Leading Medicine Fall 2023, Houston Methodist The Woodlands Hospital edition

LEADING MEDICINE

CANCER PREVENTION

Learn How to Reduce Your Risk

Tips for Your First Mammogram

The Causes of Swollen Feet & Ankles

8 THINGS TO KNOW Before Your First Mammogram

Turning 40 means scheduling your first mammogram. Even though you may know what a mammogram is and its importance, that first one can be intimidating. Here’s some valuable and reassuring information from Dr. Kelli Y. Ha, a breast radiologist with Houston Methodist Breast Care Center at The Woodlands.

1. IT IS NOT AS UNPLEASANT AS YOU MAY IMAGINE.

“It is difficult to feel fully relaxed during a mammogram,” said Ha. “You’ll feel definite pressure and maybe some discomfort but usually, the process is not painful.”

2. IT WON’T TAKE VERY LONG.

Ha said the whole mammogram process is quick and easy, sometimes lasting only five minutes. After removing your top and bra, a technologist positions one breast on the specialized X-ray machine. Next, the machine compresses the breast for a few seconds while the technologist takes an X-ray. This process is repeated two or three times for each breast.

3. YOUR TECHNOLOGIST WILL WALK YOU THROUGH EACH STEP.

“Mammogram technologists are always female and completely professional,” assured Ha. “The technologist clearly explains the process as she does it, all while maintaining just enough casual

conversation and keeping you stressfree,” Ha said.

4. YOU MAY GET CALLED BACK FOR MORE IMAGING.

Though no one wants to go back in for more imaging, sometimes it is necessary. “Do not panic or assume the worst. Often the call back is precautionary,” explained Ha.

5. DO YOUR HOMEWORK WHEN PICKING AN IMAGING FACILITY.

The mammogram process itself is the same, whether in a general imaging facility or one specializing in breast imaging. Make sure your mammogram is read by a specially trained breast radiologist, an expert in diagnosing tumors. If necessary, the radiologist can help you find better treatment options.

6. WE PROVIDE 2D & 3D MAMMOGRAMS.

A 3D mammogram provides a clearer picture of the breast, reducing the possibility of being called back for follow-up imaging and improving the likelihood of spotting breast cancer as early as possible.

7. FIND AND STICK WITH YOUR IMAGING FACILITY.

Staying with one imaging facility is convenient and ensures your doctor has easy access to past mammograms when looking for any changes. It also allows your doctor to partner directly with the radiologist. “You can request past images be sent to a different facility,” assured Ha. “But it’s easier to research and find a

specialized breast imaging center that you’ll stick with.”

8. IT’S WORTH THE PEACE OF MIND.

Lastly, remember that it is much easier to treat breast cancer when it’s caught early. Getting yearly mammograms is the best way to provide doctors with the information they need, ensuring your peace of mind. •

PINK CONCERT SERIES

Houston Methodist will be lighting up Market Street The Woodlands with pink lights in honor of Breast Cancer Awareness Month. Join us on Thursday, Oct. 5, for the start of a concert series and “Light It Up Pink.”

Schedule Your Mammogram

You do not need a doctor’s referral to get a yearly mammogram. To schedule, please visit houstonmethodist.org/ breast-care or call 936.270.3600 .

YOUR PRECONCEPTION CHECKLIST: 5 THINGS YOUR DOCTOR WANTS YOU TO KNOW

As you prepare to embark on the exciting journey of parenthood, there are a few things you can do to get your body ready for pregnancy. Dr. Cassandra Schakett, obstetrician-gynecologist with Houston Methodist an Obstetrics and Gynecology Associates at The Woodlands offers five pieces of advice for hopeful moms.

1. START TAKING PRENATAL VITAMINS.

Prenatal vitamins contain vital nutrients for both you and your baby, including folate, iron, and vitamins D, B6 and B12.

“I recommend my patients begin taking prenatal vitamins at least one month before they start trying to conceive and through the duration of the pregnancy,” Schakett said. “While prenatal vitamins do not help a woman achieve pregnancy, taking them before conception can decrease the risk of certain fetal anomalies.”

2. SELECT AN OBSTETRICIAN-GYNECOLOGIST AND MAKE A PRECONCEPTION APPOINTMENT.

Typically, women who aren’t pregnant see their obstetriciangynecologist once a year, but pregnant women will on average see theirs 15 times during the year.

“During a preconception appointment, we will discuss any health issues or medication you are taking that could affect your pregnancy,” Schakett said. “We identify any risks and assess the best course of action moving forward.”

3. STOP CONTRACEPTION.

If you are using contraception, you can stop. If you have an IUD or Nexplanon, schedule an appointment to get it removed — better yet, combine it with your preconception doctor appointment.

4. TRACK YOUR OVULATION.

For people with a 28-day cycle, ovulation typically occurs anywhere from cycle day 10-20. It would be best if you attempted to conceive every day or every other day during that time. You

can also use an over-the-counter ovulation predictor kit to test your ovulation starting on cycle day 10 until you get a positive result.

5. BE PATIENT; DON’T STRESS.

If you are under age 35, you should try to conceive during your peak ovulation period for 12 months before making an appointment with your doctor to discuss fertility. If you are older than 35, give it six months. If your periods are irregular, it’s best to schedule an appointment with your obstetrician-gynecologist now to discuss. •

DELIVERING EXCELLENCE

Houston Methodist Childbirth Center at The Woodlands promises expecting mothers the ultimate personalized care and support during childbirth. This state-of-the-art facility and expert team of doctors and nurses are dedicated to guiding expecting mothers every step of the way, from prenatal education to postpartum care that includes lactation services and maternal mental health. Featuring private labor and delivery suites, a level III neonatal intensive care unit and access to the latest medical technology, mothers can trust the center to deliver the best experience and support for both them and their babies.

Let’s Talk Baby

Get all your pregnancy and family planning questions answered by scheduling a visit with one of our obstetriciangynecologists at Houston Methodist The Woodlands Hospital. Book your appointment by visiting houstonmethodist.org/ gynecology or call 936.270.3662 for The Woodlands and 936.270.4749 for Conroe.

HEALTHY SOLUTIONS For Cancer Prevention

We’ve all been impacted in some shape or form by cancer. It is one of the most prevalent health concerns in the U.S. According to the American Cancer Society, it is estimated that in 2023 alone, there will be over 1.9 million new cancer cases diagnosed in the country. While these numbers are overwhelming, there are ways you and your loved ones can fight back.

The most common cancer types include:

■ Breast

■ Colorectal

■ Lung

■ Prostate

■ Skin

“Educating ourselves about risk factors and adopting healthy lifestyle choices can significantly reduce our chances of developing cancer,” said Dr. Priya Ramshesh, oncologist with Houston Methodist Neal Cancer Center at The Woodlands.

REDUCE

YOUR BEST DEFENSE AGAINST CANCER

Detecting cancer in its earliest stages increases the chances of successful treatment and improves overall outcomes. It allows for a broader range of treatment options that are often less invasive and more effective. Plus, early detection improves the chances of complete recovery and long-term survival. Regular screenings with your doctor and being attuned to your body’s signals are vital to catching cancer at its earliest stages when it is most treatable.

Know Your Body

One of the most important steps you can take is to be familiar with your body’s normal patterns. Ramshesh advises paying attention to any changes or unusual symptoms that continue for an extended period. “Early detection starts with you,” Ramshesh said. “Recognize the signs that require medical attention, including unexplained weight loss, persistent coughing, changes to your skin, unrelenting pain, and abnormal bleeding or discharge.”

YOUR RISK Don’t

Between 30-50% of cancers are preventable by eliminating your risk factors and adding a healthy routine.

Add movement by taking the stairs, parking farther away or gardening.

Dr. Priya Ramshesh

Stay Connected With Your Doctor

Establishing a close relationship with a doctor who understands your medical history and can guide you through screenings and exams is invaluable. Regular checkups and open communication allow your doctor to monitor your health, address any concerns and recommend appropriate screenings based on your risk factors.

Get Regular Screenings

Routine screenings are crucial in detecting cancer early. Houston Methodist offers state-of-the-art screenings for various types of cancers — breast, cervical, colon and rectal, lung, ovarian, prostate, skin and uterine. When and what screenings you need vary depending on your age, gender, family history and other risk factors.

“If a screening uncovers anything concerning, your primary care provider (PCP) will guide you to the right specialists, ensuring a collaborative approach to your well-being,” explained Ramshesh.

Be Your Advocate

Take an active role in your health care by asking questions, sharing any changes or concerns, and discussing your family’s medical history with your doctor. Don’t hesitate to seek a second opinion. It’s important to gather different perspectives when facing a potential cancer diagnosis. •

Wear Sunscreen

Protect

LUNG CANCER SCREENING CRITERIA: WHO SHOULD GET TESTED?

Most health insurance plans cover lung cancer screenings, provided you meet the following criteria:

■ Between the ages 50-77

■ A current smoker or have quit within the last 15 years

■ 20 pack years (multiply the number of packs per day by the number of years smoked)

The screening costs $225 for noninsured or those not wishing to use insurance. Your doctor will need to order the screening.

First Stop: Your Primary Care Provider

When it comes to discussing cancer prevention and which screenings may be right for you, your PCP is a good place to start. Your doctor can help guide you to cancer screening tests appropriate for your age and risk level. To find a PCP near you or schedule an appointment, visit houstonmethodist.org/pcg/north or call 713.441.7265

Sche dule an Appointment

If you or a loved one has been diagnosed with cancer and would like to schedule an appointment, visit houstonmethodist.org/ cancer to find an oncologist at the Houston Methodist Neal Cancer Center near you.

Make sure you get screened regularly.

SHOULD I WORRY ABOUT Swollen Feet and Ankles?

The puffy, tight, shiny skin of your swollen feet and ankles isn’t only noticeable and uncomfortable, but could be a cause for concern. Swelling, or edema, in the lower legs — can occur for various reasons, some of which may indicate a serious underlying medical issue.

WHAT CAUSES SWOLLEN FEET AND ANKLES?

“Swelling in the lower legs happens when blood or fluid accumulates and is unable to be pumped out towards your heart,” said Dr. Joseph M. Besho, a vascular surgeon at Houston Methodist DeBakey Cardiology and Cardiovascular Surgery Associates. “Sometimes you know why — a salty meal, pregnancy, physical injury, standing or sitting for a long time. But occasionally, it can be more serious, reflecting issues within the circulatory system, specifically the veins, heart or kidneys.” Pain, cramps, skin discoloration, varicose veins and ulcers are common manifestations of venous insufficiency, where the valves in the leg veins are damaged and unable to adequately pump blood out of the legs.

CARE ACROSS OUR COMMUNITY

IS LEG SWELLING DANGEROUS?

“Minor, intermittent leg swelling is often not a significant concern,” said Besho. “But if it happens frequently, is painful or persists for several weeks, you should definitely consult your primary care doctor.” Other common symptoms include achy, tired, heavy legs, burning, sensation, discolored skin, spider or varicose veins or ulcers.

Fortunately, there are treatment options to help reduce symptoms and prevent long-term problems if diagnosed early.

HOW TO GET RID OF SWOLLEN LEGS

“Initial treatment includes compression therapy and elevation, which redistributes blood or fluid that accumulates in the legs,” explained Besho. “These therapies are excellent for alleviating symptoms initially, however both surgical and nonsurgical options exist for more definitive management. Both involve minimally invasive techniques to close nonfunctioning veins in order to redirect blood to the healthy veins.”

It’s important to consult your primary care physician for evaluation and possible treatment if you are suffering from these symptoms. •

Houston Methodist The Woodlands provides unparalleled patient care with convenience in mind across Montgomery County. Visit our Houston Methodist Comprehensive Care Center in Kings Harbor for cardiology, on-site lab services, primary care, orthopedics and sports medicine and

Make an Appointment

Whatever the cause of your lower leg swelling, it’s important to see a doctor. With today’s medical advances in vascular disease, you can recover quickly from treatments and get back to enjoying life to the fullest. To schedule an appointment, visit houstonmethodist.org/debakey/woodlands or call 936.270.3933

CAUSES FOR LOWER BACK PAIN

Do you ever wonder why you’re experiencing lower back pain?

Not only does the lumbar spine in your lower back support the weight of your upper body, but it is also responsible for everyday movements, such as bending, twisting and coordinating the muscles of your hips, pelvis, legs and feet.

“The bones, muscles, ligaments, disks and nerves found in the lumbar spine are heavily used,” said Dr. Cyril T. Sebastian, a neurosurgeon at Houston Methodist The Woodlands Hospital. “It can be affected by both injury and deterioration over time — causing pain in the lower back.”

COMMON CAUSES OF LOWER BACK PAIN

A lower back strain or sprain can result from an acute injury — such as lifting something too heavy or playing sports — or develop over time due to repetitive movements or poor posture. Treatment can involve anti-inflammatory medications, muscle relaxers, at-home therapy and rest until the pain recedes.

Sebastian says that osteoarthritis and degenerative disk disease are generally the cause for chronic back pain, but speaking to a doctor will help determine reasons for your back pain.

“Your healing can take anywhere from a few days to a few months. But there may be other reasons if your pain continues or gets worse,” explained Sebastian.

COMMON CAUSES OF CHRONIC LOWER BACK PAIN

The source of chronic lower back pain usually involves issues with the lumbar disks, nerves, joints or vertebrae. Sebastian shares causes for chronic lower back pain below.

A herniated disk occurs when the inner gel of one of the five disks in your lumbar spine slips or squishes beyond the outer rind and presses on surrounding nerves which then causes your pain.

Facet joint damage happens over time when the joint cartilage connecting the five lower back vertebrae breaks down from compressive force and stress from poor posture or repeated overuse, resulting in inflammation, stiffness and muscle spasms.

A spinal compression fracture occurs when a vertebra in your lumbar spine essentially collapses in on itself. Often due to osteoporosis or trauma, it results in sudden pain and limited spinal mobility.

Lumbar spinal stenosis happens when the spinal canal in your lower back narrows, placing pressure on nearby nerve roots. Causes may include one spurs, ligament thickening and degeneration of disks or joints.

Spondylolisthesis is when a lumbar vertebra slips forward, over

the top of the vertebra below, placing compressive force on the disk that separates the two vertebrae. If the lumbar disk flattens from this force, it can lead to nerve compression and sciatica. Scoliosis is a sideways curvature of the spine that makes degeneration of the lumbar joints and disks more likely. If it’s severe, scoliosis can place significant stress on the lower back and lead to pain.

WHEN TO SEE A SPECIALIST

“If your lower back pain does not respond to rest or self-care, you may want to see a specialist,” said Sebastian. “Depending on your diagnosis, he or she will design a treatment plan to help reduce your pain and get you back into the everyday activities you enjoy.” •

Whether you’ve had back or neck pain for a few days or several long years, we are here to help. Visit houstonmethodist.org/spine to find a doctor near you. Join us in November for a virtual seminar where our team will present the latest information on nonsurgical treatment options and address any questions you may have. Visit join.houstonmethodist.org/back-neckevent-woodlands to register.

Dr. Cyril T. Sebastian

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