Leading Medicine Spring-Summer 2022, Houston Methodist The Woodlands Hospital edition

LEADING MEDICINE SP RING/SUM M ER 2022

Stay in the Race: Avoid Injury While Running or Walking

Your Family’s Summer Health Tune-up When Is the Right Time for

JOINT

REPLACEMENT?

YOUR LINK TO HEALTH INNOVATIONS, NEWS AND TIPS IN THE WOODLANDS AND MONTGOMERY COUNTY

STAY IN THE RACE: Avoid Injury While Running or Walking

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unning and walking can help reduce your risk of cardiovascular disease as well as improve your mood. However, injuries are common, especially Alysia for runners. Many Robichau, MD factors can contribute to chronic (overuse) and acute (sprains and strains) injuries, including shoe condition and overtraining.

“If you haven’t been active, check with your doctor first and then start slowly,” said Dr. Alysia Robichau, a board-certified primary care sports medicine physician with Houston Methodist Orthopedics & Sports Medicine at The Woodlands. “Increase intensity and distance gradually. Running and walking are great ways to help stay in shape, but you need to pay attention to proper form and training to avoid injuries.”

Below are some common conditions, their symptoms and prevention techniques.

ACHILLES TENDINITIS

What it may feel like. The Achilles tendon connects your heel bone to your calf muscle. It helps you walk, run and jump.

Achilles tendinitis can cause pain above the heel in the lower leg after activity and it may feel worse in the morning.

Prevention. Warm up before working out, switch up your exercises, increase the length and intensity of your workouts slowly and rest when you have symptoms.

RUNNER’S KNEE

Runner’s knee, or patellofemoral pain syndrome, may occur when your kneecap is out of alignment, or because of overuse or injury.

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What it may feel like. Pain typically builds gradually beneath or around the kneecap. Squatting or using stairs can make it feel worse. Your knee may also feel stiff after sitting for long periods of time.

Prevention. Consider strengthening exercises for supporting muscles, such as your hip abductors, hip extensors and quadriceps.

SHIN SPLINTS

Shin splints are common in new runners and walkers as well as those returning to activity after an extended time off.

What it may feel like. Shin splints can feel like sharp, dull or throbbing pain in the shin while running or walking.

Prevention.

Increase your mileage gradually Modify your training schedule and avoid hills Stretch your calf muscles prior to running Wear appropriate shoes for your foot type and training intensity, and replace them every 400 to 600 miles

SPRAINS AND STRAINS

A sprain is a stretch or tear in a ligament, the band of connective tissue that joins bones. A strain is a twist, pull or tear of a muscle or tendon, the cord of tissue connecting muscle to bone.

What it may feel like. Signs of a sprain include tenderness and pain, bruising,

FIVE BEGINNER TIPS TO GET RACE READY Signing up for a 5K race is great way to stay motivated and have fun when starting a new walking or running regimen. These tips can help you get race-ready and avoid injury.

1. Always stretch, warm up, and cool down before and after running.

2. Know your limits. Create a schedule for yourself and progress at your own pace.

3. Over time, add a short jog in between your walk to progress your pace. Interval jogging is great and can be increased to a full jog over time.

4. Stay hydrated.

5. Wear comfortable, supportive footwear.

swelling and muscle tightness. Symptoms of a strain include pain, muscle spasm and loss of strength.

Prevention. Take time to warm up and cool down, and strengthen the muscles around the ankles and knees with balance exercises.

“Starting a running or walking regimen is a wonderful fitness goal,” added Robichau.

“Just be sure to pay attention to your body and modify your activity, if necessary.”

Learn More If you have pain during or after walking or running, and it continues despite rest and modified activity, contact Houston Methodist Orthopedics & Sports Medicine at The Woodlands at 936.321.8000 or visit houstonmethodist.org/ortho-woodlands to schedule an appointment.

LEADING MEDICINE FROM HOUSTON METHODIST THE WOODLANDS HOSPITAL

IS IT HEARTBURN OR SOMETHING MORE?

H Nathaniel Avila, MD

ave you felt a painful, burning sensation in your chest or tasted acid in your throat after eating? It’s probably heartburn and you’re not alone. Most people experience occasional acid indigestion.

But, if you have heartburn more than twice a week, you may have a condition called gastroesophageal reflux disease, also known as GERD.

WHAT CAUSES GERD?

GERD happens when stomach acid frequently flows back up into the esophagus (the tube connecting your mouth and stomach).

The acid irritates the lining of the esophagus, resulting in an uncomfortable burning sensation. Other symptoms may include chest pain, difficulty swallowing, hoarseness, chronic cough, and regurgitation of food or sour liquid.

Understanding the causes of GERD can help find the right treatment to manage your symptoms. “Certain foods as well as overeating, excessive weight gain, and increased levels of stress may trigger heartburn and GERD,” said Dr. Nathaniel Avila, a board-certified, fellowship-trained gastroenterologist with Houston Methodist Gastroenterology Associates at The Woodlands.

Sometimes GERD is caused by a hiatal hernia or delayed gastric emptying. “Delayed gastric emptying is a digestive disease called gastric stasis or gastroparesis,” explained Avila. “With gastric stasis, the stomach doesn’t empty properly, causing a backup of fluid, bile and acid.”

The inability of the stomach to move food or acid down to the intestines can cause the stomach to expand, which leads to symptoms such as stomach fullness, bloating, pain, heartburn and regurgitation. If left untreated, the acid contents of the stomach can irritate or cause injury to the esophagus. A diagnostic test may be used to measure stomach emptying and diagnose the problem.

TREATMENTS FOR GERD

Treatment for GERD and gastroparesis varies, depending on the type and severity of symptoms. Many people find relief with the following lifestyle changes: Avoid eating meals before bedtime, preferably 90 minutes prior to sleeping Eat smaller, more frequent meals and consider time-restricted eating Tightly control sugar intake Incorporate wellness exercises to help manage your stress Your doctor may also recommend over-the-counter (OTC) antacids or OTC or prescription-strength medications that help suppress acid production.

CHRONIC HEARTBURN? 10 FOODS TO AVOID Avoiding these foods may help reduce your symptoms of chronic heartburn, GERD and gastroparesis: Caffeinated and Onions Peppermint carbonated beverages Chocolate Spicy foods Citrus fruit Tomato-based sauces Fried or fatty foods Vinegar Garlic

ALTERNATIVE TREATMENTS

“If lifestyle changes and medications don’t provide relief, your doctor may recommend a minimally invasive procedure as a next step,” added Avila. The following procedures can help reduce acid reflux and treat gastroparesis: Endoscopic techniques for GERD: Surgeons may use an endoscope to sew small stitches that tighten your esophageal sphincter muscle to reduce acid reflux. Endoscopic radiofrequency is another option. Controlled energy is transferred into the sphincter muscles, making it tighter to prevent reflux.

POP procedure for gastroparesis: This is a scarless surgery (no incisions needed) for treating gastroparesis.

The procedure can be performed through the mouth with an endoscope, by opening the stomach muscle and allowing food and acid to empty from the stomach without resistance and improving your symptoms.

Take Control of GERD Don’t ignore signs of chronic or worsening reflux, bloating, or the inability to eat a full meal. Our doctors at Houston Methodist Gastroenterology Associates at The Woodlands can help you minimize symptoms and stay in control of the condition. Visit houstonmethodist.org/gastro-woodlands or call 936.270.3333 to schedule an appointment.

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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 you’ll find a Eric Price, MD 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 get an orthopedic evaluation when pain prevents you from doing what you love, whether that’s playing golf, going for a boat ride or walking at the park,” said Dr. Eric Price, a board-certified, fellowshiptrained orthopedic surgeon and director of the orthopedic surgery program at Houston Methodist Orthopedics & Sports Medicine at The Woodlands.

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 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?

Do you have difficulty walking, standing up or bending over?

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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.

Are you experiencing stiffness and a limited range of motion?

Do you have inflammation, stiffness and swelling in the joint?

Do you suffer from pain while at rest, or does pain keep you awake 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?

Is joint pain wearing you down mentally and emotionally?

LEADING MEDICINE FROM HOUSTON METHODIST THE WOODLANDS HOSPITAL

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 because it takes extra pressure off your joints.

“We recommend a conservative approach to managing hip and knee pain, which means trying other treatments before considering surgery,” added Price.

Make an Appointment

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, your doctor will discuss 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 smooth recovery. “We provide education on nutrition and exercise to help you prepare for surgery,” explained Price. “We also spend time discussing expectations for pain after surgery.”

Recovery times are different for every patient, but most people go home the same day as 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.

Are you dealing with joint pain?

Houston Methodist The Woodlands Hospital is the only DNV-certified Orthopedic Center of Excellence in hip, knee, shoulder, and spine surgery in Montgomery County, validating excellence in patient care, rehabilitation, education and outcomes. Take the next step and schedule an evaluation with an orthopedic specialist. Visit houstonmethodist.org/ ortho-woodlands or call 936.321.8000 to schedule an appointment.

HOUSTONMETHODIST.ORG/THEWOODLANDS

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PREPARING FOR PREGNANCY:

GIVE YOUR BABY A HEALTHY START

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f you’re trying to conceive or thinking about starting a family, taking care of your health should be a top priority. There are steps you can take now to help prevent complications — and give your baby a healthy start — if you do become pregnant.

Dr. Elise Breaux Rogers, obstetriciangynecologist with Houston Methodist Elise Breaux The Woodlands Hospital, suggests taking Rogers, MD the following steps to set the stage for a healthy pregnancy: Select an obstetrician-gynecologist and make a preconception appointment. A preconception visit can be helpful for women who are getting ready for pregnancy or have concerns about fertility. Your obstetrician-gynecologist will ask about your medical history and may perform a physical exam, pelvic exam, and blood and urine tests to check your overall health.

Include 400 to 800 micrograms of folic acid in your diet every day to help prevent birth defects, such as spina bifida.

Some foods naturally contain folate, such as leafy greens, citrus fruits, peas and lentils. Other foods may be fortified with folic acid. “Your doctor may recommend a folic acid supplement to take before and during your pregnancy,” said Breaux Rogers.

Maintain a healthy diet. Eat plenty of fruits, vegetables and whole grains. Choose beans, nuts and lean meats, which are good sources of iron. Boost calcium intake with low-fat dairy and/or calcium-fortified foods.

Stop smoking, drinking alcohol and doing drugs, all of which can cause birth defects or other problems with your pregnancy. If you need help quitting, see your doctor.

Avoid exposure to toxic substances, such as cleaning solvents, lead and mercury, some insecticides and paint.

Also avoid changing the cat litter box. Cat feces can contain a parasite that leads to toxoplasmosis, which can cause birth defects in unborn children.

Get regular exercise. Try to exercise 30 minutes a day most days of the week. If you're in the routine of exercising before you conceive, it may be easier to stay fit during pregnancy.

If you do become pregnant, discuss your plan for exercise with your health care provider.

Aim for a healthy weight. It's best to be at a healthy weight before becoming pregnant. Being overweight or underweight can affect your fertility, and may increase your risk during pregnancy for high blood pressure, gestational diabetes and other problems.

Control health problems. Diabetes and high blood pressure can complicate a pregnancy, so it’s important to work with your doctor on ways to help manage them.

Discuss the medications you’re taking with your doctor.

He or she can review the safety of all prescription and overthe-counter medications, and herbal remedies you currently take.

Stay up to date on vaccines and screenings. “Check with your doctor to make sure you have the immunizations you need to protect against COVID-19, flu, pertussis (whooping cough), chickenpox, etc. Be sure to stay on schedule with Pap tests and other health screenings,” added Breaux Rogers.

Schedule a Preconception Visit

Meeting with a health care provider can help you stay on top of medical concerns and answer your prepregnancy questions. Visit houstonmethodist.org/obgyn-woodlands or call 936.270.3333 to find an obstetrician-gynecologist at Houston Methodist The Woodlands Hospital.

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LEADING MEDICINE FROM HOUSTON METHODIST THE WOODLANDS HOSPITAL

YOUR FAMILY’S

SUMMER HEALTH TUNE-UP

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he summer months are a great time to schedule health checkups for your family and make sure everyone is up to date on exams and screenings. Not sure Anuradha where to begin? We’ve Namuduri, DO got you covered.

Dr. Anuradha Namuduri, a boardcertified family medicine physician with Houston Methodist Primary Care Group, recommends talking with your doctor about the health tests below. “A checkup with your primary care provider can help you stay on top of your health and detect problems early,” said Namuduri.

FOR HER

Moms usually put the needs of everyone else before their own. Be sure these screenings are on your to-do list.

Pap test. A Pap test looks for cancer in the cervix. If detected early, cervical cancer is highly treatable.

When to get it: After age 21, get a Pap test every three years. Once you hit 30, you can be tested once every five years.

Talk to your doctor about getting an HPV test at the same time.

Mammogram. A mammogram is your first line of defense against breast cancer.

When to get it: Schedule an annual mammogram starting at age 40. If you have a family history of breast cancer, your doctor may recommend you begin screenings earlier.

FOR HIM

Men are known for avoiding doctor appointments. Not this year! Here’s what you need to know: Prostate cancer screening.

Depending on your risk, your doctor may recommend a digital rectal exam or a blood test to measure the amount of the substance

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prostate-specific antigen (PSA), which can indicate prostate cancer.

When to get it: Men age 50 or older should discuss the PSA blood test with their doctors. Black men and those with a family history of prostate cancer should ask their doctor about starting screenings earlier.

FOR BOTH OF YOU

“Your doctor may recommend regular checkups to test your cholesterol, blood pressure and other aspects of your health,” added Namuduri.

Colonoscopy. A colonoscopy is the best way to look for (and remove) polyps, small growths that can become cancerous.

When to get it: Most men and women should start getting screened at age 45, and then once every decade after that.

Those at high risk may require earlier or more frequent screenings.

FOR THE KIDS

“Good health is a lifelong project. Instill healthy habits in your kids by scheduling these appointments,” said Namuduri.

Sports physical. If your child will be joining a team this school

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year, they’ll need a doctor’s approval to participate.

When to get it: Although school district rules vary, one physical at the end of summer will typically cover your child for the school year.

Immunizations. Vaccines are a powerful tool for keeping your kids — and the kids around you — healthy. Ask your doctor about vaccines recommended for your child.

Complete Your Health Checklist

We’re here to keep you and your family healthy. Visit houstonmethodist.org/pcg or call 936.270.4901 to schedule an appointment with a primary care physician.

HOUSTONMETHODIST.ORG/THEWOODLANDS

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KEEP YOU MOVING without joint pain

Live life without joint pain.

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At Houston Methodist Orthopedics & Sports Medicine, 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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The Woodlands

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