Leading Medicine Fall 2020, Houston Methodist The Woodlands Hospital edition

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LEADING MEDICINE FA LL 2020

A Man's Guide to Doctor Visits Stroke Warning Signs for Women

BE VIGILANT ABOUT RESPIRATORY ILLNESS YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN THE WOODLANDS AND MONTGOMERY COUNTY


LEADING MEDICINE to Provide Personalized Cancer Care

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ouston Methodist The Woodlands Hospital offers leading-edge medicine in Montgomery County. Our physicians work with medical researchers at Houston Methodist Hospital in the Texas Medical Center to bring advances to the patient’s bedside as quickly and safely as possible, and offer patients the option to Dr. Priya V. participate in clinical trials. Ramshesh “Our researchers are actively working on every aspect of cancer treatment with the purpose of sharing that innovation with the communities of Houston,” said Dr. Priya Ramshesh, a board-certified oncologist at Houston Methodist Cancer Center at The Woodlands.

CLINICAL TRIALS FOR CANCER CARE

Clinical trials are available at all campus locations, with more than 20 offered at Houston Methodist Cancer Center at The Woodlands. These trials comprise a range of studies and innovative therapies in a number of areas, including: Chemotherapy Imaging technology advancements Latest radiation techniques Leading surgical techniques Prevention in high-risk populations Targeted therapy “Increasing awareness about these opportunities is key to better outcomes. The success rates for stage 4 cancers are going up, and we could not have done this without clinical trials. Patients should know that they have options, and they have a choice to participate locally,” Ramshesh said. “For example, due to clinical trials, we now have innovative nonchemo treatments like immunotherapy — targeted therapy available to patients from bench to bedside in the community.”

THE POWER OF PERSONALIZED MEDICINE

“We’re in an era when we are moving away from one-sizefits-all treatment to personalized medicine,” Ramshesh noted. “All patients receive personalized cancer care. And for many patients, participating in clinical trials adds another level of personalization.” Houston Methodist recognizes that navigating all the aspects of cancer care can be exhausting, and adding out-of-town travel for clinical trials can be too much of a burden for some patients. “This is why it makes sense to bring clinical trials to the community, so patients don’t have to drive into the city to participate,” Ramshesh added.

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TREATING GYNECOLOGIC CANCER WITH SMART TECHNOLOGY Women with gynecologic cancers can now receive personalized, advanced brachytherapy treatment in The Woodlands. A new HDR (high dose rate) system designed with smart technology offers 3D imaging to help plan individualized treatments, and it allows doctors to record and easily reproduce the Dr. Peter Morgan patient’s treatment position. One of the most important benefits, according to Dr. Peter Morgan, radiation oncologist at Houston Methodist Cancer Center at The Woodlands, is that it allows the physician to perform safety checks without leaving the room as older systems required. “Being able to check everything while remaining with your patient allows you to talk to them and explain what is going on. It makes the whole experience better,” said Morgan. The Cancer Center is currently using the new technology to treat gynecologic cancers with plans to treat breast, prostate and skin cancers in the future.

Explore Your Options

To learn more about personalized care and treatment options available at Houston Methodist Cancer Center at The Woodlands, visit houstonmethodist.org/cancerwoodlands or call 936.270.3413.


STROKE Warning Signs for Women

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omen might not think of stroke as a top health threat. But in reality, women have a higher risk of stroke than men. About 1 in 5 women Dr. Nhu Bruce will have a stroke in her lifetime compared to 1 in 6 men. And although the risk of stroke increases with age, it is possible for middleaged and younger women to suffer a stroke. That’s why it’s important to recognize stroke symptoms and act quickly. Marquis Clarke, a blogger and mother of two young children, was shocked when she had a stroke at age 28. “Everyone around me kept saying my symptoms must be related to stress, but deep down I knew something was very wrong,” Clarke recalled. She experienced neck pain and headaches in the week leading up to the stroke, but it was a significant change in her vision that prompted her to call her mom and then 911. “I was working at my computer and noticed everything was blurry and the letters were all mixed up. Then I started seeing black streaks across my vision and eventually my vision went completely dark.” Clarke had an abnormality in her vessel wall, causing blood to split the artery and form three clots. The clots went to three different areas of her brain affecting vision, equilibrium and memory. Quick evaluation and treatment helped prevent further damage from the ischemic strokes. Now 18 months later, Clarke still has some dizziness and minor vision issues, but she is feeling better and finding a new normal.

RECOGNIZE STROKE SYMPTOMS “Women are more likely than men to have atypical, vague symptoms, which can make it difficult to recognize when someone is having a stroke,” said Dr. Nhu

Bruce, a board-certified neurologist and director of the stroke program at Houston Methodist The Woodlands Hospital. They’re also more likely than men to brush off symptoms and delay getting help. It’s crucial to familiarize yourself with all the possible signs of stroke. If you or a loved one experiences any of the following symptoms, call 911 and seek immediate attention. Common stroke symptoms for both men and women: Arm weakness Face drooping Severe headache with no known cause Speech difficulty Sudden vision problems Trouble walking or lack of coordination Unique stroke symptoms in women: Confusion, disorientation or memory problems Dizziness, double vision or vertigo Fatigue General weakness Nausea or vomiting

TIME IS CRITICAL

A stroke happens suddenly without warning, and the results can be devastating. During a stroke, the brain is deprived of oxygen when blood flow is cut off by a clot or ruptured vessel. “Every two minutes treatment is delayed, nearly 2 million brain cells are damaged,” Bruce said.

Marquis Clarke recovered from a stroke at age 28 due to fast action.

Getting treatment quickly can save a life and even reverse the stroke. “The most effective stroke treatments are administered within 4½ hours of the onset of symptoms. The data shows that the sooner you come to the hospital, the greater likelihood of having a better outcome,” Bruce said. “As a comprehensive stroke center, we treat all aspects of stroke from ischemic to hemorrhagic stroke, and we offer mechanical thrombectomy for patients who have a blood clot causing their symptoms.”

Listen to Your Body

Don’t ignore symptoms or delay getting medical help because you think your symptoms may turn out to be a false alarm. Call 911 right away. Visit houstonmethodist.org/neuro-woodlands to learn about other neurological conditions treated at Houston Methodist The Woodlands, or call 936.270.3333 for an appointment.

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BE VIGILANT ABOUT RESPIRATORY ILLNESS

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ou’ve heard about the dangers of COVID-19, flu and other respiratory illnesses that affect the lungs, making it difficult to breathe. There are steps you can take today to prevent disease and boost your respiratory health in case you do get sick. Taking good care of your lungs can improve your quality of life and protect against respiratory illnesses Dr. Hammad N. that can take a toll on your lungs. Qureshi

RECOGNIZE SERIOUS SYMPTOMS

It’s important to know that anyone can have mild to severe symptoms with either COVID-19 or flu. “However, having a respiratory illness poses a higher risk of experiencing serious complications in older adults and anyone who may have underlying health conditions,” said Dr. Hammad N. Qureshi, a pulmonologist and medical director of the Intensive Care Unit at Houston Methodist The Woodlands Hospital. Monitor your symptoms if you’re not feeling well: Mild respiratory symptoms include having a low-grade fever, nasal congestion, runny nose, sore throat, mild cough and mild body aches. What to do: Get tested for COVID-19. Stay home and isolate yourself from others to avoid spreading illness, even if you test negative for COVID-19. Moderate respiratory symptoms include fever over 100.4 F, persistent cough, temporary shortness of breath and feeling like you need to stay in bed. What to do: Get

tested for COVID-19 and contact your doctor about worsening symptoms. Severe respiratory symptoms include difficulty breathing, shortness of breath, wheezing, pain or pressure in the chest, confusion, trouble staying awake and bluish lips or face. What to do: Seek emergency medical care for severe respiratory symptoms. Mild cases of respiratory illness can often be managed with rest, fluids and fever-reducing medicines at home. However, don’t wait to see a doctor if you’re in a high-risk group and experiencing worsening symptoms. Mild or moderate symptoms can quickly become severe for older adults and those who have heart disease, diabetes, cancer or chronic respiratory problems.

MANAGE YOUR HEALTH CONDITIONS

If you have chronic respiratory conditions, such as asthma or chronic obstructive pulmonary disease (COPD), it’s important to manage the condition closely with your doctor. Keeping up with your regular checkups is essential in controlling symptoms and protecting your health. Continue taking medications as directed and contact your doctor with any questions or concerns about managing your condition. “Patients may feel more comfortable on a telehealth or video visit where there is less risk of exposure,” said Qureshi. Ask your doctor for recommendations before going in for appointments and consider having medications sent directly to your home so you don’t have to make extra trips to the pharmacy.

LUNG CANCER SCREENING A respiratory condition that often goes undetected until it spreads is lung cancer. That's why staying on track with lung cancer screening is important. If you’re a current or former smoker, ask your doctor about lung cancer screening.

Who Should Get Tested? Testing may be recommended if you meet the following criteria: Age 55-77 years No current signs or symptoms of lung cancer Tobacco smoking history of at least 30 pack-years (calculated

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by multiplying the number of packs smoked per day by the number of years smoked) Current smoker or former smoker, who has quit within the last 15 years Have not had a chest CT scan in the last year


Make an Appointment

A written order is required for all lung cancer screening procedures. Request an order or schedule an appointment by calling 713.441.LUNG (5864). Visit houstonmethodist.org/lung-screening for more information.

PROTECT YOUR LUNGS EVERY DAY

Qureshi recommends taking these steps to keep your lungs healthy:

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Get regular exercise. Being physically active can increase lung capacity and improve lung function. Exercising makes your heart and lungs work harder, which increases oxygen and improves circulation around the lungs. Any form of exercise that involves taking deep breaths can help improve your lung capacity.

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Quit smoking and vaping. Smoking irritates the airways and impairs lung function. Vaping releases chemicals that also cause long-term damage to the lungs. Smoking and vaping can lead to lung cancer and COPD, and worsen complications due to COVID-19 or other serious respiratory infections. It’s never too late to quit, and the benefits of quitting kick in right away. Talk to your doctor about getting support to quit smoking.

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Minimize exposure to allergens. Allergens can trigger respiratory problems and other issues. Keep allergies in check and improve indoor air quality with these tips:

Avoid mold spores Control dust mites Keep surfaces in home clean and uncluttered Minimize pet dander Prevent pollen from getting inside by keeping windows and doors closed Ventilate when using products with strong chemical odors

STAY HEALTHY

“By following recommended respiratory etiquette, we can help protect ourselves and others,” said Qureshi. Stay vigilant with these tips to prevent the spread of illness: Stay home from work or school if you feel sick Practice social distancing Get a flu shot Wear a cloth mask in public Wash hands often Wipe down frequently touched surfaces

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Time for a Joint Replacement?

10 SIGNS YOU NEED A HIP OR KNEE REPLACEMENT

J Dr. Eric Price

oint discomfort can put a damper on your day-to-day activities. Basic movements, such as walking up a flight of stairs or sitting in a low chair can become obstacles. Plus, you may feel discouraged when you’re unable to participate in your favorite sports or hobbies. Hip or knee replacement surgery can offer pain relief, better mobility and an improved quality of life — but is it right for you?

WEAR-AND-TEAR ON JOINTS

“The natural cushioning in your joints can wear out over time or due to injuries, and the experience can be excruciating,” said Dr. Eric Price, an orthopedic surgeon and director of the orthopedic surgery program at Houston Methodist Orthopedics & Sports Medicine at The Woodlands. “With joint replacement surgery, an orthopedic surgeon removes the damaged joint surfaces and replaces them with an artificial joint made of plastic or metal parts.” Here are 10 signs that it might be time to consider joint replacement surgery: 1. You have frequent or intense joint pain with activity. 2. You have difficulty walking, sitting down or standing up. 3. You suffer pain while at rest (day or night), or pain that interferes with sleep. 4. You have inflammation, stiffness and swelling in the joint. 5. Your symptoms have been long-lasting or progressively getting worse. 6. T ests show that osteoarthritis is causing wear-and-tear damage to your joints.

7. You’ve tried rest and medications to reduce inflammation, and it hasn’t worked. 8. Steroid injections and medications no longer provide adequate pain relief. 9. You’re suffering side effects from pain medications. 10. Joint pain is taking a toll on you physically and mentally.

OTHER FACTORS TO CONSIDER

If pain is interfering with your daily life and your symptoms haven’t responded to conservative treatments, surgery may be recommended as a next step. Your age, the condition of your joints and other health factors are also taken into consideration when evaluating you as a candidate for joint replacement surgery. Having a hip or knee replacement can change your life, but it’s not something you want to rush into. The timing is important, because planning for joint replacement surgery requires thinking about how your recovery may affect your ability to work or perform tasks at home. To achieve your best recovery, you’ll need to follow through on your doctor’s instructions and do daily exercises as part of a rehabilitation program.

Learn More

Explore options for orthopedic care with Houston Methodist Orthopedics & Sports Medicine at The Woodlands. Visit houstonmethodist.org/ orthopedics or call 936.321.8000 to make an appointment.

EXCELLENCE IN ORTHOPEDIC CARE WITH A COMPREHENSIVE APPROACH Choosing a hospital with a highly accredited orthopedic surgery program can make a big difference in your overall experience, and it’s another reason to feel at home with your care at Houston Methodist The Woodlands Hospital. The hospital’s orthopedic program received the Orthopaedic Center of Excellence (COE) designation from DNV GL Healthcare. Houston Methodist The Woodlands is the only hospital in Montgomery county and the second in the state to receive this designation. “Achieving Center of Excellence designation shows that we are committed to excellence and performing at the highest level

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from diagnosis and treatment to rehabilitation, education and outcomes,” said Dr. Eric Price, director of the orthopedic surgery program at Houston Methodist Orthopedics & Sports Medicine at The Woodlands. Price said the achievement was driven by a comprehensive team approach to care. “Everyone involved is dedicated to providing excellent patient care, from doctors and nurses to anesthesiologists, physical therapists, social workers and hospital staff at all levels,” said Price. “Our patients benefit from shorter hospital stays, less pain, faster recovery and better outcomes.”


A MAN’S GUIDE TO

DOCTOR VISITS

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en often don’t like going to the doctor. Some would rather tough it out than have to go in and talk to a doctor about symptoms. Others say Dr. Tarek Rafati they feel healthy and believe it’s unnecessary to get an annual checkup. But if it’s been a while since you’ve seen a doctor, there are many good reasons to prioritize your health by scheduling an appointment with a primary care doctor.

MAKE TIME FOR YOUR HEALTH

Taking time to assess your overall health with a doctor is important. It could even save your life so you can keep doing all the activities you enjoy. “It’s good to build a relationship with a primary care doctor you know and trust. Being familiar with you and your health history helps your doctor troubleshoot problems and keep you healthy now and in the future,” said Dr. Tarek Rafati, a primary care physician with Houston Methodist Primary Care Group in The Woodlands. An annual exam may include an assessment of height, weight, blood pressure, skin cancer risk, eating and exercise habits, and emotional well-being. The doctor will ask about your family health history and answer any questions you have about sleep and snoring, sexual health or other health concerns. “Men should get a flu shot every year and a tetanus-diphtheria and pertussis (Tdap) or tetanus-diphtheria (Td) booster every 10 years,” said Rafati. “Your doctor may also recommend other vaccines depending on your age and health history.”

HEALTH TESTS FOR MEN Ask your health care provider which tests you should get — and when — based on your health, family history and lifestyle.

20s

30s

Eye exam (if you don’t have vision problems)

Diabetes screening (if overweight)

40s

50s 60+

Blood pressure screening Cholesterol test Hearing test (if you have trouble hearing)

Colon cancer screening Lung cancer screening (for current or former smokers)

Prostate cancer screening (ask your doctor) Abdominal aortic aneurysm screening (if you have ever smoked) These are general guidelines and are not intended as medical advice. Talk to your doctor about screening tests that may be right for you.

Need a Doctor?

If you’re a guy who hasn’t set foot in a doctor’s office for a few years, it’s probably time for a checkup. Need help finding a doctor? We can help. To find a primary care doctor close to you, visit houstonmethodist.org/pcg/north, call or text 713.394.6724. HOUSTONMETHODIST.ORG/THEWOODLANDS  7


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LEADING MEDICINE IN GREATER HOUSTON

Getting your annual mammogram is still important. Houston Methodist can see you safely. Getting your annual mammogram is one of the most important steps you can take to stay healthy. That’s why our Breast Care Center is taking every necessary precaution during the coronavirus pandemic to keep you and our staff members safe.

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936.270.3333

HOUSTONMETHODIST.ORG/THEWOODLANDS

During the coronavirus pandemic, we are:

Screening all patients, ensuring only those without COVID-19 symptoms are seen in the office.

Wearing masks and other personal protective equipment while providing patient care.

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Implementing additional sanitation processes to disinfect all equipment and surfaces.

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Redesigning waiting rooms and check-in procedures to ensure social distancing.

Visit houstonmethodist.org/breast-care or call 936.270.3600 to schedule your mammogram today.

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