Leading Medicine Fall 2022, Houston Methodist West Hospital edition

STRESS AND YOUR STOMACH

How Tension Takes a Bite Out of Your Digestive System

Stress, worry and anxiety can take a toll on your stomach: Just think back to how you felt the last time you went on a job interview, got pulled over for speeding or had to make a public speech. Those nervous butterflies in your belly are difficult to ignore.

“Your gastrointestinal tract has a nervous system just like the brain, and it’s highly sensitive,” said Dr. Samir Ashfaq, gastroenterologist with Houston Methodist West Hospital. “Stress activates our sympathetic nervous system, which can lead to a queasy stomach and other symptoms.”

While not all gastrointestinal conditions are caused by stress, it can worsen your symptoms. Here’s a look at common conditions and how they’re affected by stress:

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■ Irritable bowel syndrome (IBS) is an intestinal disorder that’s often marked by cramping, gas, bloating, diarrhea or constipation. Some IBS sufferers find that stress causes flare-ups.

■ Heartburn causes burning or pain behind your breastbone. It occurs when the muscle between your esophagus and stomach opens up, allowing stomach acid into your esophagus. Stress can slow down digestion, keeping food in your stomach longer, which can be a trigger for heartburn.

■ Indigestion — or feelings of bloating or nausea, belching, gas and diarrhea — is often caused by eating too much or eating too fast, consuming high-fat foods, or eating during stressful situations.

Stress can worsen underlying health conditions and trigger unhealthy eating and smoking, both of which are known to affect indigestion. “It can also be a sign of gastroesophageal reflux disease (GERD) or ulcers,” Ashfaq said. “Generally, indigestion worsens during high-stress times and improves once the trigger has passed.”

If you’ve been experiencing any of these symptoms more than two to three times a week, it may be time to schedule an appointment with a gastroenterologist. During the initial evaluation, your doctor will start the process of discovering the cause of your digestive issues to help you find relief.

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Dr. Samir Ashfaq

Get a Handle on Hand and Wrist Pain Get a Handle on Hand and Wrist Pain

From washing dishes, to playing with kids, to working, we use our hands constantly. But what happens when wrist or hand pain interferes with your daily activities or sleep? The good news is you don’t have to suffer. Many treatments are available to relieve your symptoms.

“Over the last two years, we’ve seen an increase in overuse injuries from computer and cell phone usage as a result of more people working from home,” noted Dr. Darshan Patel, an orthopedic hand and wrist surgeon with Houston Methodist Orthopedics & Sports Medicine at West Hospital. “Additionally, these activities can worsen long-standing existing hand or wrist conditions.”

COMMON HAND CONDITIONS

■ Carpal or cubital tunnel syndrome. Carpal (wrist) and cubital (elbow) tunnel syndrome are usually caused by repetitive movements or vibrations from work-related or sporting activities. Symptoms include numbness, tingling and pain in the hand, forearm or elbow.

■ Osteoarthritis. Inflammation that causes pain, swelling and stiffness in your joints. It is usually caused by natural agerelated wear and tear of joints or after an injury.

■ Cysts. Bumps that occur on the fingers, hands and wrist. “These masses are typically benign and can form due to underlying arthritis or bone spurs,” Patel said.

■ Trigger finger. Popping, stiffness or clicking in your finger, which can lead to it being stuck in a bent position. It is often caused by overuse or arthritis in the wrist or finger joints.

TREATMENT OPTIONS

Caring for hand injuries involves different phases of treatment, Patel explained. “You can start with modifying activities during the day, using braces at night, and taking over-the-counter antiinflammatory medication for pain.” If these options don’t help your symptoms, your doctor may recommend steroid injections.

Surgery is often seen as a last resort for many common hand conditions. Luckily, most surgeries can be performed in an outpatient setting using local anesthesia and nerve blocks, which allows for a faster recovery and return to daily activities.

“When it comes to hand conditions, it’s best to start conservative measures earlier rather than waiting until the symptoms become severe,” Patel stressed. “If you have nagging pain throughout the day or pain that limits your daily activities, it may be time to be evaluated by a specialist.”

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PREVENTING HAND INJURIES AT WORK

Here are a few tips to care for your hands, especially if you work on a computer:

■ Take regular breaks. Try to build in 10-minute breaks from the activity, keyboard or mouse every hour.

■ Perform hand stretches, including nerve glide exercises and gentle massage that stretch and soothe irritated nerves.

■ Use an ergonomic keyboard, mouse, chair and desk.

Talk to a Specialist

Noticing pain in your hands while performing daily activities? Schedule an appointment with Houston Methodist Orthopedics & Sports Medicine. Visit houstonmethodist.org/orthopedics-west or call 832.522.8280 to find a specialist in Katy-West Houston.

Dr. Darshan Patel

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.

Finding the right provider and treatment plan is a highly personal decision for you and your family. 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. Waqar Haque, a board-certified radiation oncologist at Houston Methodist Neal Cancer Center at West Hospital, offers advice for people just starting on their cancer journey. Here are just a few things to look for when choosing a cancer team.

1PERSONALIZED APPROACH

When it comes to medical care, we all want to be treated like an individual, not a condition or disease. In cancer care, this is especially important. “When developing a treatment plan, we must look at the whole person, not just their diagnosis,” Haque explained. “At Houston Methodist, we take a patient-centric approach, which takes into account your medical history as well as your family, job or hobbies. All these things shape our treatment recommendations.”

2COLLABORATIVE CARE

Cancer treatment takes a group of experts working together, including hematologist-oncologists, radiation oncologists, surgeons, nurses and many other specialists. “Cancer treatment is a long journey with many decisions along the way,” Haque explained. “A multidisciplinary approach ensures collaboration at every step of care, which means every option is explored.”

Certain health conditions can be affected by cancer treatment, such as arthritis, neuropathy (nerve damage or dysfunction), diabetes or some cardiac conditions. For example, a person who is on blood thinners may be unable to have cancer surgery. “Many

people have health conditions that must be considered during cancer treatment,” Haque noted. “As a comprehensive health system, we are able to include other specialists in treatment planning to ensure the patient’s safety at every step of the way.”

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 medical care:

■ Nurse navigators (see side bar)

■ Physical, occupational or speech therapy

■ Registered dietitians

■ Financial navigators and social work

■ Acupuncture or massage therapy

■ Fertility preservation

3ADVANCED TREATMENT OPTIONS

Every cancer has its own unique fingerprint, which influences how it grows and spreads. “Every person’s cancer is unique, which is why what works for one person may not work for another,” Haque said. “At Houston Methodist, we use tissue typing and molecular therapy to create highly individualized treatment plans based on our patient’s 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 tools can be very effective,” Haque explained. “But for a patient who perhaps wants to avoid radiation or cannot have surgery, it’s important to have alternatives. This is where clinical trials come in.”

Clinical trials allow researchers to develop new approaches to treating cancer, which means more options for you to consider. Houston Methodist is the only health system offering FDAapproved clinical trials at multiple locations across the Greater Houston area.

Most importantly, experts say you should trust your cancer team and feel like an equal partner in all the decisions about your care. And don’t hesitate to get a second opinion, especially if you are contemplating which treatment path to take. •

Dr. Waqar Haque

WHAT IS A NURSE NAVIGATOR?

Oncology nurse navigators are registered nurses who specialize in cancer care. They support 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 help coordinate your appointments so you can schedule multiple services on the same day at the same location. This helps you maximize your time away from work or family.

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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.

THE BEAT GOES ON Can Your Smartwatch Really Detect an Irregular Heartbeat?

Smartwatch technology advances each year, from tracking exercise habits to sleep habits. The latest addition to wearable health devices is smartwatches with electrocardiogram (ECG) capability, which reportedly are able to detect an irregular heartbeat — an often-dangerous medical condition that can lead to heart attack or stroke.

sleep habits and avoiding excessive alcohol use are equally important.

“A smartwatch with ECG can be an added layer of protection against AFib, but it can’t replace a healthy lifestyle and regular medical care,” Iftikhar said. •

It’s easy to believe that a smartwatch can help improve your health. But can it actually warn you of a heart condition? According to Dr. Irfan Iftikhar, a cardiologist with Houston Methodist DeBakey Heart & Vascular Center at West Hospital, the answer is less science fiction than you might think: “Smartwatches with ECG capability can help screen for at least one heart condition — atrial fibrillation (AFib), which is one of the most common types of heart arrythmia or irregular heart rhythm.”

Dr. Irfan Iftikhar

HOW DOES AN ECG HELP DETECT AFIB?

“An ECG measures how fast your heart is beating and provides information about whether your heart rhythm is normal or irregular,” Iftikhar explained. “This can help us catch AFib before it leads to a stroke.” Historically, ECGs have been performed in a doctor’s office or with a portable device at home.

An ECG may be recommended if you’ve had heart palpitations, chest pain, shortness of breath, or if you have a high risk of or family history of heart disease.

ARE THEY SMART ENOUGH TO DETECT AFIB?

ECGs in smartwatches flash LEDs against your skin to detect blood flow and measure heart rate. Your watch takes these measurements and sends you an alert if it detects an irregular rhythm.

“People think because this method of collecting information is so different from traditional ECGs that it’s inaccurate,” Iftikhar said. “But actually, the devices I’ve seen are very accurate. If you wear one of these watches and receive an alert, pay attention.”

A SMARTWATCH CAN’T DO EVERYTHING

Even if you’re using a smartwatch, you’ll want to manage your condition through regular check-ups with your cardiologist. Treatment usually involves taking blood thinners and other medications to control your heart rhythm or to reduce the risk of stroke. Healthy lifestyle behaviors, such as exercise, good

WHAT IS ATRIAL FIBRILLATION?

Atrial fibrillation, commonly known as AFib, occurs when the heart’s rhythm becomes irregular, interfering with blood flow in the heart. One of the most dangerous side effects is blood clots in the heart. In fact, AFib can increase a person’s stroke risk five-fold, making it one of the leading causes of stroke.

Symptoms of AFib include:

■ Chest pain

■ Extreme fatigue

■ Heart palpit ations

■ Lightheadedness

■ Shortness of breath

In many cases, AFib has no outward symptoms. It can occur at any age but it’s most common in older adults with high blood pressure or an underlying heart disease. Family history, alcohol intake and sleep apnea also increase your risk. Talk to your doctor about your risk for AFib and steps you can take to stay healthy.

Talk to Your Doctor

Concerned about AFib or have questions about how a smartwatch can help manage your condition? Schedule an appointment today with a Houston Methodist DeBakey cardiologist by visiting houstonmethodist.org/afib-west or calling 713.DEBAKEY

Finding Relief fromNeck and Back Pain

Got an aching back or neck? You’re not alone. Lower back and neck pain are two of the most common health complaints among adults in the U.S.

If you’ve got a job that requires heavy lifting or staring at a screen, you may be surprised that your daily habits are causing strain on your neck and back. Dr. Silky Patel, an interventional spine, sports and pain management specialist at Houston Methodist West Hospital, explained the common symptoms and reasons for chronic neck and back pain and what to do about it.

COMMON CAUSES

“Our lower back supports our whole body,” Patel explained. “As we get older, the disks in our spine dehydrate and we can lose muscle strength unless we are doing abdominal core exercises. This can result in herniated disks, facet arthritis or other painful issues.”

But age is not the only factor. Improper lifting can cause muscle spasms, and poor posture while sitting in desk chairs

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or looking down at your phone can cause further problems. “Neck pain is actually pretty common as we spend so much more time looking down at our phones,” Patel added. “Proper posture — sitting straight up and looking straight ahead — is critical.”

Most of the time, chronic lower pain is caused by osteoarthritis and degenerative disk disease. It is important to take steps to keep your bones strong and prevent osteoporosis to avoid compression fractures of the vertebrae. Chronic neck pain has many of the same causes.

PREVENTION AND TREATMENT

The best ways to prevent neck and back pain are to maintain a healthy body weight and practice proper posture. These simple exercises can also help prevent pain:

■ For lower back pain , lay flat on the floor and pull in your abdominal

muscles into the floor, as if a string attached to your belly button is pulling it to the floor. Hold for a few seconds and repeat several times.

■ For neck pain, a chin tuck can help with symptoms. Look straight ahead and push your chin back toward your neck and the base of your head.

When it comes to treating neck and back pain, there are at-home treatments available. “For acute, sudden pain — or throwing your back out— alternating ibuprofen and acetaminophen is helpful, along with ice and heat packs,” Patel said.

But sometimes, at-home treatments aren’t enough. “If pain doesn’t go away after a few days or it returns more than twice a year, you may want to see a doctor,” Patel recommended. In these cases, you may benefit from physical therapy, anti-inflammatory medications or injections.

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Dr. G. Silky Patel

If remedies recurring neck or pain, board-certified experts at Houston Methodist Spine Center at West

Early Detection Starts With Your ANNUAL MAMMOGRAM prefer

Advanced Breast Screenings Close to Home

At Houston Methodist Breast Care Center at West Hospital, our specialists review your mammogram history and track results over time — detecting changes earlier. That’s why getting your mammogram starting at age 40 — or earlier, if you have a family history — is so important.

Our Breast Care Center offers:

• The latest 3D mammogram technology

• Board-certified breast imaging radiologists

• Acceptance of most major insurance plans

Your health and safety are our priority. We are taking every necessary precaution to keep you safe.