LEADING MEDICINE
Get to Know Your WEIGHT LOSS OPTIONS
About 42% of people in the U.S. suffer from obesity, and by 2030, research estimates that number will be close to 50%. If you’re among the millions looking to get healthy by losing weight, it’s important to understand your options.
Although your friends may have seen success with losing weight with a GLP-1 RA drug such as Ozempic, you may need to try something different. One size doesn’t always fit all when it comes to losing weight — and keeping it off.
“Obesity is complicated, and losing weight is hard,” said Dr. Laura Choi, general and bariatric surgeon at Houston Methodist Baytown Hospital. “Even when you’ve had successful surgery and weight loss, it requires a lot of work to maintain a healthy weight range.”
There is no magic method that can help you lose weight overnight. Surgery, medications and lifestyle modifications all require you to change your habits and make major lifestyle changes, but the health benefits of losing weight can be significant.
ELIGIBILITY FOR SURGERY
Not all patients qualify for bariatric surgery. Choi noted you must meet the following guidelines:
■ Be age 18 or older (adolescents may be eligible at participating facilities)
■ Have a body mass index (BMI) of 35 or higher with an obesity-related condition, or 40 or higher without a condition.
To get a full picture of whether you qualify for weight loss surgery, talk with a doctor about your circumstances and weight loss goals.
TYPES OF SURGERY
Our bariatric surgeons have decades of experience in minimally invasive procedures to help you lose weight. Your surgeon will
help you decide which option is right for you based on your BMI, medical conditions and future health goals. Types of surgeries at Houston Methodist Baytown include:
■ Gastric Bypass: Creates a small pouch from the stomach, and connects it to the middle of the small intestine for an average of 30-35% weight loss.
■ Gastric Sleeve: Permanently removes two-thirds of the stomach for an average of 25-30% weight loss and lowers the hunger hormone Ghrelin.
“Bariatric surgery is just one part of a comprehensive treatment because obesity is a complex condition that doesn’t have a single cause,” Choi said.
OTHER OPTIONS
GLP-1 RA medications like Ozempic, Saxenda and Mounjaro can help patients manage weight and blood sugar. Some patients can lose as much as 20% of their starting weight without surgery. Although this drug has become popular, it may not be a “miracle” for everyone.
These medications have side effects like nausea, constipation and other GI issues, and researchers don’t know yet about their long-term effectiveness. For those who qualify, surgery is still a better option for losing more weight and keeping it off.
“These medications are exciting and offer excellent results for some patients,” Choi said, “but surgery is the most beneficial type of weight loss therapy.” •
Do You Qualify?
To learn if you qualify for weight loss surgery, visit houstonmethodist.org/bari-qualify or call 832.667.5673 .
Dr. Laura Choi
Know When It’s Time FOR A COLONOSCOPY
Dr. Christina Warner
Don’t let assumptions stop you from preventing or detecting colorectal cancer through a colonoscopy screening. If you think you’re too young, too healthy or too nervous for the procedure, think again. Colorectal cancer is the third most common cancer in the U.S.
“Cancers of the colon or rectum aren’t exclusively tied to age,” said Dr. Christina Warner, a colon and rectal surgeon at Houston Methodist Baytown Hospital. “Several factors play into this disease. And the number of young adults diagnosed is on the rise, so getting a colonoscopy at the right time has potentially lifesaving importance.”
How do you know when the time is right? Reflect on risk factors such as family history and symptoms you might notice, and then consider your age.
RISK FACTORS
Several risk factors are tied to colorectal cancer, no matter your age. Here are some to remember:
■ Consuming red or processed meat in excess
■ Drinking alcohol in excess
■ Family history of the disease, especially parent(s) or grandparent(s)
■ Inflammatory bowel disease
■ Obesity
■ Smoking
If you’re concerned, talk with your primary care provider about a colonoscopy or other tests. The good news is that a healthy lifestyle and balanced diet helps — your doctor can support you in forming healthy habits that boost overall well-being.
SYMPTOMS
After you’ve thought about risks, pay attention to any physical signs. Let your doctor know if you experience symptoms such as:
■ Blood in stool (red, maroon or black)
■ Changes in bowel habits, including stool shape and texture
■ Unexplained abdominal pain
■ Unintentional weight loss
YOU’RE 45 OR OLDER
Because colorectal polyps (precancerous growths) and cancerous
lesions don’t always cause symptoms, age-appropriate screenings are the key to discovering a problem. Having your first colonoscopy at age 45 establishes a baseline, as your risk naturally increases with age.
“Anyone 45 and older is considered to have an average risk of colorectal cancer,” Warner explained. “So, a colonoscopy at this age can help catch a problem early. Even better, during the procedure, colorectal polyps can usually be removed and any concerning lesions can be promptly diagnosed and recommended for treatment.”
A colonoscopy is the gold standard of colorectal cancer screening, whether you’re in your 20s or 80s. Reach out to your doctor to start an important conversation about colon and rectal health. •
WHAT TO EXPECT AT YOUR COLONOSCOPY SCREENING
Here’s what you might expect from this exam:
■ You will empty your bowels at home with help from a preparation solution before the procedure, giving your doctor a clear view.
■ Sedation will make you comfortable. No major anesthesia is needed.
■ The procedure is typically only 20-40 minutes with no hospital stay required.
■ You’ll likely go about your daily routine after just a few hours of rest.
■ Most people need a colonoscopy every 10 years.
Be Proactive
If it’s time to talk to your doctor about colorectal symptoms, or you need to find a provider to schedule a colonoscopy, visit houstonmethodist.org/ gastroenterology or call 281.422.7970.
PRIMARY CARE Beyond the Annual Checkup
Your primary care provider (PCP) is a longterm partner to help in your quest for better health. With regular wellness exams and ageappropriate screenings, your PCP understands your needs and can help catch harmful health issues that don’t have obvious symptoms.
“I already know your medical history and can provide the best treatment advice,” said Dr. Jose Ruiz-Rodriguez, an internal medicine doctor at Houston Methodist Primary Care Group in Baytown. “That’s why continuing care with the same PCP is important.”
To help manage your overall health and well-being, your doctor is your best resource. Ask about a new health fad, immunizations, hurts, pains and even your worries. Your doctor is here to listen.
FOR QUESTIONS & IMMUNIZATIONS
When it comes to the latest diet trend or learning about immunizations, instead of asking Google for advice, start with your doctor. After all, he or she understands your health history and can guide you based on clinical evidence.
“There is a lot of misinformation online regarding medication side effects, fad diet plans and advertised supplements. I am here to advise and help you understand the latest clinical guidelines to make sure you are doing no harm to your health,” Ruiz-Rodriguez said.
Everyone should get an annual flu shot, as well as a tetanus, diphtheria and pertussis (Tdap) or tetanus diphtheria (Td) booster every 10 years. Your doctor may also recommend vaccines depending on your age and health history, and if you have international travel plans.
Dr. Jose Ruiz-Rodriguez
TO FIND A LURKING HEALTH ISSUE
There are things you can’t really miss — acid reflux, asthma, urinary tract infections.
Unfortunately, some chronic health conditions, such as high blood pressure, diabetes mellitus and high cholesterol, can lurk quietly in the background. Having an annual wellness exam with your primary care doctor can help uncover these conditions.
Depending on your age and family health history, your PCP may recommend other health and wellness exams, such as prostate cancer screening for men or colorectal cancer screening.
“If a cancer screening comes back positive, then it’s my job to quickly coordinate with a specialist who manages that condition and make sure you’re seen by him or her in a timely manner,” Ruiz-Rodriguez explained.
Navigating the health care system alone can be overwhelming. Your PCP can make it easier by briefing specialists such as cardiologists, neurologists or endocrinologists on your health challenges.
Afterward, your PCP can help with a continued care plan. “I review the specialist’s findings to have a better understanding of your condition and treatment plan,” Ruiz-Rodriguez added. “Then I help navigate you through strategies and timely interventions.”
TO STAY MENTALLY WELL
Your PCP is the first person to evaluate your mental health. Health changes that can cause isolation from your daily activities as well as lead to anxiety and depression include:
■ Cancer
■ Childbirth
■ Diabetes
■ Heart attack
■ Hypertension
■ Stroke
“In primary care, we screen for those conditions and can also help with treatment — including treatment for your mental health,” Ruiz-Rodriguez added. “Sometimes you are started on medications or therapy. If need be, your PCP can help find a psychiatrist or a therapist to continue the treatment plan.”
FOR OVERALL HEALTH NEEDS
Whether it’s an acute illness such as a bad cold or you’re just not feeling right, get comprehensive care from an established relationship with your PCP. “Preventive care goes beyond the wellness exam — I am here to support you throughout your life,” Ruiz-Rodriguez noted. •
Find a Primary Care Provider
Houston Methodist Primary Care Group has more than 45 practices across the Greater Houston area. To find a doctor near you, visit houstonmethodist.org/pcg/east or call 713.441.7965
SEE YOUR DOCTOR VIRTUALLY
Life can get busy, and making time for a doctor’s visit doesn’t always fit into your day. That’s where virtual visits come in — a perfect option for your health and lifestyle. Whether from your bed, couch, kitchen or hotel, your doctor can see you.
Follow-up care and many common health issues can be addressed via video visits, such as:
To get quick access to care, visit houstonmethodist. org/pcg/east and schedule a virtual appointment with one of our primary care providers.
7 Commo n Reasons to See a Urologist
A urologist is a specialist who can help if you’re having difficulty with your urinary tract or male reproductive organs. They treat conditions of the kidneys, bladder, ureters and urethra, in addition to the penis, prostate and testes.
“Many of the urinary tract conditions we treat are quite common,” said Dr. Sandeep Mehta, urologist at Houston Methodist Baytown Hospital. “With proper diagnosis and treatment, many patients find relief.”
Mehta explained a few of the most common reasons why patients see a urologist.
1. PROSTATE CONCERNS
Urologists generally help men with two main prostate problems: Benign prostate hyperplasia and prostate cancer.
“The best outcomes for men with prostate cancer come when it’s detected early, so be sure to get screened when it’s time — age 50 for men without a family history. Get screened earlier if you have a family history or if you’re African American,” Mehta added.
2. KIDNEY STONES
When chemicals build up in the urine and crystallize, they can form kidney stones, which can be as small as a grain of sand or as large as a golf ball. Pain from kidney stones is severe and starts and stops suddenly. “A urologist can prescribe medications to help with small stones, but surgery for kidney stones is not uncommon,” Mehta said.
3.
URINARY INCONTINENCE
Many treatments are available for urge incontinence (an urge so strong you leak before getting to the toilet) or stress incontinence (when the muscles that support the bladder are weakened). A urologist can help you decide which treatment is best for you.
4. ERECTILE DYSFUNCTION
A decrease in erection quality happens to all men with age. A urologist can help you decide on a treatment. Options include injected or oral medications or, in some cases, prosthetic surgery.
5. URINARY TRACT INFECTIONS
About 60% of women will experience a urinary tract infection (UTI) in her lifetime. A bacterial infection in the urinary tract, a UTI can cause painful burning upon urination and other symptoms. “Your primary care provider can help with a single
UTI,” Mehta said. “When UTIs happen over and over or don’t respond to medication, it’s time to talk with a urologist.”
6. OVERACTIVE BLADDER
A urologist can help you identify the cause of an overactive bladder, which could include a UTI, kidney stones, diabetes, advanced age or a neurologic disorder. There are several effective treatments for this very common condition.
7.
PELVIC FLOOR DYSFUNCTION
Pelvic floor dysfunction can include concerns such as urinary and fecal incontinence and pelvic organ prolapse. Pelvic floor therapy can help, working to reduce the stress on the muscles of the pelvic floor to reduce pain and make urination easier. Occasionally, low-risk procedures can improve this condition. •
WHAT TO EXPECT DURING YOUR VISIT
Visiting a urologist can involve sensitive conversations. Your doctor personalizes your treatment plan and procedures to maximize your quality of life. Here’s what to expect:
1. Bring a list of all medications
2. Have a full bladder for a urine sample (try to drink water)
3. Share your medical history, lifestyle and symptoms
4. Be prepared for your doctor to perform a physical exam, including your genitals or rectum
5. See samples, pictographs or other aids pertaining to your condition
6. Follow-up blood tests, images or ultrasounds
7. Another appointment if your condition is complicated
If you have concerns about your urinary tract or sexual health, see your primary care provider or make an appointment with a urologist. Visit houstonmethodist.org/urology or call 832.556.6046 .
Dr. Sandeep Mehta
HIGH TIME TO LEARN ABOUT Low Back Pain
Do you ever wonder why you’re experiencing lower back pain? The lower back, or lumbar spine, supports the weight of your upper body and is involved in everyday movements of your hips, pelvis and lower extremities — such as bending, twisting and coordinating muscles.
“Because of its important role in movement, the lumbar spine is prone to overuse. The bones, ligaments, muscles and disks are often under strain,” said Dr. Comron Saifi, an orthopedic surgeon and medical director of the Houston Methodist Spine Center at Baytown. “Injury and deterioration over time can affect the lumbar spine and cause lower back pain.”
LOWER BACK PAIN CAUSES
A lower back strain 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 subsides.
“Healing from a lower back injury can take a few days or a few months. If your pain continues or gets worse, however, there may be other factors at play,” Saifi explained.
The source of chronic lower back pain usually involves issues with the lumbar disks, nerves or joints.
A herniated disk can be acute or chronic and 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. Poor posture or repeated overuse can result 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 bone spurs, ligament thickening and degeneration, or herniation of disks or joints.
Spondylolisthesis is when a lumbar vertebra slips forward, over the top of the vertebrae 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.
According to Saifi, osteoarthritis and degenerative disk disease are very common causes of lower back pain, but speaking to a doctor will help determine the root cause of your pain.
WHEN TO SEE A SPECIALIST
“You should see a specialist if your lower back pain doesn’t resolve from at-home care,” Saifi said. “Your doctor will be able to help you find a diagnosis and provide treatment that helps you get back to the activities you love most.” •
HELP HEALING YOUR PAIN
Your mild-to-moderate neck or back pain may be relieved with rest, at-home treatments and over-thecounter pain medication. Your doctor may recommend more advanced non-operative care, such as:
• Aquatic therapy: Water exercises to improve strength and flexibility gradually
• Integrative therapies: Acupuncture and massage therapy
• Pain management techniques: Medications and injections
• Physical therapy: Strengthening exercises, stretching and ice/heat packs
Houston Methodist Spine Center at Baytown provides personalized care from a team of experts. To schedule an appointment, visit houstonmethodist. org/spine-baytown or call 346.292.2225.
Dr. Comron Saifi
HOUSTON METHODIST
LEADING CARE
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