Leading Medicine Spring/Summer 2024, Houston Methodist Willowbrook Hospital edition

LEADING MEDICINE

NEWS & EVENTS

September:

WO MEN’S HEALTH & WELLNESS EVENT: EMPOWER A HEALTHIER YOU

Date: September 2024

Location: In Person

Register here: join.houstonmethodist.org/womensevent-wb

October:

STAYING ACTIVE EVENT: TIPS FOR MAINTAINING AN ACTIVE LIFESTYLE

Date: October 2024

Location: In Person

Register here: join.houstonmethodist.org/stayingactive-wb

November:

DIGESTIVE HEALTH WEBINAR: WHAT IS YOUR GUT TELLING YOU?

Date: November 2024

Location: Virtual Register here: join.houstonmethodist.org/digestivehealthevent-wb

Comprehensive Care — Now in Tomball

At Houston Methodist in Tomball, we are bringing the nationally recognized expertise of Houston Methodist to the growing Northwest Houston community. Our new state-of-the-art facility features a team of primary and specialty care doctors who work together to help keep you and your loved ones healthy. From annual checkups and immunizations to the most advanced treatments for chronic diseases and conditions, we offer patients the convenience of high-quality care close to home.

Visit houstonmethodist.org/tomball or call 281.737.1910 for information on locations and a full list of services.

What to Do About NEUROPATHIC PAIN

Neuropathic pain can be a result of physical injury, harsh medications or a metabolic condition, such as type 2 diabetes. Muscle weakness, numbness and chronic pain are just a few of the symptoms of neuropathy that can greatly affect your quality of life.

“Neuropathic pain occurs when nerve damage causes inappropriate signals to be transmitted to the brain,” said Dr. Jonathan Paek, a pain management specialist at Houston Methodist Department of Neurosurgery. “Oftentimes described as burning, shooting, tingling or pins-and-needles sensations, neuropathic pain can be triggered by something as normal as wearing socks or laying a sheet over your legs.”

RELIEVE PAIN BY MANAGING THE UNDERLYING CAUSE

The first goal is to treat the underlying cause of neuropathic pain. If the pain is caused by diabetes, then improving blood glucose control can help prevent additional nerve damage. Other causes for the pain include alcoholism, multiple sclerosis (MS), Parkinson’s disease or shingles.

“It’s very important to work with your doctor to get to the bottom of what’s contributing to neuropathic pain,” Paek said. “While addressing the root cause of neuropathic pain is the first step, changes in lifestyle choices can further improve symptoms over time.”

WAYS TO RELIEVE PAIN AT HOME

If you’re suffering with neuropathic pain, your doctor may recommend a combination of methods for managing it, including:

■ Eating a balanced diet

■ Exercising frequently

■ Getting restful sleep

■ Incorporating relaxation and mindfulness techniques into your daily routine

■ Taking over-the-counter pain relievers, such as ibuprofen and naproxen

■ Using topical pain medications, such as lidocaine ointment or patches

“To help provide relief, your doctor may recommend physical or occupational therapy that can be continued at home,” Paek said.

WHEN OTHER TREATMENT IS NECESSARY

You should consult your doctor if neuropathic pain doesn’t respond to over-the-counter medications or persists despite lifestyle changes. Does the pain affect your ability to function, work or sleep? Your doctor could also prescribe other medications, such as antiseizure medications or antidepressants.

“Transcutaneous electrical nerve stimulation (TENS) or injections that can block pain from specific nerves may also be options recommended by your doctor,” Paek explained.

WHEN SURGERY MAY BE NEEDED

“If lifestyle measures, physical therapy and medications just aren’t enough to provide adequate relief, a surgical implant under the skin can block inappropriate nerve firing and relieve pain,” Paek stated. “These are not first-line treatment options but are very effective alternatives when neuropathic pain is severe and does not respond to typical treatments.” •

Fin d Relief From Pain

Dr. Jonathan Paek

Don’t Take Osteoarthritis Sitting Down: STAYING

ACTIVE TO HELP YOUR KNEE PA IN

Dr. Scott Rand

Osteoarthritis is often known as a wearand-tear disease. Unfortunately, when osteoarthritis strikes the knees, you may decide to take it easy and opt out of the activities you once enjoyed.

Dr. Scott Rand, a primary care sports medicine physician at Houston Methodist Willowbrook Hospital, doesn’t want to see that happen. He explained while patients with osteoarthritis may experience knee pain during exercise, physical activity by itself is rarely the cause.

The real culprit for osteoarthritis is genetics or injury.

“If your parents both had knee replacements, chances are higher you’ll have a problem, too,” Rand said. “As a primary care sports medicine doctor, I strive to help my patients manage their pain symptoms so they can stay active longer.”

IS MY KNEE PAIN OSTEOARTHRITIS?

Osteoarthritis is the disease process of losing the cartilage in your knee — the tissue that cushions the ends of bones to decrease friction with joint movement. This is different from rheumatoid arthritis, a condition where the immune system attacks joints and their lining.

You should consult a doctor who can diagnose your knee pain as a symptom of osteoarthrosis or something else. Osteoarthritis has hallmark signs, which may include:

■ Inflammation and swelling

■ Joint tenderness or a feeling of the joint giving out

■ Pain described as deep and aching

■ Stiffness at times, though more common with rheumatoid arthritis

■ Varying amounts of discomfort during an activity or prolonged inactivity

“Although pain often occurs while standing, running or walking, it can also occur when sitting for extended periods of time. Symptoms are often most noticeable when using the stairs,” Rand explained.

CAN I PREVENT IT?

Family history, aging or injury are the common causes of osteoarthritis.

While some studies indicate supplements such as glucosamine can help, there are actions you can take to reduce pain, including:

■ Building strength, especially in the quadriceps (muscles that control the knee) and hips

■ Managing weight to decrease stress on the joints

■ Quitting smoking, because it lowers blood supply and delays healing

“Strength training and exercise are helpful, and maintaining a healthy weight is so important,” Rand said. “The mechanical forces across the knee joint are unique. One pound on your body is anywhere between four and nine pounds of force on your knee. If you’re overweight, any amount of weight loss could make a big difference.”

HOW DO I TAKE CONTROL?

If your symptoms lead you to decreased physical activity, you may inadvertently add to the problem.

The good news? Your doctor can help you manage osteoarthritis pain by ensuring that your fitness routine builds muscles around the knees. With regular check-ins, your doctor will monitor your symptoms and, if needed, adjust your plan.

“My main focus is nonoperative or conventional care to reduce or delay your need for surgery,” Rand said.

When medical care is needed, it often starts with these steps:

1. Topical ointments are available over the counter and deliver skin irritants that stimulate blood flow to decrease pain.

2. Oral medications, such as an over-the-counter acetaminophen or a prescribed anti-inflammatory can help with pain and swelling, but require close monitoring of your kidney function by your doctor.

3. Injection therapies are administered by your doctor in the office. He or she will recommend corticosteroids, hyaluronic acid or platelet-rich plasma (PRP) injections, depending on your need.

There is no one size fits all approach. Your doctor will help determine the best course of action for your knees. •

Take Control Over Knee Pain

YOU CAN FIND KNEE PAIN RELIEF

If osteoarthritis knee pain is coming between you and your fitness routine, consult your doctor. He or she may recommend exercise modifications to help build strength, manage weight and decrease pain symptoms, such as:

Joining a water aerobics class

Riding a bike on an even terrain

Starting a swim routine

Strength training with a professional trainer

Trying light elliptical or stationary bike exercises

Walking or hiking on a trail with soft ground

When these exercises no longer offer you relief, it’s time to talk to your doctor about injections or surgery.

SHED THE STIG M A: Topics to Tackle With

It can feel embarrassing to discuss certain health topics, but you should always feel comfortable talking to your doctor. There is no room for stigma in the doctor’s office: Caregivers can’t evaluate symptoms they don’t know exist. A urologist or urogynecologist can help you achieve your best health, so it’s important to talk with your primary care doctor to get a referral if you notice symptoms.

Dr. Christine Pan, urogynecologist, and Dr. Jeffrey Farum, urologist, both at Houston Methodist Willowbrook Hospital, shared some of the symptoms and concerns that bring out the shyness in patients — and why it’s so important to start the conversation.

MEN

PROBLEMS URINATING

Prostate problems often reveal themselves through urination issues. See a urologist if you experience:

■ A weak stream

■ Blood in urine

■ Difficulty emptying the bladder

■ Painful urination

“Many men view difficulty with urination as a normal part of aging,” Farnum said. “While it may be common, difficulty with urination is certainly not normal and should be evaluated by a professional.”

URINARY TRACT INFECTIONS (UTI)

If you’re having recurring infections, you may be referred to a urologist for further evaluation. Because the male urethra is long, a UTI will likely need treatment, whether it’s the result of kidney stones or sexually transmitted disease.

“For men, any urinary tract infection is

considered complicated and should be evaluated,” Farnum said. “Depending on the age of the patient, prostate enlargement or scarring of the urine channel are typically discovered as a result of a male UTI.”

REPRODUCTIVE AND SEXUAL HEALTH CONCERNS

Urologists are experts in reproductive and sexual health for men, and they are familiar with questions and concerns related to:

■ Erectile dysfunction

■ Male infertility

■ Vasectomy

LOW TESTOSTERONE (LOW T)

There’s more to low testosterone than a sluggish sex drive. It’s also associated with:

■ Changes in sleep habits

■ Erectile dysfunction

■ Fatigue

■ Feeling irritable or depressed

■ Increased body fat

■ Reduced muscle mass

“Younger men can also struggle with testosterone-related symptoms — especially those who are overweight or have underlying health conditions, such as diabetes or sleep apnea,” Farnum explained.

Your primary care physician can test for low testosterone and recommend lifestyle changes to boost your levels if needed.

Dr. Christine Pan

Dr. Jeffrey Farnum

Your Doctor WOMEN

VAGINAL BLEEDING AFTER MENOPAUSE

Bleeding after menopause is unusual, and you should talk with your doctor or gynecologist right away if you experience this type of bleeding, which could be a sign of:

■ Cancer

■ Endometrial hyperplasia

■ Infection of the uterine lining

■ Uterine fibroids or polyps

While your bleeding could be harmless, you should still take action quickly.

“Don’t take a wait-and-see approach in these cases, as you may need urgent medical attention,” Pan advised.

PELVIC PAIN

Talk to your doctor if you experience pain in your pelvis during exercise or intercourse. Your doctor may refer you to a urogynecologist to rule out:

■ Interstitial cystitis (IC) or bladder pain syndrome (BPS): Long-term pain in your bladder that can feel like a urinary tract infection (UTI)

■ Urethral syndrome: Infection and inflammation in the urethra

“Take note if the pain is accompanied by feeling bloated or a heaviness in your abdomen, and seek immediate care if fever and vomiting are present,” Pan said. “Too often, women brush off pelvic pain and discomfort, but we need to rule out serious underlying conditions.”

PELVIC ORGAN PROLAPSE

If the muscles, tissues and ligaments supporting a woman’s pelvic organs weaken, pelvic organ prolapse can result. The uterus, bladder and rectum can slip and create a bulge in the vagina due to childbirth, some neurological conditions, obesity or previous surgery.

A urogynecologist can develop a treatment plan, which could include physical therapy, support devices or reconstructive surgery.

URINARY INCONTINENCE

There are two main types of urinary incontinence in women:

■ Stress incontinence: When your pelvic floor muscles weaken and you leak urine when you laugh, cough or exert yourself

■ Urge incontinence: When the bladder muscle squeezes to empty out urine when it is not supposed to

“All forms of incontinence can be disruptive and impact quality of life. From lifestyle changes and therapy to medication

or surgery, there are so many ways we can help women take back control of their bladder,” Pan said.

FECAL INCONTINENCE

Fecal incontinence is an unexpected leak of feces from the rectum due to loss of control. It is more common in women than in men and can be caused by age, childbirth, nerve damage, hemorrhoid surgery and other issues.

If you suffer from fecal incontinence, your doctor can help you develop a personalized treatment plan, which could include dietary changes, pelvic floor physical therapy, medications or surgery. •

Are you ready to tackle your health concerns? To find a specialist who fits your unique needs, visit houstonmethodist.org/care-willowbrook or call 281.737.2500. Don’t Be Shy

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:

• Innovative pain control methods

• Physical therapy to improve mobility and range of motion

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

Schedule an appointment: houstonmethodist.org/jointpain