LEADING MEDICINE
BY THE NUMBERS: Learn and Control Your Blood Pressure
High blood pressure is called “The Silent Killer” because it doesn’t have symptoms until it’s severe, yet it can increase your risk of a serious problem like heart attack, stroke or heart failure.
“Blood pressure is the measure of the force of your blood pushing against the walls of your blood vessels,” explained Dr. Kanval Shah, a cardiologist at Houston Methodist DeBakey Heart & Vascular Associates at The Woodlands. “It is important to check your blood pressure because high blood pressure can quietly lead to several cardiovascular diseases.”
To help keep your heart healthy, it’s important to know your numbers and to take action if they’re high.
WHAT IS BLOOD PRESSURE?
Blood pressure is measured in millimeters of mercury (mm Hg).
The first (top) number indicates the amount of pressure when the heart contracts, while the second (bottom) number is the pressure when the heart relaxes. Normal blood pressure is a reading lower than 120/80 mm Hg.
“The closer to those numbers you are, the healthier your blood pressure,” Shah said. “When those numbers go up, we get concerned about high blood pressure.”
The four stages of concerning blood pressure include:
1. Elevated blood pressure: 120-129/80 mm Hg
2. High blood pressure stage 1: 130-139/80-89 mm Hg
3. High blood pressure stage 2: 140/90 mm Hg or higher
4. Hypertensive crisis: 180/120 mm Hg or higher*
*Call your doctor right away
You can monitor your blood pressure with a cuff at your local pharmacy, a health fair, at home or a doctor’s office.
“Even if you are in good health, get your blood pressure checked at least once a year,” Shah explained. Check it more often
if you have high blood pressure or certain risk factors, such as:
■ A high-salt diet
■ Advanced age
■ African-American ancestry
■ Chronic conditions like diabetes, sleep apnea or kidney disease
■ Excess weight or obesity
MANAGING YOUR BLOOD PRESSURE
To help keep your blood pressure in check without medications, Shah recommended these healthy habits:
■ Increase your activity
■ Know your blood pressure numbers
■ Limit alcohol and quit smoking
■ Reduce salt intake in your diet
■ Target a healthy weight and BMI
“Lifestyle modifications are a powerful way to help control your blood pressure,” Shah said. “For some patients, adding medications to healthy lifestyle changes can make all the difference.”
Be sure to keep track of your blood pressure numbers and talk to your doctor if they are elevated to help keep this silent killer at bay. •
Protect Your Heart
Ask your primary care provider if you would benefit from seeing a specialist. At Houston Methodist DeBakey Heart & Vascular Associates at The Woodlands, our doctors specialize in providing better options for heart and vascular care. To schedule an appointment, visit houstonmethodist.org/ debakey/woodlands or call 713.DEBAKEY.
Dr. Kanval Shah
FIND CANCER EARLY: 6 Cancer Screenings to Know
Cancer treatment is most effective when the disease is spotted early. That’s why it’s so important to know and keep up with routine cancer screenings.
“It’s easy to forget regular screenings when you’re busy,” said Dr. Timothy Wagner, radiation oncologist at Houston Methodist Neal Cancer Center at The Woodlands. “But cancer can grow without symptoms, and early detection gives the best chance for a positive treatment outcome and cure.”
Consider these recommended screening guidelines:
BREAST
To detect changes in your breast tissue early, doctors review your mammogram history and track the results over time. That’s why it’s important to start getting annual mammograms on time — by age 40, or younger if you have a family history of breast cancer. Depending on your risk factors, including the density of your breast tissue, your doctor might recommend an MRI too.
“You should continue to get screened regularly if you’re in good health,” Wagner said.
CERVICAL
Screening for cervical cancer should begin around age 25 and continue until age 65. Human papillomavirus (HPV) is related to cervical cancer, so you should get a primary HPV test or HPV test with a Pap smear every five years, or a Pap smear alone every three years.
“Your doctor is your best partner in cancer prevention,” Wagner said. “He or she can explain your risks and how to stay cancer-free.”
COLORECTAL
Everyone who turns 45 should talk with his or her doctor about a colonoscopy or stool-based test. If a stool-based test comes up abnormal, you will still need a colonoscopy. The most important thing is to get screened until you are age 75. After that, talk with your doctor about continuing.
ENDOMETRIAL
If you’re menopausal, you should talk with your doctor about signs of endometrial cancer, including bleeding or discharge. If you have
any concerns, call right away. Depending upon your risk factors, an exam or biopsy may be needed every year.
LUNG
If you’re between the ages 50 and 80, you smoke or you quit within the past 15 years, and you have a 20-pack-year history, you should get screened for lung cancer every year. If you smoke or smoked in the past, talk with your doctor about screening for lung cancer.
PROSTATE
Men should start getting screened for prostate cancer at age 50. Start talking with your doctor by age 45 if you have a father or brother who had prostate cancer before age 65 or if you’re African American. Start at age 40 if you had multiple relatives diagnosed at an early age.
“As part of screening, you’ll get a prostate-specific antigen (PSA) blood test, and you may have a digital rectal exam to look for any signs of cancer,” Wagner said. •
IF CANCER IS DETECTED
Your doctor can help you find the best treatment. In general, look for cancer centers with:
■ Access to clinical trials
■ Comprehensive care teams
■ Emotional and nutritional support
■ Leading technologies and advanced treatments
Connect With Your Doctor
Houston Methodist provides personalized care to ensure you stay on top of your health. To schedule an appointment or find a primary care provider, visit houstonmethodist.org/pcg/woodlands or call 713.363.7640.
Dr. Timothy Wagner
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 health issues that don’t have obvious symptoms.
“I always listen to you and learn your medical history to provide the best treatment advice,” said Dr. Brotee Rahman, an internal medicine doctor with Houston Methodist Primary Care Group at The Woodlands.
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,” Rahman 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, such as the pneumococcal vaccine, depending on your age and health history. If you have international travel plans, you may need preparations for diseases such as malaria.
Dr. Brotee Rahman
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, prediabetes and high cholesterol, can lurk quietly in the background, or present with symptoms that people overlook. 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,” Rahman 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,” Rahman added. “Then I help navigate you through strategies and timely interventions. The communication between the patient, the PCP and the specialists is one of our core values here at Houston Methodist.”
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,” Rahman added. “Sometimes you are started on medications or non-medicationbased therapy. If need be, your PCP can help find a psychiatrist or a therapist to continue the treatment plan. It is very important not to underestimate the link between mental health and physical health.”
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,” Rahman 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/north 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/north and schedule a virtual appointment with one of our primary care providers.
IT’S TIME TO TALK ABOUT Your Knee Pain
Knee pain is hard to ignore. You feel it with just about every move you make. If you’re active, an achy knee can also make the first few minutes of a workout pretty miserable — or totally disrupt your exercise routine if the pain is bad enough.
It won’t be long before you want to do something about it, but what’s the best way to relieve knee pain? And should you see a doctor about it?
Knowing how to get rid of knee pain starts with trying to get to the bottom of why your knee hurts in the first place — as well as whether the pain warrants seeing a doctor or if there are things you can safely try at home first.
The most common causes of knee pain include:
■ Acute injury (to the meniscus, ligaments or cartilage)
■ Arthritis
■ Growing pains
■ Overuse (too much activity)
“Knee injuries are extremely common in recreational athletes, and they tend to be bothersome, as the knees are used for almost every daily activity, in addition to sports,” said Dr. Greg Seelhoefer, a primary care and sports medicine physician with Houston Methodist Orthopedics & Sports Medicine at The Woodlands.
INJURIES TO TALK ABOUT
“In general, if you have an injury that causes new pain that exceeds normal soreness, results in the feeling that your joint is giving way, or leads to swelling, it is important to be evaluated sooner rather than later,” Seelhoefer explained.
The major signs you need evaluation for a new knee injury include:
■ Any trauma
■ Inability to fully straighten or bend
■ Instability (buckling or “giving way”)
■ Popping that causes pain
■ Swelling
If you’ve experienced an acute injury to the knee — felt or heard a pop, for instance — make an appointment with your doctor.
PUSHING THROUGH THE PAIN
If you’ve tried the at-home remedies and are still trying to stay active through the pain, it’s time to see a sports medicine doctor. Pushing through injuries or pushing too hard can only make an existing injury worse or increase the risk of additional injuries.
“Even if your pain is minor and not improving, you need it evaluated,” Seelhoefer said. “If caught early, we can help guide you through a recovery process that allows you to get back to being active sooner.” •
STAYING ACTIVE EVENT
Learn tips for maintaining an active and healthy lifestyle. Join us on Feb. 19, to have your questions answered and more. Visit join.houstonmethodist.org/ stayingactive-tw to learn more and register.
Schedule an Appointment
If you’re experiencing knee pain, a Houston Methodist sports medicine physician can help. To learn more or schedule an appointment, visit houstonmethodist.org/ ortho-woodlands or call 936.321.8000
Dr. Greg Seelhoefer
6 SIGNS You Should
See a Gastroenterologist
If you have unexplained or frequent digestive issues, such as abdominal discomfort or changes to your bowel habits, someone’s probably told you to see a gastroenterologist. A gastroenterologist, sometimes referred to as a GI doctor, specializes in conditions of the digestive tract, which includes:
■ Bile ducts
■ Gall bladder
■ Gastrointestinal tract
■ Liver
■ Pancreas
“Some patients wonder if their symptoms mean they should see a specialist,” said Dr. Hassan Dakik, a gastroenterologist with Houston Methodist The Woodlands Hospital. “There are several common reasons why you might want to schedule a visit.”
ONGOING DIARRHEA
If your stool is liquid more often than solid, it’s time to see a gastroenterologist. “There are a few digestive disorders that can cause chronic diarrhea, most commonly irritable bowel syndrome,” Dakik noted. “Luckily, treatments are available that can help.”
CONSTIPATION
Fewer than three bowel movements a week could mean constipation — especially if they’re very small, very hard or difficult to pass. “A specialist can help you decide whether lifestyle changes, medications or both can help you be more consistent,” Dakik said.
FREQUENT HEARTBURN
If you have heartburn more than a couple of times a week it may be gastroesophageal reflux disease (GERD). “Untreated, GERD can cause permanent damage that can lead to trouble swallowing and painful ulcers. It can even increase your risk of developing cancer,” Dakik explained.
SUDDEN ABDOMINAL PAIN
Stomach ulcers and peptic ulcers can lead to burning pain after
eating and can cause swelling and scarring. Gallstones, pancreatitis or liver disease can cause consistent severe pain. “Pain that is severe and lasts for hours or comes on suddenly is usually more than a bellyache,” Dakik noted.
BLOOD IN THE STOOL
Blood could indicate hemorrhoids, which can be managed at home. Or it could be something more serious, like colorectal cancer. “Don’t assume blood in your stool is a sign of hemorrhoids,” Dakik explained, “especially if it’s accompanied by changes in your daily habits or the color and consistency of your stool.”
IT’S COLONOSCOPY TIME
If you’re over age 45 or your family has a history of colorectal cancer, it’s time for a colonoscopy. While the idea of a camera on a long flexible tube searching your colon for polyps or signs of cancer doesn’t sound appealing, it could save your life. “Properly timed colonoscopies can help us avoid colon cancer altogether. And, even if there is a problem like cancer, earlier detection increases the chance of survival dramatically,” Dakik said.
If you’ve noticed any of these six signs, it’s time to consider scheduling an appointment with a GI doctor. “If your condition is chronic, he or she will also discuss how best to manage your condition over time. Your doctor may also talk to you about additional testing if your symptoms don’t improve,” Dakik said. •
Need Care Now
From managing conditions like acid reflux to more complex concerns and treatments, Houston Methodist Gastroenterology Associates at The Woodlands provides you with the best possible care. To schedule an appointment, visit houstonmethodist.org/ spg/gastroenterology/the-woodlands or call 936.270.3880
Dr. Hassan Dakik
HOUSTON METHODIST LEADING CARE
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To find care near you, visit houstonmethodist.org/care-thewoodlands or call 713.790.3333