Houston Medical Times News

Serving Harris, Galveston, Brazoria, Fort Bend and Montgomery Counties

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Volume 9 | Issue 11

Inside This Issue

November Edition 2019

Heart Walk Your Way to a Healthier Lifestyle

By American Heart Association

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Paralyzed Veteran Now a Marathoner See pg. 13

INDEX Legal Matters........................ pg.3 Mental Health...................... pg.5 Oncology Research......... pg.6 The Framework.................... pg.7 Marketing Essentials........ pg.12

he month of November means cooler weather, a focus on gratitude, festive meals and family time. November also means that more than 30,000 Houstonians will join the American Heart Association (AHA) and walk to save lives. The annual Heart Walk invites the Houston community to participate in physical activity and partner with AHA to achieve the mission of longer, healthier lives.

But the Heart Walk is bigger than one day each year – it’s part of a year-round initiative to be Healthy for Good, a movement designed to inspire people to live healthier lives by making small, simple changes that can create a difference for generations to come.

Each year, the Heart Walk honors an individual who has made positive lifestyle changes to improve their quality of life and health. The 2019 Lifestyle Change Award, presented by BlueCross BlueShield of Texas, will go to AHA’s own Teresa Carroll. As Vice President of the Houston Heart Walk, Teresa has made significant lifestyle changes in her personal health journey. Teresa improved her diet and increased her physical activity, going from high cholesterol to a healthy range and losing 85 pounds so far.

“There are several reasons why I wanted to be healthier. I was only 30 years old, I weighed more than I should and I had high cholesterol. It was a wake-up call. I started eating better and being more active. I even found that

I liked to exercise! That’s the secret to losing weight - finding something you enjoy and doing it consistently. I’ve come a long way, but my journey isn’t over yet,” said Teresa.

If you’re not sure where to start, walking is one of the simplest and most

That’s the secret to losing weight – finding something you enjoy and doing it consistently...

— Teresa

Age Well Live Well See pg. 16

popular ways to increase your physical activity. With every step, you travel further down the path to a healthier lifestyle. Research has shown that walking can have a significant impact on your health by lowering your chances of heart disease and increasing your chances of living a longer, healthier life.

Walking is also one of the most versatile forms of exercise, because you can do it just about anytime, anywhere.

Follow these tips to start your own Healthy for Good journey.

• Make sure you have comfortable clothes and supportive shoes.

• Begin with short distances. Start

with a stroll that feels comfortable and gradually increase your time or distance.

• Keep your head up, core engaged and shoulders relaxed. Avoid carrying heavy items or hand weights because they can put extra stress on your elbows and shoulders.

• Walk at an easy pace for the first few minutes to warm up. Then gradually increase your speed.

• If you can’t talk or catch your breath while walking, slow down.

• Add variety and challenge with brisk intervals. Walk one block fast, two blocks slow and repeat several times. Walking up hills or stairs is a great way to increase muscle tone and burn more calories.

• Stretch your hamstrings, calves, chest, shoulders and back at the end of your walk since your body is warmed up.

• Fit walking into your schedule whenever you can. Just remember your overall goal is at least 150 minutes each week.

• Celebrate your achievements and enjoy the benefits of walking. For every hour of brisk walking, life expectancy for some people may

see Heart Walk.. page 18

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Houston Medical Times

Legal Matters Texas Passes Consumer Protection Law on Pharmaceutical Drug-Pricing Transparency

By Ebad Khan, J.D. Polsinelli, PC

drug-pricing transparency within the pharmaceutical industry. Senator Kelly Hancock, a sponsor of this Bill in the Senate, stated the following in a press release, “Prescription drug costs are a significant portion of the household budget for many Texans. When the price of a prescription spikes, people s Texas residents are largely deserve to know why their wallets are dependent on prescription drugs taking a hit. This legislation serves as a to manage their healthcare conditions. much-needed consumer price check on As the costs of prescription drugs a complicated industry that, frankly, continue to spiral and the complexity could do with a lot more transparency.” of the pharmaceutical industry This drug-pricing transparency increases, consumers have dealt with law requires all pharmaceutical their fear of not knowing whether they drug manufacturers to submit an would be able to afford the cost of their annual report to the Texas Health drugs. To overcome this fear, the Texas and Human Service’s Commission Legislature recently took aggressive (“HHSC”) that includes the current action to enact one of strongest wholesale acquisition costs (the cost drug-transparency laws in the country. manufacturers charge to wholesalers This new Texas law (H.B. or direct purchasers) of all drugs sold 2536) requires pharmaceutical drug in or into Texas. Additionally, in manufacturers, pharmacy benefit the event the wholesale acquisition managers, and health plan issuers to cost of a drug increases (a) 40% or report specific data and information more over the preceding three years, Hou_Med_times_ad_7_2019.pdf 1 7/22/19 3:16 PM in order to create and foster or (b) 15% or more in the preceding

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year, manufacturers must report, among other things, the following: the name of the drug, whether it is a brand name or generic, aggregate company-level research and development costs for the most recent year, and a statement regarding the factors that caused the increase in costs. Both the annual report and the increase in costs report will be made available by HHSC on its website.

This new law further requires all pharmacy benefit managers (“PBMs”) to file an annual report with the Texas Department of Insurance (“TDI”).

The annual report must include the aggregate amounts of rebates, fees, price protection payments, and any other payments collected from manufacturers, and the payments that were passed on to health insurance issuers and their enrollees or retained as revenue. This information will be made available by TDI on its website.

Finally, the law demands that all health insurance issuers file an annual report to TDI as well. In this report, the issuers must, among other things,

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list the names of the 25 most frequently prescribed drugs, the percent increase in spending for the 25 drugs, and the percent increase in premiums that can be attributable to those 25 drugs. TDI will also make this information on its website.

In passing this law, Texas has clearly shown its intent to act in the best interest of its residents by shielding them from any additional increases to pharmaceutical drugs. By publicizing the above mentioned reports, Texas shifts the burden to the pharmaceutical industry to introspectively consider whether any increase to drug costs to the consumers could withstand the scrutiny resulting from this newfound transparency and the justifications that the industry may provide.

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Texas Children’s names Adult Congenital Heart Disease Program leadership team Esteemed Cardiologist and Cardiovascular Surgeon to Guide Largest Program in Texas

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exas Children’s Hospital is proud to announce two new leaders of the Adult Congenital Heart Disease (ACHD) Program at Texas Children’s Heart Center®. Dr. Peter Ermis serves as medical director of the ACHD Program and Dr. Edward Hickey will serve as surgical director of the ACHD Program beginning Oct. 1.

Together, the esteemed cardiologist and cardiovascular surgeon will guide the largest ACHD program in the state. Texas Children’s is ranked #1 in the nation for cardiology and heart surgery by U.S. News & World Report.

Texas Children’s ACHD Program allows patients with congenital heart disease to receive seamless continuity of care from birth throughout adulthood. As pediatric patients with congenital heart defects transition

into adulthood, the program’s multidisciplinary team of experienced congenital heart disease specialists advises them on health and lifestyle choices for their adult needs, including physical challenges, exercise options and family planning. The program offers comprehensive medical and surgical care in collaboration with colleagues at Texas Children’s Pavilion for Women and Texas Children’s Fetal Center. The hospital’s ACHD Program is accredited by the Adult Congenital Heart Association (ACHA) and is one of only three programs accredited in Texas.

Ermis, a native Houstonian and dedicated member of Texas Children’s ACHD Program team since 2014, also serves as assistant professor at Baylor College of Medicine.

Dr. Peter Ermis

Dr. Edward Hickey

“I’m honored to take on a leadership role in the program where I began my cardiology career,” said Ermis. “As this population of patients grows, it is even more important they are cared for by congenital heart disease specialists who recognize their specific needs as they transition to and live through adulthood. Our team is revolutionizing the way we care for

these patients and I look forward to continuing to do so in partnership with Dr. Hickey.”

Ermis received his undergraduate degree at Rice University. He earned his medical degree from the University of Texas Health Science Center at San Antonio and went on to complete his residency and pediatric and adult see Texas Children’s...page 18

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Mental Health Hope is a Key Factor in Recovering from Anxiety Disorders University of Houston Study Indicates Hope Increases in Therapy

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niversity of Houston associate professor of clinical psychology, Matthew Gallagher, has added his voice to a debate that spans the ages — the importance of hope. Gallagher reports in Behavior Therapy that hope is a trait that predicts resilience and recovery from anxiety disorders.

The concept of hope has long stirred opinion. In the sixteenth century, Martin Luther celebrated its power, claiming “Everything that is done in this world is done by hope.”

Two centuries later, Benjamin Franklin warned that “He that lives upon hope will die fasting.” Into the conversation, Gallagher reports that psychotherapy can result in clear increases in hope and that changes in hope are associated with changes in anxiety symptoms.

More than pure philosophy, Gallagher has empirical evidence. His study examined the role of hope in predicting recovery in a clinical trial of 223 adults in cognitive behavior therapy

(CBT) for one of four common anxiety disorders: social anxiety disorder, panic disorder, generalized anxiety disorder and obsessive-compulsive disorder.

“In reviewing recovery during CBT among the diverse clinical presentations, hope was a common element and a strong predictor of recovery,” said Gallagher who reports that moderate-to-large increases in hope and changes in hope were consistent across the five separate CBT treatment protocols.

In terms of psychotherapy, hope represents the capacity of patients to identify strategies or pathways to achieve goals and the motivation to effectively pursue those pathways.

Significantly, the results of this study indicate that hope gradually increases during the course of CBT, and increases in hope were greater for those in active treatment than for those in the waitlist comparison. The magnitude of these changes in hope were consistent across

different CBT protocols and across the four anxiety disorders examined, which underscores the broad relevance of instilling hope as an important factor in promoting recovery during psychotherapy.

“Our results can lead to a better understanding of how people are recovering and it’s something therapists can monitor. If a therapist is working with a client who isn’t making progress, or is stuck in some way, hope might be

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an important mechanism to guide the patient forward toward recovery,” said Gallagher.

Hope is closely related to other positive psychology constructs, such as self-efficacy and optimism, that have also been shown to have clear relevance to promoting resilience to and recovery from emotional disorders, said Gallagher. 

November 2019

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Oncology Research A Patient’s Guide to Managing Cancer as a Chronic Illness

By Anish Meerasahib, M.A, M.D., Texas Oncology

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very day in laboratories and clinics across the world, biologists, physicists, researchers, and physicians are working to identify cancer cures.

Their work has led to important breakthroughs in cancer diagnosis and treatment. But for some types of cancer that remain beyond the reach of the ultimate solution – a cure – treatment has advanced that makes it possible for some patients to live with and manage cancer as a chronic illness.

The American Cancer Society defines chronic cancer as controlled or stable cancer, meaning tests and scans show the cancer is not progressing over the course of time. Some cancer types, such as chronic leukemia, and some lymphomas and ovarian cancers, are ongoing – meaning they are never completely gone from your body. Some

cancers that have spread or come back in other parts of the body, such as metastatic breast cancer or prostate cancer, may also become chronic cancers.

The ACS estimates the five-year survival rate for all cancer patients increased about 20 percent in the past 30 years. People are living longer, fuller lives as a result. Each patient experiences cancer differently. Living with cancer as a chronic illness is very different from a patient’s life after cancer. Below are considerations for living with chronic cancer.

“New” vs. Recurring Cancer.

Understand your diagnosis and what it means for your long-term health and quality of life. Sometimes, chronic cancer is diagnosed after a recurrence, when the first cancer type returns. This is different than being diagnosed with a second cancer. It’s essential to openly communicate with your oncologist and care team to understand your diagnosis and have a complete picture of your long-term treatment plan.

Stick to the Plan. Adhere to your treatment plan, medication, and

follow-up appointments.

When you are managing cancer as a chronic illness, treatment becomes a “normal” part of life.

The goal of long-term treatment for chronic cancer is to help patients live their best quality of life for as long as possible. This requires an ongoing partnership between patient and care team. Patients may experience unpleasant side effects. For example, the National Institutes of Health reports that pain occurs in 50 percent of people with cancer. Adhering to the treatment plan, staying consistent with medication and follow-up treatments, and communicating honestly are ways for patients to stay on top of managing their care.

Take Care of Yourself. Dedicate time to care for your emotional well-being – and know you’re not alone.

Learning you have cancer is

devastating – learning it’s not going away may bring an entirely new set of fears and frustrations. Some patients experience depression, and living with uncertainty may feel overwhelming at times. This is normal, and patients are encouraged to seek support. A part of taking care of emotional well-being may also include making lifestyle changes, such as changing the way you eat, the activities you have the energy to participate in, and learning to become more open about your emotional health.

The number of Americans currently living with a history of cancer is approximately 14 million, according to the Journal of Oncology Practice. That’s a lot of hope for a lot of people living with cancer. At Texas Oncology, we’re honored to serve our patients through every season of their cancer journey. 

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The Framework

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he University of Texas MD Anderson Cancer Center today opened its newest free-standing facility in The Woodlands. Serving patients in The Woodlands, Spring, Conroe and communities north of Houston, MD Anderson Cancer Center The Woodlands offers local, convenient access to the nation’s top-ranked comprehensive cancer care.

To keep pace with population growth, MD Anderson relocated its previous facility in The Woodlands to a larger building designed for the best possible experience for patients and care providers. The new building, located at the corner of College Park (TX242) and Fellowship Drive, is four times the size of the former location, and it incorporates all services in The Woodlands into one single, easy-to-navigate facility with

free parking.

Patients will continue to receive the same high-quality, multidisciplinary care provided at the original location, as well as an expanded Ambulatory Treatment Center and diagnostic imaging center. The new location also provides support services including clinical nutrition, social work and cancer pain management. In the winter, additional interventional radiology, endoscopy, bronchoscopy and procedural services will be available, with plans to add a women’s imaging center in the future.

“MD Anderson is committed to expanding access to our expert subspecialty cancer care in the greater Houston area,” said Peter WT Pisters, M.D., president of MD Anderson. “This new facility provides a new level of services that

MD Anderson Cancer Center’s new facility in The Woodlands will significantly enhance cancer care and the overall experience for patients in The Woodlands and surrounding areas.”

MD Anderson The Woodlands offers numerous wellness resources, including Salus, an area for wellness, connection, learning and support, where patients may attend classes and support groups. It also houses a marketplace where patients and visitors may buy coffee, snacks and refreshments.

“This expansion allows the MD Anderson team to offer its full range of expert care – from cancer screenings and treatment to survivorship support – to patients

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throughout the north Houston area,” said Kent Postma, vice president of Ambulatory Operations at MD Anderson. “We look forward to experiencing this new facility with our patients we previously served in The Woodlands and to maximizing the care and patient experience opportunities for all patients.”

MD Anderson The Woodlands is the institution’s third outpatient campus to open this year. MD Anderson’s five campuses aim to improve local community access to subspecialized cancer care and innovative clinical trials. 

November 2019

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Houston Medical Times

Exercise Could Slow Withering Effects of Alzheimer’s

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replicated in a larger trial, then maybe one day doctors will be telling high-risk patients to start an exercise plan. In fact, there’s no harm in doing so now.”

Reduced brain atrophy The study published in the Journal of Alzheimer’s Disease compared cognitive function and brain volume between two groups of sedentary older adults with memory issues: One group did aerobic exercise (at least a halfhour workout four to five times weekly), and another group did only flexibility training.

Both groups maintained similar cognitive abilities during the trial in areas such as memory and problem solving. But brain imaging showed that people from the exercise group who had amyloid buildup experienced slightly less volume reduction in their hippocampus – a memory-related brain region that progressively deteriorates as dementia takes hold.

It’s interesting that the brains of participants with amyloid responded more to the aerobic exercise than the others,” said Dr. Zhang, who conducted the trial at the Institute for Exercise

RELAX

xercising several times a week may delay brain deterioration in people at high risk for Alzheimer’s disease, according to a study that scientists say merits further research to establish whether fitness can affect the progression of dementia.

Research from UT Southwestern found that people who had accumulation of amyloid beta in the brain – a hallmark of Alzheimer’s disease – experienced slower degeneration in a region of the brain crucial for memory if they exercised regularly for one year.

Although exercise did not prevent the eventual spread of toxic amyloid plaques blamed for killing neurons in the brains of dementia patients, the findings suggest an intriguing possibility that aerobic workouts can at least slow down the effects of the disease if intervention occurs in the early stages.

“What are you supposed to do if you have amyloid clumping together in the brain? Right now doctors can’t prescribe anything,” said Dr. Rong Zhang, who led the clinical trial that included 70 participants ages 55 and older. “If these findings can be

and Environmental M e d i c i n e .

“Although the interventions didn’t stop the hippocampus from getting smaller, even slowing down the rate of atrophy through exercise could be an exciting revelation.”

However, Dr. Zhang notes that Dr. Rong Zhang reviews data at the Institute for Exercise and Environmental more research Medicine (IEEM). A new study conducted at the IEEM shows regularly exercising is needed to may slow down brain deterioration in people at high risk for Alzheimer’s disease. determine how or if the reduced atrophy rate benefits yielded no proven treatments that would cognition. make an early diagnosis actionable for Elusive answers patients.

The search for dementia therapies Fitness and brain health is becoming increasingly pressing: Dr. Zhang is among a group of More than 5 million Americans have scientists across the world trying to Alzheimer’s disease, and the number is determine if exercise may be the first expected to triple by 2050. such therapy.

Recent research has helped His latest research builds upon scientists gain a greater understanding numerous studies suggesting links of the molecular genesis of the disease, between fitness and brain health. including a UT Southwestern discovery For example, a 2018 study showed published last year that is guiding efforts that people with lower fitness levels to detect the condition before symptoms experienced faster deterioration of vital arise. Yet the billions of dollars spent on nerve fibers in the brain called white trying to prevent or slow dementia have see Alzheimer...page 16

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Man Struck by Lightning Reunited With Memorial Hermann Life Flight Crew, EMS Personnel Who Helped Save His Life over the park, Coreas quickly began to make his way to his truck when the hursday, Oct. 3 was a normal day unthinkable happened: Coreas was for Alex Coreas. He went to work, struck by lightning. came home and went on an evening According to the Centers for walk with his three dogs at nearby park. Disease Control and Prevention, the As a fast-moving storm was passing odds of being struck by lightning in the United States in any one year are 1 in 500,000. For those who are struck, the consequences can be debilitating, even fatal.

About 10 percent of those struck by lightning die. Those who survive may suffer muscle injuries, eye injuries, burns and skin lesions, according to the CDC. Coreas’ lightning strike was captured on security cameras at Stuebner Airline The lightning that hit Alex left a ‘heart-shaped’ hole in the ground.

Veterinary Hospital. Hospital employees and bystanders

By Jade Waddy

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quickly rushed to Coreas and found him unresponsive and without his socks and shoes. They quickly began administering CPR and called Cypress Creek EMS.

Coreas’ heart wasn’t beating when paramedics arrived, but they continued to provide care and Alex Coreas with Life Flight crew Coreas’ heart began to beat again. Cypress Creek EMS called struck by lightning at all.” for Life Flight to quickly transport him The lightning strike tore to the hospital. through Coreas’ shoe and melted his

A small window of time sock. opened when the dangerous weather “The doctors believe the conditions and storms moved in the lightning traveled all the way through opposite direction of Life Flight’s my body and came through my head intended flight path, allowing the crew and out of my ear and damaged my of Pilot Mike Mock, Sean Manard and right ear. I can’t hear,” Coreas added.

Robert Atripaldi to safely reach Coreas.

Although he will need

Life Flight transported Coreas additional surgery to repair his right to Memorial Hermann-Texas Medical ear, he’s thankful to be alive.

Center where he spent several days “I’m just so very thankful to recovering from his injuries. everyone for their role in saving my

“I remember waking up in life,” Coreas said. “I’m now encouraged the helicopter because I heard the to get my own CPR training because propellers and asking about my dogs,” maybe I can save someone’s life in the Coreas said. “I don’t remember being future.”

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U.S. News & World Report Has Named Houston Methodist Hospital to Its Honor Roll, A List Of The Top Hospitals in the Country

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his i s t h e t h i r d t i m e Houston Methodist Hospital has been named to the Honor Roll, and is also the eighth year in a row it’s been named the No. 1 hospital in Texas.

The rankings are based on scores in patient care, patient safety, outcomes, nursing, advanced technology and reputation. U.S. News has ranked Houston Methodist Hospital as one of the top hospitals in the country for the past 27 years.

This year, Houston Methodist Hospital is ranked in nine specialties, the most of any hospital in the state. Five of the ranked specialties appear in the

top 25 in the country.

Houston Methodist also appears in the regional and state rankings with Houston Methodist Sugar Land Hospital tied for No. 5 in Houston and tied for No. 9 in the state.

U.S. News recognizes Houston Methodist Hospital with a perfect score in nine common adult procedures and conditions including abdominal aortic aneurysm repair; aortic valve surgery; heart bypass surgery; heart failure; colon cancer surgery; chronic obstructive pulmonary disease (COPD); hip replacement; knee replacement; and lung cancer surgery.

Celebrating

“Being named to t he Honor Roll i s a significant accomplishment and will serve as a wonderful footnote as we close our first 100 years of serving the Houston region. It will also set the bar for our next 100 years,” said Marc Boom, M.D., president and CEO of Houston Methodist. “This is a tremendous achievement for our physicians and employees who dedicate themselves every day to our patients.”

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Long Patient Wait Times Are Costing You

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atience is a virtue, but patients don’t always feel the need to practice it. And that makes sense; as more practices offer shorter wait times and more one-on-one time with the doctor, why would they want to put up with long patient wait times?

Attitudes towards patient wait times are changing If you’ve worked in the healthcare field for quite a while, you’ve probably heard the term “healthcare consumerism.”

While the term encompasses many different things, the big idea is that patients expect their healthcare experience to be more like a customer service experience.

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options out there. And while they may not be able to turn back the clock and choose another office, they can prevent other people from making the same mistake.

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Wouldn’t it be great if a doctor or hospital’s reputation was based solely on their professional merits? Of course, you strive to provide the best level of healthcare you can. But in this day and age, that’s not enough to earn a strong patient referral.

And patient referrals are not just limited to someone’s family and friends. A recent Vitals study showed that healthcare facilities with long wait times tend to receive much poorer reviews than those with shorter waits. The highest reviewed practices had average wait times of 13 minutes, while

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patients are no longer willing to put up with long wait times at the doctor’s office—just as they wouldn’t wait a half-hour in line at the store to buy an item.

Reasons for shifting patient attitudes

The truth is that patients have never enjoyed long wait times in the office. In many cases, they simply accepted it as the norm.

While some offices have always attempted to streamline processes, we all know that practices and hospitals have a reputation for scheduling appointments that rarely begin on time.

So what’s different now?

Patients have become empowered to take control of the situation.

They know that there are other

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those receiving low star ratings had wait times of 34 minutes.

Patient reviews have greater reach than ever before 90% of patients have researched a doctor or hospital before visiting. Chances are high that most of your patients have looked you up online. They may have been pleased with your reviews, or they may have decided you were worth a shot despite them—but after a visit, they could change their mind.

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Houston Medical Times

Paralyzed Veteran Now a Marathoner

By Todd Goodman

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he National Veterans W heelchair Games have given Army Veteran Candice Caesar a new social circle and extended family—but the inspiring part is what she’s had to overcome.

Caesar was stationed in Germany in 1999 when she was involved in a motor vehicle accident. The vehicle slid on black ice and crashed. A Soldier in the back seat, who was not wearing a seatbelt, flew forward and slammed into her, breaking several of her vertebrae. She also punctured a lung and sustained a traumatic brain injury.

She was paralyzed.

“I couldn’t move anything on my right side,” she said.

A German doctor fused her vertebrae but nicked her vocal cord in the process, leaving her barely able to speak for six years.

Doctors told her they didn’t

think she would walk again.

“I couldn’t believe it,” she said. “You don’t know what you’re talking about. I went straight into denial. And that is when I leaned on my faith and said, ‘I’m going to walk a marathon.’ I did not know that a marathon was 26.2 miles.

That is just what came into my brain. You don’t know what you’re talking about. I just didn’t believe them.”

As she lay in bed, she lamented her lost military career.

She was going to be a drill sergeant, get her commission, and become a physical therapist.

“I had a plan and now you’re telling me I can do none of these things?” Caesar said. “So, now you’re taking away my career and you’re telling me I can’t walk? Well, you’ve got to leave me something.

I can’t have my Army career, but I can have movement over my body.

And that’s what happened.”

That attitude, as powerful

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as it is, only works when it’s turned on, she said.

The first time she walked, she took two steps and then it was back into the wheelchair.

“There was a lot of falling,” she said. “There was a lot of bleeding. There was a lot of crying. Some days I lay in bed and said, ‘God, why did this happen to me? I need to die. I can’t kill myself, but just let me die. Let me close my eyes and just die.’ I was in an Army Veteran Candice Caesar, a walking quadriplegic, runs her awful place.” first marathon with her son by her side. She was paralyzed in a

She was desperate to 1999 auto accident. get home to her two-year old son, whom she hadn’t seen was available.

“I blew whistles,” she said. since the accident. She begged “When I wanted him to stop, I doctors to discharge her. After approximately five weeks in the blew once. When I wanted him to hospital, using a flat-bed crutch turn around, I blew twice. My kid and a cane, she was able to walk was trained like a dog, basically. enough to go home. She covered But that’s the best I could do.”

A speech therapist inspired her right side in band-aids so her her, working on her swallowing, son would know not to touch her there. With communication an her pitch, and her ability to issue, as she could barely speak project. She even suggested see Veteran...page 16 above a whisper, she used what

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November 2019

Houston Medical Times

Page 14

TIRR Memorial Hermann Celebrates 60 Years of Pioneering Rehabilitation Care Dear Doctors and Staff, Let us take the guesswork out of fracture referrals.

No more waiting for appointments!

We at the Orthopedic Care Center wish to offer your patients and staff easy scheduling of patients.

Our office has extended office hours on Fridays to accommodate patients with fractures.

On behalf of the Orthopedic Care Center

Lubor Jarolimek M.D.

ORTHOPEDIC CARE CENTER 2121 OAKDALE HOUSTON, TX 77004

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IRR Memorial Hermann is celebrating 60 years of pioneering rehabilitation care. Founded in 1959 as one of the first polio treatment centers in the United States by William Spencer, MD, TIRR Memorial Hermann’s commitment to providing high level, quality rehabilitation care to thousands of patients throughout the world has earned it annual recognition as one of the top rehabilitation centers in the nation.

“Our commitment to every patient who comes through our doors is rooted in the vision of Dr. William Spencer and his belief in protecting the individuality of the person facing disability and giving them the chance to pursue the goals and dreams important to them,” said Jerry Ashworth, Senior Vice President and CEO of TIRR Memorial Hermann.

“For 60 years, TIRR Memorial Hermann’s talented team of affiliated physicians and employees has provided thousands with compassionate, individualized care to meet the needs of their rehabilitation journey.”

T

Rehabilitation, Dr. Spencer led TIRR to become a worldwide model for comprehensive medical rehabilitation programs, serving as president until his retirement in 1987.

“From the beginning days as pioneers in the treatment of polio, to addressing the needs of conditions ranging from spinal cord injury and traumatic brain injuries to stroke treatment in adults and spina bifida in children, TIRR Memorial Hermann has continued to set the bar for high quality, personalized rehabilitation care,” said Gerard Francisco, MD, Chief Medical Officer at TIRR Memorial Hermann.

TIRR Memorial Hermann’s ability to push the envelope has led its affiliated physicians and researchers to develop important techniques, programs and devices used for rehabilitation care. This includes the development of Harrington rods by orthopedic surgeon Paul Harrington, MD, for the treatment of scoliosis; nationally recognized spinal cord and brain injury programs and research

During TIRR Memorial Hermann’s first decade, it quickly became known for its groundbreaking work, including the development of the physiograph, a device capable of recording vital functions that is recognized as a prototype for the monitoring systems used today.

Access to renowned physicians at what was then called the Southwestern Poliomyelitis Respiratory Center, presented it as a premiere facility for the treatment of polio.

It gained further notoriety for its success in the rehabilitation of patients with spinal cord deterioration caused by disease or trauma and for pioneering an interdisciplinary team approach to rehabilitation. Regarded as one of the Fathers of Modern

centers; and the Independent Living Research Utilization Program.

“Dr. Spencer’s early efforts to integrate TIRR Memorial Hermann into the Texas Medical Center gave us access to enormous research resources and collaborators from other institutions. The infrastructure provided by the Texas Medical Center has facilitated our ability to create a program of research that integrates physicians, nurses and therapists,” said Mark Sherer, PhD, senior scientist and associate vice president for research at TIRR Memorial Hermann. “This access has provided the resources needed to continue moving forward with research in line with Dr. Spencer’s original vision.”

for over three generations

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see TIRR...page 18

Houston Medical Times

Page 15

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November 2019

Houston Medical Times

Page 16

Age Well Live Well

expectations and capacity. It can be an overwhelming and seemingly never-ending task.

“As a former family caregiver for two grandmothers, I experienced a lack of preparation in multiple ways,” Frost said. “Families need to know their loved one’s preferences for care, living arrangements and health needs, and creating regular opportunities to talk with your family can give insight and understanding on important, personal choices. Building a solid foundation for your family member’s continuum of care helps the entire family navigate each issue that comes up.”

Organizations can choose to participate in the Texas Talks

campaign with their employees by going to the HHSC website, hhs.texas.gov, and searching for “Texas Talks.” Select “Request the Texas Talks Toolkit” link to receive a free toolkit that includes template emails and articles which organizations can send to their employees this fall. In 2018, over 150 organizations participated in the Texas Talks challenge by requesting the HHSC toolkit and sending out the campaign materials to their employees, encouraging them to proactively think and talk about aging issues with their family members and friends.

To learn more, email AgeWellLiveWell@hhsc.state.tx.us or call 800-889-8595.

“I’m excited about the results, but only to a certain degree,” Dr. Zhang said.

“This is a proof-of-concept study, and we can’t yet draw definitive conclusions.”

Expanded research

Dr. Zhang is leading a five-year national clinical trial that aims to dig deeper into potential correlations between exercise and dementia.

The trial, which includes six

medical centers across the country, involves more than 600 older adults (ages 60-85) at high risk of developing Alzheimer’s disease. The study will measure whether aerobic exercise and taking specific medications to reduce high blood pressure and cholesterol can help preserve brain volume and cognitive abilities.

“Understanding the molecular

basis for Alzheimer’s disease is important,” Dr. Zhang said. “But the burning question in my field is, ‘Can we translate our growing knowledge of molecular biology into an effective treatment?’ We need to keep looking for answers.”

she said. “To walk I have to pick my hip and quad up and put it down.

I’ve got a lot of movement. It’s still weak, but it’s movement.”

So much movement that she did what she assured her doctors in Germany that she would do—run/ walk a marathon. So far, she’s done 17 marathons and 73 half marathons in 43 states. When her Houston VA doctor advised her to find other activities, as running was too tough on her body, Caesar joined Paralyzed Veterans of America Texas Chapter and discovered a slew of things she could do, to include Wheelchair Games.

“I had the best time with Wheelchair Games,” she said.

“When I left (this year’s games in Louisville, KY), I had 20 new connections. I will never be alone

again in another state. I didn’t understand the different activities and organizations that I could be a part of and learned all of that by going to Wheelchair Games and being hooked up with the Paralyzed Veterans of America. They just have no idea how they’ve changed my life.

Her favorite event at the games was using a hand cycle to do the 10K. There was a “killer hill” that she had to pass several times.

That hill almost got the best of her, but she persevered and once she conquered it the first time, her confidence soared.

“When I passed somebody using his legs and I’m using my arms, that just gave me a little extra power,” she said. “I thought, ‘Oh! I can beat people using their legs!’

For me, I was like, “Oh, my God, I’m passing him up!’ That gave me some extra motivation. I could have gone another 10K around the course, I had that much fun at Wheelchair Games.”

Caesar is determined to make these games an annual event, no matter what is going on in her busy life. Since the accident, she’s gotten two bachelor’s degrees and a master’s degree in speech pathology and currently works as a speech pathologist, working with autistic children. She continues to receive care for her spinal cord injury at the Houston VA Medical Center.

“I have to be at the Wheelchair Games,” she said. “I have people to hang out with, people to talk to, connections to make, and some rivals to beat.” 

Have You Had the Talk?

By Will Armstrong Texas Health and Human Services

T

alking about potential aging needs and issues with family members is important, yet many families never have conversations about aging because it can be overwhelming and uncomfortable.

Texas Talks is an annual fall campaign from Texas Health and Human Services that encourages families to talk about aging needs and issues with their loved ones.

The campaign provides tools, resources and easy-to-digest guides for families to use as a stepping stone to begin discussions answering important questions such as: • What type of Medicare does mom or your spouse have?

• Have they met the deductible for the year?

• Who is the legal guardian should anything happen, and is it written down?

• Is a will written?

• How do they feel about assisted living, or is home health their

Alzheimer

Continued from page 8 matter. Research in mice has similarly shown exercise correlated with slower deterioration of the hippocampus – findings that prompted Dr. Zhang to investigate whether the same effects could be found in people.

Veteran

Continued from page 13 something at the time, which seemed unthinkable—a career change.

“She said, ‘You can be a speech pathologist.’ What are you talking about? I can’t remember anything!

I can’t speak! I can’t hear! And the therapist told me, ‘I’m going to get you right.’”

When Caesar was medically retired from the Army in 2002, life was tough, with many nights spent in tears. However, she kept getting physically and mentally stronger, incorporating more and more muscles.

“When I left the Army, I was able to walk with a cane, with assistance, and some leg braces,” November 2019

preference?

• Can they afford home health?

• Do they have long-term care insurance?

“I think many of us are culturally uncomfortable with growing old,” said Camden Frost, a former caregiver. “I hope we continue to work toward changing these negative attitudes and perceptions about aging.”

Conversations about aging normalizes aging and empowers families to quickly respond to age-related needs and issues when they arise. Most families don’t talk about potential aging needs, challenges and preference until after a health care emergency.

This sets up a dynamic where a family member must figure out how to respond to the immediate health care emergency and everything else from finances and perhaps even caregiving

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Houston Medical Times

Page 17

Take one tablet daily to view the CME courses you want.

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ADDRESSING ACEs: Learn how to identify, treat and reduce the effects of trauma and toxic stress and reinforce resiliency in young patients. Earn ethics CME.

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Join more than 100,000 medical professionals who get free CME with Texas Health Steps Online Provider Education. Choose from a wide range of courses relevant to your practice, including short tutorials and podcasts on topics like Medicaid guidelines, ethics and mental health — all available 24/7.

Learn more at TXHealthSteps.com.

PRECONCEPTION AND PRENATAL HEALTH: Integrate best practices for preconception health care and counseling into preventive medical checkups.

Content on the Texas Health Steps Online Provider Education website has been accredited by the Texas Medical Association, American Nurses Credentialing Center, National Commission for Health Education Credentialing, Texas State Board of Social Worker Examiners, Accreditation Council for Pharmacy Education, UTHSCSA Dental School Office of Continuing Dental Education, Texas Academy of Nutrition and Dietetics, Texas Academy of Audiology, and the International Board of Lactation Consultant Examiners. Continuing Education for multiple disciplines will be provided for some online content.

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November 2019

Page 18

Heart Walk

Continued from page 1 increase by two hours. Walking can also help you think better, feel better and sleep better. You can reduce your risk of heart disease, stroke, diabetes and several types of cancer.

Enjoy increased energy and stamina.

Improve your mental and emotional well-being and reduce your risk of depression.

You want to be Healthy for Good.

And we want to help, with science-based

Texas Children’s Continued from page 4

cardiology fellowship at Baylor. He is board certified in pediatric cardiology, adult cardiology and adult congenital heart disease. Ermis is a fellow in the American College of Cardiology and member of the American Academy of Pediatrics, Texas Heart Institute Cardiac Society and the International Society on Adult Congenital Heart Disease.

Hickey, a recognized leader in cardiovascular surgery, most recently served as associate professor of cardiac surgery at the University of Toronto and cardiac surgeon and chief of the ACHD

Marketing Essentials

Continued from page 12 like what they see, they may seek out a second option.

Your competition is changing Depending on your area of specialty, the competition surrounding your practice or hospital is likely a lot different than it was just 10 or 15 years ago.

Primary care doctors and some other specialties are competing with urgent care clinics, including those in retail locations like a CVS. Urgent care clinics now compete with telehealth apps on mobile devices. If you want to keep patients in your practice or hospital, you have to create an experience of care

TIRR

Continued from page 14 Today, as TIRR Memorial Hermann celebrates its 60th anniversary, the hospital is ranked the best in the southern half of the United States, according to U.S. News & World Report’s annual listing of Best Hospitals for Rehabilitation. The hospital has ranked among the top five November 2019

Houston Medical Times

information and you-based motivation.

Healthy for Good is a movement of everyday people everywhere who are committing to improve their health in simple, innovative and substantial ways.

Lace up your shoes and join the movement. Commit to building a healthier you and a healthier Houston by Heart Walking with us on Saturday, November 9. Sign up today at houstonheartwalk.org. Follow us on social media – @ahahouston – and post a picture of your Healthy for Good activities with the hashtag #houstonheartwalk. 

HOUSTON

Published by Texas Healthcare Media Group Inc. Director of Media Sales Richard W DeLaRosa Senior Designer Jamie Farquhar-Rizzo Teresa Carroll

program at The Hospital for Sick Children. In addition to his leadership role, he will also perform congenital heart surgeries and serve as associate professor of surgery at Baylor.

“I’m thrilled to join Texas Children’s and lead the ACHD Program alongside Dr. Ermis,” said Hickey. “Treating these unique patients requires dedication from an entire team and it is evident Texas Children’s is paving the way in this field. I’m looking forward to joining this innovative and collaborative group as we continue to develop tailored approaches for our patients.”

Hickey received a bachelor of medicine degree from the University of

Southampton in the U.K., where he also completed his general surgery residency.

He went on to complete higher surgical training in cardiothoracic surgery and simultaneously earned his doctorate of medicine research thesis from Oregon Health & Science University and the University of Southampton, respectively. Hickey then received the John Kirklin Fellowship from the Congenital Heart Surgeons’ Society, University of Toronto and spent two years at The Hospital for Sick Children.

He also completed residency training in cardiovascular surgery at the University of Toronto followed by a clinical fellowship in congenital heart surgery. 

that keeps them coming back and is competitive with these modern healthcare environments.

Losing a patient is expensive

According to Vitals, 30% of patients have simply left a doctor’s office because they were dissatisfied with the wait time. In some cases, the cost of acquiring a new patient can be a couple hundred dollars— worth it when you consider the lifetime value of that patient, but not if you lose them!

And when one patient leaves, you miss out on the opportunity for several more patients. This includes their family and friends and, of course, several people reading your negative reviews.

What can you do to reduce the wait?

It may be time for an audit of

your systems and processes. Think about what you could do to really streamline appointments and make sure everyone is in and out in as little time as possible. Could you…

• Automate check-ins or keep these online?

• Keep better estimates of the amount of time needed for certain times of appointments?

• Text patients when you’re running behind and allow them the option to reschedule?

Best of all, listen to your patients and their needs. Even if you fall behind in scheduling, your patients will appreciate transparency and your willingness to fix the issues over time. https:// healthcaresuccess.com

in the country in all but three years since the magazine began publishing the list 30 years ago.

TIRR Memorial Hermann’s footprint has grown outside of the Texas Medical Center and now includes inpatient rehabilitation at TIRR Memorial Hermann The Woodlands Medical Center and TIRR Memorial Hermann Greater Heights, as well as six outpatient centers.

“The lives we touch every day have all shaped TIRR’s first 60 years and are part of our story,” Ashworth said. “TIRR Memorial Hermann will remain committed to raising the bar in advocacy, clinical care, research and education to improve and address the needs of people living with disabilities.”

To learn more about TIRR Memorial Hermann visit www.tirr. memorialhermann.org. 

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Web Development Lorenzo Morales Distribution Robert Cox Accounting Liz Thachar Office: 713-885-3808 Fax: 281-316-9403 For Advertising advertising@medicaltimesnews. com Editor editor@medicaltimesnews.com

Houston Medical Times is Published by Texas Healthcare Media Group, Inc. All content in this publication is copyrighted by Texas Healthcare Media Group, and should not be reproduced in part or at whole without written consent from the Editor. Houston Medical Times reserves the right to edit all submissions and assumes no responsibility for solicited or unsolicited manuscripts.

All submissions sent to Houston Medical Times are considered property and are to distribute for publication and copyright purposes. Houston Medical Times is published every month P.O. Box 57430 Webster, TX 77598-7430

Houston Medical Times

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Page 19

November 2019

Houston Medical Times

Setting the pace for cardiovascular care in Greater Houston.

At Memorial Hermann, our team of world-renowned, affiliated heart physicians provides innovative cardiovascular care – from revolutionary new medications, to minimally invasive procedures for correcting atrial fibrillation or repairing heart valves to innovations in heart and lung transplants. These cutting-edge solutions are less traumatic and aim to reduce a patient’s pain and recovery time. Our innovations are putting Memorial Hermann at the forefront of advancing heart health in Greater Houston and helping our patients lead a better quality of life.

Learn more about heart care at heart.memorialhermann.org

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