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November: “No Stomach for Cancer”

November is Stomach (gastric) Cancer Awareness Month

Stomach (gastric) Cancer:

  • Defined by the National Cancer Institute (NCI) as cancer that forms in tissues lining the stomach.
  • The stomach is located in the upper abdomen, between the esophagus and small intestine.
  • The cancer occurs when cells in the stomach become abnormal and multiply.
  • 90-95% of stomach cancers are adenocarcinomas – meaning they arise form the mucosal tissue lining the inside of the stomach.
  • Abnormal cells may spread over time to invade deeper into the stomach wall or eventually spread to nearby tissues or organs.
  • Adenocarcinomas further classified as an intestinal type or diffuse type – based on how the cells look under a microscope.

***Usually stomach cancer grows slowly over the course of several years causing few, if any, symptoms.***

Stomach Cancer Stats:

  • 5th most common cancer type worldwide.
  • 1 million new cases each year, globally.
  • 1 in 111 men and women will be diagnosed in their lifetimes.
  • 1-3% of stomach cancers are related to inherited cancer syndromes.
  • 80% risk in hereditary cases:
    • Hereditary Diffuse Gastric Cancer (HDGC) increases the risk for diffuse gastric cancer (80% risk by age 80) and lobular breast cancer (42% for women by age 80)
  • 4% 5-year survival rate for Stage 4 stomach cancer patients (overall 5-year survival rate is 29.3%).
  • 3rd most common cause of cancer deaths globally.
  • $1.8 billion was spent on the care of stomach cancer patients in the U.S. in 2014.
  • Only 0.23% of the National Cancer Institute’s 2013 budget was dedicated to stomach cancer.

Did You Know?

  • Stomach cancer is difficult to detect and is typically diagnosed in late stages.
  • Treatment of H. pylori infection (a common bacterial infection of the stomach) can decrease the risk of stomach cancer development.
  • A diet high in smoked, salted, and pickled foods, tobacco use, and obesity can all increase stomach cancer risk.
  • People who carry the BRCA1 and BRCA2 gene mutations, which increase the risk of breast and ovarian cancer, may also have an increased risk of developing stomach cancer.
  • Stomach cancer can be hereditary, sometimes caused by a gene mutation (CDH1 is one such gene).
  • Preventative complete stomach removal (gastrectomy) is the treatment of those with a CDH1 gene mutation.
  • Stomach, lobular breast, and colon can or are all risks for those with a CDH1 gene mutation.
  • A person can live a normal life without a stomach.
  • Early detection of stomach cancer is the key to survival.


October: National Physical Therapy Month

Soreness vs. Pain:  What Is the Difference?

**The benefits of exercise are endless, however, there may also be some physical discomfort associated with these activities due to stresses placed on the body.

**When discomfort is experienced – it is important to know the difference between exercise-related muscular soreness and actual pain. 

  • Muscular Soreness:  a healthy and expected result of exercise.
  • Pain – an unhealthy and abnormal response to exercise, and may be indicative of injury.

Soreness vs. Pain:  How To Tell the Difference –

Type of Discomfort:

Muscle Soreness – tender when touching muscles, tired or burning feeling when exercising, minimal dull, tight and achy feeling at rest.

Pain – ache, sharp pain at rest or when exercising.


Muscle Soreness – during exercise or within 24-72 hours after activity.

Pain – during exercise or within 24 hours of activity.


Muscle Soreness – 2-3 days.

Pain – may linger if not addressed.


Muscle Soreness – muscles.

Pain – muscles or joints.

Improves With:

Muscle Soreness – stretching, following movement.

Pain – ice, rest.

Worsens With:

Muscle Soreness – sitting still.

Pain – continued activity.

Appropriate Action:

Muscle Soreness – resume offending activity once soreness subsides.

Pain – consult with a medical professional if pain is extreme or lasts > 1-2 weeks.

Muscle Soreness:

  • After activity, muscular soreness usually peaks 24-72 hours after the activity.
  • This is the result of small, safe damage to muscle fibers called Delayed Onset Muscular Soreness (DOMS).
  • During this time, your muscles may be tender and feel tight and achy.
  • Movement may initially be uncomfortable, but moving and gently stretching your muscles will help in decreasing soreness.

**During the few days that you experience muscular soreness, you may want to perform alternate exercise activities in order to give your sore muscles an opportunity to recover, while still strengthening other muscles.


  • You might experience pain during or after exercise.
  • This may feel sharp and be located in your muscles or joints.
  • Pain may linger without fully going away – maybe even after a period of rest.
  • This could be indicative of an injury – and pushing through the pain can cause further injury to occur.
  • If pain is extreme, or it is not resolving after 7-10 days, you should consult a medical professional.

How A Physical Therapist Can Help:

  • A valuable resource throughout your exercise journey.
  • Can perform a variety of pre-activity assessments to determine our readiness for exercise.
  • May recommend specific exercises that can best prepare you for your desired activities.
  • They will discuss with you the best strategies for introducing and progressing exercise activities while minimizing your injury risk.

**If exercise unfortunately leads to injury, your physical therapist can assist in your recovery.

They Can:

  • help with initial pain management,
  • identify and address all factors that may have contributed to your injury to prevent further problems,
  • and provide specific recommendations regarding reintegration into exercise as appropriate.



Avoid Addictive Opioids.  Choose Physical Therapy for Safe Pain Management.

  • No one wants to live in pain, but no one should put their health at risk in an effort to be pain free.
  • Since 1999, Americans have increasingly been prescribed opioids – painkillers like:
    • Vicodin
    • OxyContin
    • Opana
    • methadone
    • and combination drugs, like Percocet
  • People addicted to prescription opioids are 40 times more likely to become addicted to heroin.
  • Don’t just mask the pain.  Treat it.

CDC Opioid Prescription Guidelines recognize that prescription opioids are appropriate in certain cases, such as:

  • cancer treatment
  • palliative care
  • end-of-life care
  • certain acute care situations

if properly dosed.

For other pain management, the CDC recommends nonopioid approaches including physical therapy.

Patients should choose physical therapy when:

  • …The risk of opioid use outweighs the rewards – Because of these risks, experts agree that opioids should not be considered firstline or routine therapy for chronic pain.
  • …Patients want to do more than mask the pain – Opioids reduce the sensation of pain by interrupting pain signals to the brain.  Physical therapists treat pain through movement while partnering with patients to improve or maintain their mobility and quality of life.
  • …Pain or function problems are related to low back pain, hip/knee osteoarthritis, or fibromyalgia.  The CDC cites “high quality” evidence supporting exercise as a part of physical therapy treatment plans for those familiar conditions.
  • …Opioids are prescribed for pain.  Even in situations when opioids are prescribed, the CDC recommends that patients should receive “the lowest effective dosage,” and “opioids should be combined” with nonopioid therapies, such as physical therapy.
  • …Pain lasts 90 days.  At this point, the pain is considered “chronic”, and the risks for continued opioid use increase.  An estimated 116 million Americans have chronic pain each year.

***The CDC Guidelines note that nonopioid therapies are “preferred” for chronic pain and that “clinicians should consider opioid therapy only if expected benefits for both pain and function are anticipated to outweigh risks to the patient.

October: National Physical Therapy Month

Pain is Personal.  Treating Pain Takes Teamwork.


Physical therapists treat people of all ages and abilities.  Here are some ways a physical therapist can help you –

  • MAXIMIZE YOUR MOVEMENT:  Physical therapists are movement experts who can identify, diagnose, and treat movement problems.
  • PARTICIPATE IN YOUR RECOVERY:  Physical therapists work collaboratively with their patients and clients.  Treatment plans are designed for each person’s individual goals, challenges, and needs.
  • AVOID OPIOIDS:  Opioid risks include depression, overdose, and addiction, plus withdrawal symptoms when stopping use.  In some situations, when dosed appropriately, prescription opioids can be an appropriate part of medical treatment.  However, the CDC (Centers for Disease Control & Prevention) is urging healthcare providers to reduce the use of opioids in favor of safe alternatives like physical therapy for most long-term pain.
  • AVOID SURGERY:  Before you undergo expensive or invasive surgery, try physical therapy.  For some conditions, including meniscal tears and knee osteoarthritis, rotator cuff tears, spinal stenosis, and degenerative disk disease, treatment by a physical therapist has been found to be as effective as surgery.


  1. In 2016, healthcare providers across the U.S. wrote more than 214 million prescriptions for opioid pain medication, a rate that demonstrated 66.5 prescriptions per 100 people.  Some countries had rates 7 times higher than that.
  2. As many as 1 in 4 people who received prescription opioids long-term for noncancer pain in primary care settings struggle with addiction.
  3. From 1999 to 2015, more than 183,000 people have died in the U.S. from overdoses related to prescription opioids.
  4. While opioid use is down in younger Americans, it has risen among older adults.  For adults aged 50 years and older, opioid use doubled from 1% to 2%.
  5. Every day more than 1,000 people are treated in emergency departments for misusing prescription opioids.
  6. Veterans are twice as likely to die from accidental opioid overdoses as non-veterans.
  7. Opioid-related hospitalizations among women in the U.S. increased by 75% between 2005-2014.

October: SIDS Awareness Month

SIDS (Sudden Infant Death Syndrome) Awareness:

  • The unexplained death, usually during sleep, of a seemingly healthy baby less than 1 year old.
  • SIDS is sometimes known as “crib death” because the infants often die in their cribs.
  • Although cause is unknown, it appears that SIDS might be associated with defects in the portion of an infant’s brain that controls breathing and arousal from sleep.

Causes of SIDS:

A combination of physical and sleep environmental factors can make an infant more vulnerable to SIDS.  These factors vary from child to child.

Physical Factors:

  • Brain defects.  Some infants are born with problems that make them more likely to die of SIDS.  In many of these babies, the portion of the brain that controls breathing and arousal from sleep hasn’t matured enough to work properly.
  • Low birth weight.  Premature birth or being part of a multiple birth increases the likelihood that a baby’s brain hasn’t matured completely, so he or she has less control over such automatic processes as breathing and heart rate.
  • Respiratory infection.  Many infants who died of SIDS had recently had a cold, which might contribute to breathing problems.

Sleep Environment Factors:

  • Sleeping on the stomach or side.  Babies placed in these positions to sleep might have more difficulty breathing than those placed on their backs.
  • Sleeping on a soft surface.  Lying face down on a fluffy comforter, a soft mattress, or a waterbed can block an infant’s airway.
  • Sharing a bed.  While the risk of SIDS is lowered if an infant sleeps in the same room as his/her parents, the risk increases if the baby sleeps in the same bed with the parents, siblings, or pets.
  • Overheating.  Being too warm while sleeping can increase a baby’s risk of SIDS.

Risk Factors:

  • Sex.  Boys are slightly more likely to die of SIDS.
  • Age.  Infants are most vulnerable between the second and fourth months of life.
  • Race.  For reasons that are not well-understood, non-white infants are more likely to develop SIDS.
  • Secondhand smoke.  Babies who live with smokers have a higher risk of SIDS.
  • Being premature.  Both being born early and having a low birth weight increase your baby’s chance of SIDS.

Maternal Risk Factors:

During pregnancy –

  • is younger than 20
  • smokes cigarettes
  • uses drugs or alcohol
  • has inadequate prenatal care

Prevention Tips for Reducing SIDS Risk:

  • Back for sleeping.  Place baby to sleep on his/her back, rather than side or stomach, every time the baby is put to sleep during their first year of life.  This isn’t necessary when the baby is awake or is able to roll over both ways without help.
  • Don’t assume that other will place your baby to sleep in the correct position – insist on it.  Advise sitters and child care providers not to use the stomach position to calm an upset baby.
  • Keep the crib as bare as possible.  Use a firm mattress and avoid placing your baby on thick, fluffy padding, such as lambskin or thick quilts.  Don’t leave pillows, fluffy toys, or stuffed animals in the crib.  These can interfere with breathing if your baby’s face presses against them.
  • Don’t overheat your baby.  To keep your baby warm, try a sleep sack or other clothing that does not require additional covers.  Do not cover your baby’s head.
  • Have your baby sleep in your room.  Ideally, your baby should sleep in your room with you, but alone in a crib, bassinet, or other structure designed for infants, for at least 6 months., and, if possible up to a year.  ***Adult beds ARE NOT safe for infants.  A baby can become trapped and suffocate between headboard slats, the space between the mattress and bed frame, or the space between the mattress and wall.  A baby can also suffocate if a sleeping parent accidentally rolls over and inadvertently covers the baby’s nose and mouth.
  • Breastfeed your baby, if possible.  Breastfeeding for at least 6 months lowers the risk of SIDS.
  • Don’t rely on baby monitors and other commercial devices that claim to reduce the risk of SIDS.  The American Academy of Pediatrics discourages the use of monitors and other devices because of ineffectiveness and safety issues.
  • Offer a pacifier.  Sucking on a pacifier without a strap or string at naptime and bedtime might reduce the risk of SIDS.  If you are breastfeeding – wait to offer a pacifier until your baby is 3-4 weeks old and you’ve settled into a nursing routine.  ***If your baby is not interested in the pacifier, don’t force it.  Try again another day.  If the pacifier falls out of your baby’s mouth while he/she is sleeping, don’t pop it back in.
  • Immunize your baby.  There’s no evidence that routine immunizations increase SIDS risk.  Some evidence indicates immunizations can help prevent SIDS.

October: Infection Prevention

The ABCs of Antibiotics:


“Are these antibiotics necessary?”

“What can I do to feel better?”


Antibiotics do not kill viruses.

They only kill bacteria.

COMPLETE the Course

Take all of your antibiotics exactly as prescribed.

(Even if you are feeling better.)

Do Not Pressure Your Healthcare Provider for Antibiotics.

You Do Not Need Antibiotics For:

x Colds or Flu

x Most Coughs & Bronchitis

x Sore Throats – not caused by Strep

x Runny Noses

x Most Ear Aches

Using antibiotics in the wrong way can cause bacteria to grow into superbugs!

This could make your next infection much harder to treat.

What Is Antibiotic Resistance?

Antibiotic Resistance happens when bacteria change in a way that reduces or eliminates the ability of antibiotics to kill the bacteria.

What You Should Know About Antibiotic Resistance:

  • Each year, at least 2 million people get serious infections with bacteria that are resistant to one or more of the antibiotics designed to treat those infections.
  • At least 23,000 people die each year as a direct result of antibiotic-resistant infections.
  • THIS is why healthcare providers are being more careful when prescribing antibiotics.

How Can I Help Prevent Antibiotic Resistance?

  • Take antibiotics exactly as your healthcare provider instructs.
  • Only take antibiotics prescribed for you.
  • Do Not save antibiotics for the next illness, or share them with others.
  • Do Not pressure your healthcare provider for antibiotics.