Health Care News Updates

Protecting knees now might prevent pain later

Taking a few small steps toward protecting your knees when you are younger might help you avoid debilitating problems when you get older.

Studies have shown that nearly half of adults will get knee arthritis in at least one knee by age 85. For obese people, the risk is even greater.

“Every time you take a step you apply three times your body weight to the knee,” said Dr. William J. Bryan, an orthopedic surgeon with the Methodist Center for Sports Medicine in Houston. “When you run it’s five times, when you jump it’s seven times. If you are experiencing frequent knee pain, lifestyle changes might be in order.”

More than 30 percent of Americans are considered obese.  Carrying additional weight on your frame puts great strain on the knee joint.

“What most people don’t understand about weight loss is that it’s 70 percent diet and 30 percent exercise,” Bryan said. “If you think you can eat the same and exercise the pounds away, you are mistaken. You have to change your attitude about the refrigerator for weight loss to happen.”

Exercises like swimming, cycling and other low-impact options better protect your knees than running or aerobics. Strengthening your core muscles (abs, back and pelvis) is another key component of maintaining healthy knees.

“If you have a strong core, you can better position your foot or knee on the ground to prevent damage,” Bryan said. “This is true whether you are exercising or performing mundane tasks such as getting out of the car and walking down the stairs.”

Orthotics are also very important. If your shoes do not give you a stable base of gate when you put your foot on the ground, it will cause abnormal stress on the knee. Bryan says he has many patients whose knee pain has improved dramatically after purchasing orthotics or by having shoes specifically made to fit their feet.

“If you have knee pain that has lasted more than two weeks, you need to see a doctor because there might be something mechanically wrong with the knee,” Bryan said. “Making a few lifestyle changes might give you a better chance at staving off arthritis and/or an eventual knee replacement.”

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Methodist, Astros host Cancer Survivors Day on July 25

The Houston Astros have teamed up with LIVESTRONG and the Methodist Cancer Center to bring Cancer Survivors Day to Minute Maid Park during the 1:05 p.m. Astros game vs. the Cincinnati Reds on Sunday, July 25th. Cancer Survivors Day, the first Astros game of its kind, will celebrate the lives of those affected by cancer while generating needed funds for cancer research.A portion of the tickets purchased at www.astros.com/survivor will benefit LIVESTRONG and the Methodist Cancer Center.  Groups of 20 or more that would like to attend the game and support the cause should contact Joe Schiavi at 713-259-8314 or jschiavi@astros.com.  In addition, the first 10,000 fans at the game will receive a free LIVESTRONG bracelet courtesy of LIVESTRONG. All fans are encouraged to show their support by wearing yellow.

In America alone, there are over 11 million people living with a history of cancer. Individuals that have survived a cancer diagnosis are invited to share their victory story and by doing so have the chance to be selected for special in-park recognition. Fans may e-mail their stories or those of their loved ones to Nicky Patriarca, one of the Astros Cancer Survivor Day coordinators, at npatriarca@astros.com.

ABOUT LIVESTRONG

LIVESTRONG began in 1997 as the Lance Armstrong Foundation following the preeminent cyclist’s diagnosis with advance testicular cancer at the age of 25. The foundation believes that unity is strength, knowledge is power and attitude is everything. The charity’s programs, awareness events and advocacy work are the heart of the foundation’s efforts and the organization’s leaders and donors provide both the vision and the support for LIVESTRONG.

ABOUT METHODIST CANCER CENTER

The Methodist Hospital is an internationally recognized leader in cancer care, offering revolutionary methods of cancer prevention, diagnosis and treatment from leading medical professionals. Support from The Methodist Hospital Research Institute, as well as medical and research institutions worldwide, provide clinically proven, innovative diagnosis and treatment options to patients as soon as they are available. Methodist Cancer Center also offers patients access to participating in federally and privately funded clinical trials.

The Methodist Cancer Center website

The Methodist Hospital System website

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Receptionist becomes first Methodist employee to reach 50-year milestone

Rosemary Moreno is unique among employees of The Methodist Hospital - for one thing, she’s the only employee who has ever destroyed a building.

But Moreno is even more unique because she has worked at the hospital for 50 years, and is the first Methodist employee to reach this milestone.

“You know, it’s really hard to believe,” says Moreno, receptionist for the Ophthalmology Surgery Post Anesthesia Unit. “But to be honest, after about 20 or 30 years it all kind of runs together.”

National statistics say the average American employee works about 260 days a year. Figure that into Moreno’s half-century of service, and you get 104,000 hours. Tell this to Moreno, and she laughs.

“It’s a good thing, because when I started working here I made 75 cents an hour!” she says.

Her first day of work was June 1, 1960. The Methodist Hospital was contained in one building - now the hospital campus’ Main building. Moreno started work as a processor for the ophthalmology surgery department.

“A processor means I helped get the equipment and trays ready for surgery,” she explains. “We sterilized the tiny needles used in eye surgery, and we made saline solution from distilled water.”

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Getting your medications ready for an emergency takes planning

To help you get medically ready for an emergency, we talked to some of our experts at The Methodist Hospital about how does one obtain extra refills of medication.

Readers responded to the post on this blog and on Facebook with the following comments:

“What about all other medication when you go to get a refill and the pharmacies cannot fill it because the dang insurance companies will not let you renew a prescription until you have a few pills of a perscription left. I have been running into this problem since I take so many meds because I had a double lung transplant.”

“What about my insulin? I threw out a lot after Ike hit.”

We talked to our pharmacy experts at The Methodist Hospital and they told us that getting an emergency supply of medications, like all preparedness, takes some advance planning. You should check to see if your insurance plan has a special provision for hurricane coverage. If not, patients will have to pay out-of-pocket for an emergency supply. To hold down costs, you may want to get only an extra week’s supply to get you through the emergency.

Some insulin can be purchased over the counter while others require prescriptions. If there is a refill left on the insulin prescription, you can refill it without requiring another prescription. Talk to your doctor about an emergency supply - BEFORE an emergency threatens.

Some other things to keep in mind:

• Some people skip doses of their medication in order to create an extra supply of drugs. Skipping doses is not safe. You need the exact amount of medicine prescribed by your doctor to keep you healthy.

• If you store an extra supply of your medicine in your emergency kit, it could go out of date before you need it. Be sure to check expiration dates often if you are keeping prescription or over-the-counter drugs in your emergency kit.

• An alternative is to carry your prescriptions with you at all times. This is very impractical. You cannot carry medicines that need to be refrigerated (such as insulin) or that have other special storage needs. Do not store medications in your car’s glove box. Your car gets too hot in the summer and too cold in the winter, which can change how your drugs work.

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Do some “health care” planning before a hurricane hits

People with medical conditions should think ahead before a hurricane … If you have special medical needs, plan your evacuation before a hurricane hits.

Dr. Jeff Kalina, associate director of emergency medicine with The Methodist Hospital in Houston, says it’s important to have extra refills of medications in case the storm forces stores to close down for a number of days. Also, if you have to go to the hospital, it’s good to have a list of your medical conditions, medications and allergies written down. This will make it easier for physicians to diagnose your condition quickly.

Elderly need special care during hurricane evacuation

If you have to get elderly relatives out of the way of an impending hurricane, keep in mind they will need some extra attention during the evacuation.

Kalina says putting an older person in the back of a car in the middle of summer puts them at risk for heat exhaustion and dehydration. He says it’s imperative to have plenty of water and, if possible, ice or some kind of a fan that can cool them off if traffic comes to a standstill. During the Houston evacuation of Hurricane Rita in 2005, a number of elderly people died in their cars from the intense heat.

Sitting in a car for hours also puts an older person at risk for deep vein thrombosis or DVT. This is a condition where blood clots form in the deep veins of the lower legs and thighs and is caused by sitting in a car for long periods of time. The clot can travel unnoticed through the blood stream and lodge in the brain, heart, lungs or other areas causing severe damage to some organs, and in some cases, death. It’s important that everyone, but especially the elderly, get up and walk around at least every two hours.

Kalina urges everyone to evacuate early if they are in the evacuation zone to try and avoid being stuck on the road with nowhere to go.

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Women shouldn’t fear colonoscopies

Despite doctors’ recommendations to undergo a colonoscopy beginning at age 50, the “yuck” factor keeps many women from getting one to detect colon cancer, the second leading cause of cancer death in the United States.

“Women are usually not comfortable with the nature of the procedure and some are horrified when it comes to discussing their bowel habits,” Dr. Karen Woods, a gastroenterologist with The Methodist Hospital in Houston. “Although the disease is 90 percent preventable if polyps are detected early, fewer than 30 percent of women over age 50 get a colonoscopy. Despite recent reports to the contrary, a colonoscopy is still the best way to find colorectal cancer.”

Approximately 15 to 20 percent of women who undergo colonoscopies for their initial screening exam will have pre-cancerous polyps, so a physician’s detection rate of polyps should be at least that or higher. It’s important for women to be informed and not just pick a doctor out of the phone book or off the Internet when considering getting a colonoscopy. Recent research has shown that an inexperienced doctor can lead to less than perfect outcomes.

“Women need to ask a lot of questions before undergoing a colonoscopy,” Woods said.

“They need to know if the doctor is board certified in gastroenterology or colorectal surgery and a highly trained endoscopist; how many colonoscopies they have performed, how long they spend withdrawing the scope and looking for polyps and how often they get to the end of the colon.”

A recent Canadian study found that the test missed almost every cancer in the right side of the colon and missed a third of cancers in the left side of the colon. However, approximately 70 percent of the procedures in this study were not done by a gastroenterologist, but instead by internists and family practitioners who might lack the experience to do the test properly. This is why it’s important to make sure you find a physician who has a wealth of training and experience, she said.

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Type 2 diabetes rears its ugly head long before diagnosis

Signs and symptoms of type 2 diabetes can present themselves as long as ten years before diagnosis and most people have no idea about the damage being done.

“Diabetes damages blood vessels slowly over a period of time, much like termites roaming through the crevices of your house,” said Dr. Dale J. Hamilton, director of the Diabetes Heart Program at The Methodist Hospital in Houston. “Most people have no idea how serious these problems are until it’s too late.”

Type 2 is a condition where the body does not produce enough insulin and the cells ignore the insulin. Insulin is essential for the body to be able to use glucose for energy. When we eat, the body breaks down all of the sugars and starches into glucose, which is the fuel for the cells in the body. When glucose builds up in the blood instead of going into the cells, over time, you will begin to see damage to the heart, kidneys, nerves and eyes. Type 2 is the most common and fast-growing form of diabetes. The risk factors include:

• Blood pressure higher than 130 over 80.
• Waist line bigger than 35 inches in women, and 40 inches in men.
• HDL or “good” cholesterol less than 40 in women, and 50 in men.
• Triglyceride levels over 200.
• Fasting glucose over 100.

Some experts believe replacing sugar with high fructose corn syrup in processed foods in the United States and Canada in the 1990s has played a role in the rise of type 2 diabetes cases. High fructose corn syrup is made by changing the sugar in corn starch to fructose, another form of sugar. It has become popular because it extends the shelf life of processed foods and is cheaper than sugar. It has also become a popular ingredient in many sodas and fruit-flavored drinks.

“The problem with high fructose corn syrup is that it promotes central obesity or a big stomach, one of the major factors in type 2 diabetes,” Hamilton said. “Another problem with it is that it fools your body into thinking you are hungry. I don’t think you need to eliminate it from your diet, you just need to be aware of how much of it you are consuming on a daily basis because too much can lead to serious weight gain.”

There are some ways to rid your body of type 2 diabetes:

• Exercise at least 30 minutes at a time, five days a week.
• Lose weight.
• Talk to your doctor about medication to lower your triglycerides and LDL cholesterol.

Most patients with diabetes die from heart and blood vessel related problems, in particular heart attacks and strokes. Diabetes, the underlying cause,  is all to often undertreated. It causes no pain per se.  “Having three or more of the risk factors associated with type 2 diabetes over an extended period of time is the equivalent of already having a heart attack,” Hamilton said. “These risk factors need to be treated aggressively in order to curb the problem and give you a better chance at a longer, healthier life.”

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Methodist Sugar Land is first in Fort Bend to perform rotational atherectomy

SUGAR LAND - Cardiologist Sherman Tang, M.D., recently performed Fort Bend County’s first-ever rotational atherectomy at Methodist Sugar Land Hospital.

The procedure uses a tiny rotating burr that is coated with microscopic diamond crystals to safely remove plaque from narrowed or blocked arteries.  The burr is attached to a thin guidewire and is inserted into the artery via a catheter.  Dr. Tang guides the burr to the blockage using an X-ray camera and an angiogram.

“Rotational atherectomy is a proven technology that ablates, or sands away, the diseased plaque in an artery with minimal side effects and without impacting healthy tissue,” says Dr. Tang.  “It is like drilling a tunnel through the blockage.”

The diamond-coated burr is powered by air, and can be set at speeds of up to 180,000 revolutions per minute.  As the rotating tip moves through the narrowed artery, it scrapes away diseased plaque from the artery walls.  Those plaque particles are smaller than red blood cells and are harmlessly carried away and eliminated by the body’s circulatory system.

Patients undergoing a rotational atherectomy often receive a stent, or narrow metal tube, at the location of the blockage to keep it from closing.

The procedure takes about two hours, and patients can be up and walking within six hours. “We keep the patient overnight for observation but most can go home the next day, and return to work within a couple of days,” says Dr. Tang.

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Social networking sites can lend support to those trying to slim down

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Every day millions of people use social networking sites like Facebook and MySpace to connect with old friends and find new ones. These types of sites can also make dieters more successful.

“When we embark on a weight loss program we want encouragement, motivation and results. Websites offer so many opportunities to track the sorts of information we know helps keep our weight in check,” said Stefanie Barthmare, a licensed professional counselor with The Methodist Weight Management Center in Houston. ‘These social networking sites are a perfect place for people to record their progress, find others in the same boat or join weight loss groups. There are also blogs and chat rooms where people can swap recipes, share stories and goals or just offer support.”

A recent survey by Nielsen Online found that one in 11 minutes spent online around the world is devoted to social networking and blogging sites. Facebook, MySpace Twitter and Linkedin, to name a few, have millions of subscriber. Blogs also offer another great way for people to find information and support without having to get in your car and go to a meeting, she said.

“When we diet we tend to stick with the same things; the same food, the same support group, etc. This is why many people fall off the wagon a couple of months in,” Barthmare said. “It can be motivating to see your friends on one of these sites losing weight. It can push you to work harder and stay focused. The group dynamic when it comes to weight loss is very important and I think these types of sites really offer a new and exciting way for people to connect and support each other their way to a healthier body.”

Some good weight loss blogs include: http://weightloss.mymethodistblog.com, http://askcharles.mymethodistblog.com, www.hungrygirl.com, and www.sparkpeople.com. For more information about The Methodist Weight Management Center, log on to www.methodisthealth.com or call 832-667-LOSE (5673).

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Don’t rely on water alone when exercising in heat

Water is essential when exercising in the heat but it might not be enough to keep you healthy in Houston summers.

“Ten or 15 years ago we told everyone to drink as much water as possible to replace fluids. Now we know that is not such a good idea,” said Dr. James Muntz, an internist with The Methodist Hospital in Houston. “Water is important, but sports drinks, might be more important.”

Sports drinks contain electrolytes, like potassium, magnesium, etc, and help replace the salt and water lost in sweat when exercising heavily, Muntz said.

“Electrolyte drinks provide energy in the right quantities, so you don’t get sick,” Muntz said. “The carbohydrates, sodium, and potassium help move fluids out of the body and to the muscles, where it needs to be when we are working out in the heat.”

While was water is still important, drinking too much water in a short period of time can lead to a condition called hyponatremia, which occurs when you have low sodium in your body. When sodium levels drop in the fluids outside the cells, water will get in there and attempt to balance the concentration of salt outside the cells. The abundance of water causes the cells to swell. Most cells can adapt to the change, but the brain cannot. When this occurs less than 48 hours after exercising, in extreme cases it could be fatal if not treated immediately.

Symptoms of hyponatremia include; vomiting, loss of appetite, headache, restlessness/fatigue, abnormal mental status (hallucinations, confusion, etc.), muscle weakness and convulsions.

Other factors to keep in mind when exercising in the heat include:

• Make sure you are sweating properly. If you stop sweating when you are exercising you are dehdydrated.
• If you realize your pulse rate in the morning is 10 to 15 beats higher than your normal rate, you should take the day off from exercising. Normal pulse rate is around 70-90/ minute.
• Get acclimated to the heat before you begin an exercise regimen. Start off with 15 minutes and slowly work your way up to 45 or an hour.
• Forget about the “no pain, no gain” mantra. Recognize warning signs and take the appropriate action immediately.
• Avoid exercising between 10 a.m. and 2 p.m., the hottest part of the day.
• Don’t try to diet by sweating. It will only result in water loss, not true weight loss.
• Wear loose-fitting, light-colored clothing, and sunscreen.

“It’s very important to use common sense when you exercise in heat,” Muntz said. “If you follow a few simple rules when it comes to hydration and pay attention to what your body is telling you, you will get the results you are looking for.”

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