LEADING MEDICINE SP RING/SUM M ER 2022
Fighting Cancer with Your Fork Finding Solutions for Neurological and Spine Conditions When Is the Right Time for
JOINT
REPLACEMENT?
YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN FORT BEND AND SURROUNDING COUNTIES
ABDOMINAL PAIN — What Does It Mean?
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ramping. Nausea. Pain. When your stomach acts up, you want answers. Unfortunately, the source of abdominal pain is often elusive — there are many organs positioned in the Dr. Svetang Desai abdomen that can be involved and a variety of factors that can lead to discomfort.
UNSETTLING SYMPTOMS
Constipation is one of the most common reasons for abdominal pain. If it has been a few days or more since your last bowel movement, consider taking a laxative or seeing your doctor if the pain or constipation continues. Diarrhea and vomiting are often caused by an infection known as gastroenteritis, or the stomach flu. The stomach flu is also characterized by fever, aches, chills and nausea. Use fever-reducing medicines, get rest and stay hydrated to beat this bug. If symptoms persist beyond three to four days, involving a physician for evaluation is important to begin testing for more complicated disease. Bleeding and weight loss are key indications for the need to consult with a physician. Don't give children or teenagers aspirin without consulting your doctor, and seek medical treatment if an infant or young child shows signs of dehydration such as lethargy, dry mouth or decreased urination. Pain can be assessed to help identify the source of the problem. If your pain is ongoing or acute, and not specifically related to the stomach flu or digesting food (heartburn, overeating, constipation, gas), it may be a sign of something more serious. Consult your doctor if the pain doesn't subside or stop within several hours.
ABDOMINAL AILMENTS
Gastritis. Gastritis is inflammation of the stomach lining. It may cause upper abdominal pain (just below your breastbone). The pain is often described as a burning feeling. There are usually other symptoms as well, such as feeling sick (nausea), vomiting, and feeling full after eating. Stomach and duodenal ulcers. The pain from an ulcer may come and go. The pain is in the top part of your gut but may also feel like it goes through into your back. The pain often comes at night and wakes you up. Food may make it better in some types of ulcers, or may make it worse. Inflammatory bowel disease. There are two main types of inflammatory bowel disease: Crohn's disease and ulcerative colitis. They are both conditions that cause inflammation in the gut. The symptoms can flare up from time to time. Symptoms vary, depending on the part of the gut affected and the severity of the condition. Common symptoms include bloody diarrhea, abdominal pain and feeling unwell. Appendicitis. The appendix is a small pouch that projects from the colon on the lower right side of your abdomen. In children and adults, the appendix can become inflamed and filled with pus, requiring surgical removal. If not treated, the appendix can burst and lead to a serious infection. Symptoms include abdominal pain near the navel or lower right abdomen, nausea, vomiting, loss of appetite, and fever. Seek medical attention immediately if these warning signs are present. Kidney stones. A kidney stone is a hard consolidation that develops when crystals precipitate from the urine in the urinary tract. Most kidney stones can be passed
Help for Digestive Problems
through the urinary system with plenty of fluids and pain medication. Kidney stones often cause pain that originates in the back, near the ribs, and moves down toward the groin. Symptoms include severe pain that comes and goes and blood in the urine. Gallstones. A gallstone is formed when bile hardens in the gallbladder. If bile contains too much cholesterol or not enough bile salts, it can harden into stonelike material. Many people with gallstones have no symptoms, but some people experience gallstone attacks that often follow fatty meals and may occur at night. Treatment involves surgery for gallbladder removal. Symptoms include steady pain in the upper abdomen, migrating pain between the shoulder blades or under the right shoulder, abdominal bloating, intolerance of fatty foods, belching and indigestion.
LISTEN TO YOUR ABDOMEN
The stomach, colon and kidneys send signals in the form of pain to get your attention — and so do the spleen, pancreas, gallbladder and appendix. The key is to pinpoint abdominal pain and the problems causing it so you can seek treatment and feel better. Consult your health care professional if you experience any acute pain or persistent discomfort.
The gastroenterologists at Houston Methodist Gastroenterology Associates at Sugar Land specialize in diagnosing and treating gallstones and other digestive disorders. Call 281.801.9303 to schedule an appointment.
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Labor and Delivery
WHAT TO EXPECT WHEN IT’S
TIME FOR BABY TO ARRIVE
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s your due date approaches, you may have a rush of emotions and questions about what happens next. If your labor comes on quickly, you may end up hurrying Dr. Rosalyn to the hospital to deliver Miller your baby. Or you could experience labor pain for hours (or even days) in what feels like a marathon. “Women tend to experience longer labors with their first child and shorter labors with subsequent births,” said Dr. Rosalyn Miller, board-certified obstetrician-gynecologist with Houston Methodist Obstetrics and Gynecology Associates at Sugar Land. When labor goes on for many hours, expectant parents often worry and wonder, “Is this normal?” The answer is usually yes, and you’re not alone.
3 STAGES OF LABOR The first stage of labor includes two parts: Early labor starts when you begin having mild, irregular contractions. Try to stay as relaxed as possible and discuss with your doctor when to go to the hospital. Active labor begins when your contractions become stronger and happen closer together at regular intervals. Talk to your health care team about pain relief options and different ways to cope during active labor. The second stage of labor is the birth of your baby. This is the time when your doctor will guide you through the pushing phase and delivery of your baby. The third stage of labor is the delivery of the placenta. You’ll continue to have mild contractions and your provider will ask you to push to deliver the placenta. It’s time to breathe easy and enjoy bonding with your new baby.
EVERY BIRTH EXPERIENCE IS DIFFERENT
Every woman’s body responds differently to labor. “Sometimes the baby needs more time to get in the right position for birth, or the mother’s body needs more time to make way for baby,” Miller said. Being mentally prepared can help you handle the challenges ahead, especially if labor does not go as you planned. Miller suggests keeping the following tips in mind: Discuss options for pain control at your prenatal visits. Ask about the timing of pain control for a long labor so you know what to expect. Know when to go to the hospital. Check in with your health care provider if you think you may be in labor. Depending on your situation, your doctor may suggest that you labor at home — until contractions are stronger and closer together — before going to the hospital.
Expecting a Baby?
Houston Methodist Childbirth Center at Sugar Land is focused on you and your baby every step of the way. Call 281.274.7500 to learn more about childbirth education classes, including online classes, for expecting parents. Visit houstonmethodist.org/childbirth-sl to find an obstetrician-gynecologist, take a virtual tour or register for a virtual class. To schedule an appointment with Dr. Rosalyn Miller or another doctor with Houston Methodist Obstetrics and Gynecology Associates at Sugar Land, visit houstonmethodist.org/obgyn or call 281.882.3130. Listen to your body’s cues. If labor is slow-going, it may be your body’s way of letting you get some rest before moving into the next stage of labor. Make the most of these breaks; take a nap and relax, if you can. Move around during labor, if you can. Moving around and changing positions during labor can help prepare you and your baby for delivery.
Surround yourself with positive energy. Create a calm environment where you feel safe and supported. “Your birth experience is unique to you, and our physicians and staff are here to help you feel comfortable and focused while managing pain throughout labor and delivery,” Miller added.
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When to See a Urologist B ladder symptoms, incontinence, pelvic pain and other symptoms can be worrisome. If you have concerns related to your urinary system or sexual health, your first Dr. Zachary step may be to see your Mucher primary care provider. They may refer you to see a urologist if the issue needs further evaluation or treatment. A urologist is a specialist who provides medical and surgical treatment for conditions of the bladder, kidneys, urinary system, and reproductive systems. “At your first visit, we review your symptoms, discuss your health history and perform a complete exam,” said Dr. Zachary Mucher, board-certified urologist with Houston Methodist Urology
Associates at Sugar Land. Depending on the symptoms you’re experiencing, a urologist may also order urine tests, blood tests or imaging, such as ultrasound or computed tomography (CT) scans.
SYMPTOMS AFFECTING THE URINARY AND REPRODUCTIVE SYSTEMS
If you experience any of the following symptoms, consider seeing your doctor or urologist. Urinary tract infections (UTI). ““Women who experience recurring UTIs (two or more infections in a six-month period or three or more episodes within one year) may be referred to a urologist for further evaluation,” Mucher noted. For men, any urinary tract infection is considered complicated and should be evaluated by a urologist. Prostate problems. Men should see a urologist for symptoms such as difficulty emptying the bladder, a weak stream, painful urination or blood in urine. Benign enlargement of the prostate can be treated with a combination of medications or minimally invasive surgical interventions. “It’s also important for men age 50 and older to have conversations with their doctor about prostate cancer screening,” Mucher said. Sexual dysfunction in men. Urologists are experts in sexual and reproductive health for men, including treatment for low testosterone, erectile dysfunction, male infertility, and surgical contraception (vasectomy). Incontinence issues. If you’re experiencing urine leakage or the need to go frequently or urgently, a urologist
PROSTATE CANCER SCREENING FOR MEN
Men at high risk for prostate cancer, including African American men and those with a strong family history of prostate cancer or other cancers diagnosed at a young age, should talk to their doctor about screening for prostate cancer starting at age 40 or 45. Men at an average risk for prostate cancer should talk to their doctor about screening at age 50. Make an appointment with your doctor to discuss your risks and whether prostate cancer screening may be right for you.
can help. In many cases, lifestyle changes, medication or surgical treatments can resolve urinary incontinence and overactive bladder. Pelvic pain. Pelvic pain that doesn’t go away is not normal and should be evaluated by a doctor. “Unexplained pelvic pain could be a warning sign of bladder or kidney cancer, and it could signal prostate problems in men,” Mucher said. Kidney stones. Having blood in your urine and/or severe pain on one side of your lower back may be a sign of kidney stones. Any problems related to the kidneys should be evaluated as soon as possible.
We’re Here to Help Our doctors are focused on helping you feel better and function at your best. Call 281.746.6611 to make an appointment with Dr. Zachary Mucher or another specialist at Houston Methodist Urology Associates at Sugar Land.
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4RHEUMATOLOGIST Reasons to See a
R
heumatologists are specialists who treat autoimmune, inflammatory diseases such as rheumatoid arthritis, lupus among others which affect the joints, muscles, bones and connective tissue. They also treat and manage autoimmune conditions, such as lupus and rheumatoid arthritis. With an autoimmune disease, the immune system malfunctions and Dr. Niharika mistakenly attacks joints and other tissues in Ganti your body. Your doctor may refer you to see a rheumatologist if you’ve been diagnosed with arthritis or if there is a concern for autoimmune diseases.
UNDERSTANDING RHEUMATIC DISEASES
“Rheumatologists treat more than 100 types of rheumatic and autoimmune diseases, but the most common conditions we see are rheumatoid arthritis, psoriatic arthritis, lupus and gout,” said Dr. Niharika Ganti, board-certified rheumatologist at Houston Methodist Rheumatology Associates in Aliana. A rheumatologist may ask about your, health history, do a physical exam, take X-rays, order blood tests or take samples of joint fluid to understand what may be causing your symptoms. Arthritis and other rheumatic diseases can be difficult to diagnose and treat, so it’s important to listen to your body and talk about your symptoms with a doctor. Your primary care doctor may do certain rheumatological labs based on your symptoms, and if they are positive, you may be referred to see a rheumatologist. If you experience the following symptoms, it may be time to see your doctor or a rheumatologist: Joint pain. Everyone experiences soreness and painful joints from time to time, especially after exercise or long periods of standing or walking. However, joint pain and stiffness that limit your mobility is not a normal part of aging. When joint pain is chronic, and your primary care doctor can’t help you manage it, you should see a rheumatologist. Swelling of joints. “If you’re experiencing painful swelling in your joints, you should talk to your doctor or a rheumatologist about your symptoms,” Ganti said. Inflammation in your joints presents as swelling and may be a sign of rheumatoid arthritis, gout or another condition. Bone health. People can have reduced bone strength with aging, and this can predispose them to getting fractures. If you have weak bones on a bone scan or if you have had low-intensity fractures, your primary care doctor may refer you to a rheumatologist to help improve bone strength. Unexplained symptoms. “Rheumatic diseases can cause a range of symptoms that can be elusive and difficult to manage,” Ganti said. “You may experience rashes, joint pains, stiffness, swollen fingers and toes, dry eyes and mouth, and other problems.” A rheumatologist understands the complexity of rheumatic disease and is trained to identify treatments to help you feel better.
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WHAT DOES A RHEUMATOLOGIST TREAT? A rheumatologist has specialized training in rheumatic diseases affecting the joints, tendons, ligaments, bones and muscles, such as: Rheumatoid arthritis Myositis Psoriatic arthritis Sjögren’s syndrome Lupus Polymyalgia Vasculitis rheumatica Gout Scleroderma
Get Help for Symptoms
Talk to a rheumatologist about how to identify and manage your symptoms. Call 346.209.9402 to make an appointment with a rheumatologist at Houston Methodist Rheumatology Associates at Sugar Land.
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When Is the Right Time for
Joint Replacement? J
oint pain from arthritis can interfere with your everyday activities and limit your ability to work, play and enjoy life. Arthritis is a common Dr. Carl A. problem, and you’ll Hicks find a multitude of medications and treatments designed to provide relief and improve mobility. But how do you know if the timing is right to get a hip or knee replacement? “It’s time to do something when pain keeps you from the activities you enjoy, whether that’s playing tennis, taking a fishing trip or simply going for a walk,” said Dr. Carl A. Hicks, board-certified orthopedic surgeon with Houston Methodist Orthopedics & Sports Medicine at Sugar Land. When knee or hip pain bothers you every day, keeps you awake at night and affects your quality of life, it’s time to see a doctor. Although the decisions and the time frames are different for everyone, the path to treatment usually starts with talking to your primary care doctor or an orthopedic specialist. They can evaluate your joint pain and develop a treatment plan that’s customized for you.
EVALUATING JOINT PAIN
First, you may go through an assessment of pain and discuss your ability to function in everyday activities. Your doctor will order X-rays, do a physical exam and ask questions about your joint pain. Next, they may ask the following questions to evaluate the severity of your condition and determine the next steps: Do you have frequent or intense joint pain with activity?
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DON’T LET JOINT PAIN SLOW YOU DOWN Are you dealing with joint pain in your daily routine? You don’t have to accept joint pain as part of your life. You have the power to overcome the obstacles standing in your way so you can focus on the benefits of treatment. Break free from limitations and common misconceptions, such as: I’m too young to have joint problems. Reality: It’s not uncommon to have arthritis in your 40s and 50s. Early diagnosis can help provide relief and prevent worse problems from developing in the future. Joint pain is part of aging. Reality: Joint pain is very common, especially as you age, but it doesn’t have to prevent you from doing the things you love. I don’t have time for a long recovery. Reality: Advanced treatment techniques and targeted physical therapy make it possible to recover quickly and return to light activities within a few weeks. Having joint replacement surgery is a decision that can change your life. Choosing the right treatment path can result in decreased pain, better mobility and improved quality of life.
Do you have difficulty walking, standing up or bending over? Are you experiencing stiffness and a limited range of motion? Do you have inflammation, stiffness and swelling in the joint? Do you suffer pain while at rest, or does pain keep you up at night? Have you been experiencing symptoms for a long time? Are your symptoms getting worse? Does your pain persist even after taking over-the-counter pain medications?
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Are you suffering side effects from pain medications? Is joint pain wearing you down mentally and emotionally?
EXPLORING TREATMENT OPTIONS As a next step, your doctor may recommend conservative and nonsurgical treatments to relieve your joint pain. Medications and steroid injections may help reduce pain. Using a brace or doing physical therapy can help provide stability, build strength and maintain range of motion. Losing extra weight is also very helpful by taking the pressure off your joints.
Make an Appointment
“We recommend a conservative approach to managing hip and knee pain, which means trying other treatments before considering surgery,” Hicks said. Nonsurgical treatment options are intended to help you stay active and function better with joint pain. However, sometimes they don’t provide enough relief, or they may stop working after a while. Seeing an orthopedic specialist can help you understand all your options, including when to consider joint replacement surgery.
PLANNING YOUR JOINT REPLACEMENT SURGERY
If you’re a candidate for joint replacement surgery, you’ll discuss with your doctor the next steps involved in planning your surgery. Taking a proactive approach in the weeks and months before surgery can help set you up for a speedy recovery. “There’s a lot we do to help set you up for success. We focus on education, nutrition, physical therapy and discussing expectations about pain,” Hicks added.
Take the next step and schedule an evaluation with an orthopedic specialist. Visit houstonmethodist.org/orthopedics or call 281.201.0409 to schedule an appointment.
Recovery times are different for every patient, but most people go home the same day of surgery and are back to work in six to eight weeks. The bulk of the recovery happens in the first two months after surgery, but it’s common to continue making progress with strength and mobility up to 12 months after surgery.
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FINDING SOLUTIONS FOR NEUROLOGICAL AND SPINE CONDITIONS
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f you or a loved one has chronic pain, headaches or other troubling symptoms, identifying their root cause can present a challenge. You’re not alone. When it comes to Dr. Rony Ninan neurological conditions, there’s not always a clear path to diagnosis and treatment.
SHOULD YOU SEE A NEUROLOGIST? 10 Symptoms of Neurological Problems
A neurologist is a doctor who specializes in treating diseases of the nervous system affecting the brain, spinal cord and nerves. If you experience any of the following symptoms, you may want to ask your doctor or see a neurologist: 1. Chronic pain 2. Dizziness 3. Headaches 4. Memory problems 5. Movement problems 6. Muscle weakness 7. Numbness and tingling 8. Seizures 9. Sleep problems 10. Vision problems
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You may need multiple medical tests and appointments along the way. Having support to help you navigate the next steps can make all the difference.
CARE DESIGNED FOR YOU
The Houston Methodist Neuroscience & Spine Center at Sugar Land has a unique spine care navigation service, designed to help patients receive the complete spine care they need from diagnosis and treatment through rehabilitation services — all in one convenient location. “Neurological conditions of the brain and spine can take a toll in many ways on patients and their loved ones,” said Dr. Rony Ninan, board-certified neurologist with Houston Methodist Neurology Associates. “If you’re struggling with activities of daily living, you and your family will be connected with the specialists and resources you need to manage your symptoms and improve quality of life.”
TREATING NEUROLOGICAL CONDITIONS
Depending on your condition, you might need diagnostic imaging; physical, occupational or speech therapy; neurological management; and interventional pain care. “When necessary, our skilled orthopedic spine surgeons and neurosurgeons will review options
for surgical treatment of your condition,” Ninan added. A multidisciplinary team of physicians and health care professionals provides a full range of spinal care services. Our specialists treat a variety of disorders, including: Alzheimer’s and memory disorders Amyotrophic lateral sclerosis (ALS) Back and neck pain Brain and spinal tumors Epilepsy and seizures Headaches and migraines Multiple sclerosis (MS) Muscle and nerve injuries Muscular atrophy Myasthenia gravis Neuromuscular disorders Parkinson’s disease and movement disorders Peripheral neuropathy Sleep disorders Stroke
GUIDING YOU THROUGH TREATMENT Managing your care can be overwhelming at times, especially if you’re not sure where to start or who can answer your questions. “Whether you’re dealing with a new diagnosis or a chronic problem, having the support you need can help you be confident in the next steps of your treatment,” Ninan said.
Schedule an Appointment
To request an appointment with a highly trained specialist at Houston Methodist Neuroscience & Spine Center at Sugar Land, visit houstonmethodist.org/neuro-sl or call 281.205.4662.
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WORKING TOGETHER TO EASE YOUR PAIN Spine conditions are complex, and you may see a range of specialists, including board-certified neurologists, neurosurgeons, primary care sports medicine physicians, pain management specialists, and rehabilitation and occupational therapists. Our goal is to provide excellent, comprehensive care in a comfortable and compassionate environment, tailoring treatment to individual needs and concerns.
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FIGHTING CANCER WITH YOUR FORK D
oes what you eat really make a difference in your risk for cancer? Many experts agree that making better choices about what you put on your plate is one way to protect against the cell changes, or mutations, that can lead to cancer. Although some risks for cancer are out of your control, choosing a healthy diet is one way to take action. Dr. Kirtan “A healthy diet with plenty of fruits and Nautiyal vegetables may help prevent some types of cancer,” said Dr. Kirtan Nautiyal, board-certified oncologist at Houston Methodist Oncology Partners at Sugar Land. “Plant-based foods contain vitamins, minerals and antioxidants that can work together to offer some protection against cancer.”
YOUR DIET AND CANCER RISK
Antioxidants are important nutrients, such as beta-carotene, lycopene, lutein, and vitamins A, C and E. These healthy nutrients are abundant in fruits, vegetables, nuts and grains. Antioxidants help protect body cells from damage caused by unstable
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molecules, called free radicals. “Free radicals can damage DNA and may play a role in the development of cancer,” said Nautiyal. “We’re learning more about the potential for antioxidants to work against free radicals, and ways to get those benefits through a healthy diet,” Nautiyal explained. More research is needed to understand the links between diet and cancer, but there’s some evidence to suggest that antioxidants and other nutrients in foods may fight cancer by: Destroying free radicals that damage DNA, which can lead to cancer Helping to eliminate carcinogens (cancer-causing substances) Blocking the activation of carcinogens
SOURCES OF ANTIOXIDANTS
Here’s where you can find antioxidants in foods: Vitamin A: liver, dairy products, eggs and fish liver oil. It’s also converted from carotenoids, found in dark red, green and yellow vegetables Vitamin C: citrus fruits, tomatoes, peppers, broccoli, leafy vegetables, strawberries and potatoes
Vitamin D: milk, cold-water fish, egg yolks and liver Vitamin E: avocado, coconut or olive oils; sweet potatoes; avocados; nuts; sunflower seeds; and soybeans Allyl sulfides: garlic, onions, shallots, leeks, chives and scallions Carotenoids: apricots, papaya, sweet potatoes, tomatoes, mangoes, carrots, pumpkin, red peppers, spinach, corn and cantaloupe Catechins: green tea and berries Flavonoids: parsley, carrots, citrus fruits, broccoli, cabbage, cucumbers, squash, tomatoes, eggplant, peppers, soybeans and berries Folate: avocados; bananas; orange juice; cold cereal; asparagus; green, leafy vegetables; dried beans; peas; and yeast Lycopene: cooked tomato products, watermelon and pink grapefruit
CANCER-FIGHTING GROCERY LIST Here’s a list of superfoods for your next grocery trip. Apples
Flaxseed
Peas
Blueberries
Garlic
Squash
Broccoli
Grapefruit
Strawberries
Cherries
Grapes
Tomatoes
Coffee
Green Tea
Walnuts
Cranberries
Kale
Whole Grains
Dry Beans
Lentils
FOODS TO KNOW
Nautiyal recommends eating at least five servings of fruit and vegetables each day. “Choose a variety of colorful fruits and vegetables, with a goal to fill two-thirds of your plate with plantbased foods,” Nautiyal added. Here are some cancer-fighting foods you may want to add to your shopping cart: Berries — Fruits like strawberries and blueberries are loaded with antioxidants, which have cancer-fighting properties. Tomatoes — Tomatoes are rich in lycopene, a powerful plant compound that may protect against prostate cancer. Whole grains — Whole grains can help reduce your risk of colon cancer. Be sure to check ingredient labels on breads and other grains and look for the words “100% whole grain.” Red-orange fruits and vegetables — Foods such as butternut squash and sweet potatoes, are rich in beta-carotene which acts as an antioxidant to help protect cells from damage. Coffee — Your morning cup of java contains a variety of plant compounds that may be protective for some cancers. Dark green, leafy vegetables — Kale, spinach, romaine lettuce, and other green, leafy vegetables are excellent sources of fiber, lutein and flavonoids. These substances may help protect against mouth, pharynx and larynx cancers. Green tea — Laboratory studies have suggested that green tea may help slow the development of colon, liver, breast and prostate cancers.
FOODS TO LIMIT
Grilled and red meats — Red meat has been linked to colorectal and other cancers. Grilling meat over high heat can additionally form cancer-causing agents. Instead, opt for grilled vegetables, which do not create carcinogens when exposed to high heat.
Focus on Prevention
To schedule a cancer screening appointment and discuss any concerns with a doctor at Houston Methodist Primary Care Group, visit houstonmethodist.org/pcg/southwest or call 832.416.1678. If you or a loved one is diagnosed with cancer, we will assist you in scheduling an appointment with an oncologist at the Houston Methodist Oncology Partners at Sugar Land or call 281.201.6669 for next steps and a treatment plan.
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KEEP YOU MOVING without joint pain
Live life without joint pain. At Houston Methodist Orthopedics & Sports Medicine at Sugar Land, 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:
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• 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
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