Gambit's Health Book, fall 2017Healthy drinks, weight-loss surgery, classes for performers, stroke r

HEALTH S T A Y

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I N T H I S I S S U E: H E A LT H D R I N K S W E I G H T- LO S S S U R G E RY WELLNESS CLASSES FOR PERFORMERS STROKE RISKS

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Dr. Burkenstock’s SkinBodyHealth.com SEE

Dr. Burkenstock on WGNO.com and News With a Twist

Wellspring

Health and wellness news and events.

BY KANDACE POWER GRAVES

and a representative of Team Gleason, Gleason’s nonprofit.

“This project allows us to literally give a voice to those who cannot speak,” Verter says, “and I cannot think of anything more rewarding than that.”

NOW HEAR THIS

Steve Gleason and his family from the movie Gleason.

PHOTO BY SUZANNE ALFORD/OPEN ROAD FILMS

WATCH THE MOVIE GLEASON and give amyotrophic lateral sclerosis (ALS) patients a voice at the University of Queenland ALS Voice Banking Project and Ochsner Medical Student Association’s fundraiser Thursday, Aug. 24. Proceeds will be used to record and synthesize ALS patients’ voices before they lose the ability to speak. When patients no longer can talk, they can use the recorded word bank with voice-generating devices to communicate in their own voices.

“We record 1,600 preselected phrases — excerpts from novels,” says Elizabeth Verter, a medical student at Ochsner and coordinator of the voice banking program. “After that, (a software program called) ModelTalker deconstructs the words into the pure syllables and uses this data to synthesize a voice bank.”

Ochsner medical students are making the recordings, which include patients’ favorite phrases, and ModelTalker optimizes the recordings and sends

each patient a synthetic voice file that can be downloaded to various electronic devices and used with a variety of interfaces. “Patients can use an adapter to make the synthetic voice say whatever they would like to share,” Verter says.

“They see it as a way for themselves and their family to retain a very personal and important part of themselves — their voice — after they lose so much to ALS.” Gleason, which details former New Orleans Saints player Steve Gleason’s life with ALS and includes his video journals for his son, will be shown at 7 p.m. Aug. 24 at Monroe Hall (Ochsner Medical Center, 1514 Jefferson Highway). Tickets are $15, and people who purchase tickets in advance at www.gleasonscreening. eventbrite.com will be entered in a raffle for Saints game tickets, movie tickets and other prizes. The film will be followed by a questionand-answer session with Dr. Dan Larriviere, a neurologist and director of the ALS Clinic at Ochsner; Dr. Stephen Kantrow, a pulmonologist at LSU Health Sciences Center who appeared in Gleason;

EAST JEFFERSON GENERAL HOSPITAL (EJGH) now offers women undergoing chemotherapy a way to minimize hair loss during treatment. Dignicap Intelligent Scalp Cooling System, also called cold cap, is a device worn during chemotherapy infusion.

The silicone cap, which is connected to a cooling and control unit, lowers the temperature of the scalp, reducing blood flow to the area. That means less of the chemotherapy drugs reach hair cells, reducing permanent hair loss.

EJGH installed the cold cap system in its infusion center in mid-July after breast cancer patient Gail Wall and her husband donated it. Wall had rented a cap and used dry ice for the cooling system during her chemotherapy treat-

ARTIST AND BRAIN INJURY SURVIVOR EARL BRIDGES’ ABSTRACT PAINTINGS will be on display and for sale at A Therapeutic Journey: Unmasking Brain Injury art show from 5 p.m. to 7 p.m.

Saturday, Aug. 26 at the St. Tammany Art Association (320 N. Columbia St., Covington, 985-892-8650; www.sttammanyartassociation.org). The opening also focuses on art as therapy for brain injury, including an exhibit of masks painted by brain injury survivors from across Louisiana depicting their emotions as they recover. That exhibit is sponsored by the Brain Injury Association of Louisiana (BIALA). Kimberly Hill, director of outreach and resources at BIALA will give a short overview of her group and the mask exhibit.

Art therapist Kathleen Doyle will discuss art therapy.

The event is free and open to the public.

JUMPING FOR FITNESS

POOLSIDE WORKOUT

HYATT REGENCY NEW ORLEANS (601 Loyola Ave., 504-561-1234; www.neworleans.regency.hyatt.com) is offering a high-intensity interval training (HIIT) class at 8 a.m. Saturday, Aug. 26 at its outdoor pool.

The class is led by Equip Fitness instructor Jerren Pierce. HIIT workouts boost the heart rate by using a variety of movements at different intensities. It also burns calories in a short period of time.

The classes are free and open to the public, but reservations are requested through www.eventbrite. com. Participants should bring a mat, towel, water and a swimsuit for swimming after the workout.

Food and drinks will be available for purchase.

ART AND BRAIN INJURY

Gail Wall tries on the new Cold Cap system at EJGH. PHOTO COURTESY EJGH

ments at EJGH and found it to be effective but cumbersome. The system she donated is streamlined and does not require ice.

In a release from EJGH, Wall said a woman’s hair is part of her identity and a factor in her confidence.

“It’s something that is so important for women,” she said. “This disease changes everything about your life, and if this one small thing can make a positive impact in their lives during this struggle, then I want to do that.”

LOOKING FOR A NEW WAY TO BURN ENERGY? Surge Trampoline Park (6930 Veterans Memorial Blvd., Metairie, 504-267-3898; www.surgeneworleans.com) opened in Jefferson Parish earlier this month with 33,000 square feet of exercise space for adults and children ages 2 and older.

The sports and fitness park features a large area of interconnected trampolines, foam pits, a padded log roll, rock walls, a jousting beam and a flying trapeze.

The park is open 11 a.m. to 9 p.m. Monday through Thursday, 11 a.m. to midnight Friday, 9 a.m. to midnight Saturday and noon to 8 p.m.

Sunday. Admission is $12.95 for an hour and increases in half-hour increments to $27.95 for three hours.

There’s also Toddler Time from 11 a.m. to 1 p.m. on weekdays for $7.99. College Night on Thursday offers discounts to students with an ID from 5 p.m. to 9 p.m.

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GLEASON SCREENING AND ALS FUNDRAISER

HEARING INSTRUMENT SPECIALIST TONY GOYETTE of Zounds Hearing of Metairie discusses hearing health and hearing loss at 7 p.m. Thursday, Aug. 24 at the Jefferson Parish East Bank Regional Library (4747 W. Napoleon Ave., Metairie, 504-889-8143; www. jplibrary.net). The presentation is free and open to the public.

Goyette will cover how the auditory system works; causes, prevalence and symptoms of hearing loss; auditory testing and hearing aids; and emotional and medical aspects of untreated hearing loss.

CAPPING HAIR LOSS FOR CANCER PATIENTS

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The young risk factors

“Do not give an aspirin,” she says, “especially if it’s a hemorrhagic stroke — aspirin is a blood thinner and will increase bleeding.

Fifty percent of people experiencing a stroke can’t swallow, and the aspirin could end up in their lungs.

Aspirin is an acid — that can do real damage.”

and the

What next?

New research shows strokes may strike earlier than you think

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BY KATHERINE M. JOHNSON

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DURING A STROKE, up to 2 million brain cells die every minute.

Dr. Sheryl Martin-Schild is the statewide stroke medical director for the Louisiana Emergency Response Network (LERN), and the medical director of stroke and neurology at Touro and New Orleans East Hospitals. LERN’s purpose is to make sure all Louisiana hospitals are equipped to recognize, evaluate and treat strokes.

In 2009, the project launched its system of care for time-sensitive emergency support.

Martin-Schild says there are two major types of stroke: ischemic stroke, in which an artery carrying blood to the brain becomes blocked (usually by a blood clot), and hemorrhagic stroke, in which one of those arteries bursts and there’s bleeding in the brain. Both result in loss of oxygen to cells, which damages the brain. Hemorrhagic stroke is characterized by progression — as the bleeding continues, symptoms worsen.

Transient ischemic attacks (TIAs) or “mini-strokes” are the result of traveling blood clots that cause temporary stroke symptoms. The blood clots either dissolve or dislodge, allowing normal blood flow to resume. TIAs have been recognized as strokes only for the last decade.

Even if stroke symptoms are fleeting (many TIAs go unacknowledged), report to a hospital at once. A 2014 article in Practical Neurology cites a report that found 15 to 30 percent of ischemic strokes are preceded by TIA symptoms, often on the same day.

“If you don’t get diagnosed and you don’t initiate treatment, you lose the opportunity to prevent another stroke that could be catastrophic,” Martin-Schild says.

Think you’re too young to have a stroke?

The Journal of the American Medical Association (JAMA) published some startling findings this year.

After analyzing national hospital data, researchers found hospitalization for acute ischemic stroke increased significantly from 2003 to 2012 among young adults, doubling for men and women between 18 and 34 years old and increasing 41.5 percent among men ages 35 to 44 years old and 30 percent in women in the same age range.

Hospitalizations for hemorrhagic stroke mostly held steady. An editorial published in tandem with the JAMA study suggests classifying TIAs as strokes may be a factor in this increase.

“The average age at which a person suffers a stroke is 64 years old,” Martin-Schild says. “Someone 45 years old or younger is considered young, and a lower proportion of [this age range] will present for treatment in the appropriate time frame because … they think they’re too young (to have a stroke).”

Further, the JAMA study found the prevalence of a person having three or more of the five most common stroke risk factors increased markedly between 2003 and 2012 — from 19 to 35 percent in men ages 35 to 44, and from 15 to 32 percent in women in the same age group. The five factors are diabetes, hypertension, lipid disorders (high cholesterol), obesity and tobacco use.

There is concern the data may only suggest an increase in stroke diagnosis. But increased hospitalization rates for ischemic strokes are concurrent with increased incidence of risk factors, suggest-

ing the problem requires a greater focus on education and prevention.

“Researchers are still trying to understand (the cause), but lots of … bad living habits such as not exercising, alcohol and illicit drug use … account for some of the spike,” Martin-Schild says.

Genetics also dictate predisposition to stroke.

Less commonly known factors are atrial fibrillation or AFib, obstructive sleep apnea and even pregnancy — “Anything that affects the structure or function of the heart,” Martin-Schild says.

What to do when you suspect a stroke

The American Stroke Association promotes the acronym FAST to help people recognize the three major stroke symptoms: “face drooping, arm weakness, speech difficulty, time to call 911.” Symptoms also may include sudden loss of vision, clumsiness and severe headaches. Stroke victims usually experience loss of function on one side of the body, but it can affect both sides.

“That’s why it’s called a stroke — the sudden loss of function is like a stroke of lightning,” Martin-Schild says.

She says calling 911 the moment you suspect a stroke is critical.

“Use the right language,” she says.

“Say ‘I think I am having a stroke,’ and give the time of onset and what symptoms are present. The dispatcher will get an ambulance there with priority, and paramedics are trained to screen for stroke and will notify the hospital. The emergency department activates the stroke team and is ready to receive you when you arrive — this won’t happen if you come by private vehicle.”

She also debunks a stroke myth.

Stroke is the No. 1 cause of adult-acquired disability. Even though mortality has decreased (Martin-Schild says death from an ischemic attack occurs in less than 10 percent of cases, and the rate for hemorrhagic stroke has decreased from 40 to 20 percent in recent years), it can have long-term effects on cognitive and communicative functions and motor skills. Getting to a hospital as soon as possible is critical.

Doctors need to arrest the symptoms and restore circulation, then focus on determining the cause of the stroke and preventing complications, as well as beginning therapies for recovery, which are crucial in the first three months after an attack.

“A little over 20 years ago, there wasn’t much (in the way of treatment) beyond beginning an aspirin regimen and going to rehab after a stroke,” she says. “Treatment to minimize long-term damage has changed drastically since 1996, but it is time-sensitive.”

Despite the increase in ischemic strokes and subsequent hospitalizations of young men and women, older people still are more likely to experience stroke, especially if they’ve already had one.

“It’s a J-shaped curve,” Martin-Schild says. “As you get older, your risk increases. There’s increased body wear and tear, and possibly accumulated injury to the heart and arteries from conditions like high blood pressure and smoking.”

Early detection is the best prevention. “Having a good primary care provider is essential,” she says. “Often, people don’t know they have high blood pressure, high cholesterol or even diabetes.

A physician helps with aggressive medical management of risk factors, but sometimes (surgical) intervention may be necessary.”

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Weighing in

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Two doctors and a patient break down bariatric surgery

BY KAT STROMQUIST @KSTROMQUIST

IN WHAT MAY BE AN UNWELCOME CONSEQUENCE OF OUR DISTINCTIVE FOOD CULTURE, Louisiana regularly appears on lists of states with the highest rates of obesity.

On a 2015 Centers for Disease Control and Prevention map, the state joins just three others with an obesity rate higher than 35 percent, and doctors statewide often warn of related public health implications, including high rates of heart disease and diabetes.

Bariatric surgery (surgery for weight loss — bariatrics is the study of obesity) is an increasingly common way to reverse significant weight gain. Though the concept isn’t new, this treatment method has become more common as insurers have begun writing bariatric coverage into policies and social stigma has faded. “[In the past] patients, for whatever reason, didn’t want to reveal that they were having weight loss surgery, or they were afraid because of misconceptions about it,” Dr. David Treen, director of bariatric surgery at West Jefferson Medical Center, explains. “[Now] pretty much everybody knows somebody who’s had weight loss surgery.”

Bariatric surgery can be a good option for patients who have had trouble maintaining a healthy weight over a number of years. At Ochsner Medical Center - North Shore, chief of surgery and bar-

iatric director Dr. Asahel Gridley says it isn’t a first step before diet and exercise, but if those efforts repeatedly fail, surgery is worth considering — especially in the presence of other health problems that often are associated with obesity. “[For patients with Type 2 diabetes] there is a good chance you could help control your blood sugars altogether, and maybe even get your blood sugars to a much lower number,” he says.

According to Gridley, bariatric surgery also can help with sleep apnea, high blood pressure and high cholesterol.

Prospective bariatric patients should set appointments with a primary care physician, a dietitian and a psychiatrist to establish relationships for post-surgery supportive care, and to ensure they don’t have an existing health problem that conflicts with the surgery. Some genetic disorders make people ineligible, and patients with severe congestive heart failure should clear bariatric procedures with a cardiologist.

People with schizophrenia or any other psychotic disorder generally aren’t good candidates, because they can have difficulty following dietary plans. And even before surgery, the doctor wants to see that the patient can stick to a prescribed diet, Gridley says.

“Just doing the surgery itself will make you lose some weight, because it will restrict how much food you can eat,” he says. “But if you don’t make the right choices and you continue to eat the wrong sorts of foods … the weight will eventually catch back up.”

In Louisiana, the most common type of bariatric surgery is called a vertical sleeve gastrectomy (VSG). Unlike the gastric bypass or gastric band, both of which have fallen out of favor with surgeons due to potential complications, the VSG physically removes 80 percent of the stomach. This reduces stomach capacity and removes stomach cells that manufacture the hormone ghrelin, which contributes to hunger.

Treen says the loss of ghrelinproducing cells helps patients readjust their eating habits after the surgery, encouraging portion control.

“When the stomach is gone, you don’t have this churning feeling in your stomach when it’s empty,” he says. “You don’t have this feedback mechanism of an empty stomach telling the brain ‘go get some food and fill me up.’”

The majority of insurance policies explicitly state whether bariatric surgery is covered and any special requirements. Treen says some insurers only offer coverage if the surgery takes place in an approved “center of excellence.”

At West Jefferson Medical Center’s bariatric clinic, the out-of-pocket cost is about $14,000, which includes coverage for any complications that may occur. (Treen says complications are relatively rare.)

People who have had VSG surgery can expect to proceed through a protocol that gradually reintroduces normal food. For West Jefferson Medical Center patients, it usually takes about six weeks to move from liquids to soft foods to regular food. As they recover, bariatric patients are encouraged to undertake an exercise regime to build heart health and accelerate their weight loss.

“As they lose weight, they’re able to exercise more, and don’t dread it like they [did],” Treen says.

“Most importantly, [with the VSG] they don’t feel deprived. (With) some of these other procedures, you’d still be hungry after you ate as much as you could eat. …

It’s easier to stay on a diet when you’re not hungry all the time.”

Sounds great, but what is it really like?

A year and a half after her bariatric surgery, Tara Taylor feels good about the results — with a few caveats. Taylor had VSG surgery at a New Iberia clinic after reaching a point of profound unhappiness with her body image and weight, which she’d been struggling to manage since she was a teenager.

“Either I would be relatively in control on Weight Watchers … [or] I would fall off, then gain [the weight] back,” she says. “It had gotten to the point where I was having trouble sleeping and my knees were … super-inflamed.”

Since the surgery, she feels healthier and has lost a significant amount of weight. But she’s been challenged by psychological aspects of an extreme physical transformation. “I’ve cried in so many dressing rooms,” she says.

It’s also been hard managing the precise balance of carbohydrates, protein and fat her doctor recommended — she worries that the diet exacerbates her complicated feelings about food. She has had some small complications, including digestive problems. She avoids some foods due to her reduced stomach capacity, including carbonated beverages, soup and gumbo, and she’s stopped drinking alcohol almost completely.

Taylor also says people close to her have had to adjust to life after her surgery. During the first months after her procedure, she found it difficult to eat more than a few bites of food at a time. Even though they knew she was following her doctor’s advice, family members sometimes were hurt when she declined meals.

“When you reject someone’s food … people take it personally,” she says. “The last time I went home to Lafayette, there were tears.”

Taylor says the surgery has been really effective in terms of her weight loss. But like Treen and Gridley, she encourages prospective bariatric patients to look into aftercare with a doctor or support group, to help deal with any issues that might come up.

“I genuinely do like the way I look now; I’m proud of this,” she says. “But [more important] than the nutrition, is the psychological [care].”

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Party with a purpose

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Artists take the stage to promote health care services for performers.

BY SUZANNE PFEFFERLE TAFUR

New Orleans Musicians’ Assistance Foundation’s workshops push performers to become healthier and stronger. PHOTO BY TAYLOR COHEN

AN UPCOMING HEALTH CARE EVENT WILL FEEL MORE LIKE A CARNIVAL CELEBRATION, complete with flamboyant costumes, glittery makeup, live music and risque dance performances.

On Aug. 29, Carl Mack Presents and the New Orleans Musicians’ Assistance Foundation (NOMAF) will host an open-mic drag show to help performers — especially drag performers — learn more about local health care options.

The free event, dubbed “I Will Survive” after the eponymous disco hit by singer Gloria Gaynor, takes place from 5:30 p.m. to 7:30 p.m. at the Mardi Gras Museum of Costumes and Culture, and features performances by local drag performers such as Laveau Contraire, Sugar Monroe and Blazen Haven. Local musicians, face painters and tarot card readers will add to the fun. Burlesque sensation Trixie Minx is the mistress of ceremonies.

The event is part of NOMAF’s Dancer Wellness Program, which includes monthly wellness workshops that address health and injury topics relevant to various performance groups — from the Mardi Gras Indians to marching band members.

“We’re raising awareness that we have this particular program for drag queens, which are kind of a below-the-radar group of individuals who need access to services,” says Erica Dudas, managing director of NOMAF. During the disco-inspired bash, a health care

WHAT:

“I Will Survive” health care event, sponsored by Carl Mack Presents and the New Orleans Musicians’ Assistance Foundation

WHEN:

discover his performance artists — jugglers, aerialists, stilt walkers, female impersonators and others — could receive health care services from NOMC. “A lot of people might be misled by the title of the ‘Musicians’ Clinic’ and think they’re not eligible (for health care) because they’re not a musician,” Mack says. “But it’s broader than that. (Health care) is available to all types of people in the performing arts and the supportive arenas around it.”

Mack met with the director of NOMAF to discuss hosting a workshop at his French Quarter museum to attract female impersonators from around the city. The winning idea was the open-mic “drag show.” Mack will play the xylophone during the event.

NOMC is a member of the Performing Arts Medicine Association, an international consortium of doctors who help performing artists.

They provide cost-efficient access to comprehensive and preventive health care, wellness education, mental health services and social services.

An athletic trainer from the Tulane Institute of Sports Medicine designed “the course work” for the Dancer Wellness Program, which was established in 2015. The free monthly workshops teach attendees about good nutrition and how to become better performers and strengthen their bodies. It also connects them to primary clinical care.

Future workshops include an event at the Marigny Opera House Sept. 18, followed by an event at the Ashe Cultural Arts Center Oct. 21, where nearly 20 local athletic trainers will assess the physical condition of dancers. The New Orleans Public Library also will be there to sign up attendees for library memberships.

“I think that health care can be a scary topic for some people,” says Dudas. “What I’m personally looking forward to is the amount of access that people will have (to health care) and the ability to answer questions about the health care system in New Orleans. Also, it’s going to be a lot of fun.”

5:30 p.m. to 7:30 p.m. Tuesday, Aug. 29.

WHERE:

Mardi Gras Museum of Costumes and Culture (1010 Conti St., 504-218-4872; www.themardigrasmuseum.com)

ADMISSION:

Free

guide will enroll people in Medicaid and teach them about the many clinics that offer primary care or behavioral health services. There also will be a table with information about NOMAF’s upcoming events and monthly workshops.

NOMAF is a nonprofit organization that works in tandem with the New Orleans Musicians’ Clinic & Assistance Fund (NOMC). This clinic has provided medical care to musicians and performing artists in New Orleans for nearly 20 years.

Carl Mack, the founder and president of Carl Mack Presents, says he was surprised to

The Dancer Wellness Program includes monthly wellness workshops that explore health and injury topics relevant to performers. PHOTO BY ERICA DUDAS

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Drink to your health?

Local nutrition experts evaluate some popular health drinks

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BY DELLA HASSELLE

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CHLOROPHYLL. STEVIA. GINSENG. WHEN CONSIDERING INGREDIENTS OF SO-CALLED HEALTH DRINKS, a simple stroll down a grocery store aisle offers a dizzying bevy of options.

Brightly colored liquids in eye-catching packaging promise everything from bursts of energy to near-perfect gut health — a benefit that promises a trimmeddown waistline to boot.

It seems each year brings a new fad, and for good reason: Americans keep buying in. According to First Beverage Group, an organi-

zation that advises and invests in beverage companies, the growth of smaller “better-for-you” brands means the non-alcoholic beverage market is projected to grow from roughly $160 billion in 2008 to almost $190 billion by 2020.

But just how healthy are these “health” drink options? According to New Orleans-based health experts, the answer varies.

Simone Walker, clinical nutrition manager at West Jefferson Medical Center, says she always prefers her patients drink water instead.

“Often you’re drinking flavored

water anyway,” Walker says. “Just have the regular water and save yourself some calories without having the extra sugar.”

Walker says sports drinks are some of the biggest culprits when it comes to added sugars, and the extra dyes and chemicals don’t do the body any good. She only recommends sports drinks after a workout of more than an hour, or after an intense day in the heat.

Too much dietary sugar will cause weight gain, but Walker says there are other dangers that consumers may not think about when reaching for a Gatorade or vitamin water.

“The excess of sugar intake increases inflammation in the body and leads to other diseases like diabetes, heart disease and cancer,” Walker says. “Any disease you think of forms from inflammation being built up in the body over time.”

Health experts agree that some drinks are fine to consume in moderation — even if heavy exercise isn’t involved.

Molly Kimball, a registered dietitian with Ochsner Fitness Center and founder of the Eat Fit NOLA program, says she’s a big fan of kombucha and fresh-pressed juices — particularly if they’re packed with healthy greens.

Kimball says coconut water, too, can be fine to drink for some added taste and extra electrolytes, as long as it doesn’t have too many added flavors. She says the biggest mistake consumers

make is picking brands or particular products that sneak in added flavoring, which often hides even more sugar.

“Make sure you’re looking for that sometimes hard-to-miss label that says ‘unsweetened,’” Kimball says. “It’s otherwise easy to have as much as a day’s worth of sugar in a cup.”

Regardless of whether healthconscious consumers are sipping something flavored or just plain water, nutritionists agree: It’s imperative to keep hydrated, especially in hot weather.

Kimball says dehydration often causes an array of health problems. Muscle cramping can be a sign, and even grogginess or lack of mental clarity can mean you need a few more glasses of water or other hydrating liquid throughout the day.

“When people come to me, one of the first things I ask about is their fluid intake,” Kimball says. “That’s going to be the biggest thing that’s linked to our energy levels.”

According to Kimball, any number of drinks can be healthy and also count toward that ideal amount of fluid intake, including fizzy waters and herbal tea.

Walker’s advice is simpler: just have a glass of water, maybe with lemon for flavoring.

“Replacing your water intake with the drinks that claim to be healthy is just not the best thing for you,” she says.

PEOPLE IN HEALTH

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PEOPLE IN HEALTH

PEOPLE IN HEALTH

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PEOPLE IN HEALTH

PEOPLE IN HEALTH

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