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NOVEMBER 19 | 2015 | DEFENDER
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Defender Special Edition
MENTAL HEALTH MATTERS M
By JASEMINE KNOWLES Defender
ental illness has long had a stigma attached to it in the African-American community. Because of the shame attached, AfricanAmericans may be reluctant to discuss mental health issues and seek treatment. According to the Department of Health & Human Services, African-Americans are just as much at risk for mental illness as their white counterparts, but fewer of them (25 percent) seek mental health care compared to whites (40 percent). Why do so many African-Americans suffer in silence? Dr. Michael L. McClam, a psychiatrist at the Menninger Clinic in Houston, said the disparity exists because of four factors: less access to appropriate health care and financial resources, lack of knowledge and awareness, a lingering suspicion of the medical community (since the large majority of physicians are not African-American) and the belief that mental health is not an issue. “Many African-Americans may feel that culturally, mental health is not an issue that affects them,” McClam said. “Many may go to the church or seek spiritual counseling for what could be considered a mental health concern that requires special medical attention.” He said the most common mental health issues facing the African-American community reflect the broader population – depression, anxiety, bipolar illness, substance abuse, and schizophrenia. McClam added that most of these mental disabilities may stem from life stressors such as relationship problems, traumas, financial and racial issues, and problems at work. Although many African-Americans may seek prayer as a solution for the many stressors in their lives, relying solely on faith undermines the need for proper diagnosis and care. Because the church is the most powerful instrument within the Black community, it becomes the place for refuge and treatment. McClam said one way to promote a better understanding of mental illness and health among Blacks is by starting with the church. “If the [church] leadership is aligned with a more positive view of using community or medical resources along with the spiritual counseling, then Blacks may get a better understanding and seek help,” McClam said.
McClam added that outside of the church, there are a number of places where African-Americans, specifically those who are low-income, can get help for mental illness. “People can turn to the Depression and Bipolar Support Alliance or the Harris Health System, which has a huge network of outpatient clinics that have great mental health professionals,” said Dr. McClam. “Also, if the person is a veteran, the VA Hospital is helpful.” In addition to the Menninger Clinic (www.menningerclinic.com, 800-351-9058), other mental health resources include: • Harris Center for Mental Health & IDD (formerly
MHMRA), www.mhmraharris.org, 713-970-7000 • Mental Health America of Greater Houston, mhahouston.org, 713-523-8963 • DePelchin Children’s Center, www.depelchin.org, 713-730-2335 • National Alliance on Mental Illness, www.nami.org, 800-950-6264
Facts & figures • Mental illness is a condition that impacts a person’s thinking, feeling or mood and may affect his or her ability to relate to others and function on a daily basis. Each person will have different experiences, even people with the same diagnosis. • Poverty level affects mental health status. African-Americans living below the poverty level are three times more likely to report psychological distress. • Whites are more than twice as likely to receive antidepressant prescription treatments as are Blacks. • The death rate from suicide for AfricanAmerican men is almost four times that for African American women. • African-Americans and Hispanics use mental health services at about one-half the rate of whites and about one-third the rate of Asians. • Fifty percent of mental health conditions begin by age 14 and 75 percent develop by age 24. The normal personality and behavior changes of adolescence may mimic or mask symptoms of a mental health condition. • An estimated 26 percent of homeless adults staying in shelters live with serious mental illness and an estimated 46 percent live with severe mental illness and/or substance use disorders. • Approximately 20 percent of state prisoners and 21 percent of local jail prisoners have a recent history of a mental health condition. • Seventy percent of youth in juvenile justice systems have at least one mental health condition and at least 20 percent live with a serious mental illness. Sources: National Alliance on Mental Illness, U.S. Department Health & Human Services
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DEFENDER | NOVEMBER 19 | 2015
health
Meeting youths’ mental health needs
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By AMBER VERNON
aising healthy children and teens is not just about their physical well-being, but includes their mental health too. Mentally healthy children have a positive quality of life and can function well at home, in school and in their communities. Yet according to the National Institute of Mental Health, 20 percent (or 1 in 5) children either currently or at some point during their life have had a seriously debilitating mental disorder. In Houston, Texas Children’s Hospital offers a variety of services for youths’ mental health. The hospital’s clinic treats a range of conditions, including attention deficit hyperactivity disorder (ADHD), autistic spectrum disorders, anxiety, mood disorders, tics, Tourette’s syndrome and psychological symptoms that occur with other medical conditions. The clinic provides access to pediatricians, child psychiatrists and other mental health professionals. Services include: Assessment of attention-related difficulties -Provides evidence-based assessment of attention-related disorders, including ADD and ADHD. A clinician meets with the child and their family and gathers additional information, such as parent and teacher rating scales, report cards, and prior evaluations. Following the interview, the family receives feedback, including a review of the findings, education on any diagnoses, and discussion of an individualized treatment plan. Child & Adolescent Bipolar Disorders Program – Uses a comprehensive approach in
the evaluation and management of children and adolescents with bipolar disorder. Each patient and their family members will receive a treatment plan including medication management and family therapy focused on education, skill building, communication training, and problem-solving techniques. Anxiety Disorders Program – Provides an evaluation and therapy for children and adolescents. The ADP treats generalized anxiety disorder, obsessive compulsive disorder, social phobia, specific phobias, separation anxiety, trichotillomania, selective mutism, panic disorder, health anxiety, depression, and dysthymia. . Interventions are either individual-focused with significant family involvement or conducted via a family-based approach. Disruptive Behavior Disorders Program – Serves families of children with behavioral and
emotional symptoms. Disorders include ADHD, oppositional defiant disorder, disruptive behaviors, and other conditions that affect social, emotional, cognitive and behavioral functioning. Learning Disability Program – Provides comprehensive assessment of academic skills related to reading, math, written language, and handwriting for children and adolescents whose learning problems do not result primarily from a medical condition. Evaluation also includes assessment of neurocognitive strengths and weaknesses such as phonological processing, language, attention, and memory that underlie and support the development of academic skills. Neuropsychological Evaluation – Provides assessment of the cognitive and behavioral effects associated with injuries to, or diseases involving, the brain. Such information is useful in determining whether or not a neurological condition is present, providing localizing information, tracking recovery or progression of a neurological condition, and evaluating strengths and weaknesses. Pediatric Health Psychology Program – Serves children and families who are having difficulty coping with a chronic medical illness or an unintentional injury, or adhering to a medical regimen. Intervention includes inpatient and outpatient therapy, psychosocial risk screening, comprehensive assessment, and consultation and liaison services within the hospital setting. Primary Care Psychology Program – Extends behavioral and mental health services to patients and families within their pediatrician’s clinic. Services at participating Texas Children’s Pediatric Associates clinics are brief in nature and intended to address children’s problems at their early stages and prevent future problems.
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Inside The emotional impact of cancer 3B Memorial Hermann
Seminars discuss Advantage plans and benefits 4B Coping with mental challenges 6B Texas Children’s Hospital
Neuropsychological testing for concussions helps athletes 8B MD Anderson Cancer Center
Myth busters: HPV and cancer 10B Kelsey-Seybold Clinic
Diabetes rises among African-Americans 12B
Message from the Publisher
Sonceria Messiah-Jiles
We often joke about certain people being “crazy,” but mental illness is no laughing matter. It is a serious issue in our community and we must do something about it. Mental health includes our emotional, psychological and social well-being. It helps determine how we relate to others, how we make choices and how we handle stress. It is important at every stage in life, whether you are 8 or 80. To shed light on mental health matters, the Defender presents this special health edition, which looks at the problem and the solutions. We examine the stigma of
mental illness in the Black community, and provide information on children’s mental health needs. We offer insight into the emotional impact of cancer. We provide tips on coping with the most common mental health challenges. We are also pleased to include important health information from our partners – Kelsey-Seybold Clinic, MD Anderson Cancer Center, Memorial Hermann Health System and Texas Children’s Hospital. Our well-being determines the quality of our lives, and the message is clear; our mental health is just as important as our physical health.
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NOVEMBER 19 | 2015 | DEFENDER
health The emotional
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impact of cancer By JASEMINE KNOWLES Defender
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early 14 million Americans alive today have faced a diagnosis of cancer and the impact on Blacks is especially critical. According to the American Cancer Society, about 1 in 2 Black men and 1 in 3 Black women will be diagnosed with cancer in their lifetime. In addition to affecting your physical health, a cancer diagnosis can spill over into your emotions and impact the way you feel, think and act. Wendy Griffith, a senior social work counselor at the University of Texas MD Anderson Cancer Center, said reactions vary by patient, and emotions can include apprehension about body image after treatment, periods of anxiety, depression, sadness, disbelief, unhappiness, fear and worry. “Some patients may even feel a sense of guilt or shame and blame it on a behavior that may not actually be directly linked to their cancer,” Griffith said. She used lung cancer as an example. Though smoking is the strongest risk for lung cancer, some patients who never smoked contract the disease. “When patients have lung cancer, even if they didn’t smoke at all, there is a sense of shame that they may get when they tell people,” Griffith said. “Or if lung cancer patients did smoke, they tend to feel guilty for smoking and wish they hadn’t.” The American Cancer Society notes that cancer is not a death sentence, and people with cancer are living longer than ever. However, some patients struggle with maintaining hope. “Finding hope is a skill you have to work on,” Griffith said. “Once you start to find things to be grateful for, including the teeniest tiniest things, then you start seeing it everywhere.” Griffith suggested that patients find one thing a day to be grateful for, such as “not feeling pain for an hour, your child’s birthday, your anniversary next week, or even how you did your hair today.” Griffith said patients can also struggle emotionally after treatment, a crucial time when support from family and friends is needed.
Helpful hints
Here is more advice on coping with a cancer diagnosis from MD Anderson. Get informed – Be an active participant in your health ca re. Ask about your diagnosis and tre atment plan, including side effects to expect. If you have trouble remembe ring to ask questions, write them down and take them to your appointment. It als o helps to have someone accompany you to appointments so you have a se cond set of ears. Get organized – Many patients organize their health info in a binder. It can include importa nt numbers, names and addresses of your providers and a calendar with sch eduled appointments.
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“Family and friends tend to think because the treatment is over, things are going to go back to normal,” she said. “But the patient’s life may never be normal again. Patients still need support because there might be a fear that every headache or fever means something is wrong, and they will worry that the cancer is going to come back.” Griffith said besides family support, a patient may opt to speak with a social worker, counselor or therapist. There are also numerous cancer support groups, including patient matching programs to match that patient with someone else who has gone through the same treatment. In addition, doctors may recommend light exercise, acupuncture, hypnosis, eating certain foods, or aroma and massage therapy.
Adopt a policy of open communication – Keep family an d friends informed and involved . Appoint an information chief so that you are not always answering the same questions over and over. Or, start a blog to keep everyone updated. As k a friend to make you dinner or ask an old er child to take out the trash. Maintain a routine – Re gaining a sense of control and no rmalcy is important as you adjus t to new demands. Remain involv ed with work and leisure activities as much as you can. Maintain a healthy lifestyle to boost energy and improve qu ality of life. Focus on self-care – Se t aside time for yourself. Practice rel axation techniques and conside r journaling to help relieve stress and express emotions in a healthy way. Nurturing your spiritual health thr ough prayer and meditation can be bene ficial as well.
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DEFENDER | NOVEMBER 19 | 2015
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health
Seminars to discuss Memorial Hermann
Advantage Plans and Benefits
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By MEMORIAL HERMANN
emorial Hermann Health Solutions has launched a series of weekly seminars to discuss the benefits of its Memorial Hermann Advantage HMO and PPO plans in conjunction with the start of the Annual Election Period (AEP). Last year, Memorial Hermann Health Solutions contracted with the Centers for Medicare and Medicaid Services (CMS) to offer Memorial Hermann Advantage plans to Medicare beneficiaries throughout Harris, Fort Bend and Montgomery counties. “With the Memorial Hermann Advantage HMO and PPO plans, enrollees will have the reassurance of knowing our plans are backed by a full-service, clinically-integrated health system that has been dedicated to advancing the health in this region for more than 100 years,” said Debra Baverman, Business Development Officer, Government Programs, Memorial Hermann Health Solutions. “In this changing healthcare environment, enrollees need peace of mind that we are committed to their care. “Considering all of the various Medicare insurance coverage plans out there, it’s a huge decision to select one that best fits your needs,” Baverman continued. “However, enrollees should rest assured knowing that the Memorial Hermann Advantage plans are supported by the largest health system in the region giving them access to more than 5,000 affiliated doctors, 13 Memorial Hermann hospitals and five hospitals in other health systems, as well as numerous specialty centers throughout the Houston region.” Medicare beneficiaries have already begun enrolling in the Medicare Advantage Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans. The AEP, which began Oct. 15, is when anyone with Medicare can change their Medicare health plan and prescription drug coverage for 2016. The AEP enrollment period will end Dec. 7. You are eligible to enroll in or switch to a Memorial Hermann Advantage Plan if you meet the following requirements: n You are currently enrolled in Original Medicare (Medicare Part A and Part B) n You live within the Harris, Fort Bend or Montgomery counties in Texas Medicare is a federal health insurance program for people ages 65 or older, but others younger than 65 may also be eligible if they have certain disabilities or diseases such as EndStage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS), otherwise known as Lou Gehrig’s disease, or you have permanent kidney failure requiring regular dialysis or a kidney transplant. Memorial Hermann Advantage HMO and
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Seminar Schedule
To help with the process, seminars will be held weekly until the conclusion of the AEP at Memorial Hermann campuses or locations nearby to give potential enrollees the opportunity to get information or ask questions about Memorial Hermann Advantage plans: Each Monday at 9 a.m.: n Memorial Hermann The Woodlands 9250 Pinecroft The Woodlands, TX 77380 Each Monday at 9:30 a.m.: n Memorial Hermann Southwest 7600 Beechnut St Houston, TX 77074 Each Monday at 10 a.m.: n Memorial Hermann Southeast 11800 Astoria Blvd. Houston, TX 77089 n Memorial Hermann Greater Heights 1635 North Loop West Houston, TX 77008
Each Wednesday at 9 a.m.: n Memorial Hermann Katy 23900 Katy Freeway Katy, TX 77493 Each Wednesday at 9:30 a.m.: n Sugar Land Skeeters Constellation Stadium One Stadium Drive Sugar Land, TX 77498
PPO are health plans with a Medicare contract. Enrollment in these plans depends on contract renewal. Memorial Hermann Health Solutions, Inc. is the parent company of Memorial Hermann Health Insurance Company and Memorial Hermann Health Plan, Inc., both of which are Medicare Advantage organizations. The Memorial Hermann Advantage plans will provide many enhanced benefits that Original Medicare does not cover. For additional information, call 1-888-624-4540 or visit the Memorial Hermann Health Plan website at healthplan.memorialhermann. org/medicare.
Each Wednesday at 10 a.m.: n Memorial Hermann Northeast 18951 Memorial North Humble, TX 77338 Each Friday at 9 a.m.: n Memorial Hermann Memorial City Medical Center 920 Frostwood Houston, TX 77024
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NOVEMBER 19 | 2015 | DEFENDER
FEELING SICK BUT NOT SURE WHAT TO DO? SPEAK WITH A REGISTERED NURSE FOR ANSWERS TO YOUR HEALTH QUESTIONS. asaasasfdfdfdfd
When you or a family member is feeling sick, but you’re not sure if you need to see your doctor or go to the hospital, call the free Nurse Health Line. Experienced nurses will help you decide when and where to go for medical care. These trained nurses are available around the clock, seven days a week to answer your health questions by phone. Anyone living in Harris or the surrounding counties can use this free service. Funded through the Centers for Medicare & Medicaid Services and the Texas Health and Human Services Commission.
Free 24/7 Nurse Health Line 713.338.7979 (Toll-Free) 1.855.577.7979 Individuals with life-threatening conditions and emergencies should call 9-1-1.
sponsored by Memorial Hermann Community Benefits Corporation
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DEFENDER | NOVEMBER 19 | 2015
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Know the symptoms, treatment, strategies By AMBER VERNON Defender
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ental illness may be a taboo topic, but it is a common problem in America. According to the National Institutes of Health, there are many causes of mental disorders. Genes and family history may play a role. Life experiences, such as stress or a history of abuse, may also matter. Biological factors, a traumatic brain injury or a mother’s exposure to viruses or toxic chemicals while pregnant can also lead to a mental disorder. Dr. Asim Shah, the chief of psychiatry for Harris Health System and Ben Taub Hospital and an associate professor at Baylor College of Medicine, said a part of living with mental illness is being educated about it. Here are some of the most common mental illnesses and tips on how to cope after diagnosis.
DEPRESSION
Depression, also known as major or clinical depression, is among the most prominent mental illnesses plaguing Americans today. It is a mood disorder characterized by an overwhelming feeling of sadness and loss of interest in things or relationships that usually brought happiness or pleasure. Symptoms n Fatigue n Feelings of worthlessness or guilt n Impaired concentration or indecisiveness n Insomnia or excessive sleeping n Restlessness n Significant weight loss or gain n Reoccurring thoughts of death or suicide Symptoms can last for years. While some experience it once in their life, for others it can be chronic. People diagnosed with depression may have trouble performing usual daily activities. Depression can be caused by a variety of factors including grief from losing a loved one, social isolation, conflicts in relationships and physical, sexual, or emotional abuse. People diagnosed with depression can be treated with antidepressant medication, psychotherapy, and electroconvulsive therapy (ECT), also called shock therapy, if symptoms are severe.
Coping techniques n Attend all psychotherapy sessions n Don’t skip medications n Avoid alcohol and drugs n Take care of yourself
BIPOLAR DISORDER
Also known as manic-depressive illness, bipolar disorder is characterized by changes in mood, from mania to depression. People diagnosed with this disorder will experience depression and manic episodes as well as periods of normal moods in between the two. Symptoms n Unpredictable mood swings (During a manic episode) excessive talk, racing thoughts, inflated self-esteem, less need for sleep, impulsiveness n (During a depression episode) depressed mood and low selfesteem, fatigue, sadness, loneliness, helplessness, guilt, insomnia or oversleeping, suicidal thoughts, poor concentration, lack of interest or pleasure in usual activities n There is no single cause for bipolar disorder. Studies show genetics and brain structure could play a role in risk factors. Treatments for bipolar include mood stabilizers, antidepressants, psychotherapy and electroconvulsive therapy. Coping techniques n Keep a regular routine n Get enough sleep n Stay on your medication n Learn about warning signs signaling a shift into depression or mania
COPING WITH
MENTAL CHALLENG
ANXIETY DISORDERS
Anxiety disorders are characterized by an overwhelming feeling of fear and worry that can prevent the performance of daily activities. Symptoms n Feelings of panic, fear, and uneasiness n Problems sleeping n Cold or sweaty hands or feet n Shortness of breath n Heart palpitations n Numbness or tingling in the hands or feet n Nausea n Muscle tension n Dizziness Causes of anxiety disorders are unknown. However, research suggests that it may be related to brain function and environmental stress. Treatments for anxiety disorders include antidepressants and anxiety-reducing
drugs, psychotherapy, cognitive behavioral therapy and relaxation therapy. Coping techniques n Limit caffeine and chocolate consumption n n Practice deep-breathing exercises n Seek counseling if regular feelings of anxiety
occur without cause
SCHIZOPHRENIA
Schizophrenia is a mental disorder characterized by delusions, loss of personality, confusion, agitation, social withdrawal, psychosis and bizarre behavior.
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Meditate, exercise or do yoga to gain a sense of calm
POST-TRAUMATIC STRESS DISORDER
PTSD is characterized by a feeling of stress or being frightened even when there is no present danger. Symptoms n Flashbacks of trauma n Trouble remembering the trauma n Feeling tense, being easily startled n Difficulty sleeping due to nightmares Family history of PTSD, depression, or traumatic events such as assault, rape, war, or a sudden death of a loved one are all events that may cause PTSD to surface. PTSD can’t be cured but it is treatable. Treatments include counseling, psychotherapy, and antidepressants. Coping techniques n Attend peer support groups n Take time to relax n Avoid alcohol and other drugs n Exercise n Eat a healthy diet
EATING DISORDERS
GES Symptoms n Lack of motivation n Social withdrawal n Hallucinations and delusions Research shows that schizophrenia is caused by genetics and brain structure. Treatments include antipsychotic medications,
An eating disorder is an illness that interferes with your everyday diet, such as eating small amounts of food (anorexia) or severely overeating (binge-eating) and regurgitating later (bulimia). Symptoms n Extreme thinness n Intense fear of gaining weight n Severe dehydration from bulimia n Acid reflux from bulimia n Weight gain due to guilt or shame (binge-eating) A person with an eating disorder may have started out just eating smaller or larger amounts of food, but at some point, the urge to eat less or more spirals out of control due to concerns with body image. Binge-eating disorder is caused by stress. Psychotherapy, medical care and monitoring, nutritional counseling, and taking medications are ways to treat eating disorders. Coping techniques n Join a support group n Make a list of positive affirmations to recite daily n Seek counseling psychosocial treatments and rehabilitation. Coping techniques n Take the focus away from the hallucination through distractions Seek the help of friends and family when delusions and hallucinations occur
ng the Houston area for over 80 years
DEMENTIA
Dementia isn’t a specific disease. Instead, it describes a group of symptoms affecting memory, thinking, and social abilities severely enough to interfere with daily functioning.
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Symptoms Memory loss n Difficulty communicating or finding words n Difficulty planning and organizing n Difficulty with coordination and motor functions n Hallucinations n Disorientation such as getting lost n Personality changes n Agitation The most common cause of dementia is Alzheimer’s disease in people older than 60. Treatment of dementia depends on its severity. In the case of Alzheimer’s disease, there is no cure and no treatment that slows or stops its progression. However, the taking of certain medications, along with diet and exercise, can help. Coping techniques n Exercise, follow proper diet and get adequate rest n Take medication as prescribed Journal to express feelings and keep track of appointments, tasks and medication schedules n
ADHD
Attention deficit hyperactivity disorder is one of the most common disorders found in children and can continue through adolescence and adulthood. Kids with ADHD act without thinking, are hyperactive and have trouble focusing. They may understand what’s expected of them, however have trouble following through because they can’t sit still, pay attention, or focus on what’s going on. Symptoms n Difficulty staying focused and paying attention n Difficulty controlling behavior Restlessness n Frequently daydreaming n Hyperactivity n Struggle to follow instructions Scientists are not sure what causes ADHD, although many studies suggest that genes, environmental factors, and sugar play a role. Current treatments focus on reducing the symptoms of ADHD and improving functioning. Treatments include medication and psychotherapy. Treatments can relieve many of the disorder’s symptoms, but there is no cure. Coping techniques n Parents should give praise or rewards when rules are followed n Seek support through counseling and support groups n Cut out clutter and organize child’s life
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DEFENDER | NOVEMBER 19 | 2015
health
Neuropsychological testing for concussions helps By DR. JORGE GOMEZ
It’s not uncommon for parents to worry about their child as they play sports. Because young athletes are more susceptible to concussions, it’s important to know what options are available for your child if they are injured. A concussion can occur in many sports and usually occurs from a direct blow to the head. However, it can also occur with a rapid turning of the head. Common symptoms include headache, dizziness, blurry vision, appearing confused and slow to answer questions. The main treatment for a concussion is rest, which for the athlete means no athletic activity, plenty of sleep and brain rest, including minimal use of electronics. Research has shown young athletes may be more susceptible to concussions and may require a longer period of rest for their brains to return to normal function. Texas Children’s Hospital has started using computerized neuropsychological (NP) testing to evaluate an athlete’s brain function after a concussion. NP testing evaluates an individual’s brain function: how well they concentrate, remember, organize information, and how quickly they can solve problems. While not as thorough as traditional NP testing, which is done with pencil and paper and conducted by a specialist called a neuropsychologist, computerized NP testing allows similar evaluation of brain function that can be done quickly, and does not require a neuropsychologist to interpret the results. Computerized NP testing does not make the diagnosis of concussion. There can be other reasons besides concussion for an athlete to perform poorly on such a test. Concussion is still a clinical diagnosis, meaning the health care provider makes the diagnosis based on information on how the injury occurred, the patient’s symptoms immediately after the injury, and any abnormalities the provider finds upon examining the patient. Computerized NP testing has given us an additional tool for determining when an athlete’s brain has returned to normal, and therefore when they may safely return to sport. Unfortunately, injuries occur frequently in most sports. It’s important to treat sports injuries correctly in order to prevent further problems.
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healthnotes Facts about growth plate injuries Falls are common in childhood, but not every fall results in a broken bone. Therefore, paying attention to classic signs that could indicate a broken bone such as a “snap” pain, inability to touch or move the injured area, swelling, bruising or even a deformity (the area looks curved or crooked) is very important. If you suspect a child has a broken bone, it’s important to seek medical attention immediately. Children’s bones differ from adults because they have growth plates (also called physes). Because of this difference, some childhood fractures need specialized care. Growth plates are located at the ends of long bones, such as those in the arms and legs, and cause the bone to grow in length. They are made of cartilage, a soft rubbery material, which can be vulnerable to injury. In fact, when damaged, the bone can sometimes stop growing partially or completely. Treatment by a medical provider knowledgeable in these types of injuries, especially one with expertise and experience in treating pediatric patients, is necessary to prevent issues in adulthood. Children can sustain growth plate injuries from falling during a wide variety of activities. Contact and repetitive sports such as basketball, football, gymnastics, skateboarding, bicycle riding and flipping on the trampoline are common causes. Texas Children’s Hospital Orthopedic Fracture Clinic provides specialized care in evaluating and treating various fractures, including those that involve the growth plate. Physicians review x-rays to evaluate whether the growth plate or another area of the bone is broken or fractured. If the bone or growth plate is fractured, but still well aligned or in a position that is acceptable for the child’s age, the injured arm or leg can be placed into a hard cast. However, if the bone or growth plate position or alignment is not good, the child may need to have the bone reduced or moved into a better position either in the clinic or operating room within a week to prevent long-term problems.
What parents should know about broken bones By DR. VINITHA SHENAVA
As a pediatric orthopedic doctor, I see tons of broken bones. It’s not uncommon to see broken arms, collar bones or ankles. The most common broken bone we see is forearm fractures. When children are falling, they’ll often try to brace themselves with their arms, causing fractures of their shoulder, elbows, forearms or wrists. A broken bone typically results in pain, swelling, tenderness, bruising and occasionally
deformity, tears or openings in the skin. When a child with a suspected broken bone is first seen, an X-ray of the area will be taken. This allows us to see the bone, see if it’s broken and determine the extent of the injury. Depending on the location of the fracture, we might order an MRI or CT scan which allows us to evaluate the fracture in three dimensions, which is helpful in unusual or complex fractures. The majority of fractures in children can be treated with a cast.
However, a small percentage are best treated by surgery due to their location or if the bones are not well aligned. All orthopedic surgeons have the ability to treat fractures, but ones that occur in children possess unique qualities that occasionally are best treated by pediatric orthopedic surgeons who have additional training in caring for musculoskeletal problems in children. In general, children make a full recovery following a fracture and are usually back to running around, cast free, within a few months.
Dr. Vinitha Shenava
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NOVEMBER 19 | 2015 | DEFENDER
Quality health care for $50 or less a year. What a relief.
Texas Children’s Health Plan covers children from newborns to teenagers. We even cover adults and pregnant moms through STAR Medicaid. Families with children who qualify for CHIP pay $50 or less a year. Those who qualify for Medicaid pay nothing. CHIP and STAR Medicaid offer a wide range of benefits including checkups and shots, dental services, medications, and more. With Texas Children’s Health Plan you also get: ■ Over 2,100 doctors. ■ A 24-hour nurse hotline. ■ Transportation to doctor visits at no cost. ■ Pregnancy support program and classes. ■ Help losing weight through the Keep Fit Program. ■ Learn how to play soccer from the Houston Dynamo coaches. ■ Fun member events!
For more information, to receive an application, or to find an event in your area, visit us online or call today.
MK-1208-007
1-800-990-8247 | TexasChildrensHealthPlan.org
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DEFENDER | NOVEMBER 19 | 2015
health Myth busters:
HPV and cancer By MD ANDERSON CANCER CENTER
Did you know? Cervical cancer was once the leading cause of cancer death in women in the United States. Now, it’s one of the most preventable cancers. Roughly 90 percent of cervical cancers are caused by the human papillomavirus (HPV). Thanks to screening and the HPV vaccine, women today have options to dramatically reduce their risks for this disease. But HPV doesn’t just cause cervical cancer. It can also lead to anal, throat, vaginal, vulvar and penile cancers. “Many HPV-related cancers can be prevented if people know the truth,” said Erich Sturgis, M.D., professor in Head and Neck Surgery and Epidemiology at The University of Texas MD Anderson Cancer Center. “If we can get 100 percent of 11-year-olds vaccinated, we can basically wipe out HPV-related cancers.” Together with MD Anderson colleague Lois Ramondetta, M.D., professor in Gynecologic Oncology and Reproductive Medicine, they help dispel common HPV myths.
Myth #1: Only women can get HPV.
Myth #3: You must have sexual intercourse to get HPV.
Truth: HPV is spread by intimate skin-to-skin contact. While most cases are sexually transmitted, people who haven’t had intercourse can become infected. Using condoms helps, but they don’t completely protect you against the virus. They don’t cover all of the genital skin.
Myth #4: There are treatments for HPV.
Truth: There aren’t treatments for the virus. But there are ways to treat HPV-related health problems, such as precancerous lesions and genital warts.
Myth #5: The HPV vaccine protects you for life.
Truth: The vaccine is effective for at least 10 years. But doctors are optimistic that it will provide more long-lasting protection. If further study shows the vaccine is losing its effectiveness, a booster vaccine may be required.
Myth #6: The HPV vaccine increases sexual activity.
Truth: HPV is common among both men and women. About 80 percent of people will get an HPV infection at some point in their lives. In most cases, HPV goes away on its own. When it remains, it can lead to health problems such as genital warts and several types of cancer. This includes cervical cancer, anal cancer, penile cancer and oropharyngeal cancer (tonsils and base of tongue).
Truth: No research links the HPV vaccine to increases in sexual activity. Boys and girls who get the vaccine don’t have sex earlier than those who haven’t received the vaccine. Also, they don’t have more partners after they become sexually active.
Myth #2: People with HPV show symptoms.
Truth: The HPV vaccine is a safe drug and doesn’t contribute to any serious health issues. Like any vaccine or medicine, the vaccine may cause mild reactions. The most common are pain or redness in the arm where the shot is given.
Truth: Most people with HPV don’t know they’re infected and never develop symptoms or health problems from it. In 90 percent of cases, your immune system fights off the infection within two years.
Myth #7: The HPV vaccine may cause dangerous medical problems.
Myth #8: You got the HPV vaccine, so you can skip your Pap test.
Truth: Absolutely not. Because no vaccine prevents all types of HPV that can cause cervical cancer, vaccinated women age 21 to 29 should still receive Pap tests every three years. In addition to Pap tests, women age 30 to 64 also should be tested for HPV every five years. This exam checks your cervix for the virus that can cause abnormal cells that lead to cervical cancer. It may show that more frequent screening is needed.
Women age 65 or older should discuss their individual need for screening with their doctor. But the vaccine is still the best way to prevent cancer, Ramondetta said. “The HPV vaccine protects against high-risk types of HPV that can cause cancer,” Ramondetta said. “Boys and girls age 11 to 12 should receive the vaccine. That’s when the immune system is at its best to respond to the vaccine.” Yet, females up to age 26 and males up to age 21 (and up to 26 in certain situations) also can receive the vaccine. “It is a health vaccine to prevent cancer,” Ramondetta said. ” So, don’t wait until it’s too late.”
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“I have other plans, cancer” Gail Morse | Cancer Survivor People in families with a history of cancer are perfect candidates for MD Anderson’s early detection and prevention programs. The earlier we can find cancer, the better the chances of getting rid of it. Call 1-855-894-0145 or visit MakingCancerHistory.com.
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DEFENDER | NOVEMBER 19 | 2015
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Diabetes continues to rise among African-Americans be aware of diabetes risk factors, potential complications and, most important of all, prevention.
By HARRIET HILLIARD, M.D.
Diabetes is a serious problem within our local African-American community, Risk Factors particularly Type 2. In 2013, 10 percent There is no single determining factor of adults in the Houston area reported a for the development of diabetes. Risk facdiabetes diagnosis, an increase from 6.8 tors for Type 2 diabetes include: percent in 2004, according to the Harris • Obesity County Healthcare Alliance report, “The • Sedentary lifestyle State of Health, Houston & Harris County, • Age 2015-2016.” • Hypertension More African-Americans in the • High cholesterol Houston area reported a diabetes diagnosis • Family history (14 percent) than whites (12 percent) or • Prediabetes Hispanics (9.3 percent.), the report said. Harriet Hilliard, M.D. The more risk factors you have, the Despite the troubling data, there is more likely you may be to develop it someday. good news. Type 2 diabetes can be prevented or delayed in Uncontrolled diabetes can lead to some serious complithose at high risk for the disease. cations, including blindness, kidney disease, medically necDiabetes is a chronic, progressive condition. As the essary amputations, heart disease, stroke and nerve damage. Harris County Healthcare Alliance report points out, comConsider these statistics: plications from diabetes are numerous. Anyone who has • African-Americans with diabetes are almost 50 perdiabetes also has a 1.7 times greater risk for heart disease cent more likely to develop diabetic retinopathy (the most and a 1.5 times greater risk of stroke. common diabetic eye disease that can cause vision loss). Type 2 diabetes can be a silent disease – many people • African-Americans with diabetes are about three to don’t even know they have it! Because of the high risk, it six times as likely to suffer from kidney disease with more is vitally important that the African-American community than 4,000 new cases of end stage renal disease each year.
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• African-Americans with diabetes are nearly three times as likely to suffer from lower-limb amputations because of their disease.
How to Prevent It
Healthy lifestyle choices can help you prevent Type 2 diabetes. Even if diabetes runs in your family, diet and exercise may help to prevent the disease. If you’ve already been diagnosed with diabetes, the same healthy lifestyle choices may help prevent potentially serious complications. And if you are prediabetic, lifestyle changes can slow or halt the progression to diabetes. • Eat healthy foods. Choose foods low in fat and calories. • Get physical. Aim for 30 minutes of moderate physical activity a day or spread 10-minute or longer sessions throughout the day. • Lose excess pounds. If you’re overweight, losing 5 percent to 10 percent of your body weight may reduce your risk of diabetes. • Be diligent about checkups and screenings. Don’t skip appointments with your primary care physician. Dr. Hilliard is a Family Medicine physician who cares for patients at Kelsey-Seybold’s Spring Medical and Diagnostic Center. She has been nationally recognized by the National Committee for Quality Assurance (NCQA) for excellence in diabetes care.
C A N C E R
Exceptional Cancer Care Just Got Even Better In our beautiful new facility, everything is under one roof – from our connected team of experts to state-of-the-art technology for radiation therapy.
Kelsey-Seybold’s nationally accredited Cancer Center is focused on not only treating patients, but on providing personal, coordinated care that encourages healing. Now, with state-of-the-art technology for radiation therapy and our beautiful and spacious facilities, we’re better equipped than ever to help our patients be victorious over cancer. It’s just one more way our exceptional cancer care has gotten even better.
Kelsey-Seybold.com/CancerCenter | 713-442-1080
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