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GAM BIT’S HEALTH & WELLNESS > APRIL 2012 >VOLUME 4 > NUM BER 4

G A M B I T ’ S H E A LT H + W E L L N E S S

THE

RIDESTUFF WHAT TO KNOW BEFORE YOU ROLL OUT ONTO THE OPEN ROAD

NUTRITIOUS, DELICIOUS

CREOLE CREAM CHEESE

HOW TO

BIKE SAFELY

PUMP IT UP

and the High School Athlete High school athletes and their parents are invited to attend our informative health seminar on concussions in the high school athlete. Learn about the dangers of concussions, preventive steps, signs and symptoms as well as advice on when to return to the field.

Wednesday, April 11 at 7 pm Esplanade Conference Center Seminar is free and seating is limited. Call HealthFinder at 456-5000 HealtH & Wellness > bestofneworleans.com > april 10 > 2012

to reserve your seat.

Speakers include:

Wendy Jamison, MD

Mackie Shilstone

Coach J.T. Curtis

EJGH Neurologist

Executive Director of the Fitness Principle with Mackie Shilstone at EJGH

Head Football Coach John Curtis Christian School

EJGH East Jefferson General Hospital

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How and where to get your roll on

Creole cream cheese a health food? Yes!

Exercises geared toward cyclists

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HealtH & Wellness > bestofneworleans.com > april 10 > 2012

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CYCLES

LIFE HealtH & Wellness > bestofneworleans.com > april 10 > 2012

BICYCLING CAN HELP KEEP YOU HEALTHY. HERE ARE TIPS FOR STAYING SAFE ON THE OPEN ROAD. BY CARRIE MARKS

AUDUBON PARK’S BIKE PATHS OFFER A SCENIC WAY TO EXERCISE. PHOTO BY JEAN-PAUL GISCLAIR

ummer is looming and the gym is calling, but there’s a more entertaining exercise to help you get in shape for swimsuit season. The addition and expansion of New Orleans’ bike paths — like those on the east bank of the Missisippi River levee and along Carrollton Avenue — coupled with the flat landscape mean cycling in the Crescent City is easier and more sensible than ever. Dr. Scott Montgomery, an orthopedist for Ochsner Health System and the New Orleans Hornets, frequently recommends bicycling to patients of all ages and backgrounds as a way to stay active. “What we like about cycling is it’s a relatively easy and inexpensive way to get people moving,” he says. “People are becoming so much more sedentary in our society, and the cardiovascular benefits of aerobic performance, like biking, are enormous … not just for physical health, but for mental health as well.” Mark Delaney agrees. An avid cycler since the mid-1980s, Delaney’s hobby quickly progressed into competitive racing, culminating in him becoming president of the New Orleans Bicycle Club (NOBC). “Bicycling is nonweight-bearing, so it’s easier on the joints,” he says. “Your cycling workouts can go much longer, because you have the ability to vary your effort level: You can push yourself really hard or take it easy.” It’s a common return to activity for athletes who have

recently torn a knee ligament, for example, he says. As with any physical activity, preparation is essential. To begin cycling, a person should be healthy enough for low to moderate exercise and should get properly fitted for a bicycle; a badly sized bike is “the biggest pitfall for new cyclists,” Delane says. In addition to making the session more of a struggle, it also can contribute to knee and hip discomfort, Montgomery says. Stretch before and after a ride to prepare muscles and prevent the possibility of strain. “Focus your energy on stretching your legs, quads, back and hamstrings, since those are the muscles you’ll be using,” he suggests. Ask employees at the bike shop for advice: “Go in and tell them, ‘Here’s the type of cycling I’d like to do,’” Delaney says. “Whether it’s racing or recreational, they can give you a list of what you’ll need.” They’ll also be able to help you find the ideal cadence of revolutions per minute to optimize your workout; many beginner cyclists pedal too slowly, which fails to effectively engage the appropriate muscle fibers. When you’re ready to take to the road, make sure you heed traffic. Many routes put cyclists in close proximity to automobiles, increasing the risk of collision and injury. “There’s not much you can do to make people better driv-

ers, but you can put yourself in a position where you’re less likely to get in a wreck,” Montgomery says. Wear reflective clothing so you’re easily visible to motorists and familiarize yourself with hand signals. Delaney advises using a white front light and a rear flashing light at dawn or dusk, and cautions against riding while wearing headphones, as it can make you less aware of your surroundings. When approaching an intersection, he says, “make some kind of connection with the drivers around you. Make sure they see you and that you’re aware and anticipating what they’re doing next.” Always ride with traffic, and obey the rules of

the road. Montgomery and Delaney agree biking is an excellent way to stay active, see the city and enjoy the springtime weather. For prospective racers, the NOBC hosts regular events for all levels of cyclists, like the Tour de Louisiane June 9-10. According to Delaney, it’s the oldest continuously running stage race in the city. Participants advance to various levels based on their qualifying scores, competing for prizes all the way. A racing license is required, but riders can purchase one-day licenses from USA Cycling (www.usacycling.org). Find more upcoming races at www.neworleansbicycleclub.org.

WHAT TO BRING

• AIR SUPPLY — Portable, pressurized air cartridges of CO2 can inflate a flat tire when used properly with an adapter. Over-inflation can cause a tire to burst, however, so familiarize yourself with the proper tire pressures. Delaney carries a small set of Allen wrenches in case of mechanical problems. • H2O — As New Orleans slips into its hottest months, drinking enough water to stay hydrated is critical to a safe and healthy workout. Sports drinks are also fine, says Montgomery — “so long as you’re drinking.” • DRESS FOR SUCCESS — Inappropriate clothing can trap in heat and sometimes gets tangled in your wheels, leading to a brief and unpleasant ride. Delaney suggests purchasing a jersey and shorts made specifically for cycling, preferably in bright and reflective colors. “A lot of the new stuff is wellmade, in materials that are specifically designed to pull heat away from your body,” he says. The lightweight nature of the fabric makes them ideal for layering, so riders can maintain a comfortable temperature on longer rides. • LIFELINE — From flat tires to serious bruises, accidents happen on the open path. Having a cellphone to contact a medic and obtain a ride home ensures your safety in the event of a serious problem. “I also usually keep a few bucks in my pocket, just in case,” Delaney says. • SAVING SKIN — “Most people focus on the bumps and bruises when it comes to cycling, but when you exercise outdoors, your skin is exposed to the sun for longer periods, and it’s important to address that,” Montgomery says, recommending everyone apply sunscreen. For the most effective protection, opt for a waterproof formula with a high SPF.

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HealtH & Wellness > bestofneworleans.com > april 10 > 2012

• PROTECT YOUR DOME — Louisiana laws require motorcyclists and bicyclists to wear helmets, but that doesn’t mean the laws are enforced — or that everyone complies. Visit a bicycle shop to make sure your helmet is properly fitted to your head and meets state and local guidelines. “(It’s) one of the simplest and most important ways to prevent serious injury,” Delaney says.

expect results

e at to li ve

Say Cheese

Packed with vitamins and protein, Creole cream cheese is a healthy local staple.

By Russ Lane

what Creole Cream CheeSe with mint and StrawberryinfuSed balSamiC

how

Dessert recipe by russ Lane. creoLe cream cheese recipe by poppy tooker.

Makes up to 8 half-cup servings.

HealtH & Wellness > bestofneworleans.com > april 10 > 2012

STRAWBeRRy BALSAMIC vINegAR (one week lead time): 1 quart Louisiana strawberries, rinsed, hulled and halved 16 ounces balsamic vinegar 1 tablespoon whole black peppercorns

Add strawberries and peppercorns to a nonmetal, airtight container and submerge berries in vinegar. Seal the container and let it sit in a warm, dry spot for at least a day. Transfer the container to a refrigerator until ready for use. The berries are preserved in vinegar; longer sit times increase the intensity of the flavor.

Creole Cream Cheese is as versatile as its Common Counterpart and as nutritious as yogurt.

o keep a health food regime interesting, put local culinary staples in new contexts and prepare key foods ahead of time so you can quickly create sophisticated dishes. Creole cream cheese, a vitamin-packed local twist on common yogurts and cottage cheese, fits the bill perfectly. “Creole cream cheese is naturally low fat,” says slow food advocate Poppy Tooker, who hosts Louisiana Eats on WWNO FM. “If made the right way, it probably is the most diet-conscious thing you could eat.” A cross between mascarpone and a smooth cottage cheese, Creole cream cheese is a vitamin-rich protein bomb. A half-cup of Creole cream cheese packs 19 grams of protein into roughly 220 calories. It boasts more than 50 percent of the daily recommended values of calcium, phosphorus and vitamins C and D, and hefty doses of vitamins A and B-12. Creole cream cheese is as versatile as regular cream cheese or yogurt. Tooker

featured Creole cream cheese as part of a cooking challenge between chef Frank Brigtsen of Brigtsen’s Restaurant and Lynne Rossetto Kasper of NPR’s The Splendid Table during the New Orleans Roadfood Festival in March. Kasper paired the cheese with heavy cream for a sauce that complemented another local favorite, sheepshead fish. Brigsten worked the dish into a savory, ramekin-sized mirliton pie. Pulling from both its sweet and savory presentations, this recipe for Creole cream cheese with strawberryinfused balsamic vinegar and mint combines homegrown traditions with a restaurant presentation. The dessert takes a few minutes to assemble, and the leftover cream cheese, vinegar and prepared strawberries can be reserved for later use. Formerly a 350-pound rock critic, Russ Lane entered food writing after he lost 200 pounds. He now consults and lectures about lifestyle and cooking, and is finishing his first book (details at www.ikeepitoff.com.)

CReOLe CReAM CheeSe (two-day lead time): 1 gallon skim milk 1/2 cup buttermilk 1/2 teaspoon liquid vegetable rennet In a large stainless steel or glass bowl, combine skim milk, buttermilk and vegetable rennet, stir and cover with plastic wrap. Leave the mixture at room temperature for 24 hours. Use a slotted spoon to scoop solids into cheese molds. Place the molds on a roasting pan rack, cover them with plastic wrap and refrigerate for 8 hours. Remove cheese from molds and store in a separate container.

ASSeMBLINg DeSSeRT (10 minutes): 1 pint Louisiana strawberries, rinsed, dried and halved Fresh mint, chopped, for garnish 2 tablespoons sugar substitute (optional) heat a small saucepan over medium heat. Add 1/2 cup strawberry vinegar and heat until thick syrup forms on the back of a wooden spoon. Remove from heat. Drizzle 4-8 martini glasses with small amounts of balsamic syrup along the sides. Put 1/4 cup Creole cream cheese at the bottom of the martini glasses. Remove several strawberries from the vinegar and strain out as much excess liquid as possible. Combine these macerated strawberries with fresh strawberries and use them to top the cheese. Place the remaining Creole cream cheese on top, and garnish with chopped mint and one fresh strawberry drizzled with balsamic syrup. Per serving: calories 216, total fat 3.2 g (saturated fat 0.7 g, polyunsaturated fat 2.2 g, monounsaturated fat 0.3 g), cholesterol 10 mg, sodium 281 mg, potassium 962 mg, total carbohydrates 33 g, dietary fiber 1.8 g, sugars 28 g, protein 18 g.

e x e r ci s e fo r li f e

Pedal

Pushers key muscle groups to strengthen for an improved biking performance Leg presses buiLd strength in the hamstrings, quadriceps and gLutes, the muscLes that power pedaLing.

by russ lane

weights and fewer repetitions increase power, and lighter weights and more repetitions increase endurance. It also helps to understand what extracurricular training cannot do. Randall Legeai, president of the Louisiana and Mississippi Bicycle Racing Association and longtime member of the New Orleans Bicycle Club, says riders must venture outside the gym to understand their unique pedaling strokes and riding strategies. “The important thing for most cyclists is to develop a very efficient pedal stroke,” Legeai says. “There are points in the pedal stroke where, basically, both legs are pushing at the same time. The traditional method for developing a smoother pedal stroke is using relatively low gears and a relatively high cadence. It’s not a power thing, it’s an efficiency thing.” Moreover, properly fitting your bicycle to your body can make cycling more safe and effective. On rainy days or for those who aren’t ready to invest in a bike, Kraus says spinning classes are a suitable substitute. “Spinning class is much more representative of what it’s like to bike than just sitting on a stationary bike,” he says. “I would not put (personal training clients) on a stationary bike, because that’s vague.” Following are several exercises and methods that can increase strength and help you become a bicycling behemoth. A combination of trial and error and learning from trainers, seasoned cycling veterans and experts will help cyclists improve their skill, endurance, strength and drive to not just finish, but finish powerfully. “It’s interesting to get to that point (where) you’re the first person on the top of hill,” Schoen says. “The better you get, the better you realize you can be.”

glutes

To ensure proper form, Schoen recommends executing the leg press on a machine. Begin the press with knees parallel and legs bent at a 90-degree angle. With a slow, controlled movement, extend legs until they are almost straight, but keep the knees slightly bent. Ideally, you’ll feel every muscle in your leg react at different points in the exercise. Using the same controlled movement, return legs to a 90-degree angle. Daryl Ducharme, a personal trainer in North Carolina, says individuals should work up to lifting twice their body weight with both legs or their entire body weight with one leg. When training for endurance, Kraus suggests reducing the weight by half and performing the exercise until the muscles fatigue. “It’s the same thing for toning in general, but you’ve got to do it until it burns and you cannot do it again,” he says. If one leg is disproportionately stronger than the other, reduce the amount of weight on the machine and use one leg to help even out leg strength.

abdominals

For clients looking to improve core strength, Richard Driskell, a bike fit consultant at Bayou Bikes, considers Pilates to be very effective for quickly developing both abdominals and back muscles.

calves

Kraus recommends doing calf raises using your own body weight as the best way to develop calves. Place the balls of your feet on the edge of a platform, stair or curb. With the body completely straight, move only your ankle joints so your heels dip below the platform; you’ll feel the stretch. Again, moving only ankle joints, lift your heels as high as possible, hold for a few seconds at the highest position, and return to the original position.

forearms

“You can’t have enough forearm strength,” Kraus says. This essential muscle group can make the difference in holding and controlling the bicycle. He suggests using a light dumbbell and with both arms hanging naturally at your side, twist each wrist left and right until they are fatigued.

HealtH & Wellness > bestofneworleans.com > april 10 > 2012

hether you want to travel around town faster or are training for intense competitions, many exercises done off the bike can improve performances on it. It helps to understand the primary muscle groups involved in cycling. Research by Dr. Andy Pruitt, an athletic trainer and founder of the Boulder Center for Sports Medicine in Colorado, indicates that 10 percent of the power for bike pedaling comes from hamstrings, 35 percent comes from quadriceps and 55 percent comes from the gluteus maximus, the largest muscle in the butt. However, pedaling is just one piece of the puzzle. To maximize your performance on the bike, it’s necessary to train the whole body. For example, a strong core stabilizes the upper body, and forearm strength helps riders control the bike. “That’s kind of a misconception, that it’s just your lower body,” says Cheryl Schoen, a trainer at One to One Personal Training who took up cycling when she began training for a triathlon after losing 212 pounds. “You need the core to stabilize; you need your back and your upper body to have control of your bike.” Liam Kraus, a trainer with New Orleans Athletic Club, also notes that grip strength and forearms come into play. Fortunately, all these muscle groups can receive individual attention when a rider is off the bike, and Schoen — a big believer in the “just do it” philosophy — recommends getting started cycling to determine which body part needs the most strengthening. “The weaknesses will kind of show themselves: What’s sore?” she says. “When I first started, I noticed my neck and shoulders were sore. The more I had the basic strength, the easier it got.” With any weight-bearing exercise, you can adjust how you perform it to increase power or endurance: Generally, heavier

f r o m t h e p r o f e s s i o n A l s o f e A s t j e f f e r s o n g e n e r A l h o s p i tA l

Baby, let’s Wait

An initiAtive to delAy inducing lAbor until 39 weeks lowers the number of nicu bAbies by kAtie kidder crosbie

s any woman who’s experienced it knows, pregnancy is filled with uncertainties. To narrow down the unknowns, many people try to plan everything they can, including the day their baby will be born. A woman may schedule her baby’s birth in order to provide time to tie up loose ends at work, make sure the obstetrician of her choice is available, or because she’s just tired of being pregnant. For these and other reasons, the number of women who choose to induce labor has increased dramatically in the last two decades, almost doubling by some accounts. Pregnant women and their physicians often schedule elective inductions as early as the 37th week of pregnancy — when a baby is considered full term. However, an increase in babies requiring admission to neonatal intensive

HealtH & Wellness > bestofneworleans.com > april 10 > 2012

SHOW OFF YOUR

care units (NICU) has led the Louisiana Department of Health and Hospitals and the March of Dimes to create the 39-week initiative, which discourages hospitals and physicians from performing elective inductions before 39 weeks. The initiative is designed to minimize stays in the NICU and allow more babies to spend their first nights in the company of their parents. So far, it’s working. East Jefferson General Hospital (EJGH), one of the first in the state to implement the 39-week initiative, has seen a decline in NICU admissions. According to the EJGH Nursing Annual Report, babies born into NICU have decreased 20 percent since the program was implemented in 2010. “The crux of the problem is that even with ultrasound, we can be off on the due date by two weeks, plus or minus,” says

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Dr. Ann Chau, a maternal and fetal medicine physician with EJGH. “So if a mother is induced at 37 weeks, she could actually only be 35 weeks pregnant.” The difference in fetal development between 35 and 40 weeks can be substantial. According to the March of Dimes website, “A baby’s brain at 35 weeks will weigh only a third of what it will weigh at 39 to 40 weeks.” The March of Dimes also reports that preterm (any birth before 37 weeks gestation) babies tend to be smaller and may have trouble staying warm. Furthermore, they may have difficulty sucking, swallowing and staying awake long enough to eat. Other complications associated with preterm birth include low birth weight, underdeveloped organs and the potential for lower cognitive function. Chau names underdeveloped lungs as the primary cause for preterm babies being admitted into the NICU. This is especially true for Asian and Caucasian male babies, whose lungs develop more slowly than those of female infants and babies of different races. “Two-point-five percent of babies born between 37 and 38 weeks are born with respiratory complications, even though (some are) minor,” Chau says. “Only 1.25 to 1.5 percent

of babies born between 38 and 39 weeks have the same respiratory complications. These may seem like small numbers, but it takes a huge emotional toll on parents. Not to mention, a stay in the NICU can be quite expensive. That is a financial burden for parents and the health care system as a whole.” Early induction also can result in the need for a cesarean section. If a physician makes labor start before the cervix has properly thinned and opened, labor could be prolonged and the risk of a cesarean could increase. This means a longer recovery period for the mother. It may affect her ability to have a vaginal delivery in the future, and there is potential for infections. Costs also increase with a C-section, typically extending the mother’s hospital stay from two nights to four. There are times when a mother goes into labor naturally prior to 39 weeks or when it is necessary to induce labor for the sake of the mother and child’s safety. When that happens, physicians and nurses who specialize in preterm birth are prepared to help even very early babies become happy, healthy children and adults.

S M a r t ta LK O N h e a Lt h By M I S Sy W I LK I N S O N

hether outdoors on a trail or indoors at a spin class, W bicycling is a fun way for people to stay fit. It’s a safer alternative to high-impact exercises like jogging; however,

biking is not without its risks. Terrebonne General Medical Center orthopedic surgeon Dr. Lawrence Haydel discusses orthopedic issues that can arise from bike riding and shares tips to help keep cyclists in the saddle.

What are advantages of biking compared to other forms of exercise? Cycling is much better for your joints than jogging or using a treadmill, and it is a good exercise for mobility and muscle strengthening. In addition to being better for your joints, it’s also good cardiovascular exercise. It has been known to help patients with diabetes and high blood pressure.

Do you recommend biking for older patients or those with problems like arthritis? I recommend biking because it puts less stress or impact across the joints. It’s a good exercise for

patients with arthritis. It’s used very frequently in rehabilitation of our knee patients as one of the early forms of physical therapy. Biking increases the leg strength and range of motion without putting a lot of pressure on the legs. It’s very good for mobility of the joints.

What kind of orthopedic issues do you see among bike riders? Among competitive bikers, a lot of injuries are from accidents: Broken legs, fractures, scrapes and bruising are the major injuries. Among more routine riders, if they are not positioned right on the bike, they can have pain. If they bike excessively — and it’s hard to define excessive, because it’s different for everyone — they can get knee pain, knee

injuries such as torn cartilege and tendonitis. Muscle sprains are common, and patients are more prone to injury when they start off biking.

How can cyclists prevent injury? We recommend adequate stretching before (biking), which helps reduce the risk of injury to muscles and joints. Other types of strengthening, like using light weights, is always good and any other type of exercise will help because you’re trying to condition your muscles. A crouched posture and uncomfortable position can increase the risk of back pain from riding a bike.

How can people be sure they have proper posture when riding a bike? A lot of it has to do with seat height and the handlebars’ position. Everyone is going to be a little different as far as what is comfortable for them. Put the seat at the right height so

you don’t have to overflex the knee or lean too far forward while riding the bike. You want to have a comfortable position without extreme flexion of the back.

Are recumbent bikes a good option for people with back pain? They are easier on the back because you aren’t hunched over like on a regular bike, but I think most people aren’t real excited about recumbent. Most people ride conventional bikes where they sit up and ride forward.

What should you do if you sustain an injury? Any injury should be treated with rest and anti-inflammatories. You should let it heal before riding, because you can be more susceptible to re-injuring the joints. Time is the best way to get things to heal. But biking is a safe sport, and we don’t see a lot of injuries because it is a low-impact type exercise.

HealtH & Wellness > bestofneworleans.com > april 10 > 2012

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WITH MEG FARRIS

PUMP IT UP A TINY PUMP MAKES SURGERY POSSIBLE FOR PATIENTS WHOSE HEARTS ARE OTHERWISE TOO WEAK. BY MEG FARRIS

because my heart is very bad,” she says. One artery was 100 percent blocked and the other was 60 percent blocked. Both DeLeon and Massey faced a difficult choice: die from the blockages or risk dying during the surgery that should open them. Fortunately, Massey and DeLeon were in the right place at the right time. Technology offered them a new choice: using the world’s smallest heart pump. Massey and DeLeon were the first two patients on the Northshore to use Abiomed’s Impella 2.5 heart pump during surgery. Their doctors did the procedure at the Louisiana Heart Hospital in Lacombe. “It takes some of the load off the heart,” Amkieh says. “It takes some of the load for pumping the blood out of the heart when the heart muscle is weak.” During the surgical procedure, a thin catheter is put in a vessel in the groin. Doctors run it all the way up through that vessel and into the heart. A tiny pump on the catheter helps make sure enough blood is being pumped out of the heart to bring oxygen to the organs. Without this pump, the patient’s weak heart muscle is not strong enough to do the job during surgery. The Impella was approved by the FDA in 2008 but is still not commonly used in hospitals. Insurance companies pay the cost of using the Impella pumping device during heart procedures. An Ochsner Medical Center spokesperson says doctors there have

A TINY PUMP ON THE IMPELLA’S CATHETER HELPS MAKE SURE ENOUGH BLOOD IS BEING PUMPED OUT OF THE HEART TO BRING OXYGEN TO THE ORGANS.

had the Impella technology since 2009 and have used the device in more than 60 patients with excellent clinical results. “I would have died a lot earlier (without) being able to have the surgery with the Impella and get the two arteries open,” DeLeon says. “One of the arteries is the one they call ‘the widow maker,’ and it was pretty well blocked.” Massey says the Impella changed his outlook on life. He went from having no hope for the future to looking forward to more retirement years to fish and garden. Last month, Massey and his wife celebrated their 61st wedding anniversary.

One of their favorite pastimes is going to the casino, and Massey makes sure he puts in his half hour on the treadmill before he goes. “I’m feeling a lot better every day,” Massey says. “I’m going to cardiac rehab twice a week and I’m getting stronger all the time. I’m not having any shortages of breath at all. My legs are weak, but I’m gaining strength.” Look for Meg Farris’ Medical Watch reports weeknights on WWL-TV Channel 4 and anytime on wwltv.com.

HealtH & Wellness > bestofneworleans.com > april 10 > 2012

hat if you were faced with a grim decision: risk your life by having surgery or shorten it by not having an operation? This is a decision some heart patients and their families have had to make. New technology is making that choice easier — and saving lives. Bill Massey, 81, of Picayune, Miss., has experienced a lot of heart problems. Since 2009, he’s had a heart attack, congestive heart failure, multiple blockages, stents inserted to hold open arteries and bypass surgery. “It scared me because I couldn’t breathe,” Massey says. “I just felt like I was going to die, really.” He wears the LifeVest, an external defibrillator with paddles, in case his heart needs to be shocked back into rhythm. He has scars on his chest from the surgery, and wires on the inside hold his chest bone together. Last fall, when he began having shortness of breath and needed another heart procedure to save his life, doctors said his heart was too weak for surgery. Bad heart conditions are common in this area, says Dr. Ali Amkieh, an interventional cardiologist on the Northshore. “Louisiana (residents) in general have a high risk of cardiovascular disease, stroke, heart attack, high blood pressure, diabetes, smoking, all the risk factors for arthrosclerosis and heart disease,” he says. Gail DeLeon, 67, a Covington heart patient, had a health problem similar to Massey’s. “I had two major blockages, but I was not a candidate for surgery

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