LEADING MEDICINE
Emergency Care, Virtual Urgent Care or Primary Care:
KNOW WHERE TO GO
We’ve all been there: You wake up feeling off, or you sustain an unexpected injury and the panic sets in. Should you rush to the emergency room (ER), make an appointment with your primary care provider, or access virtual urgent care? The uncertainty can be overwhelming.
EMERGENCY ROOM VISIT
Symptoms that generally signal an emergency include:
Allergic reaction with trouble breathing, swelling or hives
Chest pain or squeezing sensation in the chest
Broken bones
Head, neck or spine injury
Intense pain, including severe headache or abdominal pain
Loss of consciousness
Major burns or electric shock
Pregnancy-related issues, such as severe cramping or bleeding
Poisoning or suspected overdose
Shortness of breath or trouble breathing
Sudden slurred speech, visual changes or weakness on one side of the body
Suicidal thoughts
Uncontrolled bleeding
It’s important to know where to go for care before you’re sick or experiencing an emergency. Knowing this can save you precious time, make sure you get the right care promptly and ultimately make a world of difference when it matters most. •
VIRTUAL URGENT CARE
See our providers for non-emergency urgent care needs via 24/7 video visits for minor illnesses, such as:
Coughs, cold, flu
Constipation or diarrhea
Fevers
Heartburn
Pink or red eyes
Sinus infections
Sore throat or strep throat
Urinary tract infection (women only)
PRIMARY CARE OFFICE VISIT
Make an appointment with your primary care provider for the following:
Minor health concerns
Preventive and routine care
Screenings and vaccinations
Managing chronic health conditions (diabetes, asthma, heart disease, etc.)
Referrals to specialty care
If you are experiencing a serious or life-threatening medical emergency, call 911.
Leading Care Where You Need Us
To find emergency care, virtual urgent care or primary care, visit houstonmethodist. org/care-central or call 713.790.3333
DON’T GET SMASHED:
How to Avoid a Pickleball Injury
By now, you or someone you know is probably obsessed with pickleball, the sport that’s a cross between tennis and Ping Pong. It’s a fun, easy and great exercise for all athletic levels to enjoy!
But with increasing popularity comes more doctor visits due to a spike in pickleball injuries.
“It’s not that pickleball is risky,” explained Dr. Vijay Jotwani, a primary care sports medicine physician at Houston Methodist Hospital. “Pickleball is easy to learn and it’s popular. With so many people playing, more injuries are almost inevitable.”
COMMON PICKLEBALL INJURIES
Pickleball injuries from overexertion are common. This is because new players don’t always focus on proper technique, which can cause injury. A few risk areas include:
■ Eye injuries from direct contact with the ball or paddle.
■ Fractures or head trauma from an accidental fall.
■ Knee injuries and lower back strains from stopping and starting, frequent bending and sudden changes in direction.
■ Wrist, elbow or shoulder injuries from swinging the paddle.
Pickleball has many benefits, ranging from exercise to socializing. Understanding how to reduce your risk of injury can help keep you on the court and having fun.
PREVENTING INJURIES
The best way to stay on the court is to avoid or minimize a pickleball injury in the first place. Jotwani offered a few tips to help.
Know your physical limits. Not everyone who plays pickleball
is a regular exerciser, so to avoid injury, start slowly and listen to your body. “If you have a pre-existing condition such as arthritis, consider building up your court time slowly to avoid flaring up the arthritis,” Jotwani suggested.
Be sure to warm up. Try 5-10 minutes of warmup exercises before any pickleball match. “A light jog and stretching can do the trick to get the major muscle groups ready to compete,” Jotwani said.
Get the right gear. Pickleball-specific shoes can significantly decrease your risk of injury. “Additionally, a properly sized paddle handle will decrease the risk of wrist and elbow injuries,” Jotwani explained.
Mind your form. It’s easy to pick up a paddle and play, but proper technique matters. “Take a few lessons to get your footwork right and you’re less likely to get injured,” Jotwani said. Don’t skip recovery. Cooling down after the match with several minutes of stretching or running can help minimize soreness in out-of-condition muscles. “And don’t skimp on nutrition and hydration,” Jotwani added.
If you become injured or have a new pain, talk to your doctor right away. “Having your potential injury examined will ensure it doesn’t get worse,” Jotwani stressed. •
Whether you are new to the game or a seasoned professional, our team can help you stay on the court. To learn more visit houstonmethodist. org/orthopedics/sports-medicine or call 713.790.3333 .
Dr. Vijay Jotwani
Beating the Odds: FIGHTING BACK AGAINST BREAST CANCER
When it comes to breast cancer prevention, knowing the common breast cancer risk factors is key, including:
■ Age
■ Being overweight
■ Family history
■ Genetic mutations
“The average risk is one in eight for women who do not have a family history. It’s important to know that your risk increases with age, so the risk never goes down,” said Dr. Hanh Mai, breast medical oncologist at Houston Methodist Neal Cancer Center.
While you cannot change risk factors such as age or family history, you can take preventive actions to modify your risk.
GET YOUR ANNUAL MAMMOGRAM
Since your breast cancer risk increases with age, it’s important to have a yearly mammogram starting at age 40. At age 25, talk to your primary care provider or gynecologist to help determine your risk level and if you should start getting screened sooner.
“This allows us to detect your breast cancer earlier, which decreases the chances you’ll have to have chemotherapy,” Mai explained.
Dr. Hanh Mai
Dr. Kai Sun
STAY PHYSICALLY ACTIVE
Getting 150 minutes of exercise a week is recommended. Although this can sound overwhelming, breaking up the time helps. “Thirty minutes a day over five days will decrease your risk of developing breast cancer,” suggested Dr. Kai Sun, breast medical oncologist at Houston Methodist Neal Cancer Center.
LIMIT ALCOHOLIC DRINKS
While abstaining from alcohol altogether is the best thing to do for your health, limiting it to three or fewer drinks per week can still lower a woman's risk. Women who consume two to five alcoholic drinks a day have about 1.5 times the risk of developing breast cancer. “No alcohol is best to modify your breast cancer risk,” Mai stressed.
MAINTAIN A HEALTHY WEIGHT
Women with more fat cells produce more estrogen and tend to have higher insulin levels, which are linked to increased breast cancer risk. Regular exercise and a diet with fruits, vegetables and whole grains can help keep your weight at a healthy level. “Maintaining your weight after menopause is especially tough, but if you gain even just 15 pounds, you increase your risk of developing breast cancer,” Mai explained.
BREASTFEED LONGER
The longer you can breastfeed your baby, the better it is for your long-term breast health. “The more you breastfeed, the more it decreases your risk of developing breast cancer,” Sun said. While the reasons aren’t clear, one possible explanation is women who breastfeed have fewer menstrual cycles throughout their lives, and, therefore, less estrogen exposure.
ADD SUPERFOODS
Studies indicate consuming more monounsaturated fats, such as olive oil, may protect against breast cancer. Olive oil has antioxidants and anti-inflammatory properties, which can help reduce breast cancer risk. “These studies show that people with a diet higher in antioxidants have promising results,” Mai added.
KNOW YOUR BREAST DENSITY
Breast density is usually based on age. However, some post-menopausal women continue to have dense breasts. If you know you have dense breasts, ask for an ultrasound with your screening mammogram. “This is a minimally invasive way for us to screen a dense breast and detect breast cancer,” Sun said.
CONSIDER GENETIC TESTING
Talk to your doctor about whether genetic testing is right for you, especially if you have a strong family history of breast cancer. Mutations in certain genes, such as BRCA1 and BRCA2, increase breast cancer risk. Women with this gene mutation may need to have more frequent screenings and may want to consider prophylactic surgery (breast removal).
EARLY DETECTION IS KEY
“Most breast cancers have no signs,” Sun warned. “This is why mammograms are so important. When you feel a lump in the breast, it’s half an inch. We can detect those much sooner, even at zero, with a mammogram,” she emphasized. •
WHAT TO DO IF YOU FEEL A BREAST LUMP
Your first action after feeling a breast lump is to schedule an appointment with your primary care provider. Your doctor will look for a variety of features and characteristics to answer questions such as:
• How large is the lump and does it change in size?
• Does the lump move under the fingers, or is it attached to the skin?
• Is the lump painless or painful and accompanied by red, itchy or inflamed skin?
• Is the lump affecting the nipple, causing inversion or creating discharge?
• Does the lump become more painful around your period?
• Is there more than one lump on one or both breasts?
Schedule Your Mammogram
To schedule your mammogram at a Houston Methodist Breast Care Center, visit houstonmethodist.org/mammogram-scheduling or call 346.356.PINK (7465)
SAY GOODBYE TO HEARTBURN: Home Remedies for Acid Reflux
Dr. Christopher Kim
Heartburn is the uncomfortable burning feeling in your chest that results from gastric secretions (stomach acid) moving from the stomach into the esophagus. Even though it can feel like chest pain, heartburn has nothing to do with the heart — it’s a symptom of acid reflux.
“Stomach acid is an important part of digestion, but it belongs in the stomach,” said Dr. Christopher Kim, a gastroenterologist at Houston Methodist Hospital. “When the lower esophageal sphincter relaxes abnormally, stomach contents, including acid, back up into the esophagus.”
While an underlying medical condition or a medication can trigger acid reflux, most often it’s caused by your diet and lifestyle choices, such as the food and drinks you consume, and how much.
“That’s good news,” Kim said, “because that means there are ways you can prevent heartburn and relieve symptoms on your own.”
HOME REMEDIES FOR HEARTBURN
To avoid heartburn or find fast relief, consider these tips from Kim:
■ Avoid Trigger Foods: Certain spicy or acidic foods, caffeine, chocolate and alcohol can trigger reflux. Once you identify a food or drink that causes reflux, avoid it whenever possible.
■ Eat Less and Eat Slowly: Having more food in your stomach puts more pressure on the valve that keeps acid inside, making heartburn more likely. Avoid tight-fitting belts and clothes that put pressure on your stomach and that can contribute to heartburn.
■ Maintain a Healthy Weight: Extra weight puts pressure on your stomach, increasing the chance of reflux. Eat a balanced
diet of fresh foods and get 150 minutes of physical activity each week to achieve and maintain a healthy weight.
■ Adjust Your Sleep: A foam wedge under your mattress or blocks under the bedposts can help prevent and ease reflux by raising your chest. Sometimes, sleeping on your left side can aid in digestion and limit reflux. In addition, you should avoid eating two to three hours before bedtime so your stomach has time to empty.
■ Stop Smoking: Quitting smoking can make reflux less severe and less frequent, and in some cases even stop it altogether.
WHEN TO TALK WITH A DOCTOR
Over-the-counter medications such as antacids can provide temporary relief for mild heartburn, but you should talk with your doctor if your symptoms don’t go away or get worse.
“Daily antacid use is a sign that it’s time to be evaluated by a gastroenterologist,” Kim said. “Your doctor can help you determine whether you need additional treatment for acid reflux. Chronic heartburn can lead to serious conditions like esophageal cancer, so it’s important to talk with your doctor if heartburn just won’t quit.” •
Get Help With Heartburn
It’s important to pay attention to your symptoms. To find a gastroenterologist who specializes in heartburn, visit houstonmethodist.org/gerd or call 713.790.3333
DITCH THE MASK: New Treatment for Obstructive Sleep Apnea
If you’ve been diagnosed with obstructive sleep apnea, it’s time to take action. Effective treatments can help you get a better night’s sleep while avoiding serious health consequences.
“High blood pressure, heart disease, heart attack, type 2 diabetes and stroke are just some of the problems that can arise from sleep apnea,” explained Dr. Eric Powitzky, otolaryngologist at Houston Methodist Hospital.
“Not to mention how it can impact your sleep hygiene, productivity and relationships,” added Dr. Omar Ahmed, otolaryngologist at Houston Methodist Hospital.
There are several effective treatments for obstructive sleep apnea, an obstruction of the upper airway during sleep that causes you to stop breathing.
CPAP AND SURGERY
For many years, the most common and effective treatment for obstructive sleep apnea has been the continuous positive airway pressure (CPAP) machine. This machine delivers oxygen into the nose and mouth through a mask that keeps the airway open while you sleep.
“Treatment with CPAP can lower your risk for chronic health conditions and improve sleep,” Ahmed said, “but many patients find the mask uncomfortable to wear every night.”
For patients who can’t tolerate CPAP or who have very severe sleep apnea, sleep surgery may be an option to open your throat and improve breathing, either by removing soft tissue or adding support.
BEYOND CPAP: HYPOGLOSSAL NERVE STIMULATION
Hypoglossal nerve stimulation is one of the latest and least-invasive treatments to help you find relief from sleep apnea. “This uses a device to activate your hypoglossal nerve, which is responsible for controlling the muscles in your tongue,” Powitzky explained. In this treatment, a device is implanted in your upper chest using
two small incisions. It is activated only during sleep. The device detects your breath and stimulates your nerves to push the tongue forward and open your airway.
Not everyone is eligible for hypoglossal nerve stimulation, Ahmed explained. Criteria include:
■ Body mass index < 35
■ Moderate to severe sleep apnea (not mild)
■ Obstruction that happens at the palate or base of the tongue
“Patients who fit the criteria find that hypoglossal nerve stimulation can work very well, eliminating the need for a CPAP machine,” Powitzky said. “When you are ready to take action, talk to your primary care provider about what will work best for you.” •
OBSTRUCTIVE SLEEP APNEA (OSA)
Have you been told you snore loudly? Are you tired or sleepy during the day? With obstructive sleep apnea (OSA), the flow of air into the lungs is either partially or completely obstructed in the upper airway, causing at least 10 seconds of unconscious stoppage breathing. A narrow airway, large tongue or obesity are some of the risks for OSA. Treatment helps keep your airway open while you sleep so your breathing is not interrupted. Ask your doctor about being evaluated for OSA through a sleep study.
Rest Easier With Help
It’s time for you to get the restful night’s sleep you deserve . To speak to a specialist or learn more, visit houstonmethodist.org/ent-central or call 713.441.1368 .
Dr. Eric Powitzky
Dr. Omar H. Ahmed
The recommended age to start your annual mammogram is 40. Schedule yours today.
At Houston Methodist Breast Care Centers, our board-certified experts use the latest imaging technology to provide you with cutting-edge breast screenings — such as 3D mammograms — to detect even the smallest lumps and abnormalities with accuracy. We offer:
• 10+ convenient locations across Houston
• Online scheduling with readily available appointments
• Expanded hours available at most locations
• Access to medical records and test results through MyChart
Scan Code to Schedule Your Mammogram houstonmethodist.org/mammogram-scheduling 346.356.PINK (7465)
We do not require a doctor’s order for your annual screening mammogram.