Healthnovember 2012

Everything to Gain

ViCkie brown is living life to its fullest after

weight loss surgeryPAge 4

Vickie Brown’s incredible weight loss is setting a

healthy example for the younger generations in

her family, including her daughter Kelsie.

Baylor

reAl patients. reAl stories.

A PAin in your leg?Learn what causes shin splints and how to avoid them PAge 7

Selecting the right ScreeningYour guide to colon cancer exams PAge 3

WAXAhAchie edition

Visit Baylorhealth.com/ Waxahachie for informative videos, interactive quizzes, online event registration and much more.

You know about heart disease—how it’s a product of high blood pressure and high cholesterol levels, and how it can lead to a heart attack. But how much do you know about peripheral vascular disease, or PVD? The answer is, more than you think.

In PVD, the artery wall thickens due to plaque buildup. “It’s the exact same disease process as heart disease. It’s just occurring in an area of the body outside the heart,” says Jepsin Maliyil, MD, a family physician on the medical staff at Baylor Medical Center at Waxahachie.

Who’S At riSk?Anyone at risk for heart disease is also at risk for PVD. Risk factors include:

• High blood pressure• Diabetes• High cholesterol• Smoking or history of smoking• Family history of coronary artery

disease or PVDAnd risk is cumulative. In other words,

the more risk factors you possess, the more likely you are to have PVD.

But having no risk factors doesn’t neces-sarily mean you’re in the clear. That’s why you should alert your doctor if you have symptoms, particularly pain in your legs when you walk that goes away with rest and discoloration or sores that won’t heal.

treAtment oPtionSAs with heart disease, most cases of PVD are treatable or even avoidable with life-style changes.

Baylor Medical Center at Waxahachie, 1405 W. Jefferson, Waxahachie, TX 75165

President: Jay Fox; Senior Foundation Officer, Baylor Health Care System Foundation: Melissa Dalton; Marketing and PR Manager: Julie Martin. Baylor Medical Center at Waxahachie Board of Trustees: Paula Baucum; John Chiles; James D’etienne, MD; Bobby Dyess, Chair; Edwin Farrar; Leroy Fenton; Jay Fox; Todd Fuller; Nancy Hightower; Bill Houston; Mackey Morgan, DDS; Cindy Murray; Jim Pitts; Bonney Ramsey; Paul Stevens; Pam Underwood.

Patient Information and Volunteer Opportunities: 972.923.7000 or 972.935.9095; Giving Opportunities/Baylor Health Care Foundation: 214.820.3136. Visit BaylorHealth.com or call 1.800.4BAYLOR for information about Baylor Medical Center at Waxahachie services, upcoming events, physician referrals, career opportunities and more. Baylor Health Care System Mission: Founded as a Christian ministry of healing, Baylor Health Care System exists to serve all people through exemplary health care, education, research and community service.

BaylorHealth is published six times a year for friends and supporters of Baylor Medical Center at Waxahachie. BaylorHealth is published by McMurry. © 2012 Baylor Health Care System. The material in BaylorHealth is not intended for diagnosing or prescribing. Consult your physician before undertaking any form of medical treatment or adopting any exercise program or dietary guidelines. Physicians are members of the medical staff at one of Baylor Health Care System’s subsidiary, community or affiliated medical centers and are neither employees nor agents of those medical centers, Baylor Medical Center at Waxahachie or Baylor Health Care System. Photographs may include models or actors and may not represent actual patients. If you are receiving multiple copies, need to change your mailing address or do not wish to receive this publication, please send your mailing label(s) and the updated information to Robin Vogel, Baylor Health Care System, 2001 Bryan St., Suite 750, Marketing Department, Dallas, TX 75201, or email the information to robinv@baylorhealth.edu.

“It’s always better to prevent than treat,” Dr. Maliyil says. “Lifestyle modi-fication will be the first thing to do.”

The most important step is to quit smoking. Next, be physically active. Aim for 30 minutes of exercise five days a week or more, but even three days a week has been found to be beneficial,

according to the American Heart Association. Eating a healthy, plant-based diet and taking medication for high blood pressure, high cholesterol and diabetes as necessary also are key.

If a blockage occurs, you may need to undergo a minimally invasive procedure such as angioplasty, stent placement or clot removal. In the event these proce-dures are not possible, bypass surgery may be required.

Beyond the HeartThink plaque buildup only affects your heart? Think again

Do You Have PVD?To find a vascular surgeon on the medical staff at Baylor Waxahachie, visit Baylorhealth.com/Waxahachie heart or call 1.800.4BAylor.

2 BaylorHealth.com

Confused about the different sCreening options out there for colon cancer? Watson Roye, MD, a general surgeon on the medical staff at Baylor Medical Center at Waxahachie, explains the differences.

colonoscopy. Colonoscopy, the pro-cedure in which doctors use a scope to look for lesions or polyps, is the gold standard for colon cancer screening.

Ask an ExpertTo determine the best colon cancer screening strategy for you, talk to your doctor. For a referral to a physician on the medical staff at Baylor Waxahachie, visit Finddrright.com today.

“Even though it’s invasive, if we find a lesion we can often deal with it at that moment and not have to ask someone to come in again,” Dr. Roye says. The test is typically performed under seda-tion, but people often find the prep beforehand—which involves emptying the colon—unpleasant.

Fecal occult blood test. This test, performed in a doctor’s office, looks for blood in the stool. It can be a first warning sign that you might need a colonoscopy.

Barium enema. First, your doctor coats the inside of your colon with barium, then takes X-rays to look for abnormalities. Because it is less accurate than a colonoscopy and polyps can’t be removed during the test, it’s less likely to be used for colon cancer screening.

Screening SAvvyWhich colon cancer exam is right for you?

ct scan (virtual colonoscopy). This test has become less popular in recent years. While it’s fairly sensi-tive, you will need to follow up with a traditional colonoscopy if doctors find abnormalities. Also, many people find it less comfortable than a tradi-tional colonoscopy. Dr. Roye usually recommends CT scans only when someone has areas a traditional colo-noscopy couldn’t image because of anatomical abnormalities.

Why Get Screened?One in 20 Americans will develop colon cancer, making screenings crucial.

“If we find it in its early stages, we can treat it with the scope or a surgical procedure and often no other treatment is needed,” says Watson Roye, MD, a gen-eral surgeon on the medical staff at Baylor Medical Center at Waxahachie.

Also, colon cancer often doesn’t cause symptoms until it’s in advanced stages, so don’t wait for symptoms to appear. Get screened today.

42Texas ranks 42nd among states for the percent of people over age 50 who are screened for colon cancer.Source: American Cancer Society

BaylorHealth.com 3

reAl patients. reAl stories.

Ten pills and one insulin shot. That was Vickie Brown’s daily regimen before

undergoing weight loss surgery at Baylor All Saints Medical Center at Fort Worth. The medication was necessary to manage her diabetes, high blood pressure and high

cholesterol levels, and depression. These days, her medicine cabinet is looking sparse.

“After the surgery, I went back to the doctor and they checked my blood pressure,” says the 54-year-old Fort Worth resident. “When they said 120/60, I got scared. I had never seen my blood pressure that low.” (Her blood pressure was in the healthy range.)

Brown’s health issues were a big part of the reason she opted for weight loss surgery, but so were her fi ve children. “I have a 7-year-old, and there were things I couldn’t do with her because I could hardly walk,” she says. “Now I have a lot of energy. I can go to the mall or the park and walk all day.”

Weight loss surgery isn’t just for looks. It can treat a whole host of medical conditions, including

diabetes and high blood pressure

Vickie Brown (seated) is able to do the things she loves with her family after weight loss surgery. From left: her daughter Kelsie, husband Cleveland, daughter Clevetta and granddaughter JaKayla.

Hear More from VickieTo learn more about Vickie’s weight loss journey, visit Baylorhealth.com/exclusive today.

If you are overweight—80 pounds or more for women, 100 for men—you may qualify for weight loss surgery. You may also be a candidate if you struggle with diabetes, heart disease or sleep apnea. Read on to fi nd out how weight loss surgery might be able to help you get certain chronic conditions under control.

diABeteSMore than 80 percent of people who have type 2 diabetes are overweight or obese.

Brown is just one of many people with diabetes who have benefi ted from weight loss surgery. In fact, two recent studies showed that obese or overweight patients with type 2 diabetes who underwent the procedure fared better than those who stuck to diet, exercise and medicine only.

“Gastric bypass is shown to have a direct eff ect on metabolism and is shown to have a positive eff ect for those with diabetes even before weight loss occurs,” says Sina Matin, MD, medical director of the Baylor Weight Loss Surgery Center at Grapevine.

That’s because the surgery changes the way your body processes food, meaning you don’t absorb all the fat and calories you eat. Many patients, like Brown, are able to stop most or all diabetes medications.

high Blood PreSSureObesity and high blood pressureare markers for heart disease.

Excess weight forces the heart to work harder, which is why high blood pressure and obesity often go hand in hand, says Manuel Castro, MD, medical director of weight loss surgery at Baylor University Medical Center at Dallas.

The reverse is also true—a lower number when you step on the scale can equal a lower number when

you put on the blood pressure cuff . “Management becomes easier, and most people can stop most blood pressure medications,” Dr. Matin says.

And as the pounds come off , weight loss surgery patients fi nd that exercise—a major factor in lowering your blood pressure—becomes easier.

Joint PAinFor every pound gained, you putfour pounds of pressure on yourknees and six on your hips.

Not only can weight loss surgery take the pain out of your joints (by lessening the amount of pressure placed on them), but it also can delay the need for a joint replacement. “And once a person gets a knee replacement, for example, it lasts longer,” Dr. Matin says.

Before the surgery, Brown’s back and knee pain kept her from walking more than a mile at a time. “Now I go four to fi ve miles without stopping,” she says. “It made a big change in my life.”

AdditionAl heAlth BeneFitSWeight loss surgery helps otherconditions you might not expect.

The list of medical conditions that can be treated by weight loss surgery goes on and on, and also includes high cholesterol levels, sleep apnea, acid refl ux, some cases of urinary incontinence and certain types of migraines. It can lower your risk of cancer, heart attack and stroke, and even out hormonal imbalances, too, Dr. Castro says.

And let’s not forget how weight loss aff ects the way we see ourselves and our quality of life.

“Weight loss surgery patients gain the ability to travel again, to go places,” Dr. Matin says. “They have the ability to do things in society that were limited before.”

Sources: American Heart Association, Arthritis Foundation, ObesityinAmerica.org BaylorHealth.com 5

The Right Choice for Weight LossAt Baylor Medical Center at Waxahachie, candidates for weight loss surgery work with their sur-geons to choose the procedure that best meets their needs.

gastric bypass: The stomach is stapled to make a small pouch that’s attached to the small intestine in such a way that fewer calories are absorbed. People who have diabetes or a very high body mass index, or both, might be good candidates for this procedure.

Sleeve gastrectomy: The stomach is stapled to make a small pouch, but the natural connection between the stomach and the small intestine stays in place. Some people prefer the sleeve because it restricts the amount of food you take in but doesn’t change how your body pulls nutrients from that food.

laparoscopic gastric band: An adjustable band is placed around the top part of the stomach to create a small pouch, helping patients feel full sooner. Some people choose this option because the band is reversible and removable.

Your medical history and risk factors play a big role in which oper-ation might be best for you, says Renee O’Daniel, MSN, RN, a certified bariatric nurse and the bariatric coordinator at Baylor Waxahachie. Insurance coverage can also be a consideration, since not all policies cover all types of surgery.

“People considering weight loss surgery can attend a seminar or schedule a one-on-one consultation with one of our weight loss surgeons,” O’Daniel says.

Find Out If Weight Loss Surgery Is for YouTo learn more about weight loss surgery at Baylor Waxahachie or to schedule a consultation, call 1.800.4BAylor.

eVerYone knows that misunder-standings can cause trouble. But miscommunication in a health care setting can lead to serious risks.

That’s why researchers at Baylor Health Care System are joining forces with University of Texas at Arlington and the University of Texas at Dallas (UTD) to study how physicians and nurses can use video game-like simulators to improve communication skills.

“Miscommunication can lead to failure in the delivery of safe care, so it’s extremely important to innovate and develop more eff ective ways to help our clinicians improve their communication skills,” says Yan Xiao, PhD, director of patient safety research at Baylor Health Care System. He is co-leading the Baylor research team with Susan Houston, PhD, RN, FAAN, NEA-BC, director of nursing research at Baylor Health Care System.

Although it’s similar in theory to a video game, the learning tool uses

even more sophisticated technology to create a simulated health care environment. Nurses and physicians will engage in scenarios they might encounter on the job, role-playing in real time to appreciate the perspectives of others.

Participants will control and interact with physician and nurse avatars and master interdisciplinary, patient-centered communication skills. During the training, participants take turns playing both roles.

“We think this perspective-sharing will be instrumental in helping clinicians

understand the best way to communicate interprofessionally,” says Louann Cole, MHA, a research analyst for Baylor’s Institute for Health Care Research and Improvement.

Part of the research has involved in-depth interviews with physicians and nurses, as well as an exhaustive review of communication strategies. This information was synthesized by game developers at UTD.

“Eff ective communication techniques are embedded in the game,” Dr. Houston explains. “You get points for using those techniques when you’re put into a patient situation.”

The researchers hope the three-year study, which is funded by a grant from the Agency for Healthcare Research and Quality, will demonstrate the value of the technology.

“This is a fun and engaging way to learn,” Dr. Xiao says, “and we hope it will help physicians and nurses work better as a team to serve patients.”

Playing to WinBaylor studies gaming technology as a tool for improving communication and patient care

Get in the GameThis study isn’t open to volunteers, but to learn about research trials at Baylor seeking participants, visit Baylorhealth.com/Advancingmedicine.

6 BaylorHealth.com

shin spLints—pain in the lower leg caused by exercise—is a catchall for a lot of diagnoses, including ten-dinitis, inflammation of the lining of the bones in the lower leg and stress fractures. Here, Marc Roux, MD, an orthopedic surgeon on the medi-cal staff at Baylor Medical Center at Waxahachie, answers questions about this common condition.

what causes shin splints?Lots of the time they’re caused by overuse. They are common in soc-cer players and runners, especially runners who are ramping up their training.

how can i prevent shin splints?Make sure you warm up and cool down properly before and after a run, and include both static and dynamic stretching. If you start to have dis-comfort, step back your intensity or

Hurting?For a referral to an orthopedic surgeon on the medical staff at Baylor Waxahachie, visit Finddrright.com or call 1.800.4BAylor.

distance. Buying shoes at a specialty running shop where the staff can match your arch and heel strike to the appropriate shoe can help, too.

how can i treat shin splints?Add more stretching, and massage your leg with ice. If running is causing your shin splints, switch to elliptical training, biking or swimming to main-tain your cardio fitness while allowing your leg to heal. As the pain starts to dissipate, you can gradually add run-ning back again.

what are the signs that shin splints need medical attention?If you’ve tried stretching, ice mas-sage and low-impact exercise and they aren’t working, you’re unable to return to your activities, the pain is worsen-ing or you’re having pain with normal, day-to-day activities and not just exer-cise, you should talk to a doctor.

He or she may recommend dedi-cated stretching work with a physical therapist or trainer, and if you’re not improving you may need an MRI to check for a stress fracture.

eASe your PAinHow to keep shin splints at bay Two Stretches

to Try1. Sit in a chair and put one leg out straight. Flex your toes toward and away from you 10 times. Repeat with the other leg.

2. Stand on the edge of a stair with your heels off the step. Drop your heels below the step, then raise up on your toes. Repeat 10 times.

Having flat feet or rigid arches can make you more prone to shin splints

BaylorHealth.com 7

Baylor Health Care System 2001 Bryan Street, Suite 750 Marketing Department Dallas, TX 75201

NON-PROFIT ORG.US POSTAGE

PAIDBAYLOR HEALTH

Three patients. Three cancers. One hope.

w w w. d a l l a s h o p e . c o m

W FA A c h . 8 At 6 : 3 0 P M

NoV. 8, 15 & 17

• 25.8 million Americans currently have diabetes1

• One-third of Americans with diabetes do not know they

have the disease

• Family history, age, ethnicity, obesity and high

cholesterol are all risk factors

• Diabetes is a result of elevated blood sugar levels. When

measured, 70-100 mg/dL is a healthy blood sugar;

100-126 mg/dL is considered pre-diabetes

• The health of the heart and vascular system, eyes,

kidneys and feet can all be jeopardized by diabetes

It’s important for people with diabetes or those at risk for

the disease to avoid a high-fat, high-carbohydrate diet.

A healthy carbohydrate range for people with diabetes is

30-45 grams per meal for women and 45-60 grams per

meal for men. The typical amount of carbs in a snack is

15-30 grams. Know the facts on what you’re eating. See

the chart at right for carbohydrate counts of some popular

food items.

If you have diabetes, ask your physician, a dietitian, or

diabetes educator to explain your insulin to carb ratio.

Request from your physician a referral to the Diabetes

Education Center for self-management training classes.

1 American Diabetes Association Physicians are members of the medical staff at one of Baylor Health Care System’s subsidiary, community or affi liated medical centers and are neither employees nor agents of those medical centers, Baylor Medical Center at Waxahachie, or Baylor Health Care System © 2012 Baylor Health Care System BMCWAX_289_2012 BHM CE 09.12

Join the conversation online:

Facebook.com/Groups/DiabetesDialogue

DO YOU KNOW DIABETES?Food Item Amount of Carbohydrates

Cheese Dip with Tortilla Chips20g = 2tbsp of dip

& 1oz of chips

Pasta Salad 35g = 1 cup

Creamy Coleslaw 10g = ½ cup

Sandwich Cookie 25g = 1 small cookie

Lean Turkey & Cheese Sandwich on Whole Wheat Bread

24g

Brown Rice 45g = 1 cup

For a physician referral or for more information about diabetes services in Waxahachie, call 1.800.4BAYLOR or visit us online at BaylorHealth.com/WaxDiabetes

1405 West Jefferson Street, Waxahachie, TX 75165