Leading Medicine Spring-Summer 2023, Houston Methodist Hospital edition

LEADING MEDICINE SPRING/SUMMER 2023

How Smart is Your Smartwatch

JOINT PAIN:

Learn the Facts About Stroke

Your Body’s Signals to Consider Surgery

YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS FROM HOUSTON METHODIST

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THE BEAT GOES ON Can Your Smartwatch Detect An Irregular Heartbeat?

From tracking exercise and activity to sleep habits, smartwatch technology accelerates each year. One of the latest additions to wearable health devices is smartwatches with electrocardiogram (ECG) capability, which reportedly can detect an irregular heartbeat — an often-dangerous medical condition that can lead to heart attack or stroke.

It’s easy to believe that a smartwatch can Dr. Adi Lador help improve your health. But can it warn you of a heart condition? The answer is less science fiction than you may think. “Atrial fibrillation, or AFib, is one of the most prevalent types of heart arrhythmia or irregular heart rhythm,” said Dr. Adi Lador, an electrophysiologist at Houston Methodist DeBakey Cardiology Associates. “Smartwatches with ECG capability can help screen for AFib.”

HOW DOES AN ECG HELP DETECT AFIB?

“An ECG measures the rate at which your heart beats and tells you if that rhythm is regular or irregular,” said Lador. “This may assist us in early detection of AFib and help prevent strokes.”

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.

IS MY WATCH 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.

“Because this method of collecting information differs from

conventional ECGs, some people can’t believe it is accurate,” explained Lador. “The devices I’ve seen, though, are relatively precise. Please pay attention if you receive an alert when wearing one of these watches.”

An alert does not always mean you have AFib. False positives can occur, so it’s important that you have a doctor review the data.

“Overall, the ability of a smartwatch to detect AFib has the potential to improve early diagnosis and management of the condition, especially if you don’t have any symptoms,” said Lador.

A SMARTWATCH CAN’T DO EVERYTHING

A smartwatch with ECG is an added layer of monitoring, but it can’t replace a healthy lifestyle and regular medical care.

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,” explained Lador.

Healthy lifestyle behaviors, such as exercise, good sleep habits and avoiding excessive alcohol use are equally important. org/

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Schedule an Appointment If you have questions about AFib or how a smartwatch may help you manage your condition, visit houstonmethodist.org/debakey or call Houston Methodist DeBakey Heart & Vascular Center at 713.DEBAKEY (332.2539) to schedule an appointment.

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GET THE FACTS ABOUT STROKE What You Don’t Know Can Hurt You A little awareness can go a long way, especially when it comes to your health.

Though not receiving as much attention as other serious diseases, stroke is the fifth leading cause of Dr. John Volpi death and the primary cause of serious long-term disability for Americans. And it’s not just older adults who are at risk. In fact, about a third of strokes occur in people under age 65, according to the Centers for Disease Control and Prevention. So, no matter your age, it’s never too early to learn what you can do to prevent a stroke.

straightforward,” explained Volpi.

“For every 30 points we lower the LDL, or bad cholesterol, the risk of heart disease and stroke goes down 10%.”

3. L ifestyle choices consist of being active and social, avoiding smoking of all types, eating a healthy, balanced diet and getting a good night’s sleep. Volpi said even modest

L

exercise, like stretching two to five minutes a day or tending a garden, has shown to make a significant impact on risk. “I would recommend the Mediterranean diet for vascular health,” he added. “It includes good plant fats, such as olive oil and nuts, fresh vegetables, lean meats and low carbs.” Also, avoiding salty foods is important. org/orthopedics or

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LEARN TO RECOGNIZE STROKE Stroke is a leading cause of serious, long‑term disability and the fifth‑leading cause of death in the U.S.

STROKE 101

A stroke occurs when blood flow in the brain is interrupted, and brain cells die.

There are two main types of strokes: ■ An ischemic stroke results when a brain artery becomes blocked by a blood clot.

■ A hemorrhagic stroke is caused by a blood vessel in the brain that bursts.

B

E

BALANCE

EYES

Does the person seem dizzy?

Is there difficulty seeing clearly?

Ask if there is a sudden loss of balance.

Ask if there are sudden changes in vision.

PREVENTABLE STROKE RISK FACTORS

1. High blood pressure increases your risk of stroke by two to four times. “Blood pressure is the No. 1 risk factor for stroke,” stated Dr. John J. Volpi, a vascular neurologist and director of the Eddy Scurlock Stroke Center at Houston Methodist Neurological Institute. “No organ in the body suffers more from high blood pressure than the brain.”

Reducing your systolic blood pressure — the top number — cuts the risk of stroke in half.

2. High cholesterol is a personal risk for anyone who is at a higher risk of stroke or heart disease. More than four decades of science tell us that the lower the cholesterol, the better.

According to Volpi, we now have many tools for reducing cholesterol for patients who have struggled with older treatments. “The payoff is

Centers for Disease Control and Prevention and the National Stroke Association

?

F

A

S

T

FACE

ARMS

SPEECH

TIME

Does the face look uneven?

Does one arm drift down?

Does their speech sound strange?

Ask the person to smile.

Ask the person to raise both arms.

Ask the person to repeat a simple phrase.

If you observe any of these signs, it’s time to call 911 and to be taken to the nearest emergency room.

DO NOT DELAY. DO NOT DRIVE YOURSELF. DO CALL 911.

For more information on stroke, visit houstonmethodist.org/stroke or call 713.790.3333.

Be Stroke Smart

For more information about Eddy Scurlock Stroke Center, visit houstonmethodist.org/eddy-scurlock-stroke-center or call 713.441.3850.

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JOINT REPLACEMENT:

Getting You Back to an Active Lifestyle

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Severe joint pain can keep you from enjoying life to the fullest. But thanks to advances in less invasive replacement surgery, you can get back to an active lifestyle with less downtime than you might think.

“Joint replacement may be necessary when the cartilage that cushions the bones in a joint wears away, leading to pain, stiffness, and Dr. Stephen decreased mobility,” explained Dr. Stephen Incavo Incavo, an orthopedic surgeon who focuses on hip and knee replacement at Houston Methodist Orthopedics & Sports Medicine.

Joints are the parts of the body where two bones meet, enabling movement and stability. If a joint is damaged, it can cause significant pain and limited mobility that can negatively impact quality of life. Hip and knee replacements are the most commonly performed joint replacements, but replacement surgery can be performed on other joints as well, such as the ankle, wrist, shoulder and elbow.

Common reasons joint pain develops include: 1. Arthritis 2. Overweight or obesity 3. Past injury Without treatment, joint pain gets worse over time. Having surgery can seem daunting, but the results can be life-changing.

Advancements in technology and techniques have made joint replacement procedures much safer and more effective, with quicker recovery times.

WHY SURGERY COULD BE YOUR NEXT STEP

“Many patients worry that surgery is too painful to endure,” Incavo said. “We work to minimize postoperative pain that is associated with surgery so patients can get back to the activities they enjoy quickly.”

Essentially, joint replacement is more like joint resurfacing.

When a joint becomes worn out, the nerve endings in the bones become exposed, causing pain. The surgeon places a new surface on the end of the bones, like a cap that is designed to cover up and protect the nerve endings.

There are several reasons to consider joint replacement surgery, including: 1. Long-lasting results. In many cases, people can enjoy improved joint function and relief for upwards of 20 years and even longer. In our experience, over 95% of patients who have undergone hip or knee replacement surgery are very happy with their replacement and would do it again.

2. Minimal recovery time. Advances in surgical techniques have led to the development of less invasive joint surgery

options that offer quicker recovery times and reduced risk of complications compared to traditional surgery.

3. Increased activity. New technology and approaches make joint replacement outcomes feel more natural. Most patients who have joint replacement surgery can get back to lowimpact activities, such as swimming or walking within four to six weeks. Most patients have no activity restrictions when fully recovered.

Houston Methodist developed a Rapid Recovery Program to streamline healing after joint replacement surgery. Patients who are relatively healthy and have good family support are eligible to go home on the same day as the surgery. With telemedicine connectivity, patients can attend follow-up visits with their care team from the comfort of home.

For inpatient procedures, many patients are up and walking within hours after surgery. Whether you recover in the hospital or at home, your care team is dedicated to your success.

“With the proper patient education, skilled surgical technique, and comprehensive rehabilitation, joint replacement can help alleviate your pain and restore function, allowing you to return to a normal lifestyle,” Incavo said.

The sooner you talk to an orthopedic specialist about your persistent joint pain, the quicker you’ll be back to enjoying life to the fullest.

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SIGNS IT’S TIME TO CONSIDER SURGERY: 1. Difficulty performing daily activities due to pain 2. Limited range of motion 3. Swelling in the joint 4. Pain while resting or sleeping 5. Persistent or worsening pain 6. Medications are no longer effective

Start Living Life to the Fullest Again, With Less Pain Schedule an evaluation with an orthopedic specialist.

Visit houstonmethodist.org/jointpain or call 713.441.9000.

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Your Partner in Navigating Cancer Care Imagine having someone who helps guide you, every step of the way, through your or a loved one’s cancer journey. Cancer is a life-altering experience that can Kerrie Shojaie be confusing, stressful and overwhelming for patients and their families. This is where an oncology nurse navigator comes in.

“When a patient is diagnosed with cancer, they can feel unsure where Anjali Keshavamurthy to start,” said Kerrie Shojaie, oncology nurse navigator at Houston Methodist Hospital. “We help them navigate through this journey that is challenging, not only emotionally, but physically, and oftentimes financially.”

WHAT IS AN ONCOLOGY NURSE NAVIGATOR?

An oncology nurse navigator is a registered nurse who specializes in helping patients and families through their cancer journey.

They provide a range of services, including

education, support, and advocacy. Their primary goal is to ensure that patients receive the best quality care and support.

“Our goal is to champion a relationship with the patient at diagnosis or jump in to assist at any point in time during their cancer journey,” said Anjali Keshavamurthy, an oncology nurse navigator at Houston Methodist Neal Cancer Center. “Our roles are multifaceted and provide advocacy and are an extra layer of support through this challenging time.”

WHAT DO ONCOLOGY NURSE NAVIGATORS DO?

Coordinate care. One of the key roles of cancer nurse navigators is to coordinate care. They work closely with the patient and their health care team to develop a comprehensive treatment plan. The oncology nurse navigator also makes sure that all aspects of care are integrated and coordinated. They communicate directly with doctors, including oncologists, surgeons and radiation therapists.

Provide education. Oncology nurse navigators help patients understand their diagnosis and treatment options and explain any potential side effects and ways to manage them. “We also help provide little tricks of the trade that can help them get through bad days and encourage them on how to enjoy the good days,” Shojaie said.

Connect patients to resources.

They connect patients and their families with resources, such as community outreach and support groups. “We can connect them to resources either within Houston Methodist or in the community,” Keshavamurthy said. “We also can assist with emotional support through our counseling program.”

Advocate for patients. Oncology nurse navigators connect their patients to people who can assist with insurance needs as well as oncology financial navigators to address their financial barriers. They also serve as a liaison between patients and their care team, communicating important information and ensuring patients receive the care they need.

The oncology nurse navigator prepares the survivorship care plan. As survivors, patients will have a portfolio of their treatment history including drugs, surgeries and potential long term side effects. Plus, any future follow up care.

Survivors may choose to share the plan with family or doctors.

“Our goal as oncology nurse navigators is to make sure that every cancer patient is getting what they need, with the highest quality of care, and providing them with all of the resources that are available,” Shojaie said.

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Find Comprehensive Cancer Care Near You If you or a loved one has been diagnosed with cancer, call 713.790.2700 to schedule an appointment with a specialist at the Houston Methodist Neal Cancer Center or visit houstonmethodist.org/cancer to learn more about our services.

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MANAGING THYROID NODULES AND YOUR HEALTH

Dr. Laura Minhui Kim

Thyroid disorders are common — about 12% of U.S. adults will have one in their lifetime. Thyroid problems can zap your zest for hobbies and complicate daily bodily functions.

“The thyroid is a butterfly-shaped gland in the throat,” explained Dr. Helmi Khadra, endocrine and oncological surgeon at Houston Methodist Hospital.

“It makes a hormone you need for energy, metabolism and temperature regulation.”

HYPOTHYROIDISM AND HYPERTHYROIDISM

Diagnosing thyroid problems involves checking your hormone levels. Low levels indicate hypothyroidism or when your thyroid produces too little of the hormone.

You may feel forgetful and depressed and Dr. Helmi Khadra have some weight gain. High hormone levels indicate hyperthyroidism, where your thyroid produces too much hormone. You may feel irritable and nervous and have unexplained weight loss.

THYROID NODULES

Lumps on the thyroid — benign or cancerous nodules — are sometimes found by chance. “Many patients see us for nodules a doctor notices during a routine medical exam or on imaging for an unrelated health concern,” said Dr. Laura Minhui Kim, a head and neck surgical oncologist at Houston Methodist Hospital.

The good news? Less than 10% of thyroid problems require surgery.

Managing Benign Thyroid Nodules About 95% of nodules are benign. “But that doesn’t mean they don’t cause problems when they grow,” cautioned Khadra.

Some of these include trouble breathing or swallowing, with frequent throat-clearing and a hoarse, raspy voice.

“Based on your symptoms and test results, we’ll decide how to handle nodules. If a biopsy shows that a small nodule is benign, your doctor may recommend watching it for changes over time,” said Kim. Radiofrequency ablation can treat larger benign nodules.

“We place a probe in the nodule, generating heat that shrinks it,” said Khadra. “Patients often go back to work the next day.”

Surgery for Thyroid Cancer Only about 5% of thyroid nodules are cancerous. In those cases, we recommend removing all or part of the gland to prevent spreading. There are two options for surgery:

■ Total thyroidectomy: Removes the entire thyroid gland.

■ Partial thyroidectomy: Removes part of the thyroid gland.

For total thyroidectomy, most patients stay just one night in the hospital. “We’ll see them again within two weeks after surgery,” said Khadra, “and an endocrinologist will help them maintain a healthy thyroid hormone level.”

“If we only remove part of the gland, we need to see the patient regularly to check for new nodules on the remaining side,” explained Dr. Kim.

NOT FEELING LIKE YOURSELF?

Thyroid symptoms can take a toll on your quality of life.

If something doesn’t feel right, talk with a doctor. Getting regular physical exams can help identify thyroid problems early when they’re easier to treat. Discussing your symptoms is the first step to feeling like yourself again, faster.

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SYMPTOMS OF THYROID DISORDER The thyroid makes a hormone that helps manage many body functions. If you have any of these symptoms regularly, talk with a doctor about getting checked for a thyroid disorder: • Constipation • Fast or irregular heartbeat • Fatigue • Excessive sweating • Hair loss or thinning • Hoarse or raspy voice • Irritability • Sensitivity to cold • Swelling or lump in the neck

Talk With Your Doctor Contact your doctor or visit houstonmethodist.org/ find-a-doctor if you suspect you have a thyroid problem.

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KEEP YOU MOVING without joint pain

Live life without joint pain.

At Houston Methodist Orthopedics & Sports Medicine, we know that joint pain affects every part of your life. With treatment plans customized for you, our specialists offer a full range of advanced nonsurgical and surgical techniques. Our expert joint care includes:

Conroe The Woodlands

Kingwood

Willowbrook

Towne Lake Katy-West Houston

• Innovative pain control methods • Physical therapy to improve mobility and range of motion

Memorial City

• The latest technology, including minimally invasive surgical techniques that help reduce recovery time Sugar Land

Bellaire

Baytown Texas Medical Center Pasadena

Pearland

Clear Lake

Schedule an appointment: houstonmethodist.org/jointpain 713.441.9000

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