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The Healing Hands and Compassionate Hearts of our Community

For the past 60 years, Terrebonne General Medical Center (TGMC) has proudly served the Tri-Parish region, not only through our constant commitment to the wellbeing of our patients, but through our participation in the journeys we take together as a community. For this reason, we are constantly enhancing and expanding the services delivered at TGMC to meet the needs of the people of our community. We have Brett Chiasson, ATC, MS, Master Degree Certified Athletic Trainer with the collaborated with our community and worked TGMC Community Sports Institute instructs CPR to Vandebilt Catholic High School staff at an educational training day held at Terrebonne General Medical Center. in partnership to create much needed service. In the last decade alone we developed the comprehensive Women’s Center at TGMC, opened the Mary Bird Perkins Cancer Center at TGMC, and renovated the TGMC Health and Rehabilitation Center— all so our families, friends and neighbors can receive these critical healthcare services close to home. With the health and wellness of our community remaining our core focus, this year TGMC opened the TGMC Community Sports Institute. The goal of the Community Sports Institute is to impact future generations by partnering with our school system (elementary through high school levels) on health education, athletic injury prevention, and post-care to promote healthy habits. This program supports coaches and student athletes in medical assistance and techniques to prevent injuries while on and off the field. “The TGMC Community Sports Institute will play a vital role in the development of healthy athletes in our community,” said Phyllis Peoples, President and CEO at TGMC. “Learning how to make healthy choices, developing healthy habits and preventing injuries is essential to having strong athletes and we look forward to partnering with our local schools to provide them with this knowledge,” Mrs. Peoples added. At TGMC, we are more than the sum of our advanced technology, services and state-of-the-art facility; we are the healing hands and compassionate hearts of TGMC. Terrebonne General Medical Center (TGMC) donated $600,000.00 that was Our commitment to the community has extended beyond matched with $400,000.00 by the Louisiana Board of Regents to create a $1 million endowment to Nicholls State University to provide four Professorships the hospital, with sponsorship of local events and in Nursing that were awarded during the Nicholls 2014 Spring Faculty Institute. dedicated volunteer resources through Team Terrebonne. Recipients were: Dr. Angelique Allemand, Faithful Sisters of St. Joseph Endowed Also, this year we converted our $1 million Endowed Chair Professorship, Dr. Amanda Eymard, Devoted Volunteers Endowed Professorship, in Nursing at Nicholls State University into four $250,000 Dr. Bridget Guidry, Compassionate Staff Endowed Professorship and Dr. Todd Keller, Founding Physicians Endowed Professorship. Endowed Professorships in Nursing to encourage the Pictured from left to right are: Dr. Laynie Barrilleaux, Vice President for Academic retention of great nursing professors, ensuring the next Affairs at Nicholls State University; Danny Henry, Vice Chairman, TGMC Board of generation of local nurses are trained by the best Commissioners; Morris Hebert, Chairman, TGMC Board of Commissioners; Phyllis Peoples, TGMC President and CEO; Dr. Amanda Eymard, Associate educators our region has to offer. Professor of Nursing at Nicholls State University; Dr. Todd Keller, Associate We are committed in every way to delivering Professor of Nursing at Nicholls State University and BSN Program Director; exceptional healthcare with compassion to our community Dr. Bridget Guidry, Associate Professor of Nursing at Nicholls State University; now and for the next sixty years to come. Dr. Angelique Allemand, Associate Professor of Nursing at Nicholls State University; Dr. Bruce Murphy, Nicholls State University President

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C O R R E CT I N G Y O U R C AT A R A CT S AND YOUR VISION looking through clouded glass – objects are blurred, colors are dulled, and it becomes more difficult to see at night. If you suspect that you have cataracts, the following information can guide you into making the best decision for yourself when it’s time to schedule surgery. Will I need glasses after cataract surgery? This is one of the most common questions asked by our patients when it’s time for them to prepare for their upcoming cataract procedure. Today’s cataract surgery technology offers you the option to correct the need for glasses or contact lenses, giving you the freedom to perform activities such as driving, sewing, reading, cooking and much more. Most patients will not need glasses for many activities after cataract surgery, but the amount of reliance on corrective lenses depends on the type of implant used. What is an implant? To answer this, we must first explain what a cataract is. A cataract is a clouding of the natural lens of the eye. When this lens is removed, it must be replaced with an artificial lens, or an intraocular lens implant. You might also hear this called an IOL. Do I have to have an IOL? If a cataract is removed and no IOL is implanted, the leftover prescription would require extremely thick “coke-bottle” eyeglasses to be worn, much like people had to wear long ago following cataract surgery. While the cataract would be gone, and the cloudiness would be corrected, the remaining vision would not be optimal, and peripheral vision would be very limited. Except in rare cases, cataract surgery now always includes the placement of an IOL. What are the different eye conditions that cause someone to need glasses or contact lenses? It’s important to first understand how the eye functions. 1. When you look at an object, what you really see are light rays reflecting off that object. Cataracts are one of the leading causes of vision impairment in the United States. Because cataracts usually develop slowly over a long period of time, many people have cataracts without realizing it. In some cases, cataracts occur rapidly and the condition is more obvious. But in both cases, surgery is the only cure for cataracts. Cataracts are a natural part of the aging process. Most people over the age of 55 have some sort of cataract. Some people have them at an even younger age, usually due to a medical problem or injury. Having a cataract is very similar to

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2. These light rays enter your eye through the cornea (the front surface of the eye). 3. Light then passes through your lens, which focuses on your retina. 4. The retina converts this into electrical signals that are converted into images by the brain. Vision depends on this entire chain of events, but sharp, focused vision depends largely on the lens.*


The following table explains the common eye conditions that cause a need for glasses or contacts: Myopia, or nearsightedness

Causes objects to be out of focus at a distance. This occurs because the eye is either steeper or longer than average, causing light rays to focus in front of the retina instead of on it.

Hyperopia, or farsightedness

Causes the eye to work harder to focus, often near AND far. This occurs because the eye is either flatter or shorter than average, causing light rays to have a focal point that would occur behind the retina instead of on it.

Presbyopia

Often confused with hyperopia, but presbyopia is the natural aging process that occurs in patients around forty years old, and causes difficulty focusing up close. This causes a need for reading glasses, or cheaters. It occurs in patients who are nearsighted OR farsighted, as well as people who have never had a need for glasses before. The cause of presbyopia is a loss of flexibility in the natural lens of the eye, which causes difficulty bending the lens to focus at near.

Astigmatism

Causes objects to be out of focus because of a ‘warpage’ of either the front surface of the eye, or the lens of the eye. Light is scattered in such a way that the light rays do not focus at a single point on the retina. This can occur alone, or in combination with myopia or hyperopia.

What are the different types of IOLs or implants? There are three common types of IOLs. The chart below outlines each one, and what each is designed to do for your vision:

Basic

Advanced Technology/Premium

Monofocal IOL

Multifocal IOL

Toric IOL

Can correct cataracts, and often myopia or hyperopia

Can correct both cataracts and presbyopia, as well as myopia or hyperopia

Can correct both cataracts and astigmatism, as well as myopia or hyperopia

Distance vision can usually be improved with a monofocal IOL, but most patients will still need to wear glasses for near tasks, like reading or using a computer

Ideal for patients who want the freedom to read, sew, cook, drive, play golf and do other activities without glasses or contacts

Ideal for patients who have astigmatism and want to be glasses-free for distance activities after cataract surgery

Medicare and private insurance generally cover the cost of the basic IOL and its implantation; you may have a co-pay or need to meet your deductible or a percentage

Medicare and private insurance generally cover the cost of the basic IOL; there are additional out-ofpocket expenses beyond the basic IOL for the multifocal IOL

Medicare and private insurance generally cover the cost of the basic IOL; there are additional out-ofpocket expenses beyond the basic IOL for the toric IOL

Is everyone a candidate for all three IOLs? No. Cataract surgery is a very individualized procedure, and your Advanced Eye Institute doctor and you will discuss your individual case and the options that are best for you. We want our patients to have all the information they need to make an informed decision about the IOL that is chosen for them. Following are some guidelines that can help you know what might be the right IOL for you:

Good candidates for multifocal IOL generally are: • Realistic in their expectations and easy-going. They are willing to accept some nuances such as minor visual distortions (halos, or rings around lights at night) in exchange for the freedom from or reduced dependency on glasses or contact lenses. Additionally, these minor distortions tend to become less noticeable and distracting over time, as the brain learns to “adapt” to them and selectively ignore them. Patients who are easy-going tend to “neuro-adapt” much easier. Continued on page 10

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• In good health with an active lifestyle, and hoping to reduce or eliminate the need for glasses. • Patients who have hyperopia prescriptions – these patients tend to have the very best outcomes with multi focal IOLs because of better focusing ability. They appreciate the near vision improvement they are likely to have. • Patients who have high or severe myopia prescriptions – these patients have been so used to extremely blurry vision without glasses that the improvement they gain with a multifocal IOL, even with some visual distortion, is dramatic and greatly appreciated. Poor candidates for multifocal IOL generally are: • Patients who have had near perfect vision without glasses, prior to cataract surgery. These patients have enjoyed such great vision all their lives that the minor nuances and imperfections in the multifocal IOL are generally unacceptable to them. • Extreme perfectionists. Neuro-adaptation is very difficult for these patients. • Patients with ocular disease other than cataract. Retinal or corneal disease generally reduces or eliminates the appreciation a patient would have with a multifocal IOL. • Patients who drive at night for a living, or whose hobbies or activities depend on good night vision. Preferred candidates for the toric IOL should have: • A vision-compromising cataract • Pre-existing astigmatism • An interest in reducing the need to wear glasses for distance As long as the eye is healthy enough to achieve the good outcome that the patient is expecting and has the necessary degree of astigmatism, there is little downside to placing the toric implant. However, these IOLs are meant to treat regular astigmatism, not irregular astigmatism as is found in patients with a history of radial keratotomy (RK), corneal transplant, or keratoconus. A thorough examination and diagnostic testing will be performed to confirm candidacy for the toric IOL. Most patients are candidates for the basic IOL. There are extremely rare occasions when an IOL is not placed in the eye, but generally all patients who undergo cataract surgery receive an intraocular lens implant. Will I need additional procedures to achieve the best result? Much like contacts or glasses, IOLs come in more than 60 different “powers”. As with a glasses or contact lens prescription, it is important to match the appropriate IOL power to your eye. When prescribing glasses or contacts, we use trial and error to preview different lens powers to determine which one you see best with. However, because an IOL is implanted inside the eye, and only after your natural lens has been removed, it is impossible for you to “preview” various IOL powers before surgery. Furthermore, once it is implanted it cannot be easily exchanged as glasses or contact lenses could. Fortunately, an appropriate IOL power can be estimated using advanced mathematical formulas based on the measurements of your eye’s dimensions. Although these formulas are quite accurate in most patients, there are individual variables that prevent this process from being 100%

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perfect. In particular, individuals who are extremely nearsighted, farsighted, or have high amounts of astigmatism, and patients who have had previous refractive surgery (RK, PRK, Lasik) are more likely to end up with an IOL power that is not optimal because the mathematical formulas are based on average sized eyes, not extremes or eyes that have had previous surgery. IOLs are high performance devices and require precisely tuned optics. If the IOL power is not optimal, the IOL will not perform as well as desired. In these situations, a patient may discover the vision is adequate for most tasks and that wearing a very thin pair of glasses helps them out in certain situations (e.g. night driving). Alternatively, an additional procedure, such as Lasik or PRK, can be performed to optimize the outcome. There is a 15-20% chance that a secondary procedure like Lasik will be necessary to fine tune the vision. Is there anything I can do to help improve my outcome? Yes. Follow all preoperative instructions, especially instructions regarding contact lens wear. Generally, we ask that you discontinue wearing any contact lenses for a period of time before your surgical measurements as the shape of your eye can change. Even a small change in the shape of your eye can change the IOL calculation dramatically. Also, occasionally it is necessary to ask you to return for repeat measurements, or to return for additional testing in order to get the best calculation or determine your candidacy for a particular IOL. Are there any payment options available if I’m interested in the multifocal or toric IOL? Yes, we would be happy to discuss them with you.


Are there any other options to reduce my need for reading glasses? Sometimes monovision correction with a basic IOL is also an option. Monovision correction is a technique that makes use of the fact that we have two eyes. In this technique, one eye is set for distance vision while the other is set for near vision. After an adjustment period, the brain adapts to this new optical arrangement, allowing you to see both near and far. This monovision arrangement is often used in patients who wear contact lenses full time and who are over the age of 45. Monovision may not be the best choice for all patients. How do I know if I’m ready for cataract surgery? Cataracts are not painful, but you may notice these symptoms: • Colors appear dull or washed out • Poor night vision • Cloudy, foggy or blurry vision • Sensitivity to bright light or glare, especially while driving at night • Poor night vision • Halos appear around lights • Difficulty seeing detail • Need for more light to read • Frequent glasses changes, or glasses don’t seem to work • Inability to perform activities such as reading or driving due to poor vision You and your eye doctor will discuss when it’s time for cataract surgery. Depending on your cataract symptoms, your eye doctor may recommend managing your condition with an updated prescription to your glasses or contact lenses. But as your cataracts develop, they may interfere with your freedom to enjoy your favorite activities. Let your doctor know if you experience any changes in your vision.

The physicians and staff at Advanced Eye Institute are more than happy to answer any questions you may have about cataract surgery and the premium IOLs offered at Advanced Eye Institute. Call our office at 985-446-0506 to schedule an appointment or consultation, or visit our website www.friendlyeyecare.com. *American Optometric Association. “How Your Eyes Work. | American Optometric Association.” Retrieved November 17, 2011 from http:// www.aoa.org/x6024.xml

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The First Step To A

Healthier You!

Metabolic Testing For Effective Weight Loss By: Dr. Catherine Diebold With the coming of spring, most of us begin on a journey to improve our health. Along with trying to eat right and exercise for health reasons, we want the added benefit of weight loss. For some of us, however, despite our best efforts, we seem to fall short of achieving that goal. Often, that is due to a misunderstanding of how active or inactive our metabolic rate truly is.

What is Metabolic Rate? Metabolic Rate is the term used to describe the total number of calories your body burns over the course of an average day. This can depend on many factors including your age, weight, sex, physical condition, hormone status, genetics, physical activity level, etc. Because of the many factors involved, your metabolic rate may be very different from someone else’s, even if they are the same age, sex, and weight.

Why is Metabolic Rate Important? The energy your body burns is derived from the food you eat and/or by burning stored body fat. Therefore, maintaining a healthy body weight depends on a delicate balance between the food energy you consume and your metabolic rate. When you regularly consume more food calories than your body burns, the excess calories are stored away as body fat which can create serious health conditions. In order to lose excess body fat, your caloric intake must be less than your metabolic rate. While this fact is well known, most weight-loss efforts focus largely on “counting calories” and tend to neglect the other half of the equation, i.e. metabolic rate.


For optimal weight-loss, it is important to set your caloric intake target based on your actual metabolic rate. Consuming too many calories for your actual metabolic rate will obviously undermine any weight-loss effort. On the other hand, consuming too few calories can slow your metabolism creating a chronic state of fatigue and also yield little or no weight-loss. For healthy, effective weight-loss, you need to find your personal “sweet spot” where you are eating enough calories to keep up your metabolism but still burning as many fat calories as possible. Measuring your metabolic rate helps you to do this without relying on guesswork.

Measuring Your Metabolic Rate In the past, metabolic testing was only available at universities and hospitals. Dr. Diebold now offers a simple 10-20 minute metabolic test to determine the ideal number of calories you should consume to most easily lose weight. During the test, you simply sit in a chair and relax while breathing through a mouthpiece similar to a snorkel. The air you exhale is analyzed to determine exactly how much oxygen your body consumes during the test. This can be directly related to the number of calories your body burns during the test and establishes what is called your Resting Energy Expenditure (REE). This represents the number of calories your body burns at rest just carrying out essential life processes and makes up a significant part of your metabolic rate.

From your REE measurement, Dr. Diebold can determine the ideal caloric intake target based on your actual metabolism and weight-loss goal. This caloric intake target can be used in conjunction with your current diet or alternatively, Dr. Diebold can provide healthy diet suggestions that meet the recommended caloric intake target. In either case, the recommended caloric intake will allow you to eat the maximum number of calories and still lose weight effectively.

Monitoring Your Metabolic Rate As your weight-loss efforts progress, your metabolism may change especially with changes in muscle mass, medications or other physical conditions. In such cases, it may be recommended to re-test your metabolic rate and adjust your caloric intake target accordingly. Once you achieve your weight-loss goal, you will want to maintain your healthy weight. Measuring your metabolic rate at your healthy weight gives you the information you need to “eat to your metabolism” and thereby maintain that healthy weight over the long-term. Please call 985-448-1216 to schedule an appointment with Dr. Diebold to discuss metabolic testing or other healthy weight-loss concerns.

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The Downtown Houma Market has returned to the Courthouse Square, 7856 Main Street. Hours of operation will be 9:00 AM – 1:00 PM, every Saturday throughout 2014 with just a few exceptions in the fall, due to other events. The market offers seasonal and local foods, seafood, baked goods, preserves and pickled items, art, woodworking, as well as hot breakfast and lunch items. Local small businesses will be joining in with some retail items. “This year, we are adding some exciting programs to the market. We’ll be starting a walking club, fitness class, and occasional healthy cooking demonstrations. It’s all part of a new health and wellness program sponsored by the Office of Public Health and Terrebonne Parish that we are bringing to the community,” says Brandi LeCompte, Downtown Houma Market Manager. The Terrebonne Wellness Program will also be offering health screenings and dietary advice in an effort to help people make healthy choices for themselves and their families. If you are interested in being a vendor or would like more information about the Downtown Houma Market or Terrebonne Wellness Program, please contact Brandi at blecompte@op4in.com or call 985-438-1231. Please also visit our Facebook page to view market photos and stay up-to-date with our schedule and programs.

Meet The Farmer

The Market Coordinator

Skinner Farms, LLC

Growing up, I loved being outdoors. I found a way to do that as an adult by growing vegetables. After growing for several years, the "locovore" movement started. (Locovore is a person that eats food grown locally.) I gradually increased my garden size to accommodate my list of family and friends that wanted fresh vegetables-- not store bought. Last year I decided to go big or go home by starting a farming business. I had a greenhouse built on my property. In it, 300 tomatoes plants are growing hydroponically. I have been harvesting vine ripened tomatoes since midFebruary. I still have my regular gardens and try to have something growing year round. I start my own plants from seed and often do sell the vegetable plants. The customers at the Downtown Houma Market absolutely love buying fresh vegetables and the vegetable plants. Sometimes I get asked questions by customers on how to grow something or where can they buy the item they want. I try to educate and inform as best as I can. My spring crop this year will include tomatoes, cucumbers, bell peppers, green beans, okra, eggplant, squash, zucchini, and hot peppers. Skinner Farms is locally owned and operated by Cheryl Skinner and her family in Bayou Blue.

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Hello! My name is Kacie Pitre, and I am 22 years old. I was born and raised in the small town of Chackbay, Louisiana. I am currently studying Dietetics at Nicholls State University and plan to graduate in May 2014 with a Bachelor of Science in Dietetics and also a Minor in Business Administration. I love the idea of a farmer’s market because ultimately it means giving back to the community. Being the Coordinator for the Downtown Houma Market means a great deal to me because I have learned about farmers markets in my dietetic courses and now I get to experience it first-hand every Saturday morning!


Thibodaux Regional Takes Leadership Role in Improving Health of Region with Construction of State-of-the-Art Wellness Center Thibodaux Regional Medical Center recently broke ground marking the start of construction on the hospital’s new Wellness Center, a $61 million investment in the health and wellness of communities in Lafourche and the surrounding parishes. The state-of-the-art, medically-integrated Wellness Center will be the first of its kind in the state, and among the finest in the nation. The Center is designed to improve the health and well-being of the region through prevention, fitness, education, rehabilitation, and focused sports and wellness services. The 230,000 plus square foot Center is expected to open in late 2015.

Leading the Way

“Thibodaux Regional has consistently been a leader and innovator in providing high quality care and service, including prevention and wellness services,” said Greg Stock, CEO of Thibodaux Regional Medical Center. “The new Wellness Center will bring much needed services and further exemplifies our continued commitment to serve the region.” The Center’s benefits can be realized by many throughout the region including improved health in individuals which can result in improved quality of life and decreased healthcare costs. Employers can benefit from a healthier community by a reduction in employee medical expense as well as reduced costs associated with health-related employee absenteeism. Benefits to employees are better physical and mental health, improved ability to manage stress, higher morale and productivity.

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Centers of Excellence

Centers of Excellence within the Wellness Center will include a Sports Medicine Center; Aquatics Center featuring a lap pool swimming area and warm-water therapy pools; Spine Center; Neurosciences Center; Pain Center; Rehabilitation Center; Imaging Center; Weight Management Center; Wellness Education Center; Urgent Care Center; Fitness Center; Imaging Center; and Women’s Breast Health Center. The facility will also offer medical services such as orthopaedics, rheumatology, endocrinology, physical medicine and rehabilitation, neurology, and neurosurgery, along with cardiac rehabilitation, diabetes management, and physical, occupational, and speech therapy. Other amenities include a gymnasium, indoor walking track, volleyball and football sports fields, and more.

Environmentally-Friendly

The Wellness Center is also being built with the health of the environment in mind as well. Utilizing sustainable designs, green building materials and energy-efficient systems, the Wellness Center will be LEED (Leadership in Energy and Environmental Design) certified. The Center has been awarded the 2014 Environmental Leadership Award by Louisiana’s Department of Environmental Quality.

For a virtual tour of the Wellness Center visit www.thibodaux.com.


Terrebonne Caring for Terrebonne

COVENANT CHRISTIAN ACAD.

ELLENDER MEMORIAL

HOUMA CHRISTIAN

Terrebonne General Medical Center (TGMC) Community Sports Institute is proud to engage in community partnerships to strengthen health and wellness education in Terrebonne Parish. The Community Sports Institute was created to impact future generations to come through the promotion of healthcare education, disease prevention, and athletic injury prevention. We educate students on healthy strategies while supporting coaches and athletes with medical assistance and proper training techniques to prevent injuries while on the field. Education, Prevention and Care is what we are all about. TGMC Community Sports Institute is a proud ccommunity partner caring for the Terrebonne Parish Community. The partnership is also inclusive of all elementary, middle and junior high schools.

H.L. BOURGEOIS

For more information about the Community Sports Institute please call 217-4693

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South Louisiana Medical Update