LEADING MEDICINE
BEAT THE BULGE: Treatment for Varicose Veins
Bulging veins in your limbs can be unsightly and uncomfortable, but they’re usually more annoying than dangerous. What causes venous insufficiency, and what can be done to help?
“Venous insufficiency affects 20 to 30% of adults, making it one of the most common ailments in the U.S.,” explained Dr. Ammar Hashmi, a vascular surgeon at Houston Methodist West Hospital. “The primary symptoms are swelling in the legs or varicose veins, sometimes at the same time.”
When some of your veins don’t work properly to return blood to your heart, that blood can begin to collect, causing veins to expand and bulge.
Other symptoms can include:
■ Bleeding
■ Discoloration of the skin
■ Fatigue
■ Frequent wounds from skin that tears easily
■ Heaviness in the legs
■ Swelling
■ Pain Hashmi explained a few common questions about varicose veins.
WHAT CAUSES VARICOSE VEINS?
Venous insufficiency occurs when the veins in the legs can no longer efficiently bring blood back to the heart.
There are two primary causes for varicose veins: genetics and gravity.
“We can’t control genetics or gravity,” Hashmi said. “But there are plenty of treatments to improve venous insufficiency and keep varicose veins from getting worse.”
ARE VARICOSE VEINS DANGEROUS?
Varicose veins can cause uncomfortable heaviness in your legs,
along with more frequent wounds or bleeding with wounds.
It’s unclear how big a risk of blood clots is posed by venous insufficiency and varicose veins, but there is an association. The biggest risk, Hashmi explained, is if these conditions limit your mobility.
“Mobility is crucial for your health,” Hashmi explained. “It’s best to work with patients to find treatments and solutions before their venous insufficiency begins to affect their mobility and quality of life.”
HOW ARE VARICOSE VEINS TREATED?
For many, the first and best treatment is compression stockings. These tall socks squeeze the legs from all angles. The pressure closes the small veins near the skin, forcing blood into the larger vessels deeper in the legs.
“If you sit or stand for a long time, we recommend that you use compression stockings. They are enough to slow progression and provide relief,” Hashmi said.
You may benefit from further treatment, such as vein stripping, ablation or the latest treatment, known as VenaSeal. This is where a chemical is used to glue veins closed. You can return to your normal activities within a day or two after the procedure.
“The best approach for patients is team-based,” Hashmi said. “Using technology and expertise to tailor treatment for each patient ensures that they have the best results.” •
Soothe Your Legs
Don’t live with the discomfort of varicose veins. To learn more about your options, make an appointment with a vascular specialist. Visit houstonmethodist.org/ vein-doctors-west or call 713.DEBAKEY (332.2539)
Dr. Ammar Hashmi
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. Edward Baldwin, an orthopedic surgeon at Houston Methodist West Hospital. “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,” Baldwin 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 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.
According to Baldwin, 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,” Baldwin 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.” •
We’ve Got Your Back
If you have recurring back pain, get help from one of our spine specialists. Visit houstonmethodist. org/spine-west or call 832.522.2225
Dr. Edward Baldwin, III
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. Candy Arentz, a breast surgeon at Houston Methodist Neal Cancer Center at West.
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,” Arentz explained.
Dr. Candy Arentz
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 really decrease your risk of developing breast cancer,” Arentz suggested.
LIMIT ALCOHOLIC DRINKS
Limiting alcohol to three or fewer drinks per week can 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 compared to nondrinkers. “No alcohol is best to modify your risk,” Arentz stressed. “You can also limit yourself to one alcoholic beverage a day.”
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,” Arentz 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,” Arentz 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 are showing that people with a diet higher in antioxidants have promising results,” Arentz said.
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 3D screening mammogram. “This is a minimally invasive way for us to screen a dense breast and detect breast cancer,” Arentz 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,” Arentz warned. “This is why mammograms are so important. By the time 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).
How to Prepare for This Year’s Respiratory Viruses
The respiratory or flu season begins in the fall and continues through early spring. According to Dr. Cynthia Anthis, a primary care physician with Houston Methodist Primary Care Group in West Houston, you can prepare yourself for the typical seasonality of a variety of respiratory viruses, including influenza and respiratory syncytial virus (RSV).
“We will see some level of flu and RSV this season, so take steps to be as protected as possible,” Anthis said.
BEST VIRUS PROTECTION? GET VACCINATED
“I recommend getting vaccinated to reduce your risk of symptomatic infection, though you should check with your doctor,” Anthis emphasized. “Everyone should get his or her annual flu shot by mid-October, though it’s never too late to get vaccinated.” RSV vaccines are available for those most vulnerable to developing serious illness: older adults and infants. Adults over the age of 60 are eligible for the RSV vaccine and should consider getting inoculated heading into the respiratory
season. The vaccine is also available for pregnant women late in their pregnancies to help protect newborns from RSV. Consult your doctor for your specific vaccine eligibility.
IS IT THE FLU OR RSV?
If you do get sick, it can be difficult to determine if it’s the flu or RSV, since symptoms are similar — including fever and dry cough. But testing is available for these viruses.
“Medications are available to treat the flu, so getting tested is crucial to help guide prompt, effective treatment,” Anthis stressed.
There are prescription oral antiviral treatments for the flu, even in pediatric doses. “The options are limited for treating a cold, but testing is necessary to keep someone with RSV from receiving a flu antiviral or unnecessary antibiotics,” Anthis explained.
The bottom line: If you’re feeling ill, call your doctor. Your specific symptoms will help your physician determine which test is right for you.
FEELING SICK? STAY HOME
Viruses that spread during the respiratory season are transmitted the same way — from person to person through droplets we release as we cough, sneeze and speak.
By staying home when you are sick, you help reduce the chance of inadvertently passing a respiratory bug along to someone more vulnerable and at higher risk of getting very sick, including a possible hospitalization.
“If you still have symptoms, a good course of action is to stay home, but call your doctor if you start to feel worse,” Anthis added. •
Dr. Cynthia Anthis
Stomachache or Gallbladder Disease? SYMPTOMS TO KNOW
Dr. Jonathan Redmon
The gallbladder is an organ that releases bile into the small intestine to help with digestion, especially the digestion of fats. It’s about the size of a small lemon and is located on the right side of your abdomen, just beneath the liver.
Gallbladder disease can include infection, inflammation, stones or blockages. These can lead to jaundice, severe pain and sudden changes in blood pressure.
“Some people will have gallstones and no symptoms,” said Dr. Jonathan Redmon, a general surgeon at Houston Methodist West Hospital. “If symptoms arise, that usually means there’s some kind of blockage. Blockages can become serious, and even lead to life-threatening pancreatitis.”
SYMPTOMS OF GALLBLADDER PROBLEMS
Gallbladder conditions can have a variety of symptoms. If a gallstone lodges in a duct and causes a blockage, symptoms can include:
■ Nausea or vomiting
■ Pain in the back, between the shoulder blades
■ Right shoulder pain
■ Sudden pain in the center of the abdomen
■ Sudden pain in the upper right abdomen
“For gallbladder disease, symptoms typically begin 30 minutes after eating,” Redmon clarified.
Make sure you seek immediate care from a doctor if you experience any of the following symptoms of a serious gallstone complication, such as an infection:
■ High fever and chills
■ Intense abdominal pain
■ Yellowing of the skin and whites of the eyes
If you’re diagnosed with gallbladder disease, the best course of action is often surgery to remove the organ. When the gallbladder is removed, the liver assumes many of its jobs.
“After gallbladder surgery, we typically recommend sticking to a low-fat diet for about a month,” Redmon said. “After that, the liver will be able to pick up the slack, and you can go back to a normal diet.”
PREVENTING GALLBLADDER DISEASE
The gallbladder helps break down fat. This means the fattier your diet, the more overworked it will be. Keeping to a low-fat diet can help prevent gallbladder disease.
“However, some people will have gallbladder complications regardless of their dietary habits. This is because there’s a strong genetic component to the disease,” Redmon said.
The main thing people can do to prevent gallbladder disease is to take their symptoms seriously. Oftentimes, gallbladder issues are mistaken for food poisoning or a simple stomachache. But if you’re getting these symptoms regularly, especially after eating, then it’s time to talk to your primary care doctor.
“Seeing your doctor regularly and reporting symptoms can help you prevent complications and emergency room visits later on,” Redmon explained. “The best thing you can do for your health is to listen to your body.” •
Don’t Hesitate to Seek Care
If you have concerns about potential gallbladder issues, schedule an appointment with one of our primary care doctors. Visit houstonmethodist.org/pcg/west or call 713.441.7965 .
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.