How Your Doctor Can Help You Stay in a Healthy Range
Is it Heartburn or Something More?
Shoulder Pain Solutions
Do you suffer from heartburn after eating, bending over or lying down? It’s that uncomfortable burning sensation in your chest or tasting food or acid after eating. If so, you’re not alone. But if you have heartburn more than twice a week, you may have a condition called gastroesophageal reflux disease, also known as GERD.
GERD happens when stomach acid flows back up into the esophagus (the tube connecting your mouth and stomach). The acid irritates the lining of the esophagus, resulting in a burning sensation. Other symptoms may include chest pain, difficulty swallowing, chronic cough, burping, or regurgitating food or bile.
GERD can be caused by a variety of conditions or behaviors, such as eating large meals or eating too late at night.
“In some cases, GERD is caused by underlying conditions that prevent your stomach from emptying food as quickly as it should,” said Dr. Franz Schneider, a gastroenterologist with Houston Methodist Gastroenterology Associates at Clear Lake. “These can include gastroparesis or hiatal hernia.” Gastroparesis is a condition that affects the normal muscle movements in the stomach. A hiatal hernia occurs when the upper part of your stomach pushes through your abdominal muscles.
“Both conditions can cause delayed stomach emptying after eating, which creates a backup of fluid, bile and acid,” Schneider explained. “If left untreated, the acid contents of the stomach can irritate or cause injury to the esophagus.”
Treatment for these conditions varies depending on the type and severity of the symptoms. Experts recommend starting with these lifestyle changes:
■ Avoid high-fiber meals, especially before bedtime
■ Eat smaller, more frequent meals
■ Keep a food diary and cut out foods that trigger symptoms
■ Lose excess belly fat
■ Watch sugar intake if you are diabetic
Visit your primary care provider when symptoms interfere with your sleep, ability to tolerate meals and daily life. They may recommend medication or refer you to a specialist for testing.
“Often the problem can be diagnosed with a simple gastric emptying test to measure how long it takes for food to leave your stomach,” Schneider said. If dietary changes and medications aren’t effective, surgery may provide relief. Common procedures include:
■ Endoscopic techniques for GERD: Surgeons use an endoscope to sew small stitches to tighten your esophageal sphincter muscle to reduce acid reflux. Endoscopic radiofrequency is another option. Controlled energy is transferred into the sphincter muscles making them tighter to prevent reflux.
■ Per-oral pyloromyotomy (POP) procedure for gastroparesis: This scarless surgery is performed through the mouth, so no incisions are needed. Using an endoscope, surgeons open the stomach muscle to allow food and acid to empty from the stomach more effectively. •
Avoiding these foods may help reduce your symptoms of chronic heartburn, GERD or gastroparesis:
■ Caffeinated and carbonated beverages
■ Chocolate
■ Citrus fruit
■ Fried or fatty foods
■ Garlic
■ Onions
■ Peppermint
■ Spicy foods
■ Tomato-based sauces
■ Vinegar
If you are suffering from chronic heartburn, a gastroenterologist can help you find relief. Call 281.523.3320 to schedule an appointment with a specialist at Houston Methodist Gastroenterology Associates in Clear Lake.
Your annual well-woman exam is important, even if you don’t have any health concerns.
“Every woman should schedule a yearly exam with recommended screening tests,” said Dr. Ashley Marcantel, an obstetriciangynecologist at Houston Methodist Obstetrics and Gynecology Associates at Clear Lake. “Not only does this help maintain your overall health, but can save money, time and ultimately, your life.”
Here she answers some common questions about this essential medical appointment.
A: Your annual well-woman exam is a chance to focus on preventive care and ways to stay healthy, rather than an illness or injury. Your annual checkup usually includes:
■ A general physical exam to check your heart, lungs and abdomen, along with pelvic and breast exams
■ Discussion about recommended health screenings and referral information
■ Education about your health conditions, risk factors and counseling to help you make informed decisions about your health
A: Your doctor will determine which screenings or tests are needed. Generally, these will depend on your age, medical history and current health status. Experts recommend the following screening schedules for most women:
Cervical cancer screening
■ Ages 21-29: Pap test every three years
■ Ages 30-64: Pap test every three years. HPV test every five years. Pap and HPV (or co-testing) testing every five years.
■ Ages 65+: Talk with your doctor about whether you need to continue testing.
Clinical breast exam
■ Ages 25-39: Every one to three years
■ Ages 40+: Yearly
Mammogram
■ Ages 40-74: Yearly
■ Age 75+: Talk with your doctor to determine if you need to continue screening mammograms.
Screening colonoscopy
■ Ages 45+: Every 10 years. Your doctor may recommend more frequent screenings if you have a family history or certain risk factors.
Bone density screening
■ Ages 65+: Once every two years, unless new health risks develop.
Q: WHAT SHOULD I EXPECT TO DISCUSS?
A: Your doctor will ask you questions about your health history, any changes in your health or if anything is concerning. You’ll be asked questions about:
■ Changes in your health, such as diet, toileting habits, fatigue or problems sleeping
■ Family health history
■ Last period
■ Medical history
■ Medications you’re taking, including prescription, over the counter or supplements
■ Mental health history
■ Relationships and safety
■ Sexual health and partners
■ Use of alcohol, tobacco or other drugs
Q: SHOULD I PREPARE QUESTIONS AHEAD OF TIME?
A: Yes, making a list of questions will help you remember everything you intended to talk about. “Feel free to ask questions without being embarrassed or afraid. You’ll build trust with your doctor when you have open communication,” Marcantel added. •
To find an obstetrician-gynecologist in the Clear Lake area or schedule an appointment, visit houstonmethodist.org/spg/womens-services/ bay-area or call 832.783.2330.
Your primary care provider, or PCP, is one of your most important health resources. But what does a PCP do?
“As your PCP, my job is to help you stay healthy,” explained Dr. Julie Nguyen, a family medicine physician at Houston Methodist Primary Care Group in League City. “I can diagnose things that might not feel right and help you keep an eye on your health. PCPs work with our patients to help prevent problems and learn the best ways to maintain your health.”
Your PCP performs annual check-ups and is usually the first stop if any illness or health concerns arise. They help you understand and reduce your risk for developing a wide variety of health problems. PCPs monitor your health and can recommend testing or refer you to specialty care when needed. Together, you and your PCP can help you continue to live the life you love.
“A doctor and patient should be partners in health,” Nguyen said. “Working together, we can help you live a healthy life.”
To keep an eye on your health, your PCP monitors several key numbers to check your risk for developing serious diseases. For a helpful next visit, be prepared to talk with your doctor about these important indicators and other risk factors you may have.
Heart disease is the leading cause of death in both men and women in the U.S. By understanding your numbers, you can reduce your risk of developing cardiovascular disease as well as other health conditions, such as stroke, diabetes and obesity.
■ Blood Pressure: A measurement of the amount of force your heart needs to pump blood throughout your body. Blood pressure is measured by two numbers: systolic (when your heart pumps blood out) and diastolic (when your heart rests between beats).
✓ Healthy target: less than 120/80 mmHg
Risks: High blood pressure can negatively affect the function of your heart and other major organs, such as the kidney and brain. It’s also the leading cause of stroke.
■ Body Mass Index: A measure of your weight divided by your height, squared.
✓ Healthy target: 18.5 to 25 kg/m2
Risks: The higher your BMI, the greater your risk of heart disease, high blood pressure, type 2 diabetes and certain cancers.
■ Fasting Blood Sugar: A measure of the amount of glucose in your blood after fasting for eight to 12 hours.
✓ Healthy target: below 100 mg/dL
Risks: Also called hyperglycemia, high blood sugar can damage the blood vessels and nerves that control your heart over time. It can also lead to type 2 diabetes.
■ Total Cholesterol: A measurement of cholesterol (a fat-like substance made in the liver and found in foods) in your blood.
✓ Healthy target: less than 200 mg/dL. Talk to your doctor to understand all of your cholesterol (lipid) levels, including LDL, HDL and triglycerides, and what they mean for your heart health.
Risks: Excess cholesterol can build up in the walls of the arteries, leading to narrowing or blockages in your vessels, which increases your risk of heart attack or stroke.
Some risk factors are genetic or out of your control, like family history, age and sex — but there’s still a lot you can do to keep your numbers in a healthy range.
The best way to know your numbers and understand how they impact your health is to visit your PCP. As your health partner, they can perform or order tests to check these important measurements and help you make a personalized plan to get back within healthy range if necessary. Plans can include increasing your activity level, adopting healthy eating habits, quitting smoking, limiting alcohol and learning how to check and manage your blood pressure. Building a partnership with your PCP and working with them to know and manage your numbers can dramatically reduce your risk of heart disease and other health complications. •
Chances are you may have seen a nurse practitioner (NP) or physician assistant (PA) during a doctor’s office visit sometime in your lifetime. While they are not medical doctors, these highly trained health care providers work hand in hand with physicians as part of your health care team.
These providers have the expertise to diagnose and treat patients in a variety of specialties. They undergo years of medical training — in fact, most have a master’s degree or a doctorate. Working under the supervision of your doctor, PAs and NPs perform clinical exams, diagnose and treat illnesses, order labs and tests, and prescribe medications. Houston Methodist is home to dozens of such providers, who provide expert, compassionate care throughout the system.
Houston Methodist provides primary care that’s personalized for you and your unique needs. To schedule an appointment with a primary care provider, visit houstonmethodist.org/pcg/ southeast or call 713.441.7965
For these key measurements, keeping your results within these healthy ranges will go a long way toward maintaining your best health.
Blood Pressure: Less than 120/80 mmHg
Body Mass Index: 18.5 to 25 kg/m2
Fasting Blood Sugar: 80 to 99 mg/dL
Total Cholesterol: Less than 200 mg/dL
Talk with your primary care provider about these important tests and steps you can take to get back in a healthy range. If you have diabetes or other health conditions, your goal numbers may vary.
You don’t have to be a major league pitcher to experience shoulder pain. It’s the third most common musculoskeletal complaint, after lower back and neck pain. Repetitive stress, overuse, injury and deterioration of the joint due to age or orthopedic conditions are major causes.
“Occasional aches and pains are normal as we age,” said Dr. Brittney Warren, an orthopedic surgeon at Houston Methodist Orthopedics & Sports Medicine at Clear Lake. “But if the pain lingers or is a result of a traumatic injury, it’s important to seek medical care right away to avoid further problems down the road.”
The shoulder joint is comprised of bones, muscles, tendons, labrum, bursa (a fluid-filled sac on top of the rotator cuff) and a vast network of vessels and nerves. A group of muscles and tendons, known as the rotator cuff, keeps the shoulder joint stable. There are many conditions that cause shoulder pain, including osteoarthritis, bursitis, frozen shoulder, tendonitis and rotator cuff injuries.
Over time, repetitive stress, trauma, and age-related wear and tear weaken the soft tissue surrounding the shoulder joint. This creates inflammation and, in some cases, partial or complete tears of the tendons.
Rotator cuff injuries are common and increase as we age,
If shoulder pain is keeping you up at night — don’t suffer in silence. An orthopedic specialist can identify the cause of your pain and help design a treatment plan. To request an appointment at Houston Methodist Orthopedics & Sports Medicine at Clear Lake, visit houstonmethodist.org/orthopedics/clearlake or call 713.363.9090.
especially after 40. These injuries may occur earlier in people who have jobs that require repetitive overhead motions, such as painters or mechanics.
“Arm and shoulder pain when lifting objects away from the body (i.e., placing milk in the fridge) is a common complaint from people with rotator cuff pathology,” Warren said. Weakness and night-time pain may also be symptoms of rotator cuff injury.
A thorough physical exam to assess range of motion and muscle strength, along with a review of a patient’s health history, will help identify the problem. X-rays and MRIs can look for bone spurs, joint space loss and evaluate the soft tissues.
Many shoulder conditions can be treated at home with rest, ice or heat, and nonsteroidal anti-inflammatory drugs, such as ibuprofen. Physical therapy (PT) can help fix poor posture and strengthen supporting muscles. When shoulder pain persists despite home remedies and PT, a steroid injection or surgery may be recommended.
“Minimally invasive arthroscopic shoulder surgery is a good option for people with many shoulder conditions who have tried other treatments to relieve the pain and regain function,” Warren noted. Arthroscopic surgery is performed using keyhole-sized incisions around the shoulder. Surgeons insert a small camera to see inside your shoulder and use miniature instruments to repair the tendon with bone anchors and sutures. The goal of this repair is to help restore shoulder function and relieve pain. •
Pelvic floor disorders, including urinary incontinence, accidental bowel leaks and pelvic organ prolapse, are commonly viewed as a normal part of aging. But these symptoms should not be taken lightly.
“Women often feel alone and will suffer silently with symptoms related to pelvic floor issues until they severely interfere with their quality of life” said Dr. Emily Rutledge, a urogynecologist at Houston Methodist Urogynecology Associates at Clear Lake. Pelvic floor refers to the group of muscles around your bladder, uterus, vagina or anus.
Keeping silent is rarely a medical risk, but doing so can severely impact your overall well-being. Here are some common questions from women who have experienced pelvic floor issues — along with some helpful answers.
Q. I suffer from urinary leakage when I sneeze, laugh, cough or exercise. Is this normal?
A. It may feel as if you’re alone, but you’re not — 1 in 3 women will experience a pelvic floor disorder, such as urinary incontinence, in her lifetime. Generally, women suffer silently because these problems due to embarrassment. On average, women wait about five years from symptom onset to seek help and be evaluated.
Q. Is incontinence just a part of getting older and something I must accept?
A. “Not at all. Women of all ages can be impacted by incontinence,” Rutledge explained. “And with so many treatment
options available, it’s not something you have to just live with.” Treatments range from bladder training, pelvic floor muscle exercises, medications and vaginal inserts to minimally invasive surgical procedures.
Q. I feel a bulge and heaviness down below. What’s causing this?
A. “Pelvic organ prolapse can be responsible for these symptoms,” Rutledge said. “It is similar to a hernia through the vagina. The most common reason that this happens is from childbirth, particularly vagina deliveries.” Pelvic organ prolapse is a loss of the normal support of the pelvic organs (i.e. bladder, vagina, uterus, and rectum). They begin to slip down from their normal position and bulge into the vagina. This can eventually lead to problems emptying your bowels and bladder. There are many treatments available for this common condition.
A. While pelvic floor disorders are rarely medical emergencies, both prolapse and urinary incontinence can greatly affect your life. In fact, women with these conditions may choose their clothing, schedules and activities around the fear of losing bladder control or discomfort from prolapse. These conditions may also impact sexual function and confidence during intimacy.
B ottom line — if you are experiencing pelvic floor issues, don’t let shame or embarrassment keep you from seeing a specialist. “I understand that these are very private issues that can be difficult to discuss,” Rutledge shared. “During evaluation, my goal is to reassure patients that they are not alone and discuss options that can help them find relief.” •
I f you have unanswered questions about pelvic floor disorders, visit houstonmethodist.org/pelvic-health or call 713.441.5800 to make an appointment with a urogynecologist.
