Leading Medicine Fall 2014, Houston Methodist Clear Lake Hospital edition

LEADING MEDICINE YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN THE CLEAR LAKE AREA

RISK FACTORS What determines your likelihood of developing breast cancer

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Expert Help for Hip Problems

Keep Your Circulatory System Healthy

FA LL 2014

HEALTH BREAK

HELP FOR HIPS Minimally invasive techniques can treat several hip disorders

FEMOROACETABULAR IMPINGEMENT (FAI) – a disorder where small

changes in anatomy within the joint cause damage to the hip cartilage through a “pinching” type mechanism.

FAI patients experience deep groin pain with prolonged activity and can lead to decreased range of motion and accelerated development of arthritis in young individuals.

LOOSE BODIES – fragments of bone or cartilage that become loose and move around within the joint; they may cause catching or popping.

Schedule a Consultation

We invite you to contact one of our orthopedic specialists to determine whether your hip pain makes you a candidate for hip arthroscopy. To schedule an appointment, call 713.790.3333.

2 LEADING MEDICINE IN THE CLEAR LAKE AREA

Slow Cooker Turkey Chili Recipe INGREDIENTS 1 Tbsp vegetable oil cooking spray 1 lb ground turkey 2 cans (10 oz) of low-sodium tomato soup 2 cans (15 oz) of kidney beans, drained 1 can (15 oz) of black beans, drained 1 small onion, chopped ½ green pepper, chopped 2 Tbsp chili powder ½ tsp cumin 1 tsp red pepper flakes ½ tsp black pepper INSTRUCTIONS

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Heat oil in a skillet over medium heat. Cook the turkey until evenly browned, then drain.

Lightly coat cooking spray inside the slow cooker. Add cooked turkey and all other ingredients. Stir and cover.

Set slow cooker to high and simmer for 4 hours. Let cool.

Then, transport the chili to a party!

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NUTRITIONAL INFORMATION Makes eight servings. Each serving contains 245 calories, 8.6 g total fat, 42 mg cholesterol.

CHILI PHOTO BY ISTOCKPHOTO; GARDENING PHOTO BY THINKSTOCK

The phrase “getting your knee scoped” has become common as the arthroscopic procedure is performed routinely by orthopedic Dr. Jeffrey surgeons around Jaglowski the world.

Generally speaking, smaller incisions and less invasive surgery can amount to less pain and quicker recovery.

Surgeons use a small camera and surgical instruments inserted directly into the joint to diagnose and repair the injury. This technique has been performed on many joints, most commonly the knee and the shoulder.

Recent technological developments and advancements in surgical

technique have made arthroscopy possible in many other joints, most notably the hip. Hip arthroscopy may relieve painful symptoms of hip problems, including damage to the labrum, cartilage or other soft tissues surrounding the joint.

Orthopedic surgeon and hip arthroscopy specialist Dr. Jeffrey Jaglowski highlights some of the conditions that have seen great success with hip arthroscopy: LABRAL TEARS – like the shoulder, the hip has a strong tissue “gasket” around the socket. The labrum helps stabilize the joint and, if torn, can cause pain and “catching.”

SNAPPING HIP SYNDROME – caused when a tendon rubs across bony prominences (or projections) in and around the joint. This type of snapping or popping can be heard or felt and is often harmless and does not need treatment. In some cases, however, the tendon is damaged from the repeated rubbing and may benefit from surgical treatment.

The ‘cardio’ in cardiovascular is just half the story. Vascular disease can affect your whole body

Stay in Circulation W

hen you think about your cardiovascular system, do you think first about your heart? Don’t forget that your blood vessels are every bit as important to your health.

Vascular diseases show up in places you might least expect — from the large arteries that send blood to your major organs to the tiny veins that carry it back from the tips of your toes.

“Having a parent, sibling or child with vascular disease raises your own risk, but the most significant risk factors for vascular disease are smoking and diabetes,” said Dr. Mary Mercado, board-certified cardiologist at Houston Methodist St. John Hospital.

Read on to learn more about common vascular diseases and actions you can take to protect your health. n

ABDOMEN ABDOMINAL AORTIC ANEURYSM Warning signs: Usually without symptoms; but a rupture causes sudden pain in the abdomen or back that’s severe, persistent or constant.

Take action: Call 911.

What’s happening: The large blood vessel that supplies blood to the abdomen, pelvis and legs expands abnormally or balloons outward.

LEGS

PHOTO BY THINKSTOCK

PERIPHERAL ARTERY DISEASE (PAD) Warning signs: Calf or leg pain; cold, pale or blue feet; difficulty walking; leg or foot sores that don’t heal.

Take action: An ultrasound or angiogram is used for a diagnosis. Your doctor may recommend a bypass or stent if the artery is more than 75 percent blocked.

What’s happening: PAD is the partial or complete blockage of an artery in the leg. It’s one of the most common vascular diseases, affecting about 8 million Americans, so Mercado urges primary care doctors to perform routine screening for PAD. According to the Vascular Disease Foundation, people with PAD are five times more likely to have a heart attack, and two to three times more likely to have a stroke.

We’re Here to Help

To schedule an appointment or to determine what type of doctor you need, call our Physician Referral and Health Information Line at 713.790.3333.

PELVIS DEEP VEIN THROMBOSIS (DVT) Warning signs: Redness, pain, swelling and heat in one leg.

Take action: Call 911.

What’s happening: DVT is a serious blood clot in a leg or pelvic vein. If the clot breaks loose, it can travel into the lungs, causing a pulmonary embolism.

Symptoms include sudden difficulty breathing, heart palpitations, chest pain, and blue lips or fingers. DVT and pulmonary embolism are emergencies that require immediate treatment.

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Knowledge is power when it comes to these four unchangeable factors in developing breast cancer

Y

ou might think you’re safe from breast cancer if no one in your family has had it. But family history is just one of the factors that determine your risk for the disease. One in eight women will be diagnosed with breast cancer in her lifetime.

“Too often, breast cancer awareness is associated with wearing pink in October but not taking action. Use this special time of year to increase your awareness and understanding of your personal risk factors. Then take steps to mitigate them,” said Dr. Mary HernandezZhang, internist with Houston Methodist St. John Hospital.

Here, we put the spotlight on four of the greatest risk factors for breast cancer.

YOUR DATE OF BIRTH

Unfortunately, the number of candles on your birthday cake affects your risk level most. The majority of women diagnosed with breast cancer are older than 50, and the risk increases as you age. What’s more, two out of every three invasive breast cancers found are in women 55 and up.

YOUR BACKGROUND

Asian, Native American and Hispanic women have lower odds of developing breast cancer and

4 LEADING MEDICINE IN THE CLEAR LAKE AREA

ILLUSTRATION BY TRACI DABERKO

Are You at Higher Risk?

Easy Online Scheduling

To schedule your mammogram, visit houstonmethodist.org/online-scheduling or call 281.333.8858.

of dying from the disease. On the other hand, Caucasian women are more likely to be diagnosed with breast cancer, and African-American women are at greater risk of dying from it. These are factors that may be important to consider if another risk factor exists.

YOUR FAMILY TREE

If your mother, sister or daughter has had breast cancer, your risk is doubled.

Even if that’s not the case, you’re not necessarily in the clear. Fewer than 15 percent of women diagnosed with breast cancer have a family history of the disease, which means it’s important to schedule the screenings that are right for you (see “Screening Sense”).

YOUR GENES

Thanks to celebrities like Angelina Jolie, you might know that a woman who has the BRCA1 or BRCA2 gene mutations is at higher risk for breast cancer — by 55 percent to 87 percent — and for ovarian cancer, as well.

“The goal is to find the mutation in women before they develop cancer,” Hernandez-Zhang said. “A simple blood or saliva test is able to tell a woman

whether she’s at high risk.”

If your personal and family history warrants it, your physician may recommend genetic testing, which Dr. Mary looks for altered Hernandez-Zhang BRCA genes and other mutations. The results can help your doctor determine screening recommendations, medications to reduce the risk of a cancer diagnosis, and even preventive surgery.

Talk with your physician if you have a personal or family history of the following: • Breast cancer at age 50 or younger • Ovarian cancer at any age • Male breast cancer at any age • Ashkenazi Jewish ancestry and a personal or family history of breast or ovarian cancer • Two breast cancers in the same person or on the same side of the family • Triple-negative breast cancer at age 60 or younger • A previously identified BRCA1 or BRCA2 mutation in the family n

REINDEER RUN 8 a.m. Saturday, Dec. 6 LOCATION:

Houston Methodist St. John Hospital 18300 St. John Dr. Nassau Bay, TX 77058 (across from Johnson Space Center) FEATURING:

5K Run/Walk Kids K (ages 10 and younger) Santa’s Helper (for those who want to support but not run/walk) ACTIVITIES:

Pictures with Santa Letters to soldiers Petting zoo Health fair Bouncy house Learn more and register at houstonmethodist.org/stjohn.

AGE

SCREENING SENSE BREAST SELF-EXAM: Check yourself to become familiar with your breast tissue.

Report changes to your doctor immediately.

CLINICAL BREAST EXAM: Your health care provider examines the breasts, collarbone and underarm area for lumps.

MAMMOGRAM: This X-ray exam looks for early signs of breast cancer.

20–39

Monthly (optional)

Every three years

Only for those at high risk

40+

Monthly (optional)

Annually

Annually*

To schedule your mammogram, visit houstonmethodist.org/online-scheduling. *Please talk to your doctor to determine what age you should begin receiving an annual mammogram.

HOUSTONMETHODIST.ORG/STJOHN 5

Count on This

Colorectal cancer is the third most common cancer diagnosed in men and women in the United States, but it’s also very treatable when detected early. Here’s what you need to know, by the numbers.

50

Doctors recommend everyone begin screening for colorectal cancer at 50 years old, or earlier if you have any risk factors.

FOUR

There are four common screening tests. Ask your doctor which is right for you: •F ECAL OCCULT BLOOD TEST (FOBT).

Sometimes cancers or polyps bleed, and the FOBT can detect small amounts of blood in the stool. Your doctor will give you this simple, noninvasive test to take home; don’t forget to send it back to the lab. The American Cancer Society guidelines recommend it be performed annually if used instead of colonoscopy.

• D IGITAL RECTAL EXAM. A rectal exam is often part of a routine physical exam.

•S IGMOIDOSCOPY. Your doctor checks for and removes polyps inside your rectum and lower colon with a lighted tube. ACS guidelines recommend it be performed every five years if used instead of colonoscopy.

•C OLONOSCOPY. Your doctor looks for and removes polyps inside the rectum and the entire colon using a long, lighted tube called a colonoscope. ACS guidelines recommend it be performed annually.

50,000 Colorectal cancer is the second-

leading cause of cancer-related deaths in the United States and caused about 50,000 deaths in the United States last year. Men and women suffer in almost equal numbers.

6 LEADING MEDICINE IN THE CLEAR LAKE AREA

MORE THAN

90% The five-year survival rate for people whose colorectal cancer is treated at an early stage, before it has spread, is greater than 90 percent.

“The problem is that less than half of colorectal cancers are found at that early stage,” said Dr. Valerie Bauer, boardcertified colorectal surgeon at Houston Methodist St. John Hospital. “When discovered early, colon cancer is highly treatable.”

Dr. Valerie Bauer

EIGHT

Studies have found eight risk factors: 1. Older than age 50. More than 90 percent of cases are diagnosed after 50. The average age at diagnosis is 72.

2. Colorectal polyps. Polyps are growths on the inner wall of the colon or rectum. Most polyps are not cancer, but some can become cancerous.

3. Family history of colorectal cancer.

4. Changes in certain genes.

5. Personal history of cancer.

6. Ulcerative colitis or Crohn’s disease.

7. D iet high in fat (especially animal fat) and low in calcium, folate and fiber.

8. Cigarette smoking.

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That’s the average length, in feet, of your colon. Just thought you’d want to know.

Schedule Your Screening

If you’re 50 or older and at average risk for colon cancer, plan to have a colonoscopy every 10 years or other colon cancer screening more often. Learn more and get a referral at houstonmethodist.org or by calling 713.790.3333.

Family Focus Incontinence: It’s a secret that shouldn’t be kept from your doctor

S

ome form of urinary incontinence affects 10 percent of elementary school children and about 25 million adults, reports the National Association for Continence. Whether it’s affecting your child, your spouse, your parent or even yourself, urinary incontinence (UI) can be difficult to talk about with your doctor. Here are a few pointers to help start the conversation.

PHOTOS BY THINKSTOCK

YOUR CHILD

Bed-wetting is common in childhood and can even last to the teen years. Most of the time, it is associated with “heavy sleeping.” However, one possible cause being studied is that some children’s brains don’t make enough of the hormone vasopressin, which reduces the amount of urine the kidneys make at night.

Most bed-wetting resolves on its own, as most children outgrow it. Pediatricians don’t consider bed-wetting a problem until a child is at least 6 years old.

To reduce its occurrence, remind your child to go to the bathroom right before bedtime, give plenty of liquids during the day and then taper them off in the evening, and limit caffeine.

New bed-wetting sometimes signals an underlying condition such as a urinary tract infection, diabetes or stress. Call a pediatrician if your child starts wetting the bed after a six-month or longer dry spell.

YOUR SPOUSE

The one thing many people with UI have in common is the wish to cover the problem up, hiding it even from their physicians. This is definitely not the wise course since most cases of UI can be treated and controlled, and sometimes cured.

Whether associated with coughing, sneezing, laughing, or the sudden urge to “go,” symptoms can range from mild leaking to total emptying of the bladder.

Incontinence is considered a quality of life problem; less frequently it may be associated with serious conditions.

Women are affected more often than men, and causes include pelvic floor disorders, weak bladder muscles, prostate enlargement, diabetes mellitus, and in some cases, nerve damage.

Today, there are more treatments available for UI than ever before.

“Depending upon the condition, options may include behavioral changes, exercises to better bladder control, a growing number of medications and surgery,” said Dr. Claudio Romero, board-certified urologist at Houston Methodist St. John Hospital.

Don’t let fear affect your lifestyle or cause your doctor to miss a diagnosis.

We’re Here to Help

To schedule an appointment, call our Physician Referral and Health Information Line at 713.790.3333.

YOUR PARENTS

Although incontinence can happen at any age, it’s more common in older adults. It’s estimated up to 30 percent of homebound elderly and 50 percent of those in a nursing home experience UI. Otherwise healthy seniors can become depressed and withdrawn — passing up simple pleasures, such as meeting friends, and setting them up for other conditions that may deteriorate their health. The need for frequent bathroom breaks increases the risk of falls by as much as 26 percent and bone fracture by as much as 34 percent.

“Incontinence may be a common part of the aging process but should never be considered normal,” Romero said.

Modifying behavior such as setting bathroom schedules and making environmental adjustments like raised toilet seats or widened bathrooms can have a major impact. “It’s a tough health care topic. Your parent may need you to be the one to begin the conversation.” n

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LEADING MEDICINE IN GREATER HOUSTON Just around the corner Houston Methodist has locations throughout the Greater Houston area to best serve you near your home or workplace. Our locations include hospitals, and emergency care and imaging centers.

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 HOUSTON METHODIST WEST HOSPITAL (I-10 at Barker Cypress) 18500 Katy Frwy.

Houston, Texas

 HOUSTON METHODIST SAN JACINTO HOSPITAL (Garth Rd. exit off I-10) 4401 Garth Rd. Baytown, Texas

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 HOUSTON METHODIST ST. JOHN HOSPITAL (Clear Lake Area) 18300 St. John Dr. Nassau Bay, Texas

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Sugar Land, Texas

Emergency Care Centers 713.441.ER24 (3724)

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 HOUSTON METHODIST SIENNA PLANTATION EMERGENCY CARE CENTER 8200 Hwy. 6 Missouri City, Texas NOW OPEN!  HOUSTON METHODIST VOSS EMERGENCY CARE CENTER 1635 S. Voss Rd. Houston, Texas

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Houston, Texas 713.797.XRAY (9729)

For more information about Houston Methodist or for a physician referral, please call 713.790.3333 or visit houstonmethodist.org.

SCHEDULE YOUR SCREENING MAMMOGRAM APPOINTMENT ONLINE

THE SIMPLEST WAY TO BOOK YOUR NEXT SCREENING MAMMOGRAM To schedule your appointment, go to houstonmethodist.org/online-scheduling.

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