Leading Medicine Winter 2016, Houston Methodist Hospital edition

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

WEIGHING THE RISKS HOW EXTRA POUNDS CAN AFFECT NEARLY EVERY PART OF THE BODY

YOUR

10K Training Guide VACATIONING? HOW TO HAVE A SAFE TRIP

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

W INT ER 2016 W INT ER 2016

Stay in Circulation The ‘cardio’ in cardiovascular is just half the story. Vascular disease can affect your whole body.

W

hen you think about your cardiovascular system, do you think first about your heart? Don’t forget that your blood vessels are every bit as important to your health. Vascular diseases show up in places you might least expect — from the large arteries that send blood to your major organs to the tiny veins that carry it back from the tips of your toes.

“Having a parent, sibling or child with vascular disease raises your own risk, but the most significant risk factors for vascular disease are smoking and diabetes,” said Dr. Alan Lumsden, medical director of the Houston Methodist DeBakey Heart & Vascular Center. “Blood vessels are like the Internet of the body — they connect everything.”

Read on to learn more about common vascular diseases and actions you can take to protect your health.

LEGS: PERIPHERAL ARTERY DISEASE (PAD)

WHAT’S HAPPENING: PAD is the partial

pale or blue feet; difficulty walking; leg or foot sores that don’t heal.

TAKE ACTION: An ultrasound or angiogram is used to reach a diagnosis.

Your doctor may recommend a bypass or a stent if the artery is more than 75 percent blocked.

ABDOMEN: ABDOMINAL AORTIC ANEURYSM

WHAT’S HAPPENING: The large blood vessel that supplies blood to the abdomen, pelvis and legs expands abnormally or balloons outward.

2 LEADING MEDICINE FROM HOUSTON METHODIST

PELVIS: DEEP VEIN THROMBOSIS (DVT)

WHAT’S HAPPENING: DVT is a serious blood clot in a leg or a pelvic vein. If the clot breaks loose, it can travel into the lungs, causing a pulmonary embolism.

Symptoms include sudden difficulty breathing, heart palpitations, chest pain, and blue lips or fingers. DVT and pulmonary embolism are emergencies that require immediate treatment.

PREVENT IT: Surgeries, illnesses and even long trips can keep you sedentary, putting you at risk for DVT. Get up and move as much as possible.

WARNING SIGNS: Redness, pain, swelling and heat in one leg.

TAKE ACTION: Call 911. n

PHOTO BY THINKSTOCK

or complete blockage of an artery in the leg. It’s one of the most common vascular diseases, affecting about 8 million Americans, which is why Lumsden urges patients to get routine screenings for PAD. According to the Vascular Disease Foundation, people with PAD are five times more likely to have a heart attack, and two to three times more likely to have a stroke.

PREVENT IT: If you smoke, quit. Smoking is the No. 1 risk factor.

WARNING SIGNS: Calf or leg pain; cold,

PREVENT IT: Follow a healthy diet that includes plenty of produce and whole grains.

WARNING SIGNS: Usually without symptoms, but a rupture causes sudden pain in the abdomen or back that’s severe, persistent or constant.

TAKE ACTION: Call 911.

HEALTH BREAK

Off

Miles

Off

Miles

Miles

Miles

3

Miles

3

4.5

WEEK

2

WEEK

1

Tues

WEEK

3

2

4

Miles

WEEK

Training for races can be intimidating. But at 6.2 miles, a 10K falls right between a 5K and a half-marathon, making it the perfect place to start.

Mon

Off

2

Wed

Sun

3

4

Miles

ROLLING HILLS

CROSSTRAIN

Sat Miles

3

Miles

Miles

2

Fri

Miles

2

3

Thurs

3

4

Miles

Miles

CROSSTRAIN

5

2

WEEK

Miles

3

Miles

+ 2 min SURGES

w/ 0.5 mile GOAL PACE (x4)

(x4)

WEEK

6

3

Miles

7

3

WEEK

Miles

4

4

Miles

Miles

ROLLING HILLS

w/ 1 mile GOAL PACE (x2)

3

4

Miles

Miles

+ 2 min SURGES

w/ 1 mile GOAL PACE (x3)

(x5)

Off

4

Miles

2

Miles

Off

w/ 1 mile at

8

Pounding the pavement?

Follow these tips to stay safe.

Breathe right.

Breathe through both your mouth and nose to ensure your muscles are getting enough oxygen.

Breathing from the belly, not the chest, can also help prevent side aches.

Carry ID and a cellphone. It may seem like lugging around extra weight, but these two items can save the day if you get lost or hurt, or are in danger.

Drink up. Hydrating before your run is just as important as during and after. Drink 8 to 16 ounces of water one to two hours before the run and 8 to 24 ounces afterward. During runs, use your thirst as a guide.

Lose the headphones. Drowning out your surroundings leaves you vulnerable to an attacker and doesn’t allow you to hear a horn honking or a cyclist approaching.

Run against traffic.

Facing oncoming traffic gives you the ability to see what’s approaching and react swiftly.

WEEK

RUN BETTER, FASTER, SAFER

10K

8-WEEK TRAINING GUIDE

2

Miles

5

Miles

6

Miles

4

Miles

RACE DAY!

Get to the race at least an hour early so you can get your bib and warm up!

To find your maximum heart rate (MHR), use this formula: 214 - (0.8 x age) for men and 209 - (0.9 x age) for women.

TRAINING ZONE: Zone 2: Easy 60 – 75 percent of your MHR

Zone 3: Moderate 75 – 85 percent of your MHR

Zone 4: Hard 85 – 95 percent of your MHR

SURGES: Short segments of hard but controlled running. Your heart rate should reach Zone 4.

GOAL PACE: The pace to keep in order to achieve your goal race time.

CROSS-TRAINING: Lighter days that allow you to recover from running. Choose low-impact exercises like cycling, swimming, walking and yoga.

SOURCE: ATHLETA

CHECK OUT OUR DIGITAL MAGAZINE AT HOUSTONMETHODIST.ORG/NEWSROOM/NEWSLETTERS 3

Weighing the

How extra pounds can affect nearly every part of the body

Risks

T

he lives of millions of Americans are at risk every day. Why? More than 72 million adults are obese — and obesity is a gateway condition to a host of health problems that affect the heart, joints, internal organs and more.

“Obesity affects the entire body, from head to toe,” said Dr. Vadim Sherman, a bariatric surgeon at Houston Methodist Hospital. “And extra pounds can have a tremendous impact on the long-term health and well-being of patients.”

Most dangerous is “central obesity” in the midsection. “As we gain belly fat, we increase our insulin resistance,” said Dr. Joshua D. Septimus, an internist at Houston Methodist Hospital. “We increase our risk of high blood pressure and cholesterol. Central obesity is a direct marker for fat depositing in our organs.”

Not all obesity is equal: Overweight patients with a normal waist size and blood pressure and cholesterol levels are at far lower risk than those with central fat. People who carry extra weight in their bellies are at higher risk for diabetes, heart disease and stroke.

How do you know where you stand? Know these two numbers: your waist size and your body mass index (BMI), a measure of body fat based on height and weight. Talk to your doctor about what your results mean for your health and the screenings you need to make sure you’re not in danger.

“You have the power to effect change,” said Septimus, who recommends avoiding liquid calories like soda and following a Mediterranean diet heavy in fresh produce, healthy fats such as olive oil, and proteins like fish. Following a low-carbohydrate diet and doing exercise to build lean muscle, like resistance training, will help reduce belly fat.

Just how much damage can obesity do? Here’s a look at the body’s obesity burden.

4 LEADING MEDICINE FROM HOUSTON METHODIST

NUMBERS CAN LIE Even if your body mass index (BMI) number falls within the healthy range, that may not mean you’re in the clear — or that you have license to eat junk food at will. It’s possible to be unhealthy even if the scale says otherwise.

Some people call it “skinny fat.” It’s the idea that you can look perfectly healthy while being at risk for chronic conditions because of diet, lack of exercise and genetics.

“High blood pressure and high cholesterol are called silent killers for a reason,” said Dr. Joshua D. Septimus, an internist at Houston Methodist Hospital. “Everyone, no matter your size or weight, needs an annual visit with their doctor.”

THE DANGER ZONE Women

WAIST > 35 in.

BMI > 25

Men

WAIST > 40 in.

BMI > 25

HOW EXTRA POUNDS AFFECT THE ENTIRE BODY Throat

Brain

As BMI increases, so does the risk of stroke. Obesity can be tied to depression and anxiety.

Lungs

Sleep apnea, which can be due to an airway narrowed by neck fat, causes you to stop breathing multiple times during the night.

The possibility of developing asthma increases.

Heart

The long list of risks includes heart disease, heart attack, high cholesterol, high blood pressure and heart failure.

Esophagus

Gastroesophageal reflux disease (GERD) and esophageal cancer are sometimes linked to carrying extra weight.

Pancreas

Your body can lose the ability to properly use insulin, leading to diabetes.

Liver

Fatty liver disease and cirrhosis are risks.

Back

Being heavier means having a higher chance of back pain.

Gallbladder

You are at increased risk of gallstones and an enlarged gallbladder.

Reproductive Organs

Kidneys

ILLUSTRATION BY TRACI DEBARKO

Diabetes and high blood pressure due to obesity can lead to kidney disease and kidney failure.

Women can face abnormal periods and infertility.

Men may struggle with erectile dysfunction.

Colon

Obesity has been linked to colon cancer.

Knees

Extra weight can wear down the joints, leading to osteoarthritis.

A Slimmer You Is in Sight

Start your weight loss journey today by attending a free orientation session. Visit houstonmethodist.org/weight-management or call 832.667.LOSE (5673).

HOUSTONMETHODIST.ORG 5

Have a

Safe Trip!

Vacationing abroad?

Don’t forget to pack good health.

Y

ou know the feeling: You’re finally leaving for that long-awaited vacation, but there’s a nagging little voice in the back of your mind. Did you forget something?

Passport? Check. Reservation confirmation numbers? Check.

Underwear? Check.

Now, what about your immunizations, medications and first-aid kit? Too often, these get overlooked by excited travelers heading to strange and exotic places that have different virus and bacterial strains that the travelers’ bodies are not normally exposed to.

But being prepared is important to enjoying your trip. After all, getting sick overseas can be more than miserable — it can be scary. You’re in an unfamiliar place and might not speak the language.

Fortunately, Houston Methodist Hospital has a travel health program for people traveling abroad. Travel Health Services offers pretravel health planning, vaccinations and travel health maintenance, especially for people with chronic health concerns.

6 LEADING MEDICINE FROM HOUSTON METHODIST

TRAVELER’S CHECKLIST GET PREPPED

Once your trip is booked, it’s time to make one more reservation. “It’s important to visit a travel health clinic to learn valuable information about your destination and ensure you receive the proper vaccinations for the specific area you’re visiting,” said Debbie Amos, a travel nurse.

And you need to get those vaccinations at least six weeks before your trip because some can take that long to reach the highest protection.

“Remember to check to see if your health insurance will cover you during your travels,” she added.

“If not, look for a short-term policy that does.”

Amos also suggests you get a letter from your physician in case you’re questioned about your medications. “It’s vital that you pack enough of your prescription medicine to last your trip and some extras if you’re unexpectedly delayed. But some countries have strict restrictions on bringing medicine into their borders without the proper documentation.”

CREATE A KIT

PHOTO BY THINKSTOCK

Lori Williams, a travel nurse who provides detailed advice to patients, suggests international travelers carry a travel health kit, which can help tackle any minor health issues along the way. Your kit should include over-the-counter medication for pain or fever, an upset stomach and

upper respiratory tract discomfort.

Bandages, cotton swabs and anti-itch gel are also helpful.

SEE THE DOC

During a pretravel consultation, your physician will review your health history and itinerary for any conditions that could make travel more difficult, write prescriptions as needed for travel-related illness, and the nurses will discuss and provide you with your personalized travel report tailored to your intended destinations. This report includes recommendations for appropriate vaccinations; physical examinations; precautions to take prior to the trip; items to pack; the best method for packing medications; and local and regional political concerns.

Houston Methodist Travel Health Services uses the most up-to-date computer database to monitor diseases around the world. The database is updated regularly by the Centers for Disease Control and Prevention and the U.S. State Department.

Travelers also are provided with a country profile, as well as contact information for American embassies and recognized local hospitals in case of emergency.

By checking in with Houston Methodist Hospital Travel Health Services, travelers can check off one more item to bring with them on vacation: good health. n

Call Before You Go

To schedule an appointment with Houston Methodist Travel Health Services, call 713.363.7007.

Before you leave for your next overseas vacation, check off these items to ensure a safe and healthy trip: �❑ Schedule an appointment with your physician about two months before your departure date. �❑ Get the necessary immunizations for your destination. �❑ Check to see if your health insurance covers you abroad. �❑ Obtain a letter from your physician regarding your health history, medications, allergies and immunization records. �❑ Complete the inside page of your passport with important identification and emergency contact information. �❑ Take your insurance information cards and claim form with you, as well as an emergency release form. �❑ Pack an ample supply of medication in original, labeled containers. Don’t use pill cases or an unlabeled container. �❑ Carry extra prescriptions and a letter from your physician explaining your need for the drug. �❑ Take a list of the generic names of your medications — pharmaceutical companies overseas may use different brand names from those in the United States. �❑ If you wear glasses, take an extra pair with you. Pack these and your medication in your carry-on in case your checked baggage is lost or delayed. �❑ Consider wearing a medical alert bracelet if you have allergies or reactions to certain medications, foods, insect bites or other unique medical problems. �❑ Pack a traveler’s first-aid kit for on-the-road emergencies.

HOUSTONMETHODIST.ORG 7

NONPROFIT ORG US POSTAGE

PAID

COLUMBUS WI PERMIT 62

Houston Methodist Hospital 6565 Fannin St. Houston, Texas 77030-2707 houstonmethodist.org

713.790.3333

LEADING MEDICINE IN GREATER HOUSTON

HOUSTONMETHODIST.ORG

HOSPITALS

Just around the corner Houston Methodist has locations throughout the Greater Houston area to best serve you near your home or workplace. Our locations include hospitals, and emergency care and imaging centers.

7 15

2. Houston Methodist San Jacinto Hospital

6. Houston Methodist Willowbrook Hospital

3. Houston Methodist St. John Hospital

7. Houston Methodist The Woodlands Hospital Opening in 2017

SPECIALTY HOSPITAL 8. Houston Methodist St. Catherine Hospital

SPECIALTY HOSPITALS EMERGENCY CARE CENTERS

6

5. Houston Methodist West Hospital

4. Houston Methodist Sugar Land Hospital

HOSPITALS

14

1. Houston Methodist Hospital

IMAGING CENTERS

EMERGENCY CARE CENTERS 713.441.ER24 (3724)

9. Houston Methodist Kirby Emergency Care Center 10. Houston Methodist Pearland Emergency Care Center

5 8

2

16 12

13

11. Houston Methodist Sienna Plantation Emergency Care Center 12. Houston Methodist Voss Emergency Care Center

9 1

13. Houston Methodist Cinco Ranch Emergency Care Center NOW OPEN! 14. Houston Methodist Cypress Emergency Care Center NOW OPEN! 15. Houston Methodist Spring Emergency Care Center Opening April 2016

IMAGING CENTERS 7. Houston Methodist Breast Care Center at The Woodlands Opening March 2016

4

10 11

3

9. Houston Methodist Breast Care Center 16. Houston Methodist Imaging Center

For more information about Houston Methodist or for a physician referral, please visit houstonmethodist.org or call 713.790.3333.

LEARN MORE about our complimentary concierge services for out-of-town patients at houstonmethodist.org/usa or 877.790.DOCS (3627). facebook.com/houstonmethodist

twitter.com/methodisthosp

youtube.com/methodisthospitalhou

Staying healthy begins with knowing your risk.

Protect yourself from heart disease with a preventive Staying healthy begins with knowing your risk. heart screening.

Protect from heart disease with a United States, with Heart diseaseyourself is the leading cause of death for both men and women in the it being the culprit behind one in four deaths. Join us for a free heart seminar and screening event preventive heart screening.

plus.google.com/+houstonmethodist

to learn your 10-year risk for heart disease.

Heart disease is the leading cause of death for both men and women in the United States, with it being the culpritor behind one infor four deaths. us for a freescreening, heart seminar and For more information to register the heart Join seminar and/or screening event to learn your 10-year risk for heart disease. visit houstonmethodist.org/events or call 713.790.3333.

For more information or to register for the heart seminar and/or screening, visit houstonmethodist.org/events or call 713.790.3333. facebook.com/houstonmethodist

twitter.com/methodisthosp

youtube.com/methodisthospitalhou

plus.google.com/+houstonmethodist