

Q

hat should people W know about the recovery process?

A: You’ll typically be on your feet soon after surgery with physical therapy to follow for as long as necessary. Pain can also be an obstacle when someone leaves the hospital, so it’s important to stay ahead of it with the medication we prescribe.

Q

Are there any permanent restrictions after surgery?

A: You can pursue what you want. But most people don’t return to heavy sports activities like running or basketball. However, things like walking, elliptical, swimming, bicycling, tennis and skiing can be fine.

Take the First Step

Learn more about joint health and surgery by visiting houstonmethodist.org/ orthopedics/st-john or calling 713.363.9090 to find a doctor in your area.

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Is Your Body BABY READY?

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aking sure your body is ready to support a healthy pregnancy is an essential aspect of pregnancy planning. “Addressing modifiable Dr. Elizabeth risks and making Cloninger dietary changes can have a measurable benefit for mom and baby,” said Dr. Elizabeth Cloninger, an obstetrician-gynecologist with Houston Methodist St. John Hospital. “And the benefit is not just for the first baby, but for all subsequent babies, too. Putting the effort in up front can mean an important pay-off in your children’s health.” So is your body baby-ready? Answer these questions to find out.

Do you smoke? “The No. 1 change a woman can make before she gets pregnant is to stop smoking,” Cloninger said. Smoking can cause low birth weight and premature birth. Your baby is also at greater risk for asthma and ear infections if smoking occurs in the home.

Are you taking folic acid? Inadequate folic acid intake is linked to spina bifida and other birth defects, many of which occur before a woman even

Take a Tour!

As you prepare for your baby, you want a childbirth center that can match your commitment. The Houston Methodist Childbirth Center at St. John offers expectant mothers state-of-the-art care, a comforting environment and a dedicated team. Visit houstonmethodist.org/stjohn/childbirth to learn more about our Childbirth Center or sign up for a tour.

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knows she’s pregnant. “Before you even start trying to get pregnant, take folic acid to build up a reserve,” Cloninger advised. She recommended taking 0.8 mg of folic acid or 4.0 mg if you have a family history of spina bifida. Taking a prenatal vitamin ensures that you’re getting optimal nutrition and it will meet most women’s needs for folic acid.

Do you exercise regularly? Developing the habit of regular exercise before pregnancy makes it more likely you’ll continue to exercise after you’re pregnant. “Physical exercise is important because it decreases the risks of cesarean section and gestational diabetes,” Cloninger explained.

If you have a chronic medical condition, is it under control? Seizure disorders, diabetes, high blood pressure and asthma are examples of chronic conditions that may impact your pregnancy. “Often the medications for chronic conditions can have an effect on the fetus, so it’s a good idea to work with your doctor to create a plan,” Cloninger said. A preconception consultation with your obstetrician-gynecologist can help you determine how to best handle chronic conditions during pregnancy.

Is this the right time in your life to get pregnant? “I encourage women to put real thought into their life course, and when and how children will fit into their plans. Keep in mind that difficulty conceiving and the risks of miscarriage and chromosomal abnormalities increase significantly after age 40,” Cloninger cautioned.


Tuning in to Dr. Alfredo Jimenez

Dr. Melissa Hu

TINNITUS

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lick, hiss, buzz, ring, roar! Sound familiar? Believe it or not, there’s a name for those strange sounds you’ve been hearing: tinnitus. Whether it’s a dull roar, faint hiss, unending ringing or periodic clicks or swooshes, tinnitus is real.

WHAT’S ALL THAT NOISE?

Tinnitus itself isn’t a disease, but rather a symptom of something affecting the auditory system. Tinnitus is exceedingly common — about 10 percent of American adults have experienced tinnitus lasting at least five minutes within the last year, according to the National Institute on Deafness and Other Communication Disorders (NIDCD). It’s common to experience tinnitus for short periods of time, such as after attending a loud concert, or it can also be a constant problem. Those most at risk of developing tinnitus are people who work in a noisy environment, aging adults, smokers and those with conditions affecting blood flow. The cause of tinnitus can vary from earwax buildup to noise-induced hearing loss, certain medications, cardiovascular problems or even brain tumors. “Tinnitus can be bothersome, but it’s unusual for it to be a sign of something serious,” said Dr. Alfredo Jimenez, an otolaryngologist at Houston Methodist St. John Hospital. “But if it’s a chronic problem, occurs suddenly without an obvious cause or you’re experiencing hearing loss or dizziness, it’s time to see a doctor.” During an exam, your doctor will determine if you have subjective tinnitus, which is sound only you can hear, or objective tinnitus, which is sound your doctor can also hear. Objective tinnitus is rare and usually caused by a blood vessel problem, muscle contractions or a middle ear bone condition.

HEALING YOUR HEARING Getting to the bottom of your medical problem isn’t always a simple task. When you’re looking for answers about hearing issues, the Houston Methodist St. John team is here to help. With experts in otolaryngology, audiology and head and neck services, we’re well equipped to treat your hearing problem. Visit houstonmethodist.org/stjohn to learn more about our services.

FINDING A FIX

No cure currently exists for tinnitus, but you may be able to reduce symptoms by treating the underlying cause. “Depending on the cause, we provide different treatments,” shared Dr. Melissa Hu, an otolaryngologist at Houston Methodist St. John Hospital. “For some people, simply removing impacted earwax can decrease symptoms. For others we may look into changing current medications.” If treating the underlying cause doesn’t help, you may find relief through hearing aids, white noise machines or wearable masking devices.

Schedule an Appointment Today

You can find a path to stopping tinnitus by scheduling an appointment at Houston Methodist ENT and Facial Plastic Surgery Associates today. Visit houstonmethodist.org/ appointments or call 281.335.7755.

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LEADING MEDICINE IN GREATER HOUSTON

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EXPERT JOINT REPLACEMENT ACCELERATES YOUR RECOVERY. At Houston Methodist, our Rapid Recovery program for joint replacement gets you back to your active lifestyle — faster. Personalized to your specific needs, this comprehensive approach: • Utilizes the latest pain control methods before, during and after surgery • Starts rehabilitation sooner to accelerate recovery HOSPITALS EMERGENCY CARE CENTERS SPECIALTY HOSPITALS IMAGING CENTERS COMPREHENSIVE CARE CENTER

Just around the corner

• Gets you home quickly, often in one day To find a joint doctor in your area, call 281.333.8899 or visit houstonmethodist.org/rapidrecovery to learn more.

Houston Methodist has locations throughout the Greater Houston area to best serve you near your home or workplace. Our locations include hospitals, emergency care and imaging centers.

HOSPITALS 1. Houston Methodist Hospital . Houston Methodist San Jacinto Hospital 3. Houston Methodist St. John Hospital . Houston Methodist Sugar Land Hospital 5. Houston Methodist The Woodlands Hospital Opening July 1, 2017 . Houston Methodist West Hospital 7. Houston Methodist Willowbrook Hospital

SPECIALTY HOSPITAL 8. Houston Methodist St. Catherine Hospital

IMAGING CENTERS 5. Houston Methodist Breast Care Center at The Woodlands

EMERGENCY CARE CENTERS 713.441.ER24 (3724) . Houston Methodist Emergency Care Center at Kirby 10. Houston Methodist Emergency Care Center at Voss 11. Houston Methodist Emergency Care Center in Cinco Ranch 1. Houston Methodist Emergency Care Center in Cypress 13. Houston Methodist Emergency Care Center in Pearland 1. Houston Methodist Emergency Care Center in Sienna Plantation 15. Houston Methodist Emergency Care Center in Spring

. Houston Methodist Breast Care Center

COMPREHENSIVE CARE CENTER

1. Houston Methodist Imaging Center

17. Houston Methodist Comprehensive Care Center at Pearland

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