Leading Medicine Winter 2022, Houston Methodist Willowbrook Hospital edition

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LEADING MEDICINE W INT ER 2022

The Lowdown on High Blood Pressure

Team Up With Your Doctor FOR BETTER HEALTH Is It Heartburn or Something More? Visit houstonmethodist.org/lmn/winter-2022 to read more online.

YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN NORTHWEST HOUSTON


NEWS & EVENTS LIVE ONLINE WEIGHT LOSS SURGERY ORIENTATION

D ate: Tuesday, Jan. 11, 2022 Time: 6 p.m. | Location: Online D ate: Thursday, Feb. 17, 2022 Time: Noon | Location: Online D ate: Wednesday, March 2, 2022 Time: 6 p.m. | Location: Online

VIRTUAL JOINT SEMINAR

D ate: Wednesday, March 23, 2022 Time: Noon | Location: Online Register here: join.houstonmethodist.org/ jointevent-wb

VIRTUAL BACK AND NECK PAIN SEMINAR

D ate: April 2022 | Location: Online More information: join.houstonmethodist.org/ backandneck-wb

We host a variety of virtual and in-person events on cancer screening, back and neck pain, joint health and more. For a comprehensive list of events at Houston Methodist Willowbrook Hospital, visit houstonmethodist.org/events or call 281.737.2500.

4 BENEFITS OF BARIATRIC SURGERY

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re you ready to transform your life and lose weight? If you have weight-related health problems and are unable to lose pounds with diet and exercise alone, Dr. Todd Worley bariatric surgery may be an option. Weight loss surgery reduces the size of the stomach, so you feel fuller faster and eat less.

LOSE WEIGHT TO LIVE HEALTHIER

Here are four ways surgical weight loss can help you get on a path to better health and well-being: how you eat. “Bariatric 1 Changing surgery changes the anatomy of the gastrointestinal tract, restricting the amount of food you can eat or changing the route food takes through your body,” said Dr. Todd Worley, a board-certified surgeon at the Center for Weight Loss & Bariatric Surgery at Willowbrook. Weight loss surgery is a tool to help you lose weight, but it’s up to you to maintain a healthy diet and exercise plan for long-term success. Participating in an after-care program with support through nutrition, exercise and counseling can help you stay on track. Controlling appetite. “Some types 2 of bariatric surgery involve removing a portion of the stomach where hormones

that stimulate appetite are produced,” said Worley. “As a result, bariatric surgery may reduce the production of hormones that drive appetite and desire to eat.” It’s important to recognize the changes to your body and emotions, so you can build a healthy relationship with food. Reducing health risks. “If you 3 have health problems associated with being overweight, the benefits of weight loss surgery aren’t just measured in pounds,” said Worley. “Instead, success may be measured by improvement of health numbers like blood pressure, cholesterol and blood glucose levels.” Losing excess weight can help your health in many ways: Blood pressure and cholesterol – numbers can return to normal or near normal. Cardiovascular health – reduced risk of death from heart attack and stroke. Diabetes management – reduced need for insulin and related medications. Joint pain – taking pressure off joints improves mobility and may allow reduced need for pain medications. Sleep apnea – some people no longer use a CPAP machine at bedtime. quality of life. “Surgical 4 Improving weight loss can give you a new outlook on life,” shared Worley. “Losing weight may improve self-esteem and boost confidence in social interactions.” Feeling

good about losing weight can also improve emotional health and reduce depression. You may have increased energy levels, and the ability to engage in more physical activity, which helps fuel weight loss even more.

PROVIDING COMPREHENSIVE CARE ON YOUR WEIGHT LOSS JOURNEY

Taking control of your weight can empower you to do things that once seemed impossible. The weight loss team at the Houston Methodist Center for Weight Loss & Bariatric Surgery at Willowbrook, including bariatric surgeons, doctors, dietitians, mental health professionals and endocrinologists, specializes in helping people achieve a healthier weight — and keep it off.

Take the Next Step To learn more about weight loss surgery, visit houstonmethodist.org/willowbrook-bariatric/ to attend one of our listed online orientations. In this virtual seminar, you will meet a bariatric surgeon and learn more about the risks and benefits of treating obesity with bariatric surgery.

2  LEADING MEDICINE IN NORTHWEST HOUSTON


THE LOWDOWN ON HIGH BLOOD PRESSURE

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ou may be more concerned about high blood pressure, or hypertension, in today’s stressful times. It has become a common condition, affecting Dr. Weston one in three American Hickey adults, and a leading risk factor for heart disease, kidney damage, stroke and impaired vision, including blindness. It’s also more common in African Americans, who tend to develop it at an earlier age and suffer a more severe condition. In recent years, researchers concluded a few new things about blood pressure. The likelihood of developing hypertension over your lifetime is much higher than previously thought. Even if you do not have high blood pressure by age 55, you still have a 90% risk for developing the condition in your lifetime. High blood pressure is called a silent killer because it usually shows no symptoms.

WHAT THE NUMBERS MEAN

“Blood pressure is written as two numbers,” said Dr. Weston Hickey, cardiologist with Houston Methodist DeBakey Heart & Vascular Center at Willowbrook. “The first number is the pressure when the heart beats and pumps blood. The second is when the heart is resting, between beats. A normal blood pressure range for adults is lower than 120/80 mm Hg and higher than 90/60 mm Hg.”

CATEGORY

TIPS FOR AN ACCURATE READING D on’t smoke or drink coffee or other caffeinated beverages at least 30 minutes before having your blood pressure taken. F or five minutes before the test, sit with your back supported and feet flat on the ground. Rest your arm on a table at heart level. Wear short sleeves. G o to the bathroom before the test. A full bladder can change your reading. G et two readings at least two minutes apart and average them. Source: National Heart, Lung, and Blood Institute

Take Control Team up with your doctor to take control of your blood pressure and reduce your health risks, if needed. To schedule a consultation with a cardiologist, visit houstonmethodist.org/debakey/willowbrook or call 713.DEBAKEY.

The chart below explains how health care providers assess blood pressure.

WHAT TO DO?

While high blood pressure can’t be cured, it can be controlled by lifestyle factors and medication. Among them: Lose weight or maintain a healthy weight. Eat healthy foods, including more vegetables, fruits and nonfat dairy products. Reduce salt intake.

I ncrease physical activity. Limit alcohol. Don't use tobacco products, including vaping. If your blood pressure is high, you may need to take more aggressive action. “In addition to prescribing the lifestyle changes above, your doctor may recommend one or more blood pressure-lowering drugs,” Hickey said. “These include angiotensin-converting enzyme (ACE) inhibitors, angiotensin-receptor blockers, beta-blockers, calcium channel blockers, diuretics and vasodilators.”

SYSTOLIC MM HG

DIASTOLIC MM HG

UPPER NUMBER

LOWER NUMBER

Normal

Less than 120 and

Less than 80

Elevated

120-129 and

Less than 80

Stage 1 high blood pressure

130-139 or

80-89

Stage 2 high blood pressure

140 or higher or

90 or higher

Hypertensive crisis

Higher than 180 and/or

Higher than 120

Source: American Heart Association

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Team Up With Your Doctor for Better Health W hen it comes to your health, your primary care provider is your quarterback. They have a big-picture view and understanding of Dr. Rashad your overall health, and Ramkissoon they can help you make the right moves to stay healthy. A good relationship with your primary care provider is essential for your health. “Building a relationship and partnership with your primary care provider can help you tackle health problems and stay healthy through the ups and downs of life,” said Dr. Rashad Ramkissoon, a family medicine physician with Houston Methodist Primary Care Group.

IT’S A TEAM EFFORT

Here are some ways to make the most of your health visits and build a winning relationship with your provider. Find a primary care provider. Look for a doctor who is board-certified, speaks your preferred language,

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and offers convenient appointments in a location near you. Above all, you should choose a doctor you trust who listens and makes you feel comfortable. Schedule an annual exam. It’s important to schedule an annual checkup even when you feel fine health-wise. “Annual checkups help you stay on top of your health, making it possible to prevent and detect problems early,” Ramkissoon said. An annual checkup also allows for follow-up and management of chronic conditions, and ensures the recommended screenings are performed in a timely manner. Identify communication barriers. Resources are available if you or a loved one struggles with hearing, understanding or remembering what is said in your health visits. Bringing a loved one along to your appointment may help you better understand the information shared by your doctor while providing emotional support, if needed. Contact the doctor’s office to let them know if you need help with communication or would like to have a family member or friend join you for your appointment.

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Put Your Health First

Prioritize your health by making an appointment with a primary care provider. Convenient appointments are available at a location near you. Schedule an appointment with a Houston Methodist Primary Care Group doctor in Northwest Houston by visiting houstonmethodist.org/pcg/northwest or calling 713.394.6791.

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Tomball

Spring

99 Fairfield

290

Willowbrook Cypress Towne Lake

1960


A CHECKLIST FOR YOUR NEXT CHECKUP

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Share your health history. Managing your health is easier when you build a relationship with a primary care provider who knows you and your health history. “Your doctor may recommend health screening tests based on your age, personal or family health history, and other factors,” Ramkissoon said. For example, if you have a family history of heart disease, stroke, diabetes or cancer, your doctor may emphasize ways to prevent disease and recommend screening tests to help detect disease early. Be open and honest. There’s no reason to hold back information because you’re worried or embarrassed. Your primary care provider is there to support you in improving your health, not to pass judgment on your decisions. The doctor-patient relationship is ironclad in its confidentiality, with many ethical, professional and legal standards that protect it. Having open and honest conversations about your health helps your doctor better serve your health care needs.

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Talk about mental health. Your primary care doctor can help with mental health concerns, including screening and treatment for depression and anxiety. Your doctor can also connect you with referrals to therapy, counseling or specialized care. Ask about vaccines. Your primary doctor can be a great resource to help you understand which vaccines are recommended for you and when to get them. It’s important to have these conversations with your doctor so you can make informed decisions based on the latest medical guidance. Set goals for your health. If you want to lose weight, quit smoking or make other healthy changes, your doctor can help you get started. Your chances of success improve when you have medical support for making big changes to your health.

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Going to the doctor for a yearly checkup is an important part of your health routine. Here’s a checklist to help you prepare for your next visit: Ask about screenings or vaccinations. When scheduling your appointment, find out whether you’re due for any shots or tests. Knowing in advance helps so that you’re mentally and physically prepared — especially if there are any special instructions to follow, such as fasting before a cholesterol test. Review your family medical history. Your doctor may ask about any new diseases or conditions that have occurred in your close relatives since your last visit. If needed, write down notes about your family health history to share with your doctor. Write down a list of questions. When you’re in the doctor’s office, it can be hard to remember everything. Having a list of questions prepared ahead of time can help you make sure you get answers to all your questions. Bring a list of medications. Your doctor’s office will ask about the current medications you’re taking, including all prescription and overthe-counter medications as well as herbs, vitamins and other dietary supplements. It's helpful to bring a list that includes frequency and dosage of all medications.

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IS IT HEARTBURN OR SOMETHING MORE?

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o you suffer from heartburn after eating, bending over or lying down? It’s that painful burning sensation in your chest, or tasting food or acid in your throat. If so, you’re not alone. Most people experience occasional heartburn. But if you have heartburn more than twice a week, you may have a condition called gastroesophageal reflux Dr. Gabriel disease, also known as GERD. Arevalo GERD happens when stomach acid frequently flows back up into the esophagus (the tube connecting your mouth and stomach). The acid irritates the lining of the esophagus, resulting in an uncomfortable burning sensation. Other symptoms may include chest pain, difficulty swallowing, chronic cough, and regurgitation of food or sour liquid.

WHAT CAUSES GERD?

Understanding the causes of GERD can help find the right treatment to manage your symptoms. “Sometimes GERD is caused by a hiatal hernia or delayed gastric emptying,” said Dr. Gabriel Arevalo, a fellowship-trained gastrointestinal surgeon with Houston Methodist Willowbrook Hospital. “Delayed gastric emptying and GERD are closely related, and the symptoms often overlap.” Delayed gastric emptying is a chronic digestive disease called gastroparesis. With gastroparesis, the stomach doesn’t empty properly, causing a backup of fluid, bile and acid. The inability of the stomach to move food or acid down to the intestines can make you feel bloating, pain, heartburn, regurgitation and a full stomach easily. “If left untreated, the acid contents of the stomach can irritate or cause injury to the esophagus,” Arevalo explained.

GET RELIEF

Treatment for GERD and gastroparesis varies, depending on the type and severity of symptoms. “A nuclear medicine test can be used to easily measure stomach emptying and diagnose the problem,” Arevalo added. Many people find relief with the following lifestyle changes: Eat smaller, more frequent meals. Wear comfortable, loose clothing. Avoid eating high-fiber meals before bedtime. Tightly control sugar intake if you are diabetic.

WHEN TO SEE THE DOCTOR

Visit your health care provider when symptoms interfere with your sleep, ability to tolerate meals and daily life. They may recommend over-the-counter or prescription medications, or a combination of both. Some medications control stomach acid, while others help the stomach empty more quickly.

6  LEADING MEDICINE IN NORTHWEST HOUSTON

CHRONIC HEARTBURN? 10 FOODS TO AVOID Avoiding these foods may help reduce your symptoms of chronic heartburn, GERD and gastroparesis: C affeinated and O nions carbonated beverages P eppermint C hocolate S picy foods C itrus fruit T omato-based sauces F ried or fatty foods V inegar G arlic “If conservative treatments and changing your diet don’t provide relief, your doctor may recommend a minimally invasive procedure as a next step,” said Arevalo. The following procedures can help reduce acid reflux and treat gastroparesis: E ndoscopic techniques for GERD: Surgeons may use an endoscope to sew small stitches that tighten your esophageal sphincter muscle to reduce acid reflux. Endoscopic radiofrequency is another option. Controlled energy is transfered into the sphincter muscles making it tighter to prevent reflux. P OP procedure for gastroparesis: This is a scarless surgery (no incisions needed) for treating gastroparesis. The procedure can be performed through the mouth with an endoscope, by opening the stomach muscle and allowing food and acid to empty from the stomach without resistance and improving your symptoms.

Uncover the Problem Don’t ignore signs of chronic or worsening reflux, bloating or the inability to eat a full meal. Our doctors can help you minimize symptoms and stay in control of the condition. Call 281-737-GERD (4373) for more information or visit houstonmethodist.org/heartburn-wb to schedule an appointment.


Robotic-Assisted Gynecologic Surgery

HELPING WOMEN RECOVER FASTER

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omen today have more treatment options than ever before when facing gynecological conditions such as uterine fibroids, ovarian cysts, Dr. Julia endometriosis, pelvic Romero organ prolapse and cancer. Traditionally, gynecological surgery involved having an open procedure with a large incision. Today there is the option of minimally invasive surgery. With laparoscopic procedures, including robotic-assisted laparoscopy, patients can go home the same day and recover much faster, usually in as few as two weeks. This is compared to two to three days of hospitalization and four to five weeks of recovery after open cases. Robotic-assisted laparoscopic procedures allow for more precision and better visualization compared to traditional laparoscopic surgeries. This gives the surgeon the ability to perform more complex cases with fewer complications as compared with open and even traditional laparoscopic procedures. These less invasive surgical procedures involve small incisions usually less than half an inch as opposed to a much larger incisions of 5 to 7 inches required for open surgeries.

DA VINCI® SURGICAL SYSTEM

Surgeons such as Dr. Julia Romero, FACOG, Obstetrician Gynecologist and Surgeon of Excellence in Robotic Surgery at Houston Methodist Willowbrook Hospital,

Learn More

perform minimally invasive and robotic surgery using the da Vinci Surgical System, an FDA-approved, robotic-assisted surgical system. The da Vinci system allows the surgeon to operate from a console while viewing a 3D image of the surgical field. “The da Vinci robot translates the surgeon’s hand, wrist and finger movements into precise, real-time movement of small surgical instruments inside the patient’s body,” Romero explained. “It’s important to understand that this is not artificial intelligence. The robot does not decide what to do. The surgeon guides every movement of the robotic arm during surgery. The robot is a tool that allows better control and surgical precision.” Women may benefit from roboticassisted surgery in a number of ways, including: Small incisions and minimal scarring Less pain Less blood loss and need for transfusion during surgery Less risk of infection Shorter hospital stays Quicker recovery and return to normal activities

HELP YOU HEAL

Whether you are facing hysterectomy, myomectomy (removal of uterine fibroids), removal of ovarian cysts, surgery to repair vaginal/uterine prolapse, or treatment for endometriosis or excessive menstrual bleeding, our surgeons are skilled in robotic-assisted gynecological procedures that may help you heal faster so you can get back to work, family and life.

Call 281.737.2500 to make an appointment with an obstetriciangynecologist at Houston Methodist Willowbrook Hospital or visit houstonmethodist.org/gynecology-wb to learn more.

HYSTERECTOMY: KNOW YOUR OPTIONS Hysterectomy (removal of the uterus) may be recommended to treat fibroids, endometriosis, cervical and uterine cancers, or other gynecologic conditions. After a hysterectomy, a woman will no longer have menstrual cycles and is no longer able to have children. If the ovaries are removed, the patient will experience surgical menopause. If a woman with fibroids wants to have children, there are options, such as myomectomy (removal of fibroids) that preserves the uterus. For younger women who are done or not planning on having children, it is common to have a hysterectomy without removing the ovaries. “It’s important for women to know that early-age hysterectomy is an option that can improve quality of life for those suffering with symptoms without fear of going through early menopause,” noted Romero. A hysterectomy can be performed in several ways, depending on the reason for surgery and the patient health history: O pen/abdominal hysterectomy is a traditional approach with one larger incision. V aginal hysterectomy is a lessinvasive approach with a vaginal incision and no abdominal incision. L aparoscopic hysterectomy involves multiple small cuts in the abdomen, and the organs are removed through those incisions. L aparoscopic-assisted vaginal hysterectomy involves multiple small cuts in the abdomen to guide organs out through the vagina. R obotic surgery is like the laparoscopic approach; however, the surgeon uses robotic assistance to make precise surgical movements.

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GET CARE NOW

Houston Methodist offers safe, quick access to high-quality care — so you can feel better now. Sniffles got you down? Whether you’re suffering from the flu, a cold, a skin rash or even pink eye, we are here for you with a variety of ways to get care quickly, including:

VIRTUAL URGENT CARE 24/7 on-demand video visits through the MyMethodist app

SAME DAY CLINICS Same-day sick visits for many common health conditions

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And, with enhanced safety measures in place at all our locations, you can rest assured your safety is our priority. houstonmethodist.org/care-options

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