Leading Medicine Spring-Summer 2022, Houston Methodist West Hospital edition

LEADING MEDICINE SP RING/SUM M ER 2022

What to Expect When It’s Time for Baby to Arrive

Head Off Heartburn When Is the Right Time for

JOINT

REPLACEMENT?

YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN WEST HOUSTON/KATY

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 Dr. Michael sexual health, your first Brooks step may be to see your 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 of males and females. They will review your symptoms, ask about your health history, and perform a complete exam.

“Depending on your symptoms, we may order blood or urine labs, imaging studies,

such as computed tomography (CT) scans, or perform diagnostic procedures,” said Dr. Michael Brooks, a board-certified and fellowship-trained urologist with Houston Methodist West Hospital.

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. “For men, any urinary tract infection is considered complicated and should be evaluated by a urologist,” Brooks added.

Incontinence issues. If you’re experiencing urine leakage or the need to go frequently or urgently, a urologist can help. “In many cases, lifestyle changes, medication or surgical treatments can improve your bladder symptoms,” Brooks said.

Pelvic pain. Pelvic pain that doesn’t go away is not normal and should be evaluated by a doctor. Unexplained pelvic pain can be related to benign conditions or could be a warning sign of more concerning diagnoses of the pelvic organs.

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 blood in the urine, in the absence of an infection, should be evaluated as soon as possible,” Brooks noted.

We’re Here to Help

PROSTATE CANCER SCREENING FOR MEN

Men at high risk for prostate cancer, including Black 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.

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 techniques,” Brooks said.

“It’s important to have conversations about prostate cancer screening and detecting prostate cancer at earlier stages, even before symptoms are present.”

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).

Our doctors are focused on helping you feel better and function at your best. Visit houstonmethodist.org or call 713.790.3333 to find a Houston Methodist urologist in Katy or West Houston.

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Aching Legs Could Be a Warning Sign of Vascular Disease

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o you suffer from chronic pain, aches and fatigue in your legs? Does the pain interfere with walking, or occur even when you’re resting? Recurring Dr. Philip L. or persistent pain in your Auyang legs may be a sign that your vascular system, the network of veins and arteries that carries blood to and from your heart, is not working well.

“Peripheral vascular disease can be a concerning cause of leg pain,” said Dr. Philip L. Auyang, a vascular surgeon with Houston Methodist Cardiovascular Surgery Associates. “Clogged arteries can lead to inadequate blood flow to the legs.

Fortunately, there are treatments to alleviate the problem.”

Before you can be diagnosed with peripheral vascular disease (PVD), your doctor will take a careful history and perform a focused physical exam.

Diagnosis also may involve imaging, such as a noninvasive arterial test (similar to a blood pressure test but done on the leg), an ultrasound, a CT scan or an angiogram.

“Exams and tests also rule out nonvascular causes of leg pain, such as injury, arthritis or spine conditions,” added Auyang.

RESTORING BLOOD FLOW

If it is determined that your pain is a result of a narrowing of the arteries in your legs, your doctor may recommend one or more of the following treatments: Lifestyle changes. You may need to take steps, such as quitting smoking, reaching and maintaining a healthy weight, exercising, and controlling high blood pressure, high cholesterol levels and diabetes.

Medications. Your doctor may prescribe cholesterol-lowering medications and blood pressure medications to reduce major risks to your cardiovascular health. Additional options could include blood thinners

Don’t Ignore Leg Pain

Whatever the cause of your leg pain, it’s important to see a doctor.

With today’s medical advances in vascular disease, you can recover quickly from treatments and get back to enjoying life without leg pain.

Visit houstonmethodist.org/heart or call 713.790.3333 to find a Houston Methodist DeBakey cardiologist or vascular specialist in Katy or West Houston.

and other medications to prevent blood clots, widen blood vessels and relieve symptoms.

Angioplasty. With this minimally invasive procedure, a tiny balloon is threaded into the artery to the point of blockage and then inflated to restore normal vessel size and blood flow.

Stents. Stents, frequently used in combination with angioplasty, are small, hollow mesh tubes placed in the arteries to keep them from closing again.

Thrombolytic therapy. This involves injecting a clot-busting drug into the artery to break up a blood clot that is causing poor blood flow.

Endarterectomy. This technique involves surgical removal of plaque to improve blood flow in a blocked artery.

Bypass surgery. In this case, surgeons use some of your own veins or artificial grafts to create a new route around the blocked blood vessel.

VARICOSE VEINS AND LEG PAIN

Sometimes it’s not your arteries, but your veins that are the problem. “Tiny spider veins are usually not bothersome,” Auyang explained. “However, bulging or twisting varicose veins can result in leg pain, heaviness and even itching.”

Depending on the severity, your doctor may recommend you wear surgical compression stockings during the day to enhance blood flow from the legs to the heart. Elevating your legs while you rest also helps. “In some cases, varicose veins or poorly functioning superficial veins may need to be removed surgically or treated with a laser or injections to shut them down,” Auyang added.

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When Is the Right Time for

Joint Replacement?

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oint pain from arthritis can interfere with your everyday activities and limit your ability to work, play and enjoy life. Arthritis is a common problem, and Dr. Zach Shirley you’ll 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 about your pain when it prevents you from participating in activities you enjoy, or you make and change plans based on the joint pain you are anticipating,” said Dr. Zach Shirley, an orthopedic surgeon with Houston Methodist West Hospital.

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?

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 take a conservative approach to managing hip and knee pain, which means surgery is usually a last resort after trying other treatments,” Shirley 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. “We provide guidance on nutrition, physical therapy, mindfulness training, and even have a pre-op joint replacement class to help you prepare for surgery,” Shirley added.

Take the next step and schedule an evaluation with an orthopedic specialist.

Visit houstonmethodist.org/jointpain or call 832.522.8280 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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HEAD OFF HEARTBURN

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f you’ve ever experienced heartburn — that burning, painful sensation in your chest that occurs when stomach acids flow back into the esophagus — you know how uncomfortable, and even scary, it can be.

Heartburn is usually triggered by eating certain foods, but may also occur when exercising, bending over or being under stress.

Dr. Zeid Nearly a third of Americans each week Karadsheh experience heartburn, sometimes with acid reflux. “Symptoms can include an unpleasant taste in your mouth, a feeling you are about to regurgitate, and chest or throat pain,” said Dr. Zeid Karadsheh, a gastroenterologist with Houston Methodist Gastroenterology Associates.

MANAGING OCCASIONAL HEARTBURN

You may help prevent heartburn and acid reflux by making these lifestyle changes: Change eating habits. Limit foods that trigger your heartburn (see at right). Control portion sizes and consider eating smaller meals more often. Avoid exercising, lying down or bending over soon after eating.

Control weight. Carrying excess pounds puts pressure on your stomach and diaphragm, forcing the muscle at the bottom of your esophagus to open and acids to flow upward.

Elevate the head of your bed. Use blocks or foam wedges (available at drugstores and medical supply stores) to raise the head of your bed from four to eight inches.

Review medications with your doctor. Some prescription medications and over-the-counter anti-inflammatory drugs (NSAIDs) may contribute to heartburn.

Stop smoking. Smoking stimulates acid production and inhibits saliva, which protects the esophagus lining.

Wear clothes that fit comfortably. Avoid tight belts and clothes that put pressure on your stomach.

WHEN IS HEARTBURN SERIOUS?

For most people, heartburn is simply bothersome. “However, if you experience heartburn or acid reflux more than twice a week, or your discomfort is severe or awakens you at night, you may have gastroesophageal reflux disease (GERD),” said Karadsheh.

“Additionally, the sudden onset of heartburn in people above the age of 50 warrants further investigation.”

Left untreated, GERD can cause serious complications, such as ulcers, bleeding and narrowing of the esophagus. Some individuals with GERD may go on to develop a serious condition called Barrett’s esophagus, which increases the risk of developing esophageal cancer.

Symptoms of GERD may include: Chest pain Coughing or wheezing

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FOODS TO AVOID Many people find that one or more of these foods can trigger heartburn: Alcohol Peppermint Chocolate Raw onions and garlic Citrus fruits and juices Spicy foods Coffee, carbonated and Tomatoes and caffeinated drinks tomato-based foods Fried and fatty foods Vinegar Difficulty swallowing Persistent acid regurgitation, with or without heartburn Sore throat or hoarseness

NEXT STEPS

If symptoms fail to improve with lifestyle changes, your doctor may suggest one of the following over-the-counter or prescription-strength medications: Antacids neutralize stomach acid. They’re good for rapid — but short-term — relief.

Histamine type 2 (H2)-receptor blockers reduce stomach acid. These work slowly but have longer-lasting effects.

Proton pump inhibitors (PPIs) shut down active acid pumps in the stomach.

Finally, if medications don’t bring relief, testing may be in order. “Tests may include a barium X-ray or endoscopy to check for growths, esophageal narrowing, inflammation or erosions,” Karadsheh explained. “If necessary, there are surgical procedures and less-invasive measures that tighten the muscle at the bottom of the esophagus to prevent reflux.”

Don’t Suffer with Heartburn

Take your symptoms seriously and schedule an appointment with your doctor. Call 832.522.8560 or visit houstonmethodist.org/gi-west to find a doctor in Katy or West Houston.

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 Dr. Michael Hold end up hurrying to the hospital to deliver your baby. Or you could experience labor pain for hours (or even days) in what feels like a marathon. 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.

“In general, women experience longer labors with their first child and shorter labors with subsequent births,” said Dr. Michael Hold, an obstetriciangynecologist and medical director of the Houston Methodist Childbirth Center at West Hospital.

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. The cervix dilates significantly faster during the active phase. 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. In some cases, labor lasts longer because 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,” Hold said.

Being mentally prepared can help you handle the challenges ahead, especially if labor does not go as you planned.

Hold 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 or midwife may suggest that you labor at home — until contractions are stronger and closer together — before going to the hospital.

Expecting a Baby?

To sign up for childbirth classes at Houston Methodist West Hospital, visit houstonmethodist.org/childbirth-west or call 832.522.5522.

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.

“The staff at Houston Methodist West Hospital is at your side, helping you feel comfortable and focused while managing pain throughout labor and delivery,” Hold added.

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KEEP YOU MOVING without joint pain

Live life without joint pain.

Katy-West Houston

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At Houston Methodist Orthopedics & Sports Medicine at West Hospital, 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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