Leading Medicine Spring Summer 2019, Houston Methodist The Woodlands Hospital edition

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LEADING MEDICINE SPRI N G/SUM M ER 201

Treating Prostate Cancer on the Fast Track Summer Precautions for People with Diabetes

Orthopedic and Sports Injuries

PROTECT YOURSELF FROM HEAD TO TOE

YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN THE WOODLANDS AND MONTGOMERY COUNTY


Treating Prostate Cancer on the Fast Track

F

inding out that you or a loved one has prostate cancer can be nerve-wracking. You might have lots of questions about what to expect and what to do next. What are my treatment options? When should treatment start? How long will it take? Some forms of prostate cancer can be so slowgrowing that they can be safely monitored — Dr. Peter without active treatment — and they may never Morgan cause symptoms or threaten a man’s health. However, in cases when prostate cancer is more aggressive and fast-growing, getting the recommended course of treatment right away is essential. Prostate cancer treatment options may include surgical removal of the prostate, radiation and testosteroneblocking hormone therapy.

RAPID DELIVERY OF RADIATION THERAPY

“Our shorter, targeted type of radiation allows us to treat the prostate cancer in a shorter timeframe and get men back to their normal routine faster,” said Dr. Peter Morgan, radiation oncologist with the Houston Methodist Cancer Center at The Woodlands. With advanced technology available at the Cancer Center, prostate cancer can be treated with radiation therapy in five and a half weeks compared to the standard treatment timeframe of eight to nine weeks at other centers. This more rapid course of treatment is made possible with onboard imaging, which involves taking a CT scan of the pelvis immediately prior to each daily treatment to localize the prostate within the pelvis. “The machine delivers intensity-modulated radiation therapy (IMRT) in just one to two minutes, enabling us to deliver a targeted dose to the prostate while protecting nearby organs,” Morgan explained.

PROSTATE CANCER EXPERTISE

Experience matters when it comes to the level of precision needed for prostate cancer treatment. Morgan has trained extensively and contributed to research on the treatment of prostate cancer. “Every man’s case is unique, and we have the expertise to create personalized treatment plans that address the complexity of prostate cancer cases,” Morgan said. Convenience and fast scheduling is another important factor, especially for men who are working and have busy lives. “One of our goals is to minimize how much cancer treatment disrupts their normal life,” Morgan said. “A man who is undergoing treatment for prostate cancer can get his treatment all in one building — and close to home.”

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High-Intensity Focused Ultrasound

MINIMALLY INVASIVE CANCER TREATMENT OPTION

High-intensity focused ultrasound (HIFU) provides a low-risk, less invasive treatment option for earlystage prostate cancer. This outpatient procedure uses a specially designed ultrasound to create heat at a specific point to destroy targeted tissue. The treatment is customized for each patient and minimizes damage to the nerves around the prostate, which can help preserve sexual potency. Houston Methodist The Woodlands is the first hospital in The Woodlands to offer this stateof-the-art treatment. Talk to your doctor or call 936.270.3333 to learn more.

Here for You

If you have questions about prostate cancer treatment options, call Houston Methodist Cancer Center at The Woodlands at 936.270.3413 or visit houstonmethodist.org/cancer-woodlands to learn more.


CONCERNED ABOUT SUDDEN MEMORY LOSS?

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ll of a sudden, your partner has started forgetting things — where he or she placed the checkbook, an important meeting, perhaps even a good Dr. Randall friend’s name. If this Wright sounds familiar, you may be worried something is wrong. Are these memory lapses a sign of normal aging or symptoms of something like Alzheimer’s disease? Alzheimer’s is the most common cause of dementia, a general term for memory loss that’s serious enough to interfere with daily life. Approximately 4.5 million Americans suffer from the disease, and symptoms typically begin to appear after age 60. “Forgetting things once in a while is not a cause for panic and doesn’t necessarily mean someone has Alzheimer’s,” said Dr. Randall Wright, a neurologist at Houston Methodist Comprehensive Care Center in Conroe. “It’s only if it happens on a regular basis that it becomes a concern.”

WHEN TO SEE THE DOCTOR

If your loved one shows any of these symptoms, schedule an appointment with a health care provider. Regularly forgetting things, especially information learned recently Frequently forgetting common phrases and using odd words in their place Asking the same questions repeatedly Having trouble with everyday tasks, such as preparing meals Becoming lost in once familiar places Having sudden and unexplained mood swings or dramatic personality changes Regularly repeating the same story as if it were the first time being told

HOW TO KEEP A STRONG MIND AS YOU AGE 1. E at a well-balanced diet that includes plenty of whole fruits and vegetables and good fats. Avoid processed foods. 2. H ave meat as a side dish, not the main event (and yes, even in Texas!). 3. Take a cooking class with friends. Learn how to cook with healthy oils and to keep the nutrients in the foods you eat. 4. E xercise at least 30–60 minutes, five to six times a week. Be sure to include a mix of cardiovascular and strength training. 5. G et plenty of sleep. Aim for seven to eight hours a night. 6. L ower your stress. Try meditation or yoga. 7. E ngage in active brain training. Do Sudoku puzzles or other brain games 30 minutes, three times a week, or 10–20 minutes on most days.

Neglecting to bathe or change clothes Misplacing items in odd places, such as putting a wallet in the freezer

OTHER REASONS FOR MEMORY LOSS

Anxiety, depression and extreme stress can often make a person forgetful, according to Wright. “Your provider should first check for other conditions that may cause memory problems,” Wright said. “Certain drug interactions, fever, dehydration, vitamin deficiency, thyroid problems, minor head injuries and other medical conditions could be the culprit. In these cases, memory loss is temporary and can be improved with proper treatment.” Unfortunately, there is no one definitive test for Alzheimer’s. Rather, the disease is diagnosed if all other conditions can be ruled out. If the diagnosis is Alzheimer’s,

the symptoms will become progressively worse, but early drug treatment may delay a rapid decline.

Schedule an Appointment

Don’t wait to get help for your loved one. Schedule an appointment with a neurologist at Houston Methodist The Woodlands Hospital or Houston Methodist Comprehensive Care Center in Conroe by calling 936.270.3333.

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Orthopedic and Sports Injuries

Protect Yourself from HEAD TO TOE D ealing with orthopedic and sports injuries often comes with the territory for football players, marathon runners, gymnasts and other competitive athletes. But you don’t have to be on the field or court to end up with a painful or chronic injury. Everyday injuries — from carrying groceries or unloading the dishwasher — happen all the time and can lead to long-term problems if not treated properly. Dr. John Fackler Back problems, joint disorders and osteoarthritis are among the top reasons for seeing a doctor. “Musculoskeletal issues result in millions of orthopedic visits every year,” said Dr. John Fackler, orthopedic surgeon specializing in knee and shoulder surgery at Houston Methodist The Woodlands Hospital.

KNOW YOUR LIMITS

Fackler says it’s important to listen to your body when it’s telling you to slow down. “Sometimes we try to push through the pain, but you can end up doing more damage if you’re not careful. When you have joint and muscle pain, you can’t always walk off the pain or solve it by taking antiinflammatory medicines,” he noted. “With age, our ability to heal is not as fast as it used to be and we don’t have as much elasticity in those tendons — like a rubber band that loses its elasticity over time. The best thing you can do is modify your activities or try a new activity that puts less stress on your body, such as biking or swimming,” Fackler added.

WHEN TO GET CHECKED

Injuries are bound to happen whether you’re competing in sports or just taking a walk around the block. Minor injuries can often be treated at home with rest, ice, compression and elevation. But there are times when it’s important to see a doctor so you can avoid further damage and ensure that you can heal properly. It’s wise to get medical help if you experience the following symptoms after an injury: Instability (unable to bear weight on your knee or ankle) Limited range of motion Numbness or tingling Persistent joint pain Significant swelling or tenderness Weakness or lack of strength while moving a limb or muscle In addition, any impact to the head should be taken seriously, whether it’s from a sports collision or a minor fall at home. “When it comes to head injuries, always seek medical help for signs of concussion, such as any loss of consciousness, confusion or dizziness following a bump on the head,” Fackler said.

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ORTHOPEDIC INJURY CLINIC

Twisted ankle? Sprained knee? Bad shoulder? You don’t need an appointment to see a specialist — just go to the Houston Methodist Orthopedic Injury Clinic located on the campus of Houston Methodist The Woodlands Hospital. For immediate orthopedic care, count on our experts to evaluate and treat your injury, so you can get back to your active life. Major insurance plans are accepted. The injury clinic provides treatment for: Acute orthopedic injuries Fractures and broken bones Injured tendons Minor dislocations Painful or swollen joints Sports injuries Sprains and strains Torn ligaments Monday – Thursday, 7 a.m. – 4:30 p.m. Friday, 7 a.m. – 3 p.m. Conveniently located at 17183 Interstate 45 S., Medical Office Building 1, Suite 210, The Woodlands, TX 77385. Visit houstonmethodist.org/osm/ woodlands or call 936.321.8000. Chronic conditions, spine injuries, motor vehicle accidents and workers’ compensation injuries are not treated at the injury clinic. Please call 936.321.8000 to schedule an appointment with the orthopedic specialist for those conditions.


HEAD AND NECK

INJURY PREVENTION TIPS

Concussion Whiplash

Dr. John Fackler, orthopedic surgeon and director of rehabilitation services at Houston Methodist The Woodlands, shared the following injury prevention tips.

Injury prevention: Stay fit and maintain good posture for a strong neck and upper back. Wear headgear for contact sports or safety equipment for your activity.

BACK Herniated disk Repetitive strain Injury prevention: Protect your back from injuries by strengthening your core muscles (the muscles that wrap around your entire torso) by doing exercises, such as planks and/or abdominal bracing exercises.

SHOULDER Rotator cuff injury Shoulder instability Injury prevention: Lift properly by picking up objects in front of you and as close to your body as possible.

ARM AND ELBOW

HIP AND LEG

Bursitis Golfer’s elbow Tennis elbow

Hamstring strain Hip flexor strain Shin splints

Injury prevention: Mix up your routine by doing a variety of arm movements to avoid repetitive injuries. Learning the proper mechanics for throwing and swinging is key to avoiding upper extremity injuries.

Injury prevention: Take care of your muscles and joints by warming up and stretching before exercise.

KNEE ACL injuries Jumper’s knee (patellar tendonitis) Osteoarthritis of the knee Injury prevention: Lose weight or maintain a healthy weight to take pressure off the knee and reduce wear and tear over time. Staying active helps protect the knee because you’re building muscles in the hips, quads and thighs to support the knee.

WRIST AND HAND FOOT AND ANKLE Ankle sprains Tendonitis Turf toe Injury prevention: Wear good shoes with solid support to absorb impact and prevent ankle injuries. Balance activities can help with stability — it can be as simple as standing on one leg.

Carpal tunnel syndrome Jammed fingers Skier’s thumb Wrist sprains Injury prevention: Take breaks from activity to rest the hands and wrists. If you spend a lot of time at a desk, set a timer throughout the day for every half hour to remind you to stretch and move.

KEEP MOVING Fackler shared some additional tips to help you keep moving and stay injury-free: Warm up before you exercise — walking, squatting, cycling, jumping jacks, arm circles, shoulder rolls or lunges. Get your heart rate up, such as a brisk walk in a park with friends.

A im for 30 minutes of exercise every day — you can break this up into smaller, 10-minute bursts of exercise throughout the day. B uild strength with weights a few times a week. A dd balance activities at least once a week — stretching, yoga, tai chi. F ocus on good posture — avoid the “head forward, rounded neck” posture when looking at your phone.

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COPING WITH RHEUMATOID ARTHRITIS I Dr. Holly Smith

f you have rheumatoid arthritis (RA), you are likely all too familiar with the pain, stiffness and fatigue that can make even simple tasks a chore. You’re not alone. Approximately 1.3 million Americans have RA. While there’s no cure for this autoimmune disease (when the body’s immune system is not working properly), taking good care of yourself and working with a specialist at Houston Methodist The Woodlands Hospital can ease your discomfort and improve your quality of life.

RA: THE FACTS

RA is a condition that causes chronic inflammation of the joints, often leading to pain, swelling, stiffness and, if left untreated, joint deformities. Dr. Holly Smith, a rheumatologist at Houston Methodist The Woodlands, specializes in treating people with RA. “Initially, people with RA will feel pain in just a few joints,” she explained. “Over time, most patients with RA have symmetric involvement on both sides of the body, including small joints, such as hands, wrists, ankles and feet.” Yet, Smith points out that it’s important to remember that RA varies from person to person. “Some sufferers find the disease is mild and easy to control, while others have a more severe disease, warranting more aggressive medication regimens. In general, with the medications available today, most people should expect to achieve complete remission with a personally tailored treatment plan,” Smith said. Additional symptoms of RA include: General joint stiffness, especially after a period of rest Fatigue and possibly a low-grade fever Rheumatoid nodules (lumps, usually painless, that form under the skin) More rarely, inflammation in other parts of the body, including tear and salivary glands, the lungs, eyes or skin

RELIEVING THE PAIN

If you suffer from RA, regular, moderate exercise and a nutritious diet are important aspects of any treatment regimen. Walking or other aerobic activities, plus exercise that involves stretching your joints through a full range of motion, can aid in improving blood flow, maintaining flexibility and controlling your weight. It can also contribute to an improved sense of well-being.

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Don’t Wait to Get Help

To schedule an appointment with a rheumatologist at Houston Methodist The Woodlands Hospital, call 936.270.3333.

“Excess pounds tend to put stress on joints, so exercise and maintaining a healthy weight are important,” said Smith. “Additionally, relaxation and mindfulness techniques, such as deep breathing and guided imagery, help a person cope with pain while we work to get the disease under control. Adequate sleep is also essential.” In addition, Smith recommends medication for long-term management of RA. “Disease-modifying anti-rheumatic drugs (DMARDS) are used to achieve disease remission and control symptoms, as well as prevent long-term joint damage. Sometimes stronger medications called bilogics are also needed,” Smith said. “Anti-inflammatories and steroids can help with pain control. Ultimately, today, we expect great outcomes for people diagnosed with RA.”

VIRTUAL URGENT CARE The next time you get sick, you can skip the waiting room. See our providers via video visit — 24/7, from wherever you are. Virtual Urgent Care is available through the MyMethodist app. Download it today or visit houstonmethodist.org/virtual-care to learn more.


SUMMER PRECAUTIONS FOR PEOPLE WITH DIABETES

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he hot summer months can be a welcome change for those who love the sun and lounging on the beach. However, for people with diabetes, it’s important to be aware of the effect that excessive heat and humidity can have on your body. According to Dr. Robert Fernandez, Dr. Robert a primary care physician with Houston Fernandez Methodist Primary Care Group in Conroe, the main concern is overexertion in the heat and a change in diet. “The summer months are traditionally a time for getting together with friends for backyard barbecues and outings to the beach. It’s also a time that we tend to overindulge in alcohol and foods like hot dogs and hamburgers. And as activity levels increase, this can sometimes cause a lowering of blood sugars if not appropriately monitored.” People with diabetes — type 1 and type 2 — may react to the heat and humidity differently than others for a variety of reasons, including: Diabetes can cause complications, such as damage to blood vessels and nerves that affect the sweat glands, leaving some people unable to cool down effectively. People with diabetes may become dehydrated more quickly. Not drinking enough water can raise blood sugar, which makes you urinate more, resulting in dehydration. Some medications like diuretics (commonly prescribed to control high blood pressure) can dehydrate you, too. High temperatures can change how your body uses insulin. Fernandez also pointed out that managing blood sugar levels can be a challenge while traveling to different time zones and eating meals on the go. If you plan to travel extensively in the summertime, make an appointment with your doctor to ensure you’re healthy and prepared for your trip.

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TIPS TO STAY SAFE IN THE SUN

The following steps can help keep you safe in high heat and humidity. 1. D rink plenty of water, even if you’re not thirsty, so you don’t get dehydrated. 2. A void or limit alcohol and caffeine. They can lead to water loss. 3. L imit direct sun exposure during the hottest part of the day — from noon to 4 p.m. 4. T est your blood sugar often and adjust your insulin dose, activity level and what you eat and drink.

Keep Your Family Healthy with Houston Methodist Primary Care — 8 Convenient Locations in Montgomery County

Montgomery

Learn More

Don’t let diabetes ruin your summer fun. To find a primary care doctor in your area, visit houstonmethodist.org/pcg or call 713.394.6724.

Conroe

Magnolia

105 45

The Woodlands

1488

249 99

242

Rayford/Sawdust

Spring

Kingwood

1960

69

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The expertise to

KEEP YOU MOVING

At Houston Methodist Orthopedics & Sports Medicine, we know your body is made to move. Our specialists use the latest technology, perform minimally invasive procedures and develop customized treatment plans, including physical therapy. Whether you’re getting back in shape or back to work, we can help get you back on your feet — and keep you moving. houstonmethodist.org/orthopedics 20 convenient locations

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