Leading Medicine Fall 2022, Houston Methodist Hospital edition

FALL EVENTS

VIRTUAL WOMEN’S HEALTH EVENT

Date: November 2022 Location: Online

LIVE ONLINE WEIGHT LOSS SURGERY ORIENTATION

Date: November 2022 Location: Online

IN-PERSON COMPREHENSIVE NEURO EVENT

Date: November 2022 Location: Houston Methodist Hospital 6565 Fannin St, Houston, TX 77030

For more information about our events and to register, visit houstonmethodist.org/events or call 713.790.3333.

We host a variety of virtual and in-person events on childbirth, weight management, and more. For a comprehensive list of events at Houston Methodist Hospital, visit houstonmethodist.org/events or call 713.790.3333

When to See a Doctor for a UTI

A urinary tract infection (UTI) occurs when bacteria infect the urinary tract, causing irritation and inflammation. It affects both men and women. It's import ant to know the symptoms of a UTI in order to get the help you need.

If you experience one or more of these symptoms, it’s time to seek medical care:

Frequent and strong urge to urinate

Feeling as though you haven’t completely emptied

Urine that is cloudy, strong-smelling or discolored

Burning sensation or pain when urinating

Talk to Your Doctor

Loss of bladder control

Pain or pressure in kidneys or lower abdomen

UTIs are very common and easily treated in the early stages with antibiotics. Left untreated, a UTI can spread into the kidneys. This type of serious infection can be harder to treat. If you are experiencing symptoms, visit houstonmethodist.org/pcg/central or call 713.394.6724 to connect with a doctor – in-person or virtually.

Protect Your Bones

Why Women Are at Higher Risk for Osteoporosis

Most women don’t realize they have osteoporosis until they break a wrist or hip. That’s why many experts call it a silent disease — because you may not notice any changes until you end up in the emergency room.

PREVENTING OSTEOPOROSIS

While the risk of osteoporosis increases as we age, not all women will develop it in their lifetime. “There are plenty of steps you can take to prevent osteoporosis,” Wooldridge said. Many of these steps involve changes to your lifestyle and habits:

Dr. Gillian Wooldridge

“Osteoporosis develops as bones become thinner and more fragile with time. It's more common than people realize but often goes undiagnosed,” explained Dr. Gillian Wooldridge, a sports medicine specialist at Houston Methodist Orthopedics & Sports Medicine.

Common risk factors include menopause, small body frames, smoking, calcium or vitamin D deficiency, and long-term physical inactivity. While white and Asian women tend to be at higher risk for osteoporosis, women of all ethnicities and backgrounds can be affected.

“Unlike fractures from accidents or sports injuries, which are caused by significant trauma, osteoporosis can cause bones to break from relatively minor trips and falls in the home,” Wooldridge said.

TESTING BONE DENSITY

Women over 65, or women over 50 with certain risk factors, should be screened for osteoporosis with a bone mineral density test every two years. Known as a DXA scan, it examines the thickness of your bones.

Find Out if You Are at Risk

■ Be physically active. Physical activity like strength t raining and other weight-bearing exercises can help build up strength and preserve bone density.

■ Eat a healthy diet, including supplements for bone health. Calcium and vitamin D are important nutrients for preserving your bone density. Talk to your doctor to learn more about how much you need each day.

■ Quit smoking and limit alcoholic beverages. People who smoke have an increased risk of developing osteoporosis as do those who have three or more alcoholic drinks per day.

■ Reduce fall risk in your home. Wear supportive, nonslip shoes around the house. Remove trip hazards and install handrails in staircases and other areas where falls are common, like the bathroom. Installing bright light bulbs can help you see better, too.

Even with lifestyle changes, sometimes bone density loss happens. “Talk to your doctor about your risk and treatment options,” Wooldridge said. “These can include medications that slow bone loss and others that can help you rebuild bone density.”

•

HoustonMethodist Hospital uses the latest noninvasive technology to test women for osteoporosis by measuring bone density as well as assess bone health and strength. Our advanced evaluations identify bone weaknesses and help women consider treatment options as early as possible. Call 713.790.3311 to make an appointment with an orthopedic specialist.

4 THINGS TO CONSIDER BEFORE STARTING YOUR SEARCH CHOOSING A CANCER CARE TEAM

Hearing the news that you or a family member have cancer can take your breath away. Your thoughts and emotions start to race. Deciding what to do next feels impossible.

to ensure patient safety.” Niravath explained.

Your cancer team may include additional services to address other needs that arise during treatment. Look for a provider that offers these support services to complement your cancer care:

■ Nurse navigators

■ Physical, occupational or speech therapy

■ Registered dietitians

■ Financial navigators and social work

Dr. Polly Niravath

Finding the right provider and treatment plan is a highly personal decision. Many people feel an urgency to get started with treatment right away. However, experts say it’s a good idea to take a couple days to understand your diagnosis before making any decisions. But where do you start?

Once you know the type of cancer you have and the stage, you can begin your search for a care team. Referrals from your primary care physician, family or friends are often good places to begin. For many people, online research is helpful.

Finding the right hospital and team of specialists can make a big difference in the type of care you receive. And knowing what to look for can help you make the right decision. Dr. Polly Niravath, a board-certified breast oncologist at Houston Methodist Neal Cancer Center at Texas Medical Center, offers advice for people just starting their search. Here are just a few things to look for.

1PERSONALIZED APPROACH

When it comes to medical care, we all want to be treated like an individual, not a condition or disease. This is especially important in cancer care. A patient-centric, holistic approach to cancer treatment considers the whole person. “At Houston Methodist, we examine your medical history but also take into account everything that is important to you when creating your treatment plan.”

2COLLABORATIVE CARE

Effective cancer treatment takes a team of experts working together, including hematologist-oncologists, radiation oncologists, surgeons, nurses and other specialists. “Having a group of cancer specialists in one location ensures collaboration and a seamless patient experience where every step is thoughtfully considered,” Niravath said.

Certain chronic conditions can be affected by cancer treatment, such as arthritis, neuropathy (nerve damage or dysfunction), diabetes or some cardiac conditions. “As a comprehensive health system, we’re fortunate to have cardiologists, endocrinologists and other specialists available who can provide expertise when needed

■ Acupuncture and massage therapy

■ Fertility preservation

3ADVANCED TREATMENT OPTIONS

Every cancer has its own unique molecular fingerprint, which influences how it grows and spreads. “When it comes to cancer, what works for one person, may not work for another,” Niravath said. “Which is why we use tissue typing and molecular therapy to create highly targeted treatment plans that are tailored for both the individual and their specific type of cancer.”

If surgery is part of your treatment plan, look for a surgeon and hospital that offer minimally invasive surgical techniques to reduce complications and speed recovery. Image-guided therapy uses 3D (or higher) imaging that allows surgeons to plan the best surgical approach in virtual reality before or during surgery.

4CLINICAL TRIALS

There are many different treatment options for people with cancer, including chemotherapy, radiation therapy, immunotherapy and advanced surgical procedures. “These are time-tested treatments, but some patients want to explore other options,” Niravath noted. Additionally, some people with rare or aggressive cancers may find that they don’t respond to traditional treatments.

This is where clinical trials come in. Clinical trials are an important part of advancing cancer care. They allow doctors and researchers to develop new approaches to treating cancer, which means more options for you to consider when deciding on your care plan. Houston Methodist is the only health system offering FDA-approved clinical trials at multiple locations across the Greater Houston area.

Experts agree, the most important factor is trust. “You should trust your team and feel comfortable speaking up regarding all decisions about your care,” Niravath said. Lastly, if you are contemplating which treatment path to take, don’t hesitate to get a second opinion. •

World Class Cancer Treatment Close to Home

Visit houstonmethodist.org/ cancer to learn more about Houston Methodist Neal Cancer Center and our approach to cancer treatment. With seven locations throughout the Greater Houston area, you don’t have to travel far for exceptional care.

WHAT IS A NURSE NAVIGATOR?

Oncology nurse navigators are registered nurses who specialize in cancer care. They support and guide you at every step of your cancer journey, from diagnosis to survivorship.

Cancer care means you will have many appointments with your team. Nurse navigators can help coordinate your appointments so you can schedule multiple services on the same day at the same location. This can help you maximize your time away from work or family.

Nurse navigators can also:

■ Answer general questions about your treatment options.

■ Coordinate communication with your health care team.

■ Direct you to health care services for further diagnosis and treatment.

■ Direct you to local resources and support.

■ Provide family support.

Visit houstonmethodist.org/oncology-nurse-navigator to learn more.

CONCUSSION PREVENTION

Many people think that concussions are limited to athletes or being knocked out, but that’s not the case. Concussions can happen with any minor head injury, even with no loss of consciousness.

A concussion is a type of minor brain injury caused by a blow to the head or a violent shake or jolt to the body. No matter your age, a concussion can have troubling side effects if left untreated.

SIGNS AND SYMPTOMS

“No matter how hard of an impact you take to the head, it’s always important to check for concussion,” said Dr. Vijay Jotwani, a board-certified primary care sports medicine specialist at Houston Methodist Orthopedics & Sports Medicine.

You can’t see a concussion, but there are signs to look for. They may appear right after the injury or take a few hours to develop. If you experience any of these symptoms, you should see a doctor right away:

■ Double or blurry vision

■ Headache

■ Light and noise sensitivity

■ Loss of balance

■ Mood or behavior changes

■ Nausea and vomiting

REPEAT INJURIES

People who have had a concussion are three to five times more likely to have another one. It’s very important to take steps to avoid

a repeat head injury while concussion symptoms are ongoing. Most concussions heal without complications, but in some cases, symptoms can last for weeks or even months.

CONCUSSION TESTING FOR STUDENTS

When it comes to student athletes, most schools have strict concussion protocol that outlines when athletes can return to practice or games. “It’s important for both coaches and parents to follow this protocol correctly to keep student athletes safe,” said Dr. Kenneth Podell, a board-certified neuropsychologist and director at Houston Methodist Concussion Center. "Concussion assessment and neuropsychological testing can help get students safely back on the field."

HOME TREATMENT

“The symptoms of concussion can be managed, like nausea or headache,” Jotwani explained. For headaches, acetaminophen or Tylenol is recommended — not aspirin, ibuprofen, or other NSAIDs — which can interfere with clotting and can contribute to bleeding from damaged blood vessels in the brain.

In the first few days after a concussion, the brain needs time to recover. “The best course of action is to limit physical and mental activity for the first few days after a concussion and get some rest. Your brain needs time to heal,” Jotwani recommended. •

CONCUSSION PREVENTION TIPS

It’s important to remember that concussions aren’t limited to sports. And there are plenty of ways to prevent them. Remember the following tips to stay safe:

• Always wear seat belts.

• Wear helmets that fit when biking, skating, skiing or playing contact sports.

• Put up handrails on stairs to prevent falls.

• Install safety gates to keep small children safe.

• Improve lighting and remove trip hazards in the home.

• Strengthen your neck muscles. Strong neck muscles can absorb some of the impact of a blow to the head and decrease the risk of a concussion.

Talk to a Specialist

If you’ve recently suffered a concussion, the Houston Methodist Concussion Center can help. For more information, visit houstonmethodist.org/concussion or call 713.441.9000 to schedule an appointment.

Dr. Vijay Jotwani

Dr. Kenneth Podell

THE ART AND SCIENCE FUNCTIONAL NEUROSURGERY

Cardiologists help you take care of your heart. Orthopedic surgeons fix broken bones and joints. Gastroenterologists treat your gut issues. But why would you see a functional neurosurgeon?

(DBS) involves inserting leads (thin wires) into specific areas of the brain responsible for symptoms. Leads are connected to a small device implanted in the chest. Signals are sent to the area of the brain responsible for causing the issues, such as seizures or tremors.

DBS technology has been around for decades and is shown to be effective in treating symptoms in many conditions, including:

■ Epilepsy

Dr. Amir Faraji

These highly trained neurosurgeons help thousands of people every year find relief from the often-debilitating effects of epilepsy, essential tremor, Parkinson’s disease, peripheral nerve disease, spinal pain, spasticity and other chronic conditions. “The goal of functional neurosurgery is to minimize symptoms, restore function and give patients their quality of life back,” said Dr. Amir Faraji, functional neurosurgeon with the Houston Methodist Neurological Institute.

WHAT IS FUNCTIONAL NEUROSURGERY?

Functional neurosurgery uses advanced technology, often with implanted devices and new surgical approaches, to stop misfiring pathways of the brain and nervous system that are causing issues. “These procedures allow us to address symptoms that are resistant to traditional therapies and medications or have previously been untreatable. For many people, the results are truly life changing,” Faraji said.

There are a variety of surgical options available to functional neurosurgeons. Here are just a few being used today.

DEEP BRAIN STIMULATION

Working like a pacemaker for the brain, deep brain stimulation

■ Parkinson’s disease

■ Essential tremor (rhythmic shaking, most often in hands)

■ Dystonia (involuntary muscle spasms)

■ Obsessive compulsive disorder

■ Tourette’s Syndrome

Having access to the latest technology and precise imaging ensures surgeons are hitting the correct area of the brain. “These procedures are performed using advanced surgical robotics and real-time MRI for lead placement, so they are both incredibly accurate and very safe,” Faraji explained.

SPINAL CORD STIMULATION

Spinal cord stimulators interrupt pain signals before they get to the brain. Thin wires are inserted into the space between the spinal cord and vertebrae and connected to a small battery pack implanted near the hip. Patients use a remote control to send mild electrical impulses when they feel pain. “Spinal stimulation can help people with defined pain find long-term relief without opioids or other medications,” Faraji said.

NERVE TRANSFERS

After a spinal cord injury, the body’s own nerves can sometimes be rerouted to damaged areas, restoring some basic feeling and function. “For example, if someone with a spinal cord injury is able to move their upper arm but not their hand, we can use the nerves supplying redundant muscles of the upper arm to restore some hand movements,” Faraji explained.

When it comes to managing these chronic conditions, Faraji urges patients to explore their options so they can make an informed decision if and when the time comes. “The first step to considering surgery or other treatments is knowing what options are available,” Faraji said. •

Early Detection Starts With Your ANNUAL

Advanced Breast Screenings Close to